Scott Benner 1/29/24 Scott Benner 1/29/24

#1118 Grand Rounds: Pregnancy

The fifth Grand Rounds discussion focuses on pregnancy.

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Scott Benner 0:00
Hello friends, and welcome to episode 1118 of the Juicebox Podcast

Welcome back to the fifth episode of the Grand Rounds series. Of course Grand Rounds is Jenny Smith and myself talking directly to doctors about what you need. And today's episode is about pregnancy. 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. 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. 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 If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show

this episode of The Juicebox Podcast is sponsored by cozy Earth. use the offer code juice box at checkout at cozy earth.com. And you will save 40% off of your entire order. US Matt is sponsoring this episode of The Juicebox Podcast and we've been getting our diabetes supplies from us med for years. You can as well. Us med.com/juice box or call 888-721-1514 Use the link or the number get your free benefits. Check it get started today with us med Jenny Welcome back. How are you?

Unknown Speaker 2:11
I'm great. How are you?

Scott Benner 2:13
So good. Christmas is over. I hope your holiday was good.

Jennifer Smith, CDE 2:16
It was really really nice. It was quiet. It didn't do a lot. We didn't go a lot of places. So there. It was just nice to be quiet and enjoy time. Yes,

Scott Benner 2:27
I'm a fan of that as well. We sat around I think one of the best things we did this Christmas is we bought this big Lego thing that everybody could work on. And we like Oh, which fat? Oh, it's a 3d portrait that you hang on the wall. Oh, I see no. Spider Man. Okay, yeah. So we just saw like, it started off all four of us. Then I think Kelly and I got tired. And then Arden kept going for a while. And then the next day I saw Cole come back into it. Arden Arden was the one that was really focused on it, though. She sat down and she really hammered through it. And it's all done now. And now I'm like, Oh, we have to hang it up somewhere. So yeah,

Jennifer Smith, CDE 2:59
they started bringing those out quite a while ago, I remember, my husband's my father in law really, really, really likes Marilyn Monroe, like, really likes her. And they had one of her quite a number of years ago. And we had looked at getting it and at the time, we were like, oh, we'll just wait until it's like a little bit last, like a holiday sale or something that'll get it for him. And then it was gone. anywhere anymore. So we missed it.

Scott Benner 3:26
This was not inexpensive. But I did catch a sale. And I thought it's about the cost to take us all to a movie. And we'll kind of sit together and it was nice. So I'm glad you had a good holiday. Yeah, we

Jennifer Smith, CDE 3:38
did. Thank you, of course. And it's almost the end of the year. This

Scott Benner 3:41
is it. It's December 29. Yeah, we're making a grand rounds episode today instead of doing whatever it is we usually do at the end of the year. Usually we just sit around and chitchat. But this year, we're gonna we're gonna put some effort into these series, which I'm very excited about. Actually, as you and I are recording like the eighth or ninth episode of it today. The very first episode of it actually goes up in a couple days on December or January 2. So yay. I'm excited for people to hear it. Today. I thought we could talk about pregnancy. Well, now this is a topic that when we asked the audience about it, to be honest, not much came back from them. Oh, but of course you were very passionate about it when we were putting the list together. For people who don't know Jenny co wrote a book about pregnancy with type one diabetes called Yes,

Jennifer Smith, CDE 4:28
it's called pregnancy with type one diabetes your month to month management. Your monitor my blood glucose management? Yes.

Scott Benner 4:37
Can you put our sales voice on there? She's like, Well, hello. It's important because not only does it present a number of issues along the way trimester to trimester and after giving birth and through the postpartum time, but I think that from a human perspective, a lot of young women who are dying Most young women that I've spoken to who are diagnosed prior to the years where they want to have children spend a lot of time thinking that they can't have kids or that it's not going to work out well for them, or it won't be a healthy experience. It's a lot of fear leading up to that, right. And I'm wondering if doctors couldn't do a good job of being able to talk to them in those years. So they don't spend that time scared of what's coming. So maybe like, let's start there. Let's talk about what doctors should be saying to young type ones, or you know, anybody at all really, who might be thinking about having a baby one day, that can give them some comfort and guidance, and maybe start getting themselves together in their mind to think that this is doable? Because it is

Jennifer Smith, CDE 5:43
it is absolutely. And I think you're considering it from the right starting point. You know, any young woman who has started monthly menstruation, right or monthly period, should be told what could potentially come from now having a monthly cycle, right? I Pregnancy is a potential. And if women don't understand from an early age on what that may mean, even though in the teen years, I would, I would expect that most women are not considering pregnancy, right? That's just not what their plan is at this time. In fact, it's much more about prevention. Yeah, at that point,

Scott Benner 6:27
the way I hear my daughter talk about it, she just thinks about that if she believes it's going to hurt and she wants to avoid it. That's

Jennifer Smith, CDE 6:35
great. But hopefully somebody teaches her that that's not really the truth. But But yeah, the teen years are when to start that discussion of even if it is in a preventative way it's know that if a pregnancy happens, whether it's unwanted or you know, unplanned, I should say not necessarily unwanted, unplanned or it's later on planned and something you definitely desire, your glucose management is going to shift, it's going to need to change your targets are going to change. Understanding how to navigate insulin management and everything else within that time period becomes tighter and kind of just much more controlled overall. And so from a non scary standpoint, starting out by saying you can absolutely have children, if that's your desire, someday, even though you don't want it now, Someday you may want kids and if that's the case, you can have them. I

Scott Benner 7:34
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Jennifer Smith, CDE 9:57
Nobody in this day and age He should be being told, Well, you have diabetes, and you should consider never having children. Or you should really think that you don't need children down the road, right? They shouldn't be told

Scott Benner 10:10
that it's going to be so difficult that it that it makes them think, Oh, I can't do it or, you know, you put it off. Also, you know, this also impacts people's personal relationships. If you're, you know, getting serious with somebody, and that person one day mentioned, oh, I can't wait to have kids one day. And you know, you're secretly harboring inside of you, I can't have children, my a one C seven, I can't, the doctor said it needed to be six. And I don't I can't figure out how to do that. It just has a lot more impact on people than I think it meets the eye perhaps. Right. And from my perspective, I spend a lot of time like you have talking to people about their diabetes and how to help themselves. From my perspective, it all comes back to the basics, right? Because right now, what I hear from women who are just experiencing a cycle, just a monthly cycle, is I don't know what happens, you know, there's a week where everything goes nuts, I just accepted my blood sugar is going to be higher. And instead of teaching them how to handle that cycle, we tend to teach them that that's, that's the cost of doing business, you know, right. And that's just not right. But now, yes, that impact, which is significant, any woman with a period who has type one knows how significant it is the need for insulin, how it changes and fluctuates. But that's going to happen times a lot more during pregnancy. So if you know how to handle your cycle, prior, I think it gives you a better chance to handle your pregnancy, then it does, yeah,

Jennifer Smith, CDE 11:34
absolutely. It also sets you up with the idea, you know, anybody who's going to a gynecologist for just, you know, the yearly checkups, and all those kinds of things. That's honestly, outside of endocrine, bringing up this topic, especially from a female perspective, your gynecologist should also be bringing this up seeing on your medical history that you have diabetes, it should be a piece of the discussion, you know, what are you doing for prevention? Or are you planning a pregnancy, if you are, this is the protocol, I'll stay with you for this portion, you may need to be handed off to a high risk doctor for this portion of it, or you're going to go right to a high risk doctor for this. And the idea of then how to navigate and what to expect should be part of that discussion. So that again, there's a fear factor that's removed, you can see that it's doable. But you can also see that having kind of your ducks in a line, if you will, is really, really important. Pre pregnancy, that preconception time is so valuable. Once you are pregnant. You know, I usually when I get to start with somebody, I hope that I get the preconception time so that we have, you know, one, two, even three months to work on, as you said, getting things all in order, getting Bolus timing, getting meals that are working really well understanding exercise, insulin dosing, and timing and all of that. Once you know that, yes, it will change in pregnancy. Yes, it'll change a lot in the early weeks of pregnancy, because hormones shift considerably, to keep that pregnancy viable. And if you know that ahead of time, you're not gonna be so surprised. Yeah, if you're planning a pregnancy, you also won't be surprised with what's happening. Because you know, to watch for it, right?

Scott Benner 13:29
I think the diabetes tools are universal. Yes. And it's funny that Jenny and I were talking before we started recording, and it's about something different, but this came up managing insulin is, is a lot about Pre-Bolus, eating meals, having your settings right, knowing how to react if something goes wrong, not staring at a high blood sugar. Like these are just kind of basics that if you go through the Pro Tip series, you'll understand. And then after that, you apply them in different situations. And I really do think that one of the variables that exists for diabetes is pregnancy. Yes, not this, like separate thing off to the side. Like oh, you know, if you have type one diabetes, this is your life. But if you get pregnant, it's a new thing. It's the same thing with Swift are moving harder impacting variables. Like I think that's it, right. But if you have the tools to react, and the knowledge to say, oh my gosh, all of a sudden, my food seems to need more insulin or my I don't know, my, my, you know, my standing blood sugar. My my basil doesn't seem to be working anymore to hold me somewhere away from, you know, away from food, right? I need to react and do something correct. And it's going to, like Jenny said, with these hormonal impacts, it comes hard and sometimes it by the way, it takes it away as quickly as it gives it to you. Right? So this isn't all about more insulin. This can be at times where you have to back your insulin down. You can't be waiting three days or until the doctor calls back or whatnot. Like when you start having these impacts you need to react and Right, I mean, Jenny, to put an emphasis on the point, what's the increase, you can see in the amount of insulin that some women need during certain points of pregnancy, I'm trying to I'm trying to paint a picture of what the how much it can go up.

Jennifer Smith, CDE 15:15
Yeah, it and an overall again, we kind of think about pregnancy, insulin management or insulin dose changes. It's kind of like a long duration variable. So that's a great kind of way to describe it. It's like a marathon, right? It's not this little sprint that you get through and you take care of it. And the next day is all better, right? Things shift and change, we look at variables, and then we say, okay, over the course of a whole pregnancy, women's need for insulin can double or even triple, depending on what their preconception dose looks like, and what variables that are healthy lifestyle variables that they keep in the place. If you remain active. If you know your insulin dose timing, if you pay attention to the changes that you're seeing, and we usually say in pregnancy, a trend over about two no more than three days suggests a shift that's needed in a setting. It's not a variable. It's a setting that needs to be changed. So we change much more swiftly than many, you know, many other times of life, maybe leave it a couple more days outside of pregnancy. But yeah, doubling tripling insulin needs, especially, you know, by third trimester, by about 30 plus weeks, up until about 36 weeks or so that's the heaviest amount of insulin that you're going to see changes in insulin dosing on about a weekly basis. You know, 10% more Basal adjustments to Bolus timing. I mean, by about 30 weeks, your Pre-Bolus time could be upwards of about 45 minutes, right. So we're thinking, you know, we're thinking, well, ahead of the meal, you're thinking, I have to Bolus and we're looking, of course, nowadays, we thankfully have technology that shows where things are and how they're drifting up, down stable. So we can use that to our advantage. But it's really, really intense third trimester

Scott Benner 17:16
of pregnancy is a job in itself. But pregnancy with type one, it's a real job, like you have extra things to do now. And in a world where doctors don't often give autonomy to the patients, right? They will tell them things like well, next time you come in, we'll adjust that or call me first. That scares people, then people can't make adjustments. So in a world where they're not even able to turn a dial for 10%, more or 10% less, because they feel like they don't have the ability to seriously the wording that comes from people all the time is I'm afraid I'm going to get yelled at. I can't move my insulin because my doctor will be mad at me. Can you imagine? My doctor told me if I change my settings, they'll drop me. Right? Right. So you're taking away people's ability to like, read and react and see what's going on. A lot of them don't have that to begin with. Now you're putting them in a position that Jenny just described where their insulin needs are gonna go up maybe weekly. And then once it really hits in that third trimester, I've heard women tell me meals that took three units took nine units. Yeah, right. If you can't make the leap to go up 10% In your Basal without asking somebody? Where are you going to get the nerve to Bolus nine units for something you think, you know, historically? Three, three, you can't make that decision on your own. Right. So I think that it's more about I don't think we can't help people who have become pregnant, right? Like I know you can. I've heard plenty of stories of people like, Hey, I got pregnant, I didn't want I didn't mean to like it when she was eight. And I boom, I snap myself together. And I got it down. I did what I needed to do. But often those stories are followed by then the baby came, Mia once he went back up again. Right? Yes, she got through the pregnancy and good for the baby. But the baby's counting on the mom for a whole lifetime. So Correct. Why don't we do some things that help her throughout her life, not just for nine months. That's why I think that doctors need to hear this, so that they can be pre planning and laying this groundwork. And by the way, here's the big secret. We're not saying anything here. You shouldn't be saying to a man either, because all we're telling you is they need to understand their diabetes and how to react to it and how to make good decisions and how to see things and, and you know, and go, Oh, I know what that means. I need more. I need less, right. That's what they need. They need autonomy. And

Jennifer Smith, CDE 19:36
on a broad scale, what they also need, kind of talking about here is really a care team. Again, when I work when I get the chance to work with somebody prior to conception. A big emphasis is who is your care team? Who do you know is in your corner? Is your endo on board? Or are they going to shuffle you off to mainly be managed by a maternal fetal man? venison, a high risk doctor is your OB GYN to manage along with a high risk is your team six people deep? You know, and everybody, it's like too many cooks in the kitchen and you don't know who to believe about what? Right. So I think planning again, goes a long way when we're talking about pregnancy, which is almost the course of a year, right? And a care team that doesn't slap hands, that you say, I've made these adjustments, you let them know, because that's also very important for you to tell them what you've done. So that they could acknowledge and say, Okay, I would have suggested that it looks like they did that already. Great. We'll go from here, right? So you have to be you have to be on a team. And you all have to have even jobs on the team. And you have to have that discussion to know who is going to do what part of this? Do you want my records every week? Do you want my CGM information? Do you have an online database that I can download and send information so you can send me weekly, you know, feedback that we can connect in between our visits that we're going to have more and more frequently, right? I mean, that's a piece that unfortunately, some women who have not planned the pregnancy did want it, but they weren't quite sure that it was going to happen so quickly. And now all of a sudden, oh, here we are. I don't know who I'm supposed to go and see, it makes that early, tiny, even a little bit more, I guess, worrisome or concerning, because they're not quite sure who they're supposed to be checking in with. And

Scott Benner 21:28
you may see an increase in women with diabetes getting pregnant soon. This is a little extrapolation, but and very anecdotal, but I'm seeing on some GLP groups online, women who are just like, I don't even practice birth control. It's not necessarily I can't get pregnant, I've been trying for 20 years, they're magically getting pregnant on GLP medications. So sure, you know if maybe this is impacting PCOS, to some degree, which is allowing pregnancies and by the way, PCOS and type one can go hand in hand a little bit. So this could be the time, you know, like, you could see an inflation of people who are like, Hey, I'm pregnant. I never thought this was going to happen. I've never been planning for this. Right? You know, I'm not ready for this at all. I just think that it is so incumbent upon doctors to do more than just say, Oh, you had the baby. Now, your needs are going to change? Well, thanks. Yeah.

Jennifer Smith, CDE 22:23
Like, what does that be? Yeah.

Scott Benner 22:24
What am I supposed to do? I've lived my whole life, not knowing what I'm doing. And now I've have these crazy variables, these impacts are swaying back and forth. And the extent of your help is, look out. It's coming. You know, and if you don't know, it's so disheartening to look into a physician's eyes and say, Well, what do I do? And they got, I don't know. Yeah, just great, right.

Jennifer Smith, CDE 22:45
And even if you did have some fairly good care during pregnancy are really phenomenal team during pregnancy. As you said, that postpartum time period is a very significant shift. And it after nine months of navigating and managing and understanding insulin resistance, and I have this Bolus timing, that's like 50 minutes long, and I, you know, I've, I've stayed away from these kinds of things, because I just can't navigate and I'm trying to control in these target ranges, and now postpartum, well, goodness, all those pregnancy hormones, they like, go and get washed out, they're gone, right? But now what do you have, most women are trying hard to nurse at least to some degree, that can have a major shift in terms of sensitivity to insulin. And if you're not ready for that, if you haven't been taught ahead of time, what to expect, and how to set up, let's say you're using an insulin pump or using injections with a certain amount of insulin. If you haven't been taught to set up a postpartum strategy, or a management plan with your insulin doses, you are going to be on a roller coaster, and it's going to be a roller coaster of a lot of scary lows, quite honestly. So again, those are all things to think about. And as a physician, or you know, a clinician who's taking care of women in the ages where they may be able to get pregnant or may want to get pregnant. These are discussion points that are really, really, really important. They should almost be check offs on that list of everything else you're checking off. They should be checkups have talked about and discussed pre pregnancy planning targets, et cetera, or, you know, prevention techniques, so that they don't have something that's unplanned happen. Yeah, it's just Well,

Scott Benner 24:33
I guess a couple thoughts here. The first thing I'm thinking is, I get worried that doctors will hear Yeah, you're gonna give them information. They're not going to know what to do with it, and they're gonna make a decision that's going to hurt themselves. But I would tell them that it's like learning to drive when you put a 16 or 17 year old into a car, right? And you you say, Alright, here's the basics. You're not teaching them how to drive completely they haven't been through all the experiences and they're not going to react as well as a 25 year old or a 30 year old would in an emergency situation, right. But they're never going to get to that if you don't teach them that the brakes, you know, on the left three guests on the right. And this is how you turn and you don't over, you know, overcompensate when something happens, keep your eyes up, get to teach them all the basics, then send them out there in the world, and let them have experiences. And then one day something unexpected is gonna happen. And you'll see how those experiences aid them in that moment. Because I just I hear it too much like, well, they don't know how to do it. And I tell them to Bolus more they're going to make themselves well, if you don't, the other things can happen. Right. And the other thing is, is worse, in my opinion, right? So when we're talking about lifelong problems, life shortening issues, not I got a little low, I figured it out next time. I didn't use this much. You know, you have to give people the opportunity to to fend for themselves. Yes. You can't just act scared and tell them, they'll we can't tell them because they won't know what to do with it. That's not fair. No. Like you need a shot at taking care of yourself. And the other thing I wanted to bring up is, you were talking about the nursing and how it could lead to lows. Right? Hmm, I think that what you really need to understand as a physician is that if you don't prep somebody for that, and it happens, here's gonna be the decision tree. I'm holding a newborn baby, trying to nurse it, I got low, I'm never gonna let that happen again, right? You just put that person say once the up one or two points, because they're going to be fearful with their insulin from now on. In another situation where they didn't need to be if they knew how to use it correctly. Either that

Jennifer Smith, CDE 26:40
or they're going to stop nursing. Oh, I didn't even think because yeah, if the nursing is what's causing the sensitivity to insulin, and every time they nurse, they put two and two together, and then why gosh, if I just stopped nursing, I clearly wouldn't be low all the time, or I wouldn't have all these issues. I guess I'll just switch to formula when quite honestly, it's better to breastfeed, it's better to provide breast milk, whether it's pumped or it's nursing or whatever it is, it's just better for many reasons. And if those if that's what you put together, then unfortunately, somebody has missed their job and teaching you how to avoid that as a problem not only being too high, and also not feeling great, it great. But on the opposite of that being able to continue doing what you wanted to do to begin with, for your infant, you're

Scott Benner 27:29
just not putting people in the best possible scenario, like that point right there about them, maybe stopping breastfeeding, right. And the health implications of it aside, forget, like, put those aside for a second, you have no idea. Unless you've been a woman or been married to one for 25 years, like I have been their entire life. They'll never let go of it. I wanted to breastfeed that baby and I didn't. And it's gonna feel like a like, it's gonna be a mom guilt thing that will never leave them. And that is another opportunity to alleviate another problem from people. And with what are we talking about some pre planning some light knowledge of how insulin works, and some you know more? I don't know, laser focused knowledge about what's going to happen during your pregnancy and how to react to it. It's not undoable People do it all the time. Jenny shepherds people through it, I get notes all the time. What do you hear me jump out of the pockets all the time, one day, someone's gonna name a baby after me. It has not happened yet. But I did get a dog in something else. Not the point. The point is, is

Jennifer Smith, CDE 28:30
that I do get a lot of great name for a dog. You

Scott Benner 28:34
know, it's not, by the way, my name is terrible. Don't name your baby Scott. It's just very short and Curt, and it's not really very melodic. And I don't think you should do it. But my point is, is that I get a lot of notes from people who say that I just had a healthy baby because of this podcast. And it's just a podcast, you're a doctor, like you could you could do this for people all day long. Right? You know, right?

Jennifer Smith, CDE 28:55
I mean, on the same note of what nursing can do, if someone is also not navigating, and they have a roller coaster, or they're just ending up writing higher blood sugars, from a safety standpoint, that's also going to have an impact on their breast milk production. Okay, right. So you know, hydration is really important. Hydration is a very under discussed, unless you're talking to the nurses in the hospital, postpartum, who are really awesome at bringing you water and making sure you're drinking, drinking when you go home. There's nobody who's going to bring you your water. There's nobody who's going to emphasize how important that is. There's nobody really who's going to re emphasize for you. How important not running consistently high blood sugars is for actually providing enough you know, quality breast milk, honestly. So

Scott Benner 29:50
you're already asking a lot of your body before you're trying to make breast milk. And you see it with people living with diabetes all the time, just being the height graded slows down their insulin use the efficacy of the insulin that they have in them. Now they're pushing more insulin to get the same response. They don't know, all of a sudden they get hydrated or they, you know, they they find a better way and boom, they're dropped low they're eating, you turn the whole life into this, right, this chase that that's just you're always chasing diabetes instead of I don't know, like impacting it and bending it to their will to some degree, you know, right. Especially with CGM, you know, right. All of this is just so eminently possible. And if you're cheese, if you're kind of you're helping a person who's pregnant, you don't have them on a CGM. I mean, you've made a mistake, you know, so correct. Absolutely. We'll talk about the other side of it for a second, Jenny, because we're not horrible people who just think that doctors don't do a good job.

Jennifer Smith, CDE 30:47
First of all, not at all, there are many amazing teams out there immensely.

Scott Benner 30:50
Great, you know, just I've seen it over and over again. But it's not what everybody gets, right. And, you know, if you're in a position to help somebody, and you don't understand these things, I mean, this is gonna sound like I'm saying, just listen to my podcasts, but just trust me enough people listen to it already, that if you as a doctor, don't listen, I'll be okay. So I don't I'm not just asking you to listen. But you could take, I don't know, a couple of hours and listen through some of the Pro Tip series, or you could listen to we have like 16 episodes about pregnancy, from like pro tip episodes about pregnancy down to I think I did an interview with one woman after each of her trimesters, and then after she gave birth, right, like, yep, somebody said, it felt like my insulin needs changed as soon as I delivered the placenta. And I thought, Oh, that's so interesting. Who would think about that, you know, like, she's like that placenta came out, and I was turning down my Basal. And heading back home, I've heard other people say, it took days for my insulin needs to change, like, anywhere in between the least, you know, to look for it.

Jennifer Smith, CDE 31:53
I mean, this whole honestly, this whole, like discussion here is really the reason that, you know, we're emphasizing to the clinicians benefit, to provide education provide information to provide a start, so that somebody doesn't feel so lost through what is a fairly long amount of time, you know, in terms of a developing baby, right? I mean, it's the reason that I put together the book that I did with, with my co author was quite honestly, there, there wasn't anything. I mean, I went through my two pregnancies, my first one, especially looking up researching, doing a lot of ahead of time work to know what I was getting into, and to know how I could expect, but where was that information coming from? Like, research articles? It wasn't like a pamphlet online that was like, This is what you should expect. Oh,

Scott Benner 32:49
you're pregnant. Right? Right. Well, that's where I mean, that's how the podcast became what it is, right? I'm just one day thinking like, how do I help my daughter, and then you just pull information together, you put it into practice, it works, you keep what works, you get rid of what doesn't? And then from there, it's about how to communicate it, which is what this is about, like, I don't know something about diabetes, that you can't go read somewhere. I'm not a magic person who understands something that does the rest of you don't get to know. Right, I do understand this stuff. I do know how to implement it. But the thing I think I'm good at is describing it to other people. Right. And I think that is a thing that doctors could become good at, right? But you have to first become proficient at it as if you're trying to save your daughter, you know, like, we're as if you're Jenny, and you're pregnant, you're like, I don't know what to do, I need to figure this out. Right? Like, you have to put yourself in their position while you're collecting the data and feeling the importance of it. Right. And then you learn how to talk to people about it. And the only way you're going to learn is the same way those people are gonna learn how to use insulin, you got to start and you might maybe you'll screw it up at first, maybe you will, right? Like maybe the first time you try it, you may go, oh, I shouldn't have said it that way. And it might take you a couple of people before you really get good at it. But it doesn't take that long. And don't be scared, you know, like, just get out there and try to help somebody. Right? You'd be surprised what happens, you

Jennifer Smith, CDE 34:11
know, and I think because the grand majority of general medicine practitioners are going to see women who potentially don't have pre existing diabetes, you know, before pregnancy. I think there's an unfortunate group of women who have gestational diabetes, right? With testing in that like late second trimester, a glucose tolerance test reveals that their body is not navigating glucose. It's not navigating food the way that it should, and that there is something that needs to be done in order to have a healthy baby. They're on out right. But what I've really seen is the aftermath delivery for women who have had gestational during pregnancy, while there is postpartum, further testing To evaluate that, yes, your glucose levels have gone back to normal your body is responding like it should. I think it's an underserved under educated in terms of lifestyle changes they made in pregnancy, and how important those changes are to keep, because there's a high risk of type two diabetes, if you have had gestational diabetes, right. And so it's an under followed.

Scott Benner 35:26
Oh, yeah, it's treated like we got you. We got the baby. Right. It's over now. Right? Yeah, it's Yeah. Am I gonna get diabetes one day? Maybe? Good luck. Yeah. Yeah. Right. Like, right. Never think about it again. Oh, my gosh, the people with type two Oh, my God, like, you know, if you think people pregnant with type one aren't getting good, good information, people with type two are being just dropped left and right. Like we have somehow, as a society decided that there are some things that happened to you. And when they happen, you get pushed off onto another line, you know, like, oh, oh, they lose. Yeah.

Jennifer Smith, CDE 35:58
And, and or it's not until something really significant is happening. You know, let's say pre pregnancy, a tight woman with type two is managing quite well, right? And is again, undereducated in what to expect to happen. And so they don't know how to keep up enough. And they end up coming in and now blood sugars are all over the place and their medications they were using, they're not working anymore, or medications maybe weren't discussed well enough to say here, you're likely going to need to change to using insulin. Are you ready for that? You know, this is what it would look like. And we're going to have you follow up with a high risk doctor, to ensure that you're being managed really, really well, again, it's a missing part of education. For that group,

Scott Benner 36:43
it's become popular to say that, you know, it's not health care, you know, you're not really getting health care, right? It's not nothing's preventative. We just try to fix you after you're broken. Right, that that's how the system works. And it is how the system works. I'm not saying that. No, no, you're right. Maybe it's not that simple. Maybe it's more that we're not good at preventative. Not that we're not trying. But maybe people just don't know how to do it, or how to communicate it. Because you know what I mean? Like, I know, there's the business and the money side of it. And the money side is directed at what it's directed at. I understand all that I'm not being I'm not being Pollyanna about it. But I do think that part of the reason I wanted to make this podcast series is because I don't think that this doesn't happen just out of apathy. I think it doesn't happen because people don't think to do it like that. Everyone is like they see themselves as either working or broken. Do you don't I mean, and when you're working, you don't have to do anything about it. Like nobody does sit ups when they're thin. I mean, listen, after New Year's go outside, and everyone jogging, you're going to look at and think, oh, they should have started jogging like three years ago. Right? Like, right. But it's not till it hits you where you're like, I have to do something. It's not a very human thing to work on things that aren't obvious. But in this specific situation, if you know how to do it, you're saving a ton of problems. Right on the back end, just like you would with anything else. But here. It just seems more imminently important to me. Yeah,

Jennifer Smith, CDE 38:15
no, absolutely. I think. I mean, you set it in a very nice way you said it, that there is that there is no preventative medicine. And you know, the reason like for that, right? I mean, no money in it. Yeah, there is no, I mean, I did not I there's no way to delicately say there's no money in preventative medicine. If you've got somebody coming in who is really healthy, because you've told them this, this and this in terms of lifestyle. And yes, these vitamins, no, you don't need this, eat carrots, you whatever it is, that's a one visit. And you know what, maybe they're gonna go off on healthy life for the next five years. Because we're come back, you're taught them to be healthy. That's awesome. That's an heart hook. Your system should work. But it doesn't make money. Yeah,

Scott Benner 39:01
it's a shame. I mean, honestly, I understand how it happens and what the cycle is that brings us to that. And then once you get into that cycle, it holds us in that cycle, like that, I'll get ya get all that. So maybe this is the part of the conversation for the patients where I'm telling you, if you just go listen to the Pro Tip series, then when you get pregnant, you should probably be able to do this no trouble. Right? You know, and I do honestly believe that. I don't think that the podcast is magical. I don't think that the information is magical. I just think that it's being communicated in a way that is digestible for you understandable and will put you in a position to make good decisions, right. And I think that really is the key to this because as much as I'm hoping that doctors figure it out and that people listen to this and go I'm going to do that. I'm more certain that you're probably going to run into a doctor that helps you yes or no, it's going to be a coin flip. And you're not going to know the difference when it happens. That way really is the biggest trouble is that you're not going to know if you've got a good one OR, or NOT a good one until it's a little too late. By the way, marriage is like that too.

Jennifer Smith, CDE 40:10
Well, it all starts with three.

Scott Benner 40:12
Yeah, I could explain to you how not to do that too. But it just would take too much time. But listen, if you want a good life, you do the work first. Right? That's it, you do the work first. And then the rest is easy. And whether it's pregnancy or marriage or being a doctor, I mean, we're not really saying anything that difficult here.

Jennifer Smith, CDE 40:33
It's not rocket science. And we've said, I don't know how many times we've said that is not rocket science,

Scott Benner 40:37
effort upfront, everything else gets easier. That's all. So I know, not everybody is going to make a baby on purpose. Or, you know, and that doesn't make your pregnancy invalid, obviously, or that the love, you're going to have invalid. But if you're running around with an ad, one C, and you're a woman who could at any point be pregnant, I'm going to tell you that this podcast is full of stories from women who are in that situation. And when you hear them tell that story, what you're going to hear them say at some point is, I wish I would have learned how to do this sooner? Yes, I just don't want you all to be in the position where you're always saying, I wish I would have. Instead you could say you know what I did? You know, I learned about this thing that really impacts my life, and it made my whole life better. Right? That's what I'm hoping

Jennifer Smith, CDE 41:26
for. And if you learn it the way that it's presented, and again, digestible, right bits and pieces that you can take, you can apply based on what you see happening long term in that post partum time period, you're going to stick with what you know, because of the fact that you have been applying it already. So it's not going to get all thrown out the window because Oh, it's all over now. And I can just go back to completely forgetting everything that I've learned, you're more likely to continue it, especially if you've planned to have another child someday, right? You don't want to start out from ground zero all over again. You might as well continue with what you know, and keep things in a range, that long term is going to keep you healthy, whether you have kids or not.

Scott Benner 42:13
Yeah, that happens for some people. And then for other people, they fall into that trap where everything gets slotted above, it's the baby first, and then things that affect the baby. And then the next thing you know, you're not even thinking about yourself 20 steps down on your list, right? And when you have diabetes, that can't happen. No. So you if that's mom guilt, I don't know what does that right? What makes you although I was a stay at home dad for 20 years, I was the one like I'd make food and then like eat what was left

Jennifer Smith, CDE 42:41
your family first and then you took the scraps, right?

Scott Benner 42:44
And you think nothing of it while you're doing as a matter of fact, you feel kind of, I don't know what the word is, but you feel good about it, almost like I put people before me, it can't be like that with your diabetes, I tell my daughter all the time, all of the time. You are first. I don't care in what scenario in life. If you're out driving with your friends, if you're off to college, if you've met a boy, if you're just living your life sitting around the house, it's diabetes than anything else you want to put after that we cannot ignore the diabetes first, because it will ruin everything else if we ignore, right? Absolutely. It's diabetes first. And when you do that, it makes diabetes. This is gonna sound strange. But if you make it first, and you understand what to do, and you have the tools, which are very accessible here in the podcast, then everything else like I just said gets easy, like and then all of a sudden you don't think about I think people must believe that I'm constantly think or Jenny's constantly thinking about her diabetes. I mean, honestly, Jenny, you really think about it that often?

Jennifer Smith, CDE 43:48
No, in fact, I don't. I mean, I know a lot of people who sit with like, you know, their apps open and whatever their tools and they look at it, unless my thing makes noises yet me

Scott Benner 44:00
for some reason. It's three o'clock in the afternoon. I haven't looked at his blood sugar. Right,

Jennifer Smith, CDE 44:05
unless it's making noises at me or, you know, my pod is like, decided to give the death toll. The you know, the, for some strange reason that I addressed something but yeah, yeah, I mean, I try really hard to because I know what I am doing. And most of the time, you know, 90% of the time I'm doing similar things over and over. I can let it take a backseat, but not in a way that I'm forgetting about it. It's just because things work because I know how to make them work.

Scott Benner 44:37
It's the driving analogy again. Yes, you can get in a car and drive 100 miles. I just drove 700 miles one way and turn back around and drove 700 miles back again. I didn't hit anything. I didn't come close to dying. Like right like I just been driving a long time I have these tools that I don't even know I'm using that I'm using it doesn't weigh me down. I didn't get home ago. Oh my gosh, my life is ruined. I had to think about driving. Man I think diabetes the same way I just said, I haven't seen Arden's blood sugar today. So I opened up my phone, or blood sugar's 107. It hasn't been below 70 or over 110 in the last 12 hours, yay. But all that is, is Settings and Tools and insulin timing that I've already taught myself that happen almost automatically when we need them to happen, right. That's my point about all this. That's my point about the whole damn Podcast. I'm sick of telling people dammit, Jenny, I made myself upset. Go make a baby weight or throws up on you. It's gonna be a big ball of fun. Congratulations.

Jennifer Smith, CDE 45:42
It is fun. Sure it is.

Scott Benner 45:43
It's absolutely fantastic. Everyone should have a whole bunch of babies there. A lot of the big party. Good luck paying for college. Thank you for doing this with me. I

Jennifer Smith, CDE 45:52
appreciate it. No, that's great. Thanks.

Scott Benner 45:59
I'd like to thank cozy Earth for sponsoring this episode of The Juicebox Podcast and remind you that using my offer code juicebox at checkout will save you 40% off of your entire order at cozy earth.com. That's the sheets the towels, the clothing, anything available on the website. 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 of the sponsors. The episode you just heard was professionally edited by wrong way recording. Wrong way. recording.com. Jenny Smith holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer and most makes and models of insulin pumps and continuous glucose monitoring systems. She's also had type one diabetes for over 35 years, and she works at integrated diabetes.com. If you're interested in hiring Jenny, you can learn more about her at that link. BetterHelp is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapist who can help you with a wide range of issues. Better help.com forward slash juicebox. To get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit. For any reason at all, you can switch to a new therapist at no additional charge. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price betterhelp.com forward slash juicebox that's better help h e l p.com. Forward slash juicebox. Save 10% On your first month of therapy. 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. Hey, if you kept listening through all that, I really appreciate it. I just wanted you to know that. It's Saturday night at like nine o'clock and I'll make it a podcast and you never know who's gonna listen to it. But the fact that you listened this long, it really means a lot to me. Thank you so much.

#1117 Bold Beginnings: Medical Team

Scott Benner 1/26/24 Scott Benner 1/26/24

#1116 Southern Lobster Ears

Melanie's eleven year old son has type 1 diabetes.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 1116 of the Juicebox Podcast.

Melanie's son Shepard was diagnosed with type one diabetes when he was 11 years old. Today we're going to speak about that and the struggles that Melanie has experienced since the diagnosis. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's juice box at checkout to save 40% at cozy earth.com. 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

this episode of The Juicebox Podcast is sponsored by ag one drink ag one.com/juice box. head there now to learn more about ag one. It's vegan friendly, gluten free, dairy free, non GMO, no sugar added no artificial sweeteners. And when you make your first order with my link, you're gonna get a G one and a welcome kit that includes a shaker scoop and canister. You're also going to get five free travel packs and a year supply of vitamin D with that first order at drink a G one.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.

Melanie 2:16
My name is Melanie, I have two boys 115 one is 11. And my 11 year old is a type one diabetic. He was diagnosed in May of 2020 when things were super crazy. So we have come this far. And here we are. Was he about eight at that point? Yes. Yes. As a matter of fact, it was three days prior to his eighth birthday.

Scott Benner 2:50
Did he have his birthday in the hospital? No,

Melanie 2:53
we got out. And he spent the night at home. And I remember I woke him up. You know the next morning on his birthday at home. Thank goodness. So that was nice.

Scott Benner 3:04
Yeah. Oh, that is nice. Actually, did you have to consider that at the hospital? Do you have to ask them, hey, get us out of here. It's his birthday, or did it just work out?

Melanie 3:13
You know, I'll be honest with you, when he was diagnosed, it wasn't until several months later that I realized I was probably in such shock that I just I was just doing whatever they said the fact that wherever his he was going to be on his birthday was kind of they were in charge of that. And I didn't I don't remember talking about that at all. I just remember it was going to be what it was going to be. I mean, if you think about that time, it was traumatic anyway, going into the hospital because we were kind of in the thick of COVID. And that it was only me we literally to tag team for my husband and I had to spend the night I think we slept over only two nights. So we had to literally leave him in his hospital room alone. So one of us could go down, you know, to the sign in desk or whatever and trade off the little badge we had to have or whatever. So I was just doing whatever was necessary at the point, you know, no,

Scott Benner 4:17
I understand and even like, now that all makes sense to me, okay. Was it was it a complete surprise or do you have diabetes in your family?

Melanie 4:27
It was a total shock and complete surprise, no diabetes in our family that I know of? No auto immune and now I have some auto immune that had married and but not none of my blood relatives. So yeah, I mean, we literally had no idea and it's kind of funny. Looking back I as impatient as I am sometimes with some of the comments and things people make because They don't understand type one diabetes. I also am super patient because I mean the day he was diagnosed, I remember thinking like, Oh, this is all our fault. We he's been drinking too much Root Beer this week.

Scott Benner 5:16
I found the root beer level that gives you type one diabetes. I'm

Melanie 5:19
you know, so I, I was, you know, I was there I was part of that just blissfully ignorant, not ignorant in a bad way ignorant in the sense of the word right that I just didn't really understand. Oh, at that point, you

Scott Benner 5:34
beat yourself up about it, or were you able to get past it? Well,

Melanie 5:38
it's a good question. I will say, I think the people that took us into the hospital, it was funny. Because before we really realized what was happening, they said, I hope that you are good at math. You know, welcome to type one diabetes, I hope you're good at math. And, you know, also, I hope you understand that people are going to come at you with all sorts of things that they believe are going to be helpful, they're going to be hurtful. People don't understand this. Like, they told me that stuff that was really, that was really helpful to me. But it's still, it's still, it still bothers me sometimes. And I still, I've gotten better, let's just say that I've gotten better. Listen,

Scott Benner 6:22
if you really stop and think the sum total of things that any of us really understand is probably like, around five. I mean, honestly, Mary, if you and I went off on a different direction here. And I said, let's talk about how they clean wastewater for drinking water. Tell me all about that process. You'd say, I don't know, I turned on the faucet and the clean water comes out. How does that how does how does the financial system work? You know, like it just nobody does? Right? Not my way. Exactly. And why would it be you're busy doing the thing you're doing give a limited amount of time. It's, I don't think we think about ourselves that way. That you know, you go to elementary school to learn basics, you go to middle school to get socialized, you go to high school to try to figure out something you're good at, you might go to college to hone in on or go out into the world and get a job or you make a baby or whatever you do. And those are really the things you know about. And then the rest of what you know is from what you hear, like adults in your life, bantering back and forth. And then we all get 25 years old and go, Oh my God, my parents are morons, I've been listening to them. Right that if you're really thoughtful, you have an existential moment where you go, I don't know anything about anything. You spend the rest of your life trying to figure it out. So yeah, anyway, I'm glad you didn't beat yourself up terribly. How long? Do you think the symptoms were going on before you made it to the hospital?

Melanie 7:44
You know, he was complaining with a stomach ache for probably two weeks. And it was COVID. So of course, we were doing do it yourself projects around the house, right? I mean, isn't that but so what happened is, we had kicked him out of his room, we were repainting region, the flooring and his room, all this stuff. So he was sleeping in the guest room. And this was probably like, a couple of days into when he was really complaining about his stomach and I was really noticing. And, and, and just kind of wondering, like, what's going on? Like, understanding finally like, okay, something's not right. Because he doesn't usually complain, you know? Also, I have to say this, this is my child that is the camel of the family, right? Like, he wakes up in the morning. He gets dressed, he brushes his teeth, he eats his breakfast, he does all the things that you do. He gets his things together. He goes out to the bus stop, he gets to school, and then he goes to the restroom. Okay, this is this is he just doesn't go that often. Okay, so I have him in the guest room. And I'm now I'm understanding finally something is not right with Him. And so I sleep with him in the guest room. And I notice he gets up in the middle of the night and goes to the bathroom. And I'm like, okay, that's really strange. So then night to asleep with him in the guest room. He gets up in the middle of the night and goes to the bathroom. And I'm still not really sure what experience it was in my life that I said that minute. Okay, this is diabetes, I gotta call his doctor in the morning. Like, it's still not really understanding what the new about diabetes but just understanding that that was a symptom. And so when I woke up in the morning, I immediately he you know, he's still asleep. I'm googling all the symptoms, and, you know, he's got all of them, but one of them that was unusual is the Freedy breath. And he came downstairs and he sits by me on the couch and I say, you know, Shepherd, give me a Breathe on me and I'm expecting, you know, Kid morning or whatever right and, and it just smelled just like a pack of juicy fruit. I couldn't believe it. It was surreal, you know. And I knew then and I called his pediatrician. We didn't go we didn't couldn't get an appointment. So later in the afternoon, and so, all day long, we're super, especially him. He's super active. So we have gone on a bike ride, and then we came home and we were, you know, at the swimming pool, he was swimming, we were waiting, we had a three o'clock appointment. And, you know, he's being super active. But in the meantime, he's also drinking that root beer. So I think they said his activity level probably really helped him where he was, but we get there and his pediatrician were both my boys pediatrician, I just adore her. And she just looked right at me. And the way she said it was, he's insulin dependent diabetic. That was the word she used. And I still didn't fully understand what that meant. Yeah, say

Scott Benner 10:59
what did that mean to you when the words came out?

Melanie 11:01
Well, I'll be honest, I think the first thing and that's when the shock really started because I had been looking at the symptoms within as I just said, then we were busy all day, I was just like, oh, well, it's gonna be what it's gonna be. We're gonna find out, we're gonna get to the bottom of this, you know? I think I thought, okay, he can't ever have a root beer can you know he can? You can't have sugar anymore, I think is what I thought.

Scott Benner 11:22
I thought I'm gonna save so much money on repair.

Melanie 11:28
Yeah, I believe that's what I thought. And before we

Scott Benner 11:31
move on, Melanie, I have to tell you that I've made a mistake in the first 30 minutes and I want to clear it up. Nobody else knows about it yet, but me, but I'm going to share it with everybody. Because if I have to know this, everyone has to know this. Right? I Googled how often do camels pee based on something you said. And I was, I was faced with this sentence. They are so good at retaining moisture that their urine has the consistency of syrup. And now I'm never gonna be able to get that in my head. So that's your fault. And I needed you to live with it as well. Oh, my

Melanie 12:00
goodness, no, I don't know if I should say that about my child. Or like, what a visual.

Scott Benner 12:07
Camels urinating frequently in their pee is very concentrated. Oh, FYI, their droppings are also very dry. Yeah, well, thank you for that. Let me just click off this. And let's see, oh, my goodness, I got actually like, I felt weird. When I read the sentence. I was like syrup. Oh, my God. No, no. Anyway, now that you've been torched, you've been tortured with that. Now we can all live. Actually, I guess there's a lot of people as they did now, y'all know. So it's my take

Melanie 12:33
me a minute to move on from that.

Scott Benner 12:34
I'm telling you. I got warm. Ma, I have a question. Yes. How old are you? Well, that's not only is that a problem, the answer? The answer,

Melanie 12:49
which is funny. I've had a lot of conversations about this because I'm going to be 49 this year. So I'm getting to a big, you know, milestone. Okay. I'm 48 right now,

Scott Benner 12:58
but you're my age is what I was getting it. Okay. And geographically. Are you more north, south, east, west, northeast southwest?

Melanie 13:08
Um, um, southeast. I'm in Georgia. Okay.

Scott Benner 13:11
So this is like, this is just a question. It's not a indictment. I have a serious question. Because my children now reside in Georgia a lot of the times. I understand that, yep. What happens when you get to a certain point going south, that no one drinks a diet drink anymore? Or a no sugar drink? There's very difficult to find.

Melanie 13:34
You know what, I don't know if I'm the right person to ask that too. Because now I will say this. I grew up in North Alabama, and we did not drink diet drinks. I mean, drank all the cokes and they're all called cokes to no matter what it was. Right? You know how that works? Yeah,

Scott Benner 13:53
like tissue like Kleenex like that idea. Exactly. Exactly. But

Melanie 13:59
I mean, I've in my adult life, and of course now, we only have diet trends. Now restaurants, is that what you're referring to like you go to a restaurant and you get Diet Coke or Coke Zero pretty much or Diet Pepsi side

Scott Benner 14:11
of the road gas stations, convenience stores, they're sweet tea, there's regular soda. Juice, it's hard to find something that doesn't have sugar in it. Like, I mean, I guess once you're in the grocery store, you can accomplish it. But I mean, like out in the light Grab and Go world. It's just very difficult unless I'm stopping at the same places over and over again. But I mean, I guess my bigger question is like, soda. I'm not again, I'm so sorry. I'm not talking to you. I'm really trying to understand, ya know, in my wildest mind, I can't imagine giving somebody soda but the world does it like don't get me wrong. I understand that everybody drinks soda and I'm not trying to come off like some like health nut because that's pretty obvious. I'm not that but but my point is, is that it's just It's such a weird idea. I don't know what happened as I was growing up with the idea of empty calories stuck with me really hard, but I don't think that happens to everybody. Today's episode is sponsored by ag one and I drink ag one every morning. I originally heard about ag one on a different podcast. I had been using other drinks and not enjoying them. So I decided to try each one and loved it. I was using it every day when they approached me and I was like, wait, you want to sponsor my podcast? I heard about this on another podcast. Alright, cool. So here we are. When you use my link, drink, ag one.com/juice box. Your first order will include a welcome kit. That's an ag one shaker scooping canister, the Ag one itself five free travel packs, and a year supply of vitamin D. I drink as you want in the morning before I start my day at one makes me feel like I'm giving my body the nutrients that it needs to get through a hard day of podcasting. I'm just kidding. It's not that hard to podcast but still, I feel great when I drink age one. Ag one is my foundational nutritional supplement. It helps me start my day. It helps me to support my immune system and I think you're going to enjoy it. So if you want to take ownership of your health, it starts with ag one drink ag one and get a free one year supply of vitamin D and five free ag one travel packs with your first purchase. Go to my link drink ag one.com/juice box that's drink ag one.com/juice box check it out. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily G voc hypo pen can be administered in two simple steps even by yourself and certain situations. Show those around you where you storage evoke hypo 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 voc hypo 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.

Melanie 17:47
I will say I know where you're hitting this if you're not out of bounds or like crazy, like I will say I grew up around a lot of that, you know, but once I guess to me, that was a Northern Alabama thing once I kind of moved away and grew up whatever. I also same thing like don't Why would you drink? You're at the time I thought it was calories. Now of course I think of it as carbs. Right? But you know, why would you drink your calories save those to eat?

Scott Benner 18:23
Like, listen, it goes without saying you would make a massive change in your life. If you just stopped drinking soda. Like it would just be such a massive change for your health. And I don't know that people know that people carrying extra weight, you'd probably lose 10 pounds in two weeks. Automatic Yeah, it's just like that kind of stuff. And right anyway, so like you're a lovely lady, and you're very thoughtful and everything and you're like my kid drinks root beer and root beer and root beer. And that always threw me off like

Melanie 18:52
so no, it's a joke. It's a joke we have actually because in the summer, especially, we have a boat, we have a swimming pool. So we're you know, always outside by the pool. You know, we always have a cooler packed or whatever. And for the most part, to be honest, we drink water. My son has always liked beverages like that. So when we're at the pool or on the boat or something a root beer is like that would have been a treat. And that is just a funny joke that we have. When I look back at his diagnosis story. I'm doing air quotes. Because my husband had just bought him root beer. It was not something that we usually kept around. Okay. And so the fact that he had had that was literally Wow, that was my first thing. Oh my goodness, we've been drinking root beer all week.

Scott Benner 19:42
Like this thing that he doesn't Oh, I see. Gotcha. Yeah. So

Melanie 19:45
like it wasn't really a normal thing. It was kind of a treat. And I mean, it was just literally he had had one like, right before we went to the doctor right

Scott Benner 19:57
now, by the way now it's hilarious.

Melanie 20:02
So just so you understand now, I mean, now I've outed myself. I grew up drinking that sort of stuff. But I didn't raise my kids with that. And it's so funny too, because I also had that whole thing of, and I don't know if this is just my age of mom world or what it is, I don't know, I don't have littles anymore. But I also grew up with that idea of like, don't, don't give them juice, right. Like, have them eat the fruit don't drink the fruit, right, like, Yeah, and so now we got juice boxes in every corner of the house, right? I used to never give them juice. So

Scott Benner 20:32
I hear that so often from people like we never drank juice, but now it's everywhere. And yes, yeah, yeah, I know. I watch art and drink a juice box when she has to. And it. It's like she's taking. It's like she's taking a supplement or a pill that she doesn't want to take. But she just but she knows it works. And so she does it. But I would imagine that if diabetes disappeared tomorrow, you would never see Arden drink juice again her entire life. Yeah, so

Melanie 21:03
well, and the funny thing about it is though, I mean, like, I do think he gets sick of it. Right? I mean, especially those middle of the night ones are whatever. But Shepherd loves my type one diabetic, his name is shepherd, and he loves sweet things and sweet drinks. And I don't know, if I had given him juice as a child, he probably would have loved it. But the funny thing like talking about all this along that line, it's another memory for me. Actually, when I was pregnant, you know, you have to do those glucose tests. And, you know, I'm drinking the drink, and I'm drinking it. And it's just awful. I mean, it's just terrible. And I think you have to drink it and like, they like time yourself. I don't remember. It's been a long time. Yeah. I remember looking at the nurse and like, gosh, that drink. It's just so terrible. Is that the flavor I chose or it's just has such this distinct flavor. I can't put my I can't put my finger on it. She was like It's sugar. It's like, oh, oh, yeah, I'm not. I'm not used to drinking that.

Scott Benner 22:05
Sugar. I'm gonna shut me off. I mentioned it on a recent podcast. I was somewhere where they had what they call Mexican coke. So made with real cane sugar. Still, I guess that's still How It's Made in Mexico. And I was like, I'm gonna try this. And I could, I couldn't choke it down. And I'm just like, there's so much so much sugar. And this is what it felt like to me. Hey, before we move on, there's a famous artist named Shephard. Shepard Fairey very. I'm not sure how he says his last name FA Irey. But he has type one diabetes, too. It's not a thing that he like. I hear Him say out loud very often, but he definitely has type one.

Melanie 22:43
Last name again. Of course. I have to look him up now. I mean, F A

Scott Benner 22:46
IREYU. Wow. Okay. Anyway, cool.

Melanie 22:55
Yeah, yeah. Yeah, I always like to share things like that. With Shepard. It's nice to have just two examples, you know, just move on to succeed. Do your thing.

Scott Benner 23:07
You I, you're always like, you're always trying to model like positivity and success to your kids anyway. But I take your point, like, I've done it. I've been like art and stop. Look, this is the Olympics. See that man skiing across the screen? That's Chris Freeman. He's been on my podcast. He has type one diabetes. He's in the Olympics. Like and then. And then she goes, Yeah, I mean, okay. And then she one time she was interested by something like that, but I still did it like Chris Rutan was on like, something called, like, I don't know, one of those gladiator TV shows. And I was like, watch this. And like, That guy's got type one, you know. So definitely,

Melanie 23:41
I need to find like, a professional like a bass fit my my type one shepherd. He loves fishing. I mean, that's his. That's his goal. That's his sport, mass fishing. He loves it. So I need to Google that. Now that we're talking about that. Yeah,

Scott Benner 23:57
there was somebody on Oh, now I get confused as to whether or not this is something I've recorded or something you've heard. But somebody was on recently, whose husband was like, like, I started to make, I started a mocker. I shouldn't have, but he like he fished in college. And I was like, wait, you fished in college, like people play baseball in college like that same idea. But he doesn't. It's a professional sport, which I was completely unaware of.

Melanie 24:24
And anyway, well, and I have to learn more about it. I mean, now, you know, this is just a blossoming thing. We tried the soccer. We tried the swimming, he likes swimming. You know, he's, he's tried a lot of sports. Like I said, he's really active anyway, but we live on like a little fishing lake. And he just would rather be fishing than anything. And it finally was like, just I just had to like, knock myself over the head and be like, this is his sport. This is his thing. Like just let him go fish. He's out and he's being active. He's, he loves it. This. This is the thing he's passionate about. And so I got to learn more about it. I think locally here. or you can't really get into it like on a team or anything until your middle school, but I think some of the high schools around might even have bass fishing team. So I got to figure it all out. It's a

Scott Benner 25:09
thing I didn't know about that, obviously. So, okay, so you leave the hospital, so only three years ago, it's during COVID. They give you a pen that they talk to you about glucose monitors, like, What's the sum total of what you understand that you're trying to accomplish? We

Melanie 25:24
get a pin. And that we get told that we will not be receiving Dex comms pumps or anything like that for at least a year. Right? It's this mentality that I hear people talking about, oh, well, you have to learn how to do it the manual way, you have to really learn the math, you have to really understand it. So I'm accepting this at this point, we're still in the hospital. Right? And you have to keep in mind too, I'm here going to the classes as as we do, they take the teachers, you know, the survival skills, basically. And my husband can't come. So I'm having to learn it for for both of us. And his only choice is to just read the manual, basically. Yeah. So that was really stressful. I learned the basics, and went home, just really was trying to depend a lot on free snacks. And, you know, how am I going to survive this, trying to teach my husband everything that I kind of, you'd have sometimes you just pick up things in the classroom that you can't get from the book or whatever. We're trying to learn all this together. Finally, I think it might have been like, two months later, wasn't too long. I finally broke into I was like, we're getting a Dexcom like this is this is crazy. Yeah, I remember now it was like right around, because he was diagnosed in May. And it was like the end of June, we get the Dexcom. So that was great. And that just changes the way you treat, honestly. I mean, it's hard to be really aggressive, in my opinion, or bold, let's call it bold and bright. It's hard to be bold. When your finger pricking all the time because you're not, you know, you got an eight year old kid, they're not wanting to fingerprick all the time. So we start this new management strategy. I learned a ton of that, from listening to your podcast, thank you so much for everything that you do. I it just, it changed everything for me. I mean, it really turned on a light bulb and made me you know, go back to that conversation where we were talking about the birthday and the hospital and all that. And I was like, whatever it takes guide me Tell me, I don't know, this is this whole new world I don't understand. Well, then I started listening to your podcast. And it makes me realize like, yeah, there was a whole new world that those guys didn't even understand. Right. So now I'm gonna go up to like this. Maybe they understood it, but they certainly weren't putting it on me at that point. Let's just say that, right? You know, I go up to this next level of this, this treatment. And I'm being a little more bold and doing things like splitting boluses for, you know, Paddy, or high protein meals and things. And then I realized I really needed a pump. So we started pushing for that. So then by October, we get the dash, he starts the Omnipod Dash. And I'll never forget, we had traveled to Savannah for a soccer tournament. We're big talker, his older brothers, huge soccer player. So anyway, but we were there for shepherd for a soccer tournament. That was when he still played and we got some really crazy lows at the time, because, you know, we still didn't understand activity in the pump and, you know, lower and do in lower Temp Basal and stuff like that. So we just learned just by jumping right into it, you know, there's

Scott Benner 28:38
no better way than it's, it's upsetting in the moment. And I understand why people might not want to do that. But having the experiences so that you can see them happen is basically the best way to figure it out. Yes, yeah. It

Melanie 28:53
really is. It's It was scary. At some time, you know, but yeah, you learn so much like, I'll never forget dosing him for a milkshake. You know, and you get these milkshakes at these places. And they're, like, 100 carbs or something just crazy scary, and I just boomed us at all at front. It's like, eight o'clock at night. I'm just, I'm like such a little type one baby at this point, right? I have no idea what I'm doing, you know, when he drinks it down, but of course, it's hitting real slow, right. And so he's going I'll just hit night. That night was terrifying. And I learned a lot. I mean, I realize, yeah, I immediately was like, wow, this is what I could have done a lot differently. You know? So yeah, yeah. Just jumping right in. That's

Scott Benner 29:45
the moment right where you think like, well, there's the number, and it's really impressive. Melanie, you made the first leap. You were like, well, this is way more insulin than we usually use. But if that's what the number says, then that's what the number says. And and you Did that which is laudable because most people are like, add nama to that. And then they end up getting very high and that fear stays with them. So you, you know, you caused yourself a problem, and then you figured out how to fix it. So you learned how to Bolus for the milkshake. And you learned how to deal with probably, I would say a stubborn low that probably lasted hours, right?

Melanie 30:19
Yeah, I don't know if I even knew what that was really, at the time, right, like, but now

Scott Benner 30:25
looking back, you see, like, oh, there's too much insulin in there, it was holding low. So when we were, we were trying to bring the blood sugar up, we couldn't because we were just really, half, you know, feeding the insulin that was already in there that didn't have anything to do. But I mean, like, all of that stuff is so valuable. Because it's hard for somebody just to explain it to you. You know, when you're when you're diagnosed, like no one's going to explain that to you. No one

Melanie 30:48
No, it's just it's too much they, and they know, that's what I was like, in the hospital. I felt like they just don't put that all on you. Because how can you and it was just it all it was for us was sheer terror. I mean, I remember Shepard, just like, literally, he was like, our oldest son had already gone to bed and he got in late. By the time this really started turning disastrous, right. And he, he looked at me and my husband and just was like, can you get jack in here too? I mean, you know, they say one of the symptoms of like, a really low low is like this feeling of like, just dread. And I mean, you could just see it, he was just like, oh, no, like, this is awful. I've got it. I need my brother in here to like, we all have to be here together right now. And it was really sad and, and terrifying. But I mean, we learned, we learned a lot. You know,

Scott Benner 31:35
I watched art and deal with a low blood sugar the other day, so she's home from college now for probably coming up on two months. And now the quality of food, no disrespect to Georgia, but the quality of food is better. And as far as nutrition goes and cooking methods, you don't have to fry everything Georgia, there's, that's I'm just gonna say it. And, and so her insulin needs have gone down fairly significantly. I've stabilized or a one C and her variabilities. And she's like we made I made some changes to her settings. But she's still like, once in a while. They went out to lunch, my what day. Those people, my wife and my wife and my daughter went out for lunch. And Arden was aggressive. Like she was at school. Yeah. And about two hours later, maybe two and a half hours later. She's like, I'm getting low. And I was like, yeah, she was Yeah, I don't know why. And then she went back and looked at everything she did. She's like, I did everything the way I would have. And I was like, Yeah, I think maybe the food's just different here. And so you know, it can be you can find it. I'm sure I could find the same food in Georgia. But it seems that every time I go there, somebody's giving me a Ben Yeah, and putting nine pounds of like powdered sugar on top of it to the point where I can't even see the bank. I'm like, where is it under there? You know, and, and, you know, that kind of stuff. So anyway, so I watched your handle the low. And it was, it was protracted. It took a while for to fix it. And yeah, there's that like, far away? Look, you don't I mean, the numbers, okay, but they're not okay yet. And I did not get involved. Like, I just like, I watched her she was doing it. And I thought, but she handled this when she was at school, she can do this here to just left her alone.

Melanie 33:22
I try. I try not to go there. Because I'm just naturally a very anxious person, which has made this whole thing very difficult. But I try not to think about him going away and doing it on his own. But I also think like, there has got to come a time in his life where I don't, because I do that. I'll watch him. Like you were saying they have a look, I'll be better than me. I'm like, are you okay? You're coming up? Are you feeling better? You know, like, what do you need more? Like, do we need to prick your finger? What's this timing? And I think, Gosh, this is this has to be so annoying to him. For me it just be after him on this, you know, but it's kind of a real thing. Sometimes, especially, you know, when you throw activity in. For us, summer is so hard because we are so active. We have company at our house all the time. And, you know, it's like a vacation. You know, you're just you're you're not eating right, you're you're doing different activity, you're going to bed at different times, right? Like everything's just kind of wild. And that's, to me, that's just makes diabetes a little harder, right? It's a little more of a challenge. I mean, even your pump settings and stuff are timed. You know, so yeah,

Scott Benner 34:34
right. Yeah. And then you start leaving that back clock is set up for you. You don't really think about it that way. But it is it's set up to match what normally quote unquote, happens to you. And then you move normally three hours later when your Basal is 20% lower, because you're usually sleeping and problems. So and then people then people like me say things to you like well, there's a lot of variables and you Yeah, thanks If I did notice,

Melanie 35:03
well, and it's funny, because I don't know why I'm the way I am. Okay. We

Scott Benner 35:09
wait, Melanie, what does that mean? Go deeper on that.

Melanie 35:13
Let's go. Let's go. I guess what I was about to say is things like, like if he sleeps later, because our ratio changes for breakfast, he has a lower ratio or higher. Anyway, the number is lower. He's one to seven for breakfast right now. And then he pops over to one to nine, at like, I think it's like, was 10 o'clock when we were in school. And then when we got into summer, eventually changed it on his pump to 11. But I can't tell you how many weeks I went of like, oh, no, let me just figure this out and manually override the pump for the right, right? I just for I hear all of you guys, I'm wish that my mind works that way better, where I could set up like these different, like, or change the settings? I just would almost because I guess I just feel like, Oh, it's just gonna change back in a minute. Anyway, I'm just gonna work through this, you know.

Scott Benner 36:05
So first of all, this is such a common problem, right? You get your setting set. And then you think, well, that's done. And you don't think about that anymore. So now all of a sudden, I don't know, like, you know, you're not getting the same result at a meal that you're used to be terrific at. And instead of just thinking, Oh, I might not be using the correct amount of insulin because maybe the kids put on three pounds or grown an inch or something like that, or it's been very sedentary this week. And usually he's very active. And like all that stuff. Like yeah, it's it's hard to keep that in mind in the moment. Also, I want to just kind of throw this in here because you said something. When when you're talking about your settings, or you said you were like higher or lower, I don't know, which is at higher or lower it. It helps me immensely to talk about it as weaker and stronger. Yes, that those words helped me a lot when you're thinking about carb ratios. correction factors. Basal insulin, I'm making my Basal Yeah, I'm making it stronger. I'm making it weaker that so

Melanie 37:02
yeah, so like his breakfast is stronger, right? Yes, yeah. Agreed,

Scott Benner 37:08
right? No, it's just so much easier. More aggressive, less aggressive, whatever the word is work for you. Yes, but yeah, higher and lower is meaningless.

Melanie 37:17
Yeah. To me, it doesn't fit right. To me. Yeah. Well,

Scott Benner 37:21
yeah. Especially because when you like using your insulin to carb ratio for an example, if your insulin to carb ratio was 100, and then you make it, I don't know, 90. There's a, you lowered your carb ratio, which makes it feel like because of the words being used, that you've somehow made less than two, right? But you've made it stronger, because now one unit, instead of covering 100 carbs now covers only 90 carbs. Exactly.

Melanie 37:51
So you understand why I get confused. It's like opposite Kinda,

Scott Benner 37:55
yeah. That's why the words help there. So anyway, thank you. Thank you weaker and stronger, aggressive, less aggressive, whatever you want, no matter what. Alright, Molly, so things are rocking along, you're figuring things out, got them out, you're being active. You're not scared, which is pretty crazy. Why aren't you scared? Oh, I'm

Melanie 38:15
scared.

Scott Benner 38:15
But why aren't you buying this fear stopping you? From playing soccer from trying things from bolusing for a milk show? Well,

Melanie 38:22
first of all, I had decided early on as far as activity and the things they were going to do this was not going to change our life. It's not I mean, period. Can we be as as free and spontaneous as we were before, unfortunately, now, and that hurt me? I mean, that hurt me like to the core, that part of it. I mean, I definitely went to therapy, let's just say that I grieved that loss. But I was like that is for because he was so young. Let's say that. That was for me my burden to bear. I was going to figure out how he would never really realize right, like, I'm like, he's young enough that he is going to this is going to be His way of life. Right? You know, he might remember before diabetes some. But if we do this, right, and we and we start off on the right foot, and we're doing this from a health conscious standpoint of like, this is what you do to be healthy, then I'm going to figure out what the this is. We're going to learn to do it. And you're going to just keep doing your thing. And that's I don't know that's just how I decided I

Scott Benner 39:37
was going to deal with was that you being stubborn at first like this isn't going to change anything or was that you being hopeful? You know,

Melanie 39:43
I think it was probably hopeful. Okay, because down deep there I believe there was a voice telling me that everything was changed. Oh, okay, if that makes sense. Like I mean, I struggled with This I mean, like I said, I think I was in shock at first. And it was weird. I felt, I felt very unsupported. when this first happened and very misunderstood when he was diagnosed, are the best words I could use. And it was not for lack of a wonderful community of friends, family and all that none of that they were all awesome. I just I think I felt isolated because, and I think most of the people who are listening to this will understand it is sort of misunderstood. And it's a lot of ways of learning this new way of life that you realize nobody else has to deal with. You know, it just it felt very isolating to me, but I wanted everything to stay the same. So hard, you know, like, I was working so hard to make everything stay the same. I don't even remember what the point of this was because I started getting a little emotional. Yeah,

Scott Benner 40:57
I hear you, you're fine. So you just were fighting something that felt like it couldn't be fought, but you were gonna fight it anyway. Yeah, try to will it back into where you wanted it to be? Right, like,

Melanie 41:10
I was gonna man handle this diabetes, right to be to fit us. We weren't going to conform to it. I mean, obviously, we got to have the insulin, right. So like, we do that. And we, anyway, I just, I wanted it to be good. And I want him to be healthy. You

Scott Benner 41:28
You went to therapy for that? Yes. Yeah. What did they help you with?

Melanie 41:33
I think in any therapy situation, this is just my opinion, of course, I think just talking about it was what I really needed. Because to take it a step further, you know, talking about it to my friends, was something that I did at first, a little. But I got to the point that I felt like this broken, sad record, right over and over with the same things that I also I didn't like, I felt like, I didn't want to tell anybody about it, because I felt like nobody was really understanding. So anyway, that therapy, I think just helped me to have somebody to just unload just week after week of all the things that I hate about this, right that I I just generally am a positive person. And I felt like it. It just turned me into this. Like I only had negative things to say, yeah. And I didn't like that direction. And so it socially, I am a very social and outgoing person socially. I was starting to retreat. And then it was kind of compounding things, right? Like, then I really I wasn't talking to anybody. My husband understood and I can talk to him. I don't want to gloss over that we had each other of course, but it just wasn't the same. I don't know. So that therapy, that's I think that's how it helped me because I just went and just complained, complained and complained and got it all out. You know,

Scott Benner 43:10
I'm gonna sound like I have a rawhide wallet, that I made myself with a peace sign on it. But it's all mindset. Yeah, everything's mindset. Like like the idea, the idea that you're going to manhandle diabetes, like, I love that, like the feeling like I've got this, I'll knock it over, I'll run through it, whatever, you know, blah, blah, blah. But then once you realize you can't physically change the nature of not making your own insulin, you know, like, yeah, then you recognize there is still a completely normal life. And it's up to you not to fight against that in your mind. Right? That really is what ends up being like, I've talked to so many people who have issues that they're trying to get past, a lovely woman just last week on the podcast, who's blind, someone who's in you know, a wheelchair, then, you know, like, all these everything in between. People have had like cancer over and over again, or have lost children to horrible accidents or like, by the way, I didn't think any of this was going to happen when I started making a podcast. But now I've had all these experiences talking to these people. And I'll tell you, the ones that do well, are the ones that don't fight the reality. Yeah, that's it. They don't fight the reality. They say this is it. And so I'm gonna live very well here where I am. And that's, I don't know, it just it seems like it's mindset to me. And that's where if you're not careful, and you're just talking too quickly, or being flippant, you would say something like, I mean, there's a phrase I use in my personal life that I don't think I use in the podcast very often, but sometimes I look at people and I say, Oh, they want to be upset. Uh huh. Yeah, yeah. And it's not that they want to be upset. It's that it's their inclination to get sucked into that void. And so they kind of they almost like throw They're hands up and they, and they become a part of it. They're just like, I'm gonna dive in and be miserable along with this miserable situation. I could we could all do that everyone listening could just say, I have type one diabetes, my kid has it. They can't XYZ or these things are harder because of this. I'm always worried. This is the possibility insulin could kill me like you can you can run through all those things and make yourself go Oh, yeah. Wow, this is terrible. Right, right. Or you could look up and see Chris Freeman skating along and the other skiing along in the Olympics. They go that guy's got like, what appears to be 3% body fat? He looks like a for sure. Yeah, yeah. Like, apparently, this is all doable? Well,

Melanie 45:39
and I think that what you're describing is what was almost the worst thing was that what was happening to me, because I've always had that Sunny, I mean, are just that sort of outlook of like, you can just decide, you know, you just decide to wake up happy, decide you're gonna have a good day. Like, it's how you react to situations and blah, blah, blah, and all the things right about mindset, okay. But I was just falling into this D. Like I said, he was like, weird, it was like, one thing would lead to another, like, I wasn't even doing it on purpose. Like, like I was saying, like withdrawing from my friends or, you know, stopping talking about it, or whatever, it just, it just kind of started happening. And one thing led to another and I was like, this is getting dark. Like, I've got to get out of this like this. And, and so, all that to say, then I was having these really negative feelings about myself, almost judging myself, right? Like of like, God, how are you letting yourself get this way? Like, you know, get over it, let's move on, let's do this. But there was a part of me that just couldn't move on the way I have been accustomed to do with other challenges in my life, you know, you're

Scott Benner 46:52
stuck like something and not you consciously but something in you wants to be in that space. That's right, right. And maybe it's, maybe it's sadness, maybe it's depression, maybe it's just that feeling of loss, that it's hard to get past. But the truth is, this is terrible. Like, I'm just gonna, like preface this by saying unless you have some sort of mental illness, that is that is stopping you, everyone else, there is a conscious decision to be made. And so at some point, you have to say, I am no longer going to respond to these influences the way I am, I'm going to respond to them differently. And trust me, I know better than anybody. Because, I mean, there I was, I was a stay at home dad, my two year old daughter had type one diabetes, we're in the hospital, everything's going crazy. And all I can think is, oh, we're gonna go home, my wife's gonna go back to work. Like, this is going to be on me. And you know, if you listen to podcast long enough, you know, my brain, my wife puts it in my brain works backwards from now, whenever I hear I think, no first, and then I find a way to it. And like, whereas you might have been like, we can do it. I'm like, this isn't gonna work. And then, and then I try to find reasons why I'm wrong about that. It's just my thought process. But somehow on the other side of it, I am an eternally hopeful person. Like I wake up every morning, like yesterday did not happen. So yeah, I started fresh, right? I think that I mean, my mom's passing has helped me with this and watching her life, like completely unfold and and finish that, you know, it's a t shirt at this. It's a t shirt slogan, but life is today. Like, what happened yesterday is gone, and it doesn't exist. And you have no idea what's going to happen tomorrow. Like, this is life right here. So are you gonna sit around and bemoan it? Or are you going to live it? And I think that's the decision really. Right.

Melanie 48:51
Well, and you mentioned your mom, I think that was a piece of it. For me. I think it brought back a lot of grief. My mom passed away. 12 years ago, she was a nurse. And you know, when stuff like this happen, I mean, even my friends growing up, you know, they always call my mom Hey, advice, this or that, or whatever. And for me, it would have been great just as to have my mom, you know,

Scott Benner 49:13
also, yeah, sure. Now, this is happening. It's one sort of a loss. It's a loss of when your son's diagnosed, it's the loss of what you think life is going to be or almost what it was supposed to be, right. Yeah, yeah, that's right. And then and then there's like, some, like, little bit of your brain that it's like, here, this would be a great time to screw with Melanie. Remember, your mom died? Like, why?

Melanie 49:35
Exactly. Wouldn't it be nice if you had her here now? Huh? Yeah, well, too bad little girl. She's gone. Yeah, kind of like

Scott Benner 49:41
now you're eight years old and you just skinned your knee and nobody's coming to help you. Yeah, except somebody gave you a baby and it has the skin needs to now you're laying on the ground with your dad. You're like, oh, I don't know what to do. And it's

Melanie 49:52
funny you were saying this was a this was another diagnosis store like thing for me. You know you're in the hospital. They come in at two am they pick his finger? They give him a juice. You know, I kind of rouse a little I'm like, oh, yeah, you know, when you're in the hospital, they do the rounds, they come check on me, right everybody, I'm not thinking diabetes at all. Because I know nothing, you know? And, you know, I go to class the next day, and they're like, yeah, and you're gonna want to set your alarm and you're going to check his blood sugar every, you know, night at, like, around 2am. And I'm like, oh, oh, like, that was on purpose. Like, I have to do that now every night.

Scott Benner 50:30
Like I normally sleep at that time.

Melanie 50:35
Be true. Are you joking?

Scott Benner 50:37
To tell the diabetes to just like, you know, calm down overnight, or something? Or could it take a break? Doesn't it sleep? I know. That's that realization. Yeah. And then and then you do the thing. You do that, like everybody talks? Like, it's always the parents, right? They're like, well, I just won't sleep anymore. And then they actually try. I tried it for years. Like, I just want sleep. Yeah, it didn't work out. Well.

Melanie 51:02
I mean, the thinking just goes downhill with no sleep, right? Like, the days become a little less productive. So I will say this Omni pod five, we started it in May of last year, what's this year, so May of 2022? Like, I mean, literally, they were just rolling it out. I feel like I told my endocrinologist that it was released, right? Like it was, it was amazing. We jumped right on board. I was so excited for it. In the first round, you know, we all just got new PDFs and had to like, reset, reset everything or whatever. But the first round, I'll just never forget. It was literally first pod, no learning No, nothing. Boom, we sleep all night, for like three nights in a row. And it's like, you know, those first nights of sleep you get after a newborn, I was like a new person, you know, getting all this wonderful rest. Oh, great hours, you know, you

Scott Benner 51:52
just I'll tell you, I say it as much as I can. Sleep is one of those things that drains away very slowly. You don't see it coming. You're a different person, you can't react the same your emotions are different. It throws your hormones off, it throws off everything about you. And you turn into a different person and don't realize it.

Melanie 52:14
Yeah, so true. I mean, hence the therapy. Like that was literally like, that's one of the things my therapist was like, I think you're having an identity crisis. Like, I don't think you know who you are anymore with this new situation. And I'm sure I mean, yeah. Okay. Yeah, I was like, that sounds right. Let's talk more about that. You know, because probably what you just said, The all of those things combined are just it's just not a great recipe some days, right? Like,

Scott Benner 52:40
you don't recognize that the person you are today, like take diabetes have an extra second, whoever you are, you're the Melanie you are. It is a slow transformation from that person who was born that went off to school, like you build slowly into a person. And then suddenly, someone rushes up to you and says, So many things are going to change, that you're not going to even see them happening. And you can't take time to assimilate. You can't take time to learn. You can't grieve there's nothing to do because if you don't do it right now, Sea Shepherd over there, he's gonna die. And you go, Oh, okay, so you're in a fight or flight mode? 24/7 constantly, and then two days into it. Somebody goes by the way, that'll be while you're supposed to be sleeping too. Yeah, yeah. So so yeah. Even in a war movie. They'll say, I'll take first watch you sleep like no. Like, they

Melanie 53:35
recognize that you can't I mean, the way there's like sleep deprivation training and right, like, it's

Scott Benner 53:40
makes people crazy thing, by the way. Yeah, you should look into what they do to Navy SEALs to train them in that in that buds progress. Yeah, they don't let them sleep for ever. And it's very few people that can can like still function in that situation? Right. Yeah. And it's certainly not Yeah, it's not me and Melanie, that's for sure. Oh, count us

Melanie 54:02
out. Yeah.

Scott Benner 54:05
Yeah, who's gonna row the boat? Not me.

Melanie 54:07
Well, and I feel, I think to again, identity, we're talking about identity and me, I am out could just go ahead and say it it because I feel like I try to find the strength in it. A lot of people look at it negatively or whatever. But I'm a little bit of a control freak. I mean, I like to have a little bit of a handle on things. Okay. And, number one, diabetes, I learned pretty quickly. Go ahead and just let that go. Because sometimes you're just going to have to react, you're not always going to be able to be ahead of things, right. The whole control thing was really hard. And then you go to school, then you go to school, okay. And then the nurses and the county nurses and the people all around are just like yeah, no, that's not no we can't we're not doing it the way you said because it's policy. Ah, I mean, that was a struggle for me. And I just am so grateful for all the ideas and things that are shared on our Facebook group in your podcast and all that, because that helped me get to where we are texting diabetes. Now, not

Scott Benner 55:15
only do you know you, you call it our Facebook group, and that almost made me cry for some reason. Oh my god, I'm so, so grateful you think about it that way? Well,

Melanie 55:26
I mean, it's always like the first thing on my feed. And I always get sucked into reading. I think even just reading what people are saying and reading the comments and things that people share it I've learned so much, of course, from the podcast as well. I mean, I remember especially the early days, just listening to the pro tips and all that, like, how how much I learned, but I do feel like it's ours.

Scott Benner 55:53
Filled up. I thought she thinks of it like it's ours. That's so wonderful. Yeah, like I I actually felt like, I accomplished something when you said that.

Melanie 56:01
Yeah, well, you have, I mean, put me sure in that, be sure that I don't get the

Scott Benner 56:06
feel that way, not only because I'm not a, I'm not mentally ill. So I don't spend a lot of time sitting around telling myself all the good things I've done. Because I think

Melanie 56:14
I'm proud of you. I just want to say that I'm proud of you, and for all the work that you've done, and you should be too because, you know, it's just a community and what I would find myself talking to like the school board, saying, like, look, there's a whole community of us that this is the way we do it. And it's right, because that's because each person, you have to understand each person that lives with this disease has to treat themselves individually, personally, and what they find is right, your policy doesn't dictate that right now. We're gonna have to learn to get along.

Scott Benner 56:47
What was that noise? Do you have a phone from 1984 in your house?

Melanie 56:51
No. I had the old fashioned ring on my.

Scott Benner 56:54
Okay. It's like, well, I'm at my grandmother's house. And it's 1978 I just heard that noise. I was like, exactly how it made me feel like I could I could picture where the phone hung on her wall with a 900 foot cord on it so she could walk around her entire house on the phone. Yeah. Oh my gosh, the way we live back then for sure. But I just listened. I just pulled up Arden's CGM while you were talking. And it was her birthday, two days ago. So we've been we've been to a couple of restaurants. And I'm looking at her last 24 hours. And she's been over 123 times. And under 70 ones in the last 24 hours. That's incredible. Yeah. And I look at the last six hours. It's astonishing, like she's, you know, was asleep. And in that time, I'll even go back 12 hours to like, I don't know, midnight. She had a rise that, I don't know, five or five in the morning. And the algorithm got ahead of it. I mean, this is loop, but it stopped her at like 120. She sat at 120 for an hour and a half. And then it just brought her right back down again. She's 86 Right now thinks she hasn't. She hasn't eaten yet today. She's been in the mid 80s for four and a half hours though. Like so. Yeah, there is a way other people do this. And yeah, yeah, please stop fighting me about it really would be.

Melanie 58:15
Right. Right. Like we have. I literally use your analogy in a Zoom meeting. You know, it was like our 504 meeting, and it was a zoom. I'm pretty sure it was your analogy about imagine Hi. You know, like a high blood sugar is picture what a piece of sugar looks like, how it's pointy, and you know, whatever. And it runs through your veins was that

Scott Benner 58:38
you said that? Yeah. So. So I literally looked at

Melanie 58:43
the people and I was like when Shepard is hot, because that was the problem. They wouldn't correct him. I mean, he would be at school, like over 300 all the time. I was losing my mind. Okay, like, yeah. And I was like, what does it mean to you when he has a high blood sugar? And they all just looked at me like, you know, I had lobsters coming out of my ears because they probably had never really thought about before. I mean, I wouldn't have either Okay, no, no worries people I get it but um, so I did that whole analogy it to me it means that there's like sugar inside his veins just like scraping away at his veins and it's not good. And I want to make that, that go away as soon as possible every single time. No exceptions. And you're gonna have to work with me on that. We got to work this out.

Scott Benner 59:25
Yeah, all of us here are dying at a certain rate. You my son is not dying faster because of this. Yeah, there's damage being done to his body. And I mean, there's damage being done to all of our bodies. That's part of being alive, but you need to speed it up. And by the way, there's a strong possibility I call this episode southern ear lobster. And I don't know why. But I think it would make people go What in the hell is that? And they'll have to wait a whole hour to hear it.

Melanie 59:54
So whatever it takes, yeah.

Scott Benner 59:57
Good. Yeah. I mean, I those were words. No one's ever said to me in my life. They look never heard from

Melanie 1:00:03
the Christmas story. He looked at me like I had lobsters coming out of my ears. Is that the Maybe it's from the Christmas maybe a Christmas? Is

Scott Benner 1:00:09
that the? Is that the pellet gun Christmas movie? Oh yeah, you'll shoot your eye out. Right. So I'm gonna say something that's probably gonna shock some people and piss off some other people. I've never seen that movie. So. Oh, no. Okay. Okay, that's okay. Okay. I came to movies. A little later in my life. I love I love going to the movies, but I came to it a little later. I don't want to like bum you out. But I was really broke when I grew up. Like we didn't like pay to do things. You know, go to things like I've never seen Animal House. I don't think I've seen that either. Yeah, but other movies that like, are

Melanie 1:00:50
like just Givens like the Goonies or like,

Scott Benner 1:00:53
there's a good example. I've never seen that. Oh, what's the one where the dolls turned into a mad dolls after midnight? Chucky or a gremlin? Yeah, I've never seen that. Oh, so I've never seen all I've seen I saw jaws in a theater when I was five. And then somehow I saw meatballs in the theater. Oh, wow. Yeah. Which I think was inappropriate. And then for a long stretch until Star Wars came out. I didn't see any real movies. Well, the

Melanie 1:01:20
Christmas story I will say this about this particular one, you know, I think it plays like 24/7 around Christmas time on like TDs or something like that is when I finally saw it. And I don't think I ever really saw it or actually sat watched it until I was an adult. I think as a child. I don't know if it was because it was the theme with the shoot your eye out thing and that wasn't into guns. But I never really got into it. But as an adult, I could really appreciate it. It's good. It's

Scott Benner 1:01:47
classic. It had to be firm, but subtle. Flick says he saw some grizzly bears near Polanski's candy store. They looked at me as if I had lobsters crawling out of my ears. I could tell I was in imminent danger of overpaying overplaying my hand. So thank you. Yeah, I think it's from the Christmas story. But I don't I don't know what that is. Anyway. Yeah. My first movie was Grace. Oh, good one. Yeah. But I was really young.

Melanie 1:02:10
Well, and I'll say like, to your point, I mean, we didn't spend a lot of money doing that kind of thing. And you mentioned Greece, back in the day when everybody had VCRs. And you could like, we didn't even have a VCR. I remember for my birthday, I wanted to sleep over. How are we going to watch movies and stuff. We didn't even have a VCR. So my mom rented a VCR, for us to have for my birthday party.

Scott Benner 1:02:35
Oh, that's so nice. So here's one of the ways that I look back in hindsight. Now I know, my dad knew he was leaving us. And then he felt bad about it. So he started buying us things. And one of the things he bought would have been in let me I'm gonna do the math at about in 1983. He bought a VCR for us. And I'm gonna tell you that we were broke in a way that is hard to put into words, and a VCR back then, you know what it cost? I don't know. But I know it was a lot $1,000 Oh, my gosh, wow. In the early 80s, my dad probably didn't make $20,000 a year, you know. And so he bought this on a credit card, obviously. And it put it in the house. And then we would have to go to a pharmacy that was nowhere near our house. And they had a little room in the back where they rented tapes. And you had to give them they had the I think that there was like a deposit on everything you took out like, like every VHS tape was worth like 100 or $200 to them. So if you if you didn't return it, you'd be charged like this exorbitant number. Wow, to bring it back because they could bear they could they could only get a certain amount of them from the movie company. Yeah. And that's why you had to return it promptly. So other people could have it because they couldn't afford to have them in there. And be kind and rewind, yes. And rewind your tape so that other people don't have to like put in a tape. And it's not rewound yet, which is, you know, in a world now in a world now where you put your phone down watching live television, and then go to a computer and turn it back on and it knows exactly where you were. That must be a weird feeling for people to hear. Yeah, yeah, those things were incredibly like, I knew one person who had a VCR. And they to me were wealthy. And then when we got it, it was probably like, seen by the other people in my town is like the most white trash thing in the world that like our broke SS had a VCR. But oh, they didn't know that my dad was planning on leaving us and he was trying to be nice.

Melanie 1:04:40
He had a plan. Yeah, he's like, here's a man with a plan.

Scott Benner 1:04:42
Here's things. Maybe that'll make you feel better when I walk out. They didn't mean to bomb us out. I'm not bummed out. But I'm 50 By the way, actually, I'm 52 I just learned the other day. So don't worry, I'm okay. I'm just telling you. I'm just telling a story. Okay. All right, Molly. So Omnipod five has been good for you. That's yeah,

Melanie 1:05:02
you know, we've had a really, really good experience, I've missed the extended Bolus, that that was really hard for us, because we used it at school to overcome recess immediately after lunch. You know, we used it as tricks for, you know, different things or whatever witch that I really miss. And then when we reset it this time, I just, I was gonna be so thoughtful about it, and really pay attention and make sure the settings were tuned in and blah, blah, blah, and I just copied over my settings from the other. And his insulin needs, like his Basal rate, man, it has really gone up. So you know, reset, try number two with Omni pod Bob was, it took us a while to get dialed in. But we're there now. Thank goodness. So I'm happy again. Congratulations.

Scott Benner 1:05:51
And the, the control thing? Have you given some of it away? Or are you because it's I mean, you're going through an algorithm, you're basically saying, I'm gonna let it do things like, is that fighting with that part of your nature? No.

Melanie 1:06:05
Because when it comes to that, okay, like, I have no problem giving over to some body or something that I think is better at it than me. And I think, right, it was designed to do that. So I'm trusting like, please, please do this. This is sometimes incredibly hard. I don't I don't, I don't want to do this. You know, I want you to do it, if you can do it better. So yeah. Well,

Scott Benner 1:06:30
good for you. That's I mean, a big leap. It's not an easy thing for people to do. So it's very cool that you're able to do it. No other autoimmune stuffs popped up since then. No,

Melanie 1:06:42
good. I mean, of course, I have a fear. I think about it a lot now, especially at first, that was a little scary. But I've gotten past it. We did order the is it the trial net. And, you know, I wanted my son to do it. And my older son, and we thought about it for a while he was terrified. He didn't want to just do the fingerprick was something and and finally he broke down and just told me like I if it's coming, I don't think I want to know, and I just decided to respect that. Okay, no, good.

Scott Benner 1:07:14
Well, it's I mean, it's the right thing to do, right? You gotta to old enough, means 15. Right? Well,

Melanie 1:07:20
yeah, this was he was probably like, 13 at the time, but he's one of those wise old souls that he finally realized. Either he he really felt that way. Or he realized that if he said that I wouldn't I can prick his finger. I'm not sure. But either way. We haven't done it. That's

Scott Benner 1:07:35
more possible, perhaps just maybe he's pretty smart. I can trick this lady out of poking my finger. I maybe I could do that. Yeah. That'd be great. If you're giving them all this, like, old soul, like, credit, credit ads, he's just like, he's like, no, no, I don't want to I just don't want to do that.

Melanie 1:07:52
He's like, No, I'm just manipulative.

Scott Benner 1:07:56
Alright, do you think you'll move to Dexcom? Seven g7. When it's available to work with only part five?

Melanie 1:08:02
I suppose I'm hearing mixed reviews. But I'll be honest, I say that, but I haven't heard that much like a lot about it yet. Because I'm, I guess I'm kind of focused on our tools. Right. Yeah. I mean, what I'm really anxious about is the Enable for him to only carry one device, just his phone. Yeah. Which, I mean, who knows when that'll come? I thought I heard it was at the FDA. Now,

Scott Benner 1:08:27
normally, I don't know anything. So like, because I don't know. I don't work there, obviously. But I feel like on the pods close to iOS, or on the pod five, that's the vibe I'm getting is that there's things that happen in the background and all these companies like like the day you get something's not the day they figure it out. You don't I mean, so there's a lead up to it. And you can kind of see when they're doing things. I'm like, Oh, these are the things you do before this happens. Like, like, that's the way to like I've been around it long enough. Now that I know that as an example ducks comes like, hey, we'd like to come on and talk about the g7. I'm like, oh, okay, it's a year and a half away. Here it comes. Yeah. Like, like, they want to start this conversation now. And then, like, you can see how they plan things out. And so yeah,

Melanie 1:09:18
I definitely remember your first podcast about it. I got super excited about it. And I believe that that was before the Omnipod five, right. And so I'm excited for the idea of it. But now I'm locked into Omnipod five, right, so until Yeah, till that happens. I think

Scott Benner 1:09:33
of it like iPhone control for on the pod five Dexcom seven with Omni pod five. I think it's, I mean, you and I are talking now in July of 2023. So I'll like this is my guess. But there's I think this happens before the end of the calendar year. That's my guess. Now we'll find out when I put this out if I was really wrong or not, but and it's based on nothing someone said to me, it's just like I'm watching them do what they're doing. And I'm like, Oh, it seems like it's about six months away. That's how it feels to me. So we'll see if everything goes right, great. Yeah. Meanwhile, it shouldn't. I mean, it shouldn't be that much trouble, right?

Melanie 1:10:13
Well, and here's the thing. He is a person who is not a fan of this spa belt. He wears it. Sometimes he plays flag football, he'll wear it during that, obviously, he doesn't, you know, he swims a lot. He doesn't carry them. But when he's at school, he just wants to put it in his pocket. So here he is, you know, the kids today, don't even know what a button or a zipper is. I feel like at least mine anyway, everything's athletic, you know, pants and stuff. So here he is walking around with saggy pockets with, you know, all these devices. So it would just be nice if he only had to carry the phone. You know, you mean

Scott Benner 1:10:46
that four times a day when I'm wearing like sweatpants, and I go wear my headphones hat. And then I go back to the last place I was seated. And they're like sitting behind the chair or in the crevasse isn't like, Oh, nothing stays in my pants. like that idea. Yeah, yeah. Yeah. Kinda like that. I know what you're saying. All right. Melanie, is there anything that we haven't spoken about that you wanted to anything I missed? I don't think so. I did it. I mean, you did it. You did it. That's what I should have said. I do really appreciate you coming on and sharing all this with me. And it's a great conversation. So I can't

Melanie 1:11:21
cool talking to you. I mean, this is this is surreal. What a treat today. Thank you for having me. Not

Scott Benner 1:11:25
only tell people about that from it, why is it you're so excited to talk to me?

Melanie 1:11:29
I mean, cuz you taught me everything I ever needed to know about topics that they didn't teach me the hospital.

Scott Benner 1:11:35
I say you owe me. Is that what you're saying? A little. Maybe. So Arden says to me the other day. She goes, You know, if mom dies, and I'm like, where's this going?

Melanie 1:11:49
Okay, I'm listening. You're gonna

Scott Benner 1:11:52
have no trouble meeting a lady and I was like, You don't think so? And she started telling me about like, who she thinks I'll end up with and all this is very weird conversation. She was your wife sitting there? No, no, she wasn't with us. But don't worry. We told her about it. We got home. And so she's telling me the kind of part she's like, I think you're an add up with this kind of person. Blah, blah, blah. And she goes and if that doesn't work out, you are such a catch for some lady whose kid has diabetes or or or a woman but type one.

Melanie 1:12:19
I mean, seriously. Nailed it. Yep.

Scott Benner 1:12:23
She's like, you're not gonna have any trouble hooking a type one lady, that's for sure. So then, you know, we're laughing because it's silly. And then we go home to like, so yeah, try to imagine that my Arden and I have like the same exact personality for the most part. And Kelly and Cole sort of share a similar personality. And I our shenanigans are not like they're not Kelly's and Cole shenanigans. Like, like dig. So Cole's gone. He's off working. He's near you, actually. But we we come home to share this with Kelly. Like, we're like, I'm like, Hey, Cal Arden's decided what kind of lady I'm going to be with if you know you should die. And Kelly looks up like she's working. She looks up like what the hell is happening? Again, then we start joking back and forth. And she's like, what's wrong with you guys? And it's and she says things like, it's so much worse when you're together.

Melanie 1:13:21
Right? It just compounds Yeah,

Scott Benner 1:13:24
because everything I'm thinking, Arden's thinking

Melanie 1:13:28
about like just bouncing off of each other. It's gotta be

Scott Benner 1:13:30
absolutely horrible to be involved in if you're not her. I so like, it's yeah, anyway,

Melanie 1:13:38
I noticed kind of a twisted. I mean, a little bit crazy. That conversation

Scott Benner 1:13:43
were like setting each other up for jokes that Kelly doesn't see coming. But we're, we're just we don't even have to look at each other. Like I say something. I know what she's gonna say next. Like, you know, we can kind of, it's like talking. It's like me being here with a copy of myself. So I love it. Yeah, Kelly's like, by the time it's over, she's exhausted by us. She's like, I'm gonna I'm gonna go back to work now. Yeah, yeah, but I'm glad to know what kind of woman you'll marry if I die.

Melanie 1:14:07
Like, all right, good. I was worried about that. I could check that off the list. Exactly.

Scott Benner 1:14:11
And we're laughing and she's not amused like, just so that I'm being clear with everybody. She's not

Melanie 1:14:17
I mean, no, this is this is awkward. Yeah, one of those really strange conversation

Scott Benner 1:14:24
not awkward to get into art and I so anyway, hold on one second for me.

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6. How should insulin doses be adjusted during physical activity?

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8. How should physical activity be managed to avoid blood sugar fluctuations?

#1116 Southern Lobster Ears

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