#995 Something About Mary
Mary is an RN with type 1 diabetes whose had multiple transplants.
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Scott Benner 0:00
Hello friends, and welcome to episode 995 of the Juicebox Podcast.
Today, you're gonna hear from Mary, she's 34 years old, a type one and a registered nurse. She's also had two kidney transplants and a pancreas transplant. You're not going to want to miss this. While you're listening. Please remember, I'm sorry, it's late. I'll do it again. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're thinking about supporting the sponsors, thank you. Please use the links in the show notes of your podcast player with the ones available at juicebox podcast.com. If you can't remember the links, you know when you hear him in the ads, you can support me by buying your AMI pods. Dex comms getting your supplies from us med getting a contour next gen meter G voc hypo Penn drinking ag one buying your sheets and clothes from cozy earth.com Checking out touched by type one.org and looking into therapy from BetterHelp. If you're looking for support, check out our private Facebook group. It's absolutely free Juicebox Podcast type one diabetes on Facebook. It has 41,000 active members. This episode of The Juicebox Podcast is sponsored by Dexcom Dexcom, of course makes the Dexcom G six and Dexcom G seven continuous glucose monitoring systems. You can learn more, get your benefits checked. We're get started at my link. today's podcast is also sponsored by Omni pod. Now Omni pod makes the Omni pod five and Omni pod dash. These are both terrific tubeless pumps, you're gonna go check them out and decide which one's for you. Omni pod.com forward slash juice box. Use my link. Get yourself all set up. I mean, the nuts the what did they say? What's that saying? Soup to nuts. Everything you need soup to nuts is what does that mean? Soup to nuts? Oh, I'll look it up and tell you in the ad later. Anyway, Omni pod.com forward slash juice box check out the Omni pod five. And they Omni pod dash soup to nuts. What could that mean? It's gotta be something about how we'll figure it out.
Mary 2:41
Hi, I'm Mary. I live in Oklahoma City. I'm a registered nurse and I've been diabetic since I was nine became a registered nurse when I was 24. What else do I need to say?
Scott Benner 2:53
How old are you now?
Mary 2:54
34.
Scott Benner 2:56
Oh my goodness. Yeah. It's almost.
Mary 3:01
Yeah, like I've way past the halfway mark.
Scott Benner 3:05
Kind of nursing. What kind of nursing do you do?
Mary 3:08
I've been all over the place right now. I'm actually into like corporate nursing. Like I got into the administrative side, like more dealing with executive and explaining to them like, this is what the nurses need kind of being like liaison to like, helping them prove what the nurses needs are in the hospital, which has been really neat. I've only been doing that for like two years, but it's been really been really rewarding so far. Are you
Scott Benner 3:34
the lady on the TV show in the pantsuit holding the folder to her chest off in the corner?
Mary 3:39
I wish
Scott Benner 3:42
everyone knew that scene in every hospital Trump,
Mary 3:44
I think I think they do. Yeah, mine's really less clamoring than that. It's a lot of numbers, a lot of checking stuff, you know, seeing what the nurses are up to. And then like, translating that into like, this is this is why this is going on in the hospital.
Scott Benner 4:02
Oh, that's interesting. How did you make the transition to that?
Mary 4:05
Man, it's all part of my story. But I just since I've had like three transplants like being on the floor, and like with such a low immune system, just like didn't really feel right. But like I love nursing, so it's like, okay, like nursing is like a very, very big world. Like if you get tired of one area, like there's tons of areas to go into. And I was like, Okay, how can I like still keep my immune system up, but also like, not put myself at risk. And I got a job as a corporate nurse at this company that owns about 34 facilities around the Oklahoma area and they have like a corporate office in the city that you can do remote work but also like work in the office and I was like this perfect be great for me. And I worked in geriatrics for a while so I was a director of nursing and so like the administer Trade of side was there. And it just all fell into place. Honestly,
Scott Benner 5:03
that's amazing. Well, now you have done what they call in the business tickled their ass with a feather. Mary, you've given a little taste of the story down the road. And then it's my job to bring you back to the beginning. Because people right now are like, did she say transplants? And like she did. But I'm not telling you about that. You have to listen to the thing now. See how it works? Yeah, you're very good at this. You've never heard tickle your ass with a feather? No, I
Mary 5:30
have. Oh, yeah.
Scott Benner 5:31
That's what you've done. Good job. You've done this before. I love it.
Mary 5:36
This is the first time. So here we go.
Scott Benner 5:39
All right. So you're diagnosed when you're nine? Are there any other type bonds or autoimmune in your family that would have made anybody think one of these kids is definitely getting diabetes?
Mary 5:50
Yes, I have a cousin, older cousin, who is type one. And my dad actually passed away when I was three have like an auto immune deficiency. Of course, this was like in the 80s to like, they didn't really know what it was like, he kept getting sick. They did exploratory surgery on him, which like, isn't a thing anymore. And they saw his spleen was enlarged. They took it out and they're like, Oh, you're good. So we think there's some sort of autoimmune issue that he had. But we just don't know what it was. And then my cousin. And so my mom was very aware, like she is educated. She was a biology teacher. And so she kind of watched me pretty close. And when I was in school, I just like, was thirsty all the time and going to the bathroom. I even like my teacher even sat me in the back of the room. And she was like, Okay, I'm just gonna have you hold up a one if you need a drink and hold up to if you have to go to the bathroom, and I'll just not at you because it was like, so constant. I was like interrupting class all the time. So my mom took me to the doctor's office, of course, it was on a Friday. And they check. They check my blood sugar. And they call her back that afternoon. And they're like, Yeah, her blood sugar was like 701. Like, we want to have her come back on Monday for a recheck and my mom's like, oh, now I'm just gonna like take her to the hospital. So she packs me up and like the close it like, we grew up in Bentonville, Arkansas, and there was like, there wasn't even an endocrinologist in our area. So like, the closest place for us to go was Tulsa. So she like picked me up from school drove me to Tulsa, like the children's hospital there. And it was like, I think she's diabetic.
Scott Benner 7:34
Yeah, what did they do spill sugar in the blood sample? Like how
Mary 7:37
would it Yeah, like, how, how would it be? 701? That would be a mistake. Again, why are we waiting three days?
Scott Benner 7:44
You guys just come back? Listen, either on Monday, or if she slips into a coma? Can it Okay, either?
Mary 7:52
Either or don't? Yeah. So I was pretty lucky to not get sick. My mom, I give her credit for all of that. She noticed the signs. She knew what to do, and got me into the hospital. And I just, I didn't really understand what was going on. Because I wasn't sick. Like, I'm, I'm being admitted to the hospital. Like, what if we're paying a lot? Yeah, like because I can't gain weight. Like, I don't understand. But we also like had a neighbor at the time that was diabetic and who was very uncontrolled. And I just remember like, he was always begging us to, like, sneak him food. And I was like, I'm never gonna have a brownie again. Like,
Scott Benner 8:30
oh, you knew you knew a kid who was like, yes. on the black market looking for cupcakes.
Mary 8:36
Yes, absolutely. Yeah. And so I remember that. Like, that's the only thing I could say is like, I'm never gonna have a brownie again, like this. Is it?
Scott Benner 8:46
Your mom? Shut up.
Mary 8:49
Like, can we just stop and get a brownie? Brownie
Scott Benner 8:52
for your mother and rehab for your mother? This is only this is only a handful of years after losing her husband to
Mary 9:00
Yeah, absolutely. Yeah. She she was a trooper. Yeah, she was a single mom of two for four years. And then she got remarried to like my now Dad, like, I consider my dad because he adopted me and he is my dad. And then like, I don't even think they've been married a year. And then I'm diagnosed. Yeah, like, damn.
Scott Benner 9:20
I'd love to talk to him. I bet you there was a split second where it was like, what I do.
Mary 9:24
Yeah. He's like, he's not like, medical at all. Like, he's the smartest person I know. But like, you talk medical stuff. And he's like, what? You know,
Scott Benner 9:33
I just listen. It's been years and I'm sure he's delightful. But I bet you there was a split second where he was like, God damn, damn, damn, damn Damn. What I do when I do what I do.
Mary 9:44
What are we doing? Married the
Scott Benner 9:47
lady and her kid. Oh, oh, kids die. Great, great. Good. That's fine. It's fine. It's fine. Like you know, then you get over it. You relax a little bit. And then you go on. Yeah. So you get this diagnosis. And it's some long time ago, right? What year?
Mary 10:07
Yeah. Okay, so if I was nine, let's do some math. 9987 Yeah.
Scott Benner 10:13
- Okay, how does the management begin?
Mary 10:18
Yeah. So they're, like I said, there was no endocrinologist in our area. So we, they're like, insulin pumps, like wasn't even a thing. Like I, I'm sure, like, I date myself pretty well by saying that. So we started with just, I had to, like, eat six times a day like, was the NPH. And that was like a really hard adjustment. Like, we didn't even have, like the capability, like the capabilities that we do now are just, like, not even a thing then. So like, I had to eat at like 630-930-1233 3639 30, like, every day. Yeah. And you gave yourself the same amount of insulin. So like, if, like going to a birthday party and having pizza and cake like, wasn't a thing. Like, at all, I did have some great teachers in school because at 930 Instead of like me, like whipping out my own snack, like, they made it to where our class got to have a snack. So like, I was like, the cool kid in school. Like, yeah, we get to have goldfish.
Scott Benner 11:20
You know, Mary is the bringer of goldfish.
Mary 11:23
Ya know? So, so that was nice, but like, I'm telling you Saturday mornings, or, you know, going to birthday parties. It was it was difficult, like you were the person that like change the schedule, or you were just over there sitting like not eating what everyone else was eating. And like, Thank goodness for short acting insulin coming along. Because that like that was a game changer for all of us. Yeah. We were like, what?
Scott Benner 11:52
Mary? Hey, I think that microphones touching something. Oh, yes, my hair. I expressly at the beginning told you to be careful about that. And now look where we are nine minutes. Now. You're just talking and having a good time. And you forgot all about
Mary 12:05
your hair. Yeah, I was just tossing my hair back and forth.
Scott Benner 12:08
I guess I could feel you you were just like you're catching a stride. I was like, she's really into this story. I don't want to mention this. But I keep hearing. But it's gonna get really bad. Yeah. And I'm and it makes me mental. I don't even know another way to put it. Like I hear it. I'm like, please stop that microphone. I can hear myself in my head. Anyway. Okay, so. All right. So you are on the mother of all schedules, like they are shooting insulin into you and you are eating the same things over and over again. Yes. Jesus was terrible. Does that stick with you as an adult?
Mary 12:42
Yeah, it was terrible. Like, the variety was just not there was there was no such thing as variety, like you do like, you know, goldfish, or peanut butter crackers at 930 and 330. In your breakfast, lunch and dinner were were pretty the same, like, anywhere from 30 to 45 carbs, was it? Like you had to make it work?
Scott Benner 13:02
So how long did that go on for?
Mary 13:05
And I know I was in high school. Whenever I got an insulin pump, so at least five or six years, it was a long time.
Scott Benner 13:15
Did you stick to it?
Mary 13:17
Yes. My parents were very supportive. Of course, like, it was one of those situations where we didn't enter like, when I was diagnosed, I was in the honeymoon phase. And I was like, Oh, we got this, you know, like, a plus b equals c, right? Like, that's how it works. And then like, I get into, like, my teenage years, and the hormones just like totally threw everything off. And we were like, what do we do? Like, we're doing? Like, we haven't changed anything. Her diet hasn't changed. Like I don't even have like a sweet tooth at all. And so like when my blood sugar's would be like over 200 I'd be like, What did I do wrong? Like, I ate exactly what I was supposed to eat. Like, I was a perfectionist. Like, if I took a test and got a 99 instead of being like, that was great. I'm like, what, what was the 1%? I missed? Like, tell me what I miss. Yeah. So going through that was like, going through puberty was really difficult for me. You know, we didn't have Dex comps. We couldn't see what my blood sugar's were doing. So we would go I remember like we would, I would dread driving to Tulsa, go to the doctor's office, because I'm like, they're just going to be mad at me. Like, I didn't, I didn't do well. And we would go there and my parents are always super supportive. Like you're trying your best. That's all you can do. You know, when I would leave just feeling like I failed. Like it was a test that I failed.
Scott Benner 14:39
Yeah, well, because when your parents say you're trying your best, that's all you can do. Even as a child you know it. That's not okay. Like that. Okay, yeah, it's okay, buddy. No, it's not like you're supposed to say that. Yeah. My son once said to me, he goes, You're my dad. What else you're gonna say? And I was like, Oh, he's right. Yeah. That's totally
Mary 15:00
right. Yeah. But this doctor is telling me that I'm messing up. And it was difficult
Scott Benner 15:07
really, in those words are just that's how it felt.
Mary 15:10
No in those words. No, I did have a great endocrinologist that was like, super supportive and nice. And then he like, got a promotion and went moved to Texas, and we were devastated. And the one after that was just like, just, there's not even a word for him just very harsh. Like, I have a son and his hemoglobin or his agency is like, 4.5. And I'm like, that's not even healthy. But, okay, like, I'll try harder. Like, you know, what do we do? And there wasn't really much adjustment you could do.
Scott Benner 15:42
I was gonna say, was there any, like, suggestions after that? Or just admonishment? Yeah,
Mary 15:47
right. Like, we didn't leave, like making any changes. And so it's like, okay, like, do better. But we have no suggestion for you.
Scott Benner 15:57
That's, that's great. Oh, do you listen to the podcast?
Mary 16:00
I do. Yeah.
Scott Benner 16:01
Does it surprise you when I use a word like admonishment? But then you realize I'm an idiot at the same time, because it just took me by surprise. I said it. I was like, why is Mary's episode me being really thoughtful? And somebody else's episode? I'm just like, a, like a, like a goofy moron. I can't figure I can't even figure myself out. I'm trying to say it's got to do something with people speaking style and their voices. Yeah,
Mary 16:27
I was gonna say it's me. I have like a very sweet voice. You're drawing me into being thoughtful somehow. Yeah, you're welcome. Thank you like you meet
Scott Benner 16:35
that Sunday. Oh, no, I definitely don't give too many people come on in a row where I'm just like, you know, being zany for some reason, even when I'm editing. I'm like, I gotta spread these out a little bit. Nobody, nobody wants to kiss you. Because I can get into like a Jag. You know what I mean? Sort of like you with your, with your goldfish. I can sort of do the same thing over and over again. And so when I sit down later to edit, I'll be like, Wow, for that. 10 days, I was really like, somber or I was really goofy. And then I just, I, I take those episodes, and I kind of pepper them around each other a little bit so that you don't like turn the podcast on three times in a row. And it's like, you know, me with a seltzer bottle and a big red nose. But anyway, yeah,
Mary 17:18
that's, that's the week someone subscribed. And they're like, You know what,
Scott Benner 17:21
guys? I'm not doing this. Yeah, yeah. So I am just now. I wish you could, like I said, admonishment. And a voice inside of my head went, Ooh, good word.
Mary 17:32
We'll use that one again. Save that one.
Scott Benner 17:36
Writing it now. I'm just ruining it by bringing it up. But alright, so Well, that's a lot, isn't it? So now you've got the doctor leaves on you. And you have no instruction, do things begin to spin out of control?
Mary 17:52
You for a few years? Yes. Like I remember going in, and then just my agency thing eight and nine. And they're like, You know what, like, you are just people are just ruining yourself. Like, and it was, it was a really hard time, like, as a teenager, especially like, when I wanted to do well, you know, it would be one thing if like, I didn't care. And then I went in it was like, Well, yeah, like, that makes sense. But like, for someone who tried really hard, like, I was checking my blood sugar, like eight 910 times a day, like in between meals, like trying to figure out like, what is happening? Where is this? Like? where's this going wrong? Is it the middle of the night? Like, why is my insulin not working? You know, I got to the point where I was like, well, maybe insulin doesn't even work for me. Maybe I have something else. And then we finally got an endocrinologist, like in my area, who was phenomenal. And he's like, Hey, like, they have these insulin pumps. I think you're a perfect candidate for it. Like, since your blood sugars are all over the place. And we were like, yeah, like, let's do it. And of course, like the pump was, was life changing. For me, as I think a junior in high schools, when I got it junior or senior in high school, I got like the Medtronic, like the first Medtronic insulin pump. And I was like, wow, this is incredible. Like, where has this been my whole life? Like, imagine how different my childhood would have been. This this existed? How would you
Scott Benner 19:20
like to know what your blood sugar is, without poking a hole in your finger, you can with the Dexcom G six continuous glucose monitoring system, which is available@dexcom.com forward slash juicebox. Not only does Dexcom offer zero finger sticks, but you can get your glucose readings right on your smart device that's your iPhone or your Android don't have a phone. That's okay. You can use Dex comms receiver. On any of these devices. You're able to set up customizable alerts and alarms, setting your optimal range so that you'll get notified when your glucose levels go too high or too low. And you can share this data with up to 10 followers. Imagine what that could look like your child could be at school, and their data could be available to you, your spouse, their aunt, the school nurse, anyone who you choose, my daughter has been wearing a Dexcom for ever. And it helps us in multiple ways. Around meals, we're able to see if our boluses are well timed, and well measured. If they aren't, we can tell by how her blood sugar reacts, and then go back the next time and make an adjustment. Without the Dexcom CGM. We're sort of flying blind, but not just at meals. Also during activity and sleep. The Dexcom offers us an unprecedented level of comfort and security, being able to see my daughter's blood sugars in real time. And not just the number. But the speed and direction is an absolute game changer. If you're using insulin dexcom.com forward slash juice box head over there today to see if you're eligible for a free 10 day trial of the Dexcom G six. The Dexcom is at the center of how we've been able to keep our daughters a one C between five two and six two. for over seven years, we've been able to minimize variability and keep her blood sugar's in a stable range because of the information that we can see with the Dexcom these are our results and yours may vary. But using Dex coms feedback has helped my daughter without any food restrictions, live a more normal and healthy life dexcom.com forward slash juice box my daughter Arden began wearing the Omni pod tubeless insulin pump on February 4 2009. That was 5093 days ago. Or another way to think of it 1697 pods ago. At that time, she was four years old. Hang out with me for a moment while I tell you more about the Omni pod Omni pod.com forward slash juice box. Today Arden is 18 and still wearing Omni pod back then there was one choice just one pod but today you have a decision to make. Do you want the Omni pod five, the first and only tubeless automated insulin delivery system to integrate with the Dexcom G six, because if you do, it's available right now for people with type one diabetes ages two years and older. The Omni pod five is an algorithm based pump that features smart adjust technology. That means that the Omni pod five is adjusting insulin delivery based on your customized target glucose that's helping you to protect against high and low blood sugars, both day and night. Automatically. Both the Omni pod five and the Omni pod dash are waterproof, you can wear them while you're playing sports, swimming in the shower, the bathtub, anywhere really. That kind of freedom. Coupled with tubeless a tubeless pump, you understand it's not connected to anything. The controller is not connected to the pod, the pod is not connected to anything, you're wearing it on the body tube lessly no tubing to get caught on doorknobs or anywhere else that tubing with those other insulin pumps can get caught Omni pod.com forward slash juice box that's where you go to find out more, you may be eligible for a free 30 day trial of the Omni pod dash, you should check that out too, when you get to my link, Omni pod.com forward slash juicebox. So if you're looking for an insulin pump that is tubeless waterproof, and automated. You're looking for the Omni pod five. If you want to do it on your own, you're not looking for the automation, Omni pod dash for full safety risk information and free trial Terms and Conditions. Please also visit Omni pod.com forward slash juice box
I think this all the time. Like just we're in such an interesting place to go if I started this podcast 20 years from now. The stories like yours would almost be gone. Right? But salutely Yeah, but because of where it is now. There's just so many conversations with people who all I can think I'm Why am I why am I going from serious to emotional What is wrong with me, Mary?
Mary 24:29
I'm ready for it. Bring it on.
Scott Benner 24:31
I'm gonna cry. I don't even know you. Like, if you were just born in a different time, this wouldn't have happened to you.
Mary 24:39
Right? No, that's, I think about that all the time. But then I'm like, No, I wouldn't have my story that I have now. You know, like, it's part of my story. Like it makes me a more empathetic nurse. Like, I mean of course I would like to have not gone through three major surgeries and all that but like, yeah, the I do have those thoughts but you just can't I have to like, push them aside and be like, you know, but it wasn't it didn't exist. So here we are, and like, what can we do now?
Scott Benner 25:05
Yeah, I know. And in my regular life, I don't think like that. It's just that when you sit here and you're staring at a blank wall, and so and you are right, by the way, that you have a sweet voice, like it's I, by the way, that was weird of you to bring up on your own. You could have let me say it, but when you have a sweet voice, and it makes me you know what I think the problem is, you're talking and I'm picturing somebody I know listens to the podcast. Oh, yeah. And I can see her in my, in my mind, and she doesn't have your situation. But like, I can see her and like, you know, at a concert in apparent like cowboy boots and cut off shorts and like, you know what I mean? Like, I'm like, Is this who Mary is? I have no idea. This is who you are, by the way, but I'm attaching your story in your voice to a different person that says, yeah, it's making me upset because I I know that person better. So yeah, anyway. Do you own a pair of cowboy boots that you wear two occasions?
Mary 26:04
You know what? I wish I could say yes, but I don't.
Scott Benner 26:07
It's okay. I don't, I'm not judging you.
Mary 26:11
I know. But for people who are like, Oh, you live in Oklahoma, like as all you do is wear cowboy boots and hats. It's like no, actually, there's more to Oklahoma than that.
Scott Benner 26:19
I'll tell you I'm really I'm upset because I think the Pepperidge Farm company probably took a big hit when you went to that insulin pump out why No, they were probably like, they were probably sitting in a room going like, I don't understand what happened. But our numbers are way down. Right? Yeah, I did a little investigating found out a girl named Mary got an insulin pump. She's not buying goldfish anymore.
Mary 26:39
But that and juice boxes. So
Scott Benner 26:43
Boy, that's interesting, isn't it? The insulin pump company is really digging into the juice box market.
Mary 26:49
That's true. And now you can't even find juice boxes. That's a whole other subject.
Speaker 1 26:53
It's a COVID thing. Right? Right. Yeah, something. Also, I just want to call everyone out who like makes food. We see you making the packages bigger and putting less food in it and charging more. We're not stupid. Stop it. Yeah. Yeah, I see it. Yeah, absolutely. ripping us off. And under the guides. It's good. COVID COVID. It's over. Like, let it go. You can't keep ripping me off. Because the COVID If you don't, I mean, companies like oh, we're we're making our packaging small. I used to buy these little cookies every couple times a year. And I wish I remember the name of them. Because I shame them right now. Hold on a second. I'm sorry. We'll get back to you in a second. I found them because they made good gluten free chocolate chips.
Mary 27:39
Like little small like brand cookies, or you're saying like a cookie.
Scott Benner 27:44
They were bigger. Like you'd get a few in a bag. And the hell is the name of them. This is pissing me off now. I really want to give them crap.
Mary 27:56
Yeah, like you have to call them out by name hates never heard of
Scott Benner 28:01
Tate's bake shop. And their cookies come in like a bag. There's two cellophane things inside of the bag. And then I forgot there's maybe five cookies need solve anything. These cookies used to be like a couple of like, maybe three inches across. And they were expensive. Okay, and they're gluten free cookies were really good. And there was a time when I tried to eat gluten free for a month. And that's how I found them. And so even after I stopped eating gluten free, I still would buy these cookies once a month and buy expensive. I mean, like six bucks, maybe for I don't know, 10 cookies or something like that. That's expensive to me. I'm very cheap. And I wouldn't bought them recently. And the cookies are so much smaller now. And I opened them up and that price is double married. I don't want to lie to you. I got in the car. I had gone grocery shopping. I'm gonna have one of these cookies before I drive home. And I opened it up. And this is what I said. You mother. Look at
Mary 29:02
me threw him out the window.
Scott Benner 29:04
myself in my car. I was like you see some pitches. The cookies are significantly smaller now shame on mutates there. There it is. I hope it gets back to them. I hope so. Give me the regular cookie size. I mean, we're not
Mary 29:17
gonna mail you like a box and then be like, we're so sorry. Like, this is what the demand was like, No, it wasn't.
Scott Benner 29:23
It was. What a cost cutting thing and nothing. It doesn't say on the bag. Hey, by the way, if you're used to our cookies being bigger, Gird your loins because we're gonna rip you off here like you know, like, at least give me a heads up. It's upsetting to me, obviously. Obviously, also see how uncomfortable I was with how emotional I'm feeling. And I'm just deriving the Convert directing the conversation so
Mary 29:47
I know it would make me feel better talking about cookie yelling about
Scott Benner 29:51
cookies. I don't. What I really care about right now
Mary 29:54
shaming a cookie company.
Scott Benner 29:57
You face there, that's it. Alright, They're, I love that you curse but you're from the Midwest, by the way, I don't know why that's intriguing to me.
Mary 30:05
It's actually very uncommon. So yeah, because when
Scott Benner 30:09
we were talking before we started, I stopped myself from cursing and you curse to let me know it was okay.
Mary 30:15
Yeah, I feel like that's a that's a thing that you have to do in the Midwest, like, you're like, hey, like, I'm chill. It's all right. Like, I'm not gonna shame. You
Scott Benner 30:22
know, I definitely wasn't sure if you're gonna make me go to church or hold me in a river or something like that. So does that reference make sense? Yeah, absolutely. Okay. I don't want to be held down the river. That's today. Not today. Not ever. Not today. Oh, you would just hear me complain? I'd be like, it's called Stop.
Mary 30:47
Oh, my God, like you. But please,
Scott Benner 30:50
I want to be cleansed. But I just don't want to be in this chilly water.
Mary 30:54
And the tear, please. Such a
Scott Benner 30:57
baby. All right. Okay. So I'm sorry, you have diabetes, and then things get off the rails. But when do you have your first medical issue?
Mary 31:06
Oh, that's a good question. When was my first medical issue? Well, like, after I graduated high school, I randomly had pancreatitis. And like, it's interesting, because the amount of times I've been in the hospital now, like, if you present to the hospital, and you say like, you're type one, they're like, oh, my gosh, they're in DKA. Like, like you just mentioned, you're diabetic. And that's like, the first thing they go towards. And I understand to a degree, but we also can have other issues other than our blood sugars. And so I had been camping and got really sick, nausea, vomiting, and go into the hospital. And they're like, Oh, I bet she's in DKA. Like, you know, as an 18 year old, like, I understand what you're saying, like, I can hear you talking and like, my blood sugars are fine. Like, I'm good. Finally, after running a bunch of tests, I was in pain. I had pancreatitis, you know, I get better leave the hospital two years later, it happens again. And I'm like, Well, this is weird. Maybe it's your gallbladder. Let's just take it out. And like before becoming a nurse, like, you just kind of trust everything. The doctor says like, oh, like, they went to school, they know what they're talking about, like, sure. That's probably it. And then now, like, being in the medical field, and like question everything, of course, you know, like, trust yourself, you know, trust your body. Like not to diss the doctors by any means. But you know yourself the best. And so we got the pancreas out. I mean, not the pancreas, sorry, the gallbladder out. Two years later, it happens again. And I'm like, okay, like, taking the gallbladder out, didn't help. By this point. I'm 22. Like, I'm on a pump, like things are going fine. Like I'm managing myself through college. I actually like intern with the Juvenile diabetes Research Foundation, like, get a job. They're like, I graduate from the University of Arkansas with a degree in Health Science. And I'm like, I think this is what I want to do, like work for JDRF. And then I was at that job. And I was like, You know what, like, I'm stuck in the office. I really wanted to be on the event side of things, and it just wasn't happening. And I was like, I've got to do something else. I'd always wanted to be a nurse. But can I tell you the amount of conversations I had had with people that were like, Oh, can you do that? Like being diabetic? Like, can you be a nurse like, yeah, yeah. And I was like, Oh, I don't know. Like, it kind of threw me off. Like, oh, I can't like I always thought I could, but maybe that's not a good idea. And finally, I was like, You know what, I'm just gonna do it.
Scott Benner 33:49
boots that would have let you go to the events.
Mary 33:52
Absolutely. Absolutely.
Scott Benner 33:55
That's your own fault.
Mary 33:57
Yeah, it is. I totally take
Scott Benner 34:00
when you so when you mentioned I want to be an RN, then I guess people think about like, hustle and bustle and running around and not having a lot of downtime. And then yeah,
Mary 34:09
thank you, like, just the crazy schedule, you know, like, I think for my generation, like having consistency really helped control, like your blood sugar. Like if you had a like, predictable, consistent day, like it left less room for your blood sugar's to, you know, go all over the place. And so like to be a nurse like in the hospital, like, would you have time to eat? Like, are you gonna be able to take a break when you need to, like, what happens if your blood sugar's going low? And you're like taking care of patients? Like I think there was just a lot of anxiety with the unknown of that.
Scott Benner 34:45
Yeah. Can I ask one more question? How aware of you at this time are you about your birth father's demise? Because they're very, because now people are like saying about you. Hey, why don't we just start plucking organs out Have her and I cuz I'd be like that's what they did to my dad before he died like that would have hit me that way. But
Mary 35:06
Oh yeah, absolutely, it came up a lot. Because like, let me tell you like I could probably sit here and talk to you for hours just about my story because it's just so like wild and bizarre and unusual from the normal path. But I even had a UBI this twice and like UVI This is like the inflammation of the middle layer of your eye. It's very uncommon, and like to have it twice is like extremely uncommon, like the eye doctors. The ophthalmologists are like, I've actually never seen anyone have it twice. And I'm like, Cool. Like, I'm so glad like I'm an anomaly, but like, can we figure out like, why this stuff is going on? Like, so between the UV itis and pancreatitis? Like, I I'm very, very aware that like this probably has to do with my dad, like whatever he had, like they couldn't figure it out. And like, can we please figure it out? Like I would almost rather have like a cancer diagnosis just because it's a diagnosis.
Scott Benner 36:10
Right? It feels like answer even if it's a bad answer. Like
Mary 36:14
even if it's a bad answer, like have this here.
Scott Benner 36:17
UVI. This often happens to people who have autoimmune condition. This is what Yeah, so hold on autoimmune conditions known to cause UV itis include. I never say this right. Ankylosing Spondylitis a condition where the spine and the other areas of the body become inflamed. Any idea? Any chance you have that? You're like, not yet.
Mary 36:43
Like, like, yeah, please don't like speak that into existence. But
Scott Benner 36:47
what that Oh, put that in my head. The spondylitis is gonna give you more context for it. A type of arthritis that causes inflammation in the joints and ligaments of the spine.
Mary 37:00
Yeah, no spine issue. It's up today at 34. But I'll tell
Scott Benner 37:07
that's, it's more common among men. Yeah. Don't worry. Only 200,000 people a year have it.
Mary 37:15
Yeah. There's a statistic about getting it again. But apparently that is very rare. As many as the Mayo Clinic ophthalmologist told me, yeah, I've never I've never seen anyone have it twice. Like, oh, cool.
Scott Benner 37:29
So don't feel good about that 200,000 number because that's the same number for type one diabetes. So you know, you might, that number might be for other people, not for you and, and people listening to this podcast. Wow. Okay, so does it clear up on its own the AI thing? Or did they do something for
Mary 37:48
it? No. You have to have been basically since it's just inflammation of the middle layer of AI, you just take steroids. And so I had to put a steroid drop in my eye once an hour for like 36 hours. Wow. So
Scott Benner 38:05
did your eyes lift weights after that? Or?
Mary 38:07
I hope so. affect your blood sugar? Yes, it did. Yeah. Okay. I did, but it was like extremely painful. And I think like, throughout my life, I've been like, I came to this realization like to like trust myself and like what's going on? Because I always felt like, I was like, I was being overly dramatic on what was going on with my body. Like, I, you know, I presented with this pancreatitis, and I'm like, You know what, my stomach really hurts. Like, I'm not crying like I'm not hunched over. But I'm like, I think something's going on. Like, my back hurts. My stomach hurts. I can't stop vomiting. And they're like, oh, yeah, okay. And like with the the itis I'm like, You know what, like, my eye like really hurts. I'm having a hard time seeing like, it's in a lot of pain. And then they're like, oh, my gosh, like, you have UV itis, you know, it's like, I always feel like I was have to like, trust myself, just because I don't present the way some other people do. Like, when I get really sick, I get like, really quiet. I don't want to talk. Like, I'm just not a crier when I don't feel good. And like, I just felt like people like, weren't believing what was going on with my body
Scott Benner 39:22
because you don't look the way they expect somebody to look when they're
Mary 39:25
not presenting the way that you would expect. And so when I got up, I just again, I was like, Oh, I already know what this is, you know, and I, when I went, I called an ophthalmologist and I was like, I need to get in today. And they're like, well, we don't have anything. I'm like, No, you don't understand. Like, I have UV itis like, I need the steroid drops. I have to get in today, you know, and 10 years prior to that, like I never would have been that patient. I never would have like I would have been like, okay, like, I can wait till tomorrow. It's cool. And I'm like, no, like,
Scott Benner 39:58
I'm just gonna come and sit in the Office? Yeah, like, exactly like,
Mary 40:02
I'll wait. Like squeeze me in like, I'll wait 10 hours if I have to, but I have to be seen today.
Scott Benner 40:09
Yeah, that's interesting. Wow. Okay, so you're advocating for yourself, obviously. What's the next surgery you have?
Mary 40:17
Yeah. So I finally decided to go to nursing school. I get in, in Oklahoma City. That's what brought me to Oklahoma City. I had a cousin that was living here, going to college here. And she was like, we could be roommates. It would be fun. I was like, perfect move to Oklahoma City. Start nursing school. And that's when my anemia started. And when I first was introduced to your podcasts, I listened to your daughter's story and, you know, heard about her anemia. And I'm like, there has to be, you know, like, we all have some connections in our stories. And anemia was my like, first time that something was going on with me. I would walk myself into the ER and be like, I think I need a transfusion. And they would be like, Oh, okay. I'm like, no, like, I'm having a hard time like walking up a flight of stairs, like, I feel really exhausted. And they were like, well, like you're in nursing school, you're working full time. Like, you know, and then the bloodwork would come back. And my chemo globin would be like, 5.8. And they'd be like, Whoa, okay, yeah, you do, I would get a transfusion. And then I would go about my day. And we were like, We gotta get this figured out. Like, why are you like, losing so much blood? Like, what is going on? And I'm in nursing school at this time. So like, which was horrible, because I'm like, learning all this stuff. And like, I'm one of those people that like ignorance is bliss in this situation, because I'm like, this could be really bad. Like, why am I having all these transfusions, like, you know, I'm opening my nursing books, and like just finding all these outrageous things that could be going on and just freaking myself out. And the transfusions got to become like, where it was like, every couple of weeks, I think the most I would go would be two weeks without needing a transfusion. Oh, my God. So at that point, we're seeing a whole bunch of doctors around the, the area. I think I saw like eight or nine specialists, and then my, over the Christmas break, my parents were like, You need to take off some work, like come back home. Let's see some doctors around here. So we can figure out like what's going on? Like, okay, cool. So we do a bone marrow biopsy, and everything is fine. We still can't figure out what's going on. And I saw a doctor that was like, You know what, I bet it's stress, like stress. I don't think so. Like they tried putting me on like anti anxiety, medication, sleep medication, throwing everything at the wall to try to figure out what was going on. And thank goodness for like, again, like my parents have, like saved my life. On multiple occasions. They started like requesting that I be seen at specialty hospitals. So we tried to get into the Cleveland Clinic. We tried getting into MD Anderson. And finally we got into the Mayo Clinic in Rochester, Minnesota. So mind you, I'm still in nursing school at this point. Yeah. So we're like, Okay, we'll do it over spring break, which happened to be my birthday. So I didn't have to take off any school or anything. And we go to the Mayo Clinic over spring break, like all my friends are like, partying it up, like going to the beach. And I'm like, I'm gonna go to the Mayo Clinic trying to figure out why. Like, I keep having this anemia issue. We go to the Mayo Clinic, and they do like a full body workup. And they're like, You know what, like, we don't think you're producing enough urethral cleeton, which is like the hormone that helps produce red blood cells. And they're like, Okay, and they're like, you can do these like eco shots, and it should help. And we're like, okay, cool. So we do like an eco shot, like, it doesn't help. And then like, I kid you not. On my birthday, we do this kidney biopsy. And it can't turns out like two of the three tissue samples were already necrotic and they pull us in a room and they're like, telling us about this biopsy, and they're like, We think you're gonna need a kidney transplant. And we're like, what? Like, I'm in nursing school. I work full time as a medical assistant, like, like to hear that like you need a kidney transplant, like possibly soon, like, it was very vague. was just like, I mean, that was like life altering. I mean, not to be too dramatic, but it was like, it was it was hard to understand. I remember for the next couple of days, we were like what like, my blood work was all normal, like as far as kidney function went it like I had my diabetes under control, like the insulin pump was so helpful. Like, I was like, super confused. And of course, like, in my head, and then my parents and my family is it's like, Oh, this must have something to do with like, what's going on? Like, what happened with your dad? Like, you know, like, we know he has something autoimmune, but we just don't know what maybe this is it? And so I have this feeling that like, are we just putting a bandaid over something much bigger, much bigger. And spoiler alert, we we didn't find anything. So we are still look, I guess, in a way, like putting band aids on. But
Scott Benner 45:42
let me clarify for a second for people. So the Yeah, what was happening was is that this hormone that you seem to be deficient in, it helps the kidney something it's something in the kidney that stimulates red blood cell production.
Mary 45:58
So you're actually made in the bone marrow donors to the kidney, okay. Okay. So,
Scott Benner 46:03
in general, the way your path worked here is when you when you're anemic, and you're not bleeding, they just think you have cancer, like that's the right, that's the first step. So then they rule that out. And then you dig deeper to find out that there's a problem with this hormone and the stimulation of red blood red blood red blood cell production, which makes sense for you being anemic, but then they dig further into that and see that the reason that's happening is because you have kidney damage, Mm hmm. Okay, yes,
Mary 46:35
there is a way and I'm not very sure on how, like, you can see if it's damaged from diabetes, or if it or just other. And so they did do that. And it wasn't from the diabetes. Now, I will tell you, I having type one, I don't think ever helps. I don't, you know, like, the years that I struggled and like just being diabetic in general, I don't think our our organs are like gay. But they were able to see that like, the, the dying of the kidney cells, like wasn't diabetes related. So they're like, hey, like, there is this possibility that like, you could like, just have a kidney, pancreas transplant, and then you wouldn't be diabetic anymore. And like, I've never even heard of that. And I was like, Well, that might be diabetic. That will be cool. And they're like, Yeah, you take the same medications for it. But the thing is, is like you're probably going to need this transplant. So we would want to do the kidney first, and then maybe come back and do the pancreas later. And it was just so overwhelming. And they were like, You know what you can like, you can stop school. And I was like, No, I'm finishing school. So after spring break, I went home, finished nursing school, graduated, took my boards became a nurse. And then that October, I had my first transplant. It was actually a childhood friend of mine. Like we have been friends since I was like three. And she ended up being like a perfect match. Like even over like relatives. She gave yourself she absolutely did. Yeah. Like couldn't ask for a better friend, right?
Scott Benner 48:12
No, I mean, Jesus, she's on the Christmas card list forever. Absolutely. What year is this?
Mary 48:20
This is 2015. Yeah.
Scott Benner 48:24
How do you do that? Facebook? Phone calls? Yeah. How do you go, hey, everyone who wants to give Mary a kidney?
Mary 48:31
Right. And so I don't even have a social media. I mean, I do have a social media presence that I'm not one to even like post. I'm just kind of like a silent member. So my mom, like, she was keeping everyone updated with like, what was going on with me, you she would, you'd be like, hey, like we saw these doctors today, things are looking good. So people were kind of waiting for an update about the mayo trip. So that was kind of the way we got the word out. And then really just by word of mouth. So she just kind of put like, hey, we kind of have some sad news, she's possibly going to need a kidney transplant. And within the next year, like if you are interested in finding out if you're a match, like get with me, and I'll send you the information. And so I was very blessed to have a lot of people interested in being the donor and then I feel some sort of guilt. You know, like, I don't want to take anyone's kidney from them. Like it was. It was a difficult time.
Scott Benner 49:31
I think that's an astonishing thing to do. Yeah, I did donate it or a healthy Oregon. Like, I can't wrap my head around doing that. For some.
Mary 49:41
And like a year prior to that my uncle had just randomly donated a kidney would just just another bizarre piece of the story. I can't
Scott Benner 49:50
believe you're back from that many people. I feel like the people I know would be like I didn't see that post. Sorry. I wish I would have it If I would have given you my kidney, but I didn't say it. Yeah, no, I, I assume no one would.
Mary 50:07
Yeah, it was very sweet. And like I'm type O which like we're the universal donators, but like in order to receive, like, you have to have my exact same blood type. So that narrowed it down a lot. There are like, are over 100,000 people right now on the kidney transplant list, like if you just want to wait, but mine was getting so bad. Like, they were like, you probably should try to find someone, because I was fine just being on the waiting list, but the average was like six years. And then on top of that, what was my blood type? It could be any even longer than that. Were you gonna have to do dialysis
Scott Benner 50:42
if you went that way? Mm hmm. Yeah.
Mary 50:45
So we had the first one that October. So we went from March to transplant in October, total shock. until like, the path I was on, I did become a nurse. And so I was learning, I was still learning about all that was going on with my body while also experiencing it. And it further solidified, I wanted to be a nurse. So because I can tell you like the many times I was in the hospital, like, I may not remember what I was there for or what was going on. But like, I remembered the nurses, like if they were kind if they, you know, truly took care of me like, the nurses are what made the difference in my hospital stays. So I was like, Okay, I'm on the right. career path here. Like, this experience will just help me once limps on better. So we have the surgery, everything went great. Kidney function is great. diabetes is still going well, I had a very hard time recovering. It was a very rough recovery for me. I didn't eat for 10 days, I was having a lot of like, post procedure, nausea. And so when they started talking to me about having the pancreas transplant, I just said absolutely not. Like no. I'm like, do I have to? And they're like, no, but like, you could not be diabetic. I'm like, cool, but no, like, that surgery was so awful. Like, I don't ever want to experience that again. And they're like, Okay, well, maybe you'll change your mind later. So a year later, they're like, Are you sure you don't want to like, it's, it's already the same medication, the only thing would be as like, he wouldn't be diabetic anymore. I'm like, Okay, fine. Like that does sound nice. So they put me on the pancreas transplant waiting list, which is significantly smaller, it only has like 200 people versus 100,000 people. So they're like that, it's very high possibility, it'll pop in. So in 2018, I did have a pancreas transplant. And the recovery was a little bit better. I'll still say it was rough, but it was a little bit better. But I wasn't diabetic anymore. And like my life, like, when I tell you that transition was weird. It was very weird. Like, first of all, so many people haven't even heard of that pancreas transplant. So the idea of me not being diabetic anymore was just unheard of. And I couldn't get it out of my head. I was like, constantly thinking about what my blood sugar was thinking about the carbs I was eating. I didn't change my diet at all, you know, people would be like, do you want to go get an icy or, you know, we should have like an ice cream party to celebrate? And I'm just like, no, like, you know, I'm just happy for my organs like, it was. It was interesting, but I was I was grateful for it. I will say the thing that I wish I would have researched prior to this is that they do not have a very high success rate. And I wish I would have researched that better.
Scott Benner 53:55
Because how long did you not have diabetes for
Mary 53:59
like, almost two years, almost two years. So the pandemic comes March of 2020, if I'm remembering correct, and then May of 2020. I go into the hospital and DKA like when they told me my blood sugar was 500 I was like, okay, like it failed. You have bloodwork like monthly and they check like your pancreatic enzymes. That is like one of the first signs that your pancreas is failing. That didn't go that way. For me. It just it just stopped one day just stopped working. Went back into the hospital at the Mayo Clinic and they were like yeah, actually like this is actually pretty common. Like the pancreas is a very vascular organ like for it to work and last, you know, and I'm just like, Where was all this information?
Scott Benner 54:52
No one mentioned that in the brochure.
Mary 54:55
Yeah. Right. I'm like, oh, like maybe Yeah. And like we talked about earlier, like, you can't you can't sit there and go like, what if I, you know, go back and like change any decisions? But
Scott Benner 55:08
did they offer you another one? Like on a bike?
Mary 55:11
They did? Yeah. And I said, No, I was like, You know what, like, we have made so many advancements, like, between the decks calm and now like, the tandem pump, which is what I use, like the control like you like, and this has been my whole life. Like, I'm not interested, like, I'm not interested in having another one. And they're like, Okay, well, if you ever change your mind, let us know. And it's, you know, it's been almost three years now. And I have no desire to go through that again, just because I feel like I would still be checking my blood sugar, like worrying about going back into DKA. And, of course, when you go into DKA, that doesn't help like your transplanted kidney at all. So
Scott Benner 55:57
not looking, not looking at tax that thing? For sure. Yeah. How are the anti rejection meds? Are there a lot of them? What's the process?
Mary 56:06
Yeah, the anti rejection meds, I'm on three, the biggest side effects is like GI issues. And so you really just have to, like work on finding like the right dose, like, you want to make sure you're taking a high enough dose that keeps your immune system suppressed in order for that organ to like, stay and be like, not try to reject, but also like keeping those symptoms like from taking over your life. So that takes a little bit of an adjustment. But once you get them adjusted, it's fine. So you take prednisone and then you take two other anti rejection medication, medications, you take them twice a day, every 12 hours. But like, that's not hard. Just make sure you set your alarm.
Scott Benner 56:53
I have an interesting or maybe stupid question. Do you have? Did you have any other like auto immunity things that have kind of dissipated since you're on the since your immune system is being tamped down? Like did you have any joint pain or like any other way? Oh,
Mary 57:12
yeah, I know exactly what you mean. And no, I have been fortunate to not have not anything else things
Scott Benner 57:19
go on,
Mary 57:20
arise. Yeah.
Scott Benner 57:21
I wonder if like, I don't know. Like, I wonder if that wouldn't have helped your father at some point to kind of quit? Oh,
Mary 57:29
definitely. Yeah, you
Scott Benner 57:30
don't I'm saying
Mary 57:32
my family like got a hold of like, all his medical records, like hundreds and hundreds of medical records. And like, I read through them, and I'm just like, man, if if he had the technology that we had today, like who knows
Scott Benner 57:47
what they could have figured out because it could have figured out I said something so telling about his story. You're like they did exploratory surgery. And that really isn't a thing anymore. But they don't cut you open and just poke around.
Mary 58:01
No, and they did I remember when my family told me that I was like, what they're like, yeah, just like a why like, just a line up your stomach and then like, just, they just open you up and they just kind of look to see what's going on.
Scott Benner 58:15
Yeah, yeah, there's so much more that can be done from the exterior of the body now with with technology and imaging and and better testing and everything. It's so fascinating look inside of like, just two generations, you know? Yeah. Oh, absolutely.
Mary 58:31
No, absolutely.
Scott Benner 58:33
What's the how do you feel day to day? Like they actually stop I'm stopping myself. I want to go back two years you don't have diabetes because you have the transplant. But you couldn't shake the feeling that you were diabetic? Yes. It just didn't go away. So was it not relieving psychologically to have the new Pancras?
Mary 59:01
No, I want to say it was I mean, it didn't enter. It wasn't like a daily thought it didn't enter fear to where like, I wasn't enjoying not changing pomp sites and you know, changing decks comps, and honestly, the financial relief was really nice. Like, there are a lot of things to be grateful for. And I did I did enjoy it, but I would be lying if I said like, anytime I didn't feel good. That was my first thought or an I never got over the fact of like looking at a meal and just knowing how much insulin that would have. Like,
Scott Benner 59:41
yeah, that didn't go you every meal you looked at you guys is like five years. Yeah.
Mary 59:45
Yeah. And like, like I said, I don't really have a sweet tooth. So like, yeah, of course, like I ate more carbs. Like when I would like go to a restaurant and have like three roles instead of like one I'd be like, Wow, Like in my head being like, you know how much insulin this would take, like,
Scott Benner 1:00:04
I'm gonna have another role like a crazy
Mary 1:00:07
control now
Scott Benner 1:00:09
where the doctors at all like, they just call it a failed transplant it's not your your immune system didn't come for the pancreas. Right? Yeah. How did they tell the difference between that Do you know?
Mary 1:00:22
I don't know. But I know that like I said it's like another like mystery like huh like usually this shows up in the bloodwork and like there's things you can do to like prevent it from completely failing, you know, because they do tell you that like you're gonna get these enzyme checked. And if these enzymes are elevated, then we're going to increase you know, your anti rejection meds or because the pancreas is a very vascular organ like you were also on blood thinners. And so it could have gotten a clot. And if there's a clot and it's not working, you know, and so like they ran all the tests, they did the ultrasounds like there's no clot like, and the enzymes are still normal, yet. It failed.
Scott Benner 1:01:11
Hey, were you like, you gotta be kidding. Yes. I mean, I would have, like I'm on
Mary 1:01:16
this day. I'm like, can I just like, Can I not
Scott Benner 1:01:20
do that pile and pulled out a bed, pancreas and gave it to me?
Mary 1:01:24
Like, can I have something normal happen? Like, they're always like, wow, like, what a mystery. It's like, I'm tired of being here. Mystery when I
Scott Benner 1:01:34
terrific. Yeah, yeah. Yeah,
Mary 1:01:37
that sounds I'm sorry. Well, good. Oh, I was gonna say like, I told you, I could talk for hours. But the pancreas transplant process like you were waiting, like, you know, you that can only be from a deceased donor. And so you had to have your phone on you at all times. And you're waiting for this call. And like, when I finally got it, it was the third call, like I had been called twice, and then it ended up not going through. And so that's another thing I didn't want to go through. Like, I don't want to be attached to my phone, again, like waiting on this call and having to drop everything to go have a transplant. Like there's just so many reasons that you
Scott Benner 1:02:16
just did not about the process. Yeah. And and the outcomes that you see is not something you want to go through again,
Mary 1:02:22
no. And I think like the technology that we have today is a huge reason for that. I mean, if this was when I was nine, and I was diagnosed, like Yeah, Sign me up. But like, my control is like my last day Wednesday was 5.2. Like, I couldn't be happier with the tandem and the decks calm.
Scott Benner 1:02:42
I think it's such an interesting part of your story, that, that you're like, it's okay, let's not do it. But I think that I think people hearing that will think that you are somehow special in the way you manage your diabetes, because you don't talk about, like, you talked about the stress and the anxiety of the transplant process, but you don't talk about the stress and anxiety of having diabetes, whereas I think other people would hear that and think, Well, there's stress and anxiety somewhere. But why are you not up? Like, why does having diabetes, not bother you?
Mary 1:03:18
Oh, yeah, that's a great question. No,
Scott Benner 1:03:21
I'm just kidding. You're full of them.
Mary 1:03:24
Even like, and I do have to give like a huge shout out to even your podcast. And that's not a lie. Like, we didn't have social media. When I was diagnosed, I didn't have a diabetes community. My parents did send me to diabetes camp, and I cried when they left because I didn't know anyone. But like just having the access to all the information. And just really the Dexcom in the control IQ. And just being able to like, resource yourself with the best knowledge you can have like it really the flexibility and I think my generation understands that more than anyone like, this could be so much worse. Like we have so much freedom. And that's something that I give your podcast a lot of kudos for is like, hey, actually, like this doesn't have to change the way you live. Live your life. Like
Scott Benner 1:04:23
that's very kind, but there's something about you. You don't know what it is, though. Hmm.
Mary 1:04:28
I don't think I know what it is. No, I think, I think maybe because it's, it's all I've known. You know, like, I just diagnosed when I was nine. It's just like, it's just a part of life.
Scott Benner 1:04:39
I don't know my back's hurt most of my life. And if you told me I could get rid of it, I wouldn't be like, Don't worry, I'm used to it. Like, there's something about you. You don't, it's fine. You'd be the wrong one to ask. You don't know why you're wired the way you are. And you don't and you don't see yourself as that. You see yourself as you see you you don't know. But there's something there. Are you mad?
Mary 1:05:00
worried? No, I'm
Scott Benner 1:05:01
not ever No. No care to me.
Mary 1:05:05
It's Sunday. Yeah. Sunday, I'm really more of my parents left. Like, since my mom like lost my dad tragically, like, was very much like, learn to take care of yourself, like don't rely on anybody and like everything I've been through, I'm just like, I'm very content like, in what I'm doing. And
Scott Benner 1:05:25
that's what I'm trying to get at, like, I'm trying to figure out if it's, I'm trying to figure out if it's that you've got deeper perspective than most people. I would think so. And the diabetes is just like, at least nobody died. You don't I mean, or somebody who, at one point in your life, you're like, I probably have cancer. And that didn't happen. And so you have, you don't I mean, but there's a even like, just going back to nursing school. When someone says to you, hey, you're gonna need a kidney transplant the next year, and you're like, Well, I'm just gonna go back to Oklahoma and get my RN first. And then we'll come back and do that transplant thing. Like most people would be like, Yeah, that's a good idea. Let's transplant the kidney. And then I'll go back to school after that. So are you stubborn?
Mary 1:06:10
Very, very,
Scott Benner 1:06:12
in a pleasant way? Or like if we dated what I hate you which, which? But I'd be like, Oh, my God never bends on anything? Or would you just you just stick to a person?
Mary 1:06:24
I think it's more of a stick to a person. I mean, I don't know. You have to ask my ex boyfriends, but
Scott Benner 1:06:31
either think there's like a group of guys like they get together once a week. And they're like, it's like their support group for having dated very, yeah. Wow. Is there anywhere? Is there any way I can't call this episode? There's Something About Mary. Absolutely. After, right. Yeah, very fitting. Because before that I all I had was Mary had diabetes, and she didn't have diabetes. And she had diabetes again, which seemed to work
Mary 1:06:58
very well. Yeah, that's very long.
Scott Benner 1:07:01
That's like, that's gonna be too long. Or guests who has diabetes? Or everybody heard that? It's not there. I'm going with There's Something About Mary. Because there's because I am being serious. Like you've, you've highlighted a number of different decisions, that I think most people would have gone the other way on. And you're very and you seem happy. I am. Yeah. Yeah. Yeah. Hi, right. Yeah, no, I don't think you heard me. You're not high right now. Right? Oh, god. No. Okay. You're not happy because you're altered? Yeah, I'm not Kate. Is that a word? Yeah. Okay.
Mary 1:07:46
Never caked.
Scott Benner 1:07:47
I didn't I've never. Oh, finally, finally, me learning something about about drug culture that I didn't know already? Yeah, I mean, it's just, it's interesting. I come across this a number of times, where you ask a personal question about themselves. And you can just tell like, they don't know the answer. And I understand it. You know what I mean? Like, I understand, like, there are things I do, I don't know why they happen, or why they work or don't work, or some, you know, something like that. It's just interesting in this context. Yeah. Is there anything we didn't talk about that we should have?
Mary 1:08:27
Man? I don't think so. Like I said, I know we're running over time. I didn't even get to tell you that the first kidney failed, and I had to go on dialysis for a year, but we don't even have to talk.
Scott Benner 1:08:39
Very, why did you bring that up? Okay, hold on a second. So the friend that gave you the kidney, you don't have that one anymore? What's the what's the process you go through to go tell that person that that happened?
Mary 1:08:55
Gosh, it was it was difficult, because, well, the way it happened is you know, the pancreas like 2020 was just a really bad year for me because the pancreas failed in May. And now I get back on the pump. I've adjusted to that mentally. And then in July, I get dehydrated, and I go to the hospital and like I can't even make this up. Like they forgot about me. Like they forgot about me in the room. I get really sick. I'm left alone for two days like my insulin pump dies. That's like a whole other episode in itself.
Scott Benner 1:09:32
Abandoned in a room in a hospital. Nobody knew you're there. And you were too sick to get help.
Mary 1:09:38
Yeah, yeah. I know. Oh, my
Scott Benner 1:09:41
God, what state was this in Oklahoma. I move immediately after that, but that's okay. So how does that happen?
Mary 1:09:51
Yeah, it was. It was horrible. I went in for dehydration. I get admitted of course like when you when you're diabetic and you've had a transplant, like staying overnight to be observed is like pretty common. And I'm fine with that. There's been like several hospitalizations, which I could go on a whole tangent about how people don't understand type one versus type two. But like, they would try to take my pump off of me. And I'm like, that's fine. Like, you can monitor my blood sugars and insulin, I understand that, like, if you're going to take my pump off, you're gonna have to give me some background insulin, like, I'm gonna need some Lantis or, you know, and they just like, there's just no comprehension of that. And like, that's something I want to work on. Like, let's educate people with type one. Because like, there's just, there's just not a great understanding of it. I'm in the hospital setting. And so I lie, and they're like, Well, you turn your pump off, I'm like, Sure. And so but I didn't, I kept it on, because they weren't going to give me any background insulin. And so I let them give me like, Bolus insulin. And then like, they just stopped coming in to check on me. And like, I'm getting worse and worse, the pump dies, my cell phone dies. And so it was 2020. And so you weren't allowed to have visitors at the hospital. And so my mom would just call and check on me. And when my phone died, she was like, okay, something's wrong. So she like barges into the hospitals, like, where's my daughter, and like, comes in, and like, I am like, I'm almost dead. Like, I almost died, like I'm on 10 liters of oxygen. They have to, like, put a central line in my neck. Like without even numbing it. Like they couldn't get a line started. It was It was horrible. I luckily, I don't remember a lot of it. I think my mind like mentally blocked it for a reason. Because it was so traumatic. But I remember, once I started to get better, they were like, yeah, like your kidney didn't make it. And I'm like, Well, that makes sense. You know?
Scott Benner 1:11:54
Your kid didn't make it. I almost didn't make it. You're like, Listen,
Mary 1:11:58
I'm glad to be alive. So
Scott Benner 1:12:01
then you in the hospital, they have to find you another kidney right away. No, you can't do that. There's, it's not going to happen. You have to go on dialysis.
Mary 1:12:09
Yeah, yeah. So it's one of those situations where it's like, it's one
Scott Benner 1:12:12
of those situations, Mary, nothing you've said today is one of those situations. Very specific stuff.
Mary 1:12:20
But it's, it is yeah. So they basically just say like, I mean, it didn't completely fail, but it's like it's on its way down. It's one of those things where it's like, hey, like, you don't have to go on dialysis immediately. But like this, this isn't gonna make it like long term. So I think for like my friend that donated the first one. Like, there was a little bit of understanding there because it was, it was really, truly out of my control. I think had I like not taking my medication or wasn't taking care of myself, and it failed. There would be a lot of guilt there. But she knew like what happened with the hospital. And I think it was just a mutual, like, mutual understanding that like, there was nothing I could do.
Scott Benner 1:13:05
Oh, I bet when you left her house, she went the other room and she was like, son of a bitch. I go, I would have been so pissed at you now that you by the way, just did that the whole thing. I would have been. Oh my god, I gave my kidney to marry. And now she doesn't have it anymore.
Mary 1:13:21
Exactly. Like, can we burn this hospital down? Oh, I
Scott Benner 1:13:25
would have been so mad. Oh my god, I can't even explain to you the anger. I haven't now and it didn't happen to me. It's infuriating. And maybe you want to say it's no one's fault. But though it's pretty shaky. What happened to you at the hospital? So do you think if you would have gone in there and been treated? Well, you'd still have that kidney?
Mary 1:13:46
Oh, for sure. I went in for dehydration. Yeah, like, my blood like, and like we even have the records like my blood sugar on admission was 108 like an hour that will be permanently engraved in my head. Like, there was no reason I should have gone into DK. You don't
Scott Benner 1:14:01
do somebody over this. I'm just asking. You know what,
Mary 1:14:04
that's interesting. I actually have an uncle who's a lawyer. And those are really hard to prove. Because like, unless you're dead, like they have, like, people document that they do stuff that they don't like, it's really it's really one of those cases where it's hard to prove and it might be traumatic for you. I think that was like another issue was like was I really ready to like go through all of that again. So I mean, you know, still can it's only been three years but
Scott Benner 1:14:39
so yeah, okay, so Tom, so you have to go on on dialysis for a while and then they find you another kidney and now you have that one.
Mary 1:14:48
I went on dialysis for 10 months, and actually my aunt ended up being my second kidney donor and it's working beautifully on real
Scott Benner 1:14:58
you got another part I can't give you a kidney. Mm hmm. No, I can't. I wouldn't advise you and I was like, Listen.
Mary 1:15:10
You got a lot going on.
Scott Benner 1:15:12
What did George Bush say that day? Fool me once. Fool me can get fooled again.
Speaker 1 1:15:19
What if my favorite like misc like somebody's trying to say something and then saying it wrong. It has nothing to do with politics for me. He just Do you know this you're kind of young you might not know this, though George. Yeah. Do you know that? Absolutely. Yeah, that's fantastic. Yes. There's an old saying around here. And then he wants to say, fool me once. Shame on you fool me twice. Shame on me. He wants to say that, but he just says like, it's just so damn funny.
Mary 1:15:50
Can't be fooled again.
Scott Benner 1:15:53
Fool me Don't get fooled again. Like, he just gets into it. And he realizes, I don't know this quote, and he just rolls through it as fast as he can. And you know, he had that like weird. Like, when he was embarrassed, he'd get that like, hey, look on his face. Yeah. That's great. I'm gonna find the audio and put it in here when I it's just so funny. Anyway, I that's I imagined your ampion like that for me once, baby. But that's really wonderful.
Mary 1:16:22
Yeah, yeah. And being like blood related, I think, has also been great. Because like it is, I cannot ask for a better kidney like it is functioning perfectly. That was in September of 21. And no issues. So I'll be very, very, you know, and it's hard to like, find people that like, don't drink and don't do drugs. And like, my aunt is one of those people. And she had a perfectly healthy kidney. And when they went in to take it, they were like, actually, like, you have two arteries connected to this kidney. Like you probably won't see any effects from having this surgery. And that made me feel good. Because taking someone's kidney was hard the first time and it's definitely hard. The second time, there's no way it seems that like you just get used.
Scott Benner 1:17:13
Yeah, no, there's no way you didn't think I'm gonna take my ass kidney. It's gonna fail. Right? Yeah. And then I have to go tell her then what happened? Oh, yeah. Oh, my gosh. All right. Well, this was terrific. Um, you were, you're a great storyteller and, and lovely to listen to. I can't tell you how, yeah, how generous it is to be to come tell this whole story. Thank you.
Mary 1:17:36
I just hope it encouraged someone you know, because like the podcast, really has been like really, mentally helpful for me. I actually didn't even hear about it until one of my best friends husband's got diagnosed at the 32. And he was like, Hey, do you ever listen to the Juicebox Podcast? I'm like, What's that? Like? He's like, Oh, you gotta listen to it. I think you would really like it. And I just like binge listening to it. And I think I emailed you at like, 11 o'clock at night. And I was like, I love your podcast. Like, I wish this was around. When I was younger.
Scott Benner 1:18:08
I get a lot of emails like that. They freak me. Well, I was very nice. I just, even just now when you said that you're, you know, you know, a person who got diagnosed, and they said, Have you ever heard the Juicebox Podcast like, that is otherworldly to me that there's a person having a conversation like that out in the world. And I know it happens a lot. But it's hard to have no idea. Yeah. It's hard to like, I don't know what it's hard to do. It's hard to accept, I think on this side. That is how I bet. Yeah. All right. I'm gonna read it to you. There's an old saying in Tennessee. I know it's in Texas, probably in Tennessee. That says he's already like, he's already lost. Like, because I think I think he's in Texas, and realizes that after he says Tennessee, I'm gonna have to I'm gonna do a deep dive on this. Anyway. There's an old saying in Texas. I know. It's an unknown. Hold on now. all messed up. There's an old saying in Tennessee. I know. It's in Texas, probably in Tennessee. That says, fool me once. And then you have to hear the audio because there's a long pause. He goes shame on. Shame on you. Fool me. You can't get fooled again. The roasted the Oh my god. It's if no one's heard it. Just Google it for God's sakes. Hilarious.
Mary 1:19:28
No, it's like that clip is used in a song. Is it really? Yeah, there's a jay Cole song, which I'm guessing you don't listen to rap or hip hop?
Scott Benner 1:19:38
Well, I do I do. If my son's around, but his stuff. Yeah. Yeah. He hasn't done Jay Cole in a while. I don't know. I don't know what he's up to. Actually I do know what he's up to. Now. He tried to tell me the other day that I have to what music was he given me the other day? I don't know if I saved it. I mix something. Hell, he's at work or I would just text him.
Mary 1:20:08
So if you were feeling really inspired, you could look up Jay Cole's no role models, and he samples it and that song,
Scott Benner 1:20:17
I'll find that I've heard I think I've heard that before. But I'm just gonna like, hold on a second
Unknown Speaker 1:20:28
there's an old saying in Tennessee, I know it's in Texas, probably in Tennessee. This is Fool me once. Shame on. You. Shame on you.
Scott Benner 1:20:42
Boom, can't get fooled again. Alright, that clip, that clip adds laughter to it, which is not necessary. Whoever did that. It's hilarious enough on its own. I'm gonna find the clean the clean version of it. It's just like, you're watching him. And you could see on his face. He's like, I don't know what I'm talking about. And I can't stop now. Yeah, now.
Mary 1:21:05
See, it's so great when it's sampled in that song too. Because like, I don't even think a lot of people remember that.
Scott Benner 1:21:11
If I it's one of the favorites. It's one of my favorite things has happened in my lifetime. Like gets you so awkward. If I was a politician, I would go. If I got in that spot, I'd stop and go you know what I was just going to there's a saying I was going to recant to you. And I just feel like me. I can't remember right now. And I would just keep going. Like, I don't know why you would like, I don't know why.
Mary 1:21:36
I wanted to be internet famous.
Scott Benner 1:21:40
He is. He is for me. It's one of the best things that's happened in my lifetime as far as I'm concerned. Top 10 No, it's wonderful. That and you trick and two people to give you
Mary 1:21:52
Yeah, you're welcome. All right. I made it in the top.
Scott Benner 1:21:55
No, very. Okay. All right. The you were again, terrific. I will. Let me let me stop the recording and say goodbye to you. First things first, pay First things first, Mary, what a great, great interview. Thank you so much for coming on and sharing your story. I have the soup to nuts answer. I'll put that at the end. But I want to thank Dexcom for sponsoring this episode dexcom.com forward slash juice box head over now. Get your benefits check get started. Or just look around. And on the pod thank you to Omni pod five and Omni pod dash m the pod.com forward slash juicebox. Same thing go check it out. Might even be able to take a test drive of that pod check one out right in your house for free. Use my link find out more omnipod.com forward slash juice box links in the show notes links at juicebox podcast.com to these and all the sponsors. Okay, you ready soup to nuts. Pretty self explanatory once I looked it up, I think I was on to it at the beginning. From beginning to end soup to nuts is an American English idiom that conveys the meaning of from beginning to end derived from the description of a full course dinner. Soup to nuts. I guess you used to get nuts at the end. I guess the nuts come at the end and the soup at the beginning. So soup to nuts. Also, fun fact the 1930s feature film starring a trio of kooky people who later became known as the Three Stooges was also called soup to nuts. This episode is called Something About Mary. But it was almost called Fool me once. Played still could be am I about to talk myself out of the title? I have the title written down as There's Something About Mary because Mary's terrific or something about her. You know what I mean? But for me once, that's the George Bush thing. Hmm. I don't know. I guess I'm gonna surprise myself. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast.
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#994 How We're Taught
Tziporah has type 1 diabetes and is here to talk about how we learn.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - 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 994 of the Juicebox Podcast.
Today's guest is a returning podcast guest who is going to help me talk about the way people learn the way our brains take in information and the way it's taught to us by the people who are doing the teaching. 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 are becoming bold with insulin. If you're looking for a Dexcom on the pod, if you want to try us med a contour meter, learn more about touched by type one.org. Maybe in fact, you want to get better help, or save 40% off your order at cozier calm. If you need any of those things, or you just want to drink some ag one, please use my links there in the show notes of your podcast player, and at juicebox podcast.com. And these are the companies who sponsor the show, day in and day out year after year. If you want any of these things, or even interested in learning more, using my link is really helpful. I appreciate your consideration.
The podcast is sponsored today by better help better help is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapists who can help you with a wide range of issues. Better help.com forward slash juicebox. To get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and scheduled live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit, for any reason at all. You can switch to a new therapist at no additional charge. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price. betterhelp.com forward slash juice box that's better help h e l p.com. Forward slash juicebox save 10% On your first month of therapy. All right, we're recording. And I think that even though I've spoken with you twice on the podcast, it would be smart of me to ask you to say your first name for me.
Tziporah 3:02
Sure. My first name is Sephora. Alright, um, already
Scott Benner 3:05
don't worry. You and I are going to talk set 1015 More times my life. And I'm and one day I won't go. Like it's T and then z. And what's the sound of that makes?
Tziporah 3:17
Uh huh. It's like the like the sound of hot oil hitting a pan,
Scott Benner 3:23
Zara Sephora, but then the piece there too. And the I need all the letters.
Tziporah 3:29
Yeah, I mean, it's it's phonetic, if you know how to make the first sound and then the rest of it just sort of unfolds
Scott Benner 3:35
support. Yeah, perfect. Well, I got it. It's like Sephora, but with a T and a Z. I'm on it. Right. Yeah. Alright. So you are, by the way, you've now been on the show once recorded another episode that people haven't heard yet. And you're back because I'm going to embarrass you a little bit. Great. You are a low key one of the smartest people I've ever talked to on the podcast. And I mean, low key because you don't you don't throw it at me. You don't throw it at people when you're talking. But I feel I feel like you're a muscle car that's cruising down the street at like 40 miles an hour. Does that make sense?
Tziporah 4:12
I mean, that is a visual I've never had about myself, but thank you. Well, now it
Scott Benner 4:16
is. So I'm just very interested in picking through something that I don't want people to turn off when they hear us. Like when they hear me say this, don't be like what is this? Nevermind, but just listen for a minute. It's called Bloom's Taxonomy. Is that right? Yeah. Okay. And why are you a good person to speak to about this?
Tziporah 4:39
Well, Bloom's Taxonomy is a way of thinking about learning. And so anybody who's in an education field, whether it's like primary school, education, college, and other kinds, I think has had some exposure to this. But it gives us a framework to think about how people take in new information and use it,
Scott Benner 4:57
okay. And when, when I intersected it I don't know when, for the first time, I thought kind of I kind of flipped backwards in my head, I said, Oh, this is how people are being taught. So like, whereas you would think of it from like a teaching perspective of, oh, we're gonna we'll put these six steps into place. And we'll use these words to try to get people to remember, understand, apply these things, right? What I saw was not manipulated. Don't if that comes out if this comes out this way. I don't mean it that like that. But but this is how people are approached, when they're taught something, they don't realize it's happening, very likely. But they are being approached by educators this way. Does that make sense? Yes. Okay. And I figure if this is a thing, that Blum came up with this in the 40s, I think, and early 50s, okay, and it's been manipulated a tiny bit, I think things have been reordered once, and they changed some wording on some things. But the idea has been around for 75 years, is what I'm gonna say. And it's a pretty good way of teaching people things, it's the way that people learn, kind of mirrored back at them. And anyway, when I, I don't know how I saw it the first time because I am not an educated person. I think we all know better for listening to the podcast. And when I intersected the idea, I thought, Oh, I did this with the protests, and the beginning stuff, and I didn't realize it. And so I thought, I think maybe there's a way here to let people in on it. The people listening to the podcast, you know, so that maybe they can, I don't know, if they understand why it's being taught to them this way, or presented to them this way. Maybe that would help them pick it up better, I guess, was my thinking. How do you use it professionally?
Tziporah 6:50
Well, I'm gonna get out front and say especially because I know there was already some discussion in the private Facebook group about this. There is sort of a counterculture about Bloom's Taxonomy, that it's antiquated that it leaves out some important domains. But I think many of us who are teachers look at it as a way to demonstrate the different domains of learning and understanding and that we probably need to use all of them. I think, probably the biggest criticism, and maybe we'll talk about this is that learning isn't necessarily all in a straight line, and in a certain order. So Bloom's Taxonomy makes it look like these things have to happen in a certain sequence, you have to get a bunch of information and be able to recall it in order to then demonstrate understanding or explain ideas. Whereas I think a lot of us in the real world, sort of enter learning and a lot of different places in this little pyramid that you're probably looking at. And we need all of them. So I just wanted to say that first. Okay.
Scott Benner 7:52
Yeah. And by the way, I'm not here like, ringing some bell. And I was like, you know, whatever Bloom's Taxonomy is, they're not paying me. I just, I just thought it was interesting that it never occurred to me, that there was a way I was being taught that it doesn't mean that I would learn that way. As a matter of fact, I was a terrible student. So maybe this isn't how my brain works at all. And, but I still think the ideas are here, right? Like, if you if you apply them to diabetes, so I guess yes. I mean, how long have you had type one? I've had type one for 42 years as a long time ago. A long time. Yeah, I just interviewed somebody else a 50 years. And it was very interesting to hear his process. But anyway, that's neither here nor there. When you were diagnosed, the world that diabetes was is not any longer. Correct, right. And so there's a moment when you say, I'm going to try this more modern way. And I think what happens is, you have some of this already, right? Like, you've been analyzing things, your whole life with diabetes, you know, you had to remember a ton of stuff that you didn't know before you got type one. Now, you know, after you use it for after you've seen it, and you over and over again, it's happening to you, you begin to understand it, then all of a sudden, you can kind of flip that understanding around and apply it, make some analysts, you know, analyze things, say, Oh, I did this, and then this happened. Maybe next time, I'll change it. I think that's, but you had to teach that to yourself. And yes, and as much as I want to think that people with type one are being taught these things, I don't think they are. So I mean, by some doctors, there's some terrific doctors out there don't get me wrong, but far and away I meet too many people who are told not told anything or you know, given kind of very limited things, tools to start with. So can you go over the it's a pyramid, right, but it's set up in six steps. Can you go over them for me? Absolutely.
Tziporah 9:58
So at the base of the pyramid is the domain, these are all sort of cognitive elements the way we think about things. So that first biggest layer is remembering and recall. So this is pretty basic, like, what is diabetes? What is insulin, it is sort of more like, what you'd be expected to regurgitate on a test that just demonstrates like you've got the idea, but that you just have to recall it or spit it back out, you just have to remember it, define it, maybe.
Scott Benner 10:30
Okay, so that that's the first concept of Bloom's, which is you need, you need to recall facts and basic concepts, be able to define them, you know, I guess there's more to it than that, right? Memorize it, define it, repeat it stated, I have it written down here, I should be looking at it. Okay, so now, once you're comfortable that that's it as a teacher, you move to understand,
Tziporah 10:52
correct or comprehension. So in this way, we might ask people to demonstrate, you know, their understanding of something by saying, Well, how would a low blood sugar lead to the symptoms? Or how would a high blood sugar cause complications? How would I interpret, you know, what my Dexcom is telling me? And, you know, figure out what to do based on what it's what it's saying.
Scott Benner 11:18
So not only am I remembering it, and can I define it, which is very kind of cold and clinical definition, but I can describe it, discuss it. And you can see, as the as the teacher, maybe the doctor, you can see that I have a grasp of it. Yes. And I'm putting it back into my own words and giving him giving it context from the way I understand it.
Tziporah 11:40
Yes, I'm gonna, like insert a thought bubble here to like, I know, I've talked in other podcast recordings about just sort of the relationship between patients and healthcare providers, and how our visits are not always set up to really give us room to say back what we understand or to demonstrate our capability to apply something. I don't think that's the fault of the person sitting in the chair in front of the computer. But, you know, so much of our visit time is spent receiving information as opposed to demonstrating understanding. So it is a cue for me that different kinds of visits with different kinds of people will give us sort of more or better room to do these steps
Scott Benner 12:20
and wonder if you even need to be with a person to demonstrate the understanding. Couldn't it be an online quiz? Yeah, right. Yeah. Okay. So silly putting this into real, again, to real diabetes terms and people's experiences. You're diagnosed, they throw a bunch of words at you. Yeah, this is insulin. These are your syringes. We're going to Bolus we're going to basil, we're going to do this. You know, like, it's all overwhelming. You don't? Yeah, I don't think you really recall any of it. I've described it on the podcast is as it's like, someone walks up to you with a big garden shovel wax in the side of the head and starts asking you math questions. Yeah. And you're like, I don't know what two plus four is like, please, please don't. But then we come back to that next event that next doctor's visit. That is what they're doing, isn't it? This is what's happening. It's just not working? Because they do they start to quiz you a little bit. And they try to get you to recall some things to talk to them. That is what's happening. But the problem is what they send you home, they're not there. There's no one to ask. There's nothing to refer to. And you don't know if what you're doing is right or not. So how do you know if you understand it?
Tziporah 13:36
You mean, aside from listening to the podcast? This is not a
Scott Benner 13:39
Yeah, of course. I mean, listen, we're not here to tell people. I'm a super genius. I'm gonna write. I'm a regular genius. But it's but but no, but the idea of that for most people, they don't have that. They also don't know, this is what's happening to them. And I think that's kind of the bigger problem is that you're still frazzled? Because Because what this chart doesn't take into account when you're talking about illness, is you're not just sitting in a room, like just hearing some facts and going, Oh, I'll remember that. 1492 he sailed the ocean blue, I'll write that down. You know, like, you're not you're not just doing that. You're, you're going through a personal crisis. And yeah, and it could be that your health is in question. It could be that your loved ones health isn't question. That's right. Yeah. It's not some simple thing. That's where it falls short.
Tziporah 14:31
Well, and I think, too, that's why you know, this, we're focusing really on sort of brain stuff as it relates to thinking and information but all of the things that you just described that complicate all of that is all in the feeling domain. It's all in the affective domain that a lot of educators don't integrate like Bloom's Taxonomy originally included that domain, did it? Yeah. Okay. So like our opinions, our fears, our worries, you know, those things influence the way we take in and use information all the time. When I read posts in the Facebook group or I listen to the podcast, so much of people's stories is shaped by all of that. It's not just about the rote memorization, or can I develop a sick day plan, but it's really like, holy crap, I just got hit in the head with a shovel. And now I don't know what to do. Or even if I could figure out what to do, I'm pretty frozen in feeling overwhelmed and terrified right now. And so I think, you know, one of the main criticisms of Bloom's Taxonomy includes that, it it sort of looks at every learner as the same kind of person and doesn't give as much regard for what are all those influences that make us more or less able to take in that information? And to use it in a helpful way?
Scott Benner 15:46
It removes the humanity from it. Yeah, yeah. But if you, but I'm trying to, in Devil's Advocate, if you apply the humanity to it, and you might take the learning out of it, because we might all get stuck on how we feel and never get to the understand, apply, analyze, etc. So that's where the doctors are falling short, then in my estimation, so you know, we blurt the facts out at you, and then we bring you back to see if you understand them, but in between there, that you should be directed to anything therapy, online support, go just blabbered as somebody like, Tom talk, and get out how you feel, and then find some level of comfort or pathway in return. Yeah,
Tziporah 16:31
I mean, I think what's even more challenging, maybe the way I see it is that all of these things are happening in real time. And all of the needs need to be met in the same moment. So you know, many healthcare providers do a nice job of talking about this is really overwhelming, you know, we're here to support you, or they schedule close visits. I mean, I do think people are increasingly aware of that feeling component. And it's one snapshot in time that they get to sit with us and all those other 15 minute segments or hour long segments in our lives between visits feels like forever.
Scott Benner 17:04
Yeah. And the doctors are unaware of what happened to you, they can only assume they must start doing that thing where they apply what's happening to most people to you. True, yeah. And then it gets away from them there. So this whole, so that so the reason I'm doing this with you now is that Jenny and I are busy in the background, putting together a series for physicians. And it'll kind of take this perspective of like, you know, how to, how could doctors be helping people more better, but at the same time, if you're a patient listening to it will put you in the mindset of this is what I should be expecting, like, this is the you know, this is the path someone's leading me on even though I can't see it ahead of me. And just to know that this is their expectations, and what they're trying to accomplish, for me, I think would be a bigger deal.
Tziporah 17:55
I don't know for sure. Yeah. I
Scott Benner 17:57
don't know that it wouldn't be prudent just to say to somebody, Hey, these are the steps we're going to try to take. So that you know, like, we're not going to take them all today. But this is the path we're going on. Because that's right. Yeah, I think that helps. Okay. So
Tziporah 18:12
I mean, even I was just saying, when when I think back to even my diagnosis, you know, which we we've already established within like the dinosaur ages. I think I had like a week long admission in the hospital. Really where my family? I mean, it was the 80s Yeah, and I was a sick kid. So they brought in my family, they did all the teaching, they included all these family members, I had this, you know, the benefit of so much more time than I think a lot of families have now their families on the, on the webpage or on the Facebook group who bypass and admission altogether. Yeah. And so when I think about how all of this has evolved in the last number of decades, not just with the technology, but also with how much time is spent up front to do all of the teaching and assessment and guidance and support. I do think it's really different now than it used to be.
Scott Benner 19:04
Well, you know what, it's gonna morph again, because COVID is going to COVID is going to teach the doctors that a lot of people didn't even come into the hospital, and they were still okay, so it's gonna push it more towards virtual and which, by the way, I don't think, I don't know, I can make an argument either way, Arden saw doctor for a couple of years for diabetes through virtual because of COVID. And it didn't change her care at all. And at the same time, we weren't looking for information.
Tziporah 19:30
Sure, you know, you had enough of what you needed to do some of the other levels.
Scott Benner 19:36
Right. Right. Yeah, it's so where does this fall apart? Is it in the quality to tell people what you do for a living? I'm sorry.
Tziporah 19:45
I teach and train medical providers, health care providers of all kinds, but I'm a family therapist by training. Okay.
Scott Benner 19:52
So is where we're falling apart. Is it the the experience or the quality of the person doing the teaching does that hurt? Like, because we're always training new people? You don't I mean, like, like, the person you see in? I don't I don't know what the numbers are, I'm guessing but a nurse you see in an emergency room, for example, I would think an emergency room nurse has a fairly short lifespan. I bet you that's a really crazy job. And I bet you people don't keep it for the most part for 30 years. So you're probably seeing a lot of new people or people like cycling through. And then in your endos office. Yes. You know, like, listen, Arden goes went to, you know, a quality Children's Hospital for her endocrinology care from two years old to 18 years old. And I can still count on 123, Arden's had five nurse practitioners, five, the end the same doctor, for she had the same, the same doctor for the first, maybe, I don't know, till she was maybe 15. So, you know, the first 1112 1314 years, I don't know that she saw that doctor five times in that time. So my point is, is that if five nurses, nurse practitioners, or CDs or whatever the hell they're calling them now, CDC s, I'm not sure. If that many people cycled through, then that means that those people were coming in knew they were green every time and I could tell they were, you know, so now you're starting over again, every time it's not like you're getting this increased understanding with this whiz and person who's been with you for 15 years. You know,
Tziporah 21:40
I mean, even as you're describing that phenomenon, it occurs to me that we are focused on the person disseminating information, as opposed to the other side of the equation, which is the patient and family on the other side. In my ideal world, there would be some easy way for that person's knowledge capability, you know, evaluative skills to be able to follow them from practitioner to practitioner so that it's not really starting all over depending on the skill and capability and experience of the practitioner. So if I get a new NP, you know, in my ideal world, there will be a way to say, okay, support has already mastered these things. This is sort of where she's focused. Now, she runs into trouble here, and that that person could pick up the ball and run with it. I think we don't really have as much of that in our healthcare system in general, we probably don't have it in education either. But those sorts of ways of putting the patient and family at the center and following the next steps based on what they need, I think is probably where some of it falls down.
Scott Benner 22:40
How do you imagine that working?
Tziporah 22:43
I mean, I, I am naive, for sure. And maybe fantastical. But like, if there was some way even in our health records to be able to have a, not a report card, but a file that says, I have observed this person to be able to do X, Y, and Z, or this is what we have talked about. And here's how it's worked. I mean, some way for the story to sort of be recorded in a way that gives guidance to the next steps, the way that a lot of healthcare people document their notes. You know, they document for lots of different reasons, it doesn't always serve as an effective handoff of this kind of thing. It doesn't always give us good feedback about what is this person's cutting edge in terms of their diabetes learning. And it makes it difficult, I think, for the next educator who picks up that case, to start where the patient is, in the alternative, the next person that picks up that kid, or that grown up, might open the visit by saying, let's just take a look at whether you want to use this taxonomy or something else. Let's take a look at where you think you are, and where you've already been in your diabetes care. And let's focus on what you need next. Right? I mean, that would be revolutionary. They almost
Scott Benner 23:58
like a black belt system that that you don't I mean, like what belt? Are you?
Tziporah 24:02
You are a yellow belt with one stripe? Yeah. Now, I mean, right? Right.
Scott Benner 24:06
And then that way, when, when you got to the new doctor, or the new practitioner came in, started working in your office, they could look at immediately and say, Oh, this is, uh, I understand about their level of proficiency.
Tziporah 24:20
What I think is tricky about it is, you know, something you you alluded to earlier in the discussion. You know, when I got diagnosed, I was on a regimen that looks zero, like what my current regimen looks like. And so with every new technological advance and pharmacological advance, there is something that happens to my expertise and proficiency. Like, it's not that I D skill, but it's like, Oh, I gotta make room for a new way of thinking, to learn about algorithm pumping, made me feel real stupid for a long time because I had been used to my sort of, you know, whatever the five and a quarter and floppy disk way of management, right? And so suddenly I'm like, Whoa, I feel very disoriented. I feel novice again. But now that I've got that I feel much more in control and can do other kinds of skills and applications that I didn't used to be able to do. So the dynamic fluid nature, I think of all the advances is great, and also probably makes us feel dumb lots of the time, right?
Scott Benner 25:26
I wonder what stops that because children don't feel dumb around technology. Right? And it's because they're immersed with it. Although it is interesting that the, the more stupid proof computers and phones get, the less people understand how to actually use them, or how they operate under the surface. I heard Arjun say to me the other day she was, I don't understand things that use Wi Fi. I was like, Okay, that's interesting. She's a bright kid. And, and I, I don't know if I've ever said this on here. I don't I have two children. And they're 23 and 19, at this point. And my son's really like a bright kid and math based in his mind, and great thinker. Art is a pretty deep thinker. And I don't think under penalty of death, either of them could explain what Wi Fi is to. So if we're in that situation, where, yes, I'm more comfortable being a user, but I am not an operator, if that makes, if that makes sense. How do we help people with their diabetes to continue to grow with technology, but give them enough of an understanding of it? That if they had to fix it on their own, or ask the right questions to get to a fix that they could, and that might that might end up being a hurdle? That's something actually Jenny and I've talked about privately that she's concerned about?
Tziporah 26:50
Well, yeah, I mean, I think if somebody doesn't already have number one, like some basic skills and problem solving, and I'm not trying to like combat anybody, but lots of us never got good training and how to systematically solve problems. So if we don't have that, and if we don't understand the components of the bigger, the bigger thing, the bigger concept, the the way a pump works, the way Basal insulin works, the way Bolus is work, then we're not going to be able to do that analysis to be able to kick into gear when something goes in an unexpected way. So is
Scott Benner 27:23
it possible that the thing I've set up with the podcast really is what's necessary, which is you get enough, you get the facts. And then you get to listen, until you understand then you go into your own life and apply it. And then you look back and see what you did you analyze it? And then I don't really see you anymore. Like I probably so we didn't go through this whole thing, right? But it's remember, understand, apply, analyze, evaluate and create. Okay, so let's do the rest of them. So apply, give me apply.
Tziporah 27:57
Okay. So apply is where you would, for example, be able to say, I need to exercise I need to manage my activity level, I need to, you know, add a routine that I don't currently have, I will be able to create a plan that demonstrates an understanding of how it's going to affect my blood sugar, and then adjust my Basal rates accordingly.
Scott Benner 28:24
Okay, and then the next step, analyze, draw connections among ideas. What does that what does that mean?
Tziporah 28:30
So this is I actually think you push a lot of this, which might encourage, for example, somebody to identify patterns. So you would encourage people to be good scientists, and to take note, whether it's for a particular food or looking at Basal testing, to give them the sort of lens is to say, I've noticed this pattern. And because of that, I want to make this adjustment.
Scott Benner 28:54
You again, you're, you're easily 40, like, 40, IQ points smarter than I am. And I appreciate you treating me like a regular person. But do you see it online? Right. When people ask a question, I don't respond with the answer. I ask another question to get them to think about it. Yeah, that's what I'm trying to accomplish there. Like
Tziporah 29:14
what I think is hard about that, I do see that. And what I think is hard about the Facebook group in general is that people are coming to that place in all kinds of sort of stages of readiness and capability to do the next thing. And so if I want to, like stoke somebody's ability to think it through themselves, I'm going to do what you did, which is say, Okay, well, what would you do next? Or what data would you want to look at in order to make this decision? But some people in the moment for all kinds of reasons just need the answer. And it's very hard to gauge in an online community, it's much easier to sort of navigate in a one on one or live
Scott Benner 29:51
Yeah, what it requires online is for the person the question asker to respond again, Yeah, and be honest, like, Hey, I don't have time for that the house is on fire, you know, like, and then I'll go okay, well, I would look at this, this and this. Yes. But I can also tell when they're interested in the back and forth. And also there are some people, and I don't know how it breaks out if it's stress in their life, you know, it, room they've got left in their brain at the end of the day or whatnot. But some people want it, they just want you to tell them, they don't care, right? They, they like that the phone works. I don't care what the Wi Fi is. There are some people who want to understand. And there are some people who are taxed in a way where they'd like to understand, but they just kind of can't. Yep, yeah, that's right. It makes me wonder as whether no matter what it is healthcare, teaching a four year old, middle something, whatever you're trying to do, I wonder how much of it at the end, like evaluate, create, almost the last half of it is not as much about being taught as it is about, like, learning on your own, like being off on your own. Like, I wonder how much of this humanity thing is, we put all the ingredients in for the soup? And we're going to turn the water up, and we'll shut it off, and we just have to trust it's going to work out? Yeah, yeah.
Tziporah 31:09
I mean, so much of living with it is all of those other things, particularly at the levels of analysis and evaluation, but probably also application too. So you can have all the right inputs. But given the sort of dynamic nature of, you know, every day, plus or minus hormones plus or minus illness plus or minus stress plus or minus other health conditions, we have to be sort of nimble on our feet at those other levels, to be able to navigate it. And then if it doesn't go, Well, you know, the skill to be able to say, Okay, I had a sick day. That was a dumpster fire, why did it end up that way, requires a certain level of like, I know, to look back and to analyze it so that I can learn for the next time. And I don't know, if you know, in healthcare encounters that we have, I don't know how often that's sort of a regular feature. But if you were to ask anybody on the Facebook group, or anybody who's been on the podcast, how much of diabetes living has gone exactly the way you expected? I'm sure everybody would be like, zero. Yeah. So these other skills, I think, are really vital. But like, if you don't have that foundational knowledge, you're you can't do it.
Scott Benner 32:19
Wonder where in this process, remember, understand, apply, analyze, evaluate, create aware in that process, whether you're a physician helping somebody with type one diabetes, or you know, you're you've tried to teach somebody to build a structure to keep themselves safe and warm. When do you recognize they're not going to get this? But that doesn't mean they don't deserve to be safe and warm, or have a good blood sugar. Like when do you jump in and say, Okay, this, we've reached your ceiling? And, and maybe we can get you farther in time. And I still believe that that's true. But we don't want to waste health minutes right now. Is it? Is it watching them not be able to analyze? and evaluate is that about where you go? Oh, they're not getting it?
Tziporah 33:08
This is a really delicate question. I think, because there's lots of reasons why we might dismiss or have bias against somebody, we might assume that they can do something, but they really can't, or we might assume that they can't, which is dangerous, too. And so what I would love to see more of is some routine way. And I'm not subscribing to any particular method for health care, people, educators, providers, to be able to like assess with a patient and their family, like, how do you learn best? Will you let me know when you've had too much? Can you let me know when you need help? Like, there are certain things that I think will cue me to better care for you if I know those things upfront. But so much of healthcare in this country is like, this is what we have to offer. And you are one of however many patients I see. And this is how we're going to do it. So I think if we can move toward more personalization of the way we do the care, not necessarily the science or the algorithms or the evidence based protocols. But more like for every person who sits in front of me, let me stack a couple of minutes up front to do that assessment with you. And those are important minutes to invest. It's a hard sell sometimes to very busy people with busy clinics. I know that, but I think it would help us do better.
Scott Benner 34:27
I have to tell you, the more I talk about this and think about it, the more I come to the conclusion that you can get to more personalization by grouping people together.
Tziporah 34:35
Oh, yeah, there's actually quite a bit out there about the benefits of group medical visits. And there are some clinicians who say, this is the way to do it. You do it in community, you do the knowledge dissemination, first, you get all of that out front to a group of 10 or 12 or 15 people and then you can spend the rest of the time on analysis and having them support each other and how they do it. I mean, there's a lot of wisdom to that.
Scott Benner 34:59
I've CNET works so many times. So I'll go speak to a group of people. I don't know who they are, I don't speak to them first, right? I don't know their stories. Sometimes no kidding. 234 500 people in a room. And I'll give them kind of a primer for my thinking about diabetes. In the first hour in a second hour, I'll give them some more kind of drill down on some specific topics. And then I hang around in the afternoon, and I'll just stand up on a stage and like, go ahead, ask questions like, you know, then that's it. And so they see me maybe for three hours in a day, and over the next. It's not the first two months, but over the next like, third, fourth, fifth, sixth month, the amount of like emails for people that are just like, Oh, my God, I just want to say how great everything's going and appreciated seeing you there. And like, you know, thanks for making me think about a different way. There's no follow up. I never see them again, but you've, you've launched them in the right direction. Yeah. And then you kind of trust that the SERPs going to come together. And, and you can't, you know, I know you can't save everybody. That should be your goal. But you're not going to like, sometimes you just won't intersect people at the right moment in their life. But, but I still think that's the best way to get the most people to the finish line.
Tziporah 36:15
I do think that's, it's some of the impact of the podcast, frankly, yeah, you know, the scale of it is reaching a ton of people. And then you're hearing from people to say, hey, this really influenced the way I think about it, or I didn't know this before. And that's been a game changer. You're demonstrating it in the way that you're doing it.
Scott Benner 36:32
I also tried really hard to, like, I don't, I don't need your reviews. You don't I mean, like, I don't need you to come to me, every little thing you think I don't do right or wrong. I use people's feedback. But I do use people's feedback significantly. So but I use it to see where I'm headed. They're almost like my, like a map, like a celestial map. I'm like, okay, like, I sent out all the stars in the world, and I'm seeing where they're going. And I'm like, Okay, this did what I thought it would do, or this didn't work. And I'll like, drop it. I've started things before and been like, that did not go the way I thought like, boom, go get rid of it. And you know, and but when you start seeing people heading again, where you meant for them to go and where they wanted to go. You have to at some point, say to yourself, that works, do more of that. But you also have to be able to say that didn't work, stop, or I'm the wrong messenger, or whatever, you know, because listen, there's, I'm sure there are plenty of people saying things similar to me. But they're not gaining traction, and attract by traction. I mean, like, it's so I don't mean it like this. But it's a measurement, right? Like you have to like if something's working people tell their people about it. So if you've been making a podcast or a web series, or have been recording one minute videos on Instagram for six years, and nobody's it's not growing? Well, then it doesn't. It might not mean it's the information, it could be anything, you have no idea. It could be the color of the wall behind you. People might not like the nasally tone in your voice if there's no way to know, but it's not working. And you. And if you really want to help people, then you have to reassess and say, Okay, I've got good information here. I'm not getting it to them for some reason, and doctors have to do that same thing. Like if you don't I mean,
Tziporah 38:18
yeah, no, absolutely. I think there's a question behind that observation too, which is
Scott Benner 38:27
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Tziporah 39:10
Question behind that observation too, which is, you know, people who are operating at like a really high level are also going to say what about that didn't work? What about that did work. So I'm going to do more of the thing that did work until it doesn't work. And then I'm going to think about why it didn't work here. And so whether that's at the patient level, like we have to do that all the time, but their level two. So why is it that when I do this visit in this way for a newly diagnosed family? Why did it go south with that kind of patient? You know, that level of analysis and curiosity I think helps them be more in line with that personalized approach that I was talking about. But I think they have to know to ask the question, as opposed to saying I'm doing what I always do in the fact that it didn't work. I don't know why
Scott Benner 40:00
Hmm, you also have to be willing as the patient, you really need to be willing to say what's happening, and not absolutely not like keep secrets, or be a person be embarrassed or anything like that. And that's, I mean, again, over and over again, for years now, I've talked to people who have grown up with diabetes, and they get older, and they'll start telling you about, like, you know, my health is not where I want it to be. And I look back and, you know, I was I make up numbers in a logbook every, every time going to the doctor's office. And, to me, that should have been an indication to the doctors, like, if you're a doctor, and it's 1985, and you pick up a logbook, and you think, all these are written in the same bank. Right, this was, this was just
Tziporah 40:43
you talked to my doctor. So rude. This is
Scott Benner 40:47
this is all in the same bank, this was clearly filled out in the parking lot. Instead of saying this person is not compliant, why not say, well, this isn't working for them. I wonder what might like and by the way, you could just ask them, you could just say, hey, look, I feels like you didn't fill this book out accurately, is there a better way we could be doing this? You know, instead of just labeling them writing something in their chart and being like, I did what I was supposed to do, and they didn't do what they were supposed to do. So I guess they get to die? Like, that's a bizarre thing. You don't I mean,
Tziporah 41:18
I mean, just in the defense of current healthcare, I do think more people are moving in that direction. I think the recognition of the person behind the condition is way more prominent now in medical training than it used to be way more. And so you know, when I'm sitting with a physician, or a nurse practitioner, or somebody who's learning, they are much quicker to wonder about what they're missing in that realm than, you know, than the kind of healthcare I experienced when I was six.
Scott Benner 41:45
Yeah. And all you have to do that's terrific. All you have to do to freely wander that is to accept that this is a doable thing for people. I think that's what stops in the past. I do. I do think that's where that thinking came from, like, oh, boy, there's a person who gets it. And over here, we have a person who doesn't get it, or they don't get it. So we put them in a different pile, we put them in the gonna need a leg pile, like you don't I mean, and then you start treating them that way. And then it's, you stop trying to bring them along. And I think that I think the podcast has taught me is that people come along at different speeds. So
Tziporah 42:23
I definitely had that experience as a patient for sure. I mean, there's something very fresh, that's coming to mind now where I think, you know, I fired somebody because they, they didn't see that I needed help coming along, they were just going to put me in another pile. And I'm not trying to sound big and bad that I fired somebody, but it was not a good fit for me, because what I really needed was for someone to recognize, oh, the reason you're having trouble with this is because it's scary, or because you don't have enough information, let me back up a couple steps. Rather than just tell you this is what I do. And if you can't do it, then you've got to go to this other place.
Scott Benner 43:00
Okay. Alright, so I'm sorry. So we recall our facts and basic concepts, we were able to regurgitate these ideas, but not just regurgitate them, actually describe them, discuss them, explain them, then we get to apply. To be able to execute, implement, solve that kind of stuff, analyze, I guess, with diabetes is going to be the part where you start looking at your boluses and your blood sugars and your food and saying, you know, when I ate that my blood sugar went up when I ate that it didn't, you know, that was 10 carbs that was 10 carbs. Maybe there's something about the quality of this food or the way my digestion works with this food or whatever that's causing this issue. Now, after you've analyzed that, I would see my brain goes back to a reapply. But that's not the next step. Right? Like,
Tziporah 43:45
well, it's only not the next step. If you think that this is a linear model, if things have to go in order. I mean, that's part of why people say Oh, I'm not really sure this is a great model, because we're going back and forth between these levels all the time. So you're thought to go okay, well, let me reapply it and try something different. That's 100%. Right. But I think, you know, the way Bloom's Taxonomy was developed with Saona are the next one is for you to evaluate or synthesize information to be able to do sort of the next higher level thing I think real life is that it's much more fluid than
Scott Benner 44:16
I would imagine, you'd bounce back and forth between analyze and apply until you had outcomes you were looking at. And then you can then the evaluation wouldn't be as much about, I guess what this chart initially meant, and more about you being able to look back, step back and look and say, Oh, well, here are the things I did the work so I'll put these in my this works toolbox and I'll take things over that didn't work put this in my didn't work toolbox. Exactly. Yeah, that's perfect. And the Create, to be honest, I don't know if that's really important to diabetes. I'm not sure unless I'm missing something, like produce new original work. I guess. Yeah.
Tziporah 44:55
I mean, when I see parents who say Oh, I created this type one diabetes to sheet for my kids classroom. That is a demonstration of that sort of skill. I don't think we all have to do that to demonstrate that we have aced diabetes. Yeah. Like, I don't think that's the thing.
Scott Benner 45:11
Yeah. For me, once you've evaluated it, and it's working, I would turn that little tip of that, that pyramid, if for diabetes, I turned that into go back and live your life now. Like, you're done. You understand diabetes now? Right? Yeah, and still stay flexible, because things are gonna happen. I mean, that's the, you know, I was gonna say the bitch of it, but I don't feel comfortable cursing with you, even though I know you could because I think of you as an intellectual. But But, but you know that the thing is, it stuffs gonna change, like hormones will come into play, or even if you're older, your hormones might slow down or change, your activity could change, you're never going to be, you're never going to be at that spot where you're just Jay Z sitting on the boat looking out into the challenge. Yeah, that's not gonna happen, right? But you might, you're gonna get moments of it, where you're like, Oh, I got this, or when the wave comes in, you'll just say, I know what to do here. And it won't even become I like that it becomes unconscious at some point
Tziporah 46:12
for nothing, but when you're thinking about, you know, talking with healthcare, people about what some of the most important things are to teach about patients and living with diabetes. It's that, like, we our aim is going to be to have periods of stability, where you're like, I got this, I'm nailing it. I'm Jay Z sitting on the boat, there are going to be times where things feel confusing, unexpected. We're going to teach you how to solve those moments to like, if somebody came to me with that about diabetes management, I would say they get people, they get how hard this is, and they get how many variables are in the mix. This is not it's not linear, the learning is not linear for diabetes, especially.
Scott Benner 46:49
Right. Okay, this was very helpful. I appreciate you very much. Thank you. Yeah. Did I miss anything?
Tziporah 46:59
I don't, I don't think so. Well, maybe. Let me add one other point. The other thing that I think is like woven throughout our conversation today, and it sounds like in the work you're doing with Shani, it doesn't show up in Bloom's Taxonomy, which has to do with the way we're connected to other people, and the influence of those relationships on all of it. So if I'm in an environment or in a relationship, or in a health care clinic, where people are encouraging, they're telling me it's important, and that I matter, and they're invested in me, my motivation is going to be sort of stoked in that direction, too. If I'm in a place where people are dismissive, don't care, think I'm making a big deal out of nothing, don't get it. It's going to do something to my capability to take in new information and to do all these things. So I just, I feel like that's important to say, because I'm a relationship person. But I think healthcare people probably need to understand that too. And so do we, as patients, we have to have people around us who are like, in our corner saying this matters, you matter, you can do it, I believe in you. We're going to help you get there. Okay.
Scott Benner 48:03
Can I keep you for a couple more minutes? Sure. So I have the document open that Jenny and I are banging around in right now. And what I did was I went on to the private Facebook group, and I said, What would you guys wish your doctors would have done or known? Like, I kept it really kind of loose like that. And people came back with all kinds of examples. We broke, I broke the examples down into kind of like headers. And I'm wondering if you wouldn't listen to them and see what I'm missing. Okay. So as the steps, I have diagnosis, and hospitals kind of wanting to I think right away after that, in my opinion, understanding insolence got to be the first step. And I mean, by that, like, how it works, like you put it in here, and it does this, it might not, it might take a little more time, you know, perhaps, if your blood sugar is higher, it won't be enough like that kind of like, like just bare bones understanding of insulin. And then I think, again, you know, three and four with that is, is food, right? The same idea, like it's not just 10 carbs of this and 10 is 10 carbs of that, you know, Cheetos are not going to be as easy to Bolus for as you know, I don't know, something natural. And, and that now from there, to me understanding how to use your meter. And quickly being told what a continuous glucose monitor is, at the very least, if you want to slap it on somebody I um for in case anybody's wondering, but but at least understanding what it is so that when the confusion comes, you can say they did say there was this thing where I'd be able to see this so that you can start imagining what what that would look like and maybe cause you to ask about it. Then talking about pumping and understanding what a pump does so you can understand more about the manipulation of the insulin but then right after that I have humanity and mentality And then communication. And that's sort of where I'm at at the moment. What am I missing? That's glaring?
Tziporah 50:12
When you say communication, what do you have under that subheading, me scroll?
Scott Benner 50:15
A lot of scrolling. Okay, so what I have is some people's responses and like quick notes that I've made under them, I want my doctor to know that I am a whole person, not just the diabetic, this is not my whole life that it ebbs and flows. You already said that, how about that good. And that, under it, I just wrote treat me like a person and moved on. When I was diagnosed in 84, it was so dire, they told me, I'm going to probably go blind, my foots probably gonna fall off, I became jaded very quickly. And I was non compliant the person said, and then to avoid to avoid the pressure of this death, she didn't even go to an endo, she just went to a GP, trying trying to just say, like, Alright, I know, I gotta go and get these prescriptions. But I mean, if I'm just gonna die anyway, like, you know what I mean, like that kind of stuff. And what I wrote under that is that hope is important. And that initial messaging lasts forever. I wish they told me about being bold, that talks about the podcasts a little bit. And then I end my note under that is that goals can relieve stress. I would like my doctor not to be so by the book. And that went on for a little bit to that I said to the doctor, I think you you got to kind of turn yourself into a guru. Like, if you're going to do this for people, you're not just changing tires on cars, like you've got to, you got to know why they love the car. And you got to be part of the part of it not just standing on the outside in a white coat. I put here that honesty is got to be a bedrock of this whole thing. Based on somebody's text that just said, If you don't know something, as the Doctor, please tell me, because I'm sitting over here, imagining that you're, that you're God, you know, and that everything you're saying is, is set in stone. Anyway, it goes on like that. Think before you speak, meet people where they are create agency. This one was interesting about communication. This one talks about a teenager who goes to the doctor, and is told over and over again, you're doing great, you're doing great. You're doing great, but the moms like she's not doing great. grade one, C six and a half, it's good. It's not great. And there are a lot of things I'm seeing at home that she should be doing that she's not and that they're hurting her physically, emotionally. But she goes to the doctor, the doctor gives her the old Hey, 6.581 say you're doing great. And the mom says what happens is we walk outside at anything I tried to say after that is met with I was just told by a professional healthcare person. I'm doing great. So leave me alone. And that that's a problem. Isn't that interesting? Because super Yeah, because it's so reversed of what you might imagine. I wrote here that telling people they can't do something has no value at all. And that guilt is not a communication tool. So that's what I have for that section.
Tziporah 53:30
Okay, those are all great. They could be chapters in your next book for sure. I'll add a few others maybe for consideration, I'm here. One, I would probably call something like labels, or documentation. And the reason I am raising this is because what somebody says to you in the room is one thing, and then what they put in your chart is another thing. So the language around being non adherent, non non compliant, out of control, whatever, those things have some cachet in the healthcare world. And sometimes the way people put that in their notes then becomes part of the narrative that gets shared with other people too. So I would want people to be aware of how what they write about me in the chart, sort of precedes me and describe something about me that may or may not be the whole picture.
Scott Benner 54:24
Okay, so have it. So I have it as labels for documentation, language, like non compliant, etc. Do better charting, because your charting will proceed patients and limit a full understanding of who they are.
Tziporah 54:42
Yeah, I mean, I'm not for nothing, but I, I read the notes. You know, there has been a huge movement at the federal level to make it accessible to us, as patients to be able to see the documentation from these visits. And so when I read something that I'm like, oh, that that doesn't feel great. It is adding is a sort of dimension of complexity to my relationships with my healthcare people, because I see either what they really think, or I see how quickly they're moving, or, you know, lots of things. So this is why
Scott Benner 55:13
I would never look at my wife's texts. Sure, she doesn't like
Tziporah 55:19
me mean, you know, it's good to know your audience there. But the second thing that I was going to say relates to that first thing, which is, this is a relationship. So it's a relationship between the patient and the condition. It's a relationship between the patient and the healthcare provider. And one of the most important ingredients, I think, for any healthy relationship is having clear expectations, knowing what the other person can and can't do, does or doesn't prefer, how they work best what their strengths are. But that goes in both directions. So some of the comments that you talked about already having gotten from the group, echo that, but it's about level setting. So even for someone to say I'm not an expert on pumping, I work with, you know, CDs who are, so I'm not going to focus on this, I'm going to focus on these other things, that is a clear expectation. But so too, would it be for me to say, I just want you to know, this last six months since I've last seen you has been really stressful. And I'm open to what we're going to talk about, but I have not been able to focus on diabetes. So those those are markers of like, how safe do I feel in this relationship to be upfront with you about that?
Scott Benner 56:29
Okay. All right, I got it.
Tziporah 56:33
Sorry, I use a lot of words, but
Scott Benner 56:35
don't know where I broke it down a little bit for myself so I can fall. Okay, relationships, person, the first person that diabetes, clear expectations level setting need to feel safe. Freedom to freedom to express things that, you know, the doctor doesn't want to hear. And my explanation of that is example. I didn't do the thing. I said I was gonna do I
Tziporah 57:13
mean, that's psychological safety. Like, can I can I say something without fear of you? guilting or shaming or yelling at me?
Scott Benner 57:19
Okay, so I'm just gonna put psychological safety. You know, I do this. This week, Ovi diary. And like last week, I didn't lose any weight. And I sat down to do the recording. And I think I just said this last week didn't go great. I made some bad choices. And going to inject the week over and I'll be back in a week. I think the whole recording was like a minute and a half long, and I injected it, I got up and I shut the microphone off. I was like, I was like, that's all I had, honestly, I could have sat there and pontificated and made up reasons why it didn't go the way I thought and I actually have some real thoughts about why it didn't go away, I thought, but that week, I didn't have it in me to share it with anybody. Just like I had some stuff I shouldn't have. I'll see you guys in a week. And by the way, didn't gain any weight. I just didn't lose any weight. So anyway, I see that as like, kind of that psychological safety. For sure. Yeah. Okay. I, you know, I, I'm trying very hard not to give you a job, because there's part of me that wants to record this with Jenny, and then let you listen to them and come on and do 15 minutes on every episode.
Tziporah 58:31
So I mean, you know, I mean, if you want to chew on it, I'm happy to do it. This is like I enjoy this stuff. A bunch. Good. So,
Scott Benner 58:38
yeah, well, you've got everything I need. You got a good microphone, and you're smart. And I love talking to you. Appreciate it. I do too. Yeah, I feel like we're friends who will never meet each other.
Tziporah 58:50
Like if we meet I mean, maybe we would.
Scott Benner 58:52
Well, I mean, like if we met at a dinner party. We we'd be okay off in a corner. Oh, yeah. Yeah, yeah, for sure. I do really enjoy this patient. I thank you so much for doing this. Thank you.
Well, a huge thanks to support her for coming on the show and sharing her insights with us. I also want to thank better help for sponsoring this episode of The Juicebox Podcast and remind you that at my link better help.com forward slash juice box you can save 10% off your first month of therapy. And you'll get that savings just by signing up through that link. Heads Up a little programming note coming episode 999 is coming up quickly. It will be with Arden it'll be her third appearance on the show. And then at episode 1000. We're going to begin delivering the remastered diabetes Pro Tip series. It sounds terrific. Completely remastered audio is amazing. Same great diabetes Pro Tip series. I can explain to you how I'm going to do it but He's going to explain it 999 I'll explain it two different ways. Here's what I think I'm going to do. Episode 1000 probably comes out on a Monday. So we're going to do 1000 1001 with us to win five days in a row, right, you're gonna get five, the first five episodes of The Pro Tip series. And then over that weekend, the rest of the series will be delivered over the weekend. So that way, the episodes will be concurrent in your player for when you want to go back and visit them again. Right now they're spread out all over the place because they were recorded at different times and produced at different times. Now, they'll all be in one place. So they're very findable. I hope you can, excuse me for the way I have to put them out. But, you know, this is the only way that podcast apps let you do this. So in order for me to get them concurrent in your player, I have to put them out in order. But obviously I don't want to take a you know, a month to put them all out. So we're gonna do the first five over the week, and then the rest of them over the weekend. They'll all be in your player if you want them or not, doesn't matter. And then that following Monday, the next episode will go up and the podcast will be back to the way it usually is. So be a little special for a week. Little different. And then right back to it. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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#993 Diabetes Myths: Insulin with Type 2 is a Failure
A brand new series examining the myths surrounding diabetes.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 993 of the Juicebox Podcast.
Jenny Smith is back with me today for another diabetes myth. Today we're going to tackle the myth that if you're using insulin as a type two, it's a failure. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. If you'd like to hire Jenny, she works at Integrated diabetes that gums that diabetes for over 35 years she's a dietitian, a CDE she's wonderful, you'll hear integrated diabetes.com Speaking of good deals, use my link drink ag one.com forward slash juice box. And when you do, your first order will come with a free year supply of vitamin D and five free travel packs of 81 you can use the offer code juice box at checkout at cozy earth.com to save 40% off of your entire order. And if you go to us med.com forward slash juicebox you'll be getting a special link just for Juicebox Podcast listeners. And you can get started with us med Alright, let's get to the show shall we?
Today's episode of The Juicebox Podcast is sponsored by Dexcom. Now Dexcom makes the sensor that my daughter's wearing right now the Dexcom G seven. They also make the G six which many of you are using dexcom.com forward slash juicebox. If there's an easier way to manage type one diabetes, I don't know it. The Dexcom G seven is a simple CGM system that delivers real time glucose numbers to your smartphone or your smartwatch. No finger sticks are required. Effortlessly see your glucose levels and where they've headed. So you can make smarter decisions about food activity, and the other variables that are impacting your blood sugar. Go to my link dexcom.com forward slash juicebox to see the device. Watch great videos. Find out more about how it works. We're just get started. You have type two diabetes, type one gestational Dexcom may be for you Dexcom G seven can help you to spend more time in range, which is proven to lower a onesie. The more time you spend in range, the better and healthier you'll feel. Use the Dexcom clarity app which is built right into the Dexcom G seven app to track your glucose trends. It will even provide you with a projected a one C in as little as two weeks. dexcom.com forward slash juicebox Dexcom G seven features lightning fast 30 minute warmup time. Oh, that's twice as fast as other CGM systems. Wait, do you see how terrific it is to go from one device to the next. The way we do it here is you're wearing a G seven, and you put on the next one, but don't disconnect the first one. So the next one sits on for a half an hour. And now it's ready to go. And then you make the switch. You never lose a reading. It's absolutely fantastic. There's actually a ton that's great about the g7. You gotta go to the link to check it out. dexcom.com forward slash juice box, set your alerts and alarms wherever you want. So you're notified of lows, highs falling or rising blood sugars. And of course that 30 minute warm up is just magical. Dex comm.com forward slash juice box head over now get started. What else can you do with this link? Let me show you. Oh, let me see. New Dex calm, explore the G six explore the g7 Oh, you can put in your information to get Dexcom to contact you and get started. That's pretty cool. There's a bunch of frequently asked questions at the bottom to answer all of your questions. When you use my links, you're supporting the production of the podcast and helping to keep it free. I appreciate you listening to this ad right now. And because you were nice enough to do that. It will be no more ads for the rest of the show.
Jennifer Smith, CDE 4:19
I have 10 minutes. Alright, so whatever we can do short 10 minutes. Okay, that's
Scott Benner 4:24
awesome. I have it right here. I know you do. Don't worry, Jay. There's a list for everything you're with.
Jennifer Smith, CDE 4:32
Outstanding. You're like I got this. We're gonna
Scott Benner 4:35
let's go right to this one. All right. Let's discuss the myth that insulin is bad for someone with type two diabetes. Oh, my big one which I mentioned with oh, this person must have been on the podcast I mentioned this in my episode was that for decades? I believe that going on insulin was the last resort for someone with type two So how do we make sense of this idea? When, as soon as you're told you have pre diabetes or type two diabetes, someone says to diet and exercise, we can turn this around? Now, I guess first of all, is that always true? Like, is there a world where you couldn't if you couldn't stop if your knees didn't hurt? If you didn't have a job? Can you diet and exercise your way? Out of type two? Every time?
Jennifer Smith, CDE 5:29
Every time? No? Okay, I think, again, that's it is it's kind of a blanket statement. And unfortunately, no, as we know, every person is individual, right? Every person has a way that something will or will not necessarily work, or we'd have even insulin itself, we'd have one kind of insulin, and everybody would just be able to use the one kind of insulin right? Does lifestyle, especially for type two, in a grand majority of studies in research, you can actually find that lifestyle from the get go, especially if type two is discovered earlier, rather than later, when many, many times complications may have already set in, unfortunately. And that might be what send somebody to the doctor because of something that they're experiencing to kind of get it checked out. And then they discover, oh, well, you have diabetes as well. Right. But I think the earlier the better, which just calls for more early on health screenings from primary care, and just lab work, you should get that done yearly to check up on things and see how things are going. Because the sooner that you can catch it, the sooner you can make really awesome lifestyle changes. And you could halt the progression. Absolutely.
Scott Benner 6:50
Yeah, I'm not saying like, I'm not saying keep, you know, taking poor care of your health, if that's what's happening, I'm saying that telling someone, hey, just eat a salad, do a sit up, and this is gonna go away is not always gonna happen, right? No, and there are new medications. Now we've talked about them in the type two Pro Tip series. I'm watching two people I know, using ozempic right now with their type two with like, great success, not just awesome, not just weight loss, like lower, like they're almost no spikes at meals, like more normal blood sugar is really fantastic stuff. And I wonder if after more weight loss, if you won't see that get better and better as time goes on. But my point is, this is if you're in a position where you need the insulin, and you're not taking it, you are doing more harm than good in that in that time. And, and this is the next part of this. And you know, I started off by saying type two, but I mean, maybe this really, because I hear this from so many people. And this is the last thing I'm going to ask you in this episode is a very short episode. But I think this is a big deal. I was told not to inject insulin, because it kills the rest of your pancreas. Now, you know, that's the thing people think, Oh, that's so wrong, right? But why do they think that I can never figure this one out. Shoes and type ones.
Jennifer Smith, CDE 8:14
That it kills your pancreas. If I mean, if anything, actually injecting insulin. It can actually, it can take the stress off of the betas that from a standpoint of type two, maybe initial diagnosis, you have to use insulin for a short time because levels have been so high, you're almost at this glucose toxic level, that you have to get something to overcome that in a faster manner than many of the oral kind of therapies, or even some of the newer injectables may not hit that the way that it needs to be done. And so taking insulin helps to decrease the stress that's being put on the betas, you're asking them to work without a break. It's almost like asking them to do 24 hour 24 hour at this really high production rate that they're never going to be able to overcome. And so adding some injectable insulin can actually decrease the stress and could actually do the opposite of what you just said.
Scott Benner 9:17
I listen. Um, I don't think it I've just heard people say it over and over and over again. Listen, this whole series is about basically you and I go and why would someone think that and trying to come up with where that would come from? I don't, I don't get this one. Like you don't either use insulin, you make it worse, you use insulin, you stop your pancreas from working the rest of the way or by the way, you can use too much insulin, which I think those two thoughts live on the same plane of existence in someone's head, but I don't understand where that comes from either. Like is it? Is it that type ones. Maybe it's that when people start using insulin, they'll sometimes gain weight as type ones and then they say insulin made me gain weight. They don't. What's your answer to that? I say I tell them the same thing. Every time. Insulin doesn't make you gain weight, calories make you gain weight, you're just
Jennifer Smith, CDE 10:10
which is true. But from an from a type one perspective on a little deeper level, if they have had such high blood sugars for such a long time, then they've actually been able to maintain or most often you see weight loss prior to diagnosis, because they've been peeing out an excessive amount of calories, because the body doesn't have the insulin to actually put it into the body in storage, like it's supposed to. Yes, so you lose weight by pulling out the excess, that you're, you know, that should be actually kept, you're the ones you start taking insulin, your body's like, Yay, I've got something here that I can package this stuff away the way that it's supposed to. And so, yes, you may get back to a healthy weight, I've actually also seen, especially in kids and teens, where they may not have actually been keeping up with growth curves prior to diagnosis even. And once they start on insulin, and their body actually has the right amount there, then weight gain can actually increase. And if you're not careful, as you said initially, then caloric intake needs to be the next step in management. Just because you're taking insulin, doesn't mean that you can go hog wild with caloric intake might be a need to balance
Scott Benner 11:32
also the cause and effect is off sometimes. So like you said, the way I think about this, what you just said was like that you're in like a low level of DKA all the time, right? Yeah. So your your, your body's trying to die because it doesn't have enough insulin, but you're giving it just enough to keep it from actually happening. And so you're on this unhealthy weight to begin with. And then suddenly you add the right amount of insulin. God knows what do you hear people say all the time at their diagnosis, I swear to you, I hear it 50 times a year, I thought, Oh my God, my diet is finally working. They see it all the time. They're so thrilled before they're diagnosed because they're like, I'm finally losing the weight that I've been trying to lose,
Jennifer Smith, CDE 12:10
especially for adults who are diagnosed Oh, my God. Yeah, absolutely.
Scott Benner 12:14
So So you're basically in that situation where your body can't properly perform. And so you're underweight for the reasons, Jenny said, and then you bring the insulin in, and your body's like, Oh, good, I can do the right things now, not realizing you've been eating crazy amounts of food, because who cares, right? Because I wasn't getting people say it all the time. Well, I got I was eating ice cream. I was doing this. I never gained any weight. I thought I finally figured it out. Bla bla bla. So I think that's, I think that's that space right there. But, I mean, again, I don't I mean, that's, that's as close as I can come to digging through it. But with the certainty that people will say it online, I'm stunned and scared by it all the time, because I don't use insulin is. I mean, especially for a type one. It's just such a dangerous statement to make. And absolutely, it happens a lot. Oh, don't use it, the more you use, the worse it's gonna get, you're gonna kill your pancreas, you're gonna die. I'm like, oh, god, shut up. No, no, no, like, stop saying that's where you? I don't know. Yeah, absolutely.
Jennifer Smith, CDE 13:20
And I think from a type two perspective, for the majority of time, people feel like insulin means that they have ultimately failed in everything that they have put into action, you know, their doctor or their educator was like, let's let's do these lifestyle things that start you on these medications. And potentially, at some point, many people will still need to use insulin. And there is a progressive nature to type two. Again, lifestyle still navigated and maintained really well, at some point, many people may or may need insulin added. That doesn't mean it's a failure, it means that now you're going to have something that also helps because in the background, your pancreas isn't doing as much as it was before doesn't mean that you failed in all of your management and adjustment to your life and everything. You have to keep doing those things. Insulin is just it's an additional tool in your toolbox. That's going to help keep you healthy.
Scott Benner 14:21
And I'm not saying either that you don't want to extend that time if you can, correct Yeah, I think that's fantastic. If you get by the way, even like a slow onset, like a lot of diagnosis, like like, keep it going as long as you can. Every day you don't have to futz with all this stuff is fantastic, you know, but, but once it comes, I don't know couching it as a failure is, is dangerous. And I don't think it's not true that doctors don't say like, well, we want to keep you off of insulin as long as possible. And then people's brains fill in the rest of that with however, these myths start to exist, right.
Jennifer Smith, CDE 14:54
They're kind of reading between the line of which there's not, there's not really something written there. They're just filling it in, like you said, like the doctor, we're gonna keep insulin out of the picture for as long as we can, which again, is kind of like saying, Well, gosh, once we get to that point, but that's it, we got to add insulin now.
Scott Benner 15:12
Jenny, I'm gonna end with this because I, I'll go on forever if I talk about this, but I think that if people could get a printed list every day of all the things they're wrong about that they think they're exactly right about me included, everybody included, we'd all spend a lot of time just sat in the corner going, Oh, my God, I thought that for sure was right. Because your brain fills in the gaps with whatever information you have, and it doesn't mean it's the right information. So anyway, I appreciate you doing this. Thank you. Absolutely, thank you.
I want to thank Dexcom for sponsoring this episode of The Juicebox Podcast and remind you that you can support the podcast and help yourself by going to dexcom.com forward slash juicebox. Go get started today with the g7 for the GS six. I also want to thank Jenny and remind you that she works at integrated diabetes.com You can actually hire Jenny to help you with your diabetes. Thanks, thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. This myth series I'm enjoying it there's a handful more episodes left than the series is done. But what a great idea this was whoever thought of this on the Facebook group. Thank you wonderful. If you are a loved one has been diagnosed with type one diabetes. The bold beginnings series from the Juicebox Podcast is a terrific place to begin listening. In this series, Jenny Smith and I will go over the questions most often asked at the beginning of type one. Jenny is a certified diabetes care and education specialist who is also a registered and licensed dietitian and Jenny has had type one diabetes for 35 years. My name is Scott Benner and I am the father of a child who has type one diabetes. Our daughter Arden was diagnosed in 2006 at the age of two. I believe that at the core of diabetes management, understanding how insulin works, and how food and other variables impact your system is of the utmost importance. The bold beginning series will lead you down the path of understanding. This series is made up of 24 episodes. And it begins that episode 698 In your podcast, or audio player. I'll list those episodes at the end of this to listen, you can go to juicebox podcast.com. Go up to the menu at the top and choose bold beginnings. Or go into any audio app like Apple podcasts, or Spotify. And then find the episodes that correspond with the series. Those lists again are at Juicebox Podcast up in the menu or if you're in the private Facebook group. In the featured tab. The private Facebook group has over 40,000 members. There are conversations happening right now and 24 hours a day that you'd be incredibly interested in. So don't wait. So don't wait. Check out the bowl beginning series today and get started on your journey. Episode 698 defines the bowl beginning series 702, honeymooning 706 adult diagnosis 711 and 712 go over diabetes terminologies in Episode 715 We talked about fear of insulin in 719 the 1515 rule episode 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility in Episode 751 We discussed school in Episode 755 Exercise 759 guilt, fears hope and expectations. In episode 763 of the bowl beginning series. We talk about community 772 journaling 776 technology and medical supplies. Episode Seven at treating low blood glucose episode 784 dealing with insurance 788 talking to your family and episode 805 illness and ketone management. Check it out it will change your life
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