Scott Benner 1/23/24 Scott Benner 1/23/24

#1113 Cold Wind Healthcare Whistleblower Bedside Nurse

"George" is an anonymous bedside nurse and CDE who provides insight on working with everything from egotistical doctors to his personal frustrations with the healthcare system. His voice and name have been changed to protect his identity.

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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 1113 of the Juicebox Podcast.

We are already four episodes into the new cold wind series. I hope you're enjoying it. Today. George has had type one diabetes for 25 years. He grew up going to diabetes camps and being involved with the diabetes community. One day he decided that he wanted to become a nurse. After graduating, he did four years of bedside nursing and a diabetic bedside renal unit. And that led George to become a diabetes educator. Currently, he does diabetes education full time in a large inpatient facility. Hello, and welcome to the cold wind series from the Juicebox Podcast. These episodes will feature physicians, nurses and other professionals who agreed to come on the show anonymously to share what they see in the healthcare profession. I've altered the voices of each guest so that they can remain anonymous and feel comfortable telling us what really goes on at their job. Just listen to how well the voice altering works.

George 1:12
My name is Beth and my oldest child has type one diabetes diagnosed in October 2020. My name is Beth and my oldest child has type one diabetes diagnosed in October 2020.

Scott Benner 1:24
If you work in health care, and have a chilling story to tell about your experiences in the healthcare field, contact me today. I'll get you right on the show. Your story does not need to be specific to diabetes. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cozy earth.com.

This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one.org. And find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that. Check them out at touched by type one.org. This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. Learn more and get started today at contour next one.com/juicebox. Okay, George, what's your background?

Speaker 2 3:03
Yeah, so my background? Well, first off, I've had type one diabetes myself for 25 years, I grew up going to different diabetes camps being involved in the diabetes community. And once I was getting ready to graduate high school, trying to figure out what I was going to do, I decided I wanted to become a nurse. And so that led me to nursing school. And after nursing school I did about four years or so of bedside nursing on diabetic renal units. So I saw a lot of interesting things there. And that was ultimately to get me to a place where I felt like I could be in a good spot to be a diabetes educator. So I went on and got certified as a diabetes educator. And now that's what I do full time on it an inpatient, large hospital. Okay, so that's kind of what to do. All right.

Scott Benner 3:53
Maybe these educator now. You see you've had type one for 25 years. 25 years? Yep. Okay. How old are you? You might be asking, yeah, I'm

Speaker 2 4:01

So I was diagnosed when I was just turned five. Really? Well. In fact, I missed my fifth birthday party.

Scott Benner 4:09
As so many do.

Speaker 2 4:11
Yeah, right. I got I got sick. It was like the flu or something. And my parents had already you know, put a bunch of money down on a big like fun entertainment center place. So they're like, well, let's all your friends go to this and Oh, my God do it. Seriously. Yes. So they went to it. And it was fine. I opened my gifts at home but and sure enough, like for four to six months later, I'm diagnosed with diabetes.

Scott Benner 4:36
I think I like your parents on that. I think I like you know what, buddy, it sucks. But everyone else is gonna go you hang. Yeah,

Speaker 2 4:43
I mean, honestly, like if I think I'd probably do that. Now. You want to other people that you invited to have a good time that kind of your Red Sox, but it kind of is what it is. In that situation. There

Scott Benner 4:51
are three kids already. Wow, congratulations.

Unknown Speaker 4:55
Thank you.

Scott Benner 4:57
So we're gonna dig Again, and the these episodes are usually a little more direct than some of the other ones. So let me start first with being in the renal unit, what did you see there.

Speaker 2 5:11
So in the renal unit, it's a lot of really uncontrolled diabetes, that has led to like dialysis and kidney failure. So within that setting there, we saw a lot of people who were, you know, being started on hemodialysis or peritoneal dialysis. And when that happens, your insulin needs drastically change, you know, you could have been quite resistant to insulin for a while. And all of a sudden, because your kidneys don't function, you're ultra sensitive to insulin. Not to mention, it also stays around in your body for so much longer. So, one of the biggest issues I saw in regards to insulin and the kidney patients is that a lot of the doctors didn't know how to properly dose the insulin. It's just like when you go into a hospital, for the vast majority people, it's very generic. You know, you look at someone's bodyweight and go, Okay, they're low resistance, sliding scale. Oh, he's got a high eight, once he let's give him an aggressive resistance, sliding scale. And I'm sure for for some doctors, it might be more detailed than that, but especially with like, say, a resident, a new a new doctor, you're gonna get that a lot, right? So you might have a guy who's had horrible controllers, diabetes has a really high a one seat, maybe like, 14 15%. He's on dialysis, that changes everything. Right? You can't you can't just go in with the aggressive scales. And what would happen is we get these patients having these horribly critical low blood sugars when they're below 20. You know, I saw one time there was a lady that she had been my patient that day before and I happened to walk by her room, she was foaming at the mouth. And it was from low blood sugar. And we got her to come back. But it was that exact scenario there. Yeah, that just way too aggressive.

Scott Benner 6:58
I interviewed somebody more recently, who had to have, you know, didn't have diabetes, when they went into the hospital, had their pancreas removed, had diabetes when they woke up, and you know, needed insulin when they woke up, and they just didn't give her any. And the conversations between the nurses, she's, she looks back on now. And she's like, we're baffling. Like they didn't even like it didn't occur to the nurses that we just took their pancreas out. They need insulin now. Like it was on the level of, hey, we remove their heart, how come we're not pushing blood through her anymore? Like they just didn't even know it. And I thought to myself, like, I may have said out loud at the time. This can't be the first time they've removed somebody's pancreas. Like, how can this be a surprise? You know, but there it was, and it was so

Speaker 2 7:48
yeah, and we see stuff like that a lot. You know, honestly, with everything that's gone on in healthcare in the last couple years, like the pandemic, there's been such high turnover with nurses and doctors that, you know, you're you might have a charge nurse on the unit who's only been a nurse for like six months now. You know, and so there's your people, I think you're kind of getting into scarier situations. Okay. Because of potentially lack of experience, I think there's higher demands on doctors than ever before. Like, is that because of what why do you think I honestly think it comes down to profit, a lot of the times, you know, each individual doctor might not be thinking that way. But if you're a part of a big system, the system wants to make a lot of money. And I think that is pressure that's put on the doctors to be like, hey, you know, you got to see this many patients every single day. And when you start rushing care, you there's inevitably going to be mistakes. I don't think that every doctor is devious or wants to, you know, do something bad. Right? I just think a lot of them are so rushed, that they don't have time to sit down. They don't have time to educate themselves. And it leads to these horrible situations. And it scars these patients, you know, so

Scott Benner 9:05
you're saying that because they're pressured to see so many people, because the hospital is a private institution, it's trying to make money and it makes money by helping people with their health. And so to see this many people, you don't get the very natural experience of being able to stop once in a while or ruminate over something or go let me go find out about this before I you don't have those options anymore. You have to go go go go. No. And in fact, like I said, it's almost feels like a zombie apocalypse when you're walking through the hospital because nobody makes eye contact. People quite literally like we're almost running into each other because everyone's on their phone.

Speaker 2 9:41
Texting another doctor, another nurse about a patient. And it's like it there's just so much I think that pressure it's like go go go keep seeing patients that

Scott Benner 9:52
are they texting each other because they don't know and they think maybe this person will know over here. It's possible. I don't know for every case then that kind of funny though, like we get yelled at for using the internet to find out stuff like to do like, you know, sourced information, but now they're forced to source information to, oh, that happens all the time. Please tell me my doctors not googling my problem. Sometimes. I can't speak for your doctor. But I have definitely worked with doctors who are Oh, great. So, so we really are down to now like, you just have a prescription pad. And I don't,

Speaker 2 10:23
to an extent, yeah. And let me tell you this other story, too. Like, I had a patient where this was in the diabetes educator role. And he had a transplant rejection problem to an Oregon. They put him on high doses of steroids for a while. And so naturally, that raised his blood sugar's, he didn't have diabetes, he was in like the pre diabetes category. Yeah. But he'd never used insulin. So that's why they consulted me to teach him how to do insulin. The plan was for him to be on steroids for like two to three weeks. So he didn't need a long term prescription for insulin. Well, the doctor prescribed the Medtronic in pen. Okay, that's that smart insulin pen. Yeah, great pen, if, if you have diabetes, and you're gonna need it long term, but that's also not covered by insurance very well, especially in someone who doesn't have diabetes. So the family is kind of freaking out, they get their like, our insulin prescription is gonna be $1,000. And this is already after they're discharged. By the way, they're calling me and telling me this on the phone. So they ended up getting the prescription. And then the NPN doesn't come with insulin. It's cartridges that you load into it. And so then they have this $1,000 device that doesn't even have insulin. So I ended up calling the doctor that discharged, I'm getting the impression that she was in there a huge in a huge hurry. So she went back and ordered the intent again. So instead of I think kind of slowing down and being like, Okay, that was incorrect, I need to order something differently, ordered the infant again. And so the family gets stuck with this device they can't even use there's no insulin, they ended up going to an urgent care to get a prescription from another doctor for the insulin. And when they filed a complaint with the hospital, the hospital told them what it looks like the doctor wrote in her notes that she was ordering the correct device. And so the hospital basically told them, we're not giving you $1,000 Yeah, yeah, yeah, we're not gonna pay for the you know if that's on you guys.

Scott Benner 12:21
I have to say, too, and I think your point earlier, if you had diabetes, and got a prescription for an implant, I think it would be like a nominal amount of money. It would Yeah. And so they gave him a pen that didn't have insulin in it. That doctor meant to give him like a Novolog pen or something like that.

Speaker 2 12:38
Yeah. So the our standard is that the human log quick pen, okay. And so like, in my notes, someone's gonna need it. All right, please prescribe to a lot of quick pen with pen needles, right. And so if they just look at the bottom of the note, you could pretty much copy and paste what I wrote and turn it into a prescription.

Scott Benner 12:57
And then after having made the mistake, and you bring it to their attention, they do the same exact thing again,

Speaker 2 13:03
do the same thing. And I'm telling you, it's still happening. This particular doctor, it still happens. And so every time, you know, I tried to be polite, I'm like, Listen, this is not correct. And yet it still happened.

Scott Benner 13:16
Do you know the doctor aside of like, have these interactions? Do you know more about them?

Unknown Speaker 13:20
I do. Yeah. Yeah. I'm

Scott Benner 13:22
just gonna ask you like big dummy, like somebody you wouldn't? Where we at? I would

Speaker 2 13:27
say, I would not trust this doctor with my family's health.

Scott Benner 13:30
Okay. That's all trust me, that making this series has really enlightened me. I have not, I've not heard so many people say, I would not go to the place where I work to get health care. Yeah. And I don't know that. That means the next place is any better. And by the way, how many people now are just using urgent care to be the prescription pad? Well,

Speaker 2 13:53
and that's a problem too. That's another problem. Like, I'll see patients I'm like, Alright, so you're in with DKA? Do you have insulin at home? And like, well, I've got like, half a bio left like, Okay, well, who do you go to you for your, your normal prescription? I go, Well, I usually just, I come to the IDI like once a month. And then I got a new prescription for insulin. You have stuff like that happening, too.

Scott Benner 14:15
Yeah. I mean, there's a difference between having a report with a doctor going in and saying, Look, here are all my symptoms. What do you think? And they say, I think you need this and you go, I came to the same conclusion. I would like that if you could. But that's not what most people's situations are, their understanding around their medical needs, you could come in with a completely skewed idea of what's going on, especially in autoimmune, where so many things mimic each other to begin with. Right? And if we start getting into the point where like, any one with Google can come say, I think I need this. The doctor just goes Yeah, it sounds right to me. What the hell, you know, like, Oh, my God, we could stop now. George, we could just stop right now and I'd go this has been horrifying. And but there's more right? Well, then There's more. Yeah, the contour next gen blood glucose meter is sponsoring this episode of The Juicebox Podcast. And it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link contour next one.com/juicebox, you're going to find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, and Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the contour next gen and Contour. Next One, test trips in cash, what am I saying, my link may be cheaper out of your pocket than you're paying right now, even with your insurance. And I don't know what meter you have right now, I can't say that. But what I can say for sure is that the contour next gen meter is accurate. It is reliable. And it is the meter that we've been using for years contour next one.com/juicebox. And if you already have a contour meter, and you're buying test strips doing so through the Juicebox Podcast link will help to support the show.

Speaker 2 16:12
A lot of the examples I've seen have revolved around finances and money. Okay. And so here's an example. Now, I don't think this doctor in particular was trying to make money. I think he had a pride issue, this patient, I see that for diabetes education in the conversation that comes up, but they don't have insurance. You know, a once he was like a 13 or 14, clearly they needed insulin, the doctor had prescribed homologue Atlantis, and that was going to cost them like 700 something dollars, and there's no way they could afford that. And so I suggested to the patient, hey, you know, Walmart has rely on brand insulin, we could do a similar version of this, and it's gonna cost you like 50 bucks for the month or so. And so they're they're like, that's awesome. That's we can afford that we can't afford the 700. Right? Well, I called the doctor. He was very frustrated. I called him. And prior to calling him I had paged and just giving some recommendations because that's, that's like my job. It's not to tell them necessarily what to do. But it's to give some guidelines and recommendations like, here's what I would recommend. And so I said to him, I would recommend that this patient is put on rely on brand insulin so that they can afford it. And he on the phone, he told me he's like, it is not your job to tell me how to dose and Sony hung up on me. And so I ended up calling him back. He listened to what I had to say. And he told me he's like, I spoke to the patient's daughter who's a pharmacist. And there's no issues with finances, it'll be fine. So he ended up discharging the patient. I gave the patient my my hospital business card and said if there's any issues, give me a call. Well, sure enough, the next day, I get a phone call. And they're like, we're panicking. We don't have insulin. We can't afford it. So I ended up talking to the doctor again. He told me to direct them to the hospital on call Doctor line to the Vic and tell him how to dose the rely on Brandon sloughed.

Scott Benner 18:07
That's all ego.

Speaker 2 18:09
I'm that's my impression. Like, if you knew this doctor, he is like, I'd say more of a he's he looks stylish. He is more popular among the nurses. That's why I got the impression that it is more ego.

Scott Benner 18:24
George handsome guy. You're saying to me? He's He's He's handsome. Yeah, he's in shape. To be in the gym. Maybe everything's going his way. Yeah, yeah. Exact better car than you.

Unknown Speaker 18:35
Oh, that's for sure.

Scott Benner 18:36
I say okay, so it's, uh, oh, wow. Is that a common thing?

Speaker 2 18:41
I do see the ego kind of getting away a handful times. Yeah.

Scott Benner 18:45
So basically, all the things we see in regular society. People don't know how to leave that at the door to go be a doctor Sometimes. Sometimes. That's correct. Yeah. So this person has a financial issue. You've taken the time to understand it. Yes. Founder a fix for them. Which I hope by the way people know that rely on insulin is just Novolog. repackaged, is that correct? They

Speaker 2 19:07
do have Novolog Novolog rely on brand to be 72 bucks for that overlong. What I was doing with this patient was NPH and regular

Scott Benner 19:15
you were going that far. I'm sorry. So you were doing the the original T that's such a confusion, rely on Novolog. And there's there

Speaker 2 19:23
and it gets really confusing because they're all called no Overland. So Novolin are no violent and no violence. 7030 You know,

Scott Benner 19:30
I spend most of my life thinking who names this stuff? Right? You know how you can't confuse red and blue? Because they don't sound different. They're like, you know, I mean, like conventional blue and blah, like and I'd be like, Oh, which one is that? It's like, it's fascinating that nobody can figure this out. It's like when they build web pages and then they don't use them like Did no one try this website before they put it out as terrible. Right, right. Yeah, like think a little bit but anyway, okay. So there's dickheads that are doctors to you're saying Oh, yeah. Okay, well, there we go, then you

Speaker 2 20:03
have to highlight, I gotta highlight some really good doctors real fast, like, yeah, I've got, I got a friend and he's like the sweetest guy alive. And he'll, he'll actually be like, You know what I'm gonna spend, I'll see if less few less patients, but I'm gonna spend 2030 minutes with the patient and actually figure out what's going on, figure out if I need to call on specialists. And you know, I talked to the patients, and they're like, We absolutely love this doctor. And so you can see that that is what, on a personal level, that's what works. It's not this corporate this, see a bunch of people will be having an arrogant doctor. That's not what works. But that's that's kind of the way I feel like our society has pushed it a little bit.

Scott Benner 20:43
Is it possible that some of that arrogance is just maybe it's self loathing? Maybe they're like, I know, I'm doing the wrong thing. But this is what I got to do.

Speaker 2 20:51
It could be and I think there's also a part that if you are confronted with saying, like, Hey, you might be doing the wrong thing. What if you have done that 1000 times with someone else, right? You have to admit to yourself, I could have potentially harmed 1000 people to get to the realization that I was doing this wrong. I see. Oh, so you could be that pride of like, it's better for me just to bury my head. Put up that that wall, then for me to have to confront the reality, potentially. Have you ever heard

Scott Benner 21:21
my episode called listen to the doctor, where the endo comes on? And just flat out admits that the podcast changed how they help people? Oh, I did hear that. Yeah. I've never been prouder of a person I've never met in my entire life. You know, so cool. Yeah, just just she just said, like, I listen to the podcast, and I, I started doing things differently. And it's helping. And then she told me, she basically told her staff, they had to listen to the Pro Tip series. That's great. And some of the other podcasts, but then some of the re the rebounds she got from some of them was that guy on that podcast is Doctor bashing. And she said, he's not bashing you. You're just not doing the right thing? And he's saying? Absolutely, yeah. And I was like, wow, like, what a what a great person. Like, that's, yeah, that's the doctor you're looking for I made a mistake, you know, or I could have done something differently even, it doesn't even need to be a mistake could have just been best practice at this at a time. And now it's not any longer.

Speaker 2 22:16
You know, I had a diabetes educator, and this person does not have diabetes, just I'll preface it like that. Not saying that you have to have babies to be a good database educator at all. But I think in this case, that would have helped this person's perspective. She told me that I needed to be careful listening to this podcast, because it wasn't coming from. Like for you as an example. You're not a doctor, right? Doctor, I'm not anything. As you guys like, you should be really listening to like peer reviewed, you know, episodes and podcasts and stuff like,

Scott Benner 22:52
go right to sleep. Listen on that app, but go ahead. Yeah. So I thought that was hilarious. Well, one of the nicest things anybody's ever said to me is I do so for people who are listening who don't know, I do an episode I do management episodes. I guess I'll say it here. Like I'm the father of a child with type one. That's really all I am. My daughter's had type one diabetes, since she was two. And she's got she's going to be 20. This year. Her a one sees between five two and six to for like a decade now. And she doesn't have any diet restrictions. And a long time ago, writing a blog, I realized that I had a system that it wasn't confusing, and it was easy. And if I did these repeatable things, that I got repeatable results, and I used to write about them online, and I got, you know, feedback from people say, hey, this stuff really helps me. Thank you. Great. And then at some point, people stopped reading. And it was a weird shift in society. But people were like, why? If they can say it to my ear? Why am I using my eyes to read it? I'm like, Okay, fair enough. So I started making a podcast, which became incredibly popular. Yeah, if I had to guess, I think it's popular because it's entertaining. It's real. I don't have the ability to talk down to you. So I can't do it to begin with. And I fundamentally understand insulin and how to use it in almost a complete way. You know, but moreover, I have a way of explaining it, that is very digestible. And, and a lot of people a wide berth of people have shown that they understand the podcast and that it works for them. Yeah. And I'll just a second that. I

Speaker 2 24:29
mean, it does work. Oftentimes, in the inpatient setting, I only get to see someone for like a day, when I would like to really see them probably first three or four days in a row to make sure they're understanding everything. The way it is, I get consulted, typically, one to two days before they're getting discharged. Yeah. And so you have to pack everything and as much as possible, they're overwhelmed. That's why I always tell them about this podcast, especially at the beginning series. It's like, it really has changed people's lives. I've had emails from people saying like, Hey, I listen to that podcast and I feel like I really understand it though. It's, it's cool. So you're doing a good thing or without a doubt,

Scott Benner 25:03
you're very kind. And I appreciate that very much. But the thing here is like this podcast now has over 15 million downloads. Yeah, okay. And we interview people have diabetes, talk to doctors, you know, talk to people in industries, make pumps and that kind of stuff. But moreover, it's popular, because the information doesn't exist anywhere else. Like, if you're a physician listening now, and you're pissed, because there's a guy with a podcast, who's helping people, and you're not, you made the world that I succeeded. Like, if it wasn't for you, I'd have a different job. Yeah, I'm filling a void, you know, and so yeah, you know, that's the funny thing. Like sometimes when I get like that, oh, your doctor bashing, I'm like, You did this. Like, I didn't do this. I figured something out for my daughter. And then I saw that other people needed it. And then I figured out a way to talk to them to they could pick it up, because I'm not blowing my own horn here. But I don't get to sit in a room with people. I don't know their background. I haven't heard their story. And yet, I figured out a way to speak to them, that still helps them. And if I could do it, you have a nice car and you're handsome, and abs, like why can't you figure it out? Like you don't I mean, you went to medical school and all. So you'd think you could figure it out? If I could figure it out. I barely got through high school, George. And I'm not even kidding. The day I graduated, I was like, get the fuck out here. Really? All right. Yeah.

Speaker 2 26:28
But yeah, I mean, just real fast along those lines. I think so many people, especially our society, we put such a high level on academic intelligence. And that's just one level. I mean, you're a people person. Right? So you've got a high, I think, a social and emotional intelligence. And that's why this is helpful,

Scott Benner 26:48
right? It's not hard to help people, right. And by the way, let me say this, you're there anyway, you got up, you got dressed, you went to work, you're doing something wants to do the right thing. How would that be? You know, like, I mean, what a crazy fucking idea. Like, like, I'd be. You're already there. You're, you're functioning. But that's not specific to medicine, by the way, right? I know people who work in big industries, where people are being paid crazy money, and they'll spend more time trying to look like they're working than it would take to actually do their job.

Speaker 2 27:20
I know, I know. It's just it's just said that money is a lot of the time the big motivator, and I had a doctor, he wasn't an endocrine fellow. And he had prior been a pharmaceutical sales rep. And one day in passing, we were just talking briefly. And he thought this was funny. And I thought this was horrifying. He said, You know, when I was doing the pharmaceutical sales, I will just tell the patient whatever I needed to, to make sure that they'd get on that drug. But I don't believe that at all. Yeah. And I'm like, Are you kidding me? I

Scott Benner 27:53
can't wait. By the way, if you've used to sell pharmaceutical stuff, and you're a scumbag, and you want to come on the show, and talk anonymously, go ahead and contact me because I'd love to talk to you, too. I had a people will find an episode in this series with human resources professional. And the things that she told me she had to do in 25 years, all wrapped around finding ways to fire people who used up too much money because of their medical conditions. That was pretty horrifying. So Wow. Yeah. So let's hear more stories like this. And by the way, you've said this a couple of times, and I'd like to echo it. I don't think all doctors are are what these examples that you're giving? I probably overwhelmingly, that's not the case. Right? But if enough of them don't care, and enough of them don't know. And enough of them are busy being scored by their hospital need to keep their score up in order to get a bonus or not get fired or whatever is happening. Then your chances of walking into an institution and getting somebody who's on your side and knowledgeable. Go down. Right? And it doesn't mean that everybody's getting poor care. But a lot of people are right, you know, it this is this model that we've kind of created. It's driving good doctors away. Oh, sure. Like, one of my my friends at the hospital, he was, you know, I'm not gonna say his name. But he was actually listed as one of the top endocrinologist on your website. He just he left the hospital

Speaker 2 29:28
and went to a private practice in it in a different state. Yeah. And I was asking, like, where are you heading out? And he goes, Well, one family but you, I just need to get out of this place. And it's like, the pressure they were putting on him. He had essentially no life. Outside of the hospital. He told me that he was still doing patient prescriptions and all that stuff up to like 10 o'clock at night. Yeah, after working probably 10 hours on top of that, right. Yeah, right. Well, yeah,

Scott Benner 29:56
I mean, it's just obvious. Let me ask you a question. I I came under the impression my mom who's now passed, but a couple of years ago, was diagnosed with cancer. And the initial surgeon that diagnosed or would not do her surgery, which by the way, somebody else later did and gave her two more years of life. By and good years, bye bye. But the doctor wouldn't give her the surgery, the initial one. And I came under the impression that if she died, he would get nicked somehow in a scoring system that hurts him at work. Is that a real thing?

Speaker 2 30:35
I don't know. Personally, I wouldn't doubt it. I can't speak to that personally, though.

Scott Benner 30:39
But I got if a doctor knows about that, come on, and tell me about it. Yeah, I mean, I

Speaker 2 30:44
do know we have markers for everything. Right. I mean, everything's exam tracked everything like, like, are we washing our hands enough? Like there's there's people who are secretly watching everyone at the hospital? Keeping tally? It's like, oh, you know, he didn't wash his hands when he went in. And that's a tally. So there's there's things for literally everything. There's markers for everything. Hospitals have secret shoppers. Oh, without a doubt. Yeah. Oh, my gosh, about that. Yeah. And I know that because they signed me up to be one of them for the handwashing things.

Scott Benner 31:14
You're in charge. Now. George, go ratchet. And

Speaker 2 31:18
like, I don't I don't like I don't have to do this. Alright. Well, if you want to get the if you want to get the exceeds expectation on your performance, you need to be doing extra things. Oh, yeah. Yeah.

Scott Benner 31:27
So exceed, don't just be a nurse do something more. And by the way, rat on Patty over there, and let's get her out of here.

Speaker 2 31:34
Right. So stuff like that, you know, and listen, I did. When I was a floor nurse, I noticed that we had these snacks that were labeled as diabetic snacks, and it sounds like 12 grams of carbs. So I'm like, okay, cool. Well, then I'm looking inside the pack. And it says there's like, there's like, three packs of crackers. There's like a small apple. There was cheese. There was like, cashews like, those are mini bagel. And then I'm looking at the label from this company. It says 12 grams of carbs. I'm like that is so far.

Scott Benner 32:03
That can't be possible. Yeah, the apple off the apple is 12 grams of carbs. Right. Exactly, exactly.

Speaker 2 32:08
So I contacted the company. And I was like, and they're like, Oh, we noticed that this was inaccurate. But we'd already shipped out like 1000s to the hospital. So we're probably going to change it for the next one. So I got the got that all squared away. We had labels that fix the card count on it. And for that year, I just gotten meets expectations on the review. And I was like what I thought this was kind of bumped me up a little bit. And they said, No, you have to do something that's going to significantly save the hospital money to be able to get there exceeds expectations. Yeah,

Scott Benner 32:43
why don't you go run the parking during your break? Yeah, right. Yeah, go go park people's cars, do a little bit of that, you know, valet yourself a little, maybe you'll make some tips be fantastic. Right? When

Speaker 2 32:53
I was at this other hospital, it was the time where I wanted to make that transition into diabetes education. And so I put a proposal together, like pretty much what it would pay that kind of stuff. And they told me that they wouldn't go for it at the hospital, because it's not a significant return of investment for the investors of the hospital. So they have they elected to get new MRI machines that year, instead of hiring a diabetes educator, which I suppose in a sense, you're losing business, he talked to me because I tried to make sure that you're not going to have to come back to the hospital, right?

Scott Benner 33:28
But they said, Well, I'll buy a machine that we can build more we can build that that machine builds better than George does. That's basically the message

Speaker 2 33:35
Yes, well, that's the thing too, because I'm paying on a salary. So if I see one patient, I pay the same. And I if I see 11 patients on pay the same, I can't build because I'm an RN. They said that I basically a dying breed this role is a dying breed. Because we can bill you can hire a nurse practitioner or a physician assistant who can kind of do similar things, but then Bill, the patient for more money, essentially. Oh,

Scott Benner 34:00
so the idea is that they'll make nursing irrelevant because they can't bill for because the way the system is set up.

Speaker 2 34:07
Yeah. So the Florida is though they'll they'll still be there no problem. But like a specialty roles. So like, diabetes educator, so because I'm an RN, BSN RN, CDC, yes, that role is probably going to not be as popular to be hired at least because I can't bill. Okay.

Scott Benner 34:26
Yeah. Okay, well, alright, let's take a breath. Fine, everything's fine. Don't worry. It's all going to be okay. Good luck with your AI app is going to be your doctor in 10 more years.

Speaker 2 34:42
I wouldn't be surprised. You know, it's aI kind of freaks me out in some ways. In some ways. It's kind of cool. But I my brother in law, he's really big into it. And he's like, watch this. He's like, he highlighted an article that he read about diabetes meal plans. And then he put it into one of those aiops and said, Give me a diabetes. his meal plan that's easy for me to follow. And it's like, a minute spit them out before meal plan. And I'm like, I'm looking over it. I'm like, wow, that was that was kind of accurate. Oh,

Scott Benner 35:09
you want to hear something crazy? I have episodes that are called the math of Basal insulin math of this math of like insulin carb ratio and blah, blah, where we just have a conversation about how to do it, but in nope, at no part during the episode to somebody say, step one, take your weight step to do this. Like it's not like that, right? It's just a flowing conversation. And I've fed my own audio into my AI and said, How do you figure out somebody's Basal insulin? And it tells you? Oh, that's crazy. Yeah, from the conversation. So, but my point is, is that at some point, you're gonna sit down and tell something, this is how I feel. And it's gonna give you some possibilities, and then put you on the phone with a virtual doctor. Yeah. And you're gonna get an answer like that. And, you know, whether that ends up working or not, who knows? Right? What I'm hearing from you. Is that any conversation about how do we help the patient? How do we keep them healthier? is met with that doesn't make money. And so, you know, there's no answer here. Because money rules, money. Let me say something for people who may have some hope left. Everything's about money, or power. That's life. I'm sorry. You know,

Unknown Speaker 36:23
it's like the big three, I

Scott Benner 36:24
will say sex, money, power get perfect. The handsome doctor, if you don't need your nursing asked to tell him what to do. George like, he's a doctor. Yeah, ladies love me. I'm just here for the I almost said something I shouldn't say. But I feel like, that's it. Like, if you want to know why something's happening, it's a power move. It's a money move. Something to that degree. Now, not your personal life. I'm sure your mom is not making power, although some people are probably I don't know, my mom's doing. But like, you know, like, I'm sure the people you love are not doing that to you. But when you get out into the world, and you hear anything, if the first question you're not asking yourself is why are they saying that? I don't understand you as an adult? Yeah, yeah.

Speaker 2 37:07
So you know, yeah, and that's a big thing I tell my patients too, is, you know, you have to be able to take what I'm telling you process it and look it up for yourself to, I don't want people to take me 100% At my word, we're not giving them the information. It's, it's reliable information. But I want them to get in the habit of Hey, you look into this kind of stuff for yourself, too. You know, don't don't just necessarily take somebody's specifically straight up their word for that, that Yeah. And that's how you get like informed decision making. You

Scott Benner 37:39
have to, that leads into a completely different problem, which is that most people don't want to do that. Or they're not conditioned to do it, or they don't have the bandwidth to do it. They don't have the intellect to do it. There's a lot of reasons why people can't just pick up that baton and keep running with it. And making this podcast has taught me that. I'm not judging anybody. But there are countless reasons why people don't do well with their health. It's not the simple stuff that a bro podcast would tell you, like, you just ain't trying hard enough. Like you don't need like, it's not. It's not like, stop eating. Like, it's not like that, you know what I mean? Like most people are not just, I don't think that there's an overweight person in the world who's got a fistful of food, that's not good for them, that just is going I don't care about me. That's not how people think they're making decisions for a myriad of reasons that you don't know. And when it comes down to this diabetes stuff, you start them off with bad information, they have a bad situation, they either get incredibly scared of insulin, or, or something else happens and they do this throw, throw it up to God thing. They're like, Oh, I guess this is my life now, and, and whatever is gonna happen is gonna happen. You're ruining those people's lives. And it's needless, because if you just explain to them how to use insulin, and make sure they understand, they're going to have a better situation. But that's not what's going to happen ever. What's going to happen is that people are going to continue to make bad decisions that don't help people, because of, you know, preconceived human stuff. And this just keeps happening. I guarantee all those people in that renal unit that you were talking about at the beginning. Yeah. If I take most doctors to that unit and point to them and go look at all these poor people are gonna go out it's their own fault should eat better and exercise. You know what I mean? Yeah,

Speaker 2 39:29
that's, that's, that's the attitude. You know, I'm just blown away. Like, when I see patients, I try to see a blank slate every single time. And I'm not perfect. I mean, I'm a human. Obviously, I'm not perfect, but like, everyone is so different. Like yesterday, I saw a guy and he'd been dealing with high blood sugars and really bad low blood sugars. And so I just, I took some time, I was like, Hey, so what's going on? Tell me about your regimen at home. And he goes, Well, I take Lantis in the evening time, and I take insulin for my meals. And I said, okay, but tell me what insulin you take for your meals. And he goes, it's called 7030. And so he was taking 7030 mix to try to cover his carbohydrates. And that's like 70% of it is an intermediate acting like 12 to 14 hour insulin. Yeah. So it's no wonder that he's doing that. And then four to six hours later, a blood sugar of 20. Yeah, but I think, and he told me he's had diabetes for 15 years, and no one's ever told him. That is what he told me. It's 2023. How can that be possible? If you have someone who comes in the room very quickly, and the guy goes, Yeah, I mean, I take my long acting Lantis and then I take my insulin for my meals, if that's all they hear, and they'll take the extra second to go, okay, but clarify for me, what insulin Are you taking at the meal, right? Then you get into a situation, they're gonna say in the notes, okay, patients taking, you know, insulin with meals, consult endocrine, to figure out why he's having the lows. Yeah.

Scott Benner 40:57
It's funny. You were just told the problem. But you've went by it so quickly, that now you're going to start looking at 1000 other things. This happens all the time, by the way. Yeah, with diabetes. I've learned from making the podcast you say to somebody, Hey, how's your agency? And they go, it's good. Yep. And in the beginning, I went okay. And I just would move on from my interpretation of good, right. But it didn't take me long to say what is good mean? Yep. Because once they say that, you go, Oh, well, that's not good. Like, Greg, we're not going to call that good. Are we like your spiking in the 250s? And I'll say, but it comes back down. And I go, Yeah, but that's, that's doesn't have to go like that.

Unknown Speaker 41:35
Yeah, sure. Exactly. Yeah.

Scott Benner 41:39
Yeah, well, so when you're problem solving, the way I always think is, you need people to say the rest of the sentence, absolutely. Be clear, use all the words explained to me what's happening so that I can look at that and go, No, you know, what turns out, you're using the wrong hands on, hey, 15 years ago, you fix this guy's problem? Yeah,

Speaker 2 41:57
you know, and another thing I wanted to highlight real fast. So I do insulin pump trainings. Also, in the last year been noticing that there's been a trend of patients who should not be on pumps are being assigned pumps or given pumps. And what I mean by that is that that, obviously, there is a level of understanding that has to go into using an insulin pump. And if someone barely understands the concept of insulin, is not able to handle the technology, it's probably a good indicator that they shouldn't be started on a pump in that moment. And so that I'll get to the insulin pump trainings, it gets into really kind of scary situations, because then I'm expected to have this person start on the insulin pump. And then I'm, I'm worrying that they're, they don't even know what insulin really even does, you know, it gets these horrible situations like I've had, recently, there was a couple guys that were hospitalized because they didn't understand how to use it even after training and follow up. And I do have to say, I pin that one down on the doctor, because that was a poor assessment on their part to even say, Hey, you're you should be on an insulin pump.

Scott Benner 43:07
So it's back down to the core of why the podcast is popular because I explain to people how insulin works. Right? That's it. Yep. I had somebody telling me the other day, that my explanation of a tug of war for a meal Bolus is like the greatest thing that's ever happened to them.

Unknown Speaker 43:25
Oh, it's phenomenal. Yeah, that's a great example.

Scott Benner 43:28
Again, you know, I came up with that in my living room right. Now. I'm not reading a medical book, or you know, and I'm not, I'm not giving myself a ton of credit. I always just put you know what it is, I'm realizing talking to you. I was put into a situation where I was asked to help a person. I think I've been clear about this. In the past, I was talking to a very young mother. And it was clear to me that she had dropped out of high school because she found herself pregnant. And she was literally waitressing. And her young kid gets diabetes. She's struggling. And she's online looking for help. And no one knows how to help her. And someone points her to me and says that guy, I'll explain it to you like this is before the podcast, right? Like, it's probably just writing a blog back then. And I take my time. And I let her call me on the phone. And I let her tell me her whole story. And which, by the way, for doctors, interestingly enough, I've learned their whole story is not that important. Like, like, the details are important so that you know what they're doing, so that you can guide them well. But people have this desire to tell a bigger story. And I understand that on a personal level, but I get where doctors could be standing in a room going as part doesn't matter. Like, you know, you like I get that that happens because I've had it happen. But she explains your story. I assess who she is, as best I can. And I give her my best explanation about how to set this kid's insulin up. And she has the bravery to say I did not understand what you just said to me. And I had a moment where I thought I've just explained this to her are the best way I know how. And I was at a crossroads. I was either going to tell her I'm sorry, I can't help you. Or I had to figure something else out. You know? And in that moment, I said to her, I don't even know where it came from George, I really don't. I said, you know, have you ever been in a tug of war, like at school, you know, with a rope, and there's a flag in the middle? And she said, Yeah. And I said, Okay. Well imagine on one side of the rope is insulin, and on the other side of the rope is like food and carbs. And like all the things that make blood sugars go up. And she goes, Okay, and then I just restyled it. And she said, I get it. Thank you. That was it. I get it. Yeah. And then I spent time in my personal time, I have stood in this room, when no one's in my house, and said that out loud to nobody 25 times. Until it until it's a story, I can tell them. You could come up to me on the subway smack me in the side of the head point a gun at me and say, Tell the tug of war thing? And I'd be like, Okay, have you ever had a tug of war? Like, I would boom, go right through it. I wouldn't miss anything. A doctor can do that, too.

Speaker 2 46:06
Absolutely. Yeah. And you know, that's, I once I heard you explain that in another podcast. That's a common example. I use that with my patients to tug of war. It you're right, it makes people understand it. That a lot. A lot of people need those analogies to to understand these more complex topics, pictures.

Scott Benner 46:21
That's it. At the end of that, that story, as I'm standing in front of you like pulling on my own hands left and right to try to make the point about a Bolus. I go now imagine this, and I flip my arms from east to west and north south. And I think and I say, Now look, the insolence pulling down, and and the carbs. They're pulling up, and they're in a fight. And when neither side wins, that's a flatline on a CGM graph, and you should see people's faces go, Oh, my God, I got it. All right, just like that. Scott, who barely got out of high school, not that I wasn't smart enough. I was lazy. Let me be clear. Also, I was poor. And I was at work. Most of the time, I wasn't really working on high school. You know, I used to leave school in the middle of the day to go to a job at a sheetmetal shop to make $15. Like, I'd sneak out and not come back. And my boss would be like, aren't you supposed to be it's called like, as short a time clock need money?

Unknown Speaker 47:15
Right.

Scott Benner 47:16
Anyway? I'm sorry, we got a little off track there, but not really like so what exactly? Is there are effects that people on the ground? Can do? Or is it too stacked against them? A fix as in like for the providers or for the patient? So already it's too it's too confusing of a question, right? Because it's not it's not that simple. Right? Like, well, it's

Speaker 2 47:39
not it's not as simple. Yeah, I think I think if you want to just a straight answer the fix is you have to remove the straight business model of healthcare, it needs to be about actually helping people. And I think if we can get back to that, and get back to not having to force doctors to see X amount of patients a day to be getting good marks, rather, it's more of the the quality versus the quantity, I think. But the the issue is, and this is a huge, it's a deeper topic, but the way our our culture is, and I'm coming from the the US, we don't have a healthy culture. Yeah. And everything we do is like disrupting our endocrine system. And so that's fundamental. And we need to start the the foundations, the building blocks, and re teach people what is actual health and nutrition. And that will keep people healthier, out of situations where they're having to be in the hospital all the time, which would then mean that the doctors aren't having to see crazy amounts of patients in a day. So to answer your question, it's it's complex. I don't think there's just a straightforward way to fix this.

Scott Benner 48:53
So all we really have to do is take the money out of food and medicine and everything will be fine. Why don't we do politics at the same time while we're fixing the world? Right, exactly. Yeah, yeah.

Speaker 2 49:03
But if I could, if I could leave people with one thing I'd say, not necessarily rely as much on the sounds bad relying on the system. So if you can do things at your home, like making some of your own foods, maybe have a little garden, you know, things like that. That's going to be a starting block to getting you into a healthier lifestyle. Wow.

Scott Benner 49:25
Yeah. So no one's coming to help. I think so. Yeah. I listen, here's the other side of it. I wouldn't want people to be sitting in their easy chair tomorrow. Gone, ma'am. My shoulder stiff, My chest hurts, right? I just listen to that podcast. They said doctors aren't going to go to the hospital. Running yelling scream, My chest hurts. My arm hurts. So I think it does take it down to what I have noticed. Is that the bread and butter stuff, the stuff that happens all the time. hospitals aren't credibly good at managing?

Speaker 2 50:01
Absolutely. Yeah, you break your arm, absolutely run to the hospital, they're gonna fix you up really nicely, right? Yeah,

Scott Benner 50:07
I've seen that for sure. Like, as soon as you start adding variables, then then it gets a little dicey sometimes. And then all these other little things that we're talking about come into play, like when my daughter was in the emergency room, you know, a few months ago. And I watched them, I said to the nurse, I'm like, well, we want to do this. And they were like, Well, the doctor won't like that. And I said, I don't care. I was like, go, go, let's do it. I can't without asking the doctor. And I said, well ask the doctor, you know, I saw a fear on her face.

Speaker 2 50:35
Right, right. Because yeah, you know, you get I've been on the other end of that I've been a nurse talking to the patient where the patient is like, can we just do this, go ask the doctor, you know, and I ended up asking the doctor, and he's like, why are you calling me this is not an important thing. Just use the order set. And you're like, well, there's no order set. And as a as a as a nurse, you are taught that like, you follow the doctor's orders, you don't you don't do you don't become a rogue nurse, and just be like, Well, I'm gonna do this and this on my own, you got to get the doctor to sign off on it. Right? And maybe that means for a type one, it's like, Hey, can we do insulin to carb ratio? And maybe the doctor doesn't know how to even do that. Right? And the doctor is like, no, he's type one, he'll he needs six units with his meals. That's what he needs. Yeah,

Scott Benner 51:19
you don't realize how much of how people answer you is only based on what they understand, not what you're saying. Yeah, and,

Speaker 2 51:27
guys, I was gonna say, in that specific scenario there. Because I always tell my patient, I'm like, Listen, this is what the doctors recommended to you, it's your body, you can make the choice if you're going to choose to take the medication or not. Right. So you could, in theory, say I'm going to refuse six units, and I'm only going to accept four units. That's not me, that's not the nurse going over the order set, like you couldn't be like, I'm gonna take eight units. Well, the order is only calling for six, the nurse could not do that, that will get you in trouble. But if the patient says I only want four units, you're not breaking the order, because you're not going over the order. You could give the four units and then call the doctor and say, Hey, listen, this is what the patient wants, I

Scott Benner 52:13
wanted you to be aware that he didn't want the full six units. That's how you could handle situation. We know how difficult that is for people, though, right? Like, of course, the entire doesn't happen. It doesn't happen. Yeah, the entirety of the problem I see with people who have had diabetes for decades. And then. So what happens is that a long time ago, there was, you know, managing diabetes was not some exact science. And then that gets taught to people who have diabetes, and that colors, their personal life with it. But it also gets taught from doctor to doctor, and then that colors how care goes. And so like, and so nobody has a good answer. A lot of people are having problems. But they can't break the cycle, because nobody has the nerve to look at their doctor and say what you just said, like, I don't really want to do that. That doesn't sound right to me. And the real unintended consequence of that is that you kind of damned people to live an entire life, with their guts on fire, because they know they're doing the wrong thing. But you told them to do it. So they're doing it, like they're actually screwing themselves or hurting themselves on purpose. But they won't stop because you the person in the white coat with a fancy card, told them not to do that. And so they're just listening to you blindly. Right? Yeah.

Speaker 2 53:39
And that gets back to the whole? Well, if I've told them the wrong thing, 1000 times, I have to admit to myself that, yeah, I've potentially harmed 1000 people. And that's, that's a really hard thing to come to a realization to as a doctor, but I do think that some of my, the best doctors, I'd recommend, have looked at their practice and said, there's things I didn't know in the beginning and unfortunately, may have led to harm to some people. But now I do know this. And so I'm not going to go back to the way it was I'm going to go to the way that I learned to help and how to help people. Here's a difficult question maybe, that you may not know the answer to but sure, maybe you also might know the answer and not want to answer it. I'm not sure. But how much of not wanting to pivot has to do with liability. If I admit if I admit I doing it wrong, that I am admitting I heard, I heard somebody before then I think as long as you were practicing within the policy guidelines, you'd be okay. You're covered. You're covered. So, right. You know, you see a patient with type one diabetes, it's not going to the policy is not going to say specifics like okay, they need this much insulin. It's going to say a type one diabetic needs a long acting insulin and a short acting or rapid acting insulin with their meals. So if that's what you've been prescribing, maybe it's not the right way to prescribe it, but that's what you have been prescribing, you would be okay to then transitioning back. You know what, no, no, no, I need to go to a place where they should be. They should be like counting their carbs. Yeah. And being being aware of that, that I don't think they would get in trouble for that. Now, if they were if they were practicing with something completely outside of a policy, and then they admitted that to themselves, you would be potentially liable, right? Yeah.

Scott Benner 55:24
Here's the question. How pissed Do you think that organizations that exist now doctors, organizations, nurses, organizations, diabetes educators, like there's, there's big organizations that represent people they have? You know, you can go to conferences, and etc? Like, how pissed Do you think they're going to be that people like you were speaking up about this? Or do you think that quietly, they're gonna be like, thank God?

Speaker 2 55:48
I think there's gonna be some people who are thankful. I do think that some will be upset, though, for sure. Because I think if someone's not in the mindset of willing to change, and they're stuck in the old way of profit, profit business, well, some of the things that I'm saying, would lead to better diabetes care, which had been less interactions with the hospital. So less profit,

Scott Benner 56:10
even though that your work is in diabetes, like the things we're talking about apply across the board to other disease. Yeah, yeah. And, and issues, right, like, you're not saying anything that's like, this is super specific to diabetes, like, there's probably a lot of different care ideas that are following broken models and, and things of that sort. Right. And

Speaker 2 56:30
that's why I think you get some people who end up doing like a private practice, and say they, they won't accept insurance, you get into that situation, because a lot of times, the insurance companies dictate things about your appointments, right. As an example, we know some some midwives that do home visits. And if they were to accept insurance, the insurance told them that they could only have 15 to 20 minute appointments, but their whole practice is built around the fact that they're having hour, hour and a half appointments with their patients. Yeah, you know, and it's the same thing for other practices, other health areas, it just kind of sucks, it does, because the cost of everything is so high. So we need our insurance, to do things. But I think oftentimes, for people who really want to take back their health, they almost have to go outside of that. And that's, that comes at a cost.

Scott Benner 57:19
When Arden was my daughter was done being a child and had to move on to an adult endocrinologist, we looked around, but in the end, we went with basically a concierge doctor, and then we, you know, put some money aside to pay, you know, the, the bills, and then we have to submit it to our insurance. And then the insurance does reimburse us to be perfectly honest in a way that it's it's very affordable to do. It's not it's not actually a problem. And I know that wouldn't be everybody's situation pulling the money together to begin with, and we're having insurance that would reimburse, but, you know, the first time that I took her there, I said to her, and I'm like, You want me to go with you for the first appointment? She's like, okay, yeah, that'd be good. And because we, you know, three months earlier, we were sitting in a room with, like, you know, apple trees on the walls and stuff, and we're together anyway. So we go in, now you're in an adult situation, we're seated at some comfortable chairs with a, you know, a table in between. And there's a pad of paper there. And Arden just says, what is that? And the doctor says, oh, it's in case you want to write something down while you're here. And I thought, Oh, brilliant. Yeah. How many times you walk out of a doctor's office going? What do you say? What do you say, you know, and even that, like how was that because you know, those pronounce that the system gives you are mind boggling. And yeah, they're bad. That not helpful. Yeah. So she's like, Yeah, so I'm sorry. Just little little stuff that that takes time. And then from there, there was a point during the conversation, which is really what it was, Arden was having a conversation with a doctor as her first meeting with her. And, you know, like, there was a moment when I thought, are we taking up too much time? Like, oh, gosh, like, does she have to go? And I said, I'm sorry, are we here too long? Because no, no, you have an hour. And I was like, oh, okay, well, thanks. And then we got through a lot of other stuff that you wouldn't normally get to, and she got to hear more stories, and you know, anecdotal stuff about art and that she could she was taking away notes about and now when you talk to her, she's like, Oh, I remember that. Or didn't we talked about this a while ago. Let me go look, and then boom, I listened to what happened in real time on the phone. My doctor calls us, I don't know how to say this. Like, I want to be a little obtuse. It's so out of the ordinary. But Arden needed a medication recently. And it was a Friday evening. And the doctor, we were on the phone on a Friday evening at like 730 And she's going she's just chatting it through. You can hear there's people in our house like she's just you know, she's chatting it through with us. And she goes, Oh, you know what, I have a sample and And she goes, you can come to the office on Monday and she goes, Oh, you know what, though? It would be great to start it on the weekend. And I said, Yeah. And the next thing I know, I swear to you, I'm on the phone in the car, and I get a text. And it's from my doctor. It's her home address. And she says, we'll be up to about 11. That was that. I drove to her house, and she handed it to us on our front step. Wow. And I was like, This is what it must have been like a 1950. Without the texting, right. So you know, that's a person who cares about you. And it's not being rushed around? And you know, I mean, anybody listening to this, you're not getting that anywhere else. So no, that sucks. And I'm not saying that a hospital doctor, the hospital should be texting you their home address. Like it's obviously. Right. Yeah, right. But a tiny bit of that concern might go a long way. I'll leave this here with you. And then I'll let you wrap up, you know, this podcast doesn't just help people. It's actually a successful business. Okay, so all I did was say to myself, I'm going to help people. And if it makes money, that's great. And if it doesn't, I don't care. I never once focused on it being monetarily successful. But now it is. Because it actually helps people. And it's Yeah, I don't know that you can't do that. Do you know what I mean? Like, like, I want to help people. And like, I don't know, a Maserati. I'm not trying to say that, George, you don't eat meat, like, but like, we pay our bills. And you know, my wife works too. It's just not a single family, like, like structure, like for finances. But I am not in a pressure situation where I have to go find another job. I can actually help people and, and buy food. So it looks great. Yeah. But maybe that's not everybody's goal, I guess. Sure. Sure. Yeah. And you have to evaluate your goals and whatnot, too. But can I ask you, nurses? Yeah, just ethically? How many of them? Do you think we're like, I want to help people. And how many of them? Do you think we're like,

Speaker 2 1:02:06
I heard that pays. Well, I think the vast majority of nurses went into it saying I want to help people. Excellent. Because quite honestly, I knew it paid. Well. But there are so many other things that I could do to make a lot more money than what I'm doing right now. I mean, for goodness sakes, like you could recently I was like driving down the road. And there was like a fast food restaurant saying, hiring at like 21 bucks an hour. You were like, I can like fries. And I was like, when I got hired as a nurse. And this was not even, like 10 years ago. Yeah, it was, I got paid 27 bucks an hour. That was after going to college for four years getting passing the NCLEX. And so like, I think nurses, honestly aren't probably paid as well as they deserve. Okay. And so I think if you're a nurse, you're generally going into it because you want to help people.

Scott Benner 1:03:01
You don't think it's a thing that like, kids coming out of high school kind of blind blindly believe like, oh, it's it pays well,

Speaker 2 1:03:08
I'm sure there are some people like that. And hey, you know, if there's roles in the nursing field that pay insanely well, like, I know, I've got some people, some friends that are like single not married, they do travel nursing, and they make a ton of money doing that, right? For the standard nurse, she wants to maybe have a family and be in one location, you're not paid as highly as you think you would be. Nice. I'll just leave

Scott Benner 1:03:33
it at the icing. Okay. Does it attract people who don't belong in it?

Speaker 2 1:03:37
I think there are some people who definitely don't belong. Yeah, but I think the vast majority of nurses I work with, they probably do belong. But what I also say is the way everything is set up, it's almost inevitable that you're going to be jaded a little bit, whether that's to people's humanity, you know, that there's just things that happen that you kind of feel jaded. You know, I know after four years of doing bedside, I did x, I wanted to get diabetes experience across the spectrum, I wanted to see the worst of the worst before I started doing the education role. I remember I would come home and tell my wife, I'm like, Man, I just felt like a drug dealer today. You know, I feel like I'm feeding people's addictions, really? And so there. Yeah. Because, you know, and then it gets back into some of the patient satisfaction stuff, which is hospital profit. You know, pain is what the patient says it is. So I could be having a conversation like this with a patient and then he goes, Oh, yeah, you know, I got my morphine, you know, four hours ago. You know, I mean, 10 out of 10 pain now. And it's like, whoa, 10 out of 10 pain means you're not even having a conversation. You're basically in tears, but we're having we're joking around. Now, it's because the patient said that. He has that I have to give him the medication. Wow. People are going to be jaded, I think and you have to be pretty strong to be a nurse. I'd say. Yeah,

Scott Benner 1:04:55
I'd like to point out I guess this is a good time to point out that I know you're dealing with Apple two, and they're all the foibles that come with humanity as well. And it's not like, you know, it's not Mr. Rogers coming into the, into the ER, every five seconds, and everyone doesn't have best intentions and maybe they, you know, anywhere from seeking drugs to, you know, having treated their body terribly for 30 years, and now they're here and they're like, Yo, fix it. Like, that's not how this works. Right? Yeah, I take that point as well. I'm not saying that your actions are gonna fix humanity. I'm just saying, like, you have, like, you're, you're in control of the thing you do. Right, right. And speaking specifically about diabetes, but really thinking more holistically about about all kinds of disease sets, like, the path you put someone on, is the path they stay on, generally speaking. And so I've been making this point a lot. But if you're seeing somebody on the back end, in an ER, just remember that this is the end of a long path that also started with a doctor. Yeah, you know, and that person had a great opportunity to put them on a path that would not have ended them up in your ER, however, many years later, you know, so somebody's got to start doing the right thing if we expect anything to change.

Speaker 2 1:06:16
Absolutely. Yeah. You know, I, you said something in other podcasts where it was more or less like something that a doctor's says, Could haunt someone like the rest of their life. And even if it's just a little backhanded comment, and I see that too, you hear patients, you know, saying, like, I was diagnosed, and the doctor told me that I because I'm so overweight. That was the only reason I got diabetes, eight out, and then of course, they lose the weight, and maybe they still have it. And so they're just thinking the rest of their life that they're a failure because they were overweight. George,

Scott Benner 1:06:49
listen, most problems are because people don't communicate well. So that's so true. Yeah, sure. Just it's because you go find that person one day, and I bet you they're like, I just meant like, eat better. Like you don't mean like, yeah, exactly. I wasn't trying to shame you into feeling that way. But it done now. Like, you know, where are you going? I do a diary. About like, I use we go V I've been using we go V since March. It's December now I've lost 4040 pounds is like fundamentally changed my life. Every week, I sit down at this microphone for about five minutes. And I talk about the previous week, I shoot my week over and I shut the thing off. And about every 35 minutes, I put it out as an episode, right? Yeah, so I sit down last week to do what's going to be the last one of this episode, episode eight or nine, I forget. And I started talking about my week, which was I went shopping because I needed new clothing. Because I've lost weight. And before I know it, I'm crying in front of this microphone, remembering how terrible it felt to be a little fat kid shopping for clothes with my mom, and how much I hated going shopping and how I used to take it out on my mom. And now my mom's dead. And I can't even can apologize to her. You know, like, and I'm like, so that's that 45 years later, okay. And like, if you don't think as a doctor, you can't say something to somebody that if they were being honest with themselves, 45 years now would break them down into tears, like you're out of your mind, you know, like, like everything. And it doesn't mean that you're responsible for every way everyone feels. But there are big ideas that you could you could hit that would give people a better chance. And I'm not saying my mom did anything wrong. I'm just saying stuff sticks to you. And in ways that you just don't, you might not even recognize but that's colored my life in little ways. I only wear dark clothing. Like from my waist up. I'm very cognizant to just wear dark clothing from my waist up. My daughter took me out. And she's like, Here, put this on us. Like, I won't look good in that. And she's like, No, you will put it on. And I was like, okay, like so I was stuck having to be a good dad. So I put the shirt on. And then she pushed me in front of a mirror and I thought oh, this does look good on me. Like hot like she helped me like immensely, but I lived my whole life thinking oh, that's the wrong color all look fat in that. Oh, man. Yeah, you know, and so like, anyway, you say something to somebody. And you don't even mean anything by it. And there it is. But I'll tell you right now if I thought deeply enough, this has got something to do with elastic band of jeans that my mom made me buy. Because she was like, we can't keep buying you new clothes. It's too expensive. So here get these that stretch. Wow. And it just stuck with me. Like really? Really? And she What was she she was getting broke and she couldn't be buying jeans all the time. Right? Right. What was the real answer? Stop giving me a gallon of lemonade every day to drink and a bag of chips and like macaroni for Dinner and a giant pot like that. Yeah, but she didn't know. Right? That right. But here we are all these years later. So I don't know, George, you were really great. I appreciate this. Is there anything we haven't said that you you want to make sure we cover? No,

Speaker 2 1:10:14
I mean, I made I had a little list of things I want to send them we hit them all so good. That's

Scott Benner 1:10:18
excellent. I really appreciate you doing this. You know, we're gonna keep you anonymous, and do our best to change your voice so that nobody can even tell it to you. And I think you you really help people today and I appreciate you doing this. Yeah,

Unknown Speaker 1:10:33
I'm happy to have been here. Absolutely. Thank you. Yeah.

Scott Benner 1:10:45
A huge thanks to touched by type one for sponsoring this episode of The Juicebox Podcast. Check them out on their website touched by type one.org or on Facebook and Instagram. Aren't started using a contour meter because of its accuracy. But she continues to use it because it's adorable and trustworthy. If you have diabetes, you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour next one.com/juicebox The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com.

If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#1112 Grand Rounds: Food and Nutrition

The fourth Grand Rounds discussion focuses on food and nutrition.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 1112 of the Juicebox Podcast

Welcome back everyone to the Grand Rounds series with myself and Jenny Smith. You know sometimes I just think everybody knows Jenny So I forget to introduce her properly, but Jennifer Smith has lived with type one diabetes since she was a child. She has first hand knowledge of the day to day events that affect diabetes management. Jenny holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and a certified trainer and most make some models of insulin pumps, and continuous glucose monitoring systems. She is also all over this podcast from the Pro Tip series to defining diabetes, to ask Scott and Jenny. Also call her a friend. And I think she's one of the smartest people I know about managing type one diabetes, you can hire Jenny at integrated diabetes.com. 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. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cosy earth.com This episode of The Juicebox Podcast is sponsored by ag one drink ag one.com/juice box. When you use my link and place your first order, you're gonna get a welcome kit, a year supply of vitamin D and five free travel packs. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151. For us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. Today we're going to talk about food to just briefly go over so far we've gone over hospitals diagnosis, insulin and safety today food should be a slightly shorter episode, although I expect you to go off on some sort of a tangent at some point. So maybe it'll take a little longer. The reason I thought that you'd have a lot to say about this is because obviously your background in nutrition. So we have a few pieces of feedback from the listeners about what they prefer, what they would have preferred to hear from doctors, we'll go through a little bit of that we'll talk about it from a couple different perspectives, and we'll we'll let people get back to their lives.

Jennifer Smith, CDE 2:50
I really liked the feedback from people, especially in this because I think I think it offers a lot of perspective of knowing now what people know, and what would have been really helpful. And I think food is a big place. I mean, it's one of the three things that helps manage diabetes.

Scott Benner 3:12
So I agree, I think for this episode for these episodes, specifically, having someone go through it not knowing what they should want or need. And then having them live long enough to think back and go, Oh, you know, what would have really helped back then. And sending in that information is great, right? This person says I wish I would have known in the initial phase with MDI that my toddler can have up to five grams of uncovered carbs for a snack. I came home from the hospital terrified to feed him anything, but meat and cheese. Wow. This is this is interesting, isn't it? Because a new diagnosis may assume some honeymooning and, but But telling somebody they don't need to Bolus for anything under over under five carbs is really giving it's really setting up the quiet expectation that we think you're going to get low. Or we're okay with you being higher one or the other. Right?

Jennifer Smith, CDE 4:07
Correct. That's it's a good assumption. Yes. But it also creates a lot more confusion. Right, right. Because I guarantee that nobody said that as long as it's under five grams of carb. You don't have to Bolus for it. They didn't go on to say, but if you add up multiple things that are under five grams, and you eat them all at once, then you need to Bolus because the complete total is well more than five grams. And I guarantee that wasn't clarified.

Scott Benner 4:35
Right? That's an assumption that doctor will make like, oh, that they'll understand that. I don't mean you know, if you have five grams at two o'clock and then five grams to 230 and etc. But there's no reason to think anybody would understand that. Correct? None. Yeah. And it sets up long term problems. Because now in their mind forever and ever anything under five carbs doesn't. It doesn't need insulin, and then they see a high blood sugar. I bet they don't even put two and two together at that point,

Jennifer Smith, CDE 5:00
and they wonder unless they're paying enough attention to and have a continuous monitor, that they've really tried to pay attention to some trends or things that are, you know, happening over and over again, in those early days or weeks. Absolutely.

Scott Benner 5:17
It's just a good example of if you can, outsmart yourself. So if you over I'm not saying every doctor does this, but we know what happens you over basil somebody because you don't believe that they're going to count their carbs correctly, or Bolus on time or whatever you whatever you're imagining isn't going to happen. And then you give them this piece on top of that, they now have to, I mean, two things that are gonna send them down the wrong path and create confusion for the rest of their lives. Right, and

Jennifer Smith, CDE 5:42
some clarification there too. I mean, a lot of this is, if you're just clear upfront with some simple pieces, about insulin, about food about the variables, and even just a couple of the variables, especially for little kids, the explanation of what we might tell you right now, because sensitivity for your three year old child is going to be high, that maybe they can get away with a couple of grams of carb to nibble in between, you know, toddlers, I mean, they grab something, or they want something. I mean, they don't just sit down to a big meal three times a day, right? So you know, it brings in the idea that, well, if they want one cracker, and it's two grams, they can have that and you don't have to worry about having to give insulin for it. But then again, the understanding that that's going to change. Right now, they might not need insulin, they might be going through honeymoon. But eventually that five grams is meat, it needs to be counted.

Scott Benner 6:44
The other thing here, I mean, no disrespect to the person who was kind enough to send in the question or the statement, but they now have a misgiving. They do like she now thinks like, listen to the words. I wish I would have been told that my toddler can have up to five grams of uncovered carbs. Yeah, not true. Like Like, yeah, it might be true in that situation. Maybe the kids honeymooning, but you need all the context of that. But now moving forward. This is how she speaks. He or she speaks about it when when she says it out loud. She's got a misgiving. I'm sorry. I'm just assuming moms are the ones listening to this podcast. Not that guy's dads are a lot of dads. I know. It's funny, like I'm a dad. And I just assumed no, there's no dads listening. But. But she's got this misgiving. And now when she goes out in the public, she's spreading it. Because she's telling us like, you need to let people know, your kid's gonna have five cards that are covering, like, okay, like, so here we are, we're spinning down a rabbit hole, and nobody's ever going to get back out of it.

Jennifer Smith, CDE 7:49
And someone that may have read it and knows better already, at this point from what they've seen and dealt with thus far. can absolutely say, well, that's not the case. And may chime back in and say, Well, you know, especially, you know, with your group, they're really great about

Scott Benner 8:06
going off each other. Oh, no, they're fantastic and helping each other. However, why did I set this up to tell you this one first, because here's the next one. It's a fantastic. Even three grams of a snack, like a small cheese puff package. We have to cover that. Even within days after diagnosis, we found out real quickly, there's no such thing as a free snack.

Jennifer Smith, CDE 8:30
There you go. Absolutely. So good. Yeah, absolutely. And it just, it justifies the, the idea that individualization of the information that you give, which is really hard at initial diagnosis, you can't get to know somebody in that tiny amount of time where you're trying to give them some, save yourself or save your child kind of information. Because that's really what it is at initial diagnosis, right? They're setting you up to get you going to get you out the door to get you home. And then to be able to connect with somebody that can give you the broader scope of let's call it the correct information. Yeah, hopefully, yeah.

Scott Benner 9:14
Hopefully, you'll find a next person who will go a little deeper with you. But again, a lot of this, a lot of these episodes to me are about what happens when you say these kinds of just offhanded things in the first days or weeks, and you leave people like, like the one person figured it out, and the other person didn't figure it out. And they're both listening to this podcast. So even that didn't help completely. No, this person says, I'd like my doctor to know that my son doesn't need to be on a low calorie diet to achieve a Grade A one say somebody was told to limit calories frequency.

Jennifer Smith, CDE 9:49
That's where you said, you know, you'll wait for me to go off on a tangent. This might be my tangent, honestly. Because, depending on what facility You get diagnosed at and I'm, I'm speaking more toward the kid and teenage kind of facility, right? Because nobody anymore really pays attention to nutrition needs of a growing child or a growing teen. And I said nobody, that's not 100% Correct. But less and less I see that parents have an understanding when I get to work with somebody finally. And my question comes up, well, what parameters? Were you given for portions? Right? Because just because you can eat food and cover it with insulin, doesn't mean you need three packages of something. Right? And so initially, that's something that should be set up sooner than later, is the concept of containment of portion. Yeah. And it's not, it's a lot of just centered around carbohydrate thinking, centered around how to count the carbohydrates, with no idea that somebody needs this much, or the 13 year old needs this much in the 18 year old who plays you know, field hockey five days a week needs this much. There is a major variance, but no, just cover your carbohydrates, whatever you're choosing to eat.

Scott Benner 11:19
I don't know that this would come to a shock to anybody. But Jenny and I talk privately. Fair, a fair amount. I think that what I saw in my life is the way I grew up. In the beginning, they tried, here's some chicken, here's some beans, like, have a salad boba. And the minute we push back as kids, they were like, Screw it. And then when money got tight, it all went to, like, processed prepackaged. And you can probably I don't know the dates, but I think in my childhood lifetime, you can look back to where processed foods became more and more prevalent, and ugly, and they were cheaper, and they were more convenient. And then my parents went to that before you knew it. Like you know, you weren't making something from scratch anymore. You were making it from a package or box. How amazing is this? Look, you just dumped this into water and add meat, Mike? Okay. Yeah. I want to say I've never liked Hamburger Helper, I will not eat it. But that is what um, but that is the thing that somebody was like, here, look dinner. It's got meat in it, like, you know. And so when that's all going on, and your body gets rewired to just like, I don't know, to crave those things. That that's tough then, because now these portion control problems are insane. And I only have perspective about it. 40 years later, because I'm taking a GLP one and my brain works differently now. Right? Right. Kelly and I were out last Saturday. It's Friday. Now last Saturday, we were out and we got this like we saw this chocolate cupcake. It was like chocolate cake with chocolate icing. And it was big. It was like four around and we were like we can split this. Sure. Three goddamn days later, we couldn't eat the damn thing. Like we were like taking a fork full out of it and being like, Oh, that was good. That's enough and putting it down. But if I'm not on this GLP we probably would have like, fought each other with the forks to get to the rest of the cupcake that we would have been gone in a couple of minutes. Correct. Then so you now you're giving this stuff to your kids. They're like, Let's go like and it's not them. It's their. It's their wiring. It's their, you know, it's the I hate to sound like a hippie, but it's the way it kind of restructures your gut to want these like carbs and all this stuff that goes with it. Absolutely Sugar,

Jennifer Smith, CDE 13:33
Sugar. There is there is something to be said about sugar addiction. It's a real thing. 100% It is. And so again, if I were to go off on a tangent, it's it's definitely about the fact of today's life is busy. It's even busier than when these processed packaged all convenience, you know, you brought up a hamburger helper. And the reason it was there was because well we've got these dehydrated, like peas mixed in with noodles that you just have to pop in and Oh, then your ground beef. All you have to do is mix it together and you've got a complete meal. Yeah, we've got everything that you need within 15 minutes.

Scott Benner 14:11
But that's not good for you. It's just not it's not good. And I think that more and more, we are eating food that is not it's not fueling us. It's not actually providing nutrition. And I'm not against saying that I think people are having other issues that are probably nutrition based that we're not even aware of at this point, correct? Yeah. Arden has been getting her diabetes supplies from us med for three years. You can as well, US med.com/juice box or call 888-721-1514 My thanks to us med for sponsoring this episode and for being longtime sponsors of the Juicebox Podcast. There are links in the show notes and links at juicebox podcast.com to us Med and all the sponsors.

Jennifer Smith, CDE 14:55
Absolutely. But I think it compounds it then when you know URL In diagnosis, you've not been given the information about what your body actually needs, even on a caloric level. And by no means do I ever really recommend anybody count calories. It's tedious. It's it's just not purposeful, but understanding portions are visible. Your child needs this many portions of this in a day. Your child needs this many portions of this, making sure to emphasize that these foods should be real food.

Scott Benner 15:29
Yeah, right. Yeah. So those are the words rattling in my head. While you're talking. I, you know, you do this long enough. And, you know, you know what you're gonna say next sometimes. And while you're speaking right there, I thought when she stops, I'm going to say real food. That's exactly what I was just thinking. So portions important, right? You can't just you don't want to be taking in 10s of 1000s of calories, when that's not what you need to get by, you are going to have an issue with your weight if you do that. But also, you're gonna end up using more insulin, that then very well may cause lows later that will cause you to need to eat again to like, bring it back up. But the problem we're trying to figure out here is what should doctors be saying to people? To a not? Because you don't want the people to hear? Oh, yeah, okay, I'll have four ounces of chicken and a salad and three beans. And I'll never drink soda again, like, because if the doctor leads with that, the people who don't want to hear that are gonna be like, Man, nevermind, not listen to that. The people who already eat that way are like, Yeah, cool. That's what we eat anyway, no big deal. Right? I really think that you should lead with real food, reasonable portions. I think that's enough to get people going. Right?

Jennifer Smith, CDE 16:41
Correct. Absolutely. And I think within that, to the understanding that I think a lot of I know that a lot of parents also feel like all of a sudden there are these restrictions that are going to be in their child's life. And so they try to make up for these restrictions very early on, by not restricting in one of the places that there should be restricted.

Scott Benner 17:08
I understand it, by the way, I'm not, I'm not, I would never come down. But I know you don't want there to be like these grand changes to your lifestyle, but I think it is worth mulling over privately, we were on a bad path, it just got shown to us earlier, because of the diagnosis, this path was going to lead you to a bad place eventually, but your body probably would have hammered through it for 10 or 15 years, then you might have got a couple of medications that got you a little farther. And then somebody would have been said, take our proton pump inhibitor, if you've got, you know, reflux and and maybe you would have got through it until finally one day in your 50s you would have been like I can't like it the medicines not helping. And I can't fight through this anymore. I've got pre maybe I'm working up on some type two diabetes, you know, or all the other things that come mobility and problems like that. You're just finding out earlier. So there's a way to think about that as a bonus. I know that's a weird thing. But you can say like, you know, I or my kid was diagnosed at least now I know, this food is like I think diabetes is just shining a light on the fact that you're eating things that aren't beneficial for you sometimes. And yes, you know what? I mean? Does that make sense? No,

Jennifer Smith, CDE 18:23
it does. Absolutely. I've said that and thought that many times myself. I mean, if I wasn't diagnosed when I was with type one, I'm sure my career path would have been different. And would I have wanted to focus as much on overall like human health? I don't know, I originally wanted to be a veterinarian. So I don't know where that leaves nutrition information, right. But I'm very, I'm very happy for many reasons that I had to learn as much as I did. And obviously, where that led and how I can help people and everything. But I think that many people who live with some type of health condition, that lifestyle impact, you can start to learn a lot more about yourself and what, what makes a difference. And I mean, fortunate or unfortunate diabetes, it sure shows you a lot about the impact of food. Yeah,

Scott Benner 19:23
and I mean, we've talked about this before, but it's worth bringing up you some luck for you, right? Your mom was a person who grew food she cooked she took it seriously when the doctor told her this was What's up, you didn't push back terribly. Like Like, there's a lot that went your way. But my point is, is that, okay, some people aren't going to have that that's not going to be their trajectory. It doesn't mean you shouldn't tell them. Correct. They still deserve to know, because maybe something will happen later in the future. And they'll just like, get smacked in the head and think, oh, that's what they meant. And, you know, maybe I could be doing that. Maybe not fair enough. Like we're not going to save it anybody and I understand all that. But as the doctor, I think it's incumbent upon you to tell them the truth, without scaring them or making it sound like you're stealing something from them. And that's not going to be easy to do. But again, from my perspective, listening to you listen to other people, if you just preach real food at a reasonable amount, I think that's most of it, really, you know, cook your food, you should be able to look at it and see what it is and actually go that's chicken. I know what that is. That's chicken, right? You know, you look at Hamburger Helper, and you go, that's noodles, and peas, and is it. Keep reading, there's more in there, like ever notice you don't flip the chicken over and it doesn't say chemicals. It's a chicken. And even now, like people are smart enough to know, like, look, organic might be better because or no antibiotics that have been used or grass fed for some reasons. Like these are all reasonable ways to avoid pesticides and chemicals and things that again, I feel like I'm just I feel like I sound like Joni Mitchell's like, like guru you hear or something, which is just a reference nobody's gonna get at this point. But like, these things are going to change the microbiome in your gut. And you're going to end up one day with a headache, or an achy joint, and you're going to think, Oh, my wrist is hurt. And somehow it's going to be that those billions of little things living in your stomach have gotten messed up by something, somebody sprayed on something. I partnered with ag one because I needed a daily foundational nutritional supplement that supported my whole body health. I continue to drink at one every day because it works for me. Ag one is my foundational nutritional supplement. It gives me comprehensive nutrition, and it supports my whole body health. Drink, ag one.com/juice box, when you use my link to place your first order, here's what you're gonna get a free welcome kit that includes a shaker scoop and canister, five free travel packs, a free year supply of vitamin D, and of course, your ag one. So if you want to take ownership of your health, it starts with ag one, try ag one and get a free one year supply of vitamin D and five free ag one travel packs with your first purchase. Go to drink ag one.com/juice box that's drink ag one.com/juice box, check it out.

Jennifer Smith, CDE 22:22
You know, as I'm thinking about this, and where's the Introduction to Food started, it started at diagnosis. And majority of people with type one or younger people diagnosed with type one in a hospital setting are admitted. Right? What's your introduction to food? And what is possible to eat now that you have this new diagnosis that you're learning? Well, food has an impact on this. And now I have to pay attention to something called blood sugar or blood glucose. And we have to do these finger sticks and what the number pops up. Like, what is that? I mean, all of these thoughts are circulating around and then what comes in three times a day? Is the food from the cafeteria. Yeah, I know hospital food I worked in hospital cafeteria was when I was in college. And it's it's not

Scott Benner 23:15
It's garbage. Yeah, no, it's terrible. And it's not good for you. And by the way, that diabetic menu is ridiculous. It just it just limits you from choosing from like one portion of men, it's, you could still get apple juice if you wanted to. You know, like we live in a world now where you could walk outside and ask anybody? Hey, do you think you should drink fruit juice? And most people would go no, I've heard that's not a good idea. Right? The hospital hasn't heard why they didn't get to them. And then you realize the hospital's a private company. It's not good. I mean, it's they're trying to make money too and etc.

Jennifer Smith, CDE 23:48
Correct? Absolutely. But you know, I've, I've, I've had parents who've come to me and said, Well, you know, as we talked about this, like the process components and how to make things a little bit, you know, better overall. And, you know, I've heard it a couple of times will my child likes pancakes, and this is always happening. Okay, there's some alternatives. These are some ideas to still keep that in the picture. But they ate pancakes in the hospital. That's what they serve them after they were diagnosed now.

Scott Benner 24:17
If you're a physician, maybe a good place to start is to go back to your the board of directors or however you report things. Okay, look, I don't know how you expect me to put these people on a good path. If this is the garbage we're sending into their room as we're diagnosing them. You know, how am I supposed to stand there and go real food reasonable portions while they're eating pretend food? So under a dome that makes everything moist? Has anyone been often in the hospital ever? Like, oh, I don't want I'm hungry, but you handled it. I don't want this now. I know when

Jennifer Smith, CDE 24:50
we they actually looked at us like we had foreheads when we arrived for our first child to be born.

Scott Benner 24:57
There's no way Jenny didn't bring food whether you He weighed

Jennifer Smith, CDE 25:01
like three bags of groceries. And they looked at it like they looked at us, like, so weird, like these people who are these people? Where did they come from? What are they? Are they going to work in the food service and make their own?

Scott Benner 25:15
Ladies got a hot plate? I I remember asking you one time, Jenny, what do you do on road trips? And you were like, I bring food and I was like, oh, okay, I'm like, you don't stop at a gas station ever and get a Milky Way bar? And she was like, No. I don't do that. So, listen, I am not the picture of health, right? Obviously, I've been on a lifelong, a bad path. Somebody put me on and my bodies crave things and move me in directions, etc. But I'm doing much better now with literally just because of a GLP one medication. There's no other reason I wanted to. And I, I searched it out and everything. But even now, I found myself Jenny and I spoke together recently at an event in Texas. And I was at the airport. And I was hungry. And I stood at that thing at that airport. And I thought there's no food here. That's what I kept thinking that I can't even get a drink. If it's not a bottle of water. Like there's nothing here for me to eat. I grabbed a banana and I left. I was like, That is the only real food I see sitting here. Yeah, that was it in a giant kiosk where people were just like, grabbing things and going in different directions and everything or, and so I eat reasonably clean now. Right? And not like it's not the way you think of it. Like I'm not like, I don't know, it's not like a bro science guy or something like that. I'm not like drinking amino acids and powders and stuff. Like I've just, I just I stick to things that I can recognize. The other night someone said, let's get Chinese food. I couldn't even eat that much of it. Because I'm on a medication that tells my stomach it's full. Right? Listen between me and you. It was maybe 45 minutes after I ate the Chinese food where I was like, Hey, I gotta Excuse me. I gotta go. Excuse me a second. Because my body was like, this ain't right. And that was it. I was and I don't even want to say second. I don't want to be dainty. Like, I just get rid of this right now. It fascinating, like, absolutely fascinating. So no nutrition. I was eating for sport when I had that Chinese food. Basically. Yeah, absolutely. Okay, yeah. But again, do not tell newly diagnosed, they can eat whatever they want and just Bolus for it. Nobody should eat whatever they want. Not in today's world of crappy food. And I made a note to this. I said it's the right message with the wrong wording. Because I do understand telling people, listen, you can eat whatever you want. You just have to cover it with insulin, not only do I understand that, I've made a podcast about it. Correct? Right. I want people to understand how to use insulin. But that's from a heavier perspective than you think. Doctors say it. I'm guessing because they want you to use your insulin, I'm guessing they know you're not going to eat well to begin with. That's probably their expectation. And they probably don't want you to feel limited. I'm guessing those are about the three reasons. The reason I say it is because I think if you know how to use insulin, for whatever you're eating, that means you'll know how to use it for other things as well. And hopefully one day, you'll figure out the rest of it. But in case you don't, I want you to be able to cover Hamburger Helper because I don't want you to have poor nutrition and poor diabetes management. Right. That's where I'm Yeah,

Jennifer Smith, CDE 28:30
no, that's that's a good, very good clarification. I think from the doctor perspective of a new diagnosis, it's one of the thing it's sort of a feel good statement to hate it. It's yeah, they don't, you know, they don't want so much to change, because they know so much is going to change the fact that you don't have to change what you eat. Just make sure you take this medicine along with what you choose to eat. That's the blanket statement is you can eat whatever you want. Well, that's 100% True, as you're saying, but your level is learn to use insulin. So in the case of choosing something like Chinese food, or whatever, that you can actually manage the blood sugar, which has the impact on overall health.

Scott Benner 29:14
Right to my expectation, just to be very clear, is that I don't think most people are going to eat well. That's I hope they do. I really do. I don't think they're going to and in that case, I don't want them to be again, like poorly fueled and poorly like managing their type one though, because they have now they have two different problems instead of one different problem. And now we're just spiraling out of life. By the way. I don't see any difference between this bit of conversation here about a physician saying oh, don't worry, you can eat whatever you want. I don't see any difference between that statement and oh, I've heard there's going to be a cure. I think those are both meant very passionately like and compassionately Excuse me. Yes. But again, you you run the risk of starting somebody on the wrong path, which is don't worry, eat whatever you want. Well, people do not understand nutrition to begin with. They're like, oh, let's go, you know. And the same thing when you tell somebody like, oh, you know, I heard there's a cure these algorithms work so great, now you barely have to do anything. What people hear is I don't really have to pay attention to my diabetes. And that's the unintended message. So find a way to talk to them about food, without scaring them about it, putting them on the right path, without giving them a hall pass to eat whatever they want. Like, you got to use better words. It's all communication, really. So yeah,

Jennifer Smith, CDE 30:34
I always think, you know, at diagnosis, this, again, is, especially for kids and teens. I think a dietitian should be part of that. Team education, and in many cases it is. But I think what's left out still is the idea of, not only should it possibly be better food than maybe you're already eating, but also just how much does your kid need? Because if they go home with that, even if they are eating, you know, Doritos, or whatever it is, at least they know that the bag isn't the portion.

Scott Benner 31:12
Right? That opened it, and we're gone. And that was it. Yeah, no, people don't listen, diabetes taught that to my daughter. She's like, there's 15 in here. I went No 15 to the serving, how many servings are in it? And she's like, Oh, yep, yeah, but she was young. But she got to figure it out that way. Again, another benefit of I can't believe I'm saying this is another benefit of her getting type one diabetes art is actually a fairly healthy like, fit person. So let's go over this last little bit of feedback. And then I'm going to say something banned. And and then I want to finish with you. This person says, please just find out how people eat before you start their meal plan. Our doctor had our son snacking five to six times a day, which was not just unsustainable, but we're not snackers to begin with. So this is not a thing we used to do. They were literally telling them like, eat more. And they're like, we don't do that. She also says he or she says that we're also not junk food people. And so like snacking, see what she's saying is you made a snack, we went and got bad food to snack with because he can't cook a meal six times a day, which is the way we usually eat. And she also said, please stop telling people protein is free food and doesn't need insulin. Yeah, because it's not. I'm gonna say this, even though there are probably some incredibly low carb people who think that I am pushing insulin on people because I say I think you should know how to use insulin. I am not. And I so I'm going to just ask Jenny here to dispel the the idea that you need carbohydrates to grow. Because fell it? Well, I think you need some carbohydrates, but from the right foods. And I think that some people hear that and think, oh, Doritos counts, you know what I mean? It's, it's another one of those mixed muddled messages. Correct?

Jennifer Smith, CDE 32:55
Absolutely. Carbohydrates contain, especially the type of carbohydrates that should be being eaten, the vegetables and the fruits that should be being eaten in terms of carbohydrate content, they contain an enormous amount of antioxidants. The colors of the rainbow, are a phenomenal piece of the fruits and vegetables. And if you're aiming for lower carb, then you're aiming for the lower glycemic ones, you're not being carb free, or just being aware again, of how much of it are you eating, and you're eating those foods, not from an energy necessity standpoint, because the body can convert in a low carb environment, it can convert to using fat. And that's what many low carbers are doing. But you have to also talk with somebody who can really guide you in the right way for that, because you can really do it wrong, right?

Scott Benner 33:48
And then not be getting a nutrition that way. Correct? Absolutely. So then when doctors say you need carbs to grow, their concern is that if you do keto wrong, you're not going to have the nutrition you need.

Jennifer Smith, CDE 34:01
That would be my expectation, or that they really are just thinking that because the because the human body works very quickly and easily off of carbohydrate, but it's a quick burn, it goes in it goes out it goes in it goes out. And so if you have a really, really high carb intake above and beyond what you really honestly need, you're going to be on a constant roller coaster of hunger. And your brain is going to work off of carb and it's going to want want want want, right? Whereas if you moderate that, again, understanding what are your nutrition needs, what are your caloric needs, then your body can actually do very well. But you have to have balance, you have to know how to do that balance the right way.

Scott Benner 34:45
I'm afraid that I don't know how to do it well, but I also wouldn't lie and I'd say there are days that I fairly low carb were all like I mean, I've said on here a million times like I'll I'll smoke a couple steaks and slice them up and pick at them for days, you know, or something or something like that. But I'll still Fruit during the day are you know, I've come to starting to eat like coconut milk, yogurts and things like that. And I also supplement pretty reasonably like I'm covering my supplemental needs if I don't think I'm getting them through food. Again, that's an expense. It's not a thing people know about. I think some people think vitamins are no bullsh. I think some people think they're everything. I don't think there either. You know what I mean, you still got to eat. You can't just take a vitamin. That would be the Jetsons, that'd be the opening to the Jetsons, which is another reference, no one will know. Yes. Jenny might be,

Speaker 1 35:32
oh my gosh, I love the Jetsons. They were they were great. I used to be

Scott Benner 35:36
jealous because they'd get that pill that would come out of the machine. And then they'd cut it in half with their knife and eat it and then go about their day. And I thought, Oh, I wish eating was like that. Right.

Jennifer Smith, CDE 35:46
You know, what I always find funny about the Jetsons is that they had down what we do. All over, especially in the past five years, we've really come into zoom, and all of these online, like webcasts, and all of these, that was the Jetsons were like, they were well ahead in terms of our cartoon.

Scott Benner 36:06
It is funny. I did a thing for World diabetes Day where I spoke to 100 people for two hours, like from sitting right here. Yeah, just everybody clicked on a thing. And we were all there together and had this nice conversation. That's awesome. Yeah, it's very cool. But

Unknown Speaker 36:19
But yes, supplements were typing. Yeah,

Scott Benner 36:21
yeah. So I mean, and that's, that's another part of this, that that I think people need to be aware of, especially with diabetes. There are supplements you you might need, like you know, your pancreas is part of your digestive process. Some of you might need like a digestive enzyme or something to help that along. I don't think it's something we're ready to talk about right now. But Jenny and I are looking into another supplement to try to like take to see how it goes. And by the way, I've ordered them. Oh, there's that piece of it. So just even just a good multivitamin, but even people go wrong there. They take their multivitamins as gummies or like, you know, it's just see Jenny's face, she would never take a gummy vitamin gummies are just like you brought her own food or birth.

Jennifer Smith, CDE 37:07
Know that gummy vitamins are I mean, unfortunately, even from what looks like it's a good company. And you can find online very easily multiple reports about gummy vitamins not being consistent in content of the micronutrients and macro and things that they're that they

Scott Benner 37:24
actually do people right. So in the gummy

Jennifer Smith, CDE 37:28
I mean, even even that, you know, if you're gonna if you're gonna take a multivitamin, also look at where, where those vitamin sources are coming from? Are they actually quality? Are they synthetic? Do they have some type of spray applied to the homeless, they're supposed to be absorbed, the better. You know, I

Scott Benner 37:47
think I was listening to something recently where someone said that one of the like, chewable vitamins has like something in it that at a certain parts per million would be deadly or something like that. And I was like, What the hell, they're more expensive, okay, but buying something cheaper, that's a waste of your time is a bigger waste of money. So I'll say that I stick to pure encapsulations or Thorne,

Unknown Speaker 38:08
those are those are great brands.

Scott Benner 38:10
Those are the two brands I stick to. So for things like vitamin D, zinc, I take an iron supplement from them, I mix it with a vitamin C from them, that kind of thing. multivitamin like that, that sort of stuff. So if you don't think you're getting it, I drink athletic greens, you can probably try to find a green drink that would you know, like help you with these things. But if your foods not giving it to you, I know nobody thinks of it this way. But if I found a random person around all day, I'm gonna guess that seven out of the 10 things they put in their mouth are not valuable to them. Nutritionally. I just think that I don't know how you could look at that stuff at that airport or in the grocery store and not come to the conclusion. Like there's a potato chip aisle. That is usually also the candy aisle. Literally nothing in there is helping your body stay alive, right, the soda aisle.

Jennifer Smith, CDE 39:04
If we're if we're talking about carbohydrates, to get rid of the majority of them live in the aisles of your grocery store. Yeah, they do. 100%

Scott Benner 39:15
and they're fun. I'm not gonna lie to you better than licking whatever that is off a Dorito. I don't know what it is. It's amazing. Jenny would know about it, but it's fantastic. And we all know it. Those are those things there. I mean, if you're going to eat those things, try to find a better way. I'm not saying like you should be sitting around growing carrots in your backyard. I know that's probably not reasonable for people. But I can tell you this, I can't eat potato chips. They make me nauseous because I don't really I don't, I don't consume oil. So like I only use either cold pressed olive oil, grass fed butter or coconut oil every once in a while. Those are the only three things that like I'll cook with or use. So if I have potato chips just out of a bag, I'll get nauseous from it. But if I were to make my own potato chips which is actually a thing I know how to do. I can, I'm okay. And not only that they hid Arden's blood sugar differently than a potato chip out of a bag. Yeah,

Jennifer Smith, CDE 40:07
you'll you'll notice and a lot of it, you know, in terms of oils, I think what you're probably noticing digestive Lee yourself. And what you probably noticed in Arden's response blood sugar wise, is that I mean, the seed oils are horrible. Yeah, you're talking about canola oil. If you're talking about any of the like sunflower seed oil in the safflower oil, and all of those that are, they are cheap. They're fillers. And they are what is used in the majority of process package, right? Let's call it snack food. And

Scott Benner 40:43
every restaurant is going to use it because it's cheaper. Yeah. So anytime you go to a restaurant, something's fried. It's basically machine lubricant, or whatever the hell that ends up being when you melted down. Listen, I think if you listen to the podcast long enough, you realize that I cut the oil thing out maybe three or four years ago. I've been making small adjustments to myself for years and actually making the podcast has helped me with that. Even watching my daughter's health and like, I think we should get rid of this or that like that kind of thing. But I was a person even as a child. If you took me out for pizza, I'd be sick to my stomach. And pee. And I know if you say that out loud, people would say, oh, that's celiac, right? Oh, that sounds like see, like, I do not have celiac. I don't have I don't have a gluten sensitivity. I've been tested. They've sucked things in both sides of me to look around. I don't have those things. Okay. But as a child, take me out to a pizza joint. You need to get me to a bathroom in about 90 minutes. I couldn't live like that. And I had a lot of moments in my life where I was like, Oh, I go to the bathroom. Like, like in an emergency situation. I have not gone to the restroom out of an emergent situation in years. years. I have never heard that Chinese food the other night notwithstanding. I have not. And even then I wasn't like, oh dear Lord, I need a bush. Like I was just like, oh, I don't feel good, you know. But yeah, that doesn't happen to me anymore. And so it's nothing wrong with my body. It was something wrong with what I was putting in it. Like my body was literally saying to me, this has to get out of here. Right? And doesn't work. Yeah, this doesn't work. And you we need it to go now. But

Jennifer Smith, CDE 42:21
you can make your own pizza at home. Can you? Oh yeah, I

Scott Benner 42:24
can eat forever. It doesn't matter. I make my own pizza, I use little double zero flour I haven't brought in from Italy or wherever they make that I don't know you overpay for it a little bit. You buy actual mozzarella cheese, not something that's wrapped in plastic, it looks like it was wrapped up nine years ago. And you open up an organic tomato paste and you're on your way. Like it's not. It's just not hard. And it doesn't even cost anything extra. Like I know people are like, Oh, it's more expensive. Yeah, I spent 10 extra dollars on the flour, and four extra dollars on the pound of cheese. And in return did not have diarrhea seems worth it to me. Like so like, you know, like, on and on didn't feel sick and nauseous and not good for days sometimes afterwards. And I know now, this it feels like it's devolving into like, seriously like something you'd hear online. And it's not it's just my experience. I've gone through it. And I've seen it. I think you're talking to Jenny who didn't go through it and doesn't experience this these things. So I just,

Jennifer Smith, CDE 43:20
I mean, I I think the other, you know, piece to think about too is when I think about kids. And I think about what goes into their body, they've got a lot of growing to do, right. And you can facilitate healthy growing, and healthy movement through all the periods and stages of their life that they're going to get to. And a lot of times, I think the easiness of a lot of the process stuff with the busy life that we have, and the fact that you're trying to just have them feel like a kid like normal, right? But they've already adapted to either getting injections, having a CGM put on their body having a pump put on their body. If you tell them they can't have Doritos anymore, they're going to adapt. Right? They may be angry for you know at you for an entire week. But you know what? You're the parent.

Scott Benner 44:13
Also just you get what you expect. Honestly, what I mean by that is Jenny has two little boys. They're like real classic little boys are big energy, like, you know, no need to look crazy. Like, right, they got the whole thing going on. Yeah, but I bet you they've never had a Dorito

Jennifer Smith, CDE 44:30
unless they had them at friend's house that I did not know about I have never in I can't say that. I've never had a Dorito I mean, obviously in my childhood teen years, I know that I've had Doritos, but And I'm sorry that I'm picking on Doritos. Like there's so many other like, I

Scott Benner 44:45
think what we're saying is that is like that every day when you pack your lunch is there a grab bag of chips in it? And for a lot of people there are and for you that's not a thing. Like I'm not saying you've never had a potato chip. I'm certainly not saying that. But I'm saying is your kids eat pretty clean. lifestyles and they're nice little well adjusted children. They're not like, like, I think it's possible people could like be like picturing. You know, like a homeschooled child that doesn't look like they've seen the sun. You know what I mean? Like, Oh,

Jennifer Smith, CDE 45:14
not at all. It's really funny. As this year, my fifth grader came home, and he's like, Mom, this is so funny. And I was like, Okay, what? I made homemade pizza on Saturday evening, it's our movie and pizza night. And then they have leftover pizza for Monday's lunch at school, right? Because there's usually several slices left. And I mean, their pizza is mostly like veggie toppings and I will make the crust and whatever. But there's a lot of greens on there pizza. I fifth graders, like my friends keep telling me that I eat green pizza. Like it looks like I've got alien pizza. And I was like, are you okay with that? He's like, Yeah, aliens are cool. I can do to go

Scott Benner 45:55
Yeah, well, that's a great, that's a great example of like, he's not being prepped, like, you said something earlier. I don't disagree with you, you want to be normal, you want to live your life like everyone else. But that in the end is a trade off. At some point, you're deciding to make a trade off. And so today, I've had a coconut milk yogurt, I've eaten two eggs. And I've had a bowl of chicken soup. This is what I've had to write. But I guarantee you when I go downstairs, I'm gonna have a couple of gummy bears, like saw them when I was coming up here. And I was like, I'm definitely having a couple of gummy bears later. Like, I'm not some person who's just like, you know, crazy lover side of it. I'm just saying there's, there's obvious things you can avoid that will really help you. And, you know, too many calories, too much processed oil. They are easy things to eliminate. Like it's a weird thing when you first go through your house. And like for us it was like, well, we make our own popcorn. What are we going to do? And it was always with canola oil. And so I said, Well, we're not gonna use canola oil anymore. We can make popcorn with olive oil tastes weird. And so like, my whole family was like, What are we like? There's just like a bone of contention. I spent six months buying different oils and making popcorn until one day I was like, I've got the answer. It's coconut oil. You can make popcorn. And it tastes good. Doesn't it? Like popcorn? Yes, I figured it out. Was fun. It was not fun. Did I throw away a lot of oil? I might have. Okay, but I figured it out. And I think you I think people could figure it out. Even I swear to you, this little girl came on. She has been on before her episodes called bugs in your belly. Oh came on first. Because she's talking about like, gut biome. She was like this, like 12 year old girl was like, Oh, my gut biome like, Oh my God, that's awesome. She's talking about all of it and everything I've had her back on since then. And she just turned me on to like organic grass fed butter. I think I spent $3 more on butter now than I used to. And I want to tell you, it's made a big difference. And I don't know another way to tell you like it's been it's made a difference in my life. So

Jennifer Smith, CDE 48:04
you don't eat. So you say you know, it's $3 more, but you're not eating stick after stick every day. The cost of it actually, it evens out to your favor. Even though the cost is higher, you're doing something better, health wise, and you're not eating so much of it that that $3 really makes that much of a difference.

Scott Benner 48:26
I could make the argument that I am saving in toilet paper what I'm spending in butter and I am not trying to be funny. So there you go, you're doing a good thing for yourself. And at the end. Listen if it's three extra dollars a week for butter, let's just say that okay, let's call it 10 Let's call it $150 A year for more butter 10 years from now when I'm not dying, all think that was worth it. And I think that's just sometimes the way you got to think about this stuff. Also, I know people can't afford everything and but there's still ways to do little things.

Jennifer Smith, CDE 49:01
Yeah, I say pick, pick your battles, right? Pick your things that if you look at where what are the 80% of foods that you eat over and over and over again? Where can you start to either decrease processed or decrease the brand this brand is better this brand has less ingredients where can you start to pick some things to introduce better you know everybody I mean things are expensive today and the price of eggs when I look at that man really, I honestly we've considered like getting chickens because

Scott Benner 49:41
they're expensive. It's weird to me you don't have chickens, but go ahead.

Jennifer Smith, CDE 49:44
We can have them and we've thought about it for a number of years that already but you know there is there is a trade off the quality of nutrients that go into something that has yes a higher price but again when You portion things out, you may actually be doing better in many, in many ways by spending a little bit more. Again, not on everything. Maybe you pick and choose. Yeah.

Scott Benner 50:10
So that's a great place to stop doctors, please put people on these paths. And I just wrote down that you and I should do a small series about how to remove processed foods from your life. Oh, I think that's a good idea. So hey, all right. I know you have to go. So I'll talk to you. Awesome. Thanks.

If you're enjoying the grant, if you're enjoying the Grand Rounds series, please share it with someone else who you think might also enjoy it. As always, thanks to Jenny for coming on the show. And I'd like to thank ag one for sponsoring this episode of The Juicebox Podcast and remind you that with your first order, you're gonna get a free welcome kit. Five free travel packs in a year supply of vitamin D. That's at AG one.com/juice box. Arden has been getting her diabetes supplies from us med for three years. You can as well us med.com/juice box or call 888721151 for the episode you just heard was professionally edited by wrong way recording. Wrong way recording.com. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community. Check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#1111 RJs Mom

Jessica is 32, an engineer in the military and the mother of a 7 year old boy named RJ.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to episode 1111 of the Juicebox Podcast.

On today's episode I'll be speaking with Jessica and engineer in the military and a mother of a seven year old boy named RJ who has type one diabetes. He was diagnosed at five years old. We talked about a number of different things today, including Omnipod, five Dexcom, libre three, and some of the history of type one diabetes in Jessica's family. There's also some conversation about hypothyroidism. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones, it doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. Please don't forget 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.

This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one.org. And find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that check them out at touched by type one.org. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met.

Jessica 2:21
I am Jessica. I am a mother of a son with type one diabetes, his name is RJ and me and his dad, my husband we do as much as we can to keep him happy while also keeping him you know safe while he's at home and at school and managing his diabetes. And, you know, just trying to make sure he has the most normal life that a kid his age should have. It's a good plan.

Scott Benner 2:52
How old is RJ?

Jessica 2:53
He is seven? Seven?

Scott Benner 2:54
How old was he when he was diagnosed?

Jessica 2:56
He was five years old.

Scott Benner 2:58
Okay. Do you or your husband or anybody in your family have type one diabetes?

Jessica 3:05
Yes. On my side actually. I have a I believe it's a second cousin. He had type one diabetes. He did not know he had it. And he actually he was he's a professional NFL player. He did not know he had it. He actually passed away due to decay. So we found this out kind of after the fact after our son was diagnosed.

Scott Benner 3:32
How long ago was that?

Jessica 3:35
That the second cousin had it? Yeah, that passed away. That was many years ago, possibly. I want to say eight or nine years ago.

Scott Benner 3:47
And he died as an adult I imagine. Yes. As an adult. Yes. So So diagnosed, and then not. Not dying. Sorry. Yeah.

Jessica 4:02
Yes. He was not diagnosed. And he ended up passing away. Wow. Due to decay. Yes. That's

Scott Benner 4:11
crazy. Oh my gosh, yes. All right. Okay, let's see. But that's not something that you were thinking about when you were having kids.

Jessica 4:23
Not at all I knew and in this happened before my son was even born and so I didn't even kind of know at the time that he had even passed away because of that reason. I knew that my family had a history of type two diabetes and pre diabetes but not type one. So at that when my son was diagnosed, I didn't even kind of know the difference between the two.

Scott Benner 4:51
So okay, okay. So talk about our J's onset. What did you notice first, and how did you figure out that he had type one So

Jessica 5:00
his onset happened around COVID. We had just, I'm in the military, so we had just was called PCs, we had just had a change of duty station from California to Tucson, Arizona. And, you know, we're wrapped up in that that transition, you know, he's in daycare. At the time, he was a young, five year old, he wasn't old enough to start school yet, due to how they, the school we had moved to the district moved to how they do the age difference, or whatever. So, um, he was, obviously during COVID, you're looking out for symptoms of COVID, during that timeframe. So he, you know, he was tired and exhausted a lot leading up to the diagnosis to him being in DKA. And so we thought that it was because of the temperatures that we were dealing with in Tucson, we were we had just came from the Bay Area in California. So very cool weather, to the complete opposite of triple digit heat and things like that. So we kind of thought that he was just really having a tough time adjusting to the temperatures to the new weather, and things like that. But yeah, he was, you know, doing the classic wetting the bed at the time. And, again, like that was, I literally, he had worked her bed, and he came in our room, in the middle of the night. And I said to my husband, he might have diabetes. I was like, half asleep at the time. And, you know, if days go on, and you know, symptoms are still happening to where his preschool teacher calls us and says, Hey, RJ, he has not been eating today. He slept through recess, which is not like him whatsoever. And I knew that too. So it was really his day, his his preschool teacher had only been with him for a few months that really made, you know, just realize like something is really wrong.

Scott Benner 7:16
Just to go overnight, that night, when he came to you, what made you say he might have diabetes? Like what? What triggered that in your mind?

Jessica 7:23
I knew from I cannot remember where, and I might have just googled it too. But it was just a distant memory of a sea of hearing extreme thirst. And, you know, Bedwetting, and exhaustion, I knew that that was something and I just hit diabetes and you know, kind of rolled back over and with asleep, you know, that's, and I guess it Yeah,

Scott Benner 7:54
well, that's really something though they did it occur to you like that. Exactly. So when the when the teacher reaches out to you, does that kind of put it all back together for you? Again, you'd like to know, somebody else pointing it out and saying it?

Jessica 8:07
Not? Not at the time, because you like I said it was during COVID? And I'm like, if it's not COVID? What can it be? It's like everyone's main focus, right? The time was like, he's like, he's not coughing, none of the classic symptoms of COVID. So I took him I was able to quickly get him in to see his pediatrician. And I'm thinking, okay, like, they have to know something. And so when they were, you know, checking his vitals and they did the they checked his vitals and they were doing the, you know, the flashlight, the light in the eyes, you know, movement events, when there's one one of the airmen that you that he quickly leaves and goes to get hit the actual pediatrician. And so she does some, you know, checking and she's like, You guys need to go straight to the to urgent care to the emergency room. So I'm like, okay, and that's when I'm like, okay, something's got to be like really grown. Right? So, like I said, we're new to the area. I'm trying to figure out like friends, I had that point, I was having to carry him because he just was not. He was so leak, just was not able to walk, like very quickly or even like much at all.

Scott Benner 9:29
So you get that to you. I'm sorry, you get him to the hospital, and he's in DKA. I imagined I used to hate ordering my daughter's diabetes supplies, and never had a good experience. And it was frustrating, but it hasn't been that way for a while, actually for about three years now. Because that's how long we've been using us med us med.com/juice box or call 888-721-1514 With Us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omni pod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996. They always provide 90 days worth of supplies and fast and free shipping. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and Dexcom g7. They accept Medicare nationwide and over 800 private insurers find out why us med has an A plus rating with the Better Business Bureau at us med.com/juice box or just call them at 888-721-1514 get started right now. And you'll be getting your supplies the same way we do. What do they do for him?

Jessica 11:01
So we at first we were at a an ER and er that wasn't even, like part of a hospital. Like I said, I just was like, giving to the quickest because this one, and so they did a fingerstick after I was telling them the symptoms. And I guess the one meter they had it wasn't even giving a number. It was like giving some error or high or something. And so that's when they started doing some blood work. And that's when the doctor came in and was like We suspect Yes, type one diabetes. And they were like we need to get him you know, to a pediatric hospital. I see you as soon as possible. Are

Scott Benner 11:45
you frightened at that point? Do you recollect this family member? Yeah, by the way?

Jessica 11:50
No, not even not even close? No, I Yes, I'm frightened. And I'm just thinking that this could be tied to the Type Two diabetes that's in our family. I see. So my grandmother had issues with, you know, diabetes, and I think an uncle did and stuff like that. So that's kind of still in the back of my mind.

Scott Benner 12:16
You and your husband are together at that moment. The three of you are at the hospital.

Jessica 12:21
Yes, yeah. Yep. Now, do

Scott Benner 12:23
they put him in an ambulance? Or how did they get them to the next place? Yes.

Jessica 12:27
Yes. They put him in an ambulance in my in got him to the ICU, which was about about 10 minutes away. Did you ride with him? And they waited? Yes, yes. rode with him. They kind of waited till they couldn't do much there. But they still were they want it to give him some fluids prior to, you know, him leaving, so that they can make the trip.

Scott Benner 12:52
That's amazing. Well, obviously, he's okay now, which is terrific. How long? How long was he in the hospital for?

Jessica 13:00
I think we're there for about three or four days,

Scott Benner 13:03
that seems to be about the number anymore. It's yeah, what I'm hearing from people. What do you leave with as far as management ideas go.

Jessica 13:12
So if a hospital that when about, maybe a day, after, you know, once they got the confirmed diagnosis and everything, that's when they had a pediatric like nurse endocrinologist and an educator that, you know, came in, you know, and broke everything down to us and gave us some training, helping us understand what's going on why it happened, or why it could have happened, or, you know, just understanding what diabetes type one diabetes was. So, it really sucked because still, this is still I guess it's still COVID and so only one person is really allowed with the patient and that has to be paired essentially. So of course, I'm the amid Mama Bear mode, still some tilt my husband go home, I will stay. And so pretty much I'm like completely sleep deprived, because I'm not I haven't slept, you know, machines and beeping is keeping us up and things like that. So I was trying to process it as much as I could. But I was I was really getting so frustrated because I could not process anything just because my brain was was not working at all so

Scott Benner 14:34
well. Yeah, I mean, it's the same thing right? It feels like it feels like you know if anybody's ever been in a car accident before you you again you're okay you get out and people start talking to you and you just you don't process anything at all. It feels very similar to that. Exactly. Yeah. So like like having like a like just a loud band go off next to you and then somebody starts asking you algebra you know, like I don't Wow. Oh my gosh. So when you leave? Is it injections? They give you a pen, they give you a needles? Are they talking about pumps? They

Jessica 15:10
told us eventually, you know, we would, you know, hopefully be able to get on a pump. But um, yeah, we were given, you know, the the meters, the insulin pins and things like that they were able to give that to us from the hospital because our insurance was not going to be able to kick in to start paying for it. And I guess they kind of anticipated that. So, yeah, the pins, the pin needles, things like that, you know, we're given him the Lantis and hemo. Og,

Scott Benner 15:45
how did he handle everything? I mean, he's young, but was it? Like, what was his reactions?

Jessica 15:51
He was confused. He was like, what's, what is going on? You know, like, What do you mean? I have to get, you know, all these of these finger pokes and, and the shots and things like that. And at that time, we weren't even prepared to answer that question. We couldn't even, you know, like, like, why is this happening? You know, like, so I mean, he handled it as well as any, you know, five year old at the time could so no, he handled it a lot better than what what I could have.

Scott Benner 16:27
Well, how long does it take you before you feel like you understand what you're doing? Even a little bit? Like, when's the first time you remember thinking like, oh, I might have this? Oh, wow. Maybe hasn't happened, which would be completely valid, by the way? Yeah.

Jessica 16:42
It's definitely not 100%. But it sucks, because I think I had to leave for work to go to a school that I was scheduled for, like, a few months later. So I mean, we were blessed to have even before this happened, my in laws were planning to they they lived in Alaska at the time, and so they were ready to leave, leave Alaska, and come down to the lower 48 to, you know, find somewhere else to move. So they actually came and lived with us. So while I was at the school, like they were helping my husband, you know, with everything. And so that's perfect. Yeah.

Scott Benner 17:28
Yeah, kind of easy transition to have more people raise

Jessica 17:32
more hands to help. Yes, exactly. But yeah, I feel like maybe a year or so I think once. I think what he was able to get on the pop, and on a CGM. I think some months after is when we were like, okay, you know, he's reacting this way to X, Y, and Z, or he's reacting this way to this food, and stuff like that. So it took a while, maybe about a month and like, it's like, you know, better that you learn something every day. Okay.

Scott Benner 18:10
Geez, it's like it nonstop. Like, that's interesting. That's different. I should probably remember that. Yeah. It's yeah, I just thought the the point you made earlier, Jessica, about people are telling you things at the hospital, but you can't process them. I don't know that we talked about that enough. That you're being given really important information. And you're not really filing it away in a way that you can access it

Jessica 18:36
not at all. Yeah, yeah. And, and I am like, I, I, I'm a numbers. I'm an engineer. Like, that's what I do for my job. And so it was really frustrating me, because I'm like, I know this is important. Yeah. And even if it's like, my job, like is no as important as getting even more frustrated, because I'm like, when I leave here, I feel like I'm not going to know what to do. Like, because I'm just not what you're saying is so important that I'm just not grasping it. So I was really frustrated with myself and things like that. So plus,

Scott Benner 19:16
if your mind works that way, then you want one plus two to equal three. And Exactly, yeah. And that's not happening either. So you're like, well, so there are rules. VDS is the complete opposite. There are rules, but the rules don't end the same way each time. That's hard. I've been taught this while under fire. So I'm not really remembering anything and then plus the longer you get away from diagnosis, the more you start to realize that even the things you were being told back then were very elementary to begin with. And you think you're you think you're missing out on like the Holy Girl, like they've told you the secret to everything and you forgot it. And exactly, yeah, the whole situation is Back password, I think somebody would say, yeah, yeah. And, and I do get that that's why they wanted like, bring you back and tell you more later, but just your something about good.

Jessica 20:15
And even the I think his claim I'm being no fault to them, but even his clinic that we ended up going with or to the hospital, even then we are coming back like I think maybe a few days later. And we're still sleep deprived. Because you know, you're doing the finger sticks in the middle of the night and you're cheating the lows, or you're even Bolus for the highs.

Scott Benner 20:44
And you're sad. And all the psychological stuff is magnified. You know, there's just there's so everybody feels guilty, like, I'm sure your husband's like, Oh, this is coming from my side of the family, you're thinking the same thing? You know? It's exactly it's a lot. The only real answer to all of this is time. That it's time and good information. That's it. It's the whole thing. Did you ever figure out or did you ever look, excuse me? Were there other autoimmune issues in either side of your family?

Jessica 21:17
My mom has an immune disease. And then for from me and her we are, it's not the typical art. It's just sickle cell trait for me and my mom and I'm, I get an email, she's anemic and things like that. That's really the only only thing I can you know, how

Scott Benner 21:39
do you think, Jessica, how do you handle your anemia with oral or do you get infusions. So

Jessica 21:45
it's not bad, it only gets bad during, and I can't even pinpoint it. But I can kind of understand just by based off of symptoms to where, and it's not bad. It only was bad when I was pregnant with my son. So and that's when I had to, you know, take the oral pills, but usually, you know, I can quickly, you know, alleviate symptoms and stuff by you know, eating more red meat and things like that. There's only been like a couple of times where I was taking the iron pills.

Scott Benner 22:19
Okay, that's great. I actually I get low. I get like any, like, low iron symptoms, and wow, my ferritin gets low, and it almost like shuts me off eventually. So Oh, wow. Yeah, that's crazy. Arden takes actually Arden my son, I think everybody in the house is taking some sort of an iron supplement, like a couple times. Just to try to stay ahead. Yeah,

Jessica 22:43
exactly.

Scott Benner 22:45
How about for your husband? Anything for him? His side of the family? No. Okay.

Jessica 22:49
Not that not that I can think of now.

Scott Benner 22:52
Were you planning on having more kids? And are you still

Jessica 22:56
it the time beforehand? We were considering it. But now we're not. And it's not fully because of diabetes. That that type limit my son has is, is I think that I've usually when the diagnose happened, diagnosis happened, you know, you, we definitely put that those types of talks on pause because they're like, oh, we need to figure this out first and figure out our new life. And then you know, time passes and time passes or, you know, then we're like, you know, I think I think we're fine. We've always wanted to adopt a child. So and that one that's close in age. So we took that as a sign like, hey, let's make sure we don't lose sight of, of that dream that we had.

Scott Benner 23:46
So that's a love. Yeah, hopefully lovely. I do. Yeah,

Jessica 23:49
yeah. And bonus points. If they're type one. I

Scott Benner 23:52
know what you're doing, right? Yeah, I'm adopted. Exactly. Yeah, Jessica, I'm adopted. So wow, somebody saved my life 51 years ago. So yeah, it's a really cool thing to do. That's awesome. I guess I want to ask you now like because the note you sent, like, at what point in your management style because you're using Omnipod? Five now? Is that right?

Jessica 24:14
Yes, we're using Omni pod five and the libre three. Okay.

Scott Benner 24:19
Oh, wait. You you can't use on the pod five with libre three. So well.

Jessica 24:24
Yeah. No, we're not using it with it. But we're Yeah, we're in manual mode with the five we were using Dexcom. But we had some several issues with it. So we had to go. Oh, I gotta go into manual mode for the five in the CGM is liberi.

Scott Benner 24:40
I see. So do you think you'll go back to Dexcom or wasn't working for you? Well,

Jessica 24:46
um, we This has actually been our second flip flops which I don't know. I don't know if we'll go back. Because when when the sensors were working for us, it was only part five was great. But you know, we were, you know, barely making it to like four to five days with the sensors. And it wasn't an issue with them falling off. It was just them constantly saying he was low. So it was it was shutting off his. His Yeah, exactly.

Scott Benner 25:18
I wonder if now this is looking forward. So just for people listening who might not understand Dexcom G six at the moment is the only CGM that works with on the pod five. You can put on the FOD five into manual mode and just run it like a regular on the pod dash you would. So that's what you're doing right now because you have the script from pod five. Right? I wonder if I do wonder if when Dexcom G seven pairs with on the pod five in the future, which I assume it will sooner than later. I wonder if that's not the time to try. Because if liberi is working for you, but the G six was and I wonder if the G seven would because of the different insertion angle and other things possible?

Jessica 26:00
Yeah, yeah, we would definitely, we would definitely try it right now. We're, we're paying out of pocket for the Libras. Because they're, you know, kind of very expensive right now. And so we're just waiting for hopefully, the g7 g7 being integrated. And then, you know, we'll just look at it again, be able to once that happens quickly switch this script over to that.

Scott Benner 26:27
So you have a unique perspective, though, Jessica, because you have like you've done it manually with shots. And then after a while you were doing injections. Did you get a CGM first?

Jessica 26:38
No, no, we're still I think we got them all around the same time. So we got Dexcom as well.

Scott Benner 26:43
So what's the difference between manually handling things with injections, an automated system like Omnipod, five, and a pump that doesn't have automation, like what of your experience has been the differences and maybe the pluses and minuses. So

Jessica 26:59
obviously, a new E five or six year old is not going to be okay with the constant shots. So that helped out a lot being on the pump, for my son, and then him going back to his preschool, it helped as well. Because the you know, the paraprofessional was able to just quickly, you know, look at the Dexcom numbers and then look at the pump and, you know, just quickly push some buttons and, and, you know, give them insulin. So it's so funny, she would come outside while they were on the park and, you know, check check to get in range and everything and his friends would stop playing and they all go over it over the ParaPRO they were like Artie, you gotta get your blood check. So they would and then, you know, they made sure he wasn't left alone, like then it that they all stopped playing so that he could make sure he was good to go. So and then I think now, obviously, like I said, the integration with the CGM was, was amazing, when we left the that integration and went back to the manual mode. I had to I listened to I think two of your podcasts about essentially figuring out what that Basal rate should be and how to make adjustments. So I did that all on my own, didn't work with his endocrinologist with on that, not because they weren't capable. It was just I knew I was gonna be able to do it much quicker. And like I said, I'm a numbers person, I love looking at data. And I was just able to just look at those graphs and understand based off of, you know, what you were saying and just some other information that I knew was I was able to make those adjustments. So

Scott Benner 29:09
you got like his Basal said is insulin to carb ratio is his sensitivity all together just through the podcast and understanding it on your own. Yeah.

Jessica 29:18
Yeah. So I kept I didn't really change too much with the sensitivity. But I think the and I think I might have changed the car, but it was mostly mostly that that Basal rate, and kind of understanding, oh, there's different times of day based off of what he's doing that it needs to be, you know, either increased or throttled back and then taking it day by day, like, Okay, this is how he reacted, you know, to this time of day because he's having lunch at this time. So, yeah, it's been interesting,

Scott Benner 29:56
ya know, it's it. Listen, the truth is, is that digging in like that It is the way you get that bigger, broader understanding. And in the future things are gonna happen. And you're, you're gonna see like, you'll just, you'll just shift with it. You'd be like, Oh, I see this. Like, you know, there's I think this morning, even Arden and I got up this morning. She's home from college right now. It's her break. Oh, yeah. So it's cool. She's here. And but like, it was time, like, we went to the doctor's, you know, she went to the doctor last week. And it's time for her, like blood draw, you know, so I needed I needed one too. So we went together, we got up this morning fasting, and we went to get a blood draw. And I looked at her blood sugar. I was like, hey, like, you're, you know, the algorithms not having a lot of luck moving you off this like 130? And I said, Yeah, and I was, like, I said, let's just do an override. So we, she's using a loop, we just pushed her loop up to like, 150%. So basically it it increases the power of the of the algorithm and hurt her basil and stuff like that. And we'll do that. Yeah, until it's not until it doesn't need it anymore. But without all the knowledge that gets in your head. What ends up happening is you go I don't know, like, hi all day. I don't know, you know, you just you're like, oh, like bum Fuzzles. You know, you're like, I don't know what? Yeah, but so I love that. Yeah. You dove into it to understand that on your own. It's really cool. Yes, kind of outcomes is he having right now? What are your goals? And what are you hitting?

Jessica 31:27
Can you say the first part it kind of cut out? Oh,

Scott Benner 31:29
I'm so sorry. I was wondering how his outcomes are like, what are your ranges that you shoot for? A one sees that all that stuff? Yeah.

Jessica 31:37
Yeah. So he was consistently in a good range around the 6.0 6.5, a, one, C. And then like I said, when we were having the issues with the Dexcom and stuff, it went up to about 7.4. And so, obviously, I took that to heart. Hope we're now we're changing something. So I suddenly we went back, and we went into manual and everything. And so we're, I think we have that down to like 7.0 right now. So yeah, and so yeah. He his range. So we, we don't have it as tight. Because he any type of kind of activity, physical activity. He reacts very quickly as far as like, a lot of times his blood sugar dropping. And he was also running track for a while. So that was awesome. Just seeing him, you know, overcoming diabetes and kind of still being able to do like a physical activity is so taxing. So yeah, we we keep trying to have him around. Can you hold on one second? Okay. Do your thing. Okay, sorry.

Scott Benner 33:04
No, don't be sorry. Jessica's at work doing this? A lot of information here. But you know, I, I always throw this one up at the beginning. That's so cool. She's in a meeting. I bet. It's our turn to talk.

Jessica 33:22
Can you hear me? Yeah.

Scott Benner 33:24
Was it your turn to talk in the meeting?

Jessica 33:27
was making sure that no one was trying to.

Scott Benner 33:32
I was like, well, like, how old are you?

Jessica 33:34
I am 32.

Scott Benner 33:37
I was like, younger people are like, I could probably make a podcast while I'm in a meeting that's fit that.

Jessica 33:43
I didn't like, gosh, terrible. And I thought it was gonna be one of those meetings that you know, don't have to really pay too much attention. Oh, wait. Oh, this. Make sure

Scott Benner 33:54
it's not that important. Boy, everybody hearing that should think oh, we have too many meetings.

Jessica 34:02
Exactly. Exactly. Oh, that's

Scott Benner 34:05
hilarious. Well, okay, so you're at a set about a seven. Now, your range is a little loose because his activity is making him drop. Was that as big of a problem on on the pod five? Or was it was it was it catching loads from activity and stuff like that for you? Oh, yes,

Jessica 34:23
yes. Yes, it was. It was doing really good. He was in a light when he would have breaks from school or in summer camp. He was doing really well. With catching those lows, especially at night. We would get some amazing sleep.

Scott Benner 34:40
Yeah, no kidding, right? Because we're not

Jessica 34:43
having you know, to wake up that treat lows and stuff like that. So even right now like that's the drawback right now of us being a manual is we're having those lows and stuff like that. So yeah, yeah. Yeah, it's getting better though.

Scott Benner 34:58
Do you have any via like, oh, did you reach out to Dexcom? About the sensors not lasting for you? Yeah,

Jessica 35:04
yes, we did. And, you know, it. We were one trainer, I believe had called. And it was pretty much all this stuff that, you know, we had been told or the regulation or the guidelines if they said it was things we were already doing. Yeah. My biggest, like, what I think might be is because he's very lean and has very little body fat on them. So that's just my only like, theory of as to why it just did not work for him. So

Scott Benner 35:38
did hydration. Did you ever really, like lean on making sure he was hydrated? Yes.

Jessica 35:43
Yeah. He was very hydrated. He was drinking lots of lots of water. Yeah.

Scott Benner 35:54
It really does suck that. I mean, it's just what it is. Right? It's technology, but like, maybe he puts on 10 more pounds or something. And I help. Yeah, no kidding. How much does he weigh at seven years old.

Jessica 36:05
He's he is on the lighter in he's about 50 to 53 pounds. And he's short too. So he literally eats and eats and hit. It completely leaves his body

Unknown Speaker 36:18
to have his thyroid checked.

Jessica 36:21
And yes, his thyroid numbers have. And because his doctor he also looked at that too. Yeah, that came back normal. So

Scott Benner 36:30
do you remember his TSH level by any chance?

Jessica 36:34
I can look that up real quick. His most recent one? Yeah. Would

Scott Benner 36:39
you just because they'll call in range, a pretty wide range. And if he's having symptoms of thyroid issues, the medication helps a lot. You Oh, I'm not saying this is happening. But it's so worth looking if you have a second Yeah, yeah. Okay.

Jessica 36:57
Yeah, let me look right now. Yes.

Scott Benner 36:59
Okay, good. Yeah, please.

Jessica 37:01
So his TSH from October of last year was 3.850.

Scott Benner 37:11
Jessica, that's too high. He needs really needs the thyroid replacement. He does. Okay, that's it, I'm gonna send you a link. Okay, when we're done, okay, to an episode with an endocrinologist who is going to explain everything about thyroid to you, okay, and he is going to start taking that thyroid replacement. And you are going to see his blood sugar's be easier to manage. If he's experiencing any tiredness, you're going to see it go away. And I want to tell you that my daughter was the smallest person in her school. And then she was diagnosed with hypothyroidism. And she's five, seven now as a 19 year old well, so it is, absolutely can get in the way of growth and weight gain and all that stuff. So, okay, I'm going to tell you that my my doctor would medicate probably anything over about a 2.1 that came with symptoms. And really, most doctors are going to just say, oh, that's in range. But if you give us exactly what it says, yeah, so

Jessica 38:19
you have a good one question. So he had just another data point. So yeah, this recent one that was in May, and that one was 1.2700. That's

Scott Benner 38:33
interesting. So maybe it's swinging around a little bit right now.

Jessica 38:37
Okay, so this could be that could that be that there's still an issue? It could

Scott Benner 38:40
be the indication of things are coming that it got high and then it bounced low because right now he's that that the one point whatever is a great number. Yes. But even at that being how many months old now? The last one. The last one was in October was the October the three one or the one? The one that started October? When

Jessica 39:02
was it three?

Scott Benner 39:03
Yeah, I mean, I would draw that right away again, if he was over 2.1. I'd ask for medication. Another one. Okay. Yeah. Episode 413 is called thyroid disease explained it's with a doctor named Addy Benito. She's terrific. And there's an entire thyroid series explaining all of it you can find this series at juicebox podcast.com. You go up to the top and click on defining thyroid you'll see them all right there.

Jessica 39:32
Okay, yeah, yeah, that's good. Yeah, because that is something which made him kind of do a more in depth blood draw at his most recent appointment because you know, he is having the weight issues and things like that.

Scott Benner 39:48
The issue ends up becoming the doctors will most doctors will like ignore not ignore the number but the under for they're gonna be like, I don't know and then they're gonna wait for like real like they physical issues that pop up. And there's no need for that. Like if he's if this is what's happening this is listen, everybody in my family has a thyroid problem, okay? My daughter, my son and my wife, and their doctor, who is the doctor on that recording is going to, like manage them as low as they can get them without a beat without being hyper. And the I just got a blood draw this morning, because my thyroid came back like at 2.1 or 2.2. Last time, and she's checking it one more time. And I guarantee you if it's higher like that, she's gonna give it she's gonna give it to me too. So, yeah, plus, you don't want to miss out on these growing years. Exactly. If that's part of the issue, you know? Yes. 100%. Wow. Yeah, that could be the difference between some real money to play something in college and just nothing. Because by the way, I stalked you a little online. Your husband looks like a big guy.

Jessica 40:57
Yes, he played basketball in college, and I ran track. I

Scott Benner 41:02
was gonna say, we might get a little bit of college help here from this kid. He grows up. Nothing wrong with that. Nothing at all. Yeah, no, I wish you luck finding out more. And the only thing I can tell you is that if you go back and his TSH is in threes, and your doctor says that's not high enough for medication. I'd be looking for another opinion if that happened. Gotcha.

Jessica 41:23
Okay, okay. Yeah. Yeah, I will probably we'll see he was we just moved again. So we're trying to get his care set up now. So I'll talk to his endocrinologist and his PCM and kind of see what they say what? Yeah, one of them bites?

Scott Benner 41:40
Absolutely. I'll send them the episode if they don't believe you. I know. Yeah. Is your husband still in the military?

Jessica 41:47
No, he's not he. He got out after a few deployments. He was in for about six or seven years. So

Scott Benner 41:56
you were to write.

Jessica 41:58
I'm still in your

Scott Benner 42:00
your the wow. Oh, okay. Yeah. So yeah, that meeting wasn't about anything like about my safety, was it? Are you guys trying to find those people in that submarine? I'm just kidding.

Jessica 42:15
No, I will not ever on that. Topic. My true thoughts.

Scott Benner 42:22
If your true thoughts are like mine, it would be don't get into a toy submarine and try to go down to the bottom of the ocean. That was my fun.

Jessica 42:29
There's this thing called common sense. But I you know, I guess Massoud to come? I don't know.

Scott Benner 42:35
You want to see the Titanic. Watch the movie. James Cameron took pictures of

Jessica 42:39
it. Yeah, great. There's great video of that.

Scott Benner 42:42
I've heard people say like, well, who's at fault? I'm like, you're at fault for getting in the submarine. That's exactly, yeah. You gotta have a little bit of preservation in your in your heart. Yeah, I don't do I just saw a video the other day of this couple was terrible. By the way, they get up on a ledge on a building to take a picture. And though, the woman goes up first, and then she kind of gets settled, and they're on a fairly wide ledge, I mean, a couple feet wide, right. But they're clearly trying to get a photo of them being on the top of a big building. Well, he hops up, don't get me wrong, he doesn't he doesn't bump into her. He doesn't do anything. Her just natural reaction was to make space for him. And she shuffled her and fell right off the building. And I thought, like, for a picture, that three days from now, no one's going to remember. So you can get some likes on Instagram, she's, she's gone. You know? What and you by the way, you're a billionaire. Don't go into the water. If I was a billionaire, Jessica, I'd wrap myself in nine times a bubble wrap. And that's how I'd go outside. It'd be bulletproof bubble wrap. I'd be outside like the marshmallow man from Ghostbusters. Yes, please don't let anything happen to me. I get $2 billion.

Jessica 43:55
Exactly. I

Scott Benner 43:56
don't understand. Okay. I so I have. I know, you're, you're you're probably busy. And I'll wrap you up a little bit here. Okay. I want to ask if there's anything that we missed, or we didn't talk about that you wanted to know I

Jessica 44:09
don't think so. I just I just really love you know, that community that you've built and then there's some so many other ones like I mostly through Facebook, but you know, this, things like this, like it helps. But you know, just that group think is just really, you know, helps so many people just get through, you know, day by day because, you know, I'm just like I wonder if there's any other and I'm sure there is like forums like this for other you know, diseases but I don't know what I would you know, do without this this wealth of information.

Scott Benner 44:48
Very happy that it helped.

Jessica 44:49
I'm thankful Oh,

Scott Benner 44:50
I'm grateful that it's helping you and i i hope you never find out if there are other forums for other diseases. I never have to find that out. Yeah,

Jessica 44:59
yes, them So I can take

Scott Benner 45:02
at the end of my rope already. Yes, it makes you feel better. We were going to have three kids and after art and got diabetes, you're like, Okay, I think two is enough. So yeah, that's a lot. Yeah, no, really.

Jessica 45:16
And my son, he has such a big heart. And he was like mind that he's like skiing every few months. But then finally, one day, he's like, Well, we could adopt a kid that has diabetes and our help help them with it. Since I've, I've been doing mine and taking care of my diabetes. I was like, Yo, you're so sweet. Sweet his kid, if

Scott Benner 45:38
you're trying to make me cry, like you're real. All right. Yeah. Tell me that at the end. Yeah, that's really something. Okay. All right. Well, listen, you go back out and find out why those Chinese weather balloons were over Wisconsin, or whatever it is, you're supposed to be doing. It. I got Jessica, You crack me up. When we were gonna pause like we're gonna stop now. And I'm gonna say thank you very much, but just hold on one second for me that I'll let you go. Okay. All right. Thank you again.

I'd like to thank Jessica for coming on the show and sharing her story. And a huge thanks to touched by type one for sponsoring this episode of The Juicebox Podcast. Check them out on their website touched by type one.org or on Facebook and Instagram. A huge thanks to us med for sponsoring this episode of The Juicebox Podcast. Don't forget us med.com/juice box this is where we get our diabetes supplies from you can as well use the link or call 888-721-1514 Use the link or call the number get your free benefits check so that you can start getting your diabetes supplies the way we do from us med

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