#554 Kate the Great

An adult type 1, a mom and so much more.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Friends Hello, this is Episode 554 of the Juicebox Podcast. And I am here to welcome you to it.

I hope you guys know me well enough by now, to know that I would not bring you crap. You understand what I'm saying? It's a great conversation with Katie. And I want to give you a little teaser about it. But if I'm being completely honest, I'm rushing to get these episodes together. Mom's having a little bit of a health issue, and I need to get these up on the internet for you. So they arrive when you expect them to. But I don't have a ton of time. So Katie's cool. She has type one diabetes. She's had it for a long time. She's gonna talk to you about a bunch of stuff. If I'm remembering correctly, she was pregnant during this and yes, indeed, I have a follow up email from her to let you know how it's going or how it went. And I mean, listen, trust me is a great conversation. You're going to spend the next hour absolutely enjoying yourself with your headphones on. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. And if you want to keep somebody in your thoughts today, my mom's name is Beth. This show is sponsored today by the glucagon that my daughter carries g vo hypo pan, Find out more at G Vogue glucagon.com forward slash juicebox. This episode of the podcast is also sponsored by touched by type one, they just want you to head over and check them out. Touched by type one.org. They're also on Facebook, and Instagram. And by the way, the dancing for diabetes extravaganza. You know about it. If you don't head over to touch by type one.org to find out but if you do know about it, and you want to get tickets, they're available right now. The big event is on Saturday, November 13 at 7pm. It's in the Walt Disney theater at the Dr. Phillips center in Orlando, Florida touched by type one.org Tickets are on sale now. They are not expensive dance fans head over. If you're not a dance fan, you just want to support a super great organization helping the people with diabetes. Do it super great. Not a real word. I'm sorry. I'm rushing links in the show notes links at Juicebox podcast.com.

Kate 2:39
Alright, well Hi, my name is Kate. I am 38 years old. And should I just go through a little brief synopsis of my

Scott Benner 2:52
I I you know, I think it's time for me to complain. I love screwing with people and just being like, go Introduce yourself because I'm so interested to see who will like some people are very worried about the content. Some people are worried about saying too little too much. I'm all fascinated by you have to say just keep going. How old were you when you were diagnosed?

Unknown Speaker 3:10
I was 18 that was 20 years ago. Right? It was? Yeah. carry the one. Yeah, I found out right before our prom my senior year in high school, huh?

Scott Benner 3:25
That's not fun. And it

Unknown Speaker 3:27
was typical standard signs losing weight really thirsty vision issues when I when I had always had perfect vision. In fact, my friends thought that I was believing because I was still eating so much but losing so much weight so that there was an intervention regarding being bulimic and I you know, of course ended up not being that my stepfather at the time was a emergency room physician and swore because I played a lot of sports outside tennis and softball and and we were living in Georgia at the time, which of course is hot weather and he saw that I was dehydrated. So he hooked me up to an IV in my room because of course being a physician have all of those materials at the house and my mom was a are still as a labor and delivery nurse. So she also for having two clinicians at home had a urine sample cup and so they had me do that. And she brought that into work that evening. And then we got the call that I was you know on the verge of going into a diabetic coma and I should get in right away and something else my stepdad at the time had given me with some sort of like, relaxer Um, so driving to the hospital I was just in this days of like, I don't know, trying to see like some sort of a triangle And so I vaguely remember being in the hospital even though I was 18. I kind of just remember it's so weird. I've had so many endocrinologists over the time over the years, and I don't remember a whole lot of names, but I do remember his, um, and he's Canadian, too. He had a, you know, different accent, of course, very different than most of the people in Georgia. And he had held my hand and said, You know, this was an opportunity for me to become an endocrinologist and to develop a cure. And that would be very, you know, critical to that development. I always think back to that conversation at one point, I had thought about going to medical school, and then you know, going into the specialty, but then the thought of being in school for that long deterred me.

Scott Benner 5:53
The empowerment of one Canadian well, meaning man did not overwhelm you that much.

Unknown Speaker 5:59
No, yeah. So I, you know, I and I always go back and ask my mom, like, do you think that that was relevant? And I think, looking back now, I would have said it was relevant. But of course, as an 18 year old who is like, slightly drunk. I really think I can do it

Scott Benner 6:16
as an 18 year old on tranquilizers in DK. Yeah, exactly. He didn't feel like Career Day to you. Right? I can see I can see the, the desire from him. You know, like your pet your family's in medicine. He's probably trying to make you feel like, you know, here's, you know, an empowering moment and everything like that. He didn't know that. Your dad had whacked you out of your head. And you didn't know. You know, it's funny, as you're telling that story. A friend of my daughter's has two nurses, for parents. And I remember one time on a FaceTime call when she was sick, she had the flu or something looking at her, and she was on an IV in her bedroom. And I remember thinking, like, what the heck, and my daughter's like, Oh, yeah, her parents are nurses. And I was like, No, I didn't know that meant you could take it home with you. But yeah, exactly.

Unknown Speaker 7:07
And this was, you know, however many years ago, so maybe not possible anymore. But you

Scott Benner 7:15
think your dad just walked out with it just slung over his shoulder? Like, I'm just leaving with this stuff? And they're like, exactly. It's the 90s you can do whatever you want. Yeah, I don't know. Well, okay. That sucks. But how did you make out afterwards? Did you? Did you bounce back? Or was it a rocky ride?

Unknown Speaker 7:32
Um, it was, I mean, I think probably similar to a lot of people's stories at you know, I didn't. At that time, of course, there was no loop. There was no Dexcom it was manual injections. And I think the hardest part for me was just the timing of it. At the end of my senior year in high school, and I was getting ready to leave for college, and you know, just a few short months. And so I think that was really hard for my mom. And you know, leaving me at the dorms with this newly diagnosed disease. I don't know that I handled it the best that I could in college between beers and pizza and hamburgers and french fries. And then, I'm surprised that worst things didn't happen before that, you know, they they did. And I had a seizure. I think my first seizure when I was in, after a long night of partying in Spain when I was studying abroad there. Um, I think that was my sophomore year of college after my sophomore year of college, and then that was kind of like my wake up call, like, I need to get a little bit more serious about this.

Scott Benner 8:47
Hey, studying abroad is code for drinking in another country, right?

Unknown Speaker 8:51
Yes. And, let's see, then, the fast forwarding a little bit, let's see I you know, I started to clean up my act. I after college actually moved abroad to Peru. So I studied finance in Spanish in college and really the amount of Spanish that I learned while in Spain was minimal. And so I decided that I needed to go on my own somewhere and that I had a teacher in college who we used to be the former director of the an English Institute in Trujillo, Peru. So I've moved there. And then my best girlfriend shortly followed after and then I was on the time I was on the I think Medtronic 512 pump and which they said at the time that it was waterproof. I can't remember what else but I ended up on a trip and like a remote beach in northern Peru and the pump broke and of course, I'm What was I 21 traveling by I mean literally like one of those jansport backpacks so I didn't have the pharmacy with me so I had no I had no insulin I did have a syringe I think was what I had with me and then we would plug that into the vial from the pump or what I was using to refill the pump is maybe what it was I can't remember now it's been so long but and then every like hour and a half giving myself insulin until we got it was an eight hour bus ride back to Trujillo because there was only one doctor in this town and he knew nothing about diabetes. I remember calling my stepdad on the phone just in tears because I'm like, what did people do here in Peru? Do they die? And I think they do at that time I think they did die from diabetes like you know back in the early 1900s so I thought that my trip was ending short and I was coming back to the US and after discussing with a private clinic in Trujillo what I needed they found what is it called like an NPH insulin

Scott Benner 11:14
like regular and mph you were probably never on that though.

Unknown Speaker 11:17
No I was never on and that's the one we're like has a peak 30 minutes after you take it Yeah, yes so they gave me that and it was like a used vial that they had already had and it was in the refrigerator I mean it's so weird but they like showed it to me like is this what you need?

Scott Benner 11:32
And so

Unknown Speaker 11:34
yeah, so I started taking that of course they didn't explain it to me about the 30 minutes I had no idea there you know I ended up having a seizure in Peru which is I don't recommend to anybody and go into a public hospital my best friend who you know found me in the kitchen was terrified

Scott Benner 11:52
I'm waiting for clarity you do not recommend having a seizure in Peru is that right? Yeah, so what was happening is you were taking that insulin the way you were taking your previous insulin but it didn't work anywhere near the same way.

Unknown Speaker 12:07
Exactly. Okay. And because I had no guidance I mean from them they didn't know I'm

Scott Benner 12:13
the doctor that gave you an open vial of insulin was no help Ah, yeah.

Unknown Speaker 12:19
It was better than having to get on the next flight back to the US but

Scott Benner 12:23
yeah, cuz that was Your other option was to get on a plane and go into DK in the sky and just hope somebody comes and scoops you up at the airport right?

Unknown Speaker 12:30
What am I yeah guess I could have you know I could have made the I think it was I think is eight hour bus ride to Lima I could have done that and maybe there would have been a private clinic there that would have been more advanced

Scott Benner 12:42
Yeah, okay. But

Unknown Speaker 12:44
yes, it was quite the quite the experience well I opted to not well I couldn't go back on the pump at that point and then when I did come back to the US I there was a boat trip and for the week like a memorial day weekend trip and I think that was like right as Medtronic release oh you we said this was waterproof but it's not and I said okay, I'm not doing the pump thing anymore. I hated the the cords the cables the wires and trying to figure out where to best wear it. It may I hate figuring out what to wear every day and that just made it extra challenging. Gotcha. So at that time, I went off the pump and I stayed off the pump until I after having my second kiddo

Scott Benner 13:32
after the second one. I love how some of you diabetes old head say the pump By the way, just in case you're wondering. I love the pod. I know not even that just like a pump. It's like the pump. It's a weird I love it. It's absolutely hearing but you don't realize that it's other pumps? Well, I just that younger people don't seem to say it the same way they speak. And I think it's because at some point in history, there was a pump, which made it the pump. You know what I mean? Like you go on the pump. It's not like there were 10 of them. And you're like, Oh, we didn't have choices. Yeah, there were no choices. I just I think that's the right one. I mean old had in the nicest way. Like you've had that. Yes for a while. Yeah. Which to me is a is a absolute Badge of Courage. So I think of it as a great thing, but I just have always please it always just delights me to know and so you so how long is it from leaving the pump? until you've had your second kid?

Unknown Speaker 14:28
Oh gosh. Huh. That was around 21 until my second kiddo now is two and a half.

Scott Benner 14:40
I can't believe you sat still long enough to have children because it sounds like you were on a med terror as a young girl. Yes,

Unknown Speaker 14:47
I mean, I traveled all over the world like my work travels brought me all over the world. I enjoyed myself for quite some time and didn't really find my person until much Later in life so

Scott Benner 15:01
I just feel like at any point in my life if you would have said to me Do you want to go to Peru I would have gone No. And that would have been

Unknown Speaker 15:11
I have loved to travel and I have never let diabetes hold me back. In fact, I love listening to some of the especially the one about the daughter who I think it was went to Mount Everest maybe that was really interesting to me because right before we found out I was pregnant with the first I actually had my trip booked to do the Annapurna circuit in Nepal. And the this scariest part I guess from my partner, my now husband, but partner at the time was that I wanted to go by myself I'd had the trip planned before him and I met and him knowing I was diabetic and you know, some of the things that could come up in high altitude etc. He insisted on going and so it was last minute, we decided, Okay, fine, you can come with me. And then I think it was like that weekend he got the approval for work, you know, from his work to be gone. And we're about to book it when we found out I think it was literally like that Tuesday we were going to book his trip on Wednesday. So I ended up not being able to go do the Annapurna circuit in Nepal, but maybe one day but that that podcast was really helpful because of you know, high altitude challenges and what equipment to bring extra equipment and all of that it's

Scott Benner 16:35
interesting that I've that the girl's mom has been on and told that whole story, but I can't seem to get her to come on. Oh, really? Yeah, I

Unknown Speaker 16:42
heard the mom episode. Yeah, I've

Scott Benner 16:43
given up on trying. I just I don't I think it's just something she doesn't want to talk about. I'm not certain back then she was writing articles about it. She was everywhere. And I couldn't get her to come on the podcast. So I was like, Oh, I think the

Unknown Speaker 16:54
mom Isn't she a journalist? She is Yeah, yeah. Well, maybe it's she doesn't like her voice. Um,

Scott Benner 17:01
I don't know. I would love to hear that story from her from her mouth. A couple of people. I can't get that. I'm baffled by Mike. Wait, you won't do this. Right. Okay. We'll figure it out one day. How so you haven't been married that long?

Unknown Speaker 17:18
have not been married that long. You're living my dream life.

Scott Benner 17:21
Minus the proof.

Unknown Speaker 17:24
We have crunched so much into the time that we've been together. It's ridiculous. I mean, since 2000, or seem, we have built a house together had two kids together. And now pregnant with our third.

Scott Benner 17:45
It turns out when you're older, have good jobs and a little money saved. Life's not that difficult. Yeah, we need a house. We'll just make one here. You want to have a baby? It's got to be easier than that time my insulin pump stopped working on a beach in Peru. Sure. Why not? You have a much different perspective. It's that's a really nice story. You are what I point my children towards. I'm like 30 years old at minimum before you're really serious with anybody. And yeah, I think they look at my wife and I and they're like, yeah, don't worry. We see you guys have been together for freaking ever and somehow aren't that old. That's I think that's really cool. So yeah,

Unknown Speaker 18:28
but I am going into this third pregnancy and I, you know, have a few gray hairs now. And I'm like, I'm just really tired. I can't believe that I'm going to have like an infant almost going into my 40. So that's a little scary.

Scott Benner 18:43
Oh, no, after doing a lot of things, right. You screwed this last bit up, but I didn't want to was fine. Kate, what were you doing? No, no. I my wife said to me a number of years ago, she's like, what if we just had another baby right now? And I said they'd probably kill me. There's just the staying up at night is a lot of what it was like, I don't know that I can like there's part of me that thinks I figured out diabetes so I could sleep.

Unknown Speaker 19:09
Yeah, and that I can't imagine being a parent. I always you know, now that I have kids, of course, I'm really emotional. Whenever I hear kid stories and thinking about folks that have to go through their, you know, two year olds and even younger being diabetic. I'm like, I would never sleep

Scott Benner 19:27
never. There was a lot of writing

Unknown Speaker 19:32
it in fact, it wasn't until our our second kiddo who he never slept through the night until he was like 13 months old, and I was a walking zombie. And there were times where people were like, Do you need help, I'm going to come stay the night and I'll get up with them. And even then, because I was just still on my injections, but I was wearing a Dexcom and the alarms would be going off all night. So even though they were helping me I still couldn't even sleep because I was postpartum my numbers. Were still Like I'm losing weight, but I've also breastfeeding so my, you know, my, I'm burning calories that was just like a weird I always struggled a little bit postpartum with my blood sugars and figuring out, you know how to keep it. I mean, it's like a daily adjustment and then on top of the baby not sleeping through the night for 13 months, that is when actually I found your podcast. I don't even know how I found it honestly. But that is when I decided to get on the Omni pod and then eventually go to the loop. There were some logistical challenges and getting on to the loop. And also wanting to be on the on a pump again, I just always refer to myself as like this diabetic robot and I didn't want to have to wear another device and, um, and wanting to wear a bikini and not have all these things on me. But of course my like my bikini days are over and worrying about that. So less of a concern and it was really only about fleet at that point.

Scott Benner 21:02
I thought you were a humble bragging there for a second. I thought you were like, yeah, I had two kids in my 30s I'm pregnant again. And I do get into a bikini still. That's where you were quietly going with that like everyone just just you know, feel jealous now okay.

Guys, I'm gonna go over it one more time. The 2021 dancing for diabetes show his back on a live stage in front of you. Looking to get back out there in the world and see some entertainment. Start here. Saturday, November 13. At 7pm in the Walt Disney theater at the Dr. Philip center in Orlando, Florida. Tickets start at $15 just $15 Can you imagine a night out for 15 touched by type one.org go support a great organization. See some wonderful dancing. You guys might remember from years ago touched by type one used to be called dancing for diabetes, but they realized one day they're like we do so much more than dancing. We need a new name. Anyway that's not the point you know they're touched by type one now but dancing for diabetes. Etymology just wanted to let you know blah blah blah go see the thing stop messing with me. Don't make me say this over and over again. Touched by type one.org etymology entomology What is it when the history doesn't matter? No. g vo hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about all you have to do is go to G Vogue glucagon.com forward slash juicebox g Vogue shouldn't be used in patients with insulin Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk I too cannot wear a bikini Well okay, I have questions where my questions there about so when you had someone come over to watch a kid for a night what you really needed was for them to also pump for you and take care of your blood sugar so you could do at two minutes or three different things going on.

Unknown Speaker 23:23
Yeah, and in fact, the kiddo was probably like the least of it because at least I couldn't feed them and go back to sleep but you know the blood sugar thing wasn't just high or low I mean it was like a roller coaster all the time. I just um yeah, I had challenges and luckily my undergrad my endocrinologist at the time. In fact I think I found him I had like a real nasty and archeologists I I live in Nashville, Tennessee and when I first moved here in 2014 I just found one that seemed like was a good one and she ended up not being one and then you know I kept trying to find the right one so it was kind of like this revolving door. I mean, I wish that for all diabetic especially type one diabetics that there was like the the pediatrician interviews like when you find your pediatrician, you can go out and schedule these like 1520 minute interviews to see if it's the right pediatrician and I really feel like you should be able to do that for endocrinologist too. Because it was it was really challenging to find the right one and event there you know, I believe in signs and things happen for a reason and I was at a friend of mines birthday party and back when you had those things, and she there was another girl there and I noticed that she had an omni pod device on her arm. And so I started talking to her about diabetes under her knology or and finding the right endocrinologist. She Manjit oh and she also used to be an omni pop rep so she knew all the endocrinologist in the area and she mentioned the doctor that I see now and he's just been great like he's the one that said okay you know why don't you just wear you know the all your ads about just do the Omnipod trial so I was I was like okay this isn't you know so bad and then listening to the the loop conversations on the on your podcast I'm like that is what I need like I don't I need to figure out how to make this work so that I can sleep again and it was like light years change for me just to sleeping through the night and not having the Dexcom going off all the time.

Scott Benner 25:43
No kidding well it's so it's interesting too because you've had a long history with diabetes where you didn't have any of that technology where you could visually see it and then you bring the Dexcom in but you're still doing shots so the Dexcom to you in the beginning probably just felt like oh good a visual representation of how poorly I do with this is that how

Unknown Speaker 26:03
or no I wasn't doing so poorly I mean actually, I got on well I'm gonna say that and you're like well that sounds pretty poor but I was traveling so much for work this was in my late 20s I was traveling a lot for work like all up and down this was just nationally all up and down the East Coast and assassin for hire the actually people used you know would say make jokes about that just because I was flying you know diamond level or whatever Delta now and now of course because there's been no trouble for a year I'm just a peasant and coach but the stories of for my travels were one time I had them pick me up in the limo at I think it was a limo It was a car I mean still it was nice they like literally before everyone started you planing a guy in a suit appeared and he said are you you know Are you okay? And he took me down to this private car so I went down like where they bring up the luggage and they took me to my next gate well it only happened once but I mean at one point I was um

Scott Benner 27:15
you were you were going good there for a while now

Unknown Speaker 27:19
Now I don't want to travel because I'm just you know in like the middle seat in the back

Scott Benner 27:25
it's easier when someone else is paying for it That's for sure.

Unknown Speaker 27:27
Yeah, so well so anyways that you know I I was having I was going through this really rough time I mean not even looking back I wish that my endocrinologist at the time was like well let's look at your whole because I was on that I was on an injection so but it still they could have changed my basals and they could have adjusted maybe when I took the and you know split them up or something but I was having seizures my blood sugar was getting too low at like three in the morning and I was dead asleep so I'd wake up in this fog like even walk to the refrigerator to get something to eat and end up having a seizure in the kitchen. One time I hit my head in the bathroom and so I didn't want that to happen while I was traveling. Um there was a time I remember going from my hotel room not having a snack with me that was bad you know bad preparation which of course would not happen now. Um but I had to walk to the vending machine on like a different floor I'm in my pajamas in a hotel at like two in the morning I mean so I ended up getting on the Dexcom because of that and so that stops me from having you know at that time Gosh, I was having like had like 10 seizures and they actually thought that maybe I was epileptic so they did a sleep study and it was just bad basil control Yeah, that's really what it was and

Scott Benner 28:53
we go way too much Basal insulin without you using way too much basil and so on like what are the deck Yeah, I'm showing you

Unknown Speaker 29:01
I think that's what it was I honestly don't remember um, but with the Dexcom I mean that was also what years I remember that was like I was probably in my anyone sees then at that time was like 6.2 6.3

Scott Benner 29:21
you were low a lot though. Right?

Unknown Speaker 29:24
And I was low a lot in the middle of the night. Yeah,

Scott Benner 29:27
that's how you kind of you had cheated that they once a little bit the test.

Unknown Speaker 29:32
And then I got on the Dexcom and then I went from like a 6.2 to like a 5.8

Scott Benner 29:38
and you don't pass out anymore?

Unknown Speaker 29:41
I don't I don't think I've had a seizure since

Scott Benner 29:44
should we knock on something just yeah, I'll knock on wood somewhere. Want to be the one who's like, you know, like the sports announcers like that guy hasn't given up a touchdown and oh, touchdown like it I don't want to be the one to jinx you. Yeah. But but that's amazing. Just to have That well I bet you feel differently about being a robot now.

Unknown Speaker 30:03
Yes. Oh I when the technology isn't working like I've been having some Dexcom challenges this week and I've been on the phone with their support people with for a few days this week. I mean, I I'm so like, this is so critical to my well being and I think I was like a sob story on with their support. But I'm like, you know, I woke up with a blood sugar of 303 this a couple of few nights back because the Dexcom sensor, you know, the message that you get when the sensor is nearing expiration, um, like, you know, connecting, what is it set center morning, connecting in three hours, or whatever it is,

Scott Benner 30:46
and when it's over?

Unknown Speaker 30:48
Yeah, and it didn't connect all night. So my blood sugar, I had had a low before going to sleep. And then I ate some ice cream, which was also a poor choice. Knowing that I don't always get that exactly right. Yeah. Um, but you know, I had a dinner with a little bit of fat in it. And so that's what caused my blood sugar to go low, because of the timing of it, which is what I what I'm struggling with a little bit in this pregnancy right now is the timing of the insulin. And so I on top of the dinner, and then the ice cream, of course, my blood sugar Shut up. But anyways, I was on the phone with them. And I'm like, I can't be pregnant and have my blood sugar at 303. Like, this isn't gonna work. They were convinced that it wasn't a transmitter problem. And I was telling him it was a transmitter problem. So I ended up changing the transmitter and then everything was fine. I called them the next day. I'm like, Look, this needs to be fixed your if your transmitters aren't going to run for three months, don't have them at a three month term, so that my insurance only pays that have to be a two and a half months. Did they replace it? They did. They're sending me a transmitter and a sensor. Yeah, I

Scott Benner 31:55
found. What do we have something recently one of them got stuck. And they send us to, they're like, here, here's an extra one for the trouble. And I was like, Oh, yeah. And I was like, thank you very much. I've also had that where I took a sensor off one time. And I called in and I said, Look, I'm I know how to use these things. And this one doesn't work, you know, so we switched it. And I said, I'd like you to replace it. And he goes, Well, if you would have called in, I would have told you it was working. And I was like well, that would have run counterintuitive to the fact that I didn't have any numbers here. And I would have told you no. And he just like, like he pushed back. He was doing his job. You know what I mean? And I stopped him and I said, Listen to me, I am not on the phone trying to scam you out of a sensor. Is that what this is about? like is that what this line of questioning is about? I'm like, I know how to do this. I never call about replacements. We overall my daughter's Dexcom last 10 days constantly, which must infuriate people don't have the same experience. But we make it to 10 days all the time. We're really good at you know, sometimes it is user like, not error. But a little bit of anything gets bumped or something you just don't know like what you're doing. Sometimes you don't know how to like work things out. Like for instance, while you and I are recording. Arden is down to her last unit and a half and our pump. And like so we're getting every minute every ounce out of that pump. And you'll hear people say, Oh, my pumps don't last very long. Like, you know, like, you kind of get it after a while. So I just made the point that I'm like, Look, I'm like, just send me another one. And then he was like, okay, and you just realize like, it's his job to make sure you're not shaking them down.

Unknown Speaker 33:33
Yeah, like they see the medicine questions. Where do you have it? And like I have it in the same place. I always have it.

Scott Benner 33:39
Some of that's for the FDA. Yeah, those questions the FDA makes them ask some of them's for their own collection of data. And some of it's just to make sure because when you're when you're an honest person, you don't recognize how many people aren't, or how many people might be in a situation where they can't afford it. So they're just trying to get an extra one somewhere. Right, that that goes on constantly. Anyway, right? I'm glad they sent you on.

Unknown Speaker 34:01
Yep. I mean, I think that they're really great. And I want them to do as well as possible, obviously, because of you know, it is so critical to my well being and when I am with like in that the two hour window when it's warming up. I mean, I feel like I'm naked.

Scott Benner 34:16
Yeah. And that's something How long have you had it?

Unknown Speaker 34:20
The Dexcom or

Scott Benner 34:21
Yeah, CGM.

Unknown Speaker 34:22
So that was when I would have Yeah, late 20s. So it would be we have probably about 10 years now.

Scott Benner 34:32
10 years you've had it. Wow. So you had like the first Jeff Dexcom? Four or seven plus? Which? Where did Where did

Unknown Speaker 34:40
I Where did I start? I don't remember where I started. I'm on the six now. Yeah. Wow, that's

Scott Benner 34:45
crazy. I I listen, I have to agree. It's the single most important thing that we have. Yeah, and I want nothing but success for that company.

Unknown Speaker 34:55
I know. I know. And when I forget how I forget his name right now, let's just work. But the I think it was the CEO that you had on and he was shocked yes Kevin how I'm having folks in the hospital where I think it was you know around COVID and all that and how how great would that be for those folks that are in there to be on a Dexcom rather than getting finger pricks would be incredible and connecting that into which is my line of business into the electronic medical record in the hospital so that the you know nursing and staff are just getting alerts in the same EMR that there yeah, that they are getting alarms for everything else and so that they see those trends would be incredible like you know, BM for people on steroids that does such a you know has such an impact on your blood sugar's and I'm just getting a spot check every once in a while we know that that's not effective I

Scott Benner 35:55
always think through that that that exact scenario is such a great backdoor way of training medical people about how insulin works and what it looks like for real to have type one diabetes or diabetes of any kind to be able to really see blood sugars you know how valuable that would be to a nurse they how much they learn from watching your blood sugar's then what they can apply to the next person that they met. Exactly Yeah, it would be such a big deal I oh

Unknown Speaker 36:18
my gosh, I remember I cannot remember which kiddo it was but

Scott Benner 36:23
you've passed out 10 times in your life

Unknown Speaker 36:26
so there was one after we're having one of the kiddos they had me Oh I know it was the first one because that one I actually you know went through a long labor and all that but they hooked me up with what you know whatever glucose to give me to keep my blood sugar from going low because it was an eating all that and after having the kiddo and then after you know eating and getting that on they never turned it off. So then of course I spiked um it's like come on, come on people.

Scott Benner 36:57
Now they don't they it's hard to get them to understand I just interviewed somebody yesterday who is a fairly newly minted CDE who says they work at a really great institution and still the level of what people don't understand is shocking. So hey, um, is there any chance you heard the pro tip that I just put up with Jenny about postpartum no not yeah I'm just thinking as I'm as we're talking I'm like I never do this but I should have sent Kate an email last week and said hey, can you listen to this ahead of time but

Unknown Speaker 37:28
yes oh I will I'll that'll be my priority today at some point to listen to that because that is just where I struggle.

Scott Benner 37:35
Well you have so you've had this is your third right and first pregnancy MDI?

Unknown Speaker 37:42
Uh huh exactly Yep. And then and it was and here's the reason I you know, I stayed on that throughout even the next pregnancy was because I think my agency was like 5.2 at the end of the pregnancy and so my good my maternal fetal medicine my high risk ob I mean she was like if this is this is working let's not change it I'm not gonna afford to you know ask you to go on the pumper change anything if you're doing so well in fact my husband was like, we need to just keep you pregnant. So yeah,

Scott Benner 38:16
he was kidding

Unknown Speaker 38:18
yes and no thank you like the getting their pregnant the trying to

Scott Benner 38:23
get pregnant tell him we can do that without me having to carry baby for night? Or honestly, is he not allowed to do that unless you're making it No,

Unknown Speaker 38:31
no, no, but um yeah, who knows who the listen to this of parents or you know whatever will listen to this but he's kidding

Scott Benner 38:41
when I say that you're saying personal people in your life you don't want to think you're not putting out is that what this is a very 90s way of thinking about it you know, the kids don't think about things it's much more fluid now. It's it's not your job to give anything away. It's his job to earn it from you. What do you think for a while, and that's not how it works. Anyway, if your parents are listening Hi, what's up?

Unknown Speaker 39:09
Yeah, so yeah, and talking about parents it's funny because you know, my first pregnancy I told my mom You know, my mom is a labor and delivery nurse and so she sees pregnancies that don't go well or deliveries really that don't go well. People that take care of themselves and people that don't and how things can go south and I think my mom is still or was anyway still in like Steel Magnolias days and that you're, you're gonna have a baby and you're gonna die. So the first pregnancy was went so well. I mean, it really became like a second. A second job full time job, though, and managing my blood sugar's to keep to be at that 5.2 um, a lot. I mean, at the end of the pregnancy, it's just so many physician appointments. I'm staying on top of the blood pressure. And all of that and then of course the postpartum challenges which I'll listen to that episode with Jenny. And she's great. And I've learned a lot of things or at least that like validate some of the challenges I have so I don't feel so alone and you know some of these things

Scott Benner 40:16
yeah, I can't tell you how often I hear that. That was another thing about the podcast I didn't expect like I expected to tell people things that they didn't know. And that happens but I never expected that just saying something that somebody would go Yeah, that's been my finding to how valuable that feeling is. I didn't I didn't recognize that at all. And Jenny is terrific. But yeah, so so the first pregnancy goes well you're on MDI you've got a nice low a one c so it goes well on paper but Did it go well otherwise fetal birth weight was where you wanted it stuff like that.

Unknown Speaker 40:49
Yeah, everything was really great I mean I did have a like a 13 hour labor and which you know I even got to the point I was having contractions I think like every two or three minutes but baby's heart rate kept falling down and so when that happened like the third time were dropped substantially the whole team came in and said okay, we're moving into an emergency c section and so that was it and then um, but baby was healthy I was healthy I just I just had some challenges with like the roller coaster after baby and that and that baby was also sleeping through the night at 11 weeks so that was perfect to and that is extremely helpful in getting better and like being more stable when you're up every like two to three hours it's hard to to know which way is up or down.

Scott Benner 41:42
You find your intern insulin needs change almost immediately after you deliver the placenta

Unknown Speaker 41:47
yes and so they want to say they drop it by half almost I mean almost really to back to where you were pre pregnancy

Scott Benner 41:56
that's exactly what Jenny said when we when we did that episode, but there

Unknown Speaker 41:59
is still so much fine tuning because of course you're like burning those calories not sleeping but you still have you know one of the other surprises for me was like I thought when you delivered baby that your weight was going to go back to normal and that doesn't happen right away which seems so naive now but yeah, it was still like I had a baby in there so there was still a lot of weight to be lost and I was very committed and motivated to lose that weight so I wasn't I mean by the end of my maternity leave I mean I was back down to my normal weight and then eventually even because of the breastfeeding was down below it so they're worse I mean when I lose a couple pounds like I need to be adjusting my insulin right? And that was so hard to see postpartum exactly what those weight losses were on a daily basis and so I struggled there.

Scott Benner 42:47
Let me stop you make sure I understood what you said. You mean normally when you're not pregnant if you're losing weight, that means your blood sugar's are a little high.

Unknown Speaker 42:55
When I'm losing weight, well I guess depending on which way you look, if I'm gaining weight Yes, if I gained a few pounds, it does have a big impact on my my blood sugar's and same with the losing although these days I'm not really losing as much.

Scott Benner 43:13
How are you right now?

Unknown Speaker 43:15
Well, just in general, I'm not losing much but let's just

Scott Benner 43:18
I'm the third pregnancy Kate, how pregnant are you right now?

Unknown Speaker 43:22
nine weeks Oh, yeah,

Scott Benner 43:23
you can't lose weight now you're making a baby.

Unknown Speaker 43:26
Yeah, you're not I'm not trying to lose weight. But

Scott Benner 43:29
I was wondering if you were saying that high blood sugars were putting you in like a ketone situation and that's why Oh,

Unknown Speaker 43:36
no, I'm not that high. Okay. Oh, yeah. Well, I mean, high for me is you know, I don't I don't want to be going above 160 Yeah. So first pregnancy went so well, we decided to get pregnant at when our first kiddo was eight months. So we found out we were pregnant with our second when we you know, had an eight month old so they're kind of 18 months apart.

Scott Benner 44:01
Let me do a little detective work here. So and we're not going to say your last name, but your last name makes me feel like your husband is Catholic. Am I right?

Unknown Speaker 44:09
Um, I do not have my husband's last name. Okay. But yes, I was raised Catholic, but my husband was raised I believe Protestant.

Scott Benner 44:18
Okay, so it wasn't just that like we need to Pisco, paleo and I mean, okay, so you're not just trying to make babies because that's how things are done. Well,

Unknown Speaker 44:25
oh my gosh, but the very Catholic part of my family. I have a one she's a second cousin and they have 11 children. Oh, my, my mom is the oldest of seven. Yeah, there's a lot of mother kiddos and baby

Scott Benner 44:39
making a lot of tired uteruses. I would imagine. Yeah.

Unknown Speaker 44:42
I mean, how do they do that? I have no idea but

Scott Benner 44:45
basketball I would imagine. just silly putty. So okay, so you You're joking, but it went so well. You made another one. But are you not joking? Is it a bit of your age, you're like, Okay, this worked and are older so nothing

Unknown Speaker 45:01
yes there was that component to it and also just liking the idea of having kiddos closer in age to

Scott Benner 45:09
yeah it's love having kids that was that if I could go back to that spot in my life and not have all the like tired and indecision like if I if I could now somehow be younger with what's in my head now I would love to raise a baby again like I know like I really feel like I know what to do now and I would really know how to absorb like the great parts of it you know and not be so like worried all the time about stuff and you know

Unknown Speaker 45:37
worrying about sleep deprivation I mean it is a big deal a big challenge

Scott Benner 45:42
yeah I even like I look at them and immediately I'm like oh my god I gotta pay for college they don't even care and you're like how are you gonna pay for college? Like I start thinking about that right away but now I really did love it but okay so your second baby comes similar experience or no

Unknown Speaker 46:00
second baby was a little bit different like the pregnancy was similar It was not you know my a Wednesday at the end of it was not 5.2 it was closer to six and that could be also because I had like another baby at home so I didn't have as much time to devote to that second full time job of managing blood sugars so and it was a scheduled c section for that one because of the risk of like a uterine rupture having been so soon after the first c section

Scott Benner 46:36
was that just timing was that your age or was that diabetes? Was it a combination what was that concern from just

Unknown Speaker 46:44
because of like the first c section scar not are not scarred but the first c section not has I mean they say to wait like 18 to 18 months to two years to get pregnant again after a cesarean section and we waited eight months

Scott Benner 47:02
why was the first one c section

Unknown Speaker 47:04
because his heart rate kept dropping and so they they were like because my contractions were you know every two to three minutes they actually had to slow him down at one point because of the heart rate challenge but there was no point I was ever going to get my water at already broke and my there was no point I was going to be able to get to the point of even pushing because of the heart rate

Scott Benner 47:24
I'm sorry I know you said that I just ate it slipped out of my head for a second I want to make sure

Unknown Speaker 47:28
yeah that's okay i mean for me it's like it's so it's like a matter of fact so maybe I didn't say you know all the details but yeah that's why that that's why that happened so you know I'll never have that normal delivery but at the at the end of the day it's just important that you know baby's healthy and I'm healthy and all of that so um second pregnancy not as controlled baby was a little bit bigger so our first was like seven pounds whatever else is normal and then second kiddo and I think that that did have a large part because of my control was eight pounds I want to say something like nine ounces or something like that

Scott Benner 48:16
yeah there's the component to your blood sugar and the birth weight of the baby yeah okay

Unknown Speaker 48:21
interesting when they are tracking it because you know they do all the sizing a lot of sizing every like almost every other week or every week and the at the end of the third trimester and they had they were tracking me at like seven pounds so they didn't foresee that but of course that's they're doing the measurements via the ultrasound so they don't really know for sure but yeah, he was a little bit bigger Okay. Um, the interesting thing that happened with that postpartum Of course I had the same I had similar challenges as before but I was a little bit more aware of them so I think I was handling them a little bit better but what happened next was just totally off the wall and not expected so and you know, similar to any mom postpartum, I was extremely exhausted and tired. And after getting baby down for the night, I wanted to go to sleep so it's like 7pm because that would be my longest stretch of sleep so maybe for like, five hours or something like that. And I started getting ready for bed and I just started to feel like really lethargic and tired like so tired that I was holding on to the wall to get to the bed like I couldn't really hold myself up anymore. And then I got into bed and my hands were tingling a little bit and sometimes that happens if like if I My hands are cold, I'll lay on them a little bit to warm them up. And so I was like maybe I was laying on them funny. And then my feet were tingling and I'm like okay this is really weird I just don't feel right I look at my blood sugar and like okay it's not low yet but it was kind of on its way there like maybe in the 70s like maybe I should just have a couple cookies and then I'll I'll start to feel better so I had those I was in bed for like 45 minutes and I just couldn't fall asleep so I my husband came up and he was actually packing and getting ready to go on a trip and we both traveled a lot for work at that at that time. And my sister luckily was there who had just moved back from the Peace Corps in Liberia and so she was staying with us I think for three weeks and he came up and was talking to me and he was like oh my god I'm gonna go get you some more orange juice and cookies and so he brings up orange juice and cookies oh this point this will sudden my blood sugar you know skyrocketing but I'm doing it because something isn't right. Yeah, and then I you know, I'm talking to him, but he can't understand me. So he goes to get my sister and she comes up and she's like, this isn't right. So they immediately call my stepdad and he's like, if this isn't her blood sugar This is neurological and she you need to call 911 and get her into the hospital so at this point, like I am coherent so of course if your blood sugar is so low that you're you know you're incoherent you don't remember any of that. I am remembering everything very clearly. I hear myself talking and it's like coming out slowly and the thought process is slow I can't hold my arms up I can't get out of bed. I know something is really wrong and the first thing I think of is like am I having a stroke like this is what I've heard of all the signs and Is this what this is Yeah, so they call 911 the ambulance comes they do these did they do the test I don't know if they did the test in the in my in my bedroom at that point um but they were convinced that I was not having a stroke that it was just a low bloodwork because at this point my number was low even though I'd had and that was the weirdest thing it took my blood sugar forever to come up it wasn't even until after I was in the emergency room after some time that my blood sugar finally came up and so they were convinced even then that it was a low blood sugar but the two you know coincided for whatever reason. Um, but yeah, I remember Gosh, even like when my husband was they were there the EMTs were like, what do you want to cuz I'm in my nursing pajamas. They're like, what do you want to get something to wear to the hospital and my you know, my husband goes to kidney clothes and he actually gets my clothes or his clothes for me. And

Scott Benner 52:59
boy, so I am most useless most of the time.

Unknown Speaker 53:02
Yes. So in my so I'm saying this out loud. Like I had a more at home, like get me my clothes, but no one can understand what I'm saying. No kidding. Um, it was so frustrating. And I remember like trying to signal like what I wanted to say and I couldn't so he ended up just giving me my bathroom. So I'm wearing my PJs and bathroom to the hospital.

Scott Benner 53:24
But he has a blazer and a change of pants. So that's it.

Unknown Speaker 53:29
So luckily, my sister was there she stayed with our first kiddo and the ER Well yeah, because we ended up bringing baby because I was just two weeks postpartum so that I could breastfeed so baby goes with us to the hospital. And in the emergency room, they give me like, I don't know what it's called. It's like dextrose like 8000 or something. Like you actually like feel it go through your body. Yeah, and I was like, Why don't people want this like before like a softball game or like a tennis match? This is incredible. Um, but yeah, then I was my blood sugar was high for like, the next 48 hours because of all that stuff that they you know, that I had had already and that they had given me and then that's when they brought in the neurologist and started doing all the tests for having a potential stroke. And, you know, I they found out that I had a Tia. So a trans ischemic attack, like a mini stroke. And what they do for that is they give you if you're within the three to four hour window of having it, then you can take what's called a TPA, and it's a risky drug and that if you do have any sort of bleeding anywhere that you know could kill you. So we had to have like a quick group family grouping in the hospital like Should we do this or not? And you know, they had done a CAT scan and didn't see anything. So we opted to do it and then had to stay in ICU for a few days for observation and and you know, everything ended up being okay. So of course they tried to find out, you know, why did this happen? And they did an invasive Echo, I think, and which they gave me the, whatever the drug that Michael Jackson was taking. Yes, in order to go under for that and I'm like, Oh my god, this is the best nap I've had in a long time.

Scott Benner 55:36
Excuse me. No, wait, that's a beta blocker.

Unknown Speaker 55:39
That's not what was the first one you said?

Scott Benner 55:42
Oh, hold on. Let me just type in Michael Jackson juice and see what comes up. Yeah, proof propofol, PR Yeah,

Unknown Speaker 55:51
that sounds great. Okay, so they checked for that and that all looked good. They did a bajillion MRIs and didn't see anything so every you know, I was leaving there knowing that there wasn't there wasn't any damage from it which was great but also not knowing why it happened and so the last thing that they were going to test what they're gonna do a blood clotting disorder panel but they couldn't do it so soon after having the baby because it could come back with like a false positive and so I had to wait I think another four weeks or it was like at four weeks I went and did that and they come to find out I do have a blood clotting disorder called pro thumb and vector two and so of course pregnancies and surgeries both of which I had had are super high risk and also along with long trips in planes and in cars which I had done often I mean I was on like a monthly 10 hour flight to Chile for like the last two years at that point Um, so luckily that didn't happen on the plane where you know people would have thought that that was just kind of like how I talked or you know, that was normal for me What's that

Scott Benner 57:17
the clotting disorder called

Unknown Speaker 57:19
pro thrombin factor two

Scott Benner 57:23
is that better news then I might have a stroke later in my life

Unknown Speaker 57:30
well what that means now is that and I think you can have that I mean, you could actually have that your entire life and not know it. Um, what it means now is that I have to take a baby aspirin every day um and now and also what it means during pregnancy which I you know, I have a you know, I had to talk with my high risk ob prior to trying to get pregnant to make sure that it would be okay that I got pregnant so not only am I type one, but now I have this other condition and then 38 and she was like, Oh yeah, we'll get you on blood thinner shots and you'd mean you'd maintain those blood thinner shots throughout the pregnancy and as well I think through six weeks postpartum and I have plenty of patients that are profound in factor too so if she was not worried and she's like the best of the best Um, so yeah, so I've started taking Lovenox shots once or twice a day one in the morning one at night. And I mean, I don't I'm not worried. Of course my mom who was still on Steel Magnolias

Scott Benner 58:39
days dead 10 years ago so I mean, she

Unknown Speaker 58:43
was begging me to never get pregnant again and actually it was like well what why would you even do that and of course I don't want to die so you know I've been very diligent and researching and going through and doing all of the right things and really trying to manage the blood sugar hence my call to death or my calls to Dexcom about the the needing for the things to work because you know I don't need any more challenges here Um, so yeah, so that is that's that

Scott Benner 59:14
that's amazing. That's it really is like a whirlwind like your life feels like if it goes 100 miles an hour since you were like 18 years old.

Unknown Speaker 59:27
Do you have Oh, you only have one life well

Scott Benner 59:30
you're getting your you're getting your mileage out of this thing Okay, so right now you're in this third pregnancy all this has been true the nine weeks is the first trimester Is this the part where it's not too tough yet blood sugar wise?

Unknown Speaker 59:47
Well it should be it's interesting I you know, I it's crazy because you know, our kids are only three and two still so it's not like it was that long ago but I think you probably know after having kids that your memory just goes,

Scott Benner 1:00:01
we wait last night, I was working out in the basement and Arden was walking on the treadmill. And she said, Have you noticed mom's getting a little old as she points to her head? And I'm like what she does, you probably don't notice because you're married to her and your lover, but she's slowing down a little bit. And I'm like, wait, what's going on? She goes, You are too but not as bad as what is happening here. She's not as sharp as you used to be. And I was like, but I know more now. And she goes, it's unfair, isn't it? I said, Well, yeah, it is. But But she notices it. And I do too. There are sometimes I reach for words, and they're not there. And they are words I know. And I commonly use, and I'm a person who talks like a million miles an hour, so you might not notice it. But in any hour of this podcast, I have to choose a different word three times because I can't find the one I want.

Unknown Speaker 1:00:49
Right? And then you didn't tell her it's all because of her.

Scott Benner 1:00:52
Yeah, Oh, don't worry, I immediately blamed her. Are you kidding? I immediately, I was like, given the idea how rested I would be without the two of you.

Unknown Speaker 1:01:01
I think I mean, it'd be interesting to know the poll on folks that haven't had kids like, do they get gray hairs later in life than those that do have kids because I honestly think that that's the main cause.

Scott Benner 1:01:15
The first time you get a white hair inside your nose is come to Jesus moment. I'm not very young. And my vision is now I had perfect vision my whole life. And a couple of years ago, I suddenly needed reading glasses. And last night, my son says, I need to throw a little bit like can we go outside? No, I'm like, Yeah, sure. So keep in mind, I'm going to be 50 in a couple of months. And he plays baseball in college. And so I got my glasses. Oh my god, I look up at him. He's blurry, right? He's 50 feet away from me. I can't focus on him. The balls coming in, like a meteorite strike, I can't see the roundness of it anymore. And I'm catching it in front of my face over and over again. I walked inside afterwards. And I said to Kelly, I'm like, I gotta get glasses. Just have a catch with him. Yeah, I was like, because he's gonna kill me with that ball. Like he's just tossing it to me, that kick can throw a ball over 90 miles an hour, like I'm gonna eat it at some point. And I can barely keep up. Now. It's either

Unknown Speaker 1:02:15
get glasses or get like the full catcher's here.

Scott Benner 1:02:20
But I'll make another person catch with him. Like, I'm gonna hire a person because there is going to be a moment. I already can't throw to me at full speed. Like, that's just we stopped doing that a number of years ago. I just like you can't do that anymore. I can't react that quickly. But it's the it's the telling your son that. That's disappointing.

Unknown Speaker 1:02:41
Yeah, that I'm almost 50 and sorry, you have to be a little bit more delicate.

Scott Benner 1:02:46
Be gentle with me. Yeah, no, and he doesn't see anything special about people listening to understand know that he throws a lot harder than most living people. But the point is, is that he doesn't think of it that way. Yeah, he thinks of it as I am at this level. And this old guy can't keep up with me. And apparently, the witty banter that my wife and I are feeding to Arden is not quick enough anymore.

Unknown Speaker 1:03:10
To pick it up or not.

Scott Benner 1:03:11
Well, and how am I going to do that? I'm exhausted. Yeah, exactly. Anyway, yeah, I really want to keep in touch with you because I feel like when that kids 20 you're going to have like abandon the minister By the way, you're gonna have just like, left them somewhere by mistake. You know what I mean? Like, oh, mommy didn't leave you at the Strawbridge and clothier on purpose. But I needed a break. Cuz I'm 50 because you're gonna be 55 when this kids what like know what will I be? I'll be 13 they'll be in their teens. How old Will you be when the last one graduates from high school?

Unknown Speaker 1:03:47
I don't know Scott. Don't make me do that.

Scott Benner 1:03:50
I just want you to cry once while we're doing the pocket.

Unknown Speaker 1:03:54
Please now Yeah, too old too. And I think about you know, because I'm fairly certain This is going to be a boy and we have two boys already and that in itself, you know is called the gray hairs it's I love the boys. But they are a lot of work especially when they're younger. Yeah. Um, girls

Scott Benner 1:04:17
don't become trouble until they're teenagers right and you're gonna trouble it's just it's, it's that's where their hard part comes in. And boys are just like, they're like rockets that are untethered, and they just keep going off all day long.

Unknown Speaker 1:04:32
Yeah, so right now I'm like a jungle gym. I mean, they're like punching me climbing on me hitting me screaming running around like there's no calm moments. I feel like that our friends have little girls are like playing with their dolls and it's all quiet and peaceful. Like we don't have that.

Scott Benner 1:04:49
Run around the house in full costume. Sometimes he would be mortified if he knew I said that. But he had a spider man costume that he would just wear when he was like three years old.

Unknown Speaker 1:05:00
Little our oldest has like a superhero everything so he'll have different superheroes on and his underwear and socks on his shirt. He has a cape that he wears around the line he's really in the superheroes too as

Scott Benner 1:05:15
well but I know the part like my wife has said to me She's like, you know, I probably have been hit in the face by the kids a half a dozen times. So I like like heart and they don't do it on purpose. Like they're swinging their hands around or something and you're just like, you'll walk into it or something like that. Exactly. Yeah, it's really something but is it great? Like if I can get away from the the tone of the conversation and ask you a question. You waited until you were a little older? You had a full life when you were younger you were more prepared like probably emotionally and financially I'm guessing everything Did you do it the right way for your money? Do you feel good about it?

Unknown Speaker 1:05:49
Yeah, I think so. I mean, I think as a diabetic you always just have to think about like how I think maybe how well your body can recuperate after having kiddos so late and that's my only you know and Adam and I set a name when my husband and I got together we you know we said oh we want five kids so you know that Catholic background in him I only having one sister and they're 10 years apart It was like he was an only child and he loves going home and being with my family and it's a huge family and it's a lot of fun and so he wanted a big family so that I but because of the timing it just wasn't gonna happen there's no way I could have two more kids and we could adopt and we've we've talked about that but I just think because of age it's just not it's probably not going to happen and of course I've always wanted that little girl but I don't think that's going to happen either. I think I'm destined to just be a boy mom but don't fall

Scott Benner 1:06:43
into that trap like don't fall into the like we'll just give it one more shot you'll end up with four years yeah, we're three boys and one girl who just looks like a deer in headlights for 10 years.

Unknown Speaker 1:06:54
Yeah, exactly. So who knows? Yeah we'll see it could be all no I think next week for sure.

Scott Benner 1:07:03
Looking like a boy is it like an ultrasound?

Unknown Speaker 1:07:07
Oh no next week I get the lab work that'll tell me for

Scott Benner 1:07:10
sure. Okay, but did you but a minute ago you said like you think it's going to blue is it just because you think you're just gonna have a boy is for some reason

Unknown Speaker 1:07:17
well there is this test you can take and right now I'm forgetting the name of it, but it's you can take it at home which of course is like a finger prick for us diabetics that's no big deal. And it just you know you have to have a clean area because what it detects is male DNA and if it detects male DNA then it's a male if there's no male Why did chromosome found in it then it's a female you're supposed to do it at you can do it as soon as eight weeks that's when that Y chromosome can be detected and we had a strange week in Nashville we actually had snow and our kids were home and we were able to go sledding that happens like every five years here and I had ordered the test in advance so that I was ready to go right at the eight week mark and I just lost I ordered it and had it there and I did it a week early I just lost track of time and thought this is the Saturday I do it. And I realized that after I did it and packaged it up I was like oh my gosh, I wasn't supposed to do this for another week. So I really did it at seven weeks. So I wrote them and I said hey, you know I accidentally sent this in early I don't know if that's going to be like legit still valid and Should I get another one? And they're like well you know you'll most likely get so they responded to the same day or at least I saw the response the same day I got the results and they're like most likely you are going to get a girl result because it doesn't detect the male chromosome or Yeah, the male DNA until eight weeks or that's at least when it can be guaranteed. And if you did get a male result then it could be what was it could have been compromised are the word I'm looking for. I'm drawing a blank on right now but it could have been

Scott Benner 1:09:19
like whatever, like your husband touched you or something

Unknown Speaker 1:09:22
like that. Yeah, like in that was why it was so specific. Especially because we have even now even our dog is a boy. So they're and they said that, you know, even pets can you know be part of that male DNA. And if they detect that then it will show that it is a male. Um, and you know, the only thing that I did that could have potentially contaminated that's what I was looking for. Is I you know, I washed my hands numerous times, but I dried my hands on the towel that we all dry our hands on.

Scott Benner 1:09:56
So the test came back that you're having a Schnauzer, is that right?

Unknown Speaker 1:10:00
A golden doodle

Scott Benner 1:10:03
I wouldn't have said that out loud but I hear you

Unknown Speaker 1:10:08
My husband is convinced I mean it's my He is my favorite guy in the whole household He is my easiest easiest person to deal with in this house. Although not really a person but here's here's my favorite it's gonna say so yeah so if you know but even then I drive my hands on that towel but then I use an alcohol swab for where I was pulling the blood from on that finger

Scott Benner 1:10:33
so you would say okay so what does it did it come back and tell you what

Unknown Speaker 1:10:37
boy came back and told me boy Yeah, you're just

Scott Benner 1:10:41
trying to hold out hope I hear what you're saying. It's the dish towel hope Yeah, I am I'm gonna start betting I know which way I'm gonna put my money down so I'm good yeah maybe you guys just make boys

Unknown Speaker 1:10:53
that and that's exactly what our doctor said that you know some people you know the males they just have male chromosomes I guess is you know that's what they contribute and that's that's it so I think that that's Adams

Scott Benner 1:11:07
oh just have seven more and one of them will be like please don't yeah like I just I could you afford to like keep making babies or like At what point would you just say to yourself like financially I can't do this like

Unknown Speaker 1:11:18
I have not done that financial analysis but I wonder that like you have to make a lot of money to do all of that Yeah,

Scott Benner 1:11:27
yeah the the the range for college right now is Community College three to $5,000 a year up to what is this Hold on a second this isn't supposed to happen? Give me one second

that phone is not supposed to run through it can be from like three to $5,000 per Community College up to there are some private colleges that cost $75,000 and I'm not saying you need to go to one of those I'm just saying that if that's the range

Unknown Speaker 1:12:07
well that's well that's when you have to bank on your kids getting financial scholar or academic scholarships are

Scott Benner 1:12:14
but there's a certain amount of money that you make and if you make that amount of money then that's not going to happen either and it's just it's a maddening world to be in and then to have your kid come home from college and go oh, that semester was a waste of time and you're like Wait, why?

Unknown Speaker 1:12:30
Yeah, what about the X amount of money I just spent on whoa whoa, no,

Scott Benner 1:12:33
no, no, no, go back and learn something. Yeah, it's a it's an that was I can remember when we had kids your kids age which is so weird because I'm not that much older than you but the amount of money we thought was going to send them both through college ended up being the amount of money it took to get one of them through college. And now Arden has let different designs on college which might end up being cheaper and helpful very much but if they both went to the same type of institution we wouldn't have we wouldn't have had nearly enough set aside and still you know you're taking out loans and it's just a disaster. Anyway Good luck.

Unknown Speaker 1:13:19
We started with college fun for both of them hopefully that'll get us through right

Scott Benner 1:13:23
now it'll be it'll be the money you throw at them and good luck we had good intentions Good luck with this. Did you enjoy soccer when you were seven then shut up?

Unknown Speaker 1:13:36
Yeah, right now we're in swim lessons and it's just yeah, I'm not looking forward to all the the carting around to all of the activities

Scott Benner 1:13:43
you sometimes you fall into a thing he just kind of become the people that do the thing like baseball, and softball ended up being what happened around here. But you know, it could end up being anything maybe you just have like maybe the kid will just be like I would like to sit in the house and play chess. I hope not know what if they do what if they're anti Kate? I don't know what if you're like we're going to prove and one of your kids is like, No, we're not.

Unknown Speaker 1:14:10
I also I also wouldn't mean knowing that that's what I did. I also wouldn't want my kiddo to be like I'm going to Peru it's just scary and the things that happened to me there too. I didn't even get into that but um, yeah, that is scary too. And like the letting go of you know, being the parent. And them growing up is got to be really challenging, but we've got some time before there.

Scott Benner 1:14:34
Yeah, find finding the balance between what you were okay with for yourself and what you're okay with for them is tough. Yeah, but you have to try to remember that the things you did probably turned you into the person you are and if you stop them from doing stuff like that, then they'll just become some homogenized version of themselves. Right, you know, but how do you not worry about them? Like do you know I think I've said this in the podcast once. Maybe I've been a day driver of an automobile since I was 13 years old. Because I grew up in a house with a mom and didn't drive and my dad left. And we

Unknown Speaker 1:15:08
Yeah, I think I do remember listening to that. If

Scott Benner 1:15:11
that were true of my kids, I would be out of my mind.

Unknown Speaker 1:15:15
Mm hmm. Right? Gosh, I can't even I am not looking forward to the day that we they are going to be driving a car. I've also been in some really serious car accident. It because of other people on the road, never my own fault. And that is also terrifying.

Scott Benner 1:15:32
They drive away the first time and you think oh, so I put 17 years into this, and now it's gonna die. That's exactly how it feels when they drive. Yeah, that's terrible.

Unknown Speaker 1:15:42
I mean, I think but at the time, my kids are driving, we might all have like self regulated, you know, hovering cars. And you know, the statistics of how many people have died in car accidents is going to be a distant. Yeah, it'll be back where they're like, Oh, my gosh, I can't believe that many people died from car accident. They'll just be something

Scott Benner 1:15:58
new to worry about. Yeah. Do you know how many days of my senior year of high school I did not go to school? No, yes. How many? 3052. I just went to work and said like we were broke, and I needed the money. So I'm just getting up in the morning and go to work. Wow. And the place I worked was like, Are you allowed to be here? And I'd be like, Yeah, sure. It's good. Don't worry. Just Yeah, that was it. And that was in the 80s. Whenever they were like, Alright, me if he's gonna work, I ain't gonna say anything. And, and that was sort of the end of it. But if my children missed a couple of days of school every year, I'd be like, Hey, we got to really rethink what's going on here. So yeah, you know, it'll be something it'll be something else like, you know, I agree with you like cars are probably going to be self driving, and there'll be algorithms that keep us from bumping into each other and then it'll just I don't know, who knows,

Unknown Speaker 1:16:53
but who knows what it will be them I can tell you this.

Scott Benner 1:16:57
After living this year in my house, all of those possibilities are preferable to not Yeah, I would rather I would rather live a life of risk and reward then a life of no risk and staring at this wall.

Unknown Speaker 1:17:13
Oh, my gosh, I I remember listening to a podcast I don't remember which one it was that where you were talking about like how you had to go in and pick up your food but you forgot your mask. Maybe it was like Arden had a low blood sugar or something and and you needed to get the food and there was a lady in there that your people that were looking at you like you're a Martian from outer space because he didn't have the mass which of course is normal anywhere now, and I'm guilty of it too. And especially now because I'm pregnant. Um, but yeah, it's just so weird. I cannot wait for it all to be over and where this is like a distant horrible nightmare memory. Yeah, my expectation

Scott Benner 1:17:53
here is that vaccines rolled out farther and farther. The weather changes and that pretty much changes people's focus. And then I don't think personally again, like I'm all for doing whatever is valuable for people like I really am but i don't i don't know i can't imagine what would have to happen to talk people back into their homes for an extended period of time again,

Unknown Speaker 1:18:22
yeah, or to wearing masks forever.

Scott Benner 1:18:25
Yeah, it's funny like there's part of me that's like I can't wait to not need to do that anymore. And there's part of me that's like you know, I didn't get sick at all this year. Yeah, I have kids either as incredible Yeah, like maybe I would put a mask on at the grocery store still if I didn't need to or something like I don't know what I'm going to end up doing like once this part is passed,

Unknown Speaker 1:18:45
but or maybe more antibacterial whenever you go out I don't know

Scott Benner 1:18:49
like I don't do the hand sanitizer as much as I did in the beginning I just cover my face in public and I have not been I haven't even had like a cold in a year.

Unknown Speaker 1:19:01
I know I know. And with a three and a two year old and then being at school I mean we were going through cycles of colds like all the time well even like one time our oldest got him foot mouth This was when he was like I think a year or nine months or something like that and my husband got really bad like blisters all over his feet and hands and throat and um but yeah, whatever the end like the stomach virus when that goes through the house. So yeah, this year was pretty incredible. Not being sick, but then like who cared. We were all at home in our sweatpants anyway.

Scott Benner 1:19:36
Yeah, I might rather have the flu.

Unknown Speaker 1:19:39
sustain that for another year

Scott Benner 1:19:41
hand foot mouth is what proceeded Arden's type one diagnosis.

Unknown Speaker 1:19:45
And so do they think that that can or they you know, is there

Scott Benner 1:19:47
nobody guesses but I mean, it threw her auto immune system into overdrive and it didn't get rid of the hand foot mouth. So yeah, you know it. She had an autoimmune immune response and if I look back now it I mean, that's probably what happened hand foot mouth, autoimmune response. And then like a month later, she had the hand foot mouth again and my doctors, like you're not supposed to get this twice. That doesn't make any sense. So it's possible that it never handled it the first time.

Unknown Speaker 1:20:14
Yeah, it's interesting. And you know, for the record, I was never sick before. Like there was never any sort of major diagnosis for me that

Scott Benner 1:20:23
stress or anything like that even. There was some stress

Unknown Speaker 1:20:28
to be there. Were there actually, some major stresses?

Scott Benner 1:20:33
Yes, I found it. You don't have to tell me what it is. But that's probably what happened.

Unknown Speaker 1:20:37
Yeah, like familial. Yeah. So could that be it? Maybe?

Scott Benner 1:20:43
Yeah, we think we think that a school stress might have flipped my son's thyroid around recently.

Unknown Speaker 1:20:50
Stress is such a bad I mean, obviously, you know, that's like the what that does to blood sugars. Yeah, I see that firsthand. But a lot of people don't know, like, what stress is actually doing to your body? Yeah, but at least we see that.

Scott Benner 1:21:04
No, I, I completely agree. Like it's one of those valuable spots where if somebody with type one can say knowing what's happening inside of your body is actually valuable in a lot of different ways. And most people don't get any view into that at all.

Unknown Speaker 1:21:17
That's it. That's for me, that is it for me, as well as like Chinese food. I just like I'm like, I can't eat it. Yeah, yeah. No, I don't know what's in it. It's hard for me to manage it because of the unknown. And yeah, I'm sure you know, if I wanted to spend some time and really like work on that I could, but it's not worth me. So I don't

Scott Benner 1:21:41
I wear a CGM one time. And it definitely pointed out a couple foods. I'm like, Yeah, I don't want to I just won't eat those anymore. Because my body doesn't do well with it. Yeah, exactly. And you learn that from watching Arden eat all the time, like what impacts you so harshly that, you know, I'm not worth it. Mountain of insulin doesn't help it, you know, you gotta make some choices. Well,

Unknown Speaker 1:22:03
well, and speaking about also with COVID, i, this might be interesting for the pregnant community. It's interesting. And, you know, the differing opinions on it, but you know, it's like my, my ob told me to go ahead and because I had a scheduled for a vaccine at the end of February, and I reached out to my ob, like, in the case I can get scheduled Should I go ahead and do it. And they of course, sent me all this literature from like a cog and all the other ob resources that said, Yes, go ahead and get it. Um, and then when I spoke to my maternal fetal medicine physician, who is like world renown, smart lady, she said, I had an appointment scheduled for the next morning, I was like, Hey, I think you're gonna say okay, but I just want to double check, like, should I go ahead and get the vaccine tomorrow? And she said, No, I'd wait until your second trimester. I know someone else that just is like nine weeks, just like I am. And she got the moderna vaccine, like they were pregnant, but didn't know they were pregnant yet. And it was like, so few weeks back, and she ended up in the hospital for a couple days. I don't I don't know the specifics of it. So I mean, it could be unrelated. Who knows? But I don't know that it is either way. I'm like, I don't know that. I want to be the first

Scott Benner 1:23:25
we'll find out. Yeah, that's where that data is gonna come from is that just these anecdotal things that end up getting reported? Because the, you know, the vaccines are out in an emergency, you faster authorization. So they haven't been as extensively tested as you would have to to have an FDA clearance. And so you're going to wait and see, and then it's going to take time for them to collect data and have better answers. Yeah, I don't.

Unknown Speaker 1:23:51
And I think just because there's so much development in that first trimester is, you know why I'm guessing she said that, and,

Scott Benner 1:23:56
yeah, she doesn't know either. I'm sure she's just like, Look, right, this is probably the safe thing to do here safer. It's all mitigation of risk risks. You know, you're just you're just making decisions about like, is this a better decision than that one, then we'll do that one. There for the same reason that I'll end up getting a vaccine because, you know, I, I think I'm okay, I think I'd be one of those people who would just get it like a like a normal, but I don't know if I'm going to be one of those persons who is going to need a five way bypass afterwards. So I'll take a vaccine, you know,

Unknown Speaker 1:24:30
right. That's all Yes. So So now I'm going to get one of the end of March but I mean, she's had many patients end up in the ICU. So she's very much pro vaccine, but I think it was just the timing of it and not knowing like I actually had a friend from high school that just had a baby and she is a physician. So she got it in I think December the vaccine, or either that or early January, and so she got it in her third trimester and she just had the baby a few weeks back and baby's fine mom I'm fine. And so there are those anecdotal stories, but there's no one that would have had the vaccine in the first trimester and already have delivered a baby. So I'm like, I don't know that I want to be one of those. Like, let's wait and see.

Scott Benner 1:25:12
Right? Yeah. And you won't, you know, and those babies haven't grown up yet. And nobody's tracked them. And there's, there's a lot of Listen, there's a lot of valuable reasons to do either. To be perfectly Yeah, you know. And so if you can stay in your house and keep your mouth covered and wait a little longer than why not if that's something you're able to do.

Unknown Speaker 1:25:32
Yeah, it's just three more weeks at this point.

Scott Benner 1:25:35
You find out you're having a little boy and you can get vaccinated.

Unknown Speaker 1:25:38
Yep, exactly. Then I'm a free woman.

Scott Benner 1:25:40
I'm telling you right now, I if you have if you're if you find out, it's a girl, I want to know immediately. Please don't even tell you

Unknown Speaker 1:25:46
how I will be screaming it from the mountaintops, you'll hear you'll hear it.

Scott Benner 1:25:50
That's excellent. Kate, I am having a very good time talking to you, which is how I can say we've been talking for almost an hour and a half and probably don't realize it. But I want to thank you for doing this and ask if there's anything we didn't talk about that, that we might have missed?

Unknown Speaker 1:26:06
Yeah, I don't think so. I think we covered and let unless you can think of something that I should share that you think would be helpful to you know, for everybody. I'm always happy to do that. But I'm, you know, always available. If someone wants to contact me, you have my email. You are welcome to send them my way.

Scott Benner 1:26:23
Okay. Well, if somebody reaches out, I will definitely send it to you then. Okay, yeah, that's amazing. I really appreciate this. there's part of me that wants to stop the recording and ask you about all the bad things that happened to you in Peru. But anyway, I do have one question for you feel Hold on just one second. Give me one. Sure. Thanks. All right, everybody, we're back for a second to ask Kate, one more question. Are you or have you put your kids through trial net?

Unknown Speaker 1:26:48
Yeah, so I can't remember at what point they can join it I want to say it's like two years or two and a half years where you can go and get that initial bloodwork. And so our youngest is actually at the point where he could do it now but because of COVID I'm like we'll just wait until we're all in a safer you know that we're all vaccinated basically, I mean, I'm not them but the larger community and I'll take him to do it I did take the first you could go I think the location here I think the only location here in Nashville was in at Vanderbilt and I will say that it was really really hard to bring a two and a half year old there, you know, to get blood from their veins. He was screaming at the top of his lungs and then was slightly frightened because I called it the doctor to ever go to the doctor again. But it is hands down worth it. I totally believe in everything that they're doing and they can you know, of course, I'm worried about our kiddos could be type one diabetic and that of course could come at any point but if we could get in sooner than later just to delay that or and also help you know, provide data for research to find a cure for type one diabetes? Well, you know, we'll do it I'll deal with that our have really tough time getting blood, you know, from a two and a half year old.

Scott Benner 1:28:15
Did he have any bodies?

Unknown Speaker 1:28:17
He did not have the antibodies? Good. Yeah, so you know, I'm sure at any point that can be developed. And I actually learned that as part of my pro thumb and vector to work is because not only did they find that I was positive for that, but they also found antibodies that were present that made that a little bit more severe to some extent. So they did another follow up in which they found out that the antibodies then went down. Um, anyway, so I know that that is relevant to some extent, because of that.

Scott Benner 1:28:50
That's interesting. Well, I'm glad that we chatted for a second and brought that up because I I think it's a great thing. I'm actually interviewing someone tomorrow who makes that drug that they give you now when they find out that you've just been diagnosed or that when you have the you know, that drug that they say kind of stretches out the time that it takes you to get diagnosed with type one.

Unknown Speaker 1:29:11
I'm yeah, I just listened to that podcast that you had that you I'm looking at my phone right now. Number 443. That was the one I was listening to

Scott Benner 1:29:20
laugh with the person from trauma. I'm actually going to talk to somebody who works at the company that developed the drug tomorrow to find out more about what the drug does.

Unknown Speaker 1:29:28
That's awesome. I will be listening to that.

Scott Benner 1:29:31
Alright, thank you. Alright, now I'm gonna let you go for Thank you. Okay, thanks. A huge thank you to one of today's sponsors. g Vogue glucagon. Find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juicebox you spell that GVOKEGL Uc ag o n COMM forward slash juice box, hey, one more time, touched by type one.org. It's an organization doing incredible things for people living with Type One Diabetes. And they put on a really spectacular dance show. That harkens back to the beginning of this organization. If you haven't heard that episode with Elizabeth forest, find it. It's in there somewhere in the catalog. She tells you how she started this whole thing for now touched by type one.org. And a huge thanks to Kate for coming on the show. And I promised you an update. An update on Kate, a Kate date, a cup, a cup date, a cup date? Oh, no, a cake date. I'm sorry. I'm rushing like I told you earlier. And I apologize. My thoughts are not forming correctly. Kate sent a note that said this. It's a boy, three boys for an under please send help. I have come to terms with the fact that it will be pure chaos around here for the next few years. Congratulations, Kate and family. That's really amazing. Kate said that since we talk she thought of things she wish she would have brought up during the podcast that happens to everybody. Don't worry about that. She said that she's had a slight increase in her insulin needs at the very start of the first trimester. But then it plateaued and even dropped a bit again. And there's some other private stuff here. She told me it's not for you guys, but that's fair enough. Right. Kate, thanks for reaching out. I mean, I'm assuming we recorded this so long ago. Your son's probably in college by now. Mazel Tov. Thank you so much for listening. I'll be back soon with another episode of the Juicebox Podcast. And by the way, if you're enjoying the Juicebox Podcast, please leave a beautiful glowing, well written and thoughtful review. Wherever you listen. And don't forget to attach as many stars to it as your app allows. Like if your app has like a five star thing like the apple podcast app, give it five stars, they put a real thoughtful review down that might make someone else interested in listening to the show. I love you guys. I'll talk to you soon. Bye.

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#553 T1D Mom is a CDCES

Drew is a D-Mom who has become a CDCES.

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

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 553 of the Juicebox Podcast.

Today we're gonna be talking with Drew. She has a newly minted CDC he acid the end of her name. She's a mom of three, and the mother of a child with Type One Diabetes. You're gonna enjoy our conversation if you don't, for money back guarantee. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan. or becoming bold with insulin.

I'm way ahead of the music here. Oh, jeez, way ahead. I need to fill this time. Yeah, Hey, take the survey for the T one D exchange please if you're a US citizen, or a US citizen who is the caregiver of a child with type one. Anyway, if you have type one diabetes, and you're from America, T one d exchange.org. Ford slash juice box, fill out the survey help people living with type one diabetes, and support the podcast. That's it. I'm gonna tell you about the advertisers here in a second, and then we're gonna get right to drew

this episode of The Juicebox Podcast is sponsored by the Dexcom g six continuous glucose monitor. Head over to dexcom.com Ford slash juice box to learn more where to get started today. The podcast is also sponsored by Omni pod makers of the Omni pod dash, you may be eligible for a free 30 day trial of the Omni pod dash. Go over and find out at Omni pod.com forward slash juicebox.

Drew 2:01
Hi, everyone, my name is Drew. I'm married. I have three boys. It's my oldest son, that is my type one. I work as a nurse practitioner in a busy maternal fetal medicine clinic. And I'm newly certified as a CDE or now known as CDC. He is a certified Diabetes Care and Education Specialist.

Scott Benner 2:28
Oh, I don't understand why they make things more difficult. But that's interesting enough. I mean, honestly, what did you just say? A c, d c e s?

Drew 2:37
Yes. That's now the term instead of CTE CTE is now the old lingo. But I still use it because I like simplicity as well.

Scott Benner 2:47
Yeah. I told Jenny that one day and she's like, I'm a CD. And I was like, Okay. I could argue with it. I so Okay, so I, before we started recording, I told you that I had the worst time trying to find our correspondence and didn't do well, finding it. But as you're saying what you're saying it's coming back to me. So let's start with reminding the host why you came on the show?

Drew 3:11
Yes. So on your Facebook site, you had asked for people to message you if they were working on getting their CDE or had just obtained it, remember and wanted someone on the show. And so my husband is the one that emailed posing as me saying yes, I'll come on. I'm a new CD. So that's why I'm here.

Scott Benner 3:39
Drew, how many people do you think I'm corresponding with who aren't really who they say they are?

Drew 3:44
Oh, maybe if they're like, my husband,

Scott Benner 3:48
was he? Was he just like, Did he say Joseph jewel definitely want to do this? I'll just send this out there, or was he trying to prod you into doing it?

Drew 3:58
No, he said to himself, Oh, she definitely needs to do this. I'm gonna sign her up. She'll do it. And I don't like public speaking or speaking in group. So he probably knew I wouldn't do it on my own. But with a nudge and backed in a corner, I would

Scott Benner 4:16
love that. I love that you're here. I'm not certain how I feel about your husband's manipulation. And but I but at the moment, you're just talking to one person, so you're doing really well. Okay, thank you. Yeah, it's like we're on the phone. You and I are girlfriends. And now we're going to talk about what it was like to do everything. So let's get a little background first. So you're a D Mom, how long have you been How old was your oldest son when he was diagnosed?

Drew 4:42
He was diagnosed two years ago at 11. And now he's 13.

Scott Benner 4:47
Okay. And two years ago when he was 11 What did you do for a living?

Drew 4:53
I was a nurse practitioner. I have always worked in a ob Jen clinics. But at that time two years ago, I was in an anesthesia pre op clinic so I was still touching diabetics. I'm not as in as big a way as I do now. But if people would come in for surgery, I would tell them what to do with their devices or what they needed to do to change their insulin to be ready for surgery day. Okay, so that's what I was doing. When my son was diagnosed. Gotcha.

Scott Benner 5:29
not to get too far off the topic real quickly. But as you're talking I'm realizing besides Drew Barrymore, I don't think I know another woman named drew except for you now. Is it? Okay good. I feel special. Yeah, well, yeah. Is there is it a name that I'm just I don't recognize as like are there like a lot of famous Drew's that I would know when I just don't know. We're not really.

Drew 5:51
Um, I have never met another girl named Drew. So I always say, My name is Drew like Drew Barrymore. And everyone wants me to say, is that short for for Drusilla? Or another name, which Drusilla sounds horrible. So thankfully, it's not as

Scott Benner 6:08
true. So

Drew 6:11
yeah, that's a name. But it's not mine. So we're good.

Scott Benner 6:15
I don't want to come down on any drusillas but that makes me think of Godzilla, just in case you're looking for an insight into my mind there. Yeah, Drew's not so was it? Is it like one of those like Arden's and androgynous named like there are only that when we named Arden we looked on the registry for the United States there were only nine slightly over 9000 people named Arden in the US, and well over half of them were men. So Wow, I feel like drew might be a similar name like that.

Drew 6:47
I like unique names.

Scott Benner 6:50
My dear. Okay, I'm a I'm a fan okay. So you and I are going to get along swimmingly. So your, your, your son's diagnosed, he told me a little bit about the diagnosis and how it went.

Drew 7:03
Yes. This is one of my like, biggest regrets that I feel like I'm still trying to heal over okay, because, um, leading up to his diagnosis, he's 11. He's independent. I'm not watching him get his own water or go to the bathroom, right? And his complaints are abdominal pain. That's all he could say My stomach hurts. My stomach hurts. And I was watching him lose weight, but he was also active. So I felt like I was brushing that off looking back to easily brushing that off. And then it got bad, quick, right as he's going into DK a. It was the week of Christmas. And there are lots of activities at school, and he was so excited for them. And one morning before school, he comes to me crying, and he hadn't cried before over his stomach. And he's like, My stomach's really bad today. And he's crying. And I hugged him. And I felt like I was hugging a skeleton. And I my son's name is Ethan. And I said, Ethan, you're so skinny, what's happening? And I had him get on my scale, before I even realized that he lost 20 pounds, which is crazy. He went from 86 to 66 pounds. And he said, but I'm okay. I really want to go to school because there's activities at school for Christmas week. And holiday week. And so stupid Moo, let him go to school. I went to work. I call this doctor right away. And he said, Oh, yeah, get him into me. And I said, Great. So my husband is the one that picked him up from school and took him to the doctor because I'm at work. And the doctor didn't know what it was. And I wasn't using my brain either, I guess, and did labs and said, Okay, these labs will come back tomorrow. Is it there overnight, and so I get home from work that day. And I just, of course, feel sick about it. Like, he's going into DK he's very sick, right? I so I keep asking my husband over and over What did the doctor say? And my husband just kept repeating. He doesn't know we got to wait for the labs tomorrow. We've got to wait till tomorrow. I'm like, okay, and I just remember I didn't sleep. I stared at him all night. We sent him to bed and I was like, wait, I don't feel good about that. So I made him sleep with me. My 11 year old son slept with me. And I watched him go to the bathroom seven times that night. And I was like, What in the world And I knew right then I was like he has diabetes.

Scott Benner 10:03
I and as I'm getting older, I've got to be losing testosterone because you almost made me cry twice while you were saying that and I've heard these stories so many times I thought I was immune to it. Oh, my God, you. I'm sorry. That's terrible.

Drew 10:18
hugging a skeleton was like the worst thing

Scott Benner 10:21
ever. It was just not me. You told me how much he lost him. My eyes filled up and I was like, Am I gonna cry? Like we've only been doing this for nine minutes. And Drew's got a boy's name. I should be okay. But I wasn't. It's not a boy's name. You're gonna make me cry. It's just gonna happen again during this hour. Be careful.

Drew 10:40
I hope it's happy from here on out. Oh, my gosh, in the morning,

Scott Benner 10:45
I'm bed wash Good God, you you made it overnight? Or did you just like take him right then in there?

Drew 10:50
No, so still stupid me. I I we wait until the morning. And essentially, we take him in the morning. And of course, he has type one. And I remember getting there and like watching him come to life with just IV fluids, right? Because he's so massively dehydrated, and then keep coming to life with insulin. But I remember the doctors coming because you know, in my brain, I've already figured it out. I figured it out last night watching and pee a million times. The doctors come in, and they're like, you know, I'm sorry, this is what's going on. He has type one. And I remember smiling and saying like, thank God, like, there's, I'm familiar with this disease. And I know he can live with it and thrive with it still, and he's gonna make it like he doesn't have cancer. And a death sentence is where I was in that moment. So yeah, I was thrilled. And they're like, looking at me, like, do you really understand what we're saying? And I'm like, I do I do. And I'm, thank you.

Scott Benner 12:00
No kidding. Well, I guess good that, you know, right? Like, because to be, this is gonna sound strange, I guess it's good that you need to be grateful that it could have been other things. You know, because that does give you some instant perspective, that, that some people might lack in that moment. Okay, so I'm gonna, I want to say first, and I'm certainly not in charge of making you feel better. But you know, these things, they happen so gradually, that even people who understand what's happening, don't say it. And, you know, you have to really think back to when, you know, a friend or yourself is lost 10 pounds, and they come up to you, and they're like, hey, and they're gonna stand in front of you, like, waiting for you to say, Wow, you look great. You know, and nobody ever notices. And nobody ever notices when you live with somebody, they don't notice, if you gain weight, they don't notice if you lose weight, they, you know, I've had, you know, I had trouble with iron that that made me, you know, just my personality completely changed. And the people around me could finally see it. But it had to get pretty obvious first, and I couldn't tell what was happening. It's that it's that incremental change, like when it happens quickly, you're like, Oh, I just broke my arm. This is obvious. But the rest of the stuff, just your body does such a good job of trying to keep you alive while it's slipping away from its whenever it's balanced point is that, you know, it's just really difficult to see. So I hope you don't torture yourself much longer over this. Although is the torture? Did it make you want to help other people with diabetes? Like how did you At what point in this process do you say to yourself, I'm going to go back to school, get more education become a CDE that is now a CD and a couple of other letters?

Drew 13:56
Absolutely, my son played a big part in that. And I ended up transferring to another department a month after he was diagnosed, which is where I am right now, in maternal fetal medicine. So we do very high risk pregnancies. Everybody's coming in with a diagnosis. And because it's so high risk, at least half of my population has some form of diabetes. So yes, that with work and my son, I knew I needed to have I couldn't get enough education. I wanted more education to be able to take care of everyone better.

Scott Benner 14:47
Are you just a caregiver at heart? Have you always sort of felt like that?

Drew 14:53
Yes, I knew from a very young age that I wanted to go into nursing. So it's a good fit.

Scott Benner 14:58
Yeah, even personally. Though like, do you find yourself? Are you consumed with making sure everybody's Okay, not just health wise, but I have that it's a burden sometimes, like, somebody looks unhappy, or, you know, they're having an issue and it feels like my issue that I'm pretty sure I'm going to die soon from the stress. But But I don't know. I'm not sure if that, do you feel like that like somebody has a problem at school and now that's in the back of your head, and someone else has a problem with a friend, and that's the back of your head and you kind of just you're keeping track of everyone's level of, I don't know, contentment?

Drew 15:36
Yes, I do have that caregiver role in and burden sometimes Yes,

Scott Benner 15:40
it sucks. I mean, it's nice for them, but they don't appreciate it. That's the part that sucks worse. Like, at least at least, at least if you do it you like you think once in a while, someone might look up and go, Hey, thank you. But that doesn't never almost ever happen. And not that I'm doing it for somebody to say thank you to me. But it would make it easier if I thought someone was noticing it. But I guess that's sort of the job, right? Is the you just sort of quietly nudging people in the right direction and saying things that make them kind of pay attention to the stuff you think like, oh, like, look over here, this is important to maybe that is just the job. And then you get to sit around the rest of your life when you're really old and be bitter, or happy? I guess no. I mean, you're gonna pick one, like, I'm going for happy, I'm going for Look how well everyone's doing. I had a hand in this, that makes me happy. But I've met a couple of ladies, and I have to throw myself in this because I'm basically a mom, that, you know, they just they're like, ah, they spend their older years just like now I'm by myself. And that kid's got the fruits of all my labor. I'm trying not to be that person. I don't think I am. But I've seen it happen. Okay, so you're a lovely person who's trying to help people. Now, don't you 100% Welcome. You're on the show, because a lot of people contacted me and said that they wanted to know what the pathway was like to becoming a CD. And I didn't really know. And you are uniquely qualified to take us through that journey. A because you've done it but more maybe because you've done it more recently, too. So at that moment, you're in your nurse practitioner, and you decide I want to be a CD because you back then you thought that's what they were called. And what did you do next? Like what are the steps you had to take?

Drew 17:24
So I looked at the website to see if I was qualified. And it did show that it it's somewhat easier to get qualified if you're already a nurse or a dietitian. That's usually the easiest pathway. There's other qualifiers there's even a unique qualifiers pathway, which I don't really know anything about that. But me being a nurse already made it very easy. Okay, especially with having diabetes experience.

Scott Benner 17:57
So your your initial education and work life made you a good candidate, and what and what was your initial? Like, what did you do? Like, what did you go to college for? And how did you pull your career together?

Drew 18:14
I have my bachelor's degree in nursing, and then I also got my master's degree. So that's how I'm a nurse practitioner. And the qualifications, if I'm remembering correctly, correctly, we're having a bachelor's degree, and then being a nurse or a dietitian or a list of other things, but those those two are the most common. And then you also it's not simply having that you also have to prove that you've been involved in diabetes education, and then also have continuing education and diabetes.

Scott Benner 18:54
And so alright, so if I'm coming out of like high school, and I'm going to college and I want to do this, become a dietitian, is one way and yeah, and then after that, get involved in diabetes care. And be very involved in don't just like blow past somebody with diabetes one time to go, Hey, you have diabetes, I've touched you. That's not enough. Like you have to be involved in diabetes care. And then you had to get into a program to become a CDE. And how long are those programs?

Drew 19:30
So I took a nine week class to prep me for the CDE exam. So that's the only thing I lacked in order to qualify to take the exam, okay, because I had the the bachelor's degree, I had the diabetes education. So it was a nine week class, which I did welcome because I had experience on type one. I had experience and gestational diabetes, but I really lacked a lot of the type two. So I felt like I needed that to really be able to pass this exam. So it was a valuable and eye opening class.

Scott Benner 20:15
Okay, so yeah, and I'm googling so it looks like there's something called. Well, there's diabetes educator.org, there's cbdc e.org. There's a couple things that pop up when you Google, a CDE exam. And the practice tests and so yeah, you say you took a nine week. So you basically, for a CD, you had an IU and an MCAT coming up. And you you took a crash course a nine week course to take that test? Correct? Yes. And that was really valuable for you.

Drew 20:48
It was valuable in helping me with the type two stuff that I was lacking. But the other value piece in it was being able to participate with other classmates and discussion posts every week, and seeing the absurd things they posted. About like type one, and just the misunderstandings that you and I are already familiar with.

Scott Benner 21:17
Let me ask you a question. And I'm not looking for smoke to be blown anywhere. I genuinely want to use this as a measuring stick. I barely got through high school. I have no college to speak of. If I took the CD, E, E, C, D, E, what do they call it now? c d, e e s, right? If I took the CD? What? If I took the damn test? Obviously, I'm How would I do on it? Do you think you listen to the podcast? How would I make out?

Drew 21:54
I think you would do well.

Scott Benner 21:56
Like pass it. Maybe Really? Keep in mind, I can't remember what they call it anymore. And you've told me five times. So it's possible I have the recollection of a gnat. But I mean, like, Is it is it basically like stuff that you learn? Taking care of someone with diabetes? Or having it? And then there's that extra level of nursing stuff that I would obviously not know anything about? I don't think but is that the mix? Or is it more just like diabetes related facts?

Drew 22:33
You know, a lot. And if you're a good test taker, you would probably pass just using simple that action. But it's, it's insulin, right? What we already know, it's nutrition, and counting carbs and exercise and behavior techniques. And there's type two stuff in there, like the oral medications that I really had to brush up on gotcha,

Scott Benner 23:02
I want to be clear, I have no intention of becoming a nurse, a dietitian or a CDC in a couple of extra letters. That's not going to happen. But I just was wondering, like the level of what was in the test, like I'm not obviously asking you to tell everybody what's in the test. But I was just curious that if it's something that's like super technical that even like a person like me would just get in there be like, I don't know any of this, or if it is more nuts and bolts stuff about diabetes, and you answer that question. So thank you very much. So now Okay, so you take the test, you pass, which congratulations. And then what's next is to find a job.

Drew 23:40
No, I stayed in my role. So I'm still in the same role. I'm still functioning as a nurse practitioner in my maternal fetal medicine clinic. Because our clinic is so high risk, we have different champions in our clinic. So some specialize in cancer related to pregnancies, some in blood disorders, and we also have a diabetes champion. So the results already a physician that was considered a diabetes champion, so I've kind of come on board as a diabetes champion in my clinic.

Scott Benner 24:23
Okay, and now that gives you time with people with diabetes to so now you're touching more people with diabetes? Do you have to build up hours then? What do you just have to keep a certain number of hours like every year, how does that all work?

Drew 24:37
To maintain my certification? Yes. I have to continue to touch diabetes, like providing education, and I have to continue to get continuing education hours so with at least half of my patients having diabetes I'm I'm eating Like getting that requirement.

Scott Benner 25:02
And it's not. It's gonna sound crazy, but you can't get like bonus points for having a kid with type one, right?

Drew 25:12
Sometimes I use that to my advantage. I feel like more of an expert when I live with it day and night,

Unknown Speaker 25:18
I would think that you would

Scott Benner 25:21
be more immersed at home. But I don't know. But it's just the way I imagined when you run into people in a work environment. You're seeing them for how long? Right? A few minutes, half hour? If you're lucky,

Drew 25:34
and minutes, Max.

Scott Benner 25:37
Okay. So what's the um, so knowing what it's like at home, and knowing what it's like in a work environment? what's lacking in the work environment? Like Where could that be improved for people? I know that's not a question you might have been ready for.

Drew 26:01
I feel like overall, I work in an educational institution. So I work with very smart people. But even the smart people I work with, don't understand the full scope of type one, because it's so big. And like we all talk about, unless you're an endocrinologist, you get one paragraph on type one diabetes in school. Right? And so I can come home every day, and tell my husband, can you believe this happened? Can you believe that habit, I can complain about at least one thing every day, even in saying that, I still think I work in a pretty good place. And so I take those little instances of Oh, my gosh, I can't believe this happened. And I'm trying to make change in my work environment, like providing more education to the staff, to the patients, to the community to just improve care and improve awareness. Yeah,

Scott Benner 27:13
I would imagine I'm sorry, I would think that, um, the issue would be that even if you, even if you do that, if you just find better and better ways of helping people, it still happens in a room with the door closed and nobody else sees it. So the only thing that's going to happen is you become the popular CD. Because people it gets around that, you know, it goes well with you. But But the people you work with don't get to know why. And that's, I don't know, like I realized that you can't it just feels frustrating. I don't know if I'm misunderstanding, but I just yeah, you don't I mean, like if you do great, that's amazing. You do great with the people who you are with, but that that message doesn't expand for some reason.

Drew 27:58
I'm trying to work on that expansion. So for example, this month, I am giving a lecture to my fellow nurse practitioners that I work with on something simple, like CGM. I'm doing CGM. And so I'm trying to get them more comfortable with it, with reading it with understanding it. So they can be more comfortable with then recommending it, reading it giving recommendations having discussions with patients. So I'm trying to, to broaden my knowledge. I'm trying to give it to other people.

Scott Benner 28:38
Yeah, well, that's lovely. I just, you know, the other day, I had to run out to pick something up. And I got a message from a person through social media person I didn't know they asked me a question. And I found myself thinking, I have a 10 minute ride home. I can talk to this person for nine minutes, right? So I get on the phone, I asked her a couple of quick questions, we have a nice chat. At the end of the chat. The person says to me, this is the most comfortable I've been talking to anybody about Type One Diabetes since my kids been diagnosed. And they were talking about their doctors like, and I just got off the phone. Like I was grateful that he felt good about it. And I'm hopeful that I said something that might be valuable to him. But as I got off the phone, I think how can that be true? Like how can a 10 minute conversation with a person leave you for the first time feeling good? Because I didn't tell him that much. I explained a couple of simple ideas and some things to look for. And they kind of gave him a pat on the button. I was like, you know, go get them that kind of thing. Like how is it possible like a physician can't do that? Is it just that they don't live with it? And therefore there's some aspect of it that's lost still to clinical.

Drew 29:55
I agree with that. It is really clinical To them, even the thought of more than just food impacts blood sugar is lost to the majority of providers. Really? Yes,

Scott Benner 30:14
that's terrible. I, I just I get too many notes from people were like, you know, we got diagnosed, and my CD told me to listen to the podcast. And I'm like, imagine if I was a mechanic, okay. And I made my living being a mechanic and you came into me, and you're like, hey, my car doesn't run, right? And I said to you, yeah, I could fix that for you. But instead, why don't you go listen to this podcast that will explain it? That's not even a good idea personally, for the doctors like why why would the doctor not want to be the, the center of where you get great information from? Like, why would they want to farm it out to somebody, like try to imagine being a doctor. And the best option you have for a person is to tell them to go to another source, other than you, but you should be the source. And and how that doesn't make you as the physician go, Oh, hell, I should stop sending them to listen to the podcast, maybe I should listen to it like, well, I don't know why that doesn't. That is just seems counterintuitive, just on a professional level to me, like diabetes aside of it, like I would want to make myself the kind of mechanic where you were like, you know what, I could probably figure this out on my own. But I'd rather go to Scott, he's the best mechanic I've ever heard in my life. Like, I don't even I can't. Do you understand what I'm saying? And do you have any insight on why that would be?

Drew 31:34
Um, I appreciate having several different lenses and my provider lens is, we have so little time to spend with patients. So why not give these tools for your tool belt? That you can go home and do and spend as much time on as you want to?

Scott Benner 31:54
Okay, I don't I don't not understand that I do. I've just been able to, I don't know, like it's it doesn't take that long to explain it to most people, is the thing that throws me off. I think I think in a 20 minute, I believe that in 20 minutes, if you came into a room, and 20 minutes later, I could let you leave with enough information where you'd feel a little emboldened. And you could kind of safely make some changes for yourself and find a better place. But but that's the truth is is that that doesn't exist is overtly why the podcast has the popularity that it has, like if that existed for most people, I'd be talking to myself, because no one would need this, they wouldn't come here. And I don't know that I don't I'm not trying to put myself out of business. But I guess I kind of am like I would write I'd rather see people feel well, and confident and actually be healthy than to be lost. So much so that they're looking for I mean, really think about what we're saying through a podcast, like, imagine a health scenario where you're like, Well, let me go hunt down a stranger who has access to the internet and a microphone like that. So it's a pretty big drop, don't you think? Or at least it should be. But apparently it's an elevation and even That's weird. And for the providers listening in at this point. There are a lot of providers listening to this podcast, I know because I can, because of how much correspondence I get from people are like, hey, my doctor told me to listen to this, they listened to it, or the notes that, you know, I just got one the other day that said, the doctor kind of like looked at me and said, You listened anything to help you with this. It was like that. And the person goes, Yeah, maybe podcast, the guy goes juice box. And then the patient says, Yeah, and then doctors I listened to I mean, what are we doing? Like, you know, like, at some point like install like stop pretending and just get in on it. Like if you're a provider, and you're listening to this tell people this stuff, don't send them well. Let me stop myself send them back to me Still I need the downloads, but like you could be telling them to and you know, and a lot more people than I could reach. So I don't know it's the whole thing is very frustrating to me. And I don't want to get you in trouble with where you work because it sounds like you work at a great place. But those were frustrations kind of exist everywhere. No matter the level of quality institution that you reach. It seems like unless you get that special endo or that special CD who has it and knows how to talk about it.

Drew 34:37
True.

Scott Benner 34:40
This is this. I don't know you told me you're

Drew 34:42
the same frustration.

Scott Benner 34:43
You told me you weren't gonna make me sad anymore.

Drew 34:48
Well, I'm trying to make a difference where I

Scott Benner 34:50
live. Okay, so So let's do that for people then. What do you think? The answer is on the patient side do they need They come in armed with the correct questions, or do you think they really do need to go find other tools, and the doctor is a place where they check your blood work and write your prescriptions.

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And I don't mean that in a bad way actually. No, that might sound like I do but I don't like

Drew 39:28
I cannot be all the above. Yeah, I feel like you can make diabetes simple, right? Give them the basic tools, but it can also really be vast, there's a lot of it and I feel like diabetes humbles me every day because I'm learning something new. Like there's so much it has so many legs and arms. So I think both like for the basics At the very least those questions and need should hopefully be fulfilled by the provider. But there's also great tools like your podcast where you go into so many different things. And I love even beyond the treatment and management that you engineered cover just speaking with individual people and hearing the different perspectives, because even that is valuable, too.

Scott Benner 40:34
Yeah. And that's obviously something you can't get from a provider that I think is a big piece of this. I'm not coming down on people, like I just it is, it's obviously the way it is. And I'm trying to figure out if it just has to be this way, and outside tools or just an obvious need. Or if there's a way that a provider can be more like, let me use an example from a conversation I had recently that was private, right? I'll just keep everyone's details out of it. How can a provider of type one diabetes care? Look at a Dexcom graph and see that every night, around 11 o'clock, there's a high blood sugar that results in a low blood sugar at 1.1 am and come to the conclusion that the answer is to lower the basil rate at 1am. Like how can that happen? How could someone not say, Well, obviously, what we need to do is stop that initial spike so that you don't make a correction so that you're not low later at one. How can they say we're going to let all these problems happen in the past, that lead to the spike that lead to the crash. And the only thing we're going to do about it is put a band aid over the crash site so you don't crash too hard. And then that low basil rate causes another high blood sugar overnight. And it just perpetuates and goes on, like how many times do you have to look at that graph before your bank? That's not the answer. Like is it? Is that asking too much of some people?

Drew 42:00
Apparently, because I see that a lot, too. Okay, but that's what I'm hoping to fix.

Scott Benner 42:05
I appreciate that. Are you telling me that it's possible? I'm smarter than I think I am that? Because I think of myself as a moron. Like, maybe that's the problem. Maybe it's my self esteem that's making this problem? I'm sorry, if people are laughing right now. But like, honestly, like, I have that thing inside of me. Like if I can figure this out? I can't imagine who couldn't figure this out. Because it just seems obvious, but maybe it just seems obvious to me. And it's not obvious to people, maybe I need to rethink the way I think about that. Because I just don't, I don't know, you know, it just feels like somebody comes to my house every night throws matches on my patio. And the way I handle it is by having a bucket of water by the front door, instead of putting up a fence. It's a weird analogy, but like, that's how it seems to me, like we're constantly trying to medicate the the end result instead of trying to figure out how to not to get to that result. And that to me is, I mean, if you're a physician, and you're listening to this, and that's what you're telling people like, please stop doing that. Because these people live in just abject anxiety, their entire lives, just waiting for the next bad thing to come instead of feeling empowered to stop the next bad thing from ever happening. And I don't know, it makes me upset now I'm upset. And you're so nice. Dammit. Sorry. No. She's so alright, so are you seeing it? Are you? Are you able to make those kinds of impacts for people? Or do you need to find a new job where you can do it? Are you able to do it where you're at right now.

Drew 43:40
I'm able to do it where I'm at right now. I feel very supported in my role and making an impact. I'm also on committees and hospital wide. So we work on educating patients more and even in the community like school nurses. So I'm in a good role. I am very blessed to be where I'm at.

Scott Benner 44:07
So you brought that up twice now. So institutionally, that is the path to change. Correct? Being a thought leader? Yes. Okay. And how does that happen like you, but how do you go to somebody and say, I think I understand this on a deeper level than the institution does. And I want to be the one to talk to people do you have to prove it first and then do people come find you or do you have to go find them?

Drew 44:35
I'm well supported by my bosses, and they support evidence based practice. So I have to use, of course, ADA and jdrf and a cog and other governing bodies to see what they say but they allow me to make an impact.

Scott Benner 45:00
Are there things you do management Wise With Your son that you can't talk about at work?

Unknown Speaker 45:10
Sometimes,

Drew 45:13
sometimes I bite my tongue, I'm trying to think of a good situation. A lot of times I don't though. One of the most frequent things I see if somebody is low, like, low is in 65. We freak out, and we give them like 45 carbs or something insane. And every time I'm like, What are you guys doing? Oh my gosh, stop giving them a buffet of food.

Scott Benner 45:44
See, I say 65. Drew. And I think that's 15 points from being perfect.

Unknown Speaker 45:50
Like, right, that's how I

Drew 45:51
see five and stable. I'm like, well, who?

Scott Benner 45:55
Even that right, you're like, oh, man, I'll just nudge this up a little bit and get back to work. I will. Obviously that's we're in agreement about that. But it's, it's how it strikes people. That's the problem. They see it and they can't diagnosis, diagnose it as Look, this is a stable 65. This is not an emergency, but then they treat it like it's an emergency. Like, if you were 65, and your CGM had an arrow down, I'd be all for eating 45 carbs, because I wouldn't know what to do either in that scenario, but till, especially with the technology to be able to look at it and go, Well, this is a very stable blood sugar. I mean, the first thing I would do is just I would double check it with a finger stick. And then I'd be like, Alright, you know, really is 65 maybe have four carbs here. Let's see if we can't just turn this into a 75 and stable. But I was just wondering if there was actual rules, I guess is the word I'm just simple word I'm looking for that would stop you from saying something like this, somebody like is they're just like, Look, you're 65 feed them. That's what we do here. And but then why not explain the rest of them the difference between stable and falling? And I don't get why that that next sentence, like I find that most problems in life, is because we don't talk about what comes next. We don't say okay, well, this is 65. But it was 65 and following. So you treat it this way versus 65 and stable that you would treat this way. Like why not just go to that little extra effort? Is it because they don't know it? Because it's not laziness, right? Like, there's not a CD standing in front of me that goes, I understand this. Just don't feel like telling it to you. That's not the case. Right?

Drew 47:31
Right. In those moments I'm educating. It's like, Okay, now we're going to have some rebound. hyperglycemia Are you going to be around when she's 250? after this? It's just, I guess, hard to educate everybody unless you're getting them all together. And it's a more formal event. Because just because I tell Mary Sue, doesn't mean Mary Beth over here is going to realize it and she'll do it again, the next person that comes across so.

Scott Benner 48:04
So where do you make the line between the people who are never going to get it, and the people who don't have the opportunity to get it because nobody will explain it to them. Like, I've been very clear on the podcast, I don't think that like least common denominator teachings a good idea. I don't understand. In a classroom of 20 people with two kids who are going to struggle no matter what three kids, we're gonna need a lot of extra help, you know, 510 kids in the middle, we're pretty average, we're gonna do average, and then there's these five or 10, these five at the top who are getting, like we're ready for, like deeper understanding, and we never delivered to them for the fear of leaving the bottom five behind, I'm not into that I, I think you can help everybody, I think there's a way to give the top of the class, the information that they can absorb while helping the bottom, you know, who might take it up more slowly or not understand everything that's being said, there's a way to help everybody. But I feel like that everything gets just least common denominator. And that leaves a lot of people in confusion. And though and the way I see that confusion, when I talk to people is that they can imagine there something else they should be doing. But because the information they're getting is limiting. It feels like they're breaking some sort of a rule if they even try to follow their own common sense. I know I'm asking a lot of questions that don't have answers, but I'm interested in what you think.

Drew 49:33
I feel like I need to become an educator. Next. I need some more education on educating. Yes, that's really tricky. Tell me the answer to that. How do you educate everybody that when they're all on a different level,

Scott Benner 49:53
I think you have to be so my personal experience by talking from talking to people privately They think you have to be a great HR person, you have to have that like that immediate feel for like the person I'm talking to can take middle ground information, the person I'm talking to can take high end information, the person I can talk to is going to do a little more hand holding. And I make no judgments about any of those people. It's just that they all deserve a different entree into the information. So you as the person who understands it, need to understand who you're talking to quickly, and you can, you can kind of ascertain that by asking some questions, getting a vibe for the response, seeing you know, where, where their level is, sometimes people's frustration is a great way to measure them. So if they're frustrated that they believe there's more, they are more high performers who are looking for better information. And if they're frustrated, because everything feels random, and it's out of control, then those are people who don't even have this simple tools down the understanding of having a good basil rate, how to Pre-Bolus how to understand the impacts of different foods, like the simple stuff that once you get creates the ability, once you create stability, things seem less random, when they seem less random, you can feel more in control of them. So on and so forth, then it builds. So I think it's up to you to accurately and kind of quickly figure out who it is you're talking to.

Drew 51:29
Yes. And it's that's easy to do when talking to patients, and you're one on one, for sure. A harder to do on a larger scale when you're worried about educating all the nurses on this unit,

Scott Benner 51:43
right? To be able to talk the same way to everybody. Yes. So like in my, in my dream situation around this. I don't know where you work. And we're certainly not asking, but I would, I would love to come and talk to the educators and say to them, this is how I've reached people with this information. And this may be something here would help you. Because I would be amazing, right. And I think that's a great idea. Because for whatever reason, there's something about my tone, and tenor and vibe that it seems to work across levels. And I think that's where if you're looking for like, like deep down, things I'm proud of about the podcast, it's that it's that I didn't have to pick a certain person, a certain type of person go, I'm only going to help these people here. Like what I'm going to say is only going to be valuable for these people. Like I wanted to find a way to say it. So it was valuable for everybody. And even the people that you might think of as higher performers in this scenario. They benefit from having basic information that's tangible and easy to digest and understand and put back into practice. It just gives everybody needs that easy basis to start from. You don't have to start with the big words. And you know, like, for instance, this is a great example. You think this podcast is pretty helpful. I can't Okay, I can't pronounce that word that means after meal spike, what is it post? prade?

Unknown Speaker 53:09
postpresidential?

Scott Benner 53:10
Yeah, I don't know that word.

Drew 53:16
That's in my basic vocab?

Scott Benner 53:18
Yeah, I don't know, nor do I care about that word. It doesn't matter to me, like making things seem fancy or, or like they fit in a business setting. I don't I don't do I don't give a shit about that stuff. Like, I think that there's a simple way to understand this. And everyone can build on that simple understanding whether you're no matter where you are in that class, nobody has to be left behind in this scenario. And the truth is, is that when you start with a very basic concept that's easy to grasp the you know that some people just take it and run with it. And some people just come up to speed gently with it. I've seen it happen for everybody. And it's it's not, it's not attached to intellect either. Because I've seen nurses have children with diabetes, and they can't figure this out. And it's something about the nursing brain, I don't understand completely, but there's like it feels like there's rules and you follow the rules and the rules do the thing. And that's nursing to some level and then you get into diabetes, you're like well sometimes this sometimes that is the 65 stable or is the 65 following you have to get into that minutia. And they're like no, no 65 This is the rule for 65 and it takes them a while to break free of that but they do and so I don't know that anybody can't do it. It just has to has to be delivered in a certain way I had you on to talk myself into believing that this could be done and now I just all I did is talk myself into believing that you need other avenues to get the information from drew Alright. Let's not talk people out of being CDs. You feel like you're helping everyone Do you feel that like, this is a valuable use of your time? And you're happy you did this?

Drew 55:05
Yes, definitely. I'm happy. Well, it

Scott Benner 55:08
sounds to me like you're the exact kind of like foot soldier, we need to put in these scenarios. Seriously. Like, we need more people like you who have a grasp of it, and are coming in motivated, because you don't see this as a job as it's a calling for you. Is that right?

Drew 55:24
Absolutely. Yes. Otherwise, I don't know if I could do diabetes. 24. Seven, but it's, it's my life and passion. And it's, it's a good fit.

Scott Benner 55:34
Let's go. I'm glad of that. Do you ever get home and you've talked about it so much in a day, that you neglect things at home? Because you're tired or?

Unknown Speaker 55:45
Um

Drew 55:47
Yeah, I sometimes I get to that point. But I'm blessed with a good husband, that is an engineer, even though he didn't know anything about healthcare going into this or let alone diabetes. He loves numbers. He loves figuring things out. He likes research. He likes fighting with insurance companies. So he's a good partner in crime, and my son being 13 and lifts his weight as well. So even if I'm exhausted, and I take a timeout from diabetes for the night, my son's going to be fine.

Scott Benner 56:27
That's cool. That's excellent. I mean, I can't imagine that you could do it 24 hours a day, every day. Like at some point, you must be like, no one, say the word Bolus again, I couldn't go into another room. Oh, my God. Yeah, I just I would, I would definitely imagine you need some time away from it for your own sanity. And I was wondering when you say you give talks and stuff like that you talk to other people, when you talk to them afterwards, when you're mingling with people? Does it? Is it striking them? Like do you think it's, you think it's landing? And they're, and they're holding on to it? And what do you think they take from it? What do you think? I guess my question is a person who's doing the job by the book, who comes in and hears from somebody who's like, no, I really think you got to think about this, this and this. Do you think that they can go back and put that into practice? Or do you think it just lays on them as like, oh, there's something I should be doing that I don't know how to do.

Drew 57:24
I think I'm changing the way they practice, what, and mingling with people or talking with them after I give a talk. The response surprises me that they weren't even aware of what I would consider basic information. So I keep having to go back and think, okay, really start with a good foundation. Before I try to go into anything more detailed.

Scott Benner 57:56
In Do you think that's because I think the one aspect of medicine that that laymen don't understand is that medicine is basically built on a foundation of? Well, it might be this, it's most commonly your problem most commonly might be this, let's rule that out. Oh, it wasn't that well, then its next most commonly might be this, we'll try to rule that out. Oh, that was a great answer. You leave. Oh, that wasn't it? Let's go to the next, the third most less likely thing. And that that's all medicine is really is ruling out? What statistically could be the problem based on your symptoms? And yeah, yeah, right. And I don't know that that's something that people understand. I think people think they go to a doctor. And there's an all knowing all seeing shaman sitting in front of them, and you're like, Hey, here's what's up, my belly button looks like this. And I got a gray hair on my left side and look at my pinky stone. And that guy goes, Oh, that's this. And this is how that gets fixed. And that is just not how it works. And that model is not intuitive to managing diabetes. But those are the people that you're sent to. And that is the way they're trained. And so you're looking for those people to either flex, figure it out and learn how to talk to you about it. Or you have to come to the you have to come to the understanding on your own, that there's more information out there, I have to go find it for myself, this is a very well meaning person who's going to give me my prescriptions and check my blood work and tell me where my ranges are. And I think that even though I might have sounded differently a half an hour ago, I guess that the people, the doctors, the windows, were telling you, Hey, this is good information, go find this information. That is really a kindness because maybe maybe you're asking too much for them to fundamentally change how they've been taught. And what they do. I guess that might be fair. There it is. All right. Yeah. Drew what Do I make you I put you in charge, you get a magic wand? You're in charge. What happens? This seems so outside of your personality, you're pregnant pauses are fantastic. But I put you in charge, what's the first thing you do?

Drew 1:00:22
I'm in charge, where I work of the world,

Scott Benner 1:00:24
I put you in charge of the world, you fix the happiness. You fixed all

Drew 1:00:28
that, you're like that I want to be in charge of the world.

Scott Benner 1:00:32
Well, you fix the other stuff, you're down to diabetes in a clinical setting. Like, I think I know what my first step is, what's your first step?

Drew 1:00:39
my foundation would be more time. I think that truly is what limits providers, there's not enough time to sit down with a person and really do the investigation that you were referring to of how did we arrive at this number? How can we fix this? Because that requires time and talking and investigation. So time is the fundamental issue, I think,

Scott Benner 1:01:02
even for providers who, if they had the time wouldn't know what to do?

Drew 1:01:08
Well, my gosh, they should have some education. Maybe with time, though, though, they'll have more education. And no, I don't know,

Scott Benner 1:01:17
I'm hearing a little Midwestern hope in your voice. Am I right about this?

Drew 1:01:21
I'm in the south. Oh, okay.

Scott Benner 1:01:23
That's close enough. You know what I mean? Like that hopefulness that you got to come up to some of my East Coast, like, there's no way anybody's figuring this out, we're gonna tell them what to do. So my first step would be if you put me in charge, my first step would be, I would, I would take a person who could explain it. And I really do mean the basics, the keys to initial success. And I would go to each provider and give them one on one attention, give them the same exact talk, and have them mimic it back to me parrot it back to me. And then they need to sit with a person who understands it. Watch the advice be given and watch the result happen so that they can believe in it. And then you send them off to try it on their own. And I think then

Drew 1:02:09
thankless of medical school, learn one do one, teach one?

Scott Benner 1:02:14
Did I just make something up that I already know?

Drew 1:02:17
Yes, you know how medical school operates? Now, learn one, do one, teach one. That's what you just said.

Scott Benner 1:02:24
I got to be honest with you. I know that from Grey's Anatomy. But that's not where it came from out of my head just now I just, I really thought like, what would I do if I wanted to make a clone? Like, if I wanted to, if I wanted to make another me in the world, what would I do, I would assume that the person I'm talking to doesn't believe that what I'm saying is going to work. So I would explain it to them, then I would show it to them. And then when they could believe in it, I'd like to see them do it once. And then once they get the result back, then it's the same as the person with diabetes, you just need to build up trust in the process. You know, the you need to build up trust the idea that your basil has to be right, here's how you can make it right, you have to Pre-Bolus your meals most of the time, here's how to know 10 carbs, this isn't equal to 10 carbs that don't stare at a high blood sugar. You know, it really is I gave a talk the other maybe two weeks ago online for touch by type one. There's like 125 people in there. And the responses coming back are over and over and over again, the same from people. Which means makes me think that the information strikes people similarly, and all these people are sending graphs, they're like, look how much better things got. And I was like, it's like, there's the part of me it's like, Yeah, well, you know, we put the insulin in the right place and you're doing what you need to do. And then you get what you expect. And now you're on your way. I think that's the process. I just need one anyone listening, I need one hospital to have me come in and talk to everybody. I want to do a pilot program with somebody and prove it out.

Drew 1:03:57
Anybody I'll fly any that will be amazing continental

Scott Benner 1:04:01
United States I don't want to leave the country. Okay. Imagine I'm in like the Czech Republic. talking through through someone is like, you know, taking my words and like I here's what he's talking I have somewhere where people can understand me, I want to try it first day, no one's gonna take me up on it.

Drew 1:04:21
But why I'm gonna I'm gonna work on this

Scott Benner 1:04:24
because I don't know how to say post press

Drew 1:04:28
pranjal

Scott Benner 1:04:29
and I can't remember when the CD turned in. Like, I don't seem like the person you would ask. But I feel I feel an immense amount of confidence around it. Like I would I would love to. I would love to do that. I would love to even like it doesn't have to be everybody in the practice. Like just pick two people and talk to them, get them doing it in a certain way and then watch over six months watch a one sees for their patients over six months. Like I think that would be fascinating and wouldn't say anything, you know, crazy, it's not like I'd be like, Alright, listen, ground up your cinnamon, and then get your essential oils diffuser out, it wouldn't be like that, it would just be like, you know, here's where you use the insulin. And I think this will be valuable and then let people because the truth is, is that people need to see it so they can believe in it so they can build on their own which ends up being the real value of it, which is there at home making decisions that are valuable because as diabetes keeps flexing and changing, you have to know how to move with it, or it'll just overwhelm you again, I mean, I have a hormonal 1617 year old daughter, and I'm going to tell you that if I could go back and talk to the Scott I was five years ago, I'd be whispering in his ear every day, wait until the hormones come. Like I just every day I'd be telling that guy that like Don't, don't sleep on those hormones. It's it's gonna change everything and the only thing that keeps Arden's agency where it is which is now for seven years in the fives is the ability to stay flexible when the impacts change. So

Drew 1:06:06
absolutely that is our life right now. Ethan has grown like six inches in the last year and so we have fun basil names for pump and one of them is growth spurt and we have other stuff so we're constantly changing between basil rates to keep up with what he's going to do that day.

Scott Benner 1:06:26
No kidding No kidding I don't this I don't I could never imagine that that's not the truth. I swear to you It feels sometimes day to day here and you but but it's not I know that might sound crazy to people like oh my god it's gonna change every day I can't do this but you can if you know how to if you know how to look up see what's happening and go okay more basil you know a little more little more push on the meal insulin here like it's and then you see it go back the other way like okay, I'll take the Basal back to where it needs to be it's actually not it's actually very intuitive after a while for me and it's not that intensive with my time or my thought as I thought it was going to be when it started happening you just have to learn to see it as another it's just another variable it's just one you don't see happen because you don't eat the variable that it comes from inside. Right drew? I talked way too much on this one. People are gonna bitch at me like feel it coming.

Drew 1:07:24
I enjoyed talking with you.

Scott Benner 1:07:25
Did you thank you tell the people to leave me alone.

Drew 1:07:30
Oh, no, they're fine. Everyone loves you. True.

Scott Benner 1:07:33
I love I don't know why you're so nice. If I would have booked my wife on a podcast without telling her she would have punched me with an ashtray and we don't even have an ashtray she would have gone back to 1975 gotten a big glass ashtray and come back I hit me you were sweet. Why are you so nice? Let's take my

Drew 1:07:53
chin and visit me at my hospital I'm going to work on this

Scott Benner 1:07:57
Alright, well we'll do that you if you get it, I'll do it. I'm up just you know, but when we stop recording you'll tell me where you're at. But, but first you have to ask me You have to answer my question.

Unknown Speaker 1:08:07
Why are you so nice? I don't know. No, you can't be that nice to say I don't know. pleasant to be nice.

Scott Benner 1:08:17
No, that's not what I mean. Like are you holding a rage inside that you won't let out? And is that through good grooming? like have you were you raised to hold it in? Or do you not feel the rage? Which is it? That's my first question. Do you hold it in or do you not feel it?

Drew 1:08:34
Um, if I'm upset exercises is my outlet. So

Scott Benner 1:08:42
that's a fair statement. I'm gonna pick some were raised to not show anger to people

Drew 1:08:56
that's fair. My mom was always my mom is a very pleasant person. It would never be unhappy in public so I think I got some of that

Scott Benner 1:09:05
but you're not like privately like a raging lunatic like you don't like you won't get off of this and like start kicking your dog or something like that to let it out? Not that anybody should kick their dog no no no no she's not feeling like that burning not at all like I definitely would not kick a dog but the burning like there's no burning like you're like I'm irritated now. Like not at you at the world like these conversations always get me riled up like and so I get I get like oh like I want to do something about it like if you told me right now Scott pack a bag and come here I'm gonna let you talk to these people. I just walked downstairs and be like, I gotta go get like, I don't Yeah, but but but if you got me three days from now and you're like, hey, that I'd be like oh I don't know I don't like traveling. I don't really put right now you've got me. I'm actually warmer now than I was when we started this.

Drew 1:09:58
I saw the first A year after Ethan was diagnosed, I felt like I lived with a grudge on my shoulders. Because when people wouldn't know how to properly treat type ones, it upset me and I would be short with them or correct them in a not so great attitude that I realized that no one's going to come to me asking for better education, I'm not going to impact people, if I get if I live with that, and are so sensitive and upset, because I was very sensitive and was easily accessible for the first year. But now, after that first year, like people don't know they're lacking knowledge, and I need to keep a good attitude so they can really hear me and respect me and be able to come to me, if they have more questions,

Scott Benner 1:10:56
you're the right kind of person or this message that's for certain anyone listening who finds themselves to be like Drew, first of all, congratulations. Secondly, if you're in a position of teaching people with diabetes, I would say this have the nerve to speak up and try to make an impact like if you're in a job right now where you're watching something happen and you just know it's not right but you don't feel like you have a voice there. You know, try try try something to help people because I get to see the other side of it. And when they go home and they leave that practice with no answers, it's a struggle for them 24 hours a day, and it's um, it becomes as impactful emotionally as it is physically and it's just not needed. It's not fair and it's it doesn't need to be that way. So if you have the voice go ahead and speak up. Like drew is and I'm going to keep ranting and raving about it here until until until I get a doctor that comes along and goes I just tell people get your basil right do this do that do this and I tell them how to do it and don't be like God I want that I'm gonna retire done with this alright, Drew I really appreciate you doing this You're very kind

Drew 1:12:07
if you can hold on Thank you for having me on.

Scott Benner 1:12:10
No I was really my pleasure. I didn't know how much I was going to enjoy this talk like I really even that is a weirdness about me like I'm all agitated but I really had a good time talking to you. I don't think people think of things like that mostly but I had a great time even though I'm I'm all jacked up. A huge thank you to drew for coming on the show and sharing her story answering all my questions. Thanks also to Omni pod makers of the AMI pod dash and the Omni pod promise check them out at Omni pod comm forward slash juice box you may be eligible for a free 30 day supply of the Omni pod dash and the Dexcom g six let's not forget them. Dexcom comm forward slash juice box find out the speed and direction that your blood sugar is going see it right there on your phone if you want or using a receiver. Don't forget to fill out that survey at T one d exchange.org. forward slash juicebox. support people with type one diabetes support the Juicebox Podcast.

Thank you so much for listening. I'll be back soon with another episode of the Juicebox Podcast. Hey, don't forget to check out the private Facebook page for the podcast absolutely free to be in 15,000 plus people in it now talking about type one diabetes, management of insulin, all kinds of stuff. You'll find it online on the Facebook. It's Juicebox Podcast, Type One Diabetes

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#552 Diabetes Variables: Bad Sites

Diabetes Variables: Bad Sites

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 452 of the Juicebox Podcast.

Hey everybody, this is the next episode in the diabetes variable series. So it's going to be me and Jenny Smith. Jenny, of course, is a 30 plus year type one, a CDE, a nutritionist, she says a whole bunch of stuff. And she's here today to talk about a new topic, something that might come up in your life that very well may impact blood sugars. Today, the variable that Jenny and I will be talking about is bad sites. Please remember, while you're listening, that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. On the front page of Juicebox Podcast comm a lot of the series that are within the podcast have their own space, like on the website so you can see them because I know there's a lot of episodes. Today I've added the variable series. So that's there now as well. So if you're looking for a certain episode, you're not sure what episode number it is head there and do a little scrolling, you'll find it. I'll get started right after this brief message from our sponsor.

This show is sponsored today by the glucagon that my daughter carries g vo cuyp open, Find out more at G Vogue glucagon.com forward slash juice box. Alright, Jenny, so I have four of them set aside to try for today. One of them. I can't wait to see how you respond. But the other ones are our I want to start with a couple that are shorter I think and and then see see what we're going to get to so Okay, this one I think is going to be a really short variable. But I want to talk about bad sites. So just you're using an insulin pump. And the site stops being as effective as you expect, or as you've I guess, experienced already with the site. But people have the hardest time baling changing, it's like, yeah, it's that they the hope that sticks with them is sometimes fascinating. I can't tell if it's the if it's this thing supposed to last this long, dammit. Like I'm not given up or I mean, I even get if it's money. But right. You know, like if you're saying, I don't want to take this thing off. But if you have insurance. So I guess the first thing to say to people is if you have insurance, and you experience bad sites, your provider can write you a prescription for more stuff, if that becomes necessary

Jennifer Smith, CDE 3:00
to change more frequently, not at all. No. In fact, with all the pumps, I think there are people who definitely find I get today to I can maybe make it today, two and a half. If it looks like it's really, really still working well. But I don't push it anymore to day three. So yes, I mean, if you're one of those people then just don't push it. Know what you know, and ask your doctor to write for changes every 48 hours instead of every 72.

Scott Benner 3:26
Yeah, it's so an example is you know what the funniest thing about diabetes is whenever I go to talk about I always have a fresh example because that's never stops. But Arne and I are going to go shopping this afternoon together, we're going to find little baskets to put on her shelves that she put up. She put up shelves and she wants to put baskets on the shelves. I've been a stay at home dad for a long time. So that seems like a reasonable way for me to spend my afternoon to me,

Jennifer Smith, CDE 3:50
but for bunny eggs or something or what is she putting?

Scott Benner 3:54
I don't know what she's putting out there. Hopefully she's not hiding, you know, paraphernalia which I don't believe she is. But not the point. The point is that I woke up this morning to find that Arden's blood sugar had been fairly sticky at like 140 overnight. And I thought, Oh, we must have missed on the last thing that she ate and you know, the basil is holding her nice and steady. I'll Bolus this I Bolus it and it doesn't move. And as soon as that happened, I thought this site is shot. Like it just it hits me like immediately. Now do I yank the pump off or right away? No, I turned to all of our settings up a little bit and made all of her insulin stronger. And it worked. And then when the settings reverted back, it drifted back up again. So in my mind, she's not getting insulin correctly anymore, because I'm not getting what I expect. Right? And so I told her just before you and I did this, I said Listen, do one more Bolus because that's going to bridge this time. I'm going to be talking to Jenny and then I said and then we're going to pull your pump before we go before we go. Cuz, I mean to get eight more hours out of this thing. I mean, I guess we could just jack it up, it's probably leaking, right or something get or what? So what are all the things that could go wrong with a site?

Jennifer Smith, CDE 5:12
Yeah, it's like a rabbit hole of information about site, right? It really is. So what could it be, it could be that the site is in a place that just got bumped or nudged or something. And so now, it's not really working as well under the site, maybe you develop like a little tiny, like, I don't know, like a clap, let's say it, but it's not absorbing quite as well. Thus, when you bump everything up, and now you're jacking in a little bit more insulin, it's kind of pushing out enough to overcome whatever the reason for the resistance is at the site, it just could be that this area, especially if you've documented enough to know the, you know, the right hip and the left hip don't absorb as well after day two, so let's just change it when it's in those locations sooner than later. So it could be the site, right? You know, variables of site, it could be infection at the site, especially in infections, I usually, usually you know that you have something starting, even if it's a mild infection, I'm not talking something major, but usually the site hurts. It's sore. You might even notice a little bit of bruising, like outside the canula kind of area, but definitely it's sore in sites should not be sore. I mean, they should be with the little flexible canula under the skin, and or even the ones who use the steel infusion sets. It shouldn't hurt.

Scott Benner 6:45
Okay. So if I'm going to make an admission here are not an admission and admission. I'm going to admit something. omission is when you leave something out. Yeah, admit

Jennifer Smith, CDE 6:55
Okay, when you you have to admit something. What are you going to admit,

Scott Benner 6:59
I Arden's had diabetes since she was two. And I hear people say my pumps occluded all the time, I've never figured out what they mean when they say I mean, I understand the word. But mean physically, like the word makes me feel like somebody stuck bubblegum in your tubing, you know, like, but that's obviously not it. So, when people say, I got an occlusion, what are they talking about?

Jennifer Smith, CDE 7:30
Well, a true occlusion is different than a site, that's technically gone bad, okay. In a site that is occluded, occluded, means like, you know, like the tubing is straight underneath the skin. And typically, tubing will be bent visually, to some degree when you remove it. And most pumps I know, at least Omni pads. If you have an occlusion and your pad errors, it will tell you that it's either a pod error, or it will tell you that a pod occlusion is detected. And to change the pod at that point. So and all of the pumps will register an occlusion based on a certain amount of insulin that gets backed up into the pump. And it triggers the alarm to say this insulin hasn't gone in up to this certain amount. And each pump has kind of a designated amount that triggers that occlusion alarm. So an occlusion is definitely different than a sight problem. Now an occlusion could be it could be something that starts to make the site not feel good to because obviously, if you've got like a bent canula under the site, that might be more irritating than something that's just supposed to be sitting straight, right? Most often though, what I've found is that an occlusion will happen soon after a site change.

Scott Benner 8:58
Okay? But a bad not always

Jennifer Smith, CDE 9:01
but a bad site could be two, three days in, etc. But an occlusion usually is sooner than later in the life of a site, mainly because it usually happens on the sight being put under the skin. Okay? Something has triggered it to bend, etc. could it happen while you're wearing it? Yes, it could, if

Scott Benner 9:24
we're likely from the injury,

Jennifer Smith, CDE 9:26
more likely from the actual puncture under the skin,

Scott Benner 9:30
I should knock on some wood but in 13 years or more of using Omnipod arms had one bent candle ever. And I've never seen the occlusion thing. I actually think it's kind of cool that on the pod. If Omnipod thinks you're not getting insulin correctly, the thing just errors and shuts off. Yes. Like it's just like, Look, this is bad for you. I'm going to force you to put on a new insulin pump now. Yeah,

Jennifer Smith, CDE 9:51
I've always thought to it has more checks and balances to alerting sooner than later that something isn't right internally. Then the other pump So

Scott Benner 10:00
I also don't see them as much since they took the manufacturing in house. Oh, you know, interesting. Yes. Since they moved from China to I just did an interview with them not too long ago. But since they moved that they have a, if you've never seen it, it's astounding, like the man in mass in Boston. Yeah. So maybe that's it, too. Okay, so so here's the bigger question, I guess and how to wrap this up. You learn what a bad site and bad sites just a colloquial phrase, it's not a technical term, it's a phrase that stops working the way you want it to, excuse me a site that stops working the way you want it to work, you start to notice them, after experiences, like and then kind of like figure out when you can be like, This is bad. I'm jumping on this. So there's no real. I don't think there's any way in this conversation to say just look for this, this and this other than to say, if the site's not acting like you expect, if it's towards the end of the site, life, maybe switching now's a good idea. Do you have anything to add to that? Or is that kind of it?

Jennifer Smith, CDE 11:03
It's kind of true. I mean, if you have enough hindsight from your life with diabetes, right, from experiences, you can say, Well, my lunch usually does this my breakfast usually does this, my run in the afternoon usually does this kind of thing. And if it's not, and considering other variables that could be impacting towards a higher blood sugar. If none of those are really in the picture. I usually our recommendations, take take a correction. Like you kind of did you drove a correction in and you're like, Huh, I didn't do anything. Don't, don't play, just change it out. Just change it out, get some insulin going again, who knows what the reason was when you could play with thinking about what the reason is forever. Just change it out deal with the high blood sugar and move on.

Scott Benner 11:52
Okay. All right. So cool. Thank you.

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So the diabetes variable series is coming along pretty well. So far. There's trampolines, temperature, travel, exercise, hydration, food quality, tunneling, video games, stress masturbation school and today's episode bad sites. I think it's working out well putting them out on Fridays. So expect that to keep happening. And that's pretty much it, I guess, on the variables front. Now, if you're new to the podcast, don't miss out on other series like the diabetes pro tip episodes, defining diabetes, after dark algorithm pumping how we eat, there are so many to choose from. I'd also like to let you know about the private Facebook group that's dedicated to this podcast. It's called Juicebox Podcast type one diabetes, it is a private group, as I just mentioned, meaning you're going to have to answer a couple of questions to prove you're a real person to get in. But once you're in there, you're going to be with at least I mean, at this point, it'll probably be 16,000 by the time you hear this, but at least 15,000 people just like you talking about type one diabetes, it really is a kind and valuable space. So don't go there expecting like, Oh, it's Facebook, I'm gonna fight with people. It's not like that. It's actually pretty great. There's a link in the show notes if you need it. Anyway, if you don't want to, I mean, you know, cool, but I just want to let you know it was there. I hope you're very much enjoying the podcast. I hope you're just enjoying the podcast actually very much seems excessive. If you are, please share it with someone else who you think might also enjoy it. And if you're a practitioner, and you're listening Hi. And if you're a practitioner and you're listening, and you're suggesting this podcast other people hi and thank you really appreciate it. Alright guys, I'll be back really soon. plenty more to come. We're going to finish the year up super strong with a ton of great episodes. By now, the podcast has crested easily 4 million downloads. There were more downloads in 2020 One by August. Then there were in all of 2020 and 2021 might reach a real milestone at the end. So keep your eyes out for that. We'll do a little celebration when it happens at the end of the year.

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