#1754 Bolus 4 - McDonald's
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Scott and Jenny discuss how to bolus at McDonald's
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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) Friends, we're all back together for the next episode of the Juice Box podcast. (0:04) Welcome. (0:15) While you're listening, please remember that nothing you hear on the juice box podcast should be considered advice, medical or otherwise. (0:23) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (0:32) In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus.
Scott Benner (0:38) Jenny and I are gonna follow a little bit of a road map called meal bolt. (0:42) Measure the meal. (0:44) Evaluate yourself. (0:45) Add the base units. (0:47) Layer a correction.
Scott Benner (0:48) Build the bolus shape. (0:49) Offset the timing. (0:50) Look at the CGM. (0:52) Tweak for next time. (0:54) Having said that, these episodes are gonna be very conversational and not incredibly technical.
Scott Benner (1:00) We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. (1:07) So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking. (1:14) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. (1:20) In today's episode, we're gonna head over to Ronald McDonald's and see what he's got to offer. (1:31) This episode of the juice box podcast is sponsored by the Kontoor next gen blood glucose meter.
Scott Benner (1:37) Learn more and get started today at Kontoor next dot com slash juice box. (1:43) Today's podcast episode is sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the instinct sensor made by Abbott. (1:58) Would you like to unleash the full potential of the MiniMed seven eighty g system? (2:02) You can do that at my link, medtronicdiabetes.com/juicebox. (2:08) I'm hitting record to tell Jenny this because I don't want her to be able to argue with me too much.
Scott Benner (2:13) This is like Okay. (2:14) This is like asking your wife for something in public. (2:16) Feel like
Jenny Smith (2:18) I feel backed into a corner all of a sudden.
Scott Benner (2:21) Don't worry. (2:21) You will be. (2:24) Will you help me do something today? (2:26) And I know you won't have any trouble with this. (2:28) I shouldn't joke like this.
Scott Benner (2:29) But I want to do some bolus for some stuff that I know that you're gonna wanna tell people not to eat the whole time, but I'm gonna ask you not to do that.
Jenny Smith (2:37) And I yes. (2:38) A 100%. (2:39) And I will say that, have I said that before? (2:41) Like, please don't eat this? (2:43) Maybe I have, and I'm sorry if I've done that.
Jenny Smith (2:45) Because every everybody's thing you put in your bot, it's entirely your choice. (2:48) I certainly just want you to cover it the right way, which is obviously the intent for the bolus four to begin with.
Scott Benner (2:54) Exactly.
Jenny Smith (2:54) So, yes, I I don't want people to be like, oh my god. (2:57) Jenny doesn't well, no. (2:58) No. (2:58) No.
Scott Benner (2:59) I think your intention has been very clear. (3:01) It's just this one's going to knock you over, and I just want you to be able to breathe through it. (3:05) That's all.
Jenny Smith (3:06) It's worse than the boba tea.
Scott Benner (3:08) I don't know. (3:08) That one worked well and
Jenny Smith (3:09) knocked me over. (3:10) I was like, what?
Scott Benner (3:11) I gotta tell you, I thought it was I didn't think it was going to be, but as I picked through and looked at the things that I wanted to talk about today and some of the stuff I picked out, I it's I mean, it's gonna be some significant insulin and and some significant extensions and stuff like that. (3:27) But
Jenny Smith (3:27) But it's also stuff people are doing.
Scott Benner (3:30) Here's where it came from. (3:31) It came from me the other day listening to somebody talk about something, and
Jenny Smith (3:35) they Okay.
Scott Benner (3:36) They talked about how many Happy Meals are consumed in America. (3:41) McDonald's Happy Meals. (3:42) So today, we're gonna bolus for McDonald's. (3:44) Okay? (3:44) We're gonna pick out a few different things.
Jenny Smith (3:47) Okay.
Scott Benner (3:47) I'm gonna give you the number. (3:49) Actually, let's let you guess. (3:50) How many Happy Meals cheeseburger Happy Meals do you think are sold daily in The US?
Jenny Smith (3:58) I don't oh my god. (4:00) I don't even know. (4:00) A million? (4:01) I don't know. (4:02) I have no idea.
Scott Benner (4:03) Two and a half to 3,000,000 a day, they think sales exceed about 1,000,000,000 annually.
Jenny Smith (4:11) Isn't that still on their signs, McDonald, like this many billions served or something? (4:16) I don't know.
Scott Benner (4:16) I mean, it's a
Jenny Smith (4:17) It used to be when we were a kid, we'd wait for the number to change.
Scott Benner (4:20) Yeah. (4:20) It's a hell of a flex, I'll tell you that from a business perspective. (4:24) But I heard that somewhere, I thought, okay. (4:26) Like, that means they're they're beaten. (4:28) They're being eaten all the time, so we should talk about it.
Jenny Smith (4:31) Like, you know,
Scott Benner (4:32) you know? (4:32) And so I am going to I'm also gonna I'm gonna put I'm asking you to put yourself out. (4:38) I'm gonna put myself out here too. (4:40) I've, you know, I've put together a calculator to to help you put meal boluses together. (4:46) I've not made it public yet.
Scott Benner (4:47) I am gonna make it public for this episode and and leave it up. (4:51) It's gonna be behind a pretty big disclaimer you're gonna have to click on before you get to it, but it asks you for your insulin to carb ratio, your insulin sensitivity factor, your target blood sugar. (5:03) It sets a max bolus limit at 25 as a default. (5:08) You can enter carbs, fat, protein, your current blood sugar, any insulin on board, if your arrow is stable, rising, or falling, and then it will generate a meal strategy for you.
Jenny Smith (5:19) Okay.
Scott Benner (5:20) Great. (5:21) So I'm gonna we're gonna use that today while we're talking about this.
Jenny Smith (5:24) Cool.
Scott Benner (5:25) So cool. (5:25) Hold on a second, Jenny. (5:27) Hold on to your hat. (5:28) Okay? (5:28) What do you wanna start with?
Scott Benner (5:29) Should we start with do you wanna start with a Happy Meal? (5:32) Because I brought it up first.
Jenny Smith (5:33) Let's start with a typical cheeseburger Happy Meal. (5:37) Why not?
Scott Benner (5:38) Cheeseburger Happy Meal. (5:40) Let's see. (5:40) Well oh, here's the double quarter pounder with cheese. (5:43) We'll get back to that. (5:45) Okay.
Scott Benner (5:46) Menu. (5:48) I have to tell you this. (5:50) Huge props to to them. (5:53) They don't hide anything. (5:54) This
Jenny Smith (5:54) No. (5:55) Website is all there.
Scott Benner (5:56) Very easy to get through. (5:58) Hamburger happy
Jenny Smith (5:58) What website are you using?
Scott Benner (6:00) Mcdonald's.com.
Jenny Smith (6:01) Oh, McDonald's. (6:02) Okay.
Scott Benner (6:03) Yeah. (6:03) It's very clear. (6:04) Hamburger Happy Meal, 475 calories. (6:07) Now we're gonna choose some, like, standard numbers to do these with today. (6:12) So let's use insulin to carb ratio 10.
Scott Benner (6:14) What do you think a common insulin sensitivity factor would be 50. (6:19) 50? (6:19) K. (6:20) We'll make that 50. (6:21) I'm gonna make the target blood sugar 90, and I don't even wanna make you guess, Jenny.
Scott Benner (6:27) A cheeseburger happy meal comes with milk, a fry, apple slices, and the burger.
Jenny Smith (6:36) Okay.
Scott Benner (6:36) Okay?
Jenny Smith (6:37) Does it still come with a prize?
Scott Benner (6:39) I'm sure it yeah. (6:40) It does. (6:40) Actually, there's a whole part of the website that, like, tells you, like, what toy is available right now.
Jenny Smith (6:44) Oh, that's fancy.
Scott Benner (6:45) 475 calories. (6:47) This is not cheese, by the way. (6:49) This is the this this is
Jenny Smith (6:50) Cheese food.
Scott Benner (6:51) This is well well, they I'm saying this is the hamburger version of it.
Jenny Smith (6:55) Oh, okay.
Scott Benner (6:56) Okay. (6:57) Total carbs for this thing, you wanna just like, go ahead and guess, but you don't have to think about it. (7:02) Just try to guess.
Jenny Smith (7:03) Sure. (7:04) I mean, I'm a this is just the burger one, not the cheeseburger one.
Scott Benner (7:08) Yep.
Jenny Smith (7:09) The burger probably has about 30 grams in the bun would be my estimate. (7:16) I expect, unless they've changed it, that their french fries are a small fry.
Scott Benner (7:22) Yeah. (7:22) It's pretty small.
Jenny Smith (7:23) Right? (7:24) So probably also about 30 grams of carb for the french fries. (7:29) Mhmm. (7:30) The apple slices, maybe somewhere between 10 to 15 grams depending on how many are in the package. (7:39) Okay.
Jenny Smith (7:41) And milk is usually in a carton about 12 grams.
Scott Benner (7:45) Yeah. (7:45) So
Jenny Smith (7:45) this carb. (7:47) If you just want the carbs, I mean, I don't know if you want proteins and stuff too as a guess.
Scott Benner (7:51) Well, it has it it's telling us here that it's it's 60 as a total. (7:56) Six Oh, wow. (7:57) 60 carbs total. (7:59) I'm gonna take them at their word. (8:00) Total fat Really?
Jenny Smith (8:02) For all of
Scott Benner (8:03) Wait. (8:03) Wait. (8:03) Do we get
Jenny Smith (8:03) That's interesting.
Scott Benner (8:04) To get to the bigger one.
Jenny Smith (8:05) Maybe the maybe the serving fries is smaller then.
Scott Benner (8:07) Okay. (8:08) 16 grams of fat total. (8:11) Protein total, 22. (8:14) This is all listed on their website. (8:16) I'm gonna Okay.
Scott Benner (8:17) I'm also gonna give you all the benefit of the doubt that you've listened to the pro tip series already. (8:20) Your blood sugar's a 100. (8:21) I'm gonna make your current blood sugar 100. (8:23) No insulin on board. (8:24) Stable arrow.
Scott Benner (8:26) Okay. (8:28) This says that you should start with a 6.2, and then you're going to need a two point three unit extended bolus over about four hours total dose.
Jenny Smith (8:42) Fat and protein.
Scott Benner (8:43) Yep. (8:43) Total dose, eight and a half units. (8:46) Sound like
Jenny Smith (8:47) And the 6.2 is because target is 90 and blood sugar was a 100?
Scott Benner (8:51) Yes.
Jenny Smith (8:51) That extra point two. (8:52) Right? (8:52) Okay.
Scott Benner (8:53) Yeah. (8:53) It's trying trying to get you to target. (8:55) Okay. (8:55) Okay. (8:56) So now there you go.
Scott Benner (8:57) That's a that's a a hamburger happy meal. (9:00) Now let's pretend you're not a kid, and you're like a like a regular person, and you just want a french fry, Jenny. (9:06) You just want a large fry. (9:08) Right?
Jenny Smith (9:08) A large fry.
Scott Benner (9:09) Yeah. (9:09) Well, your time of the month is coming. (9:11) You're out on the road. (9:11) You're driving around. (9:12) You think, oh, salt and Styrofoam.
Scott Benner (9:15) This is what I want. (9:16) Okay?
Jenny Smith (9:16) I guess.
Scott Benner (9:17) Okay. (9:18) And we're gonna leave everything the same, but change the carbs. (9:22) Now in that large fry, there are 65 carbs Yep. (9:28) 23 grams of fat. (9:31) There's actually seven grams of protein in there.
Scott Benner (9:34) So just a large fry if your current blood sugar is a 100, you have no insulin on board, just a large fry is six point seven
Jenny Smith (9:43) Point seven.
Scott Benner (9:43) Units. (9:44) Yeah. (9:45) And it's asking for a 2.35 extended over four hours for the fat.
Jenny Smith (9:50) You So even
Scott Benner (9:51) You'll think that's a little heavy? (9:53) Right? (9:53) You think worsens
Jenny Smith (9:53) are a heavy? (9:54) Curious what so well, we had a whole packaged meal before that had I'm assuming about the same amount of fat in it as this does. (10:05) Right? (10:06) Yeah. (10:06) To make it about the same for the fat protein extension.
Scott Benner (10:09) I think there's about six more grams of fat in this, but there's Uh-huh. (10:13) There's less sugar in this.
Jenny Smith (10:14) Less sugar?
Scott Benner (10:15) Yes. (10:15) So there's no so total sugars in the fries, zero. (10:20) Total
Jenny Smith (10:20) sugars Added sugars. (10:22) Let's be clear about that.
Scott Benner (10:24) It says total sugar zero. (10:25) Added sugar zero.
Jenny Smith (10:27) Right. (10:27) Which means that these aren't no carbohydrate. (10:30) They're just I have no sugar added.
Scott Benner (10:32) They didn't sprinkle any sugar over top of
Jenny Smith (10:34) it. (10:34) Yes.
Scott Benner (10:34) Yes. (10:35) There was more sugar in the Happy Meal because of Uh-huh. (10:38) The apples, I would imagine.
Jenny Smith (10:40) And the milk.
Scott Benner (10:40) The little milk and the whole other thing. (10:42) Right? (10:42) But my point in doing this one next is the hamburger happy meal and the large fry, basically the same bolus as Mhmm. (10:51) As far as it goes. (10:52) Right?
Scott Benner (10:53) Now why don't we do why don't we do just a quarter pounder with cheese
Jenny Smith (11:00) or Okay.
Scott Benner (11:02) Royale with cheese if you've seen Pulp Fiction? (11:05) Yes. (11:05) Yes. (11:05) You have.
Jenny Smith (11:06) Many times.
Scott Benner (11:07) My god. (11:08) I know probably, like, once a year for quite some time. (11:10) 42 carbs. (11:12) This is just the burger. (11:14) 26 grams of fat in the burger.
Scott Benner (11:18) Protein, 30. (11:21) That's encouraging somehow. (11:25) So just the quarter
Jenny Smith (11:26) Because you know we're all supposed to be eating more protein and fat now. (11:29) Right?
Scott Benner (11:29) I heard that. (11:30) Yeah. (11:30) I
Jenny Smith (11:31) to sneak that in there.
Scott Benner (11:33) So this this just this quarter pounder with cheese, 4.4 unit meal bolus with three and a half, 3.54 over five hours. (11:43) And you'll probably tell me five hours is a little long, you think? (11:46) Or
Jenny Smith (11:46) might be. (11:47) Mhmm. (11:48) But it's a good I would have guessed probably at least four.
Scott Benner (11:53) Okay.
Jenny Smith (11:55) Again, everybody's digestion in terms of that is a little bit different. (11:59) So it's one of those experimental, but you go with what's recommended, and then you make if this is your thing to do once a week on Friday on your way home from work and that's what you like, then
Scott Benner (12:09) Right on.
Jenny Smith (12:09) At least you got enough experimentation time.
Scott Benner (12:12) I I'm telling you that I'm doing this a little bit because I want people to see that the calculator is kind of a quick easy way to, like, figure out some things. (12:20) I also kinda want them to to I want people listening to think, oh, I would not have guessed that much. (12:26) Like, that's kind of that's my kind of idea here.
Jenny Smith (12:29) Well, I know and I think it's it's valid because it is something that over and over when I work with people individually, it comes into the discussion, and there's there's a piece that I can see in people's face Mhmm. (12:43) You know, when we're talking about it that I never I never thought about that. (12:50) Even though we've had this fat protein piece already in the mix for several years now, it's been a little bit more forefront in discussing the impact. (13:01) I do I do see that people still undercover it, though, And I expect from a consideration of more worry that it's how can I really need this much more insulin?
Scott Benner (13:14) Yeah.
Jenny Smith (13:14) I was only ever taught to count the carbohydrates.
Scott Benner (13:17) Right.
Jenny Smith (13:18) How is it that I missed covering so much? (13:21) And now that I start using it, you see improved glycemic control, which is fantastic.
Scott Benner (13:28) Are there some people who just don't need the bolus for fat? (13:31) Because they come to me online, though. (13:32) Like, they're like, listen. (13:33) I never need the bolus for fat, or do you think their settings are just so wonky and they're used to giving themselves so much insulin they're covering it and not realizing it? (13:41) Unlike other systems that will wait until your blood sugar is a 180 before delivering corrections, The MiniMed seven eighty g system is the only system with meal detection technology that automatically detects rising sugar levels and delivers more insulin as needed to help keep your sugar levels in range even if you're not a perfect carb counter.
Scott Benner (14:02) Today's episode of the Juice Box podcast is sponsored by Medtronic Diabetes and their MiniMed seven eighty g system, which gives you real choices because the MiniMed seven eighty g system works with the Instinct sensor made by Avid, as well as the Simplera Sync and Guardian four sensors, giving you options. (14:23) The Instinct sensor is the longest wear sensor yet, lasting fifteen days and designed exclusively for the MiniMed seven eighty g. (14:32) And don't forget, Medtronic Diabetes makes technology accessible for you with comprehensive insurance support, programs to help you with your out of pocket costs or switching from other pump and CGM systems. (14:45) Learn more and get started today with my link, medtronicdiabetes.com/juicebox. (14:51) The Kontoor Next Gen blood glucose meter is sponsoring this episode of the juice box podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company.
Scott Benner (15:05) That's right. (15:06) If you go to my link, contournext.com/juicebox, you're gonna find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, and Meijer. (15:18) You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the Contour Next Gen and Contour Next test strips in cash. (15:30) What am I saying? (15:31) My link may be cheaper out of your pocket than you're paying right now even with your insurance.
Scott Benner (15:37) And I don't know what meter you have right now. (15:40) I can't say that. (15:41) But what I can say for sure is that the Kontoor Next Gen meter is accurate. (15:46) It is reliable, and it is the meter that we've been using for years. (15:50) Kontoornext.com/juicebox.
Scott Benner (15:54) And if you already have a contour meter and you're buying test strips, doing so through the juice box podcast link will help to support the show.
Jenny Smith (16:02) A blanket answer would be that something else behind the scenes has likely not been tested without the amount of fat that they've been typically eating. (16:14) Mhmm. (16:15) I mean, high fat is usually deemed at more than about 20 grams per sitting. (16:20) Right? (16:20) And at that point, the very good potential that you're going to see an impact in the later hours after that meal.
Jenny Smith (16:29) Same thing with proteins. (16:30) More than about twenty, twenty five grams of protein in a typical sitting or eating time, you have the potential to see a drift up later. (16:40) Yeah. (16:41) Again, nothing to do with the carbohydrates that you probably really precisely counted. (16:46) But as you said, I I think that there may be the fact that people have just tested their background settings, their basal, with some of the stuff in the picture that they didn't know was important to keep out to get a true base.
Scott Benner (16:58) Mhmm.
Jenny Smith (16:59) So it's making up for an issue in a way.
Scott Benner (17:03) Let me make your point. (17:04) I just I still had the numbers up from the quarter pounder with cheese. (17:08) I deleted the carbs. (17:09) So now the bolus is zero carbs, 26 fat, 30 protein. (17:13) It wants you to bolus point two up front, but to set up a 3.54 unit bolus over five hours.
Scott Benner (17:21) And that's with no carbs whatsoever, just the protein and the and the fat. (17:24) Which
Jenny Smith (17:25) is and if you're using this as an extended, which is what we're talking about from this recommendation. (17:30) Right? (17:31) An extended nature for those who are mostly eating either ketogenic or paleo, very low carb, higher protein, or all very high fat. (17:43) The idea is often covered with our insulin. (17:47) So there is no extended need Mhmm.
Jenny Smith (17:50) Because that type of insulin hits in a very slow continual time period over the time that you would need coverage for these. (17:58) And so it has been figured out.
Scott Benner (18:01) Yeah. (18:01) Yeah. (18:02) If you go to juiceboxpodcast.com, there's guides up in the menu, and you choose fat and protein insulin calculator. (18:09) It will, after you agree to the disclaimer, it'll explain the Worsol method to you in painful detail so that you can you can understand it. (18:18) There's also four episodes linked there that you can list to about fat and protein in the Worsaw method, and there's a small calculator there just to help you with fat and protein aside of of carbs.
Scott Benner (18:30) That's not a that's not the full calculator that I'm using here. (18:33) I actually I guess I'm gonna have to decide on the link right now while we're talking because I'm gonna wanna put it in here. (18:39) But first, Jenny, it's a special day. (18:41) You've lost your mind. (18:43) You've stopped at the the McDonald's.
Scott Benner (18:46) Do you want
Jenny Smith (18:47) It is a special day.
Scott Benner (18:48) It's a special day. (18:49) Do you want a Big Mac meal, a quarter pounder with cheese meal, a bacon quarter pounder with cheese meal, a quarter pounder with cheese deluxe meal, a double quarter pounder with cheese meal, 10 piece nuggets. (19:02) You're gonna pick the damn nuggets. (19:03) Spicy McCrispy meal. (19:06) Spicy McCrispy.
Scott Benner (19:07) That's not easy to say. (19:10) What what or you want a fish fillet? (19:11) What do you want? (19:12) What's Jenny gonna get? (19:13) Because we're gonna do that one next.
Jenny Smith (19:15) If literally, because somebody was like, you have to pay.
Scott Benner (19:19) Well, yeah. (19:19) I'm forcing you to buy something at McDonald's. (19:21) Which one do you gonna buy? (19:22) Which one?
Jenny Smith (19:22) Be the it would be the fish.
Scott Benner (19:24) You're such a baby. (19:25) You should have picked a double burger. (19:27) I will do the fish.
Jenny Smith (19:28) For I don't eat other than fish.
Scott Benner (19:31) People love the fish fillet. (19:32) Hold on a second. (19:33) Fish fillet meal, 950 calories. (19:37) Fair enough. (19:38) 21 protein.
Jenny Smith (19:40) This is a meal. (19:41) This isn't just
Scott Benner (19:42) Oh, Jenny.
Jenny Smith (19:43) I have to eat a whole
Scott Benner (19:44) No. (19:44) No. (19:44) No. (19:44) Listen to me. (19:45) Fish
Jenny Smith (19:46) Are you gonna make me eat a shake?
Scott Benner (19:47) Filet o no. (19:49) Filet o fish meal. (19:50) Right? (19:50) It's got a Sprite with it. (19:53) And it's a classic fish sandwich, hold on, featuring a crispy fish fillet patty made with wild caught Alaskan pollock on melty American cheese topped with creamy McDonald's tartar sauce.
Scott Benner (20:02) That's not bad. (20:03) There are 950 calories in the fish o Filet O Fish meal at McDonald's with a medium Sprite and a medium World Famous fry. (20:12) So you're gonna get a medium Sprite, a medium fry. (20:15) Jenny's gonna drink soda and go to McDonald's on the same day. (20:17) You're gonna get a medium Sprite, a medium fry, and a Filet O Fish.
Scott Benner (20:21) Only 950 calories. (20:23) But how many carbs? (20:25) Just say the first number that pops in your head.
Jenny Smith (20:27) A lot. (20:28) Oh my I don't a lot.
Scott Benner (20:29) 145.
Jenny Smith (20:30) A lot.
Scott Benner (20:30) There's a 145 carbs in it. (20:32) Okay. (20:32) And
Jenny Smith (20:33) guess, yeah, one fifty would have been like
Scott Benner (20:35) 34 fat. (20:36) Fat. (20:37) Protein, 21. (20:39) Let's make
Jenny Smith (20:39) Lower protein than I would have expected, honestly.
Scott Benner (20:42) Oh, it's probably not actually fish. (20:43) And then I'm gonna hit It says
Jenny Smith (20:45) it's Alaskan pollock.
Scott Benner (20:47) And and and because it's you, Jenny, I'm gonna put a falling blood sugar arrow, and I'm gonna make your blood sugar 80 in this scenario. (20:55) Okay? (20:56) Because I figure you prepped before you got to the McDonald's. (20:59) You're gonna need, if your insulin to carb ratio is 10, your insulin sensitivity is 50, you are gonna need an initial bolus of 14.9 units and a Warsaw, bolus extended over five hours of 3.9 for a total of 18.8 of insulin. (21:17) How many did you have yesterday?
Scott Benner (21:20) Insulin. (21:22) Wait. (21:22) She's throwing up in her mouth. (21:23) Give us a
Jenny Smith (21:24) second. (21:24) Sorry.
Scott Benner (21:25) Tell everybody, Jenny, you're a nutritionist. (21:27) Right? (21:27) What'd you what'd you what'd you get that degree in?
Jenny Smith (21:29) The only thing that actually made me pause was the amount of initial, like, fourteen units. (21:36) I don't I think No. (21:39) Quite honestly, no.
Scott Benner (21:40) Right? (21:40) You okay?
Jenny Smith (21:41) I am stuttering because if I look at, like, my stats, my total amount of insulin, honestly, in a breakdown is I only use about 26 day total.
Scott Benner (21:58) Well, you can splurge and get the Filet O Fish meal if you want to.
Jenny Smith (22:01) Use half my insulin for food.
Scott Benner (22:03) Yeah. (22:04) Well, for lunch, really. (22:06) Now let's pretend that Jenny I'm gonna I'm gonna be honest here. (22:10) If this was me, I'm probably gonna lose my mind here and get the bacon quarter pounder with cheese.
Jenny Smith (22:16) Wow.
Scott Benner (22:17) But let's just You
Jenny Smith (22:20) have to have a shake with it, Scott.
Scott Benner (22:22) I would I I couldn't. (22:23) I'm I'm a baby. (22:24) Like, you know, but people are like, you don't drink? (22:26) That's crazy. (22:27) I don't even understand being able to drink the volume of liquid that somebody who drinks beer does.
Scott Benner (22:31) Like, if you gave me that much water, I'd be like, oh, I can't do all that. (22:34) But let's just pick one. (22:35) I'm gonna pick just from the photos the one that looks like it's trying its hardest to kill you. (22:40) So I'm going with the double quarter pounder with cheese meal. (22:45) 1,330 calories.
Scott Benner (22:47) You are gonna get a beautiful medium Coca Cola with this. (22:50) Okay? (22:52) And here we go. (22:55) Carbs, 156. (22:58) The fat goes 57.
Scott Benner (23:03) Protein, 53. (23:06) I'm gonna give you the benefit of the doubt that you've that you've that that you got a falling arrow going here. (23:11) You're shooting for an 80 blood sugar, and this bolus for the double quarter pounder with cheese meal. (23:21) If your insulin to carb ratio is 10 and your insulin sensitivity is fifty, sixteen units up front, 7.25 over eight hours. (23:30) This thing, it it's saying, like, you're not getting out front of this spat all day.
Scott Benner (23:34) Do you agree with that idea that it could go up to eight hours like that?
Jenny Smith (23:38) Absolutely. (23:39) Yeah. (23:39) The teenage guys that I work with many times need pretty considerable extended boluses or in whatever, excuse me, system they're using some type of a compensation for sometimes eight to twelve hours after they're done eating.
Scott Benner (23:58) Okay. (23:59) Well, I mean, you're hitting the it's the fat, the protein
Jenny Smith (24:02) Yep.
Scott Benner (24:02) The carbs, and then the sugar from the soda too. (24:05) Right. (24:05) I mean, it's just it's it's it's everything to think of. (24:08) Total sugars in this meal, 80. (24:12) 80.
Jenny Smith (24:13) I mean, if there was one, I dare to say one, quote, unquote, healthy, potentially potential thing that you could do is just gonna eat the food. (24:26) Please just drink some water. (24:28) Yeah. (24:28) Don't put soda on top of it. (24:30) Like, I I mean, that would be my, like, one ask.
Jenny Smith (24:33) Like, just don't put the liquid sugar on it.
Scott Benner (24:36) I'm I'm hopeful that most people listening are like, I would not drink a regular Coke with this, but there's something to be said for the fact that McDonald's, when they're listing it on their website, believes that most people are going to. (24:46) So that must be from their marketing and their understanding of what happens. (24:50) Also, soda is, you know I mean, you and I have gone over this before. (24:53) Like, it is much more readily consumed than I actually thought. (24:56) I actually learned learned something about myself this week, Jenny.
Scott Benner (25:00) I learned that, you know, in the Jurassic Park film where they have the DNA kinda figured out, but they've got gaps in it, they figure they fill it with
Jenny Smith (25:08) Fill it with frog.
Scott Benner (25:09) DNA. (25:09) Right? (25:10) Mhmm. (25:10) I realized that when I think about other people and I have gaps in my understanding about what they do, I fill it with my my sensibility. (25:23) Didn't I didn't realize that actually.
Scott Benner (25:25) So, like, if I know, you know, 40% about who Jenny is and I'm trying to imagine what you do in a situation, if I don't have the information about what you would do, I fill it with what I would do, which is probably a mental illness. (25:37) I'm not gonna lie. (25:38) But, like, I so when I look when I think about this stuff, in my wildest dreams, I don't imagine getting a a Coke with with sugar.
Jenny Smith (25:45) Right.
Scott Benner (25:45) But, you know, like, that's a a ton of people do that. (25:48) We I I've said this before. (25:49) I I've had to drive south a lot for my kids, for school, and stuff like that. (25:53) You get below about North Carolina, you're lucky to find a diet soda in a refrigerator or gas station anywhere. (25:59) Like, it just culturally turns into something different.
Scott Benner (26:01) You you know?
Jenny Smith (26:02) Yeah. (26:03) I think that also brings in and you already said, like, within the group of large portion of people that listen to your podcast, my expectation is that the good majority of them don't drink a soda.
Scott Benner (26:19) Yeah. (26:19) But I bet you people go to McDonald's. (26:21) I bet you people go to McDonald's with a lot of regularity. (26:24) Right?
Jenny Smith (26:24) So I think even some of you know, many of the people are probably like, well, I wouldn't drink the soda anyway, so let's adjust this. (26:31) But now that we have a calculator, we can adjust it to what we would actually do. (26:35) But in the greater the reason it's up on the website the way that it is, as you stated, is because the small population who doesn't do it is it's small.
Scott Benner (26:47) Yeah.
Jenny Smith (26:47) The greater population has something like this as if it were water.
Scott Benner (26:53) Yeah. (26:53) I and I even feel badly that they put the price up so much. (26:56) Like, McDonald's used to be a thing. (26:58) Like, you'd fly in there with $5 and and eat like And you'd find. (27:01) Yeah.
Scott Benner (27:01) Yeah. (27:01) Yeah. (27:01) Now it's it's much more expensive than that. (27:04) So I I do think this is a good time for me to just ask you a question, let you talk for a half a second about this. (27:09) Like Oh.
Scott Benner (27:10) This idea about these like a calculator. (27:12) Right? (27:13) Like, this is it even if you're so listen. (27:17) The reason I I made the other calculator to help you figure out what your settings are is because I also kind of you know, after talking to people think that it's possible a lot of their settings aren't right either.
Jenny Smith (27:26) Mhmm.
Scott Benner (27:27) So there is a calculator up at juiceboxpodcast.com/settings that will help you put it know, you put your weight in in pounds, and it does the math for you to give you a starting spot for your your settings. (27:39) It is not perfect. (27:40) It's not gonna be exactly right, but, you know, it'll at least give you the idea that if, you know, you think your insulin to carb ratio is 20, and it might look at it and go, yeah. (27:49) It looks more like this. (27:50) You know?
Scott Benner (27:51) Like, maybe you're maybe you're not right. (27:52) Maybe you're having problems because your settings are off. (27:55) It's a good place to start. (27:56) It's not a rule. (27:57) It's not, you know, it's not it's not God.
Scott Benner (27:59) It's not your it's not your but please see your endocrinologist. (28:02) But, like, you know, you could still look and go, oh, maybe my settings aren't quite right or maybe they're good because this calculator is asking you to put in settings. (28:10) It believes you're right when it's putting in the settings.
Jenny Smith (28:12) That I was gonna say just that. (28:14) It's the idea that if your settings are true for the most part, then this is the next step up. (28:22) This is the Yeah. (28:23) I can feed it my information, and it will give me something to work with. (28:29) Is it gonna be perfect?
Jenny Smith (28:30) No. (28:30) You're not saying that it is, but it is at least a step in the right direction of determining not only how much insulin, but, like, how long is this meal gonna hit me? (28:41) And I do have to think about that because otherwise, just counting the carbs upfront, I will likely be frustrated beyond this meal.
Scott Benner (28:49) Yeah. (28:50) But and and I'm I'm I genuinely wanna I just wanna be completely clear. (28:53) I don't think this is a replacement for your doctor, for your common sense, or for anything like that. (28:59) I've just I've had
Jenny Smith (29:00) a It's a tool.
Scott Benner (29:01) Jenny, I'm up to 1,800 episodes. (29:04) I've talked to a lot of people with diabetes and I see where they trip up a lot of the times. (29:09) It doesn't mean everybody does. (29:10) I put something up the other day that just explained pre ballistic and one person post did great. (29:18) 66,000 views on Facebook.
Scott Benner (29:20) Okay? (29:20) It was just a little breakdown of some big ideas around pre ballasing and a place where you can go to hear more about it. (29:29) Most people were like, thumbs up. (29:30) This is great. (29:31) Thank you.
Scott Benner (29:31) It helped me. (29:32) One guy was like, that's not how it works for me. (29:34) I was like, valid. (29:35) Completely valid. (29:36) It doesn't work for you.
Scott Benner (29:37) I don't know why. (29:37) Your your digestion might be different. (29:39) Maybe you've got a little gastroparesis going. (29:41) I have no idea. (29:43) It's not a blanket statement.
Scott Benner (29:44) None of this is a blanket statement for anybody. (29:46) Actually, as I sat down here this morning, I got a text from somebody who's, helping another person who's more newly diagnosed. (29:56) And that person's been listening to, I think, pro tips, and they're panicking a little bit. (30:00) They they feel like there's so many things to remember. (30:02) And the response back, and I think this person did a great job in support, was you don't have to do everything they say in that podcast.
Scott Benner (30:09) Right. (30:09) Right? (30:10) Like, that's that's kinda like the whole thing. (30:12) Like, you just take the basics and
Jenny Smith (30:14) pieces you need.
Scott Benner (30:15) And build off of it. (30:16) I'm saying the same thing here. (30:18) So but let's do you wanna do a brek you know what we should do, honestly? (30:24) Because there are gonna be people that are gonna be like, I don't eat that garbage burger, Scott. (30:28) I have the chicken.
Scott Benner (30:30) So let's do the the McCrispy strips. (30:33) I'm gonna go a four piece and tell you that a McCrispy
Jenny Smith (30:37) anything baked there? (30:39) I mean, don't think
Scott Benner (30:40) Oh, I don't believe there's an oven anywhere. (30:42) No. (30:42) No. (30:42) No. (30:43) No.
Scott Benner (30:43) I don't I don't think I don't think that's happening at all.
Jenny Smith (30:47) That's funny.
Scott Benner (30:48) Yeah. (30:48) Yeah. (30:48) Where where would they put that? (30:50) That
Jenny Smith (30:51) would also take too much time.
Scott Benner (30:53) This is just the four chicken strips. (30:56) 24 carbs, 23 fat, 40 protein. (31:01) That's just the chicken strips. (31:02) Nothing else with it. (31:03) I'm gonna make your I'm gonna give you a rising arrow.
Jenny Smith (31:06) How many pieces is this again? (31:08) Four. (31:09) Just a four piece. (31:10) Okay.
Scott Benner (31:10) Four piece. (31:11) That's jeez. (31:13) Wow. (31:13) That's 2.8 up front, 3.67 over five hours.
Jenny Smith (31:18) Interesting. (31:19) The difference there. (31:20) Right? (31:21) Mhmm. (31:21) The carbs actually require less than the fat and protein.
Scott Benner (31:26) Yeah. (31:27) But, yeah, by by a by a fair amount. (31:29) By almost a unit.
Jenny Smith (31:30) Right.
Scott Benner (31:31) Yeah. (31:31) That's interesting. (31:32) It really is.
Jenny Smith (31:33) Where you may have missed what's going on with this meal and you get frustrated and you think, well, they must be telling me the wrong information.
Scott Benner (31:42) Mhmm.
Jenny Smith (31:42) The carbs aren't right on this, or I keep missing on what's happening. (31:47) A bolus this way and this happens. (31:49) A bolus this way and I get too high. (31:51) It stays too high or whatever it is. (31:54) It brings in the fact that we have to start really, really paying attention to how much of the fats and proteins.
Jenny Smith (32:02) And as I said before, the amount at which point you are likely to need to bolus for. (32:10) See, I used your little
Scott Benner (32:12) Bull bolus for. (32:13) Thank you. (32:13) Yes. (32:13) Yes.
Jenny Smith (32:14) Thank you. (32:15) The when you're going to need to bolus for the fats and proteins, honestly. (32:20) Because everybody may find that their digestive, let's call it or body tolerance for an amount is a little bit different. (32:30) Mhmm. (32:30) This amount, you're fine.
Jenny Smith (32:32) You're golden. (32:33) You just bolus for the carbs, you pre bolus the right way, and it all works out totally fine. (32:37) Or you do an extended bolus for just the carbs and it works out beautifully. (32:40) Great. (32:42) But there's likely a tipping point.
Scott Benner (32:44) Yeah. (32:44) Yeah. (32:45) Hey, Jenny. (32:47) It's breakfast, and you're gonna get a sausage, egg, and cheese McGriddle meal, which comes with a hash brown and a coffee, in case you're wondering. (32:54) Now here's the interesting thing.
Scott Benner (32:56) I bet you that there's nothing about the coffee that would impact the the bolus. (33:03) Right? (33:03) And some people really need the bolus for coffee. (33:06) So
Jenny Smith (33:06) Correct. (33:06) There's nothing to calculate.
Scott Benner (33:08) Yeah. (33:08) Yeah.
Jenny Smith (33:08) This is your own experience with caffeine.
Scott Benner (33:11) Mhmm. (33:12) So taking the coffee out of it. (33:14) Mhmm. (33:16) 63 carbs, 41 fat, 21 protein. (33:20) Insulin to carb ratio, 10.
Scott Benner (33:22) Insulin sensitivity, 50. (33:23) Why why don't we do something here? (33:25) Like, let's let's assume like, let's just look at this meal, ten fifty, target 80. (33:32) Right? (33:33) The bolus is 6.7 up front, 4.53 over eight hours for the for this.
Scott Benner (33:38) What what about I guess it's all the fat and the protein together. (33:41) Okay. (33:42) But but that's just an average insulin sensitivity, insulin to carb ratio. (33:48) Me tell you let me put in Arden's carb ratio and sensitivity without a GLP. (33:54) Uh-huh.
Scott Benner (33:55) Arden's carb ratio without a GLP is 4.5, and her sensitivity is about 36. (34:03) So that same meal, but in a more insulin sensitive person goes from 6.7 up front, 4.53 over eight hours to 14.5 up front, 10 o seven over eight hours just by changing the sensitivity in the car ratio that much. (34:21) Again, all I want from you guys is to understand the impacts of your food, make sure your settings are right, and make and and so because listen. (34:30) If there's a world where a person needed 24 carbs twenty four units of insulin for a sausage, egg, and cheese McGriddle meal, If that person needed that and looked at that number and went, I cannot possibly bolus that much. (34:44) I'm comfortable with 12.
Scott Benner (34:45) You you know? (34:46) You are gonna spend not just the next couple of hours, but the impact this is indicating could be over eight hours because of the fat and protein. (34:54) You're gonna spend the rest of your day with a high blood sugar. (34:57) Mhmm. (34:57) There's no world where you're gonna go, I probably need, like, 14 more units.
Scott Benner (35:03) You're gonna nickel and dime it all day long. (35:05) I put in a unit. (35:06) It went down. (35:07) It went back up. (35:08) I tried two.
Scott Benner (35:09) Like, I don't wanna get low. (35:10) Like, that
Jenny Smith (35:10) Yeah.
Scott Benner (35:11) That's gonna be the day.
Jenny Smith (35:12) And then if that person is the one who goes back and said, could I really have undercounted the amount of insulin?
Scott Benner (35:21) And they're gonna go, no. (35:22) I I didn't undercount the carbs. (35:24) Yeah.
Jenny Smith (35:25) Didn't undercount the carbs. (35:26) All the information was right. (35:27) It told me 24, but I was really only comfortable with 12 or 14, about half of it. (35:32) Right? (35:33) They put in, they see that they're stuck.
Jenny Smith (35:35) And as you just said, they're they're giving these little tiny nudges of insulin a little bit, a little bit again, a little bit again, and nothing is really moving it. (35:46) I would guarantee that at the point that it's finally come down, if they went back and they looked at their insulin give to correct, it is likely at or slightly more because they were trying to correct a high, which is harder to bring down once it's stuck there.
Scott Benner (36:05) Yeah.
Jenny Smith (36:06) At least the extra amount that they should have given when the system told them how much it was gonna give.
Scott Benner (36:12) Jenny, you gotta trust that what you know is going to happen is going to happen. (36:15) And a million percent, I agree with you. (36:18) You know, just timing and amount, it's a lot of insulin, but timing and amount It is. (36:22) Based against the food. (36:24) Hey.
Scott Benner (36:24) Let's do some fun things. (36:26) One packet of sweet and sour sauce. (36:28) Jenny, how many carbs?
Jenny Smith (36:30) Sweet and sour sauce. (36:31) One packet. (36:33) To 20?
Scott Benner (36:34) 11? (36:34) The spicy buffalo, though. (36:37) Only one, my friends. (36:39) Get the spicy buffalo. (36:40) Tangy barbecue sauce, 11.
Scott Benner (36:44) Also, I don't know if you noticed this, but in a lot of these places, if you ask for more than one, they'll charge you for them. (36:51) Honey mustard, six. (36:53) And there's just a little honey packet you get, I guess, for your tea or something that actually has 12 in it. (36:58) This website is again, I wanna give it to McDonald's. (37:01) It is completely
Jenny Smith (37:02) They've done a nice job.
Scott Benner (37:03) It's open and clear about what's in this stuff. (37:06) McCafe Caramel Machito. (37:10) I don't know what that is. (37:12) A large 200 400 calories, 62 carbs, 14 protein, 10 fat. (37:21) I'm not gonna throw it to the calculator, but that is that that's Jesus.
Jenny Smith (37:27) I saw something fascinating the other day as No. (37:30) As you were
Scott Benner (37:30) being I would eat at McDonald's, now I'm getting upset.
Jenny Smith (37:37) I saw something. (37:38) It's probably been around for a while, but I I don't go there. (37:41) So I it was just a commercial for advertising protein on top of your coffee.
Scott Benner (37:52) Oh, okay.
Jenny Smith (37:54) Really, on top of your drink that has a lot of calories is what I like, that's how my brain thinks about it. (38:00) Right? (38:00) So I'm thinking, well, this particular national chain is now putting, like, protein foam on the tops of their coffee drinks to accept.
Scott Benner (38:16) Try to make it sound healthy.
Jenny Smith (38:18) Kick right. (38:19) Kick into the group of, you know, the the widespread, I have to have in more protein. (38:24) I need to up my protein. (38:25) Well, gosh. (38:26) Look at that.
Jenny Smith (38:26) I can get twelve, fifteen, 18 grams of protein on my coffee drink, and now I've gotten more protein. (38:35) But whatever else was in the drink probably wasn't something you needed.
Scott Benner (38:40) So just be an egg. (38:41) Was this Starbucks?
Jenny Smith (38:43) It
Scott Benner (38:43) is. (38:43) And I think I saw this.
Jenny Smith (38:45) Yeah.
Scott Benner (38:45) Where'd I see it? (38:46) Oh, I was watching beast games. (38:47) And and they and they
Jenny Smith (38:48) You watch those too.
Scott Benner (38:49) That must be
Jenny Smith (38:50) boys love games.
Scott Benner (38:51) I do enjoy beast games. (38:52) Hey. (38:52) The vanilla shake because you brought it up a couple of times. (38:54) Come on, Scott. (38:55) Get a shake.
Scott Benner (38:55) The small shake, 480 calories, 80 carbs, 13 fat, 10 protein. (39:01) Go to
Jenny Smith (39:02) the small one.
Scott Benner (39:02) That's the the medium's 570 calories, 97 carbs, 12 protein, 15 fat. (39:10) That 97 carbs just hit me hard. (39:12) The large vanilla shake, 780 calories, 17 protein, a 133 carbs, 19 fat. (39:21) You wanna do that one in the calculator? (39:24) Let's go back to the 10 insulin to carb ratio.
Jenny Smith (39:27) Telling you to add it to your bacon something something.
Scott Benner (39:30) Yeah. (39:30) Oh, that would have probably ended my life. (39:33) So I'm gonna go back to I'm gonna go back to here. (39:37) Let me give you something interesting here. (39:39) I'm gonna put Arden settings in on a GLP medication.
Jenny Smith (39:42) Okay.
Scott Benner (39:43) Okay. (39:43) Insulin to carb ratio, 10. (39:46) Insulin sensitivity goes from 36 to you're never gonna
Jenny Smith (39:52) five or 80?
Scott Benner (39:52) Yeah. (39:53) 90? (39:53) It's about 90 on this on on that on the GLP. (39:57) I'm gonna make her target 80. (39:59) I'm gonna put in this large milkshake, a 133 carbs, 19 fat, 17 protein.
Scott Benner (40:11) I'm gonna tell you that in in Scott's world, her blood sugar is 80 in when this milkshake's happening and falling. (40:18) I'm gonna tell you that in Arden's world, I don't think she knows what her blood sugar is when she starts. (40:22) But but there you go. (40:24) It's 13.3 up front, two point three nine over four hours combined, total dose of fifteen point six nine. (40:34) I'm gonna go right back again and put her settings in without the GLP.
Scott Benner (40:38) Four point five, thirty six.
Jenny Smith (40:41) I don't even oh my god. (40:43) That's a lot of insulin.
Scott Benner (40:44) So the thirteen point three up front, two point three nine over four hours goes to calculated dose thirty four point eight seven units. (40:52) This exceeds your max bolus limit of twenty five units. (40:55) You have to the the the calculator is gonna make you verify this is what you wanna do. (41:00) So I'll I'll change the max bolus to forty so that it'll give me the number. (41:06) Twenty nine point five upfront, five point three over four hours, 34.87 units if it was a four and a half insulin to carb ratio, 36 insulin sensitivity.
Jenny Smith (41:17) That's a lot of insulin.
Scott Benner (41:19) I mean yeah.
Jenny Smith (41:21) Like, a lot and it's not it is not uncommon to have
Scott Benner (41:26) A milkshake. (41:26) Right?
Jenny Smith (41:27) Resist a milkshake
Scott Benner (41:28) And and resistance. (41:29) Yeah.
Jenny Smith (41:29) Type of resistance. (41:30) Yeah. (41:30) Ratios of four, five, or six along with correction factors that are 35, forty, fifty. (41:39) That is not odd.
Scott Benner (41:41) Jenny, this concoction has 85 total sugars in it. (41:45) 67 of them are added. (41:47) For fun, tell the people how many teaspoons of sugar is 85 grams of sugar in teaspoons.
Jenny Smith (41:54) How many teaspoons?
Scott Benner (41:55) Tablespoons. (41:56) How would you tell cups?
Jenny Smith (41:57) Yeah. (41:57) You would
Scott Benner (41:58) What's the way to tell people?
Jenny Smith (41:59) Yeah. (41:59) No. (42:00) I mean, you'd essentially divide it into teaspoons, and that's twenty twenty one teaspoons
Scott Benner (42:06) 21
Jenny Smith (42:07) teaspoons. (42:07) Dash extra. (42:08) I there's a decimal in there, but yeah.
Scott Benner (42:11) Can you imagine if I sat you at a table and I dumped twenty one twenty one teaspoons of sugar? (42:15) I was like, get it in right now. (42:17) Make it happen. (42:18) Right? (42:19) Okay.
Scott Benner (42:21) I'm not judging any I seriously, I'm I we're trying to have fun here. (42:24) I mean, I think anybody listening to this is like, these are ridiculous numbers. (42:28) Right. (42:28) But this is the this is it. (42:31) And mcdonald's.com it has the menu.
Scott Benner (42:34) You can go look if you wanna go check out the calculator just to do it for fun, just to give yourself some idea. (42:39) In the end, you're gonna eat what you're gonna eat. (42:41) I'm not in charge. (42:42) Jenny's not in charge. (42:44) But you should at least Jenny said it once.
Scott Benner (42:46) We've been saying it for years and years and years in the pro tips, the bold beginnings, and everywhere else. (42:50) I don't care what you eat. (42:52) Just please cover it with a proper amount of insulin. (42:54) There's if you're gonna eat something unhealthy, at least don't have a diabetes unhealthy go along with it. (42:59) Like, you know Right.
Scott Benner (43:00) Let's just pick one kind of thing. (43:03) Jeez. (43:04) The nuggets. (43:05) Just do the nuggets real quick. (43:08) Wait.
Scott Benner (43:09) Is there a nugget meal? (43:10) There should be a value meal with nuggets in it, shouldn't there?
Jenny Smith (43:13) I don't even know.
Scott Benner (43:14) I know you don't know. (43:15) Yeah. (43:15) I know. (43:16) That's the strips. (43:17) Where the there's no nugget meal?
Scott Benner (43:19) What a shakedown. (43:21) Wait. (43:22) McValue? (43:23) What does that mean? (43:24) Oh my god, Jenny.
Scott Benner (43:25) Look at this. (43:27) The McDouble meal deal. (43:30) I mean, that sounds okay. (43:32) Let's let's end with this. (43:34) This is the value menu.
Scott Benner (43:35) Okay?
Jenny Smith (43:36) Okay.
Scott Benner (43:37) Says like
Jenny Smith (43:38) I I have to say that I think a nugget meal has value in the listening world, your listening listeners mainly because there are a lot of kiddos, and there are a lot of kiddos who like chicken nuggets.
Scott Benner (43:55) Yeah.
Jenny Smith (43:55) That's just a favored it it is. (43:57) So
Scott Benner (43:58) For sure. (43:58) Well, listen. (43:59) I can do it very quickly even though they don't have it together. (44:01) A four piece nugget watch me do this, Jane. (44:04) Watch me math.
Scott Benner (44:05) A four piece nugget first of all, let's put the let's put the settings back. (44:09) 10:50. (44:10) So 10 insulin to carb ratio, 50 insulin sensitivity. (44:14) So let's see. (44:15) The nuggets are 10 carbs, 10 fat, nine protein.
Scott Benner (44:21) That is for for four nuggets. (44:23) Okay?
Jenny Smith (44:23) Okay.
Scott Benner (44:24) I'll make the arrow stable. (44:27) Nothing on board. (44:28) So I'm just gonna tell you upfront, just those four nuggets. (44:31) If your insulin to carb ratio is 10, insulin sensitivity is 50, it's one unit upfront, 1.26 over three hours. (44:38) But now I can go back here on the McValue menu and go to and and look at a small fry.
Scott Benner (44:44) So say let's you're gonna give your kid a small fry and a small nugget then the four piece nugget. (44:51) That's gonna take your carbs to 41, your fat to 21, and your protein to 12. (45:00) So now what was one unit now? (45:03) 1.26 over time for the nuggets. (45:05) Nuggets and fries goes to 4.1 now, 2.37 over four hours.
Scott Benner (45:11) That's that's pretty quick there. (45:13) And the apple slices, if you're gonna throw them on there, I don't know if I can find the apple slices here. (45:20) Wait sides. (45:21) I got them. (45:22) Apple slices.
Scott Benner (45:24) This website is awesome. (45:26) That takes the carbs to 45. (45:29) Actually, that's that's really the only change here is the carbs go to 45, so you're 4.1, 2.37 later. (45:35) It goes to four point five, 2.37 later. (45:38) So that would be four nuggets, small fry, and an apple.
Scott Benner (45:43) Four and a half units up front, 2.37 over time if your carb ratio was insulin to carb ratio was 10, insulin sensitivity is 50. (45:52) Even if you just double this for a small kid and say the carb ratio is 20 and make the sensitivity a 100, same meal, 2.25 up front, 1.19 over time. (46:04) Nobody is extending these things. (46:06) I think that's where they're seeing the rises later and they're
Jenny Smith (46:09) Very likely.
Scott Benner (46:10) Yeah. (46:10) Yeah. (46:10) Or they're counting on their algorithm to get in front of it, but the algorithm bowl most of these algorithms bowl is a percentage of need. (46:17) And so it
Jenny Smith (46:18) Not everything on the rise.
Scott Benner (46:19) Not the need itself. (46:21) Yeah. (46:21) Alright. (46:22) We've done it, Jennifer. (46:23) I think this is actually, I hope people had fun, but I actually think it was I hope it was helpful for people.
Scott Benner (46:29) It's a thing that's probably in your face all the time. (46:32) 3,000,000 happy meals a day are sold almost a 100.
Jenny Smith (46:35) Thanks for making me eat at McDonald's.
Scott Benner (46:37) Yeah. (46:37) Listen. (46:37) What are you gonna have? (46:38) Tell people what you're have for lunch. (46:40) Stop it.
Scott Benner (46:40) Just tell them.
Jenny Smith (46:41) For lunch today?
Scott Benner (46:42) What's what's lunch today?
Jenny Smith (46:43) Lunch today is cabbage, and, like, I've got a a dressing that I put on top of the cabbage. (46:50) It's like an avocado kind of dressing that
Scott Benner (46:53) goes on it.
Jenny Smith (46:54) And then I'm going to have a bowl of blueberries Mhmm. (47:00) And then some scrambled eggs.
Scott Benner (47:02) It's 11:30. (47:03) You've eaten already today or no?
Jenny Smith (47:04) I have not.
Scott Benner (47:05) No. (47:05) I have not eaten yet either. (47:06) I think I'm gonna go downstairs and poach two eggs and have a piece of sourdough with it maybe. (47:10) Little piece.
Jenny Smith (47:12) It's only 10:30 my time.
Scott Benner (47:14) So Yeah. (47:14) Yeah. (47:14) It's a little early for you still. (47:15) Okay. (47:16) Yeah.
Scott Benner (47:16) Listen.
Jenny Smith (47:16) Sounds good.
Scott Benner (47:17) I appreciate this very much. (47:18) Thank you.
Jenny Smith (47:18) No. (47:19) Thank you. (47:19) Happy Friday.
Scott Benner (47:20) Yeah. (47:20) You too. (47:30) Having an easy to use and accurate blood glucose meter is just one click away. (47:35) Contournext.com/juicebox. (47:39) That's right.
Scott Benner (47:40) Today's episode is sponsored by the Contour NextGen blood glucose meter. (47:44) I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which of course anticipates, adjusts, and corrects every five minutes twenty four seven. (47:55) It works around the clock so you can focus on what matters. (47:59) The juice box community knows the importance of using technology to simplify managing diabetes. (48:04) To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox.
Scott Benner (48:14) Okay. (48:15) I decided on a URL for this, for this calculator. (48:19) Juiceboxpodcast.com/bolusfour,bolus,thenumberfour,bolusfour. (48:29) If you're new to type one diabetes, begin with the bold beginnings series from the podcast. (48:34) Don't take my word for it.
Scott Benner (48:35) Listen to what reviewers have said. (48:37) Bold beginnings is the best first step. (48:40) I learned more in those episodes than anywhere else. (48:43) This is when everything finally clicked. (48:45) People say it takes the stress out of the early days and replaces it with clarity.
Scott Benner (48:49) They tell me this should come with the diagnosis packet that I got at the hospital. (48:53) And after they listen, they recommend it to everyone who's struggling. (48:57) It's straightforward, practical, and easy to listen to. (49:00) Bold Beginnings gives you the basics in a way that actually makes sense. (49:09) If you've listened to any number of podcasts or maybe watched a YouTube video, you're very accustomed to listening to the creator of that content ask you and sometimes just outright beg you without any feeling of self respect for you to follow, subscribe, share an episode.
Scott Benner (49:28) The reason that happens in podcasting specifically is because podcast players don't have a sophisticated recommendation engine like YouTube or TikTok does. (49:38) They can't watch listener behavior and then give you content that you might like. (49:44) Word-of-mouth skips that line completely. (49:47) It's an instantly expanding reach engine and really the only thing I've ever found that helps to keep the Juice Box podcast growing. (49:55) So subscribe and follow because that the algorithm understands.
Scott Benner (49:59) Set up automatic downloads, listen to the show, but share it with somebody else. (50:04) Leave a five star review. (50:06) Make it a thoughtful review that the algorithm can understand. (50:10) I really appreciate the time it takes you to do those things. (50:13) And I hate that I have to say this to you because I feel like an idiot, but subscribe and follow.
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#1753 Diabetes Spectrum - Part 2
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
In part two, Scott and Tricia explore years of missed LADA, digestive nerve damage, GLP use, and why rigid medical thinking fails people living with complex, autoimmune-driven diabetes.
+ Click for EPISODE TRANSCRIPT
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) Friends, we're all back together for the next episode of the Juice Box podcast. (0:04) Welcome. (0:15) This is part two of a two part episode. (0:18) Go look at the title. (0:19) If you don't recognize it, you haven't heard part one yet.
Scott Benner (0:22) It's probably the episode right before this in your podcast player. (0:29) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (0:33) Always consult a physician before making any changes to your health care plan. (0:44) If you're new to type one diabetes, begin with the bold beginnings series from the podcast. (0:49) Don't take my word for it.
Scott Benner (0:51) Listen to what reviewers have said. (0:53) Bold beginnings is the best first step. (0:55) I learned more in those episodes than anywhere else. (0:58) This is when everything finally clicked. (1:00) People say it takes the stress out of the early days and replaces it with clarity.
Scott Benner (1:04) They tell me this should come with the diagnosis packet that I got at the hospital. (1:08) And after they listen, they recommend it to everyone who's struggling. (1:12) It's straightforward, practical, and easy to listen to. (1:15) Bold Beginnings gives you the basics in a way that actually makes sense. (1:30) Cozy Earth is back with a great offer for Juice Box podcast listeners.
Scott Benner (1:34) That's right at cozyearth.com. (1:37) And right now, you can stack my code juice box on top of their site wide sale, giving you up to 40% off in savings. (1:45) These deals will not last, so start your holiday shopping today by going to cozyearth.com and using the offer code, JuiceBox at checkout. (1:53) This episode of the juice box podcast is sponsored by the Dexcom g seven, the same CGM that my daughter wears. (2:00) Check it out now at dexcom.com/juicebox.
Scott Benner (2:04) This episode of the juice box podcast is sponsored by the Omnipod five. (2:08) And at my link, omnipod.com/juicebox, you can get yourself a free what'd I just say? (2:16) A free Omnipod five starter kit. (2:19) Free? (2:20) Get out of here.
Scott Benner (2:21) Go click on that link. (2:22) Omnipod.com/juicebox. (2:24) Check it out. (2:25) Terms and conditions apply. (2:27) Eligibility may vary.
Scott Benner (2:28) Full terms and conditions can be found at omnipod.com/juicebox. (2:33) Links in the show notes. (2:34) Links at juiceboxpodcast.com. (2:37) And and I know you I know you don't get that reference, but that's where they that's where the Canadian researcher figured out about GLPs in the eighties. (2:46) He, he swabbed the I think it's a Gila monster.
Scott Benner (2:48) It's some some Yeah.
Tricia (2:49) Yeah. (2:49) Gila monster.
Scott Benner (2:50) Yeah. (2:50) Some big lizard that is voraciously hungry when it's hungry, but after it eats has no appetite and has no fat on it at all. (2:58) And he swabbed its mouth and found that the, GLP in its saliva was, like, significantly more than humans. (3:04) And that's how that's where today's idea came from originally.
Tricia (3:08) And So how?
Scott Benner (3:10) So I I will just tell you that I don't know how to it doesn't matter the words I use. (3:16) I appear to have a GLP deficiency because once you give it to me, I'm okay. (3:22) When you give like, Arden has no weight to lose. (3:25) But if you inject the GLP into her right now, in a couple of hours, her insulin needs are gonna start to go down. (3:32) In a couple of hours.
Scott Benner (3:34) Okay? (3:34) I know a 16 year old female with a ton of of lady problems and a a weight issue, meaning, like, two hundred and like, five three, 16 years old, five three, two hundred and twenty pounds. (3:50) Okay? (3:51) Has been on a low level of a GLP for eight days. (3:54) It's down 12 pounds already.
Scott Benner (3:56) I know. (3:57) Right? (3:58) We'll probably wake up a week from now and be 20 pounds lighter. (4:01) We'll probably wake up six months from now and be 50 and be bound to where they're supposed to be. (4:07) Now did it change their eating habit?
Scott Benner (4:09) It did. (4:10) But that can't be the entire story. (4:13) Like, because if I know if I would've taken that kid, locked her in a room, given her the same amount of food that she's had on the GLP, she would not be twelve pounds lighter today, eight days later. (4:23) Like, there's some people have deficiencies in places. (4:27) And I don't know what this juice is doing and what it's revealing, but we need more people to look at what's actually happening to people and and not to get stuck in, well, this is a type two diabetes drug.
Scott Benner (4:39) People think of it as a type two diabetes drug because that's what the original person developed it for. (4:45) But I can tell you that my wife works in drug safety and that she came home to me now, probably almost fifteen years ago and said one day, hey. (4:55) One day people are gonna take a shot and they're gonna lose weight. (4:58) And I was like, what? (4:59) And she goes, yeah.
Scott Benner (5:00) Yeah. (5:00) She goes, I just saw a ton of data. (5:02) By the way, I don't know why we didn't buy some stock when we heard about that, but we did not. (5:07) Okay? (5:07) And so but, like, she said, yeah.
Scott Benner (5:09) Yeah. (5:09) I'm seeing all this data. (5:10) There's this type two diabetes drug they're working on, and it's got this crazy side effect. (5:14) And I was like, what's the crazy side effect? (5:16) She goes, people are losing a lot of weight on it.
Scott Benner (5:18) And I was like, And that was just my wife talking about data that she saw, right, to me in our kitchen. (5:24) And then ten years later, I'm hitting myself with a pen every day, and I'm seventy pounds lighter two years later.
Tricia (5:31) Yeah. (5:31) And and I do have to say, I mean, it's not like it hasn't been seen before that certain drugs, it's all all of a sudden like, oh, has a different
Scott Benner (5:39) Yeah.
Tricia (5:40) This is a different off label
Scott Benner (5:42) Yeah. (5:42) But that's my point is that it it doesn't matter because when you get into the academia side of it, the people who sit around and congratulate themselves all the time for the great work they're doing. (5:50) Right? (5:51) They they get stuck in, like, well, it's a type two IVs drug. (5:55) Like, you're how many times I hear people like, oh, you can't have that.
Scott Benner (5:58) You have type one. (5:59) What the
Tricia (5:59) fuck that? (6:00) My GI doctor actually now I see a motility specialist. (6:04) Thank god. (6:04) I finally figured out where to go. (6:07) But long story short, like, he when he he thought I was asking I was asking about digestive drugs, but to your point, he when I he brought up the GLP ones and then referred it to as just a type two drug.
Tricia (6:22) As though I was asking to take them for me. (6:24) You know what I mean? (6:24) Like and I was getting confused.
Scott Benner (6:26) My anemia is completely gone since GLP. (6:29) Do I think that means GLP cures anemia? (6:32) Not saying that. (6:33) My best guess is my digestion works differently now, and I'm actually absorbing the nutrients out of the food I'm eating. (6:40) Right?
Tricia (6:40) I will tell you, and it's really important. (6:43) This is the other reason I'm here is it's a bit embarrassing, but I ended up finally going for the appropriate digestive test. (6:52) Like, where they they give you, like, these pellets to see how fast they move through your system. (6:56) I don't know if you or your daughter's ever had it. (6:59) I think it's, like, transenteric.
Tricia (7:02) You know, it's a test. (7:03) You go for four days, and I massively failed the test. (7:08) And it showed that I, from the sixteen years of diabetes, develop I I have severe colonic inertia. (7:17) So it didn't affect my upper tract like the normal gastroparesis. (7:22) It gave me gastroparesis in my colon.
Tricia (7:25) So it's another reason why I'm, like, very loud about what happened because I don't want this kind of thing to happen to anyone else because Lada can come with nerve damage. (7:38) And my doctor say my blood sugar must have been roller coaster because my fasting
Scott Benner (7:43) Well, so came down. (7:44) You ever tried, like, a a digestive enzyme or some, like, magnesium oxide along with your food to see if it
Tricia (7:51) So this is what I do. (7:52) This is what I do because my damage is so severe. (7:55) They told me, like, 80 like, 95% of your colon doesn't work. (7:59) I'm has yeah. (8:01) My endocrinologist told me that and my GI motility specialist.
Tricia (8:05) I'm on a drug. (8:07) No. (8:07) It's not a drug. (8:08) I take a medical device called Vibrant Capsule. (8:11) It's changing things for diabetics with nerve damage.
Tricia (8:15) It's sort of you take this it's an it looks like a pill. (8:19) It vibrates on a certain cadence when it hits your digestive tract, and a lot of type ones, especially old school who got damaged from before things got I think a little better for type ones, actually helps with peristalsis, and then I take a a medication called Motegrity. (8:38) And to your point, I take magnesium.
Scott Benner (8:40) Yeah. (8:40) And it makes the poopy come through faster.
Tricia (8:43) I this it once they put me you know how you now have the motor for people who have the gastroparesis in the upper Yes. (8:52) Stomach? (8:53) If I was not on this drug, I probably would be suicidal because my system worked so poor. (9:01) It was it's so severely damaged. (9:03) And I am five ten, and I only weigh about a hundred and twenty two pounds because it's like it's all all I can only eat
Scott Benner (9:12) so much volume
Tricia (9:13) per day. (9:13) Yeah. (9:14) And then the other thing is I used to be a very attractive woman. (9:17) You could see over the years between the GI issue and, you know, my body started to waste away from the diabetes. (9:27) And ironically, Scott, I cannot believe this.
Tricia (9:30) I got a consult and was seeing a urologist for three years between 2000, what, '11 or something. (9:43) And or something like between 2011 and 2015. (9:46) I'm I'm a type one child seeing a urologist for urgency, frequency, nocturia. (9:54) And in my labs, okay, this is why I want everybody to listen, my there was no glucose in my urine. (10:02) Okay?
Tricia (10:02) Folks, I'm going up and down with the slowly progressing type one, and when my labs were done, no glucose is being found in the urine.
Scott Benner (10:14) Mhmm. (10:15) Are you making what what is that? (10:17) The urgency, frequency, nocturia, is it you're peeing your pant you're peeing the bed?
Tricia (10:21) This no.
Scott Benner (10:22) No. (10:22) What does that mean?
Tricia (10:23) Urgency and frequency means you're at work and you're like, god. (10:26) I just peed. (10:27) Why do I have to pee again?
Scott Benner (10:28) Mhmm.
Tricia (10:29) So that's what I was seeing the urologist for. (10:31) And then at night, I started this is what I told the doctor in 2011. (10:36) I was getting very annoyed by my bladder in the middle of the night, like I drank a Big Gulp. (10:44) And that's what the doctor was like, I don't know. (10:46) It's got it's probably gone you know, go see your gynecologist.
Tricia (10:49) So my point is with slowly progressing type one, LADA, whatever you wanna call it, you're not necessarily being so bad, some of us, that you can't make it on you know, you can't stand on a commuter pus and make it make it through the the the tunnel. (11:06) You can't make it through the workday. (11:07) You're ear you could be irritated by it during the day, but it's not extreme. (11:12) Mhmm. (11:12) You could experience way too much peeing at night.
Tricia (11:17) So, you know, it's not the typical, oh my god. (11:22) I I'm peeing. (11:23) I can't I can't function, which I wanna tell people. (11:27) And it makes sense because if my fasting was normal, right, I'm not I'm not at you know, maybe my meal's going to two hundred to 02:50 or something in the early days. (11:40) Like, I probably am not reaching those highs.
Tricia (11:43) Like, I remember, what is it? (11:44) Like, Jake Cutler or one of the football players, like, I read about, like, he ends up in the emergency room.
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Scott Benner (12:29) They did send me some for free, but I've also bought a lot on my own. (12:33) So like I said earlier, Black Friday has come early at Cozy Earth. (12:37) And right now, you can stack my code JuiceBox on top of their site wide sale, giving you up to 40% off in savings. (12:44) These deals are definitely not gonna last. (12:47) Get your shopping done now or get yourself something terrific at cozyearth.com.
Scott Benner (12:51) Do not forget to use that offer code juice box at checkout. (12:55) You will not be sorry. (12:56) Today's episode is brought to you by Omnipod. (12:59) Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? (13:05) That's less than $1 a day for tube free automated insulin delivery.
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Tricia (13:58) At 500. (14:00) That that wasn't happening to me.
Scott Benner (14:02) You know what's funny? (14:03) You say that, you know, there's quiet stories about Jay Cutler being, like, a being a dick. (14:09) I don't if
Tricia (14:09) you if
Scott Benner (14:10) you know and I always wondered, like, I wonder if his blood sugar is just swinging all over the place.
Tricia (14:14) Well, he that's what they they found. (14:17) Like, he was losing, like, a ton of weight, and he also didn't have any energy. (14:21) And then he ends up, you know, yeah, in the emergency of 500. (14:27) So I'm just saying, like, doctors need to understand it can be a very different experience for
Scott Benner (14:32) person. (14:33) Hey. (14:33) So this thing you're using, it's called Vibrant Gastro?
Tricia (14:37) Yeah. (14:37) And I they like, I hope they get a lot of support. (14:43) It's a game changer for diabetics with nerve damage in their digestive tract. (14:49) You know, with lower digestive tract, you know, upper, I think there's other things for that, but it's a game changer.
Scott Benner (14:59) That's awesome. (15:00) Oh, it's awesome that somebody thought of something. (15:02) And what kind of, magnesium do you take?
Tricia (15:06) I take, what do I take? (15:08) I just take glycinate because I'm on Motegrity, which has a laxative effect.
Scott Benner (15:12) And Already.
Tricia (15:14) Yeah. (15:15) So it's like the doctor's like, okay. (15:16) Balance yourself.
Scott Benner (15:17) Yeah. (15:18) You don't wanna be gone too much.
Tricia (15:20) Yeah. (15:20) Or feeling sick, you know, or feeling, you know, just, like, nauseous or anything.
Scott Benner (15:25) Well, I I just I learned about magnesium oxide because I wanted to be ready in case I got constipated from the GLP. (15:33) So I just, like, I would take one.
Tricia (15:35) That was very smart. (15:36) That was very
Scott Benner (15:36) smart.
Tricia (15:37) Yeah. (15:37) Yeah. (15:37) Yeah.
Scott Benner (15:37) Yeah. (15:38) Well, I appreciate that. (15:39) But I I I just took one every day with the GLP to make sure I kept I I on the GLP, like, I realized you really wanna go to the bathroom every day. (15:47) Like, it's just it's super important to just keep things flowing as the as the
Tricia (15:51) It isn't it so funny, Scott? (15:52) I use such before this horrible experience just kept cascading through, you know, my life, and I, like, was so prim and proper. (16:04) Now it's like you've got diabetes. (16:06) You've been through all this. (16:07) I'm like, let me tell you.
Tricia (16:09) Let me tell the whole world I've got this horrible, severe problem and, like, you know, there's vibrant cat gastro and just really trying to help people
Scott Benner (16:20) Well, listen.
Tricia (16:21) With with diabetes.
Scott Benner (16:23) About two weeks prior to when this comes out, I will, at the end of some episode, be talking about a procedure I'm trying to get that I mean, I swallowed so hard before I said it out loud. (16:35) I was like, oh my god. (16:36) I'm gonna say this, aren't I? (16:37) Like, just okay. (16:38) And then I said it, and the woman I was talking to, she goes, I just she's like, I really appreciate that you just shared that.
Scott Benner (16:45) She's like, I think that probably impacts way more people than you think, and there's no way anyone's talking about it.
Tricia (16:51) And Yeah. (16:51) No. (16:52) I I agree. (16:52) And I sit in the waiting room at my motility specialist, and I'm pretty sure I can see there's a few people I've seen pumps, you know, saying I'm like, here we are. (17:01) Yeah.
Tricia (17:01) You know? (17:02) And and and for me, ironically, here I am young. (17:04) My blood sugars probably weren't as high, but this wasn't caught for such a long period. (17:09) And I'm in there with the old school, old guy diabetic who didn't have all this great technology, so he has damage. (17:16) And I'm always like, how ironic is it?
Tricia (17:19) You know, my doctor kinda calls it she she always says it's tragic, my endocrinologist now. (17:25) And I don't know how Scott, my sugars must not have been going or maybe it's the microbiome. (17:32) My vision, knock on wood, I'm knocking on wood, is perfect. (17:36) Okay? (17:37) So, like, it it's just very interesting.
Tricia (17:40) Although I'm constantly now being monitored because some of my liver enzymes have been out of whack to make sure I don't get what is it? (17:48) Autoimmune hepatitis. (17:50) Jeez. (17:51) And then I got put on, to your point earlier, thyroid medicine even though my TSH was normal, and it was life changing. (17:57) I got put on a small amount, and suddenly I stopped being freezing all the time.
Tricia (18:03) My my digestion improved somewhat. (18:06) So I'm like, who who cares if your TSH is normal? (18:10) I've, TPO antibodies, and my body doesn't function normally.
Scott Benner (18:15) Yep. (18:15) Medicate the symptoms, not the number. (18:18) That's what I say. (18:19) So Yeah. (18:19) Yeah.
Scott Benner (18:20) I I'll tell you. (18:21) Did you end up having kids?
Tricia (18:23) No. (18:24) It's a nice story. (18:25) I actually ended up divorcing, remarry marrying. (18:31) I think the health problems had a huge strain because I started to feel like I was crazy on on my first marriage. (18:39) I reconnected with my husband who I went to college with.
Tricia (18:43) He's just a wonderful guy. (18:45) He was my first boyfriend in college. (18:47) We we married, and I have two wonderful stepchildren. (18:51) And I I can't believe within this horrible story, I'm always grateful to the universe that I have had some wonderful, you know, come out of it. (19:03) I've I had to be treated for post traumatic stress disorder with EDMR.
Scott Benner (19:11) How'd that work?
Tricia (19:12) That took a year, but I had to do, like, a lot of cognitive behavioral therapy, e EDMR to calm the areas of my brain that associated with the medical misdiagnosis by that physician in 2016. (19:36) Mhmm. (19:38) Because I will never forget the day I my doctor, I said, let me put on a CGM, and I immediately spiked 180 with a, like, a half cup of, like, brown rice noodles. (19:56) And I I had post traumatic stress. (20:00) Could you imagine finding out that you had had type one fully progressing for sixteen years, and you had had a doctor make a mistake on your your case.
Tricia (20:16) So you were already experiencing damage, but then that doctor solidified that damage. (20:22) And so if I didn't do it, it wouldn't have calmed the area of my brain that's associated with that medical mistake. (20:32) And what I've noticed is I've had what they call post traumatic growth, which is basically like you have good things. (20:41) You can appreciate life because you've learned from this horrible experience that you've had. (20:51) And I also think time is precious.
Tricia (20:53) I don't know how much this has shortened my own life span. (20:59) And, you know, and, again, that's why I wanna get my message out that diabetes is the spectrum. (21:05) And if I see one more newsletter, Scott, that says that there's just type one and type two and doesn't talk about all of these news findings, I think I'm gonna rip my hair out. (21:15) Yeah. (21:15) And they're coming out of very prestigious
Scott Benner (21:18) Tricia, let me
Tricia (21:19) academic medical centers. (21:20) Yeah. (21:20) Let Those those letters.
Scott Benner (21:21) Let's talk about that for half a second because you brought that up a couple of times. (21:25) And I'm sorry for those of you listening who might find yourselves falling in this category, and I like you too. (21:30) You're good people. (21:31) But I see people on the LinkedIn congratulating each other all the time for doing shit that I'm like, that ain't gonna help anybody. (21:39) Like, what are you doing?
Scott Benner (21:40) Like, that's that's where you're spending your time and your resources. (21:43) I think there are a lot of academic people that like to get together and sit in rooms with each other and congratulate each other on all the good work they're doing. (21:50) And and they don't realize maybe that it's not it's not fast enough. (21:56) And even if they're right, and often they're wrong. (21:58) Like, you go back and you look at at the things that these organizations say, and you're like, oh my god.
Scott Benner (22:05) You were already fifteen years behind on this. (22:08) Like, I would never call anybody out, but I saw a video one time with this doctor. (22:12) He's a very well thought of person. (22:14) I've met him personally a couple of times. (22:16) He's a gentleman, a lovely person.
Scott Benner (22:18) Right? (22:19) And he's he says, I'm gonna make this big announcement on on his video channel, which, by the way, four people saw. (22:25) But that and I was and I was three of them because I because I watched it three times. (22:29) And he's gonna make this big announcement. (22:31) He's been doing this research for this, like, decades long decade long research.
Scott Benner (22:35) He's got big announcement for people with type one dice. (22:37) Big, big, big announcement. (22:39) Gets on, has somebody interview him so that it looks real official. (22:41) And, yeah, I'm like, sitting there. (22:42) I'm like, oh my god.
Scott Benner (22:43) The big announcement's it's coming. (22:44) It's coming. (22:44) It's gonna be something big.
Tricia (22:45) I'm looking
Scott Benner (22:46) for him. (22:46) He like I'm so excited. (22:49) And, his big announcement was that if you were a CGM and you set your alarms lower and you treat sooner, you have better outcomes. (22:58) It took him a decade. (22:59) Yeah.
Scott Benner (23:00) Took him a decade to make that announcement because he had to do research to find out if it was true. (23:04) I saw that with my daughter and then talked about it on a podcast 10 ago.
Tricia (23:09) And and Oh, I believe it. (23:10) Yeah. (23:10) Listened to one of your podcasts on digestion when you know, while I was still investigating things, and I found out more from you than I did.
Scott Benner (23:17) Of course.
Tricia (23:18) You and Arden.
Scott Benner (23:19) Yeah. (23:19) I saw a thing. (23:20) It made sense. (23:21) I watched it happen a couple of times, and I went, okay. (23:24) It proves itself out.
Scott Benner (23:25) I've done my research, and and now I mentioned to somebody else, hey. (23:30) Let me know. (23:30) If you do this, does this happen? (23:32) Yeah. (23:32) Yeah.
Scott Benner (23:32) Yeah. (23:33) Five, six, seven year you know, five, six years later, now the you know, you start hearing Dexcom saying it out loud. (23:39) Like, hey. (23:40) Make your make your make your, you know, make your high alarm lower. (23:43) You'll have better outcomes.
Scott Benner (23:44) Awesome. (23:45) Like, now they're able to by the way, they knew on day one too. (23:48) It's just they probably got to a point where they were finally able to say it out loud. (23:51) But it's and my point isn't that this person's silly or something. (23:54) My point is that the way that the world that he lives in works is he sees something, he knows it's true, and then he's gotta go through hoops to prove it out over years and years and years.
Scott Benner (24:05) He's gotta get money to find his things so he can figure it out. (24:08) I'm sure when he was saying I've got a big announcement, he was thinking, I am, like, so far behind on this, like, whatever, but I put all this work into it. (24:15) I gotta finish up now. (24:16) And and I'm not saying that shouldn't happen. (24:18) I want all that to happen.
Scott Benner (24:20) But you can't get into a room and congratulate yourself after having spent, like, half your career to figure out a thing that some jackass with a microphone figured out ten years before. (24:29) Like, right, like and and if that's happening in that specific situation, imagine all the other parts of life and medicine where this stuff is happening, where people like, real people like Tricia are suffering for decades while you're sitting in a room congratulating yourself for figuring something out and then having no way to put it into the world. (24:52) Because you go, well, what we figured out is, like, you know, we'll give them this test. (24:56) And if the test comes back between here and here, then that means go to this. (25:00) I mean you you could have spent five minutes teaching yourself how to think about this problem and figured it out much, much sooner.
Scott Benner (25:07) And I know that to be true. (25:08) Tricia, I know that to be true because I am not a special person. (25:13) I know I could not get through medical school. (25:15) I know that I my brain does not work like that at all. (25:18) I would not I couldn't do any of those things.
Scott Benner (25:21) And yet, I've, like, through storytelling and listening to people, have helped people figure out more things wrong with their life than anything. (25:29) And I'm just saying to those people, like, maybe a little more of that. (25:33) Like, you you like, I don't stop doing your your peer reviewed. (25:37) I'm not asking you to stop, but I'm asking you to, like, just see that there's other ways to think about this that get people to, like, happiness and health faster. (25:47) You know what
Tricia (25:48) listened to doctor Peter Ortiz
Scott Benner (25:51) I mean, I I think once or twice. (25:53) I heard him talking about something a week or two. (25:55) I was in the car, and he was on something, and I heard him talking. (25:58) And he seemed very reason like a reasonable guy. (26:00) Like, you know I mean?
Scott Benner (26:01) Like Well,
Tricia (26:02) he he figured out he had insulin resistance and then, like, changed his life. (26:06) But one thing I like about him is one time I did listen to him just say, listen. (26:12) We have to go back to med school and teach people critical thinking. (26:16) Yeah. (26:16) Like, he just did this whole he's like, you know what the problem with he's like, I'm surrounded by people who won't think and they won't really consider your family history.
Tricia (26:27) And my endocrinologist now said
Scott Benner (26:30) The Dexcom g seven is sponsoring this episode of the juice box podcast, and it features a lightning fast thirty minute warm up time. (26:38) That's right. (26:38) From the time you put on the Dexcom g seven till the time you're getting readings, thirty minutes. (26:44) That's pretty great. (26:45) It also has a twelve hour grace period, so you can swap your sensor when it's convenient for you.
Scott Benner (26:51) All that on top of it being small, accurate, incredibly wearable, and light, these things, in my opinion, make the Dexcom g seven a no brainer. (27:00) The Dexcom g seven comes with way more than just this. (27:04) Up to 10 people can follow you. (27:06) You can use it with type one, type two, or gestational diabetes. (27:08) It's covered by all sorts of insurances and, this might be the best part.
Scott Benner (27:14) It might be the best part. (27:16) Alerts and alarms that are customizable so that you can be alerted at the levels that make sense to you. (27:23) Dexcom.com/juicebox. (27:25) Links in the show notes. (27:27) Links at juiceboxpodcast.com to Dexcom and all the sponsors.
Scott Benner (27:31) When you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful.
Tricia (27:37) She sometimes figures out people have autoimmune lot of because they or just the sort of type one, etcetera, because they've gone around to tons of people. (27:50) And she'll say she'll say, like, she'll kinda look at it like a jig purse saw a puzzle and be like, nobody's enacting the dots here.
Scott Benner (27:58) Yeah. (27:58) It's it's it's the and it's the only thing that makes sense to me. (28:02) Like, I ask everybody who comes on about their history and their family real quick, and most of them don't even like, sometimes they don't even see the connection. (28:08) I had a lady tell me the other day, no. (28:11) Like, there's no other autoimmune in my family.
Scott Benner (28:13) And then 20 later, she's telling me, like, that her dad has Raynaud's. (28:17) And I was like, that's autoimmune. (28:19) And she goes, oh, I didn't know that. (28:20) I didn't know that. (28:21) And I was like, yeah.
Scott Benner (28:22) It is. (28:23) And then you start then you have to wonder, like, what else is going on in her family that she doesn't know about? (28:27) Like, what did Sakina know when she told me twenty years ago, you know, that, hey. (28:33) Autoimmune runs in families. (28:35) And then the problem is is that them people word police you.
Scott Benner (28:38) Autoimmune doesn't run-in families. (28:39) It's not genetic. (28:40) Or or, like, what like, stop. (28:42) Who it doesn't I don't care what word it is. (28:44) Here.
Scott Benner (28:45) A lot of people
Tricia (28:46) was in my family? (28:47) What? (28:48) That's just the way we are.
Scott Benner (28:49) Yeah. (28:49) Is she thin? (28:51) Is she thin? (28:52) A lot of us are thin. (28:54) Like, yeah.
Scott Benner (28:54) You mean a lot of us are malnourished because we have celiac? (28:57) Is that what you wanted to say? (28:59) Yes.
Tricia (29:00) Exactly. (29:02) Exact and my father always makes me laugh. (29:04) He goes, back then, we were just back in the day, our our parents would say, like, they have the big c, like and, like, whisper about it. (29:12) So then, you know, then then you've got that
Scott Benner (29:14) Well, the spree
Tricia (29:15) in families.
Scott Benner (29:16) Oh, also, the sprue. (29:18) What what? (29:18) Oh, she's got the sprue. (29:20) I'm like, what is that? (29:21) I said to my wife and by the way, when I was dating my wife, if somebody would've
Tricia (29:24) That's hysterical.
Scott Benner (29:25) If someone would've told me the lady had the sprue and that this was all genetic, I would've just moved on to a different girl. (29:30) And, like, I didn't know I didn't know I tell listen. (29:32) I tell my kids all the time. (29:33) It's why I asked you if you had kids because on there's a part of me that's like, thank god you didn't have kids.
Tricia (29:38) Oh, no. (29:38) I'm I'm really grateful. (29:40) And I think that, to your point, other things manifested in my brother's family through epigenetics. (29:45) And, like, my nephew has born with severe food allergies to, like, several food groups. (29:52) And then his like I said, he's had to watch his sugars.
Tricia (29:56) He's only 18. (29:57) And, you know
Scott Benner (29:58) Your family is
Tricia (29:59) like 17.
Scott Benner (29:59) Your family is
Tricia (30:00) like Hashimoto's. (30:01) Yeah.
Scott Benner (30:01) Yeah. (30:02) Yeah. (30:02) Your family is like bulldogs that can't breathe. (30:04) You you you're like, uh-oh. (30:06) One too many generations.
Scott Benner (30:07) Ugh. (30:08) And, like, you get you know? (30:10) And and it's And
Tricia (30:10) then my brother laughs at his wife for having all these allergy things in his family, and he's like, we just weren't good together. (30:16) You know?
Scott Benner (30:16) Like, he'll go allergies that. (30:17) Are are are immune too. (30:20) Like like, for sure I know that allergies aren't considered autoimmune, but come on. (30:24) It's your body's immune system overreacting to something.
Tricia (30:27) Please. (30:27) Yeah. (30:28) They're gonna find out things years from now.
Scott Benner (30:30) Of course.
Tricia (30:31) I don't know. (30:31) I I what you're saying, it's highly suspect.
Scott Benner (30:35) No. (30:36) It's we just don't understand it a lot, and we think we do.
Tricia (30:39) Yeah.
Scott Benner (30:39) You know what it is? (30:40) We think we do because a hundred and fifty years ago, we were riding around on horses looking for rocks in the ground. (30:46) And, like, we like we think we're so, like, you know,
Tricia (30:48) thickest think we're advanced, but you just keep looking back over x decades. (30:54) I mean, we could just look in type one itself. (30:57) I mean, since Arden's been little, I mean, you could probably just tell me stories about like, think about it. (31:02) When I was a kid, I I I don't think they ever saw they thought they they just gave you some Synthroid, and that cured the entire issue with your body. (31:11) But you you're still having downstream issues from the the Hashimoto
Scott Benner (31:15) side of still have hard the thing we're not tackling is that it's and I've been doing this thing with Erica. (31:24) We've been recording this this series about body grief, which is a thing, like, you know, like, she's talking about a lot in her life, but we haven't really dug all through it yet. (31:32) But but it the it's the impacts on you. (31:35) Like, it's not as easy as take this pill and you'll be okay because sometimes people are like, I don't wanna be sick. (31:41) Like, do you
Tricia (31:41) know what
Scott Benner (31:42) I And and thyroid is an example. (31:44) It's, such a slow moving thing for some people that if you don't take the medicine, you don't know today that you're okay. (31:49) Like, the reason people take care of their type one diabetes is because you'll fucking die if you don't.
Tricia (31:53) No. (31:54) Right. (31:54) Right. (31:54) Right.
Scott Benner (31:54) Exactly. (31:55) By the way, that still doesn't stop some people. (31:57) So, like, instead of seeing that as, like, some, like I don't know. (32:02) You know, instead of seeing that as a personality flaw, I just think of it as I think of it as it it's your it's it's that thing that people have. (32:13) Like like, I can make it through anything.
Scott Benner (32:15) I can do this. (32:16) I can get by. (32:16) Like, it's that's important, by the way. (32:18) Like, if people don't have that belief in themselves, we'd all be dead. (32:21) Like, we'd all just give up the first time something happened.
Scott Benner (32:23) Right? (32:23) So you just believe that you can overcome anything. (32:26) But there are times in your life where that belief is dangerous. (32:30) Right?
Tricia (32:30) Like That happened to me with the doctor handing me the the diet. (32:37) Right? (32:38) And I'm thinking I'm gonna cure myself. (32:40) And then I'm I have a master's degree. (32:42) Think about it.
Tricia (32:43) How ironic. (32:44) I worked in health care. (32:45) Right? (32:45) Because a lot of us who grow up with people who have type one diabetes go on to wanna help other people. (32:52) And then I learned through my whole experience, learned helplessness.
Tricia (32:58) So I didn't start there, Scott, but I started to give up because no one was help helping
Scott Benner (33:06) It's hard.
Tricia (33:06) Me. (33:07) Right? (33:07) It's So you you've got an intelligent, educated person who if you taught her things when she went to the doctor's office about, you know, tests she should have or what she's vulnerable to. (33:20) She's gonna, you know, listen. (33:22) And and and and and it yeah.
Scott Benner (33:24) I'm so I'm so sorry to say that I think that one of the one of the my takeaways from making this podcast is that you just can't that it it's hard to it's easy to say the health care system doesn't work preventatively, but I think people's minds don't work preventatively.
Tricia (33:42) Now we're biased. (33:43) If you ever seen, there's work by Danny Conno man Kahneman? (33:49) I might say it wrong. (33:49) He's a psychologist who says the amount of, like, bias on it, like, that's not on a conscious level between you and the physician, both of you, are experiencing that's in the room actually interferes with, like, doctors making the right diagnosis or or or patients maybe taking the right next step. (34:14) They're like things we're not even conscious
Scott Benner (34:16) Yeah. (34:18) I I just and I think that we over value where we're at as far as our knowledge goes. (34:23) Like, I mean, it I don't know. (34:24) What's a
Tricia (34:25) I don't anymore, Scott.
Scott Benner (34:26) Yeah. (34:26) You should.
Tricia (34:26) I do not.
Scott Benner (34:27) What's a good example? (34:28) What's a good example of oh, okay. (34:31) Nineteen o nineteen o three, the Wright brothers fly for, like, ten, twelve seconds. (34:38) Okay? (34:38) In in 1969, we land on the moon.
Scott Benner (34:42) And last week, I watched a rocket get caught by a pair of metal scissors. (34:47) So, like like so it feels like, oh my god. (34:50) Look how fast we're going because in that realm, we are really going quickly. (34:55) But if you stop and talk to somebody who understands spaceflight, they'll tell you that, like, we don't really we're not very good at it at all. (35:02) Like, we're just way better at it than the Wright brothers were about about getting off
Tricia (35:06) the ground. (35:06) Yeah. (35:07) Look at look at my nephew. (35:09) He was told to avoid all nuts and milk because he had a food allergy. (35:16) Now we know that's the worst thing, and he had to then, as he got older in middle school, go for torturous milk challenges in order to get his body used to milk.
Tricia (35:27) And then the doctors were like, start eating almonds. (35:30) You're you're allergic to tree nuts, but we've tested and you're not allergic to these because we once thought not exposing your kids to the peanuts. (35:39) Okay? (35:39) This was this was not that long ago with actually telling pregnant women and then having their babies, like, don't eat them. (35:46) Right?
Tricia (35:47) And now we're like, oops. (35:49) Backpedaling on that one. (35:51) That actually makes you have the allergy Mhmm. (35:54) And, like, sustain the allergy. (35:56) Like, so
Scott Benner (35:57) Well
Tricia (35:58) To me, I always think about that. (35:59) When I go to the doctor now, I'm like, you don't know what you don't
Scott Benner (36:03) Yep. (36:03) I'm I'm gonna I'm gonna do this. (36:05) I just pulled up a list for you because I want people to kinda, like, feel this and then, you know, like, try to apply it to what you're seeing today. (36:12) Right? (36:13) There was a time where anytime somebody was sick, we did bloodletting.
Scott Benner (36:20) Right? (36:20) Anything that was wrong with you, they put a leech on you or sliced open your vein to let out the bad blood. (36:26) That's that that's a thing that was medically, like like, accepted as a great idea. (36:32) Doctors used to drill or scrape a hole in your skull to release evil spirits, cure headaches, or treat seizures. (36:39) We would lobotomize people by taking a sharp tool, inserting it through their eye socket to scramble part of their frontal lobe.
Scott Benner (36:46) People used to get mercury pills for medicine. (36:50) That would be mercury pills, ointments, and vapors were prescribed for syphilis, constipation, teething, and more. (36:57) The reality is that mercury poisoning, tremors, and insanity, and organ failure is what came from that. (37:02) Did you know that cigarettes used to be prescribed for asthma? (37:05) Heroin for cough suppressants for children.
Scott Benner (37:08) Bayer marketed heroin as a nonaddictive alternative to morphine. (37:12) It was sold over the counter, and that's not a thing we do anymore. (37:17) Radium water in the early nineteen hundreds, energy drinks were called, contained radium. (37:23) People also applied radioactive creams to skins and genitals for vitality. (37:29) Oh, here's one.
Scott Benner (37:30) Electric belts for erectile dysfunction. (37:33) Men were sold electric shock belts to restore virility often with no regulation. (37:37) Doctors endorse them. (37:39) Yeah. (37:39) What really happened is people got burns in electrocution.
Scott Benner (37:41) If you put a nine volt battery on your balls, I think you'll find out it isn't a great thing. (37:46) Vibrating massages for hysteria. (37:48) Doctors treated women for hysteria, by manually or mechanically inducing orgasms. (37:55) And, of course, snake oil and all of the other stuff. (37:57) Like, that's just 10 things that people used to say, those are absolutely right.
Scott Benner (38:03) We should be definitely doing these things. (38:04) This is what's helping people. (38:06) And you have to step back once in a while and ask yourself, what am I doing right now that in the future someone's gonna go, oh, you poor fool. (38:13) I can't believe you did that. (38:15) Like right?
Scott Benner (38:16) And I'm not saying that anybody's doing it on purpose. (38:18) I'm saying you need to wonder and try to figure it out for yourself. (38:22) And it's at at some point, like, that's a common sense statement that I think in modern times because of podcasting and people who, like, peep people who don't know what the hell they're talking about, I'm one of them. (38:34) Like, right, like, wondering out loud about things and sometimes being awfully wrong about that stuff. (38:40) I think it allows people to say, like, oh, no.
Scott Benner (38:42) No. (38:42) Just like you we just gotta trust that what we know is right. (38:45) Like, what we know is as right as we know it to be.
Tricia (38:48) Yeah. (38:48) It's only it could only be the the the the tip of the iceberg. (38:52) I mean, this week, it just came out that now they're like hormone replacement for women. (38:56) They just, like, backpedaled all all the information, that was out there saying that it was gonna give you breast cancer, etcetera.
Scott Benner (39:05) And now that's not true anymore.
Tricia (39:07) Right. (39:07) Yeah. (39:08) Oh, unless known that. (39:09) That's the thing is it's like they've known it, and now that's finally to your point earlier about, like, the ADA, etcetera, or or the the the doctor to it. (39:19) Like, it's like we're putting certain information out like it's new.
Scott Benner (39:23) My wife has been struggling with long COVID for a couple of years now. (39:26) Like, I mean, like, really badly. (39:29) And Oh,
Tricia (39:29) I'm sorry to hear that.
Scott Benner (39:30) No. (39:31) No. (39:31) I appreciate it. (39:31) But then a woman came on the podcast, like, a few months ago and was like, oh, yeah. (39:35) I had long COVID, but I I was able to get rid of it with nicotine patches.
Scott Benner (39:38) And I was like, say again, what now? (39:40) And Mhmm. (39:41) And so I said to my wife, I'm like, hey. (39:43) I on Amazon bought you 30 nicotine patches for $30. (39:46) And a month later, she's like, I feel so much better.
Scott Benner (39:49) And and, like, I I'm like, okay. (39:52) Like, I don't know I don't know why, but who cares?
Tricia (39:55) Yeah. (39:55) What's the sign what's the
Scott Benner (39:56) you what's by the way, there's a this the science behind it is something about, like, nicotine receptors and the where COVID's being, like, I don't know, spike proteins are being, like, uptaken. (40:05) I don't know. (40:06) Like, here's here's the thing. (40:07) I don't know. (40:08) But, like, what I knew was is that I watched my wife struggle for seven years with her thyroid thing while we all just sat around and wondered out loud.
Scott Benner (40:16) And that, again, I didn't think that wearing a nicotine patch for thirty days was gonna hurt her. (40:21) And so, like, what was the harm in trying? (40:23) It cost $30. (40:25) And and and I'm not here to tell you to do it. (40:27) I am here to tell you that her long COVID symptoms have not been a problem for the last fourteen days.
Scott Benner (40:33) So it took about a week for her to start feeling better, two weeks for her to feel much better. (40:37) And today, I'm watching her. (40:38) She gotta lighten her eyes again. (40:39) She's talking faster. (40:40) She's getting rested better.
Scott Benner (40:42) Like, she's I she it's not perfect, but it's a lot better than it was.
Tricia (40:47) And and, yeah, just to think all that she went through where, like, yeah, it makes sense that, you know, she she you get this information the same way with what you were saying about the thyroid, and you're you're you're saying what hurts if she put goes on it. (41:02) It's like now she's like, yeah. (41:03) I'm gonna try this.
Scott Benner (41:04) Give me a try. (41:05) Who knows? (41:06) Like, right, like and and and listen too. (41:08) I I there's there's many people right now that are hearing us talk, and they're like you. (41:12) They're like, yeah.
Scott Benner (41:13) Like, try something. (41:14) And there's just as many as like, you know, you don't trust the science, and you're like, I'm not that person. (41:19) Like, I'm not that person at all. (41:20) Like, I my kids are vaccinated. (41:23) You you know what mean?
Tricia (41:23) There's a there's a balance, but totally and like I said, we need things that are quality controlled. (41:31) Like, I wouldn't want someone to give me this fibre pill that runs through my system. (41:36) It's it looks like a pill. (41:38) It's, like, almost like plastic. (41:40) You you Right.
Tricia (41:40) Scott, you don't wanna know what it was like the first day I had to take it. (41:43) Now it can pop it down, like, no problem. (41:45) But it's, like, an extra large magnesium
Scott Benner (41:48) pill. (41:48) Down.
Tricia (41:49) Yeah. (41:49) Yeah. (41:49) I mean, but if someone hadn't quality checked that research list, I I don't want that swimming
Scott Benner (41:54) I'm certainly not saying yeah. (41:56) I know. (41:56) I'm certainly not saying that. (41:57) Right. (41:57) Right.
Tricia (41:58) Right. (41:58) No. (41:58) I don't think we're either one of us are saying that, but we're saying, like, there needs to be a balance within the the current environment, really.
Scott Benner (42:05) Is it still vibrating when it gets in the toilet?
Tricia (42:08) No. (42:09) It it it vibrates on a timer inside of you. (42:12) And the comical thing is, like, if I was heavier and I I had probably hadn't sustained the weight loss from all of the health issues, You probably wouldn't hear it in someone who was heavier. (42:23) But because I'm very thin, my doctor was like, sometimes you're gonna hear it, and it's so funny.
Scott Benner (42:30) Really? (42:30) Like
Tricia (42:31) yeah. (42:31) I'll hear it vibrating. (42:33) It does it on a timer at a like, I think we'll do eleven something, then it will do around 01:30 in the afternoon, then it'll do around 07:30. (42:43) Sometimes I can't feel it at all, but some days I'll feel it, and it will be pretty loud. (42:50) But, again, I am so grateful for it.
Tricia (42:52) And when the doctor told me about it, I looked at him like he had 10 heads.
Scott Benner (42:57) Sure.
Tricia (42:57) This was in 2023, the '23. (43:01) And do you know that show that movie from when we I didn't watch it. (43:06) I was too old, but, like, kids were watching it. (43:08) Honey, I Shrunk the Kids. (43:09) Sure.
Tricia (43:10) Or, like, the what is this? (43:11) The Inner Space where they fly in what is it? (43:15) Dennis Quaid's in it, and he goes in a little spaceship in someone's body? (43:18) That was my reaction. (43:20) I was like, you want me to do what?
Tricia (43:21) With what? (43:22) Mhmm. (43:22) And yeah. (43:23) Like, when? (43:24) But I'm like
Scott Benner (43:25) It'll help.
Tricia (43:25) It's my yeah. (43:26) My doctor says too for diabetics who've had issues like this or other people for other reasons. (43:32) Like, eventually, it might be able to be something you could the doctor can program via an app or you you can or, you know, something via technology to time it best for your body.
Scott Benner (43:42) Mhmm. (43:43) That interesting? (43:44) Well, listen. (43:44) Let hopefully, that won't end up being the that that won't end up being the electric belt for erectile dysfunction. (43:51) It'll end up it'll end
Tricia (43:52) up being right. (43:54) To your point. (43:54) Yeah. (43:55) And who knows? (43:56) Scott, I was thinking about it.
Tricia (43:57) I don't dwell on it because it's making my life a game changer every day. (44:02) I'm like, maybe this device has, like, metal in it. (44:05) Gonna give me cancer, or one one day it's gonna, like, do something and and rupture, like, a section of my I'm like, you know, they've only been doing this for three years.
Scott Benner (44:13) Yeah. (44:14) Well, listen. (44:15) As as wildly inappropriate as it is, I do have to say that, orgasm does calm my hysteria. (44:20) So maybe maybe there's something to be said for that one. (44:24) I don't know.
Scott Benner (44:24) Don't think it's good that your doctor was doing it for you. (44:26) But, but, nevertheless, okay. (44:29) You were awesome. (44:30) Thank you for doing this. (44:31) I really appreciate you sharing your entire experience.
Scott Benner (44:33) It was Yeah.
Tricia (44:34) It was fantastic. (44:35) I'll ask you one last question Please. (44:37) For for you. (44:38) Like, what does it take from your experience to get anything through to, like, the ADA or certain kind of doctors to kinda, like, talk about this? (44:50) Or do you think it's still, like, a real struggle?
Scott Benner (44:53) No. (44:54) I I don't think that'll ever happen. (44:56) No. (44:56) I I think that I think that professional people want to sound professional. (45:00) I don't think that anything about the conversation you and I just had sounds the way that they talk to each other.
Tricia (45:06) Mhmm.
Scott Benner (45:06) And and so in, you know, in polite society that this is not gonna work this way. (45:11) Like, their thing's always gonna be their thing, which, by the way, has a ton of awesomeness about it. (45:16) Like, there's no doubt there's a
Tricia (45:18) thousand No. (45:19) No. (45:19) You you you need you need you need it.
Scott Benner (45:21) Thousands things I would go to a doctor for and and gratefully say to you, I have no idea what you're doing, but please just do whatever it is you do. (45:28) Thank you very much. (45:29) And I just think that it's more of this part of it, the unknown stuff and having to pick through people's experiences, you know, like a I don't know. (45:38) Like, you're, like I don't know. (45:39) Like, you're looking at a map and trying to figure out which way to go next and then getting there and listening to the wind to decide which way to go next again.
Scott Benner (45:46) Like, that's what it feels like sometimes. (45:47) And it's hard Yeah.
Tricia (45:49) Do you wonder if somebody was sitting on a computer and put my history into AI? (45:55) Mhmm. (45:56) Right? (45:57) Would it have actually been, like, check for this?
Scott Benner (45:59) Oh, a 100%.
Tricia (46:00) That. (46:01) Right? (46:01) A 100%. (46:01) So it's like I couldn't trust the human. (46:06) Yeah.
Tricia (46:06) So the way I critical thinking.
Scott Benner (46:08) The way I've said it before is that you're asking too much of a doctor to keep the entirety of medical knowledge and the entirety of your history together and then to be able to collate them and come up with answers. (46:19) That's impossible. (46:20) You need a whiteboard and a twenty twenty miles of yarn to and and a lot of pushbins. (46:25) Right? (46:26) Like, so you can't you can't really you can't expect a human being to do that.
Scott Benner (46:31) This is where my my full belief is is that if you if you somehow I don't know what the simplicity of it is here is. (46:39) If you sat down right now and opened up your ChatGPT app and turned on the voice the voice talking or whatever AI you use and said, hey. (46:47) I'd like to have a conversation about my medical history. (46:50) And you laid out your history without giving it any of the answers that you got. (46:55) I'm experiencing this.
Scott Benner (46:57) This is happening. (46:58) This is happening. (46:59) I have this happen. (47:00) My mom has this. (47:01) My dad has that.
Scott Benner (47:02) My what do you think is wrong with me? (47:04) I think that in about twenty seconds, it would have figured out your problem.
Tricia (47:08) Yeah. (47:08) It would have said check for this, check for that.
Scott Benner (47:11) Right. (47:11) It wouldn't say
Tricia (47:12) lab test was
Scott Benner (47:13) Yeah. (47:13) It wouldn't say 100% do this, but it would give you a list of actionable ideas that would get you to the answer.
Tricia (47:19) Mhmm.
Scott Benner (47:19) I I think that
Tricia (47:20) I think that's how it's for my brother. (47:22) Just to have my be what should my brother check for? (47:25) And it it's
Scott Benner (47:26) Yeah. (47:26) And I wanna be
Tricia (47:27) clear than physicians.
Scott Benner (47:28) I wanna be clear. (47:29) I don't think it's because, like, AI knows everything. (47:33) I think I think that it it it does two things that are really valuable there. (47:37) And one is that it can simply keep all of those ideas, like, between your health dish your health issues and your history. (47:46) It can keep it straight very simply, and it can order it very simply.
Scott Benner (47:51) And then it can go look at the Internet for simple answers to those questions and spit back out.
Tricia (47:55) Have be careful with it. (47:56) Right? (47:56) Of
Scott Benner (47:56) course. (47:57) I'm not saying. (47:57) That you don't.
Tricia (47:58) We're both we're both not saying, but it's they're we're both seeing the value in it having all of that information and ordering the information.
Scott Benner (48:06) Yeah. (48:06) It can it can keep track of things better than you can. (48:11) And and, like, that's that that's the simplicity of it right there. (48:13) I don't care what it does with making videos or pictures or, like, that that's all bullshit. (48:18) Like, I don't I don't care about that.
Scott Benner (48:19) Like, right, like, even for writing, like, yeah, technical writing, it's it's gotten way better at. (48:25) I don't know that it's ever gonna write, you know, and and and, you know, take the place of
Tricia (48:29) I'm in I'm I'm in grad school, and, like, I'll use it sometimes just to, how should I like, I'll write my paper. (48:35) I never use it to because it sounds too wonky, and I'm old, and I want my brain to do the work. (48:41) But it comes back too wordy often.
Scott Benner (48:44) Yeah. (48:44) No. (48:44) There's it's a lot about how to learn how to talk to it. (48:48) And there's a way to work with it that I don't know that everybody's gonna, like, pick up.
Tricia (48:54) I'd never tell it it's wrong. (48:55) I love being like, you're wrong. (48:57) I'm like, you're completely wrong.
Scott Benner (48:58) Well, I don't I don't even mean like
Tricia (49:00) I am.
Scott Benner (49:00) I don't mean like that. (49:01) Like, I did a I did a a letter yesterday that goes out to the advertisers at the end of the year. (49:07) Right? (49:07) I do one I do one every year where I basically say to, like, look. (49:11) Put the business aside for a second.
Scott Benner (49:13) Here's what the podcast did for people this year, like, real people. (49:16) You you know what I mean? (49:17) Like, here here's your your ad dollars got you your clicks, and it did all the things that you wanted it to do, but here's what here's why I'm doing it. (49:25) Like, I'm not doing it for your clicks. (49:27) I kinda don't care about your clicks.
Scott Benner (49:28) Like, I care that you care so that you'll pay me so I can make the things. (49:31) I can have a two hour conversation with Tricia and pay Rob to edit it down and then put it online for people to hear it. (49:37) Like, that's the part I care about. (49:38) And so I sat down and I said I went to usually, would sit and start writing. (49:45) And instead, I went to a prompt and I said, I'd like to send a letter to the advertisers this year that highlights some of the good work that the podcast does for people aside of the business stuff for them.
Scott Benner (49:56) Here's a document that has all of this year's reviews for the podcast in it. (50:01) Look at the reviews, figure out where the podcast has helped people this year, and Mhmm. (50:06) And put together a little note. (50:08) And it put the note together, and I read it. (50:10) And I was like, this is not a thing I would actually send to somebody, but it did have the bones of what I meant.
Scott Benner (50:16) And so then I went back
Tricia (50:17) in I could use it. (50:18) Find that for a paper.
Scott Benner (50:19) Yeah. (50:20) Then I went back in storm. (50:21) I rewrote the whole thing, but over top of the bones. (50:24) Like, I didn't have to sit and come up with the, like, the the structure of it.
Tricia (50:27) It's yeah. (50:28) Yeah. (50:28) It gets your brain moving to to think I I mean, and some things you're like, oh, no. (50:32) I wanna do a little bit, and I need to add that. (50:35) But it it's it's still is helpful.
Tricia (50:38) I do think for kids, it's dangerous. (50:40) Like, you and I went to school. (50:41) We know how to write. (50:42) You know I mean?
Scott Benner (50:42) I I don't know. (50:43) It's just gonna it's just gonna change how people do things. (50:46) Like, it's I dangerous
Tricia (50:47) is It's gonna change. (50:48) I would just say, like, to me, I always look at it. (50:51) It's like, yeah. (50:51) Who knows though? (50:52) Your point who knows how it's gonna change things?
Scott Benner (50:54) I think like everything else, the people who are lazy and not motivated will misuse it, and people who see it as a tool will use it correctly. (51:01) Like like, as an example, like, I could not have gone through the, like, hundreds of reviews I got this year to find the ones that actually lean into the idea of, like like so it just was easy it was able to, like, go zip. (51:13) Hey. (51:13) Here's five of them that will let the advertisers know that, you know, they're they're buying ads from you actually help people, and the and these reviews do that. (51:25) And I'm like, okay.
Scott Benner (51:26) Great. (51:26) So there they are. (51:27) And and look, I'm gonna I'll read it to you right now. (51:30) Like, I don't mind if anybody hears it. (51:31) I said, it says now, and it's me rewriting it.
Scott Benner (51:35) As we wrap up the year, I've been thinking about the work we've done together. (51:38) On the surface, it's straightforward. (51:40) But as with every year's end, I wanna take a second to look at the part that doesn't show up in any report, the outcomes that will endure for lifetimes well after the business has been forgotten. (51:51) All year long, get messages from people, sometimes long, often emotional and reflective about fear easing up, confidence coming back, parents finally feeling like they can breathe, adults with type one adults with type one saying they understand their own bodies more completely. (52:07) People who felt alone until something in an episode or an interaction in the juice box community made them feel less so.
Scott Benner (52:13) So, yes, we did good business this year, but your dollars are also making something human happen for a lot of people quietly, steadily, one episode at a time. (52:23) And I just wanted to say that I see that, and I appreciate it, and I'm looking forward to next year. (52:28) And then it gives you six reviews that came back from people, One from a parent of a child, one from an adult, one from a long term adult, one from a short term, one from an RN whose kid has diagnosed got diagnosed, but they didn't know what they were doing. (52:43) Like, it gives them the feeling very quickly. (52:46) This is not just one person.
Scott Benner (52:48) Right? (52:48) Like, it's it's it's reaching all kinds of different people and all kinds of different things. (52:52) And that's it.
Tricia (52:53) I just No. (52:54) It's beautiful. (52:54) You guys helped me when I first got diagnose nose. (52:57) I used to take you guys on I used to go for for for walks and and even, like, like I said, some of the episodes on the digestive stuff, I was like, oh my god. (53:05) I'm not crazy.
Tricia (53:06) I am not Yeah. (53:08) It's important. (53:08) Insane.
Scott Benner (53:09) It's and and it takes somebody to stay and pay attention. (53:12) Like, I'm I I don't know in the end, like, if I'll even have time to, like, look back over my life and wonder what it was. (53:19) Right? (53:19) I mean, I'll just get hit by a car. (53:20) But, like, I I think that the value of those ads on this podcast is that one person with a brain like mine gets to sit into this stew and think about it all the time.
Scott Benner (53:34) Like, it's my job to wonder about this. (53:37) Like, I've made it my job. (53:38) Nobody gave it to me, but it's my job to hear your story and to think about it. (53:42) Like, I'll think about your story forever now, like bits and pieces of it, just like I do everyone else.
Tricia (53:48) No. (53:48) No. (53:48) You will. (53:48) You'll be like, remember that time we had that woman who didn't get diagnosed for sixteen years?
Scott Benner (53:53) Well, it's even and and sometimes it's even more functional stuff. (53:56) Like, you you said you had cystic acne. (53:58) Did it go away? (53:58) Was spironolactone the the reason? (54:01) Like, why do
Tricia (54:01) you still have it? (54:02) It was it was as soon as I went on the insulin and had, like, the low first, it it really ebbed and flowed when I went on that SIBO diet. (54:11) Okay? (54:12) So I was spiking. (54:13) It it's something and I'll notice now my my acne is pretty controlled because I'm a pretty I'm I'm my a one c, everything's, like, pretty good.
Tricia (54:24) Every once in a while, if I'll have a low, which is kinda hard. (54:28) I only take two units, but maybe I did a lot of physical Mhmm. (54:31) I'll get an I'll get acne. (54:33) So it's that up and down. (54:35) Something about that will give me an acne cyst.
Tricia (54:39) Like like, say I went not even super low, but The bounce thing. (54:42) And I I bounce. (54:44) And who knows? (54:45) I don't know. (54:45) I'm a different individual than all these other genes, but, like, there's something about there was something, of course.
Tricia (54:53) I didn't have, like, really bad cystic acne before I got the the diabetes. (54:59) Yeah. (54:59) So it and and now yeah. (55:01) My nephew started to get it as soon as they caught his sugars were out of whack.
Scott Benner (55:05) And I love that you explained. (55:07) Like, that's there are some people whose brains will hear, like, that's not right. (55:10) And, like, but you you she's not telling you that, you know, bouncing blood sugars definitely made her her acne pop up. (55:16) What she's telling you is this is what I noticed. (55:18) Now take that little piece of it and see if you notice something.
Scott Benner (55:21) Like, that's the important part. (55:22) Not you don't get stuck on the what you just said is exactly wrong. (55:26) Like, I sometimes get reviews and, like, people are like, you misspoke there. (55:29) And I'm like, awesome. (55:30) I'm glad you're perfect.
Scott Benner (55:32) Fuck off. (55:33) And and, like, you're like yeah. (55:34) Like and and it doesn't it doesn't hurt anything that I use the wrong word here or the wrong connotation of something. (55:40) Like, it's the conversation that's important. (55:42) And if you can't wrap your brain around that, then this kind of communication's not for you.
Scott Benner (55:46) And that's cool. (55:47) I'm sorry that, like, it didn't help you. (55:50) But, like, you can't get so you can't word police this thing to death. (55:54) You have to, like, just let people talk to see what comes from it. (55:58) And Mhmm.
Scott Benner (55:58) A lot of times, good stuff comes from it. (56:00) And I don't see a lot of bad stuff coming from it. (56:03) Right? (56:04) Like, there's no there's 75,000 people in that Facebook group. (56:07) No one's running around going, I misunderstood something and my head exploded.
Scott Benner (56:10) Like, you know, like, it's it's okay to let people talk and see what they see what they're experiencing.
Tricia (56:15) Yeah. (56:16) If I helped one person who has this kind of family history go get all the screening and all all the appropriate tests, I think some of the root cause for me started very young where I stopped going to an endocrinologist, right, for for for checkups.
Scott Benner (56:31) Yeah. (56:31) For
Tricia (56:32) sure. (56:32) So if I if I save one person, man, it's worth it. (56:37) And I I swear if any of your sponsors, etcetera, anyone talks to the ADA, some of these other organizations, stop start telling the truth about diabetes being a spectrum. (56:49) Okay? (56:49) Like, we have the data with the CGMs.
Tricia (56:51) Like, there's so much we know, and there's so many diabetes is exploding in this country, ultra processed food, etcetera, etcetera. (56:59) The GLP one drug drugs are changing things. (57:02) But, like and to your point, what's really going on with with some of that? (57:07) Like, we have to get this information talked about more in the mainstream.
Scott Benner (57:12) Yeah. (57:13) I agree. (57:13) Okay. (57:14) You're awesome. (57:15) I'm gonna say goodbye.
Scott Benner (57:16) Thank you very much.
Tricia (57:16) I'm gonna I'm gonna miss you, and then I have to look up. (57:19) I I
Scott Benner (57:19) You're gonna miss me?
Tricia (57:20) I they're talking to me about going on possibly trying a pump, and I'm like, I'm gonna look through your episodes. (57:27) I was gonna be surprised. (57:28) Me go to the Dexcom seven, and I'm trying to see what's good for someone who's active and doesn't really go low very
Scott Benner (57:36) hope the podcast helps you. (57:37) I I tell you that from our conversation, I've made notes here for myself. (57:40) I'm gonna get on an EDMR, like, therapist to talk about it. (57:44) I'm also gonna try to get somebody on who's doing psilocybin therapy out in Colorado and get them to talk about that because of the trauma stuff that you picked up. (57:54) And I've got this Vibrant in front of me.
Scott Benner (57:56) I'm gonna reach out to people there.
Tricia (57:57) Oh my god. (57:58) Please do it. (57:59) Because my endocrinologist was the my endocrinologist and then my the liver doctor, because she's in the digestion, they're like, they know about it. (58:08) And they're like, this is incredible for diabetics.
Scott Benner (58:11) The Vibrant system is clinically proven to deliver effective relief from chronic idiopathic constipation with fewer nasty side effects than drugs
Tricia (58:19) and laxatives.
Scott Benner (58:20) So if the people at Vibrant are listening, I think that sounds like a good ad. (58:23) You should get ahead of me.
Tricia (58:24) But I have no I don't really have negative side effects from it. (58:28) And then long and short very short, I would say too, I love your idea about the EDMR because type one diabetes, like, you have to think, I saw my mom turn purple and almost bite her tongue off. (58:38) You've had your stories. (58:39) I remember listening to the one about Arden in the prom. (58:42) Like, we go through trauma.
Tricia (58:44) That shit sticks to you. (58:45) Yeah. (58:46) And it helps you calm, like, maybe that trauma you have from seeing a hypo Yeah. (58:52) Or experiencing a hypo and going to the emergency room. (58:55) So I I love what you're saying.
Scott Benner (58:57) I appreciate it. (58:57) Also, you know, those little experiences, you wanna see a real life example of how it helps somebody. (59:01) One of those girls that was there when Arden had that seizure is in is in nursing school now. (59:07) And I drove her back to school after a break recently. (59:09) She didn't she needed a ride back to school, and I was like, I'll take you.
Scott Benner (59:12) You know? (59:12) So I'm driving her back, and we've been talking. (59:14) I've known her since she was a little kid, and we're talking and everything. (59:17) And she says, I'm in nursing school now, and we already talked about diabetes. (59:22) And I was like, right?
Scott Benner (59:23) And she goes, and then I look at Arden's life, and I think, that's all they're gonna teach me about this? (59:28) How am I gonna know what I'm doing? (59:29) And then it hit her, and she was like, oh, no. (59:32) What else don't I know? (59:33) And I was like, ah, that's the right that's the right question.
Scott Benner (59:37) What else don't
Tricia (59:37) I know? (59:38) One physician who said to me, I went into this because it's a life lifestyle disease, and I care about people, and I wanna be with them through their life with diabetes and help them live better. (59:49) And I'm like, we need guys like you. (59:52) We need people like you.
Scott Benner (59:53) Yeah. (59:53) I feel like that. (59:54) I don't I just don't know that everybody whose brain is doctor y is that I think more of them just wanna do tests, like, you know, flowchart Somewhat
Tricia (1:00:02) to me. (1:00:02) Endocrinologists, some are attracted because it's very much a numbers type field. (1:00:07) So then sometimes you can get people who are less. (1:00:10) I I I don't know if the tide's changing in terms of that, but, like, you gotta be careful of just going to endocrinologists who are numbers guys. (1:00:17) To your point about your wife and the normal TSH.
Scott Benner (1:00:19) Yeah. (1:00:20) No. (1:00:20) I would imagine that we probably need people who are more diabetes related because endocrinology covers a lot of different things. (1:00:25) And so Mhmm. (1:00:26) You know, it doesn't
Tricia (1:00:26) necessarily Yes.
Scott Benner (1:00:27) Mean that they even wanted to be involved with diabetes. (1:00:30) They might just have to be because of their specialty. (1:00:32) I have no idea.
Tricia (1:00:33) Yeah. (1:00:33) Yeah. (1:00:34) Yeah. (1:00:34) And my my best I had a better experience to your story of your with your daughter's friend with the diabetes. (1:00:41) When I got handed off to the diabetes educator, she looked at me, oh my god.
Tricia (1:00:45) I can't believe your story. (1:00:47) And then she was so compassionate, and she really taught me wonderful tips about how to and I'm like, the first doctor, you know, you didn't you you didn't I didn't get that. (1:00:57) And, yeah, it's like we need those we need those people within this field.
Scott Benner (1:01:01) Yeah. (1:01:01) So Well, hopefully, they'll come. (1:01:03) Alright. (1:01:03) Alright. (1:01:04) Hold on one second for me.
Scott Benner (1:01:05) You were lovely. (1:01:06) Hold on one second. (1:01:15) Dexcom sponsored this episode of the Juice Box podcast. (1:01:19) Learn more about the Dexcom g seven at my link, dexcom.com/juicebox. (1:01:26) A huge thanks to Cozy Earth for sponsoring this episode.
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#1752 Diabetes Spectrum - Part 1
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
Scott talks with Tricia, a longtime healthcare administrator, about missed autoimmune warning signs, “normal” labs masking LADA, and how a system built on checkboxes can fail people who need critical thinking.
+ Click for EPISODE TRANSCRIPT
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 (0:0) Here we are back together again, friends, for another episode of the Juice Box podcast.
Tricia (0:16) Testing. (0:16) Testing. (0:17) Testing.
Scott Benner (0:19) Was Tricia, and she is today's guest. (0:21) And this is part one of a two part episode. (0:23) The next one's coming right away tomorrow. (0:25) Go check it out when you're done with this one. (0:28) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.
Scott Benner (0:33) Always consult a physician before making any changes to your health care plan. (0:38) If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. (0:45) That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. (0:50) These are perfect little bursts of clarity, one person said. (0:53) I finally understood things I've heard a 100 times.
Scott Benner (0:56) Short, simple, and somehow exactly what I needed. (0:59) People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. (1:07) Nothing overwhelming, no fire hose of information, just steady helpful nudges that actually stick. (1:13) People listen in their car, on walks, or rather actually bolusing anytime that they need a quick shot of perspective. (1:20) And the reviews, they all say the same thing.
Scott Benner (1:23) Small sips makes diabetes make sense. (1:26) Search for the Juice Box podcast, small sips, wherever you get audio. (1:31) The show you're about to listen to is sponsored by the Eversense three sixty five. (1:36) The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. (1:44) Eversensecgm.com/juicebox.
Scott Benner (1:48) US Med is sponsoring this episode of the juice box podcast, and we've been getting our diabetes supplies from US Med for years. (1:55) You can as well. (1:57) Usmed.com/juicebox or call (888) 721-1514. (2:04) Use the link or the number, get your free benefits check, and get started today with US Med. (2:10) Today's episode is sponsored by the Tandem Mobi system with Control IQ Plus technology.
Scott Benner (2:16) If you are looking for the only system with auto bolus, multiple wear options, and full control from your personal iPhone, you're looking for Tandem's newest pump and algorithm. (2:26) Use my link to support the podcast, tandemdiabetes.com/juicebox. (2:31) Check it out.
Tricia (2:32) It's Tricia, and I'm a 51 year old mom, former health care administrator, currently in, getting a master's in professional counseling.
Scott Benner (2:45) You're a former health care administrator. (2:48) What does that mean? (2:49) What did you do?
Tricia (2:50) I worked for a very large health care system in New York City. (2:58) My last I did many I wore many different hats working for chief executive, like, chief executive nurse as a project manager, you know, sort of chief of staff positions. (3:11) And then the last position I had, ironically, in 2020 was working for workforce or import a lot of places call employee health. (3:25) And so we really were supporting the organization in getting n 95 masks, procedures for calling out of work, getting the vaccine, declining the vaccine. (3:38) So that was a large part of my former life.
Scott Benner (3:41) For a while. (3:42) Would you consider what you did more of the business money side or the medical side?
Tricia (3:49) I did everything. (3:51) So I like you know, you just I'm 51. (3:55) You have a long career. (3:56) So for a while, I worked in supporting operation for one one of the academic medical centers. (4:05) So in that regard, managing budget, you know, helping make sure people get, across the different departments at the lab, emergency department, can fund a new MRI machine, things like that.
Scott Benner (4:19) Mhmm. (4:20) Can you give me a couple of, like, I don't know, like, high level takeaways what it's like for a system to be patient centric health related and basically a retail business at the same time? (4:37) Like, what what what are some of the oddities that come when you mix those two things together?
Tricia (4:42) Well, I think what I saw was big changes in the environment because I started working there in 2007. (4:51) Before that, I had been in corporate working for insurance companies. (4:57) Mhmm. (4:57) Very different. (4:58) And when I first started working there, they were only touting that they were patient centric.
Tricia (5:07) And as time went on, I really saw the organization realize that if we don't treat our employees well, that's gonna trickle down to the patient. (5:18) Okay. (5:19) But then at the same time, you know, I went through, like many organizations, there were times when we had to cut staffing. (5:32) You know, we were very impacted with being over the budget. (5:40) And so it was also you know, there were times that you would realize this is the business, and we're letting go, you know, Jane Doe in department x even though she's really great with patient care, and she's been here for twenty years.
Tricia (5:57) So you see those, you know, ebbs flows, and you see also just a lot of bureaucracy and, you know, that the you know, when you're working with individuals in in a c suite, just really how competitive and, you know, stressful their jobs can be.
Scott Benner (6:18) Mhmm. (6:19) Is a hospital more, a, a doctor's office that has to collect a payment or, b, a business that's selling health care?
Tricia (6:30) I'd go with more the latter, but I do have to say that going through many different leaders, I did have one leader who really always emphasized the patient. (6:45) I mean, really Mhmm. (6:47) Genuinely, earnestly, you know, just, you know, it just really permeated through the organization.
Scott Benner (6:58) And that's what was that people's preference, do you think? (7:02) Like, do you think that when it went more like that, the staff was happier?
Tricia (7:06) Yes. (7:06) Because I think, like I said, I saw I started in the beginning where it was all about patients first, and it was like, who cares about you, the employee? (7:16) Mhmm. (7:16) And when you're when your leader cares about the patient, it's generally also gonna be someone who cares about you. (7:26) So it really changed the whole environment.
Tricia (7:31) It's it's contagious.
Scott Benner (7:33) Have you ever lived through an iteration where really it was it it's about the widget? (7:38) Like, the the the health care is just a widget, and we're just here to, like, put them in people's hands as fast as we can so we can send them a bill for it?
Tricia (7:47) No. (7:47) I think I think what I saw more is, especially when I worked for corporate nursing, is just how bogged down you can get in meeting regulatory requirements.
Scott Benner (8:01) Okay.
Tricia (8:01) So, you know, that you're you're taking all of the, you know, data points about, like, pressure ulcers and, you know, smoking cessation and and how you chart in the MRI, and it just gets so bogged down with you know, the Joint Commission can show up. (8:22) The Department of Health can show up at any time. (8:24) And I was in the command center for which we called which is basically you're helping the organization as the surveyors are going, you know
Scott Benner (8:35) Yeah.
Tricia (8:35) Choosing comb for the organization. (8:37) So I think that can get in the way of, patient care is that you're trying to be sold to the letter of those regulations.
Scott Benner (8:45) Mhmm. (8:46) And then how much of the health care people receive is dictated by their by insurance?
Tricia (8:54) You know what? (8:55) I did not work in revenue cycle, but, you know, it was just an absolutely huge focus of the organization.
Scott Benner (9:07) What would happen I mean, is there a world that you can imagine where it could just go back to, like, the way it was? (9:14) Or is it just too is it all too intertwined at this point? (9:19) And do you I
Tricia (9:21) don't mean, right now, it's very very intertwined. (9:24) And even if I tell my own story, I I think one of the reasons I'm sure that contributed is just the insurance model of why I was not diagnosed with type one fully progressing for over sixteen years.
Scott Benner (9:42) Okay. (9:42) Oh, you had you had Lada and what were you being told it was type two? (9:47) No. (9:48) No. (9:48) What happened
Tricia (9:49) to not
Scott Benner (9:50) Go ahead. (9:50) Tell me. (9:50) My story start at the
Tricia (9:51) beginning. (9:52) Story is unbelievable.
Scott Benner (9:54) Let's find out.
Tricia (9:56) I got Hashimoto's at age six. (10:00) I saw an endocrinologist. (10:02) My numbers you know? (10:04) So I was born in 1974.
Scott Benner (10:07) Mhmm.
Tricia (10:07) So, you know, when I'm in grammar school, you know, they're thinking, okay. (10:14) We just treat you with some and off you go. (10:21) What happened is my number started to look better. (10:25) The doctor the endocrinologist I saw said, okay. (10:29) She doesn't have to take Synthroid anymore.
Tricia (10:31) I think I was about 11. (10:33) My parents were moving from a borough of New York to an another suburb in the Tristate area.
Scott Benner (10:44) Mhmm.
Tricia (10:44) And so my he said, you can just you can take her, you know, to the primary her primary care doctor, and then my body never functions properly.
Scott Benner (10:57) You've probably heard me talk about US Med and how simple it is to reorder with US Med using their email system. (11:03) 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. (11:08) They don't just randomly call you. (11:09) But I'm set up to be called if I don't respond to the email because I don't trust myself, a 100%. (11:15) So one time I didn't respond to the email and the phone rings at the house.
Scott Benner (11:20) It's like, ring, you know how it works. (11:21) And I picked it up. (11:22) I was like, hello? (11:23) And it was just the recording. (11:24) Was like, US med.
Scott Benner (11:25) Doesn't actually sound like that, but you know what I'm saying. (11:27) It said, hey, you're, I don't remember exactly what it says, but it's basically like, hey, your order's ready. (11:32) You want us to send it? (11:33) Push this button if you want us to send it. (11:35) Or if you'd like to wait, I think it it lets you put it off, like, a couple of weeks or push this button for that.
Scott Benner (11:40) That's pretty much it. (11:41) I push the button to send it, and a few days later, box right at my door. (11:46) That's it. (11:46) Usmed.com/juicebox or call (888) 721-1514. (11:51) Get your free benefits checked now and get started with USmed.
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Scott Benner (12:22) And today, I'm gonna tell you about Tandem's newest pumping algorithm. (12:26) The Tandem Mobi system with Control IQ plus technology features auto bolus, which can cover missed meal boluses and help prevent hyperglycemia. (12:35) It has a dedicated sleep activity setting and is controlled from your personal iPhone. (12:40) Tandem will help you to check your benefits today through my link, tandemdiabetes.com/juicebox. (12:47) This is going to help you to get started with Tandem's smallest pump yet that's powered by its best algorithm ever.
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Tricia (13:21) Functioned properly. (13:23) I had difficulty through puberty gaining weight. (13:30) I would have bouts of constipation. (13:33) My menstrual cycles were extremely irregular and then disappearing, sometimes for eight months. (13:42) I don't you know, I was seeing a primary care doctor.
Tricia (13:46) My own mother was a type one diabetic without much education. (13:52) She herself, at that point when I was a teenager, was going through a lot of high highs, a lot of low lows, a lot of emergency situation. (14:02) I actually, as a teenager, many times had to call 911. (14:06) I saw her turn purple. (14:08) I saw her convulse and start to bite her tongue off.
Tricia (14:11) So here, I have this craziness in my own home, and I march off and my issues keep growing
Scott Benner (14:19) Yeah.
Tricia (14:20) With my menstrual cycle, etcetera. (14:22) So then long story short, around 2011, I start to go to my doctor because I say, hey. (14:32) Starting to get really bad digestive issues.
Scott Benner (14:35) Wait. (14:35) Wait. (14:35) Wait. (14:35) 2011 sounds like twenty four years after they took you off Synthroid. (14:39) Yeah.
Scott Benner (14:39) Okay. (14:40) So
Tricia (14:40) So I go I go off Synthroid and then
Scott Benner (14:43) Have all these problems wait. (14:46) Yeah. (14:46) Hold on. (14:46) Tricia, you go off Synthroid. (14:48) You have all these problems that are easily attributable to not being medicated for your thyroid, and no one goes, hey.
Scott Benner (14:54) We should probably put her back on that Synthroid?
Tricia (14:56) Well, this is what I I think. (14:58) My my pair my mom got diabetes type one when she was 12. (15:06) And think about it. (15:07) It was 1960.
Scott Benner (15:08) Mhmm.
Tricia (15:09) She had very uneducated parents. (15:11) Her mother was, like, a first generation immigrant, and my mother had that mentality. (15:18) So my mother took me to the primary care, didn't ask questions about me, didn't ask questions about myself, except she just said she's thin. (15:27) And I remember the primary was like, is your fan some of your family thin? (15:30) And she said, yes.
Tricia (15:32) And so
Scott Benner (15:32) I was the end of it?
Tricia (15:33) What I yeah. (15:35) What I realized now is, like, we can't look at the care through the lens of now. (15:43) And what happened to me was a perfect storm of an and it shows the impact of type one on the family if there isn't education. (15:54) How? (15:55) So my because my mother would only say this.
Tricia (15:59) You don't have to worry about this. (16:00) You'll never get it. (16:02) You you don't have to worry about this. (16:04) The doctor told us the primary care could just handle you. (16:07) I don't think the primary care literally meant if she starts to have all these issues, you shouldn't bring her back to an endocrinologist.
Scott Benner (16:16) I think Trisha, it it occurs to me that it is so simple that, like I don't know. (16:21) If we threw you in the pool and you started to sink, and we said, oh, no. (16:25) Look. (16:25) She's sinking. (16:26) And someone said, here, give her a piece of Styrofoam to hold on to.
Scott Benner (16:29) And you held on to the Styrofoam, and you didn't sink anymore. (16:31) And then a few years later, they were like, oh, look. (16:33) She's been bobbing around in the pool for a couple of years. (16:35) She's doing good. (16:36) I don't think she needs the Styrofoam anymore.
Scott Benner (16:38) We took it from her, and then you sank again. (16:40) Is the next thought not give her the Styrofoam back?
Tricia (16:45) Well, this is kind of what I'm thinking. (16:46) Right? (16:47) I move. (16:48) I'm seeing new primary care doctors. (16:51) I don't get it.
Tricia (16:52) I'm showing and I still this was then, but I still see elements of it in the health care system.
Scott Benner (17:00) Tell me. (17:01) Tell me. (17:01) Because it's so it's fascinating to me because there had to have been a chart that said you were on Synthroid and then you weren't. (17:06) Somebody had to have read that at some point.
Tricia (17:09) Well, that chart would have been, New York, and it wouldn't have been
Scott Benner (17:15) Oh, it
Tricia (17:15) wouldn't new place I moved.
Scott Benner (17:16) It wouldn't have went with you unless your mom went
Tricia (17:19) Because it was pay it was paper charts. (17:21) So my mom I think the only thing my mom ever did my mom never read about Hashimoto's. (17:27) I remember we had a you know, we're in the information age, so we can get all of this. (17:31) But you have to think, we had a medical book in our house.
Scott Benner (17:34) Okay.
Tricia (17:34) My mom would look at it if we had bronchitis. (17:37) She didn't look up Hashimoto's. (17:38) Mhmm. (17:39) She didn't right? (17:41) Because one of the things I even found in the eighties books was it it can cause irregular menstrual
Speaker 3 (17:49) cycles. (17:49) Right. (17:50) Right.
Tricia (17:50) And, you know, constipation. (17:52) So I'm looking and I'm thinking to myself, oh my god. (17:56) I knew I was different than my friend. (17:58) I was and then the problems are getting worse in my twenties. (18:03) And I'm calling my mother and I'm saying, okay.
Tricia (18:06) Like and she would say things like, I love this. (18:09) That's I guess that's just the way we are. (18:12) I love that. (18:12) That's like a great a a great a great a great old school
Scott Benner (18:18) What what's what's your mind mom's background? (18:20) Is she Italian?
Tricia (18:21) Irish. (18:23) Her mother was first generation Irishman.
Scott Benner (18:26) That's how we are.
Tricia (18:28) Right? (18:28) Yeah. (18:29) So, like, I'm hemorrhaging. (18:31) I'm severely constipated. (18:34) Like, that that's the way we are.
Tricia (18:37) So
Scott Benner (18:37) Mom, the whole the whole where stuff's supposed to come out of, nothing's coming out of it, and the other one's doing the opposite. (18:43) I'm in a lot of trouble here, I'm bleeding a lot. (18:45) And she goes Yeah. (18:46) That's just how we are. (18:47) You were thin when you were little.
Tricia (18:49) No. (18:50) That was the whole
Scott Benner (18:50) thing. (18:51) Right?
Tricia (18:51) And the whole the whole thing, Scott, is that, like, I would have what I realized now is I was having some type of flares. (18:59) Okay. (19:00) Because then maybe the symptoms could get better for six months, and they the solution in the nineties for women, and we're really getting strong women now, is, like, okay. (19:14) Don't just throw me on the birth control pill. (19:16) Why did my cycle disappear when I'm 17 years old for eight months?
Tricia (19:20) My menstrual cycle just that's not normal. (19:23) And then it happened when I was in high school. (19:26) They called me home for I had to go home from college to the doc to the OBGYN, and they knew my cycle had disappeared for eight months when I was 17. (19:37) So they go, oh, we'll just give you a medication, make you ovulate, and then we'll throw you on the birth control pill. (19:43) So it was like no investigation of like, my your my body's screaming, like, hey.
Tricia (19:48) I don't function right.
Scott Benner (19:49) Yeah.
Tricia (19:49) And there's no prevention. (19:52) No no root cause analysis. (19:54) And then I fast forward to my thirties, and I start to get first sign, which I didn't realize now, is I suddenly, I always had beautiful skin. (20:08) I started to get cystic acne when I was about 31 or 32.
Scott Benner (20:14) What what do you And
Tricia (20:15) then the doc oh, go ahead.
Scott Benner (20:16) What do you attribute that to?
Tricia (20:19) And I had a little bit of cystic pimples in my twenties a little bit, so sometimes I wonder so now I know what it is. (20:26) I I'm pretty sure it was, like, a first sign of insulin resistance. (20:33) And then they put me on a drug called, I went to the dermatologist to put me on a drug called spironolactone.
Scott Benner (20:39) Spironolactone. (20:40) Yeah. (20:40) Yeah. (20:41) Yeah. (20:41) Yeah.
Tricia (20:41) Spironolactone. (20:42) That was
Scott Benner (20:42) a big one back then. (20:43) Yeah.
Tricia (20:43) It makes you pee pee. (20:46) By the time I was 33, I'm starting to pee more. (20:49) I think it's the drug. (20:50) I think it's the drug from the because I had a reaction right away to taking it, to peeing more.
Scott Benner (20:56) Mhmm.
Tricia (20:57) So I start to get nocturia. (20:59) Then I'm in grad school. (21:01) I'm working for a chief executive. (21:03) I'm going to NYU at at at night. (21:08) I have a very demanding job.
Tricia (21:11) At first, my job's in New Jersey.
Scott Benner (21:13) Tristan, can I stop you for a second?
Tricia (21:15) Yeah. (21:16) Is
Scott Benner (21:16) your alarm going off somewhere?
Tricia (21:19) Oh, yeah. (21:20) Hold on. (21:20) You can hear that? (21:21) Yeah. (21:21) I'm take gonna get it.
Tricia (21:22) Thanks.
Scott Benner (21:26) Guys, I put a new rock in with one of my geckos. (21:28) He's climbing all over it. (21:29) It's feeling like a good purchase.
Tricia (21:31) So so
Scott Benner (21:33) then What was that alarm for, by the way?
Tricia (21:35) Oh, that's not for anything important.
Scott Benner (21:37) You don't wanna tell me?
Tricia (21:39) For us. (21:40) No. (21:41) For us. (21:41) I usually I take medication, but I I already took it.
Scott Benner (21:44) Okay.
Tricia (21:44) So fast forward before. (21:47) Anyways,
Scott Benner (21:48) spironolactone, peeing a lot, thirties. (21:50) I got you. (21:51) Go ahead.
Tricia (21:51) So, yeah, so I go on spironolactone. (21:54) I start to pee a lot while I'm on it. (21:57) It's controlling my acne, but I noticed I already have I always have heavy menstrual cycles, but now they're off the hook. (22:05) It's like, I went from five or or or, you know, my whole life of being, like, on a scale of, like, one to five, like, being too heavy, maybe, like, five, six. (22:14) Mhmm.
Tricia (22:15) So, like, now I'm, like, an eight. (22:17) I feel like I have the flu every time I get my period. (22:20) So I'm going to the OBGYN. (22:24) I start to get more and more constipated. (22:27) I get married.
Tricia (22:28) I go for fertility treatments. (22:32) They tell me, like, I have polycystic oh, no. (22:35) They told me I had a lot of I don't think at that point I got got diagnosed with PCOS. (22:40) That came later. (22:42) But, so I'm trying to get pregnant.
Tricia (22:46) I'm surveilled all the time. (22:48) They're always taking blood.
Scott Benner (22:49) Mhmm.
Tricia (22:50) Okay? (22:51) Nothing's showing up in terms of my glucose being out of whack, but no one's giving me an a one c. (22:59) My primary never gives me an always a one c in my twenties despite family history. (23:05) My new doctors don't give me an a one c because I'm 45 even though I have family history. (23:14) I go to the primary care back in New Jersey because I'm getting more and more abdominal pain and more constipation.
Tricia (23:23) And I say to him, I'm urinating too much at night. (23:26) I'm like, what could it be? (23:27) I've got all these problem. (23:29) Gynecological. (23:30) You're you're you know?
Tricia (23:32) He goes, I don't know what to tell you. (23:34) He's like, I just go to a woman's doctor about that. (23:38) He treats my mother, who is a type one diabetic who, we can get to this later, only lives for seventy six. (23:47) We lost her last year because she had a kidney pancreas transplant. (23:50) She also was legally blind.
Tricia (23:52) Okay. (23:52) So he's treating her
Scott Benner (23:54) Not well.
Tricia (23:54) But never gives me an
Scott Benner (23:57) And they won't
Tricia (23:58) see you test. (23:58) Yeah. (23:59) Never. (23:59) Yeah. (24:00) And I've been seeing him since my twenties.
Scott Benner (24:02) When you think of a CGM and all the good that it brings in your life, is the first thing you think about, I love that I have to change it all the time? (24:10) I love the warm up period every time I have to change it? (24:13) I love that when I bump into a door frame, sometimes it gets ripped off. (24:16) I love that the adhesive kinda gets mushy sometimes when I sweat and falls off. (24:20) No.
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Tricia (25:03) Hey. (25:04) So then Go ahead.
Scott Benner (25:05) Let me stop you for a second. (25:06) I feel like your voice has gotten farther away. (25:08) Is there a way that we can change? (25:10) Like, is the is your hair covering the headphones, anything like that?
Tricia (25:15) Okay. (25:15) There.
Scott Benner (25:15) Okay. (25:16) Thanks. (25:16) Yeah. (25:16) Keep your hair off the headphones. (25:18) So yeah.
Scott Benner (25:19) So this guy's treat I'm I'm gonna make air quotes around treating your mom. (25:22) He's treating her right into seven horrible complications including blindness and and
Tricia (25:26) Oh, yeah. (25:27) Yeah. (25:27) And she's And a lot of that had started, you know, way before her way before even him, but he didn't I don't know how much he helped.
Scott Benner (25:36) And when you and when you asked him for help, he said, you gotta go find one of those lady doctors.
Tricia (25:41) Yeah. (25:41) And then he said, why are you still coming here? (25:43) You should go in New York. (25:46) And this guy was treating my dad, my brother, and my and my mom. (25:51) Mhmm.
Tricia (25:51) So, you know, I think back in the day, sometimes you really did have that old school family doctor who's like, let me I can keep an eye on this whole family. (26:00) Not him.
Scott Benner (26:01) When you saw your mom, like, struggling, you didn't think, like, is this really the doctor I wanna go to? (26:06) Like, how does that occur to you? (26:07) Because I'm
Tricia (26:08) No. (26:08) We you have to think it's a different time, and we each have her own family culture. (26:14) So my mom's never make not an educated person on type one diabetes, not educated by her parents. (26:22) She said she read a book about type one when she was younger in the library, got scared because it told her in the nineteen sixties that she would be dead by her forties. (26:33) So she you learn my mom's famous expression of what you call it, the apple doesn't fall far from the tree.
Tricia (26:41) So I always look at my story as the perfect interaction between a family that is not talking about the, type one diabetes. (26:54) It's not vigilant, you know, about it. (27:00) And then you have the interface with a nonprevented preventative siloed health care system.
Scott Benner (27:08) Okay. (27:09) How much better do you think so access to information obviously has changed a lot over your your lifetime. (27:16) But do you think it's using your your professional background and your personal experience, do you think it's where it needs to be, or do you just think it's better?
Tricia (27:25) I think from working in the hospital, I love the story. (27:28) They put all the alarms to say the when the page you know, on different pieces of equipment that are in a room with the patient. (27:37) Mhmm. (27:37) So then the nurse nurses or clinicians stop hear them so much that they start ignoring them. (27:43) My husband and I almost fell over when we looked at my chart, my online medical record.
Tricia (27:54) When I because I then started to seek care in New York, and it type one mother, paternal grandmother had Graves'. (28:01) Mother had hypothyroidism. (28:05) Paternal aunt has what is it, hyperthyroid.
Scott Benner (28:10) Oh, yeah.
Tricia (28:11) Father has, some type of autoimmune. (28:15) My dad has some type of autoimmune arthritis.
Scott Benner (28:19) RA? (28:20) Like So He had RA maybe?
Tricia (28:22) He's get it. (28:23) He gets so many different diagnosis.
Scott Benner (28:26) Mhmm.
Tricia (28:26) It's not even funny. (28:28) He he's been told he has five different types of arthritis.
Scott Benner (28:30) Irish too, by the way?
Tricia (28:33) So my father had better health when he was young younger. (28:37) He's more of a mutt, but he does have some Irish
Scott Benner (28:41) Yeah.
Tricia (28:42) On his father's side.
Scott Benner (28:43) It because it sounds like what's wrong with your family is pasty white European.
Tricia (28:48) Well, my brother and I joke. (28:50) What I see with my mom's family is it was too much of the same ethnicity over and over and over. (28:58) And when I look at my dad's family, like, he and his brothers had pretty good health and his mother and paternal and his his mother and his father were
Scott Benner (29:09) more of
Tricia (29:09) a mix together. (29:10) And my dad but my dad's mother with the Graves, she was, like, all Austrian, and there came from Pencil some area in Pennsylvania, and there wasn't a lot of heterogeneity. (29:22) Truly. (29:22) I I
Scott Benner (29:24) yeah. (29:24) I have to tell you. (29:25) I'm like I I think I've talked around this a million different ways, not on purpose, but you're the first person that kinda put their finger on it before. (29:31) Like, you're having purebred problems. (29:34) You're having, like like, you know you know, when you, like, when you say, like, you buy a puppy and they and eventually, like, you know, people say, oh, like, you know, I bought a mutt.
Scott Benner (29:42) It it thing's always healthy, but I got a I got a purebred, and it's got all these different problems because you're keeping the line too tight, and the problems breed too.
Speaker 3 (29:50) That's interesting. (29:51) Oh, yeah. (29:51) No.
Tricia (29:52) I see so many autoimmune. (29:54) My mom's, like, even in her, like, they'll be my second cousins, her first cousins,
Scott Benner (29:59) and
Tricia (29:59) so on and so forth. (30:01) And I'm like, yeah. (30:02) It's like a lot of but not a not a I I'm an avid reader. (30:06) I I remember listening to a podcast in the royal family that they all started to get, like, super messed up and have what is it? (30:13) One of them had hemophilia.
Tricia (30:14) It's like, yeah, not not enough diversity.
Scott Benner (30:17) They can look a little inbred sometimes too. (30:19) How about that?
Tricia (30:20) Yeah. (30:20) Yeah. (30:20) Yeah. (30:21) Like, a little not enough diversity. (30:23) And some of it's I mean, like, a lot of it's, like, stories of the royal family going back way, way, way.
Scott Benner (30:28) Yeah. (30:28) No. (30:29) I understand.
Tricia (30:29) Yeah. (30:30) So
Scott Benner (30:31) Well, I saw Game of Thrones too. (30:32) I know what's up. (30:35) Yeah. (30:35) But I know that's fictional in case people are like, oh god. (30:38) I think he thinks that's real.
Scott Benner (30:39) I know it's fictional, but I think the idea is there. (30:42) Right? (30:42) Like, you just Yeah. (30:43) Yeah. (30:44) Yeah.
Scott Benner (30:44) Well, anyway, because my point is that you hear a lot of these celiac thyroid, diabetes stories out of, like, England, Scotland, like, that kind of area around there.
Tricia (30:55) Yeah. (30:56) And you have to think, like, my brother did not end up getting it and his the y chromosome from my dad was, you know, protective, and I got hit on both with endocrine issues because my dad's mother had Graves'. (31:11) And I think that what I read is, like, they're you need an expert to weigh in on this. (31:16) They're I always look at it the same way. (31:18) Something with the HLA type one and Graves are I they're almost like attached houses.
Tricia (31:25) Okay. (31:25) Like, if you had two houses in a neighborhood that were attached, and then I think a lot of things, like my mom I was told my mom had very high sugars when she was pregnant with me. (31:35) They didn't think I was gonna make it. (31:38) Know, I was a a c section. (31:40) And when I was born, my mom was very sick.
Tricia (31:43) All these things. (31:44) Antibiotics when I was little. (31:46) So, you know, it's it's tons of factors from the environment that program the the stuff to turn off.
Scott Benner (31:55) Yeah. (31:55) They make the decisions. (31:56) So you live in a community. (31:57) The doctors all do the same things. (31:59) People have the same and so you're saying, like, even, like, as an example, like, I had lot a of antibiotics when I was little, and who knows what that did to my immune system long term?
Tricia (32:07) Yeah. (32:08) Yeah. (32:08) It wipes your microbiome.
Speaker 3 (32:09) Like, you know, there's a lot of theories now, and
Tricia (32:11) I'm not the expert. (32:13) But, like, I can see that everything that could go wrong, like, went wrong. (32:19) And even, like, when I probably I believe that I was experiencing symptoms early symptoms of Lada. (32:29) And my doctor actually said he's like, listen. (32:31) They can call it whatever they want.
Tricia (32:33) You're one of the slowest progressing type ones I've ever seen. (32:38) Right. (32:39) Now I say that with a grain of salt because we don't have data on me. (32:43) We don't have the a one c from, you know, around the time that it first happened.
Scott Benner (32:49) Yeah. (32:49) But you live you live through it. (32:51) You know your situation. (32:52) Also, you've said twice now I'm not the expert. (32:54) First of all, this is a podcast.
Scott Benner (32:56) So we you don't need to be an expert. (32:59) You're just sharing your experience. (33:00) Also, you've told a lot of stories about how experts didn't seem to know what they were doing. (33:04) So I I see the value in you just laying out what happened to you so that someone else can maybe pick through it and go, oh, that stuff's happening to me too.
Tricia (33:13) Well, I'm here to advocate for the like, I just got a newsletter from a large academic medical center, and it said there's only type one and type two. (33:26) People are not speaking about the fact that
Scott Benner (33:30) Your voice disappeared again, Trisha. (33:32) Did your did you cover the mic?
Tricia (33:34) No. (33:34) Hold on.
Scott Benner (33:35) No. (33:35) I'm sorry.
Tricia (33:36) Can you hear me?
Scott Benner (33:37) Yeah. (33:37) You just got farther away. (33:38) I don't know what happened.
Tricia (33:39) Okay. (33:39) Alright. (33:40) I don't know. (33:40) I'm adjusting them away from my hair. (33:42) Is that better?
Scott Benner (33:43) Maybe. (33:44) Make sure it's closer to your mouth.
Tricia (33:46) Okay. (33:49) Is that good?
Scott Benner (33:50) I mean, good's a relative term. (33:51) We got Rob. (33:52) He's gonna juice you up and make you sound better. (33:53) But I when you start disappearing into the fog, then I say something usually.
Tricia (33:57) No. (33:58) That's good. (33:58) Okay. (33:59) Okay. (33:59) Am I still disappearing?
Scott Benner (34:00) No. (34:01) No. (34:01) Go ahead.
Tricia (34:01) What what happened for me or why I'm doing this is because people do not know you can have diabetes and have a normal fasting blood sugar. (34:13) You can have you can get start to get type one diabetes and have a normal a one c. (34:21) It there is not just, like, a perfect, you know, diabetes can be a spectrum, and it is not getting enough PR. (34:30) You need to get the message out because I went to a doctor in 2016. (34:36) I was desperate.
Tricia (34:38) I could no longer eat. (34:40) I had lost so much weight. (34:42) I was shaking. (34:44) I was so weak. (34:45) My periods were crazy.
Tricia (34:47) My my iron stores I I think my hemoglobin was 7.8. (34:52) My iron my ferritin was, like, two. (34:55) Okay? (34:55) Which is just basically I had no iron in the bank. (34:58) Yeah.
Tricia (34:59) And when you don't have any iron
Scott Benner (35:01) No. (35:01) I feel like
Tricia (35:02) you have mono.
Scott Benner (35:03) I've had low ferritin in my life, and it's horrifying.
Tricia (35:06) No. (35:06) It's horrible. (35:07) Yeah. (35:08) So I couldn't use my brain. (35:10) I said I had brain fog.
Tricia (35:11) So I go to an endocrinologist based on a referral. (35:14) My primary in the city is really not doing anything for me. (35:19) I'm going from gastrointestinal doctor to gastrointestinal doctor. (35:25) They do colonoscopies. (35:27) They don't do a motility test.
Tricia (35:29) I didn't realize I needed a motility specialist because long story short, I don't know anything about GI, you know, the the specialty. (35:39) And I'm thinking my primary care does, and I was pushing her. (35:43) And after seeing five of them, I said to her, I constantly asked you if my TSH is okay because of my family history. (35:50) I said, let's send me for a full endocrine workup. (35:54) And I was confused because when I had been going for fertility fertility treatment in 2011 and 2012, I was seeing a reproductive endocrinologist who's running a ton of things on me.
Tricia (36:05) So I I said, something's this is I'm desperate. (36:10) So I go to the endocrinologist. (36:12) She says, maybe I'm gonna find something. (36:14) My blood work comes up. (36:16) I had just started maybe four months before a low carb diet because I had been diagnosed with FIBO.
Tricia (36:28) That was my one success out of going to five gastrointestinal doctors.
Scott Benner (36:33) They found out your gut your gut biome was messed up.
Tricia (36:37) Yeah. (36:37) They're like, you have really you have the start of SIBO. (36:41) Like, I I and I had a decent number, not super high. (36:43) Mhmm. (36:44) So then I so I'm diagnosed with SIBO.
Tricia (36:50) I'm on the SIBO diet. (36:52) The doctor takes out a long sheet, the gastrointestinal, and he's like, eat this. (36:57) Don't eat this. (36:58) It's like it gives me a handout. (37:00) So I'm like, oh, maybe I'm gonna, with antibiotics, get get rid of this thing.
Speaker 3 (37:04) Yeah. (37:04) Sourkraut. (37:05) Endocrinologist. (37:06) Right? (37:07) Yeah.
Scott Benner (37:07) I tell you gonna save me.
Tricia (37:10) That's well, that's what you think, especially if your physician is handing you
Scott Benner (37:14) I hear you.
Tricia (37:16) Like, five page recipe. (37:17) Like, eat this. (37:18) Don't eat this. (37:19) I mean, it was, like, crazy. (37:20) Mhmm.
Tricia (37:21) So then the endocrinologist tests my blood. (37:25) She calls me at work, and she goes, you've got a GAD antibody reading. (37:29) She goes, you might have type one. (37:32) And she says to me on the phone, but your a one c and glucose were in the normal range. (37:42) Maybe it's your low carb diet.
Tricia (37:45) I, you know, have a nervous breakdown at at my office at 05:00. (37:50) I'm like, holy crap. (37:51) I have type one diabetes. (37:53) So I have my coworker who's a nurse takes my blood sugar at odd weight. (37:59) Like, I'm in the, like, eighties or something.
Tricia (38:01) Mhmm. (38:01) Like, the high eighties. (38:04) I then go to the next appointment because she said, let's do lab let's go let's just do let's do labs and an adrenal deficiency test. (38:14) So I do that, and everything comes back the same. (38:17) You wanna know what I was?
Tricia (38:19) 97. (38:21) I was in the nineties on my glucose, and my a one c was 5.4. (38:27) Now I had been a runner, and I probably because I worked in New York City, I I had an iPhone, and then I got the watch. (38:38) I walked between 10,012 steps frequently.
Scott Benner (38:44) Yeah. (38:44) No. (38:44) If you're in the city, you're walking constantly. (38:46) Right.
Speaker 3 (38:47) Right? (38:48) Mhmm.
Tricia (38:48) Right? (38:48) So all this doctor does is re redo the blood the labs, and doctors have told me the actual process and processing time generally will make your glucose appear like your your regular fat you know, fasting glucose. (39:05) It could like, 10 lower than it is. (39:07) I've had, like, four or five doctors tell me that. (39:10) You can look it up on the Internet.
Tricia (39:12) So, like, if you get a reading on your lab that was 95 or nine you know, mine was, like, 97, you really could be, like, a 110, a 120.
Speaker 3 (39:22) You know? (39:22) Mhmm.
Tricia (39:23) So she goes, oh, I thought he was gonna find something here, but I I didn't find anything. (39:31) And I said, well, do I should I, you know, come back? (39:35) And she said, no. (39:36) No. (39:37) No.
Tricia (39:37) He's like, I don't know. (39:38) She's like, you have to go investigate what's going on with you, you know, back with a GI doctor or someone else. (39:45) So based on the second lab results, she says you know, I call my parents. (39:51) And now I look back. (39:52) I'm like, how dopey that my own family didn't say, hey.
Tricia (39:57) We've got a glucose sticker.
Scott Benner (39:59) Why?
Tricia (40:00) Well, you know, I'm living apart from them. (40:01) I'm living apart from them. (40:03) Yeah. (40:03) And and I think part of it is too and we'll put this to the side for a minute. (40:08) Psychosocially, type one has such a impact on the family, especially when the family you know, my mother suffered so many complications.
Tricia (40:20) So sometimes I think there was weird psychological component to all of this.
Scott Benner (40:26) But What what do you mean?
Tricia (40:27) Sometimes be on her way.
Scott Benner (40:28) Wait. (40:28) Stop. (40:29) Meaning Yeah. (40:30) Like, that everybody's just, like, a little dazed from this life?
Tricia (40:35) I that my mother didn't want to see it.
Scott Benner (40:39) She didn't want you to have the thing she had that she didn't even understand.
Tricia (40:43) Right. (40:44) And that she got so many complications from. (40:46) So it was like, let's not I don't think it was on a conscious level. (40:51) I think the same thing for me because my my first of all, when you hear bad news, you need I learned a long a hard lesson. (41:01) I always bring my husband with me now to appointments
Scott Benner (41:04) Mhmm.
Tricia (41:04) Because you have, like, an out of body experience. (41:08) And you might have experienced that with your own daughter. (41:10) Like, when you're first told, you kind of, like, need someone to keep your feet on the ground because you're levitating. (41:18) Levitating. (41:19) And I didn't really have that person to be logical.
Tricia (41:24) And then I think my family was acting the same, was a little bit like like that as as well. (41:30) And, of course, there's, what do they call it? (41:32) White coat syndrome. (41:33) So you'd like you you're
Scott Benner (41:35) like You think the doctor yeah. (41:37) You think the doctor knows everything, so you don't say anything. (41:39) I take notes during, like, I just pull up my note app, and I jot things down as people are talking.
Tricia (41:44) Like I go with a notepad Yeah. (41:46) To scare them sometimes. (41:48) So now to intimidate them
Scott Benner (41:50) if my
Tricia (41:50) my husband always comes with it. (41:52) But if I go alone Trish
Scott Benner (41:54) I'm like Yeah. (41:55) Trish, let me say something. (41:56) You've been talking for a half hour. (41:57) Right? (41:58) And Mhmm.
Scott Benner (41:59) What I hear is that you've intersected a number of doctors who have done tests on you, looked at numbers on paper, and if the numbers on paper didn't tell them what to do next, they didn't know what to do next.
Tricia (42:10) There was no critical thinking. (42:12) Yeah. (42:12) If my new endocrinologist said, she needed to react to that dead antibody, use critical thinking.
Scott Benner (42:19) Trisha, hate your mic. (42:20) Trisha, Trisha, I hate your microphone. (42:22) I hate it. (42:22) What can we do? (42:24) You just, like, you just it sound like you're underwater there for a second.
Tricia (42:28) Oh, really?
Scott Benner (42:29) Yeah. (42:29) And then it's
Tricia (42:29) How is it now?
Scott Benner (42:30) And it comes back. (42:31) It comes and goes. (42:32) I don't know what to say.
Tricia (42:34) Oh, I wish I'd known I would have bought something good
Scott Benner (42:36) for it. (42:37) More reliable than your doctors, but it's not great.
Tricia (42:41) Isn't that true? (42:42) Isn't that true?
Scott Benner (42:43) But but
Tricia (42:44) I I think that's my friend who's a physician said some doctors are just, like, book smart, and they're very trained to just look at labs, and then they just, like, won't take
Scott Benner (42:52) Will you do some kind of Will you do something for me? (42:55) Will you go get your Yeah. (42:56) Will you get your AirPods for me?
Tricia (42:58) Yeah. (42:58) Yeah.
Scott Benner (42:59) Okay. (42:59) Alright. (42:59) I'm just gonna sit here. (43:00) I'm gonna talk to the people while you go. (43:04) Hi, everybody.
Scott Benner (43:05) So as you may or may not know, I have these little geckos, and they live in, like, a a hot environment, very a dry, hot environment in a tank. (43:17) And I had this big, like, rock for them to, like, bask on under the under the light where they stay warm. (43:23) And I thought, I think they need more rocks. (43:27) So I, I got some more rocks, and I put them in there now. (43:29) And they are just having a little party on these rocks today.
Scott Benner (43:32) It's making me think, I hate this because I love this one plant that's in there. (43:37) Maybe I should pull that plant out and just put more rocks in. (43:41) Maybe they just love the rocks more. (43:43) You know what mean? (43:44) I mean, you don't know because you're not here, but but the plant looks nice.
Scott Benner (43:49) I can I could probably take that one out, leave that one in, and put a bunch more rocks over there, and then replace that slate with the other? (43:56) It looks so much more natural, the other rock I got too. (44:00) They look so happy. (44:03) I bet you they don't think about their endocrine issues. (44:06) Actually, one of them died.
Scott Benner (44:08) Nothing. (44:09) Just, you know, laid an egg one day and then looked at me and was like, and then and she was gone. (44:14) But the others are doing good. (44:15) They live in a little trio. (44:16) Two ladies and a boy.
Scott Benner (44:17) It's a very progressive, very seventies, very three's company, if you know what I mean. (44:22) And oh, I hadn't thought about that. (44:24) Should I name the male Jack Tripper? (44:27) And then what would the other one be? (44:29) Oh my god.
Scott Benner (44:29) It's Janet and Chrissy. (44:31) Right? (44:31) I'm gonna name my geckos Jack, Janet, and Chrissy. (44:34) But then if I bring in another one, what do I do? (44:37) If I run another male, I could call Larry or mister Roper.
Scott Benner (44:41) Does anyone remember this TV show besides me? (44:44) And she's been gone for a while. (44:45) You think she's okay? (44:47) Tricia? (44:50) Anything could happen.
Scott Benner (44:51) She could've fallen down the stairs. (44:52) Yeah. (44:52) Nope. (44:52) No. (44:53) She's back.
Tricia (44:53) No. (44:53) I'm here. (44:55) Hold on. (44:56) I'm just trying to add the the thing. (44:59) I don't
Scott Benner (44:59) know what time. (45:00) Everything's fine. (45:01) Don't panic. (45:01) I think you have a lot of important things to say, I wanna make sure people hear them.
Tricia (45:06) Yeah. (45:06) No. (45:07) Okay. (45:08) Here we
Scott Benner (45:08) Your experience is very valuable. (45:12) I have a lot of I have a lot of questions too.
Tricia (45:14) It's been frustrating because you feel like you're I mean, you
Scott Benner (45:19) are would imagine. (45:20) Also, you're in your fifties and TikTok. (45:22) You know what I mean?
Tricia (45:24) Oh, yeah. (45:25) And then I'll tell you what happened to my body.
Scott Benner (45:27) Well, hold on. (45:28) We'll get to it. (45:29) Don't you worry. (45:30) But for so do you have those headphones on now? (45:34) The AirPods?
Tricia (45:35) Know what. (45:35) Okay. (45:36) Why I'm trying to add my device. (45:39) I have, like, the new AirPods.
Scott Benner (45:42) You like to you like to jump out of this completely, come back in through your phone wearing the AirPods?
Tricia (45:48) Yeah. (45:48) That's good.
Scott Benner (45:49) Do that. (45:50) Drop drop out. (45:51) I'll let you back in.
Tricia (45:53) Okay. (45:53) Bye. (45:53) Alright. (45:54) Bye.
Scott Benner (45:56) Technology, my friends. (45:59) She didn't drop out. (46:01) I'm gonna kick her. (46:03) Give her the boot. (46:05) Let's see what do I do here.
Scott Benner (46:08) Remove? (46:10) Tricia, I'm removing you. (46:12) Come back in through your phone on the same link. (46:15) She's gone. (46:16) Knocked her right out.
Scott Benner (46:17) Bam. (46:18) Just like that. (46:20) Boom. (46:21) Shocking. (46:23) Listen.
Scott Benner (46:23) I don't know if this part's gonna stay in or not because I don't do the editing anymore. (46:27) But this lady's story is super important. (46:30) You guys really gotta listen through what she's saying. (46:34) There's a big picture situation here that you're all on some level living through and you don't realize it. (46:41) And maybe it works out for some of you, but for some it's not going to.
Scott Benner (46:45) Truth is is thirty years ago, if she would've had like a low level GLP medication, it would've put off her onset even longer, would've kept her insulin resistance down. (46:54) She probably wouldn't had a ton of these problems, would've helped her with those PCOS that she hasn't really gotten to yet. (47:00) And here she comes back. (47:03) Let us all pray for loud noises when we hear her voice. (47:06) Tricia?
Speaker 3 (47:07) Okay. (47:08) I'm here.
Scott Benner (47:08) My god. (47:09) That's so good. (47:10) Leave it like that. (47:11) Dear I
Speaker 3 (47:12) have the new AirPods. (47:13) I don't know how the Air can cancelling
Scott Benner (47:15) Fancy work.
Speaker 3 (47:16) Hopefully, it's better.
Scott Benner (47:17) No. (47:17) It's beautiful. (47:18) When we set it up, if you would've told me you were a fancy lady, I would've said just wear these or
Tricia (47:21) a jacket.
Scott Benner (47:22) So I was just telling the people listening while you were gone, I told them about my my sand geckos, but I also told them about I also told them about I
Tricia (47:32) thought I heard something. (47:33) Yeah. (47:33) Yeah.
Scott Benner (47:33) Yeah. (47:33) They're lovely. (47:34) But I also told them how important your story is because I think that you were just experiencing a mass amount of something that everybody with type one or other autoimmune issues is experiencing on some level, which is that there is a not a complete understanding of what is happening to you, but we treat it like we have a complete understanding of it. (47:56) And then you start having secondary issues, and maybe they're not all gonna be as bad as yours. (48:01) Right?
Scott Benner (48:01) Because you have a bunch of stuff that's layered on top of each other. (48:03) It becomes debilitating. (48:05) But everybody's got something like this going on. (48:07) I just had a conversation with one of Arden's friends this weekend who has type one, and she's having problems. (48:14) She can't figure out what it is, and she asks a doctor and they don't know.
Scott Benner (48:17) Or every woman who has a problem with their period, they just throw a birth control pill at you, and that either helps or it doesn't. (48:22) Or people say to you, like, let's run a thousand tests. (48:25) Let's stick this pipe up your ass. (48:26) Let's do all this other stuff. (48:27) Oh, nothing here.
Scott Benner (48:29) Sorry. (48:30) Sorry. (48:31) I'm still sick. (48:32) And they go, no. (48:34) I don't know.
Scott Benner (48:35) And and, you know, the number on the page, like, you know, how many people have a TSH of three and four and five and a doctor's telling them that's fine. (48:44) That's in range. (48:45) And meanwhile, you have 17,000 hypothyroid symptoms, and nobody will give you a Synthroid.
Speaker 3 (48:51) Oh, yeah. (48:51) And I forgot to advise that when I was going for fertility treatments so, like, oh, you have endometriosis. (49:00) So inflammatory. (49:02) Right? (49:02) Like, total it's showing my whole immune system is not
Scott Benner (49:07) You guys you properly. (49:09) We all have like, I'm gonna throw myself in there too because my kid has type one and my other kid has Hashimoto's. (49:14) And, like, there isn't a level of inflammation existing in us, like people living with autoimmune, that is just higher than the average than the general population, and it makes stuff not work.
Speaker 3 (49:27) And it My brother has low level issues. (49:32) So and we just I made him put on a CGM, and he just caught that when
Tricia (49:36) he eats white, he cannot look at
Speaker 3 (49:38) a white carb. (49:39) He goes well over two two hundred even though he hasn't had the antibody attack. (49:43) And he had severe cystic acne when he was a teen, which now I'm reading can be part of a metabolic, you know, profile. (49:53) And my brother's sons has severe food allergies, and he his a one c or some of his sugars came out a little funny. (50:03) He's on thyroid for Hashimoto's.
Speaker 3 (50:05) It's like
Scott Benner (50:06) Yeah. (50:07) Yeah. (50:08) Problem. (50:08) And nobody understands it is is my point. (50:10) And you don't you don't understand it till you've lived with it for so long that you just you've seen it come at you from so many different angles that you're like, oh, that makes sense now.
Scott Benner (50:18) Like, it doesn't make total sense, but I understand where it came from. (50:21) And I it it's just it's not it's not a broken bone. (50:25) You're not gonna go to a doctor and they're actually gonna my god. (50:27) Your your fibula is broken. (50:28) We will put a cast on that, and it will be better later.
Scott Benner (50:31) Like, it's it it just doesn't work that way. (50:33) And people don't have the expertise. (50:35) They don't have the experience. (50:36) They lean on lab values that they don't understand that apparently don't even have to be right, because it's not a perfected system either from what you were saying earlier about glucose. (50:47) And so, you know and now it's is it fair to them?
Scott Benner (50:50) It's not. (50:51) But what happens at the end of that of the rainbow, you don't get a pot of gold. (50:55) You get like, you slid off the rainbow, we don't have any answers. (50:58) So just keep walking, and good luck, and maybe you'll well, you're gonna die. (51:02) But, like, yeah.
Scott Benner (51:03) That yeah.
Speaker 3 (51:04) That's it. (51:04) Scott, these are the things I was told. (51:07) I had a male physician who stood over me who was a GI doctor, and he said, well, you don't have cancer after a colonoscopy. (51:17) And then I went
Tricia (51:17) to his office after, I
Speaker 3 (51:20) said, I'm still having severe digestive issues. (51:23) And he goes, I don't know what to tell you. (51:25) Do you think it could all be in your head? (51:27) Do you think it could just be
Scott Benner (51:29) They told
Speaker 3 (51:30) me psychological?
Scott Benner (51:31) My wife right? (51:32) My wife's thyroid exploded after she had Arden, and that's not a technical term. (51:37) And but but it's But I like it. (51:40) Is what happened. (51:41) And and they they they everything.
Scott Benner (51:44) You should exercise more. (51:46) She says nothing's changed about my exercise. (51:48) Well, you're you should eat differently. (51:49) Nothing's changed about how I eat.
Speaker 3 (51:51) Oh, should do this. (51:52) My diet. (51:52) The doctor with the diet.
Scott Benner (51:54) And then and then when that stuff didn't work, they said maybe you're depressed. (51:57) And she's like, I'm not I'm not depressed. (51:59) Like, I just and everything. (52:01) So then at some point, get so desperate. (52:03) She's like, she tried depression medication for a while for her thyroid problem.
Scott Benner (52:07) Like, right
Speaker 3 (52:08) I I I totally believe it. (52:10) And
Scott Benner (52:11) She came to me one day, and she goes, I'm taking this thy this medication for I'm not depressed. (52:15) Like, this is ridiculous. (52:16) And I was like, great. (52:17) And seven years, seven years it went on until, by the way,
Speaker 3 (52:21) it was just Yeah. (52:22) 1100%.
Tricia (52:24) Yeah. (52:24) 16. (52:25) Yeah.
Speaker 3 (52:25) Out of sixteen years.
Scott Benner (52:27) And and, Trisha, in that time, my wife, she gained an unfair amount of weight that was from not having thyroid medication. (52:33) You know, it it plagued her for most of her adult life until, by the way, somebody came up with a GLP and took fixed it for, you know, in two years. (52:41) Like
Tricia (52:41) Mhmm.
Scott Benner (52:42) They sent her right back again. (52:44) But my point about, I guess, probably where my passion comes from about people sharing their experiences is the only reason we even knew my wife had a thyroid issue is because I shared her problems with Arden's nurse practitioner when Arden was little. (53:01) And the woman just said this offhanded thing to me, and her name was Sakina Boyd, and thank you very much, Sakina. (53:08) And she just said, oh, yeah. (53:11) Autoimmune stuff, like, runs in families, and it doesn't have to be, like, diabetes diabetes.
Scott Benner (53:18) Or it doesn't have to be Hashimoto's Hashimoto's. (53:20) She's like, sometimes you just see, like, a potpourri. (53:22) Like, I don't think she used that word.
Speaker 3 (53:24) Mom's side of the family.
Tricia (53:26) Yeah. (53:26) Mhmm.
Scott Benner (53:26) Right. (53:26) And and then I stopped, I thought, oh my goodness. (53:29) And I started going through Kelly's side of the family. (53:31) Her her grandmother had what they used to call the sprue. (53:35) I don't know if you know about that, but it was celiac because
Tricia (53:37) it was celiac. (53:39) Got it. (53:39) It. (53:39) Got it. (53:40) Got
Scott Benner (53:40) it. (53:40) They'd like, grandma has the sprue. (53:42) The sprue. (53:43) This is what happens when morons talk about technical things. (53:46) By the way, no offense, but she's she's dead and she wasn't that smart.
Scott Benner (53:49) And so, like, and so, like, they're talking about the sprue over here. (53:54) Nobody everybody's shitting all the time. (53:56) Like, nobody can like, everybody gets nervous and runs to the bathroom all the time. (54:00) Like, that's the thing that happens. (54:02) You know, I've got a niece who's sick all the time.
Scott Benner (54:05) Right? (54:06) One and I've got, you know, I've got there's a there's a person who has a lot of, like, issues that he probably would call bipolar, but maybe not. (54:18) It's never been able to be knocked down. (54:20) And then I started making this podcast and asking people all these questions. (54:23) All y'all have these problems in your family.
Scott Benner (54:26) Okay? (54:26) Like, get so, like, I'm like, okay. (54:28) So Sakina shares her colloquial thought, and it makes and it saves my wife. (54:35) Right? (54:35) Because then one day I go into a doctor's office and I'm like, she clearly has hypothyroidism.
Scott Benner (54:40) And he goes, no. (54:41) Her TSH is only whatever it was. (54:43) And I was like,
Tricia (54:43) I don't There you go.
Scott Benner (54:44) I so but see, here's the difference. (54:46) Right? (54:47) I'm an asshole. (54:48) So, like so I looked at him and I said, in not a polite way, will the medicine hurt her if she doesn't have hypothyroidism? (54:55) And he goes, no.
Scott Benner (54:56) And I won't well, then fucking give it to her. (54:58) Like like like, are you out of your mind? (55:01) Like, it's not gonna hurt her to try it for a month, but if it it's the right thing, then this all goes away, and you're saying, no. (55:07) Sorry. (55:07) The number on the paper doesn't indicate this?
Scott Benner (55:10) Like, you're out of your mind. (55:11) You were willing to give her depression a medication. (55:16) You were willing to tell her that she doesn't exercise. (55:19) You were willing to tell her she doesn't eat. (55:20) Right?
Scott Benner (55:20) You were willing to say a whole bunch of things that that weren't true that you were guessing about. (55:25) But this one thing that has the most common sense wrapped around it, this you're not willing to do because the test says, what? (55:32) It's green? (55:33) That's all he said. (55:33) It's in the green, he said.
Scott Benner (55:35) By the way, when someone starts telling you your test is in the green, I think what you should hear is that person doesn't know what the they're talking about. (55:42) And, like like, if they did, they'd have a technical explanation for you. (55:45) Not it's green. (55:46) Green's good. (55:47) Green means go.
Scott Benner (55:48) Like, are you out of your mind? (55:50) Like like so, you know, so then I Kelly gets the thing and she's okay. (55:56) And then I come on the podcast and talk about it more. (55:59) You wanna know, like, I don't know if I get more notes from people who are grateful about having their thyroid problem fixed or about their diabetes being better. (56:07) Like, it's it's rampant, and and and I'm not even mad at anybody.
Scott Benner (56:12) I just think it's
Tricia (56:12) the No.
Speaker 3 (56:13) No. (56:13) No. (56:13) Yeah. (56:13) We have a I feel like we have a broken system. (56:18) And It's not the system.
Speaker 3 (56:21) Me, I ended up at a gastrointestinal doctor telling her my symptoms were getting far and far worse in spite of being put on something called LINZESS. (56:32) Okay. (56:33) I was getting worse. (56:34) And she also told me, and I was like, I'm out of here. (56:38) To distract myself and accept that I was complicated and that I just needed to be on meds, I had told this doctor, this gastrointestinal doctor who was she's probably in her early sixties.
Speaker 3 (56:51) I said, I probably should go back for an endocrinology and consult considering my family history. (56:56) She told me I didn't know what I was talking about. (56:59) And then again, I just needed to accept that I had, you know, these digestive issues and sort of move on.
Scott Benner (57:07) Yeah. (57:08) That that person's a dipshit. (57:09) And so, like, I and and that
Speaker 3 (57:11) She shouldn't she shouldn't this doctor should not be practicing.
Tricia (57:14) Right. (57:14) Right.
Scott Benner (57:15) But but you you just said the system's broken. (57:17) I just think that's a thing people say. (57:19) Forget that. (57:21) You said the real problem earlier. (57:23) It's not that the system's broken.
Scott Benner (57:25) What what was lacking when people had to help you? (57:29) Critical thinking.
Speaker 3 (57:31) Mhmm.
Scott Benner (57:31) But there's not a there's not a systematic issue. (57:33) There's a people issue. (57:35) Like, not everybody's cut out to think through a problem like this. (57:39) And and often and God bless you all who are doctors. (57:43) Like, what makes people good doctors doesn't necessarily make them good at communicating, and it doesn't necessarily make them good at, like, the the investigatory part of it.
Scott Benner (57:53) Right?
Speaker 3 (57:53) Like also realized this doctor would get anxious. (57:56) She couldn't solve a problem, didn't know how to solve a problem, so it was take a drug and get out of my office.
Scott Benner (58:01) Yeah. (58:02) She prob listen. (58:03) She's probably on the spectrum. (58:05) Like, anybody that can sit in college for eight years and learn all that stuff and then remember it, something's up. (58:11) You you you know what I mean?
Scott Benner (58:12) Like, I don't I don't know shit about anything. (58:14) I can't remember anything. (58:15) I've helped more people with type one diabetes than most endocrinologists are going to.
Tricia (58:19) Yeah. (58:20) No. (58:20) Yeah. (58:21) But just
Speaker 3 (58:21) I ended up going to finally to a doctor who was different, and and I was telling her brain fog, etcetera, etcetera. (58:30) We caught on my labs when I went through menopause that my a one c went to 5.7, and I said first, her office did goof up because they're like, oh, maybe you have type two. (58:47) I go, hello? (58:48) My mom has type one. (58:50) Look at my freaking chart.
Speaker 3 (58:52) I finally then got the doctor on the phone, and she said, well, diabetes is a spectrum, can be a spectrum. (59:00) I've seen it.
Scott Benner (59:01) Yeah.
Speaker 3 (59:02) And I said, what what do you mean? (59:04) I thought you were either diabetic or you or you weren't. (59:08) You weren't like, like, kind of, like, your story with Arden. (59:11) Like like, you know, you go dramatically to the emergency room.
Tricia (59:15) Yeah.
Scott Benner (59:16) Right. (59:16) Right. (59:16) Oh my gosh. (59:17) But you what you gotta do is listen to that episode with doctor Hamdi where he discusses that, like, in the very near future, you're gonna see people with dual diagnosis. (59:24) This is type one, and insulin resistance is basically a type one, type two diagnosis.
Tricia (59:29) There
Scott Benner (59:29) there's gonna be a lot more versions of diabetes that are gonna get
Speaker 3 (59:33) Like, yeah, like I said, why why does my why can my brother not look at a white carb? (59:38) Like, he doesn't have the antibody attack, but, yeah, he could be a high glucose responder.
Scott Benner (59:43) Not yet.
Speaker 3 (59:44) He could be like
Tricia (59:44) yeah. (59:45) Right.
Speaker 3 (59:45) This could
Scott Benner (59:46) Also Yeah. (59:46) I But well
Speaker 3 (59:47) But nobody's would look at him if I forced him. (59:50) I said
Scott Benner (59:52) Oh god.
Speaker 3 (59:53) Just said, your brother should go get thoroughly checked, and my brother finally did it.
Scott Benner (59:58) Yeah. (59:58) But thoroughly checked for what? (1:00:00) And then what are they gonna do after that? (1:00:02) Like, there's listen. (1:00:03) Yeah.
Scott Benner (1:00:03) I I'm I'm telling you all, like, right now, I probably sound like I don't I don't know. (1:00:07) Like, I guess, I don't care how I sound actually. (1:00:09) But, like, there's the something in that GLP
Tricia (1:00:13) fury.
Scott Benner (1:00:14) Well, no. (1:00:14) But something in that GLP medication is affecting a lot of things for people, and no one understands what it is yet.
Tricia (1:00:21) Mhmm.
Scott Benner (1:00:21) Right? (1:00:21) But I I'm I'll say over I'll say over and over again. (1:00:24) There are a lot of ladies pregnant now on a GLP that weren't pregnant before. (1:00:28) And and I'll and basic and, basically, what happens is that when you say that out loud It's
Speaker 3 (1:00:33) a good thought.
Scott Benner (1:00:34) Common medical wisdom is, well, yeah, they lost weight and they're healthier now, so they got pregnant. (1:00:39) Some of them are getting pregnant weeks after beginning to use it. (1:00:42) They haven't lost weight yet. (1:00:44) Like, right, they start shooting it and then boom, they're pregnant. (1:00:47) And I'm talking about people who've been trying to get pregnant for decades to the point where they don't think about
Speaker 3 (1:00:52) know this.
Scott Benner (1:00:52) Yeah. (1:00:53) They don't think about contraception anymore. (1:00:55) They just bang all over the place because they think it can't possibly happen. (1:00:58) They go, oh, I I I heard I maybe I can be a little thinner on this GLP. (1:01:02) They put it in and, woo, pregnant.
Scott Benner (1:01:04) And there's so many of them that they found each other online and created, like, a giant Facebook group about them, which then made the medical community. (1:01:12) Right?
Speaker 3 (1:01:12) What's going on?
Scott Benner (1:01:13) Think, oh, what's going on? (1:01:15) Now they're gonna start looking into it. (1:01:16) Now they'll take twenty years to figure out what's happening. (1:01:19) And, like and but in the meantime, people talking will know the difference. (1:01:23) Right?
Scott Benner (1:01:24) And so Mhmm.
Tricia (1:01:25) And
Scott Benner (1:01:25) so, like, I'm I'm sitting before you right now. (1:01:28) I'm 70 lighter than I was two and a half years ago. (1:01:31) I don't eat or act or do anything differently today than I did two and a half years ago. (1:01:36) If I I feel bad because Arden has a a needle phobia, so she has a little trouble taking shots. (1:01:42) But if you give Arden a small dose of GLP, not a full dose of it, a small, like, microdose of it, her insulin needs to go down by, like, 30%.
Scott Benner (1:01:52) There's been a man on here who had type one diabetes, all the antibodies, using all the insulin, etcetera, for a couple of years. (1:01:59) They stick him on Mounjaro for weight, and the next thing he knows, he's not using insulin for a while. (1:02:04) Now he's got Oh
Tricia (1:02:05) my god.
Scott Benner (1:02:05) Yeah. (1:02:06) He's got LADA, so it's it'll come back eventually. (1:02:09) But there's also a 15 year old girl that came on that for two years between 15 and 17 was down to, like, one unit of basal a day. (1:02:16) From, like, from, like, fifty units a day of total insulin down to one unit a day had to take her pump off. (1:02:21) But she has and has the antibodies.
Scott Benner (1:02:24) She has type one diabetes. (1:02:25) Right? (1:02:26) And she was using all the insulin, like, she and and gaining weight and all the stuff. (1:02:30) So they put her and her mom recognizes it because her mom used the GLP for gaining weight and some PCOS type symptoms. (1:02:37) So solid in the daughter, put her on the meds, and then all of a sudden, they, you know, they said, hey.
Scott Benner (1:02:42) You might have to turn your base you know, your insulin down a little bit. (1:02:44) It wouldn't stop going. (1:02:45) Her need wouldn't stop going down. (1:02:48) Like, so her situation's not another person's situation. (1:02:52) Like, your your part your point about the spectrum is well taken by me.
Speaker 3 (1:02:56) I only okay. (1:02:57) So first of all, doctors, like, especially in an urban area, I walk to all my appointments. (1:03:04) Right? (1:03:04) Doctors don't have any critical thinking about the labs in an urban area because in New York City, man, you walk. (1:03:11) Okay?
Speaker 3 (1:03:11) Mhmm. (1:03:12) So other things you talked about, like, in terms of I realized during, what you call it, 2020 with all the EMRs, I had one what I you know how you get multiple labs after you go to a doctor and they start to come in your email? (1:03:28) Yeah. (1:03:28) There was one of them I missed with my glucose. (1:03:31) My glucose was one twenty out of range.
Speaker 3 (1:03:33) Doctor never called me about it. (1:03:36) It was an o b g OB GYN. (1:03:37) Mhmm. (1:03:38) Okay. (1:03:38) Never called me.
Speaker 3 (1:03:39) And then number two, for me, having diabetes, being so physically active, not having a car. (1:03:48) And even now, I still exercise amount. (1:03:51) My doctor says, I only take two units of background insulin.
Scott Benner (1:03:55) Yeah. (1:03:55) You are super active.
Speaker 3 (1:03:57) Yeah. (1:03:58) And and, like so she's like, you don't look like my normal average type one
Scott Benner (1:04:06) Yeah. (1:04:06) So keep thinking
Tricia (1:04:07) about it. (1:04:07) Diabetic.
Scott Benner (1:04:08) That's the, like, that's the part I don't get. (1:04:10) Like, like, what oh, you don't look at the average one. (1:04:12) So and then, like, it it just I don't know what to say exactly. (1:04:16) Like, I I I'm not blaming doctors. (1:04:19) They're just people.
Scott Benner (1:04:19) Right? (1:04:20) And we have these experiences and you live with it all the time, so you have more time to think about it. (1:04:25) But not everybody thinks about it. (1:04:26) Some people just do the thing that that lady told you to do, which is just accept that you're a sickly person and be done with it. (1:04:31) And
Tricia (1:04:32) Oh, oh, oh, yeah. (1:04:33) Right? (1:04:33) Oh, yeah.
Scott Benner (1:04:34) And there's just I I don't know the answer. (1:04:36) I really don't. (1:04:37) Like, I don't but there's there's something going on that that nobody's really qualified yet.
Speaker 3 (1:04:43) If you This is my answer.
Scott Benner (1:04:44) Go ahead.
Speaker 3 (1:04:45) And that's what you and I are doing right now. (1:04:48) We have to spread the word.
Scott Benner (1:04:51) Talk about it.
Speaker 3 (1:04:51) You don't just get type one, and then there's type two. (1:04:56) CGMs are showing us that people are high some people are high glucose responders that, you know, you can be a diabetic with that an a one c can hide that you're in the early stages. (1:05:12) I know my endocrinologist now says, like, by the time it's coming out in your a one c, it's been brewing often for a very long time.
Scott Benner (1:05:21) Mhmm.
Speaker 3 (1:05:21) So I think with what you're saying with, the GPL ones, like, we're in an explosion of data and, like, we did not really see what diabetes was
Scott Benner (1:05:32) Yeah.
Speaker 3 (1:05:32) In the past.
Scott Benner (1:05:33) No. (1:05:33) I I I'll tell you right now that if if you if you my my a one c's never been a problem ever. (1:05:40) Right? (1:05:40) It but and if you took my GLP from me run today, I'd go find a Gila monster and I'd French kiss it every day. (1:05:55) This episode was too good to cut anything out of, but too long to make just one episode.
Scott Benner (1:06:00) So this is part one. (1:06:01) Make sure you go find part two right now. (1:06:03) It's gonna be the next episode in your feed. (1:06:08) The podcast episode that you just enjoyed was sponsored by Eversense CGM. (1:06:13) They make the Eversense three sixty five.
Scott Benner (1:06:15) That thing lasts a whole year. (1:06:17) One insertion. (1:06:19) Every year? (1:06:20) Come on. (1:06:21) You probably feel like I'm messing with you, but I'm not.
Scott Benner (1:06:23) Ever since cgm.com/juicebox. (1:06:28) US Med sponsored this episode of the juice box podcast. (1:06:32) Check them out at usmed.com/juicebox or by calling (888) 721-1514. (1:06:40) Get your free benefits check, and get started today with US Med. (1:06:46) Arden has been getting her diabetes supplies from US Med for three years.
Scott Benner (1:06:50) You can as well. (1:06:51) Usmed.com/juicebox or call (888) 721-1514. (1:06:59) My thanks to US Med for sponsoring this episode and for being longtime sponsors of the juice box podcast. (1:07:05) There are links in the show notes and links at juiceboxpodcast.com to US Med and all of the sponsors. (1:07:11) If you're new to type one diabetes, begin with the bold beginnings series from the podcast.
Scott Benner (1:07:16) Don't take my word for it. (1:07:17) Listen to what reviewers have said. (1:07:19) Bold beginnings is the best first step. (1:07:22) I learned more in those episodes than anywhere else. (1:07:25) This is when everything finally clicked.
Scott Benner (1:07:27) People say it takes the stress out of the early days and replaces it with clarity. (1:07:31) They tell me this should come with the diagnosis packet that I got at the hospital. (1:07:35) And after they listen, they recommend it to everyone who's struggling. (1:07:39) It's straightforward, practical, and easy to listen to. (1:07:42) Bold Beginnings gives you the basics in a way that actually makes sense.
Scott Benner (1:07:47) Okay. (1:07:48) Well, here we are at the end of the episode. (1:07:50) You're still with me? (1:07:50) Thank you. (1:07:51) I really do appreciate that.
Scott Benner (1:07:53) What else could you do for me? (1:07:55) Why don't you tell a friend about the show or leave a five star review? (1:07:59) Maybe you could make sure you're following or subscribed in your podcast app, Go to YouTube and follow me or Instagram, TikTok. (1:08:07) Oh, gosh. (1:08:08) Here's one.
Scott Benner (1:08:09) Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. (1:08:15) You don't wanna miss please, do you not know about the private group? (1:08:19) You have to join the private group. (1:08:21) As of this recording, it has 74,000 members. (1:08:24) They're active talking about diabetes.
Scott Benner (1:08:27) Whatever you need to know, there's a conversation happening in there right now. (1:08:31) And I'm there all the time. (1:08:32) Tag me. (1:08:32) I'll say hi.
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