#1099 Healing Heart
Willie has type 1 diabetes and a healing heart.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 1099 of the Juicebox Podcast.
On today's show I'm going to be speaking with Willie Willie as someone who I've been trying to get on the podcast for years. You can follow him on Instagram at T one D artists. And I think you're gonna love this episode. Willie is 40 years old he was diagnosed with type one diabetes in 2003. He also has hypothyroidism fibromyalgia, frozen shoulder, restless leg syndrome, and a little bit more. What he doesn't have is a bad attitude. Willie is who I think of when I think of hope. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box. Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cozy earth.com.
This episode of The Juicebox Podcast is sponsored by Dexcom dexcom.com/juice box get the brand new Dexcom G seven with my link and get started today. Today's episode of The Juicebox Podcast is sponsored by Omni pod and the Omni pod five. Learn more and get started today at Omni pod.com/juicebox.
Willie Streets 2:00
My name is Willie, aka Willie streets, aka the T one D artists and it's been a long time coming. In the words of my iconic hero Mr. Tupac Shakur. This won't be the real issue ever.
Scott Benner 2:16
I'm ready for that. Excellent. Willie, how long have we been interacting online? Do you think? For myself?
Willie Streets 2:22
It seems as though it's been a while. But when I go back and look at dates and whatnot, since 2020
Scott Benner 2:32
Oh, that's a reasonable amount of time. It's almost a three full years. Right. Right. Yeah. So
Willie Streets 2:38
like, right in the midst of the pain, the onset of the pandemic? Yeah,
Scott Benner 2:44
I love the podcast. You know, I hate to say and I you starting to hear people talk like this. Now the further out we get from it, you don't want to say good things that came from COVID. But it really helped the podcast. You know, people were at home and and I guess had time to consider their health then a lot of people found it. And it kind of blossomed from there was doing well. And it was growing kind of incrementally but man right around 2020 2021 It like like it took off. So yeah, so
Willie Streets 3:13
it really helped me during that time.
Scott Benner 3:17
I'm glad we'll talk about it for sure. How old are you? When were you diagnosed?
Willie Streets 3:21
I'm 40 years old. I was diagnosed March 10 2000 and 312 years? Yep, we've got 2120 years. Seven months. 22 days
Scott Benner 3:37
keeping track? Yes. That's a long time ago. 20 years a long time ago. Yeah. Were you expecting it? Was it in your family at all?
Willie Streets 3:46
When I got diagnosed? That March, I was not expecting it at all. My dad was diagnosed as a type two diabetic 1995. Okay, so I was not expecting that at all. I didn't know that I had any family history of diabetes, both type one. I had a large family history of type two. I had actual two uncles that are in both both worlds by my dad's sisters that were diagnosed as type ones. My mom's sister, my uncle, Jonas, he's passed. He was type one diabetic also. So I knew a bit about it, but didn't know of any family history. Yeah,
Scott Benner 4:36
so it was there, but not something people spoke about or didn't type to get more of the attention.
Willie Streets 4:41
It wasn't it was there. People spoke about it. But I did not know there was a difference. I just new diabetes.
Scott Benner 4:50
Oh, I got it. And you're young too. I mean, your father's diagnosed you're not maybe more than like eight or nine years old. So like you're a younger person that was a kid Yeah. I gotcha. From
Willie Streets 5:01
the beginning. Like when he there is diagnosis. Like he showed us everything, like his meter, how to use it, how to test. And it's crazy. I remember when he came home, it was like around Christmas. And he showed us actually how to use his meter and we all prick their fingers to see what our blood sugar's were. And I don't even remember chains and the lancet like we all just checked, pass it around.
Scott Benner 5:28
So he was pretty open about it than he was. Yeah. Is that a thing that you remember him working at? So
Willie Streets 5:35
my dad was always a bigger guy. So he was always working on his health. My mom was big into what was the QVC, home shopping club, all those things. So they will buy all types of gadgets, AV rollers, ad lounges, all of those things, and he will work on his his body, his weight and things of that nature. But on his diabetes, when he was actually diagnosed, he did not work on that. And he says it today, because he makes sure him and my mom make sure that my health is at the most optimal level, because he's had many complications over the years.
Scott Benner 6:17
Yeah. It's such a shame that even even 20 years ago, what what was really known about it, and even the medications that are available now that weren't available. I mean, you look at that story, and you bring it to present day and you think, Oh, he takes ozempic He probably drops all that weight and is a once he goes down and you know, he's he's doing better in a year. It's something How old is he now? How old are your parents?
Willie Streets 6:40
My dad just turned 66. And my mom will be 60 Fool in December.
Scott Benner 6:46
I mean, it sounds like at the very least he laid down a foundation for you and then took it more seriously. Isn't it interesting? It's easier to help somebody else than it is to help yourself. A lot of the times were
Willie Streets 6:57
very, my dad. Yeah, he really took it serious. Because I mean, it's because of him that I believe my life was saved upon my own diagnosis.
Scott Benner 7:08
Tell me a little bit about it. What do you recall from the time that you were diagnosed?
Willie Streets 7:11
Let me take you down this, this tunnel. So a lot of people when they speak about their diagnosis, it's usually some kind of like a physical ailment that occurs, whether it's sickness, virus, things of that nature. But all for me. It was more of a traumatic experience, more emotional. In 2003. My parents were going through a lot. My dad, my mom was on the brink of separation. Because my dad was out here in the streets doing and my parents actually lost their home. Like I remember that day. There was a sheriff's note on the door. My older brother, he's six years older than me, he went and got the U haul truck pack, the U haul truck, went and put everything in storage. We were staying at a motel was a travel Lodge, my parents were staying in one room, me and my brother, my younger brother, who's three years younger than me, we're standing in another room. I remember their neck rare for about three weeks. And me and my younger brother, we would like do whatever to uplift each other. Because I mean, that's my heart. That's my, that's my best friend always. And we would go to like this bowl of Rama and play bowl, play, shoot, shoot pool and bowling and things of that nature. And about two weeks later, my parents had got a house while it was an apartment. And that first week there that that first week there I don't know what occurred. But I remember not being able to sleep and continuously having to get up and go to the bathroom, repetitively, repetitively. And there was a McDonald's that was down the street, and I will walk to that McDonald's and fill up these big cups of lemonade. And I've spoken to other type ones recently, and they were like, you had that lemonade cream. And also, like, I did not know that was a thing. They said something with the citric acid and I've never heard that before either. That's interesting. Yeah, there's some with lemonade, vinegar. All of those things like people crave it. After a few days of not being able to sleep in going into the bathroom repetitively and drinking gallons of water on in. Like I remember sleeping in the bathroom on the floor, because I knew that I will have to get up and go back to like having to go back to the bathroom after going and laying in the bed. And my dad worked overnight. And I remember one morning it was like seven o'clock in the morning. And he was sitting on the couch. So my parents had me me men's women's Biden like they were We're all good. And I walked into the living room and I said, I don't feel good. He's like, what's wrong with you? And I said, I don't know. Like, I can't stop using the bathroom. I said, I can't stop using the bathroom. I'm so thirsty. I feel so dehydrated, like my buddy string. And he looked me straight in the eyes and said, you're a diabetic.
Scott Benner 10:23
He recognized that from his life. Yeah, yes.
Willie Streets 10:26
He recognized. US said to him, like, I just need to go to the hospital. So he told me grandma stuff. My parents don't drive. They've never driven. I mean, lived in a city always called public transportation. We're not. So we hopped on a bus went to the local hospital. Scott, I'm going to mention where I'm from. So I'm from Wilmington, Delaware. I know we got a connection with Delaware.
Scott Benner 10:55
I could tell by your area code when you signed up to be on that. I knew where you were from that?
Willie Streets 10:59
Yeah, right. So I know about your connection with University of Delaware
Scott Benner 11:03
and my wife. My wife got her undergrad there. I spent a lot of time in Delaware. Yes,
Willie Streets 11:08
yes. Yes. So we went to a local hospital, St. Francis, a small hospital, a small private hospital. And before diagnosis, I was big into my physical well being. I'll follow this routine by a former great Philadelphia, running back where he would do 1200 Sit ups and 2100 Push Ups per day. And that was me. I would do that. Hey, are
Scott Benner 11:41
you talking about Herschel? Yeah, no, no.
Willie Streets 11:46
Yeah, he used to be my guy. But, uh, yeah, follow that routine. And I was I was fit like, I mean, I'm a little under six feet tall, 180 pounds. And when I got into that hospital, first thing they asked me to do was step on the scale. When I stepped on that scale, weigh 244 pounds. And my heart just sunk
Scott Benner 12:11
in. Okay, that's a lot of weight.
Willie Streets 12:14
And I could picture my dad sitting in the chair, but his hands like on his
Scott Benner 12:18
face, like heartbroken. Yeah,
Willie Streets 12:23
like, I'm his junior. So, you know, even like, we've had a bunch of problems growing up, as you know, boys and our fathers do. I could, I knew that his heart was broken. His soul was very broken. But yeah, that was the day I was diagnosed on a couple years ago. So right before the pandemic started, so that first February 2020, I actually contacted St. Francis Hospital, because I didn't have my parents didn't have any paperwork. I didn't have any paperwork on the grounds of my diagnosis. So I contacted them. And they told me that they get rid of medical records after 10 years. They don't have to keep them. But they do keep the intake and discharge papers. So I emailed them and fax them. And they were like, yes, shortcoming. Come and get them. So I went and got them. And on there, it says, like it tell us about my diagnosis like, Oh, he's been diagnosed as type one diabetic. My blood sugar. It said it read the max reading, which was 499, I guess the meters they had didn't pass that my agency was at a 14.7. And really,
Scott Benner 13:35
you think that the stress of you're getting out of your home and your parents fighting and all that stuff? You feel like that was part of what brought it on?
Willie Streets 13:43
I do. Get that stress in being a type one diabetic for the amount of time that I have been? I do know that certain things such as stress, so hormonal imbalances and changes do alter your blood sugar. So I do believe that it pushed forward. My diagnosis. I believe
Scott Benner 14:09
that as well. Do you think did you have to say two brothers right? older and younger? Yes.
Willie Streets 14:15
Yes. Two brothers and a sister were three years apart. 7780 83. That's
Scott Benner 14:21
a spread. Do they have any issues, any autoimmune stuff at all? They
Willie Streets 14:25
do not. My younger brother, I keep telling him he, he should go get checked. He always had stomach issues, gut issues. And a few years ago, he was like, I know what it is. I just think that I'm sensitive to dairy and so he's been popping these little dairy tablets or non stop and I'm like, You should go get checked because like I know now that like I have an aunt was diagnosed with irritable bowel disease, colitis when she was a child and In just recently, she got her thyroid removed. She has hypothyroidism. I have this is all on my mom's side. I have two aunts with rheumatoid arthritis.
Scott Benner 15:12
Yeah, there's a fair amount of autoimmune, the IBS and the RA. Maybe your brother's got celiac or digestive issue or something to that effect, right? Yeah. Yeah. I
Willie Streets 15:26
told him he should go get checked out. But he's like, people don't listen.
Scott Benner 15:33
That's why I get a tricky with this podcast and make it silly and stupid. So you're listening about your diabetes? Because it is. It's just tough man. Nobody. You know, sometimes people think they have it figured out and sometimes they don't want to hear the news. So, you know, I
Willie Streets 15:47
thought I had it figured out until the pandemic, really? Everything was cool to me. I mean, I suffered from hypoglycemia on awareness. I mean, I've had many episodes of EMTs EMS at my doorstep. waking me up. I remember a paramedic telling me that it was normal.
Scott Benner 16:12
That's because he sees it so much to probably, yeah, right.
Willie Streets 16:16
He said, he said, I see it all the time. He said, at least it's not happening every day. He said, I got a guy down the street. I'm at his door, like every day or every other day,
Scott Benner 16:24
really, as well. That's a long time between your diagnosis and Pandemic time. So how were you living through that? And you said, you felt like you had it figured out? What did that look like to you? And when did you realize it wasn't? Today's episode of The Juicebox Podcast is sponsored by Omni pod. And before I tell you about Omni pod, the device, I'd like to tell you about Omni pod, the company. I approached on the pod in 2015 and asked them to buy an ad on a podcast that I hadn't even begun to make yet. Because the podcast didn't have any listeners, all I could promise them was that I was going to try to help people living with type one diabetes. And that was enough for Omni pod. They bought their first ad. And I use that money to support myself while I was growing the Juicebox Podcast. You might even say that Omni pod is the firm foundation of the Juicebox Podcast. And it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omni pod.com/juicebox whether you want the Omni pod five, or the Omni pod dash, using my link, lets Omni pod know what a good decision they made in 2015 and continue to make to this day. Omni pod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old. And she will be 20 this year. There is not enough time in an ad for me to tell you everything that I know about Omni pod. But please take a look. Omni pod.com/juice box, I think Omni pod could be a good friend to you. Just like it has been to my daughter and my family.
Willie Streets 18:14
Having to figure it out for me was more so take your insulin. As long as you feel okay, you're good. That's how it was for me for too many years. Many years. I just did not know. I wasn't given the education, the resources, the guidance, the support, that I know is needed to live your best life. Oh, it was like it was skipped. Like even going back to 2003 of my diagnosis. Like looking at the discharge papers. It actually says on there that they're not sending me home with a meter. Because my dad has accucheck meter at home. Good enough.
Scott Benner 18:58
You got one. That's perfect. Yeah. Yeah. As long
Willie Streets 19:01
as he had his accucheck meter. I was okay. That's
Scott Benner 19:05
interesting. Right now, companies are giving away like candy, you know, in here, take a meter. And it's so interesting. Yeah, right. Right. Right. Right. So yeah, Willie, basically, if you're alive, and the guy in the rescue squad tells you, it's all right. You don't pass that as much as the guy up the street. You figure, this is what this is. And I'm looking forward and I'm standing up so I'm doing okay. Yeah, right.
Willie Streets 19:30
I was not doing okay. And I hope that today, the things that I wasn't given or gifted, don't come back to haunt me now. Because those, I mean, Scott, like literally, there was 15 years in between that time where for the first six or six years before I got my current general practitioner, I was on a routine of just giving thing 7030 Mix insulin 30 units before, before breakfast 15 units before dinner. And then probably a year or so later, I realized like I needed more insulin because my blood sugar was rising. So I would just manually inject that, like insulin whenever I felt high. And that created me having so many overnight loans, like our I think it was 2005 2000 fours, a girl who I used to date I was at her house, and I woke up in the bathroom, like half naked with blood all over the place. empties. I had been off half my tongue.
Scott Benner 20:47
Oh my gosh. From a low. Yeah. You mean you were using a regular an MPH for 15 years? Not
Willie Streets 20:54
for 15 years now. So I was using that from 2003 until 2009. Okay, right around that time. Yes. And when I met my general practitioner, he looked at me and said, What are you doing? And I said, What do you mean? He said, We have to get you a Basal and a Bolus insulin immediately. And he did bring eight one C checks because Scott, during this time, I didn't have I didn't get my eight one c check. I'm just wondering that, okay, I didn't at all because I was seeing my dad's doctor and my dad had an issue with him. So I had an issue with him. And I remember going in with my dad and him saying things like, telling my dad how bad he was doing and my dad cussing him out. Because my dad is no holds barred. Like, really, like my dad telling him like, Eff you. You're not gonna be saying this to me and whatnot. So I didn't want to see him. Only use them for my script. Yeah. Yeah, that I was using that for all that time. So like, I truly hope and I tell my wife this, that the things like the education I was in giving doesn't come back to haunt me. Like, really?
Scott Benner 22:09
But you got six. You mean, you have six tough years in there. But you were you were using the insulin though, right? I was using it. Yeah. And you added more when you knew your your blood sugar was high. And it led to lows overnight, but at least it was in there and it was doing something. Right. Yeah. When they finally check your agency, which I'm guessing is right, in your like, you're around 26 or 27. In that age group right there. Right. What was it? You remember?
Willie Streets 22:34
The first one was, I think it was 10 point something like, I think it was like a 10.3. Somewhere around that. So that showed that I was running in that range for all those years,
Scott Benner 22:46
likely? Yeah. Did the fast acting insulin bring that down? Yes.
Willie Streets 22:51
So I remember getting it down to the eight. And then I remember being like around 7.5 for a few years. Then in 2017 2018, I was down to about 6.7. And from that moment on, like, I looked at it, and I started learning more about insulin. And I've been able to keep it between 5.1 to 5.64. Since that time, so since about 2018 2019, my blood sugar has been my glucose levels have my agency has been between 5.1 and 5.6. That has not been above 5.6.
Scott Benner 23:32
And as well done. Good for you. It Were there a lot of lows in there while you were figuring it out.
Willie Streets 23:38
Yes, there were. I had an incident where I was at work in 2015. So I did like I worked at for a big retail company in the shipping receiving merchandising support system. And one day I was out moving something some kind of fixture and my body just started jittering. Like, out of like, I didn't feel it coming on. I've always been hypoglycemic going to where and I don't know if that's because of how was using that. That insulin before that mph and regular regular. Yeah. And all of us next thing I know, I'm on the floor like no down, and I'm shaking. And one of the managers who's working with me, he looks at me, he's like, Well, are you are you alright? And I'm like, I'm not able to talk. And next thing I know the paramedics are there. This was throughout 2015 Because my wife and I worked at the same place. That's where we met. And I remember her meeting me there at the job because she was home on maternity leave at the time. And then don't take me to that same hospital St. Francis Hospital. It was it was it was hard.
Scott Benner 24:58
And when you Have a Dexcom now I hear it so yep, yep, you heard it because my adrenaline. Yeah. Are you nervous?
Willie Streets 25:05
I'm not nervous. No, Scott is crazy. My daughter, she's in seventh grade and she plays basketball. So at a basketball game, I couldn't enter at seven. And I didn't realize this until last year, that I could sit there calm employees, but within half an hour, my blood sugar can go up 50 to 60 points. So I was set in temp basals for her basketball games. It's crazy.
Scott Benner 25:34
Listen, I sit Nicole's baseball game one day, and he hit a ball in a gap and I was screaming and when it was over, I thought I'm gonna have a heart attack watching these baseball.
Willie Streets 25:44
So look, I will go so I started going into her bad basketball games and like doing like a peaceful meditation first.
Scott Benner 25:54
You got this didn't work. When a Temp Basal work that
Willie Streets 25:57
Temp Basal work. That was just a mental thing. Yeah. So yeah. I had another incident at work where I felt my blood sugar dropping like I started getting like real, like, jittery, that's what I always call it. And I'm walking to the break room to try to get a drink. I'm dropping everything. So I ended up getting like iced tea and some peanut butter crackers. And I go and sit down. And next thing I know, I see someone running over to me. They're like, Well, are you okay? Are you okay? And I'm like, I'm just trying to eat these crackers. I'm just trying to eat these crackers. And they're like, you're it looks like you're about to have a seizure. So they're taking the crackers from you. They're like, You can't eat if you're having a seizure. I'm like, I need these crackers. I need these crackers. And they're trying to take them from me like it was crazy. So next thing you know, there there comes the ELT again.
Scott Benner 26:46
I was gonna say so you call it jittery? If you heard Arden. Describe how it felt like she was phasing in and out. Right? I have yet is that similar for you? Yes, yes. Yes.
Willie Streets 27:00
I was thinking about this last night. I recently heard a episode where a young lady was talking about a out of body experience. And I have felt those out of body experiences. Not in the sense of like, I know, she was talking about like, seeing where things think of her parents were doing crazy things to her or whatnot. But um, more so. Like with the jittery feelings, like it's like, I can't control myself, but my brain is trying to control what I'm doing. But my hands are moving a different way. My legs are shaking. My eyes are twitching. But my mind is saying you got this will you got this? Because every time the My wife has found me in the kitchen spilling glasses of juice or whatnot over the years, she's like, You always tell me you're okay. You always say I got this. And she says, I know when you say I got this. That means Oh, hell no. Like, and I say I said thank you. I said just know I never got this.
Scott Benner 28:05
100% Sure. I don't know what's going on at that point. Yeah,
Willie Streets 28:09
I you
Scott Benner 28:10
carrying glucagon nowadays, the Dexcom g7 is sponsoring this episode of The Juicebox Podcast. And it features a lightning fast 30 minute warmup time, that's right from the time you put on the Dexcom g7. Till the time you're getting readings, 30 minutes. That's pretty great. It also has a 12 hour grace period, so you can swap your sensor when it's convenient for you. All that on top of it being small, accurate, incredibly wearable, and light. These things in my opinion, make the Dexcom g7. a no brainer. The Dexcom g7 comes with way more than just this. Up to 10. People can follow you, you can use it with type one, type two, or gestational diabetes, it's covered by all sorts of insurances. And this might be the best part. It might be the best part alerts and alarms that are customizable so that you can be alerted at the levels that makes sense to you. dexcom.com/juicebox links in the show notes links at juicebox podcast.com to Dexcom at all the sponsors. When you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful. Yes,
Willie Streets 29:19
yes, I do. Carry glucagon. I do not leave the house without something on me on a fast fast acting core. Even something with protein to stabilize it as as is once it does rise
Scott Benner 29:35
for you. Yeah. Hey, the lows are they as frequent now as they used to be? Or is that a thing from the past? That's
Willie Streets 29:41
a thing of the past like truly a thing of the past. So I'm currently like, my timer rings is always between like 91 94% God use Omnipod five, but I recently because of insurance is You all went back to using the original Omni pod barrel system. And it's the same like I thought I was going to have this huge like brain for going back to using that but it's the same everything's good but yeah, I don't have those loads as frequently at all. Okay, I still don't feel them much winner coming on.
Scott Benner 30:22
I mean you're using better insulin you know how to use it better now so you've got to CGM has a lot of advancements here for you really? Yeah. So
Willie Streets 30:29
yeah, I was because I was using Lance's from that initial visit with my doctor 2009 until 2021. Okay. glances and humor over and over log. And what do you use now? So, because of the honorable Scott Benner, the man behind the scene, the myth, the legend, I use Omni pod index calm. I did not know of this technology before the podcast before the podcast like I did not. I mean, I've heard of people wearing insulin pumps. My doctor offered me a FreeStyle Libre in 2017. But he never he just told me like this is this seven to 14 day thing you can wear to manage your or you can check your blood sugar. Yeah, I was like, Okay, I checked both 20 times a day with finger sticks.
Unknown Speaker 31:34
So that'd be better.
Willie Streets 31:37
Right? So yeah, the podcast told me that I
Scott Benner 31:41
have to ask you a question. I hope it's not uncomfortable.
Willie Streets 31:43
I'm comfortable in my skin. Well,
Scott Benner 31:45
I appreciate that. And I don't know, you're such a lovely person. And you're so connected to how other people feel, and giving of your time online and your desire to help other people. I'm just wondering where that comes from?
Willie Streets 31:59
Where does it come from? Scott, I've always had a heart. And I've always had a heart to heal, where that comes from. My parents don't even know where it comes from. But they said since I was a kid, I've always been like that, like with my friends. I remember sticking up for them. Like when they were bullies me always hopping in and be like, if you want to mess with them, you gotta mess with me. I've always been that person. Whether it was his school and work have always stuck up for the whether it was the less fortunate, the smaller person or wherever. Because I've never, I've never had a fear of man. I remember I used to tell people that my dad is six foot 300 pounds. If I'm not afraid of him, why would I be afraid of you? So like,
Scott Benner 32:52
I've had that thought a couple times in my life. Yeah, yeah. Just stand there. And you're like, I can take it.
Willie Streets 33:00
Yeah, right. Like, it's nothing. It's just, you're just to me, mere mere mere mortals. But
Scott Benner 33:06
that idea, though, that like being a guy in this space, there are not a lot of them to begin with. Yeah, they're not a lot of man. Oh, and let's be honest, like, there's, there's not a lot of black people in general talking about their diabetes online. And as a matter of fact, I was in Austin last weekend giving a talk. And this young lady in the back, she posed that question to me, she said, The podcast is great. Look at all these people here. And you can see how they're helping. What do you do to reach the people who aren't in this room, and I knew what she meant. I answered her for a while because it's something I've thought about for years, and I've tried, but I don't know. Like, I can't seem to break whatever that wall is. And that's why you're kind of a unicorn to me. So
Willie Streets 33:45
sky. Me being a black man who's always been about his business, always about his family all about God and protecting. I take that with everything I do. It's not just like I said in school, but every aspect of my life is using my heart first. It's crazy, because in the DLC diabetic online community, when I first got on like Instagram, I searched for type one diabetics, and I found many of them. And now everyone comes to me for like, they say, I'm like their online therapist. And I tell everyone, seriously, I'm like, if I can't help you guide you give you to get the educational resources you need, then I don't know who can because I take it upon myself to try to embody who you are. It's a great form of empathy, so that I can navigate the things that you need. Like I have a cousin, who's also a type one diabetic. I didn't realize this until more recent believe that she was a type one diabetic because we haven't spoken much over the years, like me and her brothers grew up like brothers. Like we did everything together. But she's their baby sister who's she's maybe 1014 years younger. I think she's 2627. Somewhere around there, then the youngest brother, so we didn't grow up that close. And she was diagnosed at 12 years old. She came to me in 2019. They live in North Carolina. Now, they moved there a few years ago. And she was asking me if I had any 7030 insulin because she had broke her pin or something. And I'm like, she doesn't want me use it her name. I'm like Khadija. You're still using that. 7030. And she's like, Yeah, I'm like, You need a regular. I said, you need a basil and a Bolus. She didn't know what that was. Right. So since then, like I've been helping her because she's, she may be a little older than that. 2728 And she's had the most complications. I've come across the someone so young. And she started off she told me that she had neuropathy and her foot. And like I said, it's got like, this is gonna be the realest. You ever heard one eight. So she got into Robert D and her foot because she actually got shot and her foot. And when she got shot her foot, they didn't get out the they weren't able to take out all the fragments of the Bolia her bones was crushed. And her foots never healed. Like her foots been broken for about six or seven years. Now. She's, and she has minimal movement in it like it's swollen. She has that she has written off at the she did not know she had written up the two years ago. She about her dad had told me she was like, You need to talk to Khadija. Because they said she's going blind. So I called her and she was like, yeah, they said, my left eye is completely blind. It's blocked. I can't see out of it. So I told her, I said, I reached out to people that I know online. When it comes to diabetes. There's like I can reach everyone. Like, I am a very communicative guy. Like it's easy to approach me. Yeah. And I will take my time to write down the things that you're going through and reach out to whoever or whomever you need to help better your your existence. You're
Scott Benner 37:36
acting as a bridge for people who don't know how to get to the doctors and the information and the technology.
Willie Streets 37:42
You're actually you know, why? Because I didn't have that. Yeah, no, I know, I didn't have that we
Scott Benner 37:48
kind of glossed over it before. Before you go on. You talked about having to embody the person that you're dealing with and really feel what what's happening to them so that you can actually help them. That's, yeah, that's it's very important, like a and it's hard to is Do you find it hard on you because I do it. And there are times it's hard on me. I mean, you and I have been talking for 40 minutes. I've almost cried twice while you were talking just when you were celebrating like successes in your in your life. It's
Willie Streets 38:15
not for it for me. It's not. I actually love it. Like you hear about people who hate diabetes all the time. I absolutely love it. And you're not going to hear that often. Because the reason I love it is because it gives me the opportunity to help other people heal other people like it gives me I don't it just feels so good to me. And I tell people that every day. If I checked my inbox or like Instagram, I'm pretty sure I got 20 messages right now. Yeah. Like I've created communities. I have one community. It's just Philly region Daya crew. That's what I call my communities, the dye crew. And we're about 65 deep. I have one that's all people of color, different origins. That's 80 Plus, I created one in Atlanta area because I had a young lady who reached out me reach out to me in the summertime she didn't have insulin. So I went and searched for people in Atlanta area and created a group for them. I I do that because there was a point in time when I didn't have that where I had to find out how I was going to get insulin. Join different programs such as three four UB prescription program, join different medical clinics, things of that nature. And like when I hear people talk about how they they're scared that they're going to lose their insurance and I'm never afraid of losing my insurance because I know the different resources and how to how to navigate them. I'm always okay, right
Scott Benner 40:01
340 B, solutions, pharmacy benefits, I'm looking into what it is right now. Can you explain it to me.
Willie Streets 40:10
So with the 340 B program, if you have a community health clinic, there are more so for people who meet under certain FPL federal poverty levels, you go to that clinic, and that clinic is linked with a pharmacy such as Walgreens, CVS, and it gives discounted prescriptions, okay? to persons who are in need.
Scott Benner 40:41
And you know how to get that's what you're saying is you know how to get to that. So you're comfortable, and you're teaching other people how to get to it as well and creating communities. By the way, next year, I might do a little tour sponsored by a company of like in person talks. So if I can actually make that happen. I'll contact you about doing one in Philly.
Willie Streets 41:01
Yes, sir. Let's, let's make it happen. I have events coming up this week. Next week in Philly, do you write for the paradise film, I have a event coming up on November the 14th. At the in theater, where like, I reached out to someone who was like, I want to do this, because I wanted to host an event T one d plus love, which means is type one diabetics plus people who they love people who mean everything to the people who shouldn't know. So we're hosting that event. And you bring people bringing their significant others, partners, family members, so that they can sit down and learn more,
Scott Benner 41:45
Willie, you're the you're the answer to a question that I've watched people ask over and over again. So I'll share some behind the scenes stuff here with what's that question, I'll share some behind the scenes stuff here. And like the diabetes space, when you talk about companies and stuff like that, I've watched and you've probably seen this too, about once a year, they get it into their head that they are going to you've seen it, they're going to help black people, right. And they started push, and it never goes anywhere. And then they let it go. And I've watched it happen time and time again over the years. And just not six weeks ago, I was on a call with somebody. And she says to me, Oh, we have a big initiative coming up, we're gonna really reach out to the black, the black and brown community and I laughed at her, I was like you doing this again? Like, I might because you keep doing it the same way. And it keeps not reaching people. And I mean, not for nothing between you and me, what it feels like is a bunch of like, I don't know, another way to say it is it feels like a bunch of white ladies trying to help and they don't know what to do. They want to help. And they have great intentions and they have resources, but they don't know how to reach people. And I think once they reach them, the people that are reaching might look up and think, you know, I'd be more comfortable. If this was Willie reaching out to me. That's the thing I don't understand. I don't understand why they never find a person like you to spearhead this kind of stuff. Because that makes sense to me. Because I feel like with some resources, I mean, look what you're doing by yourself. You know, like, I feel like with some resources you could really, like get that movement moving like that girl talking to me last weekend. I'm not gonna be the one to do it. Like you're a unicorn Willie, that you listen to my podcast seriously. And
Willie Streets 43:24
now and when you were saying that about the girl, all I'm doing is I got this Rolodex in my head. And I'm trying to I'm thinking like, do I know who that is? Because I know people in the Austin area. That whole Dallas Fort Worth area. Like I know people will over write all over the world,
Scott Benner 43:40
Scott. Yeah, no, I mean, man, listen, I've cracked a couple of social circles. I didn't expect to the podcast is big in India. I didn't expect that one. And it actually does pretty well in sort of the United Arab Emirates, like that part of the country as well. Like, there's places where I've found different cultures and they've they've jived with the podcast, but I don't make inroads in the black community. I just don't. And I can't, I mean, I'm just me, you don't I mean, like, I'm doing the thing I do, and it hits the people that hit but I've tried having guys on, I've tried to have a women on, you know, I'm not usually a person who points out the color of your skin while you're talking. So there's been a number of people on here I've been I've never mentioned it, like as we're going but I bring it up with you specifically, because you are so adept at gathering people together and getting them good information. You know,
Willie Streets 44:32
think who was there during the beginning of the pandemic. I'm very grateful to date. I was diagnosed with something called hassle when I'm going to younger, highly superior autobiographical memory, really believe it was August 2020. And you had a guess it was like August September, Cameron. Oh, Cameron. Yeah. He was terrific. So Cameron's a great friend. Yeah, yeah, we formed We begin to die crew together. You had you were talking to him about those types of things.
Scott Benner 45:05
I recall going on a hell of a rant when I was talking to Cameron. And
Willie Streets 45:09
yes, you did. I remember like it was yesterday. I
Scott Benner 45:13
remember feeling bad when it was over. I was like, oh, man,
Willie Streets 45:15
I talked about it. But um, it was needed. That's what I always tell people. Yeah, voices are needed.
Scott Benner 45:21
Yeah. They're not just saying they want to be helpful. I talked to them. I know them personally. Some of them, they really do it. They're not just trying to look like they're doing something they really when it doesn't work, they're defeated. Like, they really want it to work. But I just don't see how a 45 year old white lady who lives on the main line is going to reach you know, somebody in somewhere else who they don't have anything culturally, you know, in common. Nothing. I don't know, I just I wish one of them would just see somebody like you and say, This is the person, like we need to hire this person and let them do the thing that they're already doing and just support it instead of trying to do it themselves. But when they know damn, well, it's not gonna work, you know?
Willie Streets 46:05
Right? Because when they do reach me, I try to help them as much as I can. Yeah. So like, even a few weeks ago, I had a young lady from University of Chicago reached me about a research study they're going on, they're doing with T one DS, a black tea, Wendy's, and they couldn't really find anyone. Yeah, it's hard. Someone had someone had sent her my when I told her, I said, I'm willing to help. And I said, I have a community that I'm willing to share the information with. So we did like a 45 minute conversation, and they just wanted to know how to reach people, but not and I told them, I'm the guy. I'm the link.
Scott Benner 46:41
Yeah, no, I have 1,000,000%. I believe it completely. Is it cultural? Why can't they find people?
Willie Streets 46:46
I wouldn't say cultural. But I know for a fact that when we say the word diabetes, it gets ignored. It's not like many people say, it's the sugar everyone like people, you get the sugars. It's more so any disease, any chronic illness is hidden from like, my dad has stage five, kidney disease. And I've been advocating for him, my younger brother has signed up to actually give him his kidney. But my dad is he has to go through all these like, what I consider like pre prerequisites to make sure that everything is good, because he's getting older, right? And I remember telling him to reach out to his nieces and nephews, everyone, because like, they're very close. But he's like, Nah, I'm not going to do that. Because they're not going to help me. I know, they're not going to help me. And we hear that often. I don't know if it's because of the things that we've been through as a community as people that because of these things that when it comes to things such as health, we don't speak about them. Are
Scott Benner 48:07
you saying that a quiet struggle is a is a learned? Response?
Willie Streets 48:12
Yes. So if someone asks for money for a bill, like someone say, I can't pay my electric bill, someone will be like, okay, here are the resources for it, or I can help you or whatnot. But that same person, if they're in need of, like I said, like a kidney or whatever, they won't reach out to those resource those people, those family members, those friends. And it's, it's crazy. Like, I don't understand why.
Scott Benner 48:41
Well, that's even a severe example, like, I'm just talking about knowing that your health isn't optimal. And how can i Is there a way for me to fix this, but you know, that also, this is, it's also a little silly to talk about it in this light, because there are plenty of white people who don't know that their, their health could be better either. It starts with your doctor, having the knowledge and passing it to you and giving you the idea that there's better out there, I can go find it. And the truth is, I don't think many physicians are in that position. And do that. It's, you know, it's sad, but how is that not the case? Like how was everyone walking in? I mean, look at you had a 10.3 and a 275. Is that, you know, no one ever says to you, hey, you know, geez, if you're a one sees 10, maybe do this. You got one doctor who said use us better insulin. That's all you need it all you need it to get you on the path of doing better with somebody to say, hey, there are better tools than the ones you have right now. And
Willie Streets 49:41
at the moment, I stepped into an endocrinologist office, my endocrinologist who's like, do you want to join our team? We need you. Yeah. Because my doctor and my nurse practitioner are both women of color. And they're both like we need you because there are so many People that don't know that they can better manage to live their most optimal lives. So they're like we need you in this space. So that's a few years ago, I have made a post on the Juicebox Podcast Facebook group about taking the steps to becoming certified diabetes educator. And I started that process during the pandemic. I paused that and started doing a MPH program, because I saw that it wasn't diabetes that I needed to help navigate through, it was more of a public help. Yeah, it's
Scott Benner 50:43
right. Yeah. If you know how to get people to services, then you can do that in every space, not just in a diabetes, because I didn't know you were trying to get an MPH. Yes. Oh, that's good for you, man. That's terrific. How many kids do you have?
Willie Streets 50:58
I have three kids. So they are? Well, my oldest is about the 15th, November 23. My daughter will be 13 November 10. And my nine year old His birthday is in February, February sixth
Scott Benner 51:10
beautiful, congratulations. That's lovely. They're
Willie Streets 51:13
the best. And, you know, you raise to two wonderful children. And I tell my children every day that we prepare to take over and just to take on the world, like my kids are absolutely amazing. My oldest, he has highly functional autism, Asperger's. Okay, you're 50. And yes, something we've recognized is he was younger. So he was diagnosed with like, ADHD and stuff, but so with him, mom and I, or practicing to be able to somehow support him into adulthood, because we know that he's going to need more resources or whatnot. Yeah. My daughter. She's just like this life, wildfire. Who's ready to take over the world. She's like, she already she's in seventh grade. But she already knows where she's going to college. She already knows where she's gonna live. She already like she knows everything. She doesn't know the steps in between. So figure that part out. My nine year old, he's considered a child prodigy. He is the absolute smartest, most brilliant person that I know, like, serious Scott,
Scott Benner 52:34
like real academic, or is it very, like just aware of the world? academic
Willie Streets 52:38
world? Everything? If I asked him, or if you set to mention to him any animal, he could tell you where like, is that that tension is nation of origin, all of those things? Chemicals, biology, plants, world history, anything cultural world history, like he could tell you about every dynasty. Anything very
Scott Benner 53:07
curious, knows about the things that he reads about afterwards. That's very cool.
Willie Streets 53:11
It's excellent. Yes. And his math skills every like, he's been like, we've been talking to him and other people have also about skipping ahead and whatnot. He's like, I will never ever skip a grade because I need every every grade. He's like, he loves education. He loves his schooling.
Scott Benner 53:27
That's beautiful. That's wonderful. Yeah. Wow. How long have you and your wife been together?
Willie Streets 53:32
We've been together since 2010. So, yeah, that math doesn't add up with your oldest. Yes, because, um, I actually took March 24 2010, his biological father was was murdered. Oh, my gosh, like in front of his home. And my wife. And I, like I said previously, we've worked together since 2006. And, I mean, we've always been cool, and like close or whatnot. So I remember telling her during that time that she was going through the storm, that I will be there to help her and her baby. Make it through Willie, and
Scott Benner 54:24
your wife's son, her oldest, your oldest son is hers from another relationship. And that gentleman was murdered, and you stepped in and helped her? Yes. And that's how you guys got together after being friends? Yes.
Willie Streets 54:40
I've never any and just the other day, I got a call from his school. Because, like, I told you that as far as like, keep going, take off his hood or whatever. And I showed up at the school. And a guy who knows his uncle, his biological uncle, like as we're leaving, he goes, Man, he's like, you're gonna Great, awesome job. And I said, What do you mean? He said, Because you stepped up. I said, I did not step up. And he's like, but you did. I said, That's my child. Yeah. Yeah, I'm the only father. He knows him. But like, I make sure that he knows about his biological father. He has a relationship with his grandmother and his uncle and stuff. But um, I told him like, I'm like, Yeah, I'm going with a father does were his children, my
Scott Benner 55:29
brother's stepfather to two kids, and there's no way to discern that he's not there. Their father? Think, you know, he doesn't think about that way. He doesn't talk about that way. None of his actions would tell you that. It's really it is it is, it is a wonderful thing. You know, but I take it from your point, you don't see it as a stepping up, you just see it as this is how it is because that's my son.
Willie Streets 55:53
That's my oldest. That's what I told him. I said, That's my oldest. Yeah, he's he shook my hand was like, I appreciate you.
Scott Benner 56:00
But really, you're just, you're just a different person than like, it's like,
Willie Streets 56:03
that's what I was telling you. Like, I've always been this person. Yeah. You know, something that oh, it's not fabricated. It's like, like, my iconic hero was to Baltimore, Chicago. And he was the realist. He never held his tongue. He always he was, he was trained in political warfare, political climate. But at the same time, he was innate to his community, his upbringing, those types of things. And I'm deeply rooted there, whether
Scott Benner 56:36
you're not giving yourself enough credit, though, like Willie, the other night, you sent me an image, my mom passed away this year. And when I realized that that was going to get around the internet, I kind of got ahead of it by putting her eulogy, you know, up on the Facebook group, because I realized that my people are going to know and then it's going to be 1000 questions, I thought, maybe I'll just keep them all in this one post so that it doesn't get overwhelming. But I used an old photo of my mom that I actually have hanging up behind me when I when I make the podcast, and the other day you sent me out of nowhere, you're recreating the picture in a painting. And I don't like that's beautiful. I just I mean, I can't tell you so many people have done nice things for me over the years. But it was stunning, and absolutely lovely and unexpected. But when I saw it, if anyone else would have sent it to me, really, I would have been like what's happening. But when it was you, I thought, this completely checks out. You just have such a big heart. And I've never met you in person. I know that to be true.
Willie Streets 57:34
Scott, that's my gift to you. Because I don't think you know, the things that you do. Well, I know, you know, but the impact and influence. I just wanted to give you your flowers. That's really never in a person's lifetime, do they ever think that the influence from experience they share will become impactful. Your life truly is meaningful. And the things you do are important and impactful. Thank
Scott Benner 58:04
you. I don't know what else to say. But thank you, but I really do appreciate it. It is hard to know, when you're doing something, it's hard to know who it's reaching. Or you know, like even doing that, that in person thing. I've done a couple of them recently. And it's you look out on the crowd and you realize like all of these people listen to that podcast. It's crazy to me still, you know what I mean? Because I'm isolated when I mean I'm in a room, like I'm just in a small room with some equipment and doing this thing. And if I don't get that feedback, I'm left to just imagine that it's going well like you wouldn't know this but last night I port Isabel Isabel helps me with the Facebook group at Port Isabel endured about 45 minutes of like self loathing texts from me about how I'm not doing well enough. And I'm not growing the podcast fast enough. And I'm letting people down. Like, you know, like, like, I just had a moment where I was like, I could be doing more with all this. And
Willie Streets 59:06
you know what I'm gonna say about that. Look back at 2015
Scott Benner 59:10
No, I know. I know. But it's hard to when you're when you're in it. Like when you're in it. And it's it's like well, we I think we're going to do maybe five 6 million downloads this year. And we did like four and a half last year and I think it's not a very big leap four and a half to six it which is ridiculous. I know. It's ridiculous. Well, I don't worry. But every once in a while. I don't want to call it pressure because I don't feel like pressure. But that feeling that I know I have something and I've seen it help this many people. Why am I not reaching more people? How come I can't find a way into a black and brown community? Like why am I like why am i It feels like you know what I mean? It feels like you have the answer and you can't get it to the people with a question.
Willie Streets 59:54
But I think everyone that does this type of impactful work. Think that That way, like, every, every day, I'm helping someone navigate. So like, even like I've created a hub where I get supplies. And I reach in, like, if I see someone there need, like, I'll share the supplies with them. I had a mom, two weeks ago drive up from Cherry Hill area to meet me in a parking lot in New Castle Delaware, so that I can give her daughter some some insulin.
Scott Benner 1:00:31
So lovely like, and you're kind of creating that network where you can actually help people.
Willie Streets 1:00:36
Right? Yeah, that's we have to do because, look, I have, like I told you about my cousin, who's a type one diabetic. But everything that I do is to make my grandma's proud. Like, I look at them all the time with the visions that are secure in my head. Because in 2003, during that traumatic experience, my grandma was diagnosed with cancer. Going through her treatment, she was diagnosed with diabetes. I remember her at the time, even being more advanced than me, she was using Lantis because I remember going over to her house and she had a box of them. She used to use Atlantis and when say humor log at that time, and they said that her diabetes was offset from her treatment. And then this past year, I had me and my brother, I think like Thanksgiving last year, we started looking into our family ancestry. And the one person we wanted to look into was our great grandmother because even my parents, my grandma, my mom and her sisters and brothers never met her she passed in 1954. My great grandma Viola, okay. And we were always told that she had an indigenous upbringing that she was a native woman I want to say of the Susquehanna hawks, and that she was abandoned as an infant. And she was taken in by a family in Lancaster, Pennsylvania. So I look at her death certificate because my grandma was only 19 when she passed, and they always said that Viola passed from they said that she had became varietals that was frail, thin, and like she was dehydrated and whatnot before passing. So I look up her death certificate, Scott, you know what it reads, as diabetes, every Viola was tended to from January 19. Until February 3 by a nurse, it says it says she became frail, thin, she's always small out. So she became frail, thin, and on the death certificate every eat death due to acidosis. What year is this? 1954? Before they should have known what to do, and they lived in a rural area?
Scott Benner 1:03:04
Yeah. You know, the Egyptians, they think called diabetes, the great drain, because they believed you urinated yourself to death. Right? Yeah. That's a similar description, honestly.
Willie Streets 1:03:16
So a lot of the things I do always look and say, I just want to make my grandma's supper. Yeah. Me, Viola didn't have the best upbringing. She, I mean, she was abandoned as an infant. But she was raised by a great woman, just like just like yourself. Yeah. She raised my grandma, who was a great woman.
Scott Benner 1:03:36
I think about that all the time, that I'm just, you know, when when somebody gives you up for adoption, or abandons or whatever you're just left up to its randomness at that point, like, who lands on you and helps if anybody, and hard not to see my mom at the end of her life and realize that, you know, just this thing of her wanting to have a baby, this lady in Pennsylvania, you know, is the reason where I, you know, why I grew up where I did and how I did and all the little things that go into who you are. And it just, it's random, like the next person could have got me like they, it was actually really, the adoption agency called my mom and dad, and told them if you want the baby have to come today, or he'll go to somebody else, but there was she raised the issue. Yeah, but there was incredibly bad weather. Not normal for the area was there was a hurricane. And, and my mom and dad, like, thought through that got to me anyway and grabbed me because they said, If you don't come today, he'll go to somebody else. And that's just, you know, even that little decision, because, you know, you never know somebody could say, well, it's a hurricane. That's scary. We'll wait for the next baby. It could be that easy. So yeah, I've always thought about that. It's nice that you're thinking back on those people and still trying to be representative of
Willie Streets 1:04:56
them. It's really nice. They needed you and you needed them.
Scott Benner 1:05:00
I hope so. I hope I helped them somehow, you know? Yeah, but I have the same dude, I have the same feeling you do. Like I very much want to help people. I know about that joy that you're talking about, about how it fills you up. When you when you do that for somebody, it's undescribable. Everyone should try it if they haven't worked
Willie Streets 1:05:21
really, really good. And when I hear about people sitting there, like they're going through diabetes, burnout or whatnot, like, I did go through a burnout when I transitioned from, from MDI, to a pump, but that was about it. Because the community that I've built and how I help people that alleviates any stress for me, like it feels good. I actually, like it feels so good. Yeah,
Scott Benner 1:05:48
I don't know how to, I mean, I guess people learn it in their own time. And hopefully, they come across it in their life by really, you know, like, I tell, I'm pretty honest here, like, I'm not a religious person. But being in service to other people is incredibly filling, it very much helps you, I usually the way I usually say it on the podcast is you guys might not believe this, but this podcast helps me way more than it helps you. So and I think, and
Willie Streets 1:06:14
I've listened to every single episode many, five, five times over. And I know you've seen like, like I've shared many episodes, but I've never spoke about how how fast you got, I know we're winding down to time, you're fine. The way I found you, Scott was, again, during the pandemic, was listening to a few podcasts. And I'm trying to during the pandemic, you keep seeing all these things pop up about diabetes, and the virus, and whatnot. And I said, I need to buckle down, I got to do everything I can to make sure that I'm going to be here for my children, for my family, for my wife for life. I did a Google search of podcasts, and diabetes. And you know, what came up first hope it
Scott Benner 1:07:04
was me, or my SEO sucks.
Willie Streets 1:07:07
You know, you know, some say your top 10 medically but I say number one in my heart, like for real. So the it came up and I started listening. I took a break for about two months. And then like I began, I started, I started going on these walks with my pup. And on his walks, I would just plug you in, tune you in and started from episode one. And I went through every single episode because I just wanted to, I liked seeing the evolvement of people. And I just I can't Can't hear you reaching more, getting more articulate in your speech and how you were able to break down things. But it felt good knowing how it started naturally. And I know today because of the algorithm pumping and whatnot. Like it's less technical when it comes to like management. And I've heard this like throughout the podcast. But knowing the incremental steps you took the measurable steps you took to help people like I knew that this guy was real. Like, you're you and Orton did something for this world that one day she will recognize right now she's living her best life as she deserves. But she will recognize that one day, and I am sure you recognize it. With the 20 million plus downloads to impact.
Scott Benner 1:08:40
I feel it now. I didn't like before I was hard to accept but I'm okay with it now. And that's the wrong phrasing I maybe it's not, maybe I do maybe I accept it now. And it's just, I don't know, like, like I said it just now it just feels like an imperative to reach more people and, and to move on I and I take your point, by the way about watching me evolve in it can kind of give you the feeling like Oh, I could evolve through this too. And yes, sir. Yeah, it's a leading by example thing not you know, it's funny, Billy person probably doesn't know that. I'm not gonna mention them by name. But I, Somebody, please no one else do this. But somebody reached out to me recently. And I was doing like an Ask Me Anything on the Facebook page. And this one person was like, Would you listen to my podcast? And I did. And then I, you know, we spent maybe an hour on the phone afterwards. And I gave gave her my feedback about it. And the one thing I kept telling her was, is you have to stop explaining your story. And just tell it, you just tell it Yeah. And like I said, like you're telling me why this is an important story. I said if it's if it's a well told story. I'll know it's important when it's over. Like you don't either.
Willie Streets 1:09:56
There will be a continuation of it. Yeah,
Scott Benner 1:09:59
you don't have to tell For me, it doesn't have to be repetitive. Yeah, it's beautiful. And I got a nice note back from her. And she's like, that was really great advice. And she's like, I think it might be good advice for my life as well and start talking about how she finds herself justifying herself sometimes. And I said, Oh, that's exactly it. I'm like, you're explaining to me why it's okay that you tell your story. Just tell it. You know, and that's something that I've learned, like, making the podcast that, you know, you put yourself out there and, and it's, it's picked up by the people who, who needed or wanted. And for those who don't need it, or don't want it or don't like you, for whatever reason, that's fine. Like, just, it's not meant for everybody. It's meant for the people that will intersect well with it. Yeah, it's just
Willie Streets 1:10:44
like, I'm not into, like, always mentioned reinventing the wheel. So even before us, search for your podcast, like I had some people lined up that I was going to record with that I was going to create a pocket. And then once I found yours, I said, I'm not reinventing the wheel, because this is amazing. Like, this is the need. And I'm going to continue to share this with everyone. Thank you. Right? It
Scott Benner 1:11:15
is true. I heard somebody say it, who was I listening to the other day? I forget, they were talking about businesses, and how hard it is, once someone has the momentum, it's almost impossible to take it from them. And, and I do think that sometimes I see people going out there and doing something and they have all this desire to help. And I'm like, don't beat your head against this wall. I got this like, like, I don't I hope that doesn't sound terrible. But like, I'm dominating this space, you can't get into it now. Like I have the momentum. And it's not that you shouldn't try if you want to. I'm not saying that like absolutely do. I'm not trying to dissuade anybody from doing anything. But if you really have this heart to, you know, help, there are probably avenues that are better suited for you that you'll have a better opportunity of getting into. And I know that probably sounds pompous, but trust me, it's not like you're not going to, like if you woke up this morning and decided you wanted to make an electric car. You too late. Tesla did it. Like they did that already. So put that effort in. It's something where you can really like shine is kind of what I mean, it's a weird thought. And maybe only a few people get to have that perspective. But it is very also just in credibly intelligent of you to like, have that thought. Like, seriously, your your your I love you, man, like you're fantastic.
Willie Streets 1:12:38
So fully understood. And
Scott Benner 1:12:41
that's, that's just the exact right thought to have in that situation. I'm going to do this. Well, somebody's doing it already. How am I going to? How am I going to break through? I don't know, some people might hear that and think, no, try anyway. And I'll get old one day and one of you will do it. But like, you know, in the moment, makes a lot of sense. That probably sounded terrible. But I really do believe that. So I
Willie Streets 1:13:03
know where I come from. I'm not from a place or a town where everything is available for me. So I'll come from a disenfranchised community of black and brown people. So I know that it's harder for someone on the outside to reach in. But like when I first heard your voice and realize, like I said, I got a connection with this guy. I said because he's from the Philly area. And I spent most of my life in the Philadelphia area. So and I know that when it comes to like cultural barriers, if you can make it in Philly, you can make it anywhere. Yeah, that's true. You know, that, like, just walking the streets, like whether you're in fish town, Center City, like anywhere.
Scott Benner 1:13:53
I remember seeing on this podcast once. If you want to know what it's like to be from Philadelphia. Imagine you're walking down the sidewalk and you fall over. First, everyone's gonna laugh at you. And then they're gonna check to make sure you're okay. And then if you're okay, they're gonna break your balls while you're walking away. It's like, it's crazy. Yeah, if you can live through that, you'd be fine. You know? Yeah, it's it's a wonderful area. I just I know somebody who's getting ready to move here now, who you know is from the south and said, You know, I really am attracted to Philadelphia. I'm gonna move up here. I was like, You should like it's, I think that for five seconds back when media was very focused on just a certain few things. We got hit pretty hard because somebody did throw D size batteries and Santa Claus and an Eagles game one time and I think that were snowballs or something like that. I think that you know, gave everybody a bad taste, but maybe even with sports, that's going to change now because all of a sudden, you know, if you're a professional baseball player, build off is one of the places you want to play now. And through the Yeah, and the Eagles are fantastic. And you can see those guys bring in another guy You know, we just the Eagles just picked up a safety from what Tennessee the other day and came up here. And what did what did AJ brown tell him like when he got there? He told him like, Hey, you're a winner now? Like, right like, and that's the vibe that's around Philadelphia sports, not the flyers there. It's that rocky mentality. Yeah. But it finally exists in a way that people see it and see that oh, yeah, exactly. Right.
Willie Streets 1:15:25
We got rid of James Harden other day. We're all winning.
Scott Benner 1:15:29
Really, I can't tell you, I woke up and James Harden was gone. And I was like, Oh, my God.
Willie Streets 1:15:35
It was too much going on about that conversation. Like, let's just move past it. Seriously, just
Scott Benner 1:15:41
that guy. The minute we got him. I was like, this is going to end poorly. Like, it's like, it's like when you see your buddy dating the girl and you're like, Man, that's gonna end with your shirt on fire in the street. Like,
Willie Streets 1:15:52
I told my brother that he's like, he's gonna be this. He's got them. Like, no,
Scott Benner 1:15:56
my son did the same thing. He's like, No, he's great. Two years later by kids like, Oh, thank God. Like, yeah, no, James Harden is a hot girl burns your clothes at the end. That's exactly what
Willie Streets 1:16:10
he sees. He sees something different.
Scott Benner 1:16:12
No kidding. That's hilarious. Something different.
Willie Streets 1:16:14
He's become a persona that can nobody meet.
Scott Benner 1:16:19
Yeah, and interesting enough when he decides to when he turns it on. Do you think that's one of the best basketball players on the planet? It's crazy. Yeah.
Willie Streets 1:16:26
He's very, very gifted. Yeah, no kidding.
Scott Benner 1:16:29
Anyway, all right. are we covering everything that we wanted to? I want to make sure we're not missing anything. Look,
Willie Streets 1:16:33
I had a bunch of things. Yeah, I have. I have some notes. Some bullets. But um, for the most part, yeah. We didn't delve into I do have some some complications. Well, I'm gonna consider him really complications, like I don't have any diabetes related complications. But talking about the pandemic 2020. I caught COVID Like that early, solid, two years without catching COVID until 2022. July 30. I mean, these dates are remember more. And after that, I started getting this crazy brain fog. Yeah. Where I couldn't remember. Like, from point A to point B, what was I doing? And coming from knowing that guy had the superior memory, like I had to like really, like look into like, what's going on scary. Like I was diagnosed Previously, I had high blood. I have hypothyroidism also, you know, I've got my levels below. too. Nice. On top of that, like I was diagnosed with fibromyalgia, because I've always like I've had I have this chronic pain, especially at these different points, like my knees, my back, my shoulders. Like I went 12 years with being told that I had a torn rotator cuff, getting injections or whatnot, come to find out. There shoulder to shoulder many times older calcific tendinitis. So I had start seeing a physical therapist for that I have more or less, which is restless leg syndrome, Polly Orthology, which is a chronic arthritis. I've been tested for you, but it's, it always comes up negative. Well,
Scott Benner 1:18:22
you gotta be careful that ra thing you can come up negative and still have it. It's right, you are describing it, maybe they're calling the RA Fibro, is that possible? Possible.
Willie Streets 1:18:32
But like when they connect, they connected with the neural, neurological in differences there like it seems more like Fibro if not Fibro. So I have a appointment with a neurologist in March to get screened for Ms.
Scott Benner 1:18:53
Really?
Willie Streets 1:18:54
Yes.
Scott Benner 1:18:55
Do you think that's possible? I do. How come? What are you saying?
Willie Streets 1:19:00
It's more like the brain. The main reason why I continue to do as much as I can in the community is because I have to put it out there before it goes away. That's why I finally decided I needed to be on a Juicebox Podcast is because I did not want to lose the gift that I have of giving your flowers sharing insight and education. I did not want to lose that in my brain where I was able to put it out there. Even though they say things such as Fibro and a mess that they say it doesn't get worse. It just it just there. Yeah.
Scott Benner 1:19:43
See, I've always wondered because you're one of the people I've been trying to like I've been saying forever, like she'll come on the podcast and you're always like, no, no, there'll be a time there'll be a time I never knew what that meant. I don't pry like you know what I mean? Like I figured you had your reasons, but I'm thrilled that you that you want to I just remember you like coming at me one then you're like, I'm gonna, I'm gonna get on the podcast now. I'm like, I'm gonna use that link and get on. I was like, Oh, great. That's fantastic. I didn't know this is why though. That's kind of a little sad, but you're telling me yes. But
Willie Streets 1:20:10
I have a friend, a close friend in the diabetic online community. And she's always like, that's your car, you gotta get on there. You gotta get on there. So I sent her a message the other day. And I said, I'm getting on. And she was like, for real? She's like, okay, like,
Scott Benner 1:20:28
I'm so happy. No, I'm thrilled you're here, I really am. So when you go to this appointment, they're gonna give you testing. And they're going to tell you more about, about what maybe can be done or
Willie Streets 1:20:37
very, right. So I have no fears, none at all. And I'm okay with that, it's better to be diagnosed, than to just sit there in a waiting, like, trying to manage Interborough life.
Scott Benner 1:20:54
Yeah, Willie, thank you for saying that. Like, that's the thing that I, it breaks your heart over and over again. And you've told you're telling the story for the last hour and a half of people who need help. And just for whatever reason, decide, I'm just going to silently go down with the ship instead of like, stepping forward and trying to, like, make things better for themselves. I just wish more people would, would do that. And you know, have that opinion of like, I, there's got to be something out there I could do and try and go after it. Like, don't just give up the first time somebody says Now there's nothing you can do. You know, like, just really work towards it. I do that with my kids. And my, you know, myself and my wife, like I don't give up like, I started using that we go V for weight loss. And I look at oh my god, like
Willie Streets 1:21:44
look at your brain and get out there with coal and catch that ball.
Scott Benner 1:21:48
I could do it now.
Willie Streets 1:21:51
It's not gonna knock you over this. Well, now
Scott Benner 1:21:53
I don't want anything. No, my Oh, my. But no, like, that's the like when I had that thought. I'm like, What's, like, why are people afraid? Like, I'm going to try this thing. Maybe it'll make my life better. And look, now, it's 10 months later, not even. And it is better. I weighed 40 pounds less. I'm like, in a significantly better healthy situation. And, you know, people are like, what are you going to do? Like, you know, do you keep taking the injection? I'm like, I don't know, I'm going to do whatever I need to do. But I'm not. I'm not sitting back. Like, I really thought about your dad when you started talking hour and a half ago. And I thought that poor bastard. Like if he just had this pen I have sitting here. He probably because really I haven't. I don't know what I talked about on here sometimes. But my brother has type two diabetes. And he and I were just texting the other day, seven, eight to a five six on weego V and hasn't really gotten his diet together yet. He lost. He's lost like 35 pounds. And his a once he dropped to full points. That's just awful. We go we just while he's ozempic? Because it's type two. Same, same drug. Yeah. And so that's significant. And you say that out into the world. And somebody goes, Oh, I tried it. It made me nauseous. I don't like okay, if it's not for you, it's not for you. But don't get swayed everybody else from thinking about it. Like know
Willie Streets 1:23:18
what I say about that? Like, I'm like how you say what you're like you try to your brother tried into things that it doesn't benefit you. Yeah, I've looked at the advent of insulin. I mean, we're in year 101. Just think of how it's going from, or is no pork, to beef. to regular. We got fast acting ultra fast acting like, yeah, exactly. Things that things change. Things evolve to, like medicine, science, like they do things like that. We didn't think that were once capable, right? Like, these things are here. And they're making lives better.
Scott Benner 1:24:01
Yeah, you need attitudes that say, Oh, what's that about? Let's see what that does. Let's see where that goes. Not, not the like, Oh, you want to lose weight? You should exercise. You think I didn't exercise. It didn't work for me. Sometimes you get influencers online and they're, you know, rock solid and they're like, all you got to do is sit up and I'm like yeah, I did a sit up I'd never ended up looking like you. So I you know, I don't know what to tell you. But I need this thing. And your point of what's going to happen next is huge. I'm texting last night with a woman who I don't think would want to be identified but it might come on the show. Eventually he talks about her like 13 year old daughter who doesn't have a lot of weight to lose or anything like that. But he's the type one and was able to get we go V because she had a couple of pounds over whatever you know, the the chart said so it got through insurance. But how about the kids barely using any insulin now and not seeing crazy spikes from food? Like I think there's a world where you're gonna see GLP medications on people with type two and type one type one. Yeah, and I think you're good Gonna see it significantly shift, not just the community of health, but maybe the world's health. You know, I say that now I'll sound crazy to people. But you might look back 20 years and go, Wow, we don't have the same problem with food that we did 20 years ago, because this medication came along help people's brains not be so like, you know, ravenous for carbohydrates and stuff like that. So
Willie Streets 1:25:24
we made life less complicated. And speaking order. I did want to, as I give you your flowers, I wanted to give flowers to someone else, please. My number one episode that I've listened to where there's two 371 explaining type one, I've shared that with the feels like 1000s of people on your journey, but there's another one. Number 531 Mike Green. Yeah, wasn't my wonderful after dark complications. Yeah, Mike pulled me in. I said tears will Mike. But Mike kept saying, like he, as I rephrase, he kept saying, like, like, he kept putting in a but like, I've been through this, but it's not the end of me. I can do this still never give up. He kept on saying there are better things out better insulins. I wasn't given this information previously. But now that I have it, I know what I can do. And he was like, now parents of young children, they have these things at their fingertips. And they can use them now. He kept embodying that and it like it spoke to me like, like, like, he's like, like, I've never been big into religion, church or whatever. But impactful speeches where you can feel like someone is pouring their heart into it. Like I felt that from Mike. And I still feel that. So even in preparation of today. You know what I did this morning?
Scott Benner 1:27:11
Did you listen to him again, Scott,
Willie Streets 1:27:13
me and my pup, after I dropped my daughter off to school, got back to the house, put on his leash harness. tuned into Mike.
Scott Benner 1:27:21
It's one of the best episodes of the podcast. It really is he he did a favor for people with diabetes that they'll never appreciate fully. Maybe it sounds like you do. But he got on here and laid out his life. And what happened to him? And
Willie Streets 1:27:39
I believe he was the first after dark episode.
Scott Benner 1:27:42
He's one of them. He's up there. I think the first one was drinking. And then we did and I don't know where it went after that. I forget. It was somewhere around yeah. But he was in the he was towards the beginning of it. And he just he's got a similar heart as yours. Like he really does want. What happened to him to help other people?
Willie Streets 1:28:00
And it does. Yeah, no,
Scott Benner 1:28:02
it very much does. It's one of the hardest things about social media making the podcast is there is part of me, who just everyday wants to say, hey, you should check out this one and this one. But I know if you don't feed people new content, then your thing kind of withers away. So like there, it's just it's overwhelming. So you pump out new content so that people have a choice during the week. And hopefully they stay with the podcast, and then you hope they find their way back to stuff like that. Because even the Pro Tip series feels like that, to me, there's part of me that thinks I should just put the Pro Tip series out every day. And that that might be the best way to handle except that's not how this medium works. So it's it's you know, content content content, and then mix in hey, don't forget about this, or you should go check out that it's a it's hard to get people back to those episodes. But there's so many of them that are valuable, you know, for more than just sometimes it's just entertaining or, I mean, how about that lady? You talked about her kid being diagnosed on an airplane while they were like going from country to country? Like that's horrifying, you know? But yeah, Mike, Mike does a real solid for people with type one. And that was even harder for me because my friend's name was Mike. He passed away from type one a number of years ago now. And to hear him to hear another man named Mike and have to interact with him with his name. It was almost like he was speaking to you. It was terrible for me, like it really was hard. And, you know, I don't bring my friend Mike up a whole lot because his story is not mine to tell. And you know, he's not here to tell it anymore. You know, he's just one of those people who didn't come along. He was he had everybody else's story. They put him on regular and mph and they left them there forever. And he had a doctor who didn't help him and he was standing up and moving forward. So he thought he was okay, except that entire time his body was deteriorating, you know, and then by the time he bumps into it Doctor Who says, Hey, this is no vlog and this is Lantus. He doesn't know what he's doing. He's making himself low all the time. And he's got a story he told me once about crashing his car from a low blood sugar, because they moved him from regular and mph to fast acting, but didn't really tell them how to use it. So he shot is fast acting the way he would have shot his regular and then got caught up in a conversation then realized he had to go eat gotten his car. And the police reports of the crash or he wasn't hurt somehow. But the police reports of the crash are horrifying. And he doesn't remember any of it. He fell out of bed from a low blood sugar, broke his arm, and then eventually ended up on dialysis and, and then eventually had a heart attack. And that's all from not having the right tools.
Willie Streets 1:30:46
And you know, it's crazy. But again, I have I have a story. Similar to that crash, Nicole are not knowing what happened. Crashing into a telephone pole.
Scott Benner 1:30:57
I bet they you sound like you got low quite a bit. Yeah. You're lucky to be alright, after something like that happens to you.
Willie Streets 1:31:04
You know what change that it made me get on the route on more? My daughter as seven years old? 2018? Yeah, we purchase our house 2090. So yeah, my wife was at work. And I'm at home with the kids instead of summertime. She finds me in the bed, I mean, a bathroom, laid out. And my wife is trying to call she's not getting getting me. So she brushed his home. And my daughter at seven years old tells him my wife, Mommy, I don't know what I would do. If I lost him. He's like, I don't know what I would do. And she's like, I was so scared. And like, when I came to him, my wife told me that my heart just dropped. And I said, That was 2013 2018. So from that moment on, I opened up the books, and figured out how am I going to live my best life. For myself first and for my family.
Scott Benner 1:32:11
Yeah, it's what it takes man. I mean, it's one of the things I've learned talking to people over and over again, is that just, it's just a very human thing. People take care of themselves for other people. It's very infrequently for themselves. So, you know, when my friend didn't have kids, and maybe if he did, I don't know, maybe he would have had that thought, you know, like, I gotta be here. But instead, you know, instead, I'm left behind to tell you all that, you know, to take care of yourself, and you have to keep up with the times and you have to understand the tools that are available to you. And you need to know what diabetes can and, and is doing to you if you're not on top of it, because, you know, keep
Willie Streets 1:32:55
on telling us? Yes,
Scott Benner 1:32:57
I'm trying,
Willie Streets 1:32:58
I hear I hear and I share that. I
Scott Benner 1:33:01
appreciate it very much, man. I you stayed very long with me. I appreciate that. So, thank you. I mean, I'm gonna take back what I said earlier, you ought to go record yourself. Just do it. You know, I could easily see you sitting down and doing 15 minute episodes, where you just chat through your day about diabetes and, and get it out into, you know, into a community that I maybe I can't find as easily. And maybe you could maybe you could be that bridge there and and get this information to people I can't find it. Oh,
Willie Streets 1:33:33
Scott, look out for me on World diabetes there in November 14. Oh, yeah, I have something that I'm releasing that. I tell everyone. That's a part of it. We're going to take on and over the world.
Scott Benner 1:33:47
Nice. That's excellent. Where will people find that? You
Willie Streets 1:33:51
can find it on my Instagram, at my Instagram to indie artists. And everyone's going to share. So I have a huge community that came together as I just reached out to people one time, and they're like, I got you Well, great.
Scott Benner 1:34:09
Well, I can't wait to find out what it is actually, when I stopped recording. I'm gonna ask you so you can tell me privately, although, well, this will come out after that. So I know you were just telling me.
Willie Streets 1:34:20
So you asked how do we reach the community people of color? Oh, well Black, Brown community so I guess I am that link to previous years 2001 2014 and 2022. On World diabetes, they released a video or like 15 people stating their diagnosis and things about diabetes was like 20 seconds. So this year, I said we got to change this up a bit. Because in this space, everything is looking the same. So I asked myself, I said, How many type ones do I know of color? And when I went into looking at like my followers and stuff, and people I follow, I said, Wow, I did not realize I had this, this amount. Okay, so I created this, this chat with people with persons and I reached out to each of them individually. I said, Can you shoot me a 45 second clip of telling you who you are, where you're from, how long you've had diabetes, something you want to share with the world. And I got, like, 80 responses back. It's excellent. And I created a video that has 50 plus people on it. And they're all sharing a bit of their story. And how they're basically telling people like you can live with this. Some people were stating the obvious facts of the complications, the risks, but it's more so about the reward of community. And we're going to release that on World diabetes de 2023. To take the take on and take over the world. If
Scott Benner 1:36:21
I were you, I would love to share that as well. And I would ask you to put it in the in the group too.
Willie Streets 1:36:26
And it's not just people here in the US. These people are from all over people from the UK, people from India. I even got some people from the Middle East. I've got persons from that are actually going through war right now along the Gaza Strip. I told them, I'm not going to hold off on their videos. Because right now, during this time, many of them are basically fighting for survival. Yeah. And don't. Don't don't want to. Yeah, no, I
Scott Benner 1:37:01
understand that I actually, behind the scenes, I've been trying to get supplies sent to that area. And I'm not having a lot of luck with it. I reached out to some people who I thought could come through and so gets up into those companies and the, you know, pretty big machine. It's hard to I think they say it's hard to turn the Titanic, it kind of feels like that sometimes we
Willie Streets 1:37:23
get so many different communities organizations that say they're doing that, but yeah, until you actually see it there. You'll notice actually bring Yeah,
Scott Benner 1:37:33
it didn't happen until it happened. So people like Oh, I think we could do that. And I'm like, great, and then you kind of don't hear back from them. And you know, anyway, I'm still trying on that one. It's, it's not easy to get anything to move. So when you get something accomplished like that, it's a big deal to get all those people to send their videos that put them together and everything. People don't know man until you try to do something like this. Getting content to people or creating something every day or every week it's it's an insane amount of time and effort and even dude, if you're watching some guy on Twitch like play a game they're putting 50 hours a week into bringing that video to you like you don't you don't realize that but it's it's tough. Hey um can I call this episode heart to heal
Willie Streets 1:38:15
and call it whatever you want Scott because I feel like if I'm gonna hit the hill to your to your
Scott Benner 1:38:21
very nice man, you're one of the kindest people I've ever virtually met. Willie I sincerely mean that. I appreciate you coming on the show and, and, and sharing all this with everybody. Thank you.
Willie Streets 1:38:31
I appreciate you brother.
Scott Benner 1:38:33
I know you do. Thank you
think it was well worth the wait to have Willie on the show. Thank you so much Willie for coming on the podcast and adding your story to all the others. Today's episode of The Juicebox Podcast is sponsored by the Dexcom G seven which now integrates with a tandem T slim x two system. Learn more and get started today at dexcom.com/juice box. If you'd like to wear the same insulin pump that Arden does, all you have to do is go to Omni pod.com/juice box that's it. Head over now and get started today and you'll be wearing the same tubeless insulin pump that Arden has been wearing since she was four years old
don't forget to check out Willie on Instagram at T one D artist Willie sent me this just after we recorded I hope you enjoy it.
Speaker 2 1:39:36
I'm trying to think out of the box but willingness stop. I was a kid for 20 years and that the blink of an eye all that just stop. And as I went from boy to a man, I sweat out when it was cold. I remember looking in the mirror like damn Lou. Is this the end of the row Because I haven't been through a lot, but I'm noticing the plot of how my story got told. So I switched up the game. Got my mind a little clearer. Got a little bow instantly. It's crazy how that one phrase help erase the fear, had the grasp and think fast, leave my pen passed in the rear. Whether we're starting over or getting bolder, knocking this chip off my shoulder, I buckled down and got my mind clear. jotted down some key points and added some more detail scarf real and that you truly know what you got here. And if anybody ever asked, I don't gotta boast nor brag considering my pass. But let me magnify and clarify Benner, you're the real deal. And not only as a stamp have been signed, tagged, and Sue, Sincerely yours, Willy Street.
Scott Benner 1:41:04
If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community, check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#1098 Cold Wind: Healthcare Whistleblower, Clinical Pharmacist
Today's anonomous guest is a clinical pharmacist working with patients in the hospital.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, welcome to episode 1098 of the Juicebox Podcast.
Today I'm introducing a brand new series called cold wind. The long title is cold wind health care whistleblowers. On today's show, we'll be speaking anonymously to a person we'll be calling Valerie. Valerie is an inpatient clinical pharmacist working with patients in the hospital. She has a five year old son who has type one diabetes. And she's here on the show today to give a behind the scenes look at what happens at her place of work. We're going to learn about Valerie's comfort level with taking her own son to the hospital she works at and so much more. Each episode of cold wind will feature an anonymous guest whose voice has been changed to protect their identity. The voice altering process we're using feels natural. You'll never know what they actually sound like. Just listen to how well the voice alternative works.
Speaker 1 1:18
My name is Beth and my oldest child has type one diabetes diagnosed in October 2020. My name is Beth and my oldest child has type one diabetes diagnosed in October 2020.
Scott Benner 1:33
When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefits check and get started today with us met.
"Valerie" 2:10
My name is Valerie I am inpatient clinical pharmacist, which means that I work in a hospital with patients who are in the hospital as opposed to like a retail pharmacist who would work at say a CVS or Walgreens. I have been doing this for about 10 years now. Well, I currently work at a pretty large hospital in an urban setting. So it's like an 800 Plus bed hospital. It's part of a larger healthcare system with Sister hospitals and other locations. Excellent.
Scott Benner 2:39
And you're so you're a pharmacist by trade though?
"Valerie" 2:41
Yes. Okay.
Scott Benner 2:42
went to undergrad, then how does all that work? How do you get that degree? Yeah,
"Valerie" 2:47
so, pharmacy has changed a lot over the years that used to be able to practice with just an undergraduate degree basically with like an extra two years. And then they made pharmacy a doctorate degree program. So most people have an undergraduate degree and then they go to four years of pharmacy school. I have my undergrad degree in biochemistry. And then I attended pharmacy school and I actually did a joint degree programs. So I have a master's in clinical research and an MBA as well as my doctor of pharmacy.
Scott Benner 3:20
Valerie, that is a lot and thank you for explaining it. Do you have a connection to type one diabetes? Yes.
"Valerie" 3:27
And so my son is five years old, he was diagnosed type one when he was one.
Scott Benner 3:33
Any other autoimmune in your family? No, no. Okay, so you have a five year old who's had type one diabetes for four years? Correct. Okay. Do you have any other kids?
"Valerie" 3:45
I have a seven year old also seven year old as well. Okay.
Scott Benner 3:48
Now you're on the show today, because I reached out into the world and said that I was looking for people working in hospitals, nurses, doctors, pharmacists, anybody at all? Who would be willing to talk about why the treatment of diabetes in a hospital setting is the way it is. That's what got you to come on. Is that correct? Correct.
"Valerie" 4:13
Okay, yes. And my specific role in my health system now is unique, and we are trying to improve our treatment of diabetes in the hospital. So we are implementing a lot of things within our healthcare system, which has included the role of the pharmacist being part of the diabetes management team, and patient as well as inpatient diabetes educators. That is something that our health system used to outsource to a third party without the pharmacist component. And now it's a more of an internal program and it's been going on for about a year now and our health system so you've
Scott Benner 4:52
been doing it for a little while. So what did What job did this give you? How are you helping in the process?
"Valerie" 4:58
So what my job is tells now is every patient who is in our hospital, we can run a report and look at if they have had glycemic excursions. And so we sort of prioritize looking at those and look at the hyperglycemia. First, anyone who had a blood sugar less than 70 in the last 24 hours, then we try to look at all the patients who've had a blood sugar over 300. And then we'll look at patients that have had at least two blood sugar's over 180. And we do this on a continual basis. So it's always just looking back at the last 24 hours to patients in the hospital. Is
Scott Benner 5:33
that happening for every patient that's in the hospital or just people who are flagged,
"Valerie" 5:37
it is happening, the report is run for every patient in the hospital. Our team, as it exists currently cannot address every patient that shows up on that report. So that's why we try to prioritize the way that we deal with the extreme like the hypoglycemia is first and then the extreme hyperglycemia.
Scott Benner 5:56
If this is seen, if if hyper or hypose are seen what happens then do you contact the physician? What do they do?
"Valerie" 6:05
Yeah, so as the pharmacist, there are certain things that we can do now within our scope. And that sort of as we're expanding the program, there are more things that we can do. So we can modify their sliding scale or their nutritional insulin orders, kind of going back and forth about modifying their Basal regimens. And with or without provider approval, depending on which particular physician is covering the patient's determines a lot about what we will do automatically. Or if we want to ask that provider first. And then as far as the, the nurses who serve as the diabetes educators, they try to meet with all of the patients who they have a little bit different report. So they're looking at agency mostly and trying to meet with all the patients that have the agency greater than mine. So
Scott Benner 6:52
if there's someone being treated in the hospital, and your system flags them as having higher blood sugars, you can make an adjustment to their dose for their meal, for example, and then the nurse that comes in the room with the actual insulin, they're not making that decision, it would be the pharmacy in your situation.
"Valerie" 7:11
Yes, a bedside nurse has no autonomy to make any decisions about the orders. Okay, and the computer
Scott Benner 7:19
from the gecko. I bet that surprises a lot of people. Don't you imagine the wind you think that people think like the nurse must be the one making decision about this or the doctors making like there's a doctor outside the door somewhere he's making or she's making the decision? I
"Valerie" 7:33
think that people with children with type one that have dealt with this school nurse will have some kind of understanding of this, because that's a lot of the conflict that comes up with school nursing, right? It's like the nurses saying, Well, I have to follow what's in the doctor's orders right here. And the parent is saying like, well, they're sick, or well, this happened, like I know that they need more insulin today. And the nurses kind of saying, well, that's not what the orders say. So that is also how it works in the hospital,
Scott Benner 7:59
your health system, or at least the hospital you're working in. What did they see that made this program come about? What do you think got it started? Well,
"Valerie" 8:09
there's, there's more kind of a push from the accrediting bodies. So Joint Commission and CMS to say that we need better glycemic management, in hospitals. So that was sort of the pitch behind it. So this is one initiative that our health system has chosen based on like kind of initiatives that were put out there saying like, we need hospitals to do better at these things. This is one thing that our health system decided to focus on. Okay.
Scott Benner 8:36
Did you have anything to do with this? Or were you just happily surprised when you heard about it?
"Valerie" 8:41
No, it just happened to coincide with my son having recently been diagnosed with diabetes, I have always worked in an inpatient hospital setting. So I have not really as a person, like, I don't know, as a health care professional, I would say, I don't really like like the ambulatory care setting as much the diabetes that was never a disease state that really interested me, it was always like, oh, diabetes is boring, until my son was diagnosed. And then it's like, oh, you know, all of that changed for me, I have a completely different perspective on it. So then, as this program happened to me implemented, you know, right after that, and that was why I, you know, got involved in it and applied prior to that I was working on overnights,
Scott Benner 9:25
can you maybe try to tell me something that maybe you haven't thought of before, I'm going to ask you to think about something prior to your son's diagnosis. If this new thing would have happened at your hospital, do you think you would have been met by you with like, oh, I don't know why we're doing this or this is more work. Like you see the value in it now because you know about type one from a personal perspective, but do you think you would have seen the value in it prior to that?
"Valerie" 9:54
No, not at all.
Scott Benner 9:56
How would it have struck you if if it came back that came across here? desk. It was 10 years ago except for example,
"Valerie" 10:03
you know, I think that we tend to think about things in that way as okay, like this isn't an inpatient issue or an outpatient issue. This is like an acute care setting or an ambulatory care setting. And it's like diabetes, other than if a person is newly diagnosed or in DKA is sort of like an ambulatory care disease state, like a chronic care, you know, something that you work with outpatient. And so that just has never been my thing that I've enjoyed. I've preferred working in a more acute care setting, inpatient setting. So that is primarily why I would have been like, Oh, this isn't, you know, this is more applicable to outpatient and even trying to recruit pharmacists to the position that is the responsible on IT people with like, Oh, this is really like an outpatient issue, even though we know we know, in our clinical care setting that having good glycemic management can improve outcomes for patients in the ICU and things like that. That's kind of the extent of it there, right? It's like, well, yeah, but we don't want to monitor all the like oral diabetes meds and that kind of stuff.
Scott Benner 11:10
But is it fair to say that even though we know outcomes are better if blood sugars are tightly managed in a hospital setting that that doesn't make it exactly a top of the line concern. I used to hate ordering my daughter's diabetes supplies, and never had a good experience. And it was frustrating. But it hasn't been that way for a while, actually for about three years now. Because that's how long we've been using us med us med.com/juice box or call 888721151 for us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omni pod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996. They always provide 90 days worth of supplies and fast and free shipping. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and Dexcom G seven. They accept Medicare nationwide and over 800 private insurers find out why us med has an A plus rating with a better business bureau at us med.com/juice box or just call them at 888-721-1514 get started right now. And you'll be getting your supplies the same way we do.
"Valerie" 12:48
Right? Yeah, I mean, because it's it's not because it's not like an acute thing, right? I mean, hyperglycemia is, but if your sugar's sitting at 210 While you're in the hospital, but you're here because you just had a stroke, and you can't eat food anymore, because you have you know, aphasia and dysphasia. And you can't swallow, we're more worried about that right than the fact that your sugar's sitting at 210. Or that you just had a heart attack or you know, whatever it is that you're here for. That's always the priority. And then it's like, well, your blood sugar is a secondary kind of thing that we're looking at.
Scott Benner 13:25
Yeah, they focus on the thing that they think is going to kill you first. Correct? Yeah, by the way, because I only knew the word ambulatory from Grey's Anatomy, I actually looked it up, it actually means able to walk about and not bedridden. That's what it means.
"Valerie" 13:42
So yeah, I guess that is what the word at face value means. But then that makes sense why we call it like ambulatory care. So yeah, like ambulatory care setting is an outpatient setting. I think we kind of use those terms interchangeably in health care, outpatient ambulatory care. But yeah, inpatient doesn't necessarily mean that you can't get out of bed. But you are assigned to a hospital bed. So Oh, okay.
Scott Benner 14:06
That's interesting. That's such a word that you just hear all the time. And then when I looked at what it meant, I was like, that seems random. But, but, yeah,
"Valerie" 14:14
well, and then when you're talking about like patient care, like and the patient ambulating, like, can they walk around? It's used in that context, too. So
Scott Benner 14:20
earlier, you said we may or may not adjust the doses? It depends on the doctor. And then you giggled. Why did you why did you have that reaction? So
"Valerie" 14:31
yeah, I mean, in preparation for this, I listened to you know, I tried to get caught up on some of your podcasts more recently having to do with, you know, healthcare, healthcare system, health care providers. And I think so I think that people who don't work in hospitals sometimes forget that, like doctors are people too, and they come with their own personalities and their own like inclinations and their own ways that they were trained and Like, just like any other place that you work, you know, there's some co workers that you love and that you're easy to get along with and very collaborative. And then there's some co workers that are like not team players, and very much like, this is the way I do it. And I mean, their personalities come into play. So like, physicians, you know, pas, rnps, any everybody is that way, we're all people at the end of the day. So some are more receptive to interventions from pharmacy or from, you know, other specialties, and some are less receptive to that.
Scott Benner 15:36
So you're saying that it's possible that some doctors might have an ego that doesn't allow them to take direction from a pharmacist?
"Valerie" 15:42
That's possible.
Scott Benner 15:45
I like that it makes you giggle every time. Okay, so working where you work, knowing what you know, having had the experience for four years of taking care of a human being with type one diabetes, what is your comfort level, with your child going into a hospital system through the ER, zero,
"Valerie" 16:03
I am not at all comfortable with my child going. So I mean, so for example, when my son was diagnosed was during the height of COVID. He was diagnosed March 27 2020, we kind of realized that you knew he was sick from the pediatrician. And so our our pediatrician diagnosed him, which is different than a lot of people's stories, and it was a Friday afternoon. And most kids, he wasn't sick enough to be in full blown DKA. But his sugar was high on the meter, you know, over 500. And my first thought was like, he cannot go to the hospital because they weren't allowing parents to come in when their kids were admitted, like that had just happened that week, where it was like we parents, like we don't know, you know, and my pediatrician is part of the same health system. And that was what I was kind of saying to her was like, if he has to go in the hospital, like, I can't be there with him. So this is even before like, knowing anything about diabetes, it's just the hospital for someone who can't advocate for themselves can be a scary place. Yeah. And then when you add in a very specific disease state like diabetes, where it's very misunderstood, it's very different, like what diabetes means to one person can be vastly different. Even if you are a healthcare professional, that it's like, yeah, you need someone there to advocate for you. So actually, my son at diagnosis was never even admitted to the hospital. We managed him outpatient. The only time we have been in the hospital was where I work and the ER and it was because he was he was throwing up, I don't even check him for ketones at home, right? It's like, but if you if you're sick enough to where you can't keep fluids down, that's where I get worried. We need to go get you IV fluids. And they really weren't hearing me, like they were worried about he had a little congestion like, oh, let's get a chest X ray. And I'm like, you know, I could have done that other urgent care, like, I'm here because he's been throwing up and they're like, well, it's sugars only, you know, at the time, I think when they first stuck on when he came in, it's like, Oh, it's 130. And it's like, well, you glycemic decay as a thing. You know, I'm worried like, can we get Can we look at as bicarb? Like, can we look at it as the anion gap. And they just weren't receptive to hearing me even though I it's like, I work here, you know, in the meantime, you know, they have it's the children's er, so they have someone come in, and it's like, Oh, does he want a popsicle? And I'm like, Well, is it a sugar free popsicle? How many carbs are in it? They're like, I don't know. And it's like, what do you know that he's diabetic? Like, has anyone Wait, do you do this? Do you know, with all the patients, I'm starting to ask these questions that it's like, how much awareness is there among all of you about like, type one and what that means and like, you know, everyone keeps coming in and saying, Well, it's sugar is this, whatever it was when he was first admitted? It's like, well, we've been here for five hours, and we have a CGM. And like, I've been giving him insulin during this time as his sugar is gone up. Like, you know, you're not supposed to do that in the hospital. But that is what I'm gonna do with my son and Sarah because otherwise you're you're waiting. You're just sitting there and you can't do anything. Yeah,
Scott Benner 19:06
the process in the ER at this point takes forever so my daughter has had, she had some pain that we couldn't figure out at while she was away at college, and she spent 12 hours in an ER twice in three days. Then I'm going to ask you, Valerie, how many times was Arden's blood sugar checked by the hospital staff in a 24 hour stay over three over three days to different stays. We
"Valerie" 19:35
typically check blood sugar every six hours. So
Scott Benner 19:39
so if I told you Arden's blood sugar was never checked while she was in the ER would that surprise you? Know, if I told you she was 19 in there with a roommate from college, obviously scared in pain, put on morphine, and no one ever wants asked her what her blood sugar was, or check to see But it was it wouldn't surprise me that's not surprising to you. Okay? So aside from the idea of your, your child being diagnosed during COVID, you now have this experience of going in for vomiting. And even though you're in there saying I'm a pharmacist, by the way, a pretty well credentialed pharmacist, not just like, you didn't just get out and be like, I'm gonna go push pills, you really put your eggs into your education, if you don't mind me saying, Yeah, and you work there. So you're standing in front of somebody going Hi, I work here. I'm a pharmacist. I'm worried about my kids blood gases. I'm worried about this kind of stuff because I'm concerned about DKA. They don't even know that you could have DKA with a lower blood sugar. Today's episode is sponsored by ag one and I drink ag one every morning. I originally heard about ag one on a different podcasts. I had been using other drinks and not enjoying them. So I decided to try each one and loved it. I was using it every day when they approached me. And I was like, wait, you want to sponsor my podcast? I heard about this on another podcast. Alright, cool. So here we are. When you use my link, drink, ag one.com/juice box. Your first order will include a welcome kit. That's an ag one shaker scooping canister, the Ag one itself, five free travel packs, and a year supply of vitamin D. I drink ag one in the morning before I start my day, ag one makes me feel like I'm giving my body the nutrients that it needs to get through a hard day of podcasting. I'm just kidding. It's not that hard to podcast. But still, I feel great when I drink age one. Ag one is my foundational nutritional supplement. It helps me start my day, it helps me to support my immune system. And I think you're going to enjoy it. So if you want to take ownership of your health, it starts with ag one drink ag one and get a free one year supply of vitamin D and five free ag one travel packs with your first purchase. Go to my link drink ag one.com/juice box that's drink ag one.com/juicebox Check it out.
"Valerie" 22:08
No. And it's like, I'm not even gonna get into that argument with you right now. Just please, like, draw his blood. Because they're kind of like, you know, do we even want to get IV access? And it's like, yeah, yes. That's the whole reason why we're here right now. Like, I'm not no, don't send us for a chest X ray, like give him fluids first, and then you can do whatever else workup you want. Um, but yeah, I mean, me advocating for that it still took several hours and going to do the chest X ray first before anybody did what I was even there to do.
Scott Benner 22:39
Is there any validity to me saying with the complaints you came in the door with, they know they can do a chest X ray and Bill for an insurance won't be upset. So it's a thing they do to make money? Because you're there now. So
"Valerie" 22:53
no. So I think that a lot of people have that concept of it was interesting, because so let me answer your question. And then I'll say that the care is directed poor, you know, what can be billed for? That comes into play and in a lot larger scope than the individual, like health care providers standing in front of you. We don't care about that. Like as the clinician trying to help you as a patient, like, I am not ever thinking about billing, because that's I work for a large healthcare system. That's their job to figure that stuff out. Now, they might implement policies or things that I have to abide by that correlate back to billing, but it doesn't influence how I'm like directing my care right now with you as a patient. Okay,
Scott Benner 23:40
so the clinicians not thinking, hey, chi Ching, chest X ray, because they said this, but the policy could be set up so that even in the situation where you don't need a chest X ray, if you present a certain way, we're definitely going to do it anyway. Yes.
"Valerie" 23:54
And I would say even more so than billing. I think what drives maybe unnecessary testing is a concern about the liability if you didn't do it.
Scott Benner 24:05
Yeah, that's fascinating. Because Artem presented with initially she presented with appendicitis, it was pretty classic presentation. And they gave her a CAT scan. And then they came back hours later and said, your appendix is fine. But we see cysts all over your ovary. And we have to go do a another test now to see if they're twisted because they could require surgery like so this is what 19 year old Arden was told by herself in a hospital 700 miles away from my house with just a roommate sitting with her who by the way, had never had a medical issue and had literally never been in the hospital before. Try to imagine I'm managing Arden's blood sugar remotely through a roommate because Arden's high as on morphine, right, so we're doing all that. And you know, they said okay, we're taking you back For an ultrasound now she gets on the phone with me she's faced she's clearly scared. She's loaded on the morphine Arden's not a drinker or a drug user. So the morphine hit her really hard. And she's like, Dad, like, I have to go get a thing because if these cysts are twisted, then they might burst and I might need surgery. And I'm like, Okay, well go get the test, then call me when you get back from the test. So she calls me back a couple of hours later, the doctors here he's gonna give me the results from the ultrasound. And he literally gets on Arden's phone puts a smile on his face, because Hi, and I'm like, is she okay? She doesn't have any cyst on her ovary. And I went, what? You're the guy that four hours ago said that you took a CAT scan and saw cysts all over her ovary. And he goes, CAT scans, not a good way to tell if they're cysts on an ovary. I said, But you're the one who said that based on the CAT scan. She needed this other tests because this was a definite problem. It was clearly there. And now we just have to make sure that she's not in an emergent situation. And now you're telling me up, see. And he's like, yeah, good news. She doesn't have those tests. The good news, you're the only one who presented the bad news. I said, Okay, what's next? He goes, We're gonna send her home. I go Arden, are you still in pain? Yes, Mike, you're just gonna send her home? Well, she doesn't have an appendix. And I was like, could it be something else? He goes, Well, we're gonna have her follow up with her. OB. I said based on what? No answer. And then he treated her after 12 hours and let her go. So she spent the entire next day in a bad situation. And like not feeling well was not getting better. There's she had this low abdominal pain that had stabbing. The stabbing eventually went up into her. What would you call it? That kind of the center of your stomach your why is this basic word escaping me? Helped me a bottom my ribcage in the middle.
"Valerie" 26:56
I don't know what's in the anatomical word for that. Or even write about them. But for unknown, yes. Right away.
Scott Benner 27:03
Thank you right about there. And then the day goes on. She's able to eat and then she's like, you know, maybe it's gonna get better. And then all of a sudden around midnight. She's texting me dad the stabbings in my chest. It's going through the left side of my chest into my shoulder. Yeah, that's scary. Right. And so now you you do a little more looking at points. The gallbladder makes sense, right? They didn't check her gallbladder when she was there. Last time. I sent her back to the ER at two o'clock in the morning. And then I get on a plane and arrive where she is at 10am. When I get there at 10am They've done nothing for her except put her on more morphine. They have not checked her blood sugar in the now eight hours that she's been there. And as I walk in the door, there is a burly man standing over her in a raised voice demanding that she leave because she's been. He told her, we straight at you, you have to go. her roommates crying. Arden who does not cry about anything has puddles of tears in her clavicle. And she is telling him I am not leaving here until you tell me what's wrong with me. And you have to admit me. If you can't figure it out in the ER, that's the sentence I gave her before I got on the airplane. Yeah, if it wasn't for that sentence, he would have kicked her back out again without ever testing her gallbladder. Which by the way, it didn't end up being. But literally when I walked in, a jacked guy in his 50s was yelling at my 19 year old daughter to get up and leave the emergency room. And again, he had never touched her, checked her blood sugar, didn't check her for anything. She had had any testing. They ran some blood work, the same blood work. They ran 24 hours earlier. In that same room. There were four other sick people cordoned off into corners. And I often said that woman's been vomiting for six hours and no one has helped her. And then she pointed to the other lady and said, Wait, do you hear how they talked to her? And I stood there for a little bit. I was able to strong arm them into checking Arden's gallbladder within the proper test. And while I was there, I watched the doctor walk in to this woman who had Ms. And no no excuse me. Cystic fibrosis. And he walks in he goes Hey, so cystic fibrosis. Tough call. I was like what what just happened? Did he just look at her and go wow, cystic fibrosis tough roll the dice, honey, because that's what he did. I looked over and she had a look on her face like, ah, yeah, it's a terrible thing that has happened to me. Like this is your bedside manner right here. It was fascinating. Right? Yeah, I gotta go back and tell you Arden would have been better off laying in her bed and hoping it went away. Then what ended up happening to her that hospital? Fascinating. I'm sorry. Good night. No,
"Valerie" 30:00
I mean, that is a very so and that is a very nothing that you just said about that surprises me, unfortunately, I guess because I work in health. So it's hard for me to see them. So well, you know, I read a lot of this stuff on the on the juice box group and see and it's like, oh, yeah, I'm always, you know, people are rightfully so because they have a different expectation of what's going to happen when you show up to the ER, like, very offended and surprised. And I'm usually like, yeah, that doesn't surprise me. And some of it goes back to what I was saying as far as like inpatient versus outpatient, like, do you like to work in an acute care setting? Or do you like to work in an ambulatory care setting, so somebody with good bedside manner, who likes talking to their patients and is very sensitive, they are going to likely want to work in an insecure setting, like as a primary care provider or pediatrician, the type of people who, like the environment of an emergency room, are not the type of people that like, take your feelings as a patient into consideration. Because you can't because your career is dealing with traumas. And you know, the worst possible things that have happened to people, they roll into the ER. And that's what you don't see when you're in the ER waiting room, because you're seeing the people that physically got themselves there. You don't see the ambulance bay and all of the like five gunshot wounds and car accidents and everything coming into the back of the ER through the ambulance. And so you're thinking like, well, there's five people here, but it's like, no, they just brought 20 people and you know, what's the explanation
Scott Benner 31:42
for not doing a gallbladder test in eight hours with classic gallbladder symptoms? That I
"Valerie" 31:49
mean that that would be the only thing is that you triage, you triage your patient like ers work through a triage system. And it's like, every time someone more urgent comes in, you just bumped ahead of you. Yeah, so
Scott Benner 32:05
they weren't literally trying to make her leave. Without doing the test. I basically had to bring New Jersey to the, to where she was to the south, which straightened everybody up pretty quickly. And then got me a physician to speak to who assessed her and said, Yeah, it's very appropriate for us to test for gallbladder. I'm not sure why that hasn't happened. We'll do it right now, eight hours later. But the other guy, the other person was trying to kick her out
"Valerie" 32:29
someone telling her to leave when she's there for that. But that, unfortunately, I mean, that is whatever individual made that decision, right? That was like, I just need to clear out this, er, I'm tired of this person asking me and they're like, Oh, I'm gonna bully them into leaving, instead of like staying here and advocating for themselves. That's not necessarily a system thing. I mean, that's that, that individual deciding to deal with it that way. But
Scott Benner 32:58
I'm completely convinced that what happened was, is he needed to move somebody out of that building. And she was young, and he thought he could lean on her a little bit, and she just go, that's what I think. Except I, well, she's my kid. And I armed her with the right words before I got on the airplane. Yeah, yeah. So but who would know that? Like what regular? You know what it always always, here's what scares me. People on the Facebook group, you know, people get ketones, right? They get sick, they come on, they're like, I don't know what to do here. Hey, my ketones are really high as my blood sugar. I'm not sure what to do. And a flood of people go to the hospital, go to the ER, go to the ER and others. Pardon me? It's like, oh, I don't want to say something that puts you in a bad way. Like, you know, I mean, if you need an ER, you need an ER, but have you tried drinking a lot of water and giving yourself some more insulin? Like, is it maybe a bent cannula? Did you like you know, have you been sick? Do you think you can get this down on your own? Because you're gonna get to that er, and then all the stuff that we've talked about in the last half an hour is all going to exist? Maybe? And that's the thing I don't it's a coin flip? Like, am I going to show up and find a nurse who understands DKA? Or am I not? And then if I don't more than likely not? More than likely not. So. All right. But you also see people who are admitted, correct? Like, yes, yes,
"Valerie" 34:20
yes. So only I only we only looked at the patients that are admitted, right?
Scott Benner 34:24
So I'm gonna move away from this er idea and talk about somebody who's admitted for kind of like long term care, which could mean a couple of days to longer. I imagine. I'm in there with type two. They're feeding me. I've seen the type two diet at some pretty big hospitals. And it's fascinating how many carbs and crappy food are in it. Correct. It's not even it's not a type two diet. It's just you don't get to pick off as many portions of the menu. They only give you one dessert, but they'll still give you what we
"Valerie" 34:56
do with people on a carb controlled diet. Yeah, and there's a standard, and it's 45 grams for women, 60 grams for men.
Scott Benner 35:05
But on that list is grapefruit juice, apple juice, stuff like that stuff that's going to drive your blood sugar up in a split second. Right,
"Valerie" 35:13
the glycemic index of those foods is not taken into consideration at all. But we actually go back and forth about whether patients and even you know, we're kind of told to it's, you know, the nutrition services, it's a whole nother department kind of, of the hospital. And like whether or not patients are allowed to order more than their carb control, because it's like, okay, if I'm assuming this person is eating 60 grams of carbs with each meal when I'm dosing their insulin, but they're not, because maybe a relative is bringing them food, that's one thing, but they can actually order more than what their diet should be. And, you know, trying to like, figure that out and work with these other departments. And like, you know, we get information from one person versus another person has been a challenge that we that's one of the biggest challenges we found with our program, as it is currently is, is the diet. And then of course, as a type one parent, I'm like, oh, you know, and a lot of you I mean, you don't if you're insulin dependent, the type two diet is meaningless, kind of at that point. I mean, like, we're not trying to control you through your diet anymore. Like you need insulin, and we but but we do need to be able to dose that insulin with some concept of what you're eating at each meal. The diet is really, it's really tricky. No,
Scott Benner 36:35
I mean, that seems you just said something that didn't, it never occurred to me that people would just bring in outside food, of course, right. I'm not saying that the patients in certain settings and situations are not culpable in some of the problems that we're having. I'm certainly not saying that. I'm not saying that the people working in hospitals are ill intended. I don't think that either. I think that what you're describing is a system that is basically not set up to understand or control blood sugar. No, the understanding is just not there.
"Valerie" 37:07
The understanding 100% is not there. So the whole the whole thing about type one versus type two, I have tried very hard in this role to like get rid of those labels and just refer to patients as insulin dependent or non insulin dependent, that's a lot more useful way to describe someone's diabetes, if they are insulin dependent, they need Basal insulin every day, they've got to have some insulin on board. If they're diabetic, they may or may not need Basal insulin to avoid going into DKA. I mean, their sugars can be high and uncontrolled, but they're not going to become acidotic. You know, it's still a the terminology and talking to other like talking to the nurses is hard and other providers and using that terminology I find brings a lot of clarity to it. So if we could get rid of the type one, type two, that would be very helpful. Yeah. And then also just the idea of, of Yeah, like, what, what is this patient doing on their own, like the autonomy of the patient. So you have like this, some patients that are doing you know, all of like the podcast listeners, like doing their best to really like get a handle on their management. And then you have patients that just lie to you. And it's like, yeah, I take 80 units of love me or twice a day, and then we give them 80 units and their sugar's 20. And it's like, no, you don't. So but but they don't know, they think that they will be in trouble, I guess or like, you know, they say that they're doing it, which is what they've been saying to their doctor outpatient, which is why they're on that huge dose. But it's like, they don't understand the ramifications of saying that they're compliant, and then we give them that and it's like, no, we don't find out until we give it to you that you don't really take that out.
Scott Benner 38:56
Yeah. Is it possible that there are maybe two distinct, I don't know societies and diabetes, people who are steadfastly trying to understand trying to pull their education together and and to do a, you know, a better job, and that there are a group of people who have maybe just sort of, for whatever number of reasons bad direction bad, you know, education, intellect, not being desirous of caring, whatever, whatever. They're just not they have a onesies that are in the 10s elevens twelves. And that hospital employees see sick people more frequently than well people so they're accustomed to seeing diabetics who are higher a one sees higher variability don't have as much idea about how to handle themselves is and then you come in there with your kid, because he got a little stomach flu or whatever. And you actually know how to keep his a one to where she gets a one to 6.8 on our loss. Yeah. So you know how to keep it a one Seeing the sixth is you have a better understanding coupled with expectations. And that's why the hospital system looks roughshod to you and to me, but to most people, they probably don't even care or think about it when they're in there. Is that fair? Oh,
"Valerie" 40:18
100%. I mean, that's. So that's kind of the difficulty that I was listening to your podcast, like leading up to this, some of the more recent ones, you had one with Jenny, where you kind of went over, like the things that people were saying that like health care providers had ever said to them. That was very offensive. And they're like, there was one where the mom was like, Oh, the kids sugars 400. And they said to them, well, it's okay. As long as you get it down. There is a real, it's not like, Oh, that was stupid advice. Because, and that kind of the response, right? That's all the parents responses. Like, That's so dumb. It's not okay to be four, seven? Yes. And no, right? I mean, it is, it is what it is, you're 47. And you talked about that, like, you know, you just have to work with what you have get it down. So I think that they're coming from the perspective of like, it's okay, you don't have to freak out and go to the hospital, just because you hit four, seven, you can as long as it comes down, it will be okay. Right? That's a different conversation than like, is it okay to be for someone every day? Exactly. And so what we're looking at in an acute care setting is like, Yeah, are you going to immediately die from this, and most things diabetes related, as long as it's not hyperglycemia, no one's going to immediately die from it. Yeah. And so you have these different levels of education. I mean, you're taught as a health care provider, that everything should be communicated to patients at no higher than eighth grade literacy level, where I work at the large hospital on urban setting, the majority of our patients don't, they're indigent care, meaning they don't have private insurance, they don't have government insurance, they are not insured at all. They're typically, you know, homeless, a lot of mental health issues, substance abuse issues. So the idea that you could even provide education, or the patient's going to do anything that you you say they should do, I mean, they don't even have somewhere to sleep, much less like a way to get to the pharmacy to pick up their insulin. And so we have, you know, these frequent fliers where it's like, especially people who are type one, that are insulin dependent on that have all these psychosocial barriers to being able to manage their disease state. And that's the majority of the patients that we see. So it's a completely different perspective than, like the outpatient, Endo, who's seeing you know, you.
Scott Benner 42:43
So, yes. And so what you're telling me, I feel like this is what you're saying to me. You're saying, look, there are a lot of people who have a lot of things trying to kill them. And they come to a hospital. And their blood sugar is not nearly on the top of our list about what we need to do for them. Even when they're admitted. You're still trying to get them through this thing that's happening. And because that's overwhelming, Lee, what happens in a hospital setting that kind of, I don't know, rinses through the staff. And so when someone comes in there who's like, Hey, I've had type one diabetes for 40 years, my one sees five and a half. I know what I'm doing. That's completely foreign to people. No, that's
"Valerie" 43:28
where you get the comments like, Are you sure you have diabetes? Oh, wait, that's where that comes from. Because it's, you'd never see someone with diabetes, like you're taught, like, you have a very basic understanding of diabetes, and it's all taught from a diagnosis perspective, right? So like, your concept of diabetes is someone's a one sees higher than seven. And it's like, you come in with a 5.5. They're like, Are you sure you have diabetes? And it's like, you know, we know like, Yeah, I'm insulin dependent. Not like, but you know, if all you see is type two diabetics, then that that's not diabetic, you know,
Scott Benner 44:06
insane that somebody would even have anyone seen the fives and be using the word diabetes.
"Valerie" 44:11
Right? That's, that's foreign to Well, I mean, that's what people say, Oh, aren't you a nurse? Aren't you a nurse? And it's like, Yeah, but that this is a nurse that has been working for 20 years now in a huge hospital where all of her patients are type two. And so she doesn't see type ones unless she's maybe on like a med surg floor like saw someone after impact you or something or like the type one that said you have a onesie and the fives you're not going to decay all the time. So you're not in the hospital. Yeah,
Scott Benner 44:42
it feels like what you're saying. Seriously? Interesting, right? That it's commonly known that people who are law enforcement for over there's this scale that they go up as the longer they're in law enforcement. And by the time they get I think it's to a decade if I remember correctly. Their ability to trust people, even people that they're not intersecting at their work, it gets lower and lower and lower, because that's the experience they're having all day long, because they are seeing criminals, mostly. And then they run into a nice person. And they're like, I don't know, like, you know, are you going to shoot me? Are you going to like, flip out and bite me? And are you going to do this kind of thing? Because that's what gets. That's how they're colored. As as the time goes on, I was pulled over once. I want you to try to picture this. I'm a young man in my 20s, maybe in my late, mid to late 20s. I'm driving I think at the time, a Volkswagen Passat. I mean, it's a lady's car. I'm wearing a tie. And I'm going to my job. I get pulled over speeding to work because I'm late. And I watched the police officer in my I just want to be clear with you, lily white town where nothing happens ever come down my side of my car, one hand on the car, one hand on an unbuckled gun to come get my driver's license from me. And I'm looking in the rearview mirror going, what is happening here, and no lie when that person turns the corner. It's an older police officer, somebody who's been at it for 20 years, who doesn't want this day to be the day that they get. They get it. And meanwhile, nothing they're looking at indicates that I'm going to jump out with my GAC and start popping off. Do you see what I'm saying? And so like it, but I understood, I understood what they were doing, because I have a friend who's a cop. But if it was just me, I'd be like, wait on me. Like, I'm just going to work at a credit union right now. Like,
"Valerie" 46:42
I'm the least, that is that is so interesting, because that happened to me also when I was in undergrad. And I mean, my car was maybe a little more sketchy because I had a lot of stickers on it. You know, what a college student. But I'm still, you know, like a young, white female, I wouldn't think I would look like a threat. And I realized when he pulled me over, I had left my wallet and like the way back, I was like a Ford Explorer. So it was very bad. And so I just started to open the door once I realized, and he pulled his gun on me. Yeah. And I was like, Oh, my God, you know, like, and it's but yeah, it's like, Oh, you thought I was gonna like, do you know? Okay, I see that. But I was the one of course, like, scared. It's like, Oh, my God. And he's like, ma'am, stay in your vehicle, like, oh,
Scott Benner 47:28
yeah, the worst thing I've done is not told my parents where I was last night. But so taking that idea that you can be in a high pressure situation over and over again, where you see a specific scenario over and over again. And then suddenly someone comes into it, who doesn't fit it, you're not going to get the service that you expect in that hospital? And so the answer really has to be, you need to understand your diabetes care backwards and forwards, go in there and immediately begin to explain it in a way that lets the people listening know, I know this better than you do. Here's what we're going to do this is what's going to work for us. But you tried that and you couldn't even get them to listen. So what luck Am I gonna have, I'm not a pharmacist, but I don't work at the hospital.
"Valerie" 48:17
They did listen, eventually, it's just you know, don't be a Don't be surprised at how long it takes you to get your point across. Be Don't be surprised at how many people you have to keep repeating that too, because the healthcare is so specialized. And now you are going to have so many different people in and out and it's like, you know, the nurse assistant or the patient care technician, they don't necessarily need to understand your diabetes, but that's typically the person in the hospital who's doing the blood thing or, you know, if your checks your finger sticks, so if you have just drinking apple juice, and this is what we're assuming it's like a pre premium blood glucose, like you should probably tell that patient care technician I just drank an apple juice, but like, they don't necessarily know what that means. Is
Scott Benner 49:11
it my real goal to separate myself from what they normally see. Like to let them know if I am in fact a person who understands this on a greater level to like, get out in front of it and go look, I recognize what you normally see in this setting, but this isn't us. And and here are some examples of why that is like is it is just as easy as saying I have a glucose monitor and a pump and I know what I'm doing my one season the four in the fives, it's in the sixes like don't worry, we can help like, I'll help you with this. I know how to Bolus for food. Like we want to keep our pump on while we're here. Like that kind of
"Valerie" 49:42
stuff. And you and you need to lead with that. And that's like it was interesting because you had a conversation with that same Look Jimmy about the things and she was talking about her prescription for her test strip and the pharmacy technician saying like, Oh, why would you need like eight to 10 a day and I I did that. I did that as an intern when I was in pharmacy school, and I was an intern in a retail setting. And I had a woman come in who was newly diagnosed type two starting on insulin, and the inch, because so what we see is, oh, look, here's a prescription for 10 test strips a day. Medicare doesn't pay for that, I can tell you right now, it's not gonna go through your insurance. And it's gonna be a problem, because you're not gonna want to pay cash for it, where you need a prior authorization from your doctor. It's like a whole that sets off a whole chain of events. And it's like I said to her, you know, you shouldn't need to test your sugar this many times a day. And no, I didn't, I didn't say it in a rude way, like, Oh, this is a problem. I also did it, you know, she was also very nervous. And it's like, Oh, my God, like, it's overwhelming, right? Like, I've got to do this many fingers six in this many injections. And so part of it was me trying to say like, let's start with what insurance will cover. And if you find that you're needing to test more than that, then there's a process to get them to cover more. But it's not like an immediate thing that can happen. And part of it was kind of trying to reassure her that it's like, Hey, you're not going to have to be sticking yourself every two hours, indefinitely. Like you might feel like you need to do that now to get really tight control. And the reality is like, yeah, we aren't like my son's on Omnipod and Dexcom. And it's like, we still have a prescription that says eight to 10 times a day, but I'm not sticking a stinger eight to 10 times a day. But like everyone, I like to work supplies. And I mean, that that poses a bigger question of like, what what are the ramifications of that on the healthcare system at large? Like, you know, certain people aren't like, the idea is that, you know, there's someone at that insurance company whose job is for it to be profitable. And it's like, you know, giving, like, people getting more supplies than they need, is that somehow taking away from people that, aren't you? No, not really, because we don't have socialized medicine? But
Scott Benner 51:52
are you saying, Valerie that if I worked at that hospital, or somebody like me with the understanding that I have, at my level, my job would not allow me to take as good of care if somebody is I even would know how to do?
"Valerie" 52:03
In some ways. Yeah, there are constraints within the healthcare system that come down to billing like that with the insurance with the outpatient stuff, for example. I mean, everyone, that's the, like a diabetic or a parent of a diabetic kind of knows that with insurance, you're restricted to what's on your formulary, unless you go through a process to try to get her authorization. And so it's kind of that same concept. It's like, well, there's certain protocols and policies in place, like like with the nurse, and what the order says, say, you are type one, and you have your orders in the computer for you know, your insulin, and you get your meal tray. And it's like, okay, you know, that nurse has this order to give you four units, and you're like, why would normally take six units to cover this? She can't just give you six units, right? Like she has to give what's ordered, or she has to try to call and get that order changed, which is, there's policies in place to let them do I mean, there's not most hospitals, most health systems don't have that. So
Scott Benner 53:06
that's where you're stuck with like, go ask the doctor. And then even in your situation, I might have to go ask the pharmacist and then those people are busy with 1000 other things. And just getting to this like idea of like, changing my dose by two units, which seems so important to me, and is important to me. It's not important in the grand scheme of things in this ecosystem that I'm now in because I've gone to the hospital.
"Valerie" 53:27
Oh, yeah, not at all. I mean, there would be providers who would be annoyed that you would call them about that, and like really like, and they're just gonna say, no big try to teach you a lesson. I'm like, don't call me about stupid stuff like this anymore. Because if that person sugar goes up to 250, after this meal, when normally at home, they never get over 150. Like, it doesn't matter in the grand scheme of things. It matters to you as an individual. It matters to me as a parent of type one, but like, it doesn't matter as far as like the clinical outcome of that patient's hospital stay.
Scott Benner 54:00
So I only got art in the test for the gallbladder because I had the nerve to stand up to the male nurse, push him back, force him to the doctor force the doctor into the room, remake my concerns to the doctor. And I reached the doctor who was older and seemed more reasonable. And heard what I said and agreed with me. So the test happened. But if I don't do all of that, eventually we would have gotten kicked out of that hospital. If I just stood there waiting for somebody to help me. Somebody would have handed me paperwork and told me to leave. I think yeah,
"Valerie" 54:35
potentially or you would have been there like during shift change, and then someone new, a different attitude. But yeah, I mean, yeah, it sounds like you definitely my biggest lesson is you have to advocate for yourself. And I mean, that's in all aspects of health care, right? Like if you have a lump or you have a funny mole or whatever. Like, you can tell your primary care about it and then like Do you need to follow up with a dermatologist or you need to follow up with, you know, whatever specialist, you have to do that, like, no one's gonna call and make that appointment for you. But people I think don't realize that because you kind of think they're there to help me. It's like, they're there to do their job. And sometimes that's make a referral and whether you follow up on that referral or not, that's up to you. So it's kind of the same coming into the hospital. It's like, if you think, oh, everyone here is gonna now manage my diabetes. For me. It's like, well, they're gonna keep you alive. You know,
Scott Benner 55:33
they're gonna try not to make it worse. Yeah, hospital equals try not to let me die. Right? Yes. And, and even like, I had a surgery on my toe recently, it didn't even happen in a hospital. It happened in an office building. You know, like I was put under, in a place that could have been an insurance company. Seriously, you know, like you go into you go into an office building, and they have a surgical suite. And that's that. Yeah. Okay, I got it. But, and I think everybody listening gets it. I really appreciate you sharing your knowledge on this. Just for fun. Tell everybody where you're at right now doing this in the hospital? Are you at least on a break?
"Valerie" 56:10
Are you still in a conference room? Yes. I took my lunch break. Okay. And it's Friday, and it's a holiday. So you know, what happens in the hospital on days like today is that everyone's like getting discharged. Actually. They tried to discharge everyone yesterday. So that because it's a long weekend below for? Yeah.
Scott Benner 56:28
It's interesting. That's very interesting. Okay. I know we're calling you Valerie. So I'll say Valerie, thank you very much for doing this. I really do appreciate your time. Yes, I
"Valerie" 56:37
appreciate it. Thank you.
Scott Benner 56:44
This episode of The Juicebox Podcast is sponsored by ag one. Drink ag one.com/juice box. head there now to learn more about ag one. It's vegan friendly, gluten free, dairy free, non GMO, no sugar added no artificial sweeteners. And when you make your first order with my link, you're going to get a G one and a welcome kit that includes a shaker scoop and canister. You're also gonna get five free travel packs in a year supply of vitamin D with that first order at drink ag one.com/juice box. A huge thanks to us med for sponsoring this episode of The Juicebox Podcast. Don't forget us med.com/juice box this is where we get our diabetes supplies from you can as well use the link or call 888-721-1514 Use the link or call the number get your free benefits check so that you can start getting your diabetes supplies the way we do from us med if you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community. Check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#1097 Grand Rounds: Hospitals, Urgent Care and Initial Contact
Scott Benner and Jennifer Smith RD, LD, CDCES share diabetes insights for clinicians who want to do better. Today, they talk about the importance and impact of the initial contact in hospitals and urgent care when first diagnosed.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 1097 of the Juicebox Podcast.
Welcome back to the 10th season of the Juicebox Podcast we are starting strong in 2024. With a brand new series called Grand Rounds, these episodes will be myself and Jenny Smith. And Jenny and I are going to be talking to two distinct audiences in these episodes. On one hand, these conversations are directed to clinicians. But on the other hand, they're also directed to patients. People living with type one diabetes deserve good care, and they need to know what to expect and demand from their physicians and physicians. It feels like sometimes some of you don't know you're from a hole in the ground. So with good humor, and much love, this is the Grand Rounds series, where we're going to try to explain to doctors what they don't know about diabetes. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show. This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. Learn more and get started today at contour next one.com/juicebox. This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one.org. And find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that. Check them out at touched by type one.org. Hey, Jenny, welcome back. Hi, how are you? I'm good. Thank you. How are you? I'm fine. Look at us on a Monday again. We've been doing so many Fridays lately. And now today, beginning of the week energy you're getting from us? Yay. I don't know what that means.
Jennifer Smith, CDE 2:23
Like, I don't know, weekend into Monday. I don't know if there's energy there. Maybe Yeah,
Scott Benner 2:29
well, we're about to find out. It's funny. We did the first Grand Rounds episode, which is like an overview of what we're going to talk about. And I think I vacillated a little bit I said I like it's hospitals. First, it's diagnosis first. And then as I really thought about today, like most people are going to end up in some sort of an urgent care hospital care scenario first, right? It's it's very few and far between where people figure out they have diabetes, and, you know, go right into a hospital like, right into a diagnosis. I mean, like, you don't end up at your physician going, Hey, I'm here I have diabetes, like you manage me from here. Like I think a lot of people end up in some sort of an emergent situation initially, do you think that's fair?
Jennifer Smith, CDE 3:12
I think it's fair in the majority of like a diagnosis setting, I think for adults, who may be a little bit more in tune with what their body has been feeling like, and they've just paid enough attention recently to say, This isn't me, like I, I feel horrible, or I've noticed, you know, I clearly can eat like the whole entire refrigerator. And I'm still like losing weight, or I, you know what I mean? That might prompt them to make an appointment with a primary care doctor to actually just go in and go over. And that obviously isn't an emergent, especially unless they call and they get a really good sort of intake nurse who's like, I don't know these symptoms, maybe you should just go to the emergency department instead of coming in here most often they're going to be and sometimes they're also caught, like, you know, you go in for a new job, and they might have you do a physical and you get a fasting glucose or even just a random glucose that kind of sparks up. Hey, we should do more testing here because this glucose number is out of range. But in general, yes, it's more emergent.
Scott Benner 4:20
I'm thinking then that these these two topics are kind of one one a there, you know, I don't know if I can, for sure say but I'm just going to start with hospitals. Because I think hospitals, urgent care, those sorts of things. These are the people who are probably least prepared to give you information and most likely to say something, it's just gonna say, Look at me starting right off most likely to say something that puts you on a bad path.
Jennifer Smith, CDE 4:51
Correct? Not in not because they're meaning to but because again, as we said in the you know, initial sort of discussion, it's because they Really, that's not a specialty for them? Sure they have, they have broad knowledge of a lot of different conditions. And a lot of honestly, I mean, emergency departments are a lot of like test results, right? And what do you do? What specialty do we knew now call it and because of this test result, or this type of trauma or this type of thing that the person came in with, so they have a lot of information. But they're like snippets, right? It's just the tip of the iceberg of information.
Scott Benner 5:27
And I think through that their professional experiences, especially if you're in an emergency room, or, you know, urgent care, any emergency situation, when you see people who have diabetes, they're not coming there, because things are going great normally. So these are people whose blood sugars could be wildly swinging around, they might be having a ton of low blood sugars, they might be having so many highs that they're having other kinds of concerns. And so that when that's your experience with people with diabetes, I think it's then when you meet a new person, newly diagnosed person, whether you mean to or not, you're colored in that direction, right? Like, you lean into, oh, this is bad. Or you want to make sure about like this, because all when I see the people they can't feel their feet and like like, and then does, it may not become a self fulfilling prophecy, then when you bring a newly diagnosed person who is going to be in shock, once you tell them what's going on, their blood sugar's are probably very high. So they're altered to begin with. And now you're saying all these things to them that they did not expect in their life. And if you're coming from the, oh, this is really bad. Then you predispose somebody to believe they now have a thing that's really bad. And you know what I mean by that? Yeah, I
Jennifer Smith, CDE 6:43
do. And I think something that also goes along with it, I mean, my husband would be the first to say that I clearly should never be a poker player, I have no poker face, I just don't like I, if something's up with me, like it's, I have a different expression for a lot of things. And so I think that's another piece in this. That's not verbal. But you know, if you're walking in with lab information, or a urinalysis or something, as the first point of contact of this new information for the family, or for the adult, or whoever it is, you're going to say, hey, you have diabetes, you know, I know you shouldn't be like looking like a happy, happy person. But really, you should also look like this isn't like the Grim Reaper expression on your face, right?
Scott Benner 7:31
I don't mean to say that people should be disingenuous. As a matter of fact, one of my favorite restaurants, there's a teacher, a school teacher that works there as a as a weight as waitstaff. And she teaches very young children. And so she comes at you with that energy. And the entire time you're talking to her you're like, I don't feel like this is real. But I actually think it's who she is. But it's still like, it makes you feel like is she pretending? And so you don't want to come to somebody with this happy energy? Like, oh, don't you have diabetes? No big deal. Because Correct. That's also like a lot about what we're going to talk about here is the path you're sending someone on. So you don't want to send them down a doom and gloom path, because if they think there's no hope they might live, like there's no hope. And they might educate themselves as if it doesn't matter what I learned, because I'm gonna end up back in that hospital one day, right? You also don't want to let them think like, everything is just amazing. And this is super easy. And you know, or that, you know, we talked about earlier to, you don't start telling them about a cure that you heard about an even yet, right? Because Because I know where that comes from, it comes from a, I want to make you feel happier, we're better about this. Correct. But what you might not know if you're in an emergency room is when you tell somebody something's going to be cured. Soon, you predispose them to not learning about it and not taking care of it because they think it's a temporary issue. Right?
Jennifer Smith, CDE 8:56
Yeah, absolutely. And I think that's another piece that temporary, it's a good, it's a good word, because I think something also that gets laid down early on not every time but many times is just do these simple steps. And it will, it will work right. And or, here's your here's your dose, you know, let's say this is a new diagnosis of type one diabetes, obviously and here are your doses. The explanation beyond that, even though you may not know what that transition may look like, should never lead the person to believe that these start these starting doses or this starting is where it is going to be that there will be movement you will follow up with a care team the care team will direct this your doses may change they will change you know all these all these points to have them understand that this is a like a moving picture. All right,
Scott Benner 10:00
if you put me in this position, I would tell people, listen, this is scary, I understand, it's going to get easier over time. But that's only going to come if you learn a few things. And really, at its core, you're gonna have to learn how insulin works. Now we're setting you up best we can, with some settings, and some ideas, just like you said, These things are going to morph and change. As a matter of fact, it's possible. Don't say things to them, like you might be in a honeymoon period, say it's possible, you may still be getting some assistance from your pancreas that will over time, and I can't tell you how much time will dwindle to nothing. And that could be a week, it could be a month, it could be a year, I don't know. But I can tell you that that's going to keep changing as that changes the how you use manmade insulin, the amounts. And I think, you know, a lot of the strategies are going to change as you move forward, leaving them with the idea that it's not going to stay static is super important in a society where people think about pills fixing things, correct? Yeah, right, exactly.
Jennifer Smith, CDE 11:09
Because most of the medications, honestly outside of insulin, and maybe a couple of other things, other medications, oral or even injected Ra, I take it in the morning. And that's it, I don't have to think about what I'm doing the rest of the day, because the medication just does what it's supposed to do. The understanding that you're giving them of this medicine, I hate calling insulin medicine, because it is something that your body does naturally make, right, just in the case of diabetes, it doesn't. But this insulin that you're taking essentially, will need to be adjusted, we are just at a starting place. And to understand, again, we're not your specialty team, we're setting you up with a place to be able to get out of the hospital, essentially, and then move forward into a team that can provide you with that detailed information. We are just covering the basic,
Scott Benner 12:08
I think when you're doing triage work, which is what that is, right? It's triage and initial, and then you move people on to something else. For most things that happen in an emergency room, the thing that's happening now goes away, when you get to the next step, I broke my leg, you know, hey, broke your leg, it looks good, it looks bad, I just shouldn't be a problem, we're gonna get you to somebody, boom, you leave. Right? A day or two later, what was said to you in the emergency room is no longer impactful to you. It's over. Now, this is a situation where the least knowledgeable person in your care plan and I mean care plan from day one being diagnosed, the day you die. The least knowledgeable person is the first person you see. And they imprint ideas on you. And they don't know like, I'm talking to the doctors. Now I know you don't know you're doing it. It's because you don't have diabetes, like and I get it. But you start saying things like, Don't worry, it'll be fine makes people not pay attention. When you tell people to worry, you ruin their lives. Like they, some people will go home and be burdened in ways you can't imagine. You need to say, I don't know a lot about this. But what I know for sure is all of management, at its core is how insulin works. You need to get to an endocrinologist and learn about insulin. And if your endocrinologist doesn't teach you go out into the world, do your best to find that information. Otherwise, you get lost in a direction you either get lost in over management direction, which causes significant psychological issues for people. Right, I was just talking to a girl the other day on the pocket. She's 21 diabetes, and she was five years old. And still, when she got to her adult endocrinologist who would just tell her you're a one sees too high. Just say that to her a couple times. Then one day, he said, Eat Fewer carbs. Well, then it got in her head. And that's all she could think about. Right? I'm not gonna eat more than 20 carbs today. And then she started having a disordered eating pattern. And if somebody else in her life hadn't come around to her and said, Hey, you're not eating well at all. This is what she would have done out of that fear. Because she said once she started using such a small amount of insulin, even though she wasn't nourishing herself. After she started using such a small amount of insulin, she saw more stability. And that's the building made her ignore that she wasn't eating anymore. Of course, yeah. And then when somebody finally came along and said, I don't think you're even nourishing yourself, and it was time to inject more insulin for her her meals. She was frightened and she couldn't do it. Right. I tell you that like quick story that people were listening, because that all came from a someone who just didn't know how to help her with her insulin and said once you just need fewer carbs, that throwaway idea caused that landslide of problems for that lasted two years. contour next.com/juicebox. That's the link you'll use. To find out more about the contour next gen blood glucose meter, when you get there, there's a little bit at the top, you can click right on blood glucose monitoring, I'll do it with you go to meters, click on any of the meters, I'll click on the Next Gen, and you're gonna get more information, it's easy to use, and highly accurate. smartlight provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips, as if all that wasn't enough, the contour, next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next one.com/juicebox. And if you scroll down at that link, you're gonna see things like a Buy Now button, you could register your meter after you purchase it, or what is this, download a coupon, oh, receive a free contour, next gen blood glucose meter, do tell contour next one.com/juicebox head over there now get the same accurate and reliable meter that we use.
Jennifer Smith, CDE 16:08
Right, and you're talking about somebody who had been speaking with what we would consider is a specialist within the diabetes, you know, community, right. And so back stepping to the baseline. And I don't say baseline in a very generic way or in a you know, a not not educated way. But it's a baseline of information that those who don't have a specialty outside of this specialty of navigating so many different types of things that come in to an emergent situation, I mean, that that takes a special type of clinical mind, right to be able to navigate between, you know, this type of wound versus this type of vomiting versus that type of headache, there's a lot of consideration there to figure out and know what tests to do. It's a very quick paced environment. So nobody would expect them to be specialists in just one thing. But I do believe that from a general place. diabetes in and of itself is a hate thing easy, but it is, if you understand the baseline of type one versus type two diabetes, then in an emergency situation, test results are something that should be easy to interpret, right? And then what you provide with the family or the person who is going to be newly diagnosed, it should come from at least that baseline of this is what type one diabetes is. This is what it means. And I think those those basics for the person who this is very new four, are really important. Because again, I mean, we've talked in other things about, you know, blame or feeling guilty, and from the person who now has this diagnosis. And I think that even keel of you know what, we found out why you're feeling the way that you do you have type one diabetes, this is what that means. And, you know, I think that's at least a way for someone to accept the information, as well as for you to give them none of these like gray areas of like the unknown what to do with it.
Scott Benner 18:20
You know, it's funny, you said that we don't, we wouldn't, and shouldn't expect a person in an emergency room, for example, to know the ins and outs of diabetes. That's great. And you and I sitting here philosophizing about it is exactly right. But the person who's just been diagnosed five seconds ago, you're the most learned person in the world to them. Correct. And so if you don't know, the best thing you can say, is I don't know a lot about this, you know, and I'd be afraid to tell you something that would lead you in the wrong direction. But I hear I listen to this podcast, I probably don't tell them that you but but but you know, here's what I do know, it's a lot about how insulin works. When you get to the next step. If you feel like you're not getting good information about how insulin works. Don't accept that as a baseline. Everything's about how insulin works. You know, it's not difficult. Once you understand it, it takes a while to understand it. Be patient, be kind to yourself, I mean, that's the thing. I always feel dopey saying stuff like that, but it's absolutely true. Like you gotta give yourself a break. It's gonna take some time. This is the kind of stuff you can lead them with. You know, you're gonna learn as you go, right? I know plenty of people who live well with this by the way, if you don't, it's okay still lie and say you do. Okay. Like you know, like you don't say Nick Jonas to them, apparently that's one of the feedback things from the people that are like, without telling me about Nick Jonas when I'm diagnosed. But But ironically enough, down the road, there are some people who are very comforted to know that people who they they see as they know, functioning well in the world and that they're aware of have Diabetes. But yeah, it's funny how many people said like, Please don't tell me about Nick Jonas? Well, my kids being tagged
Jennifer Smith, CDE 20:05
with that is what? And again, that's, it's almost a, like you said before, oh, there'll be a cure kind of comment. It's not that bad. Yeah, when really, you're the one living this new thing. It is it's, it's
Scott Benner 20:20
ever happened to you the worst
Jennifer Smith, CDE 20:22
thing that's ever happened to you, right? I mean, in general, to when someone comes in emergent lead with this diagnosis, nine times out of 10, especially for kiddos are going to be admitted, there is going to be at least a day or two, depending on the status, when you come in with this type of diagnosis, depending on the status of the child, the teen, the young adult or the adult, there's going to be an admission, which means that you're again, you're the first explanation of this new diagnosis as the clinician who's there. But expanding on that, being able to say you know what, we're going to admit you, if that's what's going to happen, and there will be there will be specialists who will come and explain this further. I don't know all the answers, I'm not going to pretend to know all of the answers, you will have specialists who come in and explain and sit down and talk with you and answer all of the many questions that I know are probably sort of circulating in your head right now. And I think that's important to explain, because like you said, You're the first know all like, you're like everything right now in terms of delivering this new diagnosis to somebody, but also explaining, I know, I know what you have, but I can't do much more. That's why we're going to get you to the people who do
Scott Benner 21:47
it's an awesome responsibility to have one of those jobs that people just blindly trust teachers, police officers, doctors, you know, you don't realize that what gets said is it's gospel. It just it right away is and you know, if you're listening right now, and you're a nurse that's in working in an ER or a doctor that works in some sort of intake, and you think I've I went through this in school, I know, you don't know anything about diabetes, if that's all you know, and I will offer as a personal anecdote about that, that this podcast is strewn with doctors and nurses whose children or selves have been diagnosed with diabetes. And when they were diagnosed, they thought, oh, this will be easy. I know about this. I learned about this in school. And then five minutes into it, they realize, oh, they only told us enough. So we don't kill somebody. Right. Right. And, and bringing up that kind of language. There's this phrase I used in the podcast a number of years ago. I swear to you, I wasn't trying to start a catchphrase. I said, I think some doctors not all by the way, by the way, there's plenty of doctors listening right now and nurses and doctors who are very good with diabetes and insulin management who are just saying Hallelujah, like preach to people, right, but, but for the ones that aren't, I used to say, I haven't said in a while. Often you get what I call don't die advice. Like it's enough management, that you'll you'll be alive today. And you're not going to have a seizure. But there's no no view of long term health or long term stability mentally, physically. It's just enough that you won't die today. Oh, yeah. Yeah, once the seven, that's pretty good. You know, like that kind of stuff. Your blood sugar went up to 300. But it came back down. Yeah, yeah.
Jennifer Smith, CDE 23:32
And in an emergent situation, I think that you're not going to die right now information. I don't think that that's, that's very important. It's really, really important. This is a baseline, this is what's going to get us through to the next point, right. And that next point, again, is specialty. It's someone who's going to teach you not just how not to die, but is going to teach you how to live honestly, with this and strive and do all the things that you want to do in life that comes from a good specialist that that's not don't and as the person with diabetes, you know, newly diagnosed, shouldn't expect to get that either. Yeah, but as the clinician addressing them for the first time there, you should explain that to them. I am I am your baseline of information. This is what I know from the test results that we have. This is what it means. This is the basic definition of what you have. And we are going to get you people who can really explain this at a much higher level for you and I think that's really important for to not try to be the No at all. In that situation. Right? to not try to explain beyond what you truly don't grab it points. Essentially stick
Scott Benner 24:55
to what you know, and check into what you think you know, before you start spreading it around As if it's true, because there was two pages in your book in college. And, you know, even when you think about managing diabetes in a long term setting in a hospital, I mean, honestly, Jenny, they, you know, if your blood sugar's under 300, while you're in the hospital, they're going to be thrilled. They're going to be focused on not making you low, and they're gonna have you eat, and then they'll shoot your insulin later, even when sometimes people who really understand their care will say, I, you know, I can't let my budget or up to 200 and sit here all day. Oh, no, we're okay with that. Whose way? Like, I'm not okay with that. But once you say it's okay, now a person goes out into their life, and it's okay. You know, 200 is fine. Like, because that's what happens in the beginning, you're giving good you're giving don't die advice, which is very, very important. But if you don't say the rest, like over time, we need to tighten these tolerances, right? They'll just live like that forever, right? Some feedback from people, even a small pamphlet with resources and basic information would have been amazing to get to the hospital. Please, somebody educate the hospitals, I want doctors to understand that a diagnosis also causes mental trauma. And not just a mental trauma. But it's, I went through it having my daughter diagnosed, I didn't know which way was up. Like I've said it a million times in this podcast, it feels like someone ran up to me, hit me in the head with a shovel and started yelling math at me. And if I didn't remember it, my daughter was gonna die. That's exactly how it felt. And it went on for days. If you think the third day I was better off than I was on the first day. I wasn't every conscious moment you sit there thinking, Oh, my God, Everything's ruined. Like it's over. Like everything I thought is gone. Like because you don't know. Right? You don't you don't know that. It's, it's incredibly doable. And that millions of people live with it well, and like all that stuff. So you're just sitting there in a panic. And you're like, Oh, it's my problem to take care of the kid. But if you're an adult, it's almost worse, because it's on you. And you're the one who's going to get a low blood sugar and not be able to think at the same time. And you're going to end up with an adult endocrinologist who has you point out all the time very likely, mostly helps people with type two diabetes, at least when you're a kid you get at Children's Hospital? It's a little more. Yeah, yeah. Right.
Jennifer Smith, CDE 27:23
You know, right. I, you know, I think too with that, because of the constraints of hospital stays, that are dictated by essentially diagnosis status within that diagnosis, and honestly, insurance that covers all of that, right. I think that many times from a clinician standpoint, they're trying to pack as much as they possibly can to send you out the door with more than just the This Is How Not to Die. Right? And what gets lost in that it's great that you bring in the mouth mental component to that because what gets lost is the consideration for how much in of traumatic type of setting the human brain can actually retain.
Scott Benner 28:10
Very little from my experience. Yeah, well, and you're,
Jennifer Smith, CDE 28:13
I mean, you're not a dumb person by any means. So you know, I know it just in the many discussions we've had you grab on to information very easily and very quickly and you get it and you can dig deeper and you can understand much more so I think it was it not your daughter I would have been alright probably would have been okay, you would have gotten it you know if it is a nephew, okay, you have to care for him over the weekend, I got this, I got this, like I can do it, you know, but for somebody that you like your, your arm, right? It's like a piece of your body is your child, honestly, as a parent, and so you, you have this mental piece of not only do I have to keep them alive, but oh my gosh, I have to keep them alive with this new stuff that
Scott Benner 28:57
I'm supposed to do. And they'll say to you look too much is gonna kill them too. And you're like, wait, what, and then it's not enough is gonna cause long term complications. And too much is gonna cause a lot of it's about how it's said. It's the delivery, it's your communication and your delivery and listen, and to Jenny's point. I'm pretty good at diabetes. But on day four. On day four, I was crying in a room because someone was trying to teach me how to add fractions a thing that by the way, I knew how to do. I was beside myself. And it wasn't because I was learning how to like figure out a dose based off of carbs. That was easy. It was because of the pressure that came with it. Like what do you mean? Like she's like, when her doses were i My daughter was two years old when her doses are a half a unit and you make a math mistake and now you're at a unit and a half. Well, geez, right? I might just we'll just toss her out the window right? Like let's get it over with because I'm like, I'm gonna screw this up and I'm gonna kill her and then that fear turns into while just let her blood sugar boil little high. And then all the sudden it's, the doctor will say to you like, well, you know what? Let's make your let's make it I don't know 70 to 200, but we're going to treat 90 is low, but two hundreds, okay? Well, once somebody tells you two hundreds, okay, 220 doesn't seem that far over 200 Correct. And then you start, like, getting farther and farther away from healthy. And no one tells you on day one that a high blood sugar makes someone altered. I don't know that my daughter's not the person she's supposed to be because their blood sugar's 250. No one says that the mean, if they said it to me would have freaked me out more. So you're in this like paradox where you need the information, but you need it correctly. And that means time, it means a thoughtful explanation. And again, if you can't give it, I think it's better not to say anything. Right?
Jennifer Smith, CDE 30:54
That's, that's where understanding that those beginning pieces of information need to come with the explanation that this is a start, we will adjust. And you will, again, have some specialists who are going to help navigate the adjustments. Right now, the safe target range may be this to this and it may be very broad. This, again, is a starting place. So everything as the as the first person that this person who's newly diagnosed, is going to encounter, the baseline you give them should be this is just the start, this is going to be an OK place. And we're going to move further beyond this. So that you can really, again, live the life or have your kid live the life that they want.
Scott Benner 31:45
The number of people pointed out that as a an adult diagnosis. They're like I needed an endo console in the hospital, and didn't get one because the hospital so don't worry, like leave here, call this number, we'll get you set up with an endocrinologist. And then the endocrinologist sometimes will tell you, they don't have an opening for three months. So now you're holding insulin, you know that. And somebody told you it's dangerous, be careful, or worse, they didn't tell you it was dangerous. And they make it off you like loosey goosey and fancy free. And then there's so much feedback from here from people like I gave myself way too much insulin almost killed myself. And you know, and because who knew it was? Because if you take two Advils or three Advils, you're kind of okay. And that's how and until you've had a tea, you've had a serious medical issue, like a day to day thing that's always with you, right? You don't ever think about your health that much. And people just don't think about it, it's a thing you take for granted, you know? Correct, right.
Jennifer Smith, CDE 32:45
And as the adult level, which is great to bring in, because as I mentioned initially, many, many adults are actually not diagnosed in an emergency room scenario, right? They're actually, as an adult, they're like, I just don't feel good, or I just have not felt great i or I'm doing this and I didn't used to do this or whatever it is, and then they it's a primary care. And then like you said, the primary care may say, hey, let's get you to see a specialist, especially if that primary care, did a great job and actually did enough testing to diagnose type one versus type two diabetes, hey, you know, I'm not your specialist, let's get you to the specialist. But again, there is there's a problem in that we don't have enough specialty, with enough time on their schedule, to be able to get that newly diagnosed person in within two days or even three weeks, it many times is much delayed, and what does that leave the person who now has to take medicine, they now have to take, you know, their blood sugar, they have to understand a little bit about food and about, you know, activity and maybe their job is a heavily active kind of lifestyle in all of these things that in no way can primary or general medicine really expand on to the degree that's needed. I think there's a very big deficiency in our healthcare system in terms of the ability to get what you need when you need it. There just is and that's not, that's not a knowledge component from the clinical staff. That's, that's just the way that healthcare is set up. And it's
Scott Benner 34:24
unfair to talk to people who are working in emergency and, and to put this on them. But I think it's incredibly true. You're whether you know it or not, you're in charge of what happens to those people 30 years from now. And and it's you might say, Well, how is that possible? But I mean, I've done my best to say it here over and over again. If you put someone on the wrong path, they might never get off of
Jennifer Smith, CDE 34:48
it. Especially if they never get to see somebody who can clear it up for them
Scott Benner 34:52
right or the next person they get to is inept, or whatever. And you know, and now you have a doctor telling you Oh, you're a onesie aid. I mean, ADA says seven. So that's not too bad. Right? Right. Right. Yeah. And it's gonna be a problem. And so I think some people also go to scare tactics. I can't believe how often I hear from people that they've been scare tactic than a hospital before, but telling them trying to relate to people by telling them your dog has diabetes, your cat has diabetes. That's not good. Don't do that. Now, right? Telling them Oh, my grandmother lost her foot. I know all about diabetes. Don't do that either. Don't do that either. Right? There are some things that feel confident. It's funny, isn't it? When you see a conversational thought, hit someone's head, and then they speak it out loud? And you think, why would you say that? And even I think a moment later, the person might even think like, oh, I shouldn't have brought that up. But it's too late, then. Like it's too late. So you're sitting with a person who thinks their life, they either think their life is doomed, or they have so little understanding of it, they don't know, to put the effort into it to stop their life from being doomed. Right? Right, they need, they need a good launch from you. And that launch might just hopefully be to across the street tomorrow for another appointment. But you don't want to put a thought in their head that they can't get rid of that that sticks with them. And, and especially in that scenario, like you have to treat them like they were just in a car accident, and that they aren't following what's happening. Right? Because the other thing here, I this is also, I think very important. If the people are healthcare professionals who are being diagnosed, the parents or the adult, do not assume they don't need your help, or they don't need someone's help. And they've got it because they're doctors, because the amount of conversations I've had with doctors who said I was not educated properly, because they looked at me and thought, Oh, well, you're a doctor, you know. And that was it. That's incredibly dangerous. Those people then have to go home, by the way, and fight with their own ego for a minute where they're like, I should know this, then they feel defeated. That's a big one. Don't do that to health care professionals. I don't know like there's I feel like I could just talk about this forever. But I don't want to muddle it.
Jennifer Smith, CDE 37:07
Yeah, well, I think, you know, from my previous hospital and clinic based sort of experience, I had the unique advantage to work with a really wonderful endocrine team, within a big hospital system. And within this hospital, the emergency department actually came to the endocrine team and said, you know, we actually know that we don't, we want to navigate managing those with diabetes, both type one and type two and newly diagnosed, especially who come in better. But we also are a big city emergency department, right. And so from a staffing standpoint, we don't have time to walk through somebody's medication, exactly other than take it once a day or take at this time of day, and some of the education and so they worked really, really intensively with our endocrine team to develop actually a protocol of education specific to diabetes. And in stackable hours, not that we were there at two o'clock in the morning. But within hours of normal daytime operation, when people with diabetes were diagnosed, we got a page to come to the emergency department and actually provide the education as well as the medication dictation about how to start something and how to dose it, et cetera. So I think, you know, system to system if they adapted or adopted something similar to this. And if you have any, say within your, you know, for kind of talking to emergency or urgent care kind of staff, if you have any ability to have some poll about what could be done, you may actually be able to make more of a difference for those who are diagnosed with diabetes in that emergent situation, by just pulling somebody in, even if they're not going to be admitted for additional information that especially for the adults, if there's somebody on staff that could come, that would be a huge advantage for
Scott Benner 39:12
that big deal. Right. Now, of course, I don't want to overwhelm the person who's in that position who probably doesn't have enough information. I don't want them to and I don't want them to. But But I think again, saying things you don't know, is maybe the worst thing you can do. Like really and assuming too, that the next person they get to is going to fix the whole thing is also like so there is some responsibility there for you to give them some basic information and education. Or tell them there are places online you could go to, like meet other people who have diabetes, because unlike if I come into the emergency room in heart failure, I'm going to go to a cardiologist who is now going to manage my heart. I will just do what that person says and this thing will go as well as it could if I come in there with cancer, I'm going to go to an oncologist and they're going to take care of everything a broken leg, someone's going to fix it, they're going to teach me and then they're going to send me to physical therapy afterwards, you get diabetes, you go talk to somebody, they go, here's insulin, good luck. And then you go home, and now you're in charge. And that is just what happens type two or type one. That's what happens to diabetes, it's not a thing that the doctor is helping you with, or putting you on a path. And then you don't really have to do anything except take this thing on an empty stomach or like that. It's so different than that. And I know it's a misunderstood thing within the population, and that part of the population are nurses, and doctors and everything else. And I know it's misunderstood by them as well. But it's why we're doing this. And also, the opposite side of this, which I'm going to at the end of every one of these episodes bring up. This episode is not just for somebody who's a physician, or in a position to help somebody, you should be listening to this and saying, This is what I should be expecting. You know what I mean? Because maybe you're listening now. And yes, you already have diabetes, but you're gonna end up back in the emergency room one day for something if your mount but odds are, and you get there, and those people are going to still not know anything about your diabetes, you know, and they're, but they're gonna say they do and, etc.
Jennifer Smith, CDE 41:15
No, that's a great point to bring up. Because I, I was gonna bring up similar that as the person with diabetes or the family with diabetes, you have to know how to be an advocate for yourself, honestly, you have to be the one to say, You know what, I don't expect you to know all the answers here. I know that you can help me with this emergent situation, or maybe not. So let's can we get the specialty? Right? Is it within hours that a specialist would be here? Let's get them in here. Because I don't know what to do. I've clearly not done something right. Or I've been sick enough to bring myself to the emergency department with diabetes. I want to make sure that this gets, you know, figured out the right way.
Scott Benner 41:57
There's also a way to not I mean, it's hard, but you got to not flip out a little bit. These people. It's not their fault. They don't know about this. Like it's no, no, not not a little bit. It's not negligence, it's not apathy. It's just It's the system and the way it works, right. So it's a number of years ago, but Arden and I take her to the emergency room once for stomach pain. And we're there for a couple of minutes, and the nurse comes in and she goes, we're gonna get that insulin pump off of her. And I went, No, we're not. No, we're definitely not doing that. She has no, we'll get her some Basal insulin. I'm like, Whoa, no, no, you want to inject. I'm like, I haven't done that in 10 years. I don't even know how to do that right now, like, because you see that that's what the pump is doing. The pumps already doing that. And then at one point, her blood sugar as they gave her an IV, I guess that dilutes your blood a little bit. And her blood sugar started to go lower and lower. And she says, I'm gonna give her dextrose through the IV, maybe? I don't know, exactly, she was gonna get extra hit or something, you know? So I said, Listen, she's on an algorithm. As soon as her blood sugar jumps up, it's gonna, like start giving her instantly and we don't want that either. So tell me what you're doing. And I'll adjust the algorithms so that that doesn't happen. And then she's like, Oh, what's that? And then I explained it to her a little bit, then she became interested. And then she was a lovely person, and a thoughtful person. And in 10 minutes, she knew what we were doing. And then we were partners, you know, and now I had taught her a little something. And now she wasn't saying things like, let's take the pump off of her. Correct, trust me an hour into it. No one was more thrilled in that room than that nurse. sure that we had come to an understanding and educate each other.
Jennifer Smith, CDE 43:40
Because you had stepped up and been an advocate for your daughter, right? And or the person who has diabetes, as long as you come in. I mean, this is a piece in the education that I typically do with like, either preparing for a hospital stay or a surgery or planning for an emergency, right? Is the idea that if you come in and urgently know that they're one not going to have any extra supplies to help you, right? Right. And so you do everything you can, as long as you are verbally, okay, you can address and talk to them and you're not out of it. Then great 100% You're keeping your pump on you or 100% You're talking to them about these are the doses that I take this is this has nothing to do with the sore on my toe right now. Don't worry about
Scott Benner 44:31
it at all you want. I'm not taking the CGM off if I have one ether, like it's alright. We don't trust that thing. I'm like, Okay, I've been living my whole life trust in that thing, and it's working out pretty well for me, right? It really is. I don't know it's to dance. It's a little bit of a dance and you have to be a good community to cater to you can't just start ranting and because the minute you rant, it's over. You know, like they're gonna be like that lady's yelling at me and I don't want to be involved in this and then you're never getting anywhere. Correct. It's just a very it's incumbent on both sides to, to want to, you need to want to work together, I think. And it's it's hard because they're in and out of the room. They're tired, they probably overworked, they're probably underpaid. They've probably been eaten in six hours. And you're trying to explain your, you know, your, I don't know, your algorithm to and they're probably like, well, I don't even know what you're talking about. Right. Right. I was lucky once as Arden went into medical procedure, that one of the nurses in the room was like, my friend has diabetes. And all that happened was I used a word that she recognized. And that was enough to make her look, amigo tell me more about that. Yeah, that was it. And I said, Okay, here's how this is working. And she goes, Oh, that's great. We would probably love to use that. Let me get the doctor and find out doctor comes in and re explain it. He goes, Yeah, let's keep that on her. And I was like, great, but five minutes before that people were pulling at it. Because they don't know why it's just what they do. You know, and, and to feel, then that puts you in a position where you feel attacked. And and then you lash out. And it's tough to because you know, I have this note for myself in this in this document that we're working from for this series. It struck me a couple of weeks ago, while I was thinking about this, we always tell people, you have to advocate for yourself. But it has two different meanings. If you don't know what you're talking about advocate means please teach me you have to I need to know more. I don't have enough information, blah, blah. But if you know what you're talking about, what advocate really kind of means is you have to make them do a thing, right? They don't want to do
Jennifer Smith, CDE 46:34
advocating for yourself as explaining what you know, it's almost like proving yourself essentially proving that, like you did, hey, we've got this thing it does this, it will really help beyond what you think your protocol says. Yeah, this is above that. And this way, and again, from advocating sometimes you have to simplify it right? You don't want to tell them all the bells and whistles because quite honestly, they don't need that. And it's going to be confusing. Do
Scott Benner 47:04
what I did when I was dating my wife tell her the good stuff. Okay, no, yeah, she can find out the rest after it's too late. Way too late. Arden had a surgery once. But it was a quick one was like a 30 minute like laparoscopic thing where they were just kind of going in and looking around for something. I said, Look, she's wearing an algorithm. It's run from her cell phone, you have to keep the phone with her. And they said, Okay, that's fine. But I want you to turn off the auto Bolus thing. And I was like, Okay. And then I just didn't do that. I just picked the phone up. I was like, oh, yeah, I got it. There you go. And then I just go ahead, because she was gonna go in there, and very likely not eat insulin. Like she's sedated. Like I thought her and by the way, I thought that's what was going to happen too. But the minute she woke up, and she was like, you know, at her adrenaline kicked in everything, and her blood sugar started to go up, that thing started to Bolus in the recovery room, and I couldn't get into that recovery room for like, 30 minutes, right. And we stopped a blood sugar that was easily gonna go to 300 by just letting her algorithm run. And I never told anybody about that. And if they know me, this is when they're finding out right now. So and I don't believe they'll ever hear if you know, best then say, is really is what I'm thinking. And I think listen to this conversation, recognize that these poor people, they're not trying to screw you. And they just don't know. And it's not their fault, you know? Correct.
Jennifer Smith, CDE 48:36
They've got a protocol, they're not picking weird stuff from the air, right? They have a protocol. And the protocol is a safety based protocol. And it's based on a line of here is okay for the majority of people, or here is okay for the majority of peds. Right. And that's what they're going to use. Is it going to keep you from having a low blood sugar? It is absolutely, but it will not, you know, prevent you from having a high
Scott Benner 49:10
blood sugar. It's not a way to live long term. No, it's perfect for that set and setting in the moment. That's all the problem is again, and to end is you do not want to leave thinking this is how it works. Because you when you get into your regular life that is it's not going to fly. Right anyway. Okay, great. This is a good start. Awesome. Thank you very much. Excellent, thank you. I'm excited.
Having an easy to use and accurate blood glucose meter is just one click away. Contour next one.com/juice box. That's right. Today's episode is sponsored by the contour next gen blood glucose meter. A huge thanks to a longtime sponsor touch by type one, please check them out on Facebook, Instagram, and at touched by type one.org. If you're looking to support an organization that supporting people with type one diabetes, check out touched by type one. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones, it doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community, check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrongwayrecording.com
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!