Scott Benner 10/24/24 Scott Benner 10/24/24

#1340 Diabetes Is Back

Courtney was misdiagnosed with gestational diabetes.

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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 back to another episode of The juicebox Podcast.

Today I'll be speaking with Courtney. She's 38 years old. Was diagnosed at 29 with gestational diabetes, but later they realized she actually had Lada. She has a bit of anxiety. We talk about that and much more during this episode. 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. 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 if you are the caregiver of someone with type one diabetes or have type one yourself, please go to T 1d exchange.org/juicebox and complete the survey. This should take you about 10 minutes and will really help type one diabetes research. You can help right from your house at t1 dxchange.org/juicebox, 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, dot com, slash juicebox.

Courtney 2:22
My name is Courtney, and I was diagnosed with type 1.5 Lada or La da when I was 29 years old.

Scott Benner 2:35
How old are you now?

Courtney 2:37
I am 3829

Scott Benner 2:40
38 that's nine years. Okay, we're not going to use actual words that would tell anybody. But did you and I go to the same high school?

Courtney 2:50
No, probably not, probably

Scott Benner 2:51
not. You didn't go. You didn't go where we were talking about just now,

Courtney 2:56
um, if you lived in where we were talking about, then, no, I lived in a different part.

Scott Benner 3:02
Gotcha So,

Courtney 3:04
but very, very close.

Scott Benner 3:06
You taught that you're a teacher.

Courtney 3:08
I was until I do what I do. Now,

Scott Benner 3:10
do you want to tell me what you do now? Sure,

Courtney 3:13
I work for a company that has contracted with the US Patent Office, so I am fortunate enough to work from home, and I sit around editing patents all day, editing

Scott Benner 3:25
patents, and you get did that from teaching, what pays better,

Courtney 3:29
probably in the long run, teaching, I mean, when you're in it for 20 plus years, you know that pays off, but this has allowed me to be around my children more and be there for them pretty much every step of the way. It's pretty flexible, excellent, and it's really helps me with diabetes management. Rather than being in a classroom and having a little blood sugar and being stressed out about it while you're trying to teach, this is I can take care of it and move on with my life and go back to work.

Scott Benner 4:01
Did you enjoy teaching I did? Was it a different experience with diabetes

Courtney 4:06
when I was first diagnosed with diabetes, it's actually a weird story. So I was pregnant with my daughter when I was diagnosed with gestational diabetes, and they told me, Oh, it's a fluke, you know, it's, it's probably just like, you know, something that's just going to go away. You won't have to worry about it. After you have your baby, you'll just get tested again, and then, you know, whatever, you'll be fine. I went through pregnancy thinking I was going to be okay. After having her, I was, I was fine. After having her they tested me in the hospital, like, you know, finger pricking or whatever, and I was totally fine. And then a year later, I went back for blood work. They didn't take a, an A, 1c, or anything. They just, like, took my current glucose and it wasn't fasting, and they told me I was fine. Mm. Yeah. Um, a few months after that, I was like, not well at all.

Scott Benner 5:05
Did you call them and say not fine, not fine,

Courtney 5:09
yeah, eventually. So, I mean, there's a whole story behind that too. Like, for a few months, I was noticing really bad leg pains, like my cast were. It felt like electric shock was going through them all the time, and I had really bad like, Charlie horses in my calves. I noticed I felt really dizzy or like anxious all the time. I also was experiencing like I had to go to the bathroom constantly. And I remember, like, thinking back, like, Oh, I'm so thirsty. Just so thirsty, and my mouth felt like a desert, and I like a dope. Was like, Oh, I drank so much water. I should probably drink Gatorade. So would pound Gatorade after gallons of water, thinking I needed it. But, I mean, probably

Scott Benner 5:57
did, yeah, get your electrolytes back up. Yeah. Yeah. And, like,

Courtney 6:01
it wasn't thinking anything of it, because I had no idea what DKA was, right. And I, you know, just a month before, like, this September, I was tested, and when, like, my daughter was, like, 13 months old. And then by November, was, like, the night that I was like, Oh, this is it was Thanksgiving, my husband's family, does this, like, really fun outing with like 80 people at this, like, camp, they all grew up going to where they have Thanksgiving. They ran out of water, and I was having those symptoms where I was, like, just downing water, and there were no water bottles, but I was so thirsty, so I drank soda, because that's all that was left. And I felt absolutely horrible, like I thought I was gonna die.

Scott Benner 6:48
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Courtney 9:44
without a doubt, I remember we were driving home, and we're it was like an hour and a half away from our house at the time just thinking, like, I think I have the flu, like I'm really not okay, still not putting it together, still didn't think it was any. Thing related to diabetes that was two months ago, had the blood test done, and they're like, you're fine. I think my blood sugar was like, 110 when they told me I was fine. Oh,

Scott Benner 10:09
Courtney, let me be make sure I understand gestational diabetes in your mind. That's a thing that happens when you're pregnant. It goes away. You had a follow up, they said it's everything's fine. And so your brain's never gonna go back there again, correct, I would imagine. And this, DKA feels like the flu at first, like that, just like body beat up feeling

Courtney 10:31
Yes, okay, okay, sorry, go ahead. No, you're fine. So we go home Thanksgiving night. I just try to, like, sleep it off, not thinking anything, and actually, like, I get through, like, the next couple of days, and I'm, like, surviving, and I don't know how, but I guess my my body still works somewhat to the point where it must have brought it down to probably still a really high level, but like, high enough that I guess I would my body was just accustomed to it from being high for, I guess, the past couple of months at least. Then my husband and I, we had like, a family photo shoot, and we went out to dinner, and I got pasta, and that night, I shot out of bed, and I was like, I feel horrible. And something told me, Go get your meter from pregnancy. So I did, and my blood sugar was like, 438

Scott Benner 11:34
Wow. It finally hits you, but you don't know why, right? Just jump in your head,

Courtney 11:37
yeah. If something just says, like you're you're not okay, like something isn't right. And I had realized that I had lost a ridiculous amount of weight in like, two weeks,

Scott Benner 11:47
but nothing about the way you felt mimicked how you felt when you were pregnant. Did it?

Courtney 11:53
No, nothing. I didn't need insulin while I was pregnant. I would just I went to the nutritionist, I ate the amount of carbs that they told me to eat during meals, and I never had a problem. I stayed within range almost the entire time, until the like the last three weeks of my pregnancy, my fasting started creeping up over like 105 so they add added a Glyburide to my my regimen, and it was a very small dose, yeah, but looking back, also not a good option for someone who's really, you know, type one, and not, you know, just gestational instead of, like, thinking I need to go to the emergency room, because honestly, I didn't know enough about diabetes to know. So what did I do? I go for a run with my dog at 130 in the morning around the neighborhood.

Unknown Speaker 12:47
Why? Why did you do that one?

Courtney 12:48
Because the I was always told that walking worked, and it did while I was pregnant, I would if my if I was like, 150 or something, I immediately would pound water and go for a walk, and I would be brought back into range, like, I just think I was, like, out of my mind at that point and in denial, definitely. Can I stop

Scott Benner 13:07
you for a second? Is there any other type one in your family? No autoimmune of any kind, thyroid, celiac,

Courtney 13:17
no. Okay, so Well, I mean, this is what doctors have told me it's unrelated. I do have a cousin on my dad's side. He has type one. He was diagnosed at eight, but that's that's it. And they, every doctor has said that's not related, because it's not your father, your mother, your sister, your brother.

Scott Benner 13:36
I mean, I get what they're saying, but I don't know it seems related to me, like my my wife's brother's kid has an autoimmune issue. My wife's sister's daughter has PCOS like that. Don't sound related to you. You know what I mean? Oh yeah. How about when during the pregnancy and the gestational stuff, they were probably like, Wow, you're a light case. It was probably almost in the back of their head, you being gestational but no one said this increases your risk for type two diabetes later in life. They didn't even tell you

Courtney 14:08
that. They did. Tell me that they did, okay. Well, that's Yeah, okay. They said, within like, I think they I don't know if it was like, within five to 10 years, your risk increases by like, 50% and I'm just throwing that out there because it's been a long time, sure, but like, I remember reading that and going, what the heck this stinks. And

Scott Benner 14:29
then also amazing,

Courtney 14:32
yeah, like, at the time, like, I was doing CrossFit workouts with my husband. I was doing them while pregnant with my daughter. So, like, I in my head. I'm like, Yeah, right. I'm not. I'm not gonna end up like that.

Scott Benner 14:44
One of these kids better end up being the CEO of IBM or something. I'll tell you, you know, like, it's a big trade off here. Okay, tell me though you, you're, I'm sorry you're out for the run with the dog. Go back to that. So

Courtney 14:56
I'm running around the neighborhood. I don't sleep at all because I'm in like. Cheer, utter panic, and I'm telling my husband, like, diabetes is back. I have diabetes, like, I don't know what to do. And he's like, Oh, it'll go down in the morning, like, and then we'll call the doctor. So hours and hours later, I'm still sitting at, like, 279 according to my meter, like, and that was that morning. So I dropped my daughter off to my mom, and then I, I'm like, we need to go, like, because I need to be diagnosed. And it was a Sunday, so like, my doctor wasn't open. So we go to the ER, and they do all kinds of blood work, and they're like, Oh, well, you know, you're not in DKA, so that's good, but you have type two diabetes. Here's Metformin, and your a 1c, is 10.5 and you're just gonna need to follow up with your doctor.

Scott Benner 15:45
Courtney, you're not gonna get a lucky break in the beginning of this story at all. Are

Courtney 15:49
you No? No. Okay,

Scott Benner 15:51
so it starts better. Oh, go ahead, please. I want to know.

Courtney 15:56
So I go to my doctor and I meet with her, and she's like, and thank God for her Honestly, my family doctor, and she looked at me and said, No, you're not a type two. There's no way they've got it wrong. I'm gonna test you for type one. And I'm sitting there like, I don't even know what that is like, what? Is that? What's the difference and why? And she's like, because you're a young, healthy, active, there's more to this story. There's no way. So she did, and my C peptide was normal, which was nice when, but my dad was positive, and that was the only one that I had positive and she said, that's all it takes. And then right then and there. She said, You have a slower, progressive form of type one. She called it Lada, yes, okay. And then referred me to an endocrinologist. So off I went. I went to my endocrinologist, who then refused to give me a title, she said, I don't know what you are. From

Scott Benner 17:04
the very beginning, your kids mean everything to you. That means you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen, it like you mean it. Now up to 90% of type one diagnosis have no family history. But if you have a family history, you are up to 15 times more likely to develop type one. Screen it like you mean it, because type one diabetes can develop at any age, and once you get results, you can get prepared for your child's future. So screen it like you mean it, type one starts long before there are symptoms, but one blood test could help you spot it early before they need insulin, and could lower the risk of serious complications like diabetic ketoacidosis or DKA. Talk to your doctor about how to screen for type one diabetes, because the more you know, the more you can do. So don't wait, tap now or visit screened for type one.com to learn more. Again, that's screened for type one.com and screen it like, You mean it you're like, I've seen three people three, and somehow there's two, two options. And three people said, three different. Yeah, I bet I'm sorry. That's terrible. So which one did you end up believing? How did you how did you move forward?

Courtney 18:29
It was when I went to my second endocrinologist, my family doctor eventually, like, moved to a new practice. So she said to me, it doesn't matter, but the first endo who said she didn't know what I was, she said, Yeah, your dad, you know, came back high, but it's really not as high as I've ever seen. And I'm like, Okay, well, what does that mean? And she couldn't really give me an answer. She's like, well, your your numbers are fine right now. You don't need insulin right now, so we're just going to keep you on the Metformin. And that was fine with me, because, you know, at the time, taking insulin for everything scared the ever living crap out of me, and because I just didn't know, at the same time, though, you know, they're like, oh, test your blood sugar four times a day. Well, at that time, like my husband is a carpenter in the carpenters union here, and so our insurance is a little bit different. It's like, funded by the union, and no diabetes testing supplies were covered period. None. They

Scott Benner 19:35
were just like, that doesn't exist on our formulary. Good luck.

Courtney 19:39
Yeah. Yeah. Basically, so I was like, what so for me to be able to, like, test, and I didn't know that you could go get a Walmart brand meter or whatever, and so I'm, like, buying the Accu check, which is what I was given during pregnancy, and it was, like, $150 a month. And my husband and I were young, and still, like, I. Gearing out life at that time. So it was like a huge blow, just financially, to have to deal with that CGMS, like, I didn't even know they existed. I didn't know about Dexcom. I knew nothing. I continued to lose weight because I just started restricting myself so much that I turned into like, basically this skeleton of myself. You've

Scott Benner 20:25
got shaky information from doctors, even though one of them got it right, but, but it's still it's confusing enough. There's shaky information from doctors. You're on a medication you shouldn't be on. You're having trouble paying for the stuff that you need. You don't even really know why you're using it or what it is you're supposed to be doing. All that fear culminates into you slowing down, just not

Courtney 20:47
eating, not eating, and over exercising, trying

Scott Benner 20:51
to keep away. What did you think? Were you trying to keep away type two diabetes in your mind? Or did you not know what you were doing?

Courtney 20:58
I had no idea what was going on my my mind and heart told me you probably have what your family doctor said, because I looked it up and I'm like, this makes sense that it was probably never gestational to begin with, and that it was brought on by my pregnancy and the stress on my body from being pregnant.

Scott Benner 21:16
How long did it take you to believe yourself?

Courtney 21:19
I want to say after my second pregnancy.

Scott Benner 21:22
How long is that, since the end of the first my

Courtney 21:26
my son and my daughter are almost exactly three years apart, and my daughter was roughly 15 months old when I found out I was some sort of diabetic,

Scott Benner 21:38
so you maybe lived for almost maybe four years as a type one, with lot of not 100% sure, or treating it with insulin or anything like that. That

Courtney 21:47
part is not 100% true. So, I mean, I did end up on insulin, but okay, I was going to my Endo, and I wanted, I knew, I wanted to have another baby. So it was like maybe a a year into, you know, my diagnosis about a year and my I had my a 1c came down from 10.5 I was like 6.3 on no insulin. But I was so underweight. She was like, you have to gain weight or you're not going to be able to carry a baby like you're just not. So I had to then figure out how to eat lots of calories so that I could have another baby.

Scott Benner 22:27
And you said to her, I'm not eating, I'm over exercising. Like did she know that part, or did she just think you were losing weight? Because I don't know why she wouldn't think, if she didn't know what you were doing at home, I don't know why she wouldn't think, DKA, you know what I mean, she

Courtney 22:42
did know that I was losing weight, and I told her that I eat low carb. So maybe she thought that was

Scott Benner 22:49
why Instagram model, yeah, I gotcha. Courtney's like, I'm 38 I don't really look at Instagram that often, but I kind of get what you're

Courtney 22:57
saying. I'm 30 I look at Instagram, not Tiktok.

Scott Benner 23:02
She probably thought you were just like, doing keto or something like that, right?

Courtney 23:07
Yeah, essentially, I was, because that's what like, you know, I joined like Facebook groups, and because I didn't have any information, I didn't know where to turn or who to talk to the the diabetic educator I went to see was telling me to eat all these carbs that I wasn't comfortable with eating, because every time I did, I mean, obviously my blood sugar was going high, so like I was getting stressed out. And no one apparently thought I needed insulin at the time, because my a 1c

Scott Benner 23:35
was good. How long until they gave you insulin?

Courtney 23:39
So it was when I finally got pregnant with my son. I was about 15 weeks, and I ended up with a stomach virus that my daughter had passed to me, and I could not keep my blood sugar down, and I couldn't get under like 200 which now I'm like, Ah, like, that wouldn't be that concerning, knowing numbers that I've hit now without even trying, without even trying, yeah, like, I could just be stressed out, and all of a sudden I'm like, 200 you know, super stressed about that. She put me on levimere, a long acting to try. I was terrified. I had my Husband, husband, do the first couple of injections until I was like, All right, I could do this myself. Let's go away. And that worked out great. And then eventually, towards the end of my pregnancy, I added in meal time, and I'll tell you when that happened, that was the most terrifying experience of my entire life. I still have nightmares and stress, and this is why I still have a hard time taking, like, larger doses of insulin to cover a lot of carbs. What happened? Because my endo gave me the wrong information, and I I don't go to her anymore. I left, but I didn't know any better. What happened? Tell me the story. When she's decided to add in mealtime insulin, she said, take two to three units with every meal. And I'm like, okay, but you do know that I eat low in carbs, right? And she said, yeah, so take two units. And I was like, okay, so that night, I took two units with my dinner. Again, pregnant, no. CGM just finger pricking at least 12 times a day. The next thing I know, I am shaking like 45 minutes to an hour later, just shaking uncontrollably. I'm like, oh, oh, this is not good. And I check my blood sugar, and it's 38

Scott Benner 25:43
oh,

Courtney 25:47
panicking, Yeah,

Scott Benner 25:48
I bet you are. Was it like, I guess you don't know because you weren't wearing a CGM, right. Okay, all right,

Courtney 25:53
no, I would have, I wouldn't have had any idea. I had no clue My husband was giving my daughter a bath, and I was freaking out, like I drank juice, I there was like leftover birthday cake on the counter. I downed that, I ate a brownie, and then I just sat on the floor in the kitchen and cried for a straight hour, texting, testing, testing, testing, until I finally came back up. But I think about that moment, and I still have like nightmares about that, like,

Scott Benner 26:26
did you tell the doctor about the experience? Yeah, did you get a response?

Courtney 26:32
It was just like, oh, well, you probably should eat more carbs.

Scott Benner 26:38
Not Hey, I told you to take too much insulin there, huh? Sorry, no. Nice. Which? What kind of doctor is this? The Endo.

Courtney 26:47
That's my endocrinologist. Yes, was I was gonna say Not, not anymore, right? No, gotcha, I

Scott Benner 26:52
want to talk a little more about this. So sitting on the floor crying, did you have a feeling like I almost killed myself just now. Like, what, where was the fear? Like, I don't know how to explain what I want from you, but I want you to tell me what aspect of that story scared you.

Courtney 27:14
Well, the fact that I didn't I knew, I didn't know what I was doing, and I didn't have the right person to help me, and I was afraid I was eventually going to die from taking too

Scott Benner 27:25
much. Yeah, okay, so it just felt like you were on a path that was probably going to end very badly, and there was no answers. I see. Okay, wow, that's an existential crisis. Did you talk to your husband about it, yes, did he say I'm a carpenter, I'm gonna go to work now, leave me alone. Or did was he helpful? I just I know a couple trade guys, so I'm not sure which one. I'm not sure what guy you married. I'm trying to figure it out.

Courtney 27:53
No, I am very, very lucky. My husband is super sweet, even to this day, like right before talking to you, he texted me while he's, you know, working, how's it going? How are your numbers? Because I guess he kind of wants to figure out what kind of day I'm having, so he knows what to expect.

Scott Benner 28:12
He's planning on whether or not to work overtime or not. I might grab a couple hours Courtney. I'm gonna hang out. Yeah, gotcha. Does your blood sugar affect your mood

Courtney 28:25
when it's like, a stubborn high, and I mean, like, high, like, 200 and then I'm, like, injecting, injecting, walking, yeah, then I'm mad. I'm not necessarily mad because, like, the blood sugar makes me feel that way, but I'm mad because what I'm doing is not working. So I got you My kids know, like, when mommy's on the treadmill, stay away.

Scott Benner 28:50
I don't see any of you working towards the CEO of IBM thing, by the way. Is it isolating? Because you work from home too. So at one point you said you were a teacher, and there were things to be concerned about, about blood sugars while you were teaching, but now you're at home. Is one better? I mean, were there any type ones or people with diabetes at work? Was that even something that was could be helpful to you?

Courtney 29:17
No, not when I was teaching. It really wasn't. The funny thing is, though, when I was diagnosed with gestational and, you know, I had my little mini meltdown because I didn't even know what that meant. I was teaching at an elementary school. I didn't realize that one of my friends who was a teacher had type one I didn't even know so

Scott Benner 29:42
there was somebody you could have spoken to, but nobody knew about it. It's interesting.

Courtney 29:47
Well, somebody mentioned it to me, like, oh, you should go talk to this person, because she has type one diabetes. And I bet you she could help you, like, learn about gestational and give you some tips. And I'm like, okay, so I go to her, and I'm like, Hey, I had no idea. And, yeah, she did help me, and I remember, like, crying to her about it. And now I'm like, Oh my gosh, she must have looked at me like, girl, you have no idea. Like, you're crying over gestational diabetes. You have no idea. She's like,

Scott Benner 30:20
yours is gonna go away, yes,

Courtney 30:23
and then we, we still talk now. And she's like, shocked at like, how that happened, what happened

Scott Benner 30:31
to you, the progression of what happened to you. Yes, you know Courtney, from listening to the podcast that your story is incredibly common for people who are diagnosed like this, right? Yes, yeah. Does that make you feel any better or worse?

Courtney 30:46
I wouldn't say better, and I wouldn't say worse, but I would say just not alone, because I felt so isolated before, like no one in my orbit really understood what I was going through. And you know, my own doctor who diagnosed me with LADA was like, Oh, it'll be fine. It'll be like, brushing your teeth, you know, you'll get the hang of it. And I'm like, now I look back then I'm like, You had no idea what you were saying. Because, no, no, it's not. Every day is different.

Scott Benner 31:17
So you're running into what you know happens to so many people. You just, you're finding doctors that just don't really know about this. Even though they're endocrinologists, they just probably see more type twos than type ones to begin with. Or they, you know, they don't know enough about it to give valuable information. And here we are, like, you know what I mean? Like, like, so many people are treated the way you are. And I don't mean treated like, treated poorly. I mean like, medically treated like, this is how they think. To tell you to do it. You'll figure it out. It'll be okay. Try three units. Three sounds like too much, dude, two. Two almost killed you. Oops. You know what I mean, like, like, like, there's nothing actionable in any of your interactions so far, like, no one has said one thing to you that you could go home and go, Oh, I'll follow these steps and I'll, I'll see what happens, and I'll have an outcome, and then I can make an adjustment. Like nothing has you're just like, left blowing in the wind is how it feels. Honestly,

Courtney 32:20
that's exactly how it felt. Okay, all right. Well, then, yeah, oh, sorry, no,

Scott Benner 32:25
no, the anxiety you talked about in your note. Did that exist for you before diabetes? I

Courtney 32:32
mean, here and there. I think, like, as a typical person, I mean, I feel like when you're a teacher, there's always an element of anxiety because you're a perfectionist, you want to do a great job, and you're constantly working and busy. And I didn't have any kids yet, so that was my baby, and it would that would stress me out sometimes, especially because I was a special education teacher, there's added elements to that that are a little stressful and anxiety inducing.

Scott Benner 32:59
My sister in law is an administrator for special ed, and so I hear a lot about this, and I know it can be difficult. My niece actually is a special education teacher now, and she's been bitten. That does sound stressful to make so not a crazy amount of anxiety like prior, just normal being around life. And is it ramped up now? Is it not going away 100%

Courtney 33:26
I mean, I do go to therapy to help deal with my anxiety surrounding it. I started that two years ago. It's been helpful. Good. Yeah, my anxiety is pretty bad. It got to a point where I was, like, I'm afraid of my own body, mainly because it's progressed, and I had a really hard time wrapping my head around it. Like, after my son was born, I didn't need insulin anymore. Oh, for how long? Well, I'm thinking because I wasn't I, it had to do with nursing him, but, like, for at least nine months,

Scott Benner 34:03
not even wait, not even basil.

Courtney 34:07
I think I was taking, like, once I started taking it again, like, three or four units a day. Wow,

Scott Benner 34:13
that's interesting. For nine months as a type one, like, yeah, yeah, that's

Courtney 34:19
crazy. And I was fine, like I was eating more carbs than I had in the previous years, like two years, because I was nursing him, and I was still going low, I would nurse, and then all of a sudden, bam, like dropping, like a tank, so I couldn't use insulin.

Scott Benner 34:36
How, if at all, was your doctor helpful with that transition?

Courtney 34:39
Well, at that point, I had a new endocrinologist,

Scott Benner 34:42
and this one's better. Fingers crossed. She

Courtney 34:45
She was better. Yes, she really was. She, she had the mindset of saying, Nope, you're a type one. You're just you're at a point now where like you're going to progress, but here, like you're you're still making some on your own, and we'll just. Kind of keep going with the flow, and as your needs progress, we'll just keep adding and at that point, she was at least able to write me a script for a freestyle Libra the original, like, I guess it was a 10 day one, and I just paid out of pocket. So I had that. And then she had the mindset of, listen, you know, this is your life, and you have to manage diabetes, so whatever you need. If insurance denies it, I'll write letters until they approve it. So I'll do it for you. So she was great.

Scott Benner 35:36
Let me ask you a question. I want you to finish first though, go ahead. What were you gonna say?

Courtney 35:42
Oh, no. And then I moved and then it took me, like, an hour and a half to get to her. So I don't, I don't live there anymore, but yeah, so I had to find another endocrinologist. Were

Scott Benner 35:54
you able to find a decent one near you?

Courtney 35:56
I did, and she was absolutely amazing. I found out,

Scott Benner 36:03
she solved the practice.

Speaker 1 36:04
She just left the practice. Yeah,

Scott Benner 36:07
she's like, see a sucker. I'm out of here. I cried. Oh my god. I feel like I know your story now. Like, and, and I want to kind of shift a little bit to talking about, I want to try to figure out how to get you out of this place that you're at right now where you seem a little frozen, and just by asking you, what do you think you need? Like, what would make all of this better for you? Doesn't even matter if it's reasonable, just tell me what it is you would need,

Courtney 36:34
I guess, just someone to take the fear away. Like, I don't know how to get past it, because it just seems like everything is is constantly changing on me. I think I need consistency. Maybe if I knew what to expect, I would feel better. But I feel like every day is just, it's nuts. I mean, the past couple of nights, I've had lows in the middle of the night, and last night I was, like, all night long, not high, but like, higher than I want to be, like 130 all night long. I like to be at like 100

Scott Benner 37:04
you said, OmniPod. OmniPod. Are you using dash? No,

Courtney 37:09
I'm not using a pump at all. Oh, I'm

Scott Benner 37:11
sorry. You're not using a pump at all. You do have a CGM, though I have the

Courtney 37:15
Dexcom seven. I use the in pen, which is what I'm really comfortable with. I do really like it. Okay, and I use levemere. Okay, so

Scott Benner 37:25
I can say, would your insurance cover a more modern basal insulin like traceba?

Courtney 37:31
I believe that is the one that would be covered. You. Maybe that might

Scott Benner 37:35
be a good place to start, because you're probably, I mean, I'd be doing a lot of guessing here, but levemere doesn't really last 24 hours the way they say. So if you're experiencing like higher blood sugars 18 ish hours after you shoot your lever mirror, that wouldn't surprise me. You could try. I've

Courtney 37:54
been splitting it up into two doses. For that reason, you are

Scott Benner 37:57
splitting it okay, I don't know. I would try the more modern basal. I think that's a good step. Are you against having a pump?

Courtney 38:05
I just don't think I'm ready for it yet. I'm scared. I'm scared of, you know, the things that could happen with the pump, the malfunctioning like my brain cannot handle seeing a 300 blood sugar like ever so if, like, it fell off, or, like, you know, if it was malfunctioning and I wasn't getting any insulin, the thought of that scares me to death, but like, the fact that I know if I'm injecting on long acting and I got it, I feel safer.

Scott Benner 38:38
I hear this from people constantly, but normally from new or diagnosed people. How long because of this whole, the whole thing you just explained to me for the beginning of this episode, how long do you forget that? Forget the calendar. I know how long you've had diabetes. How long do you feel like you've had it? Does that make sense? Yeah,

Courtney 38:57
a long time. It feels like I don't really remember eating normal, like, regular, you know, like a big piece of pizza or whatever,

Scott Benner 39:08
because the argument, it's not an argument, but the perspective of, at least, if I shoot the basal insulin, I know it's in there, or if the machine, you know, revolts and takes over, and I'm fighting with Skynet or something like that. When people are like, I don't know what the pump is going to do, like that usually is an argument from more newly diagnosed people, not usually from people who've had it as long as you've had so you're still scared of like, I'm not saying it couldn't happen, but, you know, I don't think there are a ton of examples throughout the world of insulin pumps like going crazy and killing people, you know what I mean, or suddenly not not working, and your blood sugar's shooting up. And by the way, you're wearing a CGM, if your blood sugar started shooting up and you bolus and nothing happened, you could just change your pump like it's not and you work from home. So this is a great time to get accustomed to it. So you. You're doing that thing where I would normally say fear is a waste of imagination, like you're just you're deciding to believe what could go wrong, and that's the reality you're working from. That's what does that feel accurate to you? Yeah, yeah. And you want to stop that? Or, No,

Courtney 40:19
I do. I do want to stop that? I feel like I would like a little more freedom, but I also know mentally where I can and can handle things. And I'm, I guess I'm, yeah, it's just a fear. I'm scared that I will do something wrong and end up, like at 300 and then have, like, a panic attack at the same time, which will send my blood sugar higher. And

Scott Benner 40:43
do you have no you have panic attacks, like legitimate panic attacks. Um,

Courtney 40:48
I haven't in a while, but when I'm going low and I don't understand why, yeah, that that might set one off.

Scott Benner 40:56
So does the low bother you, or does the unknown about why it happened bother you, both, both, which is more strong for you?

Courtney 41:07
Probably believe the unknown. I like to be prepared.

Scott Benner 41:10
Yeah, this, this goes right back to your first example, with the with the injection and the sitting on the kitchen floor being upset, like, like, I think what, what you hated about that most was the unknown part of it. Is that accurate? Yeah, yeah. Like, so you're comfortable stopping a low blood sugar. You know how to do that. You're not scared of that. No, okay, yeah, you don't. Like, well, that's interesting. Um, is this a thing you're working on with your therapist specifically?

Unknown Speaker 41:43
Oh, yes, okay. Are

Scott Benner 41:44
we getting anywhere? Is the therapist any good?

Courtney 41:48
She's great. I love her. And yes, I mean, I'm slowly moving towards considering a pump more and more. Listen, I

Scott Benner 41:56
don't think anyone needs a pump, but if you're telling me you're getting low overnight. And I'm thinking these algorithms are pretty great right now, like you don't even look at stopping stuff like that. How low were you overnight?

Courtney 42:09
Two nights in a row, I hit 59 and it took a while to come up. And I think, though my it was my activity level, I had had like, 17,000 steps so one day and then the next day, it was like 13,000 steps. And I had done a workout, I was just moving a lot, and I think that had to do with it also. I think, you know, the change of season, my doctor said to me before, like, oh, When summer comes, you know, you're probably going to need to start lowering some of your long acting and maybe that's now, because all winter, I felt like I struggled really hard. I was either taking too little or taking too much, and it was getting really frustrating in the winter.

Scott Benner 42:56
Does your activity change from summer to winter?

Courtney 42:58
I mean, I mean I'm outside more now, like playing with my kids, but in the winter, I had a really good regimen of getting up and working out, and then working out would send my blood sugar up in the morning, along with the dawn phenomena, and then I would walk on the treadmill to lower it, and then I would work. And then on my breaks, I would take walks on the treadmill, and it wasn't like I was inactive.

Scott Benner 43:25
So your workouts in the morning are like, are weight, weight based you're lifting and that kind of stuff, okay? And that, did you ever try bolusing for it?

Courtney 43:35
I did. I was really working on that for a while, like taking a half a unit to a unit depending on what I was, just to see what would happen. But then I went to a different diabetic educator, and she said, Well, I would rather you walk on a treadmill to lower it after your workout than take insulin for the workout, because what if you have, like, a rebound low from the workout, which actually did happen to me yesterday.

Scott Benner 44:02
That happened to you, but did you take insulin for it?

Courtney 44:04
I did. I was sitting at like 150 right after lunch, maybe like an hour a half after lunch, and I thought, all right, well, I'll take a half a unit. And I knew I was going to do this weight training workout, and it was strictly weights. There was no cardio, and maybe two hours later, I was sitting in the 50s, and we were out, and I, you know, luckily, had stuff with me, but you're sitting in traffic, and I'm just feeling like, trash, yeah? Awesome. And I'm like, What the heck? Like any other time, you know, my blood sugar goes up, yeah, the

Scott Benner 44:40
anaerobic stuff puts your blood sugar up most times. Is there? I hate to ask you this, as we don't know each other, but this example of you being out and getting low after an anaerobic workout. Are you by any chance within five or six days of your period starting,

Unknown Speaker 44:58
no, ending? Yeah. No. Interesting. That

Scott Benner 45:02
sucks. Yeah, yeah, I'm sorry. I mean, listen, a diabetes educator telling you not to use insulin for anaerobic workouts, I think is a little short sighted. I mean, I think that's kind of the way you have to manage that stuff. I think you need some consistency, something that to count on. Does that make sense? Like, at least, have you ever listened to the Pro Tip series that I did?

Courtney 45:26
Yes, I have. So does that multiple times over the years? Does that

Scott Benner 45:30
one idea of like, at least when I do something, I know that what happens next is from me? Does that resonate with you? Yes, yeah, because that's what I feel like. You don't have enough of, you don't have enough of, hey, I might be low, but at least I know why. And you know what I mean, like that, I think that would help you a little bit, like the the knowledge that I did this and then this happened. So the next time I do it, my expectation is that's going to happen. If it doesn't okay, but it's gonna happen enough that it'll feel reasonably consistent to me. Hey, if you've heard

Courtney 46:06
your thyroid checked, yes, what's your TSH, then fine. Do

Scott Benner 46:10
you know what the number was for the TSH,

Courtney 46:13
oh my gosh. The last time I had it done, it was a while ago, because my endo left. So I was supposed to go in March, but she was gone

Scott Benner 46:21
because they'll tell you it's in range, even if it's a little high and needs medication sometimes,

Courtney 46:25
no, I'm pretty sure it was like completely normal, because I my my therapist, actually, I talked to her about it, and she's also very knowledgeable in that stuff, yeah, and she made me look at it again and tell her, because

Scott Benner 46:40
of the anxiety piece. What it was like these anxiety is, like, a hypothyroidism, like, definitely could, could come from that. Also being, um, having, like, uneven mood swings, weight gain, hair loss, dry skin. There's a lot of stuff that could come from that. So you don't have any, you don't have any of that. How about Yeah, you're just anxious. You're like, no, no, I just have anxiety. Thank you, yep, but anxiety that you might have had your whole life and was made worse by diabetes. Is that correct? Yes. Okay, anybody else in your family anxious? Mom, dad?

Courtney 47:17
Uh, yeah, my mom's a worrier, for sure, she my grandmother was the same way she was. She was definitely a warrior. And sometimes, you know, I can see myself sitting in it like that, just like just holding on to it for some odd reason, even though, you know, my husband's not like that, and I think that's why we work. He is a go with the flow, relaxed. Don't worry about it until it happens. Kind of guy, and

Scott Benner 47:46
that doesn't help you, right? Like his relaxed, it does it. It brings you down a little bit. That's nice,

Courtney 47:52
because if I see him worried, then I know, oh, I probably really should be worried.

Scott Benner 48:00
He looks upset, we're gonna die.

Courtney 48:04
And usually he's like, it's fine, and it's you, and it's usually fine, like, I mean, and we've been together for 22 years, so I know what to expect from him. He's He's my rock, and I don't know what I would do without him.

Scott Benner 48:18
Well, I'm glad it helps. Background, English, Irish, something like that. German, German, okay. How do your parents handle the anxiety? Do they drink, um,

Courtney 48:28
occasionally, but not excessively, not for

Scott Benner 48:32
medication purposes? No, no. Okay, so it's not like, it's not harsh. Then throughout your family either, just a little more like yours, yeah, yeah. Have you tried medication? I don't. I mean, it's not my favorite answer, but have you ever tried something

Courtney 48:50
I did and I really didn't like how it made me feel? Yeah, and my husband said he thought I actually seemed more angry while on it, and I was on it for maybe three months, and I kind of agreed with

Scott Benner 49:04
him, I'm laughing because he said, more angry, not angry. He was like, Oh, the anger is turned up. Would they give you Wellbutrin?

Courtney 49:13
No, it was Zoloft, Zoloft. Okay, interesting.

Scott Benner 49:20
Would you try another one? Or was it? It's an excursion, right? It takes like, six months to try it and see if you like it. Then you got to get off it. If you don't like it, it's a lot, right?

Courtney 49:30
Yeah, I feel like I do a good job of controlling, like, my everyday anxiety. They basically told me, like, if you're just sitting anxious all day over nothing, you know that's that's a problem, and I don't have that. The anxiety occurs when it comes to, like, when I'm low in the middle of the night and it's not coming back up, or like yesterday, that was stressful because, again, didn't know why it wasn't coming back up as fast as I wanted. It too. I mean, it was, it was going on for a while. The other thing, like this, other issue I was having was hours after eating. And I had listened to your podcast episodes about, like, fat and protein and all that, because that's a lot of what I eat, and a lot of vegetables. But for some reason, like, hours after eating, I'm like, spiking, and I couldn't figure out what the heck is happening. Like, I'll eat dinner at 435 o'clock. As soon as seven o'clock hits, I'm just spiking, and I'll keep spiking, no matter how many times I correct until like, 10 o'clock. And I could be at like, anywhere between 202 30, and then I'm just like mad, like, what? Like, why are my corrections not working at all? I am using my ratio. I've even tried, like, splitting it, like knowing Okay, high fat protein, or trying to calculate for protein and taking that, like, at the meal or right after eating, I just felt like, and then I even tried just not eating and seeing what happens. Like just not eating from like two o'clock on, and I would still at seven o'clock just be like, Oh, here we go. Here's this rise. And I'm like, but if I increase my leavenmere or change the time, for some reason it that wasn't working either. Like, I just couldn't figure it out.

Scott Benner 51:22
You're describing a scenario where I believe you would enjoy an algorithm based insulin pump. Yeah, yeah. Because then that rise starts to happen, the pump starts pushing back. It never gets that high, and you don't get low afterwards, because it cuts basal then to make up for the difference, like that. I mean, I don't want I had this feeling while you were talking earlier, that if we could start you on a pump and then put you asleep for the first six months while you learned it, and you just woke up and it was working really well. Like that would be perfect for you. Like you. I don't know that telling you to do it would be valuable for you, because I'm not sure the impact that the first part is going to have on you, the adjustment and the learning part, and not fun, yeah, but, and, but at the same time, you're paying a lot of attention to your diabetes, like, you know, a lot like, so I don't think you'd be lost, but there would be a learning curve. And then I think once the learning curve is over, I think you love it. I just don't want the learning curve to send you. I was gonna say off the deep end, but that's not a fair assessment of you. But like, you know what I mean? Like, push you further in the wrong direction, I guess is what I'm saying.

Unknown Speaker 52:35
Well, that makes sense. Is

Scott Benner 52:36
that your concern

Courtney 52:38
I'm like, a person who doesn't like change, and I think I just want things to stay the same and easy, like anybody does.

Scott Benner 52:46
Is this easy or is it just something you're accustomed to?

Courtney 52:51
It's not easy, but I feel like I'm still somewhere in between. Like I feel like there are some days I barely have to take insulin still, yeah, and then there are other days where I'm taking 10 more units than I was, like, two weeks before that. So I don't know, it's just those weeks are easy. Those weeks I'm like, I'm fine, I got this. And then, you know, comes the resistance from hormones. And I'm like, you know, miserable, and I know that a pump would probably really help that.

Scott Benner 53:23
Do you care if the pump has tubing or not tubing? Have you thought about that?

Courtney 53:27
I would prefer no tubing, no

Scott Benner 53:30
tubing. Would you build your own algorithm, like a DIY algorithm?

Courtney 53:35
I'd probably be a little afraid to do that, not knowing what I'm doing.

Scott Benner 53:39
I think OmniPod five might, I mean, if you jump around significantly with your needs, OmniPod five might still require you to do some bolusing, more than you're imagining. And I don't know if maybe the control IQ would be better for you, but then you're going to get tubing. So I mean, there's going to be gives and takes through the entire process there, I would think, I mean, honestly, I think best case scenario for you is probably, you know, a loop with with an OmniPod, but there's, you know, there's some stuff to do in there. Obviously, have to build the algorithm yourself. And I don't know if that's the thing you want to be involved in, but still, for mitigating lows, for addressing rises as they're happening, and not after they've happened. Any any of these algorithms is going to be good for you? Not islet, I don't think you wouldn't do well with that, but the rest of them, even the Medtronic, the 780 G, I think they'd all work for you, but you have the Dexcom g7 so at the moment, the only thing you could do with g7 is tandem or loop. I don't know when OmniPod five is going to be with work with g7 It's May 30 right now. So I mean, I expect it soon, but I don't honestly know. Has. Any of this been helpful for you at all this conversation, like, why did you want to come on the podcast?

Courtney 55:06
I don't know. I just wanted to tell my story with diabetes, because I I don't put a lot out there, and maybe I should try to, you know, make people more aware. Because actually, not long after my diagnosis, so probably my son was born. He's going to be seven now, so maybe he was like two or three. One of my husband's childhood good friends I saw ended up being diagnosed as a type two diabetic. And I thought, No way, no way, you are not a type two diabetic. And I messaged him, and I said, you have type two diabetes. And he was like, Yeah, I was just diagnosed. I'm like, who's your doctor? And he had the same endocrinologist that I first had, and he was a tall, skinny guy. And I said, you need to get tested for type one. Please. Please, go get tested. And he did, and it turns out he has type one. How about

Scott Benner 56:12
that? Look at you, saving lives over there. It stopped somebody from having your whole, your whole situation that nice. Yeah,

Courtney 56:19
look at you. And it's weird that it was someone that, like I knew for years, that's

Scott Benner 56:25
lucky, lucky for him. Did it make you feel better? Did it make you feel a little bit like your experience was more valuable now, because it helps somebody else?

Courtney 56:34
Yeah, it did. It really did.

Scott Benner 56:37
Before I let you go, I'm gonna ask you this one kind of question. It's just, I think, the question that pops into people's heads all the time when you're talking about anxiety, and this so you have this anxiety, it's stopping you from doing something. When you talk about doing it, you sound like you want to do it, but then you fall back into, it's like this analysis that you go back into, and then you seem like you're stuck in the analysis of it, like waiting for this perfect answer to move forward in does it feel like that, or is it just how I'm hearing it?

Courtney 57:09
No, that's exactly how it feels. Okay, don't

Scott Benner 57:13
do that. Isn't an answer that helps you, right?

Courtney 57:18
That's why I'm going to therapy to work through these things. It really does. It really does help to do that. And I am working through it. I'm getting better at it

Scott Benner 57:28
sounds like it, honestly, I'm just trying to, I'm trying to paint a picture for anybody who doesn't have anxiety, who's listening to you, what they just heard was, hey, this lady knows what to do, and she's not doing it. And if I was her, I'd just do it. Probably they feel like that because they don't have anxiety, but like, it's just worth saying out loud, because it does sound like to a person who wouldn't understand anxiety. You don't actually have a problem. You're just making the wrong decision, but you're making that decision pushed by the anxiety. It's not your conscious mind telling you what to do, it's the it's the anxiety telling you what to do. Is that right?

Courtney 58:00
Yes, and I don't want to blame it solely on my first experience with insulin, but I really do think that has a big part of it, that terrifying feeling that I felt, where I really felt like my life was in danger, coupled with the fact that, like, I have to do this for the rest of my life, yeah, just sucks. And that's where, that's where it comes from. And then the fact that, like, you know, change is scary, and I feel like I keep having to go through change and to change things up, and, like, going on a pump, is a really big change in my mind, even though, time and time again. People tell me, you know, it's fine, it's great, right? But I do think that I do follow a lot of like, you know, other diabetic people on Instagram who are, I guess you would call them influencer influencers. And there are a few of them who refused to go on a pump and then decided to do it. And watching them go through that, change has kind of helped me a little bit. So I feel like the more that I see that, and the more that people put that stuff out there, and I can go on that journey with them, I will feel more comfortable Good. I'm

Scott Benner 59:13
glad it's helping you. Yeah, also, some of those influencers are just doing the things they know you're feeling so that you'll follow them. So they do the whole like, I don't want to pump. I'm not doing that. Then they do that for about six months, till they see their engagement drop, and they go, You know what? I think I might try a pump. It's like, oh, is, is this season two of your little mini series? Okay? But I'm glad it helps you. Like, that's fantastic. I, I also completely understand, like, the situation you're in, like, I'm not saying just, I'm not saying, why don't you just do it? I was being, you know, facetious for the conversation. But the one thing I will say, from just a practical point of view, and you don't need to be told this, you're a full grown lady, like you're 38 years old. The change part, I. I'm not 20 years ahead of you, but I'm pretty far ahead of you. It's never going to stop. Like, it's a fallacy to think you're going to get to stasis, like, oh, as soon as the kids get through this part, or once they get to middle school, or after they're out of high school, or as soon as college is done, or as soon as I get another pay raise, or we move out of this house, or I get this room painted, like, all that's all bullshit. Like, that's never going to happen. You're never going to get to the end. The end is literally when you die. Like, there's no end in the middle. It just, it's constant change. It's slower, so you don't see it sometimes. But we all sit around and do that thing, like, I'll do this as soon as this happens, but that's never going to be the case. And I know that's upsetting to hear, but I, from my perspective, absolutely true. You are going to analyze this forever if you're waiting for something to become unchanged, to make a decision. Does that make sense?

Courtney 1:01:03
It does everything you're saying makes sense. And I I agree with you 100% I mean, I think about that every day. I mean, my kids are growing up before my eyes. My daughter's almost 10, and when I was diagnosed, she was a toddler. So yeah, I mean, I'm fully aware of that, but I also am seeing all these changes in diabetes technology, from when I was first diagnosed to what I have now and what I see now, and maybe part of me is waiting for something that I'll feel more comfortable with

Scott Benner 1:01:38
you. You know, I'm just saying, if you, if you wait for the cars to fly, you're going to miss out on the one that drives itself. That's true. Yeah, that that's all like, these algorithms aren't bad. They're they're not bad at all. The ones that exist now are. They're all really rock solid. They're going to get better, probably. But, you know, here's what I would ask you to talk about with your therapist. I don't know how you're going to feel if you try it, but you don't like the way you feel now. So what's it going to matter if you don't like the way you feel while you're trying it, if you're not going to like how you feel, then at least try the thing. You could always go back to your in pen. Does that makes does that seem reasonable to you, or does that not seem reasonable?

Courtney 1:02:25
No, it definitely does seem reasonable. I mean, I wouldn't say it's bad all the time, but when I discuss these things with my endo too, not just my therapist, they look at my a, 1c and they're like, you're fine. Don't make any changes, because my UNC is, it's always been pretty well. I have been below 6.2 and between like 5.6 for the past well, even after having my son at least the past five years.

Scott Benner 1:02:53
See, I would look at that and say, Courtney, look how well you're doing with a with an insulin pen, you know enough to use a pump. Like, you'll probably excel at this. Like, I don't even predict that. Like, yeah. Like, listen, may I make a suggestion to you, whatever you think, write it down, then wonder what 180 degrees different of it is. Then do that. I think that would help you, because, because you just, you just said something that made me think the exact opposite thing, that it made you and the doctor think the doctor's like, well, you have a great a, 1c, why would you change? And I'm like, if you can do it with that, imagine what you could do with better tools. Not that. Impend is not terrific, by the way, fantastic. It's a great device. I'm not saying that. I'm not saying that people need to use pumps. They don't have to. I'm saying you are describing a world where you don't want as many lows overnight, and an algorithm has the opportunity to maybe try to mitigate those for you. So since you're so good at this, slap the damn thing on and try it's just an it's just an insulin delivery system, right? And then, you know, it'll take you a couple of months to learn how the algorithm works and how to bullish for stuff. And then you can make a decision if you don't like it, then throw it out and go get your pen back. Should I chant do it at the end. Do it? Do it. I just don't want to make I just want you to be upset. You know what I mean? Do you know what I'm calling your episode? Uh oh. What, diabetes is back. It's the it's from, like, the first 15 minutes you you said that to your husband during, like, you're like, you were like, diabetes is back. I just, I don't know why, like, it was the way you said it. I was like, I'm gonna call the episode that. That's fantastic. It made it feel like you had a a lake house, and I don't know you were feeding a freshwater dolphin, and it was gone for six years, and then one day it came back, and you ran inside joke, oh, my god, the dolphins back. I don't know that's what it made me think of. Well,

Courtney 1:04:52
a dolphin would be fun, terrified,

Scott Benner 1:04:56
way better than diabetes. I think you're gonna do it. We. Tell me how it goes. I will like, you'll message me online. You'll be like, I tried to pump I lost my mind and I killed our dog, so it's your fault, like, or something like that. In a German murder, in a murderous German rage, I went through my house and threw my shits out

Courtney 1:05:18
the window. Can't I don't have to sit there.

Scott Benner 1:05:20
My husband wasn't there because he called earlier the day to see how I was and heard it my voice, so he did a little overtime. You're fantastic. I really like you. Courtney. I appreciate you coming on and doing this. Thank you so

Courtney 1:05:32
much. Thank you so much for having me. It's been awesome listening to your show for so many years and getting so many tips. You are amazing, and I appreciate you. That's

Scott Benner 1:05:44
very kind of you. Thank you.

Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it too. So screen it like you mean it one blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com for more info. A huge thanks to the contour next gen blood glucose meter for sponsoring this episode of The juicebox podcast. Learn more and get started today at contour. Next.com/juice, box. The conversation you just enjoyed was brought to you by us. Med, us. Med.com/juice, box, or call 888-721-1514, get started today and get your supplies from us. Med, I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The juicebox podcast if you're living with type one diabetes. The after dark collection from the juicebox podcast is the only place to hear the stories that no one else talks about, from drugs to depression, self harm, trauma, addiction and so much more. Go to juicebox podcast.com up in the menu and click on after dark there, you'll see a full list of all of the after dark episodes. Hey, what's up, everybody? If you've noticed that the podcast sounds better, and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording doing his magic to these files. So if you want him to do his magic to you, wrongwayrecording.com, you got a podcast. You want somebody to edit it. You want rob you?

#1339 IDU: What We Call Food

Jenny doesn’t understand why everything you can eat is called food.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Here we are back together again, friends for another episode of The juicebox podcast.

Jenny's back, and today we're going to talk about what we call food in another episode of I don't understand. 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. If you are the caregiver of someone with type one diabetes or have type one yourself, please go to T 1d exchange.org/juice, box and complete the survey. This should take you about 10 minutes and will really help type one diabetes research. You can help right from your house at T 1d exchange.org/juice, box. 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/juice box. If you're looking for community around type one diabetes, check out the juicebox podcast. Private Facebook group. Juicebox podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me, if you're impacted by diabetes and you're looking for support, comfort or community, check out juicebox podcast type one diabetes on Facebook. This episode of The juicebox podcast is sponsored by Medtronic diabetes, and later in this episode, we're going to be speaking with Heather, who will talk about the importance of education and understanding the impacts of hyperglycemia, Medtronic diabetes.com/hyper, this episode of The juicebox podcast is sponsored by cozy Earth. Cozy earth.com use the offer code juicebox at checkout to save 40% off of the clothing, towels, sheets off of everything they have at cozy earth.com. Jenny, welcome back. We're going to do another I don't understand today. Yay. Today, we're going to pick from your list again, and we think we're going to blend together two of your ideas off the list. But basically we're going to talk about food cool. So we'll start with your I don't understand you said. I don't understand why we call everything that we put in our mouth and eat food, which I took to mean you guys are eating some stuff you shouldn't be eating. And let's find out what that is so. But what was your big idea like? And also, let's be clear, you were traveling. You had a lot of free time. You were thinking about this, you got yourself upset,

Jennifer Smith, CDE 2:44
like, well and in travel, what? What do you see, especially when you're traveling in an airport or on an airplane, what do you see?

Scott Benner 2:55
It's all prepackaged, like frozen stuff that they heat back up again, stuff I can take in a bag with me, and also it's four times the cost it would be if I bought it somewhere else. That's what I know,

Jennifer Smith, CDE 3:06
absolutely 100% but it's the I guess. What brought it to mind was the convenience factor. I understand we're busy. People are busy in today, but, you know, I grew up thinking about food is something that I put in because my body needs nourishment, right? It's a basic necessity of life, just like water is, yeah. And so as we've moved on in ages, more and more products have come to market, but that quote, unquote, food that we put in isn't always nourishing our body the way that we're supposed to be nourished. We may be getting calorie value from it, which our body works, but is it really providing all the nutrients that our body requires?

Scott Benner 3:57
I don't know some, right, but not all, because they do pump that stuff full of like, I mean, they say they full of vitamins, but I don't you know what I mean. Like, you don't know. You're wondering over and you're like, there's vitamin B in this. Like, you don't even mean, like, that kind of an idea, yeah, right. It's funny too, because I'm making a supplement. I'm making a short series. I don't know if I told you this or not, but I went out to the Facebook group and I said, I don't care how crunchy it is or weird or anything, tell me every supplement you take. And I ended up, wow, ended up with a list of like, 88 things that people use, right? So I'm like, Well, what am I going to do with this list? So what I basically did was I, you know, I go to the internet and I say, like, you know, I don't know, vitamin D, and I get a breakdown of it. This is what it does. This is what you know. This is what this is what you can hope to get from it. Here are things you might want to be cautious about. Here's how it's generally dosed. And in like a five minute episode, I talk about vitamin D. And then I went to the next one and the next one, the next one. And what I thought was people can listen and decide for themselves if this is something they want to look more. We're into, but I find myself saying almost in every one, like, make sure you're getting a high quality vitamin. So I just was thinking, like, how high quality could it be if I'm putting it into, like, some processed food? Because I have to be able to say it's got some value nutritionally Correct, right? And

Jennifer Smith, CDE 5:16
that's why, you know, again, from a legal standpoint, products that have been really, really processed, meaning they took all the nutrient value out of them in the processing, then they have to be labeled as enriched and fortified, right? Because what they took out to be able to provide some nutrition value, they have to add back. And then your question is 100% valid. What does our body do with something that's been synthetically added back to replace what was naturally there in in the beginnings of what was really food, right?

Scott Benner 5:52
Probably not much. It's my expectation. You know, at Christmas last year, I bought a candy cane from this guy that makes them by hand, right? Yeah. So there was not like, you know? So I'm like, Okay, I wonder what a handmade candy cane tastes like. And I got it, and it was fine. It was good. It wasn't super excited or anything, but at least when I ate it, what I knew was, this is an indulging thing here. I'm not joking myself into believing that there's something in this candy cane that is gonna, like, benefit my overall health or well being, no, right, right? This is just sponge sugar mixed with whatever the hell else it is, yeah, and that's it. I'm taking your point, right? Like, things are packaged up in a way where you're like, Well, this is food, right? But, like, a cheeseburger from a fast food place is not you going to the grocery store buying beef and making your burger, making a burger yourself. And I'm trying to use something that's, you know, whether you make it yourself or not, like, this is not an incredibly healthy decision one way or the other. But like, still, in our minds, it's, they're both cheeseburgers, so they both have the same thing. And we think of them, I think, generally speaking, like it's the one we made ourselves. And so if you kind of extrapolate that out to Lunchables, for example, or something like that, or like lunch meat, is there a world where you'd ever go to a deli counter and buy like, sliced turkey or ham or something like that? The podcast is sponsored today by the place where I kept my oh gosh, my sheets, my towels, some of my clothing, a lot of the things that I stay warm or comfortable with, cozy earth.com I'm wearing a pair of cozy Earth joggers right now. I've recently gotten another pair in a different color. I sleep on cozy Earth sheets. They are so comfortable and soft and temperate, temperate, meaning I'm never hot or cold, which is really saying something, because my wife loves to turn that giant fan on, but they keep me nice and warm without making me, like, sweaty or moist. You know what I mean? You don't want to be moist while you're sleeping. And then, of course, the waffle towels I use every day to dry off my bits and parts after I've showered. Cozyearth.com, use the offer code juice box at checkout to save 40% off of your entire order. I'm not saying 40% off of one item. I'm saying 40% off of everything you put in the cart. Cozyearth.com, use the offer code juice box at checkout. This episode is sponsored by Medtronic diabetes. Learn more about hyperglycemia at Medtronic diabetes.com/hyper

Speaker 1 8:27
Well, Hi, I'm Heather lackey. I am a wife and mom. I have two children that are seniors in high school, and I've had type one diabetes for 34 years, and I'm a dietitian and a diabetes educator. You know, I'm the Director of Global Medical Education. I lead a team of clinicians that are developing content. How do

Scott Benner 8:50
you feel when your blood sugar's high? Irritable,

Unknown Speaker 8:52
thirsty, hungry.

Scott Benner 8:56
What do you enjoy most about your job? See

Speaker 1 8:58
education working. See people thriving. That's kind of the fuel that feeds, you know, my fire.

Scott Benner 9:06
What would you like to see community members talk about more hyperglycemia

Speaker 1 9:10
is the critical thing, right? That leads to short term and long term complications. Hyperglycemia is the greatest unmet need and the treatment of diabetes currently, and I think that that's where technology can help if

Scott Benner 9:25
you're having trouble with hyperglycemia and would like to talk to other people in the diabetes community. Check out the Medtronic champions hashtag, or go to Medtronic diabetes.com/hyper

Jennifer Smith, CDE 9:37
we go to a place that actually has do I buy sliced I don't eat it. My kids don't eat it. My husband does eat turkey and chicken. But I go to a place that's actually farm. Oh, okay, so there. So we have some place here that supplies stuff. I know where it came from. I could go visit the farm if I really wanted to. Yeah, I know what went into the product, and I know that that's. From a standpoint of everybody's availability, that's not everywhere. I get that entirely at a deli. You still have options your grocery store. You've got options in different deli cuts and different brands and things like that. And I think in terms of what I view as what should be called food, it should have the least amount of processing in the least amount of ingredients, right? If you're getting deli chicken, what's in it? Can you read all the ingredients? How long was it? You know, you know what I'm saying? Yeah,

Scott Benner 10:28
I do a thing where I just get, I'll get a turkey breast from the store, and then I'll either bake it or smoke it and then slice it myself. But I listen, I'm nowhere near where you are on all this. And I don't mean that, like, pejoratively, but like, I look at deli meat, I'm like, That can't be good. Like, do what I mean. Like, it feels like it's been pressed together and it's just wrapped in plastic, and they unwrap it and they cut it and they put it back in, but they don't cover it up. But I'm like, Ah, well, that seems wrong to me. Oh, yeah, yeah. And I just remember somebody telling me at some point that, like, salt and nitrates, or something, was very high in deli meats. And I was like, Okay, well, I'll try to avoid that then. But you can look at that and just think it's Turkey, right? Yeah, right, yes.

Jennifer Smith, CDE 11:12
So we've been, you know, all along, I think we have set up a we've set up the equation for people to incorrectly or understand that broad term of food, because we don't get we get math in school, we get how to read. We get, you know, basically, how to understand science, etc. But what we really should be getting as humans is a baseline of education from kindergarten through at least High School of Nutrition, what is

Scott Benner 11:48
food? Why am I? What is food? Why?

Jennifer Smith, CDE 11:50
What physiologically happens? You know, kindergarten, you learn the food groups as the grades go on. What are the nutrients? What does that do in your body? Like your understanding of vitamin D, right? Is it a quality source? What does it actually do in your body? Why do I need it? I think we'd have a healthier overall society if we really understood food and its purpose in our body.

Scott Benner 12:15
But you made such a good point a moment ago, like the availability for people. So I just looked up like, why do we process food preservation, safety to eliminate microorganisms, convenience, taste and texture? Who knew that processing can improve the taste of certain foods by adding ingredients like spices, sugars or fats and changing the texture? Food processing methods can change the texture of foods, making them more appealing or easier to consume, I have to tell you. I'm sure I've told you this in the past, but when my kids were little, I used to buy them frozen chicken nuggets, and then one day, I was like, What am I doing? Like, why don't I just buy the chicken and cuddle up myself and make my own nuggets and texture, like the texture my son bit into it, he goes, this isn't chicken. And I'm like, Oh, my God, that's crazy, like that. That's chicken. It really is. And he goes, that's not what this tastes like, like the feeling in his mouth. So it can, you know, if you process it, it says you can fortify it, concentrate nutrients from mass production to feed large populations, cost effective cultural and traditional practices like pickling and fermenting, but that's not what we're talking about. Of course, the drawbacks are nutrient loss, additives and preservatives, and then highly processed foods often contain little nutritional value and may contribute to poor health. So so what starts out as let me see how old I can sound here. My grandmother used to buy tin cans of Charlie's chips. Do you know what that is? So I don't know what she would get. Okay, oh, boy, man, I guess I'm pretty old. Okay, here we

Jennifer Smith, CDE 13:50
go. Either that or your grandmother did different things. I

Scott Benner 13:53
don't know. I know, you know, like the idea of, like, a holiday popcorn tin, like, you know, like, right? So when my grandmother went to the store to buy potato chips. Her potato chips came in one of those bins from a company, and they were called like, Charlie's chips. And I'm okay betting, if I could go back into a time machine, I would learn that Charlie's chips were potatoes, salt and fried and grease. And I'm probably right. And now, because this was good, this is the 70s, right? So, I mean, maybe not, but my expectation is that somewhere along the way, that's how my grandmother ate a potato chip the first time, and then eventually it became what it is now, right? And so when you stop and think about like, even like a like, I'm just gonna say like, a very popular Nacho chip, will say that, right?

Jennifer Smith, CDE 14:38
That's a good way to say, what a yes, very kind. We all know.

Scott Benner 14:42
Everyone who's been on this planet knows that if you lick whatever that is off that chip, you're like, This is so good. I don't even know what this is, right? But I bet you, if you broke it down, like, in our minds, we're eating a corn chip with some like flavor on cheese on Yeah,

Jennifer Smith, CDE 14:57
they think it's cheese, right? It says nachos.

Scott Benner 14:59
Cheese on the bag, and so, but that is not what you're eating. You're not eating my grandmother's potato chip with a little bit of cheese on it, or something like that. And so over time, that's happened to everything. Yes, yeah, everything, yeah, really, even to the point where, you know, even the people will tell you I would I was overseas, and I heard somebody say recently, it was overseas, and I had a peach. I picked a peach off a tree, I ate a peach, and I bought I bit into it, and I thought, This isn't what a peach tastes like. So, like, even our fruit and everything's modified in one way or another, right? Because it's the yield, right? But how much of that is about the size of our country, because this takes us into your other I don't understand, which is, why does the US allow ingredients that other countries will will outlaw,

Jennifer Smith, CDE 15:51
right? And I think that you actually the peach story reminds me, years ago, for an anniversary, my husband, and I went to France, and it was a little like grocery store, like around the corner, and we went and we got a couple of things, and one of them was yogurt. And I opened the yogurt and it looked different, and I tasted it. And we ate yogurt so much while we were there. It was the tastiest yogurt, honest. It's the peach story, really. It was, my goodness, like, this is not Americanized yogurt, and it tasted like just really good. I don't know what the difference in it, but it was really, you cannot, and I don't really eat very much dairy now. So maybe there are some things that are on the market that are similar enough, but I mean, it was very different. And so that brought in that other thought, like, I don't understand why, despite having smaller populations in in area Europe, is still a really big place.

Scott Benner 17:01
It's not, they're not feeding 20 people, right? They're still, they have a they're smaller and they have a smaller population, but they still have to cover their population with the size of their industry. So, right? So understand,

Jennifer Smith, CDE 17:13
no, it could be, but then why are we like, don't we want our US people to Healthy People, right? Do you know that's my problem. You're confusing

Scott Benner 17:25
someone sitting on the board of directors somewhere is like, How much money are we making this month with right? Yeah, it's like, everything else. Listen, social media is a great example, right? Like, you know, because you and I, before we started recording, Jenny was listing out her, gripes with her gripes with the world I don't

Jennifer Smith, CDE 17:43
understand. Yeah, and listen,

Scott Benner 17:45
the first time you open up Instagram or Tiktok, you go, Oh, wow, my God, this pictures are everybody blah, blah. The 10th time you do it, you're like, Ah, I'm good. Like, you know what I mean? Like, I've seen this already. So how do we up the ante to keep you coming back to the app? I think that's what happens with the food as well, right? Like, let's just keep upping the flavor. Put more fat in it, more sugar, more salt. Like, so that you're just like, oh my god, this is awesome.

Jennifer Smith, CDE 18:08
Those are the top three, if you look into any food science. I mean, there are, there are lots of different books all about it, right? Supersize Me, all of those different options to look at. They focus on those three ingredients, sugar, salt and fat, yeah, and the food industry has figured out how to marry them to the point that they are addicting. Yeah.

Scott Benner 18:29
Do you want me to tell people the thing you told me that we looked up to see if it was true, and it looks like it might be sure that in 1988 Philip Morris bought Kraft Foods. Acquired Kraft Foods, a major food conglomerate. So, uh, so basically, a tobacco company that made cigarettes was like, Hey, let's buy a food company. And a couple years earlier, it looks like RJ Reynolds bought Nabisco, yep. So then there's reasons that it might make sense, you know, for the for them to diversify like that. Obviously, they had to shift away from tobacco because it was becoming less, you know. And

Jennifer Smith, CDE 19:07
do you, I mean, if you really think about it, then do you really want? Are those the people that you want putting quote, unquote, food in your mouth? Well,

Scott Benner 19:15
they're money people. It's hard, but that's what. But they're money people. When you stop and think about like they were in the cigarette business. They had something that, you know, they made that was really addictive. And they were probably like, hey, people aren't smoking as much. They're not going to stop eating. Why don't we shift over here and keep going? And obviously, it worked out pretty well, absolutely, for them, but not for us.

Jennifer Smith, CDE 19:39
Yeah, right. Look at the health of our country, right, right. We've got phenomenal emergency care. But why? It's because as a nation, we've continued to get sicker and sicker, and That's atrocious for all of the knowledge that we have. But

Scott Benner 19:52
then they'll just but then that same money will probably just go buy like a healthcare system,

Jennifer Smith, CDE 19:56
sure, and new medications and new things. Put band aids on the problems that could easily be fixed by people just eating an apple. Yeah.

Scott Benner 20:05
So we went, we went on, by the way, if you're listening and this is your life, don't, but don't get mad at us. Like, I mean, like we're not blaming you. This is the situation. Like, I mean, honestly, I thought you said it a minute ago. I think it's worth repeating, convenience, cost, you know, etc. Society is set up like this to support this kind of food. Now you can't just to just dash off and go, I'm not going to be involved in this anymore. Like you. People probably don't have the knowledge of where to start. You grew up with your mom making food that she grew like, so you have some I did knowledge about it, right and how to handle it. You're predisposed to do those things. But if I just asked you to, you know, if you didn't grow up that way, and I just asked you in your 40s to just shift all of a sudden, like, Hey, Jenny, go start making your own yogurt. All you need is a goat. And you'd be like, Hey, listen, what happens? Happen? Sorry, you know? Like, Oh, I

Jennifer Smith, CDE 21:00
did years ago, actually, I bought a yogurt maker after I did you were laughing. Although we have toyed with buying our own chickens, and just because we can have chickens, but we've not done that. No

Scott Benner 21:16
doubt in my mind that you've thought about buying chickens, not at all.

Jennifer Smith, CDE 21:22
They have the best eggs. They're fresh. They're always there. You know, I

Scott Benner 21:25
would love that. Listen. We went on an, I said, on the podcast, so people might know. But like, we went on a family vacation for the first time in years recently, and we went off to, like, a warm location on an island, and just sat around for a week, and my kids came, Kelly, myself and my son's girlfriend, and we got home, and we weren't home for like, 48 hours, and my son goes, Hey, you know, the entire time we were on that island, I got up eight, went to the bathroom, everything was as normal as could be, and I'm home 24 hours, And my stomach's upset, like, just like that. He's like, he's like, it's the food, right? Because he's like, 24 he's like, right? Like, am I seeing this correctly? And I'm like, Yeah, I don't know exactly how, but I think so, yeah. So especially

Jennifer Smith, CDE 22:15
if the food on the way home. Travel wise, again, you know, as we started out talking about travel, food is really hard on your system. Travel, in and of itself, is hard on your system. Most people get dehydrated when they're traveling, especially through flight. So absolutely, he was right.

Scott Benner 22:32
I remember the first time that I said to you, like, I don't understand when you're on a long car trip and you stop for gas, you don't get food. And you were like, No. And I was like, Well, where does the food come from? You were like, I bring it from home. I was like, oh, fascinating.

Jennifer Smith, CDE 22:46
He looked at me, like, how the crazy lady, that's

Scott Benner 22:50
such a good idea. But no, yeah, so Cole's, Cole's input was from his own personal experience. Was even though we were eating in restaurants every day, usually, but we did shop at the grocery store. But in fairness, the grocery store there was insanely expensive, I'm sure, but still, he's like, my stomach was like, great the whole time we were there. And he's like, I got home and like, he's like, I'm not eating crazy stuff, in my opinion, and I don't feel well all of a sudden. And so, I mean, it's, Listen, I'm not a doctor, right, and or anything, but it's got, it's got to be this. It's what's in the food. Like, we're all and then we run around patching up problems. And, and I grew up in this, you know what I mean? So, I mean, I was, like, really broke growing up. So we ate, like, garbage food, like whatever was available, stuff and, and I actually grew up with people who thought that, like, you know, some of that packaged food, which I'm sure in that time, a lot of people thought they saw it as, like, amazing. They were like, sure, you know what? I mean, like, there's a cookie. It comes in a bag. You don't have to bake it Isn't that insane, you know, like, that kind of thing,

Jennifer Smith, CDE 23:51
or TV dinners. Let's bake it in aluminum foil and,

Scott Benner 23:55
oh my god, yeah, the turkey with the fake gravy and the fake stuffing. See, now you said that, and I'm like, Oh, why don't they make those anymore? Those were good. Right away. I was like, Oh, awesome. I remember those. The gravy, like, yeah, the gravy was, like, thin. You'd like, whip it up a little bit try to make something happen. The potatoes were, like, hard

Jennifer Smith, CDE 24:18
potatoes, no, sort of what they were, but, but you'd put some butter

Scott Benner 24:22
and salt and pepper on and you're like, This is passable.

Jennifer Smith, CDE 24:26
But I remember the first time I had potatoes at a friend's house. I had gone for dinner, and her mom was also was not. She wasn't the cook that my mom was. She did the best that she could, you know, but she had mashed potatoes, and I tasted them and I ate them because I was very polite that just, you know, I was raised that way. And I came home and I was like, Mom, I don't know what you do different with your potatoes, but we had potatoes that were supposed to be mashed potatoes. They were like, they were like, wet and sort of like they were, they were just. Really, really soft. Yeah, do they go? They were probably boxed powdered potatoes, water powdered potatoes. Like, are you seeing my mom? Like, chop them up, boil them, smash them, you know, blend them up, whip them with the beater, and put butter and, yeah, with our mashed potatoes,

Scott Benner 25:15
maybe even a little sour cream in there to reach them. Listen, I'm going to tell you right now you've now again, this is really interesting. You have, like, fired off young broke Scott memories, those box mashed potatoes. If you made them thicker, if you didn't put as much liquid in, they were awesome. But I know they're not. I know if you gave it to me right now, I'd be like, I don't know what this is. I don't want this. But as a kid, growing up, I don't know, like, it's right, it's one of my memories. Listen, we say this all the time here. I don't know if we say this. I don't know if I've ever said this on the podcast or not, but my wife like she eats well, because we're older now and she understands. But if you asked her to go pick the things that really fire off the memory centers for her. It's like she grew up in a trash can, like, the stuff that really like, she's like, Oh, this. Like, I'm seriously, like, listen to this. So I won't tell her, like a garbage person, like, she she, if you left her to her own devices, she'd be like, Oh my God. And she'd say things that you'd be like, those aren't real foods, but it's the stuff she remembers from being a kid, sure. You know, I guess it just sticks to I have some stuff here. I asked chatgpt Why the US allows food additives that other countries have outlawed. It says, I'm curious. Some reasons might be regulatory framework differences,

Jennifer Smith, CDE 26:35
but right there, right there, regulatory framework differences, right there is Europe. Does it better? Because the citizen, I just feel like, the citizens are like, I'm not eating this, and we don't want our citizens eating this. Why do we want our Americans like, don't we care about each other?

Scott Benner 26:53
Yeah, the two so the two entities, the FDA and the EFSA, use different criteria and processing for evaluating food additives. The US tends to rely more on industry provided safety data, and has a high and has a they wouldn't lie about this, that has a higher threshold for banning substances, whereas the EU often applies what they call Precautionary Principle, meaning that substances can be banned if there's even a potential for harm, even if the science isn't definitive,

Jennifer Smith, CDE 27:20
right? So they're all the food, food colorings,

Scott Benner 27:23
yeah. Well,

Jennifer Smith, CDE 27:24
so the easy one, what you're

Scott Benner 27:25
just hearing here is there's a referee. And in Europe, the referee goes, I'm going to side on the side of the people eating the food, and our referee goes, I'm going to side on the side of the people making the food. Now, why could that be? Well, because lobbying in an economic interest. The Food and Chemical Industries in the US are powerful and have significant influence over regulatory processes through lobbying. So they're making the food and the rules about how the food is okayed

Jennifer Smith, CDE 27:53
and who's lobbying for your food. Who did you say from 1988

Scott Benner 27:57
Yeah, it might be, or it could be a an old tobacco company. I mean, what a cookie company. I guess you're right. Like,

Jennifer Smith, CDE 28:07
I just, I just want people to be smart. That's just it. I want

Scott Benner 28:10
everyone to know that. Before we started recording, Jenny told me she made her own baby food for her kids. I did.

Jennifer Smith, CDE 28:18
So I was eating it anyway. What's right? I mean, why?

Scott Benner 28:21
No. But I mean, like, you know, you got put on the right first foot as a kid, and you stuck with it. Also, you stuck with it, probably a little bit because of how you were raised, but also, I think, because you got diabetes too when you were a kid, so it was probably easier on you to eat real food too, right? I mean, listen, there's no doubt that a lot of the conversations that people have, you know, in the Facebook group and everything, they're like, I mean, they're eating stuff that I'm like. If you ate something different, this would definitely be easier. Now, I'm not into telling people how to eat, because of all the things that we've listed here, you know, finances and, you know, I mean, they could be addicted to it by now, like, you know, whatever. Like, there's 1000 reasons why people are eating the way they are. I want them to be able to cover their food well with insulin and not, you know, correct compound issues. But the truth is, the you know, the simpler the food, the simpler the ingredients, the simpler the bolus things should be as well,

Jennifer Smith, CDE 29:14
for the most part, correct, absolutely. And you know, there is no lie in that there are food deserts. And when they talk about food deserts, we're not talking about there's no food available. But in the beginning of this, like defining the word food, right? There's truly no real food available in a food desert, there are things that provide calories, fats, proteins, sugars, yeah, but are they really providing quality in which food in itself should provide? Yeah, no, it's

Scott Benner 29:49
back to your original point. Like, I don't understand why we're allowed to call all of this food, right, right? Because it's not. It's not, there's nothing. It's food ish, maybe, right? Right? But, yeah, but you're saying that there are people who live in places where their only option for breakfast is Captain Crunch or something like that, and right, you know, and their stuff is everything they're able to buy is boxed or processed. It's easy to say, like, I mean, listen, it really is easy to say, don't buy anything in a bag or a box. You'll probably be better off. But how are people supposed to accomplish that when the world's been now set up this way for them? So that's really probably the biggest thing. Is that in Europe, where we're talking about, in other places, their lives are set up differently, differently. And it's true. Like, if anybody who works with anybody who works in America and has an office overseas, you'll hear them complain, like, man, they take off a lot. Or, like, you know, when they go on fake hair, they have a baby. Like, in Canada, like, I work with this lovely woman who, like, I met and, like, we were starting to build up a rapport, and then she's like, Well, I'll see you next year. I'm having a baby. I'm like, What shit? Yeah, like, she just get

Jennifer Smith, CDE 30:54
a baby. Here, they get a year maternity leave in Canada, and then they will reserve your at least. When I was working with a couple of people who I worked with for pregnancy in Canada, a year maternity leave paid at least to some degree, and they will reserve your job for you unpaid for another year following that. Yeah,

Scott Benner 31:14
no, it's it. Listen, my wife was riding the train right up until, like Cole was coming out, trying to save up time to be with the baby after he was here and but my point is, is that if their society runs differently, then maybe they have more time to come home and make chicken nuggets out of a piece of real chicken, is my point. Yeah? So it's, he can't blame any like, it's not, it's not a blame game. It's like, it's no, it's the way we set the country up, is it put us in a situation now, right?

Jennifer Smith, CDE 31:42
I guess what made me really think about it as a like I don't understand, is hoping to bring to light that there are some things that maybe people can start to think about right in considerations, especially if you have the ability to do so, the smallest little changes can lead to another change can lead to some improvement. And we're all talking about diabetes management here. The simpler the ingredients, the less the ingredients, the more they're real food ingredients, yeah, honestly, everybody wants it to be a bit easier and less cumbersome to navigate. Blood sugar after food intake.

Scott Benner 32:20
Yeah, and you hear so many people with type one talk about, like they have digestion issues, and we've talked about that before, but like, you know, is it because you're trying to digest, you know, sweeteners cardboard that's in something like, I mean, listen this artificial colors and sweeteners, some food additives that are banned in other countries, such as certain artificial dyes and sweeteners remain widely used in the US due to their low cost and long established use. While these ingredients have raised health concerns like links to hyperactivity in children and cancer risks, the FDA maintains that they are safe at current consumption levels, but it goes on here to talk about it just picks a certain ingredient to make a point with, and it just struck me, brominated vegetable oil. Bvo is an emulsifier in some sodas. Now, I bet you, when you drink a soda, you think, well, the liquidy parts water, that for sure, unless it's brominated vegetable oil, like it's banned in Europe, but allowed in the US, despite concerns about its effects on health, it's approved. Its approval has not been reversed, in part because the industry lobbying and slow regulatory response. So you know, every time you pay a soda company, they take a couple for themselves and a couple to fight about so they can keep selling you more soda. I listen, I'm I'll have a soda sometimes, and I know when I'm drinking them, I'm like, This is not good for me. But I sometimes see people go down the soda aisle in the grocery store and they have so much soda in their cart. Like, yes, and I'm not one of those people, but you, like, part of you, just wants to grab them and go, please don't. Please don't, yeah, yeah. Like, that can't be right. You know what I mean, the

Jennifer Smith, CDE 34:00
biggest time that I see, very big carts full of soda or that type of thing? It's usually around the time of the big sporting events, right, where you're celebrating the Super Bowl, or some big sporting celebration, the Fourth of July, any of those things where, you know you got to drink something, heaven forbid, you would just drink water because it's so hard to find.

Scott Benner 34:28
Well, I want to, I want to stick up for other people. Water sucks. You know why? Because it tastes like nothing, but. But my point is, but, but to not joke about it. There's an example of, like, I need to be hydrated, right? And a glass of soda is not going to hydrate me the same way an equivalent glass of water would, right? But like a baby, I'm like, but I want it to taste good. And by the way, if we had more time, we could relate that back to your thought, which was, hold on, it's not going to. Yeah. Why are we? Jenny was off on a tangent earlier. Why are we afraid to feel emotions? How come people think they always need to be happy,

Jennifer Smith, CDE 35:09
like, happy to the nth degree?

Scott Benner 35:14
I'm putting that on myself about the about, like, water, like, just drink it and shut up. And now you're not thirsty anymore. Go on your business. Take a nice pee. It'll be over. Here's some other examples of additives allowed in the US, but banned elsewhere. Potassium bromate, which is used in bread products in the US, but banned in the U EU, Canada and other countries, due to concerns about carcinogens. So keep in mind too, even bread like I have a bread maker, I'll make bread in it goes bad pretty quickly because there's no preservatives in it, but it does not taste like whatever bread from a store tastes like at this point. Do you know what I mean? You know? I don't know. It's completely different. RBGH, recombinant bovine growth hormone is allowed in the US for dairy cows to increase milk production, but banned in the EU and other regions because of its potential health risks for the cows and the humans. And then something here I can't even azo dicarbonide, carbon carbon amide, a dough conditioner used in bread in the US, but banned in Europe and other countries due to its links to respiratory issues. So when I make bread, it's flour, salt, butter, a little bit of sugar.

Jennifer Smith, CDE 36:34
I use yeast or no, yes,

Scott Benner 36:36
yeast, that's it. That should be it. I think that's the five ingredients. I don't have a dough conditioner in it called azodicarbanamide. No, so, all right, so why are we allowed to call this stuff food? Jenny,

Jennifer Smith, CDE 36:50
right? Did we answer my question that these aren't they're not food.

Scott Benner 36:55
I mean, I think we I don't want to sound like a conspiracy nut, but it sounds like to me that the answer is money.

Jennifer Smith, CDE 37:02
Regulatory being fed by the

Scott Benner 37:05
money. Seems like money's the answer, but, but, yeah, so companies listen. Companies own stuff. They want to make more money. They find ways to do this. Now, the other thing is, you wonder, like, how many scientists did we have to, like, hire until somebody figured out that recombinant bovine growth hormone made cows make more milk. I don't know. I don't know what the other well, I'd love to hear the other side of the argument, like, what's the other side? Like, where are we going to get enough cows to make milk? Yeah, also, I would imagine this, let me I'll sound old again for a second. There are nine different types of milk in my grocery store, like, nine different brands from different companies. I bet you, if it wasn't so easy for me to grab milk that when I poured it, I would take exactly the amount I was going to use and no more. Come on, everyone's like, filled up their cereal bowl, eating their cereal when they're done. Like, there's a big pool of milk at the bottom right. Like, that was extra milk you didn't need. Jenny doesn't need cereal, but if she did, she'd understand what we were talking about. Were talking about. My point is, is that I want things to be readily available for everybody, but maybe there's that feeling of it's there so I can have more of it, or I can waste it like there's nothing special. You know what I mean

Jennifer Smith, CDE 38:16
that could be and, you know, commodity food, obviously, right? I mean, a lot of the public school systems get, sort of their food comes from more commodity types of options, so that it's not as expensive to feed. Thankfully, we have public school food systems, because there would be a lot of kids who wouldn't get one or even two meals a day, unfortunately, right? They're needed. I see the other side of it entirely. I do, but I my bigger picture is, why can't we just clean it up for everybody? Like I just, I don't understand how we can think that it's okay to keep things so unhealthy. People are getting rich in a way, yeah, by keeping other people sick,

Unknown Speaker 39:05
yeah? And it makes

Jennifer Smith, CDE 39:07
me really sad,

Scott Benner 39:08
yeah, or on just the wrong path that eventually catches up to them, right? Yeah? No, I listen. I can remember, like, crystal clear. I went to the grocery store with my grandmother once, and she died when I was 13. So I was pretty young. This is a long ass time ago, is what I'm saying, like, 40 years ago or more. And she's just going through the aisle, and her ice cream that she liked was there. She was so excited. And I was like, I couldn't understand why she was so excited. I said, Why are you so excited? And she goes, Oh, they don't always have it, so I don't get it that often. And I was like, okay, but now there's like, I don't know how long a grocery store aisle is. I mean, it's got to be a couple 100 feet, right? Don't you think? I mean,

Jennifer Smith, CDE 39:50
I don't even know. I have no idea. I haven't I know what you're talking about.

Scott Benner 39:55
In my grocery store there is a full aisle of just ice cream, yes.

Jennifer Smith, CDE 39:59
And bars and cakes and cookie ice cream, and in a six

Scott Benner 40:03
foot tall container, a couple of 100 feet long, from 40 different companies, ice cream, it's always there. It's never not there. It's always full. As a matter of fact, if you take a couple out, somebody runs out, shoves a couple back in,

Jennifer Smith, CDE 40:16
and you'll notice that they're not all called Ice Cream, because illegally, they can't be. Did you know that? Yeah, no, I know there's a difference between dairy treats and ice cream. Dairy treats

Scott Benner 40:27
that sounds like a cow fart when you go to the movie theater and you go to put butter on your popcorn. It's called buttery flavored topping.

Unknown Speaker 40:37
Yeah, it's

Speaker 2 40:38
oil. Oh, and it's not good

Scott Benner 40:44
oil. It's not like the cheese dust on that very famous, like chip where you're like, you know what? This might be giving me cancer, but this is awesome. It's not like that. It's like, you put it on the popcorn. You go, Oh, I just ruined $900 worth of popcorn with this oil.

Jennifer Smith, CDE 40:59
See, if you're like, Jenny, you take a big bag with you, and you have your own popcorn in the bag, and nobody checks it anymore. My

Scott Benner 41:05
wife makes fun of me when I do that. Oh, I

Jennifer Smith, CDE 41:07
do that. That's like, I put my I put, you know, drinks in there too, like, water bottles. I'm like, there's no reason they just paid like, $80 to come to these movies. We're not buying, not

Scott Benner 41:17
gonna buy $50 worth of, uh, popcorn and water bottles of water. No, all right, Jenny, listen. I don't know the answer, other than I think the answer is money, and people trying to make money. But I'll tell you this, if you hear this and you get upset by it, I'm very, very clearly not, like I don't talk about political stuff on the podcast. But you know, people have power, but they only have power when they're united and in day groups. That's right. If you are waiting for five people in a boardroom to decide that your health means more than profits, you might want to wait on someone else. Yeah,

Jennifer Smith, CDE 41:52
that's right, yes, you will be out of luck. So make your own choices, your labels, yeah,

Scott Benner 41:59
and eat like Jenny. Just make, you know, push up carrots and give me your babies or whatever. My God, all

Jennifer Smith, CDE 42:05
right, pretty easy in a blender, you know.

Scott Benner 42:09
Anyway, I appreciate this very much. Thank you.

Prolonged hyperglycemia can lead to serious health problems and long term complications. Learn more at Medtronic diabetes.com/hyper this episode of the podcast was sponsored by Medtronic diabetes. Huge thanks to cozy Earth for sponsoring this episode of The juicebox podcast. Cozy earth.com use the offer code juicebox at checkout to save 40% off of your entire order. If you're living with diabetes, or are the caregiver of someone who is and you're looking for an online community of supportive people who understand. Check out the juicebox podcast, private Facebook group. Juicebox podcast, type one diabetes. There are over 41,000 active members, and we add 300 new members every week. There is a conversation happening right now that would interest you, inform you, or give you the opportunity to share something that you've learned. Juicebox podcast, type one diabetes on Facebook. And it's not just for type ones, any kind of diabetes, any way you're connected to it, you are invited to join this absolutely free and welcoming community. 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, if 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 Alright, kids, we're done. We're at the end. Just do me one last favor if you can, if you could please, if you have the need or the desire for something that one of the sponsors is providing, please use my links or my offer codes. They help the show so much, and that means me, you're helping me to make this podcast every day. You're helping me to support the private Facebook group do all the things that I'm doing. I'm not asking you to buy something you don't want or something you don't need. But if you're going to get one of these items, use my links or my offer codes. They help me a ton. Thank you so much for listening and for supporting. I really do genuinely appreciate it. I'll be back very soon with another episode. The episode you just heard was professionally edited by wrong way recording wrong way. Recording.com Do.

#1338 The Facts of T1 Life

Sierra shares her experience raising 5-year-old Harper.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
We're all together again, friends for another episode of The juicebox podcast.

My notes say that Sierra is 32 years old. She's the mom of a type one. Her daughter Harper had a glucagon incident. We're going to talk about that at some point. Sierra's dad had type one as well, but she didn't know a lot about it. This is a good one. You're going to like this. Oh, wow. And look at this. Sierra has a really kind of cool job. Well, you'll find out about that in a second. 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/juice, box. Are you an adult living with type one or the caregiver of someone who is and a US resident, if you are, I'd love it if you would go to T 1d exchange.org/juice, box and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa. This is the way t 1d exchange.org/juice box. It should not take you more than about 10 minutes. I'm having an on body vibe alert. This episode of The juicebox podcast is sponsored by ever since 365 the only one year where CGM, that's one insertion and one CGM a year, one CGM one year, not every 10 or 14 days ever since cgm.com/juicebox this episode of The juicebox podcast is sponsored by us Med, usmed.com/juicebox or call 888-721-1514, get your supplies the same way we do from us med. This show is sponsored today by the glucagon that my daughter carries, gvoke hypopen. Find out more at gvoke glucagon.com. Forward slash juice box.

Sierra 2:19
My name is Sierra. I'm the mother of a type one diabetic. Her name is Harper, and she was diagnosed just after her second birthday.

Scott Benner 2:30
How old is Harper now?

Unknown Speaker 2:32
She's five now? Oh, wow.

Scott Benner 2:35
So three years so far, yes,

Sierra 2:37
she was diagnosed on New Year's Eve in 2020, so middle of covid,

Scott Benner 2:44
Sierra, your connection is a little janky. All of a sudden. I wonder why that is. You're you're dipping in

Sierra 2:50
on a mountain, so that might have something to do with it.

Scott Benner 2:54
Oh, well, that we can make allowances for also. Siri. Just thought I said Siri when I said Sierra. So I guess I'm gonna have to be careful about that. Does that happen in your house a

Sierra 3:05
lot? I don't actually have Siri, so I don't have a problem. But if I did, I'm sure I would,

Scott Benner 3:09
yeah, okay, so how high up on that mountain are you? Well, I

Sierra 3:13
can just tell you I am in Crater Lake National Park right

Scott Benner 3:16
now. Oh, this is not where you live. Then you're vacationing. Oh,

Sierra 3:20
no, I work here, but I don't live here and work here like many people do, so I commute in and commute out

Scott Benner 3:28
every day, like on a jet plane. Or how do you get in and out? Believe me, if

Sierra 3:32
there was like, a transportation device that I could just, like, step into and appear here, I would totally use it. I actually have a two and a half hour commute each morning that I spend a lot of time listening to

Scott Benner 3:43
you, but you make $8 million a year, so it's all worthwhile, right? I totally wish I'm trying to understand why you have a five hour daily commute that you're okay with. So

Sierra 3:54
I started my career with the association that I work with at the other park that we work out of, which is the Oregon caves National Monument. And I actually live in the town just outside of Oregon caves. And when my boss retired, I took her role, and I've only been in this position for a year now, moving just hasn't made sense, and I can do a lot of work remotely, so I don't have to come over here every day. It just kind of depends on the timing of the season and what's happening as far as operational changes and seasonal changes, all

Scott Benner 4:34
you had to say was, I'm a hippie. I would have understood if that's what that's I

Sierra 4:39
crossed my mind to introduce myself as a hippie, because I kind of live in a hippie community.

Scott Benner 4:45
Just said, Scott, I'm a hippie. I'm helping the world, man. And I would have been like, okay, yeah, that's right. Keep the green. My car runs on biodiesel that I make out of old vegetables.

Sierra 4:56
I'm not that much of a hippie. Well,

Scott Benner 4:59
then, yeah. Yeah, then Stolen Valor, then Sierra. You have to try harder, darn it. I'll work. Okay, so we'll all remember that you're at the top of the world while you're talking. And we'll, we'll be accepting, okay,

Sierra 5:10
surrounded by snow and beautiful views.

Scott Benner 5:13
Well, you know, it's funny how this happens to me all the time, like things happen in bunches, and it's not on purpose. But yesterday, I recorded with somebody from Australia, and we had to do kind of a similar talk in the beginning for people listening, like, look, there's going to be some glitches in the audio here, but she lives on Mars, and, you know, there's like a, like a tiny string that goes under the ocean, and that's what she's talking on. So let's all like, you know, be under. My mind

Sierra 5:36
was blown when I learned that the continents were connected by wires in the ocean, it's just so crazy to be still.

Scott Benner 5:44
I assume that most people thought I made that up, and then heard you say it too, and was like, Oh my God, is he right about that? It's a real thing. People cabling under the water. It's fantastic. Yeah, yeah. Who thought that that was a good idea? And then I like, when people in their house, they're like, I don't know if I know how to change out this screen door. I'm like, I bet you could figure it out. Anyway. So Harper was diagnosed about three years ago. Normally, we'll tell a bunch of stories and etc and ask you stuff, but you have, like, a specific story, so I like to get to them a little faster when that's the case Absolutely. But let me just learn a little bit before we jump in. So two years old, any other type one in the family, any reason for you to think there would be a diagnosis. So

Sierra 6:26
my dad had so many health issues, but he passed away when I was really young. So I don't have a full like list of what he had, but I do remember him carrying insulin and needing injections. And he would always tell us, if he passed out or became unresponsive, or anything along those lines, that we just needed to get him sugar as soon as possible. We thankfully

Scott Benner 6:52
telling me your dad had type one diabetes, but you never spoke about it that way. I

Sierra 6:56
don't know exactly I asked my grandmother after Harper was diagnosed, and she shook her head at me, and she was in her 90s and wasn't as coherent as she had been, so she she told me no, and his siblings tell me that he didn't have type one, but I like We still have his case that he carried his syringes and vials in.

Scott Benner 7:24
Yeah, so hold on. How old are you now?

Sierra 7:25
I am 32

Scott Benner 7:27
you're 32 your dad passed. How long ago?

Sierra 7:30
When I was eight,

Scott Benner 7:31
he definitely had type one diabetes. What? I

Sierra 7:35
think, too, but he had several surgeries, and he was in a really crazy the car accident while he was working for road construction in California. So I'm not sure if it was like typical onset type one or if he had organ damage that caused type one.

Scott Benner 7:53
Before we move forward, I have to ask you a question about your voice. You sound like the third female character on a sitcom, who's the sexy but too cute to be sexy friend with freckles. The way your voice breaks and cracks. Does it always do that? Are you doing it on purpose? It does okay.

Sierra 8:10
It's me.

Scott Benner 8:11
It's fine. I There's no problem with it. I just You literally like, I feel like you're five, three freckles, dark hair, bob haircut, and you're standing behind the other two actors, and you're just waiting to deliver your line where everybody's like, Oh my God, she's adorable. Like, like, are

Sierra 8:26
you looking at my Facebook page right now? Because you're like, literally, I'm five, two and three quarters, but give dark, nailed it. I do, and it's a bob cut. Hey,

Scott Benner 8:35
Sierra, we talked about this before we started recording. But I swear to you, I don't know what you look like. Tell people what we were talking about before we started recording. Oh, gosh, I don't remember about the Oh, Jesus, here you ruined that.

Sierra 8:49
Oh, you can read people. I'm so sorry. I'm nervous.

Scott Benner 8:53
That's fine. I haven't made you not nervous yet. In seven minutes, I'm slipping. Okay. So, um, yeah. Like we were talking prior about, like, my wife, who does not say a ton of kind things to me, not because she's mean, but because we've been married for a really long time, and she's probably out of stuff. I

Sierra 9:07
recall the conversation. Yes, you are a people reader, and the fact that you can, like, pick out my description is a little creepy.

Scott Benner 9:16
I am so proud of myself right now, like there's a part of me that wants to say, if you take insulin or Sulfonyl ureas, 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 in people with diabetes ages two and above that, I trust low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypopin can be administered in two simple steps, even by yourself in certain situations, show those around you where you. Or GVO kypopen and how to use it. They need to know how to use GVO kypopen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gvoke, glucagon.com/juicebox, gvoke 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 gvoke, glucagon.com/risk for safety information. Hey, Sierra was coming on to tell a glucagon story, but you don't get it now, because this is a perfect episode. And just end it right here, but we'll move forward. But anyway, I don't, I swear to you, I don't know what you look like. I don't think I've ever seen you. If I did, I didn't know it. And you just feel like that character, like the girl that came into the facts of life a few years into the run. That's who I picture. Oh my god, that is who I'm picturing. Hold on a second. I'm not familiar with that. You're young. You don't know the facts of life. Hold on facts of life. Freckles. Is that going to get me there? If that gets me there, I'm going to be really amazed. Uh, no, that just gave me a lot of people with freckles. Hold on character. With dark hair and freckles.

Unknown Speaker 11:23
Come on, Scott.

Scott Benner 11:25
Do it. Do it. She's not here. Oh, man, that pisses me off. Now I look like an ass. You know what I'm saying, because I was so close. Hold on a second. I'm gonna go one more time. Cast, okay, and then we can move on. Do you know George Clooney was in the facts of life? I

Sierra 11:41
am so out of touch with TV. Oh,

Scott Benner 11:43
it's from the 80s.

Sierra 11:44
I'm a hippie. Remember? Oh, you

Scott Benner 11:46
didn't have a TV. You guys were just like, your parents were just like, smoking outside, and you were like, that whole thing was happening. Yeah? Hold

Sierra 11:55
on, sometimes my dad had long hair and braids. Your Dad, wait,

Scott Benner 11:59
your white father had braids, yeah,

Sierra 12:03
and, and he was raised super Mormon, so like a clean cut, shaven student tie. He got away from that as fast as he could.

Scott Benner 12:12
Okay, I'm never gonna think of this actress's name, but there's literally a, I have a girl in my head that I think you look like, All right, I'll figure this out maybe, and put it at the end, but I'm not gonna bore people right now. People are like, hey, jackass, her daughter had a seizure and they needed glucagon. Can you get to it please? And I'm like, anyway, okay, so it sounds like there's diabetes in your background. Is there any other autoimmune in your life?

Sierra 12:37
My siblings have thyroid issues, and I don't know of any others my aunts, there's type two and thyroid that I know of for sure.

Scott Benner 12:49
Are you sure you don't have a thyroid issue?

Sierra 12:53
So funny, you asked that.

Scott Benner 12:55
No, it's not funny. Hoarseness is a symptom of hypothyroidism. Oh, well,

Sierra 13:01
okay, so I had some labs done less than a year ago, and my thyroid was over three, and I was put on some I don't remember the name of it, but it was a thyroid medication. And then it went up over four and then I cut out monster energy drinks from my day to day life, and started drinking a lot more water, and my thyroid levels came down, and my doctor refused to refill my thyroid medication. And then I was assigned a new primary, and she ran new laps, and now I am in normal ranges. What's the range? I know it's under two good because I listened to you. Thank you. Reduced

Scott Benner 13:51
thyroid hormone levels can lead to my ex edema, causing the vocal cords to swell, which affects their vibration and sound production. Interesting.

Sierra 14:00
This has been my whole life, though. I mean, that doesn't mean that that hasn't been a thing my whole life, but the

Scott Benner 14:06
doctor who believes that stopping drinking Monster Energy Drinks makes thyroid hypothyroidism go away. Did he palpate? I'm assuming it was a guy, because it doesn't feel like a thing. A woman would say, did he palpate the thyroid? Did he feel for lumps, goiters, nodules? Nobody's

Sierra 14:21
ever touched it, except for at my annual exam, and that was back in November.

Scott Benner 14:28
Did they say they felt nodules or anything on your thyroid? Oh, I would maybe, if I had insurance, if I was a person like you had insurance, I might say, Hey, is my hoarseness have anything to do with my thyroid? Could I get a scan? And I might ask to get my thyroid scanned. I

Sierra 14:43
actually have an appointment coming up, so I will ask for that, because I never thought of it. Thank you. Relating to sound. Thank you, yeah,

Scott Benner 14:49
no, no, no, I was thanking myself. I don't know what just happened there. I was like, literally giving myself credit, without saying why. That's okay. I have to be honest with you. So that just popped into my head. I was like, wait the horse voice, like I didn't know it first, and the our conversation brought it up to the top of my mind. So anyway, good luck with all that. I would definitely test your daughter, though.

Sierra 15:11
Yes, yeah, she gets, um, her let, well, we had her labs called in, but we have to drive an hour and a half to get them done. So we've been,

Scott Benner 15:19
yeah, well, everything's fine. You should actually get a helicopter, although I think that just killed the president of Iran, and if he can't get a decent helicopter, I'm not sure how you're going to so All right, so the kid gets diabetes. How do we figure that

Sierra 15:30
out? Typical onset, she was drinking a lot of water, peeing a lot, peeing so much. I actually posted on a local mom's group asking about like, recommendations to reduce the heavy wedding and, like, we saw how much water she was intaking, so the how much coming out made sense, but we just didn't understand, like, what was going on. And I was the kind of person that would Google symptoms and learn that I was dying, and, you know, Dread stuff, to figure out that it really wasn't actually happening. And I don't know why, but for some reason, I just didn't Google her symptoms, maybe because covid was in its throes and everything was going to kill you. So she she started out with the heavy wedding. She had been recently potty trained like consistently every night she did not wet the bed, and then she started like overflowing, so we put diapers back on her at night. The mom's group that I posted on suggested that I put in diaper liners that are basically like maxi pads that you stick in, and it adds additional absorption to the diaper, and she was filling those up and her diaper and still overflowing. Gosh,

Scott Benner 16:48
I don't think anybody's ever said the word maxi pads on the podcast, so I think you, you might have just done a first for us. Thank you. I

Sierra 16:55
just did a fist pump because yes, have to get a first. That's

Scott Benner 16:58
kind of like an old word, isn't it?

Sierra 17:00
It is kind of, yeah, but I want you to imagine, like, the biggest ones you can think of, because that's what they were like, okay, she started getting really tired, and she was sleeping through the night, which I was stoked about. I was like, bragging to my sister how my two year old was sleeping through the night, and I was getting all this awesome sleep. And I called her doctor, I listed the symptoms that she was experiencing, I asked them what they thought, and they hesitant to have her come in because of covid. So they told me that if she developed a fever or started vomiting, then they would want to see her, but for now to just hold off and see where it goes. We kept an eye on her, and we were doing home projects, DIY and just trying to stay busy. And she day before New Year's Eve at really late in the evening. So I was like, Okay, I'm gonna call her a doctor first thing in the morning. And then the next morning, she started the Kumul breathing. She was panting and Barry looked over Jake. She barely woke up. She would wake up and drink water and go right back to sleep. And so I called her doctor, and they were like, you know, you don't call unless something is wrong. So why don't you just come in this afternoon? So we got ready, packed bags, hit the road got there, like, as soon as we walked into her doctor's office, her pediatrician was like, We need to get a urine sample, which was really simple because of how often she was peeing. So they brought a little potty training toilet into the room, and we sat her down, and

Scott Benner 18:40
she was like, no problem. Here you go.

Sierra 18:41
Yeah, yeah, exactly. She pulled that sucker up and they dipped it, and then they came back in and told us that she either had pneumonia or type one diabetes that we needed to head to the nearest emergency room without stopping. We were not to get lunch, we were not to do anything, just go. And so we kind of discussed which emergency room made the most sense, and they told us to go to the one that had the pediatrician unit. They told us that they were going to call ahead, and that would actually put us closer to the airport, because they suggested that we would be getting flown to Portland, Oregon, to oasa, O, H, s, u. And so we hit the road and we drove the next 45 minutes to the hospital. And I just actually learned this last month that we went to the wrong emergency room. We went to the one that was actually closer to the airport, but not the one that had their pediatrician unit. So we went inside, we stood in line to register, and we were like, You guys are expecting us. We're pretty sure our daughter has diabetes. And they were like, just kind of shrugged, and

Scott Benner 19:51
no, we don't know who you are, lady, yeah, and

Sierra 19:56
it all makes sense now, but for the past three. Years, I was like, Why did they treat us like that? So we sat in the waiting room for what felt like forever. They finally called us back, and it took them forever to get IVs put in, because she was so dehydrated and so little too yeah, they finally got some labs drawn and they confirmed and her blood sugar was like, 458, it really like, I hear these diabetes diagnosis stories where it's like, off the charts, and I think it's because she was probably still in honeymoon at the time, yeah, going

Scott Benner 20:31
back and forth. My favorite part of the story is when you're telling all your friends, like, Oh, my kid sleeps. I'm getting so much sleep. And she's like, laying there in DKA, probably like, yeah,

Sierra 20:40
looking back, looking back, looking at pictures from that timeline, like her eyes are so sunken and she's so like she looks sick. How did you how did we miss it? But it when it's in front of you, you just don't see it. They told us that we would be flown to Portland. They didn't tell us where. They just said Portland. They said that we were waiting for one of two pediatric jets that service Oregon and Idaho, and the one that was available was about four hours away. And so they, they told me that I would be able to fly with her. And so I looked at my partner cliff, and I, I was like, go home, pack an overnight bag, get what we need, and then come back, and then you'll drive up, and I'll fly with her. And so he runs out, and he leaves, and it's just, I'm like, laying on a gurney with Harper on top of me, and they're trying to get IVs put in, and they're trying to do all of these tests and things in there. It's just not working for them. He gets back and like, right before he walks in the door. I'm not sure what their Mercy Flight staff. I'm not sure what their official titles are, their

Scott Benner 21:53
life, their life flight employees, but I don't know what exactly you were talking about. Yeah, yeah.

Sierra 21:59
So the EMTs, I guess that go on the plane. They were at the hospital. They were strapping Harper onto a gurney to get a ride in the ambulance over to the jet, and they were that's when they told me that I couldn't ride with her because of covid. Cliff walks in, we tell her goodbye, and then we run out because it's a four hour drive. Excuse me, sorry, you're fine. It's a four hour drive from Medford to Portland, normal driving speeds. But when you're racing a jet, you don't drive normal driving speed.

Scott Benner 22:35
Is that how it felt? You were like, I gotta get there before the jet. Yeah, that's amazing. So

Sierra 22:39
we hadn't eaten anything all that whole day. So we, like, ran through a drive through really quick, and then we hit the road. And staff on the jet were really great. They let us know as soon as they landed. They kept into contact with us from every step that they took, because it was like, I think it was like an hour and a half light from from where they were to where they took her, and they let us know when they transferred her over to the hospital. And then the hospital staff started calling us, and they were like, where are you right now? And I would like, tell them the exit number or the mile post. And they're like, You need to slow down,

Scott Benner 23:16
making great time. Yeah,

Sierra 23:18
yeah. And we're like, Um, no. They're like, well, like, you need to make it here in one piece and alive. And we're like, we know, but we're also going to make it there as fast as we can. So, so we made it there two days in the NICU, and then we spent another two and a half days in the ICU. And her a 1c was over 15 and,

Scott Benner 23:45
um, jeez, was it really Today's episode is sponsored by a long term CGM. It's going to help you to stay on top of your glucose readings the ever since 365 I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGMS, the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link, Eversense, cgm.com/juicebox to learn more about the Eversense 365 some of you may be able to experience the Eversense 365 for as low as $199 for a full year at my link, you'll find those details and can learn about eligibility ever since cgm.com/juice box, check it out. You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you, but I'm set up to be called if I don't respond to the email, because I don't trust myself 100% you. So one time I didn't respond to the email, and the phone rings the house. It's like, ring. You know how it works? And I picked it up. I was like, hello, and it was just the recording was like, us, med doesn't actually sound like that, but you know what I'm saying. It said, Hey, you're I don't remember exactly what it says, but it's basically like, Hey, your order's ready. You want us to send it, push this button if you want us to send it, or if you'd like to wait, I think it lets you put it off, like a couple of weeks, or push this button for that, that's pretty much it. I push the button to send it and a few days later box right at my door. That's it. Us. Med.com/juice, box. Or call 888-721-1514, get your free benefits checked now and get started with us. Med, Dexcom, OmniPod, tandem freestyle, they've got all your favorites, even that new islet pump. Check them out now at usmed.com/juice box, or by calling 888-721-1514, there are links in the show notes of your podcast player and links at juicebox podcast.com to us, med and all the sponsors, yeah, wow. Yeah, that's something.

Sierra 26:06
It is. I'm gonna take a sip of water, really,

Scott Benner 26:09
yeah. Hey, listen, while you're sipping water, I'm gonna send you something through the messenger. That's who I imagine you look like. So for people listening, I was imagining Pamela, pretty, Pamela. Pamela Adlon. I know her as an adult from California cation, and it didn't even occur to me that the girl from Californication is was the little girl from facts of life, but it is. It's the same person. Anyway, she talks like you in my estimation or my memory, which then made me think of what she looked like, and that's why I described you. It's just bizarre that you actually fit relatively that description.

Sierra 26:47
Yeah, I'm not as petite, but yeah, that's very similar. She's

Scott Benner 26:54
an actress. She's not allowed to eat. I mean, the Fair's fair. Also that lady's 57 right now. So I don't know what she actually looks like right now. I'm gonna, I'll find out anyway, that's what I was thinking of. And apparently, made a crazy living. If you go to her IMDB page, doing voiceover work and cartoon stuff,

Unknown Speaker 27:15
that's cool. Yeah,

Scott Benner 27:16
you're working too hard. You could be voicing like, you know, a cartoon.

Sierra 27:21
Hey, maybe being on your podcast will get my voice out there.

Scott Benner 27:25
Can you imagine if she finds out about this? She's like, Why was I mentioned on a diabetes podcast? Doesn't make any sense at all.

Sierra 27:34
Oh, too funny. I'm

Scott Benner 27:35
not kidding you. Though she works consistently in animation, she is probably shoveling money into her bank account. I'll be damn why are we working so hard here? I know, seriously. All right, all right. So now we're at the hospital. I'm gonna fast forward you a little bit, right? So we're at the hospital. Everything you know happens the way it happens. I imagine you guys get home, what's your management like at home? So I want

Sierra 28:00
to mention that at the hospital, we had an incredible team who reminded us over and over again that there's more to it than what we're going to be learning okay, and that things are going to be fluid and that they're going to change, and that the next time that we see them, We will know more about diabetes than they do. So I'm thankful that we ended up where we ended up, even though it was the wrong Hospital and the wrong pediatric wing and NICU. But since then, our our pediatrician has actually had another type one onset, and she sent them there instead of to OHSU, like she had intended to send us originally,

Scott Benner 28:43
interesting. Well, you ended up in the right place, then, yes, exactly,

Sierra 28:47
good. So we came home, we were MDI. We were finger sticking our don't die. Advice was to bolus her after she ate. We were supposed to carb count, give it to her, and then allow her to eat for 30 minutes. And then once she was either finished, if she finished sooner than 30 minutes, then we could bolus her, but if she was still kind of munching, she could Munch for a full 30 minutes. And then after that, we would remove any additional carbs and bullet her for what we estimated that she actually ate.

Scott Benner 29:24
So every meal was a 300

Sierra 29:28
blood sugar. Yeah, okay, at least Yeah. I was actually reviewing my my chart notes prior to the meeting to kind of see where we were then. And it was like, I was constantly calling the hospital and telling them that she was like, 366 and not coming down. And the advice was pretty regularly, well, don't correct until the four hours has passed, and give the insulin its chance. And it's I mean by bolusing after the meal, we weren't giving the insulin its chance at all. We. Were giving the food and the carbs such a head start that there was no catching up, right? We didn't have a Dexcom. We had a one month follow up that we in January. We went to back to the office in Portland in person, and they gave us a sample Dexcom and transmitter. So we got a little peek into what was happening, but only for 10 days, because we didn't know what a restart was at the time, I got to see what was happening with our blood sugars and how crazy roller coaster they were, because they told us that we could see patterns on paper. But I'm not that kind of a visual person, and I just couldn't see it until it was on the Dexcom. And then it was like, Oh my goodness. I had been on different diabetes groups on social media, and I started seeing conversations about pre bolusing and the insulin action time and all of those things. So we started dosing half of what we were giving her before she ate. And I don't know that we were really giving it enough time, but we were still dosing her before, and then we were dosing her after. And I remember this conversation with one of the mail in medical supply offices, yeah, and I told them that we were doing between 10 and 12 injections a day, and he was just like, wow, that's a lot for a little one. And it was just like a punch in the gut, because, like, I didn't want to, but it's what she needed.

Scott Benner 31:37
So you have this process that you go through where you're like, This is what you guys told us. Here's what we're figuring out by listening to other people. And that, of course, requires more injections. I do not feel good about poking my two year old this many times. And then you get better and better results. And then the response from the doctor is, wow, you're jabbing her a lot.

Sierra 31:57
Well, he wasn't a doctor, he was just a medical the medical supply, sorry, customer service, dude, yeah, but yeah, that was exactly

Scott Benner 32:04
yeah, okay. And then how did, and that hits you, how? Like, guilt. Oh, yeah, yeah, I would imagine, were you able to push past that, or did you stop injecting as much? Did it push you off of it? No,

Sierra 32:16
not at all. I was like, well, she needs what she needs, and her health is my priority, not, not your opinion, so

Scott Benner 32:23
yeah, or how badly I feel when I'm stabbing a two year old, because I I tell you what I've I firmly remembered what that felt like. And it's, it's not, it's just not fun, like, you know, like you're with little legs, and you grab them with your hand, and then you kind of have to hold them still, and you're pinching, and they're like, get away. And it's just terrible. I told that story before, but like, I can remember, like, running after Arden with, like, a needle in my teeth. Yeah, that's how

Sierra 32:51
it was with Lantis. She did not want the Lantis shot. She knew that one was gonna feel different. And yeah, she would, she would fight us on that one. The meal injection, she adapted too quickly. And she learned how to count to 10 so fast, because we were counting to 10 every time we gave her an injection, she

Scott Benner 33:10
just started talking about, I don't know something bigger, you know,

Sierra 33:14
I know

Scott Benner 33:16
quantum physics or something. Oh, she

Sierra 33:19
is so smart already. But, I mean, if I had that kind of mental capacity for sure, listen, you

Scott Benner 33:26
still think it's a good idea to drive that far to work. So I mean, you're not learning at all.

Sierra 33:35
I'm learning from you. Listen, meanwhile,

Scott Benner 33:37
what I should really be saying is you should all find jobs that are farther away from your home so that you can listen to my podcast more, because that would make me more successful, that I want more than anything. No, no, seriously, what I wanted is for you guys to be happy. This is going to be weird. Arden calling in Hold on a second. Okay, haven't done this in a while. Face Time. She may have just finished her. You have more than an hour, by the way, if we go over, okay, let's see what happens here. Hey, you're gonna be on the podcast. Is that okay? I don't know if you want to put this on the podcast. You don't want this to be on the podcast. Just listen to this real quick. Okay, well, let, let's let Sierra here, but I'll have Rob bleep it out. Okay, okay, I don't care. Um,

Speaker 1 34:25
so I, like, literally slept in because I haven't slept for like, two days, and I wake up and I'm like, let me check my emails, because mom said there's a package for me. And I'm like, looking. And do you remember a couple days ago how I told you they sent out this survey, and I filled the survey out, and I just like it on the school, okay, so apparently, with all the surveys that the school does too, like you can, like, win, like you like, win a prize if, like, your name is picking a raffle and

Scott Benner 34:52
I want a projector, seriously,

Speaker 1 34:55
yeah, it just got an email about it, and the girl in charge texted me. Good afternoon. Your survey response was chosen as last week's prize winner. You can pick up your projector from Bradley Hall. It's ready whenever you are front desk. We'll

Scott Benner 35:08
have it nice. So do you think they're trying to pay you off? I

Speaker 1 35:12
don't know, but the survey I was like, terrible, terrible, terrible, probably worse, terrible. And I just want to protect it from the school. Maybe I should start saying well, listen,

Scott Benner 35:25
either they gave you the projector to try to shut you up, or they appreciated your honesty one way or the other, you got a new projector. That's so funny. Well, good for you. Do you have any classes left? Or you just have to do the thing today? What thing you have to do a presentation? Yeah,

Speaker 1 35:43
that's my omnipodence left. I have that at five, but I have to go like, a half hour before, because we have to, like, practice or something. But I'm gonna start cleaning up

Scott Benner 35:51
my room right now. Okay, I set a higher target for you overnight, but it's over now, just so you know. Okay, all right. Well, I love you. Congratulations on your new projector. Call me later when you get it so I can say it. Okay,

Unknown Speaker 36:05
bye.

Scott Benner 36:09
So in case any of you are wondering if that's my daughter or not, by the way, Rob, you can leave all that in. She doesn't care that she won the projector. She loves the the funny part of it where she would be in the in the survey, and yet she won the projector. It's hilarious. All right, Sierra, I'm sorry about that. Could you hear that? By the way, I could Yes.

Sierra 36:28
It reminded me of like, when you give a one star review on Google and the company comes back and is like, Wait, we'll give you this. If you change your review,

Scott Benner 36:35
would you like a coupon? They were like someone give that girl a projector. She was way too articulate in this response, because she wrote, she read to us what she wrote, and it was not good about one specific instructor.

Sierra 36:51
Really. You have to be honest, or they don't know that. They need to change it. Sarah,

Scott Benner 36:55
listen, every person who sent a kid through college knows there is a semester or a class where you're thinking to yourself, I just paid an obscene amount of money for my kid to Google and YouTube things.

Sierra 37:06
I took a class at a local community college, and I felt like I wasted my time because of how many personal stories he told. Yeah, it was just a waste of time and a waste of money during

Scott Benner 37:18
covid, the teaching went down so significantly at my son's school that I called to complain, and the dean actually said to me on the phone, yeah, the quality of the education right now is not as good, but you'll still have the diploma when it's over, and you can trade off that, my gosh, like he literally said, and trade off that, it's a good school. Use our name, get a job. I'm like, won't he need to know how to, like, actually do the thing? And they were like, they were like, covid. I love how covid was an answer for everything. Like, we don't really have to educate you covid. Keep paying. Covid. Okay? All right, listen, so the kids getting the the MDI treatment. How does she manage now? Now

Sierra 38:03
she's OmniPod five and g6 Okay, and her last a 1c was 6.60

Scott Benner 38:09
good for you with a five year old. Yeah, fantastic. It's hard. No, no, no kidding. Seriously, good job. What kind of glucagon Do you carry

Sierra 38:18
now? We have the is it back? Semi, yeah,

Scott Benner 38:23
back. Semi. I like when people I like when people call it back. Squimmy, yeah, it's my favorite one. I

Sierra 38:29
had to, like, stare at the box and get the letters in the right order. So

Scott Benner 38:33
this is the nasal glucagon with the powder.

Sierra 38:35
And we just switched to that because she is starting kindergarten in the fall, and we want her to have the easiest option on her. Okay, we also have the G voc hypo pin now, because of you, when we had, is this a good time to transition into the glucagon story? Are

Scott Benner 38:54
you producing? Don't worry, I got you keep going. She

Sierra 38:59
was diagnosed New Year's Eve, and then on February 1, so just barely a month, we had the Dexcom. It was screaming that she was over 300 I think our settings were to repeat the high alarm every five minutes. And it was just like overwhelming, how much it was screaming. So I decided to give her a correction dose, which we had been very specifically told not to give nighttime corrections, because they were worried that she would go low at night and that we would be sleeping and wouldn't catch it. Because prior to getting the Dexcom sample, we were still in the waking up at 3am checking her blood sugar and going back to sleep. Some nights, we would do more finger sticks, just to like, if it was a higher activity day, we would keep better track. I opted to give her a correction, and she was at 300 when my. Her their correction and I gave her a unit which was actually less than what our correction factor was. I should have given her a unit and a half, and then we laid down. And I don't sleep when she's not in range. I'll lay down, but I like, can't turn off. So I was, I understand, yeah. So I was watching the Dexcom, waiting, watching, waiting, watching, and she's sleeping at some point below started alarming, and so we tried to wake her up, and we tried to give her carbs, and she just wasn't responding, because she was at that point in her sleep where you just couldn't get her out of it. And so we were trying to wake her up. We were sitting her up. We were like, moving her around, just doing anything that we could to try to get her to be coherent. And we were putting her juicebox straw in her mouth and trying to get her to drink it, and she just wouldn't. And she got down to 46 and I had called the on call endo at that point. Well, prior to that point, their sense of urgency in the situation just wasn't there because it was an emergency in our living room. Yeah, we were panicking and trying to get her to wake up, and she was crying and just upset. And they were just like, okay, why'd you do what you did not

Scott Benner 41:35
now, that's not what we're talking about now, exactly. And

Sierra 41:39
at the time we had the red case Lily, you mix it before you inject it, they were just like, go ahead and give her the glucagon. And I'm like, in full panic. And I have to mention that I have been through Incident Command training through work,

Scott Benner 42:00
and didn't help you that day. No, training is

Sierra 42:03
great until you're in it, and it's your child, and it's an emergency, and

Scott Benner 42:09
that needle looks like it'll go halfway into her leg. Like, you know what I mean? Like, it's like, a big needle. Yeah, huge,

Sierra 42:15
yeah. So they told me to mix it, and so I did, and then she tells me to only inject half of it, because she's so small and I don't know where my brain was, other than fight or flight mode, but I mixed the glucagon, I pulled it into the syringe, and then I sprayed half of the glucagon mixture all over our living room. Wait,

Scott Benner 42:45
like on an old TV show,

Unknown Speaker 42:47
yeah?

Scott Benner 42:53
This is your big moment. You're like, I'm on Grey's Anatomy right now,

Sierra 42:57
yeah, so that was how I got the syringe to only have half of the glucagon in it.

Scott Benner 43:03
I'm glad you find that as funny as I do, by the way, hilarious visual. You're like, hold on, okay, there we go. Did you tap it? Too? I bet you tapped it.

Sierra 43:13
I don't remember that detail, but yeah, so, so then I injected the other, the remaining half, and the woman on the phone tells me to put the remainder in the fridge in case we need it later. And I'm like,

Scott Benner 43:27
that's gone.

Sierra 43:28
I don't have any more.

Scott Benner 43:31
I also yelled clear before I did it. I don't know why.

Sierra 43:37
Oh, that needle, though. I just I remember the resistance that she had in her thigh to that needle compared to the insulin injection needles. It was just so different and so big. And they tell they warned us that it was going to burn, and so like she's screaming, because the injection is so different, and then the solution is painful, right? But it did its job, and her blood sugar came up, and she ended up back in the three hundreds. We had another glucagon kit on the hand, so it wasn't like we were completely out, right, but we just didn't have the open one anymore. And I

Scott Benner 44:18
can try to get it off the floor, but I think it's also on the sofa, so everywhere. By the way, the most on brand thing you've said this whole time is my partner cliff. I was like, of course, he's your partner. And like, just the Oregon screaming from you, Sarah, but, like, but, um, but, but, but, what was the post mortem. Like, when you guys talked about it, we've

Sierra 44:42
talked about it a few times, and we were both just, like, in so much fight or flight that neither one of us really knew what to do. And he was trying to console her and, like, get her to wake up and get her to drink juice while I'm on the phone with the on call indo not get. Using the response that I'm expecting. We actually didn't even call an ambulance after we injected the glucagon, which was part of our training, was glucagon ambulance, and then, yeah,

Scott Benner 45:12
did you do glucagon mushrooms? I might have done that like Jesus Christ. Let's go commune in the woods. This is weird.

Sierra 45:21
My goodness, that probably would have been what I needed at the time.

Scott Benner 45:26
Well, listen, at this point, I think there's some major institutions that you can get rid of this PTS day with mushrooms at

Sierra 45:33
just open. Oh, I'm

Scott Benner 45:35
sure they're going to be on every block in Oregon. Don't you worry. It's

Sierra 45:38
it's going to be just like the dispensaries every every half block. Did your

Scott Benner 45:43
dad ever yell at you? Come on in and get high. We'll get rid of it. There's a therapist here. Meet bill.

Sierra 45:50
He'll sit in the room with you. He's gonna talk

Scott Benner 45:53
through your trauma. Don't worry. Bill looks high too. No, he's not. It's fine. Okay. That's terrible. Listen, I have been through a glucagon incident twice.

Sierra 46:06
I have listened to them and they have made me cry. Yeah, no, I

Scott Benner 46:10
bet you they do. They make me cry. What I think about them? We've never actually used it, though. It's just always the irony of it. It's like we've always kind of gotten out of it right before, yeah, but we would have used it the first time, but I couldn't even figure out how to put the lily needle together. It's so complicated. It's not though, but it is when somebody's screaming at you, your kid's gonna die, that's different. Get what I mean? So we had gone

Sierra 46:33
through training both of our moms how to use the glucagon, and we're like, it's really simple. You just follow these instructions on the case. It's not simple in the moment at all. Tell

Scott Benner 46:44
me about your professional training for stuff. What were you saying earlier?

Sierra 46:49
We have gone through Incident Command training. I'm first responder CPR certified through work. When I when my career was at the Oregon caves, we would occasionally have cave emergencies that we would need to respond to, and being in a cave environment, underground and also in a very remote area with limited services, we needed to know how to respond in those emergency

Scott Benner 47:13
situations cave, what was happening? I might have helped you. Yeah,

Sierra 47:17
put put me at work, and I've got my head on straight. Listen

Scott Benner 47:20
to commiserate with you for a second. I have been in burning buildings. I have seen and worked around dead bodies. I've seen a live woman after a car accident folded in half under the dashboard of a car that we had to extricate her from, and when my kid had a seizure, I couldn't figure out how to put that thing together

Sierra 47:39
either. It's such a different situation. It's when it's not somebody who's connected to you. I can keep my head on straight, and I can stay calm, and I can call the shots. But when it's in my living room at midnight with a screaming two year old, that's my screaming two year old. Yeah? No way,

Scott Benner 47:56
yeah. I try to imagine, like, the president United States can't get Netflix to work. You know what I mean? Like, it's probably like, like, three hours earlier, they were ordering an airstrike on something, and now they're like, I can't find this new show on Netflix. Like, like, that's how I felt. Like I was like, because when it was over, I'm like, That's not who I am, you know, am I ugly? My wife was super focused, so she was good, you know, actually, had she had four hands, I'm assuming we would have got the LUCA got it.

Sierra 48:23
I wonder if Cliff had been in charge of it, if you would have sprayed it across the room. Probably.

Scott Benner 48:34
What a ridiculous sight. Anyway, she was okay. Afterwards. You didn't even go to the hospital. It

Sierra 48:38
was fine, right? No, we didn't. We didn't go to the hospital. She had some stomach ache from it. Yeah, she didn't actually vomit afterwards. They what they didn't tell us about was, and I actually haven't okay. I haven't listened to all of your recordings. I've listened to a lot, goodbye, but I haven't heard anybody else mention this either. Is the fact that the glucagon can deplete your liver from its glucose stores, right? And so there were follow up lows for like, the next two days we were constantly like, we got to a point where our endo told us not to bolus for meals, and we reduced our Lantis because her body was just storing the glucose instead of her blood sugars becoming a roller coaster.

Scott Benner 49:29
Interesting. Yeah, I believe this is mentioned in episode 789, important things to know about Chivo, kypophand, and probably in the remastered pro tip, 1014 glucagon low BGS. But yeah, like so the stuff in the needle is not the stuff that makes your blood sugar go up. It's the stuff that makes your liver go Oh. You need glucage in here and take it like it releases it from your liver. And as a matter of fact, you can maybe get away with shooting glucagon twice in a number. Urgency, but there's going to be diminishing returns as you go forward,

Sierra 50:03
right? And that's they did kind of tell us that, like, once you use glucagon, you can't exactly use it again on such a small person, so

Scott Benner 50:13
small. I mean, how big could her liver be? You know what? I

Sierra 50:17
mean? Yeah. I mean, she was just such a tiny little thing, then she still is the follow up after that was just like low after low after low, and we had to change our insulin to carb ratios. We had to change everything and just go back to bolusing after the meal, because the glucose just wasn't there for the insulin to combat anymore. In that time frame,

Scott Benner 50:43
the liver size of a human female at two years old can vary, but on average, typically weighs 300 grams. The dimensions of the liver in a young child can be roughly six to eight centimeters in length. How about that? Not crazy? All this stuff crazy. Yeah, by the way, chat, GPT four. Oh, amazing. I don't know if it's gonna take over the world or not, but until it does, I love it. If it goes to Skynet later, I'll be like, I was wrong, but for right now,

Sierra 51:11
right now,

Scott Benner 51:12
right now, it's legit. Do you think it'll play this recording as it laughs later, as it's crushing our skulls with its metal feet. Probably not,

Sierra 51:21
I hope not. If it's crushing us,

Scott Benner 51:25
it'll be like, I remember when this guy on a podcast said this, and it'll just play it outside anyway. Sorry, it's okay. Sorry, sorry, you went through all that. It sounds like, believe it or not, I feel like you held you handled it really well. I mean, we went to the hospital after the first seizure when she was two. We felt like we didn't need to, yeah, but we gave into the like, well, they told us to, and we did it. And then the next two hours were like, just we sat in the hospital and, like, why aren't we here? Like, you know, I mean, like, so even the people in the hospital we're like, you probably didn't have to come. We're like, well, great, right? Thanks.

Sierra 52:04
Thanks for that. We

Scott Benner 52:04
have this crappy meter and these needles. This is all we have. Like, we don't know what we're doing. You know what I mean, it was 2000 and, like, six, you know what I mean? Point is, I take, you know, I wish we didn't go in that scenario, and I can see where, where you would you know, can I ask? Was she? I know she's only two, so this is why I asked. Was she altered in any other way in the days after? Did you notice her like anything different about her personality? Nothing

Sierra 52:33
that stands out? I just remember that she didn't, she wasn't her. Okay? I guess I should take that back and say that she wasn't herself following up, but nothing that was like extreme. I think it was more like she was recovering from

Scott Benner 52:47
a sickness, yeah, like run down or beat up or something. Yeah, exactly. Arden was really weird after her last one for a couple days, like melancholy, almost. And I don't I never knew if it was psychological or if it was physical or a mix of it, right? But at 18, 1718, years old, she slept in our bed for like three nights afterwards.

Sierra 53:09
I don't blame her. Yeah, that's where I would want Harper and I mean, like, prior to diagnosis, she was learning how to sleep in her own bed, and then I just got her back in her own bed, like, last month, oh,

Scott Benner 53:24
you put her, like, in a nest in your room,

Sierra 53:28
yeah, yeah, till she started kicking me. And now she's no,

Scott Benner 53:33
Listen, kid, this is all well and good, but now I've got a bruise, so you've got to go. I just, I just imagine you building an eagle's nest in the corner of your room, in your tree house that I imagine you live in, if you live in a tree house,

Sierra 53:47
there are some amazing tree houses in the state.

Scott Benner 53:50
What I love about the upper Northwest is that when you make up ridiculous stuff, somebody goes, no, that's here. We have

Sierra 53:59
that. That's true. Yeah. Also,

Scott Benner 54:00
I have to take a couple screens with you so the people try again. Can you be more ridiculous? But I don't know. California's giving alcohol to like homeless people now, so I don't know what's going on. I have to hit you guys once in a while, so the Canadians feel good about how I talk to them. So yeah, I'm still sure they have pet penguins, and they just don't want to tell us, you can take it. It's excellent. Good for you. Yeah, yeah. You seem like one of those tough hippies, not like the sensitive ones. Oh, people are like, there aren't just two kinds of people. And I'm like,

Sierra 54:36
in my head, there are, yeah, it's simpler that way. And

Scott Benner 54:40
in Canada, people have pet penguins. And if you don't like it, don't listen to the podcast. I don't know what to tell you. I also know there are no penguins in Canada, but go ahead, what I would

Sierra 54:50
have a pet penguin if I was allowed to. They smell. But who would I mean? You just have to take care of it, right?

Scott Benner 54:57
Jesus Christ. Okay, my God. My. Dog is so old. I'm like, is this over yet, buddy? Like, are we done? Like, you get up in the morning. He's like, hey. And I'm like, Oh, one more time. All right, let's do it again today. His leg just feels like it's gonna fall off him. And like, Oh, my listen. I want to be clear. It's horrifying. It's so sad. But he is, like, over 16 years old, wow. And you're just like, man, it's all right. Like, you his, he's completely like, cataract over. He's incontinent. He's now his hip. And I'm just like, you look at him. You want to be like, Dude, you gotta, you gotta just, just give up. Like, it's over. You

Sierra 55:40
know what I mean? Like, just go lay in your doggy bed and go to sleep, buddy, the worst

Scott Benner 55:44
thing in the world, because it's gonna be me. Sierra, it's gonna be me when it when the time comes, someone's gonna look at me and say, You gotta do it. And then I'm gonna be the one crying at the veterinarian's office and talking to him and like, I, you know what I mean? Yep,

Sierra 56:03
I actually, I had a childhood dog who she lived to be about 16 years old, and it got to a point where it was like, okay, her quality, quality of life isn't there anymore. So we are lucky enough to have a local veterinarian that will come to your home and do it instead of you having to go into the office.

Scott Benner 56:22
It's the worst thing, like, and, I mean, I don't mean to make light of it, because I'm certainly not, but it's just like, it's, I don't know when to do it, yeah, like, you know what? I mean,

Sierra 56:33
it's such a hard decision to make, and it really sucks when you are the one who has to make that decision and make that phone call and set the appointment. It's all just awful. Yeah, I hate it all, and I

Scott Benner 56:44
want to take it all. I don't want it to be my wife. I don't want her to have to live with it like, I want it to be me, like, you know what I mean, but I like, that's big picture thinking, like, small picture thinking I just look at him, like, if you could just close your eyes, that'd be great, you know, because so peacefully. Yeah, please. Meanwhile, Arden comes home in like, three or four more days, and she knows how bad he is, and she's just like, is Indy gonna be okay till I get home? And we're like, yeah, sure, it's gonna be fine, you know? So we're trying really hard to get him to her return, which is even, that's even another strange thing, like, I don't know why people have kids, because you have to think about all this stuff you don't even like. Is it better for the dog to be put to sleep when she's not here, or when she is here, or like, like, I don't know, like, you know what I mean. So it's gonna work out the way it works out. I guess I don't know why we got through that off of, oh, because pet penguins. Yeah, if the penguin was gonna die, I'd be like, Oh, the penguin died. I think I'd be Oh, I

Sierra 57:39
think it would be so heartbroken. I love penguins. OmniPod,

Scott Benner 57:42
you love penguins. Have you ever seen a penguin? Cute?

Sierra 57:45
They are so they're so awkward on land, and then they are just like, so smooth in the water, and they can fly. They just have to be underwater.

Scott Benner 57:54
I know otters are cool too. Otters are really cool. Yeah, I don't know if that's not what we're talking about, though, but otters are fascinating to watch, like swim and pop out of the water and do apparently, they're very nasty animals.

Sierra 58:04
Oh, we have river otters here. I've seen them a few times in the wild. Yeah, they're

Scott Benner 58:10
apparently not pleasant. Oh, well, I like them. Beautiful to watch, beautiful to watch, hard to interact with.

Unknown Speaker 58:17
Yeah, yeah. I

Scott Benner 58:19
think I just described my wife. Oh, I can't wait to get a review about that. One more misogyny from this guy says his wife's like a river otter. Every once in a while is here. About every six months, I get somebody who can't hear sarcasm, and then I get a review from them. They always make, by the way, those always make me laugh the most. I'm like, Oh, wow, you've misunderstood that significantly. That's crazy. But whatever Are we done talking about this? Do you have any other details that I have not drawn from you?

Sierra 58:55
Since that incident, we learned how to get her to drink juice while she's sleeping, instead of having to wake her up and force her into being coherent, she has had severe lows since, not many, but one time she was awake and coherent, and she was telling me that she felt weak and shaky. And so we did a finger stick, and she was at 26 Wow. And we were able to give her some marshmallows and some juice boxes, and she was able to rebound on that one on her own. And looking back on the glucagon situation, I don't think that we necessarily needed it. I think we were just so new and so panicked that we just took the don't die advice and did what we could. Yeah, it was definitely dramatic, but I look back on it now and I laugh. And I just was recently listening, and I heard that, not scared, prepared episode. And I just, I love that so like as we move in and transition into her. For riding a school bus and being taken care of by school staff. That's my plan. Is to be prepared and not be scared.

Scott Benner 1:00:06
Good for you. Oh, I think it's probably the only way to live honestly and honestly, even with this conversation, I don't know another way to talk about this except joke through it and make stupid. Like, if I actually had you come on here and tell, like, a somber story about this. Like, first of all, I don't think anybody would listen to it. And secondly, if they listened to it, when they got to the end, they'd feel like, you know, throwing themselves in front of a bus. Like, I don't want people to feel that way. Like, I want them to know like, this could happen, and you need to be ready. And here's how it works, you'll probably be fine. Like, get in there. Like, you know what I mean, like, and try not to think about it every day, because you can't live like that either. You know you can't. Yeah, that's why I appreciate when people share these stories seriously like, you know, I keep doing them whenever somebody offers one, just because I think that. You know, it's important to be knowledgeable and not scared, but it's also important to be honest about what it's like and in the moment, it's terrifying, it is horrible. Yeah, yeah. There's no way to sugarcoat it. Like you think someone's dying in front of you and you feel like you have a split second to change it. Yep, yeah. So yeah. And

Sierra 1:01:14
a simple decision in that moment could take you the wrong direction.

Scott Benner 1:01:19
It's hard, yeah, yeah. Oh, no, we'll make it. I don't need this, and that's why I can't begrudge you shooting it then later saying, like, oh, we probably didn't need to do that. I say to that, Oh, well. Like, you know, better safe than sorry in that situation for sure. You know absolutely yeah, but I've talked about this on a couple of others, but you know, I did this in person. Talk one time. There's like, three, 400 people there. They were adults who either had diabetes or were the the spouse of somebody with type one. And they were more newly diagnosed, some of them, but not all of them. And when I brought up glucagon, no one knew what it was like. They didn't know what it was. They didn't have it in their house. They wouldn't know how to use it if they had it, like they were they were like, wait, what? Some people were like, What happens if your blood sugar gets too low? Like, they didn't even know. And I think, like, it's incumbent upon somebody to talk about it once in a while, you know? So, yeah, I appreciate you doing this all the way from, like, whatever mountaintop you're on right now.

Sierra 1:02:16
I'm on a volcano.

Scott Benner 1:02:17
Are you really I am I imagine you make $25,000 a year and you're living off of bread crumbs. Is that true or like, do people do people like? No good. You're being paid reasonably.

Sierra 1:02:28
I'm being paid I wouldn't drive two and a half hours if it wasn't worth it. Is

Scott Benner 1:02:32
it one of those jobs nobody else wants, so they have to pay you more? No, no. Okay, it's

Sierra 1:02:37
It's the great association we fund the education in science here. Nice. I find a lot of pride and joy in it, and I've always loved to be outside. So to get to be paid, to be in a situation where I get to be surrounded by beautiful wilderness, I couldn't ask for a better situation.

Scott Benner 1:02:54
I hope your end doesn't come at the hands of a bear. But other than that, that's really nice. Okay, so

Sierra 1:03:00
before, before you let me go, you got a bear story last I guess it was two winters ago. It was the first snowfall of the winter, and I was the first person at the office at Oregon caves, where I was working at the time, and I decided that I was going to go on a solo hike. It's just a one mile loop up and over the cave, but I found bear tracks in the snow, and I started to follow them. And then my like sense of self awareness popped up, and I realized that I didn't want to die by the paws of a bear. And I turned around and went back. What

Scott Benner 1:03:38
in the hell made you not go the opposite way the paws of the bear.

Sierra 1:03:42
I wanted to see a really clear print in the snow, like they were just kind of like kicked around, like it had come onto the trail and turned around. So the prints weren't like that crystal clear paws and toes kind of look. So I like started following them initially, to get a picture of a better paw print.

Scott Benner 1:03:59
You weren't doing this for a photo for Instagram.

Sierra 1:04:02
I'm not even on Instagram. It was just my own personal self.

Scott Benner 1:04:07
How long did you track the bear before you thought to yourself, oh, I probably shouldn't track a bear. It

Sierra 1:04:12
was probably within like, 10 feet of the trail, and that's when I was like, I don't want to actually die today. It was just a black bear. But still, yeah, I'm

Scott Benner 1:04:21
sure that would be comforting when it was slicing your throat open. Oh, look, it's only a black bear.

Sierra 1:04:30
I could take a black bear.

Scott Benner 1:04:31
I'll just punch him in the groin like it would be like a Bugs Bunny cartoon. He'll probably run away. Listen as I make fun of you, I've told this story on the podcast before, but I had somebody do something to me in traffic once, when I was young and I was on a motorcycle, and I got so mad that I pulled off this side of the road and through traffic, went after the person, like, I don't know what I was thinking I was gonna do. They almost killed me, and they did it on purpose. And when I was maybe two width of a car. Away, the driver disappeared and then popped back up from their glove compartment and pointed a Glock at me. Oh my gosh. And I still took more steps after I realized it was a gun, yeah. And I think about that all the time, like, why didn't I just stop? Like, what is

Sierra 1:05:16
just going and your brain was like, stop.

Scott Benner 1:05:18
And by the way, I'm not like, I don't know. I was only gonna yell at him, like, Do you know what I mean? Like, I'm not I listen. I know myself. I physically couldn't manhandle a person to begin with. Like, like, I wasn't like, you know, I just wanted to be like, my god, what are you doing? You almost killed me. And it was crazy. What I was doing. Make no mistake, it was also the early 90s. You were allowed to be crazy, then it didn't really matter. There's no rules. Like, there is now, like, right now, they'd be like, he's insane. Put him down. I'm like, that's how we all acted in the 80s, just so you know. And so it wasn't just me, no, no, no, but yeah, I saw that gun, and I was, like, my brain registered gun, like, enough that I knew what kind of a gun it was, yeah. And I kept going at like, toward like, forward. And then I went in my and then my conscience hit me, and I put my hands up, and I went, sorry. And I just backed away. Oh, my goodness. I feel like that's what happened to you when you realized I shouldn't be tracking a bear, you went like that, yeah, oh, I gotta go. What am I doing?

Sierra 1:06:17
This is not a smart decision. Abort.

Scott Benner 1:06:21
I'm an idiot pretty much, yep, no wonder I couldn't figure out that glucagon. Jesus, God, moron. You and I could have a podcast together. You're fantastic.

Sierra 1:06:37
Thank you.

Scott Benner 1:06:38
You're welcome. I'll never have you back on No, I'm just kidding. I try not to repeat guests. That's all I meant. Yeah, you were really lovely, and I appreciate you doing this and retelling what I'm sure is a difficult story to help people. So thank you very much. Sincerely. Is very kind of you.

Sierra 1:06:58
Thank you. I appreciate it, of course. Hold

Scott Benner 1:07:00
on one second for me,

the conversation you just enjoyed was brought to you by us. Med, us, med.com/juicebox, or call 888-721-1514, get started today and get your supplies from us. Med, are you tired of getting a rash from your CGM adhesive? Give the Eversense 365 a try. Eversense cgm.com/juicebox, beautiful silicone that they use. It changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. A huge thank you to one of today's sponsors, gvoke glucagon. Find out more about gvoke hypopen at gvoke glucagon.com, forward slash, juicebox. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash 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 I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, do.