Scott Benner 3/15/23 Scott Benner 3/15/23

#868 Out of the Shadows

Lisa has had type 1 diabetes since she was a child.

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

Scott Benner 0:00
Hello friends and welcome to episode 168 of the Juicebox Podcast.

On today's show we're going to be speaking with Lisa who has had diabetes for almost 40 years. But she's not really that old. It's interesting, isn't it? Lots of perspective, still young person. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. US residents who are type ones or the caregiver of type ones, please go to T one D exchange.org. Forward slash juice box and complete their survey because the information that you will share will help to move type one diabetes research forward T one D exchange.org. Forward slash juice box go fill out that survey Juicebox Podcast listeners get 35% off at cozy earth.com That's off your entire order. So if you're looking for sheets, or pajamas, or joggers, or anything, just super comfy, check out cozy earth.com. use the offer code choose box at checkout to save 35%. Whether you're looking for individual couples or help for your team, better help is the online therapy place that you should check out better help.com forward slash juicebox. That's who's sponsoring this episode of The Juicebox Podcast. And so when you go to my link betterhelp.com forward slash juice box, you will get 10% off your first month of therapy. That's better help. H e l p.com. Forward slash Juicebox Podcast is also sponsored today by touched by type one head now to touched by type one.org. To find out all of the good things that touched by type one is doing for people living with diabetes. And if you look at their calendar, see what's coming up in the future. There's a speaking thing. It's in Orlando, it's months from now I know but I committed to being there. So if you'd like to hear me speak live, or you're just in the area and you want to check it out, touched by type one.org

Lisa 2:36
My name is Lisa Blaine. Hi Ken Hughes.

Scott Benner 2:41
Good and what do you have type one diabetes?

Lisa 2:44
Yes. So I am a type one diabetic. I was diagnosed at the age of nine. I'm going into a my think we are number 38. Having diabeetus

Scott Benner 2:58
38 years nine years old that makes you 47. Yeah. I was erasing something on my whiteboard while I did the math. So did you I

Lisa 3:10
know. I just grabbed my assignment paper to kind of do the math myself. Because yeah, when you when I say it out loud. It's just It's crazy. Yeah. How, how how long? It's been so

Scott Benner 3:21
I can imagine. So. Alright, so 30 years?

Lisa 3:25
Yeah, I know. No different though. So I mean, some people. They're just like they I just don't, I don't know what it would be like to not have diabetes. So I guess that's what I'm trying to say.

Scott Benner 3:37
Do you not remember at all the first nine years?

Lisa 3:41
No, like I do. But I was a kid. And when this came into my family's life, we were there was no other diabetics. I think I went to public school. And there was one other person. And that was it. And nowadays, it's just so much more common, which is it's different to hear so many people take to tape one. So yeah, at the time, I was the only one. So I mean, my family knew about it, but I wouldn't broadcast it. So

Scott Benner 4:15
was it something you kept to yourself? Yeah, it was

Lisa 4:19
something that I kept my like the family all knew like that. But when I went to school and stuff, I wouldn't really. I would never tell anybody.

Scott Benner 4:27
Well, what did it mean, really, at that time to have diabetes took a shot before you left for school and wanted dinnertime?

Lisa 4:35
Yeah, so I was I had to do. We didn't I did my needles. My family. I was in the hospital for two weeks when I was diagnosed and then my family had to eat that my sister was three and a half years older. So they took our family through everything explaining everything. My parents had to learn how to give shots. I think my sister did too, although she's never given me an needle, and then again, me being nine years old. And then I'd have to do a morning shot. And then I was on the think Lantis and monta. That's how important so that's how far back we we go and that, yeah, so I was on the two different insulins. And then there was a morning shot and evening shot as well.

Scott Benner 5:21
You know what I'm finding myself thinking, Lisa, is that I wish I wish I could talk to someone's parents from back then. Because yeah, I wonder what they were told. You know,

Lisa 5:32
and, yeah, and that's the one thing where I haven't just going through my journey, and I cannot imagine and that's where it really pulls at my heartstrings. I have, because because I have a son now, who's not diabetic, but I can't imagine because I'm just trying to I try to manage myself and do his scheduling and school and stuff. And I can't imagine having to manage that on top of it. I'm also gonna manage myself, but to manage a little one. Lisa

Scott Benner 6:05
would have run the recording while you're trying to get your microphone set up, everyone would completely believe you that you would not be able to do it. Being seated, though, I wonder if they were told that your life expectancy was shorter.

Lisa 6:20
When I was first diagnosed, my grandmother had approached my mom and said, I didn't I didn't look well, she thought there was something wrong. And and I guess she shouldn't say it like this, but she was kind of hinting at the that. She wasn't sure about me. Like just looking like I was like, I was very sick.

Scott Benner 6:42
Like your grandmother was like, That one's not gonna make it like like you were possibly Yeah, like that. Yeah, okay.

Lisa 6:48
Yeah. I think the tip of the iceberg what happened is, I remember I was having, like, I was young, probably well, between like, eight, well, not nine years old. And then I remember, I was so thin. And I hit it. Because you were in close and you go through growth spurts and stuff like that. But I realized how much weight loss I had, just because you see, I could see like my ribs and things like that. And when my mom came into the bathroom when I kind of hid from our end. And then she was just getting ready. And she told me that I told her that I was dying. And she just stopped everything she did. And and she said Why would you say that she was really concerned. And then she made the doctor's appointment, and then that's when I was diagnosed.

Scott Benner 7:35
Or you go, Oh, yeah, wisdom from an old lady. That kid don't look right. That one couldn't pull a plow, what are we doing? Right? I was even wondering about the doctors, like, I wonder like, when you go in and you're diagnosed back then I have to, like, do they tell you to they go, hey, you know, with current treatments, this is gonna shorten your life, or you're gonna have you know, who knows what could possibly happen?

Lisa 8:05
Hey, I don't know. I just know we went into the doctor's office. He they did a urine sample. And he came right back to my mom and said, Get her to the hospital immediately. Like, this is urgent. Yeah. I don't know what my blood sugar was that but obviously it was really high. So then they got me and admitted me. They set us up with like your setup with we have a doctor obviously to manage that they there was also a nutritionist or like a dietitian, sorry. And also a social worker to work with

Scott Benner 8:41
us. Okay, even back then. Well, that's pretty great. Yeah, so then let's kind of jump through the seasons of your life with diabetes. So early on, you were shooting the way you described earlier with insulin. Do you remember moving to a faster acting more modern insulin.

Lisa 8:59
I don't remember the timeline. I just remember like stages in life, like the growth type of thing. So newly diagnosed, you kind of it's like a learning curve for everybody. So we really focused on diet and snacks and things like that and balancing that out. And then being age nine, and then you go to that, that through that teenage years, where and again, both my parents worked that when they went through a separation so I was a grew up really quick having to manage this. So is in charge of that, so to speak, and then they would go with me to my appointments because we'd go to appointments like that and they would just review things. So then you go through that rebellion kind of stage where you're not testing as much as you should. And then I'm trying to think about college and things like that was getting a little bit easier, but then I entered into the fitness world and working out out and getting more on track with eating and really paying attention with that. So that kind of counteracted things. And then diabeetus has always been a background, so to speak, background, meaning I just I know what I have to do and like it doesn't kind of run me I just I work around it or I work with it.

Scott Benner 10:24
Well, I think it's really common for people who were diagnosed decades ago, because there wasn't a lot for you to do, really, I'm sure it felt like it. But compared to, I guess, compared to the diagnostics that day to day moment to moment diagnostics that we have available today. I mean, you were shooting insulin eating to a schedule, basically. Right. And then, and, I mean, honestly, the blood tests weren't very good, right? You're Did you ever use urine tests? Probably. Yeah. You might not. Yeah. Right. And so it was more like, I mean, honestly, back then it wouldn't have felt that way. But with today's perspective, it was basically like, Here, take this pill and test or, you know, shoot this thing in your arm and test here at because even when you got the test back wasn't much you could do, right?

Lisa 11:09
No, and they were just like, an especially being, they didn't have any answers for us. So it was a matter of your blood sugars. Because again, when you're taking that insulin, it's it's throughout the body, whereas now you can really play around with it with your meals, like we I'm still in that background. And then because I'm on the insulin pump now. But back then it was like, if your blood sugar was at a number, we just didn't have the flexibility, like we would never Well, in my situation, I wouldn't go and give an extra dose of insulin, whereas now that's what you would do, right?

Scott Benner 11:45
That's exactly what I'm getting at is that it was it was very just sort of do this, then do this now and go to the next day, and then say to yourself, like, I'm not letting diabetes hold me back. And you know, going forward, but you didn't. But what was happening to your health at that point, even were you tracking a one sees back then? Or how did you measure your health?

Lisa 12:07
Thanks, did track a onesie? So I think as I've gotten older, my agency has gotten better creep down, lower and lower and lower. But when I look, I mean, there wasn't a lot of like you said there wasn't a lot of outlets back then. So you would go to your, your doctor's appointment, they would tell you what your 81 C was, they would get you to work with your dietitian if there was any issues. And that was basically it.

Scott Benner 12:36
So so if you were if you were testing hire them, they would they would they would attach that to food and then try to change your food intake. It was It wasn't really about the insulin as much.

Lisa 12:48
Yes. And I don't think they initially said that. But that's something where it's been hard for me to get out of that mindset. So because it's not always and that's taken me some time realizing that everything comes into play with blood sugar's your hormones, your stress level, whether or not you are doing like, like weight training, or you're doing distance running. So it's really, it's been hard for me to not hard, but something that I've had to get my head around all day, okay with that, especially with the hormones and things like that. Stress is huge.

Scott Benner 13:31
It's a complete relearning of something that you thought you knew already. Yeah, yeah. Right. I mean, cuz you're going along for a long, you know, I'm gonna guess I mean, 38 years ago, right? I'm gonna guess that for 20 years, you pretty much manage the way we talked about and then one day somebody said, like, you should get one of these insulin pump things and you were like, Why do I need that? And then they said, Oh, you know, and then you how I mean, what year do you remember? What year you got a pump?

Lisa 13:59
Oh my gosh, that was a must have been how long? About four? Maybe? Just a little over? 10 Maybe going on? 15 years?

Scott Benner 14:08
Right. Okay. So so you get up

Lisa 14:10
and it was a learning curve to like it's different.

Scott Benner 14:13
And, and in the pump? What insulin

Lisa 14:18
we use. Oh my gosh, you're just I can see the box downstairs. It's just

Scott Benner 14:26
part of me. Humalog Yes, yeah.

Lisa 14:29
I think so. Oh, Nova rapid.

Scott Benner 14:33
Rapid here. Yeah. Canada. Yes. See, I should have said that three you said a couple of times and I

Lisa 14:40
wasn't human log before and then now it's a one called Nova rapid so it's a fast acting insulin. And then again, you're just way off you're on this property. I'm not sure but you just found a constant drip and then every time you eat or if you had to gesture and so then you can just go to the pump and to great Managing tool,

Scott Benner 15:01
please. I'm gonna give you a strange look into my mind. I heard you stretch out a couple of words. But your last name is hyphenated. So I put you in Minnesota, in my head. I was like, there are no fancy hyphenated names and

Lisa 15:18
I'm in Canada, Ontario, Canada.

Scott Benner 15:21
So I'm just saying I'm an idiot. That's what I was. That's all I was saying. But yeah, you I don't know if you were hiding your Canada but now that I said it, it's coming out more. It's interesting. Oh, really? Okay. Yeah, please. It's fun. I love Canada, because I've never been there and I have no actual perspective for it. I don't really know. I just know what I've been told. Okay, moose, squirrels, snow, sled dogs. That's how I say it. I'm sure Yeah, depending

Lisa 15:48
on how the snow No.

Scott Benner 15:52
Well, okay, so, so Okay, interesting. So you started when you started, you got to a pump. Even for people listening nowadays who have come in at a more modern time. Even getting a pump wasn't really what it was. What it is now, like back then they were just like, Hey, you don't have to do shots anymore. Right? Yeah,

Lisa 16:08
I think the biggest thing and this is just I think the biggest game changer for technology wise. Is the blood the blood testing sensors, CGM? Yeah, yeah, those in my, in my perspective, just from they can really they can improve someone's health like with diabeetus. So much,

Scott Benner 16:34
ya know, I am always fascinated to talk to people who have who were in the before place. So you get your pump about 1015 years ago, which is not what that's not that long ago. That's in 2004 2005 range in there. And, and is that when the learning started about modern management, or was it not till you saw a CGM, and do you have a CGM? Is that correct?

Lisa 17:00
Yes, I did. Yeah.

Scott Benner 17:01
How long have you had that?

Lisa 17:03
Um, probably three or four years now. So I'm still a little bit old school when it comes to that my CGM doesn't talk to my pump. That's what they eventually I will go to that. But I'm just, I just like the I'm on the libre too. I just like that one because it lasts for 14 days. And I don't have any issues without falling off. It's just like a second skin. So just on the back of my arm, but I did. I was between sensors, just a perfect example probably two weeks ago. And just to give an idea, I tested my blood sugar sounds terrible, probably three or four times in a day with doing the manual blood test. When I'm on the CGM, I will scan my blood sugar 26 times a day. Okay. Yeah, that's it. So that's a huge difference right there. And when it comes to just in my mind that it just gives you that much more control over diabetes over managing it.

Scott Benner 18:04
Yeah, no, of course, it's a, it's a completely different window into what's happening instead of instead of those snapshots in time, and going like my blood sugar is 145 right now.

Lisa 18:15
I love it, like the technology that way, and just seeing what's going on inside your body. Like you can know when a sec, I mean, it might not be exact, just depending on your reading. But again, it's close enough that you have you know, and that's I think is a huge privilege to us, diabetics, that's just my personal opinion, I agree. Because with me being very active, I can like, I can go for a run, I can see what that exercise is doing to my pleasure, I can see I've even done a comparisons. Or I've seen where I've eaten a plant based black bean brownie, in comparison to eating a regular Browning, how fast my blood sugar will be driven up by having like a white sugar base, compared to a longer acting carbohydrate. It's amazing. Seeing those little windows, it's trying to explain that to people who are trying to even if they're just regular, they don't have diabeetus and they're trying to manage or get a hold of their weight control or just trying to understand things. They tell that's very interesting to me, because I figure that everyone knows this, but a lot of people don't have any aspect of the nutrition and I'm not knocking anyone I'm just saying that's what has helped me having diabeetus is to and that's one of my goals is to teach people about nutrition and what's happening behind the scenes and the body from from that perspective, I'm

Scott Benner 19:31
gonna say one thing I will get to that kind of what you do for a living stuff so it's very interesting to hear you talk about this because it's super is because I you can hear there's like almost like a childlike wonder because you lived through it so long without this stuff. That that your perspective is like, hey, there's a magic thing stuck to my arm as whenever I want to see my blood sugar. I just hold up the sensor to it and it scans it and there it is. is. And isn't that crazy? Because, you know, I'm not going to test my blood sugar that many times a day you have no, you have real like, it's easy to say old school but your perspective from a different time, and you can hear the wonder in your voice about the technology and what it offers. It's some. It's different than talking to somebody who has what, what is it? It's, um, it's an expectation. You don't have, you don't have the expectation. Because you knew a time without it. People who come in now, who will say like, I got the CGM, and it said, my blood sugar was 150. But I tested my blood sugar was really 140. This thing's not accurate at all. And you're and you just said, like, you know, close enough. And I was like, Ooh, that's a really like, because I feel that way. Because I've seen I've, I've raised a small child with diabetes without a CGM. And so and so when I see a number on my daughter's CGM, and it's like, it's, you know, I don't know, she's 78 I passed. And she's really like, 69. I'm like, Cool, close enough. And it's a leap that I can make, because I've seen it before. Whereas people who come in now are a generation of people who are accustomed to cell phones that are powerful enough to, you know, do what they do. And they have instant technology, and they expect things to work constantly, which you know, technology is always evolving. And no one no one thinks like, no one thinks about, hey, this company devised a way to stick a little thing under my skin. And there's something about what they coated in that reads the interstitial fluid in my body and tells me what my blood sugar is in real time. Or when I scan my thing if I've got the libre, whatever it is, like, they should hear that and be like, that's insane. And instead, they're like, it was off by six points. This thing's junk. And I'm like, what? Lisa here is just like,

Lisa 22:04
it's just you. Yeah, because I just remember as a kid, like, I didn't want to test my blood sugar. Like I just even now when I was without my sensor for a few days. I was annoyed because I'm like, how am I gonna do this? I'm working in a fast paced job. I have to stop and do this. And and just, I felt like I have trouble managing without a sensor. Yeah, like I can do it. But it's just it's such. Oh, just

Scott Benner 22:28
Lisa. Let's be clear. It diabetes way easier with the CGM way, way, way easier. Yeah, I'm just I've just, I just got caught up in a minute. Because I can hear people in my head being like, you know, my, my CGM was starting up. And I had to test my kids blood sugar three times in two hours. And I'm like, There's part there's a part inside of me that goes, I get what they're saying. And they want the technology to keep improving and I'm sure it's going to, but there's another part inside of me that raised a two year old with diabetes with a meter that looked like it came out of a bubblegum machine who's like three times in two hours? Yeah. Oh, no. Are you okay? You know, do you mean like, yeah, two different perspectives?

Lisa 23:05
I can't imagine. No, I

Scott Benner 23:07
love you. Okay, so. So let's just tell people like what do you do for a living?

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Lisa 25:46
Right now I'm just I've taken a step back from things. So I'm on that whole my journey of a new path, but same same industry. So again, I did well back in the day, I just jumped around from job to job to job, and then just kind of say this like fast, like fast forward. So having that fitness background did personal training, like studying and then just I newly, I just finished my diploma as natural holistic nutritionist. So that was a May. So I'm really happy about that. And then I was working in a health food store and working, doing like demoing and promotions for a new supplement company. And then now I am into I am a wellness and dietetics manager at large retail corporation. So right now I'm just learning like I'm just doing more background things and setting up kind of like the a wellness nutrition department within a large retailer here in Canada. And then going forwards my goals is they really want to promote nutritional guidance for people. So my goal is to hopefully be running the department and being able to put together classes of information.

Scott Benner 27:13
So where do you think the interest came from? Like, was it because you talked about earlier when you're young, right that things were adjusted through nutrition? And is that how that started for you?

Lisa 27:24
I don't know I thought about that, because my mom was just like saying things like to write. So it's just and I tried to figure out what came first if it was because I wasn't very athletic or anything growing up like I played some sports, but it wasn't really I wasn't really driven towards that. And then having diabeetus going to high school, I wasn't on a sports teams. And then I got my first gym membership. I don't know, late high school. And I just stuck with it. I think I think it was something and then now that I'm older, I just find it's more it's become more of a I'm very passionate about it. It's a hobby. It's something where you can kind of envision something and then do the work. It doesn't feel like work to me. But I can see you can see things change.

Scott Benner 28:21
A little bit about goal setting reaching a goal setting a new goal. Yes, that's right. Yeah, that idea.

Lisa 28:27
Yeah. And then with the nutrition, I don't know where that came about. I remember when I was doing the personal training back in my 20s like going to the program, nutrition would come up and I found notes that I've found like at this age, and I'm like who wrote this, they were my own notes about it, we had to deal with supplements because I have this love for the science behind supplementation and all that vitamins, minerals, all that I could talk your head off this. I mean, I love that stuff. It's the science behind it. And then And then again, when I was upgrading my personal training, that sometimes can be a struggle for the learning because it's just so black and white, the muscles and stuff like that in the body. But when nutrition comes up, it's like I know what, like the back of my hand. So there's something there with myself and nutrition. I don't know I just pick up on it.

Scott Benner 29:21
So you so do you think nutrition, the way you think about your nutrition is, is just would be in specific it's not that you don't have meaning you don't need to be meaning which what I what I want to say is I just use the wrong word. But what I was gonna say was, is it for me because of your diabetes or just because you're a person.

Lisa 29:44
I think that diabeetus has helped that because I have I have a true understanding of how foods can break down in the body when it comes to their blood sugar. So when I'm talking to people try not to get too scientific because they get that kind of clouded over vision, although they are interested. But I don't realize how much we as diabetics know the science behind the like how things break down within the body. Yeah. Which I think is just, it's just something where I mean, nutrition doesn't have to be hard and stuff, but there is there is science behind it, too.

Scott Benner 30:21
So are you talking about digestion? And how digestion of food impacts your blood sugar? Are you talking? Yeah, it's

Lisa 30:27
just just different foods and things like that. And just yeah, like, how it really breaks down? I think diabetics have a more understanding a more in depth stuff, nutrition.

Scott Benner 30:38
Yeah, we definitely see the impact of food in a different way. Because it's measurable somewhere. Right? How much of that people translate into real understanding? And then do something actionable to impact that? I don't know. But it is a journey for sure. You know, I don't think there's a right way to eat. You know, I'm not I wouldn't be into telling people how to eat for sure. But I mean, there's, there's no doubt that you you can see the impact of you know, bread or pasta or potatoes on your blood sugar versus other foods that are, you know, simpler, less complex, break down differently, don't have as much sugar, etc. But you know, it's some, it really is a process and I don't know that everybody sees it, but I think they're impacted by it. Certainly. So so once you see that once you see how food is impacting your blood sugar's do you make a change about what you're eating? Or do you add supplements that help you? I'm not I'm not certain what you're saying? Oh,

Lisa 31:43
I'm not necessarily I just view like, even when I'm studying like different, I just find it more. It's more of an interest like an aha moment. Like when you like I said, I'll talk about that black bean brownie like I've done it before, where I don't eat a regular brownie, just just not one of my things. But But I know what it would do. Because even if I had something sugary, where it had like a higher sugar content to it, I'll get that my blood sugar could be at I mean, if I've done it before, where it's at a regular level, and then you see how it impacts your blood sugar. So you're getting that straight out line, almost right? Like it's a but then if you wish, I've had a black bean brownie made with black beans. And I was just curious to see what it was going to do. Because I thought, oh Ma, it's going to affect my blood sugar. Because there's I think there was maple syrup when I made them. And I thought that it was this gradual up and then my blood sugar came back down. So it's just more the site like how things work within the body, which I find is very interesting.

Scott Benner 32:42
So with all this knowledge and understanding, where can I ask you like where you're a one C is

Lisa 32:49
the last time I ate one C, I think I was at a 6.1 Well, that's cool. Or 6.8. Maybe I might be a couple points off again, I surprised myself because I would sit in the eights. And then over the years, it's come down. I've been in the sevens. And then I've made it into the sixes never the fives. But you never know how much

Scott Benner 33:09
exercise do you get? Are you still into it the way you were when you were younger?

Lisa 33:18
Yeah, probably better. I think this is probably in the best shape of my life now that I'm in my late 40s So do you that?

Scott Benner 33:27
Is it like impact training? Is it weights? Is it cardio as I do, right now

Lisa 33:31
I'm just going through because I was doing the distance running so did the half marathons for a bit and then not really understanding. I understood nutrition but not when you're going to be doing a specific sport. So now being through sports, nutrition and all that that was an eye opener. So now I do I do running but I back down on it a bit and just say do weight training.

Scott Benner 34:00
Okay, what did you mean it was an eye opener? Eye

Lisa 34:03
Opener where I was it was working I was working a lot more physical job. And then I was I would do runs in the morning not long but I would do like 5k in the morning I'd go to work and work for four hours come home go to the gym do cardio it was just like that and then I wasn't fueling my body to what I need it.

Scott Benner 34:24
so eye opening in the in the sense that you

Lisa 34:29
in the sense of you and then I would have those not that I was always just trying to like better my fitness level. But I would always be level wired. Well, why isn't there any changes and now at the point where I am in, in this part being to education just over the years of learning. I really see that just the difference if you're going to train to that extent if you're not fueling right again, your body will just keep like it was just going to kind of recycle.

Scott Benner 34:59
So yeah, so it's the It's the feeling piece that you picked up out of all this, like what you needed to put in that your body needed. And so how did that change? Like, what were you doing before? And what are you doing now?

Lisa 35:10
Oh, now it's in, it's always up and down now like, I just really have to watch with my stress levels, and things like that and then allowing myself just to, to refuel properly. So for because I'm mostly plant based, I really have to pay attention to my protein needs and requirements. So that I'm focusing more on that, because I think I was undermining my protein intake. And, and then doing the, the more the more running, because in the summertime, I will run more. But now with my workload, I can't run as much. But I do keep up with my weight training. So again, it's just one of those where I can still eat the same, but I'm just really paying attention because I'm doing the weight training. So I'm trying to build and just making sure that I have enough protein in my diet, which again, in turn, helps with when I when I'm so busy at work and stuff and it's physical to have that protein in the background will help stabilize my blood sugar. So I'm not chasing a low and then with a rebound of a high and vice versa.

Scott Benner 36:18
Where are you getting the protein from? Because you said it was the protein from so because your plant base, you have to get it? Where?

Lisa 36:25
Yeah, so with the plant base, I'll just use more. I mean, you can get enough protein if you're doing plant base and other things like that. So I'm just now I have implemented I'm taking more shakes, I will eat meat, just not maybe not every day. So I have skipped days, so it's more plant based. So I will do shakes, I'll do plant based eggs, you can get them from black beans, and a kind of bean type of thing. And there's like protein in your plant foods as well. So again, I'm not totally right. We used to be maybe 90% plant based and now are 90 to 95. And now I've reduced it I will have some meat. It's just not every day or so on on a regular basis. But I am eating like I am eating now like tuna.

Scott Benner 37:19
What's a good example of a day of your eating? Example, whichever breakfast this morning,

Lisa 37:26
this morning, whether they have oh my i And that's breakfast is my worst meal of the day. I'm going to be honest, but again, I just figured that I mean, everyone needs you have to heavier and I'm not a clean eater every day. I believe in moderation. So for breakfast What did I have? I had half of these blueberry flat breads. I had that what else do I have? I had this other this Josef's bread, it's it's a lower carbohydrate, a little bit of protein flatbread so I had that with some natural peanut butter and then trying to think I have coffee. And then I had some water I took some vitamins went out for a run came back and now I'm just drinking water with collagen some greens in it.

Scott Benner 38:21
What vitamins do you take on a daily basis?

Lisa 38:24
Oh gosh, I have to get my go through my counter. Now I take so every day I'll have in my water I'll put greens sometimes. Right now I'm taking so lion's mane. That's a mushroom of additional mushroom to vitamin C, I do think I'll do NAC or NAC what else college and I do every day.

Unknown Speaker 38:49
What's the lion's mane for the

Lisa 38:53
lion's mane is for brain health memory. I just And then again, I haven't I used to read so many articles and just studies and things like that. So I have this chart and it talks about each of the medicinal mushrooms which I really am fascinated by them. I'm really interested in them. I have used a bunch of them. So that one is for brain health. And because just with Alzheimer's and things like that, and sometimes they say with diabeetus not that we're having a high count candidates but I think it was number three on my list. So it was one that I implemented. So it also helps with focus.

Scott Benner 39:36
Yeah. Do you find it valuable? Like can you look back and say before I started doing this, I had less focus as an example but now I'm doing better or like I wasn't measured.

Lisa 39:48
Not right now because I just started taking it under the tongue before I was using capsules and things like that and because I was taking so much stuff I think I got lost in the mix of what was where gain. So now I find that I'm more more basic with my vitamins. Although it might seem like a lot to some, I really backed down on them. And I'm really trying to focus. And I am because my mindset, I'm always in staying one step ahead. And that's what, again, this is a whole different topic that's been another frustration with myself and working with my specialist and my specialists for diabeetus. Because when I go to appointments, and I'm always looking for what can I do to, to prolong things to to keep myself in this shape, and they just kind of shrug their shoulders because I've had diabetes for so long that no one? No one knows.

Scott Benner 40:42
Are you having any impacts? health impacts? From?

Lisa 40:47
Um, no, not currently, the only I did have one of my eyes, I did have some damage that came about after I had my son. But then so I don't go to a regular I go to an actual specialist. So I had laser eye surgeries done on it, just to I think I had an overgrowth of the blood vessels. And then now every time I go back in, he just says, Just keep doing what you're doing. There's still a little bit of inflammation, but nothing, it just stays the same. But

Scott Benner 41:21
that so but that I think is from high blood sugars over time. Probably okay. Yeah. All right. And so but that's the only thing you're noticing so far.

Lisa 41:32
Yeah. And that's like, it has I didn't even notice it. It was just something that my regular eye doctor he had noticed and sent me to a specialist. And this is going back like, oh, gosh, I've been seeing him for 10 years. So 10 years, might he surprised? I'm not wearing glasses yet at my age.

Scott Benner 41:50
How old is your you have one child? Is that right?

Lisa 41:52
Yes. Yeah, he's 12.

Scott Benner 41:53
He's 12. Okay, yeah. Have you had him tested for type one antibodies? Or how do you think about that?

Lisa 42:00
I have not I have we I have tested his blood sugar. Although he doesn't. He's not impressed by that. Because sometimes you just wonder what someone is sitting at? Yeah. I'm not worried about him. The My only concern is just I don't I do have limits. I pay attention to how many? Yes, he does have popped from like, now and again, and he's just gone into a little bit of the sweets. Not crazy. But I do find myself watching. Just because I'm, I just think it's a lot of sugar. Yeah, but that's just I think that's just because how I grew up. So if he has like a mini Cantopop I'm like, okay, like, like that. Like, that's a lot of sugar. Like, that's a lot. I don't say anything, but I catch myself noticing.

Scott Benner 42:56
Right. I understand. You're, I mean, you don't drink that stuff. I imagine. So no, no, it strikes you oddly, when somebody else does. That's all I would

Lisa 43:04
write. Yeah. And that was Yeah. And that was the other thing too. I didn't realize I think it happened a few years ago, where the impact of of how this can also affect him as a child, because he knows that they're not something wrong with me. I know. It's not the greatest way of saying things, but I'm going to say it like there's something wrong with me in the whole sense that he knows that. I'm actively and being proactive, to prolong my health. So I know that maybe in the back of his mind to when he was younger, I know that might have had some kind of I mean, it gives a child fear. Right as well, right? No, I

Scott Benner 43:46
it's funny. I we don't drink sugary drinks here. Right. And then my son went off to college. And I remember about two years ago, he's maybe like a maybe he was a rising junior, and we went to a restaurant together. And he got a sweet tea. And I thought that's crazy. Like, we don't drink sweet tea, you know? And he was an athlete in school so I think he was looking for calories a lot of the times because he was just you know, going like 100 miles an hour. And but I remember how it struck me like I didn't say anything but I was like oh my god like he's drinking drinks with sugar all the things you know, but it really did shock me. I remember I

Lisa 44:28
think people would say like if you ever seen with a Cantopop they'd be What's the matter you low?

Scott Benner 44:32
Yeah, right. Well yeah, it's that expectation that you don't want to waste your you don't want to waste those carbs on on that if you I mean, I guess I guess if you love it, you love it. I don't I guess you just learned how to Bolus for it. But anyway, so is there any type one in your extended family Mom Dad side?

Lisa 44:53
Okay, so this goes back a long time. So the only person that we know of in my face Emily that had diabeetus was my dad's grandmother.

Scott Benner 45:04
Okay, that's type one, or would they not know?

Lisa 45:09
Probably type one. I don't think type two was Yeah, I don't know. We just, oh gosh, type two is more newer to us. We cuz even back as a kid and stuff it was, I mean, people might have been insulin resistant, like the older generation. But yeah, he's just you

Scott Benner 45:30
know how old she was when she passed? I don't know. So not a lot of talk about how about other autoimmune issues like hypothyroidism, celiac? Is there any of that going on anywhere?

Lisa 45:42
No, no, no. Yeah, that's why I've just kind of like it was. Yeah, I can't imagine what they like what they went through back then. Because it was what, early 80s? Well, like maybe mid 80s. The 1980s?

Scott Benner 45:59
Well, that's when your dad's an adult. Right? In the Yeah. And just,

Lisa 46:02
they I mean, again, like my family, it was like, it was a big a big event. I'm just talking for them. I don't know the impact and and realize that you when I when you have this, you don't I try not to impact others, but you don't I think reading other parents and their journeys with their parents. I thought wow, like you don't realize how many people it does. Impact?

Scott Benner 46:31
Yeah, certainly does. Does your son worry about diabetes? Do you ever talk about that? It's a possibility for him? Or how do you talk?

Lisa 46:37
Um, no, I think he has, he was like, worry. I didn't realize some stuff has come out. But hell. And I think I have a funny story. He, what was it? Well, he knows I think he did a project here. This is going back. Gosh, I don't know how old he was. Grade One, grade two. And they had to fill up something with something for Mother's Day that he had written on there. Like some of the things had to talk about your mom and staff. And he said that. I take a lot of pills and things like that. And I'm like, when he told me I was like, You didn't write that, did you? And then he brought it home. And I said I was like shocked. I'm like, what did your teacher say? And then he told her that Oh, my mom's diabetic. So I'm like, oh, so it is there like he does? I think he does. He does get concerned.

Scott Benner 47:29
Yeah. I hear other stuff that I see sometimes attached to people with type one. ADHD, do you see any of that?

Lisa 47:38
Oh, wow. No, I haven't. I don't know. I could possibly, but I don't know.

Scott Benner 47:44
No, I just mean like in your family, like, like, oh, anything you've known is diagnosed ADHD or just like a lot of other things. Do you have any uncles who are bipolar, for instance? No, nothing. Wow, you guys just got a couple of couple of diabetics sprinkled out over four generations. It's interesting.

Lisa 48:04
Yeah. And who knows? Like, I don't know, I roll. There's so much controversy of like, I mean, my mom did have to have she was sick. Or she had the mumps when she was pregnant with me. So she had to have something that the hospital gave her. I mean, I don't know. You don't know.

Scott Benner 48:24
Back then. Could have been whiskey. Yeah.

Lisa 48:28
So again, you just they can't they don't know themselves, like what the science and stuff like what causes the body to attack itself with this. Whether it's in the genetics, or if it's like some kind of environmental?

Scott Benner 48:46
What about your day to day stuff? So you haven't mentioned? Are you married or no? Yes, you are. Okay. So how involved? Is your partner with your diabetes? Not at all or not at all? Yeah, that how long so how long have you been together?

Lisa 49:03
To one T 21 years. 2020.

Scott Benner 49:06
And he Am I Yeah, yep. Yeah. And he and it's just a it's a separate thing. Is it like is diabetes almost like? Like, do you not get low ever does that? Yeah.

Lisa 49:19
That's just how I manage it. Right. So because like I again, I've had it for so long. And then And growing up and stuff. I was just raised more independent. Yeah. And I think just because the dynamics of the family, my parents went through separation and stuff. So I just I grew up really, really quick. And it was just one of those where yes, they're there to help me but I was just one where I just learned to manage on my own. And again, going through I mean, just And to think if there was, thank goodness, that I haven't had any major complications. So and that's one where I don't like to, yes, I do have my fears of certain things that have caught up like, like, like with my eyes and stuff like that. So I brought my mom with me as a support system. But I tried to kind of work through those things on my own until I get there. And then, yeah, we'll see. Right. But that's why I'm just a huge advocate to do whatever I can to stay proactive and try and do. And that's one of the things too, we're, I mean, I can't control everything. So that's why I'll reach out to my specialists and things like that. So that's, that's what I said, that's been a frustration where, and again, I guess, with this disease and having it so long that you just have to manage and

Scott Benner 50:56
yeah, I don't, I don't find there to be a right or wrong way. I'm just always interested in how people choose to do it. And how, and it makes sense to me the way you you know, the time you grew up in. And you know that you were in basically, you know, on your own a little bit with it that you wouldn't as an adult think to incorporate another person in being would it be helpful to you? Or do you not even feel like you need it for another person to be involved?

Lisa 51:23
No, I think it's just one time to like, No, I don't think it would I mean, yeah, yeah, I think it's just the way I try to manage a lot on my own. It's just one of those where and again, I don't know how you could help. Right. So I'm just trying to get my head around. I just

Scott Benner 51:51
know, it's interesting to listen that it's just such a different thought for you that

Lisa 51:55
Yeah, I think the biggest thing is just see. Yeah, because even even when I go into work and stuff, like I don't broadcast it, I'm trying to get more comfortable. But the conversation just gets missed, like I don't know.

Scott Benner 52:09
Yeah, yeah. It's hard to I just sometimes. Yeah,

Lisa 52:13
I mean, and that's kind of been my biggest thing is is not saying anything to people, and then I do have a low and then people are like, Well, what's going on here? Right? So yeah, that's all I'm that's just something where I have to learn to get more comfortable with and be more open about it. Not that I'm hiding it. I just don't I don't want the attention. Yeah. And my sister said that too. She because she asked me not too long ago, she just said, I want to ask you something. And she goes, Why do you never say like, why you never talked about? Or why do you never tell people that you're diabetic? And I was just I didn't have an answer for because I don't know why it's just one of those where they just don't. I mean, I'm getting more comfortable now that I'm working in the industry. Because people you really see them change and open up then to know that you have something like especially the type twos, there'll be talking or even type ones and stuff. And it's it's nice, that that you can possibly relate to somebody,

Scott Benner 53:17
ya know, it gives you a jumping in point. Yeah, it's a great idea. So I know we started late, and I apologize, but I have to jump off in a little bit to get on to another call. So I just want to ask you if there's anything that we didn't talk about, that we that you meant to so that I don't miss anything for you?

Lisa 53:35
No, not at all. I think I've probably touched on like, a lot of things and maybe jumped around a lot because there's Yeah,

Scott Benner 53:42
no, it's fine. I just I don't want to like I don't want to miss anything for you. That's No, no, not at all. Wow. Well, I really appreciate you doing this, like coming on and sharing how you think about things and and your path. It's, it's an interesting look into what happens when you come up one way. And then everything. There's just a paradigm shift, like diabetes just isn't like that anymore. And you got to live in both sides of it. So yes, yeah,

Lisa 54:09
I want to thank you because this is I've never done something like this before. And like I said, I'm still getting comfortable with with this whole, like being more vocal about it. No, and being asked those questions and any, any kind of Yeah, just my thoughts and feelings about diabeetus as a whole.

Scott Benner 54:30
Yeah. Lisa, you're in an interesting position, because you're not, you're not an old person. Right. But you've had diabetes for a really long time. Yeah, and you jump like I said, you jump between two different management. I mean, honestly, three different management, like styles. And it's, um, and your generation diabetes generation, like you said, it's not, you know, not always accustomed to talking about it. And you grew up in a situation that you described earlier, where there wasn't anybody to talk about it with He didn't know whether people that had diabetes to begin with. And so I don't know, I just, I like you being like, it's interesting that you were willing to do it. Like, why did you want to talk? Like, what, what drew you to do this?

Lisa 55:12
I think, because when I was working in the health food store, that was kind of when people would come in, and they'd be talking about type two, I'm still intrigued by type two diabetes, because they have, in my view, they, they have complete, almost, they have a lot of control of how they can make things go for them. So I like listening to them. I like being that little spark of light for them, because they, I know, I'm kind of getting off topic here. But to see somebody who thinks that this is like, there's there's no lights, that really, it really gives me that chance to inspire somebody. Just as because I've lived it, and I can, I don't know, with that, so and then. So that really opened my eyes that there is a real need. And then when I seen this opportunity cop, I thought Oh, heck, like why not? I never talked about this. It's going to again, just get me more comfortable talking about it on a different platform.

Scott Benner 56:26
Maybe, like, let other people know, that it would be okay to share with family members, strangers were or whatever that I think.

Lisa 56:34
Exactly. Yeah. And I'm all about inspiration. I mean, I, I'm inspired by people, I don't think I mean, some people say that I inspire them or motivate that I don't see that. So again, I mean, if I can inspire or be that light for gosh, one person, then that's a huge, that's a huge win for me. Good.

Scott Benner 56:55
Well, that's a perfect way to end. Thank you. I really appreciate it. Thank you.

First, I'd like to thank Lisa for coming on the program and sharing her story with us. And then I'm going to thank BetterHelp and remind you that@betterhelp.com forward slash juicebox. Just by going to that link and signing up, you'll save 10% off your first month of therapy betterhelp.com forward slash juicebox and of course touched by type one.org. And save 35% off your entire order at cozy eartha.com with the offer code juicebox at checkout. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast

if you're looking for community around diabetes, head to Juicebox Podcast type one diabetes on Facebook, they don't worry if you're not type one. If you type two or lotto or you got a while you were pregnant or I don't know, however it happens. You're welcome. You're welcome in our Facebook group. There are plenty of conversations going on right now that will help you check it out. Juicebox Podcast type one diabetes on Facebook private group over 35,000 members

#867 Big Lou

Lou has type 1 diabetes and a lifetime of stories.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 867 of the Juicebox Podcast

I had some good fortune recently, and I'm gonna share it with you. I got to speak with Lewis. Lewis is 70 years old. He's had diabetes since he was in his 30s. And we're going to pick through his life. This is just such a great conversation, I can't begin to tell you how much I think you're going to enjoy it. While you're listening. Of course, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please Always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. If you happen to be a US resident who has type one diabetes, or is the caregiver of someone with type one, I would like to ask you kindly to go to T one D exchange.org. Forward slash juicebox. Just join the registry and complete the survey. It shouldn't take you more than 10 minutes. The questions you'll be asked are totally HIPAA compliant. You can remain absolutely anonymous, and your answers to simple questions about diabetes will help to move diabetes research forward. You want to help people with type one diabetes, complete this survey T one D exchange.org. Forward slash Juicebox.

Podcast this episode of The Juicebox Podcast is sponsored by Omni pod five. Learn more at Omni pod.com forward slash juice box the Omni pod five is a tubeless automated insulin pump system that I'll tell you more about in the ads. You should check it out though. Omni pod.com forward slash 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. Great. That's pretty much it then do you have any questions before we begin?

Lou 2:09
No. I just appreciate you asking me to do this podcast, my daughter in law business due every day.

Scott Benner 2:18
Wow. That's lovely. I'm I appreciate you don't you have an interesting story? I can't wait to hear it. I'll tell you what, let's just keep going like and start. You can introduce yourself. You don't need to use your last name. Tell me a little bit about yourself. I'll ask you a couple questions and we'll have a conversation.

Lou 2:34
All right. My name is Luis mestres. I'm a 70 year old retired educator. I served in the United States Marine Corps, which I'm very proud of. And I've had diabeetus now for close to 38 years. Wow. 3840. If

Scott Benner 2:54
you were 32 when you got it? Yes, sir. And it was type one.

Lou 2:59
Actually, they said it was type two.

Scott Benner 3:04
So at your diagnosis, you were told type two didn't turn out that you actually had type two.

Lou 3:11
Yes, I guess so.

Scott Benner 3:12
Isn't that interesting? So what was your management like back then? Did they give you a diet change oral medication? Did you inject something?

Lou 3:22
You know, it was really, really strange, because I remember the doctor having the nurse came in, she brought in an orange and a syringe and kind of showed me how to do it. And that was basically the extent of the training I got. Yeah. So over the years, I've learned to self manage. I went to another doctor. And he said the same thing, pretty much that I would learn how to take care of myself more than possibly a doctor good because I knew my own body. But I struggled. And I've had two brothers who have passed away. One was 42. One was 40. They both were type one diabetes. And again, I think the most important thing I want to say is because of a lack of education. My brothers did not do well with diabetes. My mother was not very knowledgeable. back then. I actually we approached the the diabetes foundation for some assistance. And I'm talking now 30 Some 30 Some years ago, not now. But it seemed like they were more interested in donations and they were in assistance. And so I really wanted to send my brothers to camps, so that they could learn how to manage and now that's really available to people. I was I'm on dialysis for a while. And thank God I was able to get a kidney transplant. And all of that was the result of poor management on the diabeetus. Thank God, I'm doing pretty well. Now. I do have an insulin pump, the tantum that I use, and it is helped immensely

Scott Benner 5:24
Great. Lou, I want to pick through this a little bit though. So you're 32 years old. When you're diagnosed? Your brothers already have diabetes.

Lou 5:32
No, no, no. No, they were. No, they one was probably five years old.

Scott Benner 5:41
Little you had a five year old brother when you were 32.

Lou 5:46
Well, let me think about that. He was probably 12 Maybe, okay, that's good. Yeah, my mom had nine kids.

Scott Benner 5:53
Whoa, that's what I'm trying to get to your mom had nine kids. That's That's something else. So So of nine children to had type one diabetes. You I still think I'm not sure what you have yet. Like, we're gonna figure that out while we're talking. Was there any other diabetes in your family? Or how about other autoimmune stuff like thyroid issues or celiac disease, visit a Lago? Anything like that.

Lou 6:19
Oh, I have a brother that has factor five. Oh, geez. And I have a sister that has a low blood sugar. She's not a diabetic, but she has to watch her diet because every once in a while, she'll go low.

Scott Benner 6:37
And hold on a second. factor five. It's a blood clotting disorder. Yes. Okay. Give me a second to figure out if that's autoimmune or not.

Lou 6:54
No, it's not. It's not. No, I don't I don't know why I told you that at the beginning. Okay. It's not.

Scott Benner 7:01
It's still interesting, but okay. Yeah. All right. So I'm going back to you being diagnosed and getting given that syringe. So if you were, they told you you had type two diabetes. That's what they told me. But you were injecting insulin right away. Immediately. Regular and mph, or, or cloudy? And what do you remember what it was called? Back?

Lou 7:26
I think back then I, I want to say it was like 7030. Okay.

Scott Benner 7:31
So I mean, not for nothing. But that sounds like you have type one diabetes. It could be. And then they tell you type two because of your age. That's true. You know, because I That's how their brains used to work over a certain age. If you have diabetes, it must be type two. If it happens to you when you're a kid, oh, you have the juvenile diabetes type one. So okay, so you manage like this, going forward right away? Did they tell you about? Because basically, when you're shooting insulin like that, you're just putting in insulin and then eating at certain times, right? Like, that's the extent of the management.

Lou 8:12
And it was poor management, because I was always chasing myself. When I think back now, I would check my blood sugar. I didn't know too much about correcting. I would just take insulin every time I ate. And so I would not take the insulin until either after I ate or while I was eating, and so constantly, I was chasing myself. You know, I know now that I need to take 20 minutes before I eat. So that I'm somewhat balanced.

Scott Benner 8:47
Right? How long? I guess is a long time ago. But how long did you do the 7030? And then when did it changed? Because I'm assuming you've probably changed insulin? One, two, maybe three or four times in your life, right?

Lou 9:03
Yes, I probably have tried every insulin there is. And what's so sad. A lot of it was determined by the insurance. Yeah. You know, there was some insulin so that the doctors recommended and the insurance wouldn't pay. So I'd go back and they'd say, Well, okay, let's try this. Yeah. So insurance would pay.

Scott Benner 9:23
At some point. I imagine you went on Lantis and human log. Yes. You remember about when that was? Probably about 10 years ago. Really? Okay. Yeah. And before that before 10 years ago, you were doing regular mph.

Lou 9:41
I think I was just doing regular regular. Okay. And I think that was the extent of my management with Elaine. Oh, was still young and active and I think my body could take it, but it can't now.

Scott Benner 9:56
And no one's ever said to you, you're type one. It's a Always have you ever checked you done a C peptide test or anything like that? No? Sure, no. Okay. And so about 10 years ago, you go to Lantis. And humor log, is that when you go to a pump?

Lou 10:12
No, I'm only been on a pump less than a year. Wow, you

Scott Benner 10:15
you injected for 37 years? Yes. Were you at least using a pen? Or were they giving you syringes? How are you doing it?

Lou 10:24
syringes? No kidding. Do Yeah, I used to prick my finger and use the syringes. And that's basically what my brothers did. Yeah, again, I think the biggest thing I'd want to say today is get educated. You know, the lack of education hurt my entire family, certainly. And you're probably listening to this thinking like, well, golly, why don't you do some research? Or we did? We did to the extent that that's why we've changed so much now. You know, and my grandson has it now. He's had about a year, right. And so, you know, my, my son and my daughter in law, especially, are on top of it every day. They research constantly, they, of course, listen to you, they take him to all kinds of appointments and research management. They've got him on the, you know, they monitor it constantly on their phones, and they even have the school nurse, monitor it as you walk by the classroom.

Scott Benner 11:33
Lou, you're a good person to ask this too. But tell people when you tried to learn something 30 years ago, there was asking a doctor or finding a book, right?

Lou 11:43
Basically, I was pretty much it. Yeah. And, you know, the other thing is, is that I don't know. I don't want this to come out wrong. But culturally. I think my diet hurt us as a family. Okay. You know, you have to really, really discipline and monitor what you actually eat. Because, culturally, a lot of very rich foods and carbs were available to us.

Scott Benner 12:22
That's what we had. What are some of the staples of that diet? Things you ate over and over again?

Lou 12:28
You know, like, beans and tortillas and sweets. You know, just

Scott Benner 12:36
a lot of rice with things.

Lou 12:39
Or not so much rice but a lot of potatoes. Okay, and, and fast foods like pizza. Oh my gosh. And it's amazing. Different foods affect me differently. I can eat one piece of pizza and I'm 400 I mean, pizza, just it. I try not to ever eating pizza.

Scott Benner 13:01
Interesting. When you say pizza. Do you mean from like a brand store? Like Domino's or Pizza Hut? Yeah.

Lou 13:10
Actually now, any, any any. It just seems now as a selling product, they make it as big and as thick as they possibly can. So you buy it? Yeah, you know, if I eat pizza, I get the thinnest possible pizza I can get. And maybe one piece. But you know, when you're uneducated and young and hungry, and you eat three or four pieces, you know, and then you wonder why your 500

Scott Benner 13:38
Louis, I imagine there's a special place in hell for the first person that said we could put cheese inside of the crust. You know?

Lou 13:48
Exactly. Yeah. Yeah. Yeah.

Scott Benner 13:51
That's not a valuable use of marketing. Okay, so, and listen, you said once or twice something that made me want to ask did you as an adult was was were your finances an issue?

Lou 14:06
In the beginning, they were

Scott Benner 14:09
and you had diabetes at that point.

Lou 14:13
You know, when you start out as a teacher 40 years ago, you know, my first contract was $9,000 as us as a classroom teacher, and and then you have a couple of kids. You know, insulin used to be extremely expensive. unbelievably expensive.

Scott Benner 14:37
Did your diabetes shaped the way you build a family were you thinking more children and then you ended up having or did you do about all

Lou 14:45
you wanted to do? No, no, that that. You know, I know it has my other brothers and sisters. Yeah.

You know, they, they've either had one child or two at the Most, but we had three children and we didn't think about the diabetes. Right?

Scott Benner 15:06
And then your and your three kids don't have type one diabetes at all. But but your grants your grandchild does. Yes, right. Okay. Wow. Okay, hold on a second. I have to center myself here for a second. Wow. Um you know, it's funny when you said how much your first teaching contract was. It made me feel bad. And guilty actually felt guilty.

Lou 15:32
Yeah, $9,000 is what I started out with.

Scott Benner 15:35
Yeah, jeez. I mean, listen. 40 years ago, I was 11 years old. But I got my first job. Two years after that. I cleaned up a pet shop after school and ran the cash register. And I made I made $3 an hour to do that. Golly.

Lou 15:53
Yeah. You know, I tell my grandkids this kind of stories now. And they just I don't think they realize, you know, we've talked for $1 an hour as a kid.

Scott Benner 16:05
No, I know. I know. So what kind of teacher were you?

Lou 16:09
I was a history teacher. And for many years, I taught New Mexico history and civics?

Scott Benner 16:18
To what age groups? Did you jump around? Or did you stay in? Oh, middle school, middle school, I

Lou 16:22
was always in middle school.

Scott Benner 16:24
Okay. During that time, you're just injecting what, twice a day. Morning and at dinner.

Lou 16:39
When I first started out, I was pretty frightened of the whole process. So as I said, I, I think the biggest culprit with diabetes, when you don't have a lot of knowledge, is you're constantly chasing yourself. And what I mean by that is that you either don't take enough insulin, or you take too much, and you take it too late. You know, now, we all know that you've got to take your insulin 2030 minutes before you eat. And you've got to be able to figure out what you're going to eat. You know, and that's why I like I'm not pushing any particular one, but I use a tandem. And it does all the math for you.

Scott Benner 17:30
Yeah. Are you using control IQ? Are you wearing Dexcom? as well? Yes. Wow, good. Bye. That's it. That's a big change, huh?

Lou 17:39
Oh, my God, it's like, life changing. And I owe a lot of it to my daughter in law. She is just, I mean, she, she's, like, the family blessing. And, you know, anything I need to know, I call her. But basically, I now understand the importance of, of technology and knowledge if you're going to live with diabetes. So,

Scott Benner 18:13
Louis, is it fair to say that your understanding of diabetes at the core of it is about how insulin works, the timing of the insulin, and how food impacts you? But those are the two major things that you pay attention to?

Lou 18:26
Yeah, yeah, basically. And I think your body changes because I know I went through a period of time where I don't know I call it honeymoon. Because in the 47 years, I've had it, there are times when almost insulin resistant, and I have to take more insulin, then there are times periods of over like 40 years where it just seemed like I don't know. I don't want to say that I didn't have any diabetes at the time. But there were times when like, my blood sugar's ran really great. Yeah, for periods of time. And then, you know, there were nothing over these 40 years for me to be walking around with a 500 blood sugar level.

Scott Benner 19:23
And it's you weren't paying attention to the level that you are now. So if back then, if you I don't know, took on a home project and were very active outdoors for a week or something like that, and needed less insulin that wouldn't have occurred to you then that that might be one of the reasons why. Correct? Yeah, you weren't thinking about that way. No. At what age do you realize that you're having complications?

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At what age do you realize that you're having complications?

Lou 23:12
Probably, you know, after my brother's passed, which has been about 10 to 12 years, I knew I was really in trouble because I knew where I was headed. And that's about the time my doctor told me you have got to get on dialysis. And, of course I fought it. And you know, one day he just said, Look, you're lucky you're live in America. If you lived in my country, I'd be telling you to get ready to die. And so I was on dialysis for four and a half years. And I chose peritoneal dialysis. So I had a tube in my stomach and I hooked up to a machine every night. And these three bags of solution would go into my belly and through osmosis I, you know, cleared the impurities from my body and got up at the morning, got up morning and there was another bag full of this bad solution and I'd empty it and I'd gone to work. I did peritoneal dialysis for four and a half years and during that time, I was a school principal. So you know, you do what you have to do if you want to live. Yeah.

Scott Benner 24:42
I have a couple of questions around that story. So my first one is, what do you mean you resist it. When the doctor said you need dialysis?

Lou 24:51
I didn't want to go on it. And I just said well, let's just see where this goes.

Scott Benner 24:57
Where do you think it was gonna go?

Lou 25:00
As you know, along with depression, and along with diabeetus, sometimes you have some really serious mood swings I'm not talking about to the extent of depression, and maybe so. But you diabetes creates some real serious mood swings. By the grace of God, I have the most wonderful wife. And luckily, she is a nurse. And again, I'm blessed, because a lot of her background is diabetic care. And so, you know, she's aware of many of the things that is are happening to me. So, people with diabetes need to surround themselves with either a support group, or people that are very knowledgeable.

Scott Benner 25:56
Can you tell me some of the ways that your wife has been helpful to you?

Lou 25:59
Well, get her vast knowledge. You know, she constantly monitors me. She's such, you know, an assistance, like, you know, before I got on, on on the tandem, you know, she was constantly like, have you checked your blood sugar? You know, what are you going to eat? You better think about whether you want to eat that or not. You know, it wasn't nagging. It was helping,

Scott Benner 26:32
ya know, that making up? Were you? I don't know, would you say that you were ignoring it? Or just,

Lou 26:41
you have a tendency to ignore it? Yeah. You just have a tendency. It's just just, you know, you know, it's bad. And you still

Scott Benner 26:52
is it that you don't want to have diabetes? And you get a moment where you just want to not think about it?

Lou 26:59
I've gone through that. Yeah. Yeah. You know, I tell people, I'm as close to being an alcoholic as an alcoholic. Because, you know, I know certain foods are killing me and I still eat it. It just, you know, you know that, that same from the good book? Lord, you know, things I should be doing, I continue to do.

Scott Benner 27:24
Do you think it's from your childhood? Do you eat food that you remember fondly? Of course, yeah.

Lou 27:30
Yes. You know, a lot of Mexican food. And even now, you know, I know, tortillas are killing me, but boy, I want to eat them.

Scott Benner 27:41
Not gonna buy a low carb tortilla?

Lou 27:44
Well, we do we do that now. I know better now, you know, and I get the smallest ones. And that's where my wife comes in. You know, she buys the smallest ones. They're not the huge one. And, and they're low carb. Yeah.

Scott Benner 28:01
Do you feel fortunate to be 70?

Lou 28:05
Oh, my God, I, you know, after my brothers passed, and, you know, after what I like, I've experienced, you know, God's got me alive for some reason. I'm still having to do something for, you know, God. But

Scott Benner 28:31
is there any? I'm sorry, I'm picking through your life like this. But is there any guilt? Like because you were you were basically saved? Because you saw the experience of your brothers? And that I'm assuming motivated you to move forward? Do you ever you ever think well, is what happened to me first, maybe one of them would have been motivated to move forward? Or is that not something to think about?

Lou 28:56
I regret every day that that we didn't seek out help for them. It breaks my heart when I think about them, that we weren't knowledgeable enough to help them that we didn't reach

Scott Benner 29:19
out for help. Do you think you knew you needed it? No, no, you were doing what you were told. Right?

Lou 29:28
You know, just that stubbornness of you know I'm in charge and I'm and I'm not saying anything about being I think sometimes we get so busy in life, we forget what we're doing.

Scott Benner 29:42
Yeah. No, I agree. You and I really think about this very similarly. I carry some guilt, but for the people listening. So I I know I have this thing that helps people and then it feels like I'm supposed to find them and make sure they listen to it. And

Lou 30:01
thank God, you know, you're on a mission, you're actually on a mission and, and, you know, like I said, I found out about you through my daughter in law because she listens to you constantly. And she, you know, she reached out to after the Super Bowl to the to the receiver who has type one diabetes, and he did a podcast for my grandson and told him, you know, that he had diabetes in high school and, you know, to manage it, you know, and encouraged him to manage it encouraged him to go on.

Scott Benner 30:39
That's wonderful. This past Super Bowl or before? Yes, yeah,

Lou 30:43
this past Super Bowl. In fact, he contacted my grandson the day after the Super Bowl, I couldn't believe it. Oh, that's amazing. I just couldn't believe it. And so I think people with diabetes want to help other people. So they don't go through what? You know, like I tell my grandson. And he started to understand that now because he plays basketball in high school basketball. Yeah. Um, Daisy says, grandpa, my, my legs and feet feel like concrete. And, you know, we all know that experience when we're high. Yeah. You know, when when you're three or four or 500. You know, I've been so high at times that you know, I can hardly walk right?

Scott Benner 31:32
In so when you let me think we you had a pump before the tandem. What was your first pump? Medtronic, right? No, no, no, tandem is my first tandems your first pump Excuse me? That's right. I'm sorry. I'm confusing myself. With no no problem. When so when you get a pump is the transition. Is it difficult for you? Or did you find it? Relatively easy?

Lou 31:58
Very easy. I worried about it, and I shouldn't have. Okay, that training is pretty simple. It's pretty easy to manage. It just amazing. It's it's a miracle to me.

Scott Benner 32:21
I know. And so now you're What about a CGM? Did you get them at the same time? Did you get Dexcom and tandem at the same time? Or did you know I

Lou 32:30
got, I wanted the Dexcom first, so I could manage it. Before the Dexcom I had a libre. And that was great, too. I, you know, that was a great product. I was able to really monitor myself on my phone with the FreeStyle Libre. But then when I was going to the tandem, I had to switch over to the Dexcom. Because they they read each other.

Scott Benner 32:58
Right, right. Yeah, they talk to each other. And so you, right now your pump is is an algorithm. It's taking away and giving you insulin and you're basically telling it when you take carbs.

Lou 33:09
Correct? Yeah. And then of course, again, my my daughter in law, you know, she said up on my phone, the app, Calorie King. So, you know, I just open that up, or I say to my phone, Hey, Siri, how many carbs are in a tortilla? And, you know, I get the information that way. And again, so right now, in this day and age, there's so much technology around you that you can actually really help yourself. Yeah.

Scott Benner 33:41
It's, it's, and it's better right to do the work put in the effort you're gonna put effort in somewhere is what I always tell people, right? Like, might as well put it in up front and avoid because the back end efforts always, it's always cleaning up a dumpster fire or a health issue or something like that. You might as well do it first and save yourself the trouble. Correct? Yeah, you're gonna do it somewhere. So well,

Lou 34:06
you know, I'm pretty hard headed. And so it took me a lot of years to finally get to where I'm at. Again, I'm grateful for my life. I am shocked that I'm still alive after I've only I've only had to call an ambulance one time in the 40 years that I've had it. But for a low bouncer. Yeah, low blood sugar. Well,

Scott Benner 34:32
in fairness, was your blood sugar mostly high?

Lou 34:36
Yes, yeah. Yeah, a lot of most of my life. I've been high. I mean, not literally, but I mean, blood sugar wise.

Scott Benner 34:45
Louis, is there anything else you want to talk about today? You smoked a little weed?

Lou 34:51
No, not at all. But but, you know, when I'm talking high, I'm not talking 200 jumped out there. Yeah. 500.

Scott Benner 35:02
Right. Well, you have the mixture of not really understanding how to manage on top of difficult foods. Correct? Yeah. And that's going to drive you up like that. So was there? How long were you on the CGM before the pump?

Lou 35:26
I don't know, couple of years. Couple years.

Scott Benner 35:27
So did you start adjusting? Then did you start saying I don't think I'm using enough Basal insulin? Or? I think I'm not injecting enough at meals that?

Lou 35:36
Yes, yeah.

Scott Benner 35:39
Are those things I'm sorry to cut you off?

Lou 35:42
Probably in the last, you know, like I said, probably in the last five years, I've become very, very serious about managing because my grandkids are getting older, and I want to live to see them graduate from high school. And, you know, I just, I just want to see them grow. I've got five grandkids. Yeah. And they're all either in elementary or high school. And I want to manage this every day so that I can see them and continue loving them.

Scott Benner 36:14
How, how long ago, did your grandson get diagnosed, you know, a year ago, just a year, so. So five years ago, see, I'm going to tell you something, because I've spoken to I don't know, you're up to about 1000. I'm up to about 1000 people having this conversation with right. And most people, as adults, make a health change, for the love of something else. For a spouse or a child or a way of life where you'd be surprised how few people say, I wanted to take better care of myself. Like it's it's very interesting that people have such a hard time doing something for themselves. But when it's for someone else to see your grandchildren or something like that, then it's not hard at all, for some reason.

Lou 37:05
You're absolutely right. You know, I I want to live every day now. My son, my grandson is in a track meet Friday evening. And you know, I want to be there. Yeah. And I want to be feeling well, when I go to the track meet, I don't want to be my heart racing or my legs feeling like concrete, you know, I want to be a normal human being at a track me watching my grandson.

Scott Benner 37:30
That's a good message. That really is. Okay, so you get the Dexcom you make adjustments to your insulin, you start seeing how foods impact you more when you move to the pump is is the pump initially in your mind just to ignore like so you don't have to inject anymore or you have a mind on the algorithm and letting the the back do the work.

Lou 37:55
You know, the thing I liked the most about it is it does the math for you. Okay, it does all the math for you. And you just gotta you know, rely on it. And I'm relying on it now. And it's working. I'm anxious to see what my hemoglobin a one c is this next time around? You know, I used to run 11

Scott Benner 38:19
Wow. Yeah. For and what were you last time?

Lou 38:24
9.7 I

Scott Benner 38:25
believe. Okay, and you're shooting for lower and lower. You're trying to?

Lou 38:31
I'm hoping I'm hoping someday to get to like a 7.5. Wow.

Scott Benner 38:36
Let's listen. I bet you could have you made any adjustments to your the way you you know, you feel yourself with food? Or is that been the hardest thing?

Lou 38:48
Yeah, I've had to make adjustments. I don't need as much. I certainly monitor what I eat now. And I stay away from certain foods.

Scott Benner 39:03
Yeah, but

Lou 39:05
I just want I just have a hard time with pastas and pizza. And it just like I said, I can eat one or two pieces of large pizza and, um, 454 hours, right? Yeah,

Scott Benner 39:22
yeah. And do you think when you see a big number like that, do you think to put in more insulin or do you let it ride out?

Lou 39:30
No, I put in more insulin. And like I said, that's why I don't do that anymore. Because that's when I was chasing myself. Yeah. What I call chasing myself. I was always chasing myself. I was never ahead of the race.

Scott Benner 39:46
I think that one of the things that gets lost when people aren't given good education and don't understand how insulin works, is that I think it can feel like that what you're doing right now is for right now. Oh, but it's not right insulin now is for later. Right? Yeah. And it's, I've talked about it a number of different ways on here. But sometimes it's like a confusing like a time travel movie, like you don't know exactly where you are. There's something happened in this timeline, or there's something happened in this timeline. But when you start realizing that that's true, that the insulin is living on its own timeline, and the impact of the food is living on its own. And you need to artificially manipulate it so that they're doing their things at the same time. And that's all that Pre-Bolus thing is it's giving the insulin a chance to get working so that when the food hits you, they're both there. It's a fair fight at that

Lou 40:38
point. Correct? Correct. Yeah. I like where you put that. Yes,

Scott Benner 40:42
thank you. You figure that out on your own as well.

Lou 40:47
After 40, damn,

Scott Benner 40:49
Louie's, like I didn't give up but I figured it out. 40 years? Do you listen to the podcasts or you let your your daughter in law tell you stuff from it?

Lou 40:59
Once you start listening to it, I guarantee it.

Scott Benner 41:03
I have a series called diabetes pro tip I bet you might enjoy where we just it's it's very management based. But we also have a ton of conversations with people, all ages, like you just telling stories about about the things they've done, because I think that is also valuable for people. Oftentimes, I don't believe that people learn by being read, you know, read a bullet list of information, do this and this and this, I think you're gonna hear somebody else say it and think, hmm, I mean, that makes a lot of sense to me. You know, like, I can try, I can see how that fits into my life. Now I'm going to take a look at that. I want to bounce back a little bit though. You're on dialysis for those four years or so. Did you ever think you were getting a kidney?

Lou 41:53
I prayed for one. And I didn't ever think I was gonna get one. And by the grace of God, six years ago, on Easter Sunday, I get a call from Albuquerque, New Mexico. And they said, Actually, I got called three times. The first time. By the time I got to Albuquerque from Roswell, which is three hours. They found out that the individual had had hepatitis. So I lost that kidney. The second time. The doctor that was farming, the kidney had cut the ureter too short. So I didn't get that kidney. But on the third time, I got there and you know, thank God. Everything went well. And I had the kidney transplant. And, you know, I was very grateful for the family that gave their mother's kidney to me.

Scott Benner 42:50
Wow, that's wonderful. Yeah, that's really that's a selfless thing to do.

Lou 42:55
And I I want to take a moment to tell everybody to please be a donor. Please be a donor.

Scott Benner 43:03
Yeah. No, I mean, it's it. Look, I mean, look what had to happen. Three people who were donors till you get yours. Correct? Yeah. Because other things can happen. So you are on a cocktail of anti rejection medications now?

Lou 43:17
Yes, I am. I take quite a bit of medications in the morning. They're anti rejection. And thank goodness, oh, my gosh. My insurance covers. It's just, yeah, it's just

Scott Benner 43:34
the teachers. It's a miracle. It's the teachers union. Right. They set you up in retirement? Yes. Yes. Yeah. Wow. Do you have any other any side effects from the anti rejection meds?

Lou 43:52
Well, little bit of weight gain from the some of the medication that I take prednisone

Scott Benner 44:03
Yeah, that one, the steroids. Tough, right? Yes. And does it make you more insulin resistant? Do you feel well,

Lou 44:10
after, you know, you have to monitor it more. You know, there are some lot of medications that that you take that affect your insulin. So being conscious and aware of that.

Scott Benner 44:26
Do you feel I'm going to tell you a silly story. So I've got I'm not going to tell you the whole story, Louis because it's embarrassing, but I got bit by a bug. And I had a systemic reaction. And they put me on prednisone for like 10 days. And for and for 10 days. I felt like Superman. My back didn't hurt anymore. All my aches and pains are gone. Right. That's the truth. Yeah. Oh my goodness. Right. And do you have some of that benefit or does that go away after a while when you're on?

Lou 44:56
It goes away after a while but I know exactly what you're talking about. how well it makes you feel physically.

Scott Benner 45:03
15 years younger I felt 15 Years Younger for 10 days. Yeah, yeah. Yeah. And then I went off of it. And three days later, I was like, Oh, my back hurts again. Yeah, yeah. But yeah, I wasn't sure if I want it. That's the question I had was that doesn't keep happening, because I didn't think it would. Eventually, it's gonna lose its impact, I would imagine. Right? It does. Yeah, he does. What do you do for those 10 days? A

Lou 45:30
lot, a lot of yard work? Well, I got a lot done.

Scott Benner 45:35
It's funny. Oh, my gosh. Okay, so I know. I mean, I so I want to ask about the about the surgery. So you, you know, you go and first of all, you must, it must be even hard to be hopeful. The third time driving to the hospital, but you get there. And actually things are working out for you. What's the surgery like? And what's the recovery like?

Lou 46:05
You know, the first day after the surgery was a little tough, because the doctor put it that the kidney hadn't woken up yet. And so it didn't start right away. So I laid in that bed and prayed and, and, you know, I was hoping that it would work. And by the second day, it started working. And it's been working ever since. So there wasn't a lot of pain to it. To be honest with you, when I think back now. It the recovery was really, really good. My sister Eileen, who is a nurse, and of course my wife who is a nurse, nurse me to help pretty quick. Last month that I was in recovery.

Scott Benner 46:59
I bet you didn't let you lay around too long. I haven't. Oh, God, I had a Why can't I think of the word, my appendix went bad on me. And I had it out. And the doctor told me, you know, the rest of bed for a week. And on the third day, my wife comes in, she opens up the shades and she's like, come on, we're gonna go outside and rake leaves. And I was I don't think I'm supposed to do that. Because you'll be alright, let's go. So it's out there like, Oh, God, this hurts. But she got me moving. And I'll tell you I wouldn't wait around for sure if she didn't do that. So

Lou 47:34
Gotcha. You know, what's also kind of funny is that a couple of days after the surgery, had this fantastic doctor in Albuquerque, just that he goes, Well, I hope you don't mind. He goes, you had a hernia. So while I was in there, I took care of your hernia. Pick it out.

Scott Benner 47:58
You should have told us that gave me a pancreas while you're in there.

Lou 48:02
Yeah, so I got a two for one yet. I got a kidney transplant and he removed the hernia. So you know, I thought that was kind of kind of a neat thing, like a coupon

Scott Benner 48:12
day. Yeah. That's excellent. Oh, my gosh, did they talk to you about a pancreas transplant at the same time or No,

Lou 48:23
no, no, they know, they have not. Okay. And I haven't, you know, my wife has brought that up several times. But right now I'm holding and I'm doing well. Yeah.

Scott Benner 48:39
Well, I mean, it goes without saying you're doing amazing. I know, honestly.

Lou 48:45
It's amazing. I tell my wife this daily. It's amazing. The human body, just the human body, and how we abuse it. You know, like I said, I don't know how many times I must have been four or 500. And the damage he was doing to my body, but the body is just amazing. I mean, there has to be a god.

Scott Benner 49:08
Well, if you put those pizza slices in the gas tank in your car, it would stop running. And somehow your body looks at that and says, Alright, I can't believe he did this, but I'll figure out a way to get through it and keep you going. Yeah, it is. Yeah, you know what I mean? And obviously, it takes a toll. But you're right. Like it's we eat things that we shouldn't be eating. And it just keeps going somehow. And that's is astonishing. It really is.

Lou 49:38
You know, I'm a lot better now regarding health wise because I don't have as much neuropathy as I used to, as you will experienced. I went through a period of time where my feet burned actually burned. And my fingertips have got burned? I don't have that anymore. Yeah, so I know I'm in, I'm in so much better shape than I was in previous years. Yeah. Because I just don't have the neuropathy that I, that I used to have

Scott Benner 50:15
right now. I mean, I hear that story from people all the time, especially ones who are running around like you are with an 11, a one C, sometimes when they better their, their agency, their variability, get their blood sugar's down, find some stability, some of that stuff does go away. And or at least it slows it I've had people tell me like that their eyesight was deteriorating, and it's gotten better, or it held where it was and didn't continue to get worse, like you, you are doing a, you know, you're not asking as much of your body and you're slowing down that the impact that those blood sugars are having.

Lou 50:52
You know, when I think back back about one of my brothers, Thomas, you know, he lost a toe. It really affected his eyes, he lost an eye. And he really suffered. I mean, he really, really suffered.

Scott Benner 51:10
Were you close to them as adults? Do you know? Was he just not taking insulin at all? Or?

Lou 51:16
Again, I think it was the diet. Lots and lots of high carb, Mexican food. Yeah. And, and the bad part about it is we love it. You know, and so. And I just think he was a banker, a very successful banker, and I think he was just so busy. He didn't take care of himself. He just thought every day get up and go to work. He was more interested in working in stead of management.

Scott Benner 51:51
Yeah, well, listen, he probably had exactly what you had when that doctor said, You're gonna go on dialysis. You're like, now I'll be okay. I don't need that. Right. Yeah, you know, I'll be okay. I'll get to it. You know, it makes me wonder while you're talking, because you're so thoughtful about about the reasons why things happen. It makes me wonder when people get on listen to this, are we going to send more people to lunch to buy tortillas or more people to lunch to get something healthy? To eat? I want them so yeah, I wonder if I wonder if it it's interesting. How people's minds work, you know, like, especially in the face of it like this, like you mentioned earlier, just knowing like, I'm doing something right now it is killing me. And you're like, I'm gonna do it anyway.

Lou 52:38
Yeah. And, you know, you, I can't fault people. You know, I'm a pretty conservative person. You know, so I can't sit here and say, God, why are those people doing drugs? I mean, when, when I myself, you know, the foods that I eat are my drugs. Sure. And the way I have to look at it.

Scott Benner 53:03
Yeah, I mean, I think it's, you know, I was just having this conversation with somebody, and I think their episode will come out before yours. But it's, it's the dopamine, that that like, you eat that food and your and your body. Yes, your brain gets happy. And then it just doesn't last very long. And you know, how do you make it happy again, you, you feed it again, the sugar and the fat and the dopamine comes? And, and to your point, some people get that from pills. Some people get that from drugs, some people get it from risky behavior, you know, like that kind of stuff. You you got it from food.

Lou 53:40
You know, I liked what you put that day, because that's exactly it's a vicious cycle. You know, and you have to decide, you have to substitute one desire for for another, or you have to just not yet avoid it.

Scott Benner 53:57
Yeah. Listen to people who exercise a lot. That's where they get it from. They get like an endorphin rush from exercise. And they, they, they make it so that being healthy is a value to them. So that's the thing, they drive happiness, they derive happiness from like, they want to be healthy. So when they are healthy or fit or working out, they're happy about that you're happy because you were eating foods that you remember from your, from your childhood, and probably built pictures in your mind of nine kids sitting around and big meals and fun and stuff like that. It's just what happens. Like everybody gets a thing that shifting from one of those to another proves to be difficult for people. You know, and that's all it's all very understandable. It's just it's it's just the truth. That's all

Lou 54:50
right, you know? That's just it. Basically, you just have to fight that battle every day. Yep.

Scott Benner 54:58
Find something else to be happy about. All right, yeah. Other than he has that now dammit, Louis, I'm gonna end up talking to you if I don't stop talking about starting to think about it, maybe I could like make some chicken. I have rice in the fridge, I could throw together with it. You said potatoes. That sounds like a great idea. I won't, don't worry, I'm gonna go downstairs and eat something that keeps my old ass alive a little longer. So got you.

Lou 55:24
Yeah. And, you know, and over the years, you learn the game. You know, it may say sugar free, but he's got fructose in it. So they get away with it by saying, oh, yeah, that's a sugar free product. But they don't tell you that fructose is gonna kill you. If you eat it.

Scott Benner 55:41
Yeah, we use the bunch of artists such as artificial sweeteners, or there's so much fat in it. And you know, and by the way, when you eat something that they say is fat free. i My example is always like shaved ice, you know, like water ice or something like that. And the sciences, oh, it's fat free. But the minute you eat it, your body takes that glucose and turns it into fat and stores it as fat. So, you know, you get away with it for five seconds. But then something happens on the other side you need. Listen, the truth is it's clean food, you need to eat things that you look at and know what they are. This is a piece of chicken. I know what that is. This is a broccoli. head of broccoli. I know what that is. You start, you know, I don't know how they make pizza dough for Domino's Pizza. I, you know, I don't know what's in it. And you don't either, you know. And at least if you made that at home, you took a little. I mean, I do it here once in a while. I'm making Neapolitan pizza here, but I see it it's salt and flour and water. That's what the just that, you know, right. But even storebought tortillas are probably

Lou 56:51
Oh, yeah, yeah.

Scott Benner 56:53
I'm assuming there's some kills in there. Yeah,

Lou 56:55
chemicals. Yeah. Yeah,

Scott Benner 56:56
I hear you. Okay, so that the surgery wasn't too much trouble. And you haven't had to do dialysis. I'm assuming that dialysis was the was a heavy left, right. There's a long four years.

Lou 57:12
That was tough. It was tough. You know, you have to really, really, I went to see my nephew in Boston. And to this day, he tells me, he goes, I don't know how you did it. But you have to plan and ship the solution to the motel you're going to be in and hopefully when they get there that you know it's there. And then the machine that you carry at an airport, it's a nightmare, because they all want to open it up and touch it and see what's going on. You have to tell them Hey, that's my kidney. Don't touch that. Well, I've got gloves on. I said, Yeah, but you've touched 100 things before you're touching my machine. And so it always be an argument at an airport.

Scott Benner 57:55
Right? You're, you're safe with the gloves on my machines not.

Lou 57:59
Right. You know, and so it was a nightmare. Don't carry all that equipment around and travel. You know, but you do it. You do it? And but thank God, I don't do it anymore. I mean, I just thank God every day that I don't do that anymore.

Scott Benner 58:15
Ya know, I It's a mindset to get you through something like that. But when you don't see a certain end date to it. It's not like somebody said to you, Hey, you gotta go on dialysis. But don't worry. 17 months from now, there'll be a kidney here. You were just right, one day at a time hoping somebody and even is that not strange, hoping that someone passes away so that you can get a kidney?

Lou 58:38
I know in that in that said, yeah. Just you know, and I know people now that had been waiting for years for kidney, you know, and they're still on dialysis.

How I thought I thought that peritoneal dialysis was a lot easier than going into the, I used to call it the chamber.

My brothers did dialysis. Both of them. One brother was a teacher also. And he would go at five in the morning, Monday, Wednesday and Friday. And he'd go at five in the morning and he'd be there for three or four hours. And his planning period was first period. So it's principle worked with him. I don't know how he did it. Because, you know, sometimes it's pretty exhausting. When you're on dialysis. The thing that really affected me when I was on dialysis with the cramps, I used to have unbelievable cramps. I've never had one sense. But when I was on dialysis, the cramps alone was just I had one so bad I just cried one time I just couldn't take the pain anymore.

Scott Benner 59:57
debilitated the kids? No Did they The people you worked with now, some of them did

Lou 1:00:03
have tell you a quick story. We used to have a back to school dance every year. And I had hired two new teachers, two young ladies. And one of the ladies says, we're still having to go back to school dance. And I said, Yeah, we are. I said, but I'll be here. I said, until nine o'clock, and then I gotta go hook up. And I happened to look over it was two young teachers. They're looking at each other. Like, what's he talking about? You know, I gotta go hook up. The other teachers knew what I was talking about. Yeah. So one of the teachers turned over, you know, turned to them and said, he's on dialysis. He's got to hook up to a machine. That was kind of a big laughs

Scott Benner 1:00:48
They thought you had a lady waiting? That's why I guess no. Well, yeah, do you got your wife at home?

Lou 1:00:56
But you know, and I admired, uh, you know, people that are on peritoneal, I knew a coach, that he'd be on the school bus with the kids, and he'd be doing peritoneal dialysis, you'd have the bag up on a title to a poll, and he'd be hooked up on a way to gain during dialysis. So now, so if you want to live, you do it. Yeah. But it's not a good way to live like that. So that's why we go back to management, you know, you know, I don't want to irritate my grandson. But a lot of times I tell him, I say dizzy. And I don't want to scare him. But I said, you don't want to end up like this, you know, so take care of yourself. Take it serious

Scott Benner 1:01:45
right. Now. I was gonna try to get back to that thought. But you did it very well. And I actually think that's a good place to stop. Because I, I think I'd like that to be what people remember, after listening to you, you have a great story. And your outlook is amazing in the way you made it through. And had to figure out so many things for yourself as time went on. It's it's very, it's laudable that you figured it out. I hope you know that it's not, you know, that. It's not something everybody would have gotten done. Like, you really did fight through something, you know? Well, but we got Yeah, but we don't want people needing to fight through it. So. Right, exactly. Yeah. You don't want to get to this point. Like, let's say it would be nice to know, you're this tough, but let's not have to prove it. Anybody, you know, yeah. Would have been would have been better to use that time and effort on something else. But that that image of you should shipping the solution to a motel. So you could go visit somebody? That was really powerful. But when you don't when you were talking about that, I thought my gosh, I never thought about that. You know, that's really something. Wow. Is there anything I didn't ask you that you think I should have?

Lou 1:03:01
No, I think we've covered almost everything. I told my life

Scott Benner 1:03:05
story here. Yeah, it was wonderful. I can't wait for people to hear it.

Lou 1:03:09
I hope it helps somebody and certainly anybody that ever wants to call me or talk to me, you can give them you know that information. And I'll talk to anybody about diabetes, because and that may be why I'm still alive. God wants me to, to help people.

Scott Benner 1:03:30
Well, I have a Facebook group, I'm assuming your daughter in law knows about that is it's got like 35,000 people on it. So when I put your episode up, I'll make a post in there as well. And if people want to ask you questions they can ask right there. Sure. Yeah, I would be. I'd be happy to do that. Okay. Wow. Well, I appreciate you doing this with me. Thank you very much.

Lou 1:03:55
Well, I've really enjoyed it. And I admire what you're doing. I just honestly admire what you're doing. Because as I started this podcast, I told you, we lacked knowledge in our family. And that's what you're doing. You're providing knowledge for people like my family, to better manage? Well,

Scott Benner 1:04:21
I appreciate you saying that. It's my pleasure. I you know, in full transparency, I started figuring these things out for my daughter. And I started to write online about it years ago, because I was trying to drive money to research. And then I noticed one day that the way I talked about insulin, people seemed to resonate with it. And it was working for my daughter and I thought I bet you could work for other people to this way. And so it just kept sharing it and it kept growing and, and I can't tell you how I got a note from a lady last night about her child's diagnosis day and and how they found the podcast in the hospital that night, and then had shared what happened to them going forward and how well they were doing. And it caught me at the end of the day, I was reading it in bed, and I, my wife's like, what's going on? And she goes, Oh, are you going to cry? And I said, I think so. Yeah, I was just so happy for that little girl and her family. And, and, and there's that part where you can't believe that something you did or said, found a stranger and help them you know, I mean, think about it, you're, you're being helped. Because, I mean, for a number of different reasons, but specific to the podcast, your, you know, your son and his wife have a child with type one. And they start learning about it for him, and then turn to you and say, hey, you know, we're learning about a lot of these things, I think that might help you as well. And he did it. You know, like I said,

Lou 1:05:52
my, my, my daughter in law, for many reasons, is, is a saint to our family.

Scott Benner 1:05:58
You know what I wanted to ask you, they didn't how's your heart? Good. And that's crazy, right? The kidneys went, but your sharpest attack and your heart is okay. And it's interesting, right? That it didn't.

Lou 1:06:11
You know, I've been very, very fortunate. I remember a doctor telling me because I had to take a complete, complete physical everything before the transplant. And I remember the doctor told me, he said, Well, you got a heart like a horse.

Scott Benner 1:06:30
Good for you. That's amazing. It just hit me now. Because, I mean, you don't know this. But my, my my best friend growing up, and I'm old now to I'm 51. But But growing up when I was 18, my best friend got type one diabetes, he's no longer with us. He was on dialysis at the end of his life, and had a massive heart attack a number of years into it. And that's what made me like, I thought that was so interesting that your kidneys had had had the issue, but the rest of you seems okay.

Lou 1:07:02
It's really Yeah. Yeah. Unfortunate. In that aspect.

Scott Benner 1:07:07
Yeah. I mean, and just talking to you, I know that sucks to hear. Because when you're you don't think nobody thinks themselves as their age. But I mean, you're 70 and you and I are talking. There's no like, there's no, you're not pausing. You're not like, you know what I mean? Like you're you're, you know, I'm saying like you're you're it's and with all that high blood sugar is what I mean, like, yeah, age plus high blood sugar. And you don't have a deficit like that at all.

Lou 1:07:33
Thank God. Yeah, no kidding. Well, you know, I did a tour in the Marine Corps. So I think I attributed to that.

Scott Benner 1:07:39
You just don't don't want to give up. Right? Right. Yeah. Did you did you? Were you in the Marines during a conflict or

Lou 1:07:47
college during the Vietnam era? I served in the Philippines. No kidding. Yeah. Marine barracks. Subic Bay.

Scott Benner 1:07:55
How old were you when you got shipped there?

Lou 1:07:58
I was 18.

Scott Benner 1:07:59
Wow. Do you drafted or did you enlist?

Lou 1:08:02
Yeah. That was the last draft 1971 I was the very last draft.

Scott Benner 1:08:06
Louis that's the year I was born. 71. Really? Yeah. 71 Oh, ironic. No, that's crazy. How long were you there? Two years. Wow. That's a long time. Yeah. Did you know

Lou 1:08:20
it was a great tour. I was there with a detachment. In March of 73. I got to go with a detachment where the prisoner of war from Vietnam flew into Clark Air Force Base in the Philippines. And so I was there. And McCain was the third one off the plane. Alvarez was the very first one off the plane. It was it was quite a sight. It was just quite a sight when the POS POWs landed in Clark Air Force Base in the Philippines.

Scott Benner 1:08:57
Louis, you were there when John McCain was returned? Yes, no kidding. Oh, that's astonishing. Yeah, he was beat up ah, bad.

Lou 1:09:08
You know, I wasn't as close to the plane as I wanted to be because I was part of this group of Marines. But it was quite a day quite a day for me that feel

Scott Benner 1:09:19
their return feel like the return of hope, like the end of something the beginning of something new How would you describe why it was such a big day

Lou 1:09:35
just proud that they had survived. Just Just proud that an American survived that that torture and that imprisonment. You know, so he would just, I think the pride of very servicemen

Scott Benner 1:09:57
to leave you with the feeling that anything was possible. You can do anything?

Lou 1:10:01
Oh, yeah, I think could survive that. My gosh, you know, you could do anything.

Scott Benner 1:10:05
It makes me it makes me wonder how much of you being there that day has to do with how hard you're fighting with the diabetes and everything? You know what I mean?

Lou 1:10:18
Kelly, can you imagine what they went through? No, just, you know, just anyway,

Scott Benner 1:10:24
ya know, it's hard to talk about and even harder when you think back to the moment when they tried to let him go. And he said no, right, right. Yeah, yeah. He,

Lou 1:10:34
he stayed. Yeah.

Scott Benner 1:10:36
What's the story there? They found out his father was a high ranking official. So they offered to let him go. And he stayed behind with the men he was serving with instead. Is that right?

Lou 1:10:47
I believe so. I don't know, all the details involved with him, with him being released. But the important thing is, is he chose to stay and continue.

Scott Benner 1:10:59
That's absolutely. I mean, again, I don't know. It takes quite a person to make a decision like that. So obviously, he was doing it for other people as well. And, and we talked about that earlier, right. can do things you can do a lot when you're doing it for somebody else. So yeah, it's true. Yeah, Louis, thank you so much. I really I can't thank you enough for doing that. Thank you. It's my pleasure.

Lou 1:11:24
This has been great therapy for me. Thank you.

Scott Benner 1:11:26
Oh, good. I should I should take this act on the road, just sit in diners and talk to people and it's not a bad idea. Maybe I'll get a microphone and just start going into diners and asking people questions. Hopefully, it'll be fun. Yeah, no one's steal my idea.

Lou 1:11:38
Hey, well, listen. God bless you. Oh, thank you. I appreciate it via via conduce. I don't know what that means. Via go corn with yours. God. Thank you. Nice condors.

Scott Benner 1:11:57
I really I appreciate the I appreciate the good thoughts. I really do. I, I I'm happy to be making this podcast. I'm gonna keep doing it. So don't worry about that. I don't want to be listening to you. I appreciate it. Hold on one second for me. Okay. All right.

Unknown Speaker 1:12:11
All right.

Scott Benner 1:12:16
Everyone calls them big blue. And I want to thank him very much for coming on the show and sharing such a fantastic story. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox you spell that GVOKEGLUC AG o n.com. Forward slash juice box. Also want to thank Omni pod makers of the Omni pod five and Omni pod dash Omni pod.com forward slash juice box when you click on my links, you're supporting the show keeping it free and plentiful. Thank you very much. I hope you enjoyed the show today. I'll be back very soon with another episode of The Juicebox Podcast

#866 Best of Juicebox: Diabetes Pro Tip Newly Diagnosed or Starting Over

First published on Feb 25, 2019. Diabetes Pro Tip: Newly Diagnosed or Starting Over is the first in the now 25 episode Pro Tip Series. Find them all at Juiceboxpodcast.com

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 866 of the Juicebox Podcast

Hey everybody, welcome back. Today is another episode in the best of Juicebox Podcast series, and today we're going to revisit episode 210 diabetes pro tip newly diagnosed are starting over it originally aired on February 25 2019. In this episode, Jenny Smith and I begin the Pro Tip series that you now all know so well. By the way, if you're looking for that Pro Tip series, you can find it at juicebox podcast.com, where diabetes pro tip.com And of course, right here in your podcast player. While you're listening today, please remember that nothing you hear that Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. Are you a US resident who has type one or the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry complete the survey. When you complete that survey. You are helping type one diabetes research to move forward right from your sofa. You also might be helping out yourself and you're supporting the podcast T one D exchange.org. Forward slash juicebox. Today's episode doesn't have any sponsors. But I want to remind you that if you're looking for the Omni pod five or on the pod dash, you should go to Omni pod.com forward slash juicebox want to get that Dexcom G six or that brand new Dexcom G seven dexcom.com forward slash juice box. How about the brand new Contour next gen blood glucose meter contour next.com forward slash juice box. Start your day off the same way I do with a delicious scoop of ag one from athletic greens, athletic greens.com forward slash juice box. The T one D exchange is a fantastic organization that helps people with type one diabetes and I'm speaking at their next event. Check out their website T one D exchange.org. Forward slash juice box. You can get your diabetes supplies the same way my daughter does from us med us med.com forward slash juice box or call 888-721-1514 Would you like to use the same glucagon that my daughter carries? You can G vote glucagon.com forward slash juice box. Wow, there's a lot of advertisers. This is why I spread them out throughout the week cozy earth.com Sleeping on cozier sheets this sweatshirt is from cozy Earth super soft and comfortable. Everything at cozy earth.com is 35% off when you use the offer code juicebox at checkout and hold on. I can't tell you about that one. There's a new sponsor coming next week. But I'm not just talking about it yet. So you'll check back and find that. All right, thank you so much for listening to all that. Now let's jump into Episode 210 newly diagnosed or starting over from the Pro Tip series. This is Jenny Smith and I in 2019 Making the very first episode of the now very famous diabetes Pro Tip series from the Juicebox Podcast.

Welcome to the Juicebox Podcast I'm your host Scott Benner. I first interviewed Jenny Smith, the CDE from Integrated diabetes back in season one on episode 37. At that point, Jenny and I were just talking about different management ideas. But it was then that I realized how much we agreed about type one diabetes, and the management of the disease. I brought Jenny back on in Episode 105. And we really drilled down about a onesies what they were and what they weren't. After that second interview with Jenny, I decided that one day I would have her back on to discuss all of the diabetes management ideas that come up on the show. I wanted to break them down into small categories, something that was easily digestible, where we'd stay focused on just one idea. I wanted to create something that you could come back to hopefully learn from and if you found useful share with others simply and so with that in mind, I give you the first in this 10 part series, diabetes pro tip for the newly diagnosed Pro for those wanting to start over with Jenny Smith CDE

Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And Always consult a physician before becoming bold with insulin or making any changes to your medical plan. If you're a newly diagnosed person with type one diabetes, or the parent of someone who's been newly diagnosed, what do you think the first things to understand are?

Jennifer Smith, CDE 5:29
The first things to understand beyond the glucose values are, what does insulin do? How does it work? I think that's it's a huge one. That is it's under, it's under emphasized, I guess is the best way to put it. Many people, especially adults who are diagnosed are kind of given a this is your insulin, this is the dose to take and kind of go experiment at home. I feel like that's kind of the way that it is. And I think insulin is a first most important thing to really understand. How does it work? What's What's the purpose of it? How is it supposed to kind of finish working? And what is the effect for you?

Scott Benner 6:17
Okay, and so what are some, like bare bones ways to come up with those understanding. So I think, obviously, if you have a CGM, it becomes different, right? If you have a CGM, you can get yourself at a stable spot where you haven't had insulin or food for a while. And just give yourself an amount of insulin and see how it moves you. Let's talk for a second about like old school, do you still teach people that they need to do Basal testing?

Jennifer Smith, CDE 6:43
In a general way? Yes, I think especially for pumping is helpful in the beginning, because it does in that basil only time period, it does give you a general idea of how things are being kept with the rate that's at play. I do think that basil testing needs to be more explained, let's say when we are talking about pumping insulin, though, because there are as you know, a lot of variables that could be at play in that barrel basil testing time period, especially like from from a woman's standpoint, it could very much be that it's not the right time of the month to be Basal testing. Right. Right, right. So all of these various are a kid or a teen who is a kid or a teen who is really athletic. Right, and there is consistent effect of activity level. And it may be different on different days, but there could be overlap from a data goal that you had for our practice or a tournament. I so Basal testing. As a general idea, yeah, it can be a really good place to start, especially if you think things are really off in a certain place of the day. But is it the end all be all of knowing where your insulin should be? Not 100% of the time, right

Scott Benner 8:07
and so, so what I ended up telling people when I speak with them, is that you know, if you're having an issue and that issue could be anything like you're spiking at a meal, or you're you know, drifting high all the time, or you're incredibly high all the time, you know, any of those things. You have to first look at your Basal insulin. It's it's absolutely far and away the first thing I have to apologize to you Arden's texting me and I believe she's trying to tell me, it's lunch. Okay, so lunch question mark. So Arden has been sick the last couple of days and pro already kind of resistant like this to her insulin a little bit. But we are ahead of it now. So she's 106 and stable now. But to give you an idea, she woke up at 110. By the time she was getting dressed, she was 120. Then there was this diagonal up, I Bolus a unit and doubled her Basal for an hour. And 30 minutes later had to Bolus two more units to get her back to this 106. Now she never got over about 150. But she sees that rise every morning like that, that little bit of a rise. But this morning I used I'm going to save three units more than I would normally use. Yeah, it's just because she's not feeling quite well.

Jennifer Smith, CDE 9:20
Again, another reason that basil testing things like this is not it's not purposeful. In fact, I think, you know, a lot of people try to overcome that morning time rise with a Basal adjustment. But what happens then when you wake up at a different time of the day, right or you have a variable schedule, so a lot of times I actually tell people, you know what, let's look at what the rise is. Don't correct it. Let's let's watch the rise. Let's figure out how much of a rise Are you consistently having, you know what we can offset it with a with a dose of it of Bolus. Sometimes that actually hits the mark better than trying to incrementally adjust a basil behind the scene that could actually change day to day.

Scott Benner 10:06
Right right. Okay, so now this is um this is really interesting to the waiter like tell you what just happened. So this is kind of hilarious but my wife is here. I'm gonna have to walk away for a second yeah back. Arden's pump only has 10 units left at it and, and just added her lunchtime Bolus is going to be 12 units. So I just had to do a smaller Bolus as a Pre-Bolus still, and I'm going to send my wife over to like swap. Oh, no, let me go out of my way. The Dexcom G six CGM is now FDA permitted for zero finger sticks. That's right, the continuous glucose monitor that Arden has been using forever, does not require calibration from a blood glucose meter any longer. But do you know what it does do? It allows you to see your blood sugar, speed and direction. Are you rising at two points a minute falling at three points a minute, the Dexcom CGM will let you know with customizable alerts. And if you're the caregiver, or someone who loves someone with type one diabetes, and you'd like to be able to see their blood sugar when they're not with you, that's possible too. Because Dexcom has a share and follow feature that is available for Apple and Android. My daughter is at school right now. We just gave her insulin for her lunch, and I can see her blood sugar, her blood sugar started to creep up on us a little bit. So I got an alert. And we added some insulin stopping a rise. The Dexcom G six features an applicator that is virtually painless. My daughter says she can't feel it at all. And it's completely automatic. One button push and the sensor bed has been applied. You snap in the transmitter and you're on your way. You can see your blood sugar's on your Apple watch or other smartwatches on your iPhone on your Android phone. You can share it with anyone in the world anywhere. I can tell you without hesitation that the Dexcom continuous glucose monitor is without a doubt one of the main reasons why we've been able to keep my daughter's a one C between 5.2 and 6.2 for five continuous years. To find out more go to dexcom.com forward slash juice box or the links in your podcast player show notes or at juicebox podcast.com. It's going to be the best decision that you ever made. So all is okay. Yeah, my wife's it's across the street. Yeah, my wife's gonna run over. She's working from home today. And it really does just go to show. I guess the fluidity that you have to keep around diabetes because okay, I'm lucky my wife's here today. If she wasn't, I would have to tell you, Hey, I gotta go. But in the end, there's no panic here. Arden's blood sugar's 107. I wanted, I wanted to do a Temp Basal increase of 50% for an hour and a half. And an extended 12 unit Bolus for lunch. But she only has 10 units. So instead, I had her set the Temp Basal still and do an eight unit extended Bolus. So she's still going to have four units going when my wife gets there, they're going to swap that pump real quick. And then she's going to head off the launch and be okay. Right. We'll be fine to get early lunch. Yeah, on every other day. It's a 1030. And then on the 30, like,

Unknown Speaker 13:23
what does he get up at five o'clock? Do breakfast? Really that

Scott Benner 13:27
sheets 1030 Every other day and the opposite day sheets at 1130? And she's out of school by two? Oh, wow. Okay, it's all kind of very quick. I don't know if she's learning anything. But so so I Yeah. So anyway, what I wanted to say about Basal is that, I'm sure just like you, I meet people who are having trouble, right? They're either on the roller coaster and they're going to 400. And they're going to 60 and up and down, or, you know, somewhere in that problem. They're high constantly, they're always 180, you know, they can't really seem to do anything about it. And when they get to you, they have all of these theories about why their blood sugar is too high, right? And I tell them, your blood sugar's too high because you don't have enough insulin, and it's not timed correctly. Now we're gonna start with your basil. And they'll inevitably say, Well, what about my insulin to carb like, that doesn't matter. I'm like, you can have a perfect insulin to carb ratio. If your Basal insulin is not right. None of this matters, right?

Jennifer Smith, CDE 14:24
That's right. That's why we call Basal insulin, the foundation of your management, it really is we, we actually tell people, it's like the foundation of a house. If you have a sound structure that you're building on top of everything you put on top of it will work. Even if the insulin, the carbon, the correction factor, and things are a little bit off. If the basil is off, those are going to also look like they're not working well.

Scott Benner 14:51
And it becomes impossible to diagnose what's happening, right. And so what I ended up saying is that you Try to imagine we use round numbers for examples. But try to imagine your basil is a unit an hour. That's what that's what it should be. But you have it at point five. And then you have you look at some food and you say, Oh, well, that food is two units. So you and let's say you're right about that. Let's say you're 100%, right that the food takes two units, you put your two units in, all you've done is now replaced the basil that you needed, right? You're so you're resistant, you're high, now you're replacing your Basal it's possible those two units will only go towards impacting the problems your Basal insulin has. And then your blood sugar shoots up and you go, I don't understand, I put in the right amount of insulin, I counted my carbs, right, I counted my carbs. I looked at the label, and I did everything the doctor told me why didn't this work. And in the end, and you know, through this series that you and I are going to do together, I'm going to repeat a couple of things over and over that I've found to be incredibly helpful. But in the end, if your blood sugar is high or low, you've mis timed miscalculated, or a combination of those ideas. And that's pretty much it, you know that I find that to be the core of it, it's not the first step to me, not being afraid of insulin is the first step. But we're going to talk about that in a different episode. But I think that it's it's timing and amount. And I think there's a million other things that can impact your life with diabetes. But that's the seed of the tree, right? And you could throw away all the leaves and all the branches and everything that comes off of that seed, if you'd have that seed timing and amount, you're well ahead of the game. Right?

Jennifer Smith, CDE 16:34
Right. Absolutely. And I would say the that those two pieces actually go very well together, as far as not fearing insulin, you know, and not being afraid of using it because I certainly work with many people who that is a major problem it is I just want to eat 200 Because I'm afraid to give the amount my pump is telling me to give or the amount that the doctor told me to give, you know, and I think understanding Insulin is the base of that understanding it and understanding the timing, and the action of the insulin and how it also individually works for you, helps to dissipate that fear,

Scott Benner 17:18
right? I think that I think that if you can keep your blood sugar stable at 200, then you can keep it stable at 180. And if you can do it any you can do it at 140. And believe it or not, if you can do it at 120, then you can do it at 75. And you know and so because the the tools that you use to to achieve that stability aren't different depending on what level your blood sugar's at. It's all the same. It's all the same stuff. Okay, so that's that is that's excellent. So we'll talk about fear in an upcoming episode as well. I'm newly diagnosed, I go into my doctor's office, now you are uniquely qualified to tell me this. What do people get told a diagnosis? And why do they only get told what is shared with them?

Jennifer Smith, CDE 18:04
I think it there's a wide range of what people are told, I certainly think that the younger the diagnosis, especially for type one, the younger the diagnosis, the more education there is, the more information is provided. adults that are diagnosed I think, unfortunately, get the least amount of education again, and it differs system to system and provider to provider. But in the beginning, you know, they're taught how to use a glucometer. They're taught how to give an injection, they're taught that you're going to be taught essentially the basics of that insulin action. And you're going to be taught carb counting. I mean, that is pretty much the gist of what you're going to be taught.

Scott Benner 18:51
Anyone who's been listening to this podcast for any amount of time will know that I call that do not die advice. That's the that's the advice you get so that you don't die. It doesn't keep you healthy. It doesn't help you understand anything. It just keeps you from going home and falling over.

Jennifer Smith, CDE 19:05
Well, and I think another piece of that, too, is very, very soon in that beginning is how to avoid hypoglycemia. How to avoid a low blood sugar because insulin causes low blood sugar. And unfortunately, that's where the fear starts.

Scott Benner 19:24
Exactly. And so that's where it starts where the fear starts, but try to understand that from the clinicians point of view, you are frazzled. I say this all the time being diagnosed with a disease that you cannot cure. It feels like someone just walked up to you with a shovel and smacked you square in the face with it and then started yelling, Basal insulin Bolus glucometer. This is a test strip and you're like, wait, wait, what? And so the doctor sees that on your face and can't in I guess in their minds, they don't want to overload you. But the unintended problem is just what you said that you start with Fear, then everything starts with fear. It would be a simple sentence, it would be, it would be Listen, we're going to teach this to you slowly. I know that seems counterproductive, but it's not. But there's no reason to be afraid. And that's what we're going to learn. Now, the question is, do doctors not teach that? Because they don't have the time? Or they don't have the knowledge? Like what like, because there are everyone's gonna walk into a different endos office, you're gonna get an 80 year old guy who's been doing this, since people have been boiling their urine, right? And he's just gonna think that if you count your carbs, and inject and go to 300, and come back to 100, that's amazing. And that's that, right? Right. And then you're gonna get a guy who's in his 50s, who's just starting to hear about like, this CGM stuff, and you're gonna get different advice from them, you're gonna get different advice from, you know, a woman who's been out of medical school for three years and has diabetes. How do you as the patient know what advice you're getting? When you don't know anything about diabetes?

Jennifer Smith, CDE 21:03
That's a very good question. Absolutely. And I think, you know, with today's technology, honestly, I, personally, as people have come to, to work with me, or to work with us that integrated, you know, it's people come because very soon, they realize they're not getting what they need. That's not quite, they're not sure what they're missing. But they know from researching and looking and Googling it, that the information that they've gotten is so just literally the tip of the iceberg, that they're missing so much more beyond and that, you know, that their doctor is saying, Well, you have to be in good control for a year to be able to start on a pump. And most parents or even adults are saying, that's not the case. Right? Doesn't it? That's that's not doesn't make sense. I want to know what I should be doing. I want to know, what is the best for my child or for myself? I want to know, and I think those are some of the things that as a as a newly diagnosed, asking more questions of your provider, even though you may not know exactly what you're asking, when you've Googled it, and you've researched and done some of your own searching, and even asked, you know, some people I think more and more people are, they're kind of they have acquaintances or whatnot, who might have diabetes. And so they, they will ask them, they'll say, Well, they're doing this, you know, maybe I should ask about this. And I tell all the people that I work with, you know, what, if your provider is not able to meet you or can't answer, even those basic questions in the beginning, it's, it's time unfortunately, to find a new provider. It really is.

Scott Benner 22:46
And based off of that idea, I want to say I want to say the same thing to two different segments. So if you're a clinician, and you're listening to this, or if you're a person who has diabetes, or is trying to care for someone who does, there's a space that a lot of people get into, they're not given enough information up front. And they're, they're paying attention, right, they want to do well, they're paying attention, and they see inconsistencies with what's been taught to them in the doctor's office. But because you're the doctor, or because you're looking at a doctrine, you were raised to listen to a police officer, your teachers and a doctor, you're raised to believe that a person in a white coat is infinitely more intelligent than you are, there's no reason to question them. And so when they give you these concrete laws of diabetes, you go home, put these laws into practice, and they don't give you decent results. This is for the doctors, it puts people into such a psychological bad place. It just wrenches their gut, they feel like they're killing themselves or their children. And they don't understand why. And even when common sense things about their diabetes show up. They can't bring themselves to make the leap, because you've told them, we're not told them anything about that idea. And I will give you a great example. And it's a very simple example.

Jennifer Smith, CDE 24:03
Or kind of before your example. You know, it's kind of a cut and dry too. As you know, kind of going with what the doctor said, the doctor said to do this, the doctor said I should take my my insulin and eat right away. Well, if that's not working, and you don't, if you don't know that and clinically, clinicians, I think, really do need more information about what really is the real life of diabetes. What's the real life use of insulin and mastering it's action and all of that because clinical book does not mean it meets what happens at home. And when your clients come to you and your patients with or people with diabetes come to you and they say this isn't working and following all of your rules. It's not working. Instead of saying well, you must be doing something wrong because that that happens often whether as a clinician you want that expression to come out or not. It does you Make them feel like they're not doing something right. And you don't give him a weight to, to help you don't explore with them and say, Okay, I hear what you're saying, I hear that you've tried everything I've thought would, excuse me would work. And it's not let's, let's see why it's not working, maybe something is variable for you.

Scott Benner 25:23
And let's have more of a conversation and explain what's happening. So that so the doctor can glean more from what's going on. I'm at the point now, and I'm sure you're there, too. I can look at a 24 hour graph and make changes in five minutes that improve somebody's life. immeasurably in 24 hours. I don't know why a doctor can't do that. So I mean, I figured

Jennifer Smith, CDE 25:44
some can yes, some are. Some are awesome. But some are not know me

Scott Benner 25:48
well enough. Now to know that, you know, I'm not the wisest person in the world. And I can look at it and go, Okay, this is this like this. My example of, of how powerful the doctor's suggestion or non suggestion can be to people is that I was speaking with a woman in her 40s, who had had diabetes for 25 years. I looked at her graph, she was distraught. And I said, you just need more insulin? And she said, Well, no, no, because in the ocean, like I said, all these reasons why that wasn't the case. And I said, No, that doesn't make sense. And in a brief 32nd, Explanation, over a telephone call, I could literally hear the light bulb turn on in her head, and she went, Oh, my God, I just need more insulin. And I was like, right? That's it? I mean, can we go now or, you know, but but think about, think about that. A well intended, intelligent, educated person who goes to her doctor's visits, and in 20 years, can't figure out why their blood sugars are the way they are, and no one's ever helped her. So what I'm saying to people who are newly diagnosed, or people who have gotten to that point and want to start over, you have to sort of think different, you have to, you know, if you're, if you're in a situation where you're newly diagnosed, and you've gotten some real, like what I call like old timey information, you need to think differently. And if you've had diabetes for a long time, or been caring for someone forever, and it's not going the way you want, that's the first thing you have to do. You have to say to yourself, I must not be thinking like flip it upside down, look at it all the time, I have a friend who every decision they make is wrong. And I once said to them, How come when you have a reaction to something, you just don't wonder, what's the completely opposite of that, and then just do that. I was like, I was like, right, you're right, you're always wrong, you know, so like, and that's what happens every day, you get up and you do this thing with this insulin, and this pump and all this stuff. And it always goes wrong. But yet, there you are the next day,

Jennifer Smith, CDE 27:46
doing it over and over and over again, which is another reason that I you know, working especially with the women through pregnancy that I work with, that's a piece of the variability that I try to encourage them to sort of work on prior to pregnancy. You know, because if you can figure out it's why many people with diabetes, eat some of the same things over and over and over again, they have a standard breakfast, I know that it works. I know that I need this much insulin, I knew they need to use a temporary basil for this much or for you know, whatever extended Bolus, and it works for me, it's, that's the reason is once you figure it out, you're like, great, I like little magic because magic piece right here and I'm not gonna screw it up. Now.

Scott Benner 28:32
I'm gonna have this half a piece of wheat toast two eggs over easy and two tablespoons of avocado for the rest of my life. Right? Exactly. Every morning, if that's happening to you, if you're listening, and that's happening to you, I say this proudly, the there are some low carb people who will get upset and I want to tell them right now you can eat low carb your whole life. I don't care. I'm just saying that if you ended up there because you couldn't figure out insulin. You know, if you're if you're eating something you don't want to be eating there might be a way to manage this. But I tell people very proudly that at this point, my daughter is 14 years old when I'm recording this. She has had type one diabetes since she was two. And for the last five years her agency has been between five two and six two with absolutely no diet restrictions whatsoever. Anything you can think of Arden eats and eats frequently.

Jennifer Smith, CDE 29:25
And I bet her more important within that I think we talked about this in the E one Z discussion and podcasts but more important than even the a one C is her standard deviation the variability which I would estimate without even seeing her information, I would estimate that her standard deviation is very nice meaning she's got these juicy little gentle rolls through the course of the day rather than this major roller coaster because you could have anyone see a 5.4 Yes, but you can have a major you know, standard deviation

Scott Benner 29:56
and we will talk about that in coming episodes. You can't run around with your six a one C but be it 300 Half the day and 50 the other half of the day that you've just tricked the a one C test

Jennifer Smith, CDE 30:06
right? On the doctor. Yeah. Because, again that goes back to clinician. A onesie is certainly it's a starting place. It is not the end all be all there is more in depth that needs to be looked at with that a onesie. Yeah,

Scott Benner 30:19
we try very hard. Well, you know, as you go on and listen to these episodes, you'll realize I'm not trying that hard anymore. I figured it out to the point where it doesn't really take that much involvement from us. But Arden's low alarm on her Dexcom is set at 70. On my follow up, it's 120 for the high alarm on hers, it's 130. And so we'll talk about like bumping and nudging later on, but that's my concept is that smaller amounts of insulin as you try to leave a tight range, get you back into that range more quickly. And cause far fewer lows later. Yeah. Give me one second here, we'll take a pause. Okay. I'm gonna text Arden, she's now wearing a new pump. I need to know how much insulin delivered from the last Bolus. And then because it's a new pump, and she's literally gonna walk right into lunch. Excuse me, going to double her basil for I was only gonna do 50%. Now I'm just gonna double it for an hour and a half. And that way, if there's any slow start with that site absorbing and having action I'm just going to do, I'm going to do something that at some point during these you'll hear me talk about where I call it over Bolus Singh, like I just I imagined not just what her needs are now. But the momentum and higher number that I know is coming. In 2008, we made the decision to get my then four year old daughter and insulin pump, it's a decision that I wish we would have made years sooner. After seeing everything that was available, we easily settled on the on the pod that was back again in 2000 and ate. Today Arden is about to turn 15 years old, and she has been wearing it on the pod every day since then, every day. And as I mentioned in the other ad Ardens eight one C has been between 5.2 and 6.2 for five solid years. How do we do that? Well, we start by seeing an insulin pump is more than just a way to not have to take shots. The Omnipod gives you the ability to do temporary Basal rates, that's increases or decreases in your background insulin, extended boluses, which will help you spread out your insulin over the life of a meal. And so much more. The Omni pod has no tubing at all. The pod is self contained, you wear it on your body, and you control it with a wireless controller. So there's no tubes running through your clothing, and no pump that you have to jam in your bra or down your pants or wherever people have to put their pumps that just doesn't exist with the Omni pod but does exist is the ability to swim while you're getting your insulin bathe while you're getting your insulin and live life untethered. Beyond the party even features self insertion, just push a button. Now I want you to go to my Omni pod.com forward slash juice box. And when you get there, you'll get a free, no obligation demonstration pod sent directly to your house. Check it out and see what you think for yourself. I'm going to do something that at some point during these you'll hear me talk about what I call an over ball of saying like I imagined not just what her needs are now. But the momentum and higher number that I know is coming. Yep. So that's hard change

Jennifer Smith, CDE 33:49
was one thing that I was always in in. In the beginning, I was very thankful that I had noticed the difference with my animus pump change that I needed that site to just be like, just saturated with insulin to get absorption sooner. So and I was glad because when I started Omni pod in 2006, I started doing the same thing that I did with my other pump sites, you know, just Temp Basal ng up by almost 100%. For about it was usually about an hour to two hours depending on kind of where I was at that point. And if it was I was having to change that pod, especially if it was before a meal and I was going to need insulin for that meal with the new pod. I actually instead of doing it through the pod I gave an injection because I just found that a Bolus with that new pod site. It never went well. Whereas if I did a Temp Basal increase, I took a Bolus via injection for that food that I was going to eat and let the pot gets settled in. I didn't have any blood sugar issues.

Scott Benner 35:03
Okay. Yeah,

Jennifer Smith, CDE 35:04
yeah, it's everybody's strategy is different,

Scott Benner 35:06
right? But I'll tell you what it what it what that tells me is, again, this is going to be another sentence you hear over and over again, you have to trust that what you know is going to happen is going to happen. Yeah. So if you make a pod change and your blood sugar's 90, you still need to do that. Right? Right. It's okay, hold on. Yeah, good. 5.6 units. So I'm gonna do a Temp Basal increase 95% for an hour, and Bolus. seven units. All now go eat as soon as possible. So she's got 5.6 units in from 20 minutes ago or so she's still 102. And so I'm not scared of those seven units. She's going to be eating in five minutes. And look, the 5.6 units didn't do anything over the last 20 minutes. So I'm good. My goal here on this Bolus is 75. Diagonal down while she's about halfway through her meal. Anyway, that's again, stuff we'll talk about later. Yeah. Okay. So

Jennifer Smith, CDE 36:10
and comfort level with, you know, will happen?

Scott Benner 36:14
Yeah. Because, and by the way, and this, this, you have to, you have to have these experiences, like, I'm going to leave this in this episode, so that, you know, that things have to happen that you don't expect, because it's data, right? It's, it's, I did this and this happen next time, I'd like this to happen. So I'm gonna do sooner or later, more or less, whatever it is, I'm going to do, but you can't know that unless something goes wrong. Right, right. And so and so here's a great tip for somebody starting over or who is newly diagnosed. There are no mistakes. There are only experiences that build on for next time. That's it. Yep. see something happen. Instead, you can't get dramatic. You can't get upset. You can't cry. You can't go, Oh, my God, I'm killing her. You can't do it. Right. You say to yourself, Okay, bare bones, what just happened here, I put insulin in here. It went up to there. And then it came down and crashed. I bet you if I would have put that much insulin in sooner and spread it out a little bit like I could have created the resistance that that blood sugar needed. Right, right. But if you're busy running around, wringing your hands, and just you gave away an amazing opportunity, and, and I will use this as an example. This past weekend, I was helping a mother with a five year old four or five year old boy. And while I was talking to her, this kid's blood sugar went to 300 off of some Cheerios. And we talked for 20 years, that breakfast cereal. Oh my gosh, we're talking for 20 minutes or so. This poor kids blood sugar's at 300. It's not moving. And we're getting ready to get off the phone. She's like, he's hungry. I don't know what to do. And I was like, Are you? Would you like to do something that's going to sound insane? I'll help you. And she goes, I think I'm desperate enough to try something insane. I was like, great. How much insulin Do you think it'll take to bring a 300 to 90 and she says a unit? And I said How much do you think lunch is going to take and she said a unit and a half as a cool Bolus two and a half units right now. And she says she's like, what's going to happen? We're going to put his blood sugar into a freefall. And then we're going to add the lunch at exactly the right time. And then with a little bit of fast acting carbs if we need to, we'll bring it in for a landing. I said I'll never leave you will will text the whole time we'll talk again and we have to. So she does it. We get diagnosed down to 90 to 75 to 52 hours down to 50. She's texting. Oh my god. I'm like no, no perfect, like, a whole lot. I actually texted her a picture of the guys from Star Wars who are trying to blow up the Death Star. Right? Stay on target. Like just don't don't flinch. Like don't flinch to 52 down to 42 3200. I said, Okay, now's the time to start getting the lunch together. And she laughs She goes Oh, it's already it's just here on a plate. That was good. I said when we get the one at given the food. So 182 down kid gets the food 10 minutes later. Now isn't this interesting? We're dropping 10 points every five minutes on the CGM. Then he eats then all of a sudden the dropping stops the arrows are still there but now it takes longer to get the 170 took even longer to get the 160 and she gets the watch this happen 150 Still two down 140 Still two down. I said okay. It's not going to catch the arrows. Do me a favor, give him a few ounces of juice. She says we don't have juice in the house. And I thought to myself, Oh I just killed a kid over the phone. And goodbye, wrong number. She says we treat Lowe's with jelly beans because they hit him so hard. I said, that's great. But do you have any liquid in the house that has carbs in it? That's not soda. And she's like, Oh, we have lemonade. I said, that's great. I want you to give him four ounces. Eliminate. So she gives them I said, Don't go crazy measuring it. Just give him a little bit of lemonade, right? So she gives him the lemonade boom, goes to one arrow goes to diagonal down, the kid comes in, I swear to you 75 Nice and stable. It's foods been in for a half an hour. And when it was over, she's like, wow, that was nerve wracking. I said, Okay, I know that, clear your head, and then go back and look at the boluses. Look at the time you put the food in and look at the CGM and figure out how that insulin works in him. Because you just had a Master's class how insulin impacts blood sugar and how food impacts insulin.

Jennifer Smith, CDE 40:53
Absolutely, absolutely. And that's, that's the place that as you know, clinicians, they don't have the time to do that. And it's unfortunate is it's unfortunate in the stance that with somebody something like diabetes, type one diabetes, specifically, you need that hand holding, in an instance like that, you need the ability to be with somebody who can say, you're okay, write it out, you're okay, he's going to be fine. You've got jelly beans, you've got juice, you've got honey, you've got something in the house, you've got a mini glucagon that you could use if you need to, you're going to he's going to be okay, she's going to be you're going to be okay. It's, it'll be fine. But you do you have to use those learning pieces, I think it kind of goes along with a really good friend of mine. Who has had diabetes a bit longer than me, which is 30 plus years, hurt. Or her doctor actually gave her kind of a good little hint. For numbers, you know, we start to view numbers in diabetes as good and bad, right? And that comes with that feeling of frustration then, and oh my gosh, I'm like killing myself, I'm doing something bad or whatever. And he said, you know, the numbers are information to just like you said, it is okay, I'm here. Why am I here? You know, what can I learn from this? What can I do better next time. And maybe you analyze it, you know, three hours from now, maybe not in the instant. But it's information. And so he told her, you know, when the number is going to come up on the glucometer. You put this test strip in you put your blood on the strip, and you tell yourself, I am awesome. And here comes a number,

Scott Benner 42:38
right? Yeah, because I just didn't begin to tell me what to do next. And it can't be a judgment, you can't feel judged by it. You can't let you can't, you know, you can't look at it and say bad luck, you can say not what I wanted, not what I was shooting for. Right? What makes me what gets me to what I'm shooting for. And you know, it's funny as as you and I are pretty much wrapping up this first thought, right? I have so many people asked me when they're first diagnosed, what are the things I need to know? And I find around diabetes in general, everyone's looking for an amount or a number from you just once tell me how many minutes I should Pre-Bolus Please tell me how many units I should do if his budget is like this. And I tell them all the time, I don't know figure it out for yourself. And you will write like you have to but I can't give you no one can tell you that a 10 minute Pre-Bolus is going to be what's right for you. In any given situation, let alone all the time. I think it's insane that we think that just because we've set a Basal rate of you know, one and a half units at 2am that we think that that's what our body is going to need every day at 2am It's It's insanity to think that it's just the best we have with the technology we have at the moment. Exactly. And so if you listen to this thinking someone's going to tell me the rules about what I need to do when I'm starting with diabetes. We did we told you what to do it just isn't what you expected. Right? Right. And so I get that I understand that it's it's not a pill disease it's not take three of these a day and you have to have food with them like it's not that easy.

Jennifer Smith, CDE 44:12
And I think as a general to in the beginning of of learning that comfort level and learning you're learning what works for you by watching you also have to take into that the variables that can mean what you did figure out needs to change because of such an such variable right? So you know my breakfast in the morning if I don't get to go to the gym before or after my normal breakfast which I just I like it which is why I eat almost the same thing every single day and it works nicely blood sugar wise but I like it so and it's easy. So but I the variables that I had to figure out were pre eating it. Exercise, post eating it Exercise there, those are the variables, you know. And so what works in a morning, where I'm not exercising at all, is completely different than the mornings when I have exercise at such or such time,

Scott Benner 45:14
there's variables are forever changing, which is why you have to, interestingly, know what they are, and at the same time completely ignored them. And what I mean by that is that you're not a machine, right? So there's certain things that are going to make sense. Like you just said, I know if I exercise prior or post that this changes how this Bolus needs to be. But if you're walking around trying to decide constantly, am I anxious? Did I just banged my knee? Like, like, you know, like, am I going to get a client the thing I see people saying online all the time, like his blood sugar's gonna, he's gonna get sick three days from now I'm like, Oh, my God, just give him more insulin. Like, who cares if he gets sick three days from now, I so that's what I think of. When I say be fluid, I just that it's going to keep changing at such a rate that for you to try to apply static rules to it is insane.

Jennifer Smith, CDE 46:08
You've got that piece of, of life with diabetes that you can then bring into education, which is why people usually come to us because we understand it from the living it standpoint, not from the this is what the clinical book says should be happening. So do this.

Scott Benner 46:27
I'm incredibly proud to say that I've gotten to the point where if I can talk to somebody for about 45 minutes or an hour, they can have a major change in just a couple of days. That's that's communication. That's what that is. Right? Well, that's what I have in mind, Jenny for this series. Today we talked about being newly diagnosed or starting over. The next episode will be about multiple daily injections or MDI. We'll do an episode about insulin bolusing pumping CGM EMS, and on and on until you and I finished covering every aspect of the things that we talked about on the show. Please remember that the Juicebox Podcast wouldn't be possible without its sponsors for today's episode on the pod, and Dexcom Dexcom, the makers of the G six continuous glucose monitor, and of course on the pod is the tubeless insulin pump that Arden has been wearing for over a decade. You can go to my on the pod.com forward slash juice box get a free no obligation demo of the pump sent right to your house. We can go to dexcom.com Ford slash juice box to find out more about art and CGM hack you could do both.

Jennifer Smith has lived with type one diabetes since she was a child. And so she has first hand knowledge of day to day events that affect diabetes management. Jenny holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, certified diabetes educator and a certified trainer of most makes and models of insulin pumps and glucose monitors. She's an active member of the American diabetes Association, the American Association of diabetes Educators, Jenny also co authored the book pregnancy with type one diabetes your month to month guide to blood sugar management. It's available on Amazon and there's a link in the show notes. All that aside, Jenny's just a nice person. And I like having her on the show. And I love the way she thinks about type one diabetes. I am incredibly lucky that she's doing this series with me. I initially shared my idea with Jenny about putting together a series of shorter podcast episodes that would help people transition from their starting point with type one diabetes, because there's just no good reason to struggle. All you need are the right tools and a knowledge of how to use them. And that's what we're hoping to bring you. So when you see the next episode, it's about multiple daily injections. Don't skip it because you're pumping. Listen, there's good information in each one. By the time you get to the end of my talks with Jenny, it's going to feel like you sat in a room with her and I and hashed out every possible angle that you're going to need to understand. Because of the nature of these podcasts, I want to mention again that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, to Always consult a physician before becoming bold with insulin or making any changes to your health care plan. If you found this podcast to be valuable, please go to iTunes and leave a rating and a review. And don't forget to tell a friend the podcast grows when you share it

I hope you enjoyed this episode of the Best of the Juicebox Podcast if you're interested in the rest of the diabetes Pro Tip series. Again, you can find it at juicebox podcast.com diabetes pro tip.com or by going in your podcast app and searching juicebox all one word and pro tip that's two words juicebox pro tip, they should all pop right up in front of you. There are 25 episodes in the Pro Tip series. This is episode 210 Of course, but episode 211 is all about MDI episode 212 all about insulin episode 217 pre Pre-Bolus Episode 218 Temp Basal to 19 Insulin pumping to 24 mastering a CGM to 25 Bump and nudge to 26. The perfect Bolus to 31 variables to 37 Setting your Basal insulin. Episode 256 is about exercise, Episode 263 fat and protein episode 287 illness injury and surgery 301 glucagon and low Beegees 307 Emergency Room protocols 311 long term health episode 350 Bump and nudge Part Two episode 364 pregnancy 371 explaining type one that's an episode that you can give to people and it will explain type one diabetes to them. Episode 391 glycemic index and load Don't skip that one 449 postpartum 470 weight loss 608 Honeymoon 612 female hormones and God knows they'll probably be more one day. Check them out. If you're enjoying the podcast please share it with someone who you think might also enjoy it. And don't forget to check out the private Facebook group Juicebox Podcast type one diabetes. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast