Scott Benner 5/9/23 Scott Benner 5/9/23

#907 Type Two Stories: Karen

Karen has type 2 diabetes and a lot of stories.

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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 907 of the Juicebox Podcast.

Welcome back everyone. This is the fourth installment of my type two Story series. We've already heard from John, LeAnn and Michael, and today Karen, a person living with type two diabetes. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. If you have type one diabetes, or are the caregiver of someone with type one, and you're a US resident, please consider going to T one D exchange.org. Forward slash juicebox and completing the survey. Every completed survey helps someone with type one diabetes, it may help you and it definitely will help the Juicebox Podcast T one D exchange.org. Forward slash juicebox. juice box podcast listeners save 35% off their entire order at cozy earth.com when they use the offer code juice box at checkout and you'll save 10% off your first month of therapy@betterhelp.com forward slash juice box just by going to that link. This episode of The Juicebox Podcast is sponsored by the Dexcom G seven dexcom.com forward slash juice box get yourself the continuous glucose monitor that my daughter has been wearing for years. dexcom.com forward slash Juicebox Podcast is also sponsored today by the contour next gen blood glucose meter contour next.com forward slash juicebox you need and deserve a blood glucose meter that is accurate and easy to use. I had an extra contour next gen at the house that I just gave to a family friend who was concerned that they had pre diabetes on the very first day woke up fasting blood sugar 119. Now they know what they're looking for. They're going to be testing all week and writing down their numbers. You could too contour next one.com forward slash juicebox.

Karen 2:26
My name is Karen and I am 69 years old. I used to be a teacher and retired as of 2006. I'm a type two diabetic. And I guess that's a good start. Because Scott last meal I think

Scott Benner 2:46
it's a perfect start. Thank you. Okay, while you're 69 And how long have you had type two?

Karen 2:55
Well, do you want to count? prediabetes, but um, basically my diagnosis with insulin was 2009.

Scott Benner 3:05
So you've been using insulin since 2009? When right? When did you start having to doctor for this? When was it? When did it begin?

Karen 3:14
Um, about five years before that? Okay. 2004.

Scott Benner 3:22
Wow. 18 years ago. All right. What is the first? Well, were you working then? You teaching? Yes, you were Yes. What did you teach?

Karen 3:38
Mostly elementary physical education.

Scott Benner 3:41
Nice. Well, that sounds like fun, actually. Or is it not?

Karen 3:44
Well, people say, oh, there must be a lot of fun. But really, if I'm playing with the kids, I'm not doing my job.

Scott Benner 3:53
So the fun parts not there, do they? But that was a long time ago back then you let them throw balls at each other and everything right, like dodgeball?

Karen 4:03
Well, occasionally, but we usually use firewalls, so they didn't hurt.

Scott Benner 4:08
I don't think they let you throw balls at each other anymore.

Karen 4:10
No,

Scott Benner 4:12
I don't think so. I don't think you're even like that.

Karen 4:15
I don't know if you can even get hugs anymore. I used to get like 40 or 50 hugs a day. Really, but yeah, but the thing that Well, I had mostly kindergarteners, but the thing that I missed the most was if I dropped something like 24 kids would die to pick it up. Or if I lost something, I can't find my needle race to get it for me. Karen I

Scott Benner 4:49
don't want to be creepy but I could have used a couple of those kids to put my socks on this morning. That would have been a go.

Karen 4:54
There you go and they would have been happy to do that If he would have fought me would have fought to do.

Scott Benner 5:02
Mr. Scott's back hurts. I've got the left one. Okay, so what's the first? Well, since it's funny, type two is different than type one my questions. Alright, so prior to 2004 You live in a life had you had children? No, no. Okay. Would you consider yourself in shape out of shape? A good eater, a bad eater? Like, how did you think of yourself as an adult?

Karen 5:32
I was a pretty good eater, sometimes not. But you know, we all do that. And I've always fought with weight. But at the same time, being told that I created my type two really irritates me a little because the incidence of type two is anywhere from 11 to 17%. From what I've seen, and that's a small amount of fat people who have diabetes, and there's a lot of others who are fat who don't have it. So to say that they're still the cause, because I'm not sure is really fair.

Scott Benner 6:16
Karen, I like your math on that. You're like, listen, there's 10 of us here. Two of us have diabetes. We're all fat. Yeah. So is there. Type Two in your family line? No, no? Okay. Well, okay, you start You shocked me there. Okay, that's fine.

Karen 6:39
And some great grandmother had type two. Well, that's a great grandmother. Well, that's. Well, yeah, but she had 10 children, too. So gak in the 30s. You know,

Scott Benner 6:51
Karen, what are you saying? She used herself up and everything came for? Kind of 30 she had? How many of her? Do you know much about her? Did any of the children not survive?

Karen 7:04
No, all of the children survived except one who was killed at age 19. In the war? No, he was killed on a train track in the Upper Peninsula of Michigan. Oh, my gosh, I can't believe you know, in a snowstorm

Scott Benner 7:21
in the snow. Well, you

Karen 7:23
know, you know how families tell story. They share a lot of things.

Scott Benner 7:28
It's interesting. I I always wonder how accurate any of those old stories are that have been passed down? You don't I mean, like, I'm talking to my mom, and she can't. She's not getting right. What we did last week, and I think, yeah. Tell Tell me the story about your uncle again. You're sure about live.

Karen 7:48
I've had more than one, you know, story about that. And he was he is probably drunk at the time. And snowstorm on the train tracks. And, um, you know, I looked it up online. One time when ancestry he had a free thing, and I saw his death certificate, so I'm pretty sure that was accurate. Because he had, he had been asked to go to play with John Philip Sousa is banned, but he was only 15 years old at that time. Oh, yeah. Like when can that? Really? Yeah.

Scott Benner 8:31
Okay. All right. Well, that's great. Oh, sorry. Sorry. We're getting too far away. No, that's your great grandmother had type two diabetes that we

Karen 8:39
and 10 kids

Scott Benner 8:41
and a really tired vagina imagine so.

Karen 8:46
And she she and her husband were immigrants. So

Scott Benner 8:53
wow, from where? Finland and are so you are? Are you finished or part finish? Half finish. Very nice. I appreciate you saying that. So we can title the episode.

Karen 9:11
Well, I'll have a friendly Anders in the up we'll be happy about that.

Scott Benner 9:16
I'm just wondering right now how many people know who John Philip Sousa was?

Karen 9:21
Yeah, that's true. I was impressed when I was in in orchestra. So

Scott Benner 9:27
Oh, I love it makes sense. Okay, so you in 2004 start experiencing symptoms. What are those symptoms?

Karen 9:37
Well, it was mostly my blood tests showed that my glucose levels are a little high.

Scott Benner 9:43
So you're just in your, in your yearly physical or whatever. And the doctor starts talking about like, Oh, you're pre diabetic, that kind of thing.

Karen 9:53
Exactly. Okay. And he put me on Metformin.

Scott Benner 9:56
And did that do well first of all, do you remember what Pre diabetic meant back then what were they telling you a one C was?

Karen 10:03
I really don't know. Okay. I don't know, back then if they really set a one, see

Scott Benner 10:10
if that was the measurement or if they were doing were they do fasting? Were they doing like a fasting blood glucose maybe

Karen 10:17
more or less to to be diagnosed? I think I did that. But that was right away. I should I would do my fingers check and have blood glucose of 115.

Scott Benner 10:34
And that pretty regularly regularly. So they put you on they put you on Metformin. Wow. Did you experience any weight loss from the Metformin? No, no. Did you experience a lessening of your blood sugar? Did it help with that?

Karen 10:51
I don't think so.

Scott Benner 10:52
No. And how long did they leave you just on Metformin? Five years? And you don't feel like it did anything for you? Not really

Karen 11:00
well, it gave me diarrhea.

Scott Benner 11:05
Karen, you and I are gonna have fun I can tell.

Karen 11:10
I mean, yeah, it was, you know, I found that found more bathrooms people must have sensed like in stores or whatever, where they said no public bathrooms. They must have sensed urgency in my eyes or face. Because they would let me use bathrooms. I have seen bathrooms that you would not think

Scott Benner 11:31
existed. Yeah. What's behind this sheet in the in the clothing store? Oh, my goodness. All right. All right. This is where they keep the mop bucket. Okay. Absolutely. So you had you had stomach pain and loose stool? To say the least? And yeah, but no, but no. improvement. So what was said to you, as best you can remember as long time ago, but as best you can remember what was said to you about? I'm going to use Metformin. And then when you'd go in subsequently for other visits, what was the conversation like?

Karen 12:13
Well, just, you know, that I was doing okay, it was my primary care physician, who had been with me for a while I started with him. I hadn't had a real physician for a while. And when he started practice, I finally had some pain in my chest kind of more or less at the top of my stomach, you know, like a reflux thing. So, you know, I'm thinking heart, whatever. So I went in to him, and he's, he's been my doctor ever since. And now his kids who were about to at the time are adults. And through college, and so on. So it's been a few years.

Scott Benner 13:03
And so you're with this guy for a very long time. But for five years, you don't see. Well, I guess there's no, there's no worsening of it. Is that right? Right. So they're so in their mind, I'm guessing what that meant was, you would have gotten worse without the Metformin. So therefore, the Metformin is helping. I guess so. Yeah. But, but my point, Karen, is that there's not a lot of conversation around a lot of explanation, right, you're not right, you don't leave there feeling like you really understand what's happening to you. Right. Right. Okay. Right. Did the stomach problems ever go away with the Metformin? No, it's stuck with you forever.

Karen 13:48
But I also had reflux diagnosed separately, you know, right. Without taking the Metformin. So, later,

Scott Benner 13:58
let me ask you this 2004 is Oh, god, what's 2022? Give me a second. For give me a sum on this. Alright, so, um, so one, that's the one I'm accessing 818 years ago. That's not what I want to know those 69 minus 18. That's one. You were 51 when this started, okay, so,

Karen 14:24
but I should tell you something, go ahead. When I was 44 I had bad hemorrhoids. I had a hemorrhoid ectomy. internal external fistula, a whole smear, no bleeding problems. My mother has bleeding disorder that was discovered in Finland. So I was tested for it. Yeah, false. The doctor who tested me for looked at my hemorrhoid ectomy results and said, Oh, you had a very bloody sir GE no problems. You don't have von Willebrand disease. So,

Scott Benner 15:06
okay, hold on, let me carry on. Let me go slower here. Hold on a second. I think I have this. So, and again, we're having a good time. So you had very bad internal and external hemorrhoids that had excised somehow. And, and your mom has van Wilbur brands,

Karen 15:25
buying Willow brands, as do I Okay, but it's a bleeding disorder. Yeah.

Scott Benner 15:31
But the the doctor who examined you, I'm guessing you're getting ready to tell me just looked at your surgery and said, What? What were they? What were they inferring from the notes from your surgery?

Karen 15:44
He said, You had a very bloody surgery, and you didn't have any bleeding problems. So along with your testing, I don't think you have been well grants.

Scott Benner 15:58
Okay, because he thought that a bloody surgery would have led to something that would have indicated this.

Karen 16:04
Right. Okay. Now, two weeks before I saw him. I had quit taking birth control pills, because of my painful periods because I had had and Demetrius Okay. Okay. And well, I had the hemorrhoid ectomy. I was taking birth control pills to try to control the

Scott Benner 16:26
pain. Yeah, the pain not the bleeding. Monthly. No. Okay.

Karen 16:30
No. In fact, the only symptom I ever had was nosebleeds when I was a kid. And even then, it was iffy. You know, I had nosebleeds and yeah, it happened after I had a tonsillectomy. So before I had the tonsillectomy, I hit your eggs every night. But after I hadn't had select me, I did have to go back in for some clotting in my throat. But then I was fine.

Scott Benner 17:03
How old? Were you around the tonsillectomy? Like regular age? Four. Oh, really? Okay. Can I go backwards for a second to ask a question? Certainly. Did the removal of the hemorrhoids help with your issues?

Karen 17:18
While it was very painful, and I couldn't sit very well, I could stand but I couldn't sit very well. So yes.

Scott Benner 17:26
So So by the time you had gotten to the, to getting the, the procedure, you were not able to sit at that point.

Karen 17:36
Not very well, well, I kept shifting or you know, like, if I went to a movie, I was constantly moving. You know,

Scott Benner 17:45
was there bleeding with the hemorrhoids or just paying?

Karen 17:49
Very little bleeding? Okay, but he gave me some nitroglycerin ointment that worked. So that helped with the pain and the bleeding travels. zere.

Scott Benner 18:03
Interesting. Okay. So you weren't losing blood from the hemorrhoids? No. Okay. You were just in pain. And when you sat down, you were tilted one way or the other. Right? Yes. Okay. The endometriosis was being treated. I guess I'm making air quotes with a birth control pill was well, hopefully but it didn't really help. I was gonna say it didn't really help much. Right. Right. Okay.

Karen 18:35
So in February, I had a diagnostic laparoscopy which showed that I had endometriosis. For sure.

Scott Benner 18:47
Do they do something for that? Or? Well,

Karen 18:51
the next thing was a hysterectomy. In April

Scott Benner 18:58
How old were you then?

Karen 19:00
44 Okay. Oh no. 4535

Scott Benner 19:04
And you did you did this to me?

Karen 19:07
Yes. Yeah. Total complete. Self Pingle Oh for correcting me, et cetera.

Scott Benner 19:16
Wait, what did you just that's the

Karen 19:18
whole whole surgery name and got a whole you know, 20 letter. Description.

Scott Benner 19:27
I'm looking this one. I mean, you said oh, it was like you said nitroglycerin pills at one point. So I was like, what is happening here?

Karen 19:38
Was it it wasn't pills. It was anointment ointment. Excuse me. That's okay.

Scott Benner 19:43
I don't see the hysterectomy other name for it? Well, they

Karen 19:47
probably don't list it because it's my it's on my sheet.

Scott Benner 19:55
Wait, no hold on my diagnosis. Is it an offer? To me, overarching Yeah, so I won't be gone this far. Hold on a second Karen let's figure it out.

Karen 20:08
I think so Pingle refers to the fallopian tubes or something.

Scott Benner 20:13
It says the total hysterectomy is the surgeon removes your uterus and your cervix but not your ovaries. total hysterectomy is most common type hysterectomy with Oh, for ectomy, the surgery moves your uterus, one or both of your ovaries, and sometimes your fallopian tubes. Okay,

Karen 20:32
I don't have any of it. They just, it's gone anymore. It's all Yeah, it's all gone. And I had an appendectomy at the same time because my one ovary was bound into with scar tissue with the app, appendix. Holy

Scott Benner 20:49
crap. Karen, or do you have any brothers or sisters?

Karen 20:53
Yes. Brother,

Scott Benner 20:55
does he have any significant health issues?

Karen 20:57
Other than bipolar? No?

Scott Benner 21:00
Interesting. You sound like, it's so interesting. I don't want to say what I was gonna say. I'm waiting till we talk a little longer.

Karen 21:06
That's what I that's what I always tell my doctors I'm I'm always interested.

Scott Benner 21:13
That's for sure. So you're so your brother hasn't had his butt cut open or anything else like that? Okay,

Karen 21:18
no. All right.

Scott Benner 21:20
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Karen 24:44
My mom had hemorrhoid ectomy TWICE,

Scott Benner 24:47
TWICE. She loved it so much. She went back Yeah,

Karen 24:51
sir. In fact, my doctor at that time said this will be the worst pain you'll ever have. worse than childbirth or, you know, which I haven't had but

Scott Benner 25:06
take his word for his right. Yeah, five stars. Five stars. I love it will return. You tell me about the pain. How long did it last afterwards?

Karen 25:18
Well until you could really pass stool, it was bad. Because you're, I was afraid to push it off.

Scott Benner 25:27
I bet you know, days weeks,

Karen 25:31
probably at least a week

Scott Benner 25:33
and pain. Pain medication slows down your bowel motility. So I assume you don't want too much of that either. Right?

Karen 25:40
Right. But I still did.

Scott Benner 25:44
Heroin? No.

Karen 25:49
No. But he he had a step down. The surgeon was very good. I liked him a lot. He had a step down procedure. Like after a week or so I called and said, I'm running out of pain pills do How can I have some more? And they said, No, you can't have any more of those. But we have something else. Well, it all worked. As he stepped me down. It worked. So he obviously had it figured out

Scott Benner 26:16
and they didn't return. Is that right? No. Oh, good for you. That's excellent. Did you change your diet at all in in? Like, go with more fiber or like that kind of an idea?

Karen 26:28
Um, yes, but not just because of the hammer deck to me. Just just because I've always been fed tend tended towards him.

Scott Benner 26:38
I don't know what to say. I don't think I'm supposed to say that. But it's okay for you to like it's okay. I know what you're How tall are you?

Karen 26:49
I heat six.

Scott Benner 26:51
And how much do you weigh now?

Karen 26:52
Right now I weighed about 270.

Scott Benner 26:56
And through your whole life around that weight? No, no. How so? Where were you say in your 40s?

Karen 27:03
Um, well, depending on when but after I had the hysterectomy, I had lost way beforehand. But I was very, very thin because I bled all day, lost a lot of blood had to have blood products. And I was so thin. Yeah, people said I was anorexic. And when I was the ASEAN, I weighed 139 pounds because I tend to be very large bone. So, you know, I'm not saying large boned in the sense that some people say I'm saying I really am. I've never, ever had a boyfriend whose hands were bigger than my

Scott Benner 27:49
shoulders, things like that. You're saying? Yes. Okay, so when did you find out you had von Willebrand? I mean, you knew your mom had it. So

Karen 27:59
right. Well, after I bled all day with a hysterectomy, I was I had a hysterectomy. First thing in the morning. And then last thing at night. I went back in just before midnight to have a hematoma evacuation. In other words to take out the blood and clotting.

Scott Benner 28:21
Okay, that sounds terrible. I'm sorry, that just shocked me for some reason.

Karen 28:26
It was kind of serious. Yeah. Right. Yeah, that the doctor that I had had been my OBGYN residency supervisor, he does have some time in his office. And so they knew each. And this doctor also knew my mother. So he was familiar with von Willebrand and he was an ontology specialist. So he knew quite a bit about federal grants.

Scott Benner 29:00
And how do they help you with that? Or Can't they?

Karen 29:04
You can't give me too much after the fact. So he gave me a packed red blood cells. And I felt great.

Scott Benner 29:12
Really? Do you have a lot of them through your life? A lot of that what I would describe as like low iron feeling tired gaining weight, like from the from the iron?

Karen 29:24
Well, I do but not necessarily from that yet reason.

Scott Benner 29:29
Why do you think you do?

Karen 29:32
Um, I think from well, I have depression, bipolar. I'm fighting thyroid right now, which is why my weight is up, I think, because I can't seem to follow anything. And I'm, you know, I just think there's other things going on. Yeah. Go ahead. I'm sorry. Plus, the meds I take make you tighter,

Scott Benner 29:57
right. Thyroid you've learned about recently in your Life.

Karen 30:01
Yes, I just had an ultrasound on Tuesday.

Scott Benner 30:04
Are they calling it Hashimotos? or hypothyroidism?

Karen 30:07
I haven't. I haven't heard anything but I'm taking levothyroxine

Scott Benner 30:12
you're taking that? Said helping?

Karen 30:15
Yeah, somewhat but I'm on 50 micrograms. Okay, slowly. Yeah, slowly increasing, hopefully

Scott Benner 30:25
good. What what point did you realize you were depressed?

Karen 30:32
This would be after the, the. The history.

Scott Benner 30:40
Oh, I was gonna say the first time somebody dug into your butt because that would have depress the hell out of me. I would have been like, I mean, no,

Karen 30:47
that was like

Scott Benner 30:51
that's an indication of how bad the hemorrhoids were if they were like, so you're gonna put a speculum where and then cut? What sounds good. Hey, get in there, buddy. Okay, so after the hysterectomy. Had you had no indication of, of depression prior to that?

Karen 31:10
No, not really. Worrying. I was always super active did 1800 things? Yeah,

Scott Benner 31:17
yeah. Do you think it was a shift in your hormones that cause that? No, no. Was it the loss of the idea that you could have a baby? Did it depress you that way?

Karen 31:28
Well, that was a little bit depressing. But I already knew that. At age 44, you're kind of you know, thinking that yes, that anyway. And if you don't have a boyfriend or a husband or whatever, I don't think it's a wise thing to necessarily have a child. And

Scott Benner 31:46
did you want children?

Karen 31:49
Of course. As an elementary teacher,

Scott Benner 31:54
that might be enough kids. You know what I mean?

Karen 31:57
Yeah. I wouldn't have taken them home.

Scott Benner 32:02
Unless you never did illegally. That's nice. Oh, no, I wouldn't do the I didn't think you would kind of second. second ago. You just listed off a bunch more things. So I'm picking through them. So your your brother's bipolar. But you are? At what age did you realize you were

Karen 32:22
this would be at 44?

Scott Benner 32:24
Everything sort of happened at once? Hmm.

Karen 32:27
Yes. That's why I kind of interrupted you and went ahead and said, Wait a minute, but there's one more surgery

Scott Benner 32:34
that year, which was a gallbladder gallbladder took it out again.

Karen 32:40
Yes. Okay. And at that time, because of my reflux, they did something called a Nissen fundoplication. Where they wrap a part of the fundus, from the stomach around your esophagus to make like a false fails. Okay. It doesn't really work. But there is one plus I cannot lie.

Scott Benner 33:07
You can't finally, something happen on the positive side.

Karen 33:12
It sounds like a really weird. Plus, but you know, it's like, Oh, well.

Scott Benner 33:19
Aaron, I have to tell you, because your story is going to be part of the type two Story series. It's just going to be called type two stories and then Karen, but if it wasn't, I was gonna call it no fun. Does.

Karen 33:33
That would be good. Thank you. I wouldn't mind.

Scott Benner 33:37
It's so. Okay. I have sort of a big question for you. Yes. At some point in your life, do you just think, well, I got it. I gotta shift body. Like, like, I have way too many things wrong with me. And there's a lot of stuff here. Like, I mean, listen, it's easy to look in from the outside, right and see a person who's overweight and say, Oh, they don't try hard enough. Or they whatever. Exactly, yeah. But you have but I don't feel that way. No, I don't you have a good attitude? I don't imagine you do. But I'm just saying like you have so many things wrong with you like medically, that I'm starting to lose track of it where I'm writing it down. Because I had some notes I had to keep so I was like, Oh, this this is just the type to interview. I won't need my whiteboard. And now I'm writing in the gaps.

Karen 34:32
Thyroid I told you I told my doctors I'm always interested

Scott Benner 34:35
Well, no kidding. Gallbladder reflux, thyroid, endometriosis. Hemorrhoids that require surgery, bipolar, and depression and I missing anything.

Karen 34:50
Um, well, I also have some more autoimmune type things like I have localized psoriasis.

Scott Benner 35:00
Psoriasis I forgot one little brands. Okay, what else?

Karen 35:06
Um, I think that's about it because the thyroid we already covered. And when I went in to see the, the endocrinologist last month, because before that my PCP handled all of the diabetic problems or insulin prescriptions and that kind of thing. You know, I said to him, Am I really a type two? Because I listened to the Juicebox Podcast. And you're always asking him about this thing? And he said, Oh, yes, you definitely are. Well, I still question some of that.

Scott Benner 35:48
Karen, I have to tell you like as you're speaking, I kept thinking like, we sure she doesn't have type one diabetes. And not because not because we haven't even talked about your diabetes yet. But because right because the the bipolar and the thyroid and like, and the endometriosis and like it all feels like you're telling me is you just feels like you've come on as a type one and you're telling your story. Have they ever done testing?

Karen 36:14
No, not really. Um, I don't know why the cuz I've only seen him once. I don't know why the endocrinologist said that. Exactly. But I will ask him feature.

Scott Benner 36:27
I would I would love for you to get tested.

Karen 36:31
Yeah, I would do. I mean, if I say yeah, I want you to. Now bear in mind, I have been tested, I had so many blood tests. I had 16 tubes filled for four different doctors. Last time I went, got my blood drawn. So that was quite a bit.

Scott Benner 36:54
There was this one time, Arden was sent in for a diagnostic thing. And the the phlebotomist was like, oh, excuse me. And she left the room with this little tray and came back with more. There wasn't enough tubes in the room, Martin within. Arden looked at me and she's like, that that's a first and I said, Yeah. And she's like, Oh, and this lady just, I mean, we were having long form conversations. While this ball was coming out, it just felt like it wasn't going to stop. So. So you've never been tested for antibodies?

Karen 37:30
No, boy, that would not that I know of anyone.

Scott Benner 37:33
That would be I mean, that seems obvious to me. Because, well, go ahead.

Karen 37:38
Do you have any just seen the endocrinologist once though? You know, hasn't been on time to ask a question.

Scott Benner 37:48
Right. Okay. So let's do the rest of this. So, okay. Yeah. So you are eaten Metformin for five years in 2009? Somebody gives you insulin for the first time? Uh huh. How does that go?

Karen 38:03
Um, well, it was the day of a wedding of a friend and I missed the reception because my blood sugar was low. I hadn't expected it. I was taking Lantis and didn't really understand what I was doing, you know, so I thought, well, I better do that before I go to the reception and eat food and so on, but didn't really have a lot of instruction.

Scott Benner 38:29
So they just gave you Lantus and you would shoot it once a day. Yes, and nothing else at the time. No. Okay. Not then. And so without good direction you ended up low. And do you go back

Karen 38:44
super super low now that I know what that is, but at the time low?

Scott Benner 38:48
Why imagine for the first time any low feels scary as hell? Right? You know,

Karen 38:53
so I was afraid to drive 15 minutes to go to the reception, etc.

Scott Benner 38:59
Given me character driven memory, but

Karen 39:04
yes, I did. Okay. But I didn't know about Lowe's. Okay. So and the, the whole reception was full of EMTs I probably would have been okay and nurses

Scott Benner 39:17
out there. But, but tell me about that a little bit. So they give you this Lantis but they don't explain anything to you. You're just it's handed to you like a pill that you shoot with a needle. Is that right? Correct. Just take this now we're gonna do this.

Karen 39:32
Take this much. Do this. Yeah.

Scott Benner 39:35
No training, understanding what it's going to do what might happen or not happen what you're looking for with your meter. Nothing like that's described. Right? Okay. How long do you go on just doing Lantis?

Karen 39:49
Oh, I'm probably a year,

Scott Benner 39:53
a year. And then do they move you to a mealtime insulin as well?

Karen 39:57
Yes. Which I got moved to Novolog for fast acting and Novolog myth 7030 For long term.

Scott Benner 40:08
Okay, so just the Lantis was not doing anything for you. Right? Not doing enough, right? So now you're going to shoot it meals? What's the description from them about how to do that? What is your understanding of what you're about to start doing?

Karen 40:24
Um, well, I just followed directions, you know, the, how much I was supposed to take. And what times and then before meals, I had the sliding scale thing. So, you know, did the finger sticks. And, you know, of course, my problem with that is when you do finger sticks before your meal, you don't necessarily know how much you're taking, you know, as for carbs during the meal, and you don't know if afterward, you've really accomplished that, because they don't tell you to take your blood afterwards.

Scott Benner 41:05
So they would tell you to test at your mealtime and probably use some sort of a ratio they gave you that involve your your current blood sugar. And then you were supposed to say how much? How much how many carbs you were gonna eat? And then shoot?

Karen 41:21
No, nobody said that. How many carbs? I was going to eat just these just shoot

Scott Benner 41:24
this amount, and then don't look again after that. Right. Gotcha. What part of the country you live in? Michigan? Okay. It doesn't matter anymore. I get I give up. I don't trust anybody. It doesn't matter.

Karen 41:42
I will tell you this, that it is true that most type twos don't have a clue.

Scott Benner 41:49
Yeah, we're doing this.

Karen 41:52
You know, it's it's much easier to find things on Juicebox Podcast or on the Facebook group than it is for any type to group. Yeah. I've tried to find out.

Scott Benner 42:08
Current Tell me about that. So you're saying that you joined type two groups. But they weren't helpful? Not really, is it? Because it's full of people who are all lost and don't know what's happening?

Karen 42:21
Currently? Yes.

Scott Benner 42:23
Well, that's a shame.

Karen 42:25
Currently, yes.

Scott Benner 42:26
And I mean, you're not getting any. Listen, nobody told you what the Metformin was going to do what what their goal was, nobody's telling you what the insulins goal is, it's just do this. Thanks. Do you think? Can you step out of this as your as it step out of it for a second? Don't think, okay, as your story for a second, just look back at kind of look back at it? What, why? Why would someone not explain it to you? Do you come off? I'm being really like, serious now. Like, do you come off as somebody who just wouldn't understand? So it's not worth my time?

Karen 43:00
Now, I think I come off as somebody who already knows,

Scott Benner 43:03
okay, and so do you think that they think, Oh, I don't need to explain to Karen she understands it? Like, is your confidence? Maybe stopping them? Or do you think that this is just what happens?

Karen 43:16
I'm both. Okay. Partially both. Because I do know a lot about the physical body. If you're a physical education teacher who's not just moved into a position, you've had to take anatomy and physiology, you've had to take kinesiology, you've had, I have three physiology classes in college, you know, undergrad, that's not even the graduate. So, you know, I do understand a lot. So I think it does seem like that. That's a possibility. And also, in my family, I happened to have physicians, and about eight nurses. You know,

Scott Benner 44:03
I always feel like they're not they know something that they're not telling you. But But you're making me wonder if they don't know. And they're just like, Oh, good. She knows.

Karen 44:12
Yeah. Or she'll find out

Scott Benner 44:15
oh, yeah, but such an odd thing, isn't it? Like, especially with insulin, which can make you so low, dangerously low? If you lose it rock, use it wrong? And the idea is they'll figure it out is, uh huh. I don't know, the whole thing is just free

Karen 44:31
and my agencies were horrible.

Scott Benner 44:35
So it wasn't helpful. What were your agencies? 19 Oh, my God.

Karen 44:40
Well, yes. Then I brought it down each time. 19 then 12.

Scott Benner 44:48
Karen, let me ask you a question. I only ask you real serious question here. I don't know and I haven't been doing the types of stories conversations long enough. I don't have a real like slick way of saying this yet. Was So I'm just gonna say, are you eating your way to a 99? One C? Or is your body like just so incapable of handling it that any food drought drives? You highlight that? Probably both. Okay.

Karen 45:12
So is that what you eat? You know, but at the same time, then I happen to run in after a few years, went into a program nearby. There's a couple, they call themselves chick pea and bean and they have a foundation, that's 501, C three, and did meetings and so on. And they had a thing for diabetics for how to become vegan. And the reason that I did this is because the husband Mark reversed his type two,

Scott Benner 45:53
by being vegan. So you thought maybe that would be helpful.

Karen 45:57
Right? And, you know, I'm not looking for perfection. I mean, I don't exactly think that, I'm going to totally reverse it. But if it does a better job, you know,

Scott Benner 46:09
you could lose then and your agency would go down, and you'd feel better overall, you're not trying to be a Tiktok star or anything like that. You just want to write Yeah, you feel better. Did that not work for you?

Karen 46:21
It works great, but I couldn't keep falling it.

Scott Benner 46:25
Tell me why. So first of all, what endemic? So what does it work? Great mean? You were losing weight?

Karen 46:33
Oh, yeah. How much? I I lost at least 50 pounds. Oh, my God, I had to have another sleep study for my apnea. Because you know, it was over treating at that point. So yeah.

Scott Benner 46:51
You lost 50 pounds, just eating vegetable based, right meals. And then what what about the pandemic stopped you from doing that?

Karen 47:02
Well, my mom lives in a very small town. She's now 91, close to 92. If you're living alone, during the pandemic, that's no fun. So I moved back home with her, partly to you know, have somebody to be with but also to help take care of her a little bit. And my small hometown doesn't have a lot of possibilities, you know, and I was lacking in energy. I think the thyroid was getting me back then. Three, four years ago, and couldn't really do a whole bunch of things that I would like to write. So there you are, you know, Karen,

Scott Benner 47:51
she is it fair to say that you grew up? I don't know. I should be asking. Did you grow up in like an economically depressed situation? Like, did people not know about food? When they were raising you that kind of stuff? No, no. So so they didn't know about food? But you had money? I'm sorry, I shouldn't have mixed those questions.

Karen 48:15
No, that's okay. Um, when I was a kid, we didn't always have money, but we always knew what we're doing. But things have changed since I was good. I was born in 53. You know, used to be a good dinner to have fried chicken. How long it's been since I've had fried chicken, you know, I mean, we use polyunsaturated oils now is supposed to be good. Like, you know, you want to do that, you know, so,

Scott Benner 48:46
so just in general, people's understanding of nutrition was lacking. And so this is really interesting. Hold on a second. I said, cough. Sorry. We've been sick here for months. Now. I don't even know how I'm getting this podcast at this point. But I am not gonna cut that out. I swear to you, I had to start doing situps the other day because I think my wife's on her way out and I might have to date. So he's been sick for so long. It's just It's that good. She got the COVID that translated into bronchitis that seems to have gone into a third thing. She's been sick for like two months almost. And really beaten the hell out of her so but every day I know you've said that before. I mean, nothing like this has ever happened before. So we're it's kind of got the house on a is she 44 Karen, you're hilarious. Yeah, make me cough. I think I spilled something on my chest. So you grew up in this place where it In time, not not a place but a time when like you said fried chicken was good. You were loves that nice, hot, healthy, tasty meal and with throw some potatoes with it and their sin, and everything sort of goes in that direction. So were you heavy as a child?

Karen 50:18
Um, I thought I was, but I wasn't really okay. Um, again, I'm, I have a big frame. And I always seen my friends would be, you know, like little, you know, five, five foot people who were tiny anymore a size six, you

Scott Benner 50:37
know? Yeah, you're saying if you were born in 19, let's go further. If you were born in like, 2000, you would have just been on the girls rugby team in college or something like that would have like, kind of that kind of a built right. Alright, okay. So. But my point is, is that you're out of a generation that just doesn't know what food is supposed to be. And listen, we're all guessing right now that we're right now that we're correct right now, but 330 years from now, my kids might be on whatever our podcast is. 30 years now go and listen. We were eating like this. And we thought it was good. You know? Yeah. So I take the point that we kind of went from the Depression era, where those people, they didn't have anything. And then things got better and the 50s happen and Leave It to Beaver. And now we're all gonna live in houses and smile and everything and, and one person's working in one person's not there's plenty of food moms at home cooking, and making these big meals. And that's the that mom grew up as a child, probably not even eating every day. So that changes the psychology of around food there. And I mean, you already know like food pyramid, which I think is basically been debunked. Yeah. And like you said, like, they were coming up with these. Well, there's that whole thing right where I don't want to dig into it, because I don't know enough about it to talk about it. thoughtfully. But I think the the sugar lobby put out this report to make oils look bad or oils to shoot, I don't know it was one of the other and

Karen 52:18
when and then the, you know, like pork, the other white meat, they hired surgeons to cut the fat out of those meats that they tested.

Scott Benner 52:30
Right like things things like that were going on. There was a marketplace. tomfoolery going on for like sugar was like, Hey, listen, it's fats fault. That was like it sugars fault. And like, you know, and, and then one, one idea takes hold, almost like the like almost like, you know, VHS and Betamax. There's this argument in public and one of them wins. And then we go in this direction. And so we acted like sugar wasn't a problem, even though sugar stored as fat. So, you know, if you ever had gone to like a water ice place, or like an Italian ice place, and there's a sign up that says no fat, like this, like you're eating, it's sugar. And as soon as your body gets it, it's like lost or this as fat. If you didn't intake any fat, but your body turned it into fat. And right. And so now they're coming up with the idea of like, well don't eat red meat, because it'll give you a heart attack or this and we're going to come up with other oils, canola, vegetable, like all these other words, these are going to be healthy oil, which is I've said on here before, if you've ever deep fried something, fill them fill the pan out, deep fry it, and then look and see how much less oil is left in the pan when you're done. That oil is in the food. Right? But if I scooped out a cup of that oil and said Here drink this, you'd go no, no, I would. I would never do that.

Karen 53:57
I've just been watching Life in Alaska in the Arctic Circle, I think it was called. And they're, they're eating fat because they need it to stay warm and to be healthy. Right? Wow.

Scott Benner 54:13
My greater like rambling point is, is that you could just be a mix of wrong place wrong time. crappy, crappy genetics.

Karen 54:26
Now, let's also add in the point that I've done four times, fasting weight loss programs under medical supervision through our hospital and lost weight each time but can't keep it off.

Scott Benner 54:40
How much did you lose doing the fasting?

Karen 54:44
Oh, 75 pounds the first time 100 pounds later, you know?

Scott Benner 54:50
What was the most recent time you did that? How old were you?

Karen 54:53
Um, it was I'm trying to think probably 20 Some years ago, while maybe more like before the hysterectomy, maybe, because I had done that right before and I was doing it during the time that my doctor told me that when I had the hyponatremia from gallbladder surgery, I couldn't keep doing that, because I had gone back down to my lowest weight. I see. You can't, you can't see me diet anymore. You need to get more calories more, you know? Well, you don't tell a fan. Sorry, you can't do it anymore. Do

Scott Benner 55:39
you think you have a psychological attachment to food?

Karen 55:45
I think I have some, but I don't know anybody who does that.

Scott Benner 55:50
Right? Do you just think you over eat more than than the average Overeater. Now I really know it. But that's interesting. I'll tell you something, Karen. I have I don't know if I've ever said along here. But I am the fattest person who doesn't eat that you'll ever meet in your entire life. Like I don't, I'm not a big food person. i There's, there's times in my life where I thought maybe I'm just not eating enough. Like maybe my body thinks we're starving. And it's like holding on to fat.

Karen 56:17
But yeah. Especially when some of these thin people say, Oh, I wish I could gain some weight. If I eat more, I lose. Well,

Scott Benner 56:31
you're way though, like the funny part of that statement? That doesn't make a good point. Like some people's metabolisms just run differently. I think that's pretty obvious. And at the same time, underlying other underlying medical issues could be keeping weight on you like your thyroid or stuff you might not even know about, right? You know, I get through this illness. I think I said this recently, but I had to take a steroid pack to get rid of my bronchitis, they gave me an antibiotic, right? And, and for the 10 days, I'm on the steroid, I'm like, This is amazing. Like, like, the first thing that happens is my like, the, the liquid in my body like regulates, like IP, like crazy for like 20 hours. And if you Google, it'll tell you like steroids raises your blood sugar and some people urinate that that is not what's happening to me. Like, like, my back stops hurting. You know, I, I lose five pounds of water weight, my back stops hurting, I feel terrific. Etc, etc. As soon as the theory is gone, you know, the the water weight comes, I've retained water my entire life, like I'm pregnant. I mean, there's just no other way to put it. Like I my body retains water. And I mean, in a world where we can't get a doctor to explain what Lantis is going to do to you. I don't have a lot of like, serious Yeah, yeah. Like, like people like you should go to a doctor like for what? So they can go try sit up through this, like, you know, nobody knows. Like, great. You have

Karen 58:08
to find the right doctors. I'll tell you I'm I'm very encouraged right now. Because back years ago, I went with a friend that I met online, had COPD, and was trying to quit smoking. So she went to a quit smoking clinic at Mayo Clinic. And I learned a lot about Mayo Clinic then. And my new hematologist is from Mayo Clinic. And he called me firstly, I saw him and then went down and he had bloodwork done. I'm at home and he called me said your blood glucose was 67. And I wanted to make sure you were okay. He called me not a

Scott Benner 58:56
nurse, right. Somebody helped and cared and was concerned and understood what to be concerned about. Well, how did you

Karen 59:04
different from from Mayo Clinic, that's kind of how they work. And it's like, wow, and he's called me again to discuss what my bloodwork is because you look at just my blood work. I don't have von Willebrand disease. It's interesting, but there's another component to the diagnosis, which is experience. Actually, that got the experience

Scott Benner 59:31
and everything else so so tell me something you you get this you get this incident 2009 That's still a long time ago I didn't start the podcast till 2015 So what was your What was your experience between then and when you found the podcast?

Karen 59:49
Ah, bleeding for mean for the fan will advance

Scott Benner 59:53
no need for the diabetes now like for type talk? What was your What was your life like? 2009 until one Whenever you think of it as getting this

Karen 1:00:01
kind of random, you know, I was trying, but I didn't seem to be doing anything effective. I had the high a onesies and you know, didn't know what to do and I kept bringing it down, but at the same time, the lowest I ever got it was nine on my own. Then I started listening to while my doctor said, you should get a CGM. Okay, so he wanted me to get libre to. And I called the talk to the DME who I cannot say enough goodness, about this DME, but they said, Well, I said, I'm worried that if I wear it on my arm or leg or something like that, I'll knock it off. And they say, Well, if you want to wear it on your abdomen, you have to get the Dexcom. So I got the Dexcom. You know, and the G six is wonderful and that I brought my eight onesies down to it first it was 6.6, then six point you now below six. And I've gotten to the kidney specialist and the endocrinologist and they've all said, Keep doing what you're doing. You're like, Okay, I'm doing better. But what am I doing?

Scott Benner 1:01:30
Is is the addition of the CGM just allowing you to see I mean, it's pretty, it's pretty obvious, right? It just allows you to see where your blood sugar is, how you can more effectively move it and what and what food is doing to you.

Karen 1:01:45
Exactly, that's it. And it allows me to adjust a little bit like if I find I'm going high, for example, if I'm sick, or if I've had a vaccination, my blood sugar might be higher. So then I increase a little bit on my fast acting. Yeah.

Scott Benner 1:02:06
It taught you you can see basically, you can see inside of your body now and it teaches you how to it teaches you how to use insulin, right? I mean, it's funny because I think people might expect some bigger epiphany. But that's it. Really, if you can see, I didn't know you're using a CGM. But if you can see your blood, you can use insulin correctly. And that stops spikes and lows. Have you lost weight on a CGM?

Karen 1:02:36
No, no. I've gained you've gained weight, believe it or not? Well, and I think that goes to the thyroid. Oh, okay.

Scott Benner 1:02:44
Yeah, you do have a lot of different components. So your goal right now is to get your thyroid medication dialed in. Right, if that doesn't start to help you, what about going back to the vegan stuff? Karen, how come we don't do that?

Karen 1:03:00
I'm going to do that. I went to an online class, but chickpea and Bing did, and they're very supportive. They live near me. So we haven't been able to do anything that online for the last few years. But I'm hoping that we'll be able to go in person, I'm better in person. If I see people in person, I'm better off to get knowledge or to better, you know, yeah. catch on to things.

Scott Benner 1:03:34
Are you still ahead? I'm sorry. Good.

Karen 1:03:36
I'm sorry. I had to take a class once. Couldn't get it any other way. And I had to do it through by mail. You know, the correspondence courses? Yeah. It was the worst class.

Scott Benner 1:03:49
Are you are you able to exercise at all?

Karen 1:03:53
Yeah, somewhat. Okay.

Scott Benner 1:03:55
So, do you live with your mother still?

Karen 1:03:59
Somewhat? About 50% of the time maybe.

Scott Benner 1:04:03
Okay. And that's the whole power. Yes, yeah. Okay, is there anything it's hard?

Karen 1:04:11
Hard to do my own thing though. She's very resistant to it. And she grew up on a farm with up you know, during the Depression, they always did have enough food because he lived on a farm. And you know, it was a dairy farm so if you're talking beef or dairy boy, my mom's really into that. Yeah.

Scott Benner 1:04:38
Not so much into tofu or something like that. No, no, that at all. And, and you don't have any trouble. When you're vegan, you're, it's easy. It's easy for you when you're doing it or do you struggle to

Karen 1:04:52
know it's easier? It is much easier. I can eat as much as I want. First of all, Secondly, I'm full from eating more fiber and so on, I think more so than I was when I was in the fasting programs and then adjusting to eating again. And I had dieticians, counseling me, and, you know, all meetings and everything to support but you know,

Scott Benner 1:05:27
in the end, it's, it's calories in, that's what it is, right? It's, it's you have to write even amount of calories for you right now you're trying to lose weight. So you have to be at a deficit so that you lose weight. And then once you get to the weight you need to be you need to be at a don't go back into a surplus so that you can maintain the weight,

Karen 1:05:45
right? But being vegan, you can pretty much eat whatever you want. And you're not going to kind of go over that you don't reach this is the easiest thing I've ever done. Wow. And let me tell you, I, I fought so hard with the fast food programs. One time I went to a store, and I was trying to find something like most women will experience this if they had a period, you know, that you just get where you want to talk about eating kitchen, you just want to eat anything, you know, and you're looking for something that will satisfy you. And it's pretty hard to find it. I did the grocery store. And these are following me. Because I think they thought I was trying to steal things. And I was reading the nutritional labels to find something that was going to satisfy me, but would not be too much of a calorie load. Yeah. No,

Scott Benner 1:06:53
no. Oh, my gosh. So you are managing your diabetes right now just like a type one does. You're on a basil and pretty much are you planning to use the pump?

Karen 1:07:03
No, no, no, I would like to be in a way. Okay, I think

Scott Benner 1:07:09
you're shooting a Basal insulin and covering your meals with fast acting. Correct. Okay. And you learned that on the podcast? Yes. I'm happy for you that this is going well.

Karen 1:07:22
I mean, I still, I still do what my doctors have said, but I've added a little bit from the podcast to help you. And from the the Facebook page.

Scott Benner 1:07:33
Oh, and the Facebook page is helpful for you even though you have type two because you're using

Karen 1:07:37
it right. And because I was on a Dexcom page and Facebook, someone said go to choose backs. It's for type ones. But you'll learn things that will apply. Yeah. So that's how I got to the page and then to the Juicebox Podcast.

Scott Benner 1:07:56
I'm glad. Well, that's excellent. I'm happy that it's helping you. Thank you. Oh, no, please. It's my pleasure. All right. Karen, hold on a second. Yes, there was way more to remember about you than I thought there was gonna be I keep waiting for, by the way, not one of these has gone the way I expected so far. Which is good. Because I thought well, let me do stories about people with type two. You know, see if we can't get more people with type two to step up. I do think there is there is some theme, which is no, no really different than any other illness for some reason, which is Nobody tells me what what's happening. I just you have this take this pill you have this inject this, like that kind of stuff. Nobody really explains and I'm beginning to believe that they don't know. You know, so

Karen 1:08:47
I don't know. But with the bleeding disorders, the Hemophilia Foundation, which I don't know if final brands is really a haemophilia or not, but it's covered by them, ego to support meetings, and they have sessions where they teach you about various things. They have camp for the kids that it's all run by the Hemophilia Foundation in which I don't feel like the diabetic kids are getting seems like there's, there's more individual or something that people are going to different states or you know, I didn't really understand that. So that might be my problem. But to me, that's much more supportive. And I learned much more about being a fleet disordered individual than I have about having diabetes. And there's more people with diabetes, even tied to walk pin.

Scott Benner 1:09:50
Karen, I believe I, I'm starting to believe, like I have like short term goals for the podcast, long term goals for the podcast and you know, The size of the podcast I keep, I think about like, well, the podcast helps people because I make it, it keeps it out in the world, new people find it, they can mine it for information. But if I just stopped making the podcast, it will wither away and die. Like that's how people's minds work. Like you don't I mean, like, people complain that all the new movies suck. But no, but nobody goes back and watches, you know, bullet or something like, you know, they, the old stuff is old. And so to keep helping people, you have to continue to make the thing. And I keep thinking like, how is this going to like long term? Like, how do I get it to a point where it can long term help people? Because this is not, this isn't crazy, right? Like, some doctors don't have a good job of explaining your diabetes to you. We hear those stories from people and don't, and those people's lives are worse for it. And how are we going to get to a point where that's not the case? Like what's the answer? And there are times that I think that in the current model, that answer doesn't really exist. Like there's no like thing, like, there's no magic thing that people aren't doing that if they just did it, everybody who had diabetes would be doing better. I think I think maybe what the podcast is teaching me is that this is it's sort of a virtual meeting. Right? Like they might you can go to on your own schedule, fight. And I I'm almost thinking there are days when I think that's what it is. It's almost like it's almost like AAA, on some level, and, and with management talk mixed into it. And I don't know that there's a better way right now like that, with the technology that exists for reaching people. I don't know if I don't know that there's a better way than this, this idea. So hopefully, someone comes up with it. But I don't think it's not a brochure. It's not a video you watch online one time. It's not a you know, it's not a checklist, like these things have all been tried. They don't help. So, anyway, I found it.

Karen 1:12:15
I do think that the Hemophilia Foundation has found a way to do that. I don't know if it's because it's a smaller population, if it's because they've started getting drug companies involved, which he didn't used to when I first started going to their things. You know, that money is helping, but at the same time, you know, gee, where's the support? How come nobody knows anything? Um, it's also loosey goosey.

Scott Benner 1:12:46
I don't think they know how to deliver it. And I think that this is, I think, I think that I found the most successful way so far, to help people understand diabetes. It's this, and it's not just make a podcast, because trust me, after I made one, a lot of other people tried, and it's no disrespect any of them. I think it's wonderful, but I can see who listens to podcasts. And those other podcasts are not listened to on any great. Like, with any great amount of, I don't know, a big, it's not a big level. And so, so there's something about the information, the format, me, the people who come on, like, you know, all that mixed together is just working, and there's no way to take credit for it, but generally means like, it's like a it's like a TV show that's on for 15 seasons. It's not it's not like they sat down on day one, and they're like, let's make a let's make mash. You know what I mean? Here's what it's gonna be, it's gonna last forever, people are gonna love it, blah, blah, blah, it's gonna, you know, you don't plan something like that. I just got lucky. Like, whatever this is, however, it occurs to me to do it. It just seems to work. And

Karen 1:14:01
yeah, but you're Alan Alda. You have a perception of people, and what they think and feel that is unusual. And I think yeah, it pays off.

Scott Benner 1:14:14
You know, it's funny that somebody said to me, I don't want to say who I talked to when I said this, but I told them I said, I think part of my job is kind of counterintuitive to how people think like people go out into these spaces, they like well, the people will tell you what they need. And you know, we'll just we'll we'll give them what they want. And to some degree, I give you what I think you need. I don't stop to think about I mean, I'm not I'm not I'm not unfeeling about people's feelings or anything like that. Like I'm not harsh, but we don't like if we didn't you and I, for example, didn't spend 20 minutes talking around the fact that you weigh what you weigh. You don't like we didn't nice it up and we didn't You've called yourself fat and we just started talking, that's an honest conversation. And is it gonna hurt someone's feelings? Like, I hope not, but maybe it will. But what I can tell you for sure is that if you went on, you know, a podcast run by like some big diabetes organization and started calling yourself fat, they'd never put that online that nobody would this would get cut up or you know, diced up. This is a real conversation, you're 69 year old lady who's got a ton of health issues. And I don't have type two diabetes, although I really want you to go get an antibody test. And, and, and this is this is your life, like you just laid it out for us? Nobody does. everybody's worried about it's going to hurt someone's feelings or it's going to be perceived incorrectly. I don't care about that. Like, I want to figure out why people with type two diabetes. Don't get help. Yeah. Why don't they? And my big question around it is why don't they understand what they have? How come every person I talked to with type two? Doesn't know what what's happening to them.

Karen 1:16:05
That's what I want. Why I wanted to talk to you. I mean, when you invited me it was just not a good time at that point. And then I had to have knee surgery and then my reading became up.

Scott Benner 1:16:19
Can we put effort into getting you on this podcast? We really did and I'm glad that we did. I'm glad we did it. Seriously.

Karen 1:16:26
Thank you so much. And I really appreciate you being flexible because once I bollocks stuff don't trying to put it on my calendar.

Scott Benner 1:16:36
Don't even think twice about this is well worth it. By the way. I have to go because I have to record with Jenny and a little bit. Okay, but John Philip Sousa wrote Stars and Stripes Forever. Yes. He's, uh, he was uh, he wrote a lot of like, what I guess we'd call like patriotic music back then. Which is Stars and Stripes. Hold on one second. All right. Is the stars destroyed forever public domain. Old enough to be in the public domain. So all you need to perform a song isn't okay. It is. Oh, that means I can play a little bit of it at the end. All right. I'm gonna go I appreciate you doing this. So much. Hold on for one second for me. I want to talk to you just before you go. Okay. Okay, thank you so much. Thank you

first, a huge thanks to Karen for coming on the show and sharing so honestly, and of course dexcom.com forward slash juice box head over and get yourself the Dexcom G six or Dexcom G seven continuous glucose monitoring systems. Don't forget the contour next gen is that contour next one.com forward slash juice box. super accurate, easy to use. And lovely to hold in your hand. Contour next one.com forward slash juice box dexcom.com forward slash juice box. Fill out the survey AT T one D exchange.org. Forward slash juice box. Want to save 35% on your entire order@cozier.com you can with the offer code juice box 10% off your first month of therapy@betterhelp.com forward slash juice box. And of course, get a free I didn't even mention this the beginning. Get a free five travel packs a free year of vitamin D with your first order of athletic greens from athletic greens.com forward slash juice box. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast but just let me say this before I go. If you have type two diabetes, and you're looking for a place to talk to other people with diabetes, check out the private Facebook group Juicebox Podcast type one diabetes, but don't let that name throw you. It's for everybody who has diabetes Juicebox Podcast type one diabetes is a private Facebook group with over 40,000 members. Actually here at the end, I'd like to throw in a plug for the type two Pro Tip series that I did with Jenny Smith. You can find it in the featured tab. On the private Facebook group. There's a list of them. You can also find them at juicebox podcast.com or search your podcast player for juicebox type two pro tip

#906 Postpartum Depression

Katies has type 1 diabetes and is here to share her postpartum depression story.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 906 of the Juicebox Podcast.

Today's show is with a type one named Katie. And she's here today to discuss the postpartum depression that she experienced after the birth of her child. There are some sensitive issues in this episode, please be aware of that. Also, remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. Now if you have type one diabetes, or are the caregiver of someone with type one diabetes and a US resident, completing the survey AT T one D exchange.org. Forward slash juicebox will help other people living with type one may actually help you to it's definitely going to help the podcast T one D exchange.org. Forward slash juicebox you from your home in about 10 minutes can help move type one diabetes research forward at T one D exchange.org. Forward slash juicebox. All you have to do is complete the survey. It is completely HIPAA compliant and absolutely anonymous.

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.

Katie 1:46
early for me to say,

Scott Benner 1:48
oh don't worry. This is the earliest I've been up in a while to do the podcast was about a half an hour ago I was I was looking at the shower and I'm like, I'm like Get in. Get in the shower. Get in. So anyway, alright, you go ahead and introduce yourself.

Katie 2:04
Okay, my name is Katie. I am a type one diabetic and have been for about five years almost now. And I have a little girl who is two.

Scott Benner 2:16
How old are you? Katie?

Katie 2:18
I am 26 I'll be 27 in July.

Scott Benner 2:21
Oh, wow. You got to get diabetes when you were 21.

Katie 2:26
Yeah. 20. I was 20. I think I just a couple months after I turned 22 It was definitely leader. Yeah,

Scott Benner 2:35
how old your baby

Katie 2:37
is gonna turn to tomorrow.

Scott Benner 2:39
Oh, happy birthday. That's wonderful. Married? Yes, married.

Katie 2:45
And then we actually are do with our second little girl in June 1, we could you

Scott Benner 2:51
are you how far along? Are you right now?

Katie 2:54
30 weeks. So our duty is six, six. But they said probably a week to two weeks really though? Depending on how things go.

Scott Benner 3:03
Oh, well, congratulations. So now I'm sure when when we were supposed to record this originally you weren't pregnant?

Katie 3:11
Nope. I was not I had? Well, so when we set it up. I had had my daughter like six months before. But then I mean, we were scheduled like, six months later. And then about a year since we rescheduled?

Scott Benner 3:25
Yeah, it did the disappointment of not being able to be on the podcast, make you like just decide like, wow, I've got to make some big life changes. I'm gonna have another baby, or did I not have anything to do with it at all?

Katie 3:36
No, it was more of just like, so my husband comes from a big family. So he definitely wanted to have more kids. And me and my brother were more like three and a half years. And it just seemed like a big gap when we were never in the same schools or anything. So we wanted to try to have them a little bit closer. So

Scott Benner 3:55
it's so interesting, where people's ideas come from, like you had an experience where you were farther apart it made you think, Oh, I wish the kids were closer in age. And I had an experience where there wasn't enough time for everybody. So I thought well, let me spread my kids out so that I can focus on them more clearly. It's there's no right answer. It's just the thing that that occurs to you based on the thing that happened to you.

Katie 4:23
It's really Yeah, and my husband's kind of the same way his little his like, brother that's like next. So he's the oldest and then his brother is the next oldest there. They were 18 months apart. And he's like we loved it. We were always in the same schools and doing stuff together. And so we just kind of went that route but I was really two years apart. I was like, I don't think we're going to try it for the 18 months or anything crazy like that.

Scott Benner 4:49
It's pretty it sounds pretty close to me. Do you know what you're having you have a boy now Do you know what this one is? We have a girl now. We have another girl. I'm sorry I missed her did that 202 Little girls, that's beautiful. Okay, so why were you coming on last time?

Katie 5:07
So last time, I had messaged you, because I was pregnant with my first daughter, along with the pregnancy series, kind of it was like a little bit of head when of when I got pregnant. I can't remember her name, but they were so helpful. And it was so nice to like, go into pregnancy, understanding, like, what to expect and have some sort of like, I had no idea what I was getting myself into with diabetes, because I was obviously diagnosed, and up later, so I hadn't been doing this my whole life, right. And then everything was great. I had worked with Jenny even and then left the hospital had my little girl, she was super healthy, everything was great. And then it was like, three months later, maybe three or four months later, like we were just going on about life and everything. And I ended up having postpartum depression really bad. And it just kind of like, blindsided me to the point where like, no one mentioned, like, you know, after leaving the hospital, like they all talk about the baby lose and everything. No one really ever said to me that like, oh, no, you know, in a couple months, like this could happen, or no follow ups. No doctors ever mentioned it or anything. And so I just felt like it could be a good, yeah, to add to the like, pregnancy series, because like, everything else, I was like, you know, kind of expecting ready to manage. But that one totally what blindsided me in general just to have it and to deal with it. But then, like the diabetes, which is like out the window? Yeah. I mean, I had

Scott Benner 6:34
a three month old at the time. Right? And you hadn't had type one that long, either. So is it a case where, like, the second day after the baby arrived, you're like, I don't feel blue at all? I did it. I'm not gonna have like, you just feel like okay, well, that's not gonna happen. And is that is that it? Did you expect that if you were going to have postpartum that it would just hit you immediately.

Katie 6:56
I guess. So. I mean, I didn't really expect, I didn't really have too many expectations around it. But like, I had her and then like, we left like the two days later, and they sent you home with a worksheet and you're like, fill it out in a week. And it's like, you know, checking how you're feeling or whatever. And then you go to your six week appointment. They didn't even mention it or ask anything and my OB appointment around it. And so like, everything had been good. So like, we just were like, she was healthy. And we were kind of settling in and then it just kind of crept out of nowhere like it. I just didn't know that it could like hit you so many months later, because I had heard about the baby blues and kind of, you know, they sent me home. You fill this out in four or five days. So

Scott Benner 7:38
yeah. Okay, so two things, and I hate to do this. Can we try this without your headphones real quick? Yeah, no problem. Thanks. And then I'm gonna ask my question.

Katie 8:01
Alright, can you hear me?

Scott Benner 8:02
Yeah, actually, you're louder. I think we're gonna go with this. Okay. All right. I think we'll see for a second let me ask my question. I'll let you answer it, then I'll decide. Did you see it coming? Or did it creep up very slowly? Or was it just one day you were like, oh, hell, I feel like depressed.

Katie 8:22
Um, it came on slowly. I think. I it started with me, like becoming a little bit more anxious, like, especially around my daughter and my husband. And then it kind of led to more like noticeable stuff. And then it was kind of finally like, I hadn't like in my husband had noticed that like, things were off. But we were still adjusting to life with new baby. And I had been home by myself with her on my maternity leave and everything. And then it finally just kind of got to a point where I was like, Okay, I'm in way over my head. And I don't know what's happening. And I don't know what to do.

Scott Benner 9:00
Tell me, tell me about anxious around my husband and my daughter. What did what did that feel like? How did it manifest?

Katie 9:06
It started pretty small, like things with my daughter, like, I just would feel like, you know, we're not playing with her in the right way or playing with her enough. Or, I remember very clearly it was like, a little bit later on, but it was like we were sitting there. I mean, she's like, tiny. So I just had her on a blanket and we were just hanging out. And I got up to do something like, grab the phone or whatever. And I came back and like a notice the little red mark on her arm and I was like, did a bug bite her and I'm like, looking all over and I'm like, There's no bugs like in the house that I can think of like you don't I mean, it's not like we've had a bug problem. Like I started just kind of spiraling off of that, like if I hadn't have left her alone for that 30 seconds or whatever it was. And like okay, well what happens now? Like is she gonna get super sick? Is it like, what bitter was it a spider and you know what I mean? Like that kind of just like spiral I couldn't get out of here and it was with everything.

Scott Benner 10:00
And once it was there, it it touched everything. Well, yeah,

Katie 10:05
cuz like, and my husband is a police officer so that I mean is already kind of like, you know a scary thing, especially in the time that everything was going on with COVID and all the different protests and different stuff going on but and so it was like outside of like just normal worry for him it was like, I mean, we lived in a city too. So like you hear sirens and ambulances all the time. And literally every time I heard one, I would just be waiting for somebody to come knock at my door to tell me that he wasn't coming home, like, just spiraling to worst case scenario. And I could not stop myself and like reason with it at all.

Scott Benner 10:41
prior to giving birth, had you ever felt like that before?

Katie 10:46
I had felt like it a few times. He when He started the department as like a brand new cop within want to say probably like, the first I know it was within the first year, they actually lost somebody, an officer on duty that was on his squad. So it kind of hit really close to home really soon. And so like the thought had crossed my mind, but it wasn't like, every time I heard a siren or every time I heard anything that like that's where I would go until the kind of the postpartum depression started sinking in. And like it was just like, it was almost like it couldn't function without like, being worried about somebody or something happening.

Scott Benner 11:27
Oh, that's interesting. So little bite on your on your daughter turns into I only walked away for a second. Now I can't walk away anymore. What about this over here? This might hurt her? Or are we did it go into everything real? Like, you know, we have to start a I don't know, we have to start a college fund right now. And I can't afford it. We're buying the wrong foods. We don't live in the right place. Did it just overwhelmed me like that?

Katie 11:55
Yeah, it did it. And it was things that like, it was more of like I didn't even notice like until I started like getting help and trying to figure it out. But like, you know, you see, especially now there's so many like parenting things online. And every time I saw something new, or, you know, this is the best way to feed your kids, or this is the schedule you should be on. Like, it just made me feel like, oh my gosh, we are doing something so wrong. Like we need to figure out how to do this. And what is gonna happen if we don't figure this out? What kind of thing? Would it?

Scott Benner 12:27
This is a question. I don't know if you'll have the answer to or not. But I was just talking to someone yesterday, a younger person, their thing has nothing to do with your thing. But I found myself asking them Are you being impacted by social media too much by the by our ability to take in so much information from so many different perspectives like, like, if you were just at home, and your husband was at work? And I don't know, you maybe had a job or you were staying home with the baby or your circle was smaller like that? Do you think you would have known about all the things that you should be upset about, like, quote unquote upset about? Or was it outside influences that were showing you? This is the right way to do this, and this is the right way to do that. And then that becomes overwhelming to

Katie 13:17
I think it played a part in it. But like, I mean, like the bug bite like that, you know, everybody gets bug bites, but then you're like looking at this little tiny baby and it just felt consuming. But then when I would be on social media, it just kind of like added to that. And kind of made it even more difficult. But I don't think like if I had never been on social media, like it wouldn't have happened.

Scott Benner 13:39
Do you have a bunch of, of things now, like stuff you bought? Because you thought you needed it?

Katie 13:46
No. And it wasn't, I wasn't even as much of like, buying things as much as like, feeling like I was going to do something wrong, or I didn't do it the right way or good enough. And it was going to impact her.

Scott Benner 14:02
And then where does that because there's nothing intrinsically wrong with the idea that I want to do the right thing. Right. So that's not the problem. The problem is what that It's intrusive, that it doesn't go away that it spreads to everything like where does it actually become troublesome?

Katie 14:19
It became troublesome when like it would send me like spiraling to the point where like, like back to the bug bite just because like that one I was so distinctly remember was like I was like literally on the floor crying because I felt like such an awful mom because I had left her for that 30 seconds for that to happen. To the point where like, it was just like everything became that big of a deal in like to me that it was hard to

Scott Benner 14:48
function. And you couldn't put it down after

Katie 14:52
no I couldn't well and it was like you know even if like my husband was like she is totally fine like it's not even read anymore and like we move on like Two days later, I would still like be carrying it with me, even if like we moved on with like, the next thing that day or whatever.

Scott Benner 15:08
Did the things or the when those things happen big or small? Did they pile up? Or do they feel like separate incidences? Like, like, did you when you thought about them? Were you like, oh, there was the bug bite thing? And there was this thing and that thing? And they seem separate? Or was it just the feeling of like, see, I'm screwing everything up, like, like a more combined feeling.

Katie 15:32
It was more of like a combined feeling. And like, I mean, we're about to go into it again, but left for the newborn is your schedules aren't what they should be. And they're not sleeping through the night or napping as long as they you want them to or you know, like, so all of that felt like it was my fault. And I wasn't doing it correctly. And that's why it was all happening.

Scott Benner 15:58
Can I ask you? What kind of mom you have? Like, did you have one of those moms where you're like, my mom did everything right? And everything looked great? Or was she like a hot mess or somewhere in between?

Katie 16:10
Somewhere in between? I wouldn't say like, she did everything right all the time. But like, she was the like, she was the mom that was taking us to like soccer practice, then like our house was the house to hang out at and so like she, but she wasn't perfect either. And didn't like feel like she was trying to be either. So like, we were kind of somewhere in between. But it did feel like, you know,

Scott Benner 16:35
I was right. I was wondering if you had some like shining beacon of an example. And you were trying to do that, too. Did you ask for help. During this

Katie 16:48
kind of I it was hard to ask for help. Because at the same time, like, I didn't know what was wrong. And I didn't know what I needed, I guess because like it started with just like these like feelings of you know, anxiety and like worry and stress. And I was obviously already tired. And just like feeling not good enough. But then it really I really started to spiral to the point where I was just like, you know, maybe they'd be better off without me. Like, I could just walk out the front door and never come back type thing. And then and just kind of got worse from there. And so my husband kept asking me like, well, you know, what's going on, like, just a long day, and when he got home from work, and he just couldn't really put it into words at the time, or know what to ask for what I needed. And then it got to the point where that's even hard to save. But my husband had taken my daughter somewhere just like to give me a break. And obviously he's a police officer and I had had the thought before I'm like, you know, there's weapons in the house. And then like, I tried to just like brush them off or whatever, but I was literally standing like, at his stand like that we keep like in a separate room of like all of his gear. And just looking at him like, you know, I could take his gun out right now and this could just all be over and I could just, she'd be with her dad and everything would be good. And I could just like be done. And like that was a super scary moment for me. And so after that that's kind of where I was just like I kind of like it hit me that like something really big and outside of like normal is going on. Yeah, and I needed help

Scott Benner 18:34
had you had a plan to kill yourself ever in your life

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Katie 19:25
No I had not it wasn't even like a plan I just I don't even really like remember like deciding to go do it like to go in there or anything and I just kind of ended up in there and it was just like there I was kind of it was weird.

Scott Benner 19:41
Yeah. When it when that happened. It's very, very kind of you to share that with everybody by the way. And I didn't expect to have this many emotions. I haven't been awake for an hour yet today just like flooded me my skin got hot while you were talking. You kind of like curled up for a second like you were going to spring forward and I was like what is she going to say? A and that was really very honest. So thank you. You. Okay, so you have that thought. And it's like, in hindsight, it's a thought of escape, right? It's, I'm trapped in a corner, I can't find my way out. There's I just can't. And you start seeing yourself as another thing that might be hurting the structure of your family or your baby.

Katie 20:25
Yeah. And it just felt like, yeah, it just needed a way out, I guess. Yeah. Because like, I had had, like, the previous thoughts of like, you know, I could just, like, walk out the front door, like, and, you know, 20 minutes before my husband always gets home at this time, you know, I'll just leave her in her crib. She'd be safe, and I could just walk away and be done. And so i Namie obviously, that escalated. But yeah, it was just kind of that feeling of like, I'm not helping, and like, I'm creating problems.

Scott Benner 20:57
Right. And, wow, that's really that's really something and you're, you're still young still to like, it's just, it's a lot. You know, I wanted to ask after, after your daughter was born, how were your blood sugar's

Katie 21:14
right after delivery. I obviously cut back on my insulin like a ton. And for the most part was doing well. I mean, I had some lows. I was breastfeeding, which kind of threw another like variable into it, but they were kind of going back to normal. I mean, we were a couple months in at that point. So life had kind of like studied out and we were getting into a routine. So nothing like

Scott Benner 21:41
you weren't liking or dropping real drastically, or always high or always low or anything like that.

Katie 21:48
No, I was still adjusting to like the demands of a newborn and life around her. And so sometimes I would like Bolus me planning to eat and then she'd wake up. So I'd rush to her and be like, oh, shoot, I didn't eat and now I'm low kind of things. But it wasn't like a constant thing. Before and then. And even during, like I was still managing, to an extent, but like I was, I had just put me like, so far back on the list of things that like, I cared about, or like, prioritize that, like, it just kind of fell away that I did the bare minimum to not be like, super high all the time. But I wasn't Pre-Bolus seeing or counting carbs. I was just like, yeah, that looks like it's maybe 50 carbs, who knows? We're sitting down to eat, and I'll just eat it.

Scott Benner 22:36
I just wanted to make sure you weren't bouncing all over the place at this. And I just was checking. I asked you earlier, did you ask for help? And what I should have also asked, Did you know you needed help? In the beginning when it started? Like, were you even aware there was an issue? Or is it a thing that's happening? And I don't know what to say like almost like, you know, when you're getting sick, and like the first day, you can look back and say, Oh, I was getting sick on Monday. I didn't feel well on Tuesday. It wasn't a Wednesday I realized I was sick, like, was it happening? And you weren't aware of it? Or was it happening? You're like, oh, this is wrong. I need this to stop. But not enough to know I should go to another person like and your husband I imagined is doing. Like he's doing the thing I would have done I would have been like, yeah, all right. Yeah. So

Katie 23:29
back, I could see like that it started probably like when she was like three or four months. And then I want to say it was probably around six months, maybe one like, I got to the point where I was as bad as I was. And I was like, Okay, now or like, I need help. But in the meantime, like, I was a new mom, like I was just thinking that I was just not able to, like, meet the new, like needs of a newborn. Like maybe I just wasn't cut out for this. Never in my head was like thinking like, oh, this could be like postpartum depression coming on or anything like that.

Scott Benner 24:04
Right? Ya know, where there wasn't a world where you would have called your mother and said, Hey, I don't feel like I'm doing a good job here. Or no.

Katie 24:13
There wasn't ever like, I mean, like a few things that happened. Like, you know, just adjusting to like, newborn stuff where I was like, I called my mom and I was like, Hey, she seems like she's sleeping like a ton today. Like, is this normal? Should I be worried about it kind of thing? And she would be like, you know, no, we're trying to hit certain, you know, just don't make her feel comfortable or whatever. Just like adjusting to life with a newborn kind of things but never like falling to be like, I think something might be wrong with me or I'm not doing this right or something else is going on. Like it never. Like I said until like I was in that moment. Like it never even really occurred to me that like something else was

Scott Benner 24:51
happening. Yeah, no, I think I understand. But is there in hindsight, can you look back and tell me what would have helped you in that moment? uh

Katie 25:03
honestly, I mean, I ended up well, so when we first when I first started, like, went to my husband and I was like, Look, I need help. I was like, I didn't know what I needed. And he's like, of course, he's a cop, which he's like, so good hearted, but he's like, you know, I can take you to the hospital right now. And I'm like, You're gonna who lock me up and make me a crazy person? Like, no, you know what I mean? Like, that was like, the feeling that I got. So I was like, you know, no, I'm fine. And so it took us like a week or two to kind of like, figure things out. And through his department, they do, they have like a family therapist and different things. And so I ended up going there, and then they're like, you know, we'll just kind of try to work through it and see, and then, you know, I don't know if you're going to need to be on medication or not, because that was something I didn't necessarily want to do. I have my pilot's license, just like to fly for myself, not like for an airline or anything, but they're very strict on like medications and different things. So I was very wary of doing that. And putting, even like, more possible issues in the way of getting my medical, on top of the type one diabetes and things. But even after trying to, or go into therapy for a while, and stuff, like it just got to a point where even my therapist was like, you just need to go get on some medication with your doctor to like, really start helping get through this. Yeah. So I don't think there was anything like, my husband could have done differently where I could have like, change, like, I just needed to get on the medication and get some help and kind of work through it.

Scott Benner 26:39
You did that?

Katie 26:41
Yeah, it was not an easy. Like I said, I really didn't want to do it. And then I even like said, Okay, I'll go see, like the therapist or whatever. And talk to him. And then, like, we made the appointment. And then the morning of I was like, I didn't want to go I just felt like that made me. I don't know. It made it like official that something was wrong with me. And I was doing something wrong, rather than just like it was in my head.

Scott Benner 27:08
So even though even though you weren't doing physically doing something wrong, like it wasn't like, it wasn't like I held up two cards in front of me. One was red, and one was green. And I said which one's red? You pointed to the green one, right? Like it. But it felt like you were doing something wrong.

Katie 27:25
Yeah. And it just felt like I wasn't. I wasn't doing things correctly. Like, I wasn't like living up to be a good mom. Like I wasn't meeting, I guess what, like, I thought in my head, a good mom was or a good way for like, does that make sense? Like it was just like, and then actually going was like admitting it? Like, I'm not good enough. And all of that kind of feelings.

Scott Benner 27:52
Yeah. I mean, from me, obviously, I don't, I can't know your situation. But for me, it was, I'm going to let everybody down. I'm not going to stand up to my responsibilities, everybody's going to be hurt, when I don't do the thing I'm supposed to do. And I don't know what the thing is I'm supposed to do. It isn't until you're, if you're lucky until you're older and you have more experiences that you can realize that there's no right thing to do. You know, it's you're just sort of life is like you're just like paddling down a stream, right. And you can't plot it out before you get in the boat. because there'll be rocks where you don't expect in the stream will split in different places. And so you just, you just live and react. And if you're still on the boat you want, you know, and no one tells you that no one tells you there's not a right way to live. And that's tough, because really, you're watching you. You're having very normal reactions that are just magnified so big that they're not manageable. And, like, you know what I mean? Like, it's the postpartum that, like just ramps everything up, because there's nothing wrong with thinking, Oh, I walked away from the kid, the kid got hit by something. Maybe I won't do that, again. You don't even like and then just move on and move on. Or you know, but you are. I don't know what I'm doing. Like, I mean, I never knew. I'll tell you. Katie the day Cole was born. The nurse came in with him. A couple hours later, he was born kind of cold, like so they had to warm them up. And so he's gone for a couple of hours. And they brought him into the room. They wheeled him in on like one of these little like, I don't know, to get to go. I don't even know what to say it's like a bassinet, but up on top of a rolling like piece of furniture. Yeah, right. And they roll them in. And you're like, Oh, the baby's here. And it didn't take two seconds like I looked at my wife and we were both like, hey, hey, hey, easy where she going? Cuz she turned around. She's like, enjoy the baby. And we were like, Whoa, like, like we actually said, Where are you going? And she's like, well, you know, she can spend time with the baby. I'm like, we don't I think what I tried to be funny, I said, you don't know us. But you might be breaking a law leaving that baby with us, like I like we're not, we don't and she goes out, you'll be fine. And she just left. And we were fine. But I wasn't depressed while I was trying to do it. You know what I mean? So, but every feeling you've described, so far, everyone knows those feelings. Just not everyone gets them in a moment when they, they aren't as clear minded as they would be in a normal situation. So so the medication did it help you?

Katie 30:49
Yeah. And so I had been going to this like therapist that they do through my husband's department, and they do some of like, different behavioral therapy and different things. And I was like, super skeptical. And then, you know, I just assumed they'd be like, Here, take medication. And that's not the case, like, but when I did go in, they were like, hey, like, I obviously was like, a mess. At that point, I didn't even want to go, I went in. And of course, they like have, they had to fill out a survey online. And he's like, looking at the results. And he's like, you know, start talking to me about it. And I just kind of like, completely broke down. He's like, there's something seriously going on. And this is like, so outside of your control. And that was the first time that it like occurred to me that like, it wasn't my fault, or it wasn't like something that I did, right. And so he was like, you know, a lot of people actually have it happen, you know, more like three to six months after the baby, rather than, you know, two to three weeks, like the baby blues, or right after, which was something I had never heard. I mean, I didn't know tons about postpartum depression and stuff. But it was something that like, I never even occurred to me. And so we had done some different things. And I was meeting with him. I think it wasn't maybe twice a week or once a week for a little while. And it was just to the point where like, I would start to feel better. And then by the time I came back, something had happened. And I mean, our lives are me and my husband live a crazy life, it seems like we always have something going on or changing. And so something would happen, it would, it would just like, put me right back to the start. And then it was kind of to the point where he's like, okay, you know, call your doctor which it worked out. But he's like, just call your doctor right now and say, like, you need to come in, and you need to get on something. And for some reason, that was like a really hard thing for me to even ask for or do. And so I did it in his office, like as I was balling, and they got me in that same day. And he's like, it'll take a little while to work. But even in the first couple of weeks, like I noticed, it felt kind of like a weight lifted off like, and we ended up increasing my dose later on, just to kind of help get back to like a normal steady state. But it was something I had fought for a while. Because part of it was from just like, my aviation and getting my medical and part of it was just like, you know, I don't want to go on this and be on it forever. And I felt like doing therapy, I could fix it myself. But then having to take that extra step felt like, it still kind of felt like I was failing, and I didn't do enough the right way to

Scott Benner 33:33
avoid it. You're doing a very good job of explaining this. Thank you. Would they give you some like Wellbutrin?

Katie 33:39
Um, it was so awful off.

Scott Benner 33:42
How long were you on it for?

Katie 33:45
I was actually on it for a year and so that which I am kind of upset, or I am not upset about it. I wish my OB would have been better about it. I mean, I went in, obviously, my therapist had kind of sent me over and so he's like, Here, take this, like, some notes or whatever. And my OB opened it up or whatever, and looked at it and like, she's looking at me like, Are you kidding me? Like you're living like this? Well, yeah. And so she basically wrote me a prescription and she's like, Well, do you need to stay home from work or anything like anything else? And I was like, no. And she wrote me the prescription and sent me on the way on my way. And that was kind of the end of it. She's like, if you don't feel better, you know, call back or whatever. And we can change the dosage. And so I did when a little bit later, but it wasn't anything like driven by them. Like if I hadn't had been seeing this therapist, which, like he saved my life. Because I like without him. I don't think I would have been able to navigate it. And it's just like along with the diabetes stuff where it just depends on if you get a good doctor or not, but they would have just wrote me the prescription and who knows never seen me again and talking with him. He's like it actually takes a while. For it to kind of like, really work and balance everything out. Yeah, like, it's not something you just take for, like, you know, two weeks you feel better and when you get off like, and so he recommend doing it for about a year and he's like, as long as you're feeling better and stuff, then you can kind of go back off of it. And if you don't, or you start going off of it, and you don't feel better, then just stay on it kind of thing. And so, I had been feeling better pretty quickly, but I just kind of stayed on it for that year. timeframe.

Scott Benner 35:27
Can you tell me more about how the talk therapy helped you?

Katie 35:32
Yeah, I think like, in the beginning, it was like, even just recognizing like, okay, just because you got a bug bite doesn't mean it's your fault. Or even if it for some reason, somehow is over, you could have avoided it like that it didn't have to like spiral, quite as far. Um, and I don't remember exactly what the technique is. It's like I rapid eye movement therapy. And so it's kind of weird when they'd have you, like, watch his finger and they walk you kind of through scenarios. But not like, necessarily exactly like your life scenarios, but different scenarios. And it just helps, like, process it. They do it for my husband's department, especially like if they have like, an incident or trauma or something like that. And they can go and do kind of the same thing, just to help kind of work through it. Yeah. And so you've done some of that. And then part of it was just like, one of the days. And it was probably the best advice I got was he's like, Okay, if you want parenting information, or you need like things or whatever, because I think we were getting close to the age we were gonna start food. And they have like the baby, I don't know if you've heard of it, baby led weaning, and so you give them like, more like real foods and just let them figure it out. And you just like cut it safely rather than baby foods and stuff. Yeah. And I just felt like overwhelmed. I'm like, Well, what should we be doing? What if she chokes? Like I was still kind of in that paranoid stage. And he's like, just go buy baby food. Or if you're, like, concerned and want he's like research the very best parenting book and go by the parenting book. And when you have questions, only consult that don't consult 100 people online.

Scott Benner 37:10
Yeah, don't get 15 different opinions, because you can't pick between them.

Katie 37:18
Or he's like, or call your pediatrician and see what they recommend. But like, don't keep searching or looking for more possibilities. And so just kind of working through that. And then I mean, I, we ended up doing some stuff to like work through. I never really realized like how much it impacted me that, like, in the first year of my husband's job, they had lost an officer. And so like he's like, it's probably kind of stemming a little bit from that, that you just kind of moved on. And now things are kind of bumbling, like bubbling up with everything else going on.

Scott Benner 37:53
Here maybe Was that your first opportunity in your life to think Oh, wow, people just die surprisingly, like unexpectedly people die. Was that that officer was that the first time you experienced something like that?

Katie 38:08
Yeah. And more than that, it was like the fact that it was someone on my husband, same shift. So same squat, there's like six or seven of them. And my husband could have been the one to go to that college just as easily. Yeah. And like he was the first one. Like one of the first two people on the scene. And more of it was just like, I got a text out when this a little bit off topic. But he sent me a text, he lost his phone in the whole thing. So he had sent me a text that said, I'm okay from an unknown number. So like that when I got that that like made me panic for a minute. I'm like, why is like a random timer sending me I'm okay. And so I responded back and I'm like, Who is this and somebody said, you know, your officer lost his phone. He wanted to make sure you knew what it was. Okay. So like that had happened. I started kind of like panicking a little bit. And I'm like looking through online what's going on. Of course, it's on Facebook in the news that there's a shoot out and two officers or two officers are wounded or down. And they the suspect still inside. And so at this point, I'm just watching the news, getting live updates, and then all of a sudden it's possibly a third. Well, it's been an hour since I talked to him and gotten that I'm okay message. And looking back now, and I wish somebody when he started the job would have said, you know, the news is a couple hours behind, because when he finally came home, and I could talk to him because like he was dealing with the situation and then had to be debriefed and all of this stuff. So I mean, it took hours before I got a phone call even that he was coming home, ya know what was going on? And while he knew when he had sent the text like it was actually over. me watching the news still fills and sees that it's still happening.

Scott Benner 39:58
I was gonna say he's back In the station talking to somebody about what went on and you feel like he's still there.

Katie 40:04
Yeah. And then like, they're still getting updates. And now they're saying there's three people. So I'm like, Okay, well, he was okay. Two hours ago when there was two people. And now they're saying it's three officers like what's going on. And so there was just like, a lot from that day. And that like, not knowing I think that impacted me more than, like, obviously, the day like I was, I knew what had happened. But like, it had kind of stuck with me more than I had realized.

Scott Benner 40:32
When my good friend, a good friend of mine is a police officer. And we were really young, like, in our early 20s. And a guy he worked with committed suicide. And he was, like, I can picture him in my head, even though I didn't know him that well, he was fit and attractive and had been in the military. And, you know, seemed like he had it all together. And then one day, he just took his own life. And I still worry about my friend. It's like 30 years later, you know, and because I'm like, Oh, I didn't know, I didn't know he had a job where the suicide rate was different. Like, I didn't know that. And now I know that, and I, I've never forgotten it. I don't have intrusive thoughts about it. But it is a thing. My point is that it's a thing that has stuck with me. And I wasn't dealing with postpartum, you know, and, and so I'm just trying to like, I'm trying to make sure people understand how it ramps up everything. You know, how depression or anxiety can just take, take a one and turn it to 100 for you. And, yeah, then you get caught in the loop and you can't get out of it.

Katie 41:42
And I think that was the hardest part for me is like, I couldn't take that step back and be like, Okay, this is like getting to the point where it's getting excessive or like, way out of hand, like this is a bug bite, and we'll watch it for an hour. And if for some reason, it looks like it's spreading, we'll call the doctor and we'll like address it then. Like that logic just was not there in any sort of way.

Scott Benner 42:05
Yeah. You have it now? Yes, I do have it

Katie 42:09
now. And like, it was amazing the difference that the medication did make for me, but like I said it without, I think the combination of finding someone to like, walk me through it and help me figure it all out. Yeah, in the process, as well as going and getting on the medication. Like I don't know, if I would have ended up in the same place.

Scott Benner 42:30
Yeah, I think all of this is so important, Katie, that. I don't know how obvious it is to people who listen to the podcast or not. But almost every day, I get contacted by some company who's like, we want to sell our widget or whatever through you. You know, we want to buy an app, we want you to, you know, tell people about our promo code, and, you know, etc. And I turned down almost all of it. Because while a I don't want the podcast to be a billboard, and be like, I don't see the value in it for you. But very recently, I was approached by a company that was representing like an online therapy company. And I said, I'm, I'm gonna do that one. You know, because I know how many people could use to talk to somebody, but don't know how to get involved in it, find it, how, what if they just don't realize it's a thing they need? And like, That's what I keep hearing with you. Like, I wonder if like, if you were if you were listening to the pregnancy episodes getting ready to get pregnant. And in the middle, it was like, hey, this episode of the podcast is sponsored by better help. And it's a online therapy thing. I wonder if two weeks into you feeling weird, if you wouldn't have thought, Oh, I wonder if this is something that that would help me with. And because it works that way with other things. You know, when people are MDI and they're like, Oh, I wonder if a pump would help you think, oh, on the podcast, they talked about Omni pod. And like, there's, I'm not saying you have to buy an omni pod. But there's a direction, right, like a thing I can start with. And I don't think people think about therapy at all, honestly, like, and it's a shame that you have to get into a situation where you're standing in a room thinking my could just leave, and then they'd be okay, which is obviously in no way shape or form a valid thought, right? Like you leaving your family is not the answer. And, and yet, there you are, and you had to get that far into it. And you had to get to the point where your husband was like, I can take you to the hospital. Like I mean, do you know what I mean? Like, that's it. People shouldn't have to get that far into a problem to realize it's a problem or to know that they need to look for help. And anyway, I just think talk therapy is really important for people.

Katie 44:54
I think it is too and I think the other thing about it is and I think it's getting better but like I There's just kind of like a stigma about it. And that, you know, most people don't need to need to do it for, like, unless something's going on. But if I had been more, I think exposed to it or even, you know, heard more about it, but it wasn't something that had been in my life prior like, No, and I and my family are new, really, if they had gone, talked about it, or mentioned how they did it, or anything like that, which, since, like, everything, I actually had talked to my mother in law, and she had gotten through postpartum depression and stuff, too. And, you know, kind of had some similar feelings, but it wasn't like we ever talked about that brighter, it wasn't like a topic that like anybody checked in and was making sure you're okay. I feel like if maybe that were like, understanding that you could just get online and talk to somebody. Right? Earlier on, it wouldn't have gotten so far. Yeah, no, by the time it had, and my husband's like, well, they have like, you know, they'll take you to hospital and they have like a hole, which he didn't explain it very well at the time, but like a whole unit to help you and, like, whatever you need type thing. It just made me feel like well, now you just think I'm a crazy person,

Scott Benner 46:07
you thought you were gonna go through some double doors, they were gonna swing shot, and then they'd wrap you up in a sheet real tight, and nobody would ever see you again. Like, yeah, I understand.

Katie 46:17
That, yeah, I think it is super helpful. And I wish that it wouldn't have taken me so long to figure that

Scott Benner 46:24
out. Well, but how would you have known? Honestly, yeah, and now look what you're doing, you're gonna lay this thing down here, this recording, and other people will hear it. And then the next person who thinks oh, I'm going to listen to that pregnancy series from that podcast, and then this that starts to happen to them, they'll think I could go talk to a therapist. And here's why a therapist is important. It's not, it's it's an impartial third party. That's what's important. It's somewhat because you say, Well, why can't I just talk to my husband? Or why can't I just talk to my mom, because when that happens, you're already in a state. And you're not as clear headed as you want to be. And then a person who you have relationships with, and sometimes, beef with you don't I mean, like you've been, how many? How many times? Have you been at odds with your mother? And so in that moment, you don't need the face of your mom's standing in front of you going, hey, you know, what I think is happening. You're, you seem depressed, because you might not take that well, from a person who is who is that close to you. I know, that sounds crazy. But I think that's true. Like, like, here's a exploded example. If your girls grow up to play soccer, here's my advice. Tell your husband not to coach the team. There'll be more successful in soccer if he's the coach. But it's a difficult thing to be. In another scenario being told what to do by your father, it just doesn't work. I've never once successfully seen a man walk to a pitcher's mound to talk to his own son. It doesn't go well, in so you know, doesn't mean you don't need the conversation. You just don't need it from somebody who you have other history with. And so that's why I think therapy is really important. But again, let's get to it before the wheels are off and the entrance on fire, you know what I mean?

Katie 48:21
Yeah, yeah. And I think, like in leading up to, like actually getting into therapy and like agreeing to going and not completely backing out and wanting to, but like, my husband knew what was going on, I talked to him. And like, that's how we figure it out to set it up. But like, he was there and like, would like be willing to talk. But I'm like, I don't know what to say to you. Like, this is how I felt. And this is how like, it feels overwhelming. But he was had no idea how to help me or what to say. And more than that, then it just made him like I would be telling him these things. And like, he's just scared to death and like panicking and doesn't know what to do. And so while talking about it, in general is great. It really makes a difference to have somebody that like, actually can have input or advice. Yeah, like that next step, or even just like how you're looking at it. And when, like, my husband who's so close in into it, all he can see is like, panic, I just need to fix something. So like, this doesn't get worse,

Scott Benner 49:19
right? I mean, how many people have you heard come on this podcast? And at the end of it, they joke they're like, Can I send you a copay? Why? Because we had a conversation. I listened to them. I said, Oh, I know how you feel that's happened to me. And they go it has and then that feels good. Like, oh, what happens to other people too, and then you have, you know, you have a place to work from all of a sudden. Yes, it's not because I'm some like, it's not because I could be a therapist. I don't know what the hell a therapist does. You know what I mean? Like, I don't have any I don't have any training in that. It's just a conversation. And it's just I don't know, it's very helpful. So I have other questions. Okay. How do you after going through all of this, think to yourself, you know what we should do? Why don't we have another baby? Like, that's like, how do you put yourself potentially back into that situation again,

Katie 50:16
I was nervous, kind of when we first started thinking about it, I mean, I knew, I've always wanted like, two kids, like, I didn't, my husband comes from a family of five kids, I was like, I don't think we're gonna go that far. Maybe we'll try two or three. So like, I always knew I wanted another kid, but it was hard. But at the same time, I had come so far, like, even when I saw this, like notification pop up, and I kind of had forgotten completely, since it's been so long. And I kind of just moved past it, and then kind of just started living life again. And so, like, even starting to think about it before this, I was like, you know, what were even the timeframes and trying to like, think about, and that's kind of why it hit me so hard this morning, even because I just haven't, like, thought about it that much. And so I mean, it crossed my mind. But at the same time, one of the last times I had seen, like the therapists and stuff, he's like, you know, take it for a year, if you start to go off of it, and you don't feel better, or it feels worse, like either slow down how you like, go off of it, or just stay on it for longer, like, that's fine, too. And he's like, and then the next if you have another kid, and you're, you get home and start feeling this way, call your doctor and just get on the same medication and just start early, and you know, what to look for, and how to deal with it. And I think that was what I took comfort in, when we were going to start training for a second because I have some sort of like, understand understanding of it. Now, first of all, that it could even happen three to six months after I have the baby or two weeks after, and that I can just go to my doctor and say, Look, things are not right. And this is what I need to be on. And this is what I need to do. And have at least those steps to start. Good for you. Okay, before I get to where I was before,

Scott Benner 52:11
yeah, preparation, right, knowing what to look for, and, and having the, the experience that will let you pull, you know, turn the switch right away, like, Okay, I see this coming, boom, like, do something not just like, Oh, it'll be alright. Or I could probably get through it or like, say something right away. And that way, that way, you get your husband then who's kind of like, able to watch as well, and your mom and other people in your life who could say, oh, you know, we've noticed this is happening. And you told us to look out for this. And that way it feels like it's your decision. Like they're the one telling you, hey, I'm noticing the thing, but you're the one that said, let me know if you notice this. And I think that's I think that'd be really helpful. And I mean, is there a situation? I don't know? Did the doctor tell you it's possible just doesn't happen?

Katie 52:59
Yeah, and when, honestly, the doctor really didn't do anything but write me the first prescription. And since then, I've changed boobies and realize that the one I had wasn't necessarily bad, but was definitely not really helping me through my whole last pregnancy, or anytime after. But when I was talking with my therapist and stuff, he was like, there's no guarantee it would happen again. And it could start slow. Or it could be like, you know, just feeling like it hits all at once. And who knows the timeframe. But as soon as it does, you know, ask for help or go to the OB and ask and I feel like that is honestly the reason I even messaged you in the first place. Is because if someone would have told me just like if someone like when I first got diagnosed, I listened and started, I found your podcast really early. And so I knew to ask for it. Dexcom instead of just letting them like stick me on the library. And so like, knowing that I could just go in and ask or be like, you know, is this normal? That I didn't need to wait for them to be like, oh, is something seeming a little bit off because you come home with a brand new baby, everything is off in six weeks, when you go in for your follow up. Everything is still a mess. But like nobody said, you know, like if things don't get better, or things change, or you're not feeling yourself in six months, like call us and come back in and we can figure it out and take a look at things. Didn't even like think that was an option or a thing that people did?

Scott Benner 54:28
Yeah, nothing's right after you have a baby, like nothing. Do you give birth naturally? Or do you have a C section?

Katie 54:34
I did. I got induced. And so I ended up going in. It was like, we had her the next day. So 24 hours roughly. So and then I ended up having stitches that came out like a week and a half later. So then and they were like, well, we won't restrict you. You'll just go and follow up with your OB and I was like oh great. And they're like just try not to move around. I'm like, okay, that's Oh,

Scott Benner 55:00
I just won't move around. Thanks. We'll move

Katie 55:02
around now that my husband's going back to work, and I have a new work. And so, I mean, like, you're just surviving. And so like, you go to the doctor, and they're like, how are things going? You're like, well, we're all still alive. And I'm here. So we're good.

Scott Benner 55:15
No one tells you you're gonna be wearing a diaper. There's a lot of stuff that happens that you're just like, Wait, it's just all so new and, and ridiculous. Like, almost generally me like it just you're like, why is this happening? Why is that happening? Why don't my boobs feel this way? Why, like, you know, like, it's just, everything's different all of a sudden, and on top of that, someone handed you a little bag of jelly. And if you drop it, it pops. So you're like, Oh, God, you know, just it's too much. And then your husband goes back to work. You know, most other countries, you get a lot of time off after you have a baby. And, and here, it's what your husband to skip a shift to.

Katie 55:51
He actually just took vacation. So he took two weeks off. So I mean, we were the we were home for the first two weeks, which was great. Especially because yeah, like I said, My Stitches came out. And I was literally like, couldn't move without like being in so much pain. And so he was home for about two weeks, but love my husband, but he was not. Like, I love newborns and snuggling and like stuff. And he's like, Well, she doesn't want to play or do anything. So he was less involved in the newborn stage. And so it was more like on me, because I did want to snuggle and just like love on her, but Right. And he didn't know, obviously, like he was the same way as you were, we both were, you know, deliberately take her out and they hand her back. And they're like, Okay, we'll come back and check in an hour after you fed her. And I was like, and how do I do that?

Scott Benner 56:43
Did he do the things like, did he like work on the house or go outside or try to clean the cars, that kind of stuff

Katie 56:50
completely, took apart his car and added stuff and cleaned every nook and cranny? Basically in his two weeks off? And he was around like if I needed something, but like, he just didn't know what to do with her being so small.

Scott Benner 57:04
Yeah. Katie, I unfairly know who you are through the Facebook group. And this is all like, like, multiplied for me by the fact that you appear to be like, 15 years old. Do you know what I mean? Like you're, it's, I don't know what, like, when you were talking earlier, and I was like, Oh, God, like you just, I mean, honestly, a photo. How old? Are you?

Katie 57:26
I am 26. You

Scott Benner 57:28
have no trouble passing for like 19. Right? Yeah, yeah. So it may it made it even more difficult, like for me to like, listen to you, and you're doing such an intimate, like, really, sincerely. I'm not. I'm not patronizing you. But like, you're doing a really good job of describing this. And it's not that I didn't expect you to, but I have had people on your age and a little younger. And I'm like, oh, so they're not going to tell their story. But and I have to pull it out of you that pulled out of them. But I feel like I could have started this and said, Hey Kati, so tell me about your postpartum. And I could have left, and you did such a good job of talking about it. Because of that, I want to ask you, if there's anything that I didn't ask you, or directions, we didn't go, that we should have things that you want people to know.

Katie 58:20
I think the biggest thing, which I'll be honest, like I didn't even when this finally when you first asked me I was like, Oh, I don't know. And then part of me was like, I just wish somebody would have told me so. Because I am not like a extrovert. Like I would just sit at home and never talk to people I work from home, kind of like, you know, in my bubble. And so yesterday, I told my husband, I was like, you know, when you sign up for something, and then you're like, I gotta do it. I was having that feeling. And just because I that's just not my personality. But I was like, You know what, this is something that if it helps anybody not have to go through what I go through just because they know they can ask for help. Or that they can go to a therapist or say you know, something's not right, then it'll be worth it. So I just, that's why I wanted my to say what I had to say, or just make it known. I guess the only thing is is like during the time, like I was trying to get it all figured out like my blood sugar's fell apart completely. I didn't pay any attention. And I was just like, trying to survive. And so I had worked with Jenny, and in my head, like, I was still like overthinking everything. And I finally just got to the point where I was like, you know, I wasn't paying her anymore, because we did the nine months. And I was like, No, I'm just going to, like, message her and see if she'll help me. And because I just, I needed to start over. Like, you know, when your settings are just like so far gone that like nothing's working anymore. So I sent her a message and I was just like, hey, I ended up you know, delivered. I mean, because this is like six months later. I mean, it's a long time since I've even talked to her. And I was like, you know, this is what happened I ended up getting the postpartum depression and my settings are awful and I am just trying to Like, get my life back on track. Can you just take one last look at my Dexcom and my numbers and maybe, like, start me out better because I also didn't have the best endo at the time. They just looked at my agencies, and they're like, Yeah, your agency is good. So, you know, we can back off your insulin if you get too low. But that was like the extent of an appointment. And so even like, that was a huge step for me to like, actually ask Jenny for help, even though like, I knew I wasn't paying for it or like that she didn't, wasn't obligated to help me. And it was as simple as I sent her an email. And she's like, of course, let me see what it is. And she's like, I'm so sorry, you had to deal with that. Like, I would love to help you get back on track. And it was something so simple. But even the thought of like, asking for that kind of help felt? I don't know. Like, I just like I had felt kind of through everything. Like I wasn't living up to like what I was supposed to be your the expectations or my role? Yeah. And so I just wanted people to know that. If it does happen, it can happen six months later, which is not apparently that uncommon note if no one tells you. And there is hope.

Scott Benner 1:01:15
Yeah. Oh, well, I'm glad you reached back to Jenny through, she's beautiful.

Katie 1:01:18
She's amazing.

Scott Benner 1:01:21
I'm just going to add here, because I'm old, that probably going to reiterate something I said earlier, but maybe expand on a little bit. There are no rules about life. There are no rules about how you raise your kid, about what your house looks like about what job you have, how much money you make, or don't make, you know, if you live in your bubble, or go outside of it. Like there's just there's no, there shouldn't be an expectation other than the one you set for yourself. And I know that everybody sees outside influences, and thinks well, that's it that's attainable. That person did this, I can do that. I want that. I I'm at a point in my life where I believe all the hippie stuff that I thought again, when I was 20, didn't really mean like, where I'm like, none of this matters about family and love and, and all that stuff. And then you get caught because you're like, Oh, I made a baby, the baby needs a shirt, the baby's gonna need a shoe might need to have those shoes, how am I going to pay for those, we're going to drive somewhere I want to drive somewhere in a safe car, I want to, you know, make sure they go to college, I want to make sure that they're okay. Like you start having all these things that you think you need to do. And it just, it's not really so like, it's all sort of an illusion, Katie, like really, you just you just wake up and live and make make make good decisions. And then mainly good things happen. And when bad things happen, keep making good decisions, and it turns around, and if it doesn't, ask someone for help, because it's not easy. That really, but to have an expectation constantly that the thing you have, that the life you're living is not enough, that there's more or better. That's a fallacy. Like, that's, that's not true. Like, that's you setting goals you can't find and I know that's not specifically what happened to you. But I think that maybe it's good for people to hear in this context that you can't really do much wrong. You know, don't hit people don't scream at them. They're, you don't I mean, have good intentions. Actually try and, and the rest sort of works itself out. You know, that makes me calm. Just the knowledge of I think of things backwards sometimes. But I always think like, well, we're all gonna be dead in the end anyway. Like, like you don't like so why don't I be happy today? While I'm living? It's all about now. Honestly. I don't know. I hope that's a value to people when they're listening. You were really terrific. I can't thank you enough for doing this. I know you didn't want to so I doubly appreciate it. Yeah,

Katie 1:04:13
I'm glad we finally got to it. Yeah, because we had it on the books once and my whole family ended up sick that morning and you're like, well, it'll be like eight months before we can get on

Scott Benner 1:04:23
there get it right on the air. You don't you shouldn't have to wait any longer. But even this morning, you were like a few minutes behind that start time and I'm like is the scroll not gonna come again.

Katie 1:04:35
You're just did not want to open the link. I had to like, go and get the Zoom ID separately and paste it in because if I click the link, my computer just started. I had this spinning rainbow wheel of death.

Scott Benner 1:04:46
I never gave up on you. It was only four minutes but I didn't give up just so you know.

Katie 1:04:52
Early in the morning is a big ask.

Scott Benner 1:04:53
Oh, you know what the first thought is, is did I get up and get moving this early for nothing. It's like that. And then I go, I'll just edit it all day. That's good. It'll make time for me. And but then there you are, and I was pretty thrilled. I'm gonna let you go and say thank you, but I want to ask you a question when we get off. Is that okay? Yeah. Okay. Thank you so much for doing this. I really appreciate it. Of course

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 juicebox. And of course, I want to thank Katie for how brave she was today cannot be easy to come forward and share stories like this. If you're looking for a community around diabetes, check out Juicebox Podcast type one diabetes on Facebook. It's a private group with nearly 40,000 people in it type ones type twos. Lotta you have questions about pregnancy, anything, those people are wonderful, T one D exchange.org Ford slash juicebox. Don't forget that when go fill out the survey. If you're looking for a list of other pregnancy based episodes, we have them in the private Facebook group, just go to the feature tab, or you can go to juicebox podcast.com. Find a whole list of them there. And then I don't know listen to them there if you want online or go back into your podcast app, and then search for those episodes. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#905 Best of Juicebox: Ask Scott And Jenny 11

Ask Scott And Jenny: Chapter Eleven

Originally posted on Mar 25, 2020. Scott and Jenny Smith, CDE answer your type 1 diabetes questions. Today, basal vs. temp basal adjustments, how to measure health, standard deviation.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 905 of the Juicebox Podcast

welcome back to another episode of the Best of the Juicebox Podcast. Today we're going to be revisiting episode 317. It's chapter 11 of the ask Scott and Jenny series, and it originally aired on March 25 2020. And today's episode we talked about a number of things, including Basal versus Temp Basal adjustments, how to measure health and standard deviation. 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 healthcare plan. We're becoming bold with insulin. If you have type one diabetes, and are a US resident or a US resident, who is the caregiver of someone with type one, I need you I want you I beg of you to go to T one D exchange.org. Forward slash juice box and complete the survey. That's all I'm asking. complete the survey. Take you about 10 minutes. P one D exchange.org. Forward slash juicebox. Help the people help yourself. help humanity be a helper. That's all I got.

The podcast is sponsored today by better help. Better help is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapist who can help you with a wide range of issues betterhelp.com forward slash juicebox. To get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit for any reason at all. You can switch to a new therapist at no additional charge. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price betterhelp.com forward slash juicebox that's better help h e l p.com. Forward slash juicebox save 10% On your first month of therapy. Hello and welcome to episode 317 of the Juicebox Podcast. I'm your host Scott Benner. Today, Jenny Smith and I will be answering questions that you the listeners have sent in three questions today. The questions three. As you can tell, I've been locked in my house for a number of weeks now. And I'm getting a little weird. This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. And by touched by type one, you can go to touched by type one.org or contour next one.com to find out about these wonderful sponsors. My friend Jenny Smith has had type one diabetes for over 30 years. She's also a certified diabetes educator. She has a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. Jenny is a registered and licensed dietitian, a certified trainer on most makes and models of insulin pumps and continuous glucose monitors. And as you'll find out later, very well may be a person who can talk to wildlife. The one thing Jenny definitely is, is a person who would want you to know that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, she'd want you to Always consult a physician before making any changes to your health care plan. We're becoming bold with insulin, Jenny she's good like that. She's rock solid, you know what I mean? She wants what's best for you. In today's show, Jenny and I are gonna talk about when to change Basal rates you know when to do with Temp Basal and when to put, you know, a firm change into place. We're going to talk about the measurement for success in diabetes management. And what a good standard deviation might be, not just for you, but for everybody. Bum Bum Bum Bum Bum Bum bum. bumbum bumbum bumbum. The highlight of my entire week has been that the Costco near me had paper towels.

Hey, sorry, I was moving my microphone stand a little. That's okay.

Jennifer Smith, CDE 5:07
I think I have a like, I think I have like, a problem with like, I did a finger stick, okay. And my finger really hurts. really hurts, like, like, and it's kind of like, puffy. Like, can you see that? It's like puffy and red.

Scott Benner 5:29
I can. On the top. It's puffy, but you didn't stick yourself on that.

Jennifer Smith, CDE 5:34
No, I stuck it on the side where I always do and like, I can't see anything from it. I also need like bifocals. Because I have to go like this every time I have to like see something up close. My son brings me like the directions for a game. And I'm like, like, seriously, who wrote these directions? Like, come on.

Scott Benner 5:57
You have no idea how many times because Arden's a, a side stick, like she sticks on the sides of her fingers, too. But you have no idea how many times like in the middle of the night when I do it. I'm so close to her cuticle. I'm like, How did I miss that? Yeah, and I looked down at her and she's not awake, and I go, ooh, she's never gonna know about

Jennifer Smith, CDE 6:17
this. This has never happened before. Like, and it's it like it hurts it physically. I'm like, I can't there's like no hole. I can't tell if there's like gross underneath or anything. But who knows? I don't know. Maybe there's like an alien growing underneath there.

Scott Benner 6:33
Listen, if it's too fast for you to get an infection, obviously. So it's not that did you maybe just hit a nerve, I

Jennifer Smith, CDE 6:43
must have just hit something that was just a much more sensitive spot. Or maybe I hit a spot that I had already hit. It's time it's kind of a favorite thing. Like

Scott Benner 6:54
in her sleep. Right? This is fascinating. In in art and sleep. I will. I will go to fingers that she doesn't use figuring She's asleep. She won't know in her sleep. She'll pull the finger back and give me a different finger that I'm always impressed by because sometimes I'll be like Arden and she's not awake. Right? She just she feels you in her sleep. Take the wrong finger. She's like, No, no, this one. We're still do two of them. She's like either one of these is fine, but not like I tried to use her thumbs when she's asleep. yanks him right back, fold him up in a fist. I'm like, That's hilarious.

Jennifer Smith, CDE 7:31
That is hilarious. That's super funny.

Scott Benner 7:33
So yeah.

Jennifer Smith, CDE 7:35
So how are your How are your older older kids? I hate calling them kids because they're really not kids anymore. But like, how are they doing with everything? I've got some teen nieces in Milwaukee and they are just like, they're like climbing the wall really according to what the brother in law says. They're just like, I cannot be inside anymore. I need to be not near my parents on board.

Scott Benner 8:02
We're gonna turn your question. You're very kind. How are you question into part of this episode. And here's here's why. Arden's insulin needs have gone way down since she stopped going to school.

Jennifer Smith, CDE 8:16
Do they go down in the summer too?

Scott Benner 8:18
Yes, she doesn't like being at school. That's just what it is. So now this whole the the, the incarceration is actually freedom to her. She can go to bed when she wants get up when she wants to handle her work when she wants to. She's much happier. I'm seeing more smiling. I don't think I should ever send her back to school.

Jennifer Smith, CDE 8:44
The reason a lot of a lot. I've got several people that I work with who homeschool their kids. One who I started working with was telling me about her. She's the pilot. Yeah. Her parents school homeschooled her. She's now like, out of college. She's actually doing an internship with one of the airlines and doing wonderful but she was homeschooled. And they didn't see the fluctuations like comparatively with the other kids her age that is working with who were in school. clear difference from a weekend or a holiday away to actually being physically in school

Scott Benner 9:22
right now. There's there's been even the summer takes time for her to like ramp down. Sure, but this was one day, the first day when she was unsure of how this was all gonna work. Her blood sugar didn't change. And then after she got her work in on time, she was just like free and easy and really happy. So it's interesting now my son he doesn't like the lack of activity. Like we were outside in the driveway throwing a baseball yesterday for a half an hour. He brought us he said he's my kids are both very good with money. They Don't ask for a lot of stuff. And he's like, I need a squat rack. For the basement. He's like, I need to be able to like exercise though. And I was like, okay, and the other end, he walked outside, just sat on the front step for a while, you know, just the height, I need to get outside, because he's also a boy. So like, he'll start playing a video game and lose a day to it if he if you let him, you know what I mean? And last night, he told me around midnight, I'm gonna get a shower. And then I'm gonna read for my, my economics class. And I was like, Oh, that's great. And he's like, it's not like, why is it not? He goes, because I'm going to read for an hour to get what I could get out of a five minute explanation for my professor. And I tried to do like, I did the dad thing. I was like, oh, there's nuance to the reading. you'll appreciate it later, he was looking at me, like, I don't care what you're saying. And I was asking, I was like, I tried not to be, you know, I just was like, you know, this is it. It's good. And, but he wants that he's also concerned about how much we pay for school. And that now he's basically learning through, you know, yeah, really fancy YouTube videos. So he's like, why are we paying for this? And I said, call this time is going to turn. It's one of the strange things about about the United States, at least, that I've never understood, like, why has quality distance learning not become more? I don't know. Like acceptable, especially in college. Right.

Jennifer Smith, CDE 11:28
Right. Right. I yeah, I mean, it I think it's getting better now, how people viewed the distance learning like the University of Phoenix, or whatever it is, you know, all the commercials for, but there, there are quality programs, and my sister in law actually did an online master's degree in business management. And she, she does a great job. She's a wonderful job. Cuz she did that. So there's nothing wrong with Oh, no, no,

Scott Benner 11:55
no, but why is it not more popular? Why is it why not? Is it just is like an his level of embarrassment? Like I went to school, like through the mail? Does it feel like that or something like that? You don't? I mean, like, 1960. It took a writing course from Hollywood.

Jennifer Smith, CDE 12:10
Yeah, I don't know. I think I think in today's technology world, it's getting better. In fact, some colleges, as I'm sure you've seen with even Cole, I'm sure he probably has some things he needs to submit, online and do that way already. But I think it's such a big change from the quality of as you know, in high school. And even in college, there's a lot of social networking that goes on that you, you don't get that when you have it at school, you just don't. And

Scott Benner 12:43
we talked about that. There's, you know, you sometimes meet guys that, you know, he's playing baseball with or he's met through school, and you talk to them a little bit, you go, that's an impressive kid for 20. It's going to be impressive adult and you don't know when 10 years from now, that kid or your son's going to wake up one day and go, you know, I have a position to fill and you know, who would be great for this? Yeah, that guy played baseball with 10 years ago. And so there's that piece and there's the social part of it. Like I'm not, I'm not discounting that. But for some people, they just want their degree. They're not looking for you know,

Jennifer Smith, CDE 13:16
they could care less about sitting in class next to the guy who doodles pictures of his dog, right? Yeah,

Scott Benner 13:22
I met the most interesting guy in college yet no one cares. But anyway, it just was it's interesting that they both are they're not happy. We spent number of hours playing poker the other day. You know, there's we keep talking about having a movie night but it hasn't happened yet. Everybody's that we're I think we're kind of quietly keeping things. Activities aside for when everyone loses their mind. And we really, like need the activities and so far, everybody's been okay. Kelly's under the weather, but oh, it's not um, you know, it's nothing related to all of this. Just yeah, it doesn't feel well, just a

Jennifer Smith, CDE 14:03
normal thing. I know. And that's every time you hear somebody like

Scott Benner 14:08
oh, my god, get back to person get away.

Jennifer Smith, CDE 14:12
The cough maybe they were eating a granola bar that didn't go down the right way.

Scott Benner 14:16
We're doing it on purpose for comedy reasons, too. Yeah, that would be my husband. Yeah, just everybody runs out of the room. mom's sick. Don't touch her. She's like I just I got a dry piece of Winona bringing us down with you. So and she cut caffeine out. But she did it too fast. So now she has a caffeine headache, you know, and I gave her a little tea. I'm like here have a little it's not from soda. And this, she might even

Jennifer Smith, CDE 14:43
do better if she if she's willing to do tea. She could even do something like a matcha which has a little bit of caffeine in it and could kind of ease down Calper the caffeine kind of thing because it's also much smoother caffeine than coffee coffee is like you get this big like rule

Scott Benner 15:00
Yeah, we don't drink coffee. Nobody here drinks coffee. Actually, I think the truth is that I don't believe Kelly ever has been I've never had a cup of coffee in my life. So I wouldn't even know what it is. As Jenny takes a large

Jennifer Smith, CDE 15:14
as well. I drink tea every morning, usually a couple of

Scott Benner 15:17
drops. But I'm drinking earl grey with a little bit of honey. Oh, I

Jennifer Smith, CDE 15:20
have a very good friend in Colorado who Earl Grey, and Lady Grey are like her favorites. My

Scott Benner 15:26
favorite thing it really is. Alright, so Jenny, we have a ton of ask Scott and Jenny questions. And we are gonna do like three recordings in a row over the next two weeks so that we have them all set up? Yes. Before we start, let me tell you that and there's no pressure here. But tomorrow at 3pm I'm doing a like it's just a social meet up online. And if you're free and you jumped in for a couple of minutes, I bet you these people would be very excited to

Jennifer Smith, CDE 15:55
unware zoom. And zoom.

Scott Benner 15:58
Yeah, so you could sit like this, click on a link pop up.

Jennifer Smith, CDE 16:01
What? Yeah, we zoom for our staff meetings on Wednesdays. But what at what time,

Scott Benner 16:07
three o'clock tomorrow? Three to 430 it's gonna run. It's gonna be like a free thing. Like people can come

Jennifer Smith, CDE 16:12
time. Like, dude, a two to 330 my time. I should be around. Usually, I'm working on emails at that time. So send me the link. I will

Scott Benner 16:20
even if you just popped in and you were like, Yo,

Jennifer Smith, CDE 16:23
and send me a quick text while you're doing it so that I remember you

Scott Benner 16:27
will. You're gonna find out what it was like to be Elvis in the 60s. Ah.

Jennifer Smith, CDE 16:34
Interestingly, are you recording right now? Okay, I just wanted to

Scott Benner 16:40
read you want to say something private? Hold on a second. by everybody. will gently I hope nobody finds the body. I think you're gonna be okay with where you hit it. You're so I mean, it's Wisconsin. There's so much snow on top of it. No one's ever gonna find it.

Jennifer Smith, CDE 16:58
We've got lots of bugs too, you know? Yeah.

Scott Benner 17:00
So should we just start at the top of this list? Or do you have a favorite in here?

Jennifer Smith, CDE 17:04
No, I the one that I think we had commented briefly. The last time we talked was it last week already? was about there was somebody who asked about artificial sweeteners. And that one was curious to me. But there's a good list of questions. So wherever you want to start, it's totally fine to me. Okay. Well.

Scott Benner 17:26
Can you like there are so many guys. First of all, Rudy was so nice to send in so many questions. But yeah, let's just roll through the top. Okay. Okay. Sarah asks, Please address puberty. Specifically, I think Sarah wants a question answered for her specifically, but 12 year old, pre period, girl, the spikes and drops are insane. There aren't on the pod Dexcom. So I think the question here is when to change basil, and just Temp Basal. Okay, so she's seeing drops and spikes. And she's looking for your when is this a change I make forever? And when is this just something that's happening? But that's interesting.

Jennifer Smith, CDE 18:10
It is. And it's a great, I mean, given the age of the preteen. And you know, her being a female, obviously, there are going to be, as I've talked with a lot of the people I work with who have girls about this age, who have not started a cycle yet. There are often about like a six to maybe 12 month time period before a cycle actually shows up. Okay, that if you start to track these resistant and sensitive times on a month to month basis, you may find anything to answer your question, you may find that it actually flows around the same time every month. And if you can catch that, then yes, you may be able to put a pattern in you know, Omnipod, all the pumps out there allow you to actually set up different Basal profiles to turn on at certain points. So if you can track enough to say, Okay, this cyclic nature of resistance is always coming around the 15th of the month, or whatever it is, right? If you track a couple of months, and you see that and you say, Okay, last month, we used 50% More this month, we're using 40% More, you should be able to set up a Basal profile, then that essentially is that much more at least in Basal delivery, and then just enable it for that time of the month and the duration of days that you see it typically lasts. That's you know, that's kind of then going forward into once a cycle does start, you'll be able to utilize that same kind of pattern. And once the cycle becomes regular, which is usually it takes about a year, give or take for most girls once they start their period to have kind of a consistency to it right So you should be able to use a pattern then, rather than just always employing a temporary basil. It does take using the temporary basil up front though to figure out which amount extra you need to actually create a profile from.

Scott Benner 20:16
Okay. So last night, I learned that Arden has a name for her period and she won't tell any of us what it is. It has a human name apparently human names. Yes. Awesome. I think she likes the feel like there's a person who's inflicting this on her so that she can be focused on the person doing the problem that's on the side. Yesterday I showed Arden's friend Jani, who has not been on the show yet, but will eventually she's somebody whose blood sugar I'm tracking. I showed her how to see that her pod site went bad. So she's rolling along great in the 90s just kind of bouncing, you know, 8996, like all day long, three o'clock in the morning, it shoots up and levels off at like 220. And just stays that way all night till she wakes up at like four in the morning realizes that Bolus is the Bolus takes her down a little. And then she's levels off and kind of rises back up again. And so I just pull up a 12 hour graph. I showed it to her and I said, just look at this. This is a bad site. And she's like, why? And I'm like, doesn't matter. It just is like, look at it, look at it. This is what a bad site looks like all the sudden, your insulin pump is not doing what you expect of it. Common sense here says bad sight is it is this the last day of your set. And she goes it is and I was like okay, change your palm, get yourself down and start over again. The reason I bring that up where it doesn't feel like it maybe fits here is that the way I would handle Sarah's question is I would just do it over and over again until I had that feeling of like, Oh, I know what this is. And I really believe that it's not just me. I mean, I think the podcast has proven that outright, that eventually after you do something enough, you just see it. And then all the thinking goes away. Jenny, what Jenny said is all perfect, do that. But I think that one day, it'll just be a situation where you got this as a Temp Basal increase, or Wow, this is not giving up. This is more. Right. Sorry. Exactly. So long game.

Jennifer Smith, CDE 22:21
It is a lot. It's a marathon, not a sprint. Yes. Entirely. And you know, in the beginning, though, when you're really trying to figure out the difference between a temporary or a true solid adjustment? Yeah. I think you know, when you make, let's say you make you decide you're going to make a profile change. Oh, sorry. Bringing it shouldn't have rang. I had it turned off.

Scott Benner 22:45
I didn't hear it on the sensor. You're good. Oh, good, good, good, good.

Jennifer Smith, CDE 22:49
So, you know, overall, you might make a basil change. And then you're like, Well, what, what gives three days later, you're like, that's not working anymore. And now I'm way back down that might overtime again, prove I need to maybe make a temporary adjustment, rather than a permanent kind of an adjustment. It's kind of similar to growth patterns and kids, you know, where you see a temporary need, because you're now fluxing up and Okay, all of a sudden, this is gone now, and I'm staying a little higher, but I wasn't at the rate of need. Like I was for three days. Yeah, it's come back down a little bit. But now it looks more stable. It's a little higher, but not quite. So yeah.

Scott Benner 23:29
Yeah, I think that somewhere in between, stay flexible, be and reactive, not in a negative way. But in that sort of don't wait around weigh, you know, like, and there's drifts Sara that you'll start seeing on the Dexcom line. And just by the angle of it, I don't know how to explain it to you. But you'll start to look and go, This isn't going to stop. Like this shouldn't be happening here. I'm going to try a Temp Basal increase right here. With Arden's period yesterday, I used a lot of temporary increases yesterday, because she was sitting stable at 190 boluses weren't moving her. And so to me, that meant, you know, Basal jacked it up, it worked a little bit not enough, it was the end of her pump. So we swapped her pump, you know, we just went through the steps of you know, of what it could be and, but we didn't wait around like once you saw it, we moved on it. Well, we all have one thing for certain. And that's an abundance of Time, time that can be used in many different ways. You could perhaps spend your time at touched by type one.org. Or maybe you'd go to contour next one.com To find out if you can get a free Contour Next One meter by just clicking on a link and filling out some information. So here's what we're gonna do, touch by type one.org He has a mission of elevating awareness of type one diabetes. They also want to raise funds to find a cure. But mostly they're looking to inspire people to diabetes to thrive. They have these beautiful programs and services. They're helping kids all over the world with our D box program. They put on one heck of a dance program every year in Florida. Go check them out, touched by type one.org. And once you've done that, you know what you need. You need the best blood glucose meter My daughter has ever used. And by best I mean, the most portable, the Handys fits well in your palm lights up nicely at night super duper accurate. And blood sugar test strips, the little strip things you get a second chance with if you mess up, you know, when you go into the blood, sometimes you're like, I got it, I got it, and then it doesn't beep and you're gonna throw away the test strip, not with the Contour. Next One, you just dive back in again, beep beep looking at your blood sugar. I absolutely adore this meter. As much as anyone could adore a blood glucose meter. The Contour Next One is it. So head over to contour next one.com. And see if you're eligible today for an absolutely free, no obligation meter. And if you know you need a prescription, contact your doctor. They're just sitting in their living room to no one's doing a damn thing. Just throw him an email be like yo, what's up? Let's try this new meter, send out a prescription have gotten nothing but time. Contour next one.com touched by type one.org. Those links are in your show notes right there in the app. Right that you're listening in now. And at juicebox podcast.com. Check them out support the sponsors.

Okay, well, it's so funny. It's another Sarah but a different Sarah.

Jennifer Smith, CDE 27:05
There are lots of stairs just like Jenny. Yeah, it was a popular name.

Scott Benner 27:08
So they're even spelled the same way. It's not even helpful. What would you consider the most meaningful metric or measure of successful diabetes management?

Jennifer Smith, CDE 27:21
Oh, that's a good one. And I think we've actually got we went over that a really long time ago. Any of the of the pro tips or any of those kinds of things? I think if you're looking at measurement from a site like clarity, or one of your pump upload sites that gives you all of the metrics of this is your you know, your average or standard deviation. This is what your glucose management indicator value is showing you what not, what's the best indicator is time in range. That's it in second to that really would be that standard deviation, right? Because the lower the standard deviation, the more smooth management is rather than the jagged up and down kind of Rocky Mountain. But definitely, I would say time and range. Our goal when we work with people is always, you know, at least 75% time in range less than 5% of the time low. Pregnancies a little bit different but

Scott Benner 28:23
yeah, so what are the ranges you give people? What is that range?

Jennifer Smith, CDE 28:28
I work with people on their target range, because everybody is individual.

Scott Benner 28:33
So okay, so if do you feel like most people are being told 8180? Something like that? 71

Jennifer Smith, CDE 28:42
Yeah, 70 to 180. Like, if we look just at tide pool, tide pool has automatically set up as a time and range target as 70 to 180. You can in your settings, go in and adjust that to get it tighter or make it broader or whatever. But yeah, most most practitioners, I would say are aiming for about an 80 to 180. That's the most common that I hear. So again, if you just aiming for what the standard is. That's it.

Scott Benner 29:11
I think that these companies should expand this a little bit. I've been thinking about this. I need a time in range, and a time in Nirvana, like kind of match. Right? Like I want to know.

Jennifer Smith, CDE 29:27
I want to know how to be in range, but I really wanted to be in this sweet spot. Like

Scott Benner 29:31
I'm not I'm not I'm not upset that Arden's blood sugar's 180 for an hour, right? I'm gonna get it back down again. But I want to know when I'm 70 to one to 181 3120 in there, I want to know when I'm, I even want to know like 65 really like because if because if she 65 for a couple of minutes after a Pre-Bolus Yeah, I'm already with that. Right. And so I think that everyone needs to remember that when we talk about this stuff, there's context that you need to give it. And you see all the time there's people online, or look, I was in range 100% of the time today, and somebody will come in and say, you know, what's your range? And then suddenly, they don't come back again. Because you know, they never went over 350. And we're never under 50. I'm using range all day. And even you know, what, if that's for them a success? I'm not taking that from them. I'm just saying that when you're trying to share it out loud and public, you need to tell people what that range is, or it lacks, you know,

Jennifer Smith, CDE 30:33
I've even seen something that goes along with it. I've even seen people then question, well, what are you eating? Because when we're looking at sharing our own information, and kind of patting ourselves on the back, which good for us? Absolutely, it takes work. So go ahead and pat away. But you also have to, when you're putting it out there to the public, you have to give all the information that went along with that. You can't just say look at this nice flat line. Well, people then ask, well, what are you eating? How did you get that? Because there are so many different variables that go into meeting that.

Scott Benner 31:09
So my blood sugar has been between 82 and 86. All day, I've had four hard boiled eggs yet like yeah, like tell somebody the whole story. Right? Exactly, yeah, because it feels bad. Otherwise, like, otherwise you're looking at it, you're like, oh, my gosh, you know, this person's blood sugar. I try to remember as much as I can, to say, you know, art and say one scene has been between five, two and six, two, by the way, coming up now on six years. And she doesn't have any diet restrictions. But I always think the important thing to add is, for all of you that are imagining that her blood sugar is just at three constantly. That is not the case. You know, we just don't look at high blood sugars very long, and she's not low. So, you know, I would say that Ardens deviations never where anyone would want it. A hertz is usually like 40, you know, and, but within range, it's being measured between, it's being measured between 70 and 120. Right. So, you know, and you know, and I know, I still don't want her to spike up, but she sort of doesn't, right, you know, so. And not that she doesn't ever she does a couple of times a month or you know, a couple of times a week or whatever it ends up being. But she just doesn't jump the 300 and stare at it. So I think that while the measurements are really important, the way we talk about them are, is possibly even more important. So I don't see anything wrong with a one, see if it's being done correctly, meaning no protracted lows that are giving you a false sense that your agency is lower. But what Jenny's saying is you do not want your blood sugar bouncing up and down. That is just not good for you. It would probably be better for you to be steady at 150 than to go from 70 to 300. combover. Correct. Exactly. Right. So there you go. Actually, the funny thing here is the next question from Nicole, is, what are your thoughts on a reasonable standard deviation for a growing five and a half year old? Yeah,

Jennifer Smith, CDE 33:11
that's, I think you have to have a little bit of expectation that there is going to be more variability in certain periods of life. There will be I mean, kids, I mean, she's his growing five year old kids are growing considerably from birth, I would say, honestly, until about the age of like, 10 ish, things are kind of similar and patterns of growth. They really speed up. I mean, you can see the difference. Yeah, and we've got one of those, like tree growth charts for our boys. And I usually try to every couple of months to see where are you because I know, you look like you've grown or your pants look way too short again. And I swear I just bought new ones last month, you know, but at some point that growth slows down. And certainly the teen years are a different amount of growth, not the same as far as like height or anything, although it could be for boys differently than for girls. But hormones are a bigger impact there in the teen years. For little kids like that five year old age. You can expect that in for a standard deviation of something like 20 might not be in the cards because you may have a lot more variability. Even if your time in range is kept very good. You still might have a little bit more variability in there. Because if your five year old is like my who is now seven, when he was five, I mean, he could be like I want to eat I want to eat I want to play I want to eat nope, I'm not going to eat all of that. So when you mix diabetes in there and you have to Bolus and strategize and okay now I have taken a little way and now I have to plan for this and whatever. There's going to be a lot more variability perhaps, but aiming That's why I said that metric of time and range would be really more what to look at. Yeah, we don't want your standard deviation to be 80. But if it is going up a little bit more, you know, up and down. That's kind of par for the course with littler kids.

Scott Benner 35:18
I think that common sense is incredibly important here too. Because as you're listening to Jenny, explain this, from a clinical standpoint, you're thinking about what is or isn't said to you by The American diabetes Association, or by your endocrinologist, all that stuff, you have to remember that they're just trying to give, they're not with you, they're not always whispering in everybody's ear, right. So they're just giving a baseline like, you know, your standard deviation should be less than blah, your agency should be here, your variability shouldn't go blank, like, they're just giving you a place to start. I think that it's a, it's kind of incumbent upon all of us to take what looks like the rules, I'm making little quotes with my my fingers, and realizing that that's probably not the best you should be shooting for. It's not it's not the top, they're just trying to keep people. I don't know how to say this. There's a, there's a way that if you're, well, I'm struggling here. Anyone, anyone who's been in a position of power in an organization knows that you're giving common denominator advice to your employees, to you know, the the subjects of your kingdom to like, to whom ever you're talking to, and to hear that advice and take it as gospel, I think is a mistake. Right? Do you know what I mean? Like, you know, like, yeah, do you ever go around a corner and the speed limits 25. But you're in a sports car, and you're like, I could go around this corner? 45. And it would be, you know, that's you, you're in a different car, they put the 25 there for the guy coming through in the 1975 Datsun like, do you mean like his car can't handle this curve at 25? He will roll the car and right, yeah, so for us, for instance, my standard deviation doesn't look good on Arden compared to what people say, except those people have a range between, you know, 80 and 180. While I'm shooting for a range between 70 and 120. And so, my I, I know where our standard deviation sets When I'm happy with our blood sugar, right, and I don't care what anybody else says that works well for us, right. And then people are like, whoa, but then or health or health or health is going to be great. Like, if you tell me that a person growing up with diabetes, who's got an 801 C, and the fives constantly eats whatever they want, doesn't spike high, you know, maybe sees one at twice a day for 45 minutes. If you're telling me that's a problem. I don't believe you. You're I mean, like, or here's this, that's the best we can do. So you know, we keep trying to tighten it down and make it better. But at some point, that's when you get to the the life versus management trade off. Like I got to be alive to weed. Right? Exactly. Right. Yeah. And so the problem with asking these questions are and getting the answers is that no one's going to give you a real answer. They're just going to say what feels safe. Right. And so that's the most part. Yeah, common sense. These pop it

Jennifer Smith, CDE 38:27
what I can kind of say about standard deviation, though, even in let's say, your time and range of whatever range you have set. Even for a five year old, for example, you know, if you're constantly having these big old climbs, and then constantly attacking them, and then having a drop that you're getting into the red zone, and then you're climbing again, because of the red zone, and then you're dropping again. Even if you're in range and doing that, that standard deviation, it's still it requires improvement, right? You don't want this mountain peak, you know, up, down, up, down, up down all day, because even in range, it doesn't feel good for any age person. So the smoother that is, the better the person, the child team, whoever feels

Scott Benner 39:17
if you're looking at up and down and up and down like that and worried about time and range or standard deviation, you're missing, you're Miss focusing your concern, your concern should be Pre-Bolus thing and carb ratio and understanding glycemic index and stuff like that.

Jennifer Smith, CDE 39:31
And also effective insulin right duration of insulin. Yeah, understanding how long is my insulin actually working? You know, we're under that kind of takes it a step further in that variance that you see that standard deviation, because we're kind of in the understanding that our rapid insulin is rapid. I mean, we talked about this before and that it also clears very rapidly. That's not actually the case. If you follow it out, right. There's actually a A lingering dribble of impact. So if you are getting that up, down, up, down, up, down, it's very likely that even with using a pump, you might unknowingly be stacking insulin because your duration of insulin has been too short. And with modern day conventional pumps, what you set it at is what it uses. It doesn't do anything else beyond that, right? So it can't say, Okay, there's still insulin left here. Make sure you take some of this off. But yeah,

Scott Benner 40:30
Jenny's talking with their hands while I can hear birds outside of her window, and she looks like Snow White. I talk with my hands a lot. I don't mind the hands hockey, I'm just telling you about Snow White for a second. Listen, here's what I think. Don't worry about your algebra grade worry about understanding algebra, right? You know, the grade will come if you understand the math. And with this, if you know how insulin works, the standard deviation of calm, the time and range are commonly a one CL come like you can't, don't focus on the grading focus on the work. And, you know, I don't know how many more times I can say this, I keep thinking I'm going to sync the podcast, it's timing and amount. It's understanding how insulin works use the right amount of insulin at the right time. And the rest of this becomes unimportant, you know, its background all of a sudden.

Jennifer Smith, CDE 41:18
And the important thing about that timing and understanding is that it is individualized right for you not to cut and dry of okay, the doctor told me that this should last three hours. So that's what it should last. That might be the case for Johnny. But for Susie over here in the corner, maybe she's figured out that three hours, the doctor told me it looks like it's four hours for me. So it does have to be individualized.

Scott Benner 41:41
I don't know where I was where I rolled up into a talk. And I told people look, here's the truth. I could have flown in here, got up in the morning, got showered, jumped up on the stage, grabbed this microphone and said, Hey, everybody, it's all about timing and amount. Just understand how insulin works. And you you're going to be fine. Thank you good night, and I could have left, you know, would, you know would have left out some of the details about how to get to that. But that's still the truth. Correct. Jennifer Smith is available to work with you. Check her out at integrated diabetes.com. Thank you very much to the sponsors, Contour Next One, and touched by type one. A lot of ones in there. Two ones, you know what you get when you add up to ones. One on One is equals to I'm completely alone in this room. I just want to go outside, touch a handrail. Don't walk past somebody who sneezes and not have a stroke. Soon, probably a couple more weeks, couple months the most. It'll be fine. was still wearing pants or you don't judge me. Listen, I put this up a little early. Right? Because on March 26, at 3pm, we're going to do a big zoom meet up. And I have an idea for that I think you guys are gonna like so if you're hearing this in the moment, check it out. And if not, the video will be running on the Facebook page, you can go back to it. But here's what my thought is going to get a bunch of people together. And we're all going to you know, just chit chat, see how things are going make sure nobody's like, you know, go and do because they've been locked in their house too long. And they after we all do a little Chitty chatty like that. We're going to talk about getting people's Basal insulin, right. So like a big group thing on everyone's Basal insulin. And then we're gonna come back the next week, see how people are doing and then add another step. And maybe during this whole Coronavirus thing, we can bring everyone's variability and standard deviation and a one seat down, when that'd be cool if we just all got together in a group and did something like that. Well, I hope you think it's cool, because I'm pretty excited about it. March 26, Thursday 3pm Eastern time. There's links right now on Facebook, I think the links on Instagram, send me a message if you don't know how to get to it, get there. Gonna go through people's Basal rates, just like it's a private phone call, except we're all going to be there kind of kicking in our two cents, helping everybody out. You know, if the listeners of the Juicebox Podcast can't count on each other during a time like this, then I don't know who we can count on. So while we're all busy being stressed out watching bad Netflix shows, I figured we could spend a little bit of time doing something for everybody's health. I hope to see you there. Hey, last thing if you're not a subscriber to the show, like if you just count on remembering the shows on it would help me out a lot if you hit subscribe and your podcast app would help even more if you share the show with a friend. And if you're not up to like share in the show, maybe just share the zoom with them get together and maybe they'll see something they like and they'll check it out on their own. The podcast is growing so quickly because of you guys. It isn't even letting down during this Coronavirus thing. I'm super impressed. I thought for sure. Like, oh, downloads will slow down, but they haven't. And that's really very touching. Oh, by the way, last thing next week. So the next show that comes on, let me take a look. On the 30th of March, it's going to be an after dark episode. Sexuality from a female perspective. So if your kids usually listen, don't let them listen to that one. Because there's not a lot of bad words in it. But there's a lot of clear talk. So unless you want your kids to know exactly where the round peg in the square hole are, I think you should. I think you should make sure they skip that one. I didn't believe a lot of kids listened until recently, but apparently they do. Which I think is great, but not for this one on Monday. So there's an after dark coming up on Monday. Make sure your kids don't hear it. A huge thank you to one of today's sponsors better help, you can get 10% off your first month of therapy with my link better help.com forward slash juice box that's better. H e lp.com. Forward slash juice box. If you've been thinking about speaking with someone, this is a great way to do it on your terms. betterhelp.com forward slash juice box. Thank you so much for listening to this episode of the Best of the Juicebox Podcast. Don't forget, if you'd like to hire Jenny. She works at integrated diabetes.com. Just head over there and ask for by name. As I'm saying goodbye. I'd like to thank you for listening, sharing, subscribing. If you're in the private Facebook group, anything you do to support the podcast, I appreciate. If you're looking for more of ask Scott and Jenny, there's a whole list of them at juicebox podcast.com. Right up in the top in the menu. And there's a list in the private Facebook group Juicebox Podcast type one diabetes up in the feature tab. They ask Scott and Jenny series always has more coming. So if you have questions you'd like to ask Scott and Jenny, find me in that Facebook group and let me know we'll put them on the list and make more episodes with your questions.