#916 You've Got The Right

Michelle's son has type 1 diabetes and Michelle is an HR professional here to talk about FMLA, Leave of Absense, Americans with Disabilities Act, Insurance & emplyee resources.

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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 00:00 Hello friends, and welcome to episode 916 of the Juicebox Podcast. Welcome back everybody on today's episode of The Juicebox Podcast I'm going to be speaking with Michelle. Michelle is the mother of a child with type one diabetes, but she's also an HR professional. Today we're going to talk about FMLA leave of absence, the Americans with Disabilities Act for adults, insurance, employee resources, and so much more. Do not miss it. 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 health care plan, or becoming bold with insulin. Hey, would you like to save 35% off your entire order at cozy earth.com? Well, if you're looking for great sheets or clothing, you might and you can do that by using the offer code juice box at checkout. Cozy earth.com juice box at checkout saves 35% If you sign up for therapy@betterhelp.com forward slash juice box, you'll save 10% On your first month of therapy. And when you use my link athletic greens.com forward slash juice box, you'll get five free travel packs and a year supply of vitamin D with your first order athletic greens.com forward slash juice box. This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six and Dexcom G seven continuous glucose monitoring systems. Honestly, if you have diabetes, you really want to look at it Dexcom dexcom.com, forward slash juicebox. The Juicebox Podcast is sponsored and supported by a number of great companies, all of them are listed in the show notes of the audio app you're listening in right now. And at juicebox podcast.com. When you click on those links or type them into a browser, you are supporting the production of the podcast and keeping it free for everyone. And today's sponsor, of course is Dexcom who you can reach@dexcom.com forward slash juice box.

Michelle Mata 02:17 My name is Michelle Mata. I am an HR learning and development professional. And I am also the parent of a child with type one diabetes.

Scott Benner 02:27 And HR Say that again. HR learning,

Michelle Mata 02:32 HR and learning and development professional

Scott Benner 02:34 learning and development. Yes. All right. What does that mean?

Michelle Mata 02:40 So if we look at it from the HR management side, it's the part that deals a compensation recruitment, employee relations, all the policy and administration type things that people deal with on the daily at work. And when we look at HR development, it's the training and development of employees, strategic planning, organizational development, change management, all the things that help people get better at what they do, or help the organization move forward, especially in times of change.

Scott Benner 03:14 Do you what is learning? Is that not the same thing? Is learning when you pull them into a room and you scold them and you're like like and severance. Did you ever watch severance on Apple? Plus, I've got yet Alright, well, then you're not gonna get this reference. But do you torture people until they do what they're supposed to do? Like, this is what I think learning means.

Michelle Mata 03:35 I try not to I try to make it fun. I try to make it less mundane, in what I do. So in what I do now is I do a lot of ELearning Development. So actually the Omni pod courses that all of us are having to take right now for the Omni pod five, I build a lot of those type of things.

Scott Benner 03:54 Okay. Oh, I see. Yeah. Do you direct courses? Or do people do that on their own time by themselves normally.

Michelle Mata 04:03 If it's an elearning people typically take it on their own. But sometimes I've also developed courses where we call it like a hybrid or flipped learning where they've got to do some of it online. But then they come into a classroom or virtual space and apply what they learned or use it in case scenarios, things like that.

Scott Benner 04:24 What do you think the the, the percentage breakdown is on, on materials like that, that are given to employees that are meant to actually like help them with their job versus are meant to safeguard the company from legal action later, like, like I've seen my wife take some of these words, just it's common sense about like how to treat people at work, for example. And then I always think I'm like, Oh, the company gives this not because they want you not to treat people poorly, although I hope that I assume they hope that you don't. But in case that you do, they can go hey, this isn't our All we told her in the training, is that part of it, too.

Michelle Mata 05:03 That is part of it. There's this thing called vicarious liability. And so basically, it's on the company to train the employee to say that I've trained you on this. So the liability is now off of us, sort of, and now on the employee to be able to do the right thing. But if they train everybody and forget two random people over here, then they're still liable for the actions of those two random people because they never train them. And then it even goes down the road of is that a training issue? Or is it a performance issue? Do they know what to do? But are they just not doing it?

Scott Benner 05:41 Oh, okay. Lazy. You're saying shiftless. Yes. And so this is interesting. Michelle, do you mind me asking you questions about your job like this?

Michelle Mata 05:52 In generalities? Yes, good.

Scott Benner 05:53 I'll stay. I'll stay General. People. So I'm a hard working person, I married a hardworking person. And I get up in the morning, I do my job, like, and I do it. Like, I don't have like a baseball game on and another monitor, I'm not, you know, talking to somebody on the phone while I'm working, that kind of stuff. And it is my intention to get my work done. I watched my wife work the same way. But I have a feeling that some people are not as driven. And is that more difficult to manage now that people are so remote? Or is there a way to manage it? I'm interested in in what happened through COVID? I mean, because you can walk past a cube and see somebody asleep on their hand, right? But sure, how do you see it at work at home,

Michelle Mata 06:38 I want to go back to it depends on the person. So pre COVID, everybody was in the workplace, for the most part, except for companies that were already ahead of the curve and had people remote. But for those that were working in brick and mortar places, if you were having a bad day, it was pretty much on display for everybody to know. And when COVID happened, and that whole transition to remote work started happening, some people became more productive, because they didn't have to walk down the hall and say hello to 20 people that they were going to pass by with small talk, because they could focus on what they needed to focus on at work. But then you have others who thrive on that interaction, and need it and needed to bounce ideas off of each other. And so it's actually affected their productivity negatively. So I don't want to say in a blanket statement, you know, it's good or bad. It just depends on the type of person and what drives them internally.

Scott Benner 07:39 That's interesting. Is there a percentage of new hires you expect to lose?

Michelle Mata 07:47 So let me preface this by saying I'm not currently in an HR department, but I do support HR training. My past life has been in HR roles. And this is actually the first role where I'm not in an HR department. So this is a little different, right? As far as people we tend to lose at the start. So HR departments have they're doing the right thing. They're checking with new employees that 30 day, 60 day, 90 day, six month mark, even the year mark, and trying to figure out, is this person happy? Are they getting the resources they need in order to do a great job? And you know, just overall, is there a sense of worth also being fulfilled when they're at this job? And if it's not, well, can we move them to a role that might be better for them?

Scott Benner 08:38 Because you like the person on the onset, you think you have a good quality person, and then you put them into a setting and it's not quite right for them, you don't want to lose the person. So you have to find the thing that they're better at that maybe you still have somewhere else that needs to be filled? Is that kind of

Michelle Mata 08:54 exactly. And it may not even be the person it might be that that person and their manager are just not a good fit for each other. I've seen that happen at times.

Scott Benner 09:02 Yeah. How does it how, how is it that the qualities, this is generalization? The qualities that make a good employee are very infrequently the qualities that get you into management?

Michelle Mata 09:17 Does that make more time?

Scott Benner 09:19 How come? How come? How come we've all worked for a manager where we're like, how did this person get this job and why is it not bill over here? Who is obviously the right person for this like, like how does that happen? Like how much networking and politics exists? When people are ladder climbing? Do you think it's a lot?

Michelle Mata 09:42 I think people who know how to politic well, right tend to get those promotions, extroverts. You tend to see a large percentage of extroverts get those promotions and people who take risk at times and are willing to say yes, you Even though it might be detrimental to the rest of the team to try to get that work done. And so I know in my experience, I've definitely tend to see a certain type of personality get promoted versus others. So I would almost agree with you there. But it's not always the case.

Scott Benner 10:18 I always wonder why the business doesn't? Well, actually, I used to wonder why the business doesn't just say, Look, I know what it looks like, person A, but it's clearly Person B. And we're just going to even though they're not going to push themselves or put themselves in a position, why don't we help them move up. But then what I noticed was that as people move up, the skills that help you move up are not always the skills that help you do the job. And then those people tend to want to surround themselves with other people who aren't, say, as good at the job as they might be. Because nobody wants to be outshine. It's sort of how the mediocrity rises. And I don't know, it is a huge generalization. I'm sure people listening are like my managers amazing. And they know everything about your business inside and out. But I've just, I don't know, I've seen it a lot. And I've seen and I'm always weirded out by the idea that, that I'm, frequently I've seen people put more effort into keeping their job than it would take to do their job in a way that would guarantee that they would stay. Does that make sense? No,

Michelle Mata 11:22 that totally makes sense. And there's a phenomenon right now called Silent leak, or quiet, quitting, that actually discusses just that it's actually a thing right now, where people are kind of doing that office space, bare minimum thing, and just doing enough to keep the jobs. There are situations though, and I've seen this in practice as well, where somebody does really well on their job. And they get pegged for the promotion. And they get promoted. And they're terrible as a manager. Yeah. But they performed well as an individual contributor. Because no, they enjoy doing, they don't have the contact that they had maybe with their salespeople, or with the students that they were working with. It just kind of depends on you know, what was their thing. And if they're things suddenly taken away from them, because they're now in this role that less than their forte, there's, they're going to have performance issues.

Scott Benner 12:15 Yeah. My wife has a great manager of people. And everyone that she's ever worked for has, you know, sent a Christmas card to my house years after they hadn't worked for any more, she gets notes all the time from people like you made my whole career. It just happened the other day, a guy contacted her through LinkedIn and said, You know, I don't know if you remember me, but 20 years ago, you on boarded me at this job at a low level, and you helped me and you helped develop me. And now I just want to share with you that I have a family and I bought a house. And I think it's all because of how you helped me to be in my career. And over and over and over again, Michelle, enough that I'm comfortable saying it out loud and being recorded saying it right, like it happens. But there are times that her her superiors, will say one thing and then do another and this isn't at the company she's with now, but I've seen frequently in the past, they get you in a room and they say, look, build good relationships with your employees, they say all the right things. And then when you do those things, they pull you into a room and it's more like just crack the whip. Like just who cares if they're happy? Like it, like what gets said publicly is not how it gets managed sometimes, and I don't think my wife has that self promoting in her. So she's, she's learning that still in her late 40s. But she just likes to do a good job and help people to do a good job too. But anyway, I've just, this is fascinating to me. We should probably dial this in the diabetes at some point. Tell me a little bit about that. Your child has type one how many kids you have? I have one perfect stop there. It's great. College is expensive. And how old

Michelle Mata 14:00 and he is five years old. And he was diagnosed just before his fourth birthday.

Scott Benner 14:05 Oh, this is just a little over a year then.

Michelle Mata 14:07 We're a little over a year in

Scott Benner 14:09 okay. Did I by the chance just joke about not having more children and you're pregnant? I apologize if I did.

Michelle Mata 14:14 So surprisingly, I'm not okay. And if we go that direction, it's going to be because we would be adopting a second child. So my son, Ben is his name, man. Ben's adopted.

Scott Benner 14:27 Ben is adopted. Yes. Oh, my dad's name was Ben.

Michelle Mata 14:31 Actually the name actually,

Scott Benner 14:33 you want to hear something bizarre. I don't. I've definitely never said this before. My last name is Benner. My dad's name has not been that was his nickname. And then the first question is, why would someone give you a nickname? That's the same as your last name. I don't understand that. But here's why my father's nickname was Ben. Oh, this is hilarious. I noticed that this out loud before. My dad's real name was Laverne and he was a big straw Long kind of hulking guy whose name was Laverne. I don't think he enjoyed it. So he took a nickname. But my grandmother would call him that all the time, which would freak me out because no one called him that. And then then my little tiny grandmother would walk by and be like, Laverne come here, I'd be like, who she talking to? But then so much better. So much better. Okay, so you, you

Michelle Mata 15:25 sounds like a Marvel character, Ben banner.

Scott Benner 15:27 It does write all that alliteration. And you know, yes, yeah. Anyway, he was a mostly decent person. You so you adopted, because this was I'm sorry, this is too personal. You weren't able to have children or you just always wanted to adopt? Or how did that work out?

Michelle Mata 15:47 It was always in the cards. So my husband and I were both adopted by Ken, when we were young. And we were raised by our grandparents, in a very loving environment. And just because of our past, it was always part of our future.

Scott Benner 16:04 So that's very nice.

Michelle Mata 16:06 Do you notice how he led to Ben,

Scott Benner 16:07 do you know I'm adopted?

Michelle Mata 16:10 I didn't know. Oh,

Scott Benner 16:11 I there was so much silence on like, I thought you were like, Oh, is he being sarcastic about my adoption? Because no, no, I've tried to

Michelle Mata 16:17 remember. Listen to so many of your podcasts and like, Did I miss something?

Scott Benner 16:21 You did? I was adopted as an infant. So by by liver Hernan my mom yeah, it's, it's a it's a wonderful thing to do. Okay, so you and by the way, what part of the country you're from because you said you were adopted by kin. I'm in the South. I was gonna say, that is not a word that is used frequently where I live. But you just you just ripped out Ken Like, it was nothing. I was like, she's so. Okay. All right. So adopted Ben. Four years later diabetes. So obviously, you didn't know that it was coming or have any idea about it? Were you able to get into his record? Is there anything to learn more about that?

Michelle Mata 17:02 No, we have very limited knowledge on his background.

Scott Benner 17:05 Okay. Okay. All right. So that's the new thing. So you don't know if there's other autoimmune in his past? Had does he have anything else that's totally immune?

Michelle Mata 17:15 Not that we're aware of. That's autoimmune. But he does have sensory processing disorder. And in him that manifests looking like ADHD. And then he also has a unilateral hearing loss. So he was a hearing aid. And one year,

Scott Benner 17:30 oh, my gosh, you knew all this when he was when he was born.

Michelle Mata 17:34 We knew about the hearing loss. We got the diagnosis, of course, for diabetes years later. And for the sensory processing, we actually got that diagnosis a week before he was diagnosed with diabetes. And that's what actually led me to contacting the pediatrician about the possible type one diagnosis

Scott Benner 17:54 now, Michelle, wait to use up your copay. You're over what is that called? your out of pocket all in one week?

Michelle Mata 18:01 No kidding. I guess we were due.

Scott Benner 18:05 I'm interested in what it's like to deal with and help him learn and grow with the hearing.

Michelle Mata 18:12 We jumped on that quickly. We're blessed to be in an environment where we had access to a nonprofit that gave us a loaner hearing aid. So he's had access to hearing aid. When he became eligible around seven or eight months, I think was eight months he was wearing a hearing aid. And so we've worked really hard to make sure he had speech therapy to make up for the lack of sound that he didn't have in the first couple of months of his life. And if you met him now, and if he didn't have his hearing aid on, you would never imagine that he had hearing loss, because he will talk your ear off.

Scott Benner 18:51 Does he read lips? No, no. Does he know any sign language?

Michelle Mata 18:57 He knows well, he's no little more when he was younger, he could tell you more and all dead now.

Scott Benner 19:04 Because he doesn't. So because of the hearing aids, it's sort of like a skill he doesn't need

Michelle Mata 19:09 yes and no. So there's times where he'll take the hearing, hearing aid off because he's got audio fatigue. The sound for the hearing aid, there's this little device that we're able to use to to mimic what he hears. And actually the sound that you heard earlier, hearing through a tin can kind of mimics that except add some robotic elements to that. And that's kind of what it is. And so after, after so many hours, he decides he wants to take it off and just kind of give his mind to rest.

Scott Benner 19:40 That's interesting. That's really interesting. Okay, and is that both years? I'm sorry, just one year. And then the sensory stuff. Is that like, autism spectrum or how does that work?

Michelle Mata 19:55 We're going to be diving into that in the next few months to find out.

Scott Benner 19:58 Okay, how did it go? isn't

Michelle Mata 20:01 like ADHD, he's impulsive, and he's hyper. And he, he's really into Sonic the Hedgehog right now. And that is a great description of his personality.

Scott Benner 20:14 Just balls up and, and runs forward spinning in a circle.

Michelle Mata 20:19 Gotta go fast.

Scott Benner 20:21 Okay, so that's how you saw that. diabetes presents, how and how do you figure it out?

Michelle Mata 20:29 So his diabetes? I don't know, it's diabetes. You know? What was that?

Scott Benner 20:37 Like? What's the first thing that made you say, hey, something's wrong.

Michelle Mata 20:42 Okay, so So being in the south, and being that we were in the potty training aid area, we didn't realize the first two signs were actually signs. The first one was the bedwetting but we are potty training. So you know, what, three year old doesn't wet the bed. And then we're in the south, and who doesn't drink an excessive amount of water because it's hot all the time, usually nine to 10 months out of the year. So we didn't really think much about those two. What really kind of started setting us off is when closer towards his diagnosis. We started getting reports at daycare that he was getting fatigued. So we didn't know why. And when we had taken him to the doctor the week before, for the sensory processing diagnosis, I noticed that he had lost weight. And so I didn't really understand why because he was eating everything under the sun. But then I started pressing him more about that and asking questions. And he mentioned that his stomach hurt. So that day, we caught the pediatrician said we need to make an appointment. They said come on the next day. And and sure enough, they it was going to be type one. And they didn't tell us right then in there that it was type one what they told us was we call it the hospital. We've already talked to the ER doctor, they're waiting for you. But you've got to go right now.

Scott Benner 22:10 Great, okay, thanks. Because the stomach hurt? What did you think when his stomach hurt?

Michelle Mata 22:18 That is what wanted me to call immediately to the pediatrician. So my husband actually picked figured it out quicker than I did. We both come from families that have type two diabetes. So he kind of clued into that and thought, okay, the weight loss, and you know, all these all these five things together. Yeah. Made sense on diabetes. And that's, that's why we made the call.

Scott Benner 22:43 Okay. Well, it's excellent, good job. And that's about a year ago. So he leaves the hospital with what kind of gear

Michelle Mata 22:52 needles,

Scott Benner 22:53 just like regular syringes,

Michelle Mata 22:55 just regular syringes and lancets and a meter. And a meter.

Scott Benner 23:00 It's like you got diagnosed when, when Arvind was diagnosed? And then how do you like, why do you know about the podcast, like what leads you to try to find other things out?

Michelle Mata 23:13 So the moment that he got diagnosed, of course, we're staying in the hospital. And my husband and I start deep diving into everything. And he finds podcast, I think maybe within a day or two. And so we start reading, and reading and reading. And I just finished up a graduate degree a couple of months before. And I start diving into this, just like I would have studied for any of my courses. And so we're learning everything. And anything we can to figure out what does type one mean? Because we already know what type two means. But this is so different than that. And so, one of the resources that came up was your podcast. Wow.

Scott Benner 23:54 That's cool. I was just thinking, I mean, how old are you? Michelle? You look like you're 34 for some reason. I'll say thank you. Is that not? Is that not the case?

Michelle Mata 24:07 That is not the case. But I will take it,

Scott Benner 24:09 I think you're not gonna answer.

Michelle Mata 24:12 But I'm an older parent. Okay.

Scott Benner 24:14 All right. But so your life prior to this, would you describe it as fairly smooth flowing?

Michelle Mata 24:22 Um, as smooth as it can be? Yeah. Yeah.

Scott Benner 24:25 It's just, um, it's, I'm struck by the fact that you adopted a baby, which was lovely. And you took a baby that you knew had, you know, a medical issue to begin with, which is even more lovely. And then so many things have happened in the past year or so. That? I don't know. It seems to me, like it could feel unfair to you. And you don't come off that way. So I think that's really great. I was wondering, how you how you find yourself thinking about it when one thing After another goes, not the way you expect.

Michelle Mata 25:03 You know, we know his situation. And had he remained in that original situation. And as not adopting him, he wouldn't have had all the resources that we would he would have now to be able to thrive. I don't think he would have had access to sound as early as we gave it to him. I don't think that the sensory processing would have been seen, the way that we look at it in the sense that, okay, we this is a condition, and we need to find the tools and the resources and therapists to be able to help them with it. And then even the diabetes, how do we manage it in a way that allows him to be able to have a good childhood? Because when his numbers are out of range, that intensifies, is his impulsivity and his hyper activeness? Okay, yeah. And so I mean, I won't lie, there's challenging days, there are days that we are flat out exhausted. Because he's like a solar powered Energizer Bunny, that just never turns off until he goes to sleep. But at the same time, we also know that, you know, he's in our life, we 100% committed to making sure that he had a great life.

Scott Benner 26:12 How long? This is my last question about you and your family size, and I want to get into your profession and how the things you understand will help people living with IBD. So so you're adopted, so you know what that feels like your husband's adopted, he knows what that feels like. So my question for you is, and this is basically I think, a question I wish I would have asked my mom years ago, does he feel like your son yet? Or does it take time? Was it immediate? Is it a growing thing? Are you having trouble with it?

Michelle Mata 26:44 I think, for my husband and I, he's always felt like our son, we brought him home from the hospital. So at least we've known him since, you know, since he was an infant. And for him, we we've had the discussion already that he's adopted, and we talked about his adopted, and that even our dogs adopted, and he still sees us as mom and dad, he doesn't see that as anything different just yet. He may later on, I'm pretty sure he will. But at the moment, where Mom and Dad

Scott Benner 27:15 Yeah, I never thought about that way. I never considered that my parents who raised me aren't my parents didn't, it never struck me that way. But I've known a number of adopted people, and they always seem to just fall on one side of it either. Hey, these are my parents, and I don't care that they didn't give birth to me. Or the other side of it is I think people were sometimes burdened by it as they're growing up. And anyway, I just want to know how you felt, but that's definitely wonderful.

Michelle Mata 27:43 No, sure. And I've seen both sides of that, especially in the adoption forums. Just depending on which one you're in, tend to lean more towards a certain way. Yeah.

Scott Benner 27:55 I just always imagine when I was messing up as a kid that somebody must have been looking at me and thinking, that's not even my kid. Why am I going through all this? Let's give it back. Just speaking about me specifically. So okay, so you reached out for a great reason you and I'm gonna list some of the things you put in your note that we could talk about family medical leave, which people might notice FMLA leave of absence, reasonable accommodations under the Americans with Disabilities Act for adults with type one and parents and caregivers of children. So this is, I think this is amazing. So you have all this knowledge. Now you have a kid with diabetes. Let's share it with everybody else. How do you think we should attack these topics? You can make better decisions in the moment with the most accurate CGM on the market, the Dexcom G seven dexcom.com. Forward slash juicebox. My daughter just moved to the g7 from the G six and she already loves the new smaller size and ease of use. You can learn more and get started today@dexcom.com forward slash juicebox. Due to recent Medicare changes, millions more people are now covered for the Dexcom CGM. The G seven is the smallest most accurate CGM system covered by Medicare and it is easy to use and to get started with no other CGM system is more affordable than the Dexcom G seven for Medicare patients. The G seven is a simple to use system it delivers real time glucose numbers to your smartphone or your smartwatch. With no finger sticks required. Effortlessly see your glucose levels and where they're headed. So you can make smarter decisions about food and activity in the moment. This amazing tool is going to help you to take better control of your diabetes dexcom.com forward slash juicebox whether you're looking for a brand new system, changing from another company, or looking to upgrade that G six dexcom.com Ford slash juice box, the new G seven comes with a refreshed app that is just a delight to use. My daughter is 19 years old, she's been using index comm for well over a decade. It is at the core of how we make decisions about insulin, food activity. All of the variables that impact diabetes, check it out@dexcom.com forward slash juicebox. There are links in the show notes of your podcast player, and links at juicebox podcast.com. To Dexcom. And all the sponsors, when you click the links, you're supporting the podcast. I'm sure you know better than I do.

Michelle Mata 30:43 So I kind of made a checklist because I had to get my frame of reference back into making sure that I am noting the law appropriately or at least the the requirements of it. And so let's start with FMLA for a second. Okay. Okay, so most people no FMLA, people who are working with a covered employer are eligible for FMLA. So it's not everybody. If you work for a public agency, if you work for government or local law public school, you're covered. If you work for a private sector employee that has at least 50 or more employees, for at least 20 weeks, work weeks, during the year, they're considered a covered employer. But that employer also has to have a location where the do more employers are within 75 miles of each other. And that employee has to have worked for that company for 1250 hours, or roughly 25 hours a week for a year. Okay. So you're just not instantly eligible, right, you have to wait for a year. But then there's a few other things. So that's the first event. What makes it tricky is that if you're in your first year of work, you might be working for an employer that doesn't have any type of extended leave of absence policy. So I work for one employer that in addition to FMLA, if somebody was sick during the first year and didn't qualify for FMLA, they would have six months, or rather six weeks of FMLA. Light to call it, but it's a leave of absence. And so they would have to use it all at one time. So if they got into a car accident, they hadn't met a medical condition, if they were giving birth to a child, and didn't qualify for FMLA, they could take a leave of absence for that. That's a generous employer. Not all employers do that. I have definitely worked for employers that did not have this hyper provisions. There's also the thing where, and some people may not be aware of this. But if you work for a company that was a covered employer and you qualified for FMLA, left that employer and came back, you will still be covered under FMLA.

Scott Benner 33:03 You don't have to redo the 1000 some hours and all that other stuff. Exactly.

Michelle Mata 33:07 If you already have the year and you were eligible. Otherwise, you just pick up right where you left off.

Scott Benner 33:12 Okay. Yeah. So give me some examples of when people use, you know, leave or FMLA like is like injuries can it be for other people in your family.

Michelle Mata 33:24 So the law says that you can use FMLA. And I'll talk about how it applies specifically to diabetes. So most people know it for adoption or pregnancy. But in terms of diabetes, it's for the care of an immediate family member. So this includes your spouse, your child or your parent, but not your loss, who have a serious health condition. And if you have to take leave for yourself because of your serious health condition. And it can be applied in different ways. So the law is kind of vague in the way that it's applied, because every company can apply it differently. And what I mean by that is, so it gives you 12 months of eligible leave, that 12 months can be on a rolling calendar year. So let's say today is I just say hypothetically, just so I can be able to think of dates. So let's say that today is hypothetically April 16. So your leave day would start today, and would end April 15 2023. That's a rolling calendar year it moves every day. Some apply it based on the calendar year, and some apply it based on the fiscal year. But what I've seen more common than anything else is a rolling calendar year. And the way that I tell people to think about FMLA is kind like a pizza. You might take a slice that you need for yourself, you might take a slice that you need for your child. And then as time passes, the slices are put back or you might need a few hours here. Have pepperoni slice, to take your child over to their appointment to go get there, he wants to be checked, right? And then time passes, and that pepperoni piece is put back. But this particular pool of hours, the 12 weeks that you're eligible to take is for any FMLA related condition. So you don't get 12 for your parent, you don't get 12 for your spouse, you don't get 12 for your child, and 12 for you. It's 12 weeks for everybody.

Scott Benner 35:29 I see. Okay, so if, yeah, so my I can't, if I use a month up, because my wife is sick, I'm down to 11 months, it doesn't matter if the next time somebody gets sick, it's my child.

Michelle Mata 35:43 Well, so I say in the 12 month period, so in the 12 month period, you're allowed to take 480 hours, the 12 weeks. So if you take a month, right now you have roughly two months remaining for anything else that comes up during the year.

Scott Benner 36:02 Is it is it purposely confusing? Do you think?

Michelle Mata 36:07 I think it is. I've had to create trainings for both employees and managers on how to administer FMLA or understand it for themselves. And yeah, it can it can be really confusing. Those that use it on a regular basis. Definitely know it. Well. But I think it's intentionally confusing. unnecessarily.

Scott Benner 36:29 Yeah, I think that about medical insurance, so I think they don't want you to use it. So they make it hard to use.

Michelle Mata 36:35 Oh, so yeah, I have I have thoughts about that, too. Yeah. So yeah, and you know, that thing with FMLA, it can be used on short term basis. So you might only need it for a week. So in this case, if you had a parent who had a child who was newly diagnosed with type one, right, they might need it for the week or two as they're getting adjusted into this new lifestyle. Because, I mean, it's exhausting when you have the new diagnosis, and then it can be used intermittently, intermittently. For your doctor appointments here, there. Let's say that you have an episode where you've got low blood sugar, and it leaves you feeling sluggish for a few days, you know, that's a situation that you might need it. Or it might be on a long term basis, just depending on what's happening. And so we saw a lot of people needing it, you know, a COVID, for example, although that's a whole nother situation. But for long term, people typically use it when they're having a surgery or something like that. I.

Scott Benner 37:37 So I think this is wonderful, this exists. And yet I have personal perspective, where I've seen people just abused the hell out of this. And they know how to get the right doctor's note, and they know how to do things like that. And they end up taking off the summer and saying something like, I'm tired and my something hurts, you're like, okay, and then they're there, that person goes for two months, three months looks something like that, while you're busy at work. And it's um, I don't know, like, I know, you can't police everything perfectly and make sure that only the people who really deserve it are using it. But I don't know. It's, you know what I mean? It's nice to see that happen do when that's happening. Was that do employers generally know when they're being taken advantage of versus when

Michelle Mata 38:25 we start to see trends? I mean, obviously, if somebody is always taking FMLA, on a Monday and a Friday, that starts to show a pattern, or after any major holiday or Super Bowl. And then we might see situations where if there's certain things happening at work, and we noticed that the FMLA falls frequently, during those particular things at work, oh, oh, I see might start to ask questions. So there's that. But yeah, it does come down to what the doctor list on the FMLA paperwork. There, there's a set of federal paperwork that can be given to the employee, they take it to their doctor, or their doctor completes it. And based on what the doctor says on that paperwork, specifies how much leave that employee can expect to take. And then what

Scott Benner 39:21 is leave? Is it paid leave? Or is it just you can miss work without us being able to fire you?

Michelle Mata 39:28 It depends on the company. So most everywhere is it's unpaid leave, but if you have vacation time, if you have sick time, if you have general PTO bank, that company will specify how leave should be used at their company. So one place that I was at, if I remember, right, you had to use your stick time first. And then you would use any floating holidays, and then you would use vacation time.

Scott Benner 39:56 And if that was all gone, then you could dip into family medical leave.

Michelle Mata 40:02 So at one place, it was used in combination of so you could be paid while you're on FMLA. At other places, they would make you use all that before you take FMLA,

Scott Benner 40:13 which is then unpaid after you, because you've used up all your other time.

Michelle Mata 40:17 Right, right. Which leads into discussions about short term disability and long term disability.

Scott Benner 40:22 Yeah, at what point do you have to assess that and say, This is not just a short term thing, I have to protect myself in other ways, because long term disability would be covered, right? Like some percentage of your income. It Yes,

Michelle Mata 40:37 it's usually a percentage of the income, it's, it's definitely not 100%. Generally, I see anywhere from 60 to 80%, depending on what the policy is,

Scott Benner 40:45 okay. And those policies vary by state or by company or by insurance company that the company uses.

Michelle Mata 40:52 They vary by company, and they do vary per year based on the broker that that company is using. I see.

Scott Benner 40:58 Now, just just bare bones, like human interaction, in the HR department, somebody's using FMLA over and over and over again, or they're always taking leave, even if they don't even want to designate whether they actually need it or not. It's just it's being used a lot. At what point does the company say listen, I feel bad for you, but I have a job to get done here. And it's not getting done.

Michelle Mata 41:23 If they're covered under FMLA federally protected.

Scott Benner 41:26 You can't say I know that Michelle, but I'm saying in the coffee room. Yeah, we gotta get the hell out of here. Like it like, you know, like, how does that? I mean, that happens, right?

Michelle Mata 41:37 It does happen in I'm gonna say questionable companies. It's usually I call it a constructive discharge where the environment is made so intolerable, that the employee feels that they have to leave because it's just a hostile condition. So if you

Scott Benner 41:54 come back to work, if you come back from work, Becky, and now Jim is over here, and he's got your job, and you're now in charge of emptying the wastepaper baskets. They are done with you. That's kind of it.

Michelle Mata 42:08 Not quite. Okay. So you take leave. Okay, your jobs protected. But it doesn't have to be the same job. It does have to be a similar job. So if you were an account manager, but you come back and they're making you clean out wastebaskets, right. Obviously, there's gonna be some discussion.

Scott Benner 42:28 I have to say, Michelle, at the same pay, maybe I just clean out the wastepaper baskets.

Michelle Mata 42:31 I mean, if they're gonna pay you the same amount, wastebaskets may not be a bad kid.

Scott Benner 42:37 I might agree. I'm just saying that there's a human aspect of this. And there's also I mean, there really is the there is the the simple truth that there's a job needs to be done. So if you're going to be gone for six months, okay, you're federally protected, I get to hire somebody else to do this job. And when you come back, I can't afford to pay both you so something's got to give like, I think it's the difference between not that you shouldn't use it if you need it. You absolutely should. But I've just seen people turn what I think what should have been a week and a half into three months, and feel like, Oh, I'm on vacation. Now. It's all cool. I have some money saved, I'm gonna go back. And I just don't think it's reasonable to expect that people stopped being people because you're federally protected by FMLA. I don't know why.

Michelle Mata 43:22 I mean, no, I mean, there certainly are going to be people who take advantage of it. Hopefully, I'm not having to interact with those type of people. But yeah, I mean, there's definitely that human component where if somebody is given the opportunity to take advantage of a situation, they might milk it.

Scott Benner 43:38 Yeah. Yeah, no kidding. Alright, so family medical leave, we would use it for anything, my kid got diagnosed, and we're going to, I need to spend two weeks figuring this out, you know, before I go back to work, that's a great example why you might use that for diabetes. Getting to adults, though, I want to talk a lot actually, about the American with Disabilities Act. This is something that is asked in the forums about constantly, it's something I don't know enough about. And, and the way I usually see it brought up in conversation is simple. It's an adult with type one diabetes, who's gonna go to a job interview. And the first question they ask somebody is, hey, do I go into this interview and tell them I have diabetes? Or do I keep it private?

Michelle Mata 44:23 So the equal opportunity, Employment Commission EEOC is the federal agency charged with the enforcement of these type of things? And so they have a page, all related to diabetes. I'll send it to you. So you have it for the show notes. You're welcome. And so what they recommend is don't talk about it until you get the job. And even when you get the job, don't talk about it until you start your job.

Scott Benner 44:55 That's written by somebody who understands people. That's perfect.

Michelle Mata 44:58 Yeah, yes, yes. And the reason for that is, you know, even if you were in the interview, and you brought it up on your own, and said, I have type one diabetes, at that point, a professional HR Recruiter right and or hiring, the interviewer should not be asking you any other questions, aside from will this require a reasonable accommodation? That's it, that's all they should be asking. Now, if you're offered the job, and you decide to disclose it, before you start the job, they may be able to require you to take a medical exam, to find out if your condition is in a in a place where it would put them at risk. So if you're in a in a, let's say, manufacturing, let's say that you're about to take a manufacturing job, and it requires you to be on an automated line. And you know, you're constantly back and forth and back and forth. But you get confused, often, because you've been having lows for the last three to six months because of uncontrolled Beegees. Right, that could be a risk to the employer. Right? And you right? Yeah, yeah, yeah, yeah. And that person themselves, but let's say that the person is type one, and they're going for a law enforcement job. And they have very well controlled Beegees and have not had any major episodes in quite some time. Would that pose a risk of the employer? Probably not.

Scott Benner 46:31 So if I'm coming in, because I think the way I hear people ask the question is, is this going to stop me from getting this job? Is it going to hurt me, you know, getting the job. So the difference between what you're saying, which is, hey, just don't say anything till you're at work. But once that happens, doesn't? Doesn't the employer looking at you and go, Oh, well played? Well, or do they look at you and go, you son of a bitch? Like, like, do you don't? I mean, like, what happens? It's almost like you get married? And

Michelle Mata 47:00 I don't know. And you're like, boom, guess how much student loans

Scott Benner 47:04 threw off my wooden leg three months into our marriage? Like, how did you hide that from me the whole time? Like, you know, like, it's something that it's gonna seem big to the other person. And you, you kept it quiet, like it feels distrustful? And does the employer respond differently? Because of that, and so there's no win, right? Because if I mentioned it earlier, I might not get the job, I might taint myself in the eyes of these people. And if I wait until afterwards, I'm the person that lied to them to get the job, I think is that the, here's the rub,

Michelle Mata 47:37 your your condition, right? In this case, type one. But it could be anything. It could be migraines, it could be asthma, it could be psoriasis, it could be any condition, right? They can't hold that against you in the hiring process. It's not a condition of your employment. And it should you know, that condition shouldn't affect your ability to perform well, on the job.

Scott Benner 47:57 So I'm going to tell you a story here. Tell me because I hear what you're saying. And I appreciate your professional opinion. But one time when I was 21 years old, I was awoken by some loud knocking on a door I might have been 20. It was a rap rap app on my door. And I was asleep and I sprung up to see what happened and I opened the curtain and there stood my girlfriend who is not my wife right now, just you know, this is not a story about Kelly. And this girl is in a T shirt, no bra with a sweatshirt pullover hair going in six directions, and she's pissed. Okay, Misha, opened the door, and I go, Hey, you okay? And she says, and I'm quoting, you cheated on me in my dream. So my point is. My point is, is that you can't always count on people to be reasonable in a situation.

Michelle Mata 48:47 No, sure. And here and here's the thing, there's, I'm gonna say there's two types of HR people, right? You've got one type that went to school for it studied it has has learned, you know, all the legalities of it. For my employment law course. For example, my professor was, was an employment law attorney. All right. So you've got that grip, right? Whether they're studying it at undergraduate or graduate level and seeking certifications, then you have another group that just falls into it. And the kind of trying to figure out their way. They might know, the most recognizable laws, but they're definitely having to seek additional resources to figure out oh, well, what does this really mean? And I want to say to certain extent, HR is interesting because we're required to interpret the law without being lawyers. So it makes things really tricky at times.

Scott Benner 49:46 Yeah. I just, I'm just wondering about how often you can reasonably expect people to do what they're supposed to do without being be impacted by some. I don't know, I don't know what I'm trying to say,

Michelle Mata 50:05 No, I mean, you're gonna have some people that look at a condition and say, Oh, well, I don't want this person working on my team. I mean, this is, this is gonna

Scott Benner 50:13 affect and their response is not going to make sense that it's just gonna be like, Oh, you have diabetes like like how many people we all know this, right? Don't understand diabetes fundamentally at all it type one or type two, they definitely don't understand the difference between the two of them most of the time. And so now I'm in this, I'm in this interview, and I go, by the way, I have diabetes. And now the person interviewing me is imagining their 79 year old grandmother who has type two, or they had a friend and college that passed out all the time. And now suddenly, they're looking at me, like, Oh, this guy is gonna pass out all the time. Or, you know, he's gonna get dizzy, or this is gonna happen, and they can't ask the questions, because the ADA stops them from asking the other than what you just said, right? Well, will this require any accommodations? Right? But even if you say, Look, I'm very well managed, you know, blah, blah, blah, here's how it's gonna go, it's going to be fine, I still think they look at you and think that's both you're gonna pass out like my grandma. And you don't I mean,

Michelle Mata 51:11 yeah, you're gonna, you're gonna have some employers that get hyper cautious about it, and start taking away what's called tangible benefits. And so those are promotions, transfers, incentives, right, they start impacting you negatively at the workplace. Okay, companies get in trouble for this. So I've got a couple of examples that I pulled actually from the the EEOC, and how companies got in trouble for doing bad things to type addicts basically. And so there was one case this. And this got resolved. But it was a company that had unlawfully discriminated against two employees after they discovered through a questionnaire that their employees health conditions and medical or other learned about their employees, health conditions and medications, and learned that they had diabetes and hypertension. So that particular company had to pay $77,000, which is not enough, but then also furnish or other remedial relief, right to the people that they fired, another company had laid off and a supervisor who had been with the company for 38 years, based on having disabilities, diabetes, and kidney disease, and this person was laid off shortly after telling their employer that they would need dialysis. And then there's another one where the company got in trouble because the employee asked for a different schedule to be able to accommodate being able to stay in range better, and even had a doctor's note asking for this. And the company said, let's

Scott Benner 52:56 give you all 24 hours of every day at your house.

Michelle Mata 52:59 Pretty much. Yeah. And that constructive? discharge, right. So yeah, basically made the work environment so terrible that this employee felt that they had no other choice than to leave it. So companies do get in trouble for it.

Scott Benner 53:16 Yeah, I know. But, and I appreciate that. And that should be. And I agree with you that the number was too small, even. But my point is, is that I just want a job. I don't want to be in a lawsuit. I'm not trying to like change the world. Like you don't even want to go to work, I want to get paid. I like you to like, treat me fairly, I want to do something I enjoy. I like to go home. That's pretty much it. And and I'm trying to think about how do we tell people I guess they need to understand this side of it, so that they can understand what they're going to make available to people. Like I just wouldn't want people to believe that it's so cut and dry that it's perfect. You know, I mean, like, don't worry, you're

Michelle Mata 53:56 not, you're gonna you're gonna have even HR people, you're gonna have some HR people that are not doing the right thing.

Scott Benner 54:03 Yeah. Well, because they see their problems coming down the pike too. Like, if you come in for an interview, and you even remind me of a person I had to fire six months ago, that's gonna make me think, well, I don't want to go through this again, with you know, they said the same things in their interview or whatever. If people get biased by by all kinds of things that they see. And yep, see, you know, and I also don't like the idea of being dishonest coming through the door. But I mean, do you are you like you can't know, right? It's like a blind date. How do you know how the person is going to react when you say to them? Look, I have an insulin pump on and I might have though, we just went through this with Arden going to college. They wanted her to have a disability meeting. So we're like, Alright, so we get on the, you know, on the call with a person and it's very strange for the first couple of minutes. And then we stopped, stomp the person here. It's on Zoom, everything's on Zoom. And, and we said, Listen, we want to be clear. We don't One anything, we have no real ideas that Arden is going to need anything, we just need you to understand what this is in case something happens. I said because something is going to happen at some point. And when that does, we don't want her to be, you know, I don't know, given a given a an absence because her insulin pump fell off while she was on her way to class, she had to turn around and go back and get another one or something like that. Like, we just want you to understand that. But it's our expectation that she's never going to use any of the accommodations that we say might be necessary. And the conversation got more real after that. And it became obvious that the person who came to the meeting came to the meeting expecting to be met with let me see what I can wring out of you. Do you know what I mean? Like how many ways I can take advantage like that? They their expectation was that we were going to try to take advantage of Arden's diabetes and get Arden I don't know a puppy or something like that, you know, a pony that she could ride to class. And we were like, look, we don't want anything like we just Is it cool if we put an insulin refrigerator in our dorm room? Like it's just a little one, you know? Like, that's what we cared about. Like, could you you know, one of our classes his way across town, do you think you could find out if there's a refrigerator over there that we could keep a vial of insulin in so she doesn't have to hump insulin around with her everywhere she goes, because Arden's college is spread out over a town. And, and she was like, oh, that's all you want. Or like, yeah, she was, that's no problem. I was like, Oh, okay. So at the end of the call, I'm like, What were you expecting? And she said, Oh, you have no idea what people come on these calls asking for. And I was like, oh, and she goes in half the time. I don't think they really need them. And I was like, oh, okay, that to me seemed like the real kind of backroom dealing with that scenario. You don't I mean, I think it's why you see, adults. You know, what, one of the biggest, if you want to start an argument online about diabetes, you know what you can do Michelle, go online right now and ask for accommodations at Disney. Yes. I know that das pass. We call it the pancreas pass here. But you asked that question online. Hey, guys, I'm worried about my kid being in the heat. This is our first time going to Disney with diabetes, blah, blah. Is there a past that Bo, here's what happened next parents will come in and say, Oh, I didn't know that was something and other parents will come in and say, Oh, we've done that. Here's how you get it. And then adults with diabetes will come in and be like, You are not disabled. Stop it. Don't do this stand in line, you can blah, blah, blah. And I'm like, I always wonder like, where does that come from? And I used to think it was just that they didn't that these adults who, by the way, not every adult with diabetes says this, but there's enough of them. And I'm telling you, I've seen it over and over again. I always thought oh, they just don't want to be considered disabled. Like it's a it's kind of like, you know, a headspace idea. But now, I think

Michelle Mata 57:58 I think you're right on that. Because I mean, that's that's the other argument that you could start really quickly by saying diabetes, or type one diabetes is a disability. And some people who say flat out No, it has not disabled me in any way form matter whatsoever. Right?

Scott Benner 58:11 Yeah, there's such a difference between the legal distinction between disability and what you might personally believe is a disability. And that I know people get confused, not confused. But some people are coming from one perspective, and some people are coming from another perspective when they're online. But it's funny that while you've been talking about this, I started thinking about those adults thinking, Oh, this isn't about them all the time. Just I don't want to be disabled. It's maybe it's because they've been through the hiring process. Maybe it's because in their heart, they're like, don't tell people you're disabled. And and I don't know, I think there's so many different perspectives around that argument. I just know that if you want to start an argument, just say that out loud, it gets very riled up. And so I don't know that there's an answer, right? Because you're not going to know who you're talking to.

Michelle Mata 58:59 No, I mean, here's the thing, who's to say that you don't hire somebody and three months down the line, they go skiing and have a traumatic accident, which prevents them from working for the next three months? Yeah. I mean, you never know. You never know. I

Scott Benner 59:12 would never see Michelle. I've not tried it. I'm not ending my life, crashing into a tree with my face. That's all I know, about. That's what I imagined skiing is and I will not do it. I'm sure that's not what it is. But it's too late, that skiing and sharks. That's not how I'm going out, Michelle. But yeah, but I take your point, like, you could hire a perfectly healthy person who doesn't have one problem in the entire world and they could, you know, snap their legs stepping off a step, and now they're looking for FMLA or they need a disability or they need a some sort of an accommodation. So, do you think so what would you do? You're gonna have Ben one day, and you're gonna send Ben off to a job interview. What are you going to tell him? to do, how are you going to ask him to handle it?

Michelle Mata 1:00:03 I mean, I would give him my professional recommendation, which, which would be, you don't have to disclose anything until your first day.

Scott Benner 1:00:09 Okay, that's your that's the that's what I thought you were gonna say,

Michelle Mata 1:00:13 yeah, that's gonna be my recommendation. In the meantime, though, I would recommend that somebody do their homework. So here's, you know, I think the most people that listen to your podcast know that the American diabetes Association has a page that's dedicated to reasonable accommodations. Another resource that they can use, it's called Ask Jan. And Jan stands for the job accommodation network. So you could look up accommodations that have been recommended for diabetes, or any other condition under the sun.

Scott Benner 1:00:43 Okay. And these will answer a lot of your wonder mints about how things work. how the process works in the laws work will will that make me feel good about that? Or is it more of a how to? It's more of a how to Oh, okay. Okay. Yeah. All right. Yeah, less of an FAQ more of a, do these things, and this will go in your direction. Okay. Oh, that's, that's terrific. Yeah. Or

Michelle Mata 1:01:05 if you're thinking about asking this, here's, here's how it's been applied in XYZ organization, or how others have been advised to ask for it.

Scott Benner 1:01:15 Interesting. In your note to me, you said that you could also discuss employee resource groups and employee assistance programs. I've wondered what those were.

Michelle Mata 1:01:26 Okay, so, I happen to work for an employer, that is considered a best place to work for disability inclusion.

Scott Benner 1:01:37 And global, unlike the Emmys, how do you how did you get that? How does that work?

Michelle Mata 1:01:41 Sure. So if you think about, like, the Chamber of Commerce type organization, right, it's, it's a nonprofit, that's, that's similar to that, except that they focus strictly on disabilities, it's called Disability in. And every year, they have companies voluntarily go through the disability Equity Index report. And so they're rated on a number of things, it could be, you know, how they support teammates, how they support disability organizations that their teammates might refer to. If there's advocacy within the organization, just a number of different points. And so in 2020, to 415 companies participated, the organization I work for is one of them. And we scored a 90 out of 100. So next year, we're hoping for 100. And so some of the themes that they look for, and they kind of gathered as a result of this report is that accommodations are still a foundational practice. Inclusion is an emerging trend. And the sense of belonging is imperative for success at companies. So these are considered disability friendly companies. And so the other thing is that organizations that are certified disability workplaces might be eligible for certain federal grants or contracts. So they might be able to do work that other companies don't get to do.

Scott Benner 1:03:14 Oh, yeah. So when you're nice to people who have a disability is to do more things that makes them more money. I see what you're saying. Are there companies who are being nice to people with disabilities just to get contracts with things? Probably. Michelle, I always see the bad part of you. By the way, funniest thing has happened last hour, is you said E OC.

Michelle Mata 1:03:40 What does that stand for? Equal Employment Opportunity Commission?

Scott Benner 1:03:43 And all I heard was those turtles in Finding Nemo saying that they were writing the EOC. Is that what it was called? I'm gonna answer that with Whoa. It was like, I was even proud of myself for not bringing it up while you were talking. I don't know what that says. But yeah, a couple of times. I'm like, please stop using that acronym. You're breaking my brain.

Michelle Mata 1:04:11 I'm surprised that I haven't gone there yet. Because I am pretty random at times. So okay, good back on track. Okay, no, it's okay. Because I guess I don't want to forget this. So okay, in addition to disability in and you can look at the different companies that are disability friendly, and there's even a disability recruitment, Virtual Job Fair, during the year two, so things you could take a look at. A company might also have a employee resource group. And so again, the organization I work for, we have one and we have one focused on different things. There's one for women, there's one for Hispanics, one for veterans, and I'm on the advisory committee for our disability group. And so what we do is we support our teammates and their loved ones who have disabilities, through educational webinars, allowing them to write blogs, spotlighting them on social media and supporting each other through our discussion boards.

Scott Benner 1:05:17 That's interesting. And is this something that if my company doesn't have this? How would I start something like this? How would I, you know, is that something you can spearhead with, with a company to walk in HR and say, Hey, I really wish we had an employee assistance program. And here's why. And there's seven of us here have diabetes. So I think it would be great. And there's a girl over there has something going on. And there's I think there's enough of us that this would be helpful, do you think they'd be open to hearing about that?

Michelle Mata 1:05:43 I'm gonna go with it depends on the company. So I know some organizations that they're just kind of starting to look at that. And so they might start with one group, versus doing a ton of them, right. And so usually, what's happening behind the scenes is either in HR, or somewhere and leadership. They have located a dei champion, to be able to move those type of things forward. So if it's coming from the employee, yes, that does mean a lot. But it also means that you have to have somebody at the top or somebody in HR who's willing to say, this is important.

Scott Benner 1:06:19 Do you think when I guess maybe when that happens at places, maybe people know someone personally and it brings it top of mind to them? And as a thing that would be valuable to do? Is there a reef resource online? Like if I was gonna go to HR and say, Look, no pressure, but I wish you guys would check into this. Can I take them a link to something?

Michelle Mata 1:06:38 I would start with a disability and website.

Scott Benner 1:06:42 Okay. Well, you know what that is off top your head again?

Michelle Mata 1:06:46 Disability in.org?

Scott Benner 1:06:48 Yes, a billet. I see what you're done to me. Is it i n?

Michelle Mata 1:06:54 I n dot o RG?

Scott Benner 1:07:00 Hey, I spell disability, right. So proud of myself. It's Monday, disability in.org. We empower businesses to achieve disability inclusion and equality. Are you in Oh, I see the pun. Okay. So, um, so maybe I would just like drop this on somebody and be like, Could you check into this? I, it'd be great if blah, blah,

Michelle Mata 1:07:20 blah. Right. We could do this to support the employees.

Scott Benner 1:07:23 Yeah. Okay. Yeah, well, because expecting someone to do it just on their own is random. You know what I mean? Like people are busy at work. I don't think there's anybody right now in an HR office, whose head down doing the work and in the back of their mind thinking, I really do want to get that disability and thing going here, like you don't mean like, if somebody doesn't spearhead something, or bring it to light, it's hard to expect it to get started. It's funny to how much this conversation mimics the conversations about going to school as a child with diabetes. You don't mean like, like, like, heading into school, expecting people to understand. There's things they legally have to do for you. But But at the same time, some people may be great at it. And some people may not be meaning some people may be supportive, and some people may be less. So some people may see it as an annoyance while other people are happy to accommodate. It really is. I don't I don't see it as being much different to be perfectly

Michelle Mata 1:08:21 No, I mean, the reasonable accommodation process is a lot like the 504 and IEP meetings.

Scott Benner 1:08:27 Yeah, that's exactly what I was. That's how I was thinking about it. While you've been talking. Is there anything I haven't asked you or that you haven't gotten to that you think is important?

Michelle Mata 1:08:35 Um, let me let me talk about insurance benefits for a second. Yeah. Yeah. So people like getting paid? I do. Yeah. So when somebody's whether it's the parent or the individual with type one, you definitely want to consider the entire compensation package, you might hear this as total reward sometimes. And so some people might think, Oh, I'm gonna get paid buku dollars. So it doesn't matter what my insurance is, well, if you're getting paid, like booze, but your insurance plan is a high deductible plan, and you're gonna have to pay out of pocket for all your decks comms and all your Omni pods and all your insulin and everything. Until you meet that deductible. Well, how much in compensation? Are you really getting? Because your money is obviously going over there? Yeah. So So just because you get paid just because you're going to take a job that pays you a lot of money, but has a terrible, high deductible plan may not be great, especially if you have type one, right? Because because of what you're having to spend. Yeah, so I'm not I'm not saying take take the high paying job, right. It's all a balance. What I am saying is do your homework. So if you're going up for a job or you're considering changing jobs, and you're in the interview process, ass asked the recruiter for a copy of the medical insurance information once you get into once you get into that role where they're starting to Seriously, considering you for, you know, for a job. I mean, this is not every job right? If you're going for a job, if you're going for a job at the movie theaters, this is overkill.

Scott Benner 1:10:07 Yeah. Michelle's trying to stop you from in the first. What did they tell you? In your first interview? Your question is not how much does this pay? You're gonna you want to you want to get past that part.

Michelle Mata 1:10:17 Exactly, exactly. Yeah. So this medical question would come up along the question of like, Okay, what does this job pay? Ask for the the Summary of Benefits plan. This is a list that tells you like, what all the co pays are for in network out of network, what's covered what's not covered, and just kind of like a cute little summarized plan. And so you definitely want to take a look at that. So so know what your deductible is going to be. And then I remember I had post some questions out, actually on your facebook group on Reddit and a couple places. And so one of the questions that came up is, can I continue to cover my child who's in college after they turn 26? And the answer is no, because that's a provision of the Affordable Care Act, that children can be covered to 26. And once they're 27, they've got to be able to cover their own.

Scott Benner 1:11:13 Yeah, okay. Yeah, that comes up a lot. And by the way, my son just graduated from college. So it's in my head, too, that I have four more years where I can cover his health insurance. But But your point, I just want to go over it real quickly, as you're going for a job that pays $70,000 a year. Congratulations. And it's got a great insurance plan that's going to end up costing you $5,000 out of pocket for your whole family. So you're making $65,000 Or you're you know, you're making $5,000 less, but you get that same job. And somebody's like, Oh, don't worry like this take us because we pay 80 We're going to your but then you learn that they have no insurance, and you're out of pocket. Now you're 1520 grand a year for your for your medical stuff. You're better off taking the other job lower paying but the insurance. Yeah, right. Yeah. And I guess people don't think about that readily. Maybe people with diabetes do but

Michelle Mata 1:12:08 I mean, I've seen situations where and this is back in my recruiting days where people would jump ship for $1 or even 50 cents, and not consider what that meant for insurance.

Scott Benner 1:12:18 I don't understand people's brains work like that. I wish I wish I could have the same job my whole life.

Michelle Mata 1:12:24 Well, you've kind of done that for yourself. I mean, yeah,

Scott Benner 1:12:27 I've had two jobs. Basically, I've been somebody's parent, and I've made this podcast. The other jobs before that. I don't remember anymore. So I tend not to think about them as much. Wow. Okay. Thank you. So what? I don't want to I'm we're not done. But I really appreciate this because I I don't hear anybody talking about this, to be perfectly honest. You know,

Michelle Mata 1:12:47 no, sure. And I see this questions every once in a while. I mean, they're not always top of mind. And they're not the fun things to talk about, or they're not the annoying things to talk about. They're just the things to talk about.

Scott Benner 1:13:00 I'm the one, I'm the one on my house, Michelle, when when Kelly's like, it's time to go around insurance coverage again this year. And I'm like, Ah, I feel like a child and like, I don't want to do just take what we had last time. Why don't we have to think about this?

Michelle Mata 1:13:12 And no, it's not. I mean, this is as fun as trying to shop for home insurance or car insurance. Yeah, but But you know, for type one, I mean, this is everything

Scott Benner 1:13:21 super important. It just really Yeah.

Michelle Mata 1:13:25 So another thing that comes up,

Scott Benner 1:13:27 I'm gonna last for a moment. So please just keep talking. Okay. So

Michelle Mata 1:13:31 another thing that I see that comes up is life insurance and how people get denied for life insurance. And so one thing that they might want to find out if they do plan to leave another job is to find out if the life insurance that they have with their current employer is portable. And what that means is if they leave the organization, as long as they pay for the entire premium, the amount that they paid, and the amount that the company paid for them, they can continue to have the life insurance, because what happens when a type one applies for life insurance? You're getting denied.

Scott Benner 1:14:04 Yeah, so that happens, even if you if can that happen to me if I take a job, and the job is like, oh, it comes with life insurance, but not for you. Arden so

Michelle Mata 1:14:12 So typically, what happens is you can get a set amount of life insurance without having to go through a medical examination. Right? Right. And you can max that out. But if you want more than that, then you would have to go through the medical exam. And at that point, you could get denied because a type one diagnosis.

Scott Benner 1:14:31 And if you're not denied, there could be a larger premium for a lesser payout.

Michelle Mata 1:14:37 If you're not denied, yeah, it'll be it'll be a larger premium.

Scott Benner 1:14:40 Yeah. Okay. I have to admit, that's one of those things like we've always been lucky that my wife jobs offered some life insurance. And we talked about like, should we get more? And then it's like term and then there's other kinds and we're like, we don't know what we're talking about. And then before you know it, you're just like, I'm not doing this, because I don't know what it is. I Don't want to get ripped off, get any mean. But I would like to understand it better, but it's just I don't know, IT companies then put you on a web portal where you click through a couple things that are talking Turtles explaining diabetes to your life insurance to you. And you just think I know this. I don't know what this means, then I'm out. Yeah.

Michelle Mata 1:15:20 Yeah. And the gist of it with life insurance is this like, is the amount that you can that you make, right? If something were to happen to you today, and you don't exist, but you have dependents that are that are living off your income, right? Because their children or it's your spouse who doesn't work, you know, G have a way of being able to replace your income for the next, you know, set amount of years, next set amount of time. Should for whatever reason, you leave this planet?

Scott Benner 1:15:50 Yeah, that's how we have enough. hate, I hate that we have this, we have enough on the kids, that if they were to pass away, we could take care of their funeral arrangements and things like that without digging into money that we have. And I'm covered lesser than my wife is because my wife, you know, makes more money than I do. And I think if I died, she'd be like, Yeah, well, that's inconvenient, because I have to wash the dishes now, but I can still pay the bills. And whereas if she died, I'd be like, I need to do some sit ups and queued the kids up because I need some lady to come in here and make some more money. You don't I mean?

Michelle Mata 1:16:28 Yeah, I mean, you see situations like that. I've even seen it where, let's say that you have, you know, one spouse who is, you know, the breadwinner for the family. And the other spouse is at home and they have five kids will if that stay at home spouse passes away. And those kids are school age, like somebody's still having to take care of them during the day. Yeah. So and that, you know that that takes resources that takes income. And even though that family wasn't paying anybody for child care, right, there was, there's still a value to the work that was done at the home.

Scott Benner 1:17:02 You don't have to count on the guy in high school that liked you that you didn't like that much. But he's still single. So yeah, yeah. Do you remember me from from college? Yeah, you don't

Michelle Mata 1:17:13 want to have to depend on the Hey, remember, when we were 20? We said we would marry if?

Scott Benner 1:17:18 Well, my husband just got hit by a tractor trailer, and I need you to be interested in me again, or vice versa, like I, my wife would be at a loss. She doesn't know when the garbage goes out. You don't I mean? Like, I'm sure she kind of does, but she wouldn't remember. You know, there's just some things people do when and, you know, when it's financial, you need coverage, it because it just goes away. It's not like, you know, if you don't have that life insurance, your company's not going to keep sending a check. So, so fight through the pain of how annoying and adult it is to have to learn about life insurance. Is that what you're telling me? I'm supposed to do? Michelle?

Michelle Mata 1:17:53 That's exactly what I'm saying. It's not pretty. It's a little ugly, but it's important.

Scott Benner 1:17:58 Getting old, probably should do. You know, I mean, how much longer can I make it? Michelle? It can't be?

Michelle Mata 1:18:03 Um, I don't know. I mean, you could take out insurance policy on your voice. So that way, if for some reason anything ever happened to your throat, and you couldn't do the podcast anymore?

Scott Benner 1:18:11 Could I legally? Is that a true thing? Are you making that up? Michelle trying to be funny. You're no,

Michelle Mata 1:18:16 no. I mean, there are some people that because of whatever work they do, they they insure certain things. I mean, years ago, JLo insured her booty?

Scott Benner 1:18:30 Did she? I think Ben Affleck just bought that policy out. It's okay, well, I'm going to do that, then. I'm not gonna get life insurance, but I'm gonna get insurance on my voice. That would be ridiculous. That's amazing. I appreciate you doing this. Did I miss anything? Did you miss anything? Are we good?

Michelle Mata 1:18:52 Um, oh, one other thing to look into, as you're looking into the the employee benefits is also check out the short term and long term disability plants, your company, some companies pay for those for the employees. And short term disability is considered WHERE condition might last like seven days to 30 days, whereas the long term is going to be anything from 30 days, maybe up to two years. And so there's always an elimination periods. It's weird that they call an elimination period. But they may not start the disability payments until seven days later, or 14 days later, right?

Scott Benner 1:19:34 I see. Yeah, I see. I'm so cynical that every time you say something like this, I put myself in the HR person's position. And I think I'm interviewing you and you say, Hey, tell me when does your long term and short term disability kick in? And in my mind, I'm just putting an X on the paper. I'm like, No, like you. I don't know why I'm just I am I is this like an East Coast cynicism thing, Michelle, like do you not think that way?

Michelle Mata 1:19:58 It could be I tried I'd be optimistic. But I try to also be an optimistic realist about things, too. I mean, I mean, I've seen some questionable things, you know, when I've interviewed people.

Scott Benner 1:20:10 To me, it's like, it's like, it's like, if I'm in an interview, and I'm like, Hey, I have a question about the company. Sure. What closet? Can I shoot heroin? Like, like, like, I'd be Oh, I'm sorry. You're, uh, no, like, right? Like that kind of thing? Like, tell me, how long does it take for the short term disability to kick in makes me feel like you're planning on taking short term disability. But I know that, but I know that for a person who has a real issue, it's just fact finding. But how do you relay that to the person you're speaking to? Without saying, I know this sounds janky. That I'm asking about this?

Michelle Mata 1:20:46 No, I mean, sure. I mean, you know, the whole idea about this is the, these should be normal questions anybody should be asking. So that way, it doesn't feel like you're the oddball asking this particular type of question. It also depends on the type of organization too. And I've certainly been a part of, you know, job interviews in the past where I never even had to ask for this information, because they just said, here's the benefits book. And if you have any questions, let us know. And they gave me everything.

Scott Benner 1:21:16 Excellent. And then then you don't have to ask the questions. But you can get the answers. Exactly. Yeah. That See, Michelle, that that I can't believe I'm saying it like this, because I don't mean it like this. That's a really valuable piece of information, not to say that other things you've said haven't. But instead of sitting there and asking all these questions, it's going to lead somebody to think I think this person's like, not going to work. You know, like, is there a place where I can get all my questions answered in a booklet or online? I don't want to bother you with it right now. And that way, you can dig into it without looking like your pre planning a vacation?

Michelle Mata 1:21:51 No, sure. And some other things that somebody could do to kind of do some, some fact finding and digging about the company is they could go to Glassdoor. And they can look at the reviews and see what other people have posted about their interview experience. Indeed, also has some reviews that people could look at as well. There's another try remember what the name of it is right now. I think it's blind.com. Where you can go in and anonymously post about your company experience. And again, just do some fact finding. Yeah, to find out like, Okay, I know what they're offering me. I know, this is the job title that said, but is it legitimate? Like, are they gonna pull? You know, they're gonna pull a rug under me

Scott Benner 1:22:38 by right? Yeah, yeah, it pays a lot of money. But we also don't let you leave, you're going to work 18 hours a day, you know, and you, we don't make you but you're gonna see someone else do it, and that person is gonna get compensated, and you're gonna start thinking, Well, I got to stay longer. And like those things that kind of pressure you into, it's bait and switch, as well as Michelle Yeah, then and if you can find a reliable place, where you see, you know, 50% of the people are like, Look, don't go there. Because this is what's going to happen that you can kind of trust that that's what's gonna happen.

Michelle Mata 1:23:08 No, absolutely. Oh, you know, it was blind and another one fishbowl that they can check,

Scott Benner 1:23:12 fishbowl and and Glassdoor and what's the other? Indeed? Indeed? Okay.

Michelle Mata 1:23:18 Yeah. All right. I'm blind. I'm blind.com. Blind. It's an app. Oh,

Scott Benner 1:23:23 that's excellent. That's all good information. I really appreciate it. Do you like your the work you do?

Michelle Mata 1:23:28 I do. Like the work I do. I like if I'm less, I'm less than HR. These days. I'm doing more creative things where I get to build elearning trainings and animated videos, and help people generally just get better at what they do some more creative side of it.

Scott Benner 1:23:43 Yeah. firing people very difficult.

Michelle Mata 1:23:46 Yes. And I am glad that I was not having to do Employee Relations during the pandemic.

Scott Benner 1:23:51 Oh, yeah. On top of everything, You're firing me during COVID use. Yeah, like that would be terrible.

Michelle Mata 1:23:58 I just vaccination, but

Scott Benner 1:24:01 also, we got you this lovely bouquet of oranges and apples to take with you. Please don't please, please don't crash into our cars as you leave it. I just can't imagine having to take someone's job from it seems. I mean, even if they deserve it, it seems that something I don't want my soul connected. So I think

Michelle Mata 1:24:20 yeah, I mean, it was even hard as a recruiter to tell people like you didn't get the job. Because some people overshare right. And so I knew what this job meant for them. But if they weren't the most qualified candidate, they weren't the most qualified candidate who's

Scott Benner 1:24:35 the oversharing ever get them out of the getting the job?

Michelle Mata 1:24:38 Um I think you can tell I try to stay like even if I hear something I still try very, very down the middle. Yeah, you really aren't. Yeah. And you know, in, in my world, I try to find that good balance between you know, I need to apply all of the organization's policies and procedures, but yet also make sure that, that the employee is having a good experience. Yeah, where they're out to. So I tried really hard to kind of be in the middle. But, I mean, there's a lot of people on both sides and, and I've seen it get really ugly at times too.

Scott Benner 1:25:15 Wow. Okay. All right. Well, I appreciate you doing this. I appreciate it very much. Thank you. I I didn't know where else to get this information from. So it's amazing that you had it.

Michelle Mata 1:25:25 You're welcome. Glad I could help. Oh, no, you

Scott Benner 1:25:28 really have. Hold on one second. I'm gonna talk to you when we're done. Sure. Hey, how about a huge thanks for Michelle for sharing all that knowledge with us. And while we're thanking people, let's thank Dexcom makers of the Dexcom G six and Dexcom G seven continuous glucose monitoring systems. Learn more Get started today use my link dexcom.com forward slash juicebox. Are you looking for community around your diabetes? Check out Juicebox Podcast type one diabetes on Facebook, a wonderful, seriously wonderful community with nearly 40,000 people in it. Type one type two lot of gestational doesn't matter what kind of diabetes you have. Doesn't matter how you eat. You're welcome my group Juicebox Podcast, type one diabetes, absolutely free on Facebook. I hope you're enjoying the podcast. If you are please share it with someone else who might also enjoy it. And of course, subscribe or follow in a podcast or audio app. It's a big help, Spotify, Apple podcast, Amazon music, stuff like that. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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#915 Best of Juicebox: Diabetes Pro Tip: Pre Bolus

Originally posted on Mar 25, 2019.

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

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

Scott Benner 0:00
Hello friends and welcome to episode 915 of the Juicebox Podcast.

Today, we're gonna be revisiting episode 217 From March 25 2019. This is the Pre-Bolus episode of the diabetes Pro Tip series. Today, Jenny Smith and I talked about Pre-Bolus thing. I mean not today, but I don't know, like four years ago, but for years has not made this one any less of a fan favorite. 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 head to cozy earth.com You will save 35% off your entire order with the offer code juice box at checkout one word juice box at checkout at cozy earth.com to get 35% off everything they have joggers, sheets, towels, pajamas, I mean they've got so much great stuff, check them out cozy earth.com Use juicebox at checkout to save 35%.

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 therapists who can help you with a wide range of issues better help.com forward slash juicebox. To get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit, for any reason at all, you can switch to a new therapist at no additional charge. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price betterhelp.com forward slash juicebox that's better help h e l p.com. Forward slash juicebox save 10% On your first month of therapy. In the episode about insulin, I told you that, that my nurse practitioner CDE told us that fear of insulin was the biggest sticking point for people making good decisions with their diabetes, right. And after I got past my fear of insulin, the next hurdle I had to get past was Pre-Bolus. And I am now years and years later at a time where I will tell you that if you do not Pre-Bolus a meal, the likelihood of success is near zero. And if you have success without Pre-Bolus saying.

All that means is that you gave yourself too much insulin prior to that. And it's just catching up now. And so this is it. We're going to talk about Pre-Bolus And then we're going to talk about how about insulin action, right the action of the insulin and how to balance it against the impact of the carbs or your body function. So tell me, let's go over the part that people aren't gonna find comforting at first, right which is the amount of time it takes insulin to begin working in a person varies person to person and insulin to insulin. Is that pretty fair to say?

Jennifer Smith, CDE 4:07
It's pretty fair to say yes. And insulin to insulin. I would definitely say most of the the rapids on the market should be fairly similar. The rapid acting influence on the market and their time of action should be fairly similar now. Person to person. Yes, that may vary

Scott Benner 4:30
situation to situation as well

Jennifer Smith, CDE 4:32
as situation it may vary. But again, that's the learning part of it. Okay,

Scott Benner 4:37
so person, the person could end up meaning just your body chemistry could mean where your infusion set is right, you know, or your injection site. Absolutely. Say you're a person who gets stuck on I always injected my belly in the same place that spot might not be as reactive to the insulin as if you would just try a new spot. If you went to a new spot it might work quicker than it has been in your old spot. Right? If you're wearing infusion set it could we alluded to it before you could get better action from your insulin on day one than you do on day three or better on day two, then you know, two hours after you've put it on, there's a lot of different variables. But we're speaking generally here to you'll apply them to your variables later. Now, if you've heard this podcast before, you'll know that I have alluded to how insulin works in a number of different ways. So I'm gonna give my kind of cartoony description of it, and then we're gonna let Jenny talk about it for real.

Jennifer Smith, CDE 5:32
Her acuity might be better, as we'll see.

Scott Benner 5:34
So here's how I pictured in my head a couple of different ways. The first way is I think of a tug of war. And I imagine a rope with a with a flag hanging in the middle of it. And on one side of this tug of war rope is insulin. And on the other side is your carbs and your body function. It could be adrenaline, it could be fear, could be anxiety, whatever it helps to drive your blood sugar up. That stuff's on one side of the rope. The insolence on the other side, unlike a tug of war in a schoolyard, our goal is not for one side to win, our goal is for them both to pull and pull and pull until they get exhausted, and they both go, I can't do this anymore, and they dropped the rope and our flags still in the center. That flag represents the blood sugar. You start at when the impact of the carbs begins in my mind. So I'll explain a little more. If you let them both start pulling at the same time, the carbs are generally speaking, going to gain power and momentum before the insulin begins to work. So now your rope is going towards a high blood sugar and you're you're starting to head up. Now suddenly, you're 50 points higher. And what if you started with 150 blood sugar, now you're 200. And now these carbs have momentum. They have speed, they're pulling your blood sugar up. Now all the sudden, 1520 30 minutes later, the insulin is like, oh, no, no, wait, I have a job to do. I remember and it kind of comes online. But now it's pulling, it can overpower the the momentum that the carbs have created. Plus, you now have another 100 points of blood sugar to contend with. And all you have is the insulin that you counted your carbs for. So even if you counted your carbs perfectly, and realize that this meal is five units, once the momentum of the carbs is rocketing your blood sugar up, once you have a number that is higher than you started with those five units are not even going to begin to cover what's happening, let alone the food that you've put in. But if you put the insulin in first, and let the insulin come online slowly and begin to pull down and create the momentum in the other way, then you flip the script. And now the carbs are fighting. So instead of having a fight at 180, blood sugar, you're having a fight at an 80 blood sugar. And instead of your blood sugar falling at 80 It's being the attempt is that it's now trying to be pulled up by the carbs. And that's how when you see people with a stable graph, that's how they're doing it. And so for me, in a perfect situation for me, my daughter's blood sugar is diagonal down when I give her most foods. There's differences you know, food to food, situation to situation, but in a perfect world. To me, that's it, you want your insulin working, your blood sugar trending down, creating some momentum down, when you allow the carbs to begin to pull up. Right now, you'd explain that in a technical way that sounds

Jennifer Smith, CDE 8:37
and most in most settings, yes, that's 100% I mean, insulin, our rapid I've always thought that rapid is such a misnomer. Honestly, rapid indicates like now rapid is like sweating out, click, click, click lights with design, it's working. And it's, you know, still education is take your insulin and start to eat. I mean, even from most endo offices, it's take your insulin and start to eat, it's going to be working very, very quickly. That's not the case. And anybody who has been taking insulin long enough, and you've seen the spikes, and you've seen the issues, despite counting your carbs as precisely and weighing them and everything and you're still seeing these issues. It's the mismatch of insulin timing, it is so rapid take anywhere between about 15 to 30 minutes to really get that active peak, not peak, but that active phase where then when you start putting your carbs in. They will match as you said that carb digestion will start to match with the insulin you'll get a nice gentle curve up and it should then start to curve back down. And there is a lot of there's a lot of education that also focuses On, as you mentioned, watching for that curve down, watching for the curve down to start so that you know the insulin is already moving things.

Scott Benner 10:12
Yeah. And to give you some context that a person I spoke about in a previous episode, who was having trouble, told me, but what am I gonna do, I'm gonna be scared. I said, well try it a little bit this time and then a little more next time and a little more next time and go for it. And, and so I always tell this story somewhere. And I think here's the right place to tell it. Prior to glucose sensing technology being a thing that anyone knew about prior to Dexcom, I was again in the office and the CD says to me, Hey, you're gonna get one of those Dexcom things. And I thought, I don't know what that is, you know, and she starts telling me it's, it's, it's a continuous glucose monitor. And I'm like, Yeah, I again, don't know. And then she tells me this simple story. There's a 17 year old boy in her practice, who loves candy, certain kinds of candy, and he can't figure out how to Bolus it. So he gets a Dexcom, whatever the first one was, I don't even remember anymore. His whole goal was to eat this candy without a spike. So he goes out to the store. And he buys like little grab bags of these candies, and a number of them enough for a week and every day starts on this experiment first day, just like you said, eats, gives himself as his insulin, just like he had been told his whole life, blood sugar goes up to 20, something like that sits there forever. Eventually, he has to give himself more insulin to bring it back down again. Next day, he tries a little sooner, give himself a few minutes, 510 minutes gets a little less of a rise. So the next day, he goes even sooner. And then before you know it, it's a little sooner, a little more, and he starts adjusting it back and forth a little more a little sooner, a little later, until one day, he eats the candy. And his blood sugar never moves. And she tells me that story. And I thought immediately Wow, that means it's possible. Yeah, that was the first time I thought I was like, if that kid can do it with candy. I can do it with anything. Like anything, right? And so yes, give me that CGM place. And I got it. And I and I started dispense with my fear. And I started learning about it. There were hiccups along the way, right? I've given her insulin, and she's gotten lower than I meant to for two when she's eating. But you know, once twice, I'll go back to this over and over again, when something goes wrong. It's not a mistake. It's a learning experience. It's data for next time, right? Right. So I put the insulin in, and she goes down to 70 and sits at 70. While she's eating. It's beautiful. You know, like, there she goes. And then and then then a spike. Even if I really messed up on the amount of insulin, I used a spike takes you to 120. Right, right. Right. Right. It's just, it's all about that timing and amount. And I repeat it over and over again, that you all the things you and I are going to speak about all the things that people hear about on this podcast, if you want to know how to use your insulin, at its core, the very first step is timing and amount. If you get you can use the right amount at the wrong time, you can use the wrong amount at the right time, that it's too much, you have to have the right amount of insulin at the right time, you have to balance the action of the insulin against the impact of the carbs. If I do that, I don't want to say it's easy, because that's insulting to people. But let me just say I don't think about diabetes that much anymore.

Jennifer Smith, CDE 13:27
It's easier, it's much easier if you do that. It is easier. Absolutely. And it's a lot more. It gives you a lot more visual than to understand. Because it's not so much of an unknown Well, gosh, I counted the carbs, I took the right amount of insulin and this is always happening to me. Why. And if you can start to put those pieces together, it's not a wi anymore. It's like turning the light bulb on.

Scott Benner 13:58
Here's how I explain what Jenny just said. The Dexcom G six continuous glucose monitor gives you a complete picture of your glucose showing you where it's going and how fast it's getting there. There can be nothing more important. The Dexcom GS six also eliminates finger sticks for calibration, diabetes treatment decisions, and diabetes management. It also has an automatic inserter. Like it just you know, you stick it on and you push the button and the next thing you know you're wearing it. Now you can use the Dexcom receiver to get the information from your transmitter. But for those of you who enjoy using your cell phone, it works great with iPhone and Android as well. The last little thing about Dexcom isn't so little. How about the share and follow features also for Android and iPhone. Your loved ones can follow your blood sugar anywhere in the world. And if you're the parent or caregiver of someone with type one diabetes, you can be watching their blood sugar as well. You want to know what Arden's blood sugar is right now. It's 82 just glanced up and saw Just like that. Now my results are mine and yours may vary, but my daughter's a one C has been between 5.2 and 6.2. For over five solid years, the decisions we make about how to give my daughter insulin and when to give it to her, come directly from the data that comes from the Dexcom G six. And I don't know if you know this or not, but my daughter does not have one dietary restriction. Those numbers are accomplished through waffles, just as well as through salads, through burgers, just as well as through zucchini, it doesn't matter anything that impacts my daughter's blood sugar, that impact is shown to me by the Dexcom JSX. And then I make good decisions. You want to make some good decisions, go to dexcom.com forward slash juice box and get started today. That's the best decision you're ever going to make. This is a short episode, and I don't want you to have to have to add breaks. So hang on for me for one more second, let's talk about Omni pod. This past week, I visited the Omni pod headquarters in Massachusetts, where they've just moved their production facility. It's about to go live. And I got the tour of the floor where you're on the pods are going to be made from now on right here in America, right in Massachusetts, I want you to know that what I witnessed in Massachusetts on that assembly line, it didn't just renew my excitement about Omni pod, it shot me over the moon, the accomplishment of bringing a production like that into one facility, putting it under your roof that showed me a real commitment to the people living with type one diabetes. Right? This isn't being made overseas somewhere, you know, a bunch of different factories. It's all right there at the Omnipod headquarters, and its state of the art an absolutely stunning. This is a company who is behind you for the long haul. I believe that before but I believe it even more. Now, here's what you want to do go to my Omni pod.com Ford slash juice box or click on the links in your show notes or juicebox podcast.com. When you get there request a free experience kit. That's right, a pack a pod experience kit on the pod is gonna send you a pod that is an exact replica of the one you'll get when you start using the product for real, but this one's non functioning. And so it's safe to wear for you to try out, you'll be able to find out if you like it, where you want to wear it. And you'll notice how after you've had it on for a little while you don't even remember that it's there. Miami pod.com forward slash juicebox. The links in your show notes or juicebox podcast.com.

Last thing, don't forget dancing for diabetes that's dancing the number four diabetes.com. It's the little organization that does a ton of good for a lot of people living with type one, they're on Facebook and Instagram. And at dancing the number four diabetes.com Check them out. Here's how I explain what Jenny just said. I think of it as this equation that it's a mathematical equation that doesn't have any math in it. I did this that happen. So next time I'll do more or less sooner, you know, little less little more, that kind of thing. And I always just I always just keep looking at it like that. I did this and that happen. It's the idea of being in a fistfight and you want to hit first because now you have caused an effect. Right? And if you and so now, you know I've done something. And that's what happened next. Now I can make a good decision about what what I do next, instead of waiting for diabetes to do something to you. And then you're just covering up your face hoping not to get knocked out. Right? Like because you don't know what's happening. You don't know why it's happening. I have no context for what's going on. But when you make the first move, you can be sure that what happens next was impacted by what you did. I put insulin in 10 minutes before you ate 10 minutes before I ate. And my blood sugar went to 150. So the next time I'm going to try 15 minutes. And if it goes to 130 I might try 20 minutes. And you know if I get low then later I might say okay, I might need a little more a little less. Now here's where people always say well, how much Scott How long? You know, give me the time give me the amount? That answer for me. It's always going to be I don't know figure it out for yourself. Okay, you have to

Jennifer Smith, CDE 19:22
this is the starting place. Yes. This is where to start. This is how to start. You have to do your own. I mean, diabetes is a science experiment. It's a daily I feel like every day you're almost given like this new petri dish and you're told, keep the dots growing purple today. Okay, let's work on keeping the dots growing problem is that something green pops in and then these like little horny pink things pop on. You're like, oh, no, but it is it's like it's a science experiment that for the most part when you figure out what does work the timing around the most typical foods that you Eat and whatnot, it takes a lot less thinking out of the equation.

Scott Benner 20:04
Yeah. And while this isn't about Pre-Bolus, and it will come up later, but it's important for me to say, because I think this is impactful when you really stop and think about your, your habits around food. They're pretty similar. Right? So, you know, you're not I always say like this, like, if you're a person who gets a pizza on a Friday night and has two slices, you don't suddenly next Friday have seven slices, you don't go from being a two slice person to a seven slice person, right? Like, and so, so you can start making these decisions about how much insulin and when, and you can make them based on historical knowledge about what's going

Jennifer Smith, CDE 20:41
on? Yeah, I usually tell people as the Pre-Bolus piece, you've got, most people have about 20 to 25 foods that are the most common for you to eat regularly. Yeah, that's at least 80% of your control there, at least. So if you can nail the Bolus timing around those and figure it out, for the most part, you know, variations in setting will happen, whatever, yeah, but for the most part, if you've figured that out, you're also much more likely to be able to figure out food that isn't your norm, because of the similarities to what you've chosen. And what you're usually eating,

Scott Benner 21:27
because you can stay flexible. I call it saying stay fluid, right? So here's, here's where I'll tell people this, don't get mad. I don't count carbs. I actually think about it a little backwards from the VB how most of you think about it, I don't look at the food and say eat away at or measured and say okay, well, that's 25 carbs. And my pump says that, I get one unit for every 10. So that's two and a half units. In honesty, there is no accurate insulin to carb ratio set up in Ardens pump. We don't even I don't even pay attention to that. I look at a plate and I say to myself, that's seven units. I think that if she's going to sit down and gorge herself on nachos and cheese, the last time that happened, it took 10 units. But I think of it as insulin, not as carbs. And of course that takes a little practice, right? It does, it does. And it is a little contingent on you having a CGM. I'm not going to lie about that, right, because I start with a healthy Pre-Bolus. And healthy would mean in amount and time. And then I watch her CGM, and I don't really watch it, I have her tolerances set tightly enough that if she leaves that range, I find out about it. So as an example, if I were to give art in something incredibly carb heavy, I might use a Temp Basal increase, and a Pre-Bolus to try to spread out the action of the insulin across this timeline where there's going to be these carbs, right? If I make a Bolus, and 30 minutes after I do it, she's 121 30 Diagonal up. I look at that line. And it tells me something based on my previous knowledge, it's that I say to myself, ooh, this I missed, like, this isn't enough insulin. And I will give her more I will bump it and nudge it back. It's not a ton more, it's enough to stop the arrows,

Jennifer Smith, CDE 23:25
right. And the arrows are very important to bring up in this in this as well. Because if you are using a CGM, those arrows do indicate a rate of change. And again, that's not something that most people realize. They don't understand that and not understand that it's that they've not been told they've not been told, Hey, these arrows tell you that you're increasing by 30 to 60 points in the next 30 minutes. Okay, if that's the case, and I know what my plan of correction factor is, or whatever, I can say, Okay, I'm going to need this much more insulin because if I don't correct my rising 130 blood sugar in the next 30 minutes, I could be 30 to 60 points higher. I could be as high as 190. I don't want to be 190 I've obviously miscalculated someplace, I can throw in a bit more insulin to counter that expected and stabilize it. Yes.

Scott Benner 24:20
Yeah. It very much. It very much is remembering to like I guess the way I usually say it is that you have to trust that what you know is going to happen is going to happen, right? Yeah, you see, and I think that the least important aspect of what the Dexcom does is the number. It's the direction and the speed, direction and

Jennifer Smith, CDE 24:48
100% I wish more please say that again, is the direction it's the trend. It is not just the number

Scott Benner 24:56
the numbers nice like don't get me wrong. It's a starting point, but You know, if you're 60 and stable, and you haven't had insulin for three hours and you haven't had food for three hours, well, maybe you could get away with like a Temp Basal decrease of 100% for half an hour, maybe you'll rise to 90, right. But if you're 60, and you're falling, well, then you don't have enough time, because as we've now discussed over and over again, insulin doesn't begin working right away. Also, Temp Basal is our insulin. It's funny how people think of bolusing and basil is different. But once you're on a pump, it's the same thing. You can't just turn your basil off, and it starts happening right away,

Jennifer Smith, CDE 25:34
takes about 60 minutes for circulating insulin level to be different.

Scott Benner 25:38
I always write and I always try to think of it a little bit as like Ardens Pre-Bolus time like if Ardens Pre-Bolus time is 20 minutes, well then setting a Temp Basal is not really going to start working for at least 20 minutes. Plus, it's a fraction of the Basal rate if, if you're getting a unit an hour, and I say to her, okay, let's double it, let's double it to two units an hour, that impact of that doesn't begin for 20 minutes or so plus, it's not the whole unit. Actually, it's the it's the fraction of it. So when we talk about basil, we'll get to that. But so Pre-Bolus Singh is really just the idea of balancing, again, the action of the insulin against the impact of the carbs, giving yourself a chance not letting the carbs wash you away. Because here's what happens when the carbs wash you like, count your carbs exactly right. You put your insulin in, you spike up the 200. When that happens, that insulin was only for the food. It wasn't for the 200 blood sugar, and it wasn't for the momentum of the rise. And so when I see that, like, I guess an easier way to say this when when I don't have time for a Pre-Bolus and Pre-Bolus thing to me is never about the number, you can Pre-Bolus a 65 blood sugar, you know, you can Pre-Bolus a 90 blood sugar because still no matter what, if you're stable at 65, the insulin you put in is not going to start working until it starts working. So you have and so don't get me wrong if I see a 65 blood sugar and an artist needs 10 units for what she's eating. I don't put all 10 units in at a 65. I might do an extended Bolus which we'll talk about and extended Bolus but I get some insulin moving, I make sure the insulin is on the winning side of this tug of war to start. But in a situation where I can't Pre-Bolus Let's say I know the meal is five units. 100% certain it's five units. But for whatever reason life, let's call it I can't Pre-Bolus and Ardens. You know, I'm going to start eating right now. I'll give her seven units. Because I Bolus for the food, the five units for the food I knew. And I probe and I'm Pre-Bolus Singh. The rise I know is coming and the end the number I know is coming. So I'm already treating a high blood sugar that hasn't happened yet. Because I know what's going to happen because I didn't Pre-Bolus

Jennifer Smith, CDE 28:03
Right. John Walsh goes into detail about what you're doing in a little bit of a different way. He calls it super Bolus, I call it an over Bolus thing. Yeah. And he calls it super Bolus in the way that you take that five units, let's say in your example. And let's say your basil behind that meal for the next two hours is one unit an hour, you actually take your basil running for the next two hours, and you add it into the Bolus for the meal and you take it all upfront. And then to decrease the chance of being too low later. Because of so much upfront action and the blood sugar staying normal, you actually set a temporary Basal decrease, he recommends starting with 100% Because you've loaded that onto the front to avoid a low but on the back end. Some people find though that a Temp Basal 100% off is too much. They only need a 50% they still call the spike and prevent it. But in the back end, they're not having a low then. So similar kind of concept. Yeah,

Scott Benner 29:07
I consider that trading Bolus for Basal. So So you know, say 120 Diagonal up 3040 minutes after a meal and I go, Oh, geez, I got to stop that arrow. How much do I Bolus to stop the arrow? I usually Bolus an hour's worth of a base of Basal insulin. That way if the arrow stops and I stay steady, and she doesn't go down, I say okay, well obviously I was just wrong on the initial amount. But in those situations where you push the button, you know the unit and a half goes in, and five seconds later the error goes from one to 22 Diagonal out the flat you go oh, I didn't need that. Right Temp Basal off. Half hour. All I've done is trade the Basal for the Bolus. Absolutely. Here's a good place to say this and we'll say this in each of these little vignettes. Never suspend your Basal. It's always temporary basals when you suspend you're shutting your pump off when you shut your Jump off. It does not. You have to remember to turn it back on. Yes. Yep. It's always temporary because you can set a Temp Basal for a half an hour, an hour, two hours, but at the end of that time, it was bad. And I'll go back on and start delivering your Basal. It's always temporary Basil is not not don't suspend your pump. Okay, so I think Do you think we covered Pre-Bolus? There?

Jennifer Smith, CDE 30:20
I think that's pretty good. Good. Yeah, that's awesome.

Scott Benner 30:25
Don't forget that you can work with Jenny yourself. If you want just go to integrated diabetes.com To find out how. Let's also take a moment to thank our sponsors Dexcom on the pod and dancing for diabetes. There are links in the show notes of your podcast player app, or at juicebox podcast.com. But you can always go to dexcom.com forward slash juicebox. My omnipod.com forward slash choose bucks or dancing the number four diabetes.com. I hope you're enjoying the Pro Tip series. This was episode four, where we talked about Pre-Bolus. And don't forget that episode one is for those starting over, or just being diagnosed. Episode Two was all about multiple daily injections. Episode Three, we talked all about insulin. Today, of course Pre-Bolus Singh in the next episode, Temp Basal rates huge and important. And then after that insulin pumping, they're designed to be listened to in order to trust me listen to them in order. I have just a little bit of music left here. So let me thank everyone for the great reviews and ratings on iTunes. Very much appreciated. 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 l p.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 juicebox. All right, I want to thank you for listening to this episode of the Best of the Juicebox Podcast. And I'd also like to thank people who made better microphones since this was made. Those people should be lauded. And I think we're all very, very grateful. Thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast made on this microphone. The one that sounds amazing

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Summary

• Intro to the show. 0:00

• Welcome to episode 915 of the juicebox podcast.

• Nothing on the podcast should be considered medical.

• Understanding insulin action and time of action. 2:49

• Fear of insulin is the biggest sticking point.

• Insulin action and time of action.

• Tug of war analogy, insulin and carbs.

• How blood sugar works in the body.

• Take insulin and start to eat. 8:37

• Rapid is a misnomer for insulin.

• Rapid insulin is 100% in most settings.

• Continuous glucose monitor, dexcom, continuous glucose monitor.

• The story of a 17 year old boy.

• Timing and amount of insulin. 12:12

• Timing and amount is the first step to insulin use.

• The importance of visualization.

• Dexcom g6 continuous glucose monitor.

• Share and follow features for android and iphone.

• How to make good decisions. 15:38

• Omnipod headquarters in massachusetts.

• Request a free experience kit.

• Dancing for diabetes and dancingthenumberfourdiabetes.com.

• Making the first move is the key.

• Diabetes is a science experiment. 19:22

• Diabetes is a daily science experiment.

• The pre-bolus piece is 80% of control.

• I don’t count carbs. 21:28

• Don't get mad, don't count carbs.

• No accurate insulin to carb ratio set up.

• The importance of the arrows in dexcom.

• The least important aspect of dexcom is the direction.

• What is pre-bolus and pre-basal. 24:54

• Temper basal is a fraction of the basal rate.

• Pre-bolus time is 20 minutes.

• The importance of pre-bolus and extended bolus.

• Pre-bolus vs extended boluses.

• Trading bolus for basal. 28:08

• The concept of super bolus.

• Never suspend basal insulin.

• Pre-bolus and multiple daily injections.

• Sponsor, better help. 10% off first month.

#914 Diabetes Myths: How You Got Diabetes

A brand new series examining the myths surrounding diabetes.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends and welcome to episode 914 of the Juicebox Podcast

a Jenny's here today and we're going to be talking about diabetes myths. Myth. Am I saying that right? You know what I need? I need some. I need some synonyms for myths. Because every time I say it I feel like I'm like I'm butchering it. Let's see, I know what a myth is. I don't need an example of myth, myth. Synonyms folktales stories legends tales, fables, sagas, allegory parable, tradition lore folklore mythos. How come I can say mythos but not myth? Wait, I said myth. Hi, Jenny's here we're gonna talk about myth, myth, dammit. While you're listening today, please remember that nothing please remember, I can't say myths that and also 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. Quick quick, right 35% off your entire order at cosy earth.com with the offer code juice box and check out 10% off your first month of therapy@betterhelp.com forward slash juice box by free travel packs and a free year's supply of vitamin D with your first order at athletic greens.com forward slash juice box. This episode of The Juicebox Podcast is sponsored by the Dexcom G seven continuous glucose monitoring system dexcom.com forward slash juice box you want to wear the Dexcom that Arden's wearing, you're gonna have to get the G seven cuz she just switched and it's I almost cursed. It's really great. The podcast is also sponsored today by Omni pod Omni pod.com forward slash juice box you want the Omni pod dash where you want the Omni pod five it's completely up to you both can be accomplished at Omni pod.com forward slash juice box. You want to gear up like Arden you want the Dexcom and you want the Omni pod?

Oh goodness. Well, you guys can hear Jenny laughing we're back to record our first myth. Are you in the topic that we're going to do? Today? Reasons Why You got diabetes?

Jennifer Smith, CDE 2:30
No, no underneath the miracle. I'm gonna have to like,

Scott Benner 2:36
I don't know. Sure. Well, last week. Yes, we will. Alright, anyway. Okay, so let me I'm gonna scroll two reasons why you got diabetes on the master list. All right. So first one says, obviously, I caused it in my kid because I fed her too much sugar. Yeah, oh, you can't cause type one diabetes by feeding people too much sugar?

Jennifer Smith, CDE 3:07
No. 100% Incorrect.

Scott Benner 3:09
Type One is an autoimmune disease. And that's not how that works. So where's the confusion? Is the confusion is that people believe, first of all, that diabetes is the word they know. And when they hear diabetes, they think about I think most people think about older people in their life.

Jennifer Smith, CDE 3:33
I think it comes from honestly, the larger amount of the population knowing. And I say knowing in air quotes hear more about type two diabetes, right. And as we've talked before, about the differences, type two diabetes does have lifestyle component to it, and to diagnosis. It does. But I think people don't realize the very large difference in terms of why you could have type one versus having type two. And so it all with just the broad term of diabetes, it all gets lumped together. And so you know, these people will say, well, they just wouldn't feed them all that sugar or you know, if your kid wasn't eating this for lunch every day, or you know, I've heard from a number of parents who have actually been told by some of the school personnel, well, if you wouldn't put that in their lunchbox every day, maybe their numbers would look better. Like really, really come on.

Scott Benner 4:42
This is caused by eating too much sugar. We've loaded our son with sugary snacks and drinks and that's why he has diabetes, the unhealthy diet. Now here, my uncle said five minutes ago while watching television, a doctor, Dr. Pepper commercial came on and he said that pepper, that stuff will give you diabetes. So this is where I think this is where I think it comes from. Right? Because I mean, listen, forget Dr. Pepper, soda. It's not good for you know, it's just not so no. And health issues. If you drank enough soda, you would have health issues.

Jennifer Smith, CDE 5:24
Yeah, yes, absolutely. I mean, there are so many things on the market today that are not food, right? I mean, no, I don't think hopefully nobody thinks Dr. Pepper or anything of the like, is really food. But it really is not even close to being anything we should be putting in our body anyway. But again, statements like this, my personal is that I've just come to the point of I just brushed it off. I'm like these people, my educated brain is like and what, whatever, I let it go, right, I'm not going to ruminate on it, because that doesn't help me at all. If I could have five minutes with them, I would teach them why that statement is wrong. And it's not funny to many people. But some people really get very offended. Honestly, by a statement like this, that stuff will give you diabetes or, you know, the the comedic types of jokes about diabetes and again, personality wise, I don't, I don't take them in as a personal attack against me. I take it as your a dumb person who just doesn't, doesn't understand even what you're trying to be funny about. So I'm gonna let it fly, whatever.

Scott Benner 6:40
When this would get said to me about Arden when she was younger, I was always amused that the people who were saying it, we're not exactly long distance runners, you know what I mean? They weren't at the pinnacle of health and performance either. Have you looked in the mirror this morning? You know, she's got diabetes, but maybe you might want to skip it too. for other reasons. You don't look well, this year, this year is heartbreaking. My own mother saying to me, this is a quote, you got diabetes, because you ate so many sweets as a child, which I don't know how that person didn't respond. Well, who was in charge of that? Like, What an odd thing to say to me right now? Yeah, like, that was you like, like, not me? Like, I didn't have any money. I'd be like, Oh, my God, that wouldn't have gone? Well, if somebody would have said it to me, I would have been like, I didn't have money. You bought that stuff? Agreed? Yeah, that's been there. That's heartbreaking. And then I mean, like, you can deep dive into the psychology of it. Like maybe what the moms really saying is, I let you down. I feel like I let you down. You could be you know,

Jennifer Smith, CDE 7:50
this is the way that it came out. Yes. Yeah.

Scott Benner 7:53
People don't do a good job of communicating. When I was when my 18 month old was diagnosed in decay, and someone asked me how that happened. When he was so young, did he eat a lot of sugar? So now that see, this is the part this is why it's so upsetting your kids 18 months old. And in DKA. I don't understand why people think this is the time to say hey, do you think you did something wrong? Like Like, it would be like if I came up on a car accident, and you were pinned in the car, and the back of the car was on fire? And I looked in the window, and I was like, Hey, were you driving too fast? Like,

Jennifer Smith, CDE 8:30
did you not use your brakes? Did you not see what was happening in front of you?

Scott Benner 8:33
Yeah, this is your fault. Like, can you help me out the car please? Like, like, like, you know, like, it's just a that's like college, the part that throws me off, you know what I mean?

Jennifer Smith, CDE 8:46
And this is the part that I wish, you know, as people with diabetes, who are the majority listeners to your podcast? They will they will listen, they will think about this and they'll say yeah, you know, who I really wish this could go to. I wish this could be just a podcast for the like the this is the general public's information about when to keep your mouth closed. Honestly, like, if you don't know what you're talking about, please. I mean, what is it? Zipit locket put it in your pocket is like what my kindergartener has learned, right? If you have nothing right to say, or you're not supposed to be talking, close your mouth. Right? And that's, I wish this could go to the general public and just be broadcast as a commercial. Like, if you don't know, don't comment.

Scott Benner 9:37
Maybe people should just if they get this comment, you can just AirDrop them a link to this episode here. I'll tell you what, like, I've now skipped past so many statements that say the same thing. But this one catches my eye. My Type One daughter being asked if she ate too much sugar, and that's what caused her type one. Like that's the thing like now I'm trying to think like you've you think this thing? Why would you say to a kid, I don't understand why you would say to her mom, I really don't understand why you would say to the kid,

Jennifer Smith, CDE 10:12
well, you know, one other place. And maybe this comes up in these comments. But another comment I've heard from many parents along the line of the sugar piece is, well, your kid is eating sugar. Like they say all the time, I guarantee they're not eating it all the time. But it's very likely they catch the child eating sugar when their blood sugar is lower, right. And they then sort of come back with a statement of, well, it would be better if they just didn't eat so much sugar, or it was caused because of that sugar you're giving in on the back end, as the parent, you're thinking, Well, again, I could give you a whole education session on why she's probably eating sugar right now, if you would actually sit down and listen,

Scott Benner 10:58
yeah, here's the other side of it, too. I grew up, I'm older than you. I'm older than most of you. But I grew up in the 70s. And in my refrigerator, was a large plastic one gallon container, they still make them today. And you turn the top and you can pour out of it. That container was always full of some sort of juice. Now I'm making air quotes with juice, cuz it was most assuredly not juice. It was we used to get this big container of a powdered substance. And you'd put like, 15 scoops of it in there. Little warm water to melt it little cold water. And then it I don't even know what it was. But I'm pretty sure it was sugar, and or chemicals. And I don't even use plastic containers in my house. I won't even put I'm pretty sure it was both of those chemicals and sugar. And it was ruminating and like in plastic. And I don't have diabetes, type one or type two. We used to eat it Kentucky Fried Chicken all the time because it was close to our house. My mom did not know the first thing about nutrition. I clearly am not lean because of my upbringing. But that's not my point. My point is, I don't have type one diabetes, and I don't have type two diabetes. And if the amount of sugar an 18 month old could have consumed could put them into decay, then I would have 43 times that amount of diabetes right now. Correct? Yeah. And you absolutely. And here's the interesting thing. I'm talking a little out of school here, if because I don't remember the the test. But I recently went to the doctor and had like a complete physical. And this lady runs bloodwork so much that I had to pay for some of it out of my pocket, like the I mean, like she's testing things that your insurance customers, like, we don't need to know that she's like, I need to know what is B 12? Is it like stuff like that? She said to me, I forget what the test was. But she said, I can say to you with a fair amount of certainty, you're never going to develop type two diabetes. And I was interested, I was like, why I'm gonna get I'm gonna find out about what that was. Yes. And. And she pointed to a marker and she said, Look, I can't say for sure she goes, but this number here tells me you're very unlikely to get type two. And I was like, Okay, thank you. I didn't ask her. We were talking about a lot of stuff. And I didn't remember to ask, I'm going to email her and ask her. But my point is, I'd be I'd be curious. Yeah, what it was, I don't have type one yet. You know, I don't know that I will or I won't. But again, the antibodies is still something very misunderstood about diabetes type one, like for sure. And even type two, like, I just don't seem to be predisposed to it. You know, so I just that sucks when everything else gets caught in the in the way also, I just made a decision about this episode. After we record this. I'm going to send a file of it before I edit it together to Erica, I'm going to let her listen to it. And then we're going to talk about the psychology of why people might say stuff like this to people.

Jennifer Smith, CDE 14:14
That would be really interesting. From from the mental standpoint. Yes,

Scott Benner 14:20
I just it just hit me here. Let's see. This woman says, This person, by the way, I just assumed these are moms. And I could be wrong. That my type one causes diabetes because the diet I had to choose to ignore this talk, because I was gonna throw some hands and I'm not I'm not cut out for jail, it says. So that's pretty

Jennifer Smith, CDE 14:45
funny. Yeah.

Scott Benner 14:47
Candy, the week of my daughter's diagnosis, we went to a scout meeting and at the meeting, the troop leader said to me, Oh, wow, I didn't know she had such a sweet tooth. She said Skinny? Yeah. Yeah. Okay,

Jennifer Smith, CDE 15:05
again, your child has diabetes because behind the scenes, I didn't realize it, but your kid was clearly like, eating the whole bag of sugar. A whole

Scott Benner 15:14
thing had to happen. Oh, here's one. You're a terrible parent, because your child got died. diabetes.

Jennifer Smith, CDE 15:20
Oh, that's so sad again. Dip your lip. I'm sorry. Really like, Joel, you're

Scott Benner 15:30
this. This one's from a deep thinker, probably. Probably a scientist. I fed my child mac and cheese. And that's why they have diabetes that that statement came from a family member. Yeah, there's probably probably a scientist that came up with macaroni and cheese gave your kid diabetes. Oh, jeez, too much sugar cause diabetes. I'm 26 I got diagnosed at 15. Apparently, I'm too young, not fat enough. Or my parents fed me crap. So that's a light. That's, that's 10 years of people saying that?

Unknown Speaker 16:12
Yeah, absolutely. Yeah.

Scott Benner 16:15
Cheese. We moved to Canada from Europe. And my son was diagnosed here four months ago. Very often, I heard Oh, this is because of our Western diet. From considerably intelligent people. They don't know that we're from Canada, and are not from, we're not from Canada, and our diet is Mediterranean. And we don't buy prepared food at all. So this person is not eating the way they think. But it's still what happens. You know? So is there, like, really break it down for a second? And your answer might just be one word. But is there anything about diet that could make your type one diabetes happen?

Jennifer Smith, CDE 16:59
It mean, in terms of diagnosis?

Scott Benner 17:02
Or anything I could eat that would force me to get type one diabetes? No. Okay. I mean,

Jennifer Smith, CDE 17:08
that that we and I say that with the side note of? No. Because again, if we really knew the true, one point cause of type one diabetes, there would be a cure for it. Yeah. Right. So I mean, diet in and of itself, has not of all of the I don't necessarily that say that they're myths, all of the hypotheses about where type one diabetes comes from and why someone may have it versus another one may not within even the same family. There are so many unknowns about that. That you can't necessarily say no to food, but food I don't believe by any means especially just the simple thing of sugar right? is definitely not Oh, you have diabetes, because you ate all that sugar. Wrong.

Scott Benner 18:05
I'd like to point out that I don't think you should eat a lot of sugar.

Jennifer Smith, CDE 18:09
Right? We're not advocating for downing sugar.

Scott Benner 18:13
I'm not saying that we should go back to the country time lemonade and the the punch that we used to get as kids and oh my gosh, popsicles Jenny during the summer, that just your refrigerator just full of sugar.

Jennifer Smith, CDE 18:28
Did you have the little they were called Little jugs. Oh, sure. They looked like little like barrels. They were plastic like white ish. Right? And then you had an aluminum rip tap.

Scott Benner 18:40
Ever try want us an adult? Orange. I tried one as an adult. That's like what the is Oh my god. Like it makes your brain like

Jennifer Smith, CDE 18:50
because I didn't even like them as as a kid. I had. I didn't like the flavor of them. I and I liked like Kool Aid. But I did not like those. They were just not favor.

Scott Benner 19:05
Yeah. But that's a cost thing for us. Yeah, they were like, I know this is probably hard for people to imagine. But you could get like a flat of them for like $2 Yeah, it was nothingness. You know, like, and so your parents bought stuff like that because it was cheap. And they didn't nobody trust me. If you went back in a time machine, and got my mom in 1976 and said, Hey, this lemonade is bad for you. My mom would go lemons grow on trees and pollute and that would have been the absolute end of it. My five year old has diabetes because she's overweight. Oh, but you're so young and look so healthy. Yeah. Lovely. Had a couple times.

Jennifer Smith, CDE 19:53
Yeah, that's one that I've I mean, I've heard it as well. And again, I think it comes from The visual of what most people see as diabetes, which is type two diabetes, and it's even, it's very unfair, even in that line of, you know, type of diabetes, but I've got what you look great, you know, when you, you're running all the time and bah, bah, bah, like, yep, still got a dysfunctional beta cell in my body, though. So I have

Scott Benner 20:23
other autoimmune issues, if I can tell you about what it is listen, from, from an uneducated perspective. It's hard to ignore, you do not look like a person who has something, quote unquote, wrong with them. Like you just you don't. And I know that, like, if I didn't have a kid with type one. And you said to me, I don't know. Here's three people tell me which one of them has an illness. And it was me, you and I don't know, Bill Clinton. I wouldn't pick you. That's a good thing. I think it's Bill and then it's me after Bill, but that lady is definitely just thrown in here to confuse everything. So yeah, I mean, I get where it comes from. I don't I don't understand why you would say it. If you don't know, when people really just think they know.

Jennifer Smith, CDE 21:18
Well. And the thing is, I You said something that made me think that it's you said the uneducated, these are many of these statements don't come from uneducated people. Yeah, they are uneducated, in terms of one particular thing, but specifically diabetes.

Scott Benner 21:39
So the thing that always keeps me focused on not getting upset when this stuff happens is that there are maybe a billion things you could ask me about that? I don't understand. And if you pressed me, and I made a guess, I'm sure my guess might very well be wrong. The thing I don't have that these people have is I have no compunction to walk up to a person and go, Hey, you want me to tell you? What's, that's the part that that's the unplug. Here, though, I want to go, I want to go this one. This is from a I'm guessing from a widowed person because it says, oh, stress caused my type one, if that were true, then every widowed person would have type one. But I caused this the word there. I saw this the other day, people love, it's still very popular to say my I have diabetes, because I COVID. And then they'll say COVID, cause my type one diabetes. But COVID didn't give you type one COVID set off an auto immune response that ended in type one,

Jennifer Smith, CDE 22:43
redirect and forever. Not for everybody does that obviously just like this statement is every widowed person would have type one, every single person that had COVID, or every single person that had the flu, and a really or really nasty fever. Any of those if you know anything about the research being done in type one diabetes is there's a lot of viral research going on about why does one person this virus causes a reaction that shouldn't happen the way that it does, right? So stress is horrid. And the way the body reacts to stress Absolutely. In one person, person versus another could have something happen. But to tell somebody that, you know, well, you're so stressed out. Clearly, this is why this happened. It's

Scott Benner 23:35
it's, I think I think the word cause is where the confusion comes in. Like it's so close to. I don't know, I'm trying to find a simple example, like, stress doesn't make type one diabetes, you don't get stressed out and suddenly have type one. No, but you could get stressed out to the point where your body experiences turmoil that ends up in an auto immune response, that if you already had antibodies for type, one could kick the whole thing into gear,

Jennifer Smith, CDE 24:06
right? I mean, stress causes significant inflammatory response in your body. It does

Scott Benner 24:12
this is this this little misunderstanding between the word caused and like, you know, my daughter had hand foot and mouth disease, which is called coxsackievirus. And then she got type one diabetes coxsackievirus didn't like go into a laboratory and make type one and shove it into my daughter's body. Like it. She's got but she has type one, because she got Coxsackie. The point is, if she doesn't get Coxsackie that day, and just gets a virus two years later, then she likely gets the diabetes then this lady could have it's funny when I hear this statement. I mean, assuming that she was widowed at an older age, I think wow. How lucky is that? She got through most of her Life without getting type one. Like that's how that actually kind of feels to me, which is interesting. This person said I was diagnosed the same summer that I completed three marathons. And I can't tell you the number of people who told me that running the marathons made me diabetic. That's interesting. Is there anything

Jennifer Smith, CDE 25:20
I liked the next day, I started to say things like, yes, instead of a finishers medal, everyone that completed that race got type one diabetes, exactly.

Scott Benner 25:27
There's, there's the thought 1000 People ran a race, one of them ended up with diabetes, and somebody goes, oh, there was the race thing. Instead of, instead of saying 999, out of every 1000, people that ran a race didn't get type one diabetes, they see at the interest, where people's minds are interesting.

Jennifer Smith, CDE 25:49
When I think it begs of it's a it's like a deeper thought, honestly, as what you just said, along with the stress, and like the widowed person is this person without knowing as many people are walking around today without type one diabetes, specifically, right? Nobody just randomly goes to the doctor. And it's like, Yep, I want to make sure that I'm not carrying around these antibodies and whatever, right? These are not tested for factors. Unless you are doing something like trial net or whatnot, because you already know that you have type one in the family and you really want to stay on top of it. The majority of the population has no idea if you're walking around with something that could at some point get I say turned on. Right and or your body reacts a certain way. So you know, this person running the marathons, who knows, was just the point at which that piece in their body was like, Yep, it's time. Yeah. So sorry.

Scott Benner 26:51
Here's a couple of like, I hope people are listening to them, because contextually you can figure out where it comes from. Although this one's just sort of hilarious. I was told that I had not lost so much weight, I wouldn't have gotten diabetes. That's just that's, uh, that falls under the you're damned if you do damned if you don't category. I'm telling you to people. But here's this one's interesting. My two type ones were diagnosed about nine days apart, ran to a friend's husband at Target right after diagnosis. The question was, what causes that diet? And then she's she says, Yeah, dude, I did this to my kids like with food, but I get her feeling. But you understand his question. He's worried. He's like a lady. I know. Both of her kids got type one diabetes, nine days apart? Is that something I have to worry about? Like, that's the question she takes the way she takes it because of her. Rightfully so like, I'm not saying that. But like, I get where his question comes from, like, Hey, what happened here, like somebody told me, so this doesn't happen to me, is what I'm getting out of that. I think this is the case that takes the cake. When I met a stranger at a birthday party, who told me in the first five minutes of meeting him, that I really should research my kids diagnosis more, because it's likely it could just be a parasite, and then no one. And then no less than five minutes later said, I don't really understand how diabetes works, and then wanted me to explain it to him. And then a Dexcom alarm goes off, and they use cake to take care of a low. But again, you know, that can be a parasite. By the way, what is diabetes? Thank you. Thank you for your searing insight. Do you see this one I had a professor tell a lecture hall full of 200 people that type one is quote the one you get the one you're born with. I raised my hand. I said I wasn't diagnosed until I was 13. And then she talked her way out of it by going you know what I mean? shut her down. And so like so but that's another example. Right? The one you're born with means that's in your that's in your body already. Right? You're. But that's not true. either. You could develop the antibodies later in life as well. Yeah, so my God, these go on forever. I cause

Jennifer Smith, CDE 29:23
it's, you know, what's painful is that we live in a very we live in a society today where it's very easy to now get the right information. Yes. Right. I mean, these types of comments. I've heard myself since I was diagnosed almost 35 years ago. Yeah. So it makes me really sad then that people are not learning.

Scott Benner 29:58
Jenny, I heard recent li that you your phone has access to more information than the President of the United States had access to in the early 80s. I would agree. And now you can't like, and still people can't figure anything out. This one's terrible. I caused it. That and that I deserve the punishment. Oh, wow. I don't know who's I don't know what burden you're trying to lift by telling people that but that's horrible. Oh, my daughter was diagnosed because she was born by C section. So this was a myth mixed with mom shaming. So hey, cuz you couldn't push that kid out. It has diabetes. So she hits her on, like, twice. People are horrible. Yeah. Oh my gosh, um, it is my fault that my son has diabetes. Because I had gestational diabetes when I was pregnant with him. My weight must have caused my daughter's diabetes, my weight must have caused my daughter's diabetes, okay.

Jennifer Smith, CDE 31:07
Meaning they is kind of the same as the the one you just read about. Maybe the maybe this person is overweight or herself and was pregnant and overweight at the same time. And maybe that is what they're expecting, cause the daughter to have diabetes, because clearly the body was unhealthy while it was in its gestational

Scott Benner 31:30
age. This this one, here's the whole story is not important. But she does point out that like, people wouldn't even make eye contact with her after her children were diagnosed. That's they thought it was they thought more type two stuff. Just weird that like

Jennifer Smith, CDE 31:49
that. And I think in this, I think some people just don't know what. They just don't know what to say. Yeah. You know, after, after a diagnosis. It's like, I think of any kind when you hear somebody that you have gotten to know, has had something traumatic in one way or another happen. Sometimes you feel like you just don't have the right words. And you're not quite sure. You know, what to say? Yeah. Now, I mean, the response of just not even like approaching or eye contact or whatever, clearly isn't the right way to go about it either. But I don't know. It's sad.

Scott Benner 32:29
These last couple are about contagious. My kids are grown now. But I had to have three with type one. Kids would ask my kids if it was contagious. And eventually they get tired of saying no, and just started saying yes, then fake coughing on everybody. Somebody said, I've been told that it's contagious. But this one, this is the last one on the list. And then we'll wrap up. As a teen. My friend's mom was told diabetes was a sexually transmitted disease. And if her son and I dated, he would get my diabetes. Oh. Did you give it to your husband, Jenny? No. No, no. Well, that didn't work. Dammit.

Jennifer Smith, CDE 33:13
We've been married and together a lot.

Scott Benner 33:16
Jenny and her husband have a sex at least four times. And I got wedding kids and like a birthday. And it hasn't happened yet. Wow. diabetes is a sexually transmitted disease. It Well, that's the end of the list. i My takeaway is, I just always think about this the same way like you can't judge people. On their level of understanding. I mean, there are some things in here in this list that are just confusion. There's some things in here that are ignorance, there's some things that in here stupidly, it depends on who you bump into. But the one thing that I've learned from this list is that everyone believes in themselves to an absolute fault. Everybody's like, I think a thing. So the thing must be right. And then here we go. And your point about being able to look into it. Especially in a world where people spend so much time connecting to information through a phone or a computer. Why not take five minutes to find out something before you say to somebody, like just right, you're on your phone anyway, like,

Jennifer Smith, CDE 34:34
well, right. I mean, at a general, a general party, how many people you know, backyard party in the summertime, you've got a family and you can see that the child or maybe one of the parents or whoever looks like they've got an insulin pump, right. Or they've got a CGM rather than like just spewing words out of your mouth that clearly are not going to be smart because you don't have two clues. You know, whatever. VLC is on their phone at that point, get on your phone, figure it out, look it up and

Scott Benner 35:05
listen. Not to be too clear headed, because I don't want to ruin everybody's stupidity with this. But you could just ask. Just Yeah, exactly. Say, Hey, I'm very sorry to hear about this. I hope you're okay. Do you know what causes this?

Jennifer Smith, CDE 35:24
And I think the other thing that all of these statements also are kind of show behind the scenes is people want to offer you information without understanding your situation. Right? They think that they like, no. They think they know something like, what did you know about this? And I, I saw this famous person and they're doing this kind of thing. What did you ever think about doing that?

Scott Benner 35:57
No, I haven't, but thank you. And so you're saying I just need to diffuse Oak Grove water? Okay. I want it. Thank you something about cow urine? Did you say

Jennifer Smith, CDE 36:10
how we write cow urine? And you know, I'll

Scott Benner 36:12
get right to it. Honestly, like, I really am gonna, like, I'm just gonna grab Erica for like, 10 minutes, that would be great. And I'm just gonna say to her, like, read these. I don't even need to talk. You just jump on here. And tell me what you think. And you guys are gonna hear that right after my voice stops. So awesome. Yeah. Thank you so much, Jenny. Thank you.

Eric, we'll be here in just a second. But first, let's talk about the Dexcom G seven continuous glucose monitoring system. Why do you want it? Well, it's smaller, it's flatter. It's more comfortable to wear, says my daughter. It's easy to put on the new insert II system thingy, boom, like really easy, push it down, hit the clicky. Done. Very cool. I didn't want to get too technical with you there. But you definitely hit the clicky. And then it goes in, you're gonna get what you expect from Dexcom 10 days worth of monitoring out of each sensor. But now like, unlike with the G six, when you're done, you just kind of pull it off and flip goes in the garbage. There's no pulling out the transmitter and then putting the new transmitter into the new sensor bed. And like you'll see I'm already forgetting how to do it because Arden got the g7 now take a look at it, Dex comm.com forward slash juicebox. Don't get me wrong, the G six is terrific. The g7 is smaller. And there's some other good stuff about it too. Shorter warm up period for 130 minutes, pretty great. decks comm.com forward slash juicebox. Of course, you can get up to 10 followers, use your iPhone or Android phone as a receiver or you can use the Dexcom receiver all that good stuff still exists. This smaller package. You know, they say good things come in small packages. I don't know why they say that. But it is say speaking of sayings, here's one for you get it on the pod Omni pod.com forward slash juice box. Why? Well, how about tubeless? How about you can swim with it, bathe with it run around with it? How about you don't have to disconnect to do things. I just saw another story online today if somebody disconnects their palm who disconnects there. I just thought I just saw another story online today of a person who has to disconnect their tubes pump to do an activity and guess what they did? They forgot to turn it back on blood sugar. Right up. It's a quick way to DKA you don't want that. I only bought you leave on omnipod.com forward slash juice box. Your kids can leave it on when they're out playing about and adults. When you do adult stuff, you can leave it on to can you imagine those adults things but without the tubing. You would like that, wouldn't you? Of course you would dexcom.com forward slash juice box Omni pod.com forward slash juice box check out the Omni pod dash. Or if you want that sweet, sweet automation, check out the Omni pod five. That's right on the pod five paired with Dexcom G six is a beautiful marriage. Let those things make those decisions for you. More insulin less insulin, automated baby omnipod.com forward slash use Basal links in the show notes links at juicebox podcast.com. When you use my links to get these items and the other things that are bandied about on the podcast, you are supporting the production of the podcast you are keeping it free for its listeners and plentiful. That's the thing you do. And I'm not telling you to just go by Omni pod if you don't want it, but if you want it Omni pod.com forward slash fusebox. I'm not saying get a Dexcom to support me. I'm saying if you're getting to Dexcom dexcom.com forward slash Tuesday Awesome. You got it. Alright, let's get back to these. Dammit, mythos. Why can I just say it like that? Myth? Myth I can say multiple myth is myth. And that it seems like I'm saying it wrong. It's very upsetting

Speaker 3 40:27
Hi

Scott Benner 40:39
All right, as I promised when I was speaking with Jenny earlier, I harangued Erica into jumping onto this jumping onto this episode too. So Eric already knows, but you know, just to kind of lay it out for you guys. As Jenny and I were speaking during this episode, I found myself wondering, like, what makes people say these things? Like I couldn't fathom? Like, I'm trying to imagine a person coming up to me and saying, like, Oh, my kid was diagnosed with type one diabetes, or I just got diabetes or something. And the thing I say to them back is so I mean, ignorant, I guess for the lack of a better word, and often course, and mean. You know, to give you some examples that you didn't hear from when Jenny, I were recording, you got obviously the you got diabetes, because you ate too many sweets as a child, huh? Except, you know who that came from, to this adult? Their mother, which flipped me out because you were in charge of the food lady, when, when I was a kid, like, you could have made a different decision if you think that was it. People who sit in a room with you. And you know, the example here was like a commercial came on. And they're like, oh, that's soda, that stuff gives you diabetes. And like that stuff. So you're, I'm really first just looking for your interpretation. Do you think people set out to be Corson unfeeling? Or do you just, this is just a gap between their brain in their mouth most times? Or what do you? I don't know.

Erika Forsyth, MFT, LMFT 42:10
I, I would hope that most often people are speaking without pausing or speaking without thinking how their words are going to land. I think sometimes the example you just gave from the mother. Sometimes it's easier to shame somebody else, as opposed to maybe blame yourself, or consider that as an option. And not that we meet, we're looking for anyone to blame themselves or but that could be an automatic response. Yeah, I think the the ignorant comments may stem from their understanding of what diabetes is, which may be from, you know, misinformation like commercials from, you know, thinking, I think we think about cancer, there's so many different types of cancer. And people try and relate to other stories and other family members who have cancer. And I think they think that diabetes is very similar that there's one type of diabetes, and so they speak out, they make a comment, it may be that they're trying to connect with somebody, they might try and share that they have an experience with diabetes. But they don't know they obviously there isn't a real solid knowledge coming in some of those comments you just

Scott Benner 43:29
shared. I wonder too, not just in this topic. But in general, if people don't want to pre absolve themselves from a future problem. And kind of what I mean by that is, if you come up to them like that, here's the person here said that they were just flat out told by somebody else, that they were a terrible parent, for their child having type one, that they mess, their diet up, and all this other stuff. So obviously, knowing that that's not the case. And that's not how you get type one. I always think that there's like this split second decision made in the back of your brain somewhere like this, like I'm standing in front of you, and your kids been diagnosed, my kid doesn't have diabetes, I have to think you're a bad parent. Because if I think this is random, then it could happen to me and my kid. And like, almost like I have to blame you. So that I'm protecting myself. I'm making air quotes, protecting myself from this thing happening to me, because I'm a good parent. So there's no way this could happen. You must be a bad parent, you must not have done the things you were supposed to do. And that's why your kid ended up that way. And I don't think that's to shame you. I think it's to protect themselves from the fear of it happening to them, but I could be way off on that. But that's how I always think about stuff like this.

Erika Forsyth, MFT, LMFT 44:49
Yes, and gosh, I sure hope that is an internal process. You know, I hope that but I know these things are spoken and they do come out of people's mouths. And I think it gets I appreciate that perspective is I'm going to protect myself because we also are always trying to make sense of why it happened. And if we don't know why we're going to either make false assumptions, false accusations, generalizations, and those obviously, never land well. So I like yeah, that's it, maybe it is a protective factor for the person who's making the comment, and kind of rationalizing how they would never get something like that, or do something like that to themselves or their child.

Scott Benner 45:32
Now, here's another thing somebody said, and I will go, I'll say this, like, it's nice to try to understand people, and to be generous with them and everything. But if someone looks at you, and like, you say, Hey, I found out I have type one diabetes. And their first thought is, and I'm quoting here, you're not fat enough for that to happen to you. Maybe surround yourself with smarter people. Like, honestly, I don't know. Like, there seems to me like, there might be an element here of just people who don't know how to how to be, you know what I mean? Like, that's just a who would in your wildest dreams, Erica, in your wildest dreams? Would you ever say, Oh, well,

Erika Forsyth, MFT, LMFT 46:10
but I think so that we look at, and I know, we'll spend time on how to receive these comments. But I think that person who's saying that maybe is really is trying to compliment the person in our way, right? But their assumption is like, Oh, you get diabetes, if you if you have obesity, that's the person's assumption, right? That's how they're speaking out of that. And so they're trying to tell the person Oh, but you're, you're too skinny to have diabetes, and maybe they're trying to compliment. I don't know, listen,

Scott Benner 46:40
I'm not a well educated person. But if you're having that thought it would be my thought to say, you know, that's really surprising to me, because I, you know, I guess in my mind, I, I relate that to this, and you're not like that, like, why not say that instead of? I don't know, learn a couple extra words. So yeah, so my question is now, it is about that, right? Because you I'm assuming you have a couple of options here. You know, somebody says something silly or stupid to you like that. You could keep yourself together and educate them or try. You could get angry and be back, which I don't know if anybody would blame you. And you could walk away, right?

Erika Forsyth, MFT, LMFT 47:28
Yes, I think first, I would encourage you to think about, you know, here's this exchange of information, you've shared, something you've shared, you've been diagnosed, your child has been diagnosed, they respond in a way that is often maybe not helpful, even though maybe they're trying to help they're trying to relate. They're trying to compliment whatever it is, we don't know. Always the person's intent and motivation. But pay it being paying attention. First and foremost, how is that exchange of information making you feel? Are you feeling and that might dictate your next step? But is it? Are you irritated? Are you angry? Are you sad? Are you you know, raging and sigh?

Scott Benner 48:05
A murderous rage?

Erika Forsyth, MFT, LMFT 48:09
Are you? Yeah, so I think it probably depends on a that the environment, the the context, you know, where are you? Who is the person? And that would maybe dictate your next response? Is it a family member? Do you want to spend time educating them? Maybe? Is it someone? Is it a co worker? Who says, gosh, you know, I didn't you have diabetes? You don't eat a lot of sweets? Or oh, can you you know, this goes along with it? Can you eat that treat? I think your response to do I want to educate them? Do I want to be kind of a jerk back to them and be like, You have no idea go, go Google type one versus type two, or all of the different types? Do you want to just check in with yourself and you know what, actually, that's, um, you don't have to express to them how you're feeling. But you can choose to say, Gosh, internally, you're thinking I'm feeling so angry right now. I want to touch this person. Yeah, but it's not worth it to me. I'm gonna say, You know what, actually, that's really that's off base. And here, you can go look at this website. And then and then later, I would encourage you to kind of spend time on that that feeling.

Scott Benner 49:19
You know, one of the what I count as one of the most terrible things that is said to me, or has been said to me in the past about this, and I heard it a more than a handful of times when Arden was so little, I know 100% It's meant well, but I've never come closer to punching someone square in the face than when I've been told, Oh, well aren't got type one diabetes, because God knows you can handle it. And I'm like, okay, so what are you telling me that because I'm a competent person, I gave my daughter diabetes by being competent. So if I was just a big dummy, then she wouldn't get diabetes because it like and meanwhile I know people have died ladies were incompetent. So I understand I understand the message. I even understand the intent of the message. That one, that one was hard for me, but it was difficult. I think it shut my brain off. Because the only thing I could think to say was like, you know me fairly well, like, I would have just eviscerated them if I open my mouth. So I just I like just big eyes and nodding.

Erika Forsyth, MFT, LMFT 50:24
Yeah, and I think most often people are so taken aback. And usually this is in the early stages of post diagnosis. So you yourself are still grieving, you're trying to figure out what does this mean? What, what is type one, what is type two, you're trying to figure this out. So oftentimes, people are deer in headlights, and they they freeze. It's like, I can't believe you just said that. And I don't know how to respond quite yet. Yeah. And so maybe the best response is to just what you just did not with your eyes wide open.

Scott Benner 50:53
I mean, yeah, like I was. Yes, I was like, I could, I could have strangled somebody for saying that to me. Like, because that's the like, you can, you can mean, whatever you mean, from my perspective, I am a competent person, therefore, your God gave my kid diabetes. Like I was like, all right. I mean, that doesn't make like, can you not step out of a thought and break that down for a second go? Well, that's not at all comforting to somebody, you know, but I understand the idea. The idea is, well, if it was gonna happen to somebody, at least x, y, z, which, by the way, that may have been okay, like, I probably would have, I don't know, in the very beginning, I don't know how well I would have received it. But if you said that to me now, like, just recently, someone online, and I've referenced this once already, so I don't want to go too deeply into it. But they were just kind of like posing, it was like a thought exercise. If if we put Scott in a situation where he could like, accept or decline Ardens diabetes, but he knew but you know, but he knew that, like, all these people were being helped by the podcast, what would he do? I was like, well, unequivocally, I would say no, thank you to the diabetes if you gave me the option. But I was able to have that conversation. But if I wasn't me, like, can you imagine saying that to someone else? Like, it just it's a weird thing to say? I don't know. I don't get it. So

Erika Forsyth, MFT, LMFT 52:21
I think yes, people are often they're trying to be empathetic, they're trying to maybe in that moment, give you that compliment. But oftentimes, they're unskilled and how to express empathy that's appropriate. And it's hard to give people the benefit of the doubt when you're in the space of still grieving and trying to get your feet on the ground. Oftentimes, a lot of my claims will say, when they're trying to give the other person the benefit of the doubt of like, how much did I know about type one, or that there were two different types before my diagnosis? Really? Nothing? Maybe usually, you know, most people do not know anything about the difference, or that there is a difference. But then there's still that feeling of but this isn't helpful. This, this empathy, or this compliment that you're trying to give me is not helpful. So then, going back to Yeah, how do I want to respond? By checking in with that emotion? Is it your own narrative? That they're, that it is your fault? Are you feeling guilty about that? Is it touching on something that you were kind of wrestling with internally that you might, that might be and so yeah, sorry,

Scott Benner 53:28
I'll pause No, not at all. I, I just, I wish there was a way to say to the people who are eventually going to be in that situation where they're going to be struck, and for whatever reason, say a thing to tell them like, at the very least, if you can't, if you can't just get better at talking, then ask questions, instead of making leading statements like that's very, that would be a very helpful way around it. Because then at least the person hearing you would say, Oh, they don't know. So you're missing by the way, why would you know, how many diseases are there in the world and conditions? Um, I don't know anything about any of them. I know a lot about this, and very little about anything else. And I don't know why I expect my neighbor that I bumped into at the grocery store to understand diabetes. So he's just it sounds like it would have sounded to you a week before it happened to you, you know, so it's confusing. I think they're, I think they're scared. They don't want it to happen to their kid or themselves. And the unknown is frightening to people. And I think that I think that blaming the other person makes it feel that's my that is my real take. It makes it feel less likely. It's gonna happen to you if you can say, it's the comparison thing that Come on, everyone does it. You want they walk around constantly and like if you if you're uncomfortable about your weight, you find a person who you're like, Oh, well, I'm better off than they are. Or you're the amount of money you have, like, oh, I might not have any money but that guy, the fenders fallen off his car fenders are on my car. I'm doing okay. Like I just think that's I think people's brains rank things to protect themselves, but Anyway, so yes. So if I want to get if I'm really angry, and I want to get out of it, I don't know like to me, to me, I just, I just go with, like smile and wave, like, yeah, thanks. And just get the hell out of there. Because I mean, what are you going to do? You can't you also can't put yourself in the position of educating the entire world, because they're not going to remember they're not going to understand they don't really care, you know, so.

Erika Forsyth, MFT, LMFT 55:32
So you've received the comment, you're feeling the rage, anger? What what is the most effective way to respond? I think, what you could have one statement to say, you know, what, actually, I used to think that way, too. If you did, you know, I totally thought that way too. But actually, it's really different from that assumption, I, and I'd love for you to go check out and you could list any website, you know, Google Wikipedia,

Scott Benner 56:00
that haven't even have an answer in your pocket already

Erika Forsyth, MFT, LMFT 56:03
have an answer in your pocket. I know. Some people like the the etiquette cards from the behavioral diabetes Institute, you can print off a PDF of those, and they actually carry them in their bags. And we'll say, You know what, that's I used to think that way. It's totally actually incorrect. As it turns out in here, check this out. And so have I think, particularly when you're in that really raw grief stage, to have a statement memorized to say back is really helpful. So that you're not having to make that decision in the moment of like, I want to burst out in tears, I want to punch the person. I'm just gonna say this. You know what, that's actually really incorrect. Here you go, go check out this website. Great

Scott Benner 56:45
idea. And it stops you from looking crazy, which, you know, the worst thing is after this, after this interaction, where you, you didn't start it, someone else starts it with you. And then when you walk away, that person is walking away thinking, Oh, you poor thing. And you're back. They're like, you know, pulling your hair out, because they didn't understand and then you tried to hit it happens in the beginning, when you start to explain diabetes to somebody in the beginning. I don't really know this from a parenting side. You sound out of your mind. Like you really do to other people. Like if I get too low, this might happen. If I get too high, this might happen. I just long term complications, and there's needles and insulin and like you just you start rattling stuff off. And you sound unhinged. I've sounded unhinged in the past. Like when I was first diagnosed?

Erika Forsyth, MFT, LMFT 57:31
Yes, yes. But you're because you do feel this kind of gut need to want to educate everybody, because you've learned so much. And you realize, Wow, I did not realize that there was this difference, and I'm staying on that topic. But so you want to then share the information and let other people know. But then that's exhausting. And it's not as you said, it's not your responsibility to have to do that. But then allow yourself whatever that feeling is coming up in the moment to allow yourself to feel that it might not be appropriate, right? Then

Scott Benner 58:03
take take this one step further, then we'll we'll say goodbye. What happens when you get misinformation from a physician? What do you do then? Like how do you like me? Because it's now it's not a one on one. It's not you know, a person you work with or person, you know, but it's somebody who extensively has like a position of power over you. They're saying something incorrect, or doing that thing where people come in, this happens a lot. People, they struggle, they figure something out, they get together super proud, they head to their doctor's office, look what I did, I got my agency to drop a half a point, I'm super, like, stable and everything. And the doctor just immediately says to them, well, you must be low too much. And they're like, No, I fit and they won't even some people won't even hear of it. They'll try to tell you to like I've heard of people's having their pumps taken from them. After finally achieving success, the doctor is trying to turn their insulin down to make their blood sugar's higher. So wow, I don't know, how do you like that was painful.

Erika Forsyth, MFT, LMFT 59:00
I think? Well, as we have all learned, we've become really good at advocating for ourselves and our needs. And in the beginning, that's a new for some, you know, it's a new skill set, right to know what you need and be able to advocate for it. And you can do it in a respectful way of, you know, all due respect Dr. So and So, but this is my body and this is my child's body. And we found great success with this. Thank you very much for your time and your and your suggestion.

Scott Benner 59:35
I've seen a lot of people send me notes. They're like, Oh, the doctor took the palm made changes. We walked out of the room. I didn't even get out the lobby put everything back. And yes, we got going. So yes, it's a weird, weird position that you don't expect to be in but it very well could happen. So well. Thank you. And

Erika Forsyth, MFT, LMFT 59:54
but one more. One more comment of just encouragement. I think it does. comments about not only why did you get diagnosed, but how you should operate as a person with diabetes, those comments do continue right throughout your life. And they do. Either your skin gets thicker or you have all of your statements already memorized in your back pocket. And then you and it's easier to just choose to say, Oh, actually, that's totally false. But it's okay, we can still we're still good, you know, and it doesn't hit you as hard. You know, over time that does that does happen. So I just wanted to give that piece of encouragement, but in the beginning, it can feel like you're just getting barraged with those painful comments.

Scott Benner 1:00:40
Right. Okay. Thank you very much.

We're gonna thank Jenny, we're gonna thank Erica, we're gonna say that Jenny works at integrated diabetes.com You can hire if you want to. You can thank Erica. And you can thank and you can hire Erica, if you live in a couple of states, you can do the virtual with her. Erica forsyth.com Go hit her link up and see if it fits for you. If it doesn't betterhelp.com forward slash juicebox save 10% On your first month of therapy with my link. And of course, Omni pod sponsoring this episode. Thank you Omni pod Omni pod.com forward slash juice box go get the Omni pod five. And Dexcom is here to dexcom.com forward slash juice box to do G seven. Where that G six right at your fingertips at my link dexcom.com forward slash juicebox. Thank you so much for listening. I'll be back again soon with another episode of The Juicebox Podcast. If you can think of more diabetes misnomers and you want to share them, share them with me. On my Facebook group Juicebox Podcast type one diabetes. It's a private group with over 40,000 members. You can be part of it. Find it log on, make a post and say Hey, Scott, I forgot about this one. Maybe one day your example will be on the podcast.

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