#1807 Spokane or Bust - Part 2
In part two, Cassie shares building confidence after diagnosis—finding community, navigating school nurses, improving A1C to 5.4, exploring tight range goals, and advocating for her son without burning out.
Companies that Support Juicebox
Key Takeaways
- Community Changes Everything: Finding a support system—like local Facebook groups and the Juice Box Podcast community—can transform the overwhelming sadness of a new diagnosis into empowerment and proactive management.
- Hospital Education is Just the Beginning: The initial diabetes education provided at diagnosis is necessary but often insufficient for daily living. Parents and caregivers must seek out real-world strategies to refine insulin timing and carb counting without burning out.
- Navigating School and 504 Plans: Building a confident relationship with the school nurse is crucial. Empowering your child to handle their technology and advocating for their specific medical orders ensures they avoid unnecessary highs or lows during the school day.
- The Value of New Tools: Modern tools, such as the Juice Box Podcast calculators (for settings and bolusing) and AI prompts for macro breakdowns, take the guesswork out of complex meals with fat and protein, making day-to-day management much easier.
- Monitoring Siblings and Autoimmune Risks: If a child has Type 1 diabetes, it's wise to monitor siblings for other autoimmune conditions, such as thyroid issues or celiac. Push for comprehensive labs, including Free T3 and ferritin, if symptoms arise despite a "normal" TSH.
Resources Mentioned
- US Med: usmed.com/juicebox or call (888) 721-1514
- Eversense 365: eversensecgm.com/juicebox
- Tandem Mobi: tandemdiabetes.com/juicebox
- Omnipod 5: omnipod.com/juicebox
- Dexcom G7: dexcom.com/juicebox
- Touched by Type 1: touchedbytype1.org
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Juicebox Docs: juiceboxdocs.com
- Settings Calculator: juiceboxpodcast.com/settings
- Bolus Calculator: juiceboxpodcast.com/bolusfour
- Wrong Way Recording: wrongwayrecording.com
Introduction and Sponsor Messages
Scott Benner Welcome back, friends, to another episode of the Juice Box podcast.
Cassie So my name is Cassie. I am a stay at home mom of three boys. They're 14, 12, and six, and my 12 year old is our type one diabetic.
Scott Benner This is part two of a two part episode. Go look at the title. If you don't recognize it, you haven't heard part one yet. It's probably the episode right before this in your podcast player. My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference.
Scott Benner This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. While you're listening, please remember that nothing you hear on the juice box 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.
Scott Benner This episode of the Juice Box podcast is sponsored by Omnipod five. Omnipod five is a tube free automated insulin delivery system that's been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections. Learn more and get started today at omnipod.com/juicebox. At my link, you can get a free starter kit right now. Terms and conditions apply.
Scott Benner Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. The podcast is also sponsored today by the Dexcom g seven, the same CGM that my daughter wears. Check it out now at dexcom.com/juicebox. When did you realize that you needed to go find more information?
Moving Past the Sadness of Diagnosis
Cassie I had gotten to the point where I was so sad about it that I had to make a decision. It was either you are going to do just what they've told you. Right? You're only you're gonna use the little paper they gave you. Mhmm.
Cassie And you're gonna figure all this out, and you're gonna do all this math on this piece of paper, and you're gonna keep this log every day, you know, and just be sad, or you're going to find a better way because people obviously live with this and have for a long time. And so there's gotta be more information out there that makes this easier and better to understand. So either you can stay the same or you can try to be better. And in that moment, I decided that I wanted to be better. It was just a matter of how do I get better.
Scott Benner Yeah. Tell me about sad. What do you mean you were sad?
Cassie I felt like this had ruined his whole life.
Scott Benner Okay.
Cassie I was sad for the things I felt like he wasn't going to get to do.
Scott Benner Do you feel that way now?
Cassie I don't. No. Not anymore, which is really great.
Scott Benner What stopped you from feeling that way?
Cassie I think it was meeting other kids that had it. Meeting other kids and parents and getting you know, establishing a community of other people that could help you.
Scott Benner Yeah.
Cassie I felt like that's really what turned it around for me. And so this is actually how I found the podcast. They we have a an outreach group up there in Spokane. It's called STIX Diabetes Programs. They run a camp.
Cassie They're very involved with the ENDO's office. And so their outreach coordinator puts together, like, a little packet for you Mhmm. And they give that to you at diagnosis. They invite you to, to join their Facebook group. Right?
Cassie And so I was in the Facebook group, hadn't really introduced myself or anything. I'm just kind of watching things happen. We're obviously getting closer to school. And so I had asked a question about going back to school. Does anybody have any experience with the school?
Cassie The school nurse, do you have a school that you like or a nurse that you recommend? Right? Because I can ask to transfer the kid somewhere. Right?
Scott Benner Yeah.
Cassie And so someone had left a comment and said, my son doesn't go to that elementary school, but is at this middle school, which is where my oldest son was. So and the nurse there is great for the time that he gets there. Right? If you have any questions or you need help, let me know. Also, listen to the Juice Talk podcast.
Cassie It will really help you.
Scott Benner Oh, wow.
Cassie So that's where I had found out about the podcast.
Scott Benner That's awesome.
Cassie And so I immediately joined the group, and it was like that was and that was at the same time. Right? Like, I decided, am I going to better myself, or am I get or am I going to stay sad? So bettering myself is reaching out in this group and immediately provided with a resource, and then it was like the whole world opened as far as information was concerned. And I felt like I'd learned so much from the Facebook group alone.
Scott Benner Can you contextualize why what you were taught in the hospital led you to feel sad? Like, where was the gap? Now that you have more information, what's the gap that left you feeling lost?
Cassie I don't know. That's hard. I think it was just I didn't have a good grasp of what it was, I think, and it just felt so monotonous. I mean, we were sent home with so much stuff.
Scott Benner Mhmm.
Cassie Pen needles and syringes and insulin and a meter and, I mean, all this stuff. And so it just felt so monotonous to have to figure out exactly what he's eating. And then and at that time, right, they really want you to focus on counting carbs. And I already knew how to do that. That's not it wasn't hard for me.
Cassie Mhmm. But I'm the kind of person that will just measure everything. I'll measure all the food. And so now I'm, like, putting the peanut butter on the scale. Right?
Cassie Because I need to know how many carbs of peanut butter he's having so I can get it exactly right. And then I'm calculating exact the exact carbs and then trying to figure out the dosing on that. And then, well, do we round up or do we round down? Which one are we gonna do this time? Because we're, you know, on shots at the time.
Cassie It just felt so overwhelming. And how do I send them back to school on pen shots and then a nurse is gonna do this? How do I trust a nurse to do this when I don't even necessarily trust myself every time? It felt hard allowing somebody else to do that for your kid.
Scott Benner Hindsight, is there anything the hospital could have done differently that would have helped you, or maybe is it beyond their touch?
Cassie I don't know. Maybe we rushed home. Like, maybe if we'd stayed a little bit longer, we'd we had would have received a few more of those touches. Right? Because they would send in like, we did see the dietitian.
Cassie Like, she came in and did a thing with us. We saw our educator several times, which was great. But, like, they had a psychologist that would come in and talk with us. We didn't see them because we didn't stay long enough for that. And then, of course, like, me hearing about their outreach group and then the Facebook stuff, that was just for me going through the packet that they gave me.
Cassie Mhmm. Perhaps that would have been mentioned, right, if we had stayed a little bit longer. And so maybe because we shortened the stay, we didn't get the full experience. And then knowing that there were other people out there to talk to, there were different things you could try. I don't know.
Cassie Yeah. It's hard to say, but we really did wanna go home, and we had a good grasp of it. We put his Dexcom on in the hospital. We were able to show that we could give his insulin shots with no problem. Right?
Cassie And so they just felt like we had a good understanding. We were equipped, and we could go home if we wanted to. So
Scott Benner Plus there's a lot of honeymooning. So you're kinda getting a soft launch too.
Cassie Right.
Scott Benner Yeah. Yeah. But you don't know that at the time.
Cassie No. Nope. And we didn't really understand what that was like. They had mentioned the word, but we didn't really understand what that was like until we started hitting a lot of lows. And so then I got ahold of them.
Cassie I was actually calling every day. For a while, they wanted me to call every day and give them his numbers. Then they were, like, adjusting his CARB ratio and stuff. And so it wasn't until we hit a bunch of lows, and they're like, okay. Well, the honeymoon's probably kicked in now that he has insulin on board.
Cassie And so you're gonna see this that the pancreas is still helping a little bit. And I'm like, but you told me it was dead. Mhmm. Why is it working now? But he did tell us at it must have been our October appointment that he felt like the prolonged honeymoon that he's experiencing right now is because we were able to get the numbers in check so quickly.
Scott Benner He thinks you found the diabetes pretty quickly? Actually, hindsight, how long do you think it had been going on where he wasn't feeling well?
Cassie Oh, at least four weeks.
Scott Benner Four weeks. Okay.
Cassie Yeah. So he was diagnosed July 1, and I would say he was probably having symptoms the June. Noticeable. If I can look back, he it was all of June. He it was really ramping up.
The Type 1 Neighbor
Scott Benner When you saw it more.
Cassie Yeah. Mhmm.
Scott Benner So now this has been a great conversation, but we have not touched on one of the things that you put in your list.
Cassie Oh, yes.
Scott Benner Is that my fault?
Cassie No. I actually didn't even review it before we did this.
Scott Benner Okay.
Cassie At the time that I wrote that email, things have changed so much since then already.
Scott Benner Oh, let me read it to you then. Maybe you don't even relate to this. It says lack of education and general knowledge about type one in children. Mhmm. Getting buy and support from family members.
Cassie Mhmm.
Scott Benner School nurse relationships. Type one with sports. Relationship evolution with our type one neighbor.
Cassie Yes.
Scott Benner What do you wanna talk about in that?
Cassie So my neighbor is awesome. I love her so much. She was diagnosed as an adult. She was 19, and she just turned 40.
Scott Benner Cassie, real quick. If you say you love everybody, then when you say you love me, it doesn't really hit the same way.
Cassie I'm so sorry.
Scott Benner That's okay. But I mean
Cassie But I love everyone in their own unique way. Right? I know. It's just like telling
Scott Benner your child that they're your favorite, but they're all they're they're all a favorite for a their Has that ever seemed satisfying to one of your kids before?
Cassie It actually my type one likes that a lot. I'm like, you're my favorite. And he's like, but you tell that to my brother. And I'm like, I know. But he's my favorite because he's so cuddly, and you're my favorite because you're so intelligent.
Cassie And he's my favorite because he's so witty. And he's like, oh, I love that.
Scott Benner This kid's easily placated. I don't like that much. Because my kids are like, one of us has to be better than the other one. And we're like, we're like, no. And they're like, come on.
Cassie Well, I like to think of it that way for me, like, with my siblings. I am the favorite. I mean, my mom would probably disagree with that, but I think I am. So
Scott Benner You think your mom disagrees that she has a favorite?
Cassie That I'm the favorite.
Scott Benner Oh, wait. You think your mom has a favorite?
Cassie I think I'm my mom's favorite, but I think she would say no.
Scott Benner How many kids does your mom have?
Cassie Three.
Scott Benner What's wrong with you that you're not the favorite?
Cassie I don't know.
Scott Benner You know. What is it?
Cassie I'm too sassy, Scott.
Scott Benner Are you the most like her?
Cassie Probably. Yes.
Scott Benner Yeah. Okay. The one she likes the best is the one who acts the way she wishes people would be?
Cassie No. Probably not. No? No. Honestly, my mom probably does not have a favorite.
Cassie But
Scott Benner I feel like you're backpedaling now because you think they're gonna hear this.
Cassie No. She will probably hear this at some point. I actually didn't tell her about it, but I will tell her eventually.
Scott Benner Also, be honest. The one she's chosen is a favorite. She picked the wrong one. Right?
Cassie No. I I truly, I don't think she had a favorite.
Scott Benner Okay. Alright.
Cassie I don't think so.
Scott Benner Alright. I'll agree with you that you believe that.
Cassie If any of the kids were favorites, it's the grandkids.
Scott Benner Well, that's easy. That's
Cassie easy. I know. Right? Yeah.
Scott Benner Yeah. I'm just telling you, like, my kids are like, come on. Which one of us do you like better?
Cassie Which one of us do you like better? Sometimes I tell them it depends on the day. Like, today, it's the oldest.
Scott Benner They make a case for themselves too. And I'll tell you what, they're good arguments.
Cassie Yeah. They can be. They can be.
Scott Benner We've gotten it down to which one's easier. That's the new discussion. Which one of us is easier? And I was like, neither of you are easy. And then each of them is like, oh my god.
Scott Benner What about this about her? What about this about him? And I'm like, yeah. I mean, you're both the problem is what I'm telling you.
Cassie Right. You know? Yeah.
Scott Benner Alright. Okay. Alright. I believe you. I'm sorry.
Cassie No. You're fine. No. So my neighbor, we have a little community pool, and we get a membership there every summer. And so her and I will hang out and talk while the kids swim.
Cassie And this is where the lack of knowledge about diabetes ties in.
Scott Benner Okay.
Cassie She never told me she was type one. So then one summer because she's lived here, I don't know, five years now. One summer, I noticed tubing coming out from underneath her shirt. And I thought, oh, I wonder if that's an insulin pump. Oh, she must have this severe kind of diabetes.
Scott Benner Oh, you thought that when you saw the the tubing?
Cassie Yeah. Mhmm. And so and then that's what it was. She did. She had a pump.
Cassie She was on the t slim at the time, and so she would just, like, tuck it into the back of her swimsuit. And so we had kinda struck up a conversation. I'm like, hey. I didn't know you had diabetes. And she's like, oh, yeah.
Cassie I I have type one, and, you know, I was diagnosed at 19. And at that time, I I still thought it was probably type two, right, in what I understood as diabetes at the time.
Scott Benner Right.
Cassie Yeah. So in this time where he's ill, she's made comments about him at the pool. Gosh, man. He's looking a little bit thin. Man, his lips are turning blue like he's getting really cold in the water.
Cassie Like, he'd lost 12 pounds by the time he was diagnosed. And she's like, man, he's looking you know, he's going through a growth spurt or something. So when I texted her from the hospital and was like, Wes was diagnosed with type one diabetes. And she was like, I feel like such an asshole. How did I miss this?
Cassie Like, I am type one. And I couldn't even tell you that he was having symptoms.
Scott Benner She saw changes in him, but she didn't relate them back to diabetes.
Cassie No. Okay. And she goes, and these are all the same symptoms I was having. Yeah. Yeah.
Cassie So it was crazy. So the difference between where I think we're at and where she was at, she would say she didn't have a lot of support at the age of 19 when it came to this. So what's been cool about it is been able to, be able to relate to her. And, obviously, not the same. Right?
Cassie I'm a parent taking care of a child, and she is the type one. But being able to talk about it so she can she'll text me pictures of her graph and tell me, like, man, I missed the mark on this bolus. That sucks. Right? Or, you know, I had this really bad low today.
Cassie I must have given too much insulin. I feel like crap. Right? It's been cool to kinda talk about it back and forth. I had listened to all of the episodes available on the GLP stuff because I was so interested.
Cassie My mind went to, would they give it to Wes so that we can prolong his honeymoon as long as possible? Probably not, but that's where my mind went. Right? Can I get him something like that that we could microdose, and then we can just, like, try to keep this pancreas alive as long as possible? But in listening to that, then I was able to relay information to her and say, hey.
Cassie This is something I think would really help you. Like, I think based on where you're at, you should push your endo for this. I really wanna see this for you because she was experiencing a season of burnout. Right. And she did.
Cassie She ended up getting on a GLP one, and she has seen immense improvements. She ended up moving from the t slim to the Omnipod, and she loves it. It's been working so well for her. She feels like she has so much more freedom. So it's been really cool.
Cassie And I would say just from the conversations that her and I have had, the his diagnosis was a benefit in that relationship because it was almost like she had found a support system. You know what I mean?
Scott Benner Right. Wow. Does she listen to the podcast?
Cassie No. But I've told her about it. I don't know if she's ever listened to a single episode, but I've sent her ones where I'm like, hey. You need to listen to this. It's so good.
Scott Benner That's really nice for me to know. I appreciate you sharing that with me. Yeah. That means that it's possible that the thing I made helped the person who has never heard it before.
Cassie Yeah. Oh, yeah.
Scott Benner I like that.
Cassie Yeah. Absolutely.
Scott Benner Awesome. And she has diminished need for insulin. Her insulin needs have gone down.
Scott Benner You can manage diabetes confidently with the powerfully simple Dexcom g seven. Dexcom.com/juicebox. The Dexcom g seven is the CGM that my daughter is wearing. The g seven is a simple CGM system that delivers real time glucose numbers to your smartphone or smartwatch. The g seven is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes.
Scott Benner The Dexcom g seven can help you spend more time in range, which is proven to lower a one c. The more time you spend in range, the better and healthier you feel. And with the Dexcom Clarity app, you can track your glucose trends, and the app will also provide you with a projected a one c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for dexcom. Dexcom.com/juicebox.
Scott Benner When you use my link, you're supporting the podcast. Dexcom.com/juicebox. Head over there now. Today's episode is brought to you by Omnipod. We talk a lot about ways to lower your a one c on this podcast.
Scott Benner Did you know that the Omnipod five was shown to lower a one c? That's right. Omnipod five is a tube free automated insulin delivery system, and it was shown to significantly improve a one c and time and range for people with type one diabetes when they switched from daily injections. My daughter is about to turn 21 years old, and she has been wearing an Omnipod every day since she was four. It has been a friend to our family, and I think it could be a friend to yours.
Scott Benner If you're ready to try Omnipod five for yourself or your family, use my link now to get started. Omnipod.com/juicebox. Get that free Omnipod five starter kit today. Terms and conditions apply. Eligibility may vary.
Scott Benner Full terms and conditions can be found at omnipod.com/juicebox.
Cassie Yes. Yeah. She's increased her a one c dramatically. Like, it's been so good, and she's just thrilled.
Scott Benner Decreased.
Cassie Yes. Decreased. I'm sorry. Yeah. She's decreased it.
Scott Benner Yeah. Oh, that's wonderful.
Cassie Yeah. Yeah. So that's really cool.
Scott Benner Very nice. Look at you. You're out there, like, doing good works.
Cassie Doing the Lord's work. You know?
Scott Benner All I heard was that there are people who sit at the pool, and I thought, what am I doing wrong? That's all I heard, and that's all I thought. I said, what am I doing wrong? She's sitting at a pool.
Cassie Yeah. We sit in a pool. It was probably built in the eighties. I'm sure the lawn furniture is from the eighties as well. I mean, it's a thing, but it's usually the same families every year and we do.
Cassie We just go down and we Hang out. We just hang out at the pool
Scott Benner while the kids swim. I want that. I want a day where I hang out at the pool. I'm gonna do that. Yeah.
Scott Benner I don't have a pool, but I know.
Cassie We don't either. I mean, we could. The area that we live in, it gets pretty hot. Yeah. We could.
Cassie But yeah.
Navigating School Nurses and 504 Plans
Cassie No. At the time, like, when I had sent the email, we had made a turn in the relationship with our school nurse. And so because he was so newly diagnosed, it had been, like, seven weeks when he went back to school. She was so excited because she thought he was gonna be MDI, and then he wasn't. We got him on the Mobi three days before school started.
Cassie And so she was like, ugh. I don't know how to use this pump. I'm like, that's fine. He does.
Scott Benner It's got buttons on it. You'll figure it out. Let's go.
Cassie Yeah. And I don't think she ever managed it. Like, she never used it. She would just stand there, and he would bolus. So I would write a little note in his lunchbox.
Cassie He would put in his carbs, show her, administer his insulin, and then he'd eat his lunch.
Scott Benner I'm always surprised by how easily people are put off by technology sometimes. Yeah. It's just an insulin pump. It's not difficult to use.
Cassie Yeah. And she had experience with an Omnipod controller. Yeah. She had never seen the Mobi before, and so she was like, no. I don't he as long as he knows how, that's fine.
Scott Benner I watched my wife forward me a PDF today, and it looked like she had never seen a computer before the way she did it.
Cassie Oh, dear.
Scott Benner I think you'd be surprised by how many people record an episode of the podcast in the beginning before you guys hear what's happening is spent with them going, like, I'm so sorry. I'm so bad at technology. I'm like, it's not technology. It's Zoom. I mean, it I mean, there's not a lot to it, you know?
Scott Benner Or or when you say to something I say, hey. Listen. You know, your microphone just needs to be turned up. There's not enough volume in your microphone. Or I don't say microphone.
Scott Benner I go, I can't hear you. You know, you need to turn that up. You go into audio, there's settings in there. Well, in the audio, there's settings for speaker and there's settings for microphone and they can't hear me and they turn the speaker up. And they're like, oh, you're louder in my ears now.
Scott Benner I'm like, well, you turn up speaker? And I said, yeah. I said, well, turn up the microphone. That's the thing you're talking to me They go, oh, I'm sorry. I'm not good at this.
Cassie Oh my gosh.
Scott Benner Good at what? I I I don't Simple even
Cassie direction.
Scott Benner Yeah. There's sound going one way and coming back another way. Yeah. You talk into a thing, it reaches my speakers. I talk into a thing, it reaches your speakers.
Scott Benner Are we confused by this?
Cassie Confused. Yeah. Very.
Scott Benner So when somebody says, you know, I've never seen this insulin pump before. I'd rather you be MDI. I mean, what do you care?
Cassie I know. Yeah.
Scott Benner It's not that hard. It's that thing that puts people off. Any kind of change is difficult for for some people for some reason.
Cassie Yeah. But, like, the Facebook group is where I learned about texting diabetes. And then, of course, the podcast. Right? You've talked about it.
Scott Benner Yeah.
Cassie And then as soon as he was getting back to school, like, I'm on Spotify and I'm, like, searching keywords because I wanted to listen to every last episode you've ever had that talked about a five zero four plan. Mhmm. I mean, I was digging into it. Right? And so it started off a little I felt like she was overbearing.
Cassie And then it got to a point where she was like, well, I don't want you texting him and telling him to correct in class because I have to do that. Like, that's not in his medical orders. And I was like, I can tell him whatever I want, actually. So
Scott Benner That fine. Thanks. Don't worry. We got it. Yeah.
Scott Benner I'll never do it again. Don't worry.
Cassie Yeah. And then we also had, like, a a nurse. She shared schools at the time, and so we had a nurse that would come in one day a week. She was an LPN. She was the worst.
Cassie The worst. Mhmm. And I'm so glad she's not there this year. Even though I don't my kid's not there anymore. I'm so glad she's not there.
Cassie She would not follow our rules for treating Lowe's, and so she would make him do 10 to 15 carbs. And I was like, his medical orders don't even say that. The kid is so carb sensitive. Even at camp over the summer, they were like, we realized he only needed two or three. I'm like, I wrote that on his paper.
Cassie Mhmm. I told you he only needs two or three. You can't give him a 15 carb juice box. He'll reach 400 in, like, ten minutes. It just isn't gonna happen like that.
When Good Outcomes Face Medical Pushback
Scott Benner Yeah. I wanna pivot back here because we're kind of at the end, but I I wanna come full circle now that I understand your story. Right? You're going to the doctor. You've got the a one c from the sixes to the fives.
Scott Benner Right. I've now talked to you for a while. You're not crazy. Congratulations, Cassie.
Cassie You've Oh, thank you.
Scott Benner You're welcome. You've been diagnosed by a a nonmedical professional. It's not crazy. And you had some ideas. You were trying to chase after a more stable lower number.
Scott Benner You get there. The doctor tells you you're trying too hard. You're gonna burn yourself out. You weren't burned out. Mhmm.
Scott Benner No. You weren't concerned about burnout. And how long ago was that?
Cassie That was December. So it's been a full twelve months now.
Scott Benner Since he told you that?
Cassie Yes. And has
Scott Benner that been brought up again?
Cassie No. It actually has become more positive.
Scott Benner Okay.
Cassie Yeah.
Scott Benner And so he realized that you weren't burning out at some point, it sounds like.
Cassie Yes.
Scott Benner Okay.
Cassie Yeah. Yep. I think he realized that we weren't burning out. And so when we saw gosh. It must have been the October appointment.
Cassie So we had a Zoom one in July. It was, like, right after camp, so there was no a one c then. And then, of course, we got to October. Now it's been ten months, and his a one c was 5.4 again. That's awesome.
Cassie So we've maintained this almost a whole year now.
Scott Benner Yeah.
Cassie And at that point, he was like, man, great numbers. Good job. And I was like, thank you so much. I said, really? Honestly, I think a lot of this is just insulin timing.
Cassie We've really figured out the insulin timing.
Scott Benner Sure.
Cassie I review his reports every two weeks, and then I make basal adjustments as they're necessary so that we're keeping him stable in between. And so he's like, yeah. No. That's great. That's exactly it.
Cassie And he goes, so my encouragement to you, if you're ready to take the next step, there's a new metric that they're talking about. It's called tight range. And if you would like to see what that takes for him, 70 to one forty, you guys can start playing in that. But, hey. Let's play with the Dexcom reports real quick, and let's see how often are you in tight range, which they're saying 50% of the time.
Cassie Okay. Well, he's in tight range 73% of the time.
Scott Benner Yeah. So you're already there.
Cassie Yeah. So he goes, well, you're already there. So he goes, the only other challenge to you is just to increase that. It's just to do better at that.
Scott Benner I would ask him at some point, and I wonder if he would even remember. But I would ask him at some point, do you remember a year ago telling me, hey. Slow down. You're too in the weeds. Blah blah blah.
Scott Benner Like, why'd you say that to me? Yeah. And how come there's never been, you know, a mention of it again? How come you haven't said to me, hey, you know, I told you to slow down, but obviously, you were doing great. I see what you were concerned about, but that was not great messaging at the time for me.
Cassie Right. Yeah. No. It felt very defeating.
Scott Benner Yeah. No. People have it. Cassie, all the time. I mean, I'm telling you, it happens all the time that somebody comes to me or puts up a post and says, I went to the doctor today.
Scott Benner I was so excited to go
Cassie Mhmm.
Scott Benner Because we figured everything out and put it all into play, this was it. I was getting back my report card. It said what I wanted it to say and then I got yelled at for fifteen minutes. And I wonder if they really got yelled at or if somebody was just talking to them like, you got spoken to. And it feels like you're being yelled at because you tried so hard and then you did the thing that you were told was the pinnacle of it and then somebody said, oh, no.
Scott Benner You shouldn't do that. Like, people are fickle. Yeah. Like, everybody always wants to be tinkering and touching things and well, I don't know why that couldn't have just been like, hey, you're doing great. I do think it would be it's incumbent upon me to to say to you that if this is taking up too much of your time and intention, you do need to be worried about getting burned out on this.
Scott Benner But if that's not happening to you, then God bless you. You're doing a great job. How was it you're accomplishing this? You know what I mean? Like, why is that not the answer?
Scott Benner Hey. How'd you do that? You know? Like, maybe you know something I don't know. Would you share it with me?
Scott Benner It's never like that. It's always the everything's bad. Everything's gonna be bad. Let me just warn you. I'll be negative even if I don't think it's being negative.
Scott Benner People hear that negatively, and I I think they should, by the way. But alright. Well, I mean, it's fine now. So whatever. I guess don't rock the boat.
Cassie And the reason that I say he's great, like, son loves him. He is part of the camp that my son has gone to.
Scott Benner Mhmm.
Cassie I mean, he's really passionate about diabetes. The only reason that I say that I think it was coming from a good place, right, even though it felt crappy
Scott Benner No. But I believe it was too, I wanna say.
Cassie Yeah. Yeah. He has two type one kids.
Scott Benner Oh, the doctor does?
Cassie Mhmm. Our endo is a dad of two type ones himself. Yeah.
Scott Benner He's like, you don't wanna end up in the same booze hole my wife is in. Be careful.
Cassie Yeah. So one of our educators had told me at one point in time that he had actually gone back to school after his kids were diagnosed Wow. Specifically to specialize in
Scott Benner Endocrinology. What a good dude.
Cassie Yeah. In endocrinology. Yeah. And he's very passionate. He's a lovely man.
Cassie Yeah. And I think that he does really care about people. And so I think, honestly, it was coming from a good place, but it did. Like, it felt not good at the time.
Scott Benner Yeah. No. I understand the balance there. I wrote a blog. He went to medical school.
Scott Benner Jeez. I I thought they I didn't try as hard as I thought I did. He's he's like, wait. He was a doctor?
Cassie I believe he was a nurse.
Scott Benner Really? And became an MD?
Cassie He became a physician's assistant. He's PA.
Scott Benner Assistant. Hey. Listen. That's yeah. Again, all I did was write a blog.
Scott Benner That seems like harder. Very cool.
Monitoring Siblings for Autoimmune Issues
Scott Benner Well, do you have any concerns about your other boys? Do you get them tested?
Cassie So I haven't gotten them tested. Right off the bat, I had gotten the trial net kits. My oldest, who's 14, does not want to know anything at all whatsoever. And so we decided we would respect that if he does not wanna have blood work done and he doesn't wanna know. Because he has actually expressed to me, like, I found him in his room very upset.
Cassie And he said, I'm scared I'm going to get it. I can't do it. Wes is great at it. I can't do this. And I'm like, no.
Cassie I understand. And so he would rather not know. Like, if it happens, it happens. I don't have concerns for him. I have this weird mom gut feeling that maybe the youngest might.
Cassie He did want and but he's also the one that asks me, like, well, when do I get to have diabetes? And I'm like, well, you don't. I mean, you don't want it, but he's curious. He loves to check his blood sugar.
Scott Benner Yeah.
Cassie He's worn Astello for a little bit. He wore it for a couple of days. We saw some excursions on it. I was told not to worry about them, but he hit, like, one ninety on cereal. And I was like, that's wild.
Cassie He just randomly took his blood sugar a couple nights ago after we had oh, McDonald's. They get that, like, once a month at this point. He had McDonald's, and he just randomly decided to check his blood sugar. And three hours after eating, he was still one fifty. And I'm like, I don't know.
Cassie I don't know.
Scott Benner Fat. That's a lot of fat in that too. Was there a milkshake with it as well or something like that?
Cassie No. Nope. It was two cheeseburgers and a medium fry.
Scott Benner Have you tested it in the morning fasting?
Cassie We have, and he's usually, like, 100, one ten.
Scott Benner That's high.
Cassie I know. Yeah.
Scott Benner Yeah. Any other autoimmune in the family?
Cassie Yeah. So we do have my side of the family has, rheumatoid arthritis.
Scott Benner Mhmm. Mhmm.
Cassie And his side of the family has a ton of thyroid.
Scott Benner Interesting.
Cassie I only have it on one side on my side, and then he has it on both sides. His both his mom and his dad have thyroid.
Scott Benner How about your middle son? Because you said he was small. How's his thyroid?
Cassie They tested all of that in the summer at his one year mark, and everything came back beautifully.
Scott Benner We don't care about the numbers, though. What do we care about? We care about the outcome. So do you know what his t s h was?
Cassie You know, I knew you were gonna ask me this.
Scott Benner And what happened, Cassie?
Cassie I didn't look it up.
Scott Benner Mhmm. Is that information in the same place where the dustpan and the vacuum are at? Is that what's going on? Hold on a second. They I like that you said I I'm not good at cleaning that house.
Cassie No. I actually don't think. I know that it's online, like, in his portal.
Scott Benner Does he have any other thyroid symptoms?
Cassie Not that I'm aware of.
Scott Benner Do you know what
Cassie they are? I don't know. And I was honestly, I was like, I need to ask him about this. So my mom's side of the family is very small. My mom's only four nine.
Scott Benner Okay. That is small. Sorry. I didn't mean to laugh. That was weird.
Cassie My grandfather was, like, five foot. My grandmother was five one.
Scott Benner Oh my gosh.
Cassie Right? Very tiny people. I'm five four, but our oldest son is already five nine at 14. Like, he's huge.
Scott Benner Okay.
Cassie But then Wes is small, and, I mean, he would it's so funny. He had to do this, like, age verification thing on Roblox to use the voice chat with his friend, and they, like, scan the face. It's super creepy. I didn't really wanna do it. I put it off as long as I could.
Cassie Anyway, it estimated him to be nine.
Scott Benner They were like, stop it. This is a baby you put in front of us here. Don't don't try.
Cassie And he's and he's 12. But he is. Like so he was in jujitsu for a little bit. And, I mean, we figured that out. Keep the blood sugar up while he's doing that.
Cassie That was awesome. But he would often be paired with kids that were, like, second and third grade because they were the same size.
Scott Benner Okay. Here's the last thing we're gonna do together. I'm gonna read you're gonna say yes or no.
Cassie Okay.
Scott Benner Extreme fatigue, feeling tired, sluggish, or exhausted even after sleeping.
Cassie I wouldn't say often. No.
Scott Benner Feeling cold when others are comfortable, inability to warm up. Sometimes. Constipated, frequent or persistent difficulty making a poo poo?
Cassie Sometimes.
Scott Benner Dry hair, dry skin?
Cassie Yes. Very dry skin.
Scott Benner Puffy face, swelling particularly around the eyes?
Cassie Sometimes.
Scott Benner Hair loss? No. Have a raspy or deep throat, deep voice?
Cassie Yes.
Scott Benner Deep throat. I didn't mean that. Sorry. Deep throat. Muscle.
Cassie Raspy voice. Yes.
Scott Benner Talking about your 12 year old. Muscle weakness, feeling weak, particularly in the upper arms and thighs.
Cassie Thighs. Yep.
Scott Benner Brain fog, difficulty concentrating, forgetfulness, or fuzzy thinking.
Cassie Probably sometimes.
Scott Benner Does he have what they call low mood, apathy, lack of interest in activities, depression in other words? No. Slow movements. Moving or speaking more slowly than normal? No.
Scott Benner I slowed down to say that. That was interesting.
Cassie That was interesting.
Scott Benner Does he have any menstrual changes? Hold on a second. Let me skip that one. Look at me being funny. Joint muscle pain, aches, tenderness, or stiffness in muscle and joints?
Cassie Sometimes in the legs. Yeah.
Scott Benner Okay. Seriously, what was this TSH?
Cassie I'm I'm looking.
Scott Benner You're tell me it was like 2.3 or something like that, and they told you it was great.
Cassie Okay. Let me look.
Scott Benner Oh, here's one. Poor growth resulting in short stature, delayed development of permanent teeth, or delayed puberty.
Cassie Yeah. I mean, maybe. I mean, he's got all his teeth.
Scott Benner He's got all of his teeth. Look at him go.
Cassie He's got all of them. No. They said that they actually fell out very quickly for him. He's got all of his adult teeth now. Let's see.
Cassie Okay. Review now. There's things in here for Wes. Great. I'm gonna open this up
Scott Benner Uh-huh.
Cassie And I'm gonna see. I'm gonna tell you.
Scott Benner We're fine. We're at time, but that's fine. We can we can we can talk another minute. Don't worry. We're working on something.
New Tools: Juicebox Docs, Calculators & AI
Scott Benner I've revamped juiceboxdocs.com.
Cassie Oh, okay.
Scott Benner Yeah. So it's a list of doctors that listeners have sent in. It's really kinda cool. Like, you log on, the first one that pops up is in Alabama because it's in what you might call alphabetical order. And giving the example, Chelsea Zimmerman is at East Alabama Medical Center endocrinology, and there's a little badge.
Scott Benner It says she's a pediatric endo. There's also a little badge that says provider has type one. So there's, like, little badges, like, so you can kinda make through. There's an address you click on. It launches up a Google Map.
Scott Benner The you can click on the telephone number to make a phone call to them or you have a website link to click on. It's really pretty excellent. And you can search it. Like, for instance, you're in Washington. Right?
Scott Benner So I type in Washington, and just like that, there's somebody at the Mary Bridge Children's Outpatient Center in Washington. Oh. The doctor's clinic, Cavalion Place, Washington. Let's see. Advanced Diabetes and Endocrinology Care in let's see.
Scott Benner Washington again. So there's adults, pediatric. It's nice. It kinda pops up. Now we have Washington DC, Washington state.
Scott Benner And if they provide, like, good support for algorithms, if somebody says, hey. Look. They're really great with an algorithm. We have a little badge for that so you kinda know what you're looking at.
Cassie Oh, that's cool.
Scott Benner Yeah. It's great. And if you have a provider that you like, you can scroll to the bottom and submit your provider, and they'll show up in
Cassie the Perfect. Yeah. I remember looking at that in the beginning to see if there was anybody else we could find that might be close.
Scott Benner It's much better now. What they call searchable.
Cassie Searchable. Yeah. Yeah. Yeah. Searchable now.
Scott Benner Yeah. Yeah. Before, it was just my best attempt to, like, make a list. But now, I'll just say now with the advent of vibe coding through AI, you don't really need to know how to code to make stuff work anymore.
Cassie Yeah. That's crazy.
Scott Benner I'm sure all the coders are thrilled to hear that. And this is a very basic code. I also think that maybe, you know, data engineers are still probably pretty safe. And then also, telling people about stuff, juiceboxpodcast.com/settings. If you are looking to get, like, a basic starting point where your settings might be Mhmm.
Scott Benner This does it completely by weight. Oh. Do you know that boy's weight over there?
Cassie Sixty seven.
Scott Benner Sixty seven. So I put in sixty seven, and then it allows you to choose between highly sensitive, standard sensitivity resistant, or highly resistant to insulin. Where would you place him on that? Sensitive still? Because he's
Cassie Yeah. He's still pretty sensitive. Yeah.
Scott Benner It tells me from that that a starting point for his total daily insulin should be about thirteen point seven units. Does it seem right? Does he use about fourteen units a day?
Cassie Yeah. He's about 15.
Scott Benner Yeah. And it says that a a good place to start with his basal insulin would be six point eight five units a day or point three an hour. Do you have
Cassie That is almost spot on for him right now.
Scott Benner Hold on a second. One unit covers about 36 and a half carbs, it says.
Cassie His carb ratio is one to 15.
Scott Benner Okay. Well
Cassie Yeah.
Scott Benner Again, it's just a starting spot. And sensitivity factor, one unit moves him about a 131. Is that right?
Cassie Yeah. He's hit one to one twenty five.
Scott Benner Okay. And, that's just a little calculator that gave us all that just by putting in his weight.
Cassie That's crazy.
Scott Benner Mhmm. It's not. It's math. Now juicepodcast.com/bolusfour. This is the next one.
Scott Benner I'm super excited about this one. So now we take his insulin to carb ratio. What is it again? One unit covers 15. 15.
Cassie Mhmm.
Scott Benner Insulin sensitivity, we said was a 125? Yep. Target blood sugar, we're gonna make it 80. Let's pretend like he ate 50 carbs, and that meal just was 50 carbs. He's got no insulin on board.
Scott Benner His arrow is stable, and his blood sugar is currently a 110. Click calculate bolus. It tells you that he needs a bolus of about 3.57 and that you should pre bolus about eleven minutes. If suddenly that that meal had 10 units of fat in it or 10 grams of fat in it and hit calculate bolus again, it's still the same thing. Nothing different has changed.
Scott Benner And watch how it happens as I put the fat up. Now I'm at 15 grams of fat. Oh, at 15 grams of fat, it would like to see 3.57 as an initial extended bolus over three hours of point nine for a total of 4.47. The pre bolus is still at eleven minutes.
Cassie Oh, I love that.
Scott Benner Yeah. If I add protein in it, five grams of protein, and let's say I say his blood sugar is falling instead, and I hit calculate again. Well, now it says that's fine. We're still 3.57 as a a bolus again of one point o three over three hours to cover the fat and the protein, but it says please eat immediately because of hypo risk or low blood sugar.
Cassie Oh, okay. This is almost like that calculator that Nico shared, but it's, like, on steroids.
Scott Benner I made one of my own and kinda zhuzhed it up a little bit.
Cassie Now Yeah. I love that.
Scott Benner A lot of disclaimers. It's just a I'm not a doctor and I'm not a coder. None.
Cassie It's just a tool.
Scott Benner It's just a tool for you to look at, but it's Yeah. It's pretty awesome. Did you find his thyroid stuff yet?
Cassie I did. It's 1.54.
Scott Benner Damn it. It's not his thyroid. Has it ever been higher than that?
Cassie Not that I know of. This is the first time we've ever had it tested.
Scott Benner Keep testing it because they can bounce sometimes. But anything over 2.1, 2.2 with symptoms, you really gotta start asking for the medication.
Cassie Okay.
Scott Benner So look for bouncing. Like, there's a world where you check it again and it's much higher or it's super stable. It's did they do his iron by any chance? Do have low iron?
Cassie That's a good question too. Okay. I've got screenshots of everything. T four was a 7.1.
Scott Benner Okay.
Cassie Microalbumin Mhmm. Creatinine ratio, that's 15.
Scott Benner TSH was what? One point five?
Cassie One point five. Yeah. What is this? Tissue trans glutaminase IgA less than two. Some of these, I don't even know what they are.
Cassie They just said normal.
Scott Benner Did they do t three?
Cassie No. I don't think they did t three.
Scott Benner Okay.
Cassie Immunoglobulin, a.
Scott Benner Look at you.
Cassie One thirteen.
Scott Benner Look at you saying words. Hold on a second.
Cassie An a one c five point four.
Scott Benner Wait a second. If someone with thyroid symptoms despite normal TSH and total, comma, possibilities include free t three could be low symptoms often track more closely with did they do free t three?
Cassie No. Uh-uh.
Scott Benner Ask for it next time.
Cassie Okay.
Scott Benner Tell them to do a complete thyroid panel, not just TSH and t four.
Cassie Okay.
Scott Benner And then say, because here are some symptoms he's having.
Cassie Mhmm.
Scott Benner Alright. Also, low ferritin, iron deficiency, low b twelve, low vitamin d, that stuff could possibly cause some of those symptoms as well. Okay. Alright? Don't let it go though.
Scott Benner Don't just say like it was okay and then never pay attention to it again.
Cassie Oh, for sure. We're not really in that boat, So we wanna make sure that he's as healthy as possible.
Scott Benner Good. Good. Good.
Cassie I mean, is growing, and so it's just slow. And then they want to equate him being small to just, well, that's just family genetics.
Scott Benner Very well could be. I'm not saying otherwise. I'm just saying like
Cassie Yeah. No. But it is something that's very bothersome for him. I mean, to the point where he's like, well, mom, like, I've heard about, like, growth hormone. Like, is that something that the doctor would put me on to help me get bigger?
Cassie Mhmm. I'm like, well, probably not. But
Scott Benner Did you say probably not?
Cassie Yeah. I told him probably not.
Scott Benner Why not? Maybe they would.
Cassie I don't know. Yeah. I mean, that's a good question.
Scott Benner Mhmm. I also have a prompt I've been working on. So you drop the prompt into right now, I'm using it in Google Gemini. You drop the prompt and hit return. It says, please give me your insulin to carb ratio, your fat protein adjustment factor for worse off, or just type default if you don't know, and a link to a recipe.
Scott Benner Oh. So I gave it a one to 12 carb ratio. I told it default, and I gave it a recipe for baked ziti.
Cassie Mhmm.
Scott Benner You hit enter again, and it comes back and it says, hey. We've divided this recipe into one tenth. A tenth of this recipe, 47 carbs, 16 fat, 21 protein. You'd wanna do a bolus of 47 carbs at your insulin carb ratio. That's 3.91 units.
Scott Benner And then there's a extended bolus for the fat and protein. It gives it to you like that, 3.9 for the immediate, point nine five over four hours for the rest of it. It explains to you the strategy behind why you're doing it, and it breaks down the meal for you and tells you what was in the meal if you're interested in how it broke down the ingredients and all this stuff and how the ingredients impacted your blood sugar, like, in, like, two clicks. It's pretty
Cassie That's crazy.
Scott Benner Yeah. Yeah. Yeah. I'm hoping people find that stuff useful.
Cassie Now I just use my little recipe thing, and then I plug everything in and divide it, figure out my carbs.
Scott Benner See, the thing here is with the prompt, the prompt's already written. So you you really need to just drop in the link in your insulin to carb ratio.
Cassie Oh, that's so cool.
Scott Benner And it, tells you the rest. So I'm trying to figure out a way to share that. I'm not sure if I'm going to or not. But the other two calculators, did share. So they're on the website.
Cassie Well, there I mean, I've seen people ask about that. Like, if I'm creating a whole meal, how do I figure out what the carbs are?
Scott Benner Yeah. It's tough. It really is to break the whole thing apart. So Mhmm. Basically, what you what I've learned is simply put is that you can take any recipe and just say to chat GPT or to Gemini or whatever you're using, like, please, you know, I need to understand the, like, the macro breakdown of this recipe and how many carbs are in a serving, how many this is in a serving, that's in a serving.
Scott Benner And it does a really reasonably good job of giving you a return back.
Cassie Yeah. That's great. I love that.
Scott Benner Yeah. Good. Very cool. Okay. Cassie, you were awesome.
Scott Benner Thank you for doing this with me.
Cassie Well, thank you so much. I really appreciate it.
Scott Benner Alright. Hold on a second. K.
Closing & Sponsor Messages
Scott Benner This episode of the Juice Box podcast is sponsored by Omnipod five. Omnipod five is a tube free automated insulin delivery system that's been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections.
Scott Benner Learn more and get started today at omnipod.com/juicebox. At my link, you can get a free starter kit right now. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox.
Scott Benner Today's episode of the juice box podcast is sponsored by the Dexcom g seven, and the Dexcom g seven warms up in just thirty minutes. Check it out now @dexcom.comslashjuicebox. Okay. Well, here we are at the end of the episode. You're still with me?
Scott Benner Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok.
Scott Benner Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group.
Scott Benner As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me.
Scott Benner I'll say hi. Hey. Do you need support? I have some stuff for you. It's all free.
Scott Benner Juiceboxpodcast.com. Click on support in the menu. Let's see what you get there. A one c and blood glucose calculator. People love that.
Scott Benner That's actually, I think, the most popular page on the website some months. A list of great endocrinologists from listeners, that's from all over the country. There's a link to the private Facebook group, to the Circle community, and, we have a a fantastic thing there. American Sign Language. There's a great sign language interpreter who did the entire bold beginning series in ASL.
Scott Benner So if you know anybody who would benefit from that, please send them that way. Just go to juiceboxpodcast.com and click on support. While you're there, check out the guides like the pre bolusing guide, fat and protein insulin calculator, gosh, thyroid, GLP, caregiver burnout. You should go to the website. Click around a little bit on those menus.
Scott Benner It really there's a lot more there than you think. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm like 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that.
Scott Benner And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
#1806 Spokane or Bust - Part 1
After a terrifying DKA diagnosis and life flight to Spokane, Cassie shares how her son’s type 1 began, the pressure to “not try too hard,” and navigating early control, burnout fears, and honeymoon shifts.
Companies that Support Juicebox
Key Takeaways
- Honeymoon Phase Challenges: As the "honeymoon" phase ends and the pancreas produces less insulin, diabetes management often feels like starting over as pump settings and carb ratios need frequent adjustments.
- Medical Professional Perspectives: Sometimes a doctor's pushback on tightly managed blood sugars (like an A1c in the 5s) comes from a desire to prevent caregiver burnout, rather than criticism of the management strategy itself.
- Diabetes is a Marathon: Successful management is about aiming for good outcomes over the long term without tying personal self-worth to every single blood sugar reading. Mistakes and unpredictable days will happen.
- Emergency Preparedness (Life Flight): If you live in an area where critical care requires air transport, an annual air medical transport membership (like Life Flight or Airlift Northwest) can save you thousands of dollars in an emergency.
- Recognizing DKA Symptoms: Excessive thirst, frequent urination, sudden bedwetting, extreme fatigue, paleness, and vomiting are classic signs of undiagnosed Type 1 Diabetes and potential Diabetic Ketoacidosis (DKA).
Resources Mentioned
- US Med: usmed.com/juicebox or call (888) 721-1514
- Eversense 365: eversensecgm.com/juicebox
- Tandem Mobi: tandemdiabetes.com/juicebox
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Touched by Type 1: touchedbytype1.org
- Life Flight Network: lifeflight.org
- Juice Box Podcast Small Sips: Go to juiceboxpodcast.com and click on "Series" in the menu.
- Wrong Way Recording: wrongwayrecording.com
Welcome & Sponsor Messages
Scott Benner Welcome back, friends. You are listening to the Juice Box podcast.
Cassie So my name is Cassie. I am a stay at home mom of three boys. They're 14, 12, and six, and my 12 year old is our type one diabetic.
Scott Benner Have you tried the small sip series? They're curated takeaways from the Juice Box podcast, voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com.
Scott Benner Click on the word series in the menu.
Scott Benner If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me.
Scott Benner If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner Today's podcast is sponsored by US Med, usmed.com/juicebox. You can get your diabetes supplies from the same place that we do, and I'm talking about Dexcom, Libre, Omnipod, Tandem, and so much more.
Scott Benner Usmed.com/juicebox or call (888) 721-1514. Today's episode is also sponsored by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com/juicebox. The podcast is also sponsored today by Tandem Mobi, the impressively small insulin pump.
Scott Benner Tandem Mobi features Tandem's newest algorithm, Control IQ Plus technology. It's designed for greater discretion, more freedom, and improved time and range. Learn more and get started today at tandemdiabetes.com/juicebox.
Scott Benner I just realized. I'm gonna record this.
Scott Benner We'll introduce you later. Okay?
Cassie Okay. Perfect.
The Creepy Neighbor with the Shears
Scott Benner So they have a row of bush as a hedge, and they I I'm gonna guess that in the time I've lived here, in the twenty five years that I've lived here, they've planted, chopped down, dug up, and replanted this row of hedges, I wanna say conservatively five times. So it's, like, 10 or 20. I don't know. They're not quite arborvitaes. They're nicer than that.
Scott Benner They plant them at about six feet high. They grow up to a certain level. They start to top them. They cap them. Like, they'll they'll cut them to keep them at a at a height.
Scott Benner And then eventually, one day, they just go out there. They cut them down into pieces, throw them away, dig up the stumps, and then replant the same exact bush again.
Cassie Do they just love the process?
Scott Benner I think it's it's gotta be quelling some sort of a mental illness for them. Like, I don't know I don't know
Cassie another way to put it. I that's a selling point though. Mature landscaping.
Scott Benner Well, guess what? It's been four times so far, and it's working on
Cassie it for a time.
Scott Benner It's working on it for a fifth time. So there's a lot of that. There's a lot of of planting, growing, tending to ripping down for no reason, replanting again. There's also and the reason this came up and, by the way, everybody, this is are we gonna say your name, Cassie?
Cassie Yes.
Scott Benner This is Cassie. We'll get to who she is in a second. She and I were talking before we started. But the reason I bring it up is because the older person that lives at the house and as I described to Cassie before I hit record, she has to be a 150 years old because I'm sure she was a 100 years old when I moved in here twenty five years ago. So, I mean, bent over, can't stand up straight anymore, doesn't look like she should be mobile, but still spends her entire summer on her hands and knees or bent at her waist, like folds herself in half to bend to the ground.
Scott Benner I mean, I'm impressed by her flexibility every day in my life with a pair of steel kitchen shears in her hand.
Cassie Oh my goodness.
Scott Benner Grabbing leaves, weeds, anything she doesn't like one at a time and snipping them off.
Cassie She must also do yoga.
Scott Benner I mean or her back is broken and it just doesn't matter because I'm not lying.
Cassie Could be.
Scott Benner Standing up straight, bent at the waist, hands on the ground. Clip, clip, clip, clip, clip. And then the the creepiest part and then you'll introduce yourself. The creepiest part is that there are times in the middle of the summer, sometimes as late at 03:00 in the morning where it's just dead silent outside and you have the windows open and you hear this.
Cassie Oh my goodness. Stop. She's out there at 03:00 in the morning?
Scott Benner Clipping with the Sears. And I have to tell you, I don't make fun of mental illness. I think it's terrible, and I don't know what's wrong. I have had situations where I've been face to face with her and she's been like, hello. How are you?
Scott Benner And I'm like, good. How are you? Do you not remember when you screamed and yelled at me six weeks ago? And then there's times where just for no reason, you'll just be pulling out of your driveway. I haven't seen her or laid eyes on her in months and, you know, you get to the end of the driveway.
Scott Benner Nice day. The windows are down. You put your hand up to wave and she just say, you fucking asshole. And I'm like, oh my god. What is happening?
Cassie Oh, dear.
Scott Benner Whoever buys this house, I imagine we'll have a landscaper come in and cut down, I'm guessing, 65 to 70% of what's planted on it because they they literally, it's like a walking garden. There's no actual space to be on
Cassie that. Oh, I see.
Scott Benner It's really crazy.
Cassie Is that where is that where the deer should go to die?
Scott Benner I mean, listen. If Snow White was over there right now having a full on relationship with seven smaller men, I wouldn't be surprised. It's a jungle forest across now here's the high side. I can't see their house. Like, I'm not kidding.
Cassie That's how much landscaping there is.
Scott Benner I am not kidding. I can stand at my front door, look across the street from my house, and I if I didn't know there was a house there, I wouldn't be able to prove it.
Cassie Oh, dear.
Scott Benner Yeah. Wow. Clink. Clink. The first time it happened, the kids were like, yo.
Scott Benner We're gonna die. There's a murderer outside. Hey. There is a guy with a hook outside. He's sharpening the hook.
Scott Benner He's coming for us. And then it took us a while to figure it out, but no kidding. It's her. And I'm not telling you this happens one time. Like, this happens.
Cassie Consistently. Yeah.
Scott Benner Yep. Yep. And then, you know, and and to your point earlier, which we won't say out loud because it had something to do with somebody you're related to. Her property don't look any different than mine does. Like like, it doesn't get any better or any worse or any different.
Cassie Right. Yeah. Yeah.
Scott Benner Yeah. It's awesome.
Meet Cassie: Navigating the Honeymoon Phase
Scott Benner Anyway, Cassie, do you have type one or does your kid have it? What's
Cassie going on? My kid has it. Yeah.
Scott Benner Awesome for you. Let's see. Let's let's learn about you for a second. Just introduce yourself just briefly.
Cassie So my name is Cassie. I am a stay at home mom of three boys. They're 14, 12, and six, and my 12 year old is our type one diabetic.
Scott Benner How long ago was he diagnosed?
Cassie He was diagnosed in July '24, so about eighteen months now.
Scott Benner Oh, it hasn't been that long at all.
Cassie No. It it feels like forever, but also not.
Scott Benner Tell me about that. What do you mean it feels like forever?
Cassie I just feel like we've settled into it enough that it just feels normal.
Scott Benner Okay.
Cassie It's almost like we don't really remember him not having it.
Scott Benner Wow.
Cassie Yeah. Which I find interesting. I don't know. I guess I just feel like I don't remember how easy it was before we had to do all the extra stuff. But then at the same time, it still does feel very new.
Cassie He's, like, in a prolonged honeymoon at this point, and so we're just now finally seeing it start to die off. It almost feels like we're learning all over again.
Scott Benner The honeymoon's dying off.
Cassie Yes.
Scott Benner Okay.
Cassie Yeah. Yep. Alright. So we'll have days where it is very obviously on the pancreas is helping, and then you go into, like, three or four days where it is not. And, like, ratios are not working.
Cassie Pump settings are not working. So this last several weeks, I feel like for us, it's just been starting over again. So
Scott Benner Is that feeling difficult, or are you able to adjust with it?
Cassie We're adjusting. It was a little difficult at first only because we've kept such good control. We managed to get his a one c down so far right off the bat.
Scott Benner Mhmm.
Cassie And that's kind of where my email came from was because I was basically told you're trying too hard. Like, you don't need to try this hard. And I was like, I don't know why you wouldn't want me to. Like, he's doing really well, and he's happy. So it was a little frustrating because it's just like, you don't wanna lose the progress, I guess.
Scott Benner Pick through that for a second though. Who told you you were trying too hard?
Cassie That was our endo.
Scott Benner Your endo.
Cassie And he's wonderful. We love him so much. I am so thankful to be in the practice that we're in. He's really great. I And think he was just kind of looking at it from a mental health standpoint, honestly.
Cassie Like, he didn't wanna see us burn out so quickly.
Scott Benner Were you going cuckoo?
Cassie I didn't feel like I was.
Scott Benner Do you think he thought you were?
Cassie Probably.
Scott Benner Is it because you spoke very quickly and your hair didn't look combed, or what was the level of concern do you think?
Cassie Well so I think the level of concern was coming in with so many questions and ideas. So several times I was told, you're kind of getting into the weeds there. You're getting a little bit out there.
Scott Benner What's the weeds? Give me an example of, like, a bridge too far for the endo.
Cassie Oh, gosh. At the time, we were kind of just looking at a one c in general. Like, I use your little calculator on your website a lot.
Scott Benner Yeah.
Cassie That's always on for us, by the way. If I check his ninety day average before we go in to the endo, his a one c always comes back exactly what the calculator says it's going to be.
Scott Benner You know, a a listener made that for me years ago.
Cassie It's awesome. Yeah. No. It's great. Gosh.
Cassie I wish I could remember what it was. I remember what office we were sitting in. So where we live, we actually travel three hours to go see our endo.
Scott Benner Oh my gosh.
Cassie Yeah. So they'll come down and do satellite clinics here.
Scott Benner Off a mountain? What do you mean come down?
Cassie Come down from the Northern Part of Washington. So I'm in Eastern Washington
Scott Benner Okay.
Cassie But Southeast Washington. So we're a pretty big community out here. It's called the Tri Cities. We have to go up to Spokane to go see our endo. So our hospital network, all of the endos here, they don't have them here anymore.
Cassie We had one that was about an hour and a half away. They didn't pay him enough, and the practice was overloaded. He was the only one. This is what I was told anyway. And so he ended up leaving.
Cassie So now everybody they told me that there are, like, 600 families down here that travel up to Spokane for care.
Scott Benner Jeez.
Cassie Yeah. It's crazy.
Scott Benner And so it's six hours round trip?
Cassie Yes.
Scott Benner It's a whole day.
Cassie It's a whole day. Yeah. It turns into a whole day. And if we do have to go up there, that's exactly what it is. We usually schedule the appointments earlier.
Cassie Him and I leave first thing in the morning. We get up there for the appointment, and then we basically just get back in the car and drive straight home.
Scott Benner But this appointment's so amazing it's worth it, or it's just the only game in town?
Cassie It's the only game in town unless I wanna go to Seattle, which is longer.
Scott Benner Okay.
Cassie Yeah. Yep. But I do think it is worth it. I also think it's worth it. And like I said, they do satellite clinics down here, so there are times that we can get in with the satellite clinic.
Cassie So they've got a little office space that they rent out. Like, two of the endos from the practice will come down and see people here.
Scott Benner Okay.
Cassie That's an option as well. Our last one was over Zoom because they had just seen him in the office. So they are pretty flexible with
Scott Benner us. Mhmm.
Cassie But I do remember sitting in the satellite clinic and him telling me, you're really getting into the weeds here. I feel like you're in the forest, and you're just really focused on this one tree.
Scott Benner You said, dude, we're in Spokane. Of course, we're in the forest. Calm down.
Cassie Yeah.
Scott Benner Yeah. What did you think? Did you think you were? Like, when he said that, were you like, no. I'm not.
Cassie No. That's exactly what I thought. I was like, no. I'm not. How is that possible?
Cassie And I think what happened was so he had been diagnosed in July, and then I think his a one c was, like, 12. And then we saw them again. Obviously, we had education that we had to do, so we traveled up there several times. We saw them again in October, and I think it was down to, like, 6.4.
Scott Benner Okay.
Cassie And then December, we saw them in the satellite clinic, and his a one c came back at 5.4.
Scott Benner Okay.
Cassie And I cried.
Scott Benner You're like, I did it. I did the thing. It happened.
Cassie I did it. I did the thing. I did the thing. Right? Yeah.
Cassie So he he wanted to talk about burnout, and I think you're trying too hard, and it's really not that serious. He is still healthy. You guys are doing a good job. Right?
Taking Management Personally vs Realistically
Scott Benner He didn't say congratulations. Well done. How did you accomplish this? No. And why are you saying he's a good doctor?
Scott Benner I don't understand. Are you Catholic? No. No? Because I I I just find sometimes Catholics like to say everybody's great before they say something bad about them.
Cassie No. He is really good.
Scott Benner But what makes him good? I'm gonna dig into this. What makes him good if when you, on your own, figured out how to get an a one c in the fives, he said, don't do that.
Cassie And I don't think it was that he didn't want us to do it. I think he just felt like we were trying too hard too fast.
Scott Benner Well, I don't know what that means either.
Cassie I know. I know.
Scott Benner Like, do you feel overwhelmed by it?
Cassie I don't. I mean, I think there were times where I did a little bit.
Scott Benner Yeah.
Cassie I would take it very personally. So
Scott Benner Okay. We're getting to it.
Cassie If, like, if I didn't nail something and his blood sugar was too high for too long, I would take it very personally, like I had failed.
Scott Benner How personally? Like, did you lash yourself in front of people?
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Scott Benner Did you lash yourself in front of people? Or
Cassie No. No? No. But I would just I would be so upset. They would just put me into a spiral
Scott Benner Okay.
Cassie And then it was just, like, bad mood central. And my husband's like, it's
Scott Benner Oh, you're married?
Cassie Yeah. I am married. Yeah. Yeah.
Scott Benner Has he ever said, why don't you calm down, Cassie?
Cassie Well, no. I mean, not in that way. But he has said, this isn't about you. You didn't mess up. You're doing the best that you can. Like, you have the information.
Cassie It just didn't work this time.
Scott Benner Okay.
Cassie It's not perfect every time. Like, diabetes isn't predictable in most senses, and so it's not like, just because it your pizza bolus worked this time doesn't mean it's gonna work next time.
Scott Benner I think it will.
Cassie But we have had that experience.
Scott Benner No. No. Of course. Of course.
Cassie Yeah. Like, where it has and then where it hasn't. But there are lots of things that we have figured out that we just nail every time, you know.
Scott Benner Yeah. Yeah. I am supremely aware of the idea that there's a difference between saying, like, this is how it could work. And if you understand these things, it probably will work this way most of the time, which is about what I believe about diabetes. Right?
Scott Benner And the feeling that some people take away from it that tells them that if I don't do it that way and it doesn't work every time that I'm failing, like, I don't have that feeling. So when I share with somebody, hey. You should give this a shot. I think if you understood this better, if you had your basil right, you know, maybe if you understood the fat impacts of this meal, maybe this would turn out better for you. I don't expect it when I'm saying that it's being heard by somebody who hears, and if it doesn't work out, you're an abject failure.
Scott Benner But at the same time, I don't know another way to relate the idea. If you and I were standing at a at the precipice of a cliff and I said, Cassie, listen. There's no other options here. We are gonna have to try to jump over the cliff here. And I said, do you run as hard as you can and jump as late as possible without falling because if not, you are gonna fall and hit your head and it's not gonna be pleasant.
Scott Benner If that was the truth, I don't think you'd want me to explain it to you by saying just give it your best shot and if you fall, it's okay.
Cassie Right.
Scott Benner At the same time, telling somebody that if you don't do this right, you might splat. Some people don't intersect well with that pressure. Mhmm. I don't know who's who and I certainly can't I don't wanna give like a milk toast presentation, but at the same time, I'm like I'm counting on all of you to be adults and go like, okay. I didn't get it the first time, but I could try again without beating yourselves up.
Scott Benner So I'm in a bad position is what I'm saying. And I'm wondering how you heard it. That's my question. Like, what did you hear coming from me and did that lead to you feeling like you failed or no?
Cassie No. I wouldn't say so.
Scott Benner Okay. Good. I don't want that. I don't want anybody to feel that way. I just know sometimes people do.
Cassie Yeah. No. No. If anything, like, I was telling my husband, he's at work. And so I had texted him.
Cassie I'm like, hey. The recording time got moved, so don't text me during that hour.
Scott Benner I'll be talking to Scott.
Cassie Right. I'm like, don't text me during that hour.
Scott Benner If you cut your hand off at work, hold your thought. Okay?
Cassie And he's like, hope you're not nervous. It's gonna be fine. And I was like, well, if anything, I just feel more emotional about it. And it's just because the podcast has helped so much.
Scott Benner About talking to me today?
Cassie Yeah. Oh. Yeah. Oh. And so just I think it was just kind of reviewing, like, where we've been, right, since diagnosis.
Cassie Sure. Sure. So and the things that we've accomplished. But, no, like, you asking that question, I always feel like you're speaking directly to us or any of the guests, like anybody that I've listened to. You know?
Cassie And so it's really nice because I've never felt you give information, but you'll be a failure if you don't make it. Like, I've never felt that way. Like, I've never gotten that.
Scott Benner Yeah. I I definitely see diabetes as a marathon, not a sprint.
Cassie Right. Right.
Scott Benner At the same time, I think that giving expectations there's nothing wrong with expectations. There's nothing wrong with being aspirational, but you also have to understand that it very well may be a process. And that process may go longer or shorter for some people. I've had people tell me directly, I listen to the pro tip series and a month later, my a one c was no success. Like, it just all made sense to me.
Scott Benner And I've had somebody tell me that I listened to the Pro Tip series, and I didn't pull together for two years after that. But once I did, I realized, oh, I got that information there.
Cassie Right.
Scott Benner And who cares? I mean I mean, I realized you want it to be faster, but as long as you get there, I don't think it matters what path you take.
Cassie Yeah. Yeah. Yeah. No. And that's nice to hear.
Cassie For me, I am an instant gratification kind of person. And so if we have a problem, then I wanna figure it out and just do it right every time.
Scott Benner Yeah. We'll keep you out of the casino.
Cassie Right.
Scott Benner So you don't get all caught up in that, the slot machines there.
Cassie Yeah. Yep.
The Lead-up to DKA
Scott Benner I'm sorry. So he let's find out how he's diagnosed. What was, led up to that, and was there any reason for you to think it might I have always disliked ordering diabetes supplies. I'm guessing you have as well. It hasn't been a problem for us for the last few years, though, because we began using US Med.
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Cassie No. So we didn't even really know what type one diabetes was. I feel like that's a a lot of people.
Scott Benner Well, you live in the woods.
Cassie Yeah. And I didn't like, we didn't even know anybody that had a type one kid.
Scott Benner Mhmm.
Cassie I didn't even know that we had them at our school, and there were, like, five.
Scott Benner We had them. I like the way you said that.
Cassie We didn't even know we had them.
Scott Benner The place was littered with them, Scott, and I didn't even know it.
Cassie They were everywhere. No. So he was when was this? The end of his fourth grade year? And looking back now, we can see symptoms starting like that last week of school.
Cassie Mhmm. And I remember him saying to me, can you please remember to fill my water bottle today? I have been so thirsty, and I hate having to go inside to fill it because he was outside in a portable. So he'd have to get a pass, and then he'd to walk to the main building Mhmm. Fill his bottle, come back out.
Cassie And I'm like, oh, yeah. Absolutely. I had no idea how much water he was drinking at school. So that was, like, the June. Over the next couple of weeks, he was starting to look thinner.
Cassie He was really pale. He was using the bathroom more often, drinking tons of water. Mhmm. And so, like, the week right before he went into DKA, I remember him waking me up like he'd gotten in our freezer, and he was getting out ice in the middle of the night. And I was like, I don't understand what is going on with this kid.
Cassie Why does he need ice? It's not even that hot yet, But he just was so thirsty.
Scott Benner Yeah.
Cassie And so he had finally wet the bed, and he was so embarrassed. Yeah. And I was like, well, bud, I don't know. He goes, mom, I just don't feel right. He had fallen asleep, like, middle of the day, just sitting up in his chair.
Cassie He'd fallen asleep. Mhmm. And he's like, I just don't feel right. I'm not sure what's wrong with me. And he's like, and the bedwetting is weird.
Cassie And I was like, yeah. For sure, bud. I mean, I don't know.
Scott Benner Yeah. We're all in line with that one, brother.
Cassie Yeah. For sure. Like, at ten, that's weird. I And was like, well, if it continues, I'm gonna have to take you to the doctor. We're gonna have to figure something out.
Cassie And he goes, no. I'd really like it if you'd make me a doctor's appointment. Can we go on Monday?
Scott Benner Oh, wow.
Cassie Yeah. And I was like, sure. Yeah. We can go on Monday. That's fine.
Cassie And this was probably Thursday.
Scott Benner Yeah. So you were like, let's see if we need to go to the doctor. And he was like, no. We should go to the doctor. Yeah.
Scott Benner I'm in trouble. He knew he was in trouble.
Cassie Yeah. Which is interesting because he doesn't want to go there. Right? And so I just thought it was interesting he was so agreeable. And I'm like, okay.
Cassie But yeah. No. We can do that. And I said, well, we don't have a pediatrician right now, but I can take him to urgent care or something. And he's like, okay.
Cassie We just kinda let it play out. And, again, the next day, he was feeling worse. We decided we were going to travel to another town to go to a little museum. They were doing a World War two reenactment thing. Our oldest is way into that stuff.
Cassie And so we were gonna go. He was really nauseous. And so he's, like, in the bathroom dry eating, but also his stomach is super upset. So he doesn't know if he needs to go to the bathroom just chugging water. And so I was going to stay home, and my husband was gonna take the other two boys.
Cassie And he's like, no. I don't wanna miss out on the family day. I'm just gonna push through it. So we slept on the hour car ride in the car. We drug him all over at this museum.
Cassie It was outdoors. It was, like, 90 degrees. And he's begging for water. I forgot to bring my water cup in. And I remember being so irritated with him.
Cassie I'm like, I don't understand what your problem is. Like, now we're gonna have to go all the way back out to the car. It's this long walk. And the poor kid, like, looking back at pictures, he's just suffering.
Scott Benner Yeah.
Cassie You know, you just feel terrible. We go to a restaurant to eat after that. He orders food he can't eat, but he chugged three Cokes Mhmm. And then fell asleep in the booth.
Scott Benner In the booth? Yes. I got a little sleepy recording the podcast the other day. Don't tell anybody. My iron's a little low.
Scott Benner And I had to sit up straight. I was talking to somebody. She was really great. And I I hope nobody hears it, like, thinks they know where it is.
Cassie You're, like, nodding off.
Scott Benner My farting's, like, back down to seven. I'll talk about another episode. She's talking. I think her voice was just very relaxing.
Cassie Oh, yeah. And I
Scott Benner was like, I got way ahead of that. I was like, oh. I just sat straight up, like, my hands on the desk. Was like, stay here. But to fall asleep in the booth at a restaurant?
Cassie Yeah.
Scott Benner Yeah. I mean, when that happened, do you look at the do you bring the boy with you to the day out, the husband? Was he there?
Cassie Oh, yeah. He was there.
Scott Benner You look at him and go, hey. This one's dying.
Cassie Yeah. We're like, oh, man. It was crazy. And so then the next day, it's Sunday, he just, like, napped on and off all day. We go to grandma's for dinner, and then the vomiting starts.
Scott Benner Okay.
Cassie He doesn't wanna eat dinner. He doesn't have an appetite. He's laying on the sofa, and then he pukes on our floor. And I'm like
Scott Benner Thanks for having us over.
Cassie Awesome. Sorry, grandma. Yeah. So she's like, oh my gosh. You poor thing.
Cassie I'm so sorry. And so it just was fluids. Well, it just continued, like, hourly. So I had been up with him all night long. I left our bedroom door open, so he was on the couch.
Cassie He'd call for me if he needed help or whatever. And so I'm out there rubbing his back. So finally, at, like, 08:30, I get out of bed. I was so tired. And he's like, mom, I just feel really bad.
Cassie I need you. And I was like, okay. So I get up. I go out there, and I could see his spine through his pajamas.
Scott Benner Oh my gosh.
Cassie And I was like, okay. And he's already really small as it is. He's in, like, the twelfth percentile. So he's very short, very thin, which all of those things he hates. And so it was just very obvious he was ill.
Cassie So I called my husband out, and I'm like, hey. I need you to come look at him and tell me what you think. Mhmm. He was so pale. His cheeks were almost like this mottled purple.
Cassie Yeah. He just did not look right. And so my husband comes out and he goes, oh my god. We have to take him to the hospital right now. There is something seriously wrong.
Scott Benner Right.
Cassie And I was like, what? And he's like, you have to get clothes on. We need to go now.
Scott Benner What's your husband do for a living?
Cassie He's a police officer.
Scott Benner Okay. And, and you are stay at home, but did you go to school or have any background or anything prior to that?
Cassie Prior. I didn't go to school. I went straight into dispatching, 911 dispatching. That's how we met.
Scott Benner Oh, okay.
Cassie Yeah. So I did that for ten years. And then after we had the first two, then I stayed home. So
Scott Benner He's not the only person who's ever been on the podcast to say that.
Cassie Oh, really?
Scott Benner I was a dispatcher, and I met a cop that way.
Cassie Oh, yeah. I mean, I yeah.
Scott Benner Is that, like, Tinder for cops? The 911?
Cassie I I don't know. I don't know. They would come in on their lunch breaks. We were in a really small community, so there weren't a lot of them on. So there'd be, two dispatchers and then,
Scott Benner like Yeah.
Cassie Two from his agency and then two from another agency.
Scott Benner You're getting to a certain age. His eyes are both pointing in the same direction. Seems like a good bet, that kind of thing.
Cassie I was 24. He's older. He was 31.
Scott Benner Oh.
Cassie Yeah. So, no, we would just like, everybody would kinda have lunch together.
Scott Benner Right.
Cassie And then eventually, he just was like, hey. Do you wanna go?
Scott Benner Hey. Would you like it if I ruined your life? Would you like me to ruin your life? Right.
Cassie And I was like I think I can.
Scott Benner It comes with a house. What do you think? Yeah. I was like,
Cassie yeah. Let's do that. And now here we are eighteen years later.
Scott Benner That's crazy. How'd you like me to give you three kids and something to clean?
Cassie Yeah. Exactly.
Scott Benner You're gonna love it.
Cassie And I'm not very good at it, Scott.
Scott Benner Yeah. I'm not very good at it.
Cassie The house cleaning. I'm just the worst housekeeper.
Scott Benner Sucker. Yeah.
Cassie Yeah. Exactly. Thanks for the kids. Sorry about the dirty house.
Scott Benner Yeah. There were better options. I I just I didn't wanna say it at the time.
The Diagnosis Unfolds
Scott Benner So you go off to the hospital right then and there. Is that Friday? Because you said Thursday, went to the museum. Was that Friday the or is that Sunday?
Cassie So, like, Thursday was when he told me he wanted to go to the doctor.
Scott Benner Okay.
Cassie This is now Monday morning.
Scott Benner How come you didn't go to the doctor Monday? You promised him Monday.
Cassie We did to the ER.
Scott Benner Did you have an appointment at the doctor later in that day?
Cassie No. We didn't. I was just gonna take him into urgent care.
Scott Benner Oh. That's Oh, right. You don't have a pedi
Cassie We don't have a pediatrician. We still don't. And that's a whole Wait.
Scott Benner Why do you not have a pedi
Cassie The area that we live in, that's a whole another story. I mean, it's just so hard to even find one.
Scott Benner Cassie, clean the house and get the kids a pediatrician. Okay?
Cassie Yeah. Exactly. I know. Yeah. So he wraps them up in a blanket.
Scott Benner Right.
Cassie And we basically go down there in, you know, sweatpants. Right? The ER is, like, six blocks from us. It's super close. So I go in first because he's gonna carry them inside.
Cassie At this point, here's the really weird thing, and I don't we see this differently. My husband's father is remarried. He has a granddaughter from that wife who has type one. So we no blood relation at all whatsoever.
Scott Benner Yeah. I got it.
Cassie She'd only been diagnosed about eighteen months at this time.
Scott Benner Okay.
Cassie We had literally just discussed type one diabetes at dinner at grandma's house on Sunday, just the day before. Right? So he is great at listening. My son is. He's great at listening.
Cassie So I'm sure he was eavesdropping on the conversation. And we're like, wow. That's so crazy. Like, we've never met a child with type one diabetes. I bet that's so hard.
Cassie Like, I don't even know what that looks like. So as we're taking him out to the car to go to the hospital, My husband's like, okay, bud. We you know, something's wrong. We're gonna take you. I swear, he asked, do I have diabetes?
Cassie Oh. My husband's like, no. I think he said, do I have a serious disease? And I'm like, well, I don't know. It could be one or the other.
Cassie I heard diabetes. And I was like, no, bud. Of course, you don't have diabetes. No. That's not even a thing.
Cassie Like, they're gonna take care of you. Mhmm. So we get down to the ER. I go in first, and I let them know this is what he's here for. She gets up from the desk and, like, runs into triage and grabs the nurse and says, this little boy is coming in.
Cassie You need to come see him right now. And I'm like, oh my god. What is happening?
Scott Benner That's the lady at the desk, by the way. She's might maybe not even a nurse. Right?
Cassie Right.
Scott Benner Yeah.
Cassie Yeah. Yes. And so she comes out, and she's like, just come right in here, and she brings us straight into triage. My husband sits him in a chair. At this point, he can't keep his eyes open.
Cassie His head's rolled over to the side. She wants to get height and weight, and I'm like, this is gonna be impossible. We can't even get him to stand up. And she goes, okay. Listen.
Cassie I'm not diagnosing him, but I've worked in pedagogists long enough to know that this is new onset type one diabetes. So just be prepared. And I was like, I literally just told him he didn't have diabetes.
Scott Benner It was ten minutes ago. I am also not great at keeping the house. Like, let's not pile these things up right now. Okay? I think people are looking at me.
Cassie I don't even know what this means. I know. It was so crazy. It was so crazy.
Scott Benner I thought you were gonna say you thought you jinxed him by talking about it the week before.
Cassie Yeah. I
Scott Benner Because I'm not superstitious. Well, you wanna know something? I've never said this in the podcast before. I am not superstitious. My wife, I don't think is either.
Scott Benner Although, I think she might believe in ghosts. So it's who knows? But Arden's diagnosed in August, couple weeks in August. And for our anniversary, which is the August, Kelly and I went to like a nice restaurant, a place we had never been before. A place where they call the food stuff that you don't really know what it means, you know?
Cassie Sure.
Scott Benner So we ordered a few appetizers and we ordered something called sweet bread. I think thinking it was bread, but it's not. Do you know what sweet bread is?
Cassie I don't.
Scott Benner It's pancreas. What? Yeah. And there was, like, a half a minute where I was like, did we, like, put bad mojo out into the world or something? Like, we steal the pancreas from an animal and then nature came and stole one from us?
Scott Benner Like, do you know what I mean? Yeah. So Yeah. I don't really think that, but I'm not gonna lie to you. There was, like, a half a second where I was like, oh, I don't like the optics of this.
Cassie Yeah.
Scott Benner Yeah. So, anyway, you don't know sweet bread?
Cassie No.
Scott Benner Yeah. It's what it is. How to prepare and cook sweet bread preparations.
Cassie Craziest thing I've done is, like, beef tongue or bone marrow. That's about it.
Scott Benner Oh, I'm with you on that's weird. Sweet bread meat from the thymus and pancreas of cattle is prepared with this easy recipe for tender and tasty nuggets coated in flour then fried. That's allrecipes.com in case you wanna go check it Oh. So when you started talking about that, I was like, I wonder if they think they, like, brought it into existence by talking about it. Thank God you don't think that.
Scott Benner Okay. Alright.
Cassie No. Not at all.
Scott Benner They clearly saved the kid. That's nice. What was his a one c? What was his blood sugar? Do you know?
Cassie I wish I knew what his blood sugar was when we got there. I don't think they ever told us. If they did, I didn't comprehend it. His a one c was 12, though.
Scott Benner Oh, wow.
Cassie Yeah. It was 12. Yeah. So they got him back there, and he basically just went to sleep. And then that was probably, oh gosh, I don't know, sometime in the morning.
Cassie Yeah. He didn't really wake up again until, like, 03:00 in the morning, like, 3AM that
Scott Benner night. DK, obviously?
Cassie DK. Yeah. Yeah. Yeah. So he was in DK.
Cassie They called our local hospital that has, like, a small PICU. Mhmm. They asked him, well, do you want him? And they were like, no. Wait.
Cassie We have an endocrinologist on staff. We don't want him. You need to send him away. So they told us to choose Seattle or Spokane. We went to Spokane.
Scott Benner Up the mountain. That's right.
Cassie Up the mountain. Yeah. And so but they life flighted him up there.
Scott Benner Wow.
Life Flight and Hospital Experience
Cassie And I think part of why I didn't some of that information I didn't get was because a nurse had come in. So because of my husband's job, he knows the ER doctors and nurses. So they knew him when we came in. So they were very generous with us with information. So they were like, hey.
Cassie He's gotta fly. And if you don't have life flight insurance, get it now, or it's going to be very expensive. Oh. He just needs to have it before the time of the flight. So I was immediately on the phone getting Life Flight insurance.
Cassie It's, like, $65.
Scott Benner Does the insurance company go, wait. Why? Why do you want why do you want it right now? I know. Yeah.
Cassie And it you just get it through them. So what happens is if you buy the insurance membership through Life Flight, then they bill your insurance. Your insurance pays their portion, and then they just write off the rest of the bill.
Scott Benner The whole world's a scam, Cassie. I
Cassie just I know.
Scott Benner I just wanna say that.
Cassie But guess what? Yeah. It saved us a lot of money. I would have $10. The whole bill was, like, 65.
Scott Benner Oh, is that a thing you think that's not just a Washington thing. Right? Like, you should be able to, like boy, I I that's hard to preplan for, but that's not a bad thing to have in that situation.
Cassie No. It's not. And I think the membership's gone up to 85. It's like an annual thing that you pay, and then you just put your whole family on it. So anybody who lives in your household can be on your Life Flight membership.
Cassie I think it's a great thing to have. A lot of people I didn't realize how many people actually had it.
Scott Benner AIRMED care? Is that what it's called? Network? Global
Cassie Well, it just it depends because, like, we have both in the state, we have both Life Flight and we have Airlift Northwest. So ours is through Airlift Northwest.
Scott Benner Okay.
Cassie Yeah. So it just depends on the the provider. So you would have to kinda check into, like, if you were gonna look into that.
Scott Benner Oh, there's a number of them. Yeah. There's a number of them. Life Flight Network, lifeflight.org. Mhmm.
Scott Benner I'm just gonna go to lifeflight.org just so I can have it. Air Medical, $85, annual membership from Lifeflight. FireMed Ground, annual membership from FireMed Ground. Air plus FireMed Ground. This is, like, less than $200 for all this.
Scott Benner Mhmm. And there is something about Oregon here. Oregon Air Transport, Montana, Washington, Idaho, Hawaii. This is probably a bigger deal in places where stuff's more spread out, I guess.
Cassie Right. Yeah. Exactly.
Scott Benner Because you can fall out my front door and go to four
Cassie hospitals. Hospitals. Right. Right.
Scott Benner Yeah. Yeah.
Cassie Yeah. Yeah. We've got them here. I mean, our community is pretty big. Yeah. It's really weird.
Cassie Like, we're the size of a big city, but it's just a gigantic small town. Mhmm. So we just don't have a lot of the amenities that some of the other areas have.
Scott Benner What?
Cassie Yeah. So he was flown up there. I was supposed to be able to go with him. So I ran home to pack a bag because, like I said, we're only six blocks away. And then when I get back, then my husband breaks it to me.
Cassie Oh, yeah. You don't get to fly with him. You have to drive up behind him. Yeah. Because they have a training nurse on, and the training nurse is in your seat.
Cassie And I was like, that's rude.
Scott Benner It's okay. We'll meet you there. Did you and your husband drive together?
Cassie No. So he stayed here with the other two boys, and I went up. And so I think he landed up there around two in the afternoon. I was up there by thirty, 06:00 because I ended up coming home and showering. I was like, well, at least I I can at least do that for myself.
Cassie I'll shower.
Scott Benner Did you think he was in, like, mortal danger, or did you not have that feeling?
Cassie No. I didn't. We thought he had a stomach bug.
Scott Benner Wait. Even when they're life flighting him and they're telling you diabetes, you're not believing it? Or did you mean you thought he had a stomach bug prior to going to the hospital?
Cassie I guess I thought we thought he had a stomach bug going to the hospital.
Scott Benner Okay.
Cassie I didn't think he was in mortal danger, but I didn't I guess I just didn't understand what it was. Mhmm. So then he's up there, and he's he's in the PICU. And, thankfully, he was only there overnight. I mean, a lot of kids stay a lot longer than him.
Cassie He recovered very quickly.
Scott Benner That's good.
Cassie So he was admitted Monday. He was released Tuesday. They allowed us to go home Tuesday evening.
Scott Benner Okay. Did they fly him back or you drive?
Cassie No. We drove back.
Scott Benner Okay. Yeah. Did you shave your legs in the shower?
Cassie I did not.
Scott Benner Good. I think that's fine though. I think if you told me you shaved your legs, I'd be like, this lady wasn't really grasping the situation.
Cassie Nope. Nope. I sure did not. Okay. I did not.
Scott Benner I'm okay with that then, I guess.
Cassie Yep. No. I just went home and then I just changed into clean clothes. But then, course, by the time I got to the hospital, like, I was so sweaty anyway. I'm like, it doesn't even matter.
Scott Benner What's the point of all this?
Cassie What was the point of that anyway?
Scott Benner Do you have that feeling like I should prep myself before I go to the hospital? The shower weirds me out a little bit, Cassie. That's why I'm asking.
Cassie No. I just like, I had it was like the stress sweat thing. So I felt like I'd already slept overnight. Yeah. I was in pajamas, essentially.
Cassie I felt so gross. I'm like, nobody's gonna want to sit next to this person in a hospital room. Mhmm. Like, I need to at least be kind.
Scott Benner Being polite. Yeah. Yeah.
Cassie Yeah. And, like, just at least clean my body before I go. No. That's that's that was it. That was I just did not wanna smell sweaty.
Scott Benner My father-in-law has passed on now, but I'll tell this story real quickly. He he had a heart attack. I think it's the only heart attack he ever had, but he had a heart attack. He's having a heart attack. His fingers were going numb from the heart attack.
Scott Benner Like, he put Neosporin on his fingers. That was what he did there. And then when he realized he probably had to go to the hospital, he would not let my mother-in-law take him to the hospital before he showered because Oh, no. He doesn't leave the house without showering.
Cassie I see.
Scott Benner So I didn't know if it was that level of crazy or if it was something. No. Okay. You were just dirty. I gotcha.
Scott Benner Okay. And
Cassie really, I mean, I was looking at it as, well, he's already without me. So taking an extra ten minutes really isn't going to make that big of a difference.
Scott Benner Plus you have two other kids if something happens to them.
Cassie Yeah. And and, of course, they didn't grasp the situation either. So it's like as soon as I walk back in the door
Scott Benner It all resets for them a little bit. Right? They're like, you're back.
Cassie Yeah. And they just don't get it. And they're like, well, where is he? And I'm like, well, you know, he's left. And, of course, the helicopter flies right over our house as it leaves.
Scott Benner Really? Oh, you said it was close. That's right. Yeah.
Cassie Yeah. So their flight path is right over the top of the house. So we see them come and go. Sometimes it's, like, five times a day, and sometimes it's not. And so, like, I had texted our oldest.
Cassie I'm like, hey. Your brother's helicopter's leaving if you wanna look. Right? But then, of course, I walk in the house, and he's like, hey. So, like, can we go to the Lego store today?
Cassie And I'm like, okay. Your brother I'm trying to be as nice as possible here. Now we can understand. Your brother has been taken in a helicopter to a hospital in Spokane because he's very, very, very ill. We cannot go to the LEGO store today.
Cassie We can't. And he's like, oh, wow. Gosh. Well, like, are you gonna be home tonight? And I'm like, no.
Scott Benner Because I need that Thanos glove pretty badly.
Cassie So I'm like, no. We're not gonna be home tonight. Your dad will be home tonight, but I'm not gonna be home tonight.
Scott Benner Right.
Cassie So he stayed home. We could have asked grandma to stay with the kids, but it just felt so confusing for them that he decided it would be fine if he stayed, and then he did drive up the next day. So he was up to us in the morning. Mhmm. We actually started education.
Cassie They had come in right about 09:00, and we were already sitting down with a diabetic educator. So we actually were on speakerphone, and so my husband's listening while he's driving up our through the first education session.
The End of Part One
Scott Benner Yeah. How did you find them? How was the in hospital education for you?
Cassie It was great.
Scott Benner Good.
Cassie It was great. It was like, it was so simple, but a lot of the education that they use gosh. I wanna say it came from a children's hospital in Arizona was the like, they had some YouTube videos that they had shown us that explained, like, what is a pancreas? How does it work? How does insulin work?
Cassie How does blood sugar work? All these things. And so you watch these little clips as you went through the education, and it just felt so basic that it was easy to understand. I had started working through that overnight while he was sleeping. And then, you know, you're reading about insulin, and you have to give insulin when they're eating and you know?
Cassie So when they finally come in, he finally wakes up. He's hungry, and it's probably I don't know. I think they let him eat at, like, 04:30 in the morning. And she's like, okay. Well, we're gonna we're gonna give, the insulin.
Cassie This is the carb ratio that the doctor has set. And, of course, by the time I got there, the doctor had been in, but I missed him. So I didn't get to see them till the next morning. So it hadn't really been fully explained. So then she's going to give him his first shot of Humalog.
Cassie And I was like, okay. So how long do we have to do this for? And she goes, oh, have you not seen the doctor yet? And I was like, no. I didn't get here until, like, 05:30.
Cassie And she goes, yeah. Okay. So he has to do this for the rest of his life. And I was like, okay.
Scott Benner You didn't know that at that moment.
Cassie I at that moment, I didn't know that. Even from reading the literature, I hadn't grasped that yet. Mhmm. Yeah. So
Scott Benner Wow. That's really a lot. Do you know what I mean? Like, just a ton to be dropped on somebody all at once.
Cassie It was yeah. It is a lot. It's a lot.
Scott Benner And how do you feel like you made out in the weeks after? Like and I'm talking about the first month or so, you've got the information that the hospital gave you. You're coming online from not understanding diabetes at all to your new understanding? Like, what was the first bit of it like? When did you realize that you needed to go find more information?
Scott Benner This episode was too good to cut anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's gonna be the next episode in your feed.
Scott Benner Head now to tandemdiabetes.com/juicebox and check out today's sponsor, Tandem Diabetes Care.
Scott Benner I think you're gonna find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem Mobi system.
Scott Benner This episode of the Juice Box podcast was sponsored by US Med, usmed.com/juicebox, or call (888) 721-1514.
Scott Benner Get started today with US Med. Links in the show notes. Links at juiceboxpodcast.com.
Scott Benner Are you tired of getting a rash from your CGM adhesive? Give the Eversense three sixty five a try. Eversense cgm.com/juicebox. Beautiful silicone that they use.
Scott Benner It changes every day.
Scott Benner It keeps it fresh. Not only that, you only have to change the sensor once a year. So, I mean, that's better.
Scott Benner Thank you so much for listening. I'll be back very soon with another episode of the juice box podcast.
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Scott Benner And if you leave a five star review, oh, I'll probably send you a Christmas card.
Scott Benner Would you like a Christmas card?
Scott Benner How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise twenty twenty six. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation.
Scott Benner It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea.
Scott Benner There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me.
Scott Benner You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Links in the show notes.
Scott Benner Links at juiceboxpodcast.com. Have a podcast? Want it to sound fantastic? Wrong way recording.com.
#1805 Keep It Cute
Diagnosed at 13 during a routine physical, Sara shares how confidence, tech, and a determined mom helped her thrive with type 1—managing injections, school, sleepovers, and teen life without missing a beat.
Companies that Support Juicebox
Key Takeaways
- Early Detection is a Blessing: Sarah was diagnosed with Type 1 diabetes at age 13 during a routine pediatrician visit with zero symptoms, allowing her family to intervene early and implement life-changing technology like the Dexcom right away.
- The MDI Choice: Despite the popularity of insulin pumps, Sarah successfully manages her diabetes with Multiple Daily Injections (MDI) using Fiasp and Tresiba because she prefers not to have extra devices attached to her body.
- Flexible Diets Over Restriction: Initial severe carb restrictions (like 30 carbs per meal) can lead to frustration and potential eating dysfunction; using proper insulin coverage for a normal diet is much more sustainable for a teenager.
- School Independence: To avoid missing critical instructional time and maintain privacy, Matilde waived mandatory school nursing services, empowering Sarah to manage her diabetes via text message check-ins.
- Parental Advocacy: Successfully navigating T1D requires parents to actively self-educate, seek out community support (like the Juice Box Podcast), and advocate for their child's normalcy.
Resources Mentioned
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Touched by Type 1: touchedbytype1.org
- Tandem Mobi: tandemdiabetes.com/juicebox
- Eversense 365: eversensecgm.com/juicebox
- Juice Box Podcast Private Facebook Group: Search "Juice Box Podcast, type one diabetes" on Facebook
- Integrated Diabetes Services: Consulting resource utilized by the family (Gary Scheiner / Tavia).
- Wrong Way Recording: wrongwayrecording.com
Welcome and Introductions
Scott Benner Friends, we're all back together for the next episode of the Juice Box podcast. Welcome.
Sarah Hi, everyone. My name's Sarah, and I'm a junior in high school.
Matilde This is her mother. I'm Matilde Fiddler, and I'm so grateful to be on the podcast with you today, Scott.
Scott Benner How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get to kick back a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Link's in the show notes. Link's at juiceboxpodcast.com.
Scott Benner If you're looking for community around type one diabetes, check out the juice box podcast private Facebook group. Juice box 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 Juice Box Podcast, type one diabetes on Facebook.
Scott Benner Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner The episode you're about to listen to was sponsored by Touched by Type one. Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org. Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes, touchedbytype1.org.
Scott Benner Today's episode is also sponsored by the Tandem Mobi system, which is powered by Tandem's newest algorithm, Control IQ Plus technology. Tandem Mobi has a predictive algorithm that helps prevent highs and lows and is now available for ages two and up. Learn more and get started today at tandemdiabetes.com/juicebox.
Scott Benner The podcast is also sponsored today by Eversense three sixty five, the only one year wear CGM. That's one insertion and one CGM a year. One CGM, one year. Not every ten or fourteen days. Ever since cgm.com/juicebox.
Sarah Hi, everyone. My name's Sarah, and I'm a junior in high school.
Scott Benner And somebody else is with us. Who else is here?
Matilde This is her mother. I'm Matilde Fiddler. I'm a Miami native, and I'm so grateful to be on the podcast with you today, Scott.
Scott Benner Matilde, did you make Sarah come on or did she want to?
Sarah I actually asked to come on.
Scott Benner Okay. Cool. Alright. Well, let's figure out why all this is happening. Who should we talk to first? Well, who has diabetes? I do. Sarah does. How old how old were you when you were diagnosed?
Sarah I was 13 when I was diagnosed. I was going into the summer of, I was in my summer going into eighth grade and, yeah, that's when I was diagnosed.
Scott Benner And now you're a junior? Yes. Okay. How would you say it's going when you think about your diabetes? Like, what's where do you think you're at?
Sarah I think I'm very controlled. I also put a lot of hard work to control my numbers, but I'm really lucky because I haven't had any other health complications come out of it. And overall, I'd say I'm pretty stable and I'm able to, like, live the life that I lived before being diagnosed.
The Diagnosis Story
Scott Benner Yeah. Okay. What do you remember about being diagnosed, mom? Like, how did it come on? What what what did you see first?
Matilde What happened was I took the kids because I have another daughter. So both of my daughters, I my other daughter is 14 and Sarah's 16 right now. I took them to the annual visit at the pediatrician, and it happened to be that that day, we were seeing a new pediatrician. And my daughter did the annual pee pee in the cup, and she came back, and she goes, your daughter no. She goes to me, let me do a finger stick. She did the finger stick, and she said immediately, your daughter has diabetes. And I said, what the fuck are you talking about? Like, shocked. Yeah. My daughter had never had one simp. Her blood sugar at that visit was two forty.
Scott Benner Okay.
Matilde She had had a bagel and, you know, prior to the going to the doctor. The reason I had moved that pediatric visit to that day is because both of my daughters were leaving to sleep away camp for three weeks in three days.
Scott Benner Sarah, did you go? No. I did not end up going. Okay. Wait. Do you remember that moment the way your mom remembers it?
Sarah I remember the same thing.
Scott Benner Yeah. Do you remember
Sarah being shocked? Going to the going to the hospital after and being really confused and nervous.
Scott Benner Confused and nervous. And, Matilda, are you married?
Matilde I am.
Scott Benner Okay. Did you call your husband right away?
Matilde I did. He too was super confused. He had to pick up my my other daughter, Sophie, and I took my daughter to the local. They suggested go straight to the ER, the pediatric Unfortunately, we knew the a nurse that has been at that institute for many, many years. So she immediately treated us like VIP. Mhmm. Immediately, they saw my daughter. When they checked her blood sugar, I think she was at that point let's call it, like, one sixty. Right? So they said they took us right away from there to meet the endocrinology team. And I was let me tell you a wreck. Like, I think about it, and I can't even believe. It was very emotional. But I wanted to come on today to tell you what a fabulous experience we had because I know so many of your listeners have had such rough diagnosis stories, and and they got so little support. And we didn't we did not have that experience. My daughter was taken by the endocrinologist. Immediately, they explained to us that she was in the honeymoon, you know, initially. And so and within two hours of being at that appointment, they put the Dexcom on her. Okay. You know?
Scott Benner How's it feel, Sarah, to hear your mom feel so emotional about all this? And have you seen that emotion from her before or since?
Sarah I haven't really seen that emotion from her since I was diagnosed. She always is super strong about it. Encourages me to be strong about it too. And I feel like a big part of me getting through this was because of my mom and all the help she gave me because she's, like, was kinda my she's still is my partner in managing this.
Scott Benner Yeah.
Sarah So I'm really grateful to her for that.
Scott Benner Do you have a similar feeling, like, when you think back on your diagnosis, or are you are you listening to her right now and thinking, wow. This is what it feels like to have a kid apparently.
Sarah No. When I think back at it, yeah, I got a little, like, upset because, like, in in the beginning, I was really confused on, like, on why me. Like, I've never had a health issue in my life.
Scott Benner Right.
Sarah Up until that point, I was, like, the healthiest person ever. So I was very confused why, like, this was showing up now. And I don't know. I was concerned about, like, if people were gonna, like, look at me differently. And, like, I remember, like, being concerned then, like, people were gonna think, like, I eat ate too much or, like, something like that because, like, there's a bunch of misconceptions with diabetes and stuff. Mhmm. But, obviously, there is, like, a difference between type one and type two.
Scott Benner Has that been an issue? Do you did you have friends or acquaintances that misunderstood your situation?
Sarah Yeah. Like, still honestly to this day, people ask me like, oh, like, you can't I mean, does that mean you can't eat sugar? Blah blah blah. Like and it gets it kind of annoys me. But I mean, honestly, it's not it's not really their fault because they just haven't been educated on the topic. So whenever something like that occurs, I take a moment to educate people.
Scott Benner Good. Okay. So you don't get upset, you just realize there's there's no way for them to know and you help. Yeah. Okay. That's awesome. Does it make you feel good, Matilda, to hear that she's having such a an even response when people talk to her like that?
Matilde I'm extremely grateful. I want you to understand and other parents to understand that that it's a very steep learning curve, and there was a lot of support. We had therapists involved from the get go. We had nutritionists involved from the get go to really help us with that steep learning curve and to give us that support that we needed so that our living life and enjoying life momentum didn't stop.
Insulin Management and Choosing MDI
Scott Benner Let's figure out how you figured all this out. So there's some education in the hospital, and then what happens? There's a is there an outpatient education after that? Do you go back to the hospital afterwards?
Matilde So what happened? Because she was so low like, her her a one c at that point of diagnosis was six point o. Mhmm. Her blood sugar, as we all know, two forty isn't that high. That's, like, on her you know, to get caught at that to be diagnosed and found out at know, when you have zero symptoms. Zero.
Scott Benner Yeah.
Matilde It's like a a blessing and and, like, like crazy how that happened.
Scott Benner That doctor's appointment was just well timed, really. Correct. Luckily. Yeah.
Matilde Correct. Uh-huh. And then, you know, they sent us home. They sent us home. They gave us the prescriptions for the insulin. They're like, don't use it yet until you need it. And, you know, so we got the insulin, the whatever at that time, I think of Humalog junior, and you're, like, staring at it, like, when am I supposed to use this?
Scott Benner Mhmm.
Matilde So what happened is she ended up getting, let's call it a month or so later, a tonsillitis. And they put her on prednisone. And that's when the party started. You know, the three hundred blood sugar. And so then we had to do the first time the insulin. I wish, and I think Sarah agrees with me, because they had us initially on a very carb strict diet, which in my opinion, can cause, like, eating dysfunction because she was on, let's call it, I think if I can recall, 30 carbs. Nothing.
Scott Benner A day?
Matilde Yeah. And we we we went we did that for, I don't know, let's call it, like, a month ish. It's a blur, but let's maybe max two months. And then finally, thank god, the prednisone thing happened. We had to introduce the insulin injections into start bringing that blood sugar down, and then she was super skinny. Imagine. And she's tall. My daughter right now is five nine.
Scott Benner Yeah.
Matilde And she weighs, like, less than a hundred and thirty pounds, you know?
Scott Benner Sarah, I have a couple of questions for you.
Sarah Yes.
Scott Benner This one might seem out of left field. Do you get tonsillitis a lot?
Sarah No. No? That was the only time I've ever gotten it. And also, mom, you said something about eating dysfunction. I just wanna make it clear. I've never had an eating disorder to those listening. And I think it was, like, 30 carbs per meal. I don't know about per day.
Scott Benner So it's interesting. The way you remember it, mom, is that her somebody told you to kind of restrict your carbs to go lower carb. Yes. Do you remember that time as particularly difficult?
Sarah Yeah. It was Yeah. Super annoying. Like, I had to watch everything I was putting in my mouth.
Scott Benner Right.
Sarah And honestly, like, looking back on it, like, I should have just been able to eat what I wanted and just given insulin for it.
Scott Benner Yeah. You didn't quite understand that at that point. And who gave
Sarah you that Honestly, what was what I don't I still don't see the purpose in
Scott Benner that. Right.
Sarah Like, what? I don't don't understand.
Scott Benner Who gave you that information?
Sarah An endocrinologist. The endocrinologist.
Scott Benner Okay. So let me ask you a question because you you said something earlier. A lot of people do this. They come on and they tell me how great their doctors are, and then they tell stories for an hour about how the information they got wasn't great. When you tell me that that you were lucky that you got started well, what does that mean to you?
Scott Benner When you think of a CGM and all the good that it brings in your life, is the first thing you think about, I love that I have to change it all the time. I love the warm up period every time I have to change it. I love that when I bump into a doorframe, sometimes it gets ripped off. I love that the adhesive kinda gets mushy sometimes when I sweat and falls off. No.
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Matilde It means to me that they gave her immediately the technology
Scott Benner Technology.
Matilde The true diagnosis. Like, there was no immediately, I knew my kid had type one. Like, how many times parents are like, I don't know what they had. They maybe they have this. So I knew right away her diagnosis.
Matilde She was introduced to to me. The Dexcom is life changing technology immediately on her body, plus I had the insulin. Now with what you're saying is true, the diabetic educator put her on that carb restrictive diet, which I agree. No good. That's where parents it's incumbent on the parents to educate themselves, and that's where you, Scott, are a blessing in my life.
Matilde I can't tell you the amount of what I how you changed the course of learning what you did with Arden and learning with the bowl beginning series listening to other parents and and type one people share their stories, that's how I learned.
Scott Benner Oh, I'm glad. That is lovely. I am so happy that you figured that out. But I wanna go back and just put a put a kind of a cherry on that other idea. You feel like you were treated well in the beginning because you got a firm correct answer as far as a diagnosis goes.
Scott Benner Someone showed you technology and didn't make you wait for it. That really is what you consider to be a great start.
Matilde Yes.
Scott Benner Yeah. Okay. Well, I I think that's valid by the way. I just wanted to, you know, I think sometimes people hear that and they think that, you know, they got some magical doctor who, you know, knew everything. But you're just saying, look, I just got a good firm, you know, foundation and a good start on all this.
Scott Benner Then you went off and found other information. So how long after her diagnosis did you think to yourself, I have to go find other information. I don't have enough to do what I need to do.
Matilde I would say very quickly. Initially, you feel very alone. Right? Because you're like and I was so grateful that I was introduced to other mothers in my area, in the Miami area, a group of three ladies. I could message them.
Matilde And one of the questions that I that I found so impactful that I or or realizations that I found so impactful was one day I texted a mom and I said, wait a minute. This is a disease that the goalpost is constantly moving. And she goes, bingo. Yeah. That was a hard pill to swallow.
Scott Benner Right. Right. Did not to think you couldn't just figure it out, write it down, and keep doing it. It that it was gonna keep changing. And did you pass that on to Sarah?
Scott Benner Like, as you learn things about it, how do you remember your mom bringing you back information, and were you looking for information on your own, or were you counting on her?
Sarah Honestly, I counted a lot on my mom. And I remember she started listening to your podcast, and she would tell me things about it, and we used some of your tips and whatever, etcetera. And that really started to help us. And also, I met the mothers that my mom was referring to earlier. I met, like, their daughters who were younger than me.
Sarah But it was nice to see that other people were going through the same thing I was, so that was really helpful.
Scott Benner Okay. So your mom brought you information and you found other people in a similar situation and made you feel a little more comfortable while but maybe while you were figuring it out, there was a a feeling that you could get to some sort of an answer because those girls were doing well. Is that the idea?
Sarah Yeah. Since I saw them doing well, I knew I was gonna be fine. And honestly, I was fine. So it it just brought a lot of comfort.
Scott Benner Okay. Awesome. And you use what now? You have a CGM, I heard Dexcom, but do you have a pump?
Sarah I use the Dexcom g seven and FIASP multiple injections and Tresiba at night.
Scott Benner Okay. Oh, so you're using pens?
Matilde Correct.
Scott Benner Awesome. And you've been doing that for how long?
Sarah I it was ever since I've
Scott Benner Been diagnosed.
Sarah Started using the injections Okay. After I had the prednisone.
Scott Benner Tell me why you don't have a pump.
Sarah I don't like having multiple devices on my body.
Scott Benner Okay. So just it's about real estate for you and not hanging more stuff?
Sarah Yes. Correct. And I'm doing fine with the injection. So if it ain't broke, don't fix it.
Scott Benner Yeah. Yeah. How are you doing? What's your a one c right now?
Sarah Well, actually, in my last blood work, they forgot to do my a one c.
Scott Benner How is that possible, sir? What the heck?
Sarah Yeah. I'm not really sure.
Matilde But on
Sarah the Dexcom, it says, like, about about 6.2.
Scott Benner Good for you. That's awesome. Do you have a lot of lows or protracted highs that you can't get down for hours at a time, or is that not your day usually?
Sarah Like, not really, but I want normally, when I have a high, I can get it down pretty quickly. Mhmm. It just gets more challenging when it's at night. If I've eaten something carb heavy or, like, that'll hit later in the night, that's when it gets a little tricky. Yeah.
Sarah So I have another I also have another insulin for that. What is it called?
Matilde Scott, I can't remember.
Scott Benner Is it the inhaler?
Sarah Come to I think it's something with an l. Lyonjev or something.
Scott Benner Loomjev? Yes. Okay. So you're using
Sarah It's an older insulin. Correct?
Scott Benner No. No. It's a newer one. Loomjev and Loomjev and and Fiaspora, the two faster acting insulins. Why do you have both?
Scott Benner Is it not that maybe? Lispro?
Matilde May I interject? Please. It's, the one she uses for nighttime, what and and I I have to think about the name.
Sarah Lantus? Novalin. Novolin. Alright.
Scott Benner Well, who set you up with that?
Matilde Integrated diabetes, which was also introduced to us by you, Scott Mhmm. Through the the, you know, the amazing Gary Shiner. I also use their services for when we need additional support and education and and normalizing. Yeah. We use Tavia.
Scott Benner Oh, sure. Oh, you know, I'm gonna see her in a couple of weeks.
Matilde She told me to tell you hello because we met with we talked with her yesterday.
Scott Benner Nice. Yeah. She and I are doing a private event together in, like, two weeks, maybe three weeks.
Matilde So she suggested let's say Sarah goes out to party, you know, and then she eats late at night and then goes to sleep. She suggested the Novalin because it's a slower acting insulin that doesn't have a quick onset and it takes a long it stays in the body longer. Mhmm. Am I saying is it the Novalin? Am am I right about that one?
Scott Benner I mean, you're asking me what you're doing?
Matilde No. I think I we don't do it that much. Okay. It's occasional. You know, because she doesn't go out at night all the time and eat late at night all the time.
Scott Benner So what did they give it to you for? Because it's
Matilde Because it's slower acting and it stays in the body longer. So if you eat, let's call it, like, a pizza late at night, it can help with her control. We don't do it all the time. Mhmm. But the cool thing with it is that you can get it at Walmart with no prescription.
Matilde It's super strange because it's an old
Scott Benner It's it's r insulin. Right? Novalin r? You That's what you're talking about? Regular.
Matilde Think that's what it is. Yeah. We don't use it that much, obviously. Look. We don't even remember the name.
Scott Benner But if you get a sticky hi, Sarah, you use that?
Sarah Yes.
Navigating School and Independence
Scott Benner Okay. Sarah, when your mom says going out to party, she means watching Disney princess films and eating Cheetos. Right? What does she talk to
Matilde about?
Scott Benner Yeah. Yeah. Are you in Miami?
Sarah Yes.
Scott Benner Oh, is it hard to live in Miami and be a kid?
Sarah No. It's great.
Scott Benner It's great? I was just there.
Sarah Really?
Scott Benner Last year and again this year, I'm taking a group of listeners on a cruise in June, and it goes out of the Miami Port. We're using a different cruise ship this year than we used last year, and the cruise company wanted me to see it. So I went and did a cruise with my wife right before Christmas. So we were in Miami for the night then went to the port and headed out and then came back that way. So I didn't get to see a whole lot of it but that's nice place.
Scott Benner So and I know people who have lived there. But the partying is is it's Miami. Right? Like, you're out. There's get togethers.
Scott Benner You've gotta kinda deal with things.
Matilde It's Yeah.
Sarah It's more like casual get togethers
Scott Benner Mhmm.
Sarah That sometimes go late. So if if I end up having I I probably end up getting a little hungry at the end.
Scott Benner So little meal. Yeah.
Sarah Yeah. I hear Yeah. Exactly.
Scott Benner When you're doing that. Okay. When you carry your stuff, how do you carry, like, a pen? Is it just in your purse or what do you do?
Sarah I have, like, a huge black no. It's not huge. It's this black pouch with a bunch of compartments where I keep my juice, my, Gevo hypo pen, and my main insulin
Scott Benner Mhmm.
Sarah And a little sharps box and just all my supplies, my alcohol pads, my needles, everything. So that's my pouch for school. And if I'm going somewhere nicer, I'll just put my stuff in a purse.
Scott Benner Okay. And you pre bolus your meals or no? What does the fiasse work fast enough
Matilde for you?
Sarah I can.
Scott Benner What does that mean, Sarah?
Sarah In the morning before school, it's I can pre bolus.
Scott Benner Mhmm.
Sarah At school, I cannot pre bolus. It's very difficult because I don't know what I'm gonna be eating.
Scott Benner Okay. And you don't wanna shoot twice. Like, you don't wanna give yourself a little bit, then figure out what you're eating and give yourself the rest? Or do
Sarah you Honestly, that might not be a bad idea.
Scott Benner Yeah. So what if you don't mind injecting, then I would pick an amount of carbs that you know for sure you're gonna eat, hit that as a pre bolus, and then when you settle on food, just put the rest
Matilde of it in.
Sarah That's very smart.
Scott Benner Thank you.
Sarah I'm gonna do that.
Scott Benner Alright. Try that. See how
Sarah that works. Have a lot of trouble keeping my well, not a lot of trouble, but I typically spike when I'm in school.
Scott Benner Yeah. Because you're probably bolusing while you're eating. Right? Yeah. Yeah.
Scott Benner Oh, that's a good see if that works for you.
Sarah Try it.
Scott Benner That's a tip that parents use for little kids because they never be it's similar idea. They little kids sometimes sit down and don't eat. And so people are like, well, I can't pre bolus because sometimes the kid doesn't eat anything or they take a couple bites. And I I ended up saying, like, years ago, like, there must be something, you know, they're gonna eat. And I remember mom saying, like, delete at least five carbs.
Scott Benner I'm like, well, pre bolus five carbs then. And then get the insulin on your side, get it moving, helping you, and then put the rest in later. That's all. Well, good for you. Well, I guess we're we're fixing the problem.
Scott Benner No other autoimmune in the family? Thyroid, celiac, anything?
Matilde No. Scott, my father did have diabetes. He was diagnosed in his, let's call it, late thirties, early forties. I always remember seeing needles, syringes, insulin in my home as a child, young, you know, teenager, but I never understood. I never knew anything about blood sugar.
Matilde I never knew even the range. I never even knew what insulin did. My father has passed approximately, like, five years ago, So I was you know? And he did pass from diabetic related complications that eventually resulted in congestive heart disease.
Scott Benner Mhmm.
Matilde My instinct because I would go with him to a lot of doctor's appointments, and I have, like, little memories that pop in my head. Yeah. Think my father had type one and a half. Can I confirm? No.
Matilde But it was like my father was an athlete, always exercised, always jogged, and so who knows? I will I'll never really know.
Scott Benner You're never gonna know. Yeah.
Matilde He was uncontrolled due to numerous things. The technology that it was available at the time due to his personality that he loved the wine, the cheese, you know, the meat, whatever, like, the stuff, the good life.
Scott Benner How how old was he when he passed?
Matilde 70.
Scott Benner Okay. Yeah. I mean, it's hard to know. Right? Like, if he if he was misdiagnosed or I mean, what was the management like?
Scott Benner Just insulin.
Matilde For him? Yeah. You know, I recall never did he ever in my life when we would go out to eat, never did he have insulin on his person. He would check the blood sugar at home in the morning and it at night. My father loved juice.
Matilde Imagine.
Scott Benner Like Fruit like, just fruit juices, orange juice, grapefruit, that kind of thing.
Matilde Juice. All the juices.
Scott Benner Just all the juices.
Matilde You know, which is like, hello, the worst thing ever. Yeah.
Scott Benner Okay. Hey. You talked about in your note about grief, and I was wondering, you know, was that for both of you or, mom, was it just for you? What was the what what happened? How did you work through it?
Matilde Yes. You know, as it relates to there definitely was grief for my daughter feeling because, you know, I don't want her I didn't want her to carry that responsibility and burden. Mhmm. So that is very difficult. But with that being said, I'm a person that I can be brokenhearted, super but I keep it moving, and I keep it cute.
Matilde I keep it moving, and I keep it good. And you I can be devastated, but I I get up, I do my hair, I go get dressed nice, and I'm like, that's how I am.
Scott Benner Yeah. Sarah, is that how you see your mom? Is it, like, surprising to you to know that she experienced grief after your diagnosis, or were you not even aware of that?
Sarah No. It's it's not surprising to hear now, but because it's true. I guess she was going through that kind of thing, but she did keep it moving and she kept it cute.
Scott Benner So And how about you, Sarah? Did you feel grief?
Sarah Yeah. I remember being a little sad.
Scott Benner Stuck to you for a while. What do you think helped it go away? Time or something someone said or did?
Sarah Maybe, like, time, honestly. Because when you first get diagnosed, it's just a big shock and, like, my mom spoke about earlier, it's a big learning curve. So once you learn about those things and I feel like a big part of this disease is trial and error.
Scott Benner Mhmm.
Sarah And you have to go with your gut a lot in this in this disease.
Scott Benner Yeah.
Sarah It's kind of like a number game, honestly. And maybe your doctor will tell you to stick to a specific formula, but I'm just gonna tell you right now, you can't always listen to your doctor. Like, this sounds horrible, but you have to do what's best for you as well. Like, if that means giving some extra insulin, you're gonna have to do it.
Scott Benner Yeah. You think maybe that's a starting point and they're hoping you'll figure the rest of that out? Or do you think that they don't know that there should be like, what's your experience been when you've gone back to your doctor and said, hey. Look. I gave myself more insulin here or I've changed my settings.
Scott Benner Do they generally seem supportive of that?
Sarah Yes. They do. But I'm in a different situation than some of their other patients because I think the normal how many times a year do I have to go visit their mom?
Matilde She, because of her well controlled numbers and and her responsibility, she normally only goes to the Endo now in person once a year.
Scott Benner Yeah. That's what our
Matilde We do the labs. They come to my house. I lay you know, I pay a little money, and the lady comes to my house and pulls her blood. And we do the diabetic educator appointments virtually
Scott Benner Mhmm.
Matilde For the most part. But Sarah's also a youth ambassador through breakthrough type one, so we see her endo, like, at events too. You know? Yeah. I have to tell you something, Scott.
Matilde This is the most important thing that I want you to to impart to the parents. You taught me what to do when you send your kid to school. Right?
Scott Benner Okay.
Matilde So when my daughter was diagnosed, the first thing she told me was this, mommy, I cannot be like this one girl that goes to my school that has a nurse walking behind her, carrying her book bag, and giving her snacks. She was like, I beg you. She was, like, petrified.
Scott Benner That that was her situation?
Matilde Correct. Yeah. So I was, like, scrambling. So I goo you know, I looked in your podcast, like, what to do in school. So I learned from you that when your daughter was a baby, I don't even know, second grade or third grade, you're like, forget it.
Matilde We're gonna handle this between my kid and I. We don't need the nurse. We don't need anybody else. We got it. So I said to myself, okay.
Matilde Immediately, when it was time for her to inject herself, I'm like, it. You have to do it. I'll text you. We'll text each other. You're going out?
Matilde Text me. Mhmm. Because the biggest thing that I learned from you, Scott, is that you cannot take away the kid from the classroom because they they miss instructional time.
Scott Benner Yeah. No kidding.
Matilde And the public school my kid was at at the time, the rule was if I signed up for nursing services, she would have to go to the nurse three times a day, in the morning, in lunch, and at night. I mean, you know, in the afternoon. Mhmm. Who has time for that?
Scott Benner Yeah. No. You you miss a lot of a lot of instruction that way and and it can you can easily just create a gap there. Sarah, the thing your mom's talking about is that when my daughter was in second grade, there was a prescribed time that she had to go see the nurse and it was in preparation for for eating. But what no one realized is she was leaving every day as the math lesson was being taught.
Scott Benner And it's just the the way the teacher had the day set up, she'd hand out the math lesson and just a couple of moments later, Arden would have to leave. A timer would go off on her phone. She'd stand up and leave. And Arden was missing the direction every day for the math lesson and she had fallen pretty far behind to the point where we actually we thought, like, I mean, honestly, Sarah, we thought she was just a little stupid. You know what I mean?
Scott Benner And, like, like, because it had gotten pretty far out of hand. We're like, oh, Arden's not good at math. And luckily and she lived the whole year like that, second grade. And then luckily in third grade, her her second grade teacher did that thing where she leveled up with the whole class. So the whole class had the same teacher two years in a row.
Scott Benner And then the math lesson moved to a different time in the schedule. And early on in third grade, the teacher called me and she said, oh my god, Scott. She's like, Arden's not bad at math. I figured out what happened and she told me. And it took Arden a while to catch up and she did, but it still sticks to her.
Scott Benner Like, she's 21 right now. She'll be 22 this summer. And no matter how good she is at school and she's very well and she's fine with math and everything, you can still see in the back of her head, she thinks she's not good at math. Like, it's a thing that stuck to her after all that time. So not only did it slow her down in second and third grade, but it it impacted her moving forward.
Scott Benner And, you know, you just you can't miss school. Like, you don't know what it is you're gonna miss exactly. I'm glad that that worked out for you. So you guys just texted each other and handled it that way.
Matilde Yeah. We texted each other. The school made me when I selected to be the five twenty nine where she would get extended time for tests and so forth, they said to me, well, if you waive the nursing services I opted to waive the nursing services because I didn't want my kid to go three times a day to the nurse. Yeah. And I told them they're like, well, if there's an emergency, I said, you know what?
Matilde If there's an emergency, call 911 before you call me. Treat my kid like another kid.
Scott Benner That's exactly what I told them. It didn't mean I don't want the nurse if she falls and breaks her arm or she has a seizure or something like that. I I want the nurse. I'm just saying I don't think we need her to be there on a schedule constantly. Like, we can take care of bolusing for food and stuff like that.
Scott Benner So yeah. Yeah. So you basically just did what the what I was talking about in the podcast.
Matilde Correct, Scott. That's why I love you.
Scott Benner Like And it worked.
Matilde Yes. It works. Yes.
Scott Benner Why did you wanna come on the podcast, Sarah?
Sarah Because I wanted to show other parents and even if other kids are listening that you can still be perfectly normal and have this annoying disease but still live your day to day life and enjoy life.
Scott Benner That's awesome.
Sarah And I feel like a common misconception when you have this disease is that you have to stop your life and take a moment to learn everything, which is true. You do. But as you're learning, you can keep going.
Scott Benner Yeah.
Sarah Like, keep it moving. Keep the train moving. The train doesn't stop and it doesn't it's the train is not gonna stop for diabetes. So
Scott Benner Yeah. That's awesome. I mean, you got a great attitude about it. I I'm not gonna lie to you. I think that setting you up to be you know, to have some control over yourself at school goes a long way to getting yourself, you know, your self esteem and and confidence rolling in the right direction.
Scott Benner I mean, you're obviously having good outcomes. You understand how to use your insulin. That's, I think, a big part of the whole thing. You're confident. I were you were you a confident person before this?
Sarah Yes. Yeah. I think I'm confident by nature.
Scott Benner Yeah. Being tall doesn't hurt either, Sarah?
Sarah And also, I'd like to add on to the nurse thing. That was, like, obviously one of my biggest fears because there was a girl in my school who was constantly being followed around and I was not about to be that girl. Mhmm. And also, as one of my electives at school, I would help in the office and that's where the nurse was. So I would encounter her whenever I went to my little office help and she spoke about some this other girl and was telling the other office ladies about her health situation.
Sarah She was diabetic.
Scott Benner Mhmm.
Sarah And that's just a violation of privacy. So that was even more of another like, that was that was just another reason not to use this woman's services.
Scott Benner So you're there horrified listening to her spill the tea on somebody else's life. Exactly. Yeah. And you're like, woah. If you knew me, would you be talking about me like this?
Sarah Exactly.
Scott Benner Oh, so you're trying to keep your stuff to yourself.
Matilde Mhmm.
Scott Benner Do you have other people you can talk about it with though? Do you have some close friends who understand? Like, if you were with a group of girls and and you, you know, got dizzy and you couldn't help yourself, does somebody know what to do?
Sarah Yes. My close friends know what to do in that case. Like, if they see me feeling bad, like, I feel like the fur the first instinct would be, oh, do need to eat something? Or if it's really bad, they know to use the pen, like the Gevo Kypo pen.
Scott Benner Good. Good.
Sarah But I have a good supportive group of friends who look out for me.
Scott Benner Awesome. And you sound like a reasonable young person, which I'm happy about. You would never drink or do drugs. No. Is that right, Sarah?
Scott Benner Yeah. Right? And and if if your mom wasn't here, you'd say the same thing?
Sarah No. I would definitely say the same because, honestly, with diabetes, you just have you have to be even more careful with your health.
Scott Benner You're not looking for extra problems?
Sarah Correct.
Looking Ahead: College and the Future
Scott Benner Yeah. Or to make this harder. Right?
Sarah Mhmm.
Scott Benner Yeah. Okay. Very nice. Do you plan on going away to college?
Sarah I do.
Scott Benner Where are you gonna go? That's an interesting thing. Like, when you live in a place where everybody's trying to get to it, where do you think to go when you're leaving? You know what I mean? Like, a lot of people are like, oh, I wanna go to Miami to go to college.
Scott Benner Like, you're there. So
Sarah Oh, exactly. Yeah. Honestly, I feel like that is just is one of the best universities out there. And if it wasn't two minutes away from my house, catch me there.
Scott Benner Well, can I share something with you? Sure. My daughter said to us recently when I was leaving high school, she's like, I thought the worst thing that could happen to me is that I'd be one of those people who went to school five minutes from my house. And so I went to this place and then she switched and went somewhere else and she and then eventually, she's like, I'm just gonna come home and finish up at home. And she's like, I don't know if that's the right answer for everybody.
Scott Benner She's like, but I do wish I wouldn't have felt so embarrassed by the idea of looking close to home. So, I don't know. Maybe maybe that won't be your finding. She's Well pretty happy with it now.
Sarah Oh, that's so nice to hear.
Matilde But you don't think it's
Scott Benner of here.
Matilde Yeah. Yeah. I don't
Sarah think it's an embarrassment thing. I just think like, I wanna discover something new and
Scott Benner Okay.
Sarah Get out of my comfort zone a little bit. And I feel like I'm not gonna be able to do that in my same neighborhood with the same circle of people
Scott Benner Mhmm.
Sarah With, like, the same support system around me. Like, I feel like I have to step out a little bit.
Scott Benner I hear you.
Sarah And I feel like I've I've worked so hard and, like, I don't know. I want something different.
Scott Benner You're a good student? Yeah. Yeah. What is it you're interested in?
Sarah I'm interested in possibly studying communications or journalism. I'm the editor in chief of my school newspaper.
Scott Benner Nice.
Sarah And maybe or maybe going into law someday. I'm not really sure. But that's the areas I'm interested in.
Scott Benner Where do you think you're gonna look at school? Like, far mom, how far away is okay?
Matilde Yeah. Needs to be a plane, a nonstop flight easy. Mhmm. East Coast for sure. That's it.
Scott Benner Yeah. What about the weather, Sarah? Are you gonna go somewhere cold?
Sarah I mean, maybe.
Scott Benner Oh my god. I just wanna live somewhere warm so badly. I I would
Sarah Where do you live?
Scott Benner In New Jersey.
Matilde It's We can swap.
Scott Benner Yeah. You wanna come oh, you wanna be close to the city. Maybe. I'm a fifty minute train ride from Manhattan. Okay.
Scott Benner Listen to her laughing. You can't let her out of the house. She's gonna Sarah, you're gonna be a problem when you get out of there, aren't you? Listen to her laughing, but you can't let her leave, Patoni. Well,
Sarah I'm gonna be such a problem.
Scott Benner Oh my gosh. Well, that's awesome. And what do you have? Two more years?
Sarah I'm finishing well, I'm in the third quarter of my junior year. Mhmm. And then I have my senior year and then I'll be out.
Scott Benner Okay. Very nice. That's awesome. Hey. Listen, I've been wondering this the whole time.
Scott Benner It's really not apropos of anything and has nothing to do with your story, but your mom speaks more than one language. Right?
Sarah Yes.
Scott Benner Yeah. Do you?
Sarah Yes. I do.
Scott Benner Okay. Matilda, I'm sorry. Are you first generation or second?
Matilde No. I was born here in The United States. Actually, I was born in Virginia, but I've lived in Coral Gables in my whole life since I was five years old.
Scott Benner Okay. Okay. Because I was gonna I have a a friend of my daughter's her mom's first generation from Italy, and she talks a lot about the difficulty she has, like, because her mom struggles with some things, like, you know, language sometimes or but you guys don't have that issue.
Matilde No. My my family, my mother was American from The United States and my father was Colombian from Medellin, Colombia.
Scott Benner Oh. Oh, Mhmm. He hooked that mom. Is your mom still alive? Is she okay?
Matilde No. My parents have both deceased. Both deceased. My mother predeceased my father by, like, seven months.
Scott Benner Oh, gosh. Oh, I'm so sorry.
Matilde Yeah. Thank you.
Scott Benner Yeah. Sarah, can I ask a weird question? Is it weird to hear your mother say, my dad passed away, I think, five years ago? Does it make you feel like, oh my gosh, is there gonna be a time in life when I don't remember exactly when my parents left? Is that or is that too deep or you're young?
Scott Benner I don't know if that hit you or not when she said that. I I don't want you to cry. You'll be like, no. I'm thinking about it now though. Thanks a lot.
Scott Benner But but but but, like, I my mom passed away, I told you. That's why I asked, and, like, I'm starting to lose the concept of how long it's been difficult.
Matilde Yeah. No. And I'm so sorry for your loss Thank you. Scott.
Scott Benner Thank you. But, Sarah, back to my question. Do you have, like, a feeling for, like, time? Is that something or are you just so young you do not think about that like that?
Sarah No. I I I do have a feeling of time. I feel like, obviously, I was diagnosed. It's almost gonna be four years, but I feel like it's it's crazy to think because I I can't believe time has flown by that fast.
Scott Benner That fast.
Sarah Not even diabetes related. Like, I can't believe that I'm a junior in high school and starting to look at where I'm gonna go to college. Like, it feels unreal.
Scott Benner Right. No. For sure. Do you date? No.
Scott Benner No? When you think about dating, do you think about the diabetes as well?
Sarah Not really. No. Because I don't date.
Scott Benner You feel like I don't need any of that problem. But is that because you can't find you you're just not interested in it right now? You're busy with your other stuff?
Sarah Yeah. I'm, like, busy with my my own life.
Scott Benner Okay. And you don't wanna bring somebody else into it and and then you have to give time to something or somebody else. Is that right?
Sarah Yeah. I guess I'm just protecting my peace.
Scott Benner Yeah. You're telling me there's a lot of crazy people at that school. You can't find one that you think is normal? Listen, I love it when she laughs when she doesn't wanna answer between you. That's my favorite part of Sarah.
Sarah I think everything is meant to happen for a reason. And when it's the right time, it'll be the right time.
Scott Benner And you won't have trouble when when that time comes. You won't have trouble sharing your diabetes with somebody else? No. Okay. It's not a thing you'll wanna keep private?
Sarah I don't think so.
Scott Benner Okay. So it's interesting. So you don't your problem with, an insulin pump isn't that somebody will say it. It's that it's it literally is that it's on you. Yeah.
Scott Benner So you don't mind do you inject in public? Do you do people see you inject
Matilde your insulin?
Sarah I do inject in public.
Scott Benner Okay. Yeah. Okay. That makes sense. Alright.
Scott Benner Isn't it great that she's not dating?
Matilde You know, she can my kids can they don't have a curfew. They can go out. They're they're I always know where they are. They always call me, text me. You know, the culture here is, you know, in in Miami, we to is to enjoy life, go out, be with your friends, have a good time.
Matilde She's super responsible. If she wanted to date somebody, she's more than allowed, of course. But she's very busy with working out, studying with her friends. Yeah. She's very busy.
Scott Benner Do you see what your mom's doing? It's genius. She's not holding on tight so you don't feel restricted, and therefore, you don't feel like you have to, like, push back. Exactly. Did you know she was doing that to you?
Sarah Like, not really.
Scott Benner No. No. You know, Matilda, how did you figure it out? Were you were did your parents treat you the same way or did they did they try to restrict you when you rebelled?
Matilde No. No. No. No. No. I had a boyfriend my whole life.
Matilde Always. Always. But that was just how it was. I always had a little boyfriend, and I thought it was I think it's super healthy and super nice. Yeah.
Matilde You know, you get and then you end up graduating and getting a great husband like what happened to me.
Scott Benner Very nice.
Matilde But I will tell you something. I wanna tell you this, Scott
Scott Benner Yeah.
Matilde So the parents know. My kid remember she missed the sleepaway camp when she was diagnosed because she was supposed to leave in three weeks. Right. Right. The sleepaway camp, they don't have diabetic kids.
Matilde Right?
Scott Benner Mhmm.
Matilde So the next year came and I was like, oh my god. Are we gonna send her? Because my young kid my youngest wanted to go too. I had to do a lot of mental gymnastics and we had to do a lot of conference calls. We did like conference calls with the camp.
Matilde Like, I pushed myself and I pushed Sarah. She was a mom. I don't think I wanna go. And I was like, you're going.
Scott Benner Because
Matilde a mom that I met, a type one mom that has two type one kids in in this Miami area, she told me, if you were gonna do it before diabetes, you gotta do it after. So I pushed myself, you know, pins and needles shaking, but you're going. Of course, the camp made the exception to allow her to have the cell phone, which, you know, these camps are cell phone free, but she has to keep it. So that's why, you know, in preparation for if she wanted to leave her house. Scott, I never I mean, I've when I tell I've lived in Miami.
Matilde I went to undergraduate school here and graduate school here. I didn't move out of my house until I was 28, until I bought my own little apartment. Like, I'm a, like, a home girl. Like, you know?
Scott Benner Yeah. Yeah. Yeah. Move you're moving slowly. You're doing things very specifically.
Scott Benner Yeah. Yeah.
Matilde And so I wanted to just for her to have the tools, like, okay. If you wanna go, go. But, you know, get some practice, you know.
Scott Benner So you're not in any rush to leave either? Sarah, like, you think it's possible you'll go to college then come back home?
Sarah I think so. Yeah. Definitely.
Scott Benner I mean, listen, you're gonna need to save some money. This stuff ain't cheap. Yeah. Is that a thing you think about? Like, my my daughter talks about that sometimes, like, how do I make sure I can pay for my health insurance as an adult when I'm by myself and everything?
Scott Benner Is that something that's entered into your mind yet? You're a little young. You might not have.
Sarah Not really.
Scott Benner Yeah. I wouldn't have thought about it either. Don't think at your age.
Sarah I I, like, see the price of things nowadays. It's crazy. So I I just know I'm gonna have to work really hard in general.
Scott Benner Yeah. It is true. Keep making good decisions and moving forward and stuff comes together.
Matilde Absolutely. And my daughters are have faith in God and they put, you know, put God first to make good decisions. Yes. Absolutely. She's gonna be fine Yeah.
Matilde One day at a time.
Scott Benner Sarah, if you're if you're a person, like your mom describes who, you know, has a religious belief in holding, is there a feeling you ever think about like why did I get this?
Sarah Oh, definitely.
Scott Benner What have you figured out so far when you mull that over?
Sarah So, yeah, first when I was diagnosed, I was obviously very confused and I always thought why why did why do I have this? Why why didn't why me? And honestly, even on the hard days, I still feel that way sometimes, but you go through like ups and downs. Some days are harder than others, and it's hard because sometimes when you're having a hard day you see others having like an easy day, but they probably have issues in their life that you don't know about, but this is just the issue I have to carry with me for the rest of my life. Hard to accept at first, but now I know that I I guess I know it was meant to happen to me Mhmm.
Sarah And I think it's made me into a stronger person.
Scott Benner I bet it is. What constitutes a hard day?
Sarah Probably like the censor being, like, all messed up
Scott Benner Okay.
Sarah Or, like, a hard night.
Scott Benner We have to put in more extra effort or technology doesn't work the way you expect it to. Well, you know what? I I know this is not a thing you have context for, but I've spoken to people who've been living with diabetes for all different lengths of time and I I'm I'm happy that the that what constitutes a hard day for you is that your sensor didn't act right or that you had a blood sugar, you had to fight with a lecture longer because that is such a better better situation for people with diabetes. And and it makes me excited for what, you know, what a hard day will sound like ten years from now. Do you ever think about, like, the algorithms that are available in the automated systems and how they might help you overnight?
Scott Benner Like, do you ever think, like, oh, maybe I should just get a pump?
Sarah No. Not really. Because I I have my centers get faulty a lot, I'd say. Mhmm. So it tells me I'm low a lot when I'm actually not low, and it'll just mess up my numbers.
Scott Benner Possibly. Yeah. I it it is part of it for sure. It it doesn't end up being as impactful as you think, but I just wondered if you ever thought about, like, well, maybe this thing, you know, if I'm asleep at two in the morning and my blood sugar starts to drift up, this thing will push it back down and take care of it without me having to wake up. See?
Scott Benner Or if you try to get low, it can stop you from getting low so it doesn't happen as often if it is happening. Are you getting do
Sarah you get low overnight ever? Not like, not really.
Scott Benner Okay. Are you more higher when it's an overnight issue?
Sarah Yes.
Scott Benner Okay. And how often does that happen?
Sarah How often am I high overnight?
Matilde I would say, you know, let's call it a few nights a month. Mhmm. Also, Scott, there two reasons she doesn't want to use a pump.
Scott Benner Okay.
Matilde Number one is because the amount of insulin she uses.
Scott Benner Small
Matilde enough. Uses, like, her basal is very low. Her carb ratio is, like, for 10 carbs, one unit. Yeah. Her insulin needs maybe are a little low for, let's call it, for the regular Omnipod.
Matilde Mhmm. Number two is because she doesn't want it on her body. For me, she doesn't want people to see it. Yeah. And plus, she likes to keep you know, those those things irritate the body.
Matilde They irritate the skin. We've done a lot of things. We do a a patch under the Dexcom, and we do then we put the Dexcom on. We know. We treat the skin.
Matilde We put a patch. Then we put the Dexcom. Then we put another patch. We have, like, a whole system to protect her skin. So that's, like, another thing.
Matilde You know? Yeah. And then here, you're you know, they're in the bikini in the in the small clothes. So it's like
Scott Benner Just not looking for extra listen. I don't not understand. I I'm just I was just wondering if she'd thought about, like, the idea of an algorithm being helpful to her. That's
Matilde all. Sounds fabulous.
Scott Benner Yeah.
Matilde Like, I think if her body needed it, and I think she would do it.
Scott Benner K. Yeah. I mean, you you you don't know. Like, she could also do this. You know, Sarah, you might do injections your whole life and just be like, hey.
Scott Benner I'm great at this and it works for me. That'd be awesome too, you know. I'm not saying there's a right or wrong way. I was just wondering. Have I skipped anything?
Scott Benner Missed anything at all? Is there anything we forgot to talk about or something you wanted to talk about? I wanna make sure I don't miss anything because there's two of you and it's a little more confusing for
Matilde me. Ultimately, I think the most important thing is as a parent, you're the one that has to advocate for your kid. You're the one that needs to get educated and learn how to really manage this condition because the diabetic educator that you see three to four times a year for max thirty minutes to an hour, they can help, but they can't manage the day to day. You gotta figure that stuff out on your own.
Scott Benner Yeah.
Matilde And that's where your podcast is. So what you've done for the type one community is like, congratulations. You know? Thank you. I really, really appreciate you and and and what you've done for our community.
Scott Benner Well, that's very kind of you, and it's my pleasure. I very much enjoy making the podcast. So, you don't really have to thank me for it, but but I I will accept your thanks and Yeah. And I will carry them throughout my day. I'm just very happy.
Scott Benner Like to hear you talk about, you know, some of the things you've had success with and how things are working for you guys anyway. What is my last question for Sarah? I have one last question. You're so young. I don't know if it's if it's too early, but do you ever think about having kids?
Sarah Yeah. I do.
Scott Benner You do? And is that a thing that has changed for you since you have diabetes or has it not changed for you how you think about it?
Sarah No. I actually wonder about that sometimes. Like, how's that gonna work? I'm building like, caring for a human in your body while caring for yourself.
Scott Benner Yeah. It can be a lot of work. There's a ton of information and a lot of ladies have have shared their stories in the podcast. If you ever get closer to thinking about it, you can listen to them. They'll talk about how their insulin needs change and shift throughout pregnancy and stuff like that.
Scott Benner It's pretty interesting actually. I have no more questions. I feel like you guys did such a great job of telling your story. I feel like I'm I'm I feel done.
Matilde Scott, thanks a million.
Scott Benner Thank you so No. Really. You guys are terrific. This is lovely of you to do. I appreciate you taking your time.
Scott Benner Sarah, why are you not at school? What's going on?
Sarah For this podcast.
Scott Benner Oh, nice. Got a day off?
Matilde Yeah.
Scott Benner Will you go in late or no? Forget it.
Sarah No. I'm not gonna go in late. I'm not
Matilde She's really she's super responsible. She can miss today. It's not
Scott Benner a problem. Well, that even that's very nice. I'm glad that that it seemed important enough for you to do something like that. Thank you. Seriously, hold on one second for me.
Closing & Sponsor Messages
Scott Benner I really appreciate this.
Scott Benner Touched by Type One sponsored this episode of the Juice Box podcast. Check them out at touchedbytype1.org on Instagram and Facebook. Give them a follow. Go check out what they're doing.
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Scott Benner Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that.
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Scott Benner Don't take my word for it. Listen to what reviewers have said. Bold beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked.
Scott Benner People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen, they recommend it to everyone who's struggling. It's straightforward, practical, and easy to listen to. Bold Beginnings gives you the basics in a way that actually makes sense.
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