Scott Benner 9/8/23 Scott Benner 9/8/23

#994 How We're Taught

Tziporah has type 1 diabetes and is here to talk about how we learn.

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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 994 of the Juicebox Podcast.

Today's guest is a returning podcast guest who is going to help me talk about the way people learn the way our brains take in information and the way it's taught to us by the people who are doing the teaching. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. If you're looking for a Dexcom on the pod, if you want to try us med a contour meter, learn more about touched by type one.org. Maybe in fact, you want to get better help, or save 40% off your order at cozier calm. If you need any of those things, or you just want to drink some ag one, please use my links there in the show notes of your podcast player, and at juicebox podcast.com. And these are the companies who sponsor the show, day in and day out year after year. If you want any of these things, or even interested in learning more, using my link is really helpful. I appreciate your consideration.

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 scheduled 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 juice box that's better help h e l p.com. Forward slash juicebox save 10% On your first month of therapy. All right, we're recording. And I think that even though I've spoken with you twice on the podcast, it would be smart of me to ask you to say your first name for me.

Tziporah 3:02
Sure. My first name is Sephora. Alright, um, already

Scott Benner 3:05
don't worry. You and I are going to talk set 1015 More times my life. And I'm and one day I won't go. Like it's T and then z. And what's the sound of that makes?

Tziporah 3:17
Uh huh. It's like the like the sound of hot oil hitting a pan,

Scott Benner 3:23
Zara Sephora, but then the piece there too. And the I need all the letters.

Tziporah 3:29
Yeah, I mean, it's it's phonetic, if you know how to make the first sound and then the rest of it just sort of unfolds

Scott Benner 3:35
support. Yeah, perfect. Well, I got it. It's like Sephora, but with a T and a Z. I'm on it. Right. Yeah. Alright. So you are, by the way, you've now been on the show once recorded another episode that people haven't heard yet. And you're back because I'm going to embarrass you a little bit. Great. You are a low key one of the smartest people I've ever talked to on the podcast. And I mean, low key because you don't you don't throw it at me. You don't throw it at people when you're talking. But I feel I feel like you're a muscle car that's cruising down the street at like 40 miles an hour. Does that make sense?

Tziporah 4:12
I mean, that is a visual I've never had about myself, but thank you. Well, now it

Scott Benner 4:16
is. So I'm just very interested in picking through something that I don't want people to turn off when they hear us. Like when they hear me say this, don't be like what is this? Nevermind, but just listen for a minute. It's called Bloom's Taxonomy. Is that right? Yeah. Okay. And why are you a good person to speak to about this?

Tziporah 4:39
Well, Bloom's Taxonomy is a way of thinking about learning. And so anybody who's in an education field, whether it's like primary school, education, college, and other kinds, I think has had some exposure to this. But it gives us a framework to think about how people take in new information and use it,

Scott Benner 4:57
okay. And when, when I intersected it I don't know when, for the first time, I thought kind of I kind of flipped backwards in my head, I said, Oh, this is how people are being taught. So like, whereas you would think of it from like a teaching perspective of, oh, we're gonna we'll put these six steps into place. And we'll use these words to try to get people to remember, understand, apply these things, right? What I saw was not manipulated. Don't if that comes out if this comes out this way. I don't mean it that like that. But but this is how people are approached, when they're taught something, they don't realize it's happening, very likely. But they are being approached by educators this way. Does that make sense? Yes. Okay. And I figure if this is a thing, that Blum came up with this in the 40s, I think, and early 50s, okay, and it's been manipulated a tiny bit, I think things have been reordered once, and they changed some wording on some things. But the idea has been around for 75 years, is what I'm gonna say. And it's a pretty good way of teaching people things, it's the way that people learn, kind of mirrored back at them. And anyway, when I, I don't know how I saw it the first time because I am not an educated person. I think we all know better for listening to the podcast. And when I intersected the idea, I thought, Oh, I did this with the protests, and the beginning stuff, and I didn't realize it. And so I thought, I think maybe there's a way here to let people in on it. The people listening to the podcast, you know, so that maybe they can, I don't know, if they understand why it's being taught to them this way, or presented to them this way. Maybe that would help them pick it up better, I guess, was my thinking. How do you use it professionally?

Tziporah 6:50
Well, I'm gonna get out front and say especially because I know there was already some discussion in the private Facebook group about this. There is sort of a counterculture about Bloom's Taxonomy, that it's antiquated that it leaves out some important domains. But I think many of us who are teachers look at it as a way to demonstrate the different domains of learning and understanding and that we probably need to use all of them. I think, probably the biggest criticism, and maybe we'll talk about this is that learning isn't necessarily all in a straight line, and in a certain order. So Bloom's Taxonomy makes it look like these things have to happen in a certain sequence, you have to get a bunch of information and be able to recall it in order to then demonstrate understanding or explain ideas. Whereas I think a lot of us in the real world, sort of enter learning and a lot of different places in this little pyramid that you're probably looking at. And we need all of them. So I just wanted to say that first. Okay.

Scott Benner 7:52
Yeah. And by the way, I'm not here like, ringing some bell. And I was like, you know, whatever Bloom's Taxonomy is, they're not paying me. I just, I just thought it was interesting that it never occurred to me, that there was a way I was being taught that it doesn't mean that I would learn that way. As a matter of fact, I was a terrible student. So maybe this isn't how my brain works at all. And, but I still think the ideas are here, right? Like, if you if you apply them to diabetes, so I guess yes. I mean, how long have you had type one? I've had type one for 42 years as a long time ago. A long time. Yeah, I just interviewed somebody else a 50 years. And it was very interesting to hear his process. But anyway, that's neither here nor there. When you were diagnosed, the world that diabetes was is not any longer. Correct, right. And so there's a moment when you say, I'm going to try this more modern way. And I think what happens is, you have some of this already, right? Like, you've been analyzing things, your whole life with diabetes, you know, you had to remember a ton of stuff that you didn't know before you got type one. Now, you know, after you use it for after you've seen it, and you over and over again, it's happening to you, you begin to understand it, then all of a sudden, you can kind of flip that understanding around and apply it, make some analysts, you know, analyze things, say, Oh, I did this, and then this happened. Maybe next time, I'll change it. I think that's, but you had to teach that to yourself. And yes, and as much as I want to think that people with type one are being taught these things, I don't think they are. So I mean, by some doctors, there's some terrific doctors out there don't get me wrong, but far and away I meet too many people who are told not told anything or you know, given kind of very limited things, tools to start with. So can you go over the it's a pyramid, right, but it's set up in six steps. Can you go over them for me? Absolutely.

Tziporah 9:58
So at the base of the pyramid is the domain, these are all sort of cognitive elements the way we think about things. So that first biggest layer is remembering and recall. So this is pretty basic, like, what is diabetes? What is insulin, it is sort of more like, what you'd be expected to regurgitate on a test that just demonstrates like you've got the idea, but that you just have to recall it or spit it back out, you just have to remember it, define it, maybe.

Scott Benner 10:30
Okay, so that that's the first concept of Bloom's, which is you need, you need to recall facts and basic concepts, be able to define them, you know, I guess there's more to it than that, right? Memorize it, define it, repeat it stated, I have it written down here, I should be looking at it. Okay, so now, once you're comfortable that that's it as a teacher, you move to understand,

Tziporah 10:52
correct or comprehension. So in this way, we might ask people to demonstrate, you know, their understanding of something by saying, Well, how would a low blood sugar lead to the symptoms? Or how would a high blood sugar cause complications? How would I interpret, you know, what my Dexcom is telling me? And, you know, figure out what to do based on what it's what it's saying.

Scott Benner 11:18
So not only am I remembering it, and can I define it, which is very kind of cold and clinical definition, but I can describe it, discuss it. And you can see, as the as the teacher, maybe the doctor, you can see that I have a grasp of it. Yes. And I'm putting it back into my own words and giving him giving it context from the way I understand it.

Tziporah 11:40
Yes, I'm gonna, like insert a thought bubble here to like, I know, I've talked in other podcast recordings about just sort of the relationship between patients and healthcare providers, and how our visits are not always set up to really give us room to say back what we understand or to demonstrate our capability to apply something. I don't think that's the fault of the person sitting in the chair in front of the computer. But, you know, so much of our visit time is spent receiving information as opposed to demonstrating understanding. So it is a cue for me that different kinds of visits with different kinds of people will give us sort of more or better room to do these steps

Scott Benner 12:20
and wonder if you even need to be with a person to demonstrate the understanding. Couldn't it be an online quiz? Yeah, right. Yeah. Okay. So silly putting this into real, again, to real diabetes terms and people's experiences. You're diagnosed, they throw a bunch of words at you. Yeah, this is insulin. These are your syringes. We're going to Bolus we're going to basil, we're going to do this. You know, like, it's all overwhelming. You don't? Yeah, I don't think you really recall any of it. I've described it on the podcast is as it's like, someone walks up to you with a big garden shovel wax in the side of the head and starts asking you math questions. Yeah. And you're like, I don't know what two plus four is like, please, please don't. But then we come back to that next event that next doctor's visit. That is what they're doing, isn't it? This is what's happening. It's just not working? Because they do they start to quiz you a little bit. And they try to get you to recall some things to talk to them. That is what's happening. But the problem is what they send you home, they're not there. There's no one to ask. There's nothing to refer to. And you don't know if what you're doing is right or not. So how do you know if you understand it?

Tziporah 13:36
You mean, aside from listening to the podcast? This is not a

Scott Benner 13:39
Yeah, of course. I mean, listen, we're not here to tell people. I'm a super genius. I'm gonna write. I'm a regular genius. But it's but but no, but the idea of that for most people, they don't have that. They also don't know, this is what's happening to them. And I think that's kind of the bigger problem is that you're still frazzled? Because Because what this chart doesn't take into account when you're talking about illness, is you're not just sitting in a room, like just hearing some facts and going, Oh, I'll remember that. 1492 he sailed the ocean blue, I'll write that down. You know, like, you're not you're not just doing that. You're, you're going through a personal crisis. And yeah, and it could be that your health is in question. It could be that your loved ones health isn't question. That's right. Yeah. It's not some simple thing. That's where it falls short.

Tziporah 14:31
Well, and I think, too, that's why you know, this, we're focusing really on sort of brain stuff as it relates to thinking and information but all of the things that you just described that complicate all of that is all in the feeling domain. It's all in the affective domain that a lot of educators don't integrate like Bloom's Taxonomy originally included that domain, did it? Yeah. Okay. So like our opinions, our fears, our worries, you know, those things influence the way we take in and use information all the time. When I read posts in the Facebook group or I listen to the podcast, so much of people's stories is shaped by all of that. It's not just about the rote memorization, or can I develop a sick day plan, but it's really like, holy crap, I just got hit in the head with a shovel. And now I don't know what to do. Or even if I could figure out what to do, I'm pretty frozen in feeling overwhelmed and terrified right now. And so I think, you know, one of the main criticisms of Bloom's Taxonomy includes that, it it sort of looks at every learner as the same kind of person and doesn't give as much regard for what are all those influences that make us more or less able to take in that information? And to use it in a helpful way?

Scott Benner 15:46
It removes the humanity from it. Yeah, yeah. But if you, but I'm trying to, in Devil's Advocate, if you apply the humanity to it, and you might take the learning out of it, because we might all get stuck on how we feel and never get to the understand, apply, analyze, etc. So that's where the doctors are falling short, then in my estimation, so you know, we blurt the facts out at you, and then we bring you back to see if you understand them, but in between there, that you should be directed to anything therapy, online support, go just blabbered as somebody like, Tom talk, and get out how you feel, and then find some level of comfort or pathway in return. Yeah,

Tziporah 16:31
I mean, I think what's even more challenging, maybe the way I see it is that all of these things are happening in real time. And all of the needs need to be met in the same moment. So you know, many healthcare providers do a nice job of talking about this is really overwhelming, you know, we're here to support you, or they schedule close visits. I mean, I do think people are increasingly aware of that feeling component. And it's one snapshot in time that they get to sit with us and all those other 15 minute segments or hour long segments in our lives between visits feels like forever.

Scott Benner 17:04
Yeah. And the doctors are unaware of what happened to you, they can only assume they must start doing that thing where they apply what's happening to most people to you. True, yeah. And then it gets away from them there. So this whole, so that so the reason I'm doing this with you now is that Jenny and I are busy in the background, putting together a series for physicians. And it'll kind of take this perspective of like, you know, how to, how could doctors be helping people more better, but at the same time, if you're a patient listening to it will put you in the mindset of this is what I should be expecting, like, this is the you know, this is the path someone's leading me on even though I can't see it ahead of me. And just to know that this is their expectations, and what they're trying to accomplish, for me, I think would be a bigger deal.

Tziporah 17:55
I don't know for sure. Yeah. I

Scott Benner 17:57
don't know that it wouldn't be prudent just to say to somebody, Hey, these are the steps we're going to try to take. So that you know, like, we're not going to take them all today. But this is the path we're going on. Because that's right. Yeah, I think that helps. Okay. So

Tziporah 18:12
I mean, even I was just saying, when when I think back to even my diagnosis, you know, which we we've already established within like the dinosaur ages. I think I had like a week long admission in the hospital. Really where my family? I mean, it was the 80s Yeah, and I was a sick kid. So they brought in my family, they did all the teaching, they included all these family members, I had this, you know, the benefit of so much more time than I think a lot of families have now their families on the, on the webpage or on the Facebook group who bypass and admission altogether. Yeah. And so when I think about how all of this has evolved in the last number of decades, not just with the technology, but also with how much time is spent up front to do all of the teaching and assessment and guidance and support. I do think it's really different now than it used to be.

Scott Benner 19:04
Well, you know what, it's gonna morph again, because COVID is going to COVID is going to teach the doctors that a lot of people didn't even come into the hospital, and they were still okay, so it's gonna push it more towards virtual and which, by the way, I don't think, I don't know, I can make an argument either way, Arden saw doctor for a couple of years for diabetes through virtual because of COVID. And it didn't change her care at all. And at the same time, we weren't looking for information.

Tziporah 19:30
Sure, you know, you had enough of what you needed to do some of the other levels.

Scott Benner 19:36
Right. Right. Yeah, it's so where does this fall apart? Is it in the quality to tell people what you do for a living? I'm sorry.

Tziporah 19:45
I teach and train medical providers, health care providers of all kinds, but I'm a family therapist by training. Okay.

Scott Benner 19:52
So is where we're falling apart. Is it the the experience or the quality of the person doing the teaching does that hurt? Like, because we're always training new people? You don't I mean, like, like, the person you see in? I don't I don't know what the numbers are, I'm guessing but a nurse you see in an emergency room, for example, I would think an emergency room nurse has a fairly short lifespan. I bet you that's a really crazy job. And I bet you people don't keep it for the most part for 30 years. So you're probably seeing a lot of new people or people like cycling through. And then in your endos office. Yes. You know, like, listen, Arden goes went to, you know, a quality Children's Hospital for her endocrinology care from two years old to 18 years old. And I can still count on 123, Arden's had five nurse practitioners, five, the end the same doctor, for she had the same, the same doctor for the first, maybe, I don't know, till she was maybe 15. So, you know, the first 1112 1314 years, I don't know that she saw that doctor five times in that time. So my point is, is that if five nurses, nurse practitioners, or CDs or whatever the hell they're calling them now, CDC s, I'm not sure. If that many people cycled through, then that means that those people were coming in knew they were green every time and I could tell they were, you know, so now you're starting over again, every time it's not like you're getting this increased understanding with this whiz and person who's been with you for 15 years. You know,

Tziporah 21:40
I mean, even as you're describing that phenomenon, it occurs to me that we are focused on the person disseminating information, as opposed to the other side of the equation, which is the patient and family on the other side. In my ideal world, there would be some easy way for that person's knowledge capability, you know, evaluative skills to be able to follow them from practitioner to practitioner so that it's not really starting all over depending on the skill and capability and experience of the practitioner. So if I get a new NP, you know, in my ideal world, there will be a way to say, okay, support has already mastered these things. This is sort of where she's focused. Now, she runs into trouble here, and that that person could pick up the ball and run with it. I think we don't really have as much of that in our healthcare system in general, we probably don't have it in education either. But those sorts of ways of putting the patient and family at the center and following the next steps based on what they need, I think is probably where some of it falls down.

Scott Benner 22:40
How do you imagine that working?

Tziporah 22:43
I mean, I, I am naive, for sure. And maybe fantastical. But like, if there was some way even in our health records to be able to have a, not a report card, but a file that says, I have observed this person to be able to do X, Y, and Z, or this is what we have talked about. And here's how it's worked. I mean, some way for the story to sort of be recorded in a way that gives guidance to the next steps, the way that a lot of healthcare people document their notes. You know, they document for lots of different reasons, it doesn't always serve as an effective handoff of this kind of thing. It doesn't always give us good feedback about what is this person's cutting edge in terms of their diabetes learning. And it makes it difficult, I think, for the next educator who picks up that case, to start where the patient is, in the alternative, the next person that picks up that kid, or that grown up, might open the visit by saying, let's just take a look at whether you want to use this taxonomy or something else. Let's take a look at where you think you are, and where you've already been in your diabetes care. And let's focus on what you need next. Right? I mean, that would be revolutionary. They almost

Scott Benner 23:58
like a black belt system that that you don't I mean, like what belt? Are you?

Tziporah 24:02
You are a yellow belt with one stripe? Yeah. Now, I mean, right? Right.

Scott Benner 24:06
And then that way, when, when you got to the new doctor, or the new practitioner came in, started working in your office, they could look at immediately and say, Oh, this is, uh, I understand about their level of proficiency.

Tziporah 24:20
What I think is tricky about it is, you know, something you you alluded to earlier in the discussion. You know, when I got diagnosed, I was on a regimen that looks zero, like what my current regimen looks like. And so with every new technological advance and pharmacological advance, there is something that happens to my expertise and proficiency. Like, it's not that I D skill, but it's like, Oh, I gotta make room for a new way of thinking, to learn about algorithm pumping, made me feel real stupid for a long time because I had been used to my sort of, you know, whatever the five and a quarter and floppy disk way of management, right? And so suddenly I'm like, Whoa, I feel very disoriented. I feel novice again. But now that I've got that I feel much more in control and can do other kinds of skills and applications that I didn't used to be able to do. So the dynamic fluid nature, I think of all the advances is great, and also probably makes us feel dumb lots of the time, right?

Scott Benner 25:26
I wonder what stops that because children don't feel dumb around technology. Right? And it's because they're immersed with it. Although it is interesting that the, the more stupid proof computers and phones get, the less people understand how to actually use them, or how they operate under the surface. I heard Arjun say to me the other day she was, I don't understand things that use Wi Fi. I was like, Okay, that's interesting. She's a bright kid. And, and I, I don't know if I've ever said this on here. I don't I have two children. And they're 23 and 19, at this point. And my son's really like a bright kid and math based in his mind, and great thinker. Art is a pretty deep thinker. And I don't think under penalty of death, either of them could explain what Wi Fi is to. So if we're in that situation, where, yes, I'm more comfortable being a user, but I am not an operator, if that makes, if that makes sense. How do we help people with their diabetes to continue to grow with technology, but give them enough of an understanding of it? That if they had to fix it on their own, or ask the right questions to get to a fix that they could, and that might that might end up being a hurdle? That's something actually Jenny and I've talked about privately that she's concerned about?

Tziporah 26:50
Well, yeah, I mean, I think if somebody doesn't already have number one, like some basic skills and problem solving, and I'm not trying to like combat anybody, but lots of us never got good training and how to systematically solve problems. So if we don't have that, and if we don't understand the components of the bigger, the bigger thing, the bigger concept, the the way a pump works, the way Basal insulin works, the way Bolus is work, then we're not going to be able to do that analysis to be able to kick into gear when something goes in an unexpected way. So is

Scott Benner 27:23
it possible that the thing I've set up with the podcast really is what's necessary, which is you get enough, you get the facts. And then you get to listen, until you understand then you go into your own life and apply it. And then you look back and see what you did you analyze it? And then I don't really see you anymore. Like I probably so we didn't go through this whole thing, right? But it's remember, understand, apply, analyze, evaluate and create. Okay, so let's do the rest of them. So apply, give me apply.

Tziporah 27:57
Okay. So apply is where you would, for example, be able to say, I need to exercise I need to manage my activity level, I need to, you know, add a routine that I don't currently have, I will be able to create a plan that demonstrates an understanding of how it's going to affect my blood sugar, and then adjust my Basal rates accordingly.

Scott Benner 28:24
Okay, and then the next step, analyze, draw connections among ideas. What does that what does that mean?

Tziporah 28:30
So this is I actually think you push a lot of this, which might encourage, for example, somebody to identify patterns. So you would encourage people to be good scientists, and to take note, whether it's for a particular food or looking at Basal testing, to give them the sort of lens is to say, I've noticed this pattern. And because of that, I want to make this adjustment.

Scott Benner 28:54
You again, you're, you're easily 40, like, 40, IQ points smarter than I am. And I appreciate you treating me like a regular person. But do you see it online? Right. When people ask a question, I don't respond with the answer. I ask another question to get them to think about it. Yeah, that's what I'm trying to accomplish there. Like

Tziporah 29:14
what I think is hard about that, I do see that. And what I think is hard about the Facebook group in general is that people are coming to that place in all kinds of sort of stages of readiness and capability to do the next thing. And so if I want to, like stoke somebody's ability to think it through themselves, I'm going to do what you did, which is say, Okay, well, what would you do next? Or what data would you want to look at in order to make this decision? But some people in the moment for all kinds of reasons just need the answer. And it's very hard to gauge in an online community, it's much easier to sort of navigate in a one on one or live

Scott Benner 29:51
Yeah, what it requires online is for the person the question asker to respond again, Yeah, and be honest, like, Hey, I don't have time for that the house is on fire, you know, like, and then I'll go okay, well, I would look at this, this and this. Yes. But I can also tell when they're interested in the back and forth. And also there are some people, and I don't know how it breaks out if it's stress in their life, you know, it, room they've got left in their brain at the end of the day or whatnot. But some people want it, they just want you to tell them, they don't care, right? They, they like that the phone works. I don't care what the Wi Fi is. There are some people who want to understand. And there are some people who are taxed in a way where they'd like to understand, but they just kind of can't. Yep, yeah, that's right. It makes me wonder as whether no matter what it is healthcare, teaching a four year old, middle something, whatever you're trying to do, I wonder how much of it at the end, like evaluate, create, almost the last half of it is not as much about being taught as it is about, like, learning on your own, like being off on your own. Like, I wonder how much of this humanity thing is, we put all the ingredients in for the soup? And we're going to turn the water up, and we'll shut it off, and we just have to trust it's going to work out? Yeah, yeah.

Tziporah 31:09
I mean, so much of living with it is all of those other things, particularly at the levels of analysis and evaluation, but probably also application too. So you can have all the right inputs. But given the sort of dynamic nature of, you know, every day, plus or minus hormones plus or minus illness plus or minus stress plus or minus other health conditions, we have to be sort of nimble on our feet at those other levels, to be able to navigate it. And then if it doesn't go, Well, you know, the skill to be able to say, Okay, I had a sick day. That was a dumpster fire, why did it end up that way, requires a certain level of like, I know, to look back and to analyze it so that I can learn for the next time. And I don't know, if you know, in healthcare encounters that we have, I don't know how often that's sort of a regular feature. But if you were to ask anybody on the Facebook group, or anybody who's been on the podcast, how much of diabetes living has gone exactly the way you expected? I'm sure everybody would be like, zero. Yeah. So these other skills, I think, are really vital. But like, if you don't have that foundational knowledge, you're you can't do it.

Scott Benner 32:19
Wonder where in this process, remember, understand, apply, analyze, evaluate, create aware in that process, whether you're a physician helping somebody with type one diabetes, or you know, you're you've tried to teach somebody to build a structure to keep themselves safe and warm. When do you recognize they're not going to get this? But that doesn't mean they don't deserve to be safe and warm, or have a good blood sugar. Like when do you jump in and say, Okay, this, we've reached your ceiling? And, and maybe we can get you farther in time. And I still believe that that's true. But we don't want to waste health minutes right now. Is it? Is it watching them not be able to analyze? and evaluate is that about where you go? Oh, they're not getting it?

Tziporah 33:08
This is a really delicate question. I think, because there's lots of reasons why we might dismiss or have bias against somebody, we might assume that they can do something, but they really can't, or we might assume that they can't, which is dangerous, too. And so what I would love to see more of is some routine way. And I'm not subscribing to any particular method for health care, people, educators, providers, to be able to like assess with a patient and their family, like, how do you learn best? Will you let me know when you've had too much? Can you let me know when you need help? Like, there are certain things that I think will cue me to better care for you if I know those things upfront. But so much of healthcare in this country is like, this is what we have to offer. And you are one of however many patients I see. And this is how we're going to do it. So I think if we can move toward more personalization of the way we do the care, not necessarily the science or the algorithms or the evidence based protocols. But more like for every person who sits in front of me, let me stack a couple of minutes up front to do that assessment with you. And those are important minutes to invest. It's a hard sell sometimes to very busy people with busy clinics. I know that, but I think it would help us do better.

Scott Benner 34:27
I have to tell you, the more I talk about this and think about it, the more I come to the conclusion that you can get to more personalization by grouping people together.

Tziporah 34:35
Oh, yeah, there's actually quite a bit out there about the benefits of group medical visits. And there are some clinicians who say, this is the way to do it. You do it in community, you do the knowledge dissemination, first, you get all of that out front to a group of 10 or 12 or 15 people and then you can spend the rest of the time on analysis and having them support each other and how they do it. I mean, there's a lot of wisdom to that.

Scott Benner 34:59
I've CNET works so many times. So I'll go speak to a group of people. I don't know who they are, I don't speak to them first, right? I don't know their stories. Sometimes no kidding. 234 500 people in a room. And I'll give them kind of a primer for my thinking about diabetes. In the first hour in a second hour, I'll give them some more kind of drill down on some specific topics. And then I hang around in the afternoon, and I'll just stand up on a stage and like, go ahead, ask questions like, you know, then that's it. And so they see me maybe for three hours in a day, and over the next. It's not the first two months, but over the next like, third, fourth, fifth, sixth month, the amount of like emails for people that are just like, Oh, my God, I just want to say how great everything's going and appreciated seeing you there. And like, you know, thanks for making me think about a different way. There's no follow up. I never see them again, but you've, you've launched them in the right direction. Yeah. And then you kind of trust that the SERPs going to come together. And, and you can't, you know, I know you can't save everybody. That should be your goal. But you're not going to like, sometimes you just won't intersect people at the right moment in their life. But, but I still think that's the best way to get the most people to the finish line.

Tziporah 36:15
I do think that's, it's some of the impact of the podcast, frankly, yeah, you know, the scale of it is reaching a ton of people. And then you're hearing from people to say, hey, this really influenced the way I think about it, or I didn't know this before. And that's been a game changer. You're demonstrating it in the way that you're doing it.

Scott Benner 36:32
I also tried really hard to, like, I don't, I don't need your reviews. You don't I mean, like, I don't need you to come to me, every little thing you think I don't do right or wrong. I use people's feedback. But I do use people's feedback significantly. So but I use it to see where I'm headed. They're almost like my, like a map, like a celestial map. I'm like, okay, like, I sent out all the stars in the world, and I'm seeing where they're going. And I'm like, Okay, this did what I thought it would do, or this didn't work. And I'll like, drop it. I've started things before and been like, that did not go the way I thought like, boom, go get rid of it. And you know, and but when you start seeing people heading again, where you meant for them to go and where they wanted to go. You have to at some point, say to yourself, that works, do more of that. But you also have to be able to say that didn't work, stop, or I'm the wrong messenger, or whatever, you know, because listen, there's, I'm sure there are plenty of people saying things similar to me. But they're not gaining traction, and attract by traction. I mean, like, it's so I don't mean it like this. But it's a measurement, right? Like you have to like if something's working people tell their people about it. So if you've been making a podcast or a web series, or have been recording one minute videos on Instagram for six years, and nobody's it's not growing? Well, then it doesn't. It might not mean it's the information, it could be anything, you have no idea. It could be the color of the wall behind you. People might not like the nasally tone in your voice if there's no way to know, but it's not working. And you. And if you really want to help people, then you have to reassess and say, Okay, I've got good information here. I'm not getting it to them for some reason, and doctors have to do that same thing. Like if you don't I mean,

Tziporah 38:18
yeah, no, absolutely. I think there's a question behind that observation too, which is

Scott Benner 38:27
Hey, guys, just jumping in to remind you that one of our sponsors better help is offering 10% off your first month of therapy, when you use my link, better help.com forward slash juicebox. That's better. H e l p.com. Forward slash juicebox. BetterHelp is the world's largest therapy service. It is 100% online boasts over 25,000 licensed and experienced therapists. And you can talk to them however you want text chat phone or on video, you can actually message your therapist at any time and schedule live sessions when it's convenient for you. Better help.com forward slash juicebox save 10% On your first month.

Tziporah 39:10
Question behind that observation too, which is, you know, people who are operating at like a really high level are also going to say what about that didn't work? What about that did work. So I'm going to do more of the thing that did work until it doesn't work. And then I'm going to think about why it didn't work here. And so whether that's at the patient level, like we have to do that all the time, but their level two. So why is it that when I do this visit in this way for a newly diagnosed family? Why did it go south with that kind of patient? You know, that level of analysis and curiosity I think helps them be more in line with that personalized approach that I was talking about. But I think they have to know to ask the question, as opposed to saying I'm doing what I always do in the fact that it didn't work. I don't know why

Scott Benner 40:00
Hmm, you also have to be willing as the patient, you really need to be willing to say what's happening, and not absolutely not like keep secrets, or be a person be embarrassed or anything like that. And that's, I mean, again, over and over again, for years now, I've talked to people who have grown up with diabetes, and they get older, and they'll start telling you about, like, you know, my health is not where I want it to be. And I look back and, you know, I was I make up numbers in a logbook every, every time going to the doctor's office. And, to me, that should have been an indication to the doctors, like, if you're a doctor, and it's 1985, and you pick up a logbook, and you think, all these are written in the same bank. Right, this was, this was just

Tziporah 40:43
you talked to my doctor. So rude. This is

Scott Benner 40:47
this is all in the same bank, this was clearly filled out in the parking lot. Instead of saying this person is not compliant, why not say, well, this isn't working for them. I wonder what might like and by the way, you could just ask them, you could just say, hey, look, I feels like you didn't fill this book out accurately, is there a better way we could be doing this? You know, instead of just labeling them writing something in their chart and being like, I did what I was supposed to do, and they didn't do what they were supposed to do. So I guess they get to die? Like, that's a bizarre thing. You don't I mean,

Tziporah 41:18
I mean, just in the defense of current healthcare, I do think more people are moving in that direction. I think the recognition of the person behind the condition is way more prominent now in medical training than it used to be way more. And so you know, when I'm sitting with a physician, or a nurse practitioner, or somebody who's learning, they are much quicker to wonder about what they're missing in that realm than, you know, than the kind of healthcare I experienced when I was six.

Scott Benner 41:45
Yeah. And all you have to do that's terrific. All you have to do to freely wander that is to accept that this is a doable thing for people. I think that's what stops in the past. I do. I do think that's where that thinking came from, like, oh, boy, there's a person who gets it. And over here, we have a person who doesn't get it, or they don't get it. So we put them in a different pile, we put them in the gonna need a leg pile, like you don't I mean, and then you start treating them that way. And then it's, you stop trying to bring them along. And I think that I think the podcast has taught me is that people come along at different speeds. So

Tziporah 42:23
I definitely had that experience as a patient for sure. I mean, there's something very fresh, that's coming to mind now where I think, you know, I fired somebody because they, they didn't see that I needed help coming along, they were just going to put me in another pile. And I'm not trying to sound big and bad that I fired somebody, but it was not a good fit for me, because what I really needed was for someone to recognize, oh, the reason you're having trouble with this is because it's scary, or because you don't have enough information, let me back up a couple steps. Rather than just tell you this is what I do. And if you can't do it, then you've got to go to this other place.

Scott Benner 43:00
Okay. Alright, so I'm sorry. So we recall our facts and basic concepts, we were able to regurgitate these ideas, but not just regurgitate them, actually describe them, discuss them, explain them, then we get to apply. To be able to execute, implement, solve that kind of stuff, analyze, I guess, with diabetes is going to be the part where you start looking at your boluses and your blood sugars and your food and saying, you know, when I ate that my blood sugar went up when I ate that it didn't, you know, that was 10 carbs that was 10 carbs. Maybe there's something about the quality of this food or the way my digestion works with this food or whatever that's causing this issue. Now, after you've analyzed that, I would see my brain goes back to a reapply. But that's not the next step. Right? Like,

Tziporah 43:45
well, it's only not the next step. If you think that this is a linear model, if things have to go in order. I mean, that's part of why people say Oh, I'm not really sure this is a great model, because we're going back and forth between these levels all the time. So you're thought to go okay, well, let me reapply it and try something different. That's 100%. Right. But I think, you know, the way Bloom's Taxonomy was developed with Saona are the next one is for you to evaluate or synthesize information to be able to do sort of the next higher level thing I think real life is that it's much more fluid than

Scott Benner 44:16
I would imagine, you'd bounce back and forth between analyze and apply until you had outcomes you were looking at. And then you can then the evaluation wouldn't be as much about, I guess what this chart initially meant, and more about you being able to look back, step back and look and say, Oh, well, here are the things I did the work so I'll put these in my this works toolbox and I'll take things over that didn't work put this in my didn't work toolbox. Exactly. Yeah, that's perfect. And the Create, to be honest, I don't know if that's really important to diabetes. I'm not sure unless I'm missing something, like produce new original work. I guess. Yeah.

Tziporah 44:55
I mean, when I see parents who say Oh, I created this type one diabetes to sheet for my kids classroom. That is a demonstration of that sort of skill. I don't think we all have to do that to demonstrate that we have aced diabetes. Yeah. Like, I don't think that's the thing.

Scott Benner 45:11
Yeah. For me, once you've evaluated it, and it's working, I would turn that little tip of that, that pyramid, if for diabetes, I turned that into go back and live your life now. Like, you're done. You understand diabetes now? Right? Yeah, and still stay flexible, because things are gonna happen. I mean, that's the, you know, I was gonna say the bitch of it, but I don't feel comfortable cursing with you, even though I know you could because I think of you as an intellectual. But But, but you know that the thing is, it stuffs gonna change, like hormones will come into play, or even if you're older, your hormones might slow down or change, your activity could change, you're never going to be, you're never going to be at that spot where you're just Jay Z sitting on the boat looking out into the challenge. Yeah, that's not gonna happen, right? But you might, you're gonna get moments of it, where you're like, Oh, I got this, or when the wave comes in, you'll just say, I know what to do here. And it won't even become I like that it becomes unconscious at some point

Tziporah 46:12
for nothing, but when you're thinking about, you know, talking with healthcare, people about what some of the most important things are to teach about patients and living with diabetes. It's that, like, we our aim is going to be to have periods of stability, where you're like, I got this, I'm nailing it. I'm Jay Z sitting on the boat, there are going to be times where things feel confusing, unexpected. We're going to teach you how to solve those moments to like, if somebody came to me with that about diabetes management, I would say they get people, they get how hard this is, and they get how many variables are in the mix. This is not it's not linear, the learning is not linear for diabetes, especially.

Scott Benner 46:49
Right. Okay, this was very helpful. I appreciate you very much. Thank you. Yeah. Did I miss anything?

Tziporah 46:59
I don't, I don't think so. Well, maybe. Let me add one other point. The other thing that I think is like woven throughout our conversation today, and it sounds like in the work you're doing with Shani, it doesn't show up in Bloom's Taxonomy, which has to do with the way we're connected to other people, and the influence of those relationships on all of it. So if I'm in an environment or in a relationship, or in a health care clinic, where people are encouraging, they're telling me it's important, and that I matter, and they're invested in me, my motivation is going to be sort of stoked in that direction, too. If I'm in a place where people are dismissive, don't care, think I'm making a big deal out of nothing, don't get it. It's going to do something to my capability to take in new information and to do all these things. So I just, I feel like that's important to say, because I'm a relationship person. But I think healthcare people probably need to understand that too. And so do we, as patients, we have to have people around us who are like, in our corner saying this matters, you matter, you can do it, I believe in you. We're going to help you get there. Okay.

Scott Benner 48:03
Can I keep you for a couple more minutes? Sure. So I have the document open that Jenny and I are banging around in right now. And what I did was I went on to the private Facebook group, and I said, What would you guys wish your doctors would have done or known? Like, I kept it really kind of loose like that. And people came back with all kinds of examples. We broke, I broke the examples down into kind of like headers. And I'm wondering if you wouldn't listen to them and see what I'm missing. Okay. So as the steps, I have diagnosis, and hospitals kind of wanting to I think right away after that, in my opinion, understanding insolence got to be the first step. And I mean, by that, like, how it works, like you put it in here, and it does this, it might not, it might take a little more time, you know, perhaps, if your blood sugar is higher, it won't be enough like that kind of like, like just bare bones understanding of insulin. And then I think, again, you know, three and four with that is, is food, right? The same idea, like it's not just 10 carbs of this and 10 is 10 carbs of that, you know, Cheetos are not going to be as easy to Bolus for as you know, I don't know, something natural. And, and that now from there, to me understanding how to use your meter. And quickly being told what a continuous glucose monitor is, at the very least, if you want to slap it on somebody I um for in case anybody's wondering, but but at least understanding what it is so that when the confusion comes, you can say they did say there was this thing where I'd be able to see this so that you can start imagining what what that would look like and maybe cause you to ask about it. Then talking about pumping and understanding what a pump does so you can understand more about the manipulation of the insulin but then right after that I have humanity and mentality And then communication. And that's sort of where I'm at at the moment. What am I missing? That's glaring?

Tziporah 50:12
When you say communication, what do you have under that subheading, me scroll?

Scott Benner 50:15
A lot of scrolling. Okay, so what I have is some people's responses and like quick notes that I've made under them, I want my doctor to know that I am a whole person, not just the diabetic, this is not my whole life that it ebbs and flows. You already said that, how about that good. And that, under it, I just wrote treat me like a person and moved on. When I was diagnosed in 84, it was so dire, they told me, I'm going to probably go blind, my foots probably gonna fall off, I became jaded very quickly. And I was non compliant the person said, and then to avoid to avoid the pressure of this death, she didn't even go to an endo, she just went to a GP, trying trying to just say, like, Alright, I know, I gotta go and get these prescriptions. But I mean, if I'm just gonna die anyway, like, you know what I mean, like that kind of stuff. And what I wrote under that is that hope is important. And that initial messaging lasts forever. I wish they told me about being bold, that talks about the podcasts a little bit. And then I end my note under that is that goals can relieve stress. I would like my doctor not to be so by the book. And that went on for a little bit to that I said to the doctor, I think you you got to kind of turn yourself into a guru. Like, if you're going to do this for people, you're not just changing tires on cars, like you've got to, you got to know why they love the car. And you got to be part of the part of it not just standing on the outside in a white coat. I put here that honesty is got to be a bedrock of this whole thing. Based on somebody's text that just said, If you don't know something, as the Doctor, please tell me, because I'm sitting over here, imagining that you're, that you're God, you know, and that everything you're saying is, is set in stone. Anyway, it goes on like that. Think before you speak, meet people where they are create agency. This one was interesting about communication. This one talks about a teenager who goes to the doctor, and is told over and over again, you're doing great, you're doing great. You're doing great, but the moms like she's not doing great. grade one, C six and a half, it's good. It's not great. And there are a lot of things I'm seeing at home that she should be doing that she's not and that they're hurting her physically, emotionally. But she goes to the doctor, the doctor gives her the old Hey, 6.581 say you're doing great. And the mom says what happens is we walk outside at anything I tried to say after that is met with I was just told by a professional healthcare person. I'm doing great. So leave me alone. And that that's a problem. Isn't that interesting? Because super Yeah, because it's so reversed of what you might imagine. I wrote here that telling people they can't do something has no value at all. And that guilt is not a communication tool. So that's what I have for that section.

Tziporah 53:30
Okay, those are all great. They could be chapters in your next book for sure. I'll add a few others maybe for consideration, I'm here. One, I would probably call something like labels, or documentation. And the reason I am raising this is because what somebody says to you in the room is one thing, and then what they put in your chart is another thing. So the language around being non adherent, non non compliant, out of control, whatever, those things have some cachet in the healthcare world. And sometimes the way people put that in their notes then becomes part of the narrative that gets shared with other people too. So I would want people to be aware of how what they write about me in the chart, sort of precedes me and describe something about me that may or may not be the whole picture.

Scott Benner 54:24
Okay, so have it. So I have it as labels for documentation, language, like non compliant, etc. Do better charting, because your charting will proceed patients and limit a full understanding of who they are.

Tziporah 54:42
Yeah, I mean, I'm not for nothing, but I, I read the notes. You know, there has been a huge movement at the federal level to make it accessible to us, as patients to be able to see the documentation from these visits. And so when I read something that I'm like, oh, that that doesn't feel great. It is adding is a sort of dimension of complexity to my relationships with my healthcare people, because I see either what they really think, or I see how quickly they're moving, or, you know, lots of things. So this is why

Scott Benner 55:13
I would never look at my wife's texts. Sure, she doesn't like

Tziporah 55:19
me mean, you know, it's good to know your audience there. But the second thing that I was going to say relates to that first thing, which is, this is a relationship. So it's a relationship between the patient and the condition. It's a relationship between the patient and the healthcare provider. And one of the most important ingredients, I think, for any healthy relationship is having clear expectations, knowing what the other person can and can't do, does or doesn't prefer, how they work best what their strengths are. But that goes in both directions. So some of the comments that you talked about already having gotten from the group, echo that, but it's about level setting. So even for someone to say I'm not an expert on pumping, I work with, you know, CDs who are, so I'm not going to focus on this, I'm going to focus on these other things, that is a clear expectation. But so too, would it be for me to say, I just want you to know, this last six months since I've last seen you has been really stressful. And I'm open to what we're going to talk about, but I have not been able to focus on diabetes. So those those are markers of like, how safe do I feel in this relationship to be upfront with you about that?

Scott Benner 56:29
Okay. All right, I got it.

Tziporah 56:33
Sorry, I use a lot of words, but

Scott Benner 56:35
don't know where I broke it down a little bit for myself so I can fall. Okay, relationships, person, the first person that diabetes, clear expectations level setting need to feel safe. Freedom to freedom to express things that, you know, the doctor doesn't want to hear. And my explanation of that is example. I didn't do the thing. I said I was gonna do I

Tziporah 57:13
mean, that's psychological safety. Like, can I can I say something without fear of you? guilting or shaming or yelling at me?

Scott Benner 57:19
Okay, so I'm just gonna put psychological safety. You know, I do this. This week, Ovi diary. And like last week, I didn't lose any weight. And I sat down to do the recording. And I think I just said this last week didn't go great. I made some bad choices. And going to inject the week over and I'll be back in a week. I think the whole recording was like a minute and a half long, and I injected it, I got up and I shut the microphone off. I was like, I was like, that's all I had, honestly, I could have sat there and pontificated and made up reasons why it didn't go the way I thought and I actually have some real thoughts about why it didn't go away, I thought, but that week, I didn't have it in me to share it with anybody. Just like I had some stuff I shouldn't have. I'll see you guys in a week. And by the way, didn't gain any weight. I just didn't lose any weight. So anyway, I see that as like, kind of that psychological safety. For sure. Yeah. Okay. I, you know, I, I'm trying very hard not to give you a job, because there's part of me that wants to record this with Jenny, and then let you listen to them and come on and do 15 minutes on every episode.

Tziporah 58:31
So I mean, you know, I mean, if you want to chew on it, I'm happy to do it. This is like I enjoy this stuff. A bunch. Good. So,

Scott Benner 58:38
yeah, well, you've got everything I need. You got a good microphone, and you're smart. And I love talking to you. Appreciate it. I do too. Yeah, I feel like we're friends who will never meet each other.

Tziporah 58:50
Like if we meet I mean, maybe we would.

Scott Benner 58:52
Well, I mean, like if we met at a dinner party. We we'd be okay off in a corner. Oh, yeah. Yeah, yeah, for sure. I do really enjoy this patient. I thank you so much for doing this. Thank you.

Well, a huge thanks to support her for coming on the show and sharing her insights with us. I also want to thank better help for sponsoring this episode of The Juicebox Podcast and remind you that at my link better help.com forward slash juice box you can save 10% off your first month of therapy. And you'll get that savings just by signing up through that link. Heads Up a little programming note coming episode 999 is coming up quickly. It will be with Arden it'll be her third appearance on the show. And then at episode 1000. We're going to begin delivering the remastered diabetes Pro Tip series. It sounds terrific. Completely remastered audio is amazing. Same great diabetes Pro Tip series. I can explain to you how I'm going to do it but He's going to explain it 999 I'll explain it two different ways. Here's what I think I'm going to do. Episode 1000 probably comes out on a Monday. So we're going to do 1000 1001 with us to win five days in a row, right, you're gonna get five, the first five episodes of The Pro Tip series. And then over that weekend, the rest of the series will be delivered over the weekend. So that way, the episodes will be concurrent in your player for when you want to go back and visit them again. Right now they're spread out all over the place because they were recorded at different times and produced at different times. Now, they'll all be in one place. So they're very findable. I hope you can, excuse me for the way I have to put them out. But, you know, this is the only way that podcast apps let you do this. So in order for me to get them concurrent in your player, I have to put them out in order. But obviously I don't want to take a you know, a month to put them all out. So we're gonna do the first five over the week, and then the rest of them over the weekend. They'll all be in your player if you want them or not, doesn't matter. And then that following Monday, the next episode will go up and the podcast will be back to the way it usually is. So be a little special for a week. Little different. And then right back to it. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#993 Diabetes Myths: Insulin with Type 2 is a Failure

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

Scott Benner 0:00
Hello friends, and welcome to episode 993 of the Juicebox Podcast.

Jenny Smith is back with me today for another diabetes myth. Today we're going to tackle the myth that if you're using insulin as a type two, it's a failure. 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'd like to hire Jenny, she works at Integrated diabetes that gums that diabetes for over 35 years she's a dietitian, a CDE she's wonderful, you'll hear integrated diabetes.com Speaking of good deals, use my link drink ag one.com forward slash juice box. And when you do, your first order will come with a free year supply of vitamin D and five free travel packs of 81 you can use the offer code juice box at checkout at cozy earth.com to save 40% off of your entire order. And if you go to us med.com forward slash juicebox you'll be getting a special link just for Juicebox Podcast listeners. And you can get started with us med Alright, let's get to the show shall we?

Today's episode of The Juicebox Podcast is sponsored by Dexcom. Now Dexcom makes the sensor that my daughter's wearing right now the Dexcom G seven. They also make the G six which many of you are using dexcom.com forward slash juicebox. If there's an easier way to manage type one diabetes, I don't know it. The Dexcom G seven is a simple CGM system that delivers real time glucose numbers to your smartphone or your smartwatch. No finger sticks are required. Effortlessly see your glucose levels and where they've headed. So you can make smarter decisions about food activity, and the other variables that are impacting your blood sugar. Go to my link dexcom.com forward slash juicebox to see the device. Watch great videos. Find out more about how it works. We're just get started. You have type two diabetes, type one gestational Dexcom may be for you Dexcom G seven can help you to spend more time in range, which is proven to lower a onesie. The more time you spend in range, the better and healthier you'll feel. Use the Dexcom clarity app which is built right into the Dexcom G seven app to track your glucose trends. It will even provide you with a projected a one C in as little as two weeks. dexcom.com forward slash juicebox Dexcom G seven features lightning fast 30 minute warmup time. Oh, that's twice as fast as other CGM systems. Wait, do you see how terrific it is to go from one device to the next. The way we do it here is you're wearing a G seven, and you put on the next one, but don't disconnect the first one. So the next one sits on for a half an hour. And now it's ready to go. And then you make the switch. You never lose a reading. It's absolutely fantastic. There's actually a ton that's great about the g7. You gotta go to the link to check it out. dexcom.com forward slash juice box, set your alerts and alarms wherever you want. So you're notified of lows, highs falling or rising blood sugars. And of course that 30 minute warm up is just magical. Dex comm.com forward slash juice box head over now get started. What else can you do with this link? Let me show you. Oh, let me see. New Dex calm, explore the G six explore the g7 Oh, you can put in your information to get Dexcom to contact you and get started. That's pretty cool. There's a bunch of frequently asked questions at the bottom to answer all of your questions. When you use my links, you're supporting the production of the podcast and helping to keep it free. I appreciate you listening to this ad right now. And because you were nice enough to do that. It will be no more ads for the rest of the show.

Jennifer Smith, CDE 4:19
I have 10 minutes. Alright, so whatever we can do short 10 minutes. Okay, that's

Scott Benner 4:24
awesome. I have it right here. I know you do. Don't worry, Jay. There's a list for everything you're with.

Jennifer Smith, CDE 4:32
Outstanding. You're like I got this. We're gonna

Scott Benner 4:35
let's go right to this one. All right. Let's discuss the myth that insulin is bad for someone with type two diabetes. Oh, my big one which I mentioned with oh, this person must have been on the podcast I mentioned this in my episode was that for decades? I believe that going on insulin was the last resort for someone with type two So how do we make sense of this idea? When, as soon as you're told you have pre diabetes or type two diabetes, someone says to diet and exercise, we can turn this around? Now, I guess first of all, is that always true? Like, is there a world where you couldn't if you couldn't stop if your knees didn't hurt? If you didn't have a job? Can you diet and exercise your way? Out of type two? Every time?

Jennifer Smith, CDE 5:29
Every time? No? Okay, I think, again, that's it is it's kind of a blanket statement. And unfortunately, no, as we know, every person is individual, right? Every person has a way that something will or will not necessarily work, or we'd have even insulin itself, we'd have one kind of insulin, and everybody would just be able to use the one kind of insulin right? Does lifestyle, especially for type two, in a grand majority of studies in research, you can actually find that lifestyle from the get go, especially if type two is discovered earlier, rather than later, when many, many times complications may have already set in, unfortunately. And that might be what send somebody to the doctor because of something that they're experiencing to kind of get it checked out. And then they discover, oh, well, you have diabetes as well. Right. But I think the earlier the better, which just calls for more early on health screenings from primary care, and just lab work, you should get that done yearly to check up on things and see how things are going. Because the sooner that you can catch it, the sooner you can make really awesome lifestyle changes. And you could halt the progression. Absolutely.

Scott Benner 6:50
Yeah, I'm not saying like, I'm not saying keep, you know, taking poor care of your health, if that's what's happening, I'm saying that telling someone, hey, just eat a salad, do a sit up, and this is gonna go away is not always gonna happen, right? No, and there are new medications. Now we've talked about them in the type two Pro Tip series. I'm watching two people I know, using ozempic right now with their type two with like, great success, not just awesome, not just weight loss, like lower, like they're almost no spikes at meals, like more normal blood sugar is really fantastic stuff. And I wonder if after more weight loss, if you won't see that get better and better as time goes on. But my point is, this is if you're in a position where you need the insulin, and you're not taking it, you are doing more harm than good in that in that time. And, and this is the next part of this. And you know, I started off by saying type two, but I mean, maybe this really, because I hear this from so many people. And this is the last thing I'm going to ask you in this episode is a very short episode. But I think this is a big deal. I was told not to inject insulin, because it kills the rest of your pancreas. Now, you know, that's the thing people think, Oh, that's so wrong, right? But why do they think that I can never figure this one out. Shoes and type ones.

Jennifer Smith, CDE 8:14
That it kills your pancreas. If I mean, if anything, actually injecting insulin. It can actually, it can take the stress off of the betas that from a standpoint of type two, maybe initial diagnosis, you have to use insulin for a short time because levels have been so high, you're almost at this glucose toxic level, that you have to get something to overcome that in a faster manner than many of the oral kind of therapies, or even some of the newer injectables may not hit that the way that it needs to be done. And so taking insulin helps to decrease the stress that's being put on the betas, you're asking them to work without a break. It's almost like asking them to do 24 hour 24 hour at this really high production rate that they're never going to be able to overcome. And so adding some injectable insulin can actually decrease the stress and could actually do the opposite of what you just said.

Scott Benner 9:17
I listen. Um, I don't think it I've just heard people say it over and over and over again. Listen, this whole series is about basically you and I go and why would someone think that and trying to come up with where that would come from? I don't, I don't get this one. Like you don't either use insulin, you make it worse, you use insulin, you stop your pancreas from working the rest of the way or by the way, you can use too much insulin, which I think those two thoughts live on the same plane of existence in someone's head, but I don't understand where that comes from either. Like is it? Is it that type ones. Maybe it's that when people start using insulin, they'll sometimes gain weight as type ones and then they say insulin made me gain weight. They don't. What's your answer to that? I say I tell them the same thing. Every time. Insulin doesn't make you gain weight, calories make you gain weight, you're just

Jennifer Smith, CDE 10:10
which is true. But from an from a type one perspective on a little deeper level, if they have had such high blood sugars for such a long time, then they've actually been able to maintain or most often you see weight loss prior to diagnosis, because they've been peeing out an excessive amount of calories, because the body doesn't have the insulin to actually put it into the body in storage, like it's supposed to. Yes, so you lose weight by pulling out the excess, that you're, you know, that should be actually kept, you're the ones you start taking insulin, your body's like, Yay, I've got something here that I can package this stuff away the way that it's supposed to. And so, yes, you may get back to a healthy weight, I've actually also seen, especially in kids and teens, where they may not have actually been keeping up with growth curves prior to diagnosis even. And once they start on insulin, and their body actually has the right amount there, then weight gain can actually increase. And if you're not careful, as you said initially, then caloric intake needs to be the next step in management. Just because you're taking insulin, doesn't mean that you can go hog wild with caloric intake might be a need to balance

Scott Benner 11:32
also the cause and effect is off sometimes. So like you said, the way I think about this, what you just said was like that you're in like a low level of DKA all the time, right? Yeah. So your your, your body's trying to die because it doesn't have enough insulin, but you're giving it just enough to keep it from actually happening. And so you're on this unhealthy weight to begin with. And then suddenly you add the right amount of insulin. God knows what do you hear people say all the time at their diagnosis, I swear to you, I hear it 50 times a year, I thought, Oh my God, my diet is finally working. They see it all the time. They're so thrilled before they're diagnosed because they're like, I'm finally losing the weight that I've been trying to lose,

Jennifer Smith, CDE 12:10
especially for adults who are diagnosed Oh, my God. Yeah, absolutely.

Scott Benner 12:14
So So you're basically in that situation where your body can't properly perform. And so you're underweight for the reasons, Jenny said, and then you bring the insulin in, and your body's like, Oh, good, I can do the right things now, not realizing you've been eating crazy amounts of food, because who cares, right? Because I wasn't getting people say it all the time. Well, I got I was eating ice cream. I was doing this. I never gained any weight. I thought I finally figured it out. Bla bla bla. So I think that's, I think that's that space right there. But, I mean, again, I don't I mean, that's, that's as close as I can come to digging through it. But with the certainty that people will say it online, I'm stunned and scared by it all the time, because I don't use insulin is. I mean, especially for a type one. It's just such a dangerous statement to make. And absolutely, it happens a lot. Oh, don't use it, the more you use, the worse it's gonna get, you're gonna kill your pancreas, you're gonna die. I'm like, oh, god, shut up. No, no, no, like, stop saying that's where you? I don't know. Yeah, absolutely.

Jennifer Smith, CDE 13:20
And I think from a type two perspective, for the majority of time, people feel like insulin means that they have ultimately failed in everything that they have put into action, you know, their doctor or their educator was like, let's let's do these lifestyle things that start you on these medications. And potentially, at some point, many people will still need to use insulin. And there is a progressive nature to type two. Again, lifestyle still navigated and maintained really well, at some point, many people may or may need insulin added. That doesn't mean it's a failure, it means that now you're going to have something that also helps because in the background, your pancreas isn't doing as much as it was before doesn't mean that you failed in all of your management and adjustment to your life and everything. You have to keep doing those things. Insulin is just it's an additional tool in your toolbox. That's going to help keep you healthy.

Scott Benner 14:21
And I'm not saying either that you don't want to extend that time if you can, correct Yeah, I think that's fantastic. If you get by the way, even like a slow onset, like a lot of diagnosis, like like, keep it going as long as you can. Every day you don't have to futz with all this stuff is fantastic, you know, but, but once it comes, I don't know couching it as a failure is, is dangerous. And I don't think it's not true that doctors don't say like, well, we want to keep you off of insulin as long as possible. And then people's brains fill in the rest of that with however, these myths start to exist, right.

Jennifer Smith, CDE 14:54
They're kind of reading between the line of which there's not, there's not really something written there. They're just filling it in, like you said, like the doctor, we're gonna keep insulin out of the picture for as long as we can, which again, is kind of like saying, Well, gosh, once we get to that point, but that's it, we got to add insulin now.

Scott Benner 15:12
Jenny, I'm gonna end with this because I, I'll go on forever if I talk about this, but I think that if people could get a printed list every day of all the things they're wrong about that they think they're exactly right about me included, everybody included, we'd all spend a lot of time just sat in the corner going, Oh, my God, I thought that for sure was right. Because your brain fills in the gaps with whatever information you have, and it doesn't mean it's the right information. So anyway, I appreciate you doing this. Thank you. Absolutely, thank you.

I want to thank Dexcom for sponsoring this episode of The Juicebox Podcast and remind you that you can support the podcast and help yourself by going to dexcom.com forward slash juicebox. Go get started today with the g7 for the GS six. I also want to thank Jenny and remind you that she works at integrated diabetes.com You can actually hire Jenny to help you with your diabetes. Thanks, thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. This myth series I'm enjoying it there's a handful more episodes left than the series is done. But what a great idea this was whoever thought of this on the Facebook group. Thank you wonderful. If you are a loved one has been diagnosed with type one diabetes. The bold beginnings series from the Juicebox Podcast is a terrific place to begin listening. In this series, Jenny Smith and I will go over the questions most often asked at the beginning of type one. Jenny is a certified diabetes care and education specialist who is also a registered and licensed dietitian and Jenny has had type one diabetes for 35 years. My name is Scott Benner and I am the father of a child who has type one diabetes. Our daughter Arden was diagnosed in 2006 at the age of two. I believe that at the core of diabetes management, understanding how insulin works, and how food and other variables impact your system is of the utmost importance. The bold beginning series will lead you down the path of understanding. This series is made up of 24 episodes. And it begins that episode 698 In your podcast, or audio player. I'll list those episodes at the end of this to listen, you can go to juicebox podcast.com. Go up to the menu at the top and choose bold beginnings. Or go into any audio app like Apple podcasts, or Spotify. And then find the episodes that correspond with the series. Those lists again are at Juicebox Podcast up in the menu or if you're in the private Facebook group. In the featured tab. The private Facebook group has over 40,000 members. There are conversations happening right now and 24 hours a day that you'd be incredibly interested in. So don't wait. So don't wait. Check out the bowl beginning series today and get started on your journey. Episode 698 defines the bowl beginning series 702, honeymooning 706 adult diagnosis 711 and 712 go over diabetes terminologies in Episode 715 We talked about fear of insulin in 719 the 1515 rule episode 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility in Episode 751 We discussed school in Episode 755 Exercise 759 guilt, fears hope and expectations. In episode 763 of the bowl beginning series. We talk about community 772 journaling 776 technology and medical supplies. Episode Seven at treating low blood glucose episode 784 dealing with insurance 788 talking to your family and episode 805 illness and ketone management. Check it out it will change your life

#992 Hannah ReInspired

Hannah has type 1 diabetes and was reinspired after the birth of her child.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 992 of the Juicebox Podcast

Welcome back everybody today I'm gonna be speaking with Hannah. She was diagnosed when she was 12 years old and is now 26. As we recorded this Hannah had an 18 month old child said her diabetes management was terrific through her pregnancy but lost focus after the birth. And that's why we call this episode Hannah reinspired. Please remember, while you're listening 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. You know, I never record that I always say it on every episode. And somebody recently said, Oh, I thought you just recorded that and played it over and over again, it broke my heart because apparently I could have done that. If you want to help my heart feel better go to drink ag one.com forward slash juice box and start using ag one with my drink or with my drink with my link or go to cozy earth.com buy a whole bunch of comfortable stuff and use the offer code juice box at checkout and save 40% or, or or join the private Facebook group Juicebox Podcast type one diabetes or tell a friend about the podcast. Those are all the wonderful things you could do to make me happy. This episode of The Juicebox Podcast is sponsored by cozy Earth. I wear cozy Earth joggers sweatshirt, I sleep on cozy Earth sheets and dry my bits off after a shower with cozy Earth towels. I just bought a bunch of stuff with my own money. But I use my offer code. So I save 40% you can to use the offer code juice box at checkout at cozy earth.com to save 40% off of your entire order, not one item, not just stuff on one tab, the whole website 40%. use the offer code juice box at checkout. today's podcast is also sponsored by us med now us med is the place where we get Ardens diabetes supplies. You can also get your diabetes supplies from us man. They'll do it for like anybody who has insurance they take and they take like over 800 private insurances. My point is us med.com forward slash juice box or call 888-721-1514 You go to the link, where you call the number, your free benefits check if they take your insurance and I'm telling you they take like over 800 of them. So probably take your insurance. Then you get going and you get your supplies the same way we do from us med.

Hannah 2:47
My name is Hannah, and I am a type one diabetic. Diagnosed at 12 and I am now 26 years old and I'm a daily listener. So this is kind of weird talking to you because I hear your voice every day. But I don't You don't know me.

Scott Benner 3:02
What do you mean? I don't know you? I'm talking to you every day. Hannah. Exactly. When you Yeah, I'm in your closet. Yes, right now. It's hard. That's why I couldn't put my camera on. Because then you'd be like, Oh my God, that's my sweater. And it would be very disconcerting.

Hannah 3:19
I am I'm looking at your face though. Your pictures very nice.

Scott Benner 3:22
Oh, thank you. It's the only decent picture I've taken and myself in five years.

Hannah 3:27
I think I remember the story about that one.

Scott Benner 3:30
Yeah, it was nice and thin. Because because the family I was staying with only drank water. I know you're laughing because I said What are wrong, right? No, that's okay. Is it water? Its water. Is it really? That sounds very wrong to me.

Hannah 3:47
I guess it's just your now people know I don't live where you live.

Scott Benner 3:51
When I say water. I feel like I'm mispronouncing a word and everyone's looking at me. Like I when I said it like that. I like the visceral feeling inside was oh, Hannah's gonna be like, Oh, this idiot. Like, like that sounds

Hannah 4:03
How do you say it again? Water. Water Water. What? Okay,

Scott Benner 4:08
what water? All right. I know. It's not right. Don't get me wrong. I'm not insane.

Hannah 4:14
I don't know if mine's right. But yeah.

Scott Benner 4:16
Why don't want to just start coming at this from a different perspective. Why are you saying water? You lunatic? So you listen every day. This is good. Everyone should listen every day. What is? Tell me about

Hannah 4:29
it? Well, I listen. Every time you post I think that's four days a week. It is a new one comes up.

Scott Benner 4:35
I started listening on the other days.

Hannah 4:39
I don't listen on the other days. Well, okay, let

Scott Benner 4:41
me just make a note about that. doesn't support you. Okay, I gotta keep going.

Hannah 4:47
When I first started listening, I think I did listen every day I'd maybe listen to like two or three a day because I was just like taking it all and I loved it. I'd like started at the beginning and then just had it roll on repeat. But then Got a little bit too much so that I don't know, I just listened to the newest ones you post

Scott Benner 5:05
be honest, when you said it got to be a little bit too much did you quietly look at yourself one day and go? Yo, what are you doing? You've listened to a diabetes podcast three times a day for the last couple of months. Stop.

Hannah 5:17
Yeah, my quality of life is pretty low at that point,

Scott Benner 5:19
right? Like, like, your husband's like, Hey, do you want and you're like, No, no, I don't have time for this. I'm listening to a podcast that was recorded six years ago.

Unknown Speaker 5:28
Right? Why were you so

Scott Benner 5:32
like, vigorous about it.

Hannah 5:35
I think when I started listening, I really resonated with the way that you approach diabetes. And it was really impactful for me, in a lot of ways, so I just kept listening and listening. And was, I guess, just surprised that I hadn't heard of it. You know, before, because I listened to quite a few podcasts. And I just kind of found it by chance just on my podcast player and say, Oh, I have diabetes. So I should probably listen to this. And I think just the way that you approach it is through story. I love all the series that you have. But then being able to listen to people's stories is really impactful. And there's always something to be gained from each episode about people's stories. So that's why I like listening, and it's just resonated with me,

Scott Benner 6:21
it's so kind of you to say that and actually very helpful that you said that because my direct access to people who listen to the show is only through Facebook, or social media. And those people are very much focused on management, which is terrific, but they don't tell me. I really enjoyed listening to that conversation with this person. Yeah, I don't hear that from them as much. And so then I'm left to just, I have to steal up on my own and go I know, this is good. I know this is right. Like keep doing it. I always say that. I mean, today's have a pretty cool day here. Hannah. I just crossed 10 million downloads. Wow, for the for the podcast.

Hannah 7:07
That's fantastic. You're at such a huge milestone. Thank

Scott Benner 7:10
you. And I'll say this for people who then go when I stream it, am I not helping download streams? Anyway, you listen as a count is counted. So thank you. Yeah,

Hannah 7:20
but 10 Count, even if someone listens to like 15 minutes of it, that doesn't finish there are

Scott Benner 7:24
standards, IAB standards that track how podcast listeners are counted. And the company that I use for my hosting is IAB compliant. So I don't I don't know the length of time that counts as a download, but mine are legitimate. They're not like, I don't do their things people do to push up their downloads, so they can sell ads. Like, they'll put out like a bunch of like four minute episodes. So that oh, you know what I mean? So like they could have, they could have 10 listeners. But if they put out like five, four minute episodes, then they get five downloads from each listener who's subscribed, like I don't do that I put out like, right contents, either quality, or I don't do it. Right, which is, I appreciate that. Thank you. And there are people who put their podcasts on webpages and put them on autoplay. So that when, when the page loads, the podcast starts to play. And then you go, what the hell is this? And you click and stop it, but they get a download out of it or a stream. So that you know that yours are legit. I don't do any of that crap. These are people listening to the podcast.

Hannah 8:34
Yeah. So it's working, and then keep it up. It's, it's phenomenal. So it's really changed in the last half a year, six months has really changed the way that I approached diabetes in a positive way. And yeah, I just I love

Scott Benner 8:49
it. How the you've only been listening for six months. Wow. Oh, that's so cool. And you've had diabetes since you were 12. And you're 26?

Hannah 8:58
Well, yeah, so this will be this June will be 15 years.

Scott Benner 9:03
Wow. Wow. No kidding. You're married? Yes.

Hannah 9:08
I am married. I've married two and a half years. You and I have

Unknown Speaker 9:11
we do have children? Do

Hannah 9:13
I have an 18 month old?

Scott Benner 9:14
Oh my god had it because I saw you for a minute when we first started talking and you don't like you haven't lost the will to live yet. So I thought you didn't have kids?

Hannah 9:22
No, I love having a kid.

Scott Benner 9:25
Oh, we all love having kids. And that's not what I said. You don't have that stare on your face? Yeah. No,

Hannah 9:33
I slept great last night. You know, he slept through the night so I'm well well rested. He's with grandma right now. And yeah, congratulations.

Scott Benner 9:41
If only you would have had the baby a little later could have been named Scott. But yeah, but no.

Hannah 9:47
And his name does start with an S but it's not Scott. I'm sorry.

Scott Benner 9:51
Is there any way you would tell me that the S is for me?

No, thanks. Wow.

Least I know you won't lie or anything. Conversation. here's the here's the thing I can tell you about, about having a kid. That's from my, from my experience. Just last night, my day went really well. Yesterday, I worked a little too much. I got off a edited. I did an interview that went longer than I thought it was going to be. 90 or so minutes later, excuse me two hours later, it might be the longest episode I've ever made. I had just talked about a very heavy issue with a person and I was like, drained. I came downstairs, I ate some food very quickly said to my wife, I double booked myself that I have to go back up and record again, that episode went an hour and a half. I got done like literally got done turned to I have another computer next to me it turned on my computer to look at my emails. And I noticed that I've have like a warning on my phone about something and I look over at it and it's Arden is contacting me. And she says, I need help. I have a flat tire. And I'm like, wait, okay, so I start like your brain starts chugging through, like she has a flat tire. Is there a pump in the car, let me see what to do. She's at school, like, I don't know that town that well. And then she shows me on FaceTime, she doesn't have a flat tire she she made a turn in an old town along a curb. And sticking out from that curb was an old fashioned cast iron sewer. And it had a sharp corner on it. And she hit it with her back wheel. And it broke the wheel and rip the tire open. Oh geez. And she's like, I was maybe going three miles an hour. And she's and she's like, I know I hit it. But like, She's such a good driver. She's like, I'm such a I'm like, I know it's okay. Like, don't worry about it. But you know, we took care of the whole thing. And I talked her through it. My wife texted her. I was like, It's okay, we're fine. You're fine. Like, don't worry about it. And then it hit me later. This is what it is, like that idea that like everything can be okay. And then suddenly for reasons that have nothing to do with any of the decisions that you have made in your life. Something unavoidable happens.

Hannah 12:14
Yeah, sure.

Scott Benner 12:14
I hate that feeling. I really hated that feeling. I don't care about the tire the wheel like will will replace it, it's fine. But that feeling is it numbs me inside a little bit. So anyway, look forward to that number of times. Oh my god. Anyway, congratulations on the baby.

You are

you found the podcast and you started listening you said I have diabetes? I should probably listen to this but that's how was your was it about management? Was it about meeting other people with type one like what do you think really drew you in at first?

US med always provides 90 days worth of supplies, and they have fast and free shipping us med.com forward slash juice box or call 888721151 for us med accepts Medicare nationwide and over 800 private insurers. Us med.com forward slash juicebox better service and better care is what US med wants to provide for you. And they've provided that service for over 1 million diabetes customers since 1996. They carry everything from insulin pumps and diabetes testing supplies to the latest CGM like the libre three and the Dexcom G seven. But if you want the libre two or the G six, they have that too. They also have tandem Omni pod dash Omni pod five. They have so much it's where Arden gets her diabetes supplies. We use us med because well, it's easy. And, you know, it's what we're all looking for a little less to think about us med.com forward slash juice box or call 888-721-1514. The reorder process with us med is it's insanely easy. I get an email, I click on a link in the email and lol Just happens a couple days later stops at our door. If Arden's off at school. I can call or go through a link and just say hey, you know what, don't send it to the house, send it to college, and they just do that. It's wonderful. Us med.com forward slash juicebox we've been using us med now for maybe two years. And I love it. It's easy, reliable. And Arden supplies are always where they're supposed to be us med.com forward slash juicebox and never open up the drawer and go oh where Are the CGM doesn't happen like that. It's all super easy. Check them out, wouldn't you? Wouldn't you? That's not English. Just go take a look us med.com forward slash juicebox. While you're looking at things, look down at your butt at your derriere, your ass, that part back there doesn't deserve to be comfortable. But about your legs and your arms and your torso and your neck. And let's not forget about your bits and pieces. These things are inside of your clothing. They're on your sheets, and they're wrapping your towels. What do you got some garbagey towels, they feel like sandpaper sheets all like you touching them like feels like this. You know, I mean just dry like you need cozy Earth stuff. I'm not joking. joggers, the shirts, the sweatshirts,

Lija Greenseid 15:49
the scrunchies the sheets, the viscose bamboo is so soft,

Scott Benner 15:54
and temperate,

Lija Greenseid 15:55
not too hot, not too cold. I get out of the shower every day, I grab a waffle towel, I take the waffle side to get off all the water and I flip it over to the fluffy side. And I let that fluffy side work.

Scott Benner 16:05
I let it eat. You know what I mean? I'm just shine it up like an apple. Boom, boom, boom, next thing you know I'm dry. I'm soft, everything's great. And my day is on its way. Cozy earth.com use the offer code juice box to save. Don't let this blow your mind 40% off of your entire order. You go to cozier.com Right now I'm there right now free shipping over $50 I'm seeing at the moment. Anyway, let me just like let's imagine for a second Scott wants more bathhouse. So I get a bath towels, I'm gonna get some bath sheets, I get a nice wide, long towel right? Here they are already got a little sale happening. Maybe that sale still be there. When you get there. I don't know. Boom, I pop it in my cart. And then I put in the offer code juicebox and Bada bing 40% comes off the price. Good beat that with a stick. You can't Kenya No, go by Taos.

Hannah 16:58
I think just having diabetes and wanting to hear what you had to say on the podcast. At that time, my son was about a little under a year. So it's still kind of in the, in the thick of like, Baby, newborn baby time. And I did I had really good management of my diabetes during pregnancy. But then after I was pregnant, or after I gave birth, I didn't take care of it as well as it did when I was pregnant. Obviously I was it was kind of like, Oh, now I can relax a little bit. So then I was going from being pregnant, having really good management because I was eating low carb and. And then last summer I found myself just like on the roller coaster and really discouraged and really frustrated that I couldn't like get my act together. And then when I started listening to you, there was so many things that you were saying with the way that you approach diabetes that resonated with me. And I don't know, just motivated me to, like make better decisions. And just understanding the importance of Pre-Bolus and finding the right basil. And wow, figuring out how to use insulin for any kind of food because I've tried every way of eating possible. I'm really glad I have done that. Because I've learned how to give insulin for all of those kinds of ways of eating. And now I'm kind of just like, whatever. But like low carb ketogenic, vegan plant based Bernstein, gluten free, like all of the all these different kinds of ways of eating just to try to figure out what would work best. And then there was something you said in one of your podcasts that you were like, don't eat low, low carbohydrate diet. If you don't know how to take insulin, like if that's your only reason to eat a low carbohydrate diet. Don't don't do that figure out how to use the insulin. And if you want to eat low carb, eat low carb, that's fine. But figure out like you should know how to use the insulin for whatever. And that was like, oh, yeah, that makes sense. And so it just gave me that felt like this gave me this freedom to figure out how to use insulin with any kind of food that I want to eat.

Scott Benner 19:05
Am I Am I hearing that you went through those different eating styles hoping that you would land on one that just magically worked?

Hannah 19:12
Yeah, totally. Okay. Because the way that I was managing wasn't great. I wasn't very good at Pre-Bolus thing never have been dull now. I'm now and never really figured out the right, basil. I think it probably worked just fine. You know. And I've also gone back and forth between MDI and pumping so I can, I can kind of do it with both.

Scott Benner 19:34
So even so let me ask you prior to your pregnancy to get pregnant on purpose. Yes. You seem like a person who got pregnant on purpose. By the way, does that mean anything to you? That That makes sense. Like just seeing you in your room that you were in for five minutes. I was like, she got pregnant on purpose. And I don't know why exactly. You just seem like together. Does that make sense? Sure. Yeah, I appreciate I'll take that as a compliment. But we did not get pregnant on purpose the first time My wife was home sick and absence makes the heart grow fonder. And she's much here. Here's something I've never said about Kelly. No one tell her I said this. She's so much nicer when she doesn't feel good.

Unknown Speaker 20:15
Oh, really? Oh my god. She's so sweet

Scott Benner 20:19
and lovely when she's just a little. If I had Munchausen this would be a perfect relationship. Oh my gosh, she's like, you're just like, anyway, point is, is that yeah, so she was home sick, I guess you might have like, anyway, then the baby cam. And you don't occur to me, like as a person who would just be like, whatever. Let's do it now. So prior to the baby, the decision prior, where was your management then.

Hannah 20:47
So when I got married, it was just kind of all over the place. I I guess just starting more at the beginning when I was 12 and diagnosed, I was at the age when I was kind of wanting to exercise independence. And so I took it on. Basically all on my own. Like, first day in the hospital, I gave myself my first shot, no issues, and I was willing to learn, you know what I needed to do. And my parents noticed really quickly that I kind of figured it out and was doing it. And so they kind of took a little bit more of a backseat, which was totally fine. But because of that I never developed the best habits for Pre-Bolus Nene and checking my blood sugar as consistently. I definitely took insulin when I ate but I always just took it right when I sat down to eat. And then I would just check my blood sugar like before when I woke up and before bed. So those were the habits that were just ingrained for, like 10 years. So when I got my Dexcom, probably about four years ago, I realized, oh, this this isn't this isn't working very well. I didn't like seeing the huge peaks and valleys, you know, from giving insulin as you're eating? And that was discouraging, for sure. I didn't like seeing the highs and the lows? And

Scott Benner 22:12
was was some of that just maturity. Do you think?

Hannah 22:16
Yeah, I think so. And then when we got married I we knew we wanted to start a family soon ish, you know, after we got married, maybe like six months after we got married. And so prior to that, I knew that I wanted that in my endo office, they had like, guidelines for trying to conceive, you know, having an agency under 6.5. You know, having having good management, ideally being on a pump. And so that was kind of my goal is like, hey, I need to do that I needed to kind of get my act together. And then I had tried a low carb diet in college. And it worked decently well. So I went back to that, because I knew that that was going to give me stable, more stable blood sugar. So for a few months before we got pregnant, I ate a low carb diet and was able to get my agency under six. And so I felt good about that going into pregnancy, and I kept that going. But I don't like eating a low carb diet. It's not fun. And it's just kind of just sucks. I don't like it. But I did it during the pregnancy because I was terrified of having, you know, really high blood sugars all the time and potentially hurting the baby. So

Scott Benner 23:22
okay, so you see you just kind of I mean, not that I want to be clear, I don't think of eating a low carb diet as being restrictive. If it's a decision, it's a it's a choice, right? Like, I don't think and when I when I hear somebody's like, you know, I enjoy a low carb diet. I'm like, Oh, they're I don't think oh, they're stopping themselves from eating things. They I know they want to eat like, I don't think that you know. But right, if you're doing that, because of a management situation, you were stopping yourself from eating things you wanted to eat, because you didn't know how to Bolus for them.

Hannah 23:55
It absolutely that and that was where I was. And that was the struggle. And it just when you restrict, I don't know all the psychology of it. But when you make decisions to restrict it, it's like, it's kind of like the scarcity mindset where it, it can make you think about the thing, you're restricting more and make it really difficult to avoid. And so then after I had my son, I kind of went crazy and I just ate all the carbs and just you know went crazy and because I had withheld it from myself something I want I withheld it for so long. And now and then I when I find your pockets, I was like Oh, I feel this freedom to eat whatever I desire to eat, and just figure out how to take insulin for it. And that concept was just like transformational for me. And now I'm at this point where I feel a lot more freedom about how I eat, which is you know, which is huge, and it makes it a lot or sustainable? Because when you're restricting something, it's not a sustainable effort. It's like that white knuckling discipline that doesn't. It's not sustainable. So,

Scott Benner 25:12
no, I understand. And I appreciate you saying that. And I'm glad that it helped you. I'm disappointed. I'm disappointed. You wouldn't like to say the kids first initial was for me after all that, but I mean, you know, whatever. You are lovely. Let me just say that. Let's let you're still nervous now. Are you okay?

Hannah 25:30
I'm okay. I get nervous about these things. You know, what I'm nervous about is listening to this whenever you post and listening to myself talk, and then you're like, oh, gosh, that's what I said. That's what it sounds like.

Unknown Speaker 25:42
Are you thinking about that while you're speaking? Yes. Which is weird.

Hannah 25:45
I don't know why.

Scott Benner 25:46
Let me let me tell you my secret. Try hard not to give a fuck what anybody thinks. You'll be okay. All right. You're just you're just sharing what you think no one knows who you are. It's fine. Right? You know, I'm the one at risk here. I'm about to edit an episode, Hannah, will be out a long time before this one comes out. But I'm about to edit an episode where a mom comes on to talk about her trans kids. And me trying to like, you know, me here who I don't, to my knowledge, don't know, a trans person. And it's not a normal part of my day. And so I don't know, I don't know what I said, like, I have to go back and edit. And I'm like, I can't, like part of me is like, well, I can't wait to go listen to that. But but but I am more than a little concerned that I don't understand something right. And then it would come off wrong to somebody, even though there'd be no ill intention behind it at all. Because I really, you know, I kind of feel the way of the world. I feel about the world the way I talked about the way people eat like I don't, I honestly don't have a thought in the world about what people do. Like, I think it's cool, like, what works for you is great, or what you are is greater whatever, right. But anyway,

Hannah 26:59
yeah, which is a really good approach. And one reasons I like you, because all the different approaches, for example, just approaches to eating. The people that ascribe to those things, they're like, this is the only way and you have to be this way. And if you're, if you don't do this, you're wrong. In all this different kinds of ways. That's what I've noticed, like, I don't like that I don't like that approach to life in general. And I don't like that approach to managing diabetes. I think everyone can have their own way and figure out how it works best for them.

Scott Benner 27:35
I'm gonna, I'm gonna say something, right? Okay, I think that's selling. So I think that that's like, don't get me wrong. If you're just a person, like you're just a regular person, you're listening to this right now. And you in your heart believe that eating a pescatarian diet is the only way to exist. And you feel passionate enough about that, to get online and say to people, you have to be a pescatarian you have to be UK, if you don't, you're killing yourself, if you feel that way. Like God bless you, that's fine. I think when you hear people do it in social media, or, which is where you're basically talking about Instagram, Facebook, places like this, if you look hard enough, those people have a financial reason for saying what they're saying, or they are devotees of the person who has that thing. And to some degree, I noticed that with the people that listen to the podcast, like they'll they will go online and say to somebody, this podcast is what you should do, you should listen to this podcast, because because it's so it's so help them. They're so passionate about it, that when someone says, oh, gosh, my agency is nine, and I don't know what to do. Or look at this. There's this big spike. And I don't know how that happened. A person who's heard the podcast, and now understands how to use insulin, and feels the way that you've described, you know, for the last 20 minutes. They come in there with a ton of passion and say, Oh, the Juicebox Podcast, blah, blah, blah, people from the outside, look at that and go oh, look at this proselytizing about this podcast, right? It's the same thing with eating styles. Yes, you know, now the difference is, is that I don't run around telling people. You have to listen to this podcast, and you can't listen to anything else. Because if you do that's wrong. And this is right. I don't say that. I don't feel that.

Hannah 29:24
Right. And that's what I think is so attractive about the way that you do this. And why so many people listen and are on their Facebook group. And so that's a that's a beautiful approach. Yeah.

Scott Benner 29:36
Do you Do you know what I think people I believe my opinion, why people do that. I think that's fear. I think they feel like they have a thing. And if they don't feed it and grow it, that it will wither and die. And so every person who it doesn't matter, right? If we're talking about eating than if I'm out there pushing a high plant diet and you're out They're eating keto. Some people have the feeling like, well, I lost one, I'm losing. And I don't feel like that. I genuinely I genuinely believe that whatever works for you is the thing. And if that means a different website, a different Facebook group, if you want to find a different podcasts that helps you or whatever, and it's not me, that has to be okay. Of course, I can't feel like oh, well, you, you know, Hannah wants to go eat this way. So she's not gonna listen to the podcast anymore. I have to feel like, that's good. Like, if Hannah's okay, then that's good. Now where my competitive nature comes in, when you hear you hear me say like, I want to win, like I do want. I do want everybody to listen to the podcast, but but that's because I believe that anything they may need is in here. And when I find something, it's not I tried to add it. I don't know, I find that to be a different perspective. You know, I don't know if everybody would understand that. But I do my best to keep this place. very inclusive about all ideas and thoughts. I don't even on the Facebook page, I got a note the other day is like, you can't let a person say that he was like, I'm not gonna stop them. Like they're an adult. Like, why would I stop them from saying what they want to say? Why would you want to write and then when you pick through it, the reason they wanted to stop them is because they were afraid of what they were saying. It's always fear. So anyway, thank you. I'm glad. I'm glad you like it. And I appreciate that you're here.

Hannah 31:31
Thank you. One funny thing, when I first started listening, and you started talking about being bold with insulin, I was like, Okay, what does that mean? And I, for three days thought that it was an acronym. And I was trying to figure out what the acronym V O LD stood for. And he's not saying what this means. I was like, okay, the bees, probably basil or Bolus. The O is probably Omnipod. Because his daughter uses Omnipod. And that's a sponsor and the L, I couldn't figure out the L and then the D was probably Dexcom or something. Oh, my God. I thought so hard about this as a what does this mean? I

Scott Benner 32:06
love that you did that. So I

Hannah 32:09
went back to the original. I was like, Okay, where's the first podcast where he talks about bold with insulin? Because surely he says what the acronym is. And then I quickly realized, oh, this literally means just being bold with your insulin and making appropriate changes.

Scott Benner 32:24
It was hard for me not to laugh while you're telling the story. Because I mean, you you listen to a lot of the show. So you know that I don't really name the episodes with a live yet, like specificity. how impressed Are you that I said specificity? Correct. Because I found myself going away not to trip up on that word. But I just, I was talking, it's episode 11. And I was telling the story, it's back. It's back before I even had, like, I didn't have guests that frequently. I was still going through the blog posts that I had written in the years prior that I knew were really helpful for people. And I was kind of trying to contextualize them in these shorter podcast episodes. And I'm talking to myself, if you really listen to it, you hear me talking myself through what I did back then, like, I'm trying to remember it for you. And then I think I said, like, I guess I learned to be more bold with insulin. And then when I went back and edited that, that, that recording those words stuck out to me and I made it the title of the episode. It's, it's not an actual thing that you have. Well,

and then what happened was that a couple of years later,

I saw it hashtag in places. And, and I don't normally think, oh, that must have been me. But I thought I've never heard anyone say that, but me, like, I'm gonna go like, pick around. And as I picked around, I realized that somebody had listened to the podcast, and they they had taken like, picked it up as a mantle. I'm going to be bold with insulin. So it's a function of the listeners, not me. That That term is in the zeitgeist now.

Hannah 34:00
Oh, interesting. Yeah.

Scott Benner 34:01
So I love that it tortured you for a number of days. Did you ask your husband were you like, what do you think the O stands for?

Hannah 34:08
I don't think so. I think it was just my musings in my brain just thinking Oh, I wonder what this is. But I don't know why my immediate thought was this has to be an acronym.

Scott Benner 34:18
Yeah, I don't either, but that's fantastic. Well, I don't even know like if I tried like if I could come up with one I don't think I could Yeah, sorry.

Be on Battle No.

Hannah 34:36
Lost to L every time.

Scott Benner 34:39
Well, wouldn't it be funny if it was beat on low diet or low carb diet but anyhow, like, but that's You see, I think that's to completely telling because it took You as well like, like, you saw it and you're like bold. What could that mean? What like what is that? Like? I know All I meant by it was that I was being timid with insulin. Yes, that's all I was scared of it and I wasn't using as much of it as are needed. Right? Yeah. Yeah. Well, that helps you. No kidding.

Cool.

This is great. All right, so baby comes out. And you do the thing where your life is shifting huge, by the way is the thing. It's the parenting thing. Yeah, the first thing you do is give away your own health or happiness. That's how it works. When you're divvying up the pie. You look at the pie and you go baby, by the way, the pie after you have your first baby is Baby 98.5%. Husband point 5%. Me 1%. Yeah. I think I said in a book I wrote that when my son was born, I became my, my, my son and wife's major domo. They were just, she was like, Hey, how can you possibly service the baby? And I properly? Yes, I'd be like, what about me? And she's like, there's no, you, you don't exist anymore. And I was like, okay, so But you gave away your own care. But I don't think if I'm guessing, it isn't just because you're like, fifth, I don't care about myself. It was because the way you got through the nine months wasn't purposeful.

Hannah 36:14
Right? It was forced, yeah. And I didn't know how to give insulin for the way that I typically would eat. So I was just all over the place. And that was pretty discouraging, but been able to figure out and whatnot. Another reason why I love your podcast, is because there's not, it's not like you listen to these five episodes, and then all of a sudden, you have the tools that you need to now make the changes in your life, like diabetes is a long game. It's a it's a throughout your whole life, you're going to be always learning. And even just the the way the podcast is with over 800 episodes, and that they're long episodes that that kind of, you know, we're not even talking about diabetes the whole time. But just the story in your conversations. And the fact that it's just long kind of just shows that that's how diabetes is that's how you learn through it. And it's a it's a daily thing. And I think before I found your podcast, I was just so focused on Oh, my gosh, today, I my blood sugar's high. And I was so yeah, just focused on the the here and now and discouraged, and I didn't know how to just take that and learn from it.

Scott Benner 37:30
Yeah, you have that that very like micro view?

Hannah 37:34
Yes, it was very, it was a very, like micromanaging, trying to figure out so then, if my blood sugar was good, then I was feeling good. And I was like, this is fine, you know. But then if I was having a rollercoaster day, or if my blood sugar was high, and I didn't understand it, I would just get discouraged and be like, this stinks. And definitely, I've experienced a lot of diabetes burnout, which you said, I think it was a guest maybe as a therapist you had on she said, diabetes, burnout is when you're trying really hard. And you're not getting the results. Because which that was totally what I was in for a long time, especially in college. I was trying really hard, but I wasn't trying to write things. So I was trying really hard. But it wasn't working. Because it wasn't I didn't have the tools or the correct information on how to how to maybe I didn't have the right basil and I didn't know how to test for it. Or I didn't. I wasn't taking enough insulin or whatever it was, you know, like you're trying really hard and you're not getting the results. And then it's just daily. frustrations. Yeah, frustration.

Scott Benner 38:36
Yep. Yeah. And then the frustration turns into well, why am I doing this? It's not working. Right. Yeah. And then you then people stop trying and then we turn that burnout, but the burnout happens before you stop trying. And yeah, I I made a note here to myself, because you said something I want to bring up later. But before I get back to that with the hell Goddamnit Hannah,

I'm getting old fight just flew right out of my head. It's not your fault.

You were just talking about all that about the burnout. And oh, learning. I got it. I don't think that people learn the way most people tried to teach. Right? Like, oh, 100% Yeah, we're stuck in that mindset of, we'll all sit down, I will tell you a list of facts. You will retain those facts. And then I will sit down again and tell you how to use the facts. And then you will practice using the facts and now you have learned and I think that's you know, based on probably how we grow up in in, in school, right, like, you know, here's a bunch of facts that will test you on them. I was a monumentally bad student.

Hannah 39:53
I've heard you mentioned this. I know this.

Scott Benner 39:56
I would if you looked at me in school, you'd be like, Oh, that boy must bumped his head on something, you know, like, I, I look confused, I'm failing. Like, if I could get a D in something I'd be like, right on this is amazing. I'm gonna pass. And that that was most of that was most of my time in school. I was better at social studies, Social Studies was storytelling. Yeah, right. And I was bad at science science was facts and and remember the facts and then put them in the right place. I'm bad at math, math is facts and the right place. If you could put a projector on my brain and watch me figure out math, you'd be like, why is it happening like that? But, but I come out with the answer. Right? I'm literally telling myself a story about the numbers and how the numbers work. And so to me, the biggest mistake being made in patient care is that we're trying to tell people, these are the facts. These are how the facts work, go do it. Right, instead of think of all the things that you know, and I'm not even just talking to you now, when I'm talking to everybody and all the things that you know, the information that's in your head, you hear people say all the time, like, I don't know why I know that, like, Why do I know Bruce Springsteen? 73 like, you know, I know that, because the person I interviewed yesterday brought up Bruce Springsteen, and I said, Oh, Bruce Springsteen, 73 I don't even like Bruce Springsteen. Why do I know Bruce Springsteen, 73, I heard an interview with him. And he mentioned he was 73. And it stuck in my head. I don't know why. And I think that most of us know, most of what we know, in that same fashion. And so the podcast is set up like this, so that if you listen to an episode, hopefully, you're entertained, but you're not going to shut it off and go, Oh, that episode was about this, and this and this. And I'll never forget that. It'll just be three weeks from now, like something will happen with your diabetes. And you'll be like, you know, I'm probably just going to do a Temp Basal increase here. And you're not even going to know why you're doing it. And that, that, to me, is why it works. Yes, yeah.

Hannah 42:08
Yeah. And another thing that that idea is shown is the idea of carb counting, like, whenever I learned how to do that, you know, when I was diagnosed, and I hated it, and I'm the I'm like you were I look at a plate of food. And I say, oh, that's six units of insulin. I have absolutely no clue at the carb count. Because I don't like I would last a day if I had to sit and calculate all my carbohydrates. But I know, based off, you know, the type of food it is my exercise level, my, my hormones, my sleep, all these other factors that I'm not consciously thinking about, but it's intuitive that I know, okay, I need six units of insulin or whatever the number is, or I need a higher Basal or I need a lower Basal or, or whatever. And that's that idea is how I've always done diabetes, but I always felt like I was doing it wrong, because they don't do that at the endocrinologist office. Yeah. And I was like, I was always fighting the way that I was, quote, unquote, supposed to do it based on their terms. But well, the way I'm doing it is working better. And so then hearing you on the podcast, like, oh, that okay, this is okay. Yeah, this is, this is okay. I can I can figure this out on my own, because I just wanted to do the right thing. And I wanted to follow the rules with what I learned at the office, but it just didn't work.

Lija Greenseid 43:35
You don't have I'm

Scott Benner 43:35
bad. I don't know where to put commas in sentences sometimes. Sure. Yeah. But I'm a published author. You have a book? Yeah. Well, no, it's I mean, a publisher paid me to write a book. Like everybody writes stuff, and self publishes it now. And if that's good for you, that's fine. But you're not a published author, you publish yourself. I'm a published author, a publisher came after me and said, Hey, you write down your thoughts. We'll put it in a book and sell it to people. And I don't know where commas go. But that didn't stop me when they made me the offer. I was like, right on, I could do that. And I thought I can tell a story, or figure out whether I'll figure out where the commas go later. And it just made me think of that with you in the in the office, because you're like, I know how to do this. Why are you telling me I'm wrong? Or that I shouldn't do that. I can't just because I don't know where the commas go. Like that's, I don't have to do it your way to do it. And I mean, I think that I think society is proving that out. In a big way. There's been a lot of interesting little shifts, like, here's one of them, apostrophe s. Have you noticed that people have stopped using it willfully? I haven't noticed. They know what belongs there and they don't care. And they're like, I'm not doing this anymore. And it's taking over. Yeah, and it's moving towards functionality over You know, what I guess, quote unquote, is supposed to be. And so I don't know if that's right or not, it might be infuriating to some people. I just think, sure, I just think it's interesting that the, that people can move in that direction. I know, we're all worried about this generation. But if we can get them out of their house and get them around other people, they're going to be really good. Like, like they they they're not held back by what everyone says is supposed to happen. And I don't I think about diabetes management that way. Like I honestly, I don't care what anyone says, because I think they're only saying it because the person before them said it. And you know, and I think I've told the meatloaf story. In my book, I've told it in this podcast, I don't know where it originated from. But to me, it says everything you need to know about the way you're supposed to do things. And you'd be surprised how much of what you think you're supposed to be doing is based on nothing? Yeah, so count your carbs. And if you don't do it, right, that's both. Like, like, I can count carbs perfectly. And if I'm not accounting for fat, and something, it's not going to matter. Right? You know, and then you have that person thinking, but I count the carbs perfectly. Now that this didn't work, well, this is an anomaly. So that's just diabetes. So there's nothing I can do about that. So this is now what I'm going to live with. And they don't even realize like, no, it's just, you know, there's a certain amount of fat and the French fries you just ate and about 60 or 90 minutes after you eat the fries, you're gonna get a spike because your digestion slows down. And there's actually a formula you can come up with take the fat and translated into insulin, and stop that from happening. Like, wouldn't that be better to know?

Right, you know, and then good,

Hannah 46:56
or you just had a big hike, and you need way less insulin for that meal. So if you do your typical carb ratio, you're gonna plumb it, or whatever it is, you have to think about all the variables and what's going on in your day. That's so that your carb ratio is going to be changing all the time. And so I don't I just don't use carb ratios. Really, I just know how much insulin I need. And that's just, it's through years and years of personal experience and being thoughtful about what my blood sugar's doing, based off of the circumstances. Yeah,

Scott Benner 47:35
but people also need a pat on the ass a shove, you know, I mean, I don't think we're allowed to tap people on the button anymore to say, good job. But anyway, like, shove, I didn't want to say shut, but you need somebody behind you, bracing you and saying you're doing the right thing, keep going. Or, you know, if this is working for you don't doubt it. Because a lot of people, I'm gonna say many people don't have whatever the thing is, I have where I hear something, and I go, I don't care what people think it's fine. Like, like, we're just gonna keep moving. I don't take into it. And by the way, even that's a misnomer. I care what people think. I just don't, I'm just not stopped by people's opinions. And so but a lot of people are, and it sounds like you, you might have been as well, which makes absolutely, yeah, 100% which makes sense because you plan the baby. And anyway, I don't have time to go into your whole psychology, but I understand you have. And by the way, just by how you had things hung on your wall. I love it.

Unknown Speaker 48:34
But but that that is a gift

Scott Benner 48:36
you need to give to people you need to be able to tell them to trust their gut.

Hannah 48:40
Yeah, and I didn't I didn't have that before the podcast really because and I don't I don't think anyone should do this. But I quit see my endo halfway through my pregnancy because they were so against me eating a low carb diet. Every time I went they told me I was going to damage my baby, which I couldn't bear hearing but my blood sugar was awesome. And so I just stopped going because I knew that what I was doing was better for my health and for my baby. So the podcast is something that gives me the confidence to say okay, yeah, you can make these decisions and you are the master of your own diabetes health. And so I think I'm at a place now with if we get pregnant again that I'll be able to go to the author like the endos and say, Okay, this is this is what I'm doing this is how I'm doing it. You know, can you support me in this instead of just feeling like I didn't know how to advocate for myself right for back then. I was just just discouraged I just stopped building were you in the hole?

Scott Benner 49:44
Okay, I cut you off. I didn't mean to I'm sorry. Go ahead.

Hannah 49:48
So the whole later part of my pregnancy I was just on my own

Scott Benner 49:52
when when the doctor said low carb is going to hurt the baby i But first of all, I have no like I'm not a nutritionist. I don't know if that True or False or something? Right. But did they know that you were doing it because you didn't know another way to keep your blood sugar stable?

Hannah 50:10
No, I don't think they understood that because I didn't really go to them frequently beforehand, maybe once or twice a year. And then well, and they had a diabetes specific doctor, I think is really great knowledgeable. She works with type one diabetic pregnancies. That's her whole thing. And so she knows how to do it. But they didn't really know me. And the first time I went in the office, there was no congratulations or, you know, we're excited for you. It was like, here's the risks here. And here's what you need to do, you have to keep your blood sugar's in this range, this is what is expected. And, or you really could hurt your baby. And so it was just really, like scary. And so the way they approached that wasn't very helpful. And I was telling him I was eating, I wasn't eating the amount of carbohydrates they wanted me to eat. And that that was going to delay my baby's brain development or whatever, which didn't need to happen end up happening. He was perfect. But so there was just no, it was like, we were fighting against each other. There was no, I just didn't feel supported. So I just stopped going, there's no harm at all. Yeah, and I didn't feel the freedom to share my story. And they didn't know really who I was, or, or whatnot. But I'm hopeful that going forward, I can, because I do want that support, and being able to have a professional to talk to and

Scott Benner 51:33
yeah, it would be, it would be amazing. You know, what's interesting is that, in your scenario, the doctor is the doctor starts off their life with their own thoughts. And then their thoughts are fed by the parents, and then by their teachers, and where they go to college. And, and then after that they're pretty set and how they think about things. Now they see other people's experiences, but because they're in the risk aversion game, they're, they're probably seeing things from the what can go wrong, perspective more, more often than not, and, and they're not blending you into that conversation about like, who you are, whereas, you know, and this is unfair to them. But the, like making a podcast and talking to so many people like this, the voice of this podcast, it started out as mine. But now it's an it started out the same way. These were my experiences and everything, but now it's, it's blended with everybody who's ever been on, because not only do I grow with their conversations, and my responses grow with with having had their these conversations, but their stories are, are bright here, too. So, you know, like, it's not that a doctor could accomplish that, maybe. But that's what you need, you need, you need a big picture beyond what you can imagine. And it has to be, it's a lot of feelings mixed up with words, and intentions. And you know, the intention of your words and the tone that they come with. I speak differently now than I did before. Like I used to have when I first started making the podcast, if you if a person, like you talk a little slow. For me, it's not a big deal. But you're a little more measured when you're speaking. And when there's a moment when I know how you're going to finish your sentence. And in the past, I would have been compelled to say it out loud. And now there's a voice in my head that says someone's going to someone is going to hear her, like really hear her right now. And I need to let her finish that thought it's not just about her and I having this conversation, it's about the people listening to it as well. So there's tone in your voice, and intent and sometimes sadness that comes from people. And other people learn from that when they hear it. They don't know what's happening. They don't learn from it, like two plus two is four and take the test. They they learn by hearing it over and over again. You're not gonna get that from a doctor's visit, not just around diabetes, obviously, but in anything,

Hannah 54:07
right? Because you need that experience. In the end people's support and people's stories.

Scott Benner 54:15
We, you don't, you don't want the pilot pontificating about their feelings while the planes crashing into a mountain. You need an immune like if you do want the pod to go, Oh, here's what I learned. Let me get this thing out of the way. And that's what the doctors miss out on. Like, if you could find that OB right now. And tell them I came to you pregnant, and you didn't go, congratulations. You just said here's all the things that could go wrong. I bet you if you told that person outside of their practice sitting having a cup of coffee with them, they'd be mortified that they did that. Yeah, you know, but that doesn't help you because that was that because now that's your experience. Right? You know,

Hannah 54:56
and I'm probably going to see that same doctor For my next pregnancy, because she is the only one at the office that I go to that is she she does all the pregnancies. So that's what she does. So I don't know how I'll approach that I may share my experience and see if we can do it different. We'll just kind of have to see how that goes at that time. But I think and I hope that it will be a better experience together and that there can be more of a relationship to be had through that.

Scott Benner 55:29
I'll tell you, I don't know if you care. But I'd walk in and say, hi, before we get started, I need to share with you that in my last pregnancy, our first meeting was all about fear. And I didn't feel any of the joy that I thought I would feel coming to the OB, and it's not your fault. I don't think he did it on purpose. But I don't want this, this new relationship. We're about to have to get off on that same foot. Please, like do your best to treat me like everyone else. Because I think you saw diabetes walk into the room and not Hannah the last time. Yeah, yeah. Then by the way, they won't like that you'll probably get fired.

Hannah 56:14
No, I think that I could do that. It would be uncomfortable for me, but it would be the the best approach.

Scott Benner 56:21
Yeah, I mean, it's the only way because otherwise, like all of her, her. I mean, is it a hey, her sorry, her. Yeah, okay. Yesterday I made I was, I don't know if people understand. Like, I don't think doctors are just men or women. I just, I just I pick a no, I pick a pronoun, and I go with it while I'm telling the story. And yesterday, I did it on an interview. And I stopped and I was like, I'm so sorry. I'm like, was it a man? And the person goes, Yeah, I was like, okay, then I just felt like I just did it again. But she's going to, she's just going to revert to what she does. Right? You know what I mean? Maybe you'll get a little more hay because your baby came out. Okay. Or because you left me you left in the middle a little bit, right. Maybe she'll be like, Oh, it's you? Yeah. Your baby. Okay.

Hannah 57:15
Yeah, I'll probably I'll probably bring him like, yeah, here he is.

Scott Benner 57:18
Yeah. Your his look like his eyes are on his head and everything doesn't have a tail. Turn them around. Like, look, hotel? Oh, I didn't think to ask you that. When you're like, I laughed. I was like, is the kid okay? Like you come out with like a foot coming out of the side of his head or something? Right. You know, so, um, but But

Lija Greenseid 57:39
I mean, listen, that it's tough. Like, I

Scott Benner 57:41
mean, there's part of me that thinks that maybe you do a, maybe you have a meeting with her prior even and say, Look, I'm thinking of getting pregnant again. I'd really like to come back here. You know, here's, here's what I was hoping we could do. I don't know. Like, it's all about them. And trust me, it's a lot about ego. Yeah, like, if their ego can handle it, you'll be okay. But if if she can't let that go. Might be might be unpleasant. All I can tell you is that the OB that handled my first child's birth was so devoid of personal anything. It's like, it's like talking to a robot that was gonna catch your baby. But he didn't know what he was doing. Kick came out. Okay. So yeah, who knows, but we weren't dealing with diabetes while we were doing it. Right. What is your story? Like, how long have you been personally with diabetes? Because your notes are very sparse, but they mentioned some struggles a little bit.

Hannah 58:45
Yeah, for the first 10 years. So from 12 to 22, I was kind of just coasting and doing the same thing. I had a Medtronic pump. And I gave insulin right for eight. And I checked my blood sugar maybe twice a day. But I was living with unknown shame about diabetes. When I was diagnosed for some reason, because of maybe my age, where it was developmentally my personality. I was immediately filled with shame. When I was diagnosed when they told me you have diabetes. That was the overwhelming feeling, but I wouldn't have said that then I didn't know what that was. It honestly wasn't until 10 years later that that really started to come out in ways that were really unpleasant. So in college, you know, 22, pretty severe anxiety and depression, almost all surrounding diabetes, but I didn't know it, and disordered eating and diabetes, distress and denial about it, and just confusion. I wish someone would have told me or my parents when I was diagnosed that it was going to impact mental and emotional health. And maybe they do that now, I hope they do. I hope they share that. But I needed counseling, and I needed therapy to really work past all of that. And so like, I would encourage, like anyone who has diabetes, if you haven't had counseling, or therapy for it, do it because it was so helpful for me. And my counselor, she didn't know understand diabetes at all. But she understood trauma, which she she told me that a diagnosis like that at 12 is a traumatic experience. Yeah, because you, you understand, oh, this is a, well, you're losing a part of yourself, part of your body is not working. And it's going to affect the rest of your life. And so we unpacked all that we worked through it, and I did EMDR therapy, which I know, it's been mentioned on the podcast before. And that was so helpful. Because before doing that, every single time my blood sugar was high, I was filled with shame and panic. And so I wouldn't, I just wouldn't check my blood sugar. Because I couldn't handle that emotional, it was so uncomfortable. But being able to work through, being able to work through that with a counselor and doing therapy was was really was really helpful. And just be giving me more freedom to actually take care of myself in an impactful way. Because shame is a, it's a really powerful emotion. But it's never correct. Like shame says that you are a bad person, like it's an identity. It's like, I'm bad. And that was what I felt every time my blood sugar wasn't, quote, unquote, in range. And that's a lot to handle, especially, you know, as a middle schooler into high school and, and just being able to go through a grief process. Like I think anyone with diabetes will have to go through a grief process, which is, whatever the fives however many stages there, I know, there's denial, there's anger, there's bargaining, there's, eventually you get to acceptance. And that took a long time for me, like I was probably in that denial stage for 10 years. And what that looked like, for some people that maybe looks like not managing at all, which is really dangerous. For me, it just looked like keeping it kind of hidden to myself and taking insulin. So I didn't end up in hospital, but I was never told when I was diagnosed, oh, you're gonna probably have to work through this, or there's gonna be some mental impact here, or there's emotional impact here. Yeah.

Scott Benner 1:02:25
It's interesting, too, that, that most people don't exhibit enough signs so that people around them could think, oh, there's something wrong. Or this for sure. You don't even know if you're hiding it as much as it's just, you're trying to function. So yeah,

Hannah 1:02:44
and I was excelling. I was excelling. In school, I was a three sport athlete, I was, you know, doing great by everyone's standards. But beneath the surface, there was a lot of struggle.

Scott Benner 1:02:55
Yeah, no, I think that all the time, when people are telling their stories, and you know, that they're surrounded by people who would have done something had they known. I mean, sometimes there are people who are surrounded by people who know and don't help, and that's a different problem. But, but it's just, I mean, it's just terrible that that could be so true for you. And that yet, it you're so far away from the answer when the answer was really, but just seeing a therapist and, and working through it. You know,

Hannah 1:03:28
yeah. As we were working through, you know, my depression and anxiety and different just struggles I was having, it kept coming back to diabetes. And at first I was like, No, this is this doesn't have to do with diabetes. This is that's different. That's a separate thing. But it kept coming back to that. And eventually, I just realized, oh, yeah, most of this is, was surrounding my diagnosis and how that affected me at that time and that age. And I remember we, what's that?

Scott Benner 1:03:58
Is it just shocking to be diagnosed? Right?

Hannah 1:04:01
It Oh, yeah. A total shock. Yeah. And my I, I didn't know how to handle it. And there's no pause.

Scott Benner 1:04:07
It's not like, it's not like someone says to you, hey, you have diabetes. And over the next number of days, weeks and months, we are going to thoughtfully go through what all that means. It's like you're at the doctor or the hospital. And then suddenly, everything about your life changes. Yeah. That's like having a car accident.

Hannah 1:04:28
Yeah, it's it is a traumatic experience, and trauma. I think a lot of people experience trauma in their life in small ways. It may be a big thing, a different different kinds of trauma, but a diagnosis like that is there should be mental health support and emotional support for any diagnosis like that, and I I don't think it's widely understood. But also like my therapist, she didn't know she didn't have diabetes. She didn't understand what it was. I just kind of told her about it. So you don't have to Find someone who's a diabetic counselor. Yeah, if I find someone who's a counselor and is good and can help you

Scott Benner 1:05:08
understand how people's emotions are, are hurt and how they can be brought back.

Hannah 1:05:13
Yeah, and so it dramatically in two ways, it dramatically impacted my management in a positive way. Because one I wasn't having panic attacks. So then I wasn't experiencing that, you know, increase in adrenaline and cortisol, and that spikes my blood sugar. So it from a physiological standpoint, it was helping, but then also, it helped me to, it took away the burden of making the daily decisions to Pre-Bolus and make corrections and change my insulin. So it was kind of the two two ways that it really helped me be able to manage better day to day.

Scott Benner 1:05:51
That's terrific. I mean, it's just anything that works, obviously, but Right, therapy gets a bad rap from some people. And so I don't think they think to try it, I think they think it's an admission of something again, more shame. Really. Yeah,

Hannah 1:06:09
yeah. Yeah, for sure. And I, for me, it wasn't until I decided that I needed help, and was going to reach out that it was helpful, because I had tried, you know, previously, because I was encouraged to by other people, and but I wasn't ready. So it has to be when the person is ready, and they they seek it out. And they admit, okay, yeah, this is time. This is where I am. And I want to get help is when when you actually get help that changes.

Unknown Speaker 1:06:33
Yeah, I mean, shame

Scott Benner 1:06:33
looks like different things to different people, right? Like you could feel excluded. You could have, like, exposure that you don't want somebody looking at you. Care expectation, I

Hannah 1:06:45
was always embarrassed about it. Like, I never wanted to tell my friends that I had diabetes. I don't know why it was embarrassing. It just was because I also associated diabetes with like, an old fat grandma. Like, that wasn't me, why do I have diabetes? Because I didn't understand type one and type two and the difference?

Scott Benner 1:07:01
No, why do I get like an old person's disease? Yeah, why

Hannah 1:07:05
did I get oh, I'm 12. And why didn't Why do I have a grandma's disease? Because that's what everyone would say like my, I would tell my friends, I would just say hello to a few people and be like, Oh, my grandma has that. And I'm like, Yeah, cool.

Scott Benner 1:07:19
Great. Yeah. No, I mean, it's,

if you felt that way, then at least a sliver of the people you're going to bump into are going to have that same thought, now you're aware of that. And, you know, so everybody you approach, you, you kind of subconsciously believe like some of these people are judging me now. And then you get that that's that unwanted exposure, which can feel like shame. You can also your expectations are have been let down. That's a feeling that that that shame thrives inside of as well. Yeah, yeah. It's terrible. There's been episodes about shame. I should do more honestly, at but earlier, you mentioned the word scarcity. Oh, did that come from your therapy?

Hannah 1:08:03
Oh, I have no clue. I don't know. So don't remember what I said that. In regards to

Scott Benner 1:08:08
Yeah, so there's, um, you said scarcity mindset. Yeah. And it just struck me because, like, three days ago, somebody said that to me. Oh, in the oddest place, I was getting my teeth cleaned. I don't know if you're this, everyone's dentists come in and do a checkup while the person in the middle of the teeth cleaning.

Hannah 1:08:31
I for sure. That's what mine does. Right.

Scott Benner 1:08:33
And so do you have a chatty dentist? Like one that actually cares to talk to you? Yeah,

Hannah 1:08:38
mine is very chatty. It's very difficult. He's white. It's very, it's hard because my mouth is open. And there's fingers in my mouth. Oh, he's talking.

Scott Benner 1:08:46
Oh, I see. You're alive. Oh, you said he's very charity. He's difficult. And I was like, you were like, it's difficult because they're, they want to talk to you while your money with your Outlook. So my, my guy is a really thoughtful person. And, you know, does talk to you about your health before he checks you. And he asks you about your whole life. And he asked me about the podcast. I've been going there for a very long time. And you have to try to imagine that. I am who I am. Always, like, I like I, you know, like I walked into the dentist's office that day. And I had a question. And I just walked in, and there's like three people working there. And I know all these people and I'm like, Hey, I

Unknown Speaker 1:09:29
gotta ask you a question.

Scott Benner 1:09:31
Is there anybody else in here? Like any other patients, and I can see down the hallway to the doctor who I've known personally as well. And he, I say, can I ask my question? He looks at me across the distance and just start shaking his head back and forth. Like no, no, no, no, no, no, no. Meaning there's someone in here and I can't be sure what you're about. So please, oh my gosh, but all I really wanted to ask not that this matters, but it was the very early appointment. I walked in. I was like, how do you guys get Got this early every day is horrible. And so they're like, Yeah, we come to work every day at this time. And I was like, That's it, you should get a different job, this is not good. And they're like, well, we can all make a podcast, I was like, hey, hey, hey, I worked for an hour and a half today. I was like, I'm gonna go do more don't don't. But you know. So anyway, I was joking around a little bit, he comes in later to clean my to help with the teeth cleaning. And I said, I gotta thank you, I've never felt so seen in my entire life. I was like, you knew not to let me speak out loud if there was another person here. And we laughed a little bit. And he said, I've just at the end, he starts to mention, like, you know, I've known you for so long. And he's like, your life has been like, like quite a transformation, like, you know about the things you've accomplished and done, and you know, what he was talking about. And it led him to say, How's the podcast going? And I told him, that it was about to hit 10 million downloads. And that, you know, and he's like, Oh, he's congratulating me on everything I said, but I just, like, I get up every day. This thinking about how to make it, keep going, like, how to keep it going, and how to grow it. And I said, the Keep it going part and the growth part of the same, because once you see it helps somebody like, kinda like, once I hear your story, I think, well, I can't stop making this podcast because there's going to be another hand, right? And, and at the same time, there's not just another hand, there's 1000 Other hand as well. So if I could grow it, I could reach more of them, and maybe more people would have the happy outcome that you've had. And I said, so that's kind of how I think about it. And I'm always worried it's going to stop. And he's, and he's like, what I was like, it's like, Dude, it's, it's media, like, they're going to get sick of it eventually. If I don't, if I don't keep morphing it and letting it grow. But not too quickly, like the podcast can't just make some like, monumental shift, it has to slowly morph is the right word from like, like, as it grows and gets different, but not too different. So that the people who like it don't go, Oh, God, this thing changed. I'm dropping it now. Like, it's a hard thing to do, to keep to gather people in one place. And keep them interested in a way that they're like, I want to go find that podcast, I'm gonna go, I'm gonna go learn about whatever this episode is about. And he said, Oh, that's a scarcity mindset.

Don't think that way.

And I was like,

is it? Like,

I don't think it is. I think I think he's, I'm being realistic. But, but he was so worried for me, he's like, please don't think that way. He's like, let that go. And things will just flourish. And I'm like, I don't know, man. 10 million, like, is flourishing, isn't it? You know, so anyway, we had this long conversation while I was sitting in a weird angle. And he was like, looking over at me with a bright light on my face. Is it not a thing that you think about? You just kind of said it in passing?

Hannah 1:13:10
I think I just said it in passing. I think I've definitely heard the concept of a scarcity mindset versus an abundance mindset. But yeah, I'm trying to figure out if that's if what he was talking about is truly a scarcity mindset or not.

Scott Benner 1:13:26
Yeah, I think I'm being realistic. I mean, you think of all the TV shows that you bailed on in the middle? Oh, for sure. Right. And so think of all the work that that person that that TV show did to get you to try that first episode, right? And think of how at some point you were actually enjoying it. And then one day, it just wasn't important for you anymore. And the problem from my perspective, like from the TV shows perspective, if they lose enough viewers, then they don't get to make the show anymore. And it just ends. But those people go on to be producers and writers of other television shows. I'm never going to make a thing this popular ever again. Right? This is your thing. And I don't mean like I can't lose my thing. I mean, I can't just decide to go help people a second time. It very well may not work again. And I And to give you context for that. I've been talking about this a lot this week because of the 10 million but a media will tell you there's like over 4 million podcasts. That's not true. There's like 4 million parked RSS feeds meaning somebody was like, I'm going to make a podcast about pumpernickel bread. I'm going to lock down that feed I'm going to like I'm going to register the pot, the pumpernickel podcast, which I don't think you can make a whole podcast about but I do love the title. And and so there are a lot of locked down titles like the way people used to sit on and probably do still sit on like, they squat on URLs, like they'll buy a you know something.com thinking they're gonna use it later and they never or do. So that happens a lot with podcasts. So anyway, there's a certain amount of actually active podcasts, but only I think it's about a million or half a million excuse me, there's about a half a million podcasts that actually put up an episode at least once a month. And wow, of them. 95 or 96% of them, don't get enough downloads to interest an advertiser. Wow. So

Hannah 1:15:30
you know, there's a very small percentage of podcasts like yours that has

Scott Benner 1:15:35
enough downloads that an advertiser would say, Well, this is would be a valuable place to put my advertising dollars. And the reason that's important is because if you don't have advertising, then you can't treat it like a full time job. And there's an episode out today, with Stephen, it's called, I think it's called Steven Appleseed. And I've already listened. Oh, okay, great. So you Wow. Hey, Hannah, how are you? Thank you. Oh, my gosh, hey, so far, especially

Hannah 1:16:01
I listened to on my walk this morning was great.

Unknown Speaker 1:16:04
Oh, cool. So So

Scott Benner 1:16:05
Stephen is making a point at some point in there about all the quality content that he has heard from people with diabetes over the years. But how none of it ever gained, like mass exposure?

Hannah 1:16:17
Yeah, didn't gain traction, right.

Scott Benner 1:16:18
I am one of the only people who's ever done that.

Hannah 1:16:23
Well, that's interesting. You say that, because I now remember when I chose to start listening to your podcast, I clicked on it because it said diabetes. And I saw that there was a download from that day. So I was like, oh, it's current. Like, it's it's an active podcast, and they're gonna keep he's gonna keep making episodes. Yeah. So because you sometimes you click on a podcast, but the last episode was six months ago, or a year ago. And so I wouldn't be drawn to listen to that one. Right.

Unknown Speaker 1:16:50
Do you have any idea if you

Scott Benner 1:16:51
go look how many podcasts the last episode that went live says, we're just going to take a break for Christmas. But we'll be right back. And I'm like, No, you're not because it's hard to make a podcast. And it's, it's demanding and time and all that stuff. And, and so anyway, like, I wasn't boasting before, like, like, I'm one of the few people who has created a thing that's gained, what content creators might call escape velocity. Like, like I'm, I am, I get to decide how this goes. And, and it's not like, like, listen, there are other podcasts, and they have advertisers. But I guarantee you, the US advertisers have given them 20 $40 To put an ad on it. Like it's not enough. There's not enough to live off of they have an advertiser, and it looks good. But it's not a real. It's not a real business model. I guess, if that makes sense. So you have to make you have to find a balance between this sustaining itself financially, and it helping people. And I have, in my opinion, I have struck that balance. So great. Yeah. And now we're getting to the point where people who aren't medical related, are starting to ask about advertising on the show. Oh, wow. And I think that's where that's when my freedom will really like crank open? Do you have a freedom?

Hannah 1:18:11
Are you going to change the structure of the podcast? Are you always going to keep it same kind of structure?

Scott Benner 1:18:18
I can't see changing how it works at all. Like I like the three conversations, one medical episode a week. I liked that format. I liked that the medical episode is generally speaking shorter. I like that, like hearing you talk about long form content was really exciting for me, because I believe people want to hear long conversations, because they're real. But I but I, but there are people that the management base people who are mostly the Facebook base people are like, no, like, I don't I don't want to hear a two hour conversation with a girl who thought about hurting herself when she was 12. But I do. Like, I want to hear that conversation. So I'm doing the thing that you hear most creative people do. I'm making a thing that I would listen to.

Hannah 1:19:06
Yeah, well, and it is reasonable. I mean, I I choose to listen to it every day. So yeah, keeping because it's people's stories. And there's always something to relate to. And there's something that draws you into someone's story and someone's experience rather than facts. Like we were talking earlier. Yeah.

Scott Benner 1:19:23
My son tried to say to me a couple of months ago, he's like, are you ever going to make that podcast bigger than, than diabetes? And I said, it is no, and he's like, What do you mean, he's like, every day you talk to somebody who has diabetes, or it's like the caregiver, somebody with diabetes, it's about diabetes. Like it's not like it isn't. It isn't like, I think there's something amazing about hearing every conversation in the world, but everyone you're talking to has, like, like there's insulin in the refrigerator, you know? Yeah, that

Hannah 1:19:53
that there's that one commonality. Yeah, no,

Lija Greenseid 1:19:56
I love that. I

Hannah 1:19:56
wonder I wonder how many people listen And that don't have diabetes or don't aren't a caregiver, I would, I would think it's pretty low.

Scott Benner 1:20:06
It's a shame because there are episodes of this podcast that have little or nothing to do with type one that are really good episodes. Like did you

hear Perry last week?

I don't I don't know if I after dark California sober. Oh, yes. Okay. That episode could have been in any podcast? Yes. Yeah, it does it he's gotten

Hannah 1:20:29
but but someone with that that that not associated diabetes isn't gonna listen to it.

Scott Benner 1:20:33
Yeah, it's a shame it's a it's a good podcast episode. And I have a lot like that I believe that I have a lot of episodes that are like that. And and it might never, it might never find people who don't have type one or diabetes in general. But that's okay to me. Because it for the people who did find it. I hear enough from them that this is their favorite podcast, not just their favorite diabetes podcast. And that, to me means the same thing, I'm probably never gonna get to like, you know, I'm probably never gonna get to like, 5 million a month. But I don't care. As long as it's reaching people with diabetes, it doesn't matter to me if it gets past that.

Hannah 1:21:13
Yeah, there's probably there's going to be a ceiling, but it's still going to reach people in there. And I think that, like I share it with anyone that I know that has diabetes, or I don't know if they'll listen to it, but I just tell them about it. And so there's word of mouth is powerful to share it.

Scott Benner 1:21:29
It's the only way honestly, yeah, word of mouth is the only thing that works. My goal is a million a month. That's that's what I'm trying to get to a million downloads a month. How close are you halfway there? Oh, wow. So that's what I'm shooting for. I want to I want to get to a, I want to get to 12 million a year. And then I'll reassess it and see what's what's happening because of the 10 million that just happened. And I want to be clear for people like it's not it's 10 million lifetime, like I started the podcast in 2015. It took four years to get to a million. And then it only took one more year to get the 2 million. And then there was couple years in there that did really well. But they weren't like extravagantly well, but the last 5 million came in like the last 12 months. Yeah. So now we're on to it now. Like we're getting there. So. And that escape velocity is important because it gives you freedom to do other things. Like you can tell somebody to go to hell if you want to. Right? Not that I haven't so far, by the way, I really should say that the advertisers I have I'm actually very proud of them. I think I have a lot of gold standards and diabetes cares, advertisers, I think prizes are great. Yeah, yeah, no. And they're very supportive of the show. And I have no reason to want to walk away from them. I'm not saying that. But just the idea that I could, you know, is, is freeing. I don't know why. But you know, and there's even a part of me that thinks like, like, at one time, it's going to like, I mean, you guys don't know this, the pressure I live under, but if you don't use those links, I'm going to lose those advertisers. I live in that reality every day. And, and so when I lose the advertisers, I lose the show like it's gone. And then the next Hana just doesn't get this because you think oh, no, the podcasts will be there forever. But it doesn't work that way. Like content gets content that isn't new, gets stale, and it disappears. Yeah, the difference between a compendium of information that will help people and a book that nobody looks into, is the newness of the show.

Hannah 1:23:42
Have you ever thought about reposting old episodes? Like

Scott Benner 1:23:48
you because people haven't heard them?

Hannah 1:23:51
Yeah, you know, number like random numbers into two hundreds or three hundreds like that. I wouldn't necessarily go and scroll to find. But if you were to post it, and it was up, you know, tomorrow, I might listen to it. I wouldn't even know that it was from two years ago. Would you ever do that? I

Scott Benner 1:24:08
just had a conversation online with people. And I asked that question. If on Friday, I ran a best of episode kind of thing. Oh, sure. Yeah. Would that bother you? And most people were okay with it. But they wanted it clearly branded.

Hannah 1:24:25
Oh, to clearly show that this is a repost

Scott Benner 1:24:28
Yeah. Like this is this is a this is a reposted episode. Now.

Unknown Speaker 1:24:32
Would I do that? I don't see why.

Scott Benner 1:24:36
I don't see why I shouldn't. Like I don't think it's a bad idea at all. I think it would bring out those episodes to people who haven't seen them yet. And I do think that's a good idea. And I thought so when I had the conversation. The truth is that after I thought to ask people about it and came to the conclusion that it was a good idea. I forgot that I was thinking about it. So I just pulled up my to do list. So I can add it.

Hannah 1:24:58
You can do repost Fridays. or something? Yeah,

Scott Benner 1:25:00
right. And but that's, that's so interesting because I had an entire day where I thought about that, then I had conversations with people to make sure that like my thinking about this correctly. And then I thought, I think this is a good idea. And then until you just brought it up, I didn't remember that I had ever done that. And it's because, I mean, there are a few people who helped me with the Facebook group. They're very helpful. And there's this girl named Angela has been helping me lately with stuff like there's a it'll be gone by the time people hear this. But there's a survey right now about for listeners to the podcast, which has been like, Yeah, I think I took that one. Oh, my God. It's got like, 700 responses already. So thank you. It's amazing. Yeah, the person who made the survey for me is a mph grad from Hopkins. And she's in she said, she sent me a text the other day, hold on a second. I'm gonna find it because what she said was, we were talking about the survey. Hold on. I know, I'm like, this is boring. But give me a second. Even prestigious medical research groups struggled or produced surveys with this many active participants. Wow. And I was like, Ah, cool. And so like that kind of stuff, like people are helping me behind the scenes with things like that. They're all very lovely people, but the production of this podcast, and the worry about it, and all the meetings with the advertisers and all the other stuff that has to happen, sending out invoices, which by the way, I'm not good at is it's all me. It's all Yeah. And so I would like to share it. But I don't know how to do that. Honestly. I think they're part of the reason why it works is because it all begins and ends with what I think is the thing I want to do.

Hannah 1:26:43
Yeah, there is something to be said about delegation, though, I used to be a varsity softball coach. And I had to learn really quick that I had to delegate things in order to accomplish what I wanted to watch. You have to put a lot of trust in people, but you also have to influence them in the direction you want to go.

Scott Benner 1:27:02
Yeah. When I'm growing like that a little bit, I have a I have an art student right now making, like art for me that I'm not involved in. So I'm not sure if I'm gonna use that. I have to say it, but like I at least, was like, Oh, I can do that. Because I realized that like this podcast is big enough. This would look good on their portfolio. Oh, sure. I was like, why am I not taking an intern on RT, I should be doing that. So

Hannah 1:27:27
is there so many people that are part a part of the Facebook group who have been impacted that have certain gifts and abilities that may be able to contribute? You know, it's hard to find them or be willing to try it. But, but also going back to the Repost, right? If you repost Friday, there's not much to be lost in that I don't like you mean, those specific ones may not get as many views, but you'd still probably get more downloads per week.

Scott Benner 1:27:53
You see, I don't worry about them not getting views, I worry about them pissing somebody off.

Hannah 1:27:57
And then that person just stops listening. That's my bigger concern.

Scott Benner 1:28:02
So should I be concerned about that? I don't think so. I don't know. You don't think so? Because you've only been listening for six months, and I saved your life and all that stuff. So but, but like, you know, somebody who's been listening for four years might be like, just wake up in a bad mood one day and be like, you're I'll give you an example. There is a person who has been following this podcast forever. I know them from online. Always been a lovely person.

I thought always a little strange, but never in a weird way. Just, you know, lovely, different way. And about like three months ago, they just turned on me.

Oh, and I like, I mean, look, there are 34. As of this recording, there are 34,000 people in my Facebook group. I'm maybe aware of 200 of them by their avatar and because their name sticks in my head for weird reasons. As far as their posting style, I maybe only know five of them. And those are usually problem people. Because they get brought to my attention, right? This is not a this is a person I knew of if you showed me their avatar, I would have thought nice lady. And I have like a generally like, good feeling about them. Yeah, but all of a sudden out of nowhere, just like came at me like you like you don't care about people anymore. And like I'm like, What in the hell like I haven't changed the way I make this podcast. I'm completely open about the fact that there are advertisers, you know, like it's just, it's all about the ads now and I'm like, I I did something one day that just rubbed this person wrong. And they just like flipped like a light switch.

Hannah 1:29:40
But I also I don't know if that has to do with you as much as it has to do with them and maybe a circumstance in their life that then came out

Scott Benner 1:29:51
towards you. Yeah, I don't know. Maybe I somebody told me the other day. I'm not listening to the podcast anymore because you have athletic greens as an advertiser and I'm not Like, okay, yeah, like, I don't know what to say, like you. This is a person who told me previously This podcast was a really great help to me. Yeah. And I'm like, I don't like, look, it's athletic greens. It's a green drink, drink it or don't drink it. You don't have to buy it like nobody's making you do it, you know, like, and it's like, do you I wanted to say, when you're watching tennis, when CBS in the afternoon, and an ad comes on for something that you don't, I don't know, well, I don't even know what the person's problem was with it. But But you you don't have a good feeling about do you shut the tennis match off? Do you go oh, I can no longer watch tennis on CBS. Because they like Downey, get on me like, I'm like, What in God's name? Like, what kind of a thought is that? And so I am aware. Now these people are very few and very far between these interactions. Yeah, but it's still in the back of my head. I don't know how many of those people my gonna piss off if I run an extra episode on Fridays, even though I do think it's valuable for people who haven't heard them before. Who won't think to go back. And I could easily you know, I could easily ask the people who listen and love the podcast make me a list of episodes that you think should be, like, best of material. Yeah. And and they would come up with the great with great ideas for people. Yeah, man. I don't know. I should just do it. I shouldn't give a crap. What happens? Just do it? Yeah. And I'll blame you if it goes wrong. How's that sound? I'll take that. Sure. Well, if you pay my kids tuition. Well, then I don't know how far you're gonna get.

Hannah 1:31:38
If it doesn't, if you feel like it's not working, you could just stop doing it.

Scott Benner 1:31:41
I'm teasing too. I don't actually think it'll be a problem. It's just one of the things that I'm tasked with worrying about because it's my Yeah, right. So this, these are my hells, okay. They're not so bad. So I'm not complaining about them. They're just, they're just the things I'm, you know, that I think about throughout the day when I'm making this thing. Anyway. All right. Well, this was terrific. Thank you very much. You do like long conversations, and you gave one so I appreciate it.

Hannah 1:32:09
Thank you. I appreciate the opportunity to talk to you. No, it

Scott Benner 1:32:12
was really it was really lovely. You're terrific. Can you hold on one second for me? Yes, thank you

How about Hannah, given a great podcast interview, thank you so much. And also want to thank cozy Earth and remind you to use the offer code juice box at checkout to save 40% off of your entire order cozy earth.com Who else was today's podcast sponsored by Do you remember? I can tell you, us med us med.com forward slash juice box or call 888-721-1514 Do your business with us Matt just like we do. You know at the end of the cozy Earth add like way back there. I was just like, go buy towels. I thought this is how I should do all the podcasts be like go get it.

Go get up. stuff. Good stuff. Use the link.

So articulate. Thank you so much for listening. I'll be back soon with another episode that Juicebox Podcast