#1277 Grand Rounds: Dr. Tarlow

Dr. Stephanie Tarlow is a type 1 and an endocrinologist. 

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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 1277 of the juicebox podcast.

Stephanie is a 33 year old type one who happens to be an endocrinologist, and she's here today to add to the Grand Rounds series. 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. When you place your first order for ag one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. Ag one.com/juicebox. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40% at cozy earth.com and if you are a type one, or you're the caregiver of a type one and you're a US resident, I need you to go to T 1d exchange.org/juice, box and complete the survey. Completing the survey helps type one diabetes research to move forward. It may help you. You'll find out more about that after you complete the survey, and it's definitely going to help me. T 1d exchange.org/juice, box should take you about 10 minutes.

This episode of The juicebox podcast is sponsored by touched by type one, touched by type one.org and find them on Facebook and Instagram. Touched by type one is an organization dedicated to helping people living with type one diabetes, and they have so many different programs that are doing just that. Check them out at touched by type one.org this episode of The juicebox podcast is sponsored by the Dexcom g7 made for all types of diabetes. Dexcom g7 can be used to manage type one, type two and gestational diabetes. You're going to see the speed, direction and number of your blood sugar right on your receiver or smartphone device. Dexcom.com/juicebox, today's episode is sponsored by Medtronic diabetes, a company that's bringing people together to redefine what it means to live with diabetes. Later in this episode, I'll be speaking with Jalen. He was diagnosed with type one diabetes at 14. He's 29 now he's going to tell you a little bit about his story. To hear more stories with Medtronic champions, go to Medtronic diabetes.com/juicebox. Or search the hashtag Medtronic champion on your favorite social media platform.

Dr. Tarlow 2:47
Hi, juicebox. I am Stephanie tarlow. I'm a physician assistant that specializes in endocrinology and specifically diabetes at OHSU in Portland, Oregon.

Scott Benner 2:59
Do you have diabetes yourself?

Dr. Tarlow 3:02
I do. I've had type one diabetes since I was 12 years old. So this year makes that 20 years. Oh, you're 32 okay, I'm 33 very soon. Oh, happy

Scott Benner 3:14
birthday in July, perhaps Thank you. When my birthday is June, 27 Oh, well, then really, happy birthday.

Dr. Tarlow 3:20
Thank you. Birthday month.

Scott Benner 3:23
Yeah, do you do like a whole thing? No,

Dr. Tarlow 3:25
we typically go out to Eastern Oregon on this little lake for the weekend, which is nice, very

Scott Benner 3:30
nice. Well, I hope you enjoy it. Thank you. I'm gonna find out a little bit about your diabetes first. So 20 years ago, pretty long time ago, actually, Arden is, hold on. Arden's 20 this year she was diagnosed.

Dr. Tarlow 3:44
We were diagnosed the same year, from what I could tell, 2004

Scott Benner 3:48
is that right? Arden's born 2004 diagnosed, 2006

Dr. Tarlow 3:53
got it, yeah, I was diagnosed in 2004 Okay, you

Scott Benner 3:55
got two years on her. So you're winning some sort of thing that I don't think comes with an award, but so, so management back then, I'm very, very familiar with, did you get a pump at any reasonable distance after your diagnosis? No,

Dr. Tarlow 4:10
I was very against the pump and anything on my body. For that matter, I started out with the mph and regular insulin mix syringes for like, the first year. And then I remember going back a year later to have more education and learn about like carb counting in terms of, like, using ratios and varying the carbs per meal with pens. And that was like the biggest game changer, rather than having I remember my parents getting like, low carb ice cream. And I was so devastated, thinking, this is my life. But, you know, there's so much more flexibility with not fixing carbs per meal. That

Scott Benner 4:49
was it. It was just the ice cream. It said low carb on and you're like, oh yeah.

Dr. Tarlow 4:54
It was so sad. I just remember my grandma made everyone like parfaits, and mine was sugar free chocolate. But soft and stuff. I was like, God, this is so sad.

Scott Benner 5:03
You're old enough to feel it too at 12, huh? Yeah,

Dr. Tarlow 5:07
I was very much a kid that, like, would come home from school and grab a sprite, or, like, have a Costco poppy seed muffin. And so that first year was really hard, because I think I was having, like, 45 grams was the amount I was eating for breakfast, lunch and dinner, and so, yeah, that was pretty restrictive. And then it took me a very long time to give myself a shot by myself. Like the nurses in the hospital were incredible. Usually, they make you give it, you know, try to make you give it yourself by the time you leave at 12. And I was just not having it. So it took me until my parents went out of town, and I did not want my friend's mom to come over and give me the shot that I just was like, I'll do it myself finally. But it would be times where we'd be sitting down and I'd be like, Okay, I'm counting to three, and then I just say one, two, and then, like, 30 minutes would go by. And if my dad ever did it before, too, I would just cry and cry and cry. So yeah, I had a really hard time with the needles. Interesting, so I definitely empathize with my patients when they have those needle phobias. How

Scott Benner 6:13
old were you when you finally did it yourself? When that neighbor was the only other answer?

Dr. Tarlow 6:20
I was probably 13 and a half or 14 couple

Scott Benner 6:24
years. You made it a couple years? Yeah, I um, it's interesting. First of all, it's crazy that you got NPH and regular in America 20 years ago. We might bring that up again, but Arden, similar situation like Arden, got a lot of needles, obviously, in the first handful of years, no one even talked to us about a pump. For years, they never even brought it up. I didn't even know to ask about it, and so she probably had. I remember doing the math back then, we probably stuck her 10,000 times between needles and finger sticks, wow, before she got a pump when she was like four and a half, so, like, in the first two years or so, but she was really young, and I've told this story before, but like, you know, there's once in a while you're like, I think this pump site is bad. Like, I'm going to inject to like, you know, like, see, and even that stopped happening because we were just on a really good roll with OmniPod for a long time. And then one day I was like, Hey, we're gonna have to inject. And when I She's like, okay, like, she like, just was like, Okay. And then I got out the syringe, and she kind of coiled recoil, and she goes, what is that? And she wasn't being like, funny. She was like, what is that? I was like, it's a needle to put in the insulin. She's like, whoa, whoa, whoa. And then then it was crazy, because I was like, Oh my God, you don't remember the 1000s of these that you've had. Like, that's crazy, you know? And, but she didn't, and that's

Dr. Tarlow 7:46
super interesting, actually, yeah, yeah. I mean, it makes sense. Like, I think there's a lot of times too, like, nowadays I think we get kids on Dexcom so quick, like, they don't remember that small little period of finger sticking,

Scott Benner 7:58
no, I agree. And then when you go to do it even now, like, I'm like, alright, and check your blood sugar. And she's like, and she's like, Wait a minute. Like, I got the Why am I wearing this thing? And I was like, so but anyway, like, it happened so infrequently that we didn't realize for a long time, like, Arden had a pretty significant needle phobia, and it didn't rear its head until an A 1c check one time. Oh yeah, where she basically, like, spider monkeyed up the corner of a wall in the room when the when the phlebotomist came in and, like, flipped out, and I had to take her out of the room and, like, calm her down and everything. And now she's got this crazy, and I mean crazy in the sense of the word crazy that you're thinking of, like, when she gets her blood drawn, she stares at the needle. Oh, wow, oh my god. And look away. She goes, I need to see it.

Dr. Tarlow 8:46
Okay. Whatever worked. Yeah,

Scott Benner 8:48
yeah. But so anyway, one time before she left for college a couple years ago, I said you are gonna have to give yourself an injection before you leave, because if it comes up at school, we can't be doing this thing that you just described, by the way, by the way, do you prefer Stephanie or Steph,

Dr. Tarlow 9:04
either way, Steph is what most people call me. Okay, so

Scott Benner 9:08
Steph, the thing you just described, Arden, took a syringe with insulin into the bathroom at our house, and she came back about 45 minutes later, and she's like, sweaty and disheveled, and she's like, I did it. And we were like, Uh oh, I didn't know it was this bad. You know what I mean? Yeah, oh yeah. You know what? Actually ended up breaking it for what she started using a GLP, ah, that's cool. She has to do an injection once a week, and she's getting better and better at it all the time. So which one,

Dr. Tarlow 9:42
I might ask, because some of them have, like, the auto inject, which is a pretty cool feature.

Scott Benner 9:46
So she is using Manjaro now. Okay, that one's like, cap off, unlock, push button. She had a little more trouble with ozempic. Mm. Because it's like, it's push, like, it's a collapse of, like, how does it work? It works like the Jibo kypo pen, like, you have to push it into, like, click on epi pen, vibe, right? And that one is interesting. Like, something between the button and the pushing was really it was just crazy how much she struggled with it, but it was helping her, and is helping her so much with her blood sugars that even she's like, geez, I gotta use this, you know. So, yeah,

Dr. Tarlow 10:28
it's pretty awesome.

Scott Benner 10:30
Do you have people using it in the practice? This episode is sponsored by Medtronic diabetes. Medtronic diabetes.com/juicebox and now we're going to hear from Medtronic champion Jalen.

Speaker 2 10:43
I was going straight into high school, so it was a summer. Heading into high school.

Scott Benner 10:46
Was that particularly difficult?

Speaker 2 10:48
Unimaginable. You know, I missed my entire summer, so I went to I was going to a brand new school. I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was. My hometown did not have an endocrinologist, so I was traveling over an hour to the nearest endocrinologist for children. So you know, outside of that, I didn't have any type of support in my hometown.

Scott Benner 11:16
Did you try to explain to people, or did you find it easier just to stay private.

Speaker 2 11:21
I honestly, I just held back. I didn't really like talking about it. It was just it felt like it was just a repeating record where I was saying things and people weren't understanding it, and I also was still in the process of learning it, so I just kept it to myself. Didn't really talk about it. Did

Scott Benner 11:36
you eventually find people in real life that you could confide in?

Speaker 2 11:39
I never really got the experience until after getting to college, and then once I graduated college, it's all I see. You know, you can easily search Medtronic champions. You see people that pop up and you're like, wow, look at all this content. And I think that's something that motivates me. Started embracing more. You know how I'm live with type one diabetes?

Scott Benner 12:01
Medtronic diabetes.com/juicebox to hear more stories from the Medtronic champion community. Dexcom g7 offers an easier way to manage diabetes without finger sticks. It is a simple CGM system that delivers real time glucose numbers to your smartphone your smart watch, and it effortlessly allows you to see your glucose levels and where they're headed. My daughter is wearing a Dexcom g7 right now, and I can't recommend it enough, whether you have commercial insurance, Medicare coverage or no CGM coverage at all, Dexcom can help you. Go to my link, dexcom.com/juicebox, and look for that button that says, Get a free benefits check that'll get you going with Dexcom when you're there, check out the Dexcom clarity app or the follow. Did you know that people can follow your Dexcom up to 10 people can follow you. Right now, I'm following my daughter, but my wife is also following her. Her roommates at school are following her, so I guess Arden is being followed right now by five people who are concerned for her health and welfare. And you can do the same thing, school nurses, your neighbor, people in your family, everyone can have access to that information if you want them to have it, or if you're an adult and you don't want anyone to know, you don't have to share with anybody. It's completely up to you, dexcom.com/juicebox, links in the show notes. Links at juicebox podcast.com, and when you use my link to learn about Dexcom, you're supporting the podcast.

Dr. Tarlow 13:34
I do. I use it off label. Actually, I don't know how I was able to get it covered, but for one of my type ones, I was able to get the GLP one in the form of the pill covered, and it just works wonders for their blood sugar. But a lot of times I struggle with insurance. We see a lot of patients on like the Oregon Health Plan, and that coverage is pretty hard to get.

Scott Benner 13:55
What I'm hearing from doctors is this very kind of medically sound like this person I'm dealing with has type one diabetes, but they also have insulin resistance. Oh, for sure. And if they didn't have type one, they very well might be type two. I you know, I don't know. And but what I'm seeing here is that a person without like insulin resistance, who has type one diabetes, is using significantly less insulin than this person is, and I think a GLP would help them. So they're doing a they're they're sending dual diagnoses into insurance. They're like, look, they're type one and they're type two. I don't care what you guys call it on the computer, that's what I'm doctoring over here. These two problems. Yeah. I

Dr. Tarlow 14:38
mean, that's great idea, yeah. Yeah. And

Scott Benner 14:41
they're starting, some people are starting to see it get covered that way. Okay,

Dr. Tarlow 14:45
yeah, that's great to know. Because, I mean, yeah, when I have patients who come in with a car ratio of one to two, you know, that's clearly insulin resistance. That's and that hurts too. It's not like that's and so for those patients who, if they're on a pot. Pump. They're changing their pump every day, and all very much off label use like a u2 100 insulin, if I have to. Yeah, but still, I think adding something like a GLP one would be awesome. And I know they're doing quite a bit of studies right now, like through T 1d, exchange and stuff to get, like, patients on GLP ones with type one. And hopefully we'll get some sort of approval for that too, to make it easier.

Scott Benner 15:24
Yeah, I think I'm supposed to help soon with the T 1d exchange to find people for that study. So I'm excited about it, because I've been doing a lot of interviews. Actually, I have one going up probably next week with this guy, 58 years old, type one, since he was 50, definitely type one, like auto antibodies, like, you know, the whole thing using insulin for ever. Probably had Lada for the first handful of years, but then his insulin needs went up for a couple of years. He started Manjaro, and literally, is not using insulin at all anymore.

Dr. Tarlow 15:56
Wow, that's pretty incredible. Insane.

Scott Benner 15:59
It's insane. I I've interviewed a 15 year old daughter, the mother of a 15 year old girl who's down to like, four units of basal, and that's it.

Dr. Tarlow 16:07
Yeah, I have actually a patient. She's probably like, 12 or 14, and she's on two units of long acting, and we tried to increase her to three, and it was too much. And that's just so interesting. And the and her carb ratios and correction are, like, pretty average for her age, but we just cannot go up on the long acting

Scott Benner 16:26
because of a GLP or just in general. Oh, just in general. But

Dr. Tarlow 16:30
I think that's so weird. People's different insulin requirements, but yeah, no, that makes sense with the GLP, one needing way less. And I try to get that too sometimes for patients with metformin, but it just doesn't have the same

Scott Benner 16:40
effect. Yeah, Metformin is nice, but it's not going to do this. What this stuff is doing? No,

Dr. Tarlow 16:45
it sometimes decreases long, acting a little bit, but nothing to the extent that the GLP ones do.

Scott Benner 16:51
So for a number of years, Arden Zendo, who manages her diabetes now, was her endo for her thyroid when she was still a juvenile. And she kept talking. She kept talking. So the way we did it was chop, oh, I've never said Arden's Hospital in here before. Oh, well, who cares? It's over now. Chop was managing Arden's diabetes. Listen, they're great, but I was managing ardent diabetes, but I noticed that their deafness, for for thyroid, wasn't what I wanted it to be. So we found a concierge doctor to handle art and thyroid B and she also handles my daughter, my wife's and my son's thyroid issues. Right? When Arden reached 18, and chop was like, Get out of here. They said, it nicer. But, you know, I went to this endo and I said, Look, I know you don't take new patients and you don't do diabetes, really. I was like, but would you, you know, would you manage Arden's type one for me, please? She's really nice. And she said, yeah, absolutely. And then she started, you know, she's like, you know, we've been talking for years about Arden taking Metformin, because Arden's insulin to car break show was one to four or one to four and a half, she was starting to have, like, really, like, bad acne that we couldn't get rid of, you know, and then stomach issues and stuff, and heavy periods, stuff that really looked like PCOS, like, that whole thing. And she's like, let's try the Metformin. And we kind of, I almost said dicked around, but you're like, a professional, so I didn't say it, but then I said it anyway, yeah, but we dicked around for a little while with it, because you're like, I don't know. I don't know. And then once she got her as a as an adult, she's like, Scott, let's give her a GLP and see what happens. That's awesome. And I was, I was like, Cool, all right, so holy crap. Stephanie, like Arden's insulin to carb ratio now is like one to 10. Wow. And and her insulin sensitivity went from 42 to like, 65 that's impressive. Yeah, her basal went from 1.2 during the day to point 8.85, and she's using Iaps. So there are times of day when these settings are even lower or sometimes more aggressive, like, you know what I mean. And more importantly, like, we never thought of her as having weight to lose, but she lost weight and she doesn't, and she looks healthy now. It's not like, we're like, oh god, she's looks thin, like, you know what I mean? Like, she she had, she had lost a little too much. We adjusted her GLP dose, and it's moving the other direction now. But her diabetes is incredibly, incredibly stable, and even if she, like, flat out, just doesn't bolus for a meal until the last second. We're seeing, like, 180s that come back, like, in an hour or so and level out.

Dr. Tarlow 19:33
Wow. Really something. I love that. Yeah, that is beautiful, fantastic. So

Scott Benner 19:37
anyway, I didn't mean to talk about all that I was I have you on here to say I'd like you to be part of the Grand Rounds series, and all I want to hear from you is what works for people with type one diabetes. What are some of the problems you see clinically, or anything really that you want to share that you think benefits doctors listening and patients who are listening? Mm. That's

Dr. Tarlow 20:00
a great question. Yeah, I think what works is trying to find especially so I've worked, I worked with adults for five years before and at Sutter Health in San Francisco, before moving back to Portland, where I'm from, and doing peds. And, you know, I think the biggest thing, especially in that young adult population and then the teen population is really finding a way to figure out what the barriers to care are and connecting with the patient to address those and make them real. Because I think you know, for every single person, diabetes looks so different for someone they might love having lower blood sugars and run themselves in the 60s because they do not want to hide they're terrified of highs. And then the opposite is a patient who's running themselves so high because they're terrified of lows. And so maybe they're not just missing their insulin because they forget. So really trying to, like, understand the reasoning behind I do feel like I have a little advantage, like, when I see a patient's Dexcom or pump report, I can kind of tell what's going on before I walk into the room. And I think a lot of times too in the in these peds kit population, like, you know, you're with parents, and the kid does not want to get in trouble for not doing what they're supposed to. So there's a lot of maybe lying, of yes, I'm taking my insulin, and it's like, you're not. And so I really love, especially on being able to, like, go through, I think, like looking at the pump reports together to show like, well, this day there was only one bolus, and this day you didn't enter your carbs one time. Like, are you not eating all day? And really, really trying to, like, okay, yeah, I guess I realized, like I wasn't doing that the whole time. And I think the biggest thing I try to enforce is like, they're never in trouble. I just have to know what they're doing to adjust in the best way for them if they tell me they're always taking their insulin and they're on shock so I can't tell, and then I end up adjusting their doses. Then they're going to go low all the time, and then they're going to be afraid to take their insulin, so they're not going to do it. So I really think coming to terms with like taking it patient by patient, I don't think there's a one size fits all for every patient, and really, like bonding with the patient and and their family, to develop that trust so that they're willing to tell you, like, what's actually going on in life and with diabetes is like, the most important thing that you could possibly do. I like to, like, let the families know that I have diabetes, so that I think, like the patient understanding that, like, you know, when I was a kid, I used to get in trouble at my endocrinologist with my parents for only checking, you know, two to three times a day. Like, that's a real thing, and it's okay, and you will be fine. But the more you check, or, like, you know, to convince them to wear a Dexcom so they don't even have to worry about that, I think that's all, like, really important for them to see that, like, it's okay to have these problems, and you will get over them and it will be okay. I was

Scott Benner 23:06
really interested, because when I started making this series with Jenny, I could tell, from her perspective, that the most important thing is communication. And she kept saying, like, if you know, if you're the physician, if you're the assistant, if you are you need to understand the person in front of you and their specific situation and not judge them just based on your idea of how this should go. I feel like that's what you're saying. I feel like you're saying, If I don't know these people, if I don't know what's happening or why it's happening, then how do I help them? How do they do better? Right? So, how do you accomplish that, though? Like, how do you get to know them and figure out, is it questions you ask, is it over time? Like,

Dr. Tarlow 23:49
how does that all work? I think it's a mix of both. Like, when I'm first meeting a patient, you know, I let them know. A lot of times I'll be like, Oh, do you wear a Dexcom, or are you wearing a pump? And they'll be like, you know, yes or no. And I'm like, Oh, I wear the Dexcom, and they're not on a pump yet, you know, I'll, I'll say, Yeah, I didn't want to pump for the longest time. But, you know, now, with this technology out there, it's so good. Would you be willing to just like, hear somebody out about it and really just try to, like, level with them that I had that very similar experience, and I'm and I'm on their side, like, I just want what's best for them, and I don't like to use, you know, scare tactics or anything like that. I also think letting the patient talk so, like, I like to find out, you know, what do you feel you're doing well with your diabetes, and what do you think you could do better? And why do you think you're having trouble with this? And like having those open ended conversations, rather than just saying you're a 1c, is too high, you're missing insulin. Adjust your dose, see you next month, or, you know, in three months. I don't think that works. I think making those conversations and I. And letting them know, like, diabetes is a moving target. So I think a 1c is really especially in our society, like associated with a grade, and if you get an A 1c that's high, then you're failing. And I think that's totally wrong. First of all, I prefer time and range anyways. But if you look at a Dexcom report, it's basically a game. We're trying to maximize your time and range, and the best way to do that is to take your insulin and and so like, letting them really see like and going through the report like, look what happens when you take your insulin before you eat, that spike is so much reduced, versus if you take your insulin 1530 minutes into the meal, look at how high you spike. Or if you didn't take your insulin at all and then didn't correct, look at that, you know, like really trying to show them how diabetes works. I think too, like these kids are smart, they're having to act as adults at, you know, whatever age they're diagnosed, they're getting this crazy diagnosis that I think for it's really impossible for anyone to manage on their own, but just letting them know, like, even if they're doing a little bit, they're still doing a great job, but just, you know, pushing them to do more, and really just being on their team, I think developing that trust is what's so huge.

Scott Benner 26:17
Did you have trouble as a kid?

Dr. Tarlow 26:21
I didn't really, I just had, like, a great I think community is, like, so important, and it always breaks my heart a little bit when kids are embarrassed of their diabetes, because no one actually cares. Like, and I think in the way you phrase it too, like people think it's really interesting and cool. And so I was really lucky when I was first diagnosed, a family friend made a diabetes team for me with neon pink shirts. And that was the very beginning of my JDRF walks, which I've done for 20 years with, like, neon shirts, neon green, neon blue. We get the whole school involved. Like it was a big fun yearly event everyone looked forward to. And I think having that community, you know, I was never embarrassed of my diabetes. My friends were amazing with my diabetes, looking out for me, like at basketball tournaments and things like that. And then my parents would nag me to test my blood, and I would always, you know, get in a little bit of trouble when I wouldn't check a lot at the appointment, but my ANCs, I'm a perfectionist, very type A in terms of my management, and, you know, that kind of like the way I was with school work, it kind of just transferred into how I was with my diabetes care. So in that regard, I'm really lucky, like, I also think at 12, there's like, an advantage of being diagnosed at that age, because it's still kind of fresh. So and you, you're a little bit older, so you kind of have a advantage of possibly missing that burnout. So I never really experienced the burnout. Okay, that was helpful, yeah,

Scott Benner 27:53
was your mom helpful with that? Like, wrapping that amazing the community around you kind of feeling,

Dr. Tarlow 27:59
yeah, my parents are my biggest supports and and my sister and my grandparents, like, they just, you know, really connected me and to who I needed to be with, like my sister. She knew someone at the high school who was, like, this football player and like, you know, he's had diabetes for how many, however many years, and he did shock and he came, she had him connect with me and, like, come to my house when I was first diagnosed, and just talk with me. And I remember, like, you know, he was a senior in high school, and I remember calling him, and he was at the beach with his friends to tell him, I get my first injection. And he was like, so proud of me to not meant the world. Yeah, what

Scott Benner 28:41
do you do, though, if somebody comes in the office, they don't have that around them. They like, what if they live somewhere where people are not as kind and, you know, they don't have a mom or a dad who are going to help them, like, open it up, like, you know, they they can still benefit from just having a, I think, just a few friends who are, like, tight and on their side. But, you know, you know what I mean? Like, it's easy to say, like, go out there, but like, I'm not, I'm obviously, I'm not coming down on you, but obviously the place you went out into was like, oh my god, Stephanie's here. Like, what happens if you go out and people are like, we don't care. Leave us alone. You know what I mean?

Dr. Tarlow 29:15
Yeah, I think in, you know, I didn't notice it as much an adult, but when I I was really fortunate growing up. I had a great childhood, and I didn't realize until coming back to work in peds, how not every family is able to give that to their kids. And it was, you know, it's sometimes really hard to see and it's really challenging to work with. At OHSU, we have an incredible program called niche that works with interventionists that are able to actually like, go to patients houses and interact with them. They'll like, pick them up and take them to the gym. They'll text them. So we really try to get the patients who are struggling or have frequent DKA episodes connected with a niche interventionist. I think that's one of the most amazing things about OHSU. And, you know, not. Everyone has that then. So I really try to give resources of, you know, social media is big. I really like beyond type one. I think that's a great connection for people. It's like a social media for people with diabetes. And so I try to connect them with that. And then, you know, I also just talk to my patients, like, what's embarrassing you about your diabetes? Like, what's the worst thing that's gonna happen if someone sees you take a shot, or someone sees a pump on your body? Yeah, so just trying to reason with them. But you know, I do think there's some huge disadvantage that we haven't figured out, a breakthrough where, you know, if niche isn't covered for the patient and their families, like, and I have a 11 year old whose parents aren't involved like, you know, I haven't figured out a perfect way to deal with that family. It's really hard, and sometimes it keeps me up at night because it's just so unfair for an 11 year old to have to figure out diabetes. And so I think again, that goes with, you know, really encouraging and emphasizing to them that, like, every little thing you're doing for yourself is incredible. I say if you're gonna miss a shot, just don't miss your long acting, you know, let that take that always, to keep you out of the hospital, and just doing really many goals with them to get them to where they need to be. Because at 11 year old, 11 years old, if you're managing by yourself, there is no way you are going to be in Target. I just like, That's so unfair and a very unrealistic expectation. Yeah,

Scott Benner 31:26
okay. I mean, especially when what you just said there about, like, explaining to people, like, hey, look, doesn't matter if somebody sees you. Like, that's parenting, that's not medical care. You know what? I mean, like, you're just being a, you know, a big brother, a big sister in that situation, that that's something you would expect or hope that they're getting at home, and if they're not, and now on top of that, the diabetes comes. I hate to say it like this, but can you identify the people who are going to struggle? Is it not hard to figure out who's who?

Dr. Tarlow 31:53
It's not okay. It's really sad. But I feel like sometimes you're you're pleasantly surprised, but I think you know, in certain situations, you can tell who's going to struggle and have a hard time, because this kid has no idea how to count carbs, and as many times as you bring them in for education, like they're 11 years old. And what, you know, what does that look like? So, and it's hard. Like, you know, we like go to school to learn how to interpret these graphs and make and make adjustments. Like, even for families that are the most supportive, like, a lot of families are afraid to adjust settings on their own, I love and encourage them to always do so. But like, for a kid again, managing on their own, they're not going to do that. So we're making adjustments every four months. If they're able to even get to their visits consistently.

Scott Benner 32:44
Do this with me for a second. That idea of like, you just adjusting it every four months is that it's just a shot in the dark, right? Oh yeah, yeah. You're just like, you're just like, the A, 1c, went up the time and range got worse. I'm gonna put in more that. That's pretty much it,

Dr. Tarlow 33:03
yeah. Like, I mean, I'm looking to see where I need to adjust, but yeah, like, I encourage my patients to always reach out to me through my chart, our little online portal, like, much more frequently if they're noticing trends, because every four months, that's that's not enough. And being realistic, but also we don't have the availability to see patients more frequent than that in most cases, when

Scott Benner 33:27
you use a DIY algorithm and you see the difference in basal and insulin sensitivity and bolusing data. I mean, God, sometimes like hours to hours, but day to day. It really does make, or makes me feel, like, what is the point of like this? These, like quarterly adjustments. Like this is ridiculous. Like, if this is what happens to a person who has like a five, five to a six, A, 1c, then no wonder they have, I mean, because we're talking about people with eights and nines and 10s, right? Yeah, yeah, yeah, greater than 14, Oh, yeah. And so no wonder these other people are having this like, because if the variability is hour to hour, day to day, and we're adjusting every 120 days, then this is just meaningless. Like it almost meaningless, like it does fall to them understanding. And then if you get to the point where you you say, like, as your example, goes, like, they can't count carbs, then that's where you have to start talking to them about, all right, listen, you probably eat the same things all the time. Like, you know, every time you count this, you seem to be off. So forget counting it. Like, look, look what happened here. You know what I mean. Like, you use this much insulin, and it looks like two more units would have been appropriate. So next time you eat this, like, let's just make it five and like, see what that like, you have to start giving them that kind of autonomy. But then that gets outside of any real medical like, advice that you would be comfortable giving, right? Like, that's not a thing you could say to somebody.

Dr. Tarlow 34:57
Oh, yeah. 100% and it's so in. Like, you know, you have patients who could care less about their diabetes, and patients who care so much, and each one of them has their own frustrations with it. So like, I just saw a 12 year old on Monday who she's doing excellent on the pump, but her a 1c went up from like six, nine to seven, five, and she asked to go back to injections. And I was like, whoa, whoa, let's see what's going on here. And you know her pump, she's on OmniPod five, so she was getting kicked out of her pump because high blood, you know her, yeah, high blood. And because her, she was getting like 15 more units in basal in auto mode than manual mode. I'm like, we just need to make these adjustments. You are not doing anything wrong. Like, let's, let's talk about why the pump is better. And one thing I really try to stress with patients who don't want the pump yet is, like, when you give shots, you do four times a day and you're feeling good. Like, I just gave four shots a day. I'm doing a great job. But if you think about it, on your pump, it's making adjustments to your blood sugars every five minutes. You cannot beat that. You can eat pizza at bedtime and wake up with a normal blood sugar. Like, you don't have to wake up at 2am and expect to give a correction. Like, that is amazing technology. Stephanie

Scott Benner 36:16
sweat, sweating your ass off, like, Oh my God. What's wrong? Like, feeling nauseous, like all that. Like, what's interesting here to me is that, like, the A, 1c, goes up the tiniest little bit, and then the person is, like, I want out. Like this, this bad number, bad got it better last time. Like that. It's like, that simple, right? Yeah. And then yeah. And then the next thing I want to ask you about is that idea of, like, some people don't care about their diabetes. So like, do you think they don't care, or do you think that they're lost and don't know what to do? Or are there some of both?

Dr. Tarlow 36:49
That's a good question too. I have some patients that I've seen for, what, three to four years now, I guess I've, I've been back and they, we have the same visit every single time they're on the dash. So they're not in auto mode, which, you know, okay, but they're not putting in any boluses. And then they're like, you know, if I have OmniPod five, it's gonna make a difference. So we switch them to OmniPod five. There's still no boluses. You know, OmniPod five, I love it. I wear it. It does not work. If you don't bolus, it's just not going to work. So, you know, there's certain patients that don't want to that just don't want to interact with their diabetes. And I, I don't think it's that they don't care, because I think deep down, they really do, like, it's easier to put up that front than to, like, admit that they're struggling from, you know, a diabetes related depression, a severe burnout. But, you know, we have psychologists that can meet with the patients, but I don't know. I think burnout is one of the hardest things to deal with.

Scott Benner 37:55
Dig into it with me. Stephanie for a second. Like, just pick one of them in your head. We don't want any identifying conversations, right? But like somebody who you think just doesn't bolus for their meals, do they understand the long term implications of what they're doing?

Dr. Tarlow 38:11
I don't know. Does any teenager, necessarily, I think would. I don't know. I think in a in a lot of settings, people do understand the long term effects even teenagers. But I think what's really hard is when you feel fine at 200 I think the body's like a thermostat. If you're constantly running 60, you're not going to feel low. If you're constantly running 240 you're not going to notice these symptoms of running high. And it's really hard to see that in the long run, you are going to have these issues. And I have, I had so many adult patients that I would see, they would be like, God, and now their a one, Cs are like, six, five, but they've had, you know, one amputation, and they're like, if only I just would have been like, okay, it takes two minutes to bolus. Then I would have just done it. Because now they run their blood sugars perfect, because they get it, because they had to experience some sort of, you know, severe complication.

Scott Benner 39:07
The question is, how to get them there without them being smacked in the face with something,

Dr. Tarlow 39:11
right? And I just, I don't know, I really don't like to use scare tactics. I have before, I think in a certain patient, I have had to do it because nothing else seems to get through to them. I don't know. I haven't seen what, what's happened yet, but it's the time. Yeah, I think, yeah. I'm hoping it worked. Because, you know, there's a point where, like, also, you know, a lot of our kids, they don't have, like, micro albuminuria yet and things, and I think once that becomes positive too, that sometimes not always, gets parents a little more on board to then, you know, prod at the kid to take their insulin. But I think there's a fine balance, too, between parents and. Kids trying to maintain their relationship and not have it hurt so much from a constant nagging of take care of your diabetes. Digi bolus like that also plays a huge impact on families, and that's really hard.

Scott Benner 40:12
Basically, we're talking about smoking. This is, this is right, this, yeah, is smoking. It's, I feel good when I'm doing. It doesn't seem to be a problem. You're telling me that 40 years now, I'm gonna have lung cancer. That doesn't sound like something's really gonna happen to me. If you degrade, you degrade slowly, you don't feel the degradation happen. And then once it's too late, it's too late,

Unknown Speaker 40:39
right? Yeah, it's smoking. Yeah,

Scott Benner 40:41
it's smoking. And so, yeah, so like, if you I guess we, and how did we fix that in the in the population? Because, hold on a second, ready. Hold on a second. Let me go over here to this screen. How many Americans smoke today versus 20 years ago.

Speaker 1 41:03
Hold on, sorry. Oh, you're fine. Yeah.

Scott Benner 41:07
I'm just asking our our computer overlords, for some details here, American adults has significantly declined over the past 20 years. In 2021 11.1% of US adults smoke cigarettes. This represents a notable decrease from approximate 20.9% in 2004 How about that? So okay, so hold on. How did we accomplish this? Public awareness campaigns, increased taxes, smoking bans in public regulations on tobacco, advertising, health warnings on the package, smoking cessation programs, cultural, social shifts,

Dr. Tarlow 41:46
yeah, yeah. And I feel like a lot of those you know, media things were scare tactics. And it's not like, you know, that'd be like, putting on the pump, use or lose land, yeah, no, right, right,

Scott Benner 41:59
yeah. What's this say on my insulin here? Yeah, you're right, so, but is it? Is it highlighting that these people aren't they're not bad people, they're not dumb people. They don't want bad outcomes for themselves. This is just how a human brain works around stuff like this,

Dr. Tarlow 42:20
in a way, yeah, I think, like, out of sight, out of mind, you know, if you're out with your friends and you have to, you have to bolus. Why bolus? Then you're different and you feel fine. So why would I stop skateboarding right now to take insulin for this Slurpee? You know? Yeah, I don't know. I think the biggest thing I always try to emphasize is, like, you don't even know how much better you're gonna feel if you just take your insulin. Like, you're gonna be less tired, you're gonna be way less thirsty, you're gonna focus better. Like, I just really try to frame the positives also, I think too, like, you know, for the patients that aren't gonna do it. We have an option now. We have the island, and that pump is great for patients. Well, you know you have, I think we're learning more and more about it, whereas, like you have to consistently announce meals or consistently not announce meals for it to work the best, but I do think there is, like, a huge advantage to it, like in a completely different direction of the use of this pump. Like I have a family who is not from this country. They do not speak any language that would be on an insulin pump. They eat very different foods, so counting carbs is out of the question. And so we use fixed dosing for shocks right now, and that has resulted in a whole gamut of issues, from hypoglycemic seizure to running really, really high, although they never go into DK, because the parents are amazing, and they always get their insulin, but the amount of insulin really hard to figure out what they're doing at home. And so we're working toward getting them an eyelet because, you know, they will consistently be able to bolus, and the girls are getting old enough that they'll be able to use their pump to do so, yeah, and I think you know that is pretty much going to this technology that is out there is going to change diabetes, especially in this population that doesn't want to think about it, because it does the thinking for them. Like, even if I can get a patient on a tandem pump, if you're not going to bolus on a tandem I would say I could still probably get your a 1c to an eight instead of greater than 14, you know. Like, that's a huge difference in terms of risk reduction.

Scott Benner 44:43
It's good of you to use the numbers, because I think people listening might when they hear high a one say they think, like eight, you know what? I think it's a win. Yeah, for a lot of the people you're dealing with it, it absolutely is right. So I think what I've done here is, I think I built. A community of people who are actively engaged in their health. And so when we stop to talk about some of these other devices, sometimes I think most of them listen and go eyelet, like, what I'm not. I don't want that, you know, I mean, like, and of course, you don't. If your a one sees five and a half and your time and range is crazy and you know, like 90% Yeah, you probably don't want the island, not in its current form. Maybe you would in the future. I don't know what they're gonna do to it, you know, right? But for right now, I keep saying out loud, because I want people to listen. You don't realize that most people with type one diabetes are running around with crazy high a one CS and not, oh yeah, not giving themselves insulin. And you know, and that these devices will help them significantly. You could take a person with a 14, a 1c and give them a seven, oh, my God, right, even if you gave them a nine, what a great thing. And that's why talking to people like you is so interesting, because you actually talk to everybody. Yeah, you see all gamuts of people, right? Like, they're, I'm sure you help people who roll in there every time, they're like, Hey, what's up? Crack their knuckles. They're like, what is it? A five six or a five seven. And then, you know, like, you Josh around a little bit and write their scripts and go, Oh my God, you the best part of my day. And then, like, that kind of thing. Greatly, is that about what happens? Yeah, that

Dr. Tarlow 46:23
was actually my Monday. Okay,

Scott Benner 46:24
and so those people don't need help because, for whatever reason, their brain works with what's happening to them, and they're doing the things they need to do when they need to do it. But what about everybody else? And we don't talk about it because it's uncomfortable, but it's happening to most people,

Dr. Tarlow 46:44
absolutely, yeah, and then you think about it too, and there's people that go above and beyond with their care, and they're still not seeing results. And it's like, well, you know, that's okay, your child is four, they half the time their whole meal. They half the time. Don't half the time they're running around like a crazy person, and the other time they're, you know, yeah, it is so hard. Diabetes is so hard. And I think that's what everyone needs to realize, is everyone is doing the best. Well, most people are doing the best that they can. And I really think if you put any effort toward it, you should be really proud of yourself, because it is so frustrating. You can do the same thing every day and get completely different results, like that is hard, and so

Scott Benner 47:27
I think it's, it's you can say that they're doing the best they can, even if they're not, like, even if you realize, like, look, there's a world where they could do a more, right, but they're not. There's something stopping them, like, what's happening in your mind and your body and your life is not just what you talk about in your endocrinologist office. So like, How come you don't just bullish your meals? Well, you know, I know I should blah, blah, blah, but then you don't know what happens if they get home and there's a drunk parent or a high parent and they're busy, like, just trying to stay out of the way and not get hit or not get yelled at or not get you know, there's a lot of things happening to people that you yeah and so like, they could actually be living a life where dying from a diabetes complication in 30 years is not even in their top 10 problems. So they are, yeah, they are doing the best they can. And yeah, are they doing the best that's available? No, that's not your job, right? Like, how are you going to handle that bigger problem for them? Like, I think sometimes the sadness of it is, is that people who have the bandwidth to take care of themselves sometimes get diabetes, and people who don't have the bandwidth to take care of themselves also get diabetes.

Dr. Tarlow 48:38
For sure, it doesn't discriminate, and it requires as how we know it today, aside from the islet, it requires you to be literate in math, and unfortunately, a lot of our pumps do not have other languages. So I hope you speak and read English like it's really hard, especially for families that are not you know, from, you know, the the typical places that are manufacturing these devices. Yeah, it is interesting. I mean, it's a, it's a disease that affects the whole world. So I don't know how to fix that issue, but I wish that something could be done about that.

Scott Benner 49:15
I was so proud of myself for a piece of time when I put together the Pro Tip series, and then when we, like, made the bold beginnings for people who were newly diagnosed. And I can see, like, Steph, I have 50,000 active members in a private Facebook group. Like, so that's amazing. That group does. I haven't looked in a while, but the last time I looked, it does 125 new posts a day, 8000 likes comments and like hearts like combined, and it adds 150 new people every three days. So Wow. It's fascinating to watch people who either get it or are actively trying to get it, talk to each other, because the community part is, I think the most important part of it. A number of different reasons. And then I end up being in this situation where I look and I go, wow, 50,000 that's insane. Like, really, really amazing. I think I probably run the most active, valuable diabetes group on the planet. I mean, that's incredible. That's definitely, it's only 50,000 people.

Dr. Tarlow 50:21
You know it's you're getting to the people that have internet and know how to use Facebook or

Scott Benner 50:25
have time, yeah, the they have the intellect the time their husband's not chasing them with a knife, like, like, or whatever it is, right? Like, the people who are actually able to go, hey, you know what? It's two o'clock in the afternoon. I've got a couple of minutes. Let me listen to this episode about extending my bolus, like, that's not everybody, not everybody's life. And when I realized that I've just spent so much time in my own head trying to figure out, like, how do you put this together for the other people that this isn't the and I don't know the answer either, I rack my brain's trying to come up with

Dr. Tarlow 51:01
the answer, yeah. I mean, I think one thing that's just like, again, something that is brings is an ease of use of like, interact with the pump as least as you possibly can. But it allows people, I think you can't discriminate, people who might not be technologically savvy, to use diabetes technology like it needs to be offered to all patients. I think that's so important, because it's like a cheat code having a Dexcom and having a pump these days, you know, it's really unfair to not offer it to everybody. And I think that's one thing that's super important is like, you know, making that accessible. So

Scott Benner 51:40
I've been having more episodes about I let and I do it. It's kind of at my detriment, because I know that the core audience for this podcast is like, I don't want a seven, A, 1c, and I'll count my cards. Yeah, I just think it needs to get out there more, and I have the biggest platform, so I'm trying to be more aggressive about it, because of all of the other people, and these are the people you can't market to. You can't sell to them. You can't sell to their doctors, because their doctors are looking at them like, here's another one coming in who's just going to ruin their life, and nothing I can do about it, like that bad attitude exists in their life as well. Every time I've interviewed someone from from beta bionics, I've implored them to go to GPS and talk to them, because I don't even think, I don't even think most of these people are going to endocrinologists,

Dr. Tarlow 52:28
yeah, yeah, yeah. I mean, that's totally true too.

Scott Benner 52:30
Yeah, yeah. I'd like to see them educate GPS about, look, just slap this thing on people and see if they can't get things together a little bit, you know,

Dr. Tarlow 52:39
yeah. And, and, you know, I keep talking about the eyelet, like, I think tandem is an amazing pump. And I really also love OmniPod. It is true, though, there's some cool even if you have an ANC of 6.5 or whatever you have, there is some awesome part of islet that always draws me to it. That's like, I could go on a vacation to Italy, any a whole bowl of pasta and five pizzas and whatever I want, and not have to think about how many carbs that is and how to bolus for that, like, that's pretty awesome. That burden reduction is, is something I think that really you know maybe you're going to get a slightly different, a little bit higher, A, 1c but in the again, going back to risk reduction, like, what's the difference between a six, eight and a seven, one? I don't actually know if it's going to be that significant. So if it improves quality of life that much for someone who is instead, you know, counting one and a half, putting in one and a half carbs, like, for a small like, two almonds or something. You know, I think, what about giving yourself that freedom back?

Scott Benner 53:46
Yeah, no, it's awesome. I actually to go a little farther. I think OmniPod was trying to split the difference with OmniPod five. I think they were trying to be like, Look, this is more aggressive, but it also really doesn't want your involvement all that much. You just have to put in the meals. You know what I mean? Because it's not set up for you to understand how it's working like so it's not, it's not a tinker like device. You know what I mean for sure. Yeah. And so

Dr. Tarlow 54:14
part of it kind of drives me crazy

Scott Benner 54:17
conservative, yeah. And and listen, I don't work there, and I don't know anything. And I want to be clear about that, because people think I know stuff, I would imagine that they're working on that behind the scenes to make it a little more aggressive, like they hear the feedback, right? That's the feedback, yeah. So I like the idea of because they know the thing that we don't talk about, which is a lot of people aren't putting in the effort that's necessary all the time, and what if we could cover that effort with a mechanical device? And I think that's a really noble goal, sincerely,

Dr. Tarlow 54:52
yeah, and I guess going back to some of my patients that don't bull us, and you know, they have five episodes of DKA. When I do tell them about the eyelet, I see them smile about their diabetes for the first time, knowing that that's out there. So when you were asking, like, how do you get through to those patients? I think showing them there is a light at the end of the tunnel, you know, like letting them know you do this, you do this well for two months, so we somewhat know what your insulin requirements are, and then by that time, you'll be ready for your pump training, because we book a little bit far out for pump trainings, right?

Scott Benner 55:29
Training is going to be, what is it? Normal meal, small meal, large meal, something like that, breakfast, lunch, pretty

Speaker 1 55:34
much, basically, yeah, it just, I think those first like four days you have to, they really want you eating like regular meals, so the pump learns what a regular meal is. Yes, to get it like set up. I

Scott Benner 55:46
just did an interview with them that went up the other day. You'd probably really like, I'll have to, I'll

Unknown Speaker 55:51
definitely check that out. Yeah, I

Scott Benner 55:53
and because they're also looking at dual hormone now. So it's episode 1217, by the way, this dual hormone pump, which in my estimation, allows them to even probably try to be more aggressive with the algorithm, if they can catch it on the back end with a glucagon. And so I can't wait to see where that goes to, like, that's all very interesting. I also think AI is going to be really valuable for people with diabetes in the next five years, too.

Unknown Speaker 56:19
Oh yeah,

Scott Benner 56:20
yeah. But again, those are tools. That's a tool that you need to be, like, interested in using. You know what? I mean, like, it's not, it's not a thing that it's just everybody's gonna do it, but maybe one day, like, maybe one day it will get to that point. I find these conversations like intellectually inspiring and emotionally draining, because there's, at the moment, not a real answer for how do I go find a person who can't find a way to bolus for their meals and help them? You know, I keep thinking I'm going to talk to somebody who one day is going to be like, Oh, Scott, I know. And I'm waiting for that to happen, I guess. But, um, you don't have the magic bullet answer either, huh?

Unknown Speaker 57:07
Unfortunately, I do not.

Scott Benner 57:08
And how hard is that on you? You come off like, like, a really lovely person. So at what point are you not going to be able to drag your ass out of bed every day to hear somebody go, No, I don't bolus for my meals. Like, when is it? When are you gonna burn out on helping them? You know what? I mean? I don't

Speaker 1 57:27
know. I don't think I can. Because, like, you know, sure, even working in endocrinology, like, I still have nights where I'm up at 2am feeling terrible and eating four packs of fruit snacks, or my blood sugar is stuck at 300 and so I have to be there to advocate for them and to just let them know it's okay. Like I just feel like getting diabetes sucks, but it gave me a real purpose. And so I don't know I feel like I, I I really hate diabetes, but I love it. You know, does that make sense? No,

Scott Benner 58:08
no, no, I it does. I just, I worry about, like, psychological pressure that comes back to you, like, at what point do you become, like, the cop who just expects that everybody's breaking a law? You know what I mean? Because it'll happen eventually. And, yeah, and it sucks, because for you listen to all the motivation you have, it probably maybe it's never going to happen to you, or maybe it'll take forever to happen to you. But for the people who are just like, Look, I just wanted to be a doctor. Get it. I mean, like, sometimes I ask people, why do you help people diabetes? And, like, I don't know. It made sense to me, and I was like, okay, so they're not there for some bigger reason. And then how many visits do they have to how many doors do they have to open up? And then here my a 1c, is 14, and I don't know, man, I don't know how to I don't want abolish this. I don't want to have diabetes like that, like, until they just go, I don't care. You know what I mean? Like, like, when does it kill them inside? A little bit,

Speaker 1 59:02
I guess I would say one thing that really helps is having an amazing team. And I love our team, like they keep me going to, like, there are definitely days I'm frustrated where I'm like, Oh my gosh, not again. Like we had the same talk last time. And, you know, I think our team just keeps me going as well. Like, yeah, you know, the obviously, the patients, but then having my team to talk through things with, and like, you know, give new ideas of what we're going to try for next time. And even just, like a referral to just go over diabetes basics again with the educator, I think is huge, and so that's important as well. Yeah, I

Scott Benner 59:45
don't know how you don't just, like, blurt out, oh my God, just take care of yourself. I know it's hard to, like, make a person see the future, especially a younger person. I get that right, like, I understand the whole like, I. Something has to happen. Like, listen, Stephan, I've interviewed so many adults who will tell the story of it's just it feels like it's such a personal story to them. But I'm like, Oh my God, I've heard this 1000 times. Yeah, you know, I got diagnosed, and my parents took care of it for a while, and I was doing great, but then I went off to college, and I didn't really pay attention to it, but I don't know, I got through somehow, and they're like, oh, what your ANC is? Like, really high, you know? And then I got out, and I thought, Oh, I'll take care of it as an adult. But I didn't. And then always, the same thing happens to the people who get saved before complications. They meet a person that they want to be healthy for Stephanie, I'm telling you all the time, I met a guy, I met a girl. I had a baby. I wanted to have a baby. Those are the things that snap people back the fastest. Helping themselves is not nearly as easy as helping themselves. For someone else,

Speaker 1 1:00:57
you can only get all like little singles night,

Scott Benner 1:01:01
I like, where your brain jumped. You're like, we just got to get all these people hooked up, and then their diabetes

Speaker 1 1:01:07
will be better diabetes. Singles night for 18 and older. Stephanie,

Scott Benner 1:01:12
that was such a 30 year old thing to say. That was fantastic. Thank you. I was thinking, how do we find something in their life that they care about enough that they need to be healthy for it, or does it have to be a person? Because I listen, generally speaking, I'm an upbeat, hopeful person, but if I was living in a terrible situation, or if I was flat broke, or I didn't have any prospects in my life, I don't know why I'd care that much about my health. Like, what am I getting healthy? Right? You know what I mean, to go live, to go live in an alley, like, you know, I'm saying, like, like, and so, like, there's got to be a thing. Like, I just think it's a very human thing to need a goal.

Speaker 1 1:01:53
Yeah, I mean goal, my patients who are goal oriented athletes, or I have one that wants to be a pilot and have to, like, prove incredible blood sugars. These patients do so well or or, like, in my adult care, the ones that lost their license because maybe they had a car accident with a low blood sugar, you know, those ones trying to prove to the DMV they have good blood sugar, those are incredible blood sugars. So

Scott Benner 1:02:18
I'm right. Then a goal motivates people, yeah, yeah,

Speaker 1 1:02:22
okay, take some take something away or or put it at risk. And I think you see a benefit, but also the pressure of that is crazy,

Scott Benner 1:02:30
definitely. Let me say something crazy to you for a second. Okay, what if you launched a little test thing? Okay? And I'm going to tell you how much it's going to cost, the it's going to cost the $10,000 to run this test. And we're going to take 10 of your people who are like, I don't bolus, I don't do this. Blah, blah, blah, and you tell them that at the end of six months, if they can maintain this range and bolus for their meals, etc. They get $1,000 at the end of six months. You do it with 10 people and see if the goal motivates them to help themselves.

Unknown Speaker 1:03:11
That is an awesome it's not

Scott Benner 1:03:13
a bad idea. I

Unknown Speaker 1:03:14
love that because

Scott Benner 1:03:16
so now we just need to find a donor, 10 grand, somebody call Stephanie. That's all I want, like, because I want to see what happens. Do 10 of those people go, Oh, for $1,000 I can do it. I'll tell you something. This idea comes from a different a couple of different places. It comes from three different ideas that I've lived through. I'm 52 Stephanie. I'm pretty much almost dead, so I've been around a really long time. Okay? 52 the new 30. Yeah, good. Tell my knee. My father three packs a day. When he was managing his smoking, it was two packs a day. In the 80s, his boss, who really liked him, grabbed him and pulled aside and said to him, Ben, don't smoke for a month. I'll give you $1,000 and my dad did not smoke for a month. Now, he did eventually die. He did eventually die of heart failure, but so so I don't know if we needed 1000 every month to keep it moving, but he did it my dad, who would break out into a sweat if he didn't have a cigarette every couple of minutes, stopped for a month for money. Okay. Now my next thought here is an episode I did with a mom whose kid wanted a chainsaw, and I told her to pay him for every time he pre bolus up until the value of the chain saw. Did

Unknown Speaker 1:04:33
it work? Okay?

Scott Benner 1:04:36
I've heard that it worked. My third thing is that I worked in a corporate setting when I was really young, and I would frequently get pulled in to Human Resources meetings because I was seen as a common sense person, even at my young age. And they would ask me over and over again, how do we motivate people? How do we motivate people? And I would sit in those meetings and say, I don't care what anybody else says. It's. Nice to say that, oh, we need education. We need to be able to, like, motivate people. We can do monitoring. Technology will help. We want to support them. I'm like money. People care about money. Give them money. And when they finally went to a bonus system, they got the work out of people they wanted.

Speaker 1 1:05:18
I'm telling you, yeah. I mean, I think it's brilliant. I do think $1,000 is very awesome. I think if it was more like $25 I don't know if we'd see the same effect.

Scott Benner 1:05:29
No, no, you need a number that makes people go, oh, hold up. How much? Yeah, yeah, right, yeah. I'm gonna win $1,000 if I can just pre bolus my meals. Okay? Like, because that's really like Stephanie, between you and I, that's the deal. Good settings, yeah. Pre bullish, your meals. Don't stare at a high. Pretty much done, right? 100% Yeah, it's an A, 1c, in the sixes, Yep, yeah,

Unknown Speaker 1:05:55
okay.

Scott Benner 1:05:56
That's what I think. Like, I think you do that and then you say to them, Look, now you feel better. Now you know how to do it. Now we've made a habit. Now do it for yourself, right? Take your $1,000 and go do something awesome with it, and pre balls tomorrow, because you want to feel this good and be this healthy, because they have brain fog they don't even know about. You know what I mean? Like, maybe you can get them clear. And then, am I making that up? Like, like, high blood sugars? Yeah, I think

Speaker 1 1:06:28
it'd be awesome. I'd also be really curious what happens post winning $1,000

Scott Benner 1:06:33
Oh, I would be too, some people are gonna drop off, but you'll save a few of them.

Speaker 1 1:06:36
Yeah, no, I think it's great. And I think too, just like, you know, it's like brushing your teeth. You don't want to do it. You want to just go to bed and just like, you know, be ready for the day. But once you do it, it's a habit. And I think that's kind of how taking your insulin is too. Once they just do it and see, okay, that took an extra 30 seconds. Yeah, it's really not, I mean, yeah, it's, again, diabetes is hard, and it's not fun to have to be different, but it you know, it's not that much more time. It's not like you're taking 30 minutes out of your day before you eat, like it's an extra 1015, minutes. It's

Scott Benner 1:07:11
not that bad. Plus, if you were to write a research paper afterwards and present it to an insurance company and say, Look, how'd you like to save untold millions of dollars by paying everybody $1,000 a year to manage their diabetes

Unknown Speaker 1:07:26
better. Yeah.

Scott Benner 1:07:27
I mean, be brilliant workplaces. Do it right. They'll, they'll do exercise initiatives like they'll, they'll slap a like a little watch on you and give you a portal to report your your steps or whatever. And at the end of the year, they, if you've done it, they give you $500 and people who don't need $500 do it like, like, you know, you people who are like, people who have been in another step of life. If you said, I'm like, Look, I'll give you a $500 to paint my room, they'd be like, Get the out of here. I don't need your money paint your own damn room. But suddenly, when it's a game, it's a game and it has a prize. Boom, yep. Stephanie, when I was in fifth grade, my teacher did this thing in the last two months of the year where they we set up a city in our room, so everybody had to think up a business, and then we made money like and like, and everybody got money, and they were paid. And then on Fridays, all the businesses set up like a flea market, almost, and you tried to see who could make the most money, like it was just, you know, like a capitalism, you know, class almost, in fifth grade. You know, who won. It was me, you know, how I did it. I had a feeling. Did it with a roulette I did it with a roulette wheel. So I came in, I came in with a roulette wheel, and my teacher goes, Uh, you cannot do gambling as your business. And I was like, oh, okay, so what I was gonna do was I was gonna sell squares on the roulette wheel for a $1 whatever our dollar was, and whichever one it landed on the winner got half the pot. That was my plan. And the teacher goes, you cannot, you can't do that. And so I went home and I was like, damn, because I made my dad build me a roulette wheel out of like, wood. That's awesome. I went home and Pac Man was huge back then, so I made my dad buy me these little five inch paper plates and a can of yellow paint, and I laid them out, painted them yellow, cut a piece of pie out of them so they look like Pac Mans. And you put $1 down on a square, and the winner got a Pac Man.

Unknown Speaker 1:09:38
And I was allowed to do that. By

Scott Benner 1:09:40
the time the eight weeks was over, I had everyone's money. Stephanie, okay, that is awesome, yes. And I'm telling you, what it taught me about people is can be valuable in helping people with their diabetes. And I'm going to tell you right now, if I get afforded I would have already done this. I would have already started. A community thing where you can go into a portal and just track your a one, CS and your variability and stuff like that, and found ways to incentivize people to work harder for their stuff, like I would have, I would have already tried it, but I got the funding, so I'm putting it on you.

Speaker 1 1:10:15
Okay, someone reach out to me and give me the funding. Okay?

Scott Benner 1:10:18
That's all because you don't need money. You just, you just need the prize, not like the the job needs money, right? And then you any prize. How

Unknown Speaker 1:10:25
about a timeshare in Hawaii?

Scott Benner 1:10:28
Stephanie's like, I could probably get my eight 1c down for a vacation.

Speaker 1 1:10:33
Can I participate? I'm gonna stop bullets for a little bit

Scott Benner 1:10:37
every six months. This woman named Steph wins.

Speaker 1 1:10:42
One time, I'll be Steph, one time, I'll be Stephanie. You'll

Scott Benner 1:10:47
be able to trick them. That'll be lovely. Okay, I want everybody to think about this and do this. So here's what I would do. I'd give them the Pro Tip series in the podcast or the bowl beginning series. I would tell them, like, look, listen to this. Put these things into practice. Ask me questions, if you have any questions, and at the end of it, if we can, I don't know, in the first three months, if you can lower your A, 1c, and improve your variability to this level, then you win 500 and then if you can just do it for three more months, and you know, and then get to the goal that we set together, you Get another 500 and that's it. I mean, honestly, the truth is, is that it would be way cheaper to pay people for good health than it would be to spend the next 150 years wringing our hands going, I don't understand why Ben smokes so many cigarettes. How do we help him? Because you're not going to figure that.

Speaker 1 1:11:36
Yeah, when you put it that way, it's like, so it sounds so easy. It's like I know how to get to all these kids now. I'm just gonna offer them 1000 people or PlayStation games. I do really think that would work. Oh,

Scott Benner 1:11:47
my God, are you kidding me? What about just a bucket of PlayStation gift cards or something like that? Seriously, no kidding. Like, like, come in here. On boy, here's how I would do it. I go, Look, I want to first give you one of these for free for doing nothing but being you. You're a terrific kid. I love you. Now, if you want another one, when you come back in three months, you're going to pre bullish your meals, and we're going to bring your A 1c down a little bit. You do that, get to get another gift card for your PlayStation, and then we'll find another thing for you to do, and before you know it, you'll have tricked them into taking care of themselves. Yeah, exactly. I'm a genius. No one, no one listens to me. Stephanie, that is great. No one listens to me. But people care about one thing, money, okay, like, all right, I'm in I understand what to do. All right, we're good. You have anything I didn't ask you that you want to

Speaker 1 1:12:38
bring up? No, I think that was pretty much everything that sounds it was great talking with you. No,

Scott Benner 1:12:42
I had a good time. Do you think they will name a day after me one day, if this works? Yeah, you think so?

Unknown Speaker 1:12:49
I do. I think

Speaker 1 1:12:52
they do. I think we'll have an annual day for you at, OHSU, honestly,

Scott Benner 1:12:57
I want that. I want that I want to become, I want to I look at, can I be serious for a second? Not that I wasn't serious about the other stuff. I found a way to help so many people. And Stephanie, all it did was leave me with a feeling inside that there were a lot of people I didn't help. So I'm very happy with all the people who come to me and say, This saved my life, and oh, my god, I'm so healthy because of you. And thank you. And people who joke about, like, do you know there are nine states in America that have a juice box license plate because of the podcast? Like, I'm not even kidding. That's really cool. I'm not even kidding about that, okay, like, and that stuff. I don't want people to think I'm like, dead inside. Those things are all very cool and make me feel great. Five stars. I love it. I'm a T, 1d and I love this podcast. Thank you, Scott. I'm not alone. When I was diagnosed, I felt like I was the only one who knew the true meaning of diabetes. My mom introduced me to the podcast, and I realized that there are millions of people who don't who understand the feeling the same way as I do now. I love listening, and I feel comfortable listening my pets even like it. You know, these go on forever, okay, like I'm being serious, like those reviews and notes, they happen every day. They go on forever, and it's fantastic. But in my heart, it's not enough people. And I know there's a section of society I'm never going to touch, and so I want to find a way to find them too before, yeah, and

Speaker 1 1:14:21
I guess, just to add on to that, just to getting you know again, family, patients with families who are able to do these things, but I couldn't recommend enough getting involved with your local JDRF walk when it's in town, it's such a feeling of community. And also really consider going to diabetes camp. It is such a once and well, you'll go every summer after that, but it is such a unique and like special experience to be around. Even for me as an I didn't go as a kid because I was afraid of overnight camps. And going now as a provider like it is so fun and. A cool experience that I just can't even put into words. So yeah, I can't recommend that enough.

Scott Benner 1:15:05
Dr Marwa, who's actually part of the Grand Rounds series, said that during his training, part of his training was to go to diabetes camp, and that a big piece of his understanding about people's lives with diabetes comes from being at camp.

Speaker 1 1:15:19
Yeah, oh, yeah. Like the freedom at the Gales Creek camp, which is what we have here in Oregon. The counselors, they carry all the diabetes supplies for the kids, so the kids can just run and be free. And I think that is, like, the coolest thing ever. Yeah,

Scott Benner 1:15:35
no, he just, he learned about bolus thing and what people understood and what they didn't understood. He actually got to see insulin work like live in people's bodies, and he said it was a huge help when he was learning to be an endocrinologist. Yeah. Nice, amazing. Okay, all right. Well, Stephanie, thank you so much for doing this. I

Unknown Speaker 1:15:51
really do appreciate it. Yeah, thanks.

Scott Benner 1:15:53
Hold on one second. Jalen

is an incredible example of what so many experience living with diabetes. You show up for yourself and others every day, never letting diabetes define you, and that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community, or to share your own story, visit Medtronic diabetes.com/juicebox and look out online for the hashtag. Medtronic champion. A huge thanks to a longtime sponsor, touched by type one. Please check them out on Facebook, Instagram and at touched by type one.org if you're looking to support an organization that's supporting people with type one diabetes. Check out. Touched by type one. Today's episode of The juicebox podcast is sponsored by the Dexcom g7 which now integrates with the tandem T slim x2 system. Learn more and get started today at dexcom.com/juicebox, are you starting to see patterns? But you can't quite make sense of them. You're like, Oh, if I bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, you're starting to think this isn't going the way the doctor said it would. I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the juicebox podcast. It begins at Episode 1000 you can also find it at juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 thank you so much for listening. I'll be back very soon with another episode of The juicebox podcast. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes. I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.

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#1276 Weight Loss Diary: Thirteen

Thirteenth installment of my GLP journey

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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. Welcome to Episode 1276 of the juicebox podcast.

This is the 13th installment of my weight loss series. I hope you guys are enjoying it. I'm losing weight, doing good, feeling healthy. This has been the story. Please don't forget 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. I was looking for a way that we could all get nice and tan and meet each other and spend some time talking about diabetes. How are we going to do that on a juice cruise. Juice cruise 2025 departs Galveston, Texas on Monday, June 23 2025 it's a five night trip through the Western Caribbean, visiting, of course, Galveston, Costa, Maya and coz Mel, I'm going to be there. Erica is going to be there, and we're working on some other special guests. Now. Why do we need to be there? Because during the days at sea, we're going to be holding conferences, you can get involved in these talks around type one diabetes, and they're going to be Q and A's plenty of time for everyone to get to talk, ask their questions and get their questions answered. So if you're looking for a nice adult or family vacation, you want to meet your favorite podcast host, but you can't figure out where Jason Bateman lives, so you'll settle for me. If you want to talk about diabetes, or you know what, maybe you want to meet some people living with type one, or just get a tan with a bunch of cool people. You can do that on juice cruise 2025. Space is limited. Head now to juicebox podcast.com and click on that banner, you can find out all about the different cabins that are available to you. And register today. Links the show notes. Links at juicebox podcast.com I hope to see you on board. Well, it's June 8. I did not lose weight like I was hoping to at the end of the 12th episode of my weight loss extravaganza. I gained but only a little bit, choosing to look at this as the 10 milligrams working. Because if we go back to the 26th of May, I was one 90.2 then, you know, I had the drop, and I ended back on the first that last recording, 180 4.6 today, I was 180 5.6 so I gained a pound over the week, 180 4.6 went to 180 581 80 621 86 four. Now this was great, not great, but because on the sixth, which is just two days ago, so on Wednesday or Thursday of this week, I was 180 581 80 581 80 you know. So I lost weight at the end of the week, which is not common. So yes, I rose Tuesday, and it held but then I came back down again. My hunger this week has been fine, no problems. Sorry, if you can hear that cricket in the background, oh, my god, shut up. My hunger this week has been fine. I have not been overly hungry. Have not done much snacking at all, healthy food. Maybe it didn't eat quite enough this week, but still playing with my supplements that I again, I'm sorry I'm not ready to tell you about yet for like stomach stuff, like trying to get my stomach under control, working on my gut health a little bit so hunger is not bad. No cravings for sugar went up in the beginning of the week, but came back down. Just didn't come all the way back down. I feel pretty good about this week. Doctor still says to me when I tell her, she's like, Oh, try the 10 for like, another month, but we might go to the 12, so I don't know. I got my belly out here. Give this a shot and give it a go and see where we get to next week. 10 milligrams of Zep bound cap comes off, lock comes off step bound goes in. Where am I looking for? It's a nice spot right here. How's this look? I like it. Hold on.

Ooh. I pinched a little bit, no blood, though, no wetness, no leaking. Very good can. I hit the trash can. I've moved the trash can. There's no way I'm gonna hit it. Missed it by at least eight inches. I'm trying, kids, it's a long fight, but let's keep in mind. Find that, as I'm sitting here kind of bemoaning a pound this way or a pound that way. Let us keep in mind, I have lost 47.8 pounds since I started this, and I feel terrific. Get these other like kind of gut issues in line, maybe get the medication to the right spot. Lose this last 20 pounds if I can. I don't think. I don't know if it's 20 actually, honestly, I don't know how much it is, if it's 20 pounds left or what, but we'll find out, uh, I'll talk to you later. Bye, it's uh, Saturday, June 15, and I've gained two pounds again by having salt. Okay, I tried to have air fried wings. They were just in hot sauce. I'm like, Jesus, what? Like, I didn't even use a dry rub this time. Then I looked, you know, hot sauce has 400 grams of sodium in a tablespoon. Well, I didn't know that either. Now I do, and now I'm two pounds heavier, and I've made the decision, I am going to exercise this week with intention, because this medication, I mean, 10 if I'm just going to lose weight on just the Med, I gotta think this, 10 milligrams would do it, you know? I mean, I can ask the doctor to go to 12 in a couple weeks, and I probably will. But I mean, obviously something else has to happen here. So I think the the era of GLP being the only reason I lose weight is over. So if this recording doesn't pop back on in seven days with me telling you that I lost weight and I exercised, I mean, I don't know what you can I don't know I'll be disappointed in myself, but I'm going to shoot this real quick and start having a thought, and I might finish the thought up next week. But hold on, cap off. Cap on. Cap off. That capper. Lock off. Definitely not doing the same side of my belly, as I did last time, because it doesn't fight salt. I'm just kidding. I hope you can hear sarcasm. Here we go. God damn, I said, God damn, that stung a little bit. Whoo, a little drop of blood that time. Drip, drop. Whoa, okay. Uh, anyway, time, I want to talk about time for a second. I've had this experience. I've talked about it with other people, my brother who I have, a brother who's lost like 90 pounds this year, 9080 and a lot of weight this year, just dieting, exercise, no medication, no help. He has the same exact experience I'm having, and I want you to be ready for it. If you should start using a GLP specifically, or, I guess maybe not even specifically, if you start changing how you eat, you end up with more time, more time because you're not cooking sometimes as elaborate meals, bigger, bigger meals, you're not eating as much. You have more time. And you think, Oh, that's great. I have more time, but wait till you don't know how to fill it. And not that you don't have great ideas or things you want to do. There are things I want to do, but I was so accustomed to living a 24 hour day the way I was, that when there is suddenly appreciable chunks of time given back to you, you realize you don't have a plan for it, and if you're not careful, I found that it could feel lonely or lost like in an abyss, but I've I identified it and picked something that, if I ever feel like that, I'll go do. And anyway, it's been a it's a blessing now that I know how to handle it, but in the beginning, it was confusing and off putting, and I wasn't really aware of the like. I had this like, dizzying feeling, and I didn't know what it was, until I realized I have so much free time and nothing to do that I feel lost anyway. I don't feel like that anymore, but I want you to be ready for it. You can. This is not specific to me. I, like I said, I've heard, heard heard from a number of people who have felt this way, and had one very personal conversation with my youngest brother who identified the same thing. So be ready to have extra time. Less weight, more time. Okay, kids, been a week. June, 20. My second Saturday. Let's go over what happened. I did get some exercise, not exactly the way I was expecting to, but got some muscle training, some cardio. Spent a lot of time in the heat, moving and sweating. What did that bring us? Well, let's take a look. It brought us back. Let me look at it this way. On the 15th, it was 187 pounds. It's the day I recorded right 187 the next day, on the 16th, I gave myself a little break and didn't weigh myself. Sorry, rubbing the microphone. That's very unprofessional. Sorry about that. On the 17th, 180 6.8 a point two reduction. Now the next day, that's going to be the 19th, after a big burst of exercise. 180 5.6 Whoa. Crazy, right? 180 5.6 actually held for the 20th and the 21st I did get some more exercise yesterday and today, I woke up at 185.2 pounds. So am I down? I'm down two pounds since the 14th, almost two pounds since the 15th. Nearest I can tell, exercise was the difference. What do you know? We'll try it again. The thing with the extra time, I really hope you took that to heart. I want to tell you that, um, people shouldn't text me while I'm making a podcast. Hold on a second. My neighbor wants me to grab a package for them. Oh, my God, this is fantastic. Sent me a text 730 this morning on a Saturday. I was sleeping, by the way, telling me they might need me to get a package. I responded at 820 and just five hours later, she let me she said, Thank you. While I'm recording a podcast, it's okay. Everything's fine. Got my 10 Millies of zepbound Here I am going to boy, I don't want to waste a month, but I don't want to go back to the doctor and ask for the 12 just yet. So I'm gonna ride 10, get my refill with 10. I think this is my third injection of 10. You guys would probably know better than me. But anyway, what was I gonna say? Oh, yeah, so sorry. We we lost the pet this week, our oldest indie. And I feel weird that last week I was talking about how there's so much time and I don't know what to do with my time. And today, all I can kind of think about is, you know, days go slow, years go fast. Kind of stuck in my head. Days go slow, years go fast. Don't waste time anyway. Not going to waste any time. I'm going to shoot this up bound and in honor of my daughter, who does not love injections and sometimes can struggle with hers, I'm going to put this one in my butt cheek, because I'm always telling her, try different places. And she's like, No. And then I realized I come up here every week and I shoot this in like, the same location over and over again. So, all right, don't I mean, I gotta, I don't know what I'm gonna do. Hold on a second. Let me stand up a second. This is not going to be particularly easy. Hold on. Very little, but she care to work with that's not a flex.

Why'd I do this? Okay, hold on a second. Cap off. Throw it at the trash can. Ooh. It went in fancy unlock. Okay, hold on. Let me turn the microphone towards my but, you know, hold on. Don't let me forget to say something in a second. All right, I've given myself a bit of a wedge. Hold on. A second. What the AHA. Why did I say I would do this? All right, pinch ready. All right, that wasn't.

All right, there you go. Tell your friends I take an ass. Do you know, by the way, I shouldn't have said that. Somebody's gonna pull that out. Was I gonna say, oh, ass? I put a Facebook post up the other day. I used the word ass in it, and the ladies like, I love you, but I have to unfollow. I mean to her, I love you too, but I. You know what? I mean, tighten up. Hey, I decided to do like a little experiment. So as you've been hearing like, add a little light exercise, lost some extra weight. I was like, Okay. I mean, not that we all don't know that exercise helps you lose weight. But I was like, okay, you know, how do I put this? First of all, it's June 30, Sunday. How do I I know, we all know exercise can help you lose weight. I've been on this weird journey where you just inject this thing, and then you lose weight, and you get to the point where you're like, well, when, when does this stuff just maintenance? Like, like, when is it not going to be aiding in the loss anymore, just holding me where I am? I have to kind of understand what this, the juice in this thing does exactly, you know? And I mean, look, it's easy to understand what it does technically, but like, what's what am I really saying? Here's my point. So this week, things were going well. I was like, in the 185 like, low 185 let me pull up a thing. I'll tell you the numbers. But I was happy all week. I was like, This is going well, but I wanted to stretch out my I wanted to stretch out when my next injection was happening, because I had this idea for an experiment. Which I'll tell you about in a second. But if we basically go back a week ago, sorry, I just sniffed into the microphone. That was ridiculous. I'm so sorry. Like, let's just go back to the 22nd right? Was last Saturday, and I'm 180 5.2 then Sunday, 186 but then Tuesday, 180 5.2 then Wednesday, 185 even Thursday, 180 5.2 and I'm like, Alright, I know this is Thursday. I know that the magic Z upbound juice is going to start to wear off a little bit and I'm going to drift up. I just know it. But I've got these two extra pens from when I went up in dose before. So I have these pens with much like, a very low dose in it, and then I have these the 10 mill elite, or milligram pens that I'm on right now, 10 milligram pens I'm on right now, but I've got like, a seven and a half and I'm like, is there a way I can, like, I've got these two seven and a half pens left. Can I stagger this? Because obviously I'm shooting this stuff Saturday, Sunday, Monday, Tuesday, Wednesday. Okay, I'm not like, losing a ton of weight. I'm just, like, pretty much maintaining and I'm eating and none of the impacts that food normally has on me, like this. Like, you know, weight loss out of or weight gain just from being alive. It doesn't happen to me on the zip down. So the zbo is doing that, but I'm not really going backwards. Like, you know, the doctor's like, well, we could go to 12. I'm like, All right. Well, you know, let me wait and see. I don't care about moving up another, another two milligrams, if that's going to do something, but isn't it just going to piss out? You know, five days, four or five days into it. I wonder if, just as an experiment, because of these two extra pens, seven and a half pens, why don't I shoot the 10 this weekend, on Sunday, I think, instead of Saturday. And then as soon as the fifth day comes around, Friday, Thursday night, Friday, I'm gonna hit myself with the seven and a half pen two days early, but it feels like it's not there the last two days anyway. Plus it'll cover me over the weekend, right? And then I'll wait till I see it wane again five days. And then I'm gonna go 10, then I'll wait to see it. Wait. So anyway, I've got these two extra pens. I think I'm gonna try this for two weeks. I have this big idea, but I want to move it to Sunday, because I want the Monday. I want the the new injection to happen like Friday morning, the fifth day. Well, hell. I mean, Jesus Christ on a cracker. So on the 27th on 180 5.2 on the 28th I'm 180 6.4 and I'm like, Okay, it's not working. Sorry. You know, I go to my what would normally be my weigh in day, which should have been yesterday, the 29th Well, God damn, I wake up 180 6.8 I'm like, All right, not bad. It's hanging in the 186 range. Now, last night, we watch a UFC fight. I am hand to God. It's like 1130 these guys are beating that holy hell out of each other on Pay Per View. And there's these pretzels and Doritos there. And I take a handful of pretzels and Doritos and eat them, and wake up this morning. I am not kidding you, 188.2 pounds. I got up this morning, went for my constitutional, felt very cleared out, if you know what I mean, and then got on a scale to find out I was 180 8.2 versus the day before, 180 6.8 versus a week ago, 185 Five. So one, I've gained 3.2 pounds since my best weight this week off of a handful of almost cursed potato chips and pretzels in the middle of the night, basically while watching this thing. So the juice in the pen. And this is not technical, because I don't know what I'm talking about, but it's got to have something to it's got to be blocking the impact of the food too. Because I've had a handful of pretzels while I was on set bound and not gained any weight. As a matter of fact, this week, I did very well in the 185 range, as you heard, 185 maybe 186 I mean, I had a frozen yogurt this week. I had pizza earlier in the week. Like, I've eaten food, but I haven't gained any weight. I haven't waken up and woken up in the morning, been like, oh my goodness, I've gained two pounds. But Saturday to Saturday, seven days, then on the basically, on the seventh day, instead of injecting, I didn't inject, so that the magic goo is gone at that point. And I listen to me, a person shouldn't gain two pounds from having hard pretzels and 17 Doritos. Now, is it good for me? No, but it shouldn't have that kind of impact. So anyway, this week is experiment that I'm going to just tell you right now. I'm not a doctor. This is not advice. I wouldn't do this if I was you. I have absolutely no idea what's going to happen to me, but and gets what I'm going to try and I put in my butt cheek last time, it didn't help at all. I wanted, I wanted a bonus for the butt cheek thing. All right, people, 10 milligrams is up down, uncap it. Put the cap down, unlock it, find my belly, which is a pound and a half bigger than it was yesterday. Here looks like a good place. There's this little I don't want to hit that looks like a vein. Gonna go around that there. Here you go. Ready? I'm all right, I'm Zep down and up a couple of pounds, but instead of you hearing me seven days from now, the next time I come back, it's gonna be Thursday night or Friday morning, I think, I think also the trash can is really close, so wasn't gonna be hard to hit. So anyway, well, it ended up being Friday morning. It's actually more like Friday afternoon. It's a little bit after lunch, but it is Friday, July 5, and wait till I tell you what happened this week. This is something watch this opening up my magic app for the scale, renfo scale, by the way. So as you know, I'm I was on here on the 30th. On here, I sound 100 years old. My programs I recorded on the 30th. It was Sunday. I was 188.2 pounds. Now I didn't weigh myself again till the first 180 8.2 still. Now I was very careful about eating this week. And no, that's not true, careful in the way you're Let me explain. I went back to eating not quite as many calories, but I was not careful about what I ate. Meaning, I had a bowl of cereal this week. I mean, I still had, like, eggs and steak and stuff with wraps and everything, but like, once or twice I had food where I was like, Oh, what is this? I had like, a couple scoops of ice cream one night. So not, like, careful that way, but I was careful about my calories overall. Anyway, 187 on the second, then on the third, 180 5.8 on the Fourth of July. 185 and this morning, I weigh 183.8 pounds. Now, letter of the law every seven days, I shouldn't inject again until Sunday. But like I told you, I am going, I just I've been doing some reading, more reading on half life.

The half life of Zep bound is approximately five days. This means that it takes about five days for half of the dose to be eliminated from the body. Given this half life, it generally takes around 30 days for step bound to be completely cleared from your system after the last dose. So that's fine. So if I'm understanding that correctly, actually, I don't have to understand it correctly. I'm going to read to you understanding the elimination when a drug is administered, it's concentrated in the bloodstream. In the bloodstream, rise to a peak, and then it begins to decrease as the body metabolizes and excretes it. The half life is measured on how quickly this decrease occurs. So hold on. So if a drug has a half life of five days, this. Means that every five days, the concentration of the drug in your blood reduces by 50% so you inject 10 milligrams, five days later, there's five milligrams left in you. Five days after that, there's two and a half. Five days after that, there's 1.25 days after that, point seven that. So that's how it takes 30 days for it to completely go but you can see the efficacy of it is dropping exponentially as the the drug is being excreted and metabolized. So my thought here is, I'm shooting whatever. No matter what I'm shooting, I'm seeing the same seesaw effect. Day one, day two, day three, day four, day five, lose weight. Day six, day seven, gain weight, gain weight, put it back in. Day one, day two, don't I'm sorry, don't really lose weight. Day three, day four, day five, lose weight. It just keeps happening like that. First two days, nothing happens. You hold steady. Day 345, you lose weight. Day six, seven, you put it back on. Day one, two, again, you hold steady like so that just keeps happening. So I'm basically just trading back and forth the same handful of pounds over and over again. So like I said, we changed insurance, and because that happened, I ended up with two extra 7.5 milligram pence. Today is Friday, and I'm working this out with you, by the way, I don't I have a reasonable idea of what I'm doing, but I wouldn't call this, you know, any deep thinking on my part, so please don't do this. First of all, this is not medical advice. Nothing here on the juicebox podcast be considered advice, medical or otherwise, always consult a physician. But what I've decided to do is I'm going to inject this seven and a half right now. So let's do that now. Cap off, lock off, find the spot. This looks good. Let's go. Seven and a half is in now. Last time I shot 10, this is seven and a half. Now, the pharmacy didn't have 10s, so my doctor moved us to the moved me to the 12.5 right in that trash can, no problem. So the next time I shoot, it's going to be 12.5 now, when is the next time going to be well, I'm at a five. I shot 10, and today I basically have five left because of Half Life. I'm still losing weight, but we know I'm going to start gaining weight tomorrow, the next day. So now we've put in the seven and a half. My expectation is to see a hold in my weight for the next two days, so Saturday and Sunday, and then a loss, Monday, Tuesday, Wednesday. If that holds true or comes close to being what I'm expecting, then that means on Wednesday or Thursday, I'm going to shoot the 12 and a half. So if that works, then the next time you hear me, I should be more like 181 pounds. If that happens, then I'll shoot the 12 and a half, see how the 12 and a half acts, because this will be different for me again, and then I'll reassess. Five days after that on the seven and a half the other seven and a half pen that I have. So it's possible that maybe doing this staggered thing could my hope is that it leads to about a five pound weight loss in the next two and a half or three weeks. So knock on some wood. We'll see if that happens, and I'll be back very soon to tell you what's going on after I tell you what's going on with that one, I'm gonna button up this episode and put it out

if you or a loved one was just diagnosed with type one diabetes and you're looking for some fresh perspective. The Bold beginning series from the juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl. Beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player. Or you can go to juicebox podcast.com and click on bold beginnings in the menu. Hey kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the juicebox podcast. I know you're thinking, uh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community, juicebox podcast, type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in, but make sure you're not a bot. Or an evildoer, then you're on your way. You'll be part of the family. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The juicebox podcast.

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#1275 Crunchy with Kelsey

Kelsey was diagnosed at 33 years old.

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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 1275 of the Juicebox Podcast.

Kelsey is a former health coach who has type one diabetes and Hashimotos. Today we're going to talk about things related to that. I never know what to say here. Just listen, it's gonna be great. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bowl beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC as a registered dietician and a type one for over 35 years. And in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. This series begins at episode 698 In your podcast player, or you can go to juicebox podcast.com. And click on bold beginnings in the menu. Are you a US resident who has type one or is the caregiver of someone with type one? Are you tired of hearing me say that you should go to T one D exchange.org/juice. Box and fill out the survey? Well if you are go fill out the survey and I'll stop saying it really is that simple. T one D exchange.org/juice box this show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox. US med is sponsoring this episode of The Juicebox Podcast and we've been getting our diabetes supplies from us med for yours, you can as well. Us med.com/juice box or call 888-721-1514 Use the link or the number get your free benefits check it get started today with us med this episode of The Juicebox Podcast is sponsored by the ever since CGM. And sure all CGM systems use Transcutaneous sensors that are inserted into the skin and lasts seven to 14 days. But the Eversense sensor is inserted completely under the skin lasting six months ever since cgm.com/juicebox.

Kelsey 2:27
Hi, I'm Kelsey. I was diagnosed with type one diabetes in October of 2022. That math is pretty easy for you, Scott, I think it was about three months after I had my son, my first kid so kind of became a mom and a diabetic at the same time, which has been wild to say the least.

Scott Benner 2:50
You got a type one diagnosis in October, which is just a year and a few months ago.

Unknown Speaker 2:55
Yep. Okay.

Scott Benner 2:58
Were you gestational during the pregnancy?

Kelsey 3:00
I was Yeah. That's kind of how it It started in a way. Before I got pregnant. I had a I had some blood work done. I have worked with a functional medicine doctor for years. And so I do regular blood work. And I had a pre diabetic agency, I think it was six. He was like, that's weird. You eat pretty well and like you exercise and I just keep an eye on that. And so it's like, okay, odd. And I've been in health and fitness for a while now over 10 years. So I I knew about blood sugar. And I actually already had a, like a little glucometer. So I started testing my blood sugar. And it didn't look too bad. Like my, I think my fancy numbers were sort of high. They were a little over 100 But there are a few times where I ate like white rice or something. And I was like, Oh, dang, that is not normal.

Scott Benner 3:52
Oh, okay. Give me a second here. How old are you?

Kelsey 3:55
I am 33.

Scott Benner 3:57
When did you start checking your blood sugar?

Kelsey 4:00
You know, I did like, since I've been in health and fitness for so long. I had done this like carb challenge, probably when I was in my mid 20s. Okay. And so I had a glucometer then, and I didn't notice I don't remember noticing anything super crazy. Like if I went off the rails with some carbs. It got I think in like the 130s or something. So I had a glucometer already and I had actually want to CGM before too. So it's pretty familiar with like blood sugar in the technology already.

Scott Benner 4:32
And that the rice spike you talked about that's in the 130s back when you were tracking before you had diabetes. I don't

Kelsey 4:38
know why I remember but it was like plantains, okay. Plantains or something. And I was like, Oh, maybe I shouldn't need these. It was you know, it was it was something like that.

Scott Benner 4:46
Okay, all right. I have the whole thing you keep saying you're in health and fitness makes me laugh because my podcast is in the health and fitness category. And if I saw myself by looked at myself in the mirror right now, I'd be like, ah, we should all get the top 20 podcasts in Health and Fitness medicine, which is my subcategory and take a photo together and people will be like, how did that guy get in there? Right? The rest of them look like they're on testosterone.

Kelsey 5:09
I actually used to work for a few people probably in that category. Oh, totally. Right. Totally. Right.

Scott Benner 5:14
I love it when like, there's some of these, some of these podcasts I enjoy, right? But I like I see that. I see what this one guy um, I don't want to say his name. But I see him on Instagram. And he's like, my age. And he looks like he gets lift up a truck. And I'm like, Ah, all right. Just the cold plunges. All I have to do

Kelsey 5:32
you have to do the sauna and then the cold plunge, and then

Scott Benner 5:34
you'll go on a cold, maybe some red light therapy at some point.

Kelsey 5:38
Yeah. On your on your balls, put them right on my body.

Scott Benner 5:41
Take that red light, I jam it right up my face. And then I look like Hercules apparently. And I'm like, all that podcast does make me think. Should I use my endocrinologist about testosterone? Literally all it makes me think

Kelsey 5:56
you're not wrong. You're not wrong. Can

Scott Benner 5:57
we go back for a second? What did you is this a professional thing for you? What were you doing?

Kelsey 6:01
Yeah, um, so I actually have a health coach certification. So I was working one on one with clients a while ago. And then I started working for a supplement company, that it was a startup and they were owned by one of those influencers, like one of those podcasts influencers, I won't throw any names out.

Scott Benner 6:20
But later you'll tell me right when we're done recording,

Kelsey 6:23
maybe. I worked with them for a while as their marketing manager and kind of developed some courses for them. So I've been in the space for a while and like I just have a personal interest. Yeah, yeah. Have been on literally every diet that you can, you can imagine. So, yeah, it's been an interesting ride into type one from there.

Scott Benner 6:46
Have you found a style of eating that fits your body best? I would

Kelsey 6:50
have said yes. Like before I had the type one diagnosis. And now I think I'm looking at it from a different perspective, if that makes sense. So I would say paleo for sure. Just kind of like going moderate low carb, kind of avoiding grains and I've been gluten free for over 10 years. It was like after college I I went gluten free. And yeah, I would say like mostly paleo, pretty low to moderate carb. That's kind of how I feel the best I've done like him, I get into it. But I he was basically like keto while I was pregnant, like strict keto, because obviously I was diabetic and didn't have insulin, and I just couldn't handle any carbs. Yeah. And I actually felt pretty good. But I wouldn't advocate for that like long term for myself or probably any woman my age. It's just I think it's kind of stressful on your thyroid. Okay. So yeah, I would say I always kind of come back to paleo like, me veggies, little bit of fruit. That's kind of the staple. For sure.

Scott Benner 7:49
I gotta be honest. I think that's, I mean, that's how I eat on the day, like most of the time, give me like, Hey, don't you think that's how I liked it. We call it paleo. Right?

Kelsey 8:01
It's just like, like, well, I don't know. It's not even Whole Foods, right? Because like, you could argue that grains or Whole Foods, so some people call it ancestral eating.

Scott Benner 8:10
Yeah, they call it a lot of different things when they're trying to sell it. Yeah, yeah, yeah, totally. But yeah, can you do this with me for a second before we go back to your pregnancy, if you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, G voc hypo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you store Chivo Capo pen and how to use it. They need to know how to use G Bo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit G voc glucagon.com/risk For safety information. I don't know how you guys order your diabetes supplies like CGM pumps and testing equipment. But at our house, we use us Med and I'm gonna walk you through the entire process right now. I'm looking at the email from us med it says it's time to refill your prescription. Dear Arden please click the button below to place your next order. Then you click the button. That was it. Two days later, I got this email. Thank you for your order from us med we wanted to let you know that your order and to give As you in order number was shipped via UPS ground, you can track your package at any time using the link below. And then there was a link, and then it showed up at our house. Now I'm going to walk you through the entire chain of events. On the 29th, which was the Saturday, I clicked on the email on that Monday, the first I got an email it said the order had been sent. Four days later on the fifth, the package arrived. If you can do it easier than that, you go get it. But if you can't, US med.com/juice box or call 888-721-1514 Get started today with us med get your diabetes supplies the same way we do. I think you are in a unique situation here to answer some questions for me. Okay, there are things I say on the podcast sometimes that I think people might be like, Oh, he's just ranting and raving. But I know what about having to serve content to people and having to grow and the fact that if it stops, especially with a social media driven society, right, like, I'm not a big company, I can't buy an ad during the Superbowl. This is my way to reach people. I have to say you were in marketing, right? So yes, I know what I have to do. Like I have a simple marketing plan. I make content that helps people. I put them first. And then I sell ads. So I said that's that's it for me. I thought about it long and hard. And after the podcasts got very popular, companies came to me about monetizing the podcast and like they were like, You know what, like, not advertisers, like companies were like, you could sell your downloads or put it behind a paywall or do all these other things. And how many listeners you have imagined how much money that would be? And I was like, but then people won't find it. Right? I want it to be free to the people listening to it. Yeah, that's my marketing plan, make good content that's entertaining and valuable that people will share that will help them and then let whatever happens happen. And that's going well. But that's not really most people's marketing plan. Right? Most people's marketing plan is pick aside, argue, fight brand, use words that make some people mad and some people happy. And then we'll just take the money from the people who agree with us.

Kelsey 12:23
That's the marketing plan, right? Yes. Especially like for a lot of supplement companies in the space, I would say, yeah. So

Scott Benner 12:30
when when someone's out there arguing, like, Gosh, what's one of the like, You got to eat calf livers every day. And you see somebody literally with a calf liver in their hand taking a bite out of it. And you're like, oh, he really wants to sell those vitamins. So that's what I mean. That's what I think when I see it happen. Yeah, I think what, what what he wants to happen, or she sorry, is for the people who agree with them to go Yeah, look, how we can do it is is I want to be that into it. And then get into a fight with the people that disagree with them. Because the fight keeps the people that are into it into the social media that you need to keep people in touch so that they'll buy more stuff. I have all that right, right. Yeah,

Kelsey 13:11
for a majority of people. Yeah, I would say that. That's that's kind of what marketing is. Okay.

Scott Benner 13:17
Yeah. Do you think people know they're being manipulated? Sometimes?

Kelsey 13:21
Yeah. But nobody likes to be manipulated. So I think if you if you know, you're being manipulated, you'll usually kind of turn it off. But I don't know. I think people like to buy stuff, too. You know what I mean? Like, people like to try things and they want to, they want to think that something is going to help them or they're going to look a certain way or feel a certain way. So

Scott Benner 13:42
it's a way to feel like you're doing something without doing something. Yeah, yeah, exactly. I could go for a walk and maybe stop in the middle and do a sit up. Or I could try this vitamin. I'm pretty sure it's going to fix everything. I'm sure. I'm pretty sure Kelsey that it's a great secret. That's Captain only these few people who follow this person on Instagram know about I'm gonna get him on the ground floor. I'll be super skinny and very tone. By the time everybody else figures it out. Right. By the way, I take vitamins I'm not saying bye. Bye. way. Hold on a second. This is my multivitamin. All right, it's right.

Kelsey 14:19
Here here. Yeah, right with you.

Scott Benner 14:22
You know, I dosed myself a little heavy with vitamin D. I take a multivitamin. I do think I do if I drink athletic greens, you know, like that kind of stuff. But I don't think I'm gonna get taller or you know, suddenly look jacked over. I just I'm not exhausted at the end of the day. You

Kelsey 14:41
know? Totally. Yeah, you probably don't. I mean, sometimes people are just in a vulnerable space where their psychology can be manipulated a little bit more like I've been there. You know, when I was invited, super sick and I'm just like, I can't figure it out. You buy a bunch of things and try it. So I don't fault people for are no one unquote falling for marketing like that? I don't either. Yeah, it is. It is interesting. And I, if I'm being honest with you, I think the way that you're doing it, I was a Content Manager. So like organic marketing, not necessarily like the paid manipulative stuff, is what I love. And what you're doing is organic marketing, right? Like you're putting out valuable content that people will share. They'll tell their friends about and you're kind of putting all your eggs in that basket. And it sounds like it's working. Because that's literally how I heard about your podcast. Yeah.

Scott Benner 15:32
Yeah. The people who listen and succeed and are kind enough to tell somebody else there my marketing, right? Yeah, yeah, that's it. And, yeah, word of mouth. You know why? So I want everybody just, we're gonna move on in a second, Kelsey. But I want everybody to extrapolate a little farther now that we've explained all this. Why don't other people

Kelsey 15:49
do that? They don't have good content to put out that helps. They don't. Yeah, that helps people. Yeah, they don't, or they don't know that they need to put time and energy into that. I guess that makes sense. Yeah,

Scott Benner 16:04
I'm watching people online call themselves diabetes coaches, and they get a hold of you. And they take a fee, a weekly, a monthly a yearly fee from you. And basically, they look at your basil for you. And then they tell you how to Pre-Bolus your one seed drops a point. Do you think that the second coming of Christ? And do you feel like you got your money's worth? Meanwhile, yeah, you could just listen to any number of episodes of this podcast and do that on your own. So I have two

Kelsey 16:29
thoughts about that. One is, yeah, there's way more diabetes coaches out there than I am, like, I thought type one. I mean, type one is rare, right. But there's like a lot of type one coaches out there. I was, I was very surprised. You know, what

Scott Benner 16:42
did that be? What did that COVID This pocket? COVID. Yeah, do that. People lost their jobs. They're like, I have ABS I have diabetes. My one season the sixes. I know what to do. Yeah.

Kelsey 16:55
So and also be having been a health coach before. They're also just certain types of people that really, like they could go learn on their own the same information, but they really want support. I do believe that. Yeah, yes. And they do find that valuable. And it's like, yeah, you could go read this book. Or I would rather just pay you because like, I'd rather spend money than time, and you just tell me what to do.

Scott Benner 17:18
I also have no trouble with that. Yeah, I really don't. I understand that some people, that's their desired learning pattern, and it works well for them. So I'm not saying everybody should just listen to the podcast, and everybody else should go to hell. I'm saying that there are a lot of diabetes coaches. Yes, there are. And sometimes in their social media, I see a lot of words strung together that sound like they were pulled right out of the transcripts of my podcast, and that's okay. What am I gonna do? It's fine. You know, it's also, I don't know, I feel bad at my core. You shouldn't have to pay money to like, be healthy. It just doesn't seem like it's only information. You know what I mean? Right. I'm not having to mine it out of the ground and give it to you. So Right. Yeah. Anyway, you make a good point on both sides. So yeah, I mean, if you need a health coach, that's great. I mean, there's a strong, you know, argument to be made that that's what Jenny does. Oh, sure. Yeah. Uh huh. I have no trouble with that at all. I, it's fine with me. It's something to do with I don't know, it's the it might be just me. It's something tastes wrong to me. When it's on social media. Yeah,

Kelsey 18:24
there can be a weird way to do it for sure. And I mean, if if you're seeing like your same content being put out that that happens a lot and like every space, but impersonation is the best form of flattery, right? Like they're obviously finding your content valuable enough to use it themselves. So yeah,

Scott Benner 18:43
I would tell you, and I will, I will leave all the names out of it, that there is a person online right now selling themselves as a diabetes coach. Who is who How do I how do I say this? They got their information from someone else because they didn't know what they were doing. Then they wrote it all down, and what they're very good at is repeating it back to other people. Sure. Yeah. You know what I mean? So yeah, very, it's just insane. I don't know the whole thing makes me feel lucky. Anyway, not to say again, not to say there's anything wrong with helping people or taking money to help people i don't i don't actually don't have any trouble with that. It just it doesn't sit well with me. So I'm sorry. You're in the hospital. Sorry. Yeah, make a baby. The baby comes out. And 16 minutes later Kelsey baby comes like flying out or maybe didn't maybe hang hung onto your bed. I don't know what they hang on to when they're coming out but and you're a new mom and super excited. And then what happens?

Kelsey 19:43
Yeah, he hung on for quite a while. I'll just say that.

Scott Benner 19:47
Like around your livers, something like that. Oh,

Kelsey 19:49
God. He did not want to come out. My no yeah, he was born. So I guess going back like, yeah, gestational diabetes. I failed the glucose test miserably. Hmm. I think I was in the three hundreds and nurses kind of kind of kept coming back to be like, are you okay? Are you okay? I'm like, yeah, go fine. And they later told me that they were testing their glucometer on themselves to make sure it wasn't broken. That's how badly I failed it. And so they basically like tried to do it without insulin for a while I worked with a diabetes educator that are telling me all this generic that didn't work. And I'm like, Look, I'm not eating carbs. Like, I'm already like, something's going on here. And they kind of just kept telling me it was gestational and it probably go away. No one mentioned type one to me at all. And so I had him. It was just like a stressful pregnancy. I was like walking after every meal to try to get my sugar's down. paying out of pocket for a CGM. Yeah, but I was eating super healthy. So yeah, he came out perfectly healthy. No blood sugar issues, no issues, breastfeeding, like he was great. Other than just being a wild child.

Scott Benner 20:59
So you think you have a slow onset? Hold on a second? Yeah. A smart me to put a lozenger in my mouth while I'm making a podcast. Rob, you can leave that thing gone. I guess I got like a little dry. And I was like, she's telling a good story. I'm moisten up. And then I wanted to talk and sorry, so you probably were experiencing a slow onset of type one diabetes, not gestational? Yes. Okay. Yeah.

Kelsey 21:24
That would be my guess, just considering that I had a high a one C before I got pregnant. Yes. So my guess would be I was sort of in a slow burn. I was probably managing it just by being very healthy and like eating well, for so long. Yeah. But yeah, I think either my pregnancy kind of just, my pancreas just gave up or I'm guessing it was a pregnancy. And then I had a pretty tough labor too. So I'm sure that sort of

Scott Benner 21:52
played into it as well. Do you have a thyroid issue?

Kelsey 21:55
I do. Yeah. So I have Hashimotos as well. Yeah, that's not

Scott Benner 21:59
your notes, but I've started Yeah, yeah. Did you get that before or after the baby?

Kelsey 22:04
Yeah, before so I've had that. That's kind of what kicked me off in the health and wellness. I was diagnosed with that. I probably it was probably like in my late teens, but I didn't figure out what it was until like my early mid 20s.

Scott Benner 22:17
Were you very thin during that time? Yeah, so I

Kelsey 22:21
lost a lot of weight. My biggest symptoms like my hair falls out in chunks. So yeah, it's awful. So anytime my thyroids off that's kind of like my sign of like, okay, we need to go get get our labs checked. All the things like really cold really thin. Yeah, that sort of thing. And that kind of runs in my family too. Like my mom has Hashimotos and my grandma does as well.

Scott Benner 22:44
Okay. With the women in your family are both male female. This episode of The Juicebox Podcast is sponsored by the only CGM you can take off to get into the shower. The ever since CGM ever since cgm.com/juicebox. Well, I mean, sure, you could take the other ones off. But then you'd waste the sensor and have to start over again. But not with ever since ever since is a six month where implantable CGM. So if you want to take a shower without anything hanging on, you pop off the transmitter jump in the shower, when you get back out, put it back on, and you're right back to where you started. Come to think of it. You could do that whenever you wanted to. Maybe it was your prom night or your wedding day. Maybe you just don't want the thing on for a little while. But you don't want to go all through the hassle of taking it off and having to restart it and you know, starting back over with like wonky numbers and having you know all that that goes with it when you take off a CGM and put it back on Oh, but you don't have to do that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings. This gives you more confidence, more convenience and flexibility. The ever since CGM is there for you when you want discretion, a break. Or maybe just a little adult time. Ever since cgm.com/juicebox. Podcast transmitter off, pop it back on. You're right back where you started without any wasted devices are time.

Kelsey 24:14
Yeah, just the women as far as I know. Yeah.

Scott Benner 24:17
So you have and it's diagnosed Hashimotos you they were tested for antibodies? Yes. Yep. Take just T three or do you take T three and T four.

Kelsey 24:26
Oh man, I've taken it all Scott. I've taken just the generic levothyroxine I've taken combo with T three. I've taken the desiccated thyroid armor, and I am actually now just on T four. I had started working with a guy that's like he's kind of like an expert in thyroid in the field. And the T three was actually making me worse, taking it long term. So we're kind of titrating it back and trying to figure it out from there, but it does make you feel better for a little while. And then I sort of just like plateaued and got worse. What

Scott Benner 24:59
were you You trying to adjust? So for people who don't know, sometimes people take T four which you know could be tiersen Synthroid, that kind of drug. Yeah, but still have symptoms. And like Arden's one of them if you give art and just tiersen she's exhausted and like different kind of exhausted like poured in a puddle exhausted, but if she if she didn't there, yeah, but if she just takes like point two five micrograms, like the tiniest, isn't micrograms. Oh, yeah. Yeah, the tiniest little bit of T three, she's fine.

Kelsey 25:28
Okay, interesting. And how to were like, you get her lab or her lab work done pretty regularly.

Scott Benner 25:34
Her TSH stays under two. Okay, that's what we're shooting for. And again, much like you aren't seeing an integrative endocrinologist who's managing her thyroid, and actually manages her diabetes now that she's an adult too, but manages diabetes is like a that's a funny word to say. Because I think if you had that endocrinologist right here, and I asked her, What do you do for RNs? diabetes, she'd say, I write prescriptions and listen to what you told me. So

Kelsey 25:59
yeah, you guys have probably more managed than anyone else. Yeah.

Scott Benner 26:03
But on the thyroid side, she's fantastic. My son, my daughter, and my wife all need thyroid medication. Oh, your son too. Wow. Yeah, it hit him. In his sophomore year, actually, during COVID sophomore year of college. He had the weirdest onset, it was crazy. He got a itching rash from his waist to his neck. Oh, if his body heated up, or if he got excited or scared, that's thyroid related. I've never heard of that. Guess what? We didn't either. So the first thing we did was took him to what would you what would you call that person who helps you with allergies and allergist?

Kelsey 26:43
Sorry, that was a big stretch.

Scott Benner 26:47
And they tried to handle it that way. You know, all kinds of stuff. He's taken all kinds of drugs trying to suppress it, nothing mattered, he had to stop working out. He got to the point where it was November, if I remember. And he had to sit in his bedroom with his windows open to keep his body temperature like under 60. Like, like the temperature in the room had to be like under 65. Or he risked breaking out if he moved quickly. It was insane. Well, it felt like it was killing him. And we were starting to look into like injectables to like, like immune suppressing it because we didn't know what was going on. And I was just up late one night, just combing through NIH articles. And a very uncommon sign of a thyroid problem can be a rash. But what do you call it when you break out like well, not well, it's why is it simple word? hives. Thank you what though? Kelsey, you already curse So I can pursue now. Because now Rob's listening for curses while he's doing. So.

Kelsey 27:45
I haven't said any all you said. Oh, did I yeah, you write it down when someone says something nice

Scott Benner 27:52
man that I pay money to takes it out later. And so he's probably like, yeah, why don't you write it down? That would make it easier because I'll skip like, it's I'll skip one and then I'll you know, anyway, and then it'll all be a mess. So my son's in dire trouble. We figure this out. I go right to Ardens Endo. And I tell her what's going on. And she's open minded. She's like, wow, that that would be very rare. But yeah, let's give it to him and see what happens. We're most doctors would be like, that's not what that is then let him struggle for the rest of his life. She threw some tears and Adam and like a week later,

Kelsey 28:24
it was gone. Interesting. Wow. That's fine. Now he

Scott Benner 28:28
is he takes tiersen and a tiny bit of armor for T three.

Kelsey 28:32
Did you ever get his numbers tested to see like, where's TSH was at or anything?

Scott Benner 28:37
Oh my god. At one point. After we focused on thyroid, his TSH had this. I think it was a seven at 1.0. Yeah, it leapt way up. So he was in a bit of a thing. It leapt up, it went back. And then of course, so doctor, the regular doctor because I had sniffed out in July previous to this happening to him. I hope he never hears this or if he hears it, whatever. He was acting like a douchebag. I don't know another way to put it. And it was very uncharacteristic for him. And I said to him, you're going to the doctor and getting a blood test, I want to look at your thyroid levels. And it came back at like two and a half or something like that. And I only took him to his general practitioner. So his doctor was like, that's not that's not a problem. I'm pointing at him like you sure I said because this seems like this to me. And he goes, Why do you think that I said because my wife had undiagnosed thyroid when I was younger, and I had already dug a hole to push her in because I thought I was gonna have to kill her because she was such an asshole while this while this is happening to her, and like it just seems very similar. And the guy put me off and I let him put me off. And then the next time it happened I was like screw that sound like I'm going to the doctor. I know what Listen to me. So anyway, he's good now.

Kelsey 29:54
Oh, good. I'm glad Yeah, that is Yeah, that's a wild one isn't

Scott Benner 29:57
saying Although. So you say the T three is too much for you get heart palpitations or what happens to you with it? Yeah,

Kelsey 30:03
I started getting heart palpitations, I was just feeling like mixed hyper and hypo symptoms. There's like a whole different like theory on thyroid health that I'm learning out there that stalker that I'm working with has about like, if you do have an immune driven thyroid condition, the T three can actually make it a little bit worse over time. So we're just trying some stuff. It's kind of one of those things where it's like, I I know a ton about thyroid health and I still know nothing. How, bro

Scott Benner 30:32
sciency Are you going to get with your thyroid journey where you try methylated vitamins or stuff like that, or what? How far are you gonna go? Yes,

Kelsey 30:38
yes, I've tried methylated vitamins. I've done red light therapy on my thyroid. For I would say, I haven't done peptides. Like that's kind of where I'm at. Oh, and everything else.

Scott Benner 30:49
Wait the injectable one. Yeah, like,

Kelsey 30:51
there's like oral peptides too. But yeah, they're mostly injectable. I have not done that yet.

Scott Benner 30:56
Okay. You think you're going to?

Kelsey 30:58
Maybe someday? I don't know.

Scott Benner 31:00
I'd be honest with you, Kelsey, I'm definitely gonna ask for testosterone.

Kelsey 31:05
You should. You should or probably hell. What

Scott Benner 31:08
do I got to lose? I listen, everybody out. Every famous person looks amazing. And I'm walking around here talking about, you know, I don't have muscle tone in my arm. Like what the hell? Like

Kelsey 31:19
why am I doing this? Oh, yeah, they're on some stuff that costs money. Yeah, but I don't have the money. That's gonna be the problem. You could get them to sponsor your podcast.

Scott Benner 31:27
There you go. Seriously, if you can set that up. I'll absolutely do this.

Kelsey 31:31
I'm totally joking. But I'm sure I'm sure it's someone would

Scott Benner 31:36
just injecting whatever like, Oh, it is fine. I'm like, what is that accent? Did any of those things help your thyroid, your red light or your whatever else you tried?

Kelsey 31:48
Honestly, yeah, like I was really managing it very well. I think pregnancy has thrown some stuff off, which is normal, I'll probably get back to feeling better once I get it figured out. But I felt great. My levels were stable. I was on like a very stable dose of medication. It would kind of go off the rails of like, a lot of stress came up or if I you know, ate a ton of gluten or something like that. But I was doing really well.

Scott Benner 32:11
What were you using the supplement that the tea for?

Kelsey 32:14
I don't know, I think is what it was. Yeah. Yeah.

Scott Benner 32:18
Okay, that was that was your teeth, three the site. And now you stop using that though. So like, what do you are using anything over the counter right now?

Kelsey 32:24
And just taking a look at micrograms of levothyroxine? No, nothing

Scott Benner 32:30
right now.

Kelsey 32:31
nothing extra. Okay, nothing extra. Yeah. But my levels aren't. They're pretty low. And I'm trying to get those up. I think my just conversion from T four to chi three might be a little messed up right now. I know you've had kids, like your sleep is just jacked for a while. So there's a there's a lot of stuff going on.

Scott Benner 32:48
You have symptoms like your hair and stuff like that. I

Kelsey 32:51
did. And now I'm leveling out again. Okay. So I feel pretty good now. So TBD if if this soul, this will help me.

Scott Benner 32:59
I hope your doctor is like really as good as you hope because like, I know if if that happened, and we talked to our doctor, she'd like, mumble some math on the phone. And she'd be like, take an extra pill on the first day. And I'm not saying like she you don't I mean, she'd be like, we want to get a little extra in there. And I'm like, Okay, do you miss the pills ever? Are you very fastidious about taking it? Oh,

Kelsey 33:21
no. Yeah, I take them every day. I did do an experiment where I just felt like everything was off. I needed to reset and I didn't take any thyroid medication for a month. Because I had been so long since I hadn't taken any I was like, I wonder if my thyroid even works like maybe it's fine. And it doesn't so I do need to take medication.

Scott Benner 33:42
By the way, you need me as your father, I had to tuck my son down off that ladder one day. Like I'm like, Yo, man, listen.

Kelsey 33:51
It honestly I'm glad I did it as weird as that sounds. I didn't feel as bad as I thought. And I feel like I just reached like a I was able to like start over with my medication and be like, This is what I felt like without any this is what I feel like with some Is this a good dose? So I actually felt okay, surprisingly, but my Yeah, my numbers kind of my TSH went up and all that.

Scott Benner 34:12
Yeah. Wouldn't have been long before something would have got sideways. i Yeah, yeah, totally.

Kelsey 34:16
Yeah. Yeah. But I'm pretty in tune with my body. Like you can tell really quickly if I need to do something to adjust. I

Scott Benner 34:24
just want to say I'm not a doctor, but please, everybody stay on your thyroid medication. Yeah, don't

Kelsey 34:28
listen. I'm kind of like I go rogue on some health stuff. Kelsey,

Scott Benner 34:32
talk earlier. She's out of her mind. It's fine.

Kelsey 34:36
He was a health coach.

Scott Benner 34:40
Have you tried journaling? I'm sorry. I'm not laughing at you.

Kelsey 34:48
You can laugh at me.

Scott Benner 34:52
Okay, so babies out we have type one now. What got you to a doctor. I guess I

Kelsey 34:57
had him. They kind of scared me. I was gonna have have a big baby and everything he was eight pounds, eight ounces perfectly healthy. So I guess it's one thing like, I wanted to get across people's like, I was diabetic and didn't have insulin and I, you know, I didn't have perfect blood sugar but my kid was he was healthy. I was definitely really stressed about that when I was pregnant, and I know it's very stressful. So yeah, he came out. I did not test my blood sugar for three months, I was kind of scared. I didn't want to know what it was. I was trying to figure out being a mom, not sleeping like just it was a lot. And I think it was it was the morning after my husband and I went out for his birthday the night before. And just like, mind you, I had been so strict with my diet for nine months, like basically didn't need a car, but I was like, I mean cake like Screw this. So we went to dinner, we had cake. We had wine we had whatever. And I woke up the next day and I felt pretty weird. And I had been having blurry vision for a couple of weeks before that. I was like, Is this a postpartum thing? Like, this is a weird, this is a weird symptom. And I tested my blood sugar in the morning fasted and I was like 398 And that was the highest I had ever seen it. I just walked out to my husband. I was like, I'm pretty sure I'm diabetic.

Scott Benner 36:14
Now. Curse. You just said it like that nicely. You didn't go, Bill can listen to this.

Kelsey 36:21
I mean, I was probably crying. I think I was probably crying. Yeah, because I was just so scared of that. And I had put it off for a couple of months when I was finally like, I just need to look at this. And yeah, it was like it was like my worst nightmare for sure. I asked him to take off work and I basically just like started looking up endocrinologist functional medicine, doctors, like anyone that could see me and test me for antibodies. And I found one she tested me. She thought I had celiac disease. She's like, you're celiac. I don't think you're type one. I was like hey, listen, I don't think gluten makes your blood sugar go up. I don't think gluten is making my blood sugar 398 Can you please test my antibodies? And so she did. I think there's like five there's like five antibodies they test you for an all of them are super high

Scott Benner 37:09
kills he's like I don't have time for you. God damn hippies right now just

Kelsey 37:14
one of you listen to me. Do you want to put me on like zinc and

what else? Tytos curcumin and NAC and I was like I already take all of the

Scott Benner 37:30
sage on fire and profit around your head.

Kelsey 37:34
No, we almost got there though. By the Oh, God bless her though.

Scott Benner 37:39
God bless. Big moment for everybody Arden's calling. Oh, I'm making a podcast. Can you say anything that other people can hear? No,

Speaker 1 37:47
I was just gonna complain about this state. You were

Scott Benner 37:51
just gonna. Sorry. You're on microphone. Are you okay with that?

Speaker 1 37:55
I don't care. I just I literally like how is it possible? I can't find a light blue mechanical pencil.

Scott Benner 38:01
George, by the way, I'm telling you to go ahead. I'm talking to Kelsey. She's laughing God.

Speaker 1 38:06
I literally have been to four stores. I've been on the phone with people. No one No one No one and then I call Michaels. And I'm like, Hey, um, do you have like a blue mechanical pencil? We're like the wettest blue. And he's like, yeah, let me check for you. And he checks and he's like, yeah, like, we have mechanical pencils. And he's like, Alright, have a good day. I didn't even I didn't even answer yet. And I'm like, I'm like, Excuse me. Excuse me. Like he didn't say like blue like that is that's why I'm calling right. Like, I'm sure they have mechanical pencils. So then I'm like, no, like, do you like, like blue ones? And he doesn't answer for 20 seconds. And then he goes, he goes, Oh, yeah. And I'm like, Okay, thanks so much. And now I have to drive. Like two miles. It was just 20 minutes to just get a mechanical pencil.

Scott Benner 38:49
Tell people why it takes 20 minutes to drive two miles. Because no, I can't say no. You don't want to say

Speaker 1 38:58
I'm so I'm so mad. And my cramps are so bad.

Scott Benner 39:08
She's got her period. She doesn't love Georgia. Oh, just real quick. 10 thoughtful words about how the people in Georgia drive. Now. Okay. Do you think you'll get yourself in trouble?

Unknown Speaker 39:22
I don't know. I

Scott Benner 39:23
just I can't. Yeah, I'm sorry. Well, I'm sorry. You're having a tough time.

Unknown Speaker 39:29
I hate this place.

Scott Benner 39:34
Okay, you're okay. It's everything's gonna be fine. How about I finish? No, don't go ahead. Say I'm gonna finish making the podcast. I'll give you a call in a little bit. Okay, great. When's your next class?

Speaker 1 39:48
Clock class at 8am to like 11. And now as a class at five. It's

Scott Benner 39:57
bad timing. That's not good spacing, for sure. Yeah, yeah. Okay, well give me a text if you get your pencil and then I'll know you've your handle that and I'll give you a call when I'm done talking to Kelsey, who by the way is very cool. You would like her I'll see you in a bit. Okay. Oh my gosh, people say Arden's on the podcast now.

Kelsey 40:22
You only have to bleep out. Five of those words. Well, people

Scott Benner 40:25
who've listened to one of the podcasts are not surprised by that. I don't imagine.

Kelsey 40:29
I think I had listened to one episode. So yeah, I knew I knew. She's

Scott Benner 40:33
not wrong, by the way to drive two miles takes forever where she is.

Kelsey 40:38
She's going to school there. Yeah. Okay. It's in sound.

Scott Benner 40:43
It's I mean, I think people know by now she's in Savannah.

Kelsey 40:46
Okay. I've never been to Georgia. slower pace of life, I'm guessing.

Scott Benner 40:50
I think so. I don't know what it is. Like, there's not that many cars, but yet they don't move very quickly. I don't understand. Everyone needs to come here and drive for four days. And then you can go back to wherever you live, and you'll be much better at it. Need a lesson? Yeah. You just need the fear of God up. You're the entire time you're driving. Like the idea that someone's going to run headlong into you if you're not careful and moving constantly, like you know how a shark never stops moving. Oh, you gotta drive in the Northeast. That sounds to Kelsey. I'm so sorry. Where were we before Arden called and started cursing into my microphone.

Kelsey 41:24
I have no idea. Okay, the crunchy doctor. Yeah,

Scott Benner 41:27
I love it. I love that you're there with a high blood sugar. And she's like, have you tried Berberine? I'm sorry. Yes, I

Kelsey 41:36
have. So anyways, that was the last time I saw her. I just got a referral to an endocrinologist after that. Yeah, the rest is history. I got on shots first. And I got my CGM in my endocrinologist is actually amazing. She loops. So she's kind of been working with me to I got on a pump shortly after that, as first on the tandem. And my kid was just messing with the wires all the time. I pulled it out, like so many times. So I switched to the Omni pod a couple months ago. And now I actually just started looping like three days ago, so Oh, really? That recently? Yeah. Good for you. Yeah. Yeah. So I'm trying that out. But yeah, that's that's kind of the story.

Scott Benner 42:19
Well, how did you find me? Like, why did you find I mean, I It's pretty obvious. It looks like you're into this stuff. But like, how did you think that like, oh, I maybe there's something about diabetes there. Actually,

Kelsey 42:28
my mother in law told me about your podcast. Hey, all right. Yeah, she has a friend that has a son with type one. I think she just told her that I should listen to this podcast. I downloaded a few episodes and started listening. And I love podcasts. I'm a podcast junkie. So I was like, yeah, totally. I'd much rather do that than read some books. So I have another question. It's

Scott Benner 42:48
gonna sound self serving, but it's not. Is it? I don't think so. No, I think it's just it's for my edification. You work for somebody who made a podcast? Yes. Am I good at this? Yeah,

Kelsey 42:59
definitely. I think the magic of podcasting is to, there's two types of podcasts, right? Like, there's the one that you listen to that's basically like a blog. And they just like shell out information, like listicles kind of thing. And you're just like, Okay, that was helpful. And then there's other podcasts you listen to for the conversation. And also like information you get out of it, right, like Joe Rogan's, like the number one podcast and it's all conversation. Yeah, I get a lot of good conversation. And then there's like nuggets of information and a lot of your podcasts to like the Pro Series are great. But yeah, I would say you're a great conversationalist, and people like to listen to that. For sure. That

Scott Benner 43:35
was nice to you. But I'm not done picking through this yet. So you're saying to me that I'm gonna say something. I think you're gonna note, you know, Rhonda Patrick's podcast? Yes. There's no way you don't listen to that. So I Okay, so now, she's basically she feels like she's reading. Like her thesis to me. Yeah. It makes my brain want to kill itself. So but do you like it? If

Kelsey 44:00
I want to know like that level of information about a topic then? Yeah. To me, like, I learned very well, audio, listening to things. So I've actually like written really detailed blog posts for other people using her content as help. So yeah, I think if you're like really nerding out on something, which is her audience, for sure. Yeah. Then I do like that. But I also I listen to Joe Rogan, too.

Scott Benner 44:27
So you like people just chatting and talking? And yeah, whatever. Yeah. Yeah. All right. It's my last month. Do you know Gabrielle Lyon? Yes. I have an open invitation to go on that podcast. Should I do it? Oh, for sure. Seriously? Yeah. We should all email her back. Oh, that's

Kelsey 44:42
awesome. Cool. I was trying to get one of my clients on her podcast. So I think

Scott Benner 44:47
she wants to come on here. And then I said, you can come on here if I can come on yours. And then I never go.

Kelsey 44:54
Oh, no. Yeah, you should go on it. For sure.

Scott Benner 44:59
I didn't know what Like she would talk, like, I'm worried about what she would talk about, or what I would talk about like didn't mean because our our things don't seem like they overlap, but maybe they do.

Kelsey 45:09
health related, right, like you're in the health and fitness category.

Scott Benner 45:12
You're such a shill. I love it. Like, just get on goddamn podcasts and grow this thing, Scott, what's

Kelsey 45:19
wrong? You should Scott, you really should. I think that's like one of the best ways to grow your podcast is to be a guest on other podcasts. You're an interesting person and you have stuff to say.

Scott Benner 45:29
Yeah, yeah. I always think that's bullshit when people say that, but okay. Oh, no. Yeah. All right. Well, listen, on your word, Kelsey, I'm going to email her person back. When we're done. Sounds good. But back to my thought about Rhonda Patrick, should I do that? Should I do an episode a week where I'm just reading fax to people? Or do you think they wouldn't want that?

Kelsey 45:49
You could try it and like, see what the response is. I think like when I have listened to some of your I haven't listened to them all. But when I have listened to some of the Pro Series, they are like a conversation. And my brain kind of has a hard time being like, Okay, I need you. This isn't this. I was listening to the loop one and I got some nuggets out of it. But I'm like, Okay, I still need to go watch like a loop YouTube video to like, understand what all these settings are. Okay. I don't know if you would like doing that. If you wouldn't like doing it, then. I don't know if people would like listening to it.

Scott Benner 46:22
Yeah, I wouldn't do it where I was like, they're like, is he being forced to do this? It wouldn't be like that. But I have. How should I tell people this? Not people listening? I don't care if you guys hear I hear I care if the people rip me off here? Uh huh. I have a fairly robust set up in the background that I'm working on where AI is mining my content for lists of thoughts and ideas and take away is really smart. Yeah, no, yeah, no, yeah. Don't worry. I didn't do it by mistake. And also translating it into other languages for me. Okay. Not the whole podcast because AI is not there yet. You can't give something like a 60 minutes worth of audio and be like, turn it into Spanish. It'll be like go to hell. Yeah, yeah. But it can with insane accuracy. You can say, Please provide key takeaways from this episode. And if I listened to the podcast back and made my notes from it, it would come out exactly like this. Oh, that's cool. It's really something so I could read those and make short episodes out of them to help people go find the conversations.

Kelsey 47:31
I think micro content like that is a really good idea to get people in the door. Okay. And like get like a little more like, bite sized information, especially if you're doing the conversations already. But yeah, sometimes I'm just like, I just need to like, know this one thing about this app, and I can't figure it out. Like I wonder if Scott has an episode on it. But then I gotta like, listen to the whole thing and be like, Did he mention it

Scott Benner 47:53
and Arden calls then she's like, people in Georgia can't drive and like he gotta Yeah, I understand. Like, you gotta give

Kelsey 47:58
her some reason. She's looking for a blue mechanical pencil. I can't. I don't know why. Yeah, what's

Scott Benner 48:04
what's your favorite part of her call? Is it when she said and 20 seconds later? He said something.

Kelsey 48:10
She's funny. Yeah, she's

Scott Benner 48:12
like me, but pretty. My kids not pretty. Don't go look for her. She's not in Savannah. Jesus Christ.

Kelsey 48:24
Oh, the internet creepers are Yeah, somebody

Scott Benner 48:26
told me recently, I was in the park in Savannah. And I saw somebody who was wearing an omni pod that I thought was Arden. Oh, and I almost approached her but I didn't. And I said, Well, a good idea. And she'd be very polite, and then call me and go, one of your people came up to me in the park. But be it wasn't her. Interesting. that interesting. She saw another girl artists age in the park wearing it out in a pod. Ah, okay. They're out there. Back To Me milking your brain. I have a whiteboard behind me. It's, I don't want to embarrass myself. It is a five moment a six by four whiteboard on my and every idea I have about making this podcast is written down on that whiteboard. And I've been toying with something that I was calling small sips on my whiteboard, short clips, that kind of thing. And I saw I've been doing the AI and you just said micro content. Like it's a thing that if I went to college or worked in this I would know about, uh huh. That's what I'm thinking about. Right? Yeah,

Kelsey 49:25
yeah. Okay. All right, micro content. It's making shorter content on longer content that you already have.

Scott Benner 49:33
And then giving people the opportunity to go back to the longer content if they'd like. Exactly. Yeah, exactly. And so I could do a thing here. You want to workshop one with me right now?

Kelsey 49:45
Totally.

Scott Benner 49:46
Let's do it. Okay, so I'm looking at the key takeaways from the first episode of the Pro Tip series. Okay, the first episode of the Pro Tip series is episode 1000. It's called diabetes pro tip newly diagnosed are starting over. I don't know if people NOTICE but when I make new series, I start them by having a conversation about what I want the series to be about. You know, like, it's almost like a brainstorming thing if Jenny's involved Jenny and I get together and I go Jenny, I want to make a story you know, series for me to call bold beginnings, that's gonna be for really newly diagnosed people. Then she and I talk about it, we hash it out. I already have a ton of by the time I get to that point, I've already asked in the private Facebook group, what do you guys wish you would have known when you were diagnosed? And I have, when I made the bold beginning series, I had 80 pages in a document of people's responses from the podcast and from the Facebook group. And then lovely people distilled it down for me to get rid of the duplicates. And then Jenny and I made an episode going through them, and then she and I decided what we needed key takeaways from that to make the series with. So anyway, that's what this is. The Pro Tip series first episode is just her and I talking about what the Pro Tip series is going to be. Ai says that the key takeaways of that episode are understanding how insulin works is crucial for managing diabetes effectively. Basal testing can be helpful in determining the right Basal insulin dosage, especially for pump users. Basal insulin is the foundation of diabetes management and should be prioritized. blood sugar control is heavily dependent on Basal insulin. So it should be adjusted before considering other factors like insulin to carb ratio. Fear of insulin should be overcome to effectively manage diabetes. Newly diagnosed individuals should seek comprehensive education and not settle for basic information. It is important to find a health care provider who can provide the necessary support and information. Mistakes and experiences are valuable learning opportunities for diabetes management, and diabetes management requires flexibility and adaptation to changing variables. And numbers and data are information, not judgments and should be used to make informed decisions. So you're saying I could make that into like a five minute episode, like read those chat about it for a little bit, bundle it up and send it on its way and people would find that valuable?

Kelsey 52:00
For sure. All right, like the literally just talking about Basal insulin being the foundation like that. Yeah. Okay. Just hearing that in a list. I'm like, you don't even have to say anymore. I'm like, oh, okay, I need to start there. Because your endo doesn't tell you that. At least mine, didn't we they talked about the insulin to carb ratio. All right, which is like kind of the last thing you're supposed to tweak. Right? So yeah, definitely. You should do that. All right, Kelsey, don't

Scott Benner 52:27
rip me off.

Kelsey 52:29
Don't worry, I don't have any other diabetes clients, you

Scott Benner 52:32
and I and a few people who I talked to privately are the only ones who know I'm going to do this. So I am going to, I'm going to do this. I'm going to make a whole series like that of shorts. And I'm gonna do it just the way you said because you can sell vitamins to people they don't need. So you must know what you're talking

Unknown Speaker 52:49
about. No.

Scott Benner 52:53
By the way, you've been incredibly we're not done yet. But you are been incredibly honest. And I genuinely appreciate you being on the show. Thank you very much. This is Oh,

Kelsey 53:01
yes. been terrific. No, it's a pleasure. It's it's yeah, it's kind of a therapeutic.

Scott Benner 53:06
Oh, I'm good. Okay, so we're now you're managing using Omnipod dash g seven or G six. So Angie said you six and you just started looping. And so did you just do that on your own? You just went like on loop and learn or one of those Facebook groups and taught yourself?

Kelsey 53:22
My endo did kind of give me a few like bulleted of like, here's where you need to go. Yeah, I sat down for a couple hours and was like, Okay, how do I do this? The GitHub with the loop and learned Docs is amazing. I don't really know what I'm doing yet. But like setting it up was not bad at all right? Yeah.

Scott Benner 53:38
Is it a branch that is making adjustments with basil? Or is it making adjustments with boluses?

Kelsey 53:43
Right now I just have it set. I listened to your episodes with Kenny. And I have it in open loop, kind of trying to make sure my basil and my ISF is right. So I haven't even put it in closed loop yet. I don't know if I'm doing any of those things yet. I'm just kind of running it

Scott Benner 54:01
myself. Nice. Yeah. How's your insulin to carb ratio? You think it's good? No,

Kelsey 54:04
I don't that's actually one that I'm like, I don't eat a lot of carbs. But I eat a lot of protein and fat. So the the carb ratio like never really is enough for me. Because if I put in I'm really only eating like 10 carbs, I still need like two to three units of insulin for the protein and fat that kind of hit later. So yeah, I haven't quite figured that one out yet. That's

Scott Benner 54:29
pretty easy. You can put in 10. So the 10 carbs up front is not too much. You're okay with that. Yeah.

Kelsey 54:35
So I have like a one to 10 insulin to carb ratio right now.

Scott Benner 54:39
Right? So you can say I'm having 10 carbs. It'll give you a unit. But then the problem you're having is what 45 minutes an hour later you start rising from the protein. Yeah, okay. Yeah. And then that rice stops at some point you correct it, it goes back down how much you correcting it with?

Kelsey 54:56
It depends on how high I go up. I guess usually one One unit one to two units will take me back down. But I'm trying to avoid the rise in the first place, which I don't know if it that's even sure here I'm

Scott Benner 55:09
about to tell you. Okay, you help me help me, I'm helping you. Okay, so in loop, you can just say, Hey, I'm having 10 carbs, and blah, blah, blah. But you can also go in and tell it, I'm having 10 carbs, then put the time on it is 45 minutes from now. Okay. And then you're giving the algorithm the flexibility to be aggressive when it sees the rise, because it expects

Kelsey 55:31
is that in closed loop? Only Scott? Yeah, that it will do that. Okay, in

Scott Benner 55:35
the Bolus calculator, you can pick the time of the Bolus, but you can pick the future. So you can give a predated check a post that post a Did You Ever Have you ever put up? Sorry? Have you ever posted first of all, you're in your 30s? Do you even have a checkbook?

Kelsey 55:49
Yeah, I do. I use Venmo. Okay.

Scott Benner 55:51
Do you know what post dating a check is? No. Okay. All right. For young people, Jesus Christ, this is terrible. When you're broke, and it was 30 years ago, and you owed somebody $20. And you had to write them a check. You'd say, hey, look, it's Monday. And I want you to believe that I'm going to give you this money, but this money is not in my account till Friday. Today is the 10th. I'm going to write out a check for $20. But I'm going to post dated for the 15th. You can't deposit it till the 15th.

Kelsey 56:20
Oh, was that like on their honor system? Or

Scott Benner 56:23
is it well, if they tried to deposit before that the check would mark? Yeah. And then you'd by the way, get charged $25? Check balance fee, and you didn't have that anyway, and anyway, but that's not the point. postdating that's what happened. I can't believe people don't know what, oh, I'm so old. Oh, give me a second to get over that when we have water. Oh, I've lived through a thing that doesn't exist anymore. Okay, so you can post, it's really upsetting. You can post date, a Bolus and loop. So that's

Kelsey 56:55
the absorption time is like when it actually gives you the insulin.

Scott Benner 56:59
No, that's another thing, like so you can you could also tell it, you know, here's 10. If I was you, I might go end up going like, here's 15 carbs, and make the absorption time like four or five hours like to drag it out a little bit. But you can make one Bolus, hey, here's 10 carbs at one o'clock. But then make another Bolus and say, I'm eating 10 carbs. But I'm eating it at 150. And then when you push enter, it doesn't give you the answer.

Kelsey 57:26
Oh, I didn't realize you could change it. That's what changed in your time and

Scott Benner 57:30
the time on it. Yeah. And then 50 minutes from now, when the thing starts seeing you go up. It's like, Oh, I heard through a post dated Bolus that she was going to eat 10 more carbs. Now. Here we

Kelsey 57:40
go. And so you do you never really you just always like kind of count that as carbs. You don't because there's little icons in here for the food, right? Like you can choose chicken or eggs or whatever,

Scott Benner 57:50
you'll have to decide what the absorption rate you want for that second one. But what I'm basically telling you to do is Bolus for the food, another one and then Bolus for the protein rise.

Kelsey 57:59
Thank you, Scott.

Scott Benner 58:00
But you got a Pre-Bolus the protein rise but not by too much.

Kelsey 58:03
Not by too much. Okay, okay, that helps.

Scott Benner 58:06
There you go. Now it's worth your time. Coming on here. Yay. o'clock in the morning. Call. Everyone knows you're in Colorado just by how you talk to imagine.

Kelsey 58:14
Oh, really? I'm not from here. Oh, maybe

Scott Benner 58:17
you went to a lady who tried to give you like, you know, she tried to give you a dandelion tea when you said I have diabetes. I assume people were just like, Oh, she's probably in Colorado.

Kelsey 58:28
You're literally naming all the things in my, in my cabinets throughout this conversation that I Yeah, it's pretty funny.

Scott Benner 58:35
Do you feel seen or mocked?

Kelsey 58:38
Oh, it's totally fine.

Scott Benner 58:41
I was gonna say good because you're getting me for not having the communication gaps. No. I'm all for trying things. I am one of those people. Like I've taken dandelion capsules. Yeah, I've taken them for a month. And then a month later I said to myself, nothing about my life has changed so that I stopped doing, but but I've tried, but I tried probiotics. I tried different probiotics. I try I try all kinds of stuff. Yeah, that's great. Because if you trip over something that's valuable. I mean, God bless. Like it's, I'm totally into. How do I want to say this? I am not telling other people to do this. I take way more vitamin D every day than a doctor would tell you to take. Right?

Unknown Speaker 59:21
I do that?

Scott Benner 59:22
I take 10,000 I use a vitamin every day. Vitamin D every day. Yeah, that is a lot. So I don't care. What you don't need flushes out and I've got enough and that's you know, that's the thing I do. But for all the vitamins like I have a beautiful multi men's multivitamin here. I use Thorn labs for my for my vitamins. I love Thorne Yeah, they're not a sponsor. They should be but that's not the point. I'm an affiliate with them. Are you really trying to do affiliate or Kelsey? It makes me feel like I work for somebody. I like it if they buy it

Kelsey 59:53
or not. If you also use the discount for yourself, then you're kind of paying yourself to I

Scott Benner 59:57
do use my my cozy Earth discount that Get my useless. I know people are probably like he's like it makes an ad he says he's wearing those sweatpants. I'm almost always in this way. Save 40% and cozier.com with the Africa juice box at checkout.

Kelsey 1:00:13
I might use that after this actually I also live in sweatpants 40% grade discount code a damn right it is

Scott Benner 1:00:21
for you. I'm saying I take vitamins I take stuff to, you know, I take vitamin C with iron to help keep my iron up like three times a week. There's all kinds of things I do. But the truth is nothing changed, fixed or massively helped my health like the GLP medication did. Oh, did you do a goby? I've lost 40 pounds. Since March. On we go V and the weight aside, besides I just feel better and being lighter. And all that has been better for me, like from my joints to my energy to how I look and everything else. My Body Works better now than it did before. Oh, that's awesome. I do not know another way to put it.

Kelsey 1:01:01
So hey, man, whatever. Like I said,

Scott Benner 1:01:03
that's a peptide. Yeah, exactly. Yeah,

Kelsey 1:01:05
I haven't gotten there. But I might

Scott Benner 1:01:07
I plateaued at 40. And I wrote it pretty I have a weego V diary was so people who listen to that will know like, I plateaued pretty hard for a couple of months. I'm like, I am not losing weight anymore. And I went back to my doctor and I was like, Hey, what the? She goes, and she's got this great accent and she's like, she goes, we put you on zip bound now. And I was like, Yeah, let's go baby. So I just took my first injection of zap bound last week, which is haven't heard of that one already. So is that bound is Manjaro? No, as we go V is ozempic.

Kelsey 1:01:41
Oh, okay. Okay, different, different brand name? No,

Scott Benner 1:01:45
they're just distinctions for insurance reasons. You know, we go over you can like insulin, well, you can give we go to people with type two diabetes, because that's what it's been tested on. And then they tested or excuse me, ozempic to people with type two diabetes, because that's what it's been tested on. But it was that before we go view are the exact same molecule. And if I'm paying attention to how insurance works, and how people make money on that end, it's you can't patent the thing as much as you can patent the dosing strategy. And the delivery mechanism, yeah, delivery mechanism. So ozempic is one way and we go V is another way we go V's for weight loss ozempic. For Type Two diabetes, it's the same exact thing, right? So I use we go V for that time. It was beautiful. I had one side effect. Oh, god dammit, Kelsey.

Kelsey 1:02:36
I had one slide and I get into guts stuff.

Scott Benner 1:02:38
I'm just gonna tell you that I didn't have a really firm. I haven't taken a firm bowel movement in a while. Are you worried about that? No, because I was losing weight. If I would have grown a horn out of my head, and a tail would have came out of my womb, I was losing weight, I still would have been like, this is fine. And so.

Kelsey 1:02:55
So the weight the weight loss is the main goal. And

Scott Benner 1:02:59
I'll deal with it later. People don't like this phrase, because it leans on diet culture, but ain't nothing tastes as good as skinny feels. And so So, so anyway, like, this was not horrible. I was not running around with diarrhea. I did not like he's not mess myself. Like things like that. It just wasn't wasn't where I wanted it to be. I had reflux before that. And it got better on weego V, but didn't go away. And when I told my doctor those things, and she said actually, this, that bound might get you going on more weight loss, but more specifically, it should address the acid reflux. And I think you won't have the bowel movement issue.

Kelsey 1:03:40
Why if it's the same thing? Damn calcium.

Scott Benner 1:03:44
I'm not a scientist. I don't know. Was

Kelsey 1:03:47
that true? Did it did it? Did it? Did that happen?

Scott Benner 1:03:50
I had a much nicer experience in the restroom yesterday than I've had that I had last Tuesday. So Oh, yeah, it was pretty exciting. The toilet bowl even seemed excited. It was like, Oh, thank you.

Kelsey 1:04:02
No more scrubbing. I

Scott Benner 1:04:03
don't know what was happening up there. But thank you. I've only shot it once. Okay, five days ago, so I haven't even done twice. Yeah. Interesting. Yeah.

Kelsey 1:04:13
For my understanding of those things, they work. They work in the gut somehow. So I think that's like the that's like, some people in the functional medicine space are worried about so many people using it, because they don't totally know what it does to your gut and your microbiome and like the lining and everything. Yeah,

Scott Benner 1:04:29
I'm sure it's not gonna be right for everybody. Yeah, totally.

Kelsey 1:04:33
But if your your goal is weight loss, and you feel better, like hey, man, go for it. Here's

Scott Benner 1:04:37
what I think. I don't think it's 62 years old when I was clutching my chest and driving into a tree. I would have thought at least my microbiome is okay.

Kelsey 1:04:46
You've probably reached a certain point where you're just like, okay, whatever. Yeah,

Scott Benner 1:04:49
why don't we try not being fat? Let's see how that goes. Yeah, start there. Start there. Anyway, that lovely girl you heard screaming into the phone earlier. So we've been talking to her and They're chronologist for a while about insulin resistance. She it seems like she has PCOS like we've done. We've looked for PCOS like the last thing you can actually find. And so like we've ruled out a lot of issues, heavy period, acne, stomach pain, stuff like that. And for a while the doctor was like, Maybe we should put her on Metformin, but kind of doctor went back and forth about that a little bit. And then I had this experience on weego V. And the doctor said to me one day, this, you're reacting so well to this. And I was like, right, and she goes, What do you think about given art and some ozempic? And I was like, well, will insurance cover that? And she goes, No, probably not. And I was like, Well, how much is it? And she's like, there are ways and I was like, okay, so I was like, alright, she goes, take a sample pen first. And I was like, okay, and she goes, Just shoot. Point two, five. Do it every week. So she should point to five. It should be said Arden has ace absolute needle phobia. I've never talked I don't know if I talk about it on here. But she is like sweaty palms. Waitwait way please, please, please, swatting it you needle phobia. Like she has a needle. Okay, interesting. And but I said, Arden like, let's try this, like, get over it. And like so we did it. She had first week, it was tough on her. She had the nausea and like, like, over full feeling. And that persisted into like, maybe the second week, but she fought through it and you know, ate anyway, not as much, obviously. And then that part kind of went away a little bit. Now she's just up to the point where like, she's just not that hungry on it. But here's what's happened. Arden has been using ozempic point two five for I think six weeks now. My math tells me that Arden will use 11,000 fewer units of insulin next year.

Unknown Speaker 1:06:50
Holy cow. Yeah.

Scott Benner 1:06:52
How about that?

Kelsey 1:06:53
That's crazy.

Scott Benner 1:06:54
Basil went from 1.1 an hour to point seven an hour during the day. Okay,

Kelsey 1:06:58
so do you think that is due to the medication or the fact that she's eating less?

Scott Benner 1:07:04
No, it's the medication.

Kelsey 1:07:06
I guess that would change. That would be the only thing that would change your basil. Hmm. Yeah,

Scott Benner 1:07:10
he has it happen almost immediately. Wow. Arden uses a do it yourself algorithm right now she's using Iaps. Okay, Arden can fast forever without a low blood sugar. Like for like forever that algorithms insane. My point is, is that when she was 1.1 an hour, and her weight of this is going to freak you out. And when her ISF was 42, during the day, she didn't get low and she was fasting. Wow. And now her ISF is 63. Oh, wow. And her Basil is point seven. And she still doesn't get low and she's fast. So her insulin needs. I mean, I haven't really done the math, but she's gone from some days use some three day periods using an entire pod or like 180 units down to like sometimes using 60 or 70 units in three days. Oh, wow. Yeah. It's crazy. NRA onesies crazy. In the six weeks she did her a one C one from six, three to five, nine tracked as tracked in the app that in the Iaps app.

Kelsey 1:08:15
Wow, that's really cool.

Scott Benner 1:08:17
You're gonna see a lot of type ones get GLP medications in the future. But it's got to get covered by insurance first, like,

Kelsey 1:08:24
isn't that kind of how it started was for type two diabetes? Yeah, it's for type two. Yeah. So I mean, but anything that improves your insulin sensitivities. I mean, that helps Taiwan's to write about

Scott Benner 1:08:36
her acne improved by I would say 80% in three weeks.

Kelsey 1:08:40
Oh, wow. That's really cool, crazy stuff,

Scott Benner 1:08:43
like so I keep saying this over and over again. There's a group online where women are getting pregnant on ozempic. Because they probably had PCOS their whole life and couldn't get pregnant. And now this is helping that. And I saw a group of people on Reddit talking about I always pronounce it wrong, but ears danlos the connective tissue like the over flexibility in your joints. It's a an autoimmune issue. And there are some people online in a group saying they think it's helping them with symptoms from that. That's crazy. I don't even know why that was. But enough people on Reddit got together and we're like, Hey, I have danlos and I don't notice the pain as much anymore. Now, I don't know if they were were they heavier? They lost weight. It's easier on their joints, or is it actually is the peptide actually helping someone with an immune response somewhere?

Kelsey 1:09:30
I don't mean if it's doing something in your gut that you know, they say all autoimmune diseases connected to to the gut. So I'm saying that

Scott Benner 1:09:39
yeah, you're saying you're all gonna be vaping at one day, that's all I can tell you.

Kelsey 1:09:46
Probably better than what they're vaping No,

Scott Benner 1:09:48
no, by the way, do not vape a GLP mitigation. I was being farcical. I hope people can hear the sarcasm. Kelsey, is there anything we haven't talked about that we should have?

Kelsey 1:09:58
I don't think so. I guess like kind of the reason why I wanted to come or like the reason why I felt called to email you is the diabetes myth series that I heard and I think you know, a lot of people here this that are diabetic like you got you became diabetic because you eat too much sugar and like you eat the wrong things and you don't take care of yourself and blah, blah, blah, but I kind of just felt like that one hit home for me because basically, for the last 13 years, I've been focused on my health. Yeah,

Scott Benner 1:10:28
Paleo taking vitamins, paleo,

Kelsey 1:10:30
literally doing I was doing the cold plunge, I have a sauna. I did intermittent fasting. I've done three day fast like, I'm in it for a long time.

Scott Benner 1:10:41
I've done intermittent fasting, and I think it was terrific for me. Yeah,

Kelsey 1:10:45
it's especially really good for men for sure. But I guess what I was seeing is it. I still got type one diabetes.

Scott Benner 1:10:52
Exactly. I like in your intake form you described yourself as well. I'm incredibly healthy, like non Bluetooth using kinda healthy. Oh,

Kelsey 1:11:01
yeah, that was the irony of the whole thing. For me. It was like, I didn't use Bluetooth headphones. Like I was very, I turn my Wi Fi off at night. Like my phone's in airplane mode a lot. And now I'm literally just strapped to a Bluetooth device. And it's like keeping me alive.

Scott Benner 1:11:17
Forget this tumbler I'm drinking out of bottled water again. I don't care. For real though, by the way. Again, there's some news report hit the other day about like particulates in bottled water, like plastic. And I was like, Yeah, does that not obvious to everybody? Right? Don't Don't do that. Just yet. Thanks. It just makes sense. I don't care if you can quantify it or not, but stop rubbing water on plastic and then drinking it seems like a bad idea to me. Or microwaving your food in it. Oh, it's such a simple thing not to do. Do not microwave your food and plastic. Here I'll go a little farther. I'll get crunchy with Kelsey. Which Oh, is that the episode title?

Kelsey 1:11:55
That actually would probably be very on brand for me because

Scott Benner 1:11:58
I was gonna call it mechanical pencil but crunchy with

Kelsey 1:12:04
mechanical pencil. No one would get it until like that middle section.

Scott Benner 1:12:08
That's why I was gonna do it. Yeah, it's a that's a marketing ploy. By the way. Yeah, that's that is one of the things I do to try to keep you guys listening. I'm like, I'll name it. Something that happens after the halfway point. It's smart. It's smart. But crunchy with Kelsey is good. We might do that that has a ring to it. Here's another one. Don't use oil. Like just stop with like canola oil and like, just stop like just Google like, what is it that Hateful Eight oils or something like that. Just try not to use them. Try not to use use cold pressed olive oil, not hot, like heat pressed olive oil, like simple little things you can do to stop so that the things you're taking in are not being changed. And that's processing. Right. Like canola oil is processed, for example.

Unknown Speaker 1:12:53
Mm hmm.

Scott Benner 1:12:54
That little stuff is easy to do.

Kelsey 1:12:56
Yeah, eat real food. Hey, Scott. This is why you're in the health and fitness category. There you go. I know you just doled out great great health advice.

Scott Benner 1:13:05
I know I just by the way, nothing you heard that 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, canola, corn, cottonseed, soy sunflower, safflower grape seed rice, Bran.

Kelsey 1:13:20
Don't eat them. Just don't donate them. Simple. Hey, look, you just read your labels because they're in everything.

Scott Benner 1:13:26
You just got healthier. And I have this great episode with like this, like 13 year old like healthy girl. She's like, so super healthy. And she talks about like, what she eats for breakfast and like, you know, the probiotic she's on She's so lovely.

Unknown Speaker 1:13:40
That's amazing. Yeah, she's

Scott Benner 1:13:41
she's, she's really great. She she put it she say to me, she was like, you have to stop eating. I can't eat butter. It's not organic. She told me. And I was like, are grass fed? Yeah, I need to grasp that I needed to get I need to grass fed butter. Like this is one of the things she said to me. I swear to you, I went downstairs my wife like where are you going? I'm like, I'm going out the store and buying different butter. Now I buy I buy I only buy grass fed butter. And I only buy eggs like that are like organic. Like, I think the chicken is like that whole thing. Like, and I have no idea if it matters or not, but I was like the price at this point is the same. I know, right? It's not like a cost thing. So I'm like what the hell? All right. Yeah,

Kelsey 1:14:26
it's kind of did a flip. I'm like, Okay, well now I'm definitely buying the good ones. Yeah,

Scott Benner 1:14:30
they're so damn expensive. It doesn't matter. Yeah.

Kelsey 1:14:33
All right. Well, good. That 13 year old was your health coach. She's

Scott Benner 1:14:36
lovely. Oh, her first episode is called bugs in your belly. And oh, cuz she talked about she's like, there's bugs in your belly and they and I'm like, okay, and then she came back on. She's not like young sounding by the way. She's actually like, she's one of those kids that when you talk to her, you're like, I don't think I'm as smart as this kid.

Kelsey 1:14:56
That's amazing. I'm definitely gonna listen to her by

Scott Benner 1:14:59
I'm trying to find that number for you before I let you go. So you know, there are bugs in your belly episode 823 a 23. She's just She's lovely. And she'll be back on pretty soon. Oh, cool. But I appreciate you coming on and sharing your story. I think it's fantastic.

Kelsey 1:15:13
Thank you so much. Yeah, thanks for having me. Of course,

Scott Benner 1:15:16
hold on one second for me.

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