#1140 Cold Wind: Healthcare Whistleblower CDE and Dietitian

“Susan” is a type one diabetic, the mom of a type one, a CDE and also a dietitian. Her voice and name have been changed to protect her 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 1140 of the Juicebox Podcast

Welcome back to the cold wind series. Today we're going to call our guests Susan. Let's see Susan is a type one. She's the mom of a type one, a CDE and a nutritionist. And unlike some of the cold wind episodes that you've heard so far, she's not here really so much to blow the whistle on the doctors as she is the Bloat on the patients. 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. 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 You can make a significant impact on the future of diabetes healthcare, treatments and technology by participating in the T one D exchange registry. It starts with just a simple online survey about your life or your loved ones life with type one you can only takes 15 minutes, T one D exchange.org forward slash juicebox US residents only. You need to be a type one yourself or the caregiver of one. When you fill out the form completely. You are supporting not just people with type one diabetes, but the Juicebox Podcast as well. T one D exchange.org/juicebox. This episode of The Juicebox Podcast is sponsored by the insulin pump that my daughter wears Omni pod. Learn more and get started today with the Omni pod dash or the Omni pod five at my link Omni pod.com/juice box. 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. 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 alternative works.

Speaker 1 2:44
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 2:56
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. So we're going to make another anonymous episode today. So we have to first pick your anonymous name.

Anonymous Female Speaker 3:19
All right, let's go with Susan.

Scott Benner 3:21
You don't want to say what you said before we started recording.

Anonymous Female Speaker 3:25
No, I'll just play nice.

Scott Benner 3:27
Why did you used to have a fake name? Because I used

Anonymous Female Speaker 3:30
to use it to get into bars when I was under age.

Scott Benner 3:33
Okay, Susan. So, let's just start off by telling people what do you do for a living?

Anonymous Female Speaker 3:43
So I am a Registered Dietician certified, certified diabetes educator working in Canada. Oh,

Scott Benner 3:52
oh, this is gonna be so good, isn't it? And a dietitian. It's okay. If you don't want to say but are you willing to tell me what province you're in?

Anonymous Female Speaker 4:04
I mean, Ontario. Okay.

Scott Benner 4:06
Should I have said Provence? Would that have been better? No provinces, right. I know. It's right. But that's not how you guys said.

Anonymous Female Speaker 4:13
Well, I say province.

Scott Benner 4:14
Alright. Look at you trying to be fancy. I gotcha. So you are a CDE? And a dietitian. This is perfect. Yes. Tell me a little bit about what goes into becoming a CDE. Did you do it here in the States or did you do it in Canada?

Anonymous Female Speaker 4:29
I did it in Canada. And I kind of have a bit of a backstory. So I also live with type one. I was diagnosed at 26. My daughter was diagnosed at just about seven just before her seventh birthday back in 2013. Which kind of inspired me to change gears. I was kind of in a phase of my life where I was looking for what I wanted to be when I grew up. It was a bookkeeper. And I thought well, if I have to support her I might as well figure out how to make some, you know, some other people happy about what I have to say and helpful and value and value and all that. So I went back to school became a dietitian with the goal of being a certified diabetes educator here because it was kind of doing it on the fly anyway,

Scott Benner 5:16
how long does it take to become a dietitian?

Anonymous Female Speaker 5:20
Well, it took me a couple extra years, typically, it's a four year undergrad plus either a one year internship at a hospital or a one to two year master's program. So I had to go back to high school first to couple courses to get me qualified to apply for the program to become a dietitian, and then I did a one year master's. And then I went through the excruciating process of writing the exams. And then it takes takes another depends it takes about a year, if you get a job, right out of school in diabetes care, you have to mass anywhere between 800 to 1000 hours to qualify to write the CDE exam. So if you're not working in diabetes care, then it might take longer for you to really kind of collect all those hours, but I came right out of school into diabetes care. So it was pretty quick for me well,

Scott Benner 6:12
so this indicates a sincere desire to do this. I mean, you had to go back to get like high school credits just to get to, to the college credit suite. And that's a lot of work and tell me you were already a type one when your daughter was diagnosed, right? Right, or about how long? Like 13 years, I'd say 13 years type one, you have a daughter, boom, little diabetes there. You're not just a type one, not just the parent of a type one. But as somebody who said, I want to go do this professionally and then had to put a great amount of effort into making it happen. Right. Okay. That's a fair statement. Okay. So let's start with what was your experience like with your health care prior to your daughter's diagnosis prior to you being in the business? What how would you describe it to somebody looking backwards. Taking care of your health isn't always easy, but it should at least be simple. That's why for the last three years, I've been drinking ag one every day, no exceptions. It's just one scoop mixed in water once a day every day, and it makes me feel energized and focused. That's because each serving of ag one delivers my daily dose of vitamins, minerals, pre and probiotics, and more. It's a powerful, healthy habit that's also powerfully simple. Before I was taking ag one, I would get that brain fog in the middle of the day, and I just couldn't seem to get on top of it. But now that doesn't happen anymore. By starting my day with ag one I found focus and a renewed ability to perform at my highest level all day long. Drink ag one.com/juice box. When you use that link, you're supporting the production of the Juicebox Podcast. I drink age you want in the morning, but you could use it as a coffee replacement before workout or in your smoothie. If there's one product I had to recommend to elevate your health, it's a G one and that's why I've partnered with them for so long. So if you want to take ownership of your health, start with ag one try ag one and get a free one year supply of vitamin d3 k two and five free ag one travel packs with your first purchase exclusively at drink a G one.com/juice. Box. That's drink ag one.com/juice box, check it out. Today's episode of The Juicebox Podcast is sponsored by Omni pod. And before I tell you about Omni pod, the device, I'd like to tell you about Omni pod, that company I approached Omni pod in 2015 and asked them to buy an ad on a podcast that I hadn't even begun to make yet. Because the podcast didn't have any listeners. All I could promise them was that I was going to try to help people living with type one diabetes, and that was enough for Omni pod. They bought their first ad and I use that money to support myself while I was growing the Juicebox Podcast. You might even say that Omni pod is the firm foundation of the Juicebox Podcast. And it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omni pod.com/juicebox whether you want the Omni pod five, or the Omni pod dash using my link lets Omni pod know what a good decision they made in 2015 and continue to make to this day. Omni pod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old, and she will be 20 this year. There is not enough time in an ad for me to tell you everything that I know about Omni pod, but please take a look. Omni pod.com/juice box I think Omni pod could be a good friend to you. Just like it has been to my daughter and my family.

Anonymous Female Speaker 10:00
Personally, I would say that I didn't prioritize self care. So I really wasn't a very regimented diabetic, I didn't really do a lot to benefit my own health and welfare, I kind of half assed my way through things. I wore an insulin pump, I went to all my checkups and doctor's appointments and that sort of thing. But, you know, I went through the whole thing about making up all my blood sugars and telling stories out of school about what I was doing in terms of diet and exercise, and that sort of thing. So it really wasn't until my daughter's diagnosis that I paid attention to diabetes.

Scott Benner 10:39
So that's a classic story. Really, honestly, I hear it from a lot of people. But let me make sure I understand it. Because in fairness, the physicians and doctors and nurses and everybody else we're going to be talking about today, you would go in there lie about the numbers, lie about your diet, and lie about your exercise. Yeah, pretty much. Do you think now using the eye you have now being a CD? Is there any way they believed you? No. No, no chance. Back then. Did you think they believed you?

Anonymous Female Speaker 11:12
Yeah, back then I thought it pulled it off pretty well.

Scott Benner 11:14
What were your agencies while this was going on? Oh, anywhere from 10 to 13. You were telling them about a person who's doing better than you were doing? And then showing them the results of a person who was doing what you were doing?

Anonymous Female Speaker 11:25
Of course, yeah. I had no idea. I didn't understand the connection back then. Oh, okay.

Scott Benner 11:30
So you just thought they were like, Oh, right on so So did you know that that's not the agency you wanted? Yeah. Oh, yeah. Okay. And so I

Anonymous Female Speaker 11:39
had all of the information I knew, you know, I knew how to eat properly. I knew about the potential consequences of diabetes. I started it was it was also a lot for me a personality conflict, because my nursery school report card says that I don't take authority. Well, like I don't deal with authority figures. Well, right.

Scott Benner 11:59
So they figured that out when you were three.

Anonymous Female Speaker 12:03
Probably, you know, one of the worst people this could happen to you, because this is a disease where everybody's telling you what you have to do all the time, right, including the disease itself. So I had a lot of issues with personality conflicts were back in that day, everybody was using fears, you know, scare tactics and, and trying to motivate you by fear. So I would walk in and they have a blood sugar of 12 when they were testing me as I was coming in, and all of a sudden, they're like, you're gonna die, right? Well, that doesn't motivate me, it turns me off. And so I went through four or five different endocrinologist before I found one that matched with me and could work with me and understands kind of like what I need to motivate me and inspire me to do things differently and took the time to educate me and that kind of stuff. So it was it was, it was a long period of, you know, many different twists and turns in my journey to kind of get to where I am today,

Scott Benner 12:57
when you realized you were going to offer to be on this episode. Did you know you were going to be making both sides of the argument? I usually always do. Okay, because I mean, this is this is fantastic. Because I'm assuming that what you tell me later about the professional side of this, it's going to make people harken back to what you said about your time as a type one prior to being you know, the mother of a child has type one as well. So, so you are you are in I hate the wording but you're non compliant at that point. Yes. Okay. Did you think you were Oh, I knew I was okay. But you didn't care because fill that blank. And I

Anonymous Female Speaker 13:35
didn't care because it's kind of like that. It's not going to happen to me mentality and with you know, I mean, obviously, this has a lot of perspectives from what I'm doing now tied into it, but nothing was wrong with me then I didn't feel anything and nothing was different for me. I didn't you know, like when I was diagnosed? Yes, of course, I had like the frequent urination. I had the intense thirst and I had those kinds of things, which made me go to emerge. I was diagnosed, I think at like, 33. Which times 18 would be what for us numbers at all. I'm on my phone. So if

Scott Benner 14:04
you want to do it, I guess I would look on my website because it's easier that way.

Anonymous Female Speaker 14:09
Yeah, so I just usually might use my calculator, but that's like 594 milligrams per deciliter. So when I was wheeled in, the triage nurse was like, oh my god, I can't believe you're not being wheeled in here in cardiac arrest. Welcome to diabetes. Nobody in my family has a history of it. Nobody knew anything about it. It was totally new. So, yes, of course, I knew that I was really annoyed that the first thing that you know, my first introduction was that way. And then of course, I have some like 89 year old physician telling me to eat crackers and drink soda pop, which clearly was not the right approach. And it took me a while to find the team that I kind of clicked with. But I still knew that I wasn't doing things properly. I still had all of the information about targets and anyone sees what that meant. And there was no time and range back then. And it was all like you have to buy a mini fridge and have it by your pillow so that you can eat at eight o'clock. 10 o'clock, 12 o'clock, four o'clock, you have to have 60 grams for carbs at meals you have to this, this this this this right. very regimented, which was against the grain for me in every possible way. I would go in and say, you know, I went I actually went on an insulin pump, because I was not giving myself any insulin at all.

Scott Benner 15:28
So, so you wanted at least the Basal. Yeah, right. And before

Anonymous Female Speaker 15:33
looping before all of this now, we're not waiting kind of movement, technology and all that kind of stuff. I would actually adjust my Basal rates based on my regimented eating pattern, because I just got to a point where I was eating the same food every day at the same time, because I didn't want to think,

Scott Benner 15:47
to you are jacking your Basal up to cover your food. Right. That's the thing you came up with on your own. Yes,

Anonymous Female Speaker 15:54
and I didn't Bolus at all. So which is like, do as I say not as I do, right? Totally not the way that come about

Scott Benner 16:02
it. You would get low if you forgot to eat. Right. Okay.

Anonymous Female Speaker 16:06
But lows didn't scare me.

Scott Benner 16:08
Did that happen? Yeah, I would have lows. Yeah. But they didn't scare me. But this this plan was also just basically keeping you in the tents. Right? Okay. Got it. Got it. Okay.

Anonymous Female Speaker 16:21
Because I also was like, I'm a carb lover, I have a sweet tooth. I you know, I'm, I'm all about convenience. I hate cooking. So anything that I can buy that's packaged, refined, or full of greasy cheese, and pepperoni and carbs was my life.

Scott Benner 16:38
Gotcha. Okay. And you ride like that. 13 years.

Anonymous Female Speaker 16:44
Yeah, give or take. I mean, I had moments I got pregnant. When I was pregnant, I was very regimented. My agencies were like 6.1, which is a mind blower for most of my endocrinologist who keep telling me to just be pregnant the rest of my life. This

Scott Benner 16:57
also fascinates me when this happens. So you're able to hear a person say, If your agency is not in the low sixes, high fives, you're gonna have an unhealthy pregnancy, it's not good for the body for this table, and c to be like this. And so for another person, by the way, a person you've never met before, you're able to do it. But then the minute the baby comes out, and it's on you, we go back to like just putting the Basal and we'll go to 10.

Anonymous Female Speaker 17:20
Of course, and it will seem like back in that day, I was smoking and drinking and we you know, same I would quit on a dime. And never have another smoke didn't think about it didn't crave it didn't nothing. But as soon as the baby was out, right back to it, which makes even less than so

Scott Benner 17:36
it makes it I mean, it tells the entire story. But you are gonna go this way forever. But your daughter's diagnosed. And tell me what you thought. When she was diagnosed? Well,

Anonymous Female Speaker 17:48
it wasn't an instantaneous thing. So a few different things happen when she was diagnosed. First, there was a lot of different kind of pressure, because I got like, oh my god, I wouldn't wish this on anyone. But at least it was happening somebody that's happening to you, because you're the expert, and you could fix it. So that was a huge weight on me, because I wasn't diagnosed in childhood. And there's a lot of things that happen in childhood that don't have didn't happen to me. And I had no idea what the hell was going on, aside from just the basic fact that every one has a different experience with diabetes. So it doesn't matter if we're doing the exact same thing. Her career experience is going to be different than me, right. Also,

Scott Benner 18:29
I'd say that anybody who looks at somebody with a 10 a one saying goes, you're an expert at this as being generous to begin with.

Anonymous Female Speaker 18:35
I also did not let people in. So nobody knew. Oh, you

Scott Benner 18:40
were alive and had diabetes. So they thought you were an expert at it. Yeah,

Anonymous Female Speaker 18:43
okay, I got it. So I didn't go into detail with anybody in my life, because I just didn't want anybody on my back. Right. So that was that. The other thing was when she first started, this is when I dove headfirst into everything, diabetes. So I joined all the forums, I joined all the groups, I started looking, you know, looking for networks for all this kind of stuff, including Juicebox Podcast, right? To make sure that I got all the information so that I knew everything because this is now about my child. This is not me, right? So then it was kind of learning Yes, but she was still in those beginning stages in Canada, you have to be on multiple daily injections for a year before you're considered for pump therapy. And of course, like she gets diagnosed, and I'm like, hi, where's her pump? But you know, she's got a bit of the honeymoon phase going on. And so they can't really get her on a pump right away, all that kind of stuff. And then it started to kind of evolve where she would start looking at me like how can I have to do this noodle? Oh, and at first I'm like, Well, you know, I have a pump so it's different, or I wear a sensor so it's different. I don't have to poke my fingers all the time because I have a sensor that tells wasn't enough. So I could get away with it for a little while. But then it got to a point where it was like, I can't fake this anymore. And I now need to be a role model and an example if I want her to live and be able to walk and see and feel and, you know, have a functioning pedigree as well into her golden ages.

Scott Benner 20:19
So but you were still not concerned about yourself at that point? No,

Anonymous Female Speaker 20:25
I'm still not to be that

Scott Benner 20:27
you know that some? Probably some light therapy would help you figure out why this is right. Oh, listen, I've

Anonymous Female Speaker 20:34
been in therapy for years. Okay.

Scott Benner 20:35
Do you know why you don't? You're not concerned with yourself? Well, I

Anonymous Female Speaker 20:40
mean, as I'm sure you know, diabetes is very closely related or connected to depression. So there's some depression happening. There's also the defiance, there's denial, there's, you know, the mental health side of diabetes that plays heavily into my my health and wellness journey, right, gotcha. Okay, which was also a really big push or motivator for me to get into diabetes care, because I have experienced that for so long. And I understand that side of diabetes from a very personal lived experience, right? Yeah. So I mean, I do the best I can. And I counsel a heck of a lot better than I apply all of those suggestions, guidelines, you know, techniques or whatever to myself. Sure. But I'm always gonna go above and beyond for people that I care about my kids being number one. So because of her diagnosis, I got into looping I built my own pancreas, I tested it out of myself and then built one for her, we got her into looping my agency in a month dropped from 13.9 to 7.3. That automated everything and relieve the burden for me so much so that I could then focus on figuring out how to provide her with the same benefit. And kind of pushed me into going back to school because again, I was kind of at this time in my life where I'm like, this is you know, bookkeeping is not exciting. This is not what my plan was, and what do I want to be when I grow up? Her diagnosis was kind of like, the light bulb, right? Okay. When she was diagnosed, and I dove in, I was helping people I was in the CGM and a cloud Forum, which is now 60 plus 1000. Strong, which is the automated pancreas before the AI D Systems came available to market and I was I was in it, I was eyeballs deep. And people started to say, like, why aren't you doing this in a professional capacity? Because you have, you can come at this from so many different perspectives, that is so helpful, aside from just the bonus of when I'm talking to somebody, they actually know what I'm talking about. It's not just the health care provider that's going by the books. They're talking from experience, they really understand what I'm saying I'm having a low what it means it's not just oh, well go off and have your three Dexcom dextrose, or glucose tablets, right?

Scott Benner 23:14
This is what motivated you to get into it. And take care of it. Professional, right. Yeah. But it's yes, it's still it's, I mean, I'm gonna get past it. But it is most impressive to me that you still did it, because it would not be uncommon. I mean, parenting is something that happens all around all of us every day long. And there are plenty of adults who make decisions that hurt their kids. Yeah, both short term and long term. And you seem ripe to be one of those people. But then you weren't like as soon as it came to her. You were like, Okay, well, now I'll do it.

Anonymous Female Speaker 23:50
Oh, I am like a model. There. I am. The definition of Mama Bear

Scott Benner 23:54
is Susan did you just turn your stubbornness in a different direction? Yes.

Anonymous Female Speaker 24:00
That's a great way to play. I

Scott Benner 24:01
know what's going on. Trust me, I'm married. So I see what's happening. But that's really something because you could have doubled down and been like, you could have said, Look, I've had this for 20 years. I'm still walking around. She'll be fine. I'm gonna keep ignoring this. Yeah, I could have then do you have any long term complications?

Anonymous Female Speaker 24:23
I have. I have mild.

Scott Benner 24:26
Yes. I was gonna say not neuropathy. Your guests are praised. This is where I was headed. But ya

Anonymous Female Speaker 24:32
know, I have mild neuropathy that's affecting, like grip strength in my hands, but nothing that prevents me from doing anything. You know, normal. Did

Scott Benner 24:42
you notice that that go backwards or stop progressing worse when you got your a one season? More control?

Anonymous Female Speaker 24:49
It's pretty recent. So not sure. I mean, she's had she's had diabetes now for 10 years. So this issue that I'm having, it's pretty recent. I'm gonna say it's probably big was all the years leading up to her diagnosis that I just sure didn't care. Yeah. And it's showing up now,

Scott Benner 25:06
I'm going to ask you to guess it's something that I don't know how you could actually do this, but I'm still gonna guess anyway. No kids come ever, but you get neuropathy. Do you think that slows you down? And you go, Oh, geez, something actually happened. I got to take care of myself. It

Anonymous Female Speaker 25:20
might I might have got you it might not as much as not as much as my kids being affected by it. Gotcha.

Scott Benner 25:27
It almost wasn't the affected part. It was the part where she calls you hypocrite. That's what got you right? Yeah, yeah. Then I saw that was interesting. Okay, I appreciate you telling me this. This is all incredibly interesting. Now we're gonna fast forward, and you have a job now, and you're doing the job. Right. So what could your healthcare team have done for you? If anything? All that time, you weren't paying attention?

Anonymous Female Speaker 25:56
It's a good question. Because, you know, I don't I can't guarantee that if they did what I'm about to say that it would have made the difference. I'll

Scott Benner 26:06
tell you what, that's incredibly telling. Because you're talking about yourself. Yeah, you're still not sure. But go ahead. What would the best course of action be?

Anonymous Female Speaker 26:13
I think, you know, if you have to meet people where they're at. So if if somebody took a minute to make the connection, that I'm not afraid of needles, I don't have an adverse, you know, reaction to taking medications. I don't think insulin is poison. I, I'm a smart enough person to understand, you know, the science behind things. But nobody took time to explain anything to me. They just barked orders at me. And being somebody who doesn't do well with authoritative figures. That is like the complete opposite approach. Yeah, that would work with me, right? I didn't know why people were changing my doses. I didn't know what carb ratios were, I didn't like all of these things that were happening to me. I didn't understand. And I mean, the mental health aspect of diabetes back then was non existent. Okay. Nobody, nobody made that connection. I was in denial. I just didn't want to deal with it. I didn't want it. I didn't want to have to do all this extra stuff. I hated that it was interrupting my day. I didn't like that. You know, like, if I wanted to eat because I was hungry, I couldn't eat. I didn't like that I couldn't go stay over at my friend's house and not have to think about it. I like that I couldn't vote for a night of drinking and, you know, be afraid that I wasn't going to wake up the next day. So I almost dared it to happen.

Scott Benner 27:39
Because is that the depression? I think

Anonymous Female Speaker 27:43
that's yeah, it's the depression, I think, right? Yeah. And it's just, it just didn't, I don't know how to explain it. And this is part of where my issue is that I haven't been able to kind of weed through 100%. But it's kind of like, I don't know, whether it's worth it. Like what's so exciting about life that really wants that really makes me want to put all this extra effort in and this is back then. Right? Because I didn't have kids and I wasn't married and all that kind of stuff. So I mean, I wasn't I was living a good life. I was fine. I had a house, I had a car and was traveling, whatever. But I didn't really have anything super exciting to do all this extra work for

Scott Benner 28:25
right or the mundane parts of life just difficult when you're depressed. Yeah. Okay. That means they're difficult when you're not depressed. So I'm trying to imagine if there was a voice in your head, not literally a voice, but but a feeling that is just like, Oh, why are we doing all this? Then? Yeah, it makes sense that it's harder. Okay. Yeah.

Anonymous Female Speaker 28:43
Yeah. So I think, you know, back then, because that wasn't part of care. I mean, now, we're still struggling up here to get mental health support as part of the care team, the circle of care. There aren't enough mental health professionals that are knowledgeable about especially type one diabetes, and, you know, even just, you know, regular mental health support people who are qualified to provide mental health care. If you don't really understand the world of diabetes, it's almost pointless, right? Yeah, it's

Scott Benner 29:15
more difficult. Can I ask you, were you depressed prior to your diabetes diagnosis?

Anonymous Female Speaker 29:20
I don't think I was depressed, but I don't know necessarily that I was happy. Like I had, I had some, you know, traumatic events happened in my childhood, nothing majorly serious, but you

Scott Benner 29:32
had to live in Boston. I'm just kidding. I'm just

Anonymous Female Speaker 29:37
I mean, part of that was was real, right? Like, the the everybody says, everybody in Canada is so nice, right? And it's actually true. Like, I got bullied when I was young in Boston really bad. And it set me up for you know, expectation, unrealistic expectations of relationships, and it you know, like it impacts Did everything that happened after the fact when I came to Canada, I was expecting everybody to be the same. And I was the asshole, right? So I came and I was like, tried to take on this bully mentality. And I'm not going to let that happen to me again, and I'm going to be the one that's gonna and then I got bullied, like almost the opposite way where nobody wanted to have anything to do with me, rightfully so. Yeah. So then it was really hard to make friends. And so all that kind of stuff was hard. And then I was diagnosed, here in Canada, I'm trying to think of, you know, it was kind of during this whole time where, so I was going out a lot younger than like, I was 16. And I was going out, and I was partying and drinking and doing all this kind of stuff. And I had an older boyfriend. And so I was well into that kind of phase in my life when I was diagnosed. And I was going to work and people thought I was hungover because my blood sugars were so high that I was literally falling asleep. Yeah. But they don't know anything about diabetes, either.

Scott Benner 31:03
So you were on the wrong path when the diabetes came, right.

Anonymous Female Speaker 31:07
And then all of a sudden, now I like I moved out of my house when I was 16. So I had been independently doing my thing for quite a while, by the time I was 26, and getting diagnosed. I had gestational diabetes when I was pregnant, but then it went away. And almost five years to the day was my diagnosis date for type one. So it came back with a vengeance. And then all of a sudden, it's like you're gonna come into my life and disrupt my entire program, and take away or potentially or threatened to take away. The only things left that that bring me joy. Gotcha. Right, which is food going out and having a good time. Whatever. Yeah,

Scott Benner 31:45
no, I hear and you didn't like your job. And you already kind of had that feeling like I don't know if this is all worth it to begin. It's a lot of effort to be alive. kind of feeling.

Anonymous Female Speaker 31:54
Yeah. Yeah. I mean, I was I wouldn't say that I was suicidal, because I wouldn't try anything, but it was just kind of like, why bother, like, just let it whatever is gonna happen happen? Well,

Scott Benner 32:03
listen, I want to be fair, I don't think anybody whether or not they've been depressed or depressed or aren't depressed, hasn't on, you know, the end of a long day gone, like, what am I doing? This just happens over and over again, like you didn't mean? Like, yeah, we're, you know, I, my son was out of college for six months when he called me and said, like, what do people do after work? And you're laughing because it's funny, but I was sad. I was like, Oh, he just figured out that life's not like, a 24 hour party. He just figured it out just now,

Anonymous Female Speaker 32:36
I laughing because I had a similar conversation, I have a son who's 30. And when he was graduating school, I kept saying to him, like, come home, relax, enjoy travel, like, don't just think you're gonna get to sit on your butt. But wait for the job that you want, that's going to, you know, either open doors for you, or that's going to bring you some kind of happiness or make you feel rewarded or whatever, because you will rushing into a job just to make a couple extra bucks, you are going to hate life so much sooner, because you will find very quickly that it gets very repetitive, right.

Scott Benner 33:14
And I just love that. You qualified as you're gonna hate it eventually. But now it's gonna happen sooner.

Anonymous Female Speaker 33:20
Yeah, right. Because even if you have an awesome job, sometimes you just want to, like lay around for an extra hour, or you just want to go on a trip or you just want it like there's all this extra stuff. It's kind of like diabetes, but not as intense because you got to plan ahead, and you gotta do all this extra steps to just make things happen. Right? Yeah. So he just recently came back to me as well and said, like, is this it? Is this life? Like, I just get up, I go to work, I do my job. I come home, or the gym, am I dinner, go to bed, I get up and go to work and do my job? Like, Yep, yeah, that's pretty much it.

Scott Benner 33:56
That's, that's why I don't understand people who don't like sports. I'm like, what do they do? Like in their downtime? That's why people like I read, I'm like, okay, all right. So like, you know, like, begin, people have to have hobbies, if they have things to do. You know, I told him I was like, to be perfectly honest, that feeling once you have a family, if you care about your family even a little bit, that feeling completely goes away, because you don't even have time to have that feeling any longer. busy all the time. You're busy while you're sleeping. So you know. Yeah, but So, okay. Did you ask him if he was depressed when he came back to you and said that we've

Anonymous Female Speaker 34:31
had conversations about it? I don't know if I asked him at that point. But you know, he's had some issues with anxiety and stuff like that. So it could have been there. Okay, but we haven't had like a, like a direct conversation about that yet. Are there any autoimmune issues with your kids? Not that we know of, and they've all been for the predetermination testing and that kind of stuff. And she was the one that came back with two of the four markers and then a year after that she was diagnosed,

Scott Benner 34:57
ever have your tyroid checked or his, your 30 year old.

Anonymous Female Speaker 35:02
My I do have my medications for thyroid. I actually had thyroid cancer. So I had half my thyroid removed. Okay, where

Scott Benner 35:09
do you keep your TSH? I don't even know. Yeah, I so anxiety, depression, like mood stuff can come with like an unbalanced thyroid situation too. Yeah,

Anonymous Female Speaker 35:21
yeah. So he did have his thyroid checked out. And I do remember looking at his bloodwork, and it was within normal ranges because of the whole anxiety thing. He was freaking out. I think he just kind of has like a doom and gloom syndrome where he just is afraid of death. And then he spirals. Yeah,

Scott Benner 35:36
I would just look at the TSH because anything over two with symptoms, I think needs medication. Okay, well,

Anonymous Female Speaker 35:42
that's a good tip. Yeah,

Scott Benner 35:43
take that as an that's not a thing any doctor in Canada is gonna tell you. And if you're worried about it, by the time they get to you, it'll be nine months from now. Anyway. So Yeah, no kidding. Yeah. So let's talk about secure lucky. Let's talk about that. Do we all really want socialized? Medicine is a great?

Anonymous Female Speaker 35:59
I think there's benefits of both? I think it really depends on who you are. I don't know, it really depends. You have to be a huge advocate, you have to be confident you have to have a big mouth to really be able to get the best out of the healthcare system here in Canada. Why if you otherwise, you'll be forgotten. Okay. You'll be pushed to the side, you'll be forgotten,

Scott Benner 36:24
because it deals with the way it works. And Trinsic Lee is it deals with people who are dying, and then a person who's slightly better off than them. And, and by the time they get down to somebody who's like, for example, like my irons low, that's a year, right? Like, Yeah, nobody's rushing to help you if I need a certain infusion, or I think my TSH might be a little high. And that might be why I'm anxious. You're not getting somebody to whip you up and bring you in real quick. No,

Anonymous Female Speaker 36:50
I mean, first of all, nobody has that even that level of education. Nobody knows what to ask. Nobody knows, like, how to talk to health care workers. They just the majority of Canadians that are tonight's they just sit and wait. And they show up when they're told and they do they take pets that they're told, and they don't ask any questions, and they go along their merry way. Right. Okay. There's the I would say, the small group of people like me, who don't just take whatever answer they're given, or don't just take whatever Doctor they're given. It's a little bit more difficult now, especially from COVID. Because, like, our health care professionals are dropping like flies. They're not getting paid enough. They're all quitting. It's the same with teachers up here. Teachers are like, running jumping ship. Yeah. So it makes it that much more difficult to get into see anybody. Like I have a cousin who has been dealing with gastro issues for months, and she's wasting away, like literally wasting away. I think she's lost about 80 pounds, and she didn't have a lot to lose to begin with.

Scott Benner 37:56
And maybe are like, What do you mean?

Anonymous Female Speaker 38:01
You she just can't keep food down. So I've suggested that she's apparently been tested for that. She's been tested for a myriad of other things. She's had scopes done. She said all kinds of stuff done. It can't seem to diagnose her. She can't get in for eight months. No, I

Scott Benner 38:16
wasn't kidding about that. I know Canadians. I know. It takes about nine months if you're not like literally dropping dead right now to see a doctor.

Anonymous Female Speaker 38:22
Yeah. And I've known Patricia before she gets the testing.

Scott Benner 38:28
Once she's about to die, they'll see her immediately. Yes, this is true. That's all fine. Don't worry. It'll be fine. No, this is this is exactly what I'm talking about. And then you're saying then the level of care suffers, too, because people who know what they're doing are leaving the industry as well. That's right. Okay.

Anonymous Female Speaker 38:46
That's right. Now, on the flip side, like for someone like me, who has a team, who has regular appointments, who is already in the system, who has a chronic life threatening disease, whatever, like, I get priority, so it works out, okay. And it saves me a ton of money, because I'm going to the doctor or a specialist or doing this and that and everything like all the time, right? If you are just somebody who kind of pulled through life, and you're doing pretty good most of the time, and you don't really have to go to a doctor until like something comes up or, you know, you need something signed off for work or whatever. That would be ideal. And there's actually a lot of Torontonians who are looking into private medical care where it is like it mirrors what what the system is in the US. A lot of people are showing up. Yeah, and you pay for whatever you want, and you get in within the hour.

Scott Benner 39:37
Well, I mean, listen to the same goes for here, the better your insurance is, the more capable you are of paying, the quicker you're seen. But right but the truth is that a long wait in America might be 30 days, you know, six weeks to get a doctor's appointment. And if you were really in trouble and you just said hey, I can't wait that long. They'll slip you in somewhere. Yeah, but those doctors are also being paid. So every time they bring someone in, it's a Ching. So that they're, you know, that's what they're trying to do. They're trying. So you either go up to a situation where it takes you forever to be seen. And then once you're seen, if it's something they understand like diabetes, then maybe it's not so bad if you have a good team. But if it's not something, they understand that you have to advocate for yourself and say, like, you know, this isn't right, or I need my levels to be here, or you're not addressing my symptoms, like that kind of stuff. And by the way, I've, I'm now talking with Canadian and US people in this, you know, in this anonymous setting, no one's saying anything different. Like, yeah, I get like, I go to the emergency room. Have you ever been to the emergency room is a type one? I have? And do they know anything about diabetes?

Anonymous Female Speaker 40:49
I've been to I've been to the hospital for different reasons. And the so when I was pregnant, I was on pumps. They took my pump away. They wouldn't give it back after birth. They had me on a drip. One of the nurses even came in and asked me when I finally did get it back. What is that? And I'm thinking to myself, Oh, my God, like I've been on a drip getting insulin and you're in health care, like how do you not even know what it is? Maybe you don't know how it works. But how do you even know what it is or that it's a possibility for me in terms of managing my diabetes, but anyways, I had to get my obstetrician to actually write a note to get the nurses to allow me to have my pump back. And this was back, you know, like 17 years ago, but much better now. I've had surgeries since then, where I keep my pump on the entire time, because they realize you know better what to do than we do. So you just move it out of the way of the surgery and make sure that you're doing certain things prior to to keep you safe, whatever, which is a great advancement. But I also have had an experience where I went to the ER, because I just kind of I don't know, I was panicking. I wasn't sure about my heart health, I kind of felt like my chest was really tight. And I just wanted to play safe. And it turns out that I was in DKA. So they they knew I had ketones and stuff like that. But they tested me and I was moved to an inner waiting room like you go in, you get triage, you're in a waiting room. And then depending on the severity of your case, you get moved to another waiting room inside. And I was sitting in that room with another girl who was like all balled up in her chair with blankets and everything. And the doctor came in and went straight to her thinking it was me. Meanwhile, I was just sitting there watching TV, my looked completely like I looked like I had brought her there. I was just waiting with her right. And so when he caught when he went up there and said my name, I'm like, no, no, that's me. And he looked over at me and he was like, you're in the head. So he knew what it was. But he was he was mystified based on what he knew about it, that I was coherent that I was just sitting there like any regular Tuesday watching TV waiting to be seen that I wasn't throwing up that I wasn't, you know, near death. Well,

Scott Benner 43:06
now that you do this job, though. So you're a CD in a private practice or in a hospital setting. Private

Anonymous Female Speaker 43:12
Practice hospital setting clinics, family health teams.

Scott Benner 43:17
Okay, what are you not doing that you shouldn't be doing? Where people being where people falling short? Where are the cracks? What could happen that isn't happening? Tell me why those things are happening.

Anonymous Female Speaker 43:29
I would say number one, mental health. There's such a huge gap in mental health care. I have so many patients that I spend so much extra time with in my calls on purpose that I can't I say I can't help they claim that I am very helpful. And they actually refuse to be switched to a different educator because they feel that I'm helpful. However, from my perspective, they're still coming back with blood sugars in the 20s constantly they're still coming back with you know, a onesies above 10 They're still coming back with haven't taken my insulin for the last few days. I couldn't get to the pharmacy. I haven't checked my blood sugar's like today I had a patient who I haven't checked my blood sugar's in six months. Her brothers in palliative care her her daughter is dealing with spina bifida, she's a caregiver for both of them. She's super stressed out at work, so she just gave up on herself. And I can't help that, right. I can talk to them, and I can inform them and I can educate them. And that's what I try to do. And I try to encourage them to be kind to themselves and to understand, you know how closely connected depression is with diabetes and how that's a vicious cycle and all of that, but I feel like I can't help them because they're still coming back to me at the next checkup in the same situation to

Scott Benner 44:50
do you know why they're not taking your advice?

Anonymous Female Speaker 44:54
I think it's a myriad of different reasons. I think cost is a major barrier because You know, there, there are many different programs that are available. But each of them have such restrictive criteria that there's usually always something that prevents people from getting access, right. So they also don't realize that they can ask for different things. So if an endo prescribes a specific insulin, like to receive a, for example, a long acting Basal insulin, not all insurance companies will, will cover that. So then they ended up paying $400 out of pocket for, you know, a month supply, when they could be asked to be switched over to jail or basketball or something else. And

Scott Benner 45:35
the doctor doesn't help with that the doctor just writes down the first name that occurs to them, if your insurance doesn't cover it, then those people have no way of knowing that they think, Oh, this is the insulin I need. Now I have to pay the $400.

Anonymous Female Speaker 45:46
That's right. Right. And some doctors are good. Some doctors will switch them up, but not all them do.

Scott Benner 45:52
Whose fault is that? Well, for sure, I

Anonymous Female Speaker 45:55
would say it's the healthcare professionals fault. Okay. Because there should be options, there should always be options. It's not that they have to go into major detail, but there should be always options presented.

Scott Benner 46:06
Hey, I'm prescribing you to see but if your insurance doesn't cover it, let me know. I'll find another one. They do. Yeah.

Anonymous Female Speaker 46:13
Okay. Or even just saying, what kind of coverage Do you have? Before you even mentioned recibo? Maybe they might even know, based on that. We as healthcare professionals are pretty well versed for what's available under which programs, whether it's government funding, whether it's disability, whether it's employee, provider, you know, insurance, whatever, we all have a pretty good idea.

Scott Benner 46:33
So why doesn't it happen? Lazy? Laziness,

Anonymous Female Speaker 46:37
it could be because they have, you know, like, a good relationship with the big pharma rap and they want to push that product because they get more perks or whatever, you know, if there's,

Scott Benner 46:49
that's not out of the question to be true. Still Still in 2023? You're in Canada, though, do you not have laws against that kind of stuff?

Anonymous Female Speaker 46:58
Yes. But it's I don't know that it would be necessarily on purpose, or intentional, but it's also like, Okay, our endos spend maybe 10 minutes with each patient, which is why education programs are a big deal, because we spend a minimum of a half an hour with every patient, sometimes an hour, depending. Right, right. So, and those are not educating. They're not asking a lot of questions outside of what have your blood sugar's been? And how often are you taking? Or how much are you taking your medications, a lot of that information comes from us, the educators, because we will see them first, update their notes, and then the end, those just go based on what we've done to save them that time. Right. So I think a lot of it is just time constricted, we have so many people like through COVID, our type one, in just this region where I'm at has tripled type one diagnosis over the over the years since COVID. has happened. So I think that, you know, the amount of patients that are now being recognized, diagnosed and screened, and all that kind of stuff that has literally saturated, the amount of professionals that we have to properly support these people has caused a lot of the problem because there's just no time. Is

Scott Benner 48:17
this why the podcast as popular? Do you think? Because people just can't get this information anywhere else? Yes, that's simple.

Anonymous Female Speaker 48:24
I also think that there are, you know, a number I don't know what the percentage is, but there's a number of educators that are in the field that are not type one or that are not, you know, somebody living with diabetes, and they don't necessarily have anybody living with diabetes, they just came in learning from what they got at school, which is two weeks out of a four year program that talks about diabetes. So

Scott Benner 48:51
I can take a four year program, and then when I come out, say, oh, I want to be in diabetes, and I still only had two weeks of education for it. Yep. That's a valuable decision. Okay.

Anonymous Female Speaker 49:03
Now, it's up to the clinic to determine where you can go and what you can do, right. So when I came out of school, I joined a clinic that was a National diabetes and Endocrinology team across Canada. And I had to start off doing diet consultations, right basic healthy eating, I had to do workshops, which were already scripted and the slides were already done. And then I would go and I'd have to do like a core competencies test to make sure that I could get that level of care. I had to shadow people so I would hear what they were telling him what they were doing and I had to be shadowed and all that kind of stuff. Then there's like different levels. So there's like four or five different levels that I worked through. That got me to seeing patients on pumps, for example, right so I went from like almost pre diabetes education to now complex pump patients,

Scott Benner 49:55
right. How long did it take you to get through that process?

Anonymous Female Speaker 49:57
For me it was fast tracked because So I have no such lived experience. Yeah. Okay. So I would say probably on average anywhere from one to two years dependent on how quickly somebody picks up what they know about it before they come in, and how motivated they are to be moving up. So

Scott Benner 50:16
bare bare bones, we're suffering from under educated clinicians, or under motivated, or, yeah, I guess that's it right there. Either they don't care and it's a job to them, right, they're gonna go do the thing they're supposed to do, you don't do well, it doesn't matter to them, they did the thing they were supposed to do today. Or they just don't even know well enough to explain it to you. So they're basically reading to you from the first two pages of a manual. And that's, of course, not going to help anybody get anywhere. But there are people like you who understand it. Like intrinsically, even though you did not apply it to your own life, you still understand it? And like you said earlier, like you were online explaining it to people, everyone found your way of explanation valuable. You brought that to a professional life, to your giving people that amount of effort, is it helping them?

Anonymous Female Speaker 51:08
I mean, the feedback that I get, I have to say yes, is good, okay. Now, it doesn't mean that they're going to come back with improved timing, right? It doesn't mean that all of a sudden, they're going to change everything, the way that I'm recommending based on the guidelines. Okay, but they feel heard. It's a good thing. They feel Yes. And they feel informed and they don't feel judged or attacked. So so it opens them up to the possibility that over the next six months over the next year, we can actually start to make some progress.

Scott Benner 51:40
Yeah. So you're making my argument that you haven't heard yet, because it's just right now, just Jenny and I are recording with each other. But you're you're making my argument, which is hard heartening to me. My argument is, there are a myriad of implications about people taking care of their health. And not everybody is going to do a good job, not everybody's going to care. Not everybody's going to have the bandwidth to handle it, there's going to be a ton of reasons why somebody might not make out well, but that doesn't mean we shouldn't give them all of the information in a way they can digest so that hopefully they put it into practice. That's the guess.

Anonymous Female Speaker 52:13
Right? That's also a challenge though, because think about in the hundreds of podcasts that you've done, think about how much information that potentially

Scott Benner 52:23
is. The truth of it is it's timing and amount. It's understanding how insulin works. It's understanding the impacts of foods like that's the foundational information. That's right, you have that foundational information that should be enough for you to see impacts, and then be an adult make a decision if that's something you want to do for yourself or not. That's what I think we owe people is a chance. I totally agree. Yeah. Okay. But we're not even offering some people a chance. Is that fair? It

Anonymous Female Speaker 52:52
I think it's fair. It's just so convoluted, because then you've got all the socio economic and psychosocial aspects, right? So I couldn't be providing care to three different patients, right? One of them I'm providing the same like what you just kind of threw in that nice little basket, right? I can give them each the same exact basket, right? If I have adult a who, okay, put on your big boy pants, and let's get going because here's the foundation of information you need to be able to maintain a healthy lifestyle and improve your blood sugar's and your overall health and well being, he's gonna go home and be like, I'm on it. I don't want to, you know, I don't want to have heart problems. I don't want to lose my eyesight, I don't want to feel like crap, whatever, he's gonna go home and he's gonna do it, he's gonna come back and his budget is gonna be perfect, right? Which we all know, that doesn't exist. But just for sake of argument, yeah. Then I go to patient number two, right wants to do everything they can, doesn't have coverage, doesn't have an education to understand how, you know, certain things kind of work together. Might can't may or might be able to do a couple of things. But just you know, from access, you know, like maybe they can't afford to buy healthy foods. They know how to do it, they want to do it, but they can't afford it. So like different things like that based on socio economic perspective. But then you got adult three, who gets it could do it has the money for it, but then the mental, the mental health support is gone. So they don't care. They don't want to think about it. It's too much of a burden. They're not they're not connecting. How you know, like one of the big aha moments for me was years ago before I transitioned into this whole thing I think I had my son I hadn't yet had my kid my daughter's I'm not sure I can't remember but I was in a in like a phase where I was just really easily agitated. I was I was exploding on people instantaneously like with very little prodding or poking or whatever. Yeah, and I went in And I was saying to her, like, I'm just pissed off all the time. And I don't really know why. But I'm just sick of everything. And I'm so pissed off, and I just want to really be alone. And she said to me, like, your blood sugars are higher. We've had this conversation so many times I know where you're at, I know how you feel. But do you know that when blood sugars are higher for extended periods, it actually impacts your level of patience.

Scott Benner 55:19
That makes you foggy and irritable. And I'm, by the way, on top of that, you have a thyroid issue, which could also impact that so. So when she says that to you, you're not the right person to tell it to. That's the problem with you being an adult not having somebody in charge of you at that moment, because now I'm putting the person who's already like, medically irritated in charge of making themselves not that way. Well,

Anonymous Female Speaker 55:42
yes, but at the same time, I was like, what? I had no idea. Oh, yeah. When he told me that no

Scott Benner 55:49
one ever even told you that that could be an implication on on, because that's the thing I say on the podcast all the time is people at the very least this deserves to be themselves. Like, like the person they would be if they didn't, if their pancreas didn't stop working, and their blood sugar didn't get high, and they didn't become irritable, and etc. Like you at least deserve to be yourself. Yes, I think a basic necessity of this. How else can you even make a good decision? You know, it's interesting is like, it feels like what you said was, there are people who are either, you know, told, Look, here's what could happen. And they say, well, that's not happening now. So I don't really have to worry about it. Or there are people who would happens to who then go, Oh, it's too late. There's nothing I can do about it anyway. Yep, that's yes.

Anonymous Female Speaker 56:32
Or you got the exact opposite. In both situations, we're so scared that they'll never eat another cupcake,

Scott Benner 56:39
or anything. I've heard of people who have trouble bringing themselves to eating, like for anything? Yeah,

Anonymous Female Speaker 56:45
they I've had patients who have developed eating disorders that are afraid of carbohydrates I've had, I've had the spectrum, right. I think like kind of dialing back to your earlier point. Yes, everybody deserves a basic foundation of information, a little basket, right, of healthy eating exercise, whatever, that's fine. But there are so many intricacies within all of that, that don't often get touched upon. And and a lot of times come up by mistake, because it's like walking a tightrope, right? How much information do you give somebody? How much are they going to be able to digest and apply? What are they most focused on? Like? Are you talking to somebody about exercise and activity? Who is a fitness junkie that really wants to do all of that? Or are you wasting all this time talking about it making somebody feel worse about themselves, because, you know, they know how important it is, but they just can't figure it out. They don't want to do it or whatever, right. So for me, like, that's really kind of laser focusing in on the details when I got that information about how higher blood sugars impacts patients levels, I can't ever necessarily see that coming out in the general initial assessment sessions that are structured that I've been privy to. So when you're first starting at a diabetes care, and you're learning from people, it is that let's talk about a balanced plate, let's talk about, you know, the foods that impact blood sugars the most, we don't really get into the details of simple versus complex carbs too much, but we kind of talked about vegetables, meats and or plant based proteins and you know, carbs, right? So sugary foods, breads, Rice's, whatever, that's how we sort of present it right. And then we talk about medications, they all kind of do different things. If you're a type two diabetes, you have all these different kinds. If you're type one, you're basically on insulin. And this is what the two different insulins do, and here's how they work and blah, blah, blah. So they walk away, they get it, they might get some information about some of the known complications just so they're not shocked or surprised by hearing it from somebody else when they tell them they have died one or whatever. But understanding how it's all connected. Like I remember to I didn't I think it was your podcast with Jenny that flew me into the a one sea being based on evidence of retinopathy.

Scott Benner 59:00
That's something that you heard in that last handful of years where you're like, I didn't know that. I

Anonymous Female Speaker 59:05
had no idea. Yeah, right. I'm like, Oh, okay. So cuz I was just like anyone see, that's just all I've ever heard since I was diagnosed. Right. But I had no idea that the whole reason or the establishment of the agency was based on the chances or the risk of developing retinopathy.

Scott Benner 59:18
Did you find the podcast prior to your professional change? Or after? Before before? Okay, okay.

Anonymous Female Speaker 59:27
And I think, you know, to answer the question that you kind of started, we went to the left turn, but your podcasts for people living with type one that can't access healthcare the way they want to or as quickly as they need to, comes in handy, because there's the lived experience aspect of it, and it's not all just buy the book. Right? It's about how do you really live life with type one in the best way? How like all the little tips and tricks and all the rest You'll stuff about life with type one managers. What does your lab work say? What does the science book say? What did the guidelines say? What am I allowed to tell you? Right? Yeah. So that's where I think the biggest benefit is. And there are people who will trip on your podcast and learn about how to Bolus for fats and proteins that has never been discussed with me. And 26 plus years of living with type one.

Scott Benner 1:00:25
Yeah, no, no, it's actually somebody just put a post up on the Facebook group today. And they were like, hey, you know, how many carbs do you think this this was three deep fried chicken tenders, like, like chicken strips with about 25 or 30, French fries, three packets of ketchup. And people jump in to guess the carbs. And it's fascinating. How few of them under even understand that the chicken has carbs in it, because it's got breading on it or that the three packets of ketchup or like 10 carbs, like total? Yeah, people are like, Oh, this is like 30. I'm like 30. There's a 65 carbs here at a minimum, and look out for the fat rise come in 60 to 90 minutes after you start eating. And people are like, Why? They're all out there and making decisions for themselves. Now the people who have been around the podcast longer, I was also heartened by how many people that fell into the 60 to 70 carb range when they were making the gas. But a lot of people were like, is this 3035? I'm like, the fries are 30. Like, what are we? Oh, boy. And yeah, all the grease and the deep fried? So slow your digestion down? Like you don't? You don't know that? Do you? Okay. All right. So you explained that there. And now you realize you've explained it for a couple of 1000 people who the algorithm was nice enough to deliver this to today who are in the face? It's not even as easy as like, oh, well, the people are in the group, they're gonna get the information. Yeah, everything is stacked against you. Like, yeah, down to the algorithm, not feeding you the the information in the group you were in to try to find the information out to begin with? Like, if I put you in charge, I'm doing this with everybody when I'm talking to them. Yep. What fixes this as best as it can be fixed? Am I wrong saying give people foundational information? Hopefully they'll find their way to the rest of it. Is there more different? What do you think?

Anonymous Female Speaker 1:02:16
I think that's one approach. And that is kind of the approach that is mostly followed here. It's just so lackluster, because you would have three podcasts, right? So if we didn't have all this extra information to learn and to know and to grow, and to understand, like, how many podcasts you have in total now and think about how that reflects back on what people are getting when they walk into that foundational understanding appointment. Yeah, but

Scott Benner 1:02:44
in fairness, like there's over 1000 episodes of the podcast, but the people who are really just looking for management stuff, they only need the they need the defining stuff. So they understand the terms, they need the Pro Tip series, maybe the fat and protein stuff a little bit about how to change the math for their settings after that. Like I mean, that's enough to get you into a six a one. See, you don't have to understand the whole thing to live healthy, like, but I don't know what's happening, that they never go out in the world and look for more, is it because they're they think that what they're being told, is all there is? Or do you think it's because they're a little, like, out of sight out of mind, or I don't care that much? Or how much of that do you think's involved to?

Anonymous Female Speaker 1:03:24
I think it's a bit of everything. I think for most people, they're so overwhelmed by the diagnosis, that they take what they're told, and they think that's all there is. Okay. I think they're scared to do anything else. The majority of people that I talked to that, you know, they saw me three months ago, and they they increase their their ICR, where they strengthen their ICR at dinner, you know, by one point or whatever, they haven't done anything since. And I'm like, we had this conversation. I explained like, this is me thinking in my head, right? Like we have this conversation, I explained to you how you can safely adjust on your own in between appointments. And you haven't done anything and your blood sugar's are still 12 1314 After dinner, right? So what's missing? When

Scott Benner 1:04:13
I decided to make these episodes, I think in my head, I thought we'll make the people anonymous because there'll be talking about the place they work. But you're the first one was like actually talking to the patients. And I still want you to be anonymous, because it allows you to feel more free to just say, Hey, this is what you this is what I see you guys doing. And this is why it's hurting you. Yeah. So it's an interesting perspective, because everybody's trying to be polite when you talk to people, generally speaking, like nobody wants to come out and say, like, I had somebody on one of the other episodes just I think said something about like, look, some people just don't have the brain power for that too. And I was like, wow, that is not a thing. Somebody would have said out loud if they thought anybody knew who they were. So, you know, so anywhere between like your ability to understand what's happening to someone acts claiming it to you. Listen, I can tell you right now I had the ability to understand it. No one explained it to me. And it took me years to figure it out. Yeah. And I may have only figured it out because I was writing a blog that what I thought was my blogs not helping enough people just sharing, you know, because what most of blogging was back then was like, this is what's happening to me. It's just happening to you. And people go, Oh, my God, it does happen to me that people are like, Yeah, I love that blog. But that didn't help. You know what it is like, right, like? And so I was like, well, let's help people. And so once I started figuring it out for Arden, that was the first person I was trying to help artists, the first person I was trying to help. And so I figured out what to do. And then I wrote about a little bit, and then people were like, that helped me too. And I was like, Oh, that dispels the rumor that everybody's diabetes is super different from each other. It's like they're different. Your variables are a little different. But again, the foundational basics of it, are the same. And that's where I'm coming from, because I've ended up saying this in a couple different episodes. But I'll say here as well, the thing I had to learn to do more than anything else was to communicate one way with somebody, like the person I'm talking to right now cannot talk back to me. And I don't know any of their details. And they have their variables, I don't know if their IQ is 80. Or if it's 130. I don't know if they went to college or grad school or couldn't get out of high school, like, I don't know anything like that about about anybody. What I did was I endeavored to communicate in a way where everybody would be comfortable in this conversation, and that nobody would feel talked down to and or would feel like this was so elementary that they shouldn't be listening to it. And so to me, it's about communication. To me, that's what it is like, I don't think there's a person with type one diabetes that you couldn't put me into a room with, that I couldn't explain at least enough that they could keep their a onesie in the 60s. I think I can do that. I

Anonymous Female Speaker 1:06:55
know you could do that. whether it happens or not is the different story, right? But

Scott Benner 1:07:01
if I can do it, then why can't a nurse practitioner do it? Or a doctor or a CDE? Or an endo? I mean, I'm a good communicator. But Jesus, like, you don't have to be that good of a communicator to get this these points across to you? Or am I listen, let me be serious. Am I just way better at it than most of the people you meet?

Anonymous Female Speaker 1:07:20
I think so. That's the pressing. Like, seriously, and that's coming from somebody who has often been told, Oh, my God the way you said that just made all the

Scott Benner 1:07:30
difference? Yeah. So you've heard that from people? Yes.

Anonymous Female Speaker 1:07:33
And I still don't think that I am doing as much good in this world as you. That's

Scott Benner 1:07:40
nice of you to say, but it's upsetting. So is this a situation where I'm making an entire series of episodes that way? At the end, I'm going to realize I'm unfairly asking something of people they can't do. And I don't mean the patients. I mean, the providers?

Anonymous Female Speaker 1:07:54
I think it also has so many things pop into my head, I think, you know, from a provider standpoint, right? It's time, how much time do they have? How many verses haven't like supply and demand, right? How much time do they have versus how many patients they have to see, there's no way they are ever, ever ever in the weight and the model of care right now ever going to be able to do much more than say, Okay, let's review your blood sugar's, let's review what you're doing with your medications. Here's the different medication you have maybe answer one question. I

Scott Benner 1:08:26
don't know why nobody listens to me about the math, there should be mass appointments. Well, we

Anonymous Female Speaker 1:08:30
have like the education centers that we have, many of them are now doing group programs and have been for a long time because of that they're trying to get as many people together to do these programs as they can. But then at the same time, like, what's frustrating for me is one of the clinics that I worked for the National clinic that I do do workshops, and teach workshops for and stuff. And I actually introduced an entire type one specific program, all of this stuff that I was doing, I was getting pushed back. Because I mean, first of all, it was kind of like some of this stuff was a little bit, not grade six reading level, which is the standard. But in my opinion, like if you have type one diabetes, and you're signing up for something like this, you have enough of a foundation that you don't need it to be grade six anymore, you're

Scott Benner 1:09:19
asking by virtue of asking should indicate you have a higher level of competency.

Anonymous Female Speaker 1:09:24
Right? So then it was kind of like I was spending all this time and I was doing all this work. And I was developing all these workshops, and I got good feedback. But I don't really feel like I was telling the people what I wanted to tell them like I wanted to come at it from a perspective of the kinds of things that you're doing the conversations that you're having, but then it was like I had to dial it back to kindergarten again and people don't feel like they take it and apply it the same way that they might if they were listening to like real conversations that you're having in podcasts. Yeah, right.

Scott Benner 1:09:55
Jenny and I did a live event recently and it It was, you know, when it first happened, the people invited I said, like, you know, you can come and talk for an hour. I'm like, I'm not flying anywhere to talk to anybody for an hour. I was like, it's a day. And she's like, well, nobody will sit for a day. And I was like, no, they will. I was like they absolutely well, so we filled a room with people. And Jenny and I spoke for two solid hours before lunch. And then everyone out into lunch. And I know that people were organized were like, up after they eat, they're going to take off, and everyone came back in. And then we spoke for three more hours. And there was a lot of q&a in there in that three hours, but a lot of just conversational stuff. Everybody stayed to the last second. They were thrilled. And even like, we got a letter from somebody who just said like, on the way home, my blood sugar's were better. Yeah. And like, we didn't talk about anything specific. You don't mean like, it wasn't like, Hey, turn your dial here or make this number this it was more of just like a, like a, like a conversation about diabetes and life? And what are the things that people run into? And then they start making their decisions better? And then then things start going better? Yes. Listen, I can't say it enough. About four or five times a year, a hospital approaches me and asked me to come out and give a talk to the people in the hospital who are teaching their people about diabetes. And every time it happens, I get super excited. And it never actually comes to fruition. Oh, because it gets up the ladder just far. And often someone goes, he's not a health professional. And then the person who had the idea of like, you don't understand, like, I listen to guys podcast, and like, I'm in his Facebook group. There's like, 50,000 people in there while living better because of the podcasts like, we should spread this around. They're gonna we're not gonna do that. I've never once had it happen. Where I've actually been, I've ever made it to the institution. I've been asked to speak at the What's that? CDE? Convention?

Anonymous Female Speaker 1:11:49
They're the CDC. Yes, one. Yeah,

Scott Benner 1:11:51
they get all together, right? I've been approached about that three times. And then when I tell them what I want to talk about, when I get there, they always say, No, that's a shame. Yeah, and so this is just gonna keep happening. Like, like, nobody's going to. There's a lot of different reasons. One of them is I don't think anybody wants to be upstaged by a podcaster. Like, you know, like, do you really want to go to a professional like, thing? Where there are 1000s of people who have all gone to college the way you described? And like, all taken all this courses, done all this stuff? And do you really think that they want my ass up on the stage going? I don't know why you're saying it like that, you should try saying it like this. Because that nobody wants to be embarrassed like that. So like, that's not gonna happen. And trust me that's like, out of someone's mouth. I can't let you talk to those people. That way, they'll be a revolt. Somebody told me if I let you tell them that they don't know what they're doing. So I'm like, but they don't know what they're doing. Yeah. And then person was like, well, that's beside the point. And so there's the people, you're going to sit down and say, Okay, tell me what to do with myself.

Anonymous Female Speaker 1:12:52
I think it's, it's kind of the difference, like, the professionals and I'm lumping them all into one basket, I should say that, you know, to their credit, a lot of the younger up and coming endocrinologist and healthcare professionals in general, the night and day difference, right, in terms of how they approach.

Scott Benner 1:13:08
Let me say, before you go on, I don't I'm not saying this is everybody, right? But there are plenty of people getting fantastic leadership skills, taught to them constantly by people, but it's not nearly everybody. And it's I don't think it's it's probably not one in three. So like, I'm not saying they're out. Like if you're listening, you're like I do all that you're an idiot. I'm like, Well, okay, I'm not talking to you, I'm talking to the other people who aren't doing that. Right, the feedback I get is plentiful enough for me to say that a lot of people get poor direction from their healthcare providers. So

Anonymous Female Speaker 1:13:43
yes, and it's a very slow rolling ball that's moving in the right direction, right. And I think that the way it's differentiated from what I can kind of understand to simplify it as much as possible is the endocrinologist in my experiences, basically does what they need to do to keep you alive. And then I step in and try to provide quality of life. Right? So very much like you, you're educating people, and you're giving advice, almost have the same level as I would as a health care professional, but you're adding in the quality of life component, because you're allowing people to absorb and understand the information, you're able to pull the information when you're ready to accept it. You're hearing it in a conversational tone, you have the ability to listen to it two or three times when something is a little bit more complex than you're used to, or you haven't heard it before. Yeah. So So there's all of that that is also available through what you're doing. That is impossible to do in a healthcare setting. Jesus

Scott Benner 1:14:46
Am I the hope of this whole thing? Because that's not good news for anybody. You want to live in a few others. Yeah, no, not that I'm the only one obviously but I am the at this point in time. I'm the only one that has a mask. Voice yes, that can reach from California to Florida to Vermont to Canada to wherever else. I mean, the podcast is, I looked at it the other day for something. It charts in, like 45 countries. Yeah, it's global. But yeah. Do you know how hard it is to chart on Apple podcasts in one place? It's not easy. So like, when you're doing it over 40 countries, you know, people probably expect me to say like, I must be really good at this. But that's not what I think I'm what I think is the information must be necessary. Yeah.

Anonymous Female Speaker 1:15:30
And the guests that you have the people who you get, like, every aspect of what you're doing is not easy, right? So even if like, Yeah, fine, maybe starting a podcast, fine, whatever, throwing it out there, anybody could do that. But to get the people on that you have, in the past is an impossible feat for many. There are like, there's just so many challenges, right to what you're doing. And you are one of the only ones that I know of in North America, because I've been looking for lots of things over lots of years, that has, you know, the amount of people and the really good solid, applicable, easy to understand information provided, right,

Scott Benner 1:16:09
I appreciate that.

Anonymous Female Speaker 1:16:10
Thank you. Yeah, and I'm not just, you know, trying to blow smoke or anything. This is the honest opinion for me, which is why I'm having this conversation with you today. Because otherwise, I wouldn't have never seen the posts that you were looking for people to talk to you, right. So it's important for me as well to try to reach as many people as I can, in whatever way I can to try to first give them a break. Because a lot of people first of all dietitian already sets me off because people come in and they're gonna think, Oh, my God, she's gonna tell me, I can't eat this, I can't eat that I can't do this. I can't do that. So they already don't want to talk to me, right? Then they're going into their diabetes, doctor's office, and they haven't been checking their blood sugars or their blood sugar's are higher than where they're supposed to be, or they haven't made the changes that were recommended last time or whatever. So they're walking in there thinking that all they're gonna get as the finger wag the judgment, and you're bad, you're bad, you're bad. Before I can even say anything. People will say, Oh, I'm I'm eating terrible. All the wrong foods. It's all and I'm like, Listen, I'm not the food police. I will provide you with information. I don't think there's any good bad, right? Wrong, whatever, everything fits. It's just how you put it together. How often you're doing it. And how much of it you're having. Yeah, right. So all of a sudden, like you the way that you present the information, they look at me, and it's like a deer in headlights, like, oh my god, light bulbs, light bulbs, big bomb, whatever. All of a sudden, everything makes sense. Yeah. And they're not being attacked. And they don't feel like they've failed, and they're not doing anything wrong. And they're your your blood sugar readings are not a report card. And it's life changing.

Scott Benner 1:17:49
Yeah, no, you're right. It really is just to be like, like, on the same level with the person that's helping you. Yeah, not to be spoken down to is such a big part

Anonymous Female Speaker 1:17:58
of all this. And for me to say like, why didn't you make the adjustment that we talked about last time? And for them to say? Well, I was afraid I was gonna go low because I started exercising. And for me to say, I totally get it. Let's talk about strategies to prevent that low from happening so that you can improve your blood sugar's and still exercise and do what you like without feeling scared.

Scott Benner 1:18:21
Alright, well, I'm feeling good about you being out in the world. I appreciate you doing this very much. Thank you. I also hope that one of the things the podcast does is creates more clinicians to think like you and talk like the podcast. So I think that's actually happening as well, you've like I can see data that other people can't see. But the amount of people that come into the private Facebook group who say in their intake form that their physician sent them there is crazy. Wow, that's awesome. Even to me, by the way, like I look at it, I'm like, huh, wow, okay. That's cool. It's

Anonymous Female Speaker 1:18:55
amazing. Yeah,

Scott Benner 1:18:56
really great. But I mean, it's just, it's too slow. is that's the part that bothers me. And I heard you say it twice already. I have probably more reach with people who have diabetes than anyone else. And I'm not doing it fast enough. And that's the thing that burdens me. Like, I look at the downloads, I see the people, I see how many devices there are. And I'm like, it's great. It's a lot. It grows. But I think about all the people who would benefit from it. Like they don't have to listen to a whole podcast. But if you could just get like a pro tip series into their hands. You know what I mean? And it's just so hard. It's so difficult to reach people. And it weighs on me. So

Anonymous Female Speaker 1:19:38
well, you're one person who's done amazing things who has changed. I had this conversation quite frequently with a person that I met through the whole looping network, right. She often says a lot of the same. She's one person who had a child who developed type one who You know, motivated her into diving into this whole world of diabetes and she has changed lives. Yeah. She doesn't see it that way. Well, yeah, it feels bad. Because she can't be there for everybody. She's gotten out. Like when I joined, it was probably like, 1200 people. Now there's over 60,000 across the globe. And this is a 24/7 thing, right? You can't do it. And she's there. Like, she used to reply to my messages within minutes, anytime a day, three o'clock in the morning, or in the afternoon, whatever. And then she would apologize. If she took longer than a half an hour,

Scott Benner 1:20:38
I would worry, that's gonna burn you out pretty quickly. But in fairness, like that's a written thing through Facebook. I have a megaphones pretty big, dude. I mean, like, there's no at the moment, the way technology is set up right now. And the stars that have to align for me to be a person who says the thing that people understand in the way that you explained earlier? Yeah, like I have the biggest megaphone, I still can't find all the people. Right, but you're one person. Yeah. But also, but my things not, it's not like I have to answer every person individually. Like, that's what that's the problem she's involved in is that, like, if somebody asks you a question on Facebook, you have to have this one on one interaction with them. My interaction that I record one thing, and then countless people are able to hear it, but I'm still not reaching enough of them. You're

Anonymous Female Speaker 1:21:25
also editing and you're also producing, and you also get a lot going on all the people together. And you're also like, that's the stuff that people don't see, ya know, I

Scott Benner 1:21:34
mean, it's, it's easy to say I'm making a podcast, but the truth is, if you followed me around for a week, you'd be dizzy. By the time it was, yeah, yeah. So it's

Anonymous Female Speaker 1:21:41
time consuming. And you are one person. So if you can get, you know, one podcast out a week or whatever, that's,

Scott Benner 1:21:48
that's impressive. Would I turn them out? I put five out a week. No, but that's

Anonymous Female Speaker 1:21:53
what I'm trying to say. Right is that I don't think the audience if that's how you feel and some of the feedback that I know that you've been given that you've been kind of posting about, which pisses me off, but anybody who doesn't understand it's understandable that they don't understand it, because if they don't do it's like type one, if you're not in it, if you don't do it, you don't get it, right. But the amount of work that it takes to pull together what you what you're turning out, is the average person could not do it. Like, just couldn't do it.

Scott Benner 1:22:21
I don't think you're wrong. I'll take that compliment and say thank you, because I don't feel that way. Because you're you're changing the world, my friend, you're very nice. I'd like to do it a little faster, because I'm getting old. So I'd also like to retire at some point. I don't know if that's evident to anybody or not, like I'd like to, I'd like to be in a situation where I, I can relax for five seconds. And

Anonymous Female Speaker 1:22:41
yeah, and you deserve it. Right. And that's the beauty of the podcasts and everything because it's recorded, and people can access it forever.

Scott Benner 1:22:48
Yeah, everyone deserves to be able to relax once in a while. But I've had a long life in a short amount of time. And I'm, yeah, I'm looking to do one more big thing for people and then kind of go my own way. But it's just it doesn't feel like there's an end to it. That's that's the bigger issue is that it just it feels like you can't, you can't possibly stop. Because that's the other problem with the way this is social media. Like basically, think about television, my example always is, somebody has already made a perfect television show. But yet we make another one tomorrow, because not everybody goes backwards to see something that's that's ended. And so part of keeping this helping people is keeping it alive. But you have to keep making content to bring people in and it can't just be about diabetes. It has to be it has to be entertaining. It has there's so many little things that people would never understand. I'm sure there are other people out there with podcasts are like, I don't understand why my podcast isn't popular. I could listen to it and tell you why it's not. But yeah, they're never going to figure it out on their own. Well, this is why I've never tried to do. And even if somebody even if you figured it out, there's no saying you could actually do it. Like even if I said to you, it has to be more like this. Or also it has to be like real, like I'm not pretending to be something right now. Like, do you know what I mean? Like so yeah, I did an online thing the other night for more rural diabetes Day, I did like a two hour talk on Zoom. There's like, great, great bunch of people showed up. And at the same time, I was like, I'm just gonna throw my phone up here on the side, and I'll livestream it on Instagram. And it's just a two hour conversation about diabetes. I don't know if anybody will ever find it. But I know if they did, they'd be better off at the end of it.

Anonymous Female Speaker 1:24:27
Okay, so this is where that whole thing comes into play. Where if you can save one person? Yeah, no, of course it's worth it. Of course. Yeah, of course it is. And I'm sure that you've probably saved hundreds.

Scott Benner 1:24:40
I mean, I must have three at this point. I gotta have three.

Anonymous Female Speaker 1:24:45
Oh, well, you have enriched my life and you have motivated ways that motivated me in ways to provide better care to people living with type one diabetes than you'll ever know. So there's that

Scott Benner 1:24:55
I appreciate that very much. I'm going to stop on that because that makes me feel really nice and I I'd like to stop on feeling nice. So hold on one second.

Anonymous Female Speaker 1:25:02
I don't know if we covered all the material you want to seven different branches of stories but

Scott Benner 1:25:07
no, no, no, no, you did find this was perfect. Thank you

a huge thanks to Omni pod, not just my longest sponsor, but my first one Omni pod.com/juice box if you love the podcast, and you love tubeless insulin pumps, this link is for you. Omni pod.com/juice box. 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 and a year supply of vitamin D. That's at AG one.com/juice box. 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. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1139 Grand Rounds: Communication

Scott and Jenny discuss the need for clear communication between doctors and the people that they care for.

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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 1139 of the Juicebox Podcast

Welcome back to the Grand Rounds series today Jenny Smith and I are going to be discussing the communication needed between doctors and patients. 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. Don't forget to save 40% off of your entire order at cosy 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. 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 T one D exchange is looking for you. They're looking for US residents who have type one diabetes or are the caregivers of someone with type one to fill out a short survey, T one D exchange.org. Forward slash juice box. When you completely fill out the survey, you're helping people with type one diabetes, and you're helping to support the podcast. It only takes about 15 minutes T one D exchange.org forward slash juice box

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. 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. Jennifer, welcome back to the Grand Rounds series. Today we're going to talk about communication.

Jennifer Smith, CDE 2:17
Yay, yeah, let's say munication. That's a broad topic.

Scott Benner 2:22
Well, we're gonna we're gonna lean on listeners a little bit for this one actually, maybe a little more so than we have in the past, we have a lot of feedback from listeners about what they wish their doctors would do regarding communication. So I'd like to step through it. Yeah, it's kind of a long one. So we'll jump right in. The first one here says I want my doctor to know that I am an entire person who has diabetes, not a diabetic. And that this is not my entire life. It ebbs and it flows, my controls are normal, and they're okay. And in the end, I need to be treated like a person. And I think that's a good way to start. Because, you know, you and I were just speaking before we recorded and we probably should have just said this while we were recording, so I'm gonna bring it back up. Doctors need to talk to you, like they're real, and understanding how to communicate with people and be human and reflect while people are talking, not just talk at them, but see what they're going through. And respond to that, you know, instead of just yelling orders be more collaborative, I guess is the way I would think about it.

Jennifer Smith, CDE 3:28
Right. And in that collaboration, what you're going to take away, whether you're a doctor, or an educator or a nurse, or you know, whoever is the clinician, that the person with diabetes trying to interact with, they, they need to take that all into consideration for the data that the clinician is looking at, because that data is only truly numbers. And those numbers translate into somebody's life, and why they look the way that they do like you said it might be I've had a really great couple of weeks, everything's been lovely. I had a week off, you know, from my job, I got to relax, I didn't have any crazy, I have to go to school because my kid got in trouble. You know, all the variables that could sneak in, everything was calm, whereas two weeks prior to that, maybe everything was hitting the fan, right? And so, as a clinician, if you're not asking or learning how to communicate on a personal level, you're gonna miss why the information looks the way that it does. If you're really just looking at it black and white people aren't numbers.

Scott Benner 4:40
I don't imagine that anybody listening has never been in the situation where you kind of look up one day and you think I haven't cooked a meal for myself and days. Like I've been eating leftovers or I stopped on the way home or I did something like that. It builds on you. You don't recognize that you're out of your rhythm. Yes, right. And then if you to go look at that weak of blood sugars and say, I see a lot of spikes here, there's some lows. And you know what happened? Right? That what happened? First of all is mind numbing. Like, I don't know what happened, it was two months ago. That's that's the first problem with it. But the second problem is, even if I could remember, you've probably looked at the chart when Oh, that's the week that I wouldn't put two and two together, I wouldn't say oh, that's the week I stopped cooking for myself that week, because right work was hard, or to feel that humanity is important. Because otherwise, what you're saying is, Hey, what did you do? That's how it feels. And you a don't know what you did? And B, you were trying the entire time, like that, I think is the that's where the damage point comes in, is that these people are working really hard. And trying to do well, it's not going their way. Okay. But instead of saying, What did you do, do better? Find out what happened, if they don't know, then just say, look, let's just look at the graph and see what we can do here. You know, like, Let's offer a suggestion, if you don't have a suggestion than asking what happened is almost cruel. You know what I mean? Correct? Yeah, absolutely.

Jennifer Smith, CDE 6:08
Because oftentimes, whether the person with diabetes voices that or not, they are coming in, because there is something that is often not going 100% The way that they want it, they may not know themselves, how to communicate that back to you as the clinician. And so for you to, it's almost finger pointing, and it's a blame scenario, when you're saying, Well, what happened here, pointing your finger at, you know, one, high blood sugar, one really extreme low blood sugar. And again, the person may have no idea three weeks ago, what happened. But if there's a recurring theme, then your job as a clinician is to help figure that out, and give them suggestions. And be able to say, Well, I see that, you know, every three weeks, you've got this big project that you're trying to do with your business. And I can see that this translates into meals that aren't, you know, as timely or a lot of stress that keeps things high. Why don't we try this, I can see that this variable is hard for you to make it better and maybe make you feel a little bit better, better, you know, looking blood sugar's would help in this scenario, let's try this, try this setting change, try, try to, you know, have meals ordered at regular time. So they come to your office or give them a solution that they can start with, I guess,

Scott Benner 7:30
something that is clear, concise, and you know, is going to reasonably speaking work to because I think the other problem can be is when you just start like spitballing and they go home, like you knew, you know, hey, the guy said, you want to go home and you you put it into action, it doesn't work, you're like, well, he doesn't know what he's doing. And I'm still lost, and he's gonna yell at me when I go back again. And even if you're not yelling at them, they feel like they're being yelled at. Right? So it mean, I have a pretty big personality. And I still have been in that doctor's office, and I'm like, Oh, my God, like what's going on? Like, you're coming at me? Like, I don't think she was coming at me. And I think I was somewhere deep down. I knew I'm not doing well at this, you know, like, Arden was little I didn't know what I was doing yet. And any kind of feedback felt attacking because I was I was vulnerable. You know, like, I was in a bad spot. I didn't know what I was doing. I was pretty sure I was hurting my daughter. I was starting to think about long term stuff. Short term, you know, was a mess. And then that's where I don't know. Like, that's where that part of the doctors thing is so important. Like, it's how they approach you. It's like coming at a I don't know, it's like to care approaching a stray cat like kind of very slow. Yeah, exactly. I'm here to help.

Jennifer Smith, CDE 8:48
Right. And when you when you first come into that, that office space with the person who has come in, they've made their appointment time, and they made the time to bring in some records and reports and whatever your question to them is, I'm always asked, I mean, this is my no one. But well, how are you? Do you have time to hear how I am? Like I could I can tell you how I am right. But what is important right here. And now for you to know about how I am what are the biggest things and this goes to the person with diabetes. It's what are the checklist things that are really, really important so that when they say, how are you you can say, well, I'm okay, or I'm doing really great, I've changed this, I've changed that, you know, this is looking much better. So there has to be enough communication to really, to really, I guess, give to that question of how are you? And you have to be receptive of it too.

Scott Benner 9:40
Yeah. In my mind, you need to hear people and really see what's going on with them. And at the same time, you need to be a leader, right and not a leader in the way of like, Oh, God, this guy again, but like, you know, like, right, you know, prior to the podcast, and even in the early days of the podcast, I would do like I'd have a lot have phone calls with people where I would just talk to them about their diabetes. And what I learned pretty quickly, is that often, they don't know what they're talking about. They think like, they think they know what's happening. And they're not right now, you still need to listen to them and hear what they're saying. And then I hear what you're saying, you know, and what I think might be. And I never know what to think. Like, how do you know when you're just meeting somebody very quickly, right? You go back to basics. Yes. You just say, look, let's look at your basil first. And let's say that the easiest question I've ever found is away from food or active insulin. Does your blood sugar sit stable? Right? If If yes, where? You know, if that number is 90 I go, Oh, Basil is probably okay. If you tell me Oh, it's very stable at 121 3151 80 I go, Oh, Basil seems weak to me. Let's fix your basil first. And then maybe this will you know, help your meal Bolus is to work better. And I always say like, you know, adjust your basil. Get it right. Be careful while you're boasting and correcting because now you're adding extra basil on these boluses and corrections are gonna eventually need you know, less insulin. Let's get this right first. Give them a path. You know, once you get your Basal right, go back and reevaluate your meal insulin, your carb ratio and your and your insulin sensitivity. And honestly, just telling people that it mostly works for them, you know, like it's but when you start going, I don't know, let's try this at nine o'clock, like, I don't know what you're doing then be entertaining right now make a different problem. So this next person says, you know, it's a long, it's a long story. But basically, they said, I was basically told I'm probably going blind and probably losing my foot, I got very jaded, which really quickly actually did turn into me being non compliant. I stopped going to an endo just went to a GP to get my scripts. And, and I think that the takeaway here was, that hope is just is very important, and that these initial messages over and over again, I want to say initial messaging sets people on path. Contour next one.com/juicebox. That's the link you'll use. To find out more about the contour next gen blood glucose meter. When you get there, there's a little bit at the top, you can click right on blood glucose monitoring, I'll do it with you go to meters, click on any of the meters, I'll click on the Next Gen. And you're going to get more information. It's easy to use and highly accurate. Smart light provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next one.com/juicebox And if you scroll down at that link, you're gonna see things like a Buy Now button. You could register your meter after you purchase it or what is this download a coupon? Oh, receive a free Contour. Next One blood glucose meter. Do tell contour next one.com/juicebox head over there now get the same accurate and reliable meter that we use. diabetes comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US med has done that for us. When it's time for art and supplies to be refreshed. We get an email rolls up in your inbox says hi Arden. This is your friendly reorder email from us med. You open up the email to big button it says click here to reorder and you're done. Finally, somebody taking away a responsibility instead of adding one. US med has done that for us. An email arrives we click on a link and the next thing you know your products are at the front door. That simple. Us med.com/juice box are called 888-721-1514. I never have to wonder if Arden has enough supplies. I click on one link. I open up a box. I put the stuff in the drawer. And we're done. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and the Dexcom g7. They accept Medicare nationwide, over 800 private insurers. And all you have to do to get started is called 888-721-1514 or go to my link us med.com/juice box using that number or my link helps to support the production of the Juicebox Podcast. So this person thought I'm gonna die anyway. Why try? Why

Jennifer Smith, CDE 14:43
try right? Why continue to go to somebody who hasn't and in this case, not everybody but in this case they weren't being given anything. Positive, valuable. Yeah, to try positive and valuable and applicable probably to their life. They were Being maybe given some advice about well adjust this here, or change this there? Or maybe it was the don't well don't do this. Why are you eating at McDonald's every day? Or why are you doing right? I mean, don't don't badger somebody into a change that isn't really going to make much different? Yes, for that,

Scott Benner 15:20
I get the idea. So I think what probably happens is that jaded doctors who have seen more than their fair share, you know, in their defense more than their fair share of people who are just not doing well, and it probably seems hopeless. And they probably think let's just jump to the end and try to scare them. And, you know, because I've seen that work with a few people. And by the way, I've actually heard from adults who the scare thing worked on them. Well, yeah. And but more people than not say, scaring me just scared me, or scaring me froze me, or it made me think I can't win, right? It's why everything goes back to understanding how insulin works, because in every situation you find yourself in whether it's somebody who's struggling forever, or just starting out, if you give them these these basic tools to begin with, they have successes that they can build on. Right, you know, and it relieves stress. And I think that, you know, this next statement here from somebody said, I wish somebody just would have told me I could have with insulin moved my anyone say, it's funny, they just didn't have that idea, like I was told, seven, two, good a one say.

Jennifer Smith, CDE 16:26
And also almost that the numbers that they were getting, were as good as it was going to possibly get that it was all about almost a stable point of where their body wanted to sit in terms of blood sugar, and that it was going to sit there. And other variables didn't have any impact on that one of them, obviously being insulin, and that an adjustment that's more precise, could actually move the needle in the direction that you wanted to go. Even without adjusting activity or food or anything else. A lot of times it's the right place to adjust the insulin.

Scott Benner 17:03
And how hard would it be to say, look, the ADA recommends this number, but I'm your doctor, I'm standing in front of you, I don't have diabetes, my one sees probably 4.9, you're not going to probably be able to get that but I bet you we could get you into the sixes. And then work on the fives maybe make some modifications to how you eat. Who knows like, right, if you want to go low carb, maybe we could get you in the forest. Right? But when you say sevens, okay? And the only thing is a quarterly report card, and they hit the seven or even I know it doesn't sound crazy, but 7.9 in somebody's head is still seven. It's still sad. Yeah, like I did it. I'm in the sevens in the sevens. But what's your one thing? Will you tell me?

Jennifer Smith, CDE 17:44
Will I tell you Sure. My a onesie is 5.5. Okay. That's what we want. That was my last one. The one before that was 5.6. So really, I'm I it's there.

Scott Benner 17:54
Yeah, right, right. It's there. Right? It's five you have type one diabetes, it's five, five, it's five, six. You know, you manage that by understanding insulin exercise and diet, boom. Like, you know, if I didn't want to exercise if I was Jenny, but I didn't exercise you probably have a six two.

Jennifer Smith, CDE 18:11
Right? Sure. Yeah, and be using more insulin than I use respond to food differently than I respond. Absolutely. They're those big variables that you do have to understand. But mean insulin is, it's the mover of blood sugar. I mean, right. And if you have it squared away, and you have somebody to guide you, I think, thanks to the podcast, obviously, I think people have a lot better understanding of insulin, and the fear component gets removed and they're willing to do their own trials of changes. But then there are still a good majority of people who are not confident enough about making adjustments and are still going back to their clinical team to make those and because they're not made maybe at most every three months you're left with this idea of again, I'm seven I'm seven one I'm you know, whatever and the doctor says that that's that's in a really great place or it's come down so I'm I'm clearly moving in the right direction and you are but it could be improved even further you could be getting closer to what we would hope for getting in the range of people without diabetes safely. Of course, you

Scott Benner 19:21
know, and people I think generally speaking humans like reaching right they like seeing something out ahead trying for it and succeeding. It feels good it works it I mean, we spend so much time talking about oh, I'm scrolling it's you know your dopamine your D you can give people a dopamine hit with a with a good blood sugar. Like if somebody came in to this conversation right now. And they said Look, you guys are talking about a seven a one c minus 10. I you know, I'd kill somebody for a seven you don't have to kill somebody for something first of all, you just you know, need some changes insulin, yeah, just make some changes in your settings and how you're, you know, timing your insulin. That's it. I mean, honestly, good settings Pre-Bolus your insulin a once he's somewhere in the 60s, you know, it just, it really well be if you're in the 10s, you don't know what you're doing. That's all for a doctor to look at that and say, Oh, I give up on this one. If you knew what I knew, or what Jenny knew you would go, I could fix this tomorrow. I can, you know, like, what are we doing here? So,

Jennifer Smith, CDE 20:23
and the unfortunate thing about those a one C, there is sort of a range, right? A onesies over I think it's over about a nine or a 10 really is a deficit of lots of basil and Bolus, if there's a deficit, definitely. And the person with diabetes may not know what to change the clinician, the one with the degree and all of the, you know, panels on their walls and whatever. They're the ones that should be able to say, Hey, your agency is here. Clearly, there's not enough insulin and you might then start to add insulin to hopefully get those those numbers down. Anytime that a one C is kind of like above where you'd want, let's say it's above seven, but kind of under that 10, then we start looking a lot more at mealtimes. And we start looking at, okay, as you said earlier, if you can float around at a at a stable blood sugar, even if it's 120, right, and you're safe there, then your Basal isn't really the wrong thing. What we end up seeing is these major excursions around meal times, which could be relative, that the dose is not necessarily wrong, that it's the timing, people haven't been taught the right timing of their of their dose, it could be both it could be timing, and that the dose has never been appropriately adjusted. And so those those a one sees as a, you know, just average, could be brought down by attention in a different place.

Scott Benner 21:53
And a little trick to figure out if that's the case is if that stability is higher than you want it to be. But like Jenny's saying, it's very stable. If you missed on a meal prior, like she's saying, you might end up at 120 with a perfect basil. And you know, Basil is doing its job perfectly, it's holding you steady. It's not its job to shoot you down. But I tell people all the time, if you see that stability higher, and you're not sure is this my basil, or did I miss on a meal corrected. And when it starts to go down, if it goes down and stays down, you missed on the meal. If it goes down and it comes back up, that could be your Basal being two weeks. Yep, it's a simple way to just check to see what's happening. That's the thing, you should be able to empower people with this, this person says I want my doctor to not be so by the book, I'd love for her to constantly be educating me, let's talk about off label use for medications if we need to, I'd like her not to be afraid to help me change my settings, to empower me to change my settings. And just because I do have a one C that's lower, it doesn't mean that I don't need help ever. Right. And I made a note next to that, when I said you gotta be a guru a little bit. Like it's, I mean, the by the book thing, it's not going to work for this, like you need their variables, you need your information, need the tools, you need the understanding of how to use insulin, they all have to work together, you can't just say, you know, 15 minutes 15 carbs, like that kind of stuff. It's right, it's too bare bones. It doesn't it doesn't do the right things for you know,

Jennifer Smith, CDE 23:17
and it I think a lot of the beginning tidbits of information that are given, they're just a starting place, kind of like the 1515 rule, which is really, really old school, obviously at this point. But it's still being taught because it's a, it's a quick and easy teach. But then you have to end up going beyond that as the clinician when you can say, Okay, I've taught them this, they're using it. But now my job is to say this isn't working, maybe you need less, or maybe we need to consider a change to this. Or maybe we need to, to do this and in the visits with people, then you have to bring that in so that they can see why you're making suggestions, or changes. Don't just give them a directive and expect them to move forward. They need to understand why What are you seeing? What are you seeing that suggesting I should change this or to change that or to think about this differently? Because otherwise you're just sending them out with a map that doesn't apply to their life.

Scott Benner 24:19
I wonder if doctors don't feel almost embarrassed to talk out loud to think out loud. Which would be a shame because it's a large part of how I taught my daughter to take care of herself was just everything that we were doing was spoken. Hey, it's time for you to change your pod. You know, we don't want to leave it on too long. Because you're only supposed to leave your cannula in for you know, about three days. So let's not wait. Let's get that off now. Right. Oh, you know, when we put it on, we'll watch your blood sugar. If it goes up, maybe we'll have to put some insulin in with a new site next time. My daughter doesn't know it. She could not sit down and explain diabetes to you. But she can do it. Right Is it To

Jennifer Smith, CDE 25:00
become habit, because she just knows what to do,

Scott Benner 25:02
because I'm narrating her life around diabetes out loud and not all the time. Like, I don't want people to think, oh my god, this guy up this kid, you know what I mean? Like, they just don't just, you know, like, at times when something was happening, we do it, you know, a plate would come out, I'd go, hey, you know what I'm thinking here, we're going to Bolus you think about how much you think it's going to be. And then we'll compare, you know, and she'd say, I think it's 45 carbs. And I go, Alright, where do you see the carbs? You know, don't don't just guess the number. Tell me where you see it. And then I'd say I see what you're seeing too. But I think you're forgetting the breading of the chicken. So let's throw in like seven more for the reading. And that over there is fried. And so I think you're gonna get a little bump later from from the slowdown and your digestion. So why don't we put a little more in for that, too. And then years later, she just knows how to do it. Like it's not. I think that there's that the doctor brain learns differently. I imagine. I don't know, I don't have it, I have more of what you might call like, an artist's brain. Like, I just, you know what I mean? Like,

Jennifer Smith, CDE 26:05
yeah, I'm a, I'm a talker, when I, when I work with people. And I'm also when I respond to email requests or inquiries about data and whatever. I have very lengthy, like emails and a very lengthy discussion, because I talk a lot. And I want you to go forward with why I'm suggesting a change. Or even if I'm questioning, hey, let's work together. What do you think you know, your life better than I know, I see that we could do it this way. But I also think that we could do it this way. What do you think you'd like to try first, so it gives some options, and it gives them the ability to move forward out of our visit together? To try something without checking back in? Yeah, right away, or without going three months, and then saying, well, it didn't work. I didn't know what else to do. So I just kept doing it.

Scott Benner 26:57
Look, I don't know how many doctors are allowing emails. Now. I guess there's a lot of portals where you can message people. But people need to feel autonomous, like they just really do they need to like and if even if it's a new person, and you're like God, I can't let them make too many changes. They don't know what they're doing. I mean, they can move their Basil 10%, like you don't I mean, like you could, you could give them a little bit of freedom so that they could like trial and error out a little bit. And I'm assuming that the word error doesn't sound right to a doctor. But that freedom that you give them, it's how you get to where you're trying to take them, like you can't shackle them the whole time and then go, I don't know why they don't run, you know what I mean? Like, like giving

Jennifer Smith, CDE 27:36
somebody this dose adjustment, maybe you explain it, but then saying, You know what, try this for two or three days. And if this isn't quite enough, or it's just too much, then we're gonna give you this next option, giving them handing it to them and saying, here, here, here's an option. It's not just you're stuck at this. And you know what, for further collaboration, it's checked back in, send me an electronic message, and let me know, did it work? Did it not work, I am happy to check back in with you to make sure that I give you another suggestion, or to see that it actually is safe to continue changing things. Right.

Scott Benner 28:11
I think also, if you don't believe that conversating with people can lead them to understanding things that you should, I'll tell you this little story. So Jenny, and I have made all these different series together. And the feedback overwhelming, I'm talking about overwhelmingly like hundreds of 1000s of millions of downloads, right? And people come back, I listen to this my one season the sixes, blah, blah. And I even to the point where I sometimes think, what the hell did we say in there? You know, you mean, so like,

Jennifer Smith, CDE 28:40
what really hit for that person, like God, like,

Scott Benner 28:44
I don't think I know that much about it. So I did this thing recently. And it's gonna come out on my social media at some point. But I chat GTP like AI has gotten to the point now where it's fascinatingly good at breaking down conversations. So behind the scenes, I'm feeding the transcripts of everything you and I have done together into AI, and I'm telling it just one simple thing. What are the key takeaways for people living with type one diabetes? And it writes in bullet points, my brain doesn't write in bullet points, but it does. Wow, that's cool. It's so good, Jenny, that when I put it in front of you, you're gonna think you wrote that list yourself. Or you're gonna think I wrote it, or you're gonna think we wrote it together. It's really technically

Jennifer Smith, CDE 29:28
we kind of did. All we're doing is feeding information and something is putting it together and very concise.

Scott Benner 29:35
It literally can read through it and filter out all the bowls. And just come back with this is what was spoken about. I'll tell you this, we you and I did an episode called setting Basal insulin, the math behind Basal insulin or something like that. You can ask the transcript, what your Basal insurance should be based on your weight and a couple of other things. And it just from our conversation knows the answer. It figures it out for you. That's insane, right? But here's the plan. Here's my bigger point. I know I'm helping people with this conversational style. But I also know there are some people who don't enjoy this conversational style, right? So I'm finding a way to give that information to them the way they want it, doctors have to do that, too. You can't talk to people the way you learn, right? I'm sure all your engineer patients are probably thrilled with you. You don't I mean, like, seriously, but if I came in and you started bullet pointing me to death, I don't know what to do. If you told me right now to take three thoughts that I understand and write bullet points about them, I guarantee you, I'd write them out in a paragraph instead, right, and then I'd have to stop and break the paragraph apart, and then reward them. So they look like bullet points, because my brain doesn't work that way. It's really something I

Jennifer Smith, CDE 30:41
mean, what you're kind of boiling it down to is what I feel about. Educating the way that I do is getting to know a person, I understand that I have a little bit of a different way to do that. And you know how we work with people. But in an office space, time is really the constraint, I get that. But because I have the time, the nice thing is that I could tell you what impacted someone's blood sugar in one way compared to another's, because I know them, I don't know them just their name. I know them, I likely know the siblings in the house. And I know that this child goes to a grandparents house, you know, four times a week, and they're served these things versus at home, it's different. And so those are some of the things that also go into management, that may not be a setting change. And that you have to be able to learn in order to educate, or to be able to teach a strategy that's applicable to that one person. I know that I teach differently, a little bit differently for each person I have the opportunity to work with, because I meet them where their need is.

Scott Benner 31:55
I think if a doctor hears you say that and thinks I can't do that, I think yes, you could. You can you just need more practice talking to people. I swear to you just call me like get on the podcast, and we'll chat. And just after an hour, you'll be like, Oh, I can just conversationally talk about diabetes, and people understand it. That's crazy. I'll do that. You know, it's it's so doable. Jenny, this person here says, If you don't know something, just tell me you don't know. Yeah, honestly, would be the bedrock of our of our relationship. And I actually just interviewed someone recently who had that story, she asked a question about her pump, to her doctor. And instead of Bushcare, were sending her to go and go watch a YouTube video. Which, by the way, there are a lot of comments in here from people like do not go tell me to watch a YouTube video, like Teach me how to do the thing. Okay, so if you were the doctor don't know how to do it. I mean, hey, why don't you take a weekend? You know what I mean? Cuz kind of your job. Be honest. And so anyway, this doctor says, I don't know, I'm gonna find out and come back to you. And then they actually followed through and did it? Yes. And it was a big deal for this lady. You know, that would be a

Jennifer Smith, CDE 33:10
that's a big deal for me. I mean, I have fired essentially, or just not gone back to clinicians through the history of my adult life as choosing my own clinical team. Because I got the sense very much that they couldn't answer my question, they kind of be asked around not knowing how to tell me that they didn't know. And so I was just like, Okay, I'll find somebody else.

Scott Benner 33:35
I wished my doctor not only knew how to tweak, you know, my diabetes, about my lifestyle, like, have like a, she actually says here, I wish you had a primo list of referrals, mental health, you know, nutrition, stuff like that a CD, they actually knew what was there was willing to work with you. And listen, I'll say this, I know a number of doctors privately. Don't just say like, oh, there's a guy over here. I know the girl in this practice, and you know, they're crap. And you send people to them anyway, because they're part of the system or something like that. You just create another problem. Again, say, you know, I don't know anybody that's going to fit that bill should ask around a little bit, or call some offices, ask some leading questions. How do you guys deal with this? You know, like, pick on your own? But yeah, this person's like, you know, please just help me find other practitioners at times. If you can't do it, just say, I don't know, let's get you to this person.

Jennifer Smith, CDE 34:28
And sometimes that takes from the clinical or you know, the physician angle that that means that even if you can only refer to people within your organization, then know the people that you do need to refer to, right know the mental health specialists in your organization, get to know a couple of them. Who would you really click with who really would be great and who was kind of iffy and totally wouldn't be somebody for diabetes to talk to right. Get to know kidney specialists get to know good cardiologists get to know your system. I'm because I guarantee that there's not just, there's often not just one practitioner to refer to. And if you get to know those different teams, you'd have a better list that you can easily pull out or look up on your notes on your phone and say, you want to see this person, you could see this person, but they're not my first choice. Why? Who cares? It's important for the person that you're telling.

Scott Benner 35:25
And if you don't think that's important, this person says, Look, I'm a researcher and a reader. So I ended up clashing with my doctor who just wanted to take complete control and not empower us at all. If you're a doctor is like, that's how I want it, like, I'm gonna crack the whip, and everybody's just gonna do what I'm gonna say, this person said, I switch practices because of that. On top of that, she was told that her and her daughter would difficult patients. Yeah, for wanting to understand how to take care of themselves, they'll think about the psychological ramifications of that. If you're like, not everybody can speak out, here's a person who spoke up, right. And but most people aren't head down. A lot of people are head down, right? If you dominate them, they'll take that, and they'll never stick up for themselves ever. And you will be directly responsible for the poor health outcomes that they have. And you won't think so you get around at a party and tell your tell your friends, what a great job you're doing for everybody. But this is how these people could feel.

Jennifer Smith, CDE 36:20
Yeah, I think it kind of goes along with a lot of I wouldn't say a lot, but maybe half of the time I hear from parents, especially where their pediatric practice really wants to do the load of the adjustments. They really don't want the parents stepping in and adjusting and doing things in between the visits, which may not be close enough together, as their child is growing. And all those changes are happening. It's not soon enough. Now there are really awesome practices that have a lot of close, you know, I guess communication, but then the other ones do a lot of hand slapping, I did you change this? I would you adjust that. I told you not to do this, or you know, that doesn't help and long term. If the child is in the room, hearing those comments, they're also now learning that they don't have any voice in their own health.

Scott Benner 37:16
I don't know what I'm doing. And maybe worse, my mom doesn't know what she's doing. Right. I think that's a thing I see all the time, especially when we speak in public Jenny, and, you know, I, you know, I'll go to the parents and all, you know, a license stuff out for them. And then you go to the kids, and you're like, hey, you know, I told your parents and stuff today, and maybe they'll and the kids are like, my mom does not know what she's the devil coming out and say it like, she's tried three things. My one seesaw seven, maybe that's the most just the most terrible thing is taking the a child's you know, confidence in their parent away, you know, like, what's gonna happen at the end of this series, Jenny, and I gave it away a little bit here. But there's going to be an episode where I'm just gonna read the takeaways for everybody. And I'm gonna go over them with other people in like, kind of bonus episodes or supporting episodes for this series. In the end, as a doctor, empathetic kind. If you don't know something, figure it out. Teach people how to use insulin know how to talk about that very fluidly. It's all you have to do. Like, like it just, there's not much more to it than that, then let it be a conversation and give them give them power. Now look, do you have some people who, you know, you're like, Listen, if I give them power, they're gonna kill themselves in five seconds. Like, I'm, I'm not saying sure those people, you know what I mean? But those people can also be helped with basic tools, and a little bit of like, carrot and stick. Like, there's nothing wrong with saying, Hey, you're a 10. No problem. I think in six months, we could be in the eights. Like I'm going to help you get your settings right, then you do a couple things for me, we'll come back do another blood draw, we get you down to the AIDS. Now we're off to the races. I don't see why a year from now you couldn't have a six a one say, like, give people something to work towards? Like, we're basically just ants, Jenny. Humans are not good without a task. No, they're not. No, you gotta give him something to do. You know,

Jennifer Smith, CDE 39:15
right. You know, and from, from the doctor standpoint, too. I think when we're talking about diabetes, you're talking about a specialty. Right? You're talking about beyond just general practice. You've chosen to go into something that requires you to keep up with the changes that are happening. And this is very specific. And you might be you might end up being an endocrinologist who has nothing to do with diabetes and then that's great. That's your practice is not specific to that but if it is, you should be able to answer a question about a device. You should be able to keep up with what medications what is changing how to use it, who to use it for, you should be a able to answer questions, because you've chosen to specialize, it would

Scott Benner 40:04
be like if I climbed into a Nissan ultimate, it said driving school on the side of it, got behind the wheel looked over at the person in the other seat and said, which one of these makes it go? And you said, I don't know. I don't know. Well, then what am I paying you for?

Jennifer Smith, CDE 40:18
Right? Absolutely, I just I don't understand. If you've chosen, as I said, if you've chosen to specialized, you need to know your specialty.

Scott Benner 40:29
Jennifer, there is no doubt in my mind, that if I wanted to make a living a different way, I could offer private courses to doctors. And I think in three hours teach you how to take care of your patients. I know you could do it, too. There's a lot of people that could do it. But my point is, if that could be done for you, you could probably do that for yourself. You know, like you don't like go like find out that one of the things I'm always fascinated by, if someone comes in the office, they figured it out, they get their agency where they want it, they've got these great stable graphs. And the first thing that happens is Doctor yells at them out of fear. You're too low, you're gonna have a seizure. What about saying, hey, what didn't you do? Right? Could you tell me what you just did? Because I got to be honest with you. I didn't see this coming. Right? It happens all the time. And if they say something like, I listened to a podcast, don't yell at them and say the internet's not a good place for you to learn. Because your doctor's office hasn't been a good place for them to learn. They're trying to figure something out. So in the end, Jenny, meet people where they are, give them agency, and for God's sakes, think before you speak. Yes, leading a sentence in the wrong direction leads 15 minutes into the wrong direction. Start Strong.

Jennifer Smith, CDE 41:38
I wish to my point, don't point fingers do not

Scott Benner 41:41
point fingers at people like it's we're in this together and give people I can't believe I'm going to say this. You have to give people their flowers to when they do well. You got to like and it can't feel phony. You got to really mean it. You know, this is amazing. I know how much hard work this took good for you. I think there's more keep going. Right? And

Jennifer Smith, CDE 42:02
it doesn't have to be with what you what you see as where you would want them to be. If you've got somebody you've been working with who is so fearful of Lowe's that they run blood sugar's at 250 or 300. And now, your work together whatever education they've provided themself, now they're averaging a blood sugar around 190 or 200. That's a give them flowers. That's not a well, we really want to be lower than this. Oh, no, no, no, they've achieved something like, let's keep the ball rolling, right, you have to give them good positive reinforcement, regardless of what your down the road, like goal is for them. My

Scott Benner 42:44
daughter's first endocrinologist was brilliant. I could tell by talking to her. She never helped me once with diabetes. Just stood in the room smart, and said smart things and

Jennifer Smith, CDE 42:56
didn't help it that didn't translate into helping you. Oh, no,

Scott Benner 42:58
no, no, I was in a panic. You know, it might have been easy to say things like, hey, if your blood sugar is too high, you might not have enough insulin, I would have gone. Oh, that makes sense. Thank you, you know, Jenny, there's a note here from you that says Please don't look at a static number and then say everything is great.

Jennifer Smith, CDE 43:19
Right. And I wonder if I don't know if I gave context to it. But I think that I think that I was possibly talking about a one C two there. Because it is it's we understand that a one C is just an average, you really do have to get into the whereas the agency coming from what are the kind of the data points that are pointing to this because then you have more room as the clinician to say, Gosh, you came in your agency is now you know, 5.8, and it used to be 6.8. And in my mind, that's lower than I want it to be. But gosh, that a Wednesday is really stable. Look, you have like less than 1% of the time low, you have a standard deviation that's like those, those little pieces that go up to make that one standard value. That's really important to

Scott Benner 44:10
look at. I'm gonna run through a couple of things here at the end for people, I wished my doctor was a resource for other resources. Tell me, why did I have to this person says directly? Why do I have to find this podcast on my own? Listen, there are plenty of doctors and I want to say thank you to all of them that recommend this podcast every hour of every day. The Facebook group, which gets 150 new members every four days is overwhelmingly they have to answer a couple of questions. It's a private group, right? One of those Where did you hear from this from my physician from my doctor from my hospital? Like it's a fair amount of people. So thank you to all of you doing that. Obviously, I don't think we're talking to you. But you know, for everyone else, if you don't know, send me somewhere that might know and don't do that thing of like, well, I don't know what you're going to hear when you get there. Because the thing that's happened thing now is bad. So, no, I don't know like what could go wrong now maybe he wants he's nine and a half. I'm on the fast track here. You know what I mean? Like, good, go try something like whatever happened to like, I don't know get out there and do something like sometimes just doing anything and seeing a little bit of a positive return is enough to supercharge and get you going again, even local support networks, people are asking here like, please know where I can go meet other people. My teenage daughter just hears you're doing Oh, this is I think we've covered this in another one. But there are people who are looking for more, okay, so don't just look at their six five, a one C and go You're doing great. Because they might want to do better. And they'd like to hear from you. I mean, they know they're doing six fives. Great. They know they're doing great. So there's a double edged sword there. You could lull somebody into complacency. But what this person says specifically is when my daughter hears that, then I go home and try to say to her, Hey, listen, we should try Pre-Bolus. In five minutes longer. She goes, Hey, doctor said we're doing great. So yeah, you took away her desire to try to help herself. There's a way to say you're doing well. But there's always room for improvement. So here's some ideas like that kind of stuff. Right? Real quick. They don't make us feel bad about my agency Don't say things like, well, it's okay, this time, please don't use guilt as a communication tool. And then here says this is some feedback from somebody else. It just kind of gave me like a stream of consciousness that I want to kind of end here with she said, relationships, person to person person, the diabetes, clear relationship expectations, level setting, meet people need to feel safe. freedom to express things is very important. psychological safety is a big part of how you can get these visits and your relationship to work in everybody's favor. That's kind of where I'm at today with communication. If you have a minute, I'm going to share something with you, Jenny. Okay, go ahead. Anything you want to say or finish with before I jumped to the end? No,

Jennifer Smith, CDE 47:07
I was actually going to add one thing to that list is the be supportive of the caregiver. Be supportive of a caregiver, I talk a lot about like parents as the caregiver for kiddos, and be supportive in the way that you would be willing again, this goes along just communication, hear what they need, and also hear what they've tried. And if the child or the teen is in the room, be supportive of the efforts of what the parent is really trying to do. So again, you you may have some things to share with them. But really try to prop them up with all the effort they've been putting in. And if they come to you with questions, being able to again, communicate back in a way that they can understand how could this work? Could this be something that would be better, just really support them?

Scott Benner 48:05
That's a perfect way to end, I was going to share one of the takeaways with you. So from Episode The second episode of the Grand Rounds series is called diabetes diagnosis. And I asked an artificial intelligence to give me the key takeaways from that episode. And it said doctors and regular primary care settings may diagnose diabetes due to the rarity of the condition and the similarity of symptoms to other illnesses. misdiagnosed excuse me, it is important for patients to clearly communicate their symptoms and concerns when contacting their doctor's office. misdiagnosis or delayed diagnosis can lead to complications such as diabetic ketoacidosis. Doctors should be proactive in ordering appropriate tests such as blood work in your analysis. When patients present with symptoms that could be indicative of diabetes. Patients should not be dismissed or ignored when they expressed concerns or symptoms that could be related to diabetes. education and guidance on diabetes management should be provided to patients at the time of diagnosis, including information on insulin use, blood sugar management, and the impact of diet and exercise on their blood glucose levels. Doctors should be aware of the impact of their words and actions on patients mental health and well being. Collaboration between primary care and diabetes specialist can ensure comprehensive and effective diabetes management. Patients should be directed to reliable sources of information and support such as diabetes education programs and online communities. And doctors should continuously update their knowledge and skills and diabetes management to provide the best care for their patients. That's what AI picked out of your mi conversation. Isn't that fascinating?

Jennifer Smith, CDE 49:36
Well, and what it actually it's what's interesting about it is that it it sounds like the summary that you'd get in like a research project. We looked at all these things in 3000 participants in this study and these are the key takeaway points in order to be able to provide somebody with diabetes, the right care. That's what it sounds like.

Scott Benner 50:03
I'm also almost I'm being boastful a little bit here if I'm being honest, because you and I, you're a lovely person who comes on my podcast. I mean, like, We're not sitting in the same office talking to each other for a month about what we're going to do, you and I pop on when you have free time and free time is in quotes, right? Like when you you jump on here and I go, Hey, Jenny, we're going to do that Grand Rounds thing. Let's do what happens when you're diagnosed in your doctor's office today, and you go, okay, and then we chitchat for five minutes about our lives, then we have a conversation that when you asked a I provide key takeaways. That's all it said. That's what he came up with. My point is conversationally, is a good way to get out good information, right? Absolutely. That's how people's brains hear storytelling, not you reading a bullet point list of them. So Right. Also, by the way, in this is pretty far off. But that's not all i Sai. What I said was provide key takeaways in English, Spanish and Hindi. Wow. And it did that. So I finally found a way I think people are always asking for this template in Spanish is a big one. And the podcast has become very big in India, there's a ton of dialects so I don't I just picked the one that I think is the most kind of central, sure to imagine these key takeaways in other languages for diabetes, Pro Tip series for bold beginnings for that kind of stuff. Gonna be nice. So Scott, he's on it in 2024 door.

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. A huge thanks to the contour next gen blood glucose meter for sponsoring this episode of The Juicebox Podcast, learn more and get started today at contour next one.com/juice box. I have one thing to tell you. But I'll do it after the music close.

So I waited until 50. People found this on their own to say it out loud. But I've added a thing if you're listening in Apple podcasts, you can actually subscribe to the podcast pay a fee. Now the whole podcast is free. So don't now you're like, Well, why would I do that? Scott, if it's free. If you pay the fee, which I think is like 599 A month or $59 a year I think that's about it. If you do that you will get currently you will get the bowl beginning series without ads and you will get the diabetes Pro Tip series without ads in it. And so far one episode that has all the curses at it. Now, why did I wait until 50 people signed up on their own to bring this up. I wanted to make sure it would kind of pay for itself. This is not like a money. I'm not gonna make any money on this. Because the editing on like pulling ads out of old episodes and you know making episodes with curses in it. It's gonna cost money in editing. But anyway, now there's 50 People, I'm going to tell you about it because if I can get if I can get 50 more people to do it. I can add a another series without ads. And we can start offering episodes once in a while that have all the curses in them. So if I go crazy in some episode, we're cursing all the time, and we can afford the editing. I know that sounds weird that it would cost money to not edit out a curse but I have to edit the episode for the regular show. And then that basically means it has to be edited twice to leave the it's not important. This is just it's what it is. It's an added expense. Anyway, if I see this pop up, another 50 People 100 People something like that, then I'll be able to turn to the editor and say listen every time you get one with a bunch of curses in it, give me two edits give me the Kersey and the non Kersey in that way the people who are paying for the subscription can hear the cursing. And as that builds up a listenership that will also afford me the ability to take ads out of some of the more popular series and offer them to the subscribers as well. Anyway, there's no pressure to do this. But you can if you want. Besides what I mentioned, you get I think you get each episode like 18 hours earlier than normal. And ad free bull beginnings ad free Pro Tip series and some random cursing here and there. Anyway, do it. Don't do it. Please, it's entirely up to you. But it's a great way to help me pay for more content. So if you're up for it, you'll see it right there in your apple podcasts that if you're looking for community around type one diabetes, check out the Juicebox Podcast pro COVID 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. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1138 Reheated Happy Meal

Kerrie has Hashimoto's, her son, sister and aunt have type 1 diabetes.

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

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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 1138 of the Juicebox Podcast.

Carrie is a nurse she has Hashimotos her son Liam is three and has type one diabetes diagnosed at 14 months old. Carrie sister and Aunt both have type one diabetes. Carrie wanted to come on the podcast because she said that without the show she wouldn't be able to do what she's doing for her son and that she wasn't getting answers from her doctors. We spend a lot of time talking about little kids in type one and I have some remembrances about raising Arden with type one 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/juice box. 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

I'd like to take this opportunity to welcome a brand new sponsor to the show ever since CGM. I don't have an ad for you yet, but I want to welcome ever since and let you know that there are links in the show notes right now if you're looking for them. But you'll be hearing more about that implantable CGM very soon here on the Juicebox Podcast welcome ever since ever since cgm.com/juice box, this show is sponsored today by the glucagon that my daughter carries. G voc hypo pen. Find out more at G voc glucagon.com. Forward slash juicebox.

Carrie 2:07
My name is Carrie and I am a mom of a three year old type one.

Scott Benner 2:12
Is that child your only child?

Carrie 2:15
I have a nine month old. Oh, congratulations. Thanks.

Scott Benner 2:19
It's very nice. Three and a nine. You're married for how long?

Carrie 2:25
11 years.

Scott Benner 2:26
Did you not know Were you counting?

Carrie 2:29
So funny. My anniversary is next week. And I'm like I don't even know how long I've been married for. Did you? Like happens? A

Scott Benner 2:35
gift or something?

Carrie 2:38
Um, we're gonna go on vacation actually.

Scott Benner 2:39
Oh, that sounds like a gift. That's nice. Yeah, I my anniversary was just seven days ago. Oh, hi, anniversary. Oh, you're very nice. Thank you. You're now the first woman to wish me happy anniversary. So because that was the day before. And my daughter and myself and my wife, we were standing in the kitchen, like making plans about something. And I said, I said about like, well, tomorrow. What if we would like to go out like for lunch in the middle of the day? Do you have a little time we could go out for anniversary and she go like my wife paused. And Arden goes she didn't know, tomorrow's your anniversary. And I said, I said yeah, I'm seeing that right now. And she's like, Oh, no, I can't like I have a meeting and I'm like, oh, okay, no problem. So we've been married a long time. So I'm 27 years. Wow. Yeah.

Carrie 3:30
That's amazing. Is it? Yeah, totally. With two kids. Totally.

Scott Benner 3:34
I know, right. But anyway, the next day came and we did not go out to lunch. I gave my wife flowers, an arrangement I made myself. And she said thank you. She gave me nothing. And that was that's how it goes usually right. That's my expectation. I was like, I don't even know what I would want to be perfectly. Yeah. You know, like, if that's true, like if something happened, what would I want it to be? I have no idea. It's a long time. 27 years. It's insane.

Carrie 4:01
It's really insane. Yeah, but it's awesome. Yeah,

Scott Benner 4:05
no, I'm very excited about it. I think she was too. I can tell. Yeah, totally.

Carrie 4:08
Did you meet like, Did you meet like in college or

Scott Benner 4:13
Kelly worked at a movie theater that that a number of my friends worked at. And she was college aged. And I had known her for years before just like as a like as a person who worked at this theater, but I didn't know her like know her. I was aware of her I guess. Yeah. And she went on an island vacation with friends and came back very tan with her hair braided. And I became very focused on trying to have sex with her. Oh my god, that's so funny. So I purse Yeah, so I pursued her for a while. And that is where I met her at actually. That's awesome. Yeah, I think if she didn't get her hair braided, even I don't even know what would have happened.

Carrie 5:00
Yeah, it was it was it the braids? I mean, it could have

Scott Benner 5:02
ruined her life that braiding that hair. She wouldn't have done that she couldn't have she could have stayed away from me and all these problems, you know?

Carrie 5:08
Oh my god, you're so funny.

Scott Benner 5:12
I guess if we look back at it getting her hair braided was her was her major life mistake. Oh, I

Carrie 5:17
don't think it's a mistake. Not No, of

Scott Benner 5:20
course not. I'm being facetious. Okay, so wait a minute. So you have a nine month old? And a three a three year old, right? Yes. Okay. Your three year old has typed was a girl or boy. He's a boy. We're going to use his name or no. Oh, yeah, we

Carrie 5:35
can use it. His name is Liam. Okay. All right, William.

Scott Benner 5:38
How old was Liam? When he was diagnosed?

Carrie 5:40
He was 14 months old. Wow. Yeah, pretty

Scott Benner 5:44
young. Okay, do you have any type one in your family?

Carrie 5:48
I do. My sister's type one. And my aunt is type one. We have like, my family's full of autoimmune diseases. So yeah, I mean, it was definitely a shock him being so young, but I wasn't anticipating it. But yeah,

Scott Benner 6:02
we do. How old? Are you? Okay, I ask.

Carrie 6:04
I'm gonna be 41 on Saturday. Okay.

Scott Benner 6:07
So happy birthday. Thanks. There's a lot of celebration going on. Yeah, there's tons. So you're 41 you had a baby three years ago when you were like 38 diabetes. So did you recognize the diabetes symptoms and the baby.

Carrie 6:23
So I am also a nurse. So I had just noticed for like a week prior that he was like drinking a lot more fluids. He was like soaking through diapers. And it was the end of April when he was diagnosed. And I was just kind of like, I was kind of I was kind of hot we lived in well, we live in New Jersey, we lived kind of near the beach. So we were outside a lot of the park and kind of brushed it off. But then like four days before he was diagnosed, I like went to put him to sleep. And he was breathing on me and I could smell like ketones. And I turned to my husband, I was like, I think I smell ketones on the EMS breath. And he's like, whoa, what has been first of all was like, I don't even know what that is. I was like, something's not right with him, you know. And so I had reached out to our pediatrician a couple of times with concerns about the fluid, like the extra fluids and all that stuff. And she kind of brushed it off. And then there was just one day that I just remember watching him in my living room chug, like a huge bottle of water. And I was like something isn't right. So I called my pee and I was like, I want to take him in. I think there's something going on. I think it might be like suspicious of diabetes. And she's like, he's way to go. And I was like, okay, so I made my husband go to Walgreens and I was like, let's just dip his urine for ketones because I was like, something isn't right. So, took his diaper off and waited till he peed. My husband like caught his pee in his hand. And we dipped it and he had large ketones. So I called my doctor back and I was like, Okay, so now he's has large ketones. Like I'm suspicious. She's like, Oh, that's normal. And I was like, oh, no, that's not normal. Like I knew enough. So I went set my husband back out to get a glucometer. And then I ended up just doing like a heel stick on him. And he registered like over 500 Wow,

Scott Benner 7:58
look at you. Did your doctor not know you're a nurse.

Carrie 8:02
She knew I was a nurse and like I pretty much like reamed her out when I got to the hospital. I mean, she I think she was taken aback. But I think my my heart like, thinks now and I still think about it now. Like what would have happened if I didn't have that knowledge. You know, when I didn't keep pushing my doctor to be like, there isn't some there's something not right with my son, you know, and she just kept brushing it off. Like, I don't know, I think it's really sad. And I think there's so many young kids that get diagnosed, and it's so traumatic because their symptoms are so easily misdiagnosed as like, oh, labored breathing. Oh, that that's RSV or you're vomiting. Oh, you have a stomach bug, but like, these kids are in DKA. And I just, I'm just so grateful that he wasn't DK when he was diagnosed. No, of course, but

Scott Benner 8:45
you're I mean, you're specifically saying, hey, my kid has ketones. I think they have diabetes. He's drinking a lot of water. I think he has diabetes. Like it's almost like you're describing the sun. And you're saying to her, Hey, I'm going to describe the sun do you go it's around and she goes That's not it? And you're like well it's yellow and she goes no, that's not it either. It's very hot. Now it doesn't sound like the sun to me. That's just very strange. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily G vo Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage evoke hypo pen and how to use it. They need to know how to use Tchibo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit At g voc glucagon.com/juicebox G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma visit G voc glucagon.com/risk. For safety information. Yeah,

Carrie 10:20
it was really disappointing. And she was also like a really like, well known pediatrician, like, everybody, like loves her. And so I like I just the frustration around his diagnosis was like, I'm just happy that he was okay. And he was an NDK. And I was able to catch everything, but I just, yeah.

Scott Benner 10:37
Did you go with thoughtful anger? Or did you just randomly yell at her when you saw it?

Carrie 10:44
Was not thoughtful at all. You know, like, what are you going to do? Like, I literally was like, I'm pretty sure my kid has diabetes. And she's like, No, like, I mean, when I dipped his urine, he was like dark purple, like, like large ketones. And I was like, he has large ketone. She's like, if that's normal, I know. It's like Lady, Emily, a nurse, but like that is not normal for kids. Did

Scott Benner 11:06
she know that you have relatives with type one?

Carrie 11:10
I told her my sisters are very well versed. I said, I smell ketones on his breath. I can smell like the acetone on his breath. completely dismiss me. Yeah.

Scott Benner 11:19
You were in so he found a new peed? Yeah, I was gonna say that's the obvious end of that story. But you were in some sort of a power struggle with her ego.

Carrie 11:27
Yeah, for like, it was like four days that I was going back and forth with her before. I was like, You know what, like, this is ridiculous. I am doing this myself. And I just dipped his urine saw the ketones. I called her back and then I was like, she was like, that's normal. Come in. It was like a Thursday. She's like our Friday. She's like, come in on Monday for bloodwork. If you're still concerned over the weekend, and I was like, I I was like, I can't sleep until I know what his blood sugar is now, like, we need to just go to heal sick. And then it was like, I think he was 638 when he got to the ER and I was just

Scott Benner 11:54
really Yeah, 14 months old. He couldn't wait much. Right?

Carrie 11:58
No, he was like, 20 something pounds. Yeah. Good.

Scott Benner 12:01
Do you think you caught it really early? Or do you think it was going on for a bit?

Carrie 12:05
It's a once he was nine. So I don't think I caught it early. But he wasn't a DKA. So I don't I don't really know. I know that a couple more days he would have been there just by like looking at like from my like looking at his labs now. I can kind of like figure out like, he wasn't indicate but he was close.

Scott Benner 12:20
What other autoimmune stuffs in your family.

Carrie 12:23
So my sister was actually on the show. Like I want to say like eight months ago. Really? She Yeah, Michaela. She will she has. My sister has epilepsy. And she has type one. She has lupus. My mom has sarcoidosis. I have Hashimotos my other sister has Hashimotos My aunt has Addison and type one. So we have a lot.

Scott Benner 12:44
Wow. By the way, I thought sarcoidosis was just the thing they'd used on house to get you to the real answer is that actually,

Carrie 12:50
yeah, it's an actual thing. It's like, it's like a lot. It's like long. It's like a sarcoids that like get on your lungs and stuff like that. I actually don't know a lot about it. I probably should. But

Scott Benner 12:59
yeah, a rare condition that causes small patches of swollen tissue called granulomas to develop in the organs of the body. It often affects the lungs and lymph nodes and can affect your skin also. Yeah. Did you ever watch House anybody who watched the show house, and it was about this diagnostic Doctor Who would figure out tough cases. At some point in almost every episode, someone would float. sarcoidosis. Really? Yes. It was like it was almost they became a joke. Actually, at some point. They always would be like, this could be sarcoidosis. And then it never was. Like I was just kept thinking like will it ever be that actually? Anyway, I've never really got into house well, power. Watch it. You'll hear the word a lot. Yeah. I'm gonna have to listen to it. Okay, so So there's is this consistent with just the females on your side? Are there men too, with issues

Carrie 13:51
as men? So I'm one of seven kids. I'm the oldest, but there's five girls. My mom has more sisters and brothers. I maybe it is more consistent with the females. That's actually really good point. I never really thought about that. There's just more girls. I think that's probably why

Scott Benner 14:04
Okay, yeah, I see that with my wife's family though. Yeah, seems to be more specific with the females for some reason. Anyway, okay. So diagnosed in the hospital. And I'm always interested, did your nursing help or get in the way

Carrie 14:20
it got in the way? Nurses are the worst patients and probably even worse as a mother. It was we did not have a good hospital experience either. We had like a nurse lose his blood. When she did a blood draw on him. She like lost the blood vial. Like we had another nurse give him his first insulin injection with the cap on and then she came back and she's like, oh, sorry, actually didn't give him the shot. Now I'm really gonna give it to him. It was really a nightmare. And I was like, what

Unknown Speaker 14:45
they don't understand how could you I

Carrie 14:49
I don't even know it was a it was it's a well known Hospital in New Jersey, very good pediatric er. And she came in she gave him his first shot of insulin and she walked away and I I looked at my husband, I was like, That is not what an insulin injection is supposed to look like. You could see like the whole cap that was an indented on his leg. And then she comes back in five minutes later, and she's like, Oh, I'm really sorry, I accidentally gave it with a cap on now. I'm really gonna give it to him. I was like, Oh, my gosh, just give it to me. I'll give it to you.

Scott Benner 15:16
I gotta be honest, that one would have i That might have been enough for me right there. Especially after the doctor experience. I don't know that I could have like, I might have been like, we're leaving. Can we go somewhere else?

Carrie 15:26
I have to say I was really traumatized by ever. I think every parent is when you have a child that's diagnosed. And you know, like the, your it's hard to process everything. But then like when like people are start screwing up with your kid. It's like next level, like,

Scott Benner 15:40
listen, see? You're being polite that her like screwing up as one thing. She took the needle with a cap on it, and somehow believe that she gave it an injection.

Carrie 15:48
Yeah, I mean, thank God, she was honest, and came back and actually gave it to him. What's

Scott Benner 15:51
she gonna know? Yeah, you know, she should have come back in and said like, Hey, I was just kidding. That's what it looks like when you don't. I'm just trying to teach you what's happening. Well, that's faster than that. Yeah. Okay. How long did it take them to get his blood sugar down and get you out of the hospital? So

Carrie 16:11
that's actually I think what I'd never understood about his hospitals day is that like, they never got his blood sugar down. Like he was like, well, also, we were bolusing after he, when we were in the hospital, but they just cleared they were just concerned about his ketones being cleared. And then they were like, ready to send us home. And I was like, I'm not ready to go home because his blood sugar is still like, 400. Like, this is kind of ridiculous, but they like, thought that was fine. And sent us home. And so we were in the hospital for like, two nights, three days. Was this during COVID? Yeah, it was during that like, the first COVID way, but like COVID was going on. It wasn't like bad. I mean, we were wearing we were obviously wearing masks in the hospital. We were in like single room. But like it was I was kind of disappointed. I actually went to the doctor and I was like, I'm not comfortable bringing my son home yet because his blood sugar's is still 400 Like, we haven't gotten a grip on it yet, you know, but they were like, you know, it's just gonna be like, trial and error. And I was like, okay, that's whatever.

Scott Benner 17:04
I was just wondering. Yeah, I was just wondering if they were trying to move people out quickly because of COVID. But that also doesn't sound like that. Now, maybe just because he was never in DKA. They

Carrie 17:15
weren't as concerned. They just wanted to make sure his ketones were cleared, which they were by like, the next morning after a couple like, after he was hydrated, and he had a couple boluses in him. He's ketones were cleared. And then they were like, okay, like, we're gonna do a training and you guys are gonna go home in the morning, my husband and I were like, what?

Scott Benner 17:28
You might have got the medical professional bum rush. The she knows.

Carrie 17:33
I think it was Yeah, that happens. Yeah, actually, it's a shame because I was like, so overwhelmed, because they don't anybody that is like a nurse. Like they don't teach you any of this stuff in nursing school. Like I knew, like nothing. I learned nothing about diabetes in nursery school. So yeah, interesting.

Scott Benner 17:47
Okay, so he leaves on injections. Do you have anything different than what you left with? Now? What do you do now?

Carrie 17:57
So my son, my son is still MDI, we are pursuing we're in the process of pursuing a pump. Now, up until now, he was still like, pulling off his Dexcom and stuff sometimes. And it just wasn't the right timing for me to throw another device on him and deal with him pulling off two things. Yeah. So yeah, so we're in the process of getting a pump now. So we are just trying to figure out which pump is gonna be more appropriate for him. Okay.

Scott Benner 18:21
But you've been doing MDI for years. Yeah, yeah. How long have you had a Dexcom? For?

Carrie 18:27
I demanded Dexcom. In the hospital. Okay.

Scott Benner 18:31
Yeah. When the next day, how did you know about that? My sister, right. Okay. She

Carrie 18:35
was like, don't leave the hospital to Dexcom. And I was like, You got it. And I was like, I need a Dexcom. Or I'm not leaving. And they're like, Here, get out.

Scott Benner 18:41
Did it scare you about having another baby?

Carrie 18:44
I very much so. Okay,

Scott Benner 18:46
but you did it. So yeah. What was the what was the conversation like, between you and your husband?

Carrie 18:51
I just I didn't want my son. I think what Liam growing up without having a sibling and I didn't want the fear of another child with diabetes to get in the way of having a family. You know, I guess we just both kind of looked at it like, well, if we're going to have another diabetic, baby, it's going to be the best parents for him or her or whatever. So yeah, I mean, I worry about my second getting diabetes all the time, but I mean, I can't change it. So

Scott Benner 19:21
yeah, are you having that unreasonable thought that it's just five months away from happening?

Carrie 19:25
Yeah, you know, it's funny, I smell his breath, like all the time, because I get so worried you know, where I'm like, oh my god, he soaked through two diapers last night or like he you know, he has diaper was so full this morning, that those are always my first thoughts or oh, he really likes water. You know, like, all those things always go into my mind. But yeah, I don't want I don't want the fear of diabetes to get in the way of me having a family so

Scott Benner 19:45
that's excellent. Okay, so you came home with a CGM. And I mean, was he was still around 20 pounds. He didn't lose a lot of weight off of the off of his weight.

Carrie 19:57
During those he lost a pound. Okay, that was the only yeah so nothing really.

Scott Benner 20:00
And so I'm just really interested in hearing about what your experience was like absorbing diabetes and, and figuring it out with such a small person.

Carrie 20:12
Yeah, it was hard. I was also breastfeeding and I ever all my, the endo that we were seeing in the hospital was like you need to stop breastfeeding, like very much like you need to stop. And I was like if I will not take away the one thing right now. And that is going to keep him like content and happy and I'm not. I just refused to stop breastfeeding. So that was very difficult to manage the breastfeeding with a bowl thing with overnight. It was just, it was really hard. That was the hardest time of my life is when he was diagnosed and I just had a really hard time we had a hard time with the Dexcom changes and he was getting reactions to the decks comps. And yeah, it was it's really hard when they're that little ya know, it's really hard. No,

Scott Benner 20:50
it's It's, you know, so much about the dosing the insulin is is incredibly difficult. Yeah, just really, it's hard to put into words, when in a half a unit. It's like a massive amount of insulin. Oh, totally. Yeah. And you're and you can't even reason with them 14 months old, like what do you do you look at him like a Liam, listen, I need to do this man. There's going to be problems. You're like, you can't have those and breastfeeding. You don't even know what's what they're taking in. Really?

Carrie 21:17
Yeah, yes, feeding was really difficult. Yeah. So it was, it was hard. I think I went through like my own, like, emotional, like, space in my life where I just was like, I don't want to say angry, but I was kind of angry. Like, why does this happen to my kid? And why am I you know, like, having to go through this. And my son is having to go through this so young. And it was

Scott Benner 21:36
hard. Yeah. No, I imagine. Yeah. Did you go to a therapist financial with, I

Carrie 21:41
did see a therapist right after he was diagnosed for a while. But then it just kind of became like, I don't want to say like my life, but I just have on better terms with it. Now. You know, I think my biggest thing for me it was like I always hated when people would be like, well, things can be so much worse. You can have cancer. And I'm like, you're like totally dismissing what I go through on a daily basis. You know,

Scott Benner 22:01
I don't understand the idea of like, comparison. Yeah, it's actually interesting. I just put it on my list to talk to Erica about because I'm trying to figure out what the the human need is to compare everything.

Carrie 22:15
Yeah, what is that? I don't get it. I don't know. You know, he just have diabetes. And like, he does get shots. But like, think of it like he could be getting chemo right now. And I was like, what you're doing right now is like totally missing, what my like, what my son goes through and what we go through on a daily basis in my house. So like, just stop. You know, I just, that's one of my biggest pet peeves is people comparing like, it could be worse. And I'm like, but it could be better.

Scott Benner 22:37
So what if it didn't exist? When that'd be No, yeah. Like,

Carrie 22:40
what if there was a cure, it would be a lot better. So yeah, I'm always confused

Scott Benner 22:44
by I mean, I guess to me, the worst thing that's ever happened to you is the worst thing that's ever happened to you. So if the you know, a person over here has cancer, and your kid has type one diabetes, and you know, another person lives in a house, and another person is homeless, and they they all have bad things happening to them. Like, yeah, they're, you know, the guy in the house isn't maybe as bad off as the homeless person. It doesn't make the guy in the houses situation. Different to him. And yeah, and that's, that's the thing. I hate the I hate the you're a good parent for this. Yeah, that one. I'm not I'm not a fan of that at all. It could be worse is terrible. But those that one that was said to me that God gave Arden diabetes, because he knew I could handle it. Yeah, I've heard that one too. I did not find that comforting in case anyone's Yeah,

Carrie 23:34
like why like? Yeah, thanks. Yeah,

Scott Benner 23:38
I actually I responded, I said, so if I was a big screw up, then Arden wouldn't have diabetes. This let me say, Well, we started making sense. And the conversation went away pretty quickly. But But you But I mean, also, in fairness, I know what they meant. And it was it was meant to be comforting. And yeah, even if I can understand the context that they meant it in like, you can handle this, but just say I, Scott, I've known you for a while and I think you can handle this and you'll be okay. That would Yeah, that would be great. Yeah. Don't tell me that my kid got diabetes, because God was like, Oh, that guy can take care of diabetes. Also, by the way, I've met a lot of people whose kids have diabetes who can't take care of it. So yeah, same. Yeah, they gotta get bored that day, and just give it to that person. Like, try to make more so it's good. Let's just give it to her. It's fine. Yeah, I

Carrie 24:28
totally agree with you on that. But okay, so

Scott Benner 24:31
your How long did you breastfeed? I guess after the diagnosis.

Carrie 24:37
Oh, like a year. Oh, wow. Yeah. Yeah, I, um, he wasn't ready to wean and I was just like, and then I wanted to get pregnant again, have another baby because I was getting really old. So I was like, We gotta, we gotta cut it. But yeah, I think it was I think I probably did it longer for him because I just, I felt like I just didn't want to take anything away from him, you know? So we're

Scott Benner 24:59
You were you I was gonna say at least but were you pumping and then and then putting in a bottle so you can see how much it was or were you actually breastfeeding both

Carrie 25:08
in the beginning I was trying to pump to see how much but it became really difficult in the overnights because I just never knew how much he was taking in. And then I tried to get my breast milk analyzed, someone mentioned like trying to get your breast milk analyze, and it was like all carbs, and I was like, okay, but I mean, breast milk is mostly carbs anyway. Yeah, depends on the time of day. But yeah, and then it just, we ended up just bringing up our Basal dose much higher to kind of cover the overnight feeds and it just got messy. And then it was it was time. It's

Scott Benner 25:35
a balancing act. I mean, it will, it will get as he puts on body weight. I'm sure you're seeing this right. It's getting easier. We

Carrie 25:43
our growth spurts in my house are like, brutal okay with him. There are so hard this is that's been the hardest part for us. This past like six months is like dealing with growth with him and being MDI

Scott Benner 25:55
is I was gonna say is this part of the reason you're thinking about a pump now? Yeah, or overnights are

Carrie 25:59
really rough with just like growth hormones and stuff. And I think it's time that we just get on a pump just so are nicer, better?

Scott Benner 26:05
Do you think you'll try an algorithm? Or do you think you'll just go for like a manual pump?

Carrie 26:09
I'm pretty sure I'm really leaning towards the T slim, my sister has a T slim, I'm very familiar with it. It's just really, it's really comes down to is he going to keep it on. But he's going to school in September, he started in pre K. So like, I'm hoping that we can fit it in over winter break, like do like the whole pump and get used to it before he goes back to school. So that's my hope.

Scott Benner 26:31
You think he'll be okay with the Tethered part.

Carrie 26:33
We talked to him a lot about it, we're going to try and get like do like a trial where we keep like the Tethered part on him and see how he does. The problem is that he's a really smart kid. And like, I just worry about him. Like, I know, there's like tons of safety features to the pumps, but I just worry about him like doing something and I

Scott Benner 26:49
don't know. I don't know, this is a difficult decision. Honestly. Yeah. huge for us. Yeah, no. Yeah. Well, you said that you're talking to him about a lot. What you think is like grasp of his diabetes is.

Carrie 27:04
It's interesting. So I was at the park with him the other day. And he had well we use iport. So he has an iPad on one arm right now. And he has his Dexcom on the other. And this little girl i i Sometimes I'm a helicopter mom with him because I don't want kids to, you know, make him feel different about his devices or anything. And I was at the park and I was holding my other son and I was watching a little girl staring at his Dexcom and I was like, this girl is gonna come up and say something to him that I was like, have to just watch, you know, before I like happen to this. And she like walks up to Liam and she's like, what's on your arm? And he goes, Oh, that's my Dexcom checks my blood sugar. And she's like, Okay, do you like McDonald's? And he's like, yeah, she's like, me, too. And then they just walked away. And it was like, I could just breathe for a minute. Sounds like you because you know, like, yeah, he understands. But it was just that and that was it. Last

Scott Benner 27:50
year at the Jersey Shore, you didn't know what kind of attitude she was gonna have. Exactly.

Carrie 27:54
She could have been the hammer and you never know what you're gonna get there.

Scott Benner 27:57
What do you use wearing on your arm there? Yeah, exactly. Um,

Carrie 28:02
but it was it was fine. So I think he I think he did say he's like, you know, his blood sugar and like all that. He's a smart kid. Yeah.

Scott Benner 28:09
So he knows I eat I need insulin. This is why. Yep. I actually had a conversation with Arden the other day about her thyroid medication. And I was like, Oh, I don't think she completely understands what's this? Oh, really?

I made a little note for myself. Like, let's have a 15 minute conversation about thyroid review. Because she, she,

I mean, she's 19 Right. So she she was out with her friends like all night, the other night that she's home from school on a break. And she literally came home in the morning. And I just said to her Hey, before you go to sleep, take your, your, your terrassen and your T three. And she goes

Carrie 28:44
why take tiersen you'd never hear about anybody taking tiersen

Scott Benner 28:47
it's cleaner. That's why we like cleaner. Yeah, so don't be Don't worry. So she takes tears and she takes sleight of mouth. Is it Saito? I think so. Okay, do you okay, we'll talk about that. Hold on. So she I said take that before you go to sleep. And she goes, I'm gonna take it when I wake up. And I was like, no. And she goes, yeah, it's for energy. And I went, Oh, God, what did you just say? And I went, hey, it's not yet. We'll talk about this later. I was like, just take that. And she goes, okay. She went into a room. I was like, oh my god,

Carrie 29:22
it does kind of give you energy.

Scott Benner 29:25
I know where she's coming from. Like, she's like, I you know, that's the stuff that peps me up. I don't want to do that before I sleep. I'm like, that's not how that works. Exactly. We'll talk about this tomorrow. I'm like, You need to keep it 24 hours apart like you're trying to and I looked at it and I was like, we'll just talk about this later. But how long have you been taking tiersen? Oh,

Carrie 29:43
God, like six, seven years. I was starting to add Synthroid, I hated it. And then I saw an endo who was like, I think you'd do much better on tiersen and I was like, sold and I like read the ingredients and just made more sense to me to take it and it's kept my thyroid like, perfect ever since I've been taking it Never had any issues with my thyroid since I started taking it through it. I was like all over the place. And then even like, what through my pregnancies? It was it. I just think that tiersen is the best thyroid men out there.

Scott Benner 30:10
So what were your symptoms? What led you to it? To Hashimotos?

Carrie 30:13
Yeah, I was just really tired and like, I had no idea that I was I like, went to the doctor and I was like, I'm just feeling like really tired all the time. Like, I didn't have kids at the time. So she was like, Okay, we'll just do like a blood draw. And my TSH was like, 10 Oh, okay. Like really high. And then they checked for the antibodies, and I was positive for those. So yeah,

Scott Benner 30:32
yeah. How long did you do that? Before they added T three.

Carrie 30:35
They actually just added tea free for me this year. What was what led to that? Well, I don't even know I don't like it's so funny. My focus is so much on my kids and like my, their endo that like she's like, do you want to try a T three? And I'm like, Yeah, sure, throw it in. And I try it. And I was like, I feel great. I don't sleep anyway. So

Scott Benner 30:52
should we put carrots in this too? I don't see why not just do it. Well, so for Arden, her T the tiersen is the T for replacement. Right? And her numbers can be terrific. But she's still tired. Oh, really? Yeah. If you don't give her the T three. She's exhausted. Interesting. Yeah. It's and I don't just mean like tired. I mean, like dripping in a puddle tired. Like I've told I've told the story before, but I'll tell you in Arden's yearbook for her her senior year in high school that you know when they people like take out like ads, you're basically paying Yeah, yeah. Right. So we did one of those. So there's this beautiful picture of art in the middle and then around it. If you can imagine nine small photographs around one in the middle they are all like cell phone pictures of Arden asleep on different hard surfaces in our house. Like passed out. So she needs it. Yeah, like passed out, like come home from school sit down at an island and just face down on a piece of stone asleep. Oh, that's crazy curled up on the floor, like any like in just like random places like she'd get on the floor to play with the dog and you'd look over to be asleep. And wow, yeah, it was it was insane. And you add she needs it. Oh my god. It's she does not function without it. It's really interesting. As a matter of fact that the end of her last school year, I think that's what it was. She ran out of it a few days before the end of the year. And it took about seven days for her to get home and to get new. And it like it decimated or she was back to like not being able to function. Wow,

Carrie 32:19
that was really that's crazy. Yeah, holy. She has it. She

Scott Benner 32:22
knows oh my god, it's so much better. If it was 50 years ago, we would have like, put her to sleep like a dog or something. Like seriously, I don't know what to do with her like she barely could like, even now that she's on all these things. She still says sleeping for me is not refreshing. Really? Yeah. She's like, I never

Carrie 32:39
reaching her. Like a deep sleep. Is she getting to that? Like, Carrie?

Scott Benner 32:43
She sleeps forever. If you if you don't wake her up, she'll she'll stay asleep forever.

Carrie 32:49
Yeah, sounds to us.

Scott Benner 32:52
Like a nice 12 hours. Like when she got home when she got home from the overnight thing. She's like, I'll be up in five hours. So I was like, Don't imagine that's gonna be true. But okay. But But anyway, so are so are you watching that with your kids to do you add that? Yeah. bloodwork good.

Carrie 33:07
Yeah, we do like the annual bloodwork for the for his thyroid. It's been fine so far. Knock on wood. So yeah, good

Scott Benner 33:12
for you. Did your husband after all this started happening? Did he say hey, this should have been disclosed before I married you. Yeah,

Carrie 33:19
I mean, he was just kind of like Go figure. Like, like our kid gets like the worst. You know, jeans like, I don't know, my husband is like the specimen of health. His whole family lives to like 100 Right. And like, great teeth like everything is like perfect. It's so annoying. And then like my family has got like all these autoimmune diseases and like they people are dying younger and like,

Scott Benner 33:38
whatever crate teeth is hilarious.

Carrie 33:41
Yeah, he has great. My husband has great teeth. Like he has great teeth. I don't know, for some reason people might be like, we just don't have great teeth. So

Scott Benner 33:48
people in your family die younger. Yeah,

Carrie 33:52
I mean, I think the grandparents died when they were like in their 60s. That's about

Scott Benner 33:55
right. Still, though you're almost my age like this. Were you I guess you're right. You and I are like the first go round of people who did not grow up like in a salt mine, basically. So I think this is where you're gonna see a leap. Those of us who grew up a little easier, although half of us are gonna probably just go the wrong way with nutrition and it'll be a different thing that kills people but totally Yeah, but I think Yeah, for now. Yeah. If you're if you have a less impactful job, and you're actually taking reasonable care of yourself, like I'm interested to see how long people can can go even the thing being diagnostically seen Yeah, like my I've like low iron but because the diagnostics and decent like health care, like I'm ahead of that otherwise, I'd live my whole life making cells over and over again with not enough iron in my system and I probably would die sooner.

Carrie 34:47
Didn't you get an iron transfusion? I thought I saw a picture of you on I've had a

Scott Benner 34:51
couple packs. Yeah, a couple so I haven't had them in a while and I have my fingers crossed that that they won't happen again with supplementing, but I Don't know like it could. Yeah, totally. But still, it's within reason I get a little sleepy I call a doctor. They draw some blood. They go, hey, it's low. I wait a couple days, I go to the thing, a Jackie backup, and you're on your way again. So yeah, I've

Carrie 35:14
had a couple two, I always feel amazing afterwards. Yeah, this is great. It actually, like I feel better. I don't know.

Scott Benner 35:19
I can't say enough. When if your iron, I did a whole series of conversations about it, because I wanted people to know, but even what the what the testing parameters are. It's, it might not be enough. Like, you know, I had an endo on that said, if you're a woman of menstruating age, for example, that she sees 70 as the absolute bottom of where your ferritin should be. I agree with that, though. Yeah. Yeah. And that's not like

Carrie 35:47
d3 to the vitamin D, they always say like, you always want to put on the high, high, high upper end.

Scott Benner 35:52
Yeah, I take 5000 I use the vitamin D every day. That's see

Carrie 35:57
that's so crazy. But that's so good for you know, Liam's was like, critical low when he was diagnosed. Yeah, no,

Scott Benner 36:05
no, I mean, I think that's there's space for good supplementation and definitely agree with you. definitely helpful. And I actually drink Athletic Greens on top of all that, to which I don't think I'm supposed to call Athletic Greens anymore. Ag one. I don't know. Oh, did it change my link when from athletic greens.com juice box to drink? Ag one.com/juice box. So I'm assuming

Carrie 36:24
that stuff. I think I'm going to get it for my husband. So be it.

Scott Benner 36:28
This is not an ad, but they are advertisers. It's the only green drink I ever tried that I could that I could drink that, Nick. Yeah, and it's not. And it's not just that I can stomach it. I drink it. And I go, that was great. And it's over. And like, really? Oh my god, the other stuff. I couldn't get through my mouth. I was like, some of it's really gross. And it would get in your stomach and be like, sit there real weird, you know? It's not good. But yeah, he won. I'm very happy with so it's a matter of fact, I gotta keep selling it because I get it for free. As long as you guys keep buying it.

Carrie 36:59
Oh, that's good to know.

Scott Benner 37:03
No, no, if that stops, and then I'm on the hook. Because I think I gotta keep trying. I need you guys to pay. Anyway. It's worth it. I do think it's worth a try. Yeah, let's get oh, let me just say drink@one.com forward slash juice box. You get a free year supply of vitamin D and five free travel packs. Gary. You're smiling like Sorry. I feel like an idiot anyway. Algorithm. You think? Yes. You'd like to go pee slim? Control? Like you? Yeah, yeah. Okay. How much insulin does he getting in a day? He,

Carrie 37:39
I mean, he needs what he needs. So he gets like eight of the eight. His Basil is right now is eight. He's about 5050 To be honest with you. Yeah, he gets usually like, usually about eight to eight. If you log in about it's he's he's on eight of Joseba right now. Okay.

Scott Benner 37:54
Yeah, that's how much do you weigh now at three?

Carrie 37:57
He's, he's three and a half. He's 40 pounds. He's like 95th percentile for weight. 95th for height. He's the solid kid.

Scott Benner 38:05
He's your husband big.

Carrie 38:06
No, you know, it's so funny. Went to the pediatrician the other day. And he's like, you know, he's like, 90 is for weight and 95th for height. He's like, at least he's proportion that was like, You're right. He least he is. He's like at least is that overweight? And I was like, Dude, he's three. Okay. Don't even go there with a week with me.

Scott Benner 38:22
I heard you apologizing for him. And you went, Hey, listen, he is three and a half. So

Carrie 38:26
he's three and a half. Like he's still before this winter. Yeah, he's just he's a solid kid.

Scott Benner 38:30
Your husband not a big tall guy. Are you tall?

Carrie 38:32
I'm like, five, six. My husband's six foot. We're not like crazy. So I don't know. Yeah.

Scott Benner 38:37
It doesn't always work out. I mean, for instance, my children are attractive and athletic. So I don't know where the hell that came from. I used to tell people all the time that my my mailman must be a very good looking athletic guy. Oh, you're so funny. My assumption because, I mean, there's been times I've watched my kids do think things athletically, and I'm just like, I'm probably not there. But anyway, as actually as Cole gets older, he's starting to look more like me. Oh, really? Which is interesting. He's,

Carrie 39:09
I can't remember I released a new one episode recently. He's he's in college or high school here.

Scott Benner 39:14
Now. He graduated from college. He's got his first season done with college. Yeah, he's at his first job now.

Carrie 39:19
I don't know why I thought he was he was younger. Wow. Yeah. It's crazy. Because the podcast can

Scott Benner 39:23
jump around. So yeah, but he's been living on his own for eight months now. Very far from home. And he is he likes the job and he's getting good experience from it. But he's like, I need to leave here. Because I'm so by myself is like he's like, yeah, there's just nobody here and his girlfriend's somewhere else. And, you know, they're trying to figure all that out. So got it. Yeah. Okay. But he had the experience and it was it was a very good job with a great company. And he's like, I'm, you know, this is how I'm going to move up. I gotta get this so I can go to the next thing. Yeah, totally. So he's still got that I'm proud of him. He really is on his own. So yeah, you should be that's really cool. Good for him. Yeah, I would be like mental. Like, oh, same here. Yeah. So the saddest thing to me the other day he goes on. What do people do after work? And I'm like, Oh, he's got a TV to watch. He's like, I play basketball in the park. And, like, I go shopping. And he's like, talking about the things he asked to do. And he's like, can I keep gonna keep my place clean and stuff he's like, but what else do people do? And I was like, Oh, buddy, I was like, This is life. I'm sorry.

Carrie 40:32
Really nothing, no other secrets. It

Scott Benner 40:34
was like I said, when I was your age, I had a kid. So like, are getting ready to have one. I was like, I was moving towards that. I'm like, I don't know, man. I'm like, you gotta find a hobby or, you know, something. He's like, I might start going to a Boxing gym to work out. I was like, That's a great idea. Like, try that. But this is very strange moment where at 23. He was like, Oh, this, this isn't all like just Ferris wheels. And this this

Carrie 40:58
thing. What else do I do? That's funny. What else

Scott Benner 41:01
is there? That was like? Nothing. Yeah, there's nothing else.

Carrie 41:05
Welcome to adulthood. There's nothing else. There's no secrets for somebody so you can die. Sleep when you can. So funny.

Scott Benner 41:17
Can you explain how blood sugars reacted? So you're you're in a unique situation. You're watching an infant who's breastfeeding and going on to solid foods on a CGM, like what kind of shifts did you see in blood sugars,

Carrie 41:30
crazy shifts, I mean, I had to rehaul everything. I was feeding him at that point, because he just I don't know what it was about him. When he was diagnosed, no honeymoon, right off the bat, he needed a lot of insulin, he needed a lot of, you know, he needed a lot of diesel like he just had high needs for insulin. And I was really scared about that, because I was like, This just seems not right for, you know, a 14 month old be taking this much insulin, he just was resistant for a while. And then we just kind of gotten to a groove when I started listening to the juice box. And they started kind of like riding the wave of the Dexcom all day long, and kind of watching how he reacts to certain foods and kind of, you know, finding alternatives to some of the foods that he likes. Because I didn't want to him on a roller coaster all day long. Yeah. So that was that took that took all a really long time for me to figure all that out, like a really long time. Actually, I think you actually talked to my husband, right after Liam was diagnosed, I posted on the juicebox. Like, I'm losing my mind. I'm not sleeping. I don't know why my son is running so high. And I was like pleading for someone to help me and you responded, like, let's talk. And so I hadn't you like talked to my husband and and you've read off of that. Were like, he needs more basil. And you were right, because we ended up like going up a lot in his basil shortly after that. So yeah, he

Scott Benner 42:48
and I talked by phone. Yeah, yeah, I remember that. Okay, I

Carrie 42:52
think because you saw that we were like in New Jersey. And you're like, you know, like, let's talk about this. Because I think I'd post I posted a lot and the juicebox like, right when he was first diagnosed, because I was really overwhelmed. And I was just feeling so defeated by seeing these numbers all the time. Not trying to like figure out what I was missing, you know? And so yeah, you talk to my husband right after Liam was diagnosed. It's

Scott Benner 43:14
such a good guy. No, can you are? I just look to your sister's episode was nine 911. Yeah, it's called T one D lupus and epilepsy. Yep. Okay. She turned you on to the podcast, or vice versa?

Carrie 43:28
No, I turned her on to it. When we were in the hospital, we actually started listening to like the beginnings. And then shortly after, like, I contacted Jenny to start making appointments with her. Okay, I was like, I

Scott Benner 43:38
need help. Yeah, no kidding. Oh, so Jenny helped you with the baby.

Carrie 43:41
Oh, Jenny. I've been working with Jenny since he was diagnosed or so we're still working with her. Oh, that's

Scott Benner 43:45
lovely. Good, good. But still, you're still like on the group going? I don't know what's wrong. That

Carrie 43:52
yeah, in the beginning, I will. Also we did, we had some issues with our Endo. We like I had to leave the endo that we had seen at the hospital because I hated them. I thought they were not helpful at all. And then I was like, my husband, I lived in Boston for several years prior to having kids and I was like, well, then I'm moving to Boston. I'm sending I'm bringing them to Jocelyn like so it was a no brainer. And my husband's like Carrie, you're losing it and I was like, okay, maybe I am. So we did like virtual with Jocelyn because I like knew somebody that worked there from working there and whatever. So we worked with Jocelyn for like a while until we got we switched to our endocrinologist that we have now. But our endos prior to our endo Now, none of them were helpful. I just like everybody was just like, correct, correct. And I was felt like I was choosing highs and you know, treating lows. I just never gotten to a groove with him for a really long time. Yeah. So

Scott Benner 44:43
they said is his settings up? And then even as his settings were too weak, they would just tell you just the correct the high blood sugar. Yeah,

Carrie 44:53
we had I just they were questioning me a lot. They were like, Why are you doing it? It's just Yeah, it was just it was hard. We just never gotten to a groove with an endo for a while, why were you doing what? Like, you know, like your carb count was wrong. Like I had to do the logs afterwards. And you know, it was just hard. Like, I don't know how many carbs or my breast milk I was estimating, and they would get on my case that I was estimating wrong, or I was imposing enough. And it was kind of it was kind of a nightmare. And then I was like, I can't do this anymore. It's affecting my mental health. I need a new end of the socket to question me, it's gonna support me. Yeah. And then we went to chop. And it's been like, an amazing experience. So yeah,

Scott Benner 45:27
by the way, if anyone needs an indication of how upset you were, you were like, we'll relocate to where there's a better hospital.

Carrie 45:33
Yeah, that was like, we're just going to move to Boston. My husband was like, Terry, you think you're losing it? And I was like, Okay, well, then I'm going to leave. And I'm going to bring them to Boston, and we'll go see a new endo there. And he's like, we have chop here. We just need someone around here. And I was like, okay, like,

Scott Benner 45:49
you're gonna live here. We're gonna live in Boston. So yeah, it is a lot. It's just a lot of stress. And it's nonstop. I mean, honestly, it's 24 hours a day, nonstop. And the baby small, and it's got to always be in your head. Like, if he gets too low, and I can't talk him into eating something or whatever. Like, we're gonna have a real problem. Oh,

Carrie 46:09
I still have those thoughts now with him. Sure. Oh, please.

Scott Benner 46:12
I think you're gonna have them for a while. Yeah, don't worry. I

Carrie 46:15
think toddler toddler stage is even harder, because he's like, he takes swim lessons. And like, we went to swim and after swim lessons, he gets to go to McDonald's. And it's like my thing, and I have no mom guilt about it, because he enjoys it. And it's that's it. So I have mastered a happy meal for him. And we went to McDonald's, and we sit down, I Pre-Bolus him are sitting there waiting for the food and the burger comes and he looks at me. He goes, I don't want this. And I was like, why? He's like, I just don't want it. Let's leave. And I was like, oh, like, it's just you know, it's hard with toddlers.

Scott Benner 46:45
No, we're gonna I was like,

Carrie 46:47
why you want to? You told me you want to have a meal. He's like, I don't want to now and I was like, Okay,

Scott Benner 46:51
what do you do?

Carrie 46:52
I have cookies in my purse. I just gave him the cookies. And I was like, let's get out of here. Of course you wanted an hour later, but whatever. Did

Scott Benner 46:59
you go back? No, I

Carrie 47:01
had it still brought it

Scott Benner 47:02
home. Oh, yeah. He ended up his happy meal. Yeah, yeah. Can we call this episode reheated Happy Meal, maybe? Perfect. Excellent. Yeah. I mean, it's just, it's not a thing that a lot of people are going to understand. I mean, you can, you can imagine it, but I live through it. And it's frightening. And I was on edge for years. Like you really have to imagine that Arden was diagnosed in 2000 762 1006 weight of sex. And she was two years old. And she weighed like, 18 pounds when she was diagnosed. And there was no CGM. They like syringes and Novolog and, and a Basal insulin that was so ineffectual. Nobody uses it anymore. Basically, a you know, and you were just on your way. And it was up and down, and up and down. And you couldn't even tell you were just testing trying to like, get ahead of the problem and always worried. Like, I haven't talked about it in a while. But I mean, for like a full year, I'd live a whole day with Arden, like, at home with her. My wife would come home from work, and I'd be like, I have to get a shower because I didn't get a chance to get a shower. Today. I went in the shower to cry. Yes,

Carrie 48:13
really, I totally feel you on that. It's really hard. It's also really hard finding other parents or friends that you can like relate to, like, for me, at least, you know, like you like, sometimes I would find like I would talk to other moms and they will be like, Oh, my night was so hard. Like, my baby woke me up twice. And I'm like, Are you serious? Like, I treated the high for like, four hours last night I finally slept two hours. You know? Like, It's hard finding, you know, people that you can, I don't know relate to sometimes, right? Yeah.

Scott Benner 48:40
commiserating is helpful. And, and that's actually what that person is trying to do with you, except they don't understand the, the level you're at versus the and, and again, not to compare it I'm sure it's terrible for her to, like, you know, but it's not helpful for you as far as like finding, I don't know, an actual sounding board who understands your situation? Yeah,

Carrie 49:01
it's really I think it's just, it's just harder when they're younger. I know you can relate to that. You just I always just felt like for a really long time, or still do like I just wait for the next ball to drop. You know, like, what's going to happen, just kind of live your life always like on edge. Yeah.

Scott Benner 49:13
I mean, in the end, I think the best you can do is get good settings, understand how insulin works. And, you know, give yourself a chance to be in the fight. Really, you know, instead of being blind, I was blind the whole time. For those first number of years. I didn't know what I had literally didn't know what I was doing. It was a mess. And you know, how did you like figure it all out? I think writing the blog was partly helpful. Yeah, I get that because you could kind of like, relive what was going on later, when you weren't as upset about it. And then I started asking people questions. So one of the things that got me there was, I asked Arden's nurse practitioner one time I said if I gave you a magic wand, and I said you could make people with diabetes, no one thing What would you make them? No. And she said, I tell them how insulin works was that and I said, Okay, so I don't know how insulin works. That's a problem. So I'll figure out what that means. And then I just started quantifying it. Like I put it in here, I see a spike, you know, the spike crashes, like, you know, like, I just started trying to make sense of it. And then I mean, CGM is came. Yeah, it was a huge part of it. The first Dexcom kind of wasn't so much about the number it was almost about the graph and the arrows. Totally. Right. So you can kind of see like, okay, like, it's going up now. Like, I got that, like, you know, why is there not enough resistance here? I put the insulin in at a good number, like, why is the number going up? And why is it staying up? And how come I mean, I put in the right amount of insulin, but her blood sugar's really high, it's not moving. And they would tell you then like, Well, don't put more insulin and you'll be stacking. But after you watch it happen a number of times you think, well, that's, that wouldn't be stacking, because her blood sugar is never going to come back down again. And then you kind of reverse engineer, you go, Well, if I would have put more insulin up front, what did he even gone up? Right. And then that started making sense. And I started making leaps. The next leap I made was, I was afraid of insulin. Yeah, I know, I was afraid of it. And so one year, I used to write for Omni pods blog, which I don't know that it exists now or not. But I would write six pieces for them a year. They came to me at the end of the year, and like, what do you want to write about next year, and I said, I'm gonna write about not being afraid of insulin, it's going to be a six part series about not being afraid of insulin. And they were like, okay, and I told them why and, and that was it. Like, I just I talked myself into not being afraid of insulin. Like it's not like I knew something. I wrote about it in a way that talked myself out of it. Yeah, it was it really. So. I did misspeak earlier, the magic wand story, she said, I would tell people not to be afraid of insulin. So they knew how it worked. There was a little more to it than that. So yeah, so I just was like, Okay, well, I am afraid of it. There's nothing that's gonna make me not afraid of it, except maybe understanding how it works. So I'll start paying attention to how it works. And then then that leap of trusting that I knew what was going to happen was going to happen. Interesting. That was a big deal for me. Yeah, I'm sure. How many times can you not Pre-Bolus a meal, watch it go to 300 have to put into more units to bring it back down? Before you say to yourself, let me see what happens when I Pre-Bolus. Yeah. And then you Pre-Bolus And it goes to 200. But it doesn't come back down. How many times you have to do that before you think okay, well, I Pre-Bolus that help. But obviously, there's not enough insulin here. So I don't care what the carb count says. This meal needed two more units of insulin. Yeah, so I'm gonna use it. Like, why would I just do it again, tomorrow, when I know it's gonna happen again. So then I was like, alright, you know, the carb count says three, but I'm gonna use five. And then it worked. And I was like, All right, well, I'm going to trust that that's going to work. And it's almost the same kind of leap you have to make the first time you realize that, you know, if you had three blood sugar meters, and you took the same blood drop on all three, you'd get three different numbers. Yeah. And then you have to say to yourself, I have to just go with what I have. And I think those little leaps got me there. And then I started seeing it like that it slowed down. Like it's such an old reference. Now, I don't even know if it works for people. But diabetes, like it started feeling like the matrix. And I felt like I was standing in the middle of the bullets, and they weren't moving very fast. I was like, Oh, I see it all happening now. And once I saw, it's really cool. Yeah, that's how it felt it felt like before, everything was happening way too fast. And I couldn't make sense of it. And I had found a way to slow everything down. So I could kind of almost look up and like reach and grab a bullet and go, I'm just gonna move this one over here. So it doesn't hit me. Yeah. And then I don't know from there. I wrote about it more. And, you know, kind of clarified my thoughts, and then kept experimenting, and then kept getting good feedback. It was working. And then one day, I just told my wife, I was like, I have a system that works. Like, I don't I don't have a name for it. I don't quantify it. Like, I'm not going to write a book about it. But I know if I do these things that will work and then I made a podcast about it. So, so cool. Pretty much it. Yeah. Really cool. I had a lot of free time. I was a stay at home parent. Yeah. So you know, so cool. Just do the laundry. mop the floor. go grocery shopping. Yes. That's pretty much it. You know, do it again the next day. Yeah. And I honestly, I just, I'm a really emotional person. And like, her health being poor was like killing me. See? Yeah, so I couldn't let her be like that. And I couldn't Yeah, I couldn't be the one that did it. You know, like, so that this I was fighting against all of that.

Carrie 54:47
Yeah, yeah, totally. Yeah, I feel that so much.

Scott Benner 54:51
And it just feels easy now because now I'm like, the guy gets in the phone. I'm like, turn your basil up. You're like he knows everything. I'm like, not really. But I have like, I haven't have knowledge that I can look at it and with reasonable certainty know that this is what I'm seeing. Yeah, you know, so and then the doctors, they don't I don't know, if they don't have it, I tend to think of doctors biggest issue is really the same issue that all businesses have, which is that people come and go. Right, like so. Yeah. You know what I mean? Like, you bring somebody in about the time they know what they're doing, they go somewhere else, because they can sell themselves for more, because now they have more responsibility. The next person that comes in doesn't know crap, because they're just starting. And, you know, so everybody's always either dealing with somebody who really knows what they're doing, or has no idea what they're doing. And it just you can't build consistency. It's, it's, it's how free agency killed football. Yeah. You know, totally not that players shouldn't be free to move around. I support that. Like you. It's hard to build a core and keep it together now. Because people people jump around. And I think that happens in business. And I think that doctors offices are businesses. And yeah, they are usually. So you know, when you get the girl with the needle calf was probably like, she's probably in her first six months of this. Totally. Yes. So. And those people are always cycling in and out. I think that yeah, the bigger problem, actually, every problem we have in the world is a failing of people. On some level, like, it's just yeah, you're right. Yeah. It's your job. It's not your life. And so if I have a bad day, or I don't get a lot of sleep last night, or God knows, like, the, I don't know, maybe the receptionist schedule, got a little coke problem. Like, who knows? Like, you know, like, everybody's got their own lives, and they go to this thing during the day, and they put as much effort into it as they think they need to to keep their job. And then, you know, it's not really, I mean, how many people do you know who have a job they really care about? Not many. So, and then you show up with your kid, or I show up with my kid or whatever. And I'm expecting these people to be perfect. And you know, beyond reproach, and the truth is, is that they live up the street from me, and they really are just dreaming of getting home and having three beers and watching American Idol. And yeah, that's it. So true. Yeah. It's one of those. It's not a big deal. Just is what it is. If you know it, then you can work around it.

Carrie 57:23
Totally. That's all. Yeah, I

Scott Benner 57:24
agree with you. Yeah, I just don't have any big high expectations for people. Yeah, same. I think teachers are people who want to have off during the summer. It's true, not that teaching is not a big thing. But I bet you that it attracts, a lot of people are like, wow, three months off cool.

Carrie 57:40
Like, I want to be my kids school nurse eventually, because I'm like, I get the summers off of them.

Scott Benner 57:46
That's exactly my point. And by the way, I'm sure there are plenty of people who really want to shape young minds, and blah, blah, blah. I'm sure that's all true. But if if 50% of the people are just like, I just got to make it to August, and the other 50% are working really hard. Well, then you get a mixed bag. And yeah, totally. It's just yeah, what it is, I don't know, I was sitting here yesterday looking out the window. But for people who work for my Township, were picking up three branches with a machine big enough to knock a house over. And I was like, just walk over and pick it up. Oh, they could have driven over with a pickup truck and grabbed it in eight seconds. But instead, it's like, we just use 72 gallons of diesel fuel using a machine that I could be part of a war if it needed to be it was so big, and I was like, What are we doing? And you know, I don't know how I got to that. But that's my point is that I guess my point is that you need to, on your own, figure out what this is. And then advocate for yourself and see your doctors as people who if you're lucky, you get a great one. And that's great. You take their information. And if you get a bad one, then you you know, then they're the nice people with the prescription pad and you go do what you got to do and and get what you need. And then you go home and make your own decisions. I'm watching someone online. Now. This is such a common thing with people with diabetes. She's looking at a chart or graph, she puts it up online. She says what's going on here? I said this graph screams not enough basil to me. And she said, I said that to the doctor. But they told me no. And I'm like, Okay, well, what now? Because you still have the problem. They said that's not it. You say that's it. I say that's it. 30 Other people are looking at it and tell you the other thing. What are you gonna do? Like, you know, yeah, so it's up to you at some point. That's all. Forget diabetes. If you're waiting for somebody else to tell you the right thing to do. You're making a mistake. Yeah, totally. You gotta get in there. That's all. What are we not talking about? Sorry, that we should have. I

Carrie 59:48
think that's it. I don't know. I just, I was just really excited to be able to get the chance to talk to you. I mean, this this podcast has like changed my life. Oh, in so many ways.

Scott Benner 59:56
Would you take a minute to tell me how

Carrie 59:59
Yeah, I mean, first of all, it's been an amazing support system for me just having other people to like bounce things off of. But I mean, I learned so much from this podcast, like his chi completely changed by way of managing Liam. I mean, because of obviously, when he was diagnosed, I was listening to the doctors, and it just got me nowhere. And, you know, when I found this podcast, I was like, I'm doing everything on my own. I mean, not like on my own, but I mean, I'm making the decisions. And I, I mean, it's just been a lifesaver for me and my husband. We both I mean,

Scott Benner 1:00:33
I'm glad. Yeah, it's very nice. And you got your helped Mikayla hope to? Yeah, totally. Yeah. Do we get the Angelus and by any chance? Because I can use more listeners? Yeah,

Carrie 1:00:43
I should ask her. You don't really talk. But I see. out there.

Scott Benner 1:00:47
For me. Really? He should talk to her. Yeah, totally. Yeah. Feels like, feels like you owe me a little bit. And this is what I'm asking for. Yeah, sure. You got it. Liam's names, not Scott. That's too late. Yeah, you didn't name the next boy, Scott.

Carrie 1:01:00
Yeah, this is, I guess, doing everything for this podcast.

Scott Benner 1:01:05
You're very well, listen. I'll be very honest with you. I wrote the blog because I was trying to raise awareness. And at some point during writing the blog, I realized that it was, what do they call it shot in Freud? What is that? It just, it was just people complaining? Yeah. So I was I was saying what was going wrong? And other people were coming in and going, Yeah, that happens to me, too. You know, it sat and then people would like commiserate. And I thought, oh, there's value in this, like, there's value in knowing that somebody else is going through it. But it wasn't doing enough. And so I thought, like, Well, I'm gonna really try to help people. Like, like, Why buy I know this thing now? Like, I should tell them? Yeah. And then I did that. And it was, it was nice and everything. And the blog did well, but it didn't do nearly as well as the podcast, like when when I moved to podcasting, like, that's when, like, a note a week turned into like, 10 notes a day? For sure. Yeah, it was, it was really interesting. But it's just not something. The space just doesn't do what we're doing here on the podcast. Like, you know, if you stop and think about, I don't know, Instagram content that you see that kind of stuff around diabetes, it's all just very still like, hey, like, I have a recipe for this, or Don't you hate it when this happens? Like, yeah, okay. Like, yeah, great. I hate it. When that happens. Like, is there a way to stop it from happening? Could you tell me that? Yeah. And the only people who will tell you, like how they manage, I mean, often are just trying to drive you to a coaching service. So they tell you a little bit and then they want you to pay them. And I I'm not good with that either. Like, I just think that they carry between you and I, if I charge $9 a month for you to listen to this podcast, I'd be sitting in a gold chair. Okay. But well, you're very nice. But I'm trying very hard not to charge people for that. Like so like, I to me, it's like I take ads, and then the ads support the production that I it takes me 6070 hours a week to make the podcast. So like, I make the podcast and everybody gets to have these conversations, they get community, they get, you know, maybe tips and tricks and stuff like that, or learn things they didn't know before. And there's nowhere to go. You don't have to go pay somebody you don't have to like take a class, you don't have to have a frequent meeting with some jackass who just wants to have that meeting with you so they can charge you for it. Like that kind of stuff. You know, I think that's important. And yeah, you know, it to me, that seems like the right thing to do. Now, don't get me wrong. If I ever lose all the advertisers. I'm 100% gonna charge you for the podcast. You definitely should. But without at that point would be to keep it going. Yeah, I'm sure we'd all pay it too. So I just want I just want everybody. It feels really good to me to know that. You found it. First of all, you said you found at the hospital? Yeah. Was that just googling?

Carrie 1:04:01
Yeah, Google that. And I started listening to one of the series, I think it was like, I want to say it was bold beginnings. I can't remember. And I had it on playing and my husband was like, Carrie, we have so much going on right now. Can we like listen to this when we get home cuz I was like, No, this is, this is like, this is gonna be really important to us, you know, but we had, like, everybody coming in and trying to educate us so they can get us out. And so I just remember being like, Hey, I'm gonna come back to this because I just was overwhelmed. But yeah, I did find it in the hospital.

Scott Benner 1:04:28
The nurses. This guy on the internet is telling me about diabetes. Hold on. Yeah, they're like, yeah, he doesn't have diabetes. But don't worry, we're not gonna let that stop us from listening. But But anyway, like, you found it that early. So in my mind, you avoided some of the heartache that I had. Yeah, totally. I'm sure I did. That makes me feel good. Like there's things that didn't happen to you that trust me, you would not have found pleasant. Yeah. And like that, I think is terrific. And there's no reason that can't happen for anybody. I mean, you spent Yeah, a reasonable Hold on to this hour talking about, like, you just weren't getting good direction from people. Yeah, you know. So I don't think that's not the norm. I think that's what happens more often than not. I totally agree with you. Yeah. So I don't want that. I don't want that. I don't want you to I don't want that to happen to you. And I don't want you to pay for it. Yeah, that's pretty much what I'm what I'm trying to do here. So anyway, cool. Thank you very much. I appreciate you coming on.

Carrie 1:05:24
Thanks so much for having me. I was so excited for this. Oh, good. Great to talk to you. Oh, thank

Scott Benner 1:05:29
you. You were terrific. I appreciate it. Thanks. Yep, hold on one second.

Huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. 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. Once there was a time when I just told people if you want a low and stable a one C, just listen to the Juicebox Podcast. But as the years went on, and the podcast episodes grew, it became more and more difficult for people to listen to everyone. So I made the diabetes Pro Tip series. This series is with me and Jenny Smith. Jenny is a certified diabetes care and education specialist. She is also a registered and licensed dietitian and a type one herself for over 30 years and I of course, am the father of a child who was diagnosed at age two in 2006. The Pro Tip series begins at episode 210 with an episode called newly diagnosed are starting over and from they're all about MDI Pre-Bolus Singh insulin pumping, pumping and nudging variables exercise illness, injury surgeries glucagon long term health bumping and nudging how to explain type one to your family. Postpartum honeymoon transitioning all about insulin Temp Basal. These are all different episodes, setting your Basal insulin, fat and protein pregnancy, the glycemic index and load and so much more like female hormones and weight loss. Head now to juicebox podcast.com. Go up in the menu at the top and click on diabetes pro tip. Or if you're in the private Facebook group, there's a list of these episodes right in the feature tab. Find out how I helped keep my daughter's a one C between five two and six two for the last 10 years without diet restrictions. juicebox podcast.com Start listening today. It's absolutely free. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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