#1114 Future Nurse

Kayla's daughter was diagnosed with type 1 diabtes just before her tenth birthday.

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Scott Benner 0:00
Hello friends, welcome to episode 1114 of the Juicebox Podcast

Kayla's daughter had an A one C of over 13 and a blood glucose over 1000 when she was diagnosed with type one diabetes, now Zoey is home and inquisitive about what happened to her at the hospital and dreaming of being a nurse and her mom is on the Juicebox Podcast. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cozy earth.com 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 the insulin pump that my daughter wears Omni pod learn more and get started today with the Omni pod dash or the Omni pod five at my link Omni pod.com/juice box. This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash juicebox

Kayla 2:02
I am Kayla I am from the Midwest. I don't know what else you want to know and how you want me to introduce myself.

Scott Benner 2:08
Oh, that you're Kayla's? Good. That's a good start. Do you have type one diabetes? Or are you the parent of someone with type one?

Kayla 2:16
I am the parent of someone with type one drew me to go over her diagnosis or Kayla

Scott Benner 2:21
you don't have to ask me every time before you talk. It's okay. So how old is your daughter?

Kayla 2:30
It is my daughter My middle child actually. She was diagnosed January 10 of last year that was 20 days before her 10th birthday,

Scott Benner 2:40
Jen 10 I'm sorry. 2022. Right.

Kayla 2:44
2022 Yep.

Scott Benner 2:45
Okay, I'm sorry, right before her birthday. Right before her 10th birthday. Okay. And she's your middle. So you have older younger, how much older? How much younger? Um,

Kayla 2:54
yep, her brother is 12 going on? 13. And then the youngest, it will be nine this fall. Okay. So she's literally right there in

Scott Benner 3:03
the middle. Neither of those kids have diabetes? No, they

Kayla 3:07
know they do not. Thank goodness. That's been a paranor of mine ever since she got diagnosed. And I bet.

Scott Benner 3:14
Yeah. How about other autoimmune issues in your family?

Kayla 3:18
Not with my kids. And my husband has an autoimmune disorder. He has psoriasis and distant family on his side. Come to find out there is a couple of type one diabetics, which we did not know about until after our daughter got diagnosed.

Scott Benner 3:33
Wow. Do you know like how far back in his family? I

Kayla 3:36
would say they probably fourth cousins were kids. Gotcha. Then we're in there so well,

Scott Benner 3:43
okay. And how did you find out afterwards, you start asking around with the family? Yes,

Kayla 3:48
we started asking around and stuff with the family and whatnot. And one of them actually reached out to me while she was in the hospital and to offer support and stuff. And if we had any questions and things like that her daughter had got diagnosed, I think a couple years before ours. She's 16 or so now. So she would have been diagnosed as a teenager.

Scott Benner 4:07
No one ever comes up to you prior and says, Hey, before you make a bunch. We just wanted to let you know that. Yeah, no, no, everybody's like, it'll be fine. It'll be fine. It'll be fine. I don't know what that means. But okay, so Well, that's interesting. So you had somebody reached out who I'm assuming you're not like, very close to right?

Kayla 4:26
Um, no, it's, you know, the ones that reached out we see him at you know, that twice a year of family dinners type of thing. So

Scott Benner 4:33
Was that helpful hearing from someone?

Kayla 4:37
It was she she offered a lot of support, and I actually did reach out to her when I was setting up my daughter's Dexcom for the first time she helped me over the phone with that and whatnot. She's been pretty helpful.

Scott Benner 4:48
Nice. That's great. Okay, so how did your wife because this was obviously surprise to your family? Yes. How did it present? You

Kayla 4:57
know, looking back part of her diagnosis, there were signs that, you know, you just don't really correlate with, you never really think your kid's gonna have type one diabetes, but right before she got diagnosed so that Saturday, she played point in a basketball tournament, she had a couple games, and I helped coach and she kept coming up to me and say, Hey, I'm like, I seem extra thirsty. And I'm like, Oh, you're just playing hard game, just drink some more water, you'll be fine. And that sounds terrible, but and then I remember her hair being staticky. And I'm not sure if that has anything to do with it. But I just remember her hair being she staticky. And then that Sunday, she started vomiting and stuff. And then I was like, Oh, it's just the stomach flu at that point, you know, you still don't register the type of diabetes aspect.

Scott Benner 5:39
Sure. Yeah. No reason to.

Kayla 5:42
Yeah. And then that night, she got the bomb, and it got progressively worse and more like, forceful. And so we did the whole, like woods and all of that she's wasn't keeping anything down. And I told myself in the morning, if she still wasn't getting any better, I would take her in. Well, we ended up falling asleep for a little bit and woke up about I guess about six in the morning. She felt going to the bathroom and her face just she woke up her face was sunken in. And I was like, Well, this is not a normal. Flu. Yeah. And then she asked me, so she felt going to the bathroom. And my son was going over to school. So that was fine. I think my youngest was home, my youngest was home sick, and I can't for the life of me remember why it was a cold or something at that point you there's some details that you just don't remember. So I remember calling my mom to come get my youngest. And my daughter looked at me and asked me and she must have felt different. She looked at me and she asked me she goes, am I going to live? And I was like, Oh, crap that gets you you know. Wow, really? And she did. Like it must have felt different to her to kill like not

Scott Benner 6:49
ironically, or she wasn't trying to be funny or anything. She had a real concern for herself.

Kayla 6:54
No, yeah. Cuz she usually all of my kids can usually handle sicknesses like champs Wow. And so it just, I've always wanted it to feel different to her somehow. And so we took her into the emergency room, and within five minutes that nurses like, has she ever had any blood sugar issues? And I said, No, he took her blood sugar on she, she max out their thing. I mean, he couldn't even get a number. He said she has diabetes. My husband was at work. And of course, I call him and he came. And so her actual stats at diagnosis, she had an agency of 13.2. And her blood sugar was 1121. Holy Hell, her ketones were slightly above six, but she got transported via ambulance down to Children's Mercy in Kansas City. She was in the PICU for overnight there and stuff, they still they brought her blood sugar's down. And you know, we got to go home Thursday evening. So she went there in there Monday, we got to come Thursday evening, it was just a whirlwind. After that, you know, that four days are learning, they throw these binders at you and say, here's a four hour Crash Course crash course on type one diabetes, you know, and it was just crazy. No, I

Scott Benner 7:59
just talk today to a doctor. I'm gonna do a speaking event later this year. And I was speaking to a doctor at a hospital where it's going to be at. And we talked about that very thing about how impossible it really is to hear what's being said to you in a moment like that. And like, maybe you even hear it and you're nodding along with it, but you can't recall it later. You know, you don't mean like, it's just, it's the worst. It's the worst situation because they have to tell you something. And at the same time, you're gonna have very little ability to recollect it when you need it later, when she was right, hmm. like to ask, Am I going to live? She

Kayla 8:37
was and you know, when she woke up the next morning, I just looked at her I knew something was different than her to ask me that that just kind of verified what I was feeling in that moment, too. And it was just, it was not good. But and then of course, you know, at that point, we went down to Casey with her and stayed there. And my mom kept my other two kids and they were worried and you know, see, I've everybody worried. And yeah, it's just and then, you know, before we leave the hospital, you know, we're like, how do we know if we're doing this? Right? They're like, Oh, well, if you're not doing it, right, you'll be back here and it'll be IndieCade. And that's comforting. That's Thank you.

Scott Benner 9:17
Which Kansas City was this? Isn't there to Kansas

Kayla 9:20
City, Missouri. Okay. But you know, honestly, they were great. The nutritionist? Well, the diabetes nutritionist or whatever, the one that gave us the for our course, she was great. And my daughter even my daughter wants to be a nurse when she gets older. She's always been adamant about that. So she was even asking them questions and things like that. No, what are you doing and all of that. So I'm not I'm a note taker, even though when I listen to your podcast, I have a notebook. I'm a note taker. And so luckily, we've never been back in the hospital yet. But, you know, you leave the hospital with his information and stuff and then you start listening to your podcast and And, you know, you leave the hospital at the target blood sugar 150. And then you listen to these podcasts and stuff and you're like, 150 is not okay. And so I've been, I've been more strict with things like that after I started listening to your podcast and stuff, and it's just, yeah, cuz I remember, she got released Thursday, I used Friday to kind of get everything gathered and whatnot. And then I was dealing with some things on the family side, you know, back home that I probably can't discuss. But then she went back to school that following Monday, because she's very adamant about school and sports and her extracurriculars. And so, that Friday, I already have already set up a fiber for meeting and everything with the school. But that Monday, you know, you're still clueless because she's had diabetes for that, you know, about for a week. Yeah. And so I dropped her off at school and her blood sugar's in at 383. I'm like, This can't be okay. I'm like, do I get more insulin? Or what do I do? You know, I just, and But thankfully, we got everything ironed out and stuff. And I've learned a lot listening to these podcasts. And, and honestly, I've probably managed it off of more of this than what the doctors even told me. I go into endo quaintness. And he's like, Do you have any questions? And I'm like, No. And he's like, Well, I'm looking at our charts and everything, because I have nothing, because I really have nothing to say to you.

Scott Benner 11:25
Okay, can I buy $40? Back then, please? Yeah,

Kayla 11:29
yes, exactly. I'm just like, why am I here that every format, but you're

Scott Benner 11:34
not going to offer anything. I would like to suggest you just send me the prescriptions, and I'll take care of the rest. That's Yes. No, that's I mean, it's great that you found a rhythm already in a year, did she adjust well to it, or what was the first couple of months like for her, she

Kayla 11:50
jumped right back into things. So like I said, she went back to school that following Monday, and then she went back to basketball two weeks after diagnosis. And then we were already on the Dexcom, like, a weekend. So that made me feel more comfortable with things like that. She already went back to math team for StuCo meetings, she was super secretary at that time, she went back to attending the youth group every other Wednesday night. We also had her birthday party, January 30. And she was gathered under table with her friends, you know, letting them practice taking her blood sugar. And, um, just as she gives herself her shots and stuff, and so I think she adjusted? Well. I mean, I noticed towards the end of this school year, she got significantly more stressed out with having to leave the classroom to take corrections when needed, because she doesn't like to do her shots in front of anybody. Okay, so we did have kind of an issue with that she's so afraid of missing out on something. And so that's kind of an issue that I think we're still gonna be working into on the next school year, to be honest. Because she won't do a pump. I don't she tried the Omnipod doesn't like the bulkiness of it. And we haven't tried the T slim. But if she doesn't like the bulkiness of the Omnipod. She's not gonna like the T splines. So

Scott Benner 13:05
yeah, well, I mean, if she's willing to do all the injections, I don't see what the problem is. What's the thing that happens in school, you say she doesn't want to miss out or she doesn't like doing it around people.

Kayla 13:14
She doesn't. Both of them, she doesn't like taking the shots in front of other students. And she doesn't like leaving the classroom, she's afraid she's gonna miss out on instruction or something. So that's when she has to take a correction. That's almost kind of an issue. So I noticed she'll kind of ignore my text for a little while because we we text in school and stuff. I've got the nurse on her message thread. And so we all kind of are on the same thread. You know, it's we're all on communication and stuff. And and so I've

Scott Benner 13:44
how does that how does that manifest as an issue? Does she ignore texts that she just slow walk going to the nurse or how does that happen? She

Kayla 13:53
doesn't ignore them essentially, she'll eventually message me back if it's I know she doesn't ever ignore low. But when she starts to run a little bit high, and see I've got my Dexcom, I've got our Dexcom alert set from 75 to 140. And if she starts to run a little bit high on Messenger, you need to take your correction, and I'll let it go for a little while, depending on how high she's getting. But there's been a couple of times where I've had to call the school and say Hey, can you go pulls away? And but then she'll typically message me if she's in the middle of a test or something. I'll kind of let it slide for a little bit. But usually she tries to finish what she's doing before she leaves the classroom to correct Yeah. And I've told her I said, That's okay. Sometimes I said, but sometimes it's, it's not. And she's going into the middle school next year, which is our elementary, middle school is separated. And so I don't know if it's gonna be more of an issue or less of an issue going into next year. It's gonna be a whole new ballgame, essentially.

Scott Benner 14:50
And in that scenario, like she wasn't comforted by the idea of pushing a button on her pump and not having to leave the room.

Kayla 14:58
She was and we've talked to about it. And I had almost got her convinced to try the Omnipod again this summer simply because she wouldn't feel like she had to leave the classroom and stuff. Right. She just I don't know what it is. She just doesn't. Doesn't want that other thing on her body. I don't know.

Scott Benner 15:16
I mean, fair enough, you know? I'm sure she will, if she, you know, decides differently. I'm sure she'll let you know.

Kayla 15:26
Yeah, but see when she's at friend's houses or grandparents or something. I mean, she does it. She does it all without complaining. It's just school. She did not like to leave the classroom. Yeah,

Scott Benner 15:35
both interesting. I would have like given anything to leave my classroom.

Kayla 15:42
She is very particular about trying to get those straight A's and

Scott Benner 15:47
Yeah, well, very nice. Good for her. All right. Well, then, I mean, it's not that big of an issue. I would imagine her it sounds like her management is going well, right. Yeah,

Kayla 15:54
it's going it's gone. Well, so a month after her diagnosis. So by her first appointment, we went to her appointment there endo three months after diagnosis. He was like, you know, he goes I'm sure because I don't think you've probably experienced illness and stuff yet. And I was like, Oh, heck one month after diagnosis. I said all three of our kids went through influenza A the stomach flu and upper respiratory. All within a month. So I was like, we've got that down pat. I know influenza A and upper respiratory ease for ketones tend to run higher. She needs more insulin, stomach flu. She needs less. And I'm like, we've got it. We've got it down.

Scott Benner 16:30
Yeah. Little trial by fire. You got a little bit of everything there in the beginning. Yes, we did. How about how about a honeymoon? Was there any honeymoon to speak of? I mean, doesn't sound like it with what our blood sugar was when you found out but

Kayla 16:43
you know, I? I still don't know. And I've asked myself that, you know, a few times like she honeymooning, or I honestly still can't tell you if she ever honeymoon because I don't ever feel like there's been a flipping point where she's required more or we're not right, because she's still just on. She left the hospital on nine units of insulin a day for her basic bar. And she's still only on 14 units. And it's fluctuated a little bit. Yeah, but but not a lot.

Scott Benner 17:13
She's 10. She doesn't get her period yet. I imagine. No,

Kayla 17:16
no. Nope. And I'm not not looking forward to that. No,

Scott Benner 17:20
trust me. There's a number of reasons you wouldn't want to look forward to that. Some of them you've lived through and are aware of how she looks just like you by the way. I'm sorry to stalk you online. But you and she looks so similar. It's it's really something do you Yes. You see that?

Kayla 17:39
Yeah, I get I get to I see. I personally think she looks more like her dad. But I do get told a lot that she looks like me. So

Scott Benner 17:45
your son looks like your husband. And, and the little ones a mix.

Kayla 17:50
Like him too. But we will stay out of

Scott Benner 17:55
the little one seems like a mix. But the daughter that we're talking, she's got your nose and your eyes and your mouth and like everything. So yeah, that's crazy. Yeah. Very cool. Is that your husband's hair color that they have. So,

Kayla 18:09
so No, his is more of like a dirty blonde. And so, back when I was pregnant with my son, he got reconnected with his biological father and we walked into that family reunion and there were redheads everywhere. And I looked at him I was like, oh, no, and not that there's anything wrong with redheads. But I never suspected that we would have a redheaded child. And I know, there's redheads on my side of the family. But I ended up with two redheads so

Scott Benner 18:36
adorable. Don't worry about that. Yeah, so Okay, so what makes you want to come on the podcast? What? What made you reach out? So

Kayla 18:43
basically, the podcast is just helped me a lot and whatnot. And I just, I just wanted to reach out and let you guys know that and stuff. And it's really honestly like even her illnesses in her first month after diagnosis. I mean, I specifically look for episodes on illness in your podcast and listen to them. And I just

Scott Benner 19:02
Well, you're a good person to ask, Hey, I didn't mean to cut you off. But no, you're fine. Yeah, we do this thing in the Facebook group, right? People ask questions. And there's a group of experts in the Facebook group, which means these are people who are interested in helping and have an understanding of like, what's inside of the podcast when there's so many episodes. It's kind of hard to keep all straight. And they come in and they answer questions like people say like, I have a question about this. They'll say there's an episode about that right here. And so you were doing that you're using the podcast when you have questions. I'm very interested in how that worked for you like you just did you go online, dig them up? Did you ask it and Facebook then how do you find them and then how did you put them into practice? In 2015, I needed support to start making this podcast and Omni pod was there. They bought my first ad in a year when the entire podcast got as many downloads as it probably got today, um, the pod was there to support the show. And they have been every year for nine seasons, I want to thank them very much. And I want to ask you to check them out at Omni pod.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.

Kayla 20:32
So I would just go on the Juicebox Podcast, Facebook group, the Facebook group, and hit search and I would type in like a keynote of what I wanted to search, I would just go and start going through the threads and finding an episode. And that would go to the episode and listen to it. So even so I knew there was one day a birthday party was coming up with like a bounce house and cake and all of that as like I'm gonna go find an episode on like jumping and things like that. So I actually listened to like the trampoline episode, the variable. And I applied that to the bounce house. And we've been and I've just I've listened to all the variable kind of episodes and because we do a lot of like hiking and stuff on vacations, and I've noticed even with sunburns, she spikes a little bit. When we vacation. I've got family back in Wyoming when we went out that way, and it's a little bit high of a higher altitude. I noticed her diabetes actually did supremely wonderful on vacation. And I don't know what it was, I can't tell you. But it was the best time that her diabetes acted was when we were up in the mountains at my uncle's cabin, She even ate full fledged spaghetti and I was like she is gonna spike. You know, and she she was wonderful. So I don't know if that's got anything to do with anything. But yeah,

Scott Benner 21:43
at elevations people report needing less insulin. So if you had great outcomes, my guess would be that she was getting more efficacy out of the insulin she had going, which might indicate that what she has when you're home might not be quite enough. So that makes sense. Do you think she ever thought of it that way? But yeah, that's why I'm here kill. You tell the story. And then I think of it a different way. You understand? I never thought of it that way. Yeah. So that that would be my

Kayla 22:15
She did great on vacation. So yeah, that that makes sense, actually,

Scott Benner 22:20
was she and I don't because I My first guest would have been had you not mentioned the elevation. My first guest would have been well, maybe she was more active on vacation. But she plays basketball. So she already is pretty active. So that's what made me go past that and think about the elevation instead.

Kayla 22:33
Yeah, cuz she plays basketball, soccer and, and all of that. So yeah,

Scott Benner 22:38
so it's not it's not a lack of, it's not lack of hydration. It's not a lack of running around. She's doing those things. Yeah. So my thought would be if at elevations, you get more bang for your buck from your insulin, because what you usually hear is the people who live at elevation use less insulin. But in that case, then what you learned was your insulin was more powerful, but you weren't having lows, you were having better outcomes. So then I think well, maybe, maybe then maybe some of your settings need to be adjusted. I never thought of that. That's how my brain works on that one. Anyway, let's get back to how great the podcast is. My gosh, bing, bing. I'm gonna get incredibly serious here for a second. I apologize up front, because you just got done working right. You worked like a full day. And now you're doing this in your car. Yes, I

Kayla 23:29
work Monday through Friday, eight to five. Oh,

Scott Benner 23:31
well, thank you. I appreciate you very much. sitting in your car for work and making a podcast with me. I am not having a great week, my mom has passed away. And, and please, it's not why I'm telling you that I'm telling you that because I've not had a great week. And I didn't record a whole lot this week. Only when I needed to. And just to hear somebody talk about this thing that I made and how it was like accessible and valuable, made me feel good. And I haven't felt good in a couple of days. So I appreciate that very much.

Kayla 24:02
Well, that's that's good because they're, you know, I've I've even reached out. So I used to work with this guy and their kid was diagnosed with type one diabetes actually a couple months before Zoey. And I reached out to her and I was like hey, there's this wonder I don't know if she listens or not sickbay there's just wonderful podcasts and stuff and you know, I went into not my first endo appointment but my second endo appointment and I did have some issues with the school, which I can get into that a little bit later. But I went into that endo appointment and I said hey, I'm like this is what I need on my papers to give the school I said I want corrections above so I think that point they were still saying don't correct until you're oh my gosh, I want to say I was like 175 or something like that. I was like I want corrections on the paper I want to stay stayed above 140 And I said I want it to stay this and this you know because according to this papers it was like give 15 grams of sugar for are low. Well, obviously 15 grams is way too much, in most cases, to be honest. Right? And so the school is wanting to give her so many like 1015 Skittles, and that would shoot her to the stratosphere. And so I mean, I, I literally probably about every concept I apply, I have learned from the podcast versus the doctor's office. Oh, so thank

Scott Benner 25:23
you. That's really great. Yes. I mean, I'm not gonna lie to you. I needed that. That's good. Thank you. I appreciate that very much. So I felt weird about oh, I'm sorry, you have something else to say? No, you're

Kayla 25:35
fine. I was even going to say she ended up towards the end of last year. She ended up having to go to KU. It's in Kansas City as well, to gets she had a camera boys called he, he may angioma. Might have to correct me if I'm wrong, but she had a tumor of blood vessels in our hand. And so when we went to the doctor here, where I'm from versus a smaller town, he's like, I don't, because I can't tell you what that mess in her hand is because I'm gonna send you on those specialists. Well, that's when we got transferred to ku bazille. He was sitting there and he said, The wants to make sure it's not, you know, double check and see if it's cancerous and stuff like that while we're walking out. And my Dexcom starts beeping and she's angled up. And I could tell she was stressed about what the doctor said. We get in the van and she starts crying. I'm like, he should not have said cancerous in front of her. I just but it turned out she just got sclerotherapy. It wasn't cancerous or anything like that. And she's all good now. But so that was my first they kind of put her to sleep for it and everything. And Katie was great about it too. But she's not the only type one diabetic they've dealt with, obviously. So that's, that's clear and good. But I actually you got an episode on something about emergency room visits and kind of things like that. I listened to that before specifically went into that appointment.

Scott Benner 26:55
I love you, you're the best. Thank you. By the way, everyone listening should listen to the podcast the week here with us. It's a by the way also, I thought you said Chuck man, Joan a minute ago and I was like, That can't be right.

Kayla 27:06
He managed him angioma it's like a tumor of blood vessels. Okay, so what they did was they just went and they injected her with this huge needle of stuff to basically kill off the shrink the blood vessels and her tumor. sounds really weird and kind of gross. No, that's

Scott Benner 27:22
amazing that she She did great

Kayla 27:25
and KU gave me updates every so often ever blood sugar why she was put this you know, put asleep and things like that. So and then actually while I was sitting in the waiting room for that, because I switched jobs to I worked in insurance before this, what I do now and so I'm sitting there in the waiting room, you know, still paranoid about her, but so comfortable. And my new boss is like, you know, he goes I need a picture of your driver's license and stuff like that to get you started. And I'm like, okay, cred you know, I just had a lot going on and I started a new job and all of that as well. So

Scott Benner 28:00
I'm just fascinated that I know who Chuck man God is but I don't know any of his music. How is that possible? How would I know a person's name but not their work? Is that a name? You know? It's not it's not you live in the military. I don't know what gets you people you get you can eat seafood there Right? Like it has we do have safe. Well, where would you get it from? It doesn't make any sense to me. It's too far from the coasts at

Kayla 28:26
the restaurant or the store. I'm sure it's not fresh. I don't eat seafood. I can't stand seafood. My husband loves it.

Scott Benner 28:31
I'm gonna guess it's because you've been buying it in the middle of the country. You really should just go west or east and then get some for yourself anyway. I'm just not sure what makes it to you as well. Um,

Kayla 28:40
so the only seafood I've ever tried is dishing out a farm pond and you know, skin and crop in for I ended up.

Scott Benner 28:45
I don't mean like fish out of a pond. No, no. What is this? What

Kayla 28:50
is this? Oh, yeah, no, my husband likes crab and all of that. And

Scott Benner 28:53
we gotta get we gotta get you guys to a coast. Okay. Is there? I know how everybody works. All we need is a basketball tournament in Maryland, and you'll be all set. And I said go to Maryland have some seafood, you'd say I can't do I can't afford it. And if I said oh, those there's a basketball term for your daughter. Yeah. Oh, yeah, we should definitely go. I've been to some places because of baseball. And I get there and I'm just like, Where the hell are we? Like, where are we? Why are we here? Why are we doing this? Oh my gosh,

Kayla 29:26
I I feel that we live in a small town. And so we have to travel a lot for you know, my son's in football, basketball and track. My daughter this upcoming year, she'll have more sports opportunities. So she's done. She's already had basketball and volleyball camp this summer. She'll be in soccer and all of that so we actually have to travel quite a ways I remember leaving work at five o'clock and making it to his track me like right as he's running his last event or something. Yeah, and I mean, they're over an hour away just to go to the sports events. Like how me crazy I'm gonna

Scott Benner 29:57
give I'm gonna give everybody a great piece of advice. Give me two minutes. Okay. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily jeuveau Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage EVO Capo pen and how to use it. They need to know how to use Chivo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit G voc glucagon.com/risk For safety information. And if you if your kids already older, you probably got ripped off like this and you don't know it. So one year we're told we have to go to Atlanta, Atlanta, yes. And there's a baseball tournament there you have to go there because all the college scouts are going to be there and bla bla bla bla bla, and you have to use this specific hotel. So we all go to the hotel, which I'm going to tell you seemed really overpriced for what it was. And it was dirty like to the point where when Colin I got there, the first thing we did before we unpacked was went back out and bought cleaning supplies and came back and we cleaned the bathroom ourself before we even unpacked our clothes, like that was the condition of the room. And these are the two boys, you know what I mean? Like, we're like, I'm not getting in that tub. So that's the level the room. And then the next year, we head back and they tell us again, we have to go to this hotel. It's for team unity that I said, and I was like, this is both. So I looked into it more. And what I learned was that the baseball team was getting a cut of the hotel rooms. So they forced us to go to the same place so that they could get a cut. And then they would say if you don't use that hotel, your kids might not play like they literally strong armed you like that. So we went down there and Cole and I went to this much nicer hotel for less money. Cole played by the way that wasn't a problem. It was all all BS. And I'm going to count on my fingers. I apologize. 1718 1920 27 years later, my son ends up moving to Atlanta for a job. And we go to visit him. I randomly pick a hotel online, and I walk in and I go, Oh, this is the hotel that Coleman I went to the second year when we refuse to go to the crappy hotel. It was just such a weird moment. Like I walked into the lobby and I was like, I've been here before. And then I had this whole like baseball memory thing. And then it made me think of how they ripped us off of the hotel room, which is why you're now getting told that story. So anyway, they're always photograph. Don't worry, and I'll go over it again. You're either a player or a check. If you don't know which one you are, you're check. That's it. 100% Don't ever like Go with your gut constantly. If you think we're being taken advantage of you are being taken advantage of. So yeah, I agree. That's it anyway, basketball. Hmm, is she going to be tall enough? Can we get some college money out of this? Or is this just a fun thing?

Kayla 33:49
Now, you know, I think this is just a fun thing. She she's always had her. Her heart set on becoming a nurse and then she wants to do like selling and stuff on the side. She's She's it sounds really odd, but she loves painting and stuff too. She's actually a really good artist. Which I've got a picture obviously I can't show you right now. Maybe I can send it to you or something. But she's got this picture. She's painted. That looks really good. But yeah, she's she's always been adamant out. She wants to be a nurse and she's sticking to her guns on that so far. So I guess we'll see what happens in the future. But

Scott Benner 34:26
I was pretty sure my daughter was going to be a pre law student and in stead she's an art school. So you never know what happens, I guess. Yeah, you don't? Yeah, no, it's still I felt good for her. Yeah, and by the way, doesn't mean she couldn't play a little softball in college. And even like, Don't disregard like a nice d3. Whereas we're a shorter white girl could get on the court a little bit and still make a little money. A little money for school. Nothing wrong with that. Nothing wrong with that. Tell her get out there make some money. I

Kayla 34:57
keep I keep telling her you know she just played elementary Basketball. She's just going into middle school. I keep telling him like you need to be more aggressive. Don't be afraid to you know, get in there and just get at it. You know, I remember playing basketball back in eighth grade, I have a girl pulling my hair. I'm not telling you to pull anybody's hair, but definitely

Scott Benner 35:12
a girl. Yeah, definitely give her a little bit aside when she goes for the ball a little slower.

Kayla 35:17
She's too nice. And I just think that's where she's not gonna succeed in, in sports.

Scott Benner 35:23
I honestly, it takes us like two more years. And then that all goes away. Like I know, like, the girls were still worried about each other back then, like I watched it too with Arden played a lot of softballs a young person. And when they were younger, if somebody was like, I don't know, like, not get hurt badly. But you know, something would happen. All the girls would almost stop like a bunch of little moms. They're like, are you alright? And then they hit a certain age. And when that happened, they were like, keep going. She's hurt. So it goes away pretty quickly. That nice thing, although I'm waiting for it to come back with Kelly, I think it will. She's almost 50 But I think she's got a nice back up anytime now. What do you think? Are you Yeah.

Kayla 36:11
I don't know. Now my youngest, she's, I wouldn't have to worry about her. You know, being aggressive in sports. She's, she's like a mixture of it all. I don't even know what she is yet.

Scott Benner 36:23
So, so tell me, tell me a little bit about your goals. So I know where you're, I know what your your range is, which is terrific that you're keeping on CGM, by the way using a Dexcom or a libre Dexcom

Kayla 36:33
G six, she actually tried the g7. But she kept losing data signal. She's got a habit of leaving her phone in like one room and trying to go throughout the house, while her range isn't as far with the g7. Right. So she went back to the G six for the moment. I mean, I told her I said eventually, I'm pretty sure they're probably going to stop producing the G six. So you're gonna have to do the g7. At some

Scott Benner 36:54
point, I would imagine I don't think right away. I mean, obviously, they have their business arrangements with a lot of these like tandem and Omnipod. But tandem and Omni pod are like, this will be a little little incongruous with actual time, but you're starting to see them talk about G seven for Omni pod five G seven for control IQ, like they're obviously working on it and getting pretty close to bring it out. I have to tell you Arden's been using G seven for a couple of months now. And I haven't seen any disconnects, like so I don't know if that just means that Arden is like tied to her phone differently. But I haven't had a problem with it. Like she's been at college and home ball. She's using it so far. And I haven't seen anything like that. So I don't know, like how it goes. I also don't know that they don't find too in the them a little bit after they're out in the world. Like this is my supposition. I don't know anything. But I think sometimes, once they get out in the world devices, not just saying CGM and they see they get the return date on what's happening. They do have the ability to adjust them a little bit. So I always think that to maybe, you know,

Kayla 38:06
it's common. Yeah. And, and she actually mentioned that she goes, I think I might want to wait a few months to try it again and see if they make any changes. It's like, okay,

Scott Benner 38:14
I mean, it's much smaller, super easy to put on, like the warmup period thing is, what 30 minutes, and sometimes it doesn't even last 30 minutes. You can I don't know if you got to use it enough to do the overlapping. But that's amazing. You know, I told Arden about that upfront. And she's like, I'm not doing that everything I tell her. She said she's not doing by the way case, you're wondering what you're in for the last 10 years. But now that she's home, I'm like, Look, just try it. I'm like you're on like the g7 is going to run out in like six hours, like put the other one on now. And just leave it on for a couple of hours. And then whenever you think about it, just go in the app and switch it over, and then tear the old one off and throw it away. A there's no warm up because the warm up happened while you were still getting data from the old, the old one. And it's also soaked in a little bit. So it's more accurate when you turn it on. It's fantastic. Like what a what a what a great little improvement, you know, really cool, actually. So you shall get there. She thought a pump was too bulky or she didn't want to wear two things.

Kayla 39:14
She thought the Omnipod was too bulky. Okay, and she's had a couple of instances where the Dexcom has ripped off. So one time her and her brother were actually wrestling around in the front yard and he accidentally ripped it off, which it hasn't hurt her when it's ripped off, I guess. But she read houses a lot. So and I don't know if that's part of it. Maybe.

Scott Benner 39:34
And she it's new to her as well. I mean, honestly, at some point when you show her, if you put this on and this on, it's going to make decisions about your insulin for you and we're not going to like we won't that when your blood sugar starts going up the pump will bring it back down again. But that might change your mind a little bit. So and

Kayla 39:52
I predict, you know, going into this school year where she's had a lot more sporting events, you know, without me and things like that. I'm pretty that she'll eventually come to a point where she's gonna come to me and say, hey, I want to do the pump. Yeah, cuz she's gonna realize it's a lot easier when she's out of those games and things like that and practices and stuff to manage with the pump versus, you know, the shots still

Scott Benner 40:13
nothing wrong with it happening in her time. You know, let her let her come to it on her own. I think it'll be easier in general, if it's a decision she makes herself.

Kayla 40:23
She's taught her friends how to give her shots. Her brother and sister she taught how to give her a shot. Yeah, well, it's like you're more brave than I am.

Scott Benner 40:32
Oh, you just don't think you'd there's some people you wouldn't let stick you with the needle? I

Kayla 40:37
would. There's no way. No way in. Heck, I would let my eight year old child shoved me with needles. So she's a lot more brave than I am.

Scott Benner 40:47
Where she just hasn't been through enough to know not to trust those kids yet. That's very cool. So I got them, sir. Nope,

Kayla 40:56
you're fine. I was gonna say I remember the first time she stayed the night anywhere because she's usually the kid where her and her friends. I mean, during the summer, they're always at each other's houses. And so the first time she ever stayed the night, so that actually that summer, she really didn't stay the night, much of anywhere, which I think probably got to her a little bit. So the first time she actually did say that I was at her friend's house who doesn't go to our school anymore. She's goes to a different school now with her with a family that they live with. She stayed the night there. And I trust this couple. I mean, they've got a ton of kids. Plus, they're raising these other three kids now. Both their parents died in car crashes a year apart. My daughter was really close to that family and so that those were terrible funerals. And that was just a terrible time. Yeah. Her friend was in the accidents as well. And there was one point all we knew was that she had a brain bleed and they ended up messaging and FaceTiming every day while she was in the hospital and that friend did the same for her when Zoey was in the hospital and it's just been a lot. I remember I went to pick up Zoey the next morning and she actually called me Zoey started beeping lo about it was about three in the morning. And I waited. I told myself I was like I'm gonna wait five minutes and then see, well, she ended up she texted me she goes I'm on my way to her. Now she goes, I've got this. It's like okay, perfect, you know, and she straightens out and everything and the next morning I go to pick Zoey up and and she had corrected it with an applesauce pouch because Zoey is a very hard sleeper. I mean, I tell her to open her mouth and all I do is pour some stuff in our mouth and she swallows. It sounds terrible. And I'm like you need to learn how to wake up when you move out which is gonna be a while but she's like, I went to take Zoe's blood sugar just see what she actually was. And she goes I couldn't get any blood to come out. She goes some squeezing on her finger then she's like I finally just said screw it and just went to go open the applesauce Pasha but some of them out. But she goes, then some squirted all over her arm. She goes, then I think she because at that point, so we just shut up and woke up. And she goes, I had to do it all around, because I don't know how you do it.

Scott Benner 43:06
Well, to alleviate one of your possible concerns. i The only thing I was worried about when Arden left for college was that she wouldn't get up in the middle of the night if she had to. And I mean, I was like really concerned. And it was never a problem is really Yeah, absolutely fantastic one she knew it was her job to do. She just did it. And to show that it's a semi conscious decision that she made. When she can't, when she comes home for a break, she gets home and the first thing she says to me is like, you know, you're gonna have to like wake up in the middle of the night, if I get low. Like, like, I'm here, I'm home to rest, like I'm here to sleep. I'm not here to like, I'm not taking care of myself in the middle of the night. So it's, and I'm not going to tell you there weren't a handful of times where I didn't have to wake her up, like there were. But there were more times where I was I would text and say like, Hey, I you know, I don't know if you see your low and because I took care of it already. Like and it was like three, four o'clock in the morning a couple of times. So she was getting up and taking care of herself. And it was really kind of heartwarming. And at the same time, if I'm being completely honest, I'm telling the full picture. I also felt bad, because what it feels like to me is that she made that the same decision that we all make, you know, his parents, like I'm not going to I'm not going to sleep as well because of this and I'm just going to be okay with that. So I feel bad that that she had to do that and that obviously that's going to be her life. But I mean, I don't want to say it is what it is but there's no getting around it and so yeah,

Kayla 44:48
and that's that's one of my worries when she gets older and obviously it's inevitable she's gonna move about that's always been in the back of my mind. And there's you know, there's other things when your kids get older too that are in the back of your mind on how gonna affect their future and all of that, but I try not dwell on it anymore.

Scott Benner 45:04
It's good advice. But

Kayla 45:07
I'm like, you know, we're just learning to live with it. And honestly, it hasn't held her back at all, except there was one instance after volleyball camp just a few weeks ago, all of the girls up and decided to go to one of the grandparents house to have a pool party. Well, I was at work. And so my mom, the kids, my mom was supposed to go get her from volleyball camp and stuff. And so I didn't find out anything about this. And so I went to pick her up from my parents house, you know, after work and everything and, and then she seemingly breaks down and starts crying. And I was like, what, what's the matter? Then she comes out and tells me that all the girls decided to do is swim party at her grandparents house. And she? Well, for one, she's like, I didn't have my swimsuit with me. And I was like, well, we would have figured that out. Like, I'm sure grandma's got some, you know, and then she goes, I didn't think you'd let me go. Said what? And she goes, I didn't think you'd let me go. And at that point, I was like, I'm like, we would have Grimm. And I would have figured it out for you to go on it. You know, like, I don't want you to ever feel like you can't go participate in those things. Just, you know, because of your diabetes. I said, that's not the case. And that's the first time she was ever approached with a situation like that, where it's been a spur of the moment type of thing. Yeah. So she was actually really upset about that. She was the only volleyball girl that didn't go and I said that stuff comes up in the future. I said, message me your grandma. I said, we will figure it out. I said, I really I said, diabetes should not hold you back from that

Scott Benner 46:40
it has that happened again, as she handled it differently. Nothing has

Kayla 46:44
happened again since and I think after I told her that she she was better and everything. But part of me has that mom guilt to like, what have I done to make my daughter feel like I would say no. Oh,

Scott Benner 46:55
no, I was gonna say that's where I was headed next, Kayla, like, but it's not that not that you should feel like, Oh, what have I done that made her think that? I just thought, but that is in the back of her mind. Like when that came up. And everybody else is like, oh, yeah, she's thinking, Oh, I have diabetes. We're not ready for that. We're not prepared. I probably can't do it. And I know that it's it's an unbearable thing. Like as a parent to watch happen. I listened the other night. Arden had her period and her blood sugar's were, like, difficult. And somebody got food. And I know she was hungry. And somebody said, Hey, I'm gonna order I forgot what they were ordering something and Arden's like, No, I'm okay. But I knew she was hungry. And so I said, are you just not eating because your blood sugar? And she's like, Yeah, like, she's like, my blood sugar is too high. I can't eat right now. And I was like, Okay, I said, Well, we could push it really hard, and, you know, order some food and just, you know, bring it in. And then she was just like, now it's okay. But that's not what she meant. She didn't mean it was okay. She meant now this is socks, and I just don't want to think about it. So it was I know what you mean. sucks.

Kayla 48:01
Yeah. And I've ran into that situation with her a few times, too. And one was actually she wasn't high or anything. She's actually running really great numbers. Is that a birthday party yesterday? And I mean, they're obviously there was cupcakes and whatnot. And I said, I asked her, I said, Are we destined for a cupcake? And she goes, No, she goes, I don't, I don't want one. About 10 minutes pass. And I was like, I'm not trying to pressure you as a diabetic to eat a cupcake. I said that I see the look, you're given these cupcakes. I said, Are we dosing for a cupcake? She's like, No, I'll be fine. As like, that's like, that's not you know, like, I can tell that's not the answer you're wanting to give me and I said what about half of it? I said again, I'm not pressuring you. And she goes, I said, if you want I said we can just do I was like I told her I said, if you want we can just do a crap ton of insulin right now instead, and as you start to go down, you can nibble on your cupcake. She's like, Yeah, we'll do that. So I push I think it was like three and a half units of insulin with what her ratios are. And as she started to go look she's playing outside to I mean, they live kind of they've got like a ditch with some woods on the back of their property that my kids go plan and so she's down there playing everything and then I messaged her and like alright your angle Danna come up and have a few bites you come up have a few bites and she level out and then she'd go play again and I mean, it took maybe it taken you know, 45 minutes an hour to eat her whole cupcake but eventually she did and her numbers ran perfectly but so I could tell she wanted that cupcake. She just didn't want to end up going high or anything. I'm like there's ways we can do this. So you don't go high. You just may not be able to shove it on your mouth like these other kids.

Scott Benner 49:49
These monsters that are just like and then running away. You don't and better to eat it. Honestly better to eat it a little more slowly to begin with. Right like yeah, We all should probably be doing that. So Oh, good. I'm glad. I'm glad she didn't just keep saying no, it's it's good to know that she did. She's like, Oh, I work with us. And it was nice of you to stick with it too, and to notice how she felt, and not to just go, okay, she doesn't want it, then never think about it again. Look at you, you're good mom, Kayla. I,

Kayla 50:20
I try sometimes the kids try my patients. But I do try.

Scott Benner 50:24
Oh, there's a ditch behind your friend's house, you can push them into if there's a problem.

Kayla 50:30
You know, there's, if I would have seen this board to begin with, I think there was like an old flimsy two by four that was laying across the ditch to connect to properties. And the kids would cross out all the time. And my husband's for anyone that lives on the property. He's like, I built them an actual bridge, you know, so they wouldn't have to cross that two by four. And then I saw the board. I'm like, if I would have known they were crossing that, like, they wouldn't ever been allowed to cross that to begin with them. Like they're lucky, nobody ended up hurt.

Scott Benner 50:59
There is a creek that ran behind where I lived when I was younger. And we had to, like get over it to basically avoid a 15 minute walk to somewhere. And you know, in my mind's eye, this creek was running like, it was a lot of water. And it was deep. And we would like jump from logs to rocks. And like, you know, this whole thing. And I went back as an adult. And I looked down there and I was like, I is this even like a trickle, like what's going through here. But in my mind's eye, it was just a river that ran through there. So anyway, it's a it's fun when you're a little doing stuff like that I'd rather run across the board tooth, and then the bridge probably, you know, like, gosh, well, do you you said earlier, you were concerned about your other kids? Have you done trial net or anything like that, to look into whether they have markers,

Kayla 51:50
you know, I I get paranoid about them. And maybe it's I've never had anxiety before, but I think I have anxiety now. And so if I noticed the kids drink in, like an extra amount of water or something or like, one day, I'm picking Connor from basketball practice, and it was actually a football practice. And he's like, he's like, I was super thirsty today at practice. He goes, I drink more than usual. I was like, let me see the bottom of your feet, make sure his feet weren't dry and stuff like that. And he's like, mom. And so some of the signs. And I've got the trial that actually for both of my kids sitting at home, and I've had them sitting at home for about six months, and I can't bring myself to do it. And I don't know. It's like, you know, if I don't know, is that better than if I do know if they have it? You know, I don't? I don't know what to do in that instance. I don't know what I want to do yet. So I have these kids sitting at home that I've done nothing with yet. Because I don't know what decision to make, I guess. I

Scott Benner 52:50
think that's a fairly reasonable response. And it's only you're only a year into it as well. So yeah.

Kayla 52:57
And then part of me is like, you know, if the kids know what those tests are for, and if they asked for the results, and if I'm like, Yeah, you know, you tested negative for all the markers, but if I don't tell them, then they're gonna know like, well, oh, my gosh, I'm worrying. I tested positive for markers. And I don't want to lie. So I mean, there's that other aspect. And maybe I'm overthinking the trial on that. And all of that I have no idea

Scott Benner 53:18
does sound like you're thinking of a little bit, but I understand why I understand what you are. I mean, what I would say is, if your kids have markers for type one diabetes, then they're going to get type one diabetes at some point? Very likely. Yes. And that doesn't change anything, does it? What does it tell? I?

Kayla 53:42
I don't know. Because on one hand, you know, you worry about if your kid's gonna end up with it or not. But yet on the other hand, if you know your kid's gonna end up with it, maybe you worry a little bit more about when it's gonna happen. I don't know, oh, you're worried no idea. You're

Scott Benner 53:54
worried worry that would come with an actual confirmation would be worse than the worry you have worrying about what may or may not happen. Yeah, maybe

Kayla 54:03
I don't know. And there's been there's been times where, like, I'm telling you, I'm so paranoid with the other kids getting it that the other kids like they started vomiting or I think something's happening. I have taken my other kids blood sugars. Sure. And there was yeah, it's been crazy because, you know, looking back on Zoey, before her diagnosis, and honestly, probably at least a couple months before I noticed she had been getting more more moody than what she normally issues normally not my movie child and I was attributing it to you know, a girl getting older or starting to go through puberty and things like that. Then I noticed her start drinking more. She has never been my kid to wet the bed and there was a couple times where she went to bed at night and she is probably going to be so mad at me for saying that. But and then I noticed she I thought she just wasn't gaining weight. And I'm like, Well, maybe she's just getting taller and stuff. And then there was, oh, gosh, it was a few days before her actual DKA. She'd come up to me and she goes, Mom, because my feet are really dry and I'm looking, I'm like, they're starting to crack. I'm like, What the heck, you know, and, and you still don't put two and two together at that point. Or maybe I just didn't, because I never thought, you know, your people who don't experience type one diabetes are very uneducated on the signs and symptoms, and just educated and uneducated in general, as type one diabetes. And so just putting all of those together, you know, you feel really, I feel the mom guilt very badly. Oh, boy. And I mean,

Scott Benner 55:45
you know, you did get her to the hospital, and she was okay. Right? Like, how would you like know, to look for something like that? I don't know. I understand. You feel that way? I would hope that in time you wouldn't anymore. So I mean, I'm not trying to talk you out of the way you feel I felt the same way you did. But it does go away if you let it, I guess is the is the point. Yeah. And Kayla episode 156 is called worry is a waste of imagination. Did you not hear that one?

Kayla 56:17
No, I listened to your episode on mom yelled, but not that one. Maybe I need to listen to that one. Because?

Scott Benner 56:23
Because the truth is, if there's something to worry about, or not, just worrying about it without knowing is. It really is you're just imagining something bad. It's not. It's not based on anything, at least if you're going to worry, let it be about something real. Because then you're sure Yeah, because then maybe a you've got a good chance that you won't have to worry about anything. And if you do have to worry, at least your worry will be targeted and maybe valuable. Like maybe you would go to T sealed and ask them about you know, that medication that stretches out the onset of type one. Like maybe your kids would do that. And put it off for a while. Like, that would be pretty cool. You know, like, I don't know. Yeah. I get what you're saying. Don't get me wrong. But Don't torture yourself. It's a short life. Okay.

Kayla 57:14
Yeah, yeah. Oh, I think I'll get over the mom kill eventually. But I'm, it's been about a year and a half since diagnosis. Maybe I should be over it already. I have no idea. But it's there. And I think the hardest part of her diagnosis, honestly, as far as getting everything up and going and not necessarily squared away, but just trying to adapt to our new lifestyle, essentially was with school because she wanted to go. I mean, she was right back in school that following Monday, and, and the only other type one diabetic in our school. She was in high school, she just graduated this year, and she was on an insulin pump. And I think she made sure diabetes differently then, then we manage my daughter, my daughter were more strict and things like that. So in the elementary, they really had no experience and and I'm not going to say names and go into situation entirely because I think if they heard this certain administration would just go off the deep end. But but it was really rough in the beginning. There was one point I had, I had someone I said, we changed those lunch ratios for lunch and actually the endocrinologist day because that was still the point where within a month of her diagnosis, we're still going to the endo for guidance and stuff. After a month i i haven't asked the endo for guidance on any of her dosages after a month and for diagnosis, because they just they played it too safe, I guess you could say. But um, I mean, I had one of the staff yelling at me, like why are you changing this? And I mean, they're not educated in type one diabetes whatsoever. And I mean, yelling at me in front of Zoey, I'm just like, how is this okay? And I finally got it somewhere. And then the whole texting diabetes saying and and see the nurse man so we were all in it and, and this and I had to fight to get that I had to fight to get basically Zoey to be able to kind of self manage at school and stuff. Because they they were not okay with it. And I finally had to just gather an email together to everybody involved in the superintendent and stuff and I had to attach like a copy of the Missouri statute that says she has a right to dose and carry anywhere anytime in a school setting. And I had to resume at one point I had contacted the Children's Mercy social worker and I explained everything that was going on to her and she goes honestly, she goes if you have any further issues, she goes I would. She goes I would take it. Take it farther up the line. Yeah, she's like, I would contact the ADA and all of that. And so it got pretty hairy for a while. But ever since ever since that email I sent them. I was professional in it and stuff. Ever since that email I sent them. Things have been pretty good. Good. So we'll see how next year goes, but But yeah, it was very, very rough in the beginning with the school. But

Scott Benner 1:00:21
it was a big deal. When Arden was younger, one of our outgoing governors signed this bill, like literally on like, the last day, you know, when they just, you know, when they do all this stuff on the last day, they think wasn't going to be good for them getting reelected. But once they're done, they're just like, they sit through everything. So they made it okay for kids to give themselves insulin in New Jersey in their classroom. That was a long time ago already. But it was amazing how resistant they were the school was like, no, no, it has to be in the nurse's office and they talk to you about it. Like it was like, there was like a real reason. And I couldn't wrap my head around it. I then that that governor, he signed that bill. And then I found out about it. And I was like Orton to the software and some of the room now and they were like, okay, it was just like that, like, okay, so there was no real reason not to do it. Other than we were just doing what we were told, like, I gotcha, and

Kayla 1:01:11
see the reasons I was told why they didn't want her to carry her own supplies, and not even her own emergency pen. And was what if other kids getting her stuff?

Scott Benner 1:01:21
Oh, I would say those kids should keep their hands off. It's not theirs. But

Kayla 1:01:26
that's exactly what I said. And and I had to fight to get, you know, for the way to be able to text me for guidance and things like that. And I said, Look, I said none of you are experiencing type one diabetes. I said Zoey, and I have it pretty fine soon to what works for her. I said, I'm not asking for you to allow us to be on our phones to message every I said, you know, Tom, Dick and Harry. I'm like, it's literally strictly for diabetes, LA. And then they had come back with well, you know, what, if another student sees on a film, they're gonna think they can get on theirs or have special treatment? I said, Wait a minute. Yeah. I said, I don't care about the other kids. And I said, I know for a fact there's other kids in that classroom that get special treatment. So you don't even go down that road with me.

Scott Benner 1:02:10
I actually told a person one time I said, you tell those kids, if they'd like to get an incurable disease, they can have their phone to. Yeah, they think it's worth all that or otherwise, you'd be an adult and manage the situation. Like I yeah, my daughter is going to be unwell or less well, because you're worried that a kid in her class is going to look at Instagram. And that's not something you can deal with. Like, try harder. You know? I actually that reminds me one time when Arden was in middle school, she came home like very earnestly, and she goes, Dad, at the end of the day today, we were having this conversation about something. And I'm like, right, and she was it was the end of the day. And I'm like, okay, and she goes, so I looked at Instagram on my phone. And she's like, I'm so sorry. I was like, because we told her the phone is just for diabetes. It was sorry. It was like it was the end of the day. Right? And Susie, I said don't worry about it's fine. She was but it was on their Wi Fi. I'm like so okay, don't oh my god, don't worry about it's gonna be alright. So she took it seriously. We told her like the phone is for this. It's not for that other stuff. And you know, the other kids are going to be complaining and she's she said she heard it a couple of times. Like what's not fair. Norton was like, fair, nothing about this this fair? Yes, exactly. Gosh. Well, it sounds like you work through it. Okay, though. Yeah,

Kayla 1:03:35
we've we've worked through the school issues. I think for the most part, it was really rough in the beginning. And I say I had a lot of a lot of issues with them and stuff, but I think we've ironed them out and whatnot. And I know one of the arguments about Zoey self managing was She's a kid and they don't think she should have to take on that kind of responsibility. And I I told them I said, you know, she is a kid but she's a kid with type one diabetes is it in this is, um, like, it does suck if I could take it from her, I would have said but this is her life. Now this is our life. And if she doesn't learn how to manage it now, so she's never like, I want her to manage it. So she grows up to be healthy and doesn't have all these complications and, and things like that. I'm like, I like I can't help that you feel that she didn't have to have that responsibility. I'm like that. She does. I mean, point blank. I can't take it from her

Scott Benner 1:04:24
right. Also in a world where the truth is that really well, like educated people only are able to about halfway give you good information when they're helping you with your diabetes like no offense to anyone. It's a great it's a great job. And I think it's a it's wonderful that people do it. But you know, somebody who's a nurse at a school is not prepared to take care of like diabetes beyond you know that there are medical people and you can give them a checklist and they can follow it and everything which is terrific. I mean, it's amazing. But if you're looking for them for like deeper understanding, it's likely not going to come from them. And now you're, you're saying they're the end all be all. And I don't know how that goes, you know? And

Kayla 1:05:05
you know, I remember what one of the comments that really got me the most what kind of reached that crescendo of me emailing and finally getting what I want, you know, the texting, texting diabetes and then her being able to self manage kind of anywhere, anytime, which I wasn't asking for anything. I don't feel like crazy That was crazy. You know, I was I had got a phone call from when the administration that just that said, you know I just with the school nurse and everything she gets like, I think she just feels like you know, you're kind of taking that control away from her. I said what control she's my kid. I'm like I get you guys are early get really responsible for why she's in school and stuff. I said, but I'm not asking to keep anybody out of the loop. I said, I'm not saying she can't go to you guys at all. I'm like, I literally just want to be able to manage this in the best way possible for her. So she doesn't have the higher blood sugars and things like that. And there's there's been so much other stuff with this at the beginning, but way too much to get into. But yeah, and I think it's all good now. And we've kind of reached that crescendo. And you

Scott Benner 1:06:13
may, you may have had a very similar situation than I did when Arden went into high school. And I sat in a little conference room and the nurses like, well, this isn't how we do it. And I was like, oh, that's something I'm like, it's how we do it. So am I worried about you? Meeting? So is this meeting about how you feel? I'm like, we're not worried about you.

Kayla 1:06:37
Yeah, fantastic. And then, you know, it got to the point where is that we come home and she's like, I'm not comfortable making decisions at school on my own. And because I feel like I'm gonna be judged for it. And I was like, Well, great. I mean, I didn't really know how to respond to her at that point or handle that. But I mean, we finally talked it out.

Scott Benner 1:06:54
She thought she'd be judged by the school and the nurses, the school

Kayla 1:06:58
just she thought that she would make a decision that they thought was wrong. And I guess essentially hold it against her or something. I don't know, you should

Scott Benner 1:07:07
always hang out with Audra for a couple hours. She wouldn't think I got any more.

Kayla 1:07:14
I've always told her I'm like, Look, if you end up getting yourself too much in Flint, I said you have sugar. If you end up giving yourself not enough insulin. I said you have insulin to give. I'm like, Well, you know what? Episode is gonna go wrong.

Scott Benner 1:07:26
Episode Three clearly says texting is. I still think like, if you're parenting a child with diabetes, texting is the absolute wrong son Aang song on song, where did that word go? It got caught my throat unsung. There we go. I'm not going to try to say the fourth time because I got it the last time and I'm good with it. But it's technology that you can't ignore. It's very valuable. It takes away the waiting in between it allows the immediacy for treatment. It allows for a kid to say hey, I'm not sure about this, or for you to say hey, what are you doing? And like just, you can have a 32nd Texting conversation that eliminates so many problems and really doesn't interfere with their day. And yeah, I think it's just the way to go, honestly. So

Kayla 1:08:15
yep. And I listened to your episodes on that. And I listened to probably about every single episode I can find on on people's issues with school and five, a four and all of that. And I've kind of implemented all that from the juice box plus the research I've done with you know, like the ATA and you know, Missouri statutes and I just threw all that at the school. And I was like, Here you go. I'm like, I am not asking for anything nobody has asked for before. Yeah, I said, so.

Scott Benner 1:08:41
We're not doing anything crazy here. I mean, you've said it a couple of times. We're not doing anything crazy here. Just try to think outside of the box for half us I hate that term, because it sounds douchey. But, but like just try just just try to think outside of the box for two seconds here. And like, we have a thing it's going to work. Like it's going to work so much better than the thing you want to do. And isn't her health like in general, like not just her health by the way day to day, but her expectations for her health and our expectations for autonomy and all those other things that you don't realize you're building as you're going like you if you teach her? It's not on me it's on somebody else. That's how she grows up thinking and if you teach her well I'm busy at school today so with 200 blood sugars, okay, well then that's how she's going to manage her health moving forward like it that'd be a hard a hard thing to break later as a bad habit. Yep.

Kayla 1:09:38
And and that's, you know, what I told the school to I said, I'm trying to create good healthy habits now and her to manage it now. Yeah, I said, and honestly, she is my most strong willed child. But she's she's done pretty fabulous with this. I mean, we don't sounds terrific. We don't let it hold us back and we're about to go in a couple of weeks on on the river float down south for about six to seven hours. And last summer, we went to Michael's cabin in the mountains, it's completely off the grid, no cell phone service for anything, we were up there for three days. And I mean, it's, we don't let it hold us back. But I mean, we do have some things to work there still and stuff. I mean, I'm sure there's things that haven't come up yet and just the major a year and a half that we've been dealing with this, but they will,

Scott Benner 1:10:23
they'll come up and then you apply this, this way of thinking to those things. And you'll be surprised how well they work out. You know, just be got common sense. Put yourself in your health first, that that really is the way to get to it, honestly, and this thing, you know, I want to cut, we're kind of we have to wrap up here in a second. But like, the way you pass, you probably have to pay or go home or something. But

Kayla 1:10:48
I'm still staring at all of I work at a agricultural equipment company, a John Deere dealership, essentially, and some ended. So you're saying all of these combined for the last.

Scott Benner 1:10:58
But um, you talked earlier about like, you didn't think you were a person who had anxiety, but now you feel like that. And I don't know, like anxiety to me, I'm not discounting anyone's anxiety for certain, but it feels like a word that gets thrown out around a lot lately. And you know, I mean, if there's something you're worried about, then I think you should try to eliminate that worry and see if that feeling doesn't change for you as well. I just I didn't want to get off without mentioning that. So I mean, if there's a thing you're worried about, stop worrying about it. I don't mean just like magically stop worrying about like, find a way not to worry about it, like prove it to your site. You

Kayla 1:11:36
know, my husband's pretty much told me the same thing. It was like what's gonna happen is gonna happen. And I think I'm most honestly worried about my other two kids getting it. And I know, there's families out there with multiple type ones. And I don't know how they do

Scott Benner 1:11:47
it. Yeah, that they do it, because that's what they got to do. And you would too if Yeah, yeah, same thing. Same way. Everybody does everything. You know, just get up in the morning and don't give up. It's pretty much it. Yeah, like you and I are married, so I can tell you just to calm them down. But your husband can say that. And if I went downstairs and said that to the lady downstairs, you wouldn't get the podcast anymore, because I'd be dead. But yeah, here we are. And it's good advice. Yeah, I could use that advice given to me sometimes, too. By the way, I thought I wasn't saying because you're a lady. Sometimes you just, you know, you get a little wound up in something. And it's hard to, it's hard to get away from and then the one person you count on to help you is the one person who you push back on when they when they try to help you. So life's weird. I don't want to, I don't want to get too deep. It

Kayla 1:12:37
is and I probably do just need to calm down and stop worrying about you know, what could happen in the future. And I've never been that tight. But I mean, it's, I'm working on it. Let's just say that.

Scott Benner 1:12:49
Honestly, being serious, like you're aware of it. I think that's a big deal. Yeah, yeah. You don't I mean, you're not just telling like you're not telling me like I'm upset. I don't I like it's not unfocused, your your response to it, you know what's happening. So anyway, I say, here's what I do. I'd give the kids a trial, nothing. It's very likely going to come back that they don't have markers, and then you'll be okay. And if it comes back that doesn't have markers light on for a while. That's fine. You can do whatever you want. You're an adult.

Kayla 1:13:21
That is sure. I mean, as a parent, I guess we can't say that we've never lied to our kids. And

Scott Benner 1:13:26
it's not really lying. Is it? Like I'm being silly. I know, I brought this up earlier and I bumped everybody out. I'm gonna do it one more time. Okay. So people are gonna hear this some six months after this happened. So try while you're listening not to feel bad, please, please. But my mom like you've, if you listen to this podcast, like my mom got cancer, she had a significant surgery that removed it. She did chemo and rehab for a year, she was pronounced cancer free. She moved out to Wisconsin to live with my brother. And maybe about six months later, her cancer markers started to creep up again. And we did exactly what we were supposed to do. But there's no doubt like, you know, going through chemo like slowed her down a little bit. So you know, her memory wasn't as good. She's tired a little more often, like those sorts of things. And we could get her to the doctor and be like, Oh, it's a heart doctor appointment mom, she'd like a heart doctor appointment. And you know, like, and even if the doctor said right in front of her, like, you know, it's not like she's listening with the same year. She was 30 years before that. So when we took her back and the markers went up, we asked the doctor Well, what what are you going to do? And he goes, Well, right now we can't do anything except check the markers again in 30 days. And they did they went up again. So they gave her a CT scan. And the scan came back clean. So we there was nothing for us to really do in the moment. And anyway, we never told my mom that they were checking on her cancer. We never did and for the last six months for life, she got blood tests where they track the markers. And the CT scan that showed that my mom's cancer return pretty significantly arrived a couple of days after she had a stroke, and just a day or two before she passed away. And I have to tell you, I'm not just happy that she didn't know, I'm proud that she didn't know. Like, I'm happy that my mom lived the last year of her life thinking she beat cancer, and it never came back. And I'm not saying don't lie to your kids for 20 years about they have markers for type one. But if they do that, on your time, when you're able to articulate it well, in a setting that is controlled, that is right for them, you'd be able to tell them that you don't I mean, like, yeah, it's not lying. It's just good management of relationships, I think. I don't know. I'm sure people

Kayla 1:15:55
think I think my son could handle the news. But I know my youngest one 100% would not not be able to handle it yet. There's around the time of her diagnosis. Within that year or two, there was just so much death within the community. I just, she's still right. She was still worried over her sister's diabetes. And I just have to reassure her, like, you know, everything is handled. I mean, you know,

Scott Benner 1:16:20
it's She's little, like seven, right?

Kayla 1:16:23
So she's a, she'll be nine, okay, in August.

Scott Benner 1:16:26
Listen, if my if I had your situation, and my eight year old's numbers came back, and she had a marker for type one diabetes, and he told me Look, it's possible that she could get it and it's possible she won't get it. I would not pull her aside and tell her that. I just wouldn't. I'd be like, Alright, listen, we know now to pay attention a little more. I'm not gonna burden a nine year old with this an eight year old with it, right? If it came back, she had four markers, and they were like, Look, she's gonna get diabetes the next time she sneezes, then I'm like, You know what, then I might start talking to her about a little bit and even not even talking directly right away, but just prepping her in ways that she might not even see coming. I don't know, there's a way to do it as but I'm saying you can do it. Yeah, I've been talking to you for an hour, you're a bright lady, you'll figure it out. It's better than you wander around worried all the time about something that probably isn't going to happen. makes me upset. Plus, I imagine you're not able to tell you.

Kayla 1:17:23
I can only imagine what goes through his head.

Scott Benner 1:17:25
You don't have to imagine we would tell you if you asked like we were not smart enough to keep it to ourselves. So

Kayla 1:17:30
it kills us women want the truth or what you guys are thinking or not. I

Scott Benner 1:17:35
don't imagine you do if you could hear inside of my head, Kayla, I still sound like I'm like 16 years old. Like, where do you the other day here? Let we're gonna end here, right? I've been married for like 26 years, like a really, really long time. And my wife comes upstairs, and we're gonna go out like she's been working all day. And I guess if I'm being honest, she was wearing like a sports bra. And we're gonna go out so she comes out to put a real bra on. And she does it in my office while we're talking but under her shirt, and all I could think was Would it kill her to take that off while she's putting that bra on? Like, why is she wearing the shirt? While this is happening? Like I was 15 is what I was thinking. I've seen my wife's boobs so many times, Kayla. And I swear to you, we're sitting there talking about where to go to dinner, all I could think was like, I wonder why she's like, why wouldn't she just take that shirt off to do that? Anyway, so we're thinking something along those lines, in case you're wondering.

Kayla 1:18:35
Yeah, my husband the same way we've actually I'll be 30 for July 2, but we've been together since I was 16. So it's been quite some time for us to and there's moments where I'm like just to see have to you know do that every time I do the dishes or just pushes the buttons on purpose and I think you probably know what I'm talking about.

Scott Benner 1:18:56
I actually my wife came out of the shower one day and I could hear the little voice in my head Goobies I don't know what to tell you. It's how it works. I'm sorry. I get act like it doesn't you give tell people like oh, I listen to this guy. He's really good at diabetes seems really smart. But I sort of got like, that's a she. I was like, Oh, this is it? This is it. I don't I'm sorry. I apologize. I feel dumb saying it. I'm not gonna lie to you. But it's the absolute truth.

Kayla 1:19:24
So no, I'm my husband's the same way. So yeah, that's something kids.

Scott Benner 1:19:30
Yeah. Don't ask us what we're thinking if that's not what you want to hear. Yeah,

Kayla 1:19:34
I've learned that already. I think. And

Scott Benner 1:19:37
by the way, the minute it's not like that, the minute it's not like that, she'll be like, Why don't you Why don't you're interested in seeing this and I'm like, oh, okay, like I can't possibly win. So, you know, I just know you guys can't I just I'm playing the game till she decides to smother me with a pillow. That's all which I'm assuming this the decision has been made. She just doesn't have the nerve to do it yet. But it's It's one day I fully expect that's how I go out just

Kayla 1:20:02
expecting it right now. That's why she hasn't done it yet.

Scott Benner 1:20:05
I guess I should have recorded here. If anybody hears I died my sleep call a cop. That's not what happened. It's not what happened. It needs to be investigated. Okay. Thank you. All right, Kelly, you were delightful. I appreciate you doing this very much. Thank you. I really do appreciate you taking the time. Yep,

Kayla 1:20:21
not a problem. Thank you. Oh, hold

Scott Benner 1:20:23
on one second.

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. A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL You see ag o n.com forward slash juice box

if you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome. Type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1113 Cold Wind Healthcare Whistleblower Bedside Nurse

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

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

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

Scott Benner 0:00
Hello friends, and welcome to episode 1113 of the Juicebox Podcast.

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

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

Scott Benner 1:24
If you work in health care, and have a chilling story to tell about your experiences in the healthcare field, contact me today. I'll get you right on the show. Your story does not need to be specific to diabetes. Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cozy earth.com.

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

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

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

Speaker 2 4:01

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

Scott Benner 4:09
As so many do.

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

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

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

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

Unknown Speaker 4:55
Thank you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Scott Benner 18:07
That's all ego.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Unknown Speaker 47:15
Right.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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#1112 Grand Rounds: Food and Nutrition

The fourth Grand Rounds discussion focuses on food and nutrition.

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

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

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

Welcome back everyone to the Grand Rounds series with myself and Jenny Smith. You know sometimes I just think everybody knows Jenny So I forget to introduce her properly, but Jennifer Smith has lived with type one diabetes since she was a child. She has first hand knowledge of the day to day events that affect diabetes management. Jenny holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and a certified trainer and most make some models of insulin pumps, and continuous glucose monitoring systems. She is also all over this podcast from the Pro Tip series to defining diabetes, to ask Scott and Jenny. Also call her a friend. And I think she's one of the smartest people I know about managing type one diabetes, you can hire Jenny at integrated diabetes.com. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cosy earth.com This episode of The Juicebox Podcast is sponsored by ag one drink ag one.com/juice box. When you use my link and place your first order, you're gonna get a welcome kit, a year supply of vitamin D and five free travel packs. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151. For us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. Today we're going to talk about food to just briefly go over so far we've gone over hospitals diagnosis, insulin and safety today food should be a slightly shorter episode, although I expect you to go off on some sort of a tangent at some point. So maybe it'll take a little longer. The reason I thought that you'd have a lot to say about this is because obviously your background in nutrition. So we have a few pieces of feedback from the listeners about what they prefer, what they would have preferred to hear from doctors, we'll go through a little bit of that we'll talk about it from a couple different perspectives, and we'll we'll let people get back to their lives.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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