#1998 This Guy's Story Has a Twist - Part 2
This Guy's Story Has a Twist (Part 2)
Jacques kept going low at work. He tested himself through TrialNet at 45, the age cutoff, and came back positive for three antibodies. Then he got Tzield.
Jump to a moment
- It started with lows. During a treatment session he was so shaky he couldn't hold a client's head for neck traction and had to ask him for a granola bar. He has used a steroid inhaler for allergic asthma most of his life, so he self-diagnosed adrenal insufficiency. His primary care doctor ran labs: A1C 5.9, cholesterol a little high, probably metabolic syndrome — eat better, move more. At six foot three and 190 pounds, nothing about him fit a type 2 picture, and it didn't sit right.
- After their daughter's diagnosis his wife had screened through TrialNet and come back clear. With no autoimmune disease anywhere in his family, he never bothered. Last year, at 45 — TrialNet's age cutoff — he sent in the finger-stick kit. Negatives get an email and positives get a phone call. He got a call: three of five antibodies, confirmed by Kaiser. He then failed a glucose tolerance test, and half-sugar bubble tea took him to 180.
- He picked one of the two Kaiser endocrinologists listed as diabetes specialists, and within two minutes she had asked whether he knew about Tzield. She also pointed to an A1C of 5.3 in his chart from 2021 — normal range, never flagged, but for someone built and living the way he does it should have been in the fours. Normal range, wrong end of it.
- He became the first adult at Kaiser Mid-Atlantic to receive Tzield, and the nurses held an in-service the week before. It runs about $14,000 a pouch, around $200,000 in total, and pharmacy mixed each dose only after he was in the chair, because it has to be used within four hours. Fourteen consecutive days ran into the fact that no in-network infusion center was open on Sundays, so the schedule was patched across several centers. Side effects were limited to fatigue; the Zofran they gave preventively left him constipated, so he stopped it on day three.
- Before Tzield he was told he had roughly an 80% chance of needing insulin within five years. A contact who had worked on the trial told him about a third of early participants are still off insulin more than a decade later. His highest finger sticks since the infusion have been 160 and 140. He also carried real guilt: a child's risk is higher when the father has type 1 than when the mother does, so for a while he felt like the reason. His daughter barely reacted.
- TrialNet — The relatives' screening program Jacques used — at-home kit, results by email if negative and by phone if positive
- Juicebox Podcast Pro Tip Series — Management fundamentals with Jenny Smith, episodes 1000–1025
- Bold Beginnings Series — Being re-released in the feed starting around episode 2000
- MiniMed Flex — MiniMed's smallest pump yet, the size of two stacked vials, controlled from an app
- Contour Next Gen — The meter Arden carries — second-chance sampling and a downloadable coupon at the link
Every word of the conversation
Welcome and Sponsors0:03
Friends, we're all back together for another episode of the Juice Box podcast. Hey. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. This episode of the podcast is sponsored by MiniMed and the Kontoor NextGen blood glucose meter.
MiniMed, of course, the innovators behind the MiniMed flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel. To learn more, visit minimed.com/juicebox. There is one blood glucose meter in this house, the Kontoor Nextgen blood glucose meter. That meter is on my daughter's person right now and at all times.
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Sixth Grade and Preteen Hormones1:36
Yeah. So... Yeah. So so I mean, overall, it's working fine. She...
I think at the end of... Like, before the summer, so the end of last school year, her needs had gone up. You know, she's in... She's definitely a preteen, and I know hormones are are are playing a role. So it's...
Yeah. We'll just have to we'll just have to see the switch from from, like, fifth grade to sixth grade, like like, six. There's a there's a lot more changing classes. The program that she's in is a lot more intensive than fifth grade was Mhmm. From what we've heard.
So there's gonna be there's gonna be some changes. She hasn't exercised as much as we wanted to. She doesn't like the... It's the summer here in DC area, as you know. It's pretty sweaty, not not dissimilar to where you are.
So we'll we'll get back into into exercise a bit more as well, hopefully, to to both help with the resistance and with the stress. Right?
So Does she play does she play a a sport?
Ultimate Frisbee on Mondays2:43
No. She... So the thing that she does most consistently is play ultimate Frisbee, and we just have a pickup ultimate Frisbee game on on Mondays
Oh, nice.
That we both... Would we... They we both play, which is really fun. And it's a it's a mix. It's, like, adults and kids, and it's the one sport that's kinda stuck.
She's not... She... Like like I said, she's five eight, and and she can run. Mhmm. But she's not very interested in sports.
She's a big reader. She loves reading, writing. Also the program that she's in in middle school. She's in the humanities magnet I'd love for her to be... I like...
I'm really into sports. I'm not nearly as active as I should be. But as a kid, I played all the sports all the time, and it's very interesting for me to now be a parent and my kids are neither all that into it. It's kinda frustrating. I was
gonna say when you said interesting, you meant horrifying. Right?
Yeah. Not horrifying, but I I I wish it I I wish it was... So for for my oldest specifically to... Like, I... You know, exercise has so many benefits, but I...
In the in the... From the from the perspective of of being a diabetic, it's... You know, there's all kinds of value. And then the perspective of of learning learning to compete and learning to lose and learning to work at a team, like, all of that. Like, there's just so many benefits to sport, like, that I see.
And, yeah, I don't I don't I don't know. I think she'll... She'll... She might get more into into Frisbee. She's done the Girls on the Run, which is a...
Which is a kind of a cross country running
Okay.
Program. She's done that, but I don't think they do it in middle school. So we'll see what middle school brings. It sounds like PE is actually more intensive in middle school. You like PE three out of your four quarters of the year.
Mhmm. So... And that will be, like... I think it's every... It's a it's a class every day.
Yes. Every day for the week, which
is That's good.
I would have loved to when I was in school.
Yeah. That would have been great. I mean, it's... Couple that with your 10:00 lunch and you're all set. Arden got one of Arden got one of those one year, by the way, where she was eating, like, literally eating lunch at, like, five after ten or something like that.
Yeah. Yes. It's not not not ideal.
I I...
Not ideal. So we are not super into sports.
Okay. Well, that's... Listen. Let's... I'm not trying to force kids into things they don't wanna do, and it's not a big...
If you don't do sports, it's it's okay. But if... But, you know, I would... I'm trying to imagine my son one day having, like, kids who don't wanna be active.
Yes. Your son who plays college ball.
Well, now now as an older person, like, I... Leaves my house four times a week to go to a to a local park and must play basketball for two or three hours, you know, every every night. Like, he's not like... I I... He said to me the other night, he goes, I don't understand when people aren't motivated to try to do better.
And I was like, well, what do you mean? He start... He's out in the working world a little bit. He's like, peep... A lot of people seem just comfortable where they are.
Like, they're not trying to, like, move forward or, like, everything. And he said, I'm really... He wasn't being pejorative. He's like, I'm really baffled by it. And he's like he's like he's like he's like, I don't know.
Like, I just... I'm trying to, like... And I said, yeah, man. I said, you just... You played a lot of baseball.
Like, you you were accustomed to showing up every day and being faced with the idea that, like, you're not there yet. Like, wherever there is, you haven't reached it. And and you needed to keep working and trying just to stay in the game, let alone try to move forward. You know? And I was like, yep.
Some people just don't have that feeling. And and I don't know if you got it from baseball or if it's in... Innate in you or or what, but Yeah. I did walk away feeling like, I'm glad he played because, you know, now now as an adult, he's not he's not gonna be a rest on his laurels person. That's for sure.
Yes. Yes. Yeah. No. That's, I think there's just some very important life skills to learn from from sports, and and maybe you can learn other places too.
But I... Yeah. I I... And I... You know, there's...
You have to choose your battles. Right?
So Sure.
I I hear you. I'm not gonna make her make her play a sport that she she doesn't enjoy, but I'm I'm really gonna try and find her one that she doesn't know and appreciate.
That kid's gonna
Get into it.
She's gonna have played every dumb game between here and between here and the ocean and maybe and maybe a little surfing. Right?
Yeah. Yeah. Yeah. Right.
Okay. So what what what drove you to be on the podcast? What made you think this would be a good idea and I... I'd enjoy it or it'd be valuable, etcetera?
The Plot Is Thicker7:26
Yeah. So, the plot is thicker than I've, than I've shared, because... So, you know, when when it... When the when my daughter's diagnosis and our lives with it was kind of the only part of the story, I was like, you know, I I think that people would enjoy hearing it. But but then last year, the plot thickened and and then, you know, over the over the basically the past, you know, like, ten months, I would say the the story got got more interesting, and I and I think it's...
There's some some things to consider for people out there. So what happened is last year, I had some random low blood sugars. And I... My work is relatively physical, but specifically this one time, I went to see a client and I was doing, like, manual therapy. I was doing traction on their neck.
Too Shaky to Hold a Client's Head8:34
And I was so shaky that I couldn't I couldn't hold his head to to do the traction, and I had to actually ask him for a granola bar because I was, like, literally shaking, and I and I have had periods in my life before where I would be like, I think this is what low blood sugar feels like, but I wouldn't know. Right? Because I... It's it's not it's not something I I could have measured before or whatever, even as a as a kid. And so I had this number of low blood sugars, and then, you know, because I'm in health care, because the Internet is what the Internet is, I I kinda did a deep dive, and I I self diagnosed with adrenal insufficiency.
So I and I have a whole... There's a whole thing, I went into my into my laptop and I made it... I I wrote myself in a in a email draft. I wrote what I think it would be when I go talk to the doctor. So I get, like, almost either prove myself wrong or right, that I was wrong or right from the beginning.
Yeah.
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Steroids and a Self-Diagnosis11:37
And I really like my primary care doctor. So I emailed him, and I said I've had these symptoms. I was due for a physical. He's like, yep. Let's let's do it.
And so we talked through it. I am I am also... I've had asthma, like, most of my life, allergic asthma, so I've been on a steroid inhaler for a long, long time. And so how I got the adrenal insufficiency is there's, like, a small small sample size of people who... If you take oral oral steroids, it's it's pretty common because the steroids basically do what the adrenals do, and so the adrenals don't have to do it.
Mhmm. And so if you have too much... If you take steroids chronically for too long, then you can develop this adrenal insufficiency, which one of the symptoms would be low blood sugar. And so he's like... My my primary care was like, I'm not I'm not sure.
It might be related, but I'm not sure. But let's just do... Let's just run a bunch of labs. And so we ran labs, and I got my a one c back and it was 5.9. And I...
Prediabetic Numbers at 4512:50
And he was like, yeah. Well, cholesterol is a little bit high. You know, I'm 45 at the time. And he's like, yeah. Maybe some metabolic syndrome going on here.
These are like prediabetic numbers, you know. And I... So I'm six three, one ninety. I am not in the best shape of my life, But if... You know, I I do not...
In terms of how I eat, how active I am, and how I'm built, I don't fit any type two diabetes general picture.
Yeah.
And I know I know that's not a 100% how with with with people with type two, but I... There's not much about me that says type two.
Okay.
And so he was like, well, I'm gonna... You know, maybe we'll just consider something for your cholesterol. Let's let's change your diet and increase your exercise a bit and see what happens. And so I was like, okay. I mean, if that is the case, that is the case.
I'm gonna do it. So I I did I did become a bit more active, and I did change my diet a little bit. You know, there's I have a sweet tooth and I just cut back on my sweet tooth, as I would say, it was the main thing that I did. But I just... I I didn't...
It didn't sit right with me. Was like, I don't think this is right. And so to backtrack, after my daughter was diagnosed, because of the family history on my wife's side, my wife's mother's side, my wife got... Went through TrialNet, got tested, no antibodies, no nothing. Okay.
Great.
Mhmm.
I'm... There's no immune... Autoimmune disease in my family. None. None.
None. None. So I never... I didn't get tested.
Right.
Right? I just, like... I was like, it's not tested. But... So, you know, last year, I got this a one c back.
Getting In Under TrialNet's Cutoff14:38
It's like, alright. Let me just write to TrialNet. TrialNet's cutoff is forty five, and I'm 45. And, like, okay. I gotta get in quickly.
And they sent me the, you know, the package to the house, and I stabbed all my finger, and I blend into a tube. And I sent it back, and then I don't know if you know, but you, you know, you wait about four weeks, and they sent you an email if things are negative, and they give you a phone call if things are positive. And so, of course, I got a phone call Oh. In November. I think in November.
A Phone Call Means Positive15:08
Yeah. And I... Well, I got answered. I didn't know what the number... Oh, no.
Actually, I think the the person who called me had left a message, and so I had to call back. But but once I got the message, I knew. And so... Yeah. So I tested positive for three of the five antibodies.
So that was, like, the start of my LADA journey. So I went back to my private care. I was like, well, I have news for you. And so insurance Kaiser retested me and got the same results. And then I did...
In early early this year, did glucose tolerance test, which I failed not terribly, but, you know, set at about 200 for a little bit. And also when... Once I once I... I think once I got my a one c back, I started doing some finger sticks. We had an extra glucose meter lying around, did some finger sticks.
And I remember one time I had had bubble tea. You know what bubble tea is? Mhmm.
Yeah. Yeah. Oh, I'm I'm well I'm well too aware of it. I...
Yeah. Yeah. Well, I had a I had... I had half the sugar in this bubble tea because it's unnecessarily sweet. I'll just half the sugar.
And, I mean, I just... I I went to, like, one eighty, I think, halfway through this drink, I was like, oh, man. This is not good. Yeah. So I got my I failed my glucose tolerance test, and then I looked through all the all the endos on the on the Kaiser website because I'm like, I'm I'm...
Finding a Diabetes Endo16:48
I'll be damned if I get myself myself not not the the the endo with the best knowledge of diabetes because endos do, like, a lot of things. Right? Like, the
Yeah.
Endocrine system is is a whole is a whole thing. And so there was... There were two on the list that that indicated that they were diabetes specialists. And so I reached out to my... To to the one doctor t, shout out doctor t, and and, I mean, I had a video appointment with her in March, and I I spoke spoken to her maybe for, like, two minutes, and I knew I had hit the jackpot.
She she knew all the things. She asked all the right questions. She's like, you know about Tzield? I was like, oh, okay. She she knows what's going on.
So... Yeah.
Wait, You Have It Too17:37
Oh my god. Jacques, that kid gave you type one diabetes?
Correct, Scott. Yeah. Isn't that isn't that crazy?
Is that what you're here to tell me? Like, that that no. My gosh. That's bizarre, isn't it?
Yeah. It it is bizarre. But because... So, you know, so with a lot of diagnosis, those antibodies were there when I... When my daughter was diagnosed.
Sure. Sure. They... Well, so so... Yeah.
Why 5.3 Was Too High18:01
So here's the interesting thing. I had a a one c from 2021 that's in my chart. That's 5.3.
Oh, okay.
And my and my endo was like, that's a pre prediabetic a one c. It's normal range. Right? That's why it wasn't flagged. She's like, you're you're not...
You're supposed to be in the fours. If I listen to your lifestyle, how you're built, and how you eat, you should be in the fours. 5.3 is too high for you. Mhmm. And this is the same, you know...
And and when I've been listening to you talk about about thyroid thyroid numbers and how it's in the normal range, but on the on the wrong end of it, and it's like drifting in this... I don't know if it's drifting high or drifting low. That's the same. A once a once... You know, it's a range, but there's no ones within the range.
Sure. And so I had somewhere, at some stage, had picked up, you know, the antibodies got activated, and then the process very slowly kept going. And... Yeah. So so I got...
Well, I'm sorry I'm sorry to hear that, but I'm glad you caught it. And Yeah. And are are you gonna take Tzield or have you?
So I finished Tzield, like, three weeks ago.
Okay.
First Adult in Kaiser Mid-Atlantic19:19
Yeah. So that was a that was a... Another thing. So my doctor was like, I think we could get you Tzield through insurance. And I ended up being in...
So Kaiser of the Mid Atlantic is a pretty big insurance group. Mhmm. And the first first adult in Kaiser of the Mid Atlantic... Mid Atlantic to get Tzield. So they had to, you know, come up with a protocol.
They had to figure out all of the the ins and outs. And, you know, the nurses that gave me the infusion did an in service the week before I got there.
Who Gets Paid to Talk About Tzield19:54
Yeah. How how was the process? I I would... First, let me say this. I see all you influencers out there being paid to talk about Tzield.
I am not being paid to talk about it. You're welcome to... You're welcome, Tzield. Go ahead, Jacques. Tell me about the process.
Scott Scott told me he was gonna give me money to talk about Tzield.
I'm Wouldn't that be crazy? Oh, no. Oh, I just I just learned the other day that some podcasts charge their guests to be on.
I I saw that I saw post.
Oh, I was baffled. I was baffled by that. Yeah. You know, I just... I I wonder, like, when you're...
The average person doesn't realize when you... For... Here's an example. In the last couple of days, you all were like, oh my god. Did you hear Libre's coming out with a CGM that also does ketones?
And you think it's just random that you know that. Libre does a massive campaign behind the scenes to everybody who has a following of any kind to try to get them to talk. They they send you the information. Have you seen our, by the way, every company does this. It's not, like, some big secret.
Right? So if you heard about the Libre with, with ketone monitoring recently, you heard about that because a PR company sent around, you know, information about it so that people would have content. That's what that's about. What I'm talking about here is Sanofi and Tzield and the whole push behind you have to test... You know, get your...
Get people tested, get your family members tested. That's a that's a marketing campaign. That's not like... It's not just the thing you hear people talk about. So when people are talking about it, generally speaking, someone is paying them to talk about it.
Now not the... I wanna I wanna be clear. Not this... Not the CGM with the ketone thing. That's just...
There... That's people sending their press release out hoping that you'll do something with it. But when
you Sure.
But when you see, like, you know, this is a paid sponsorship with, you know, TZield or something like that. That's... They're... Anyway, my point is they're not doing it with me. And yet more people are gonna hear this story from Jacques, then that's not the point.
I don't... I'm not angry. I have enough advertisers. Okay. Tell me about the process.
So your doctor says maybe we could do it. Kaiser says yes, which is awesome. What did you mean they had to... The the team had to do what a week before?
Fourteen Thousand Dollars a Pouch22:15
They do, like, an in service on the drug. Nobody knows about the drug. Right? So so, it's a infusion, and so you have to go to an infusion center. And typically what happens at infusion centers are like rheumatoid arthritis infusions or cancer infusions is my...
And there's probably some some other
Yeah.
Ones in between. But most of the people in the infusion center are cancer patients. Mhmm. Right. So so the nurses...
So there's not, like, a lot technical about except for, you know, it's $14,000 per per pouch of of Tzield. And so it's, like, 200,000 for... That's about what I... 200,000 was the total cost to Kaiser, which I certainly did not pay. But...
So they... Only once I arrived at the infusion center would they mix it. So pharmacy... The nurse would call the pharmacy, said I'm set up. You can mix.
Because once it's mixed, it's four hours, and then they have to throw it away. So they couldn't take the chance of, you know, throwing away $14,000.
So... And
then and then they had to figure out which... Like, how could they make the infusion centers work because in theory, it is a fourteen day cons... Fourteen consecutive day infusion, but there were no in network infusion centers open on Sundays and only a few on Saturdays. So I did my first five days at an infusion center, then drove somewhere else for the Saturday, then did my five the next week, and then skipped the Sunday, then did five days at another center, then drove to the same place next Saturday. So, you know, we had to kinda cut and paste to to make it work.
Yeah.
But in the end, it it went quite well. So once once my doctor told me about it, I was, you know, initially, I was kind of not sure. Weirdly because I have a daughter with type one and I was like, well, I I know I... I I think I know pretty well how to handle type one. I'll just do the same things for myself.
And I'll... Like, whenever that time comes, when my, you know, when my insulin needs are such that I... And it will start needing to take insulin. And then I reached out on the on on the Facebook group. I reached out and said, does anybody...
As an adult, they can... Gone gone through Tzield. So one woman wrote back, and so we did... We talked back and forth, which was really helpful. So she had had it three months before, and she gave me a bit of ins and outs about symptoms and kinda what to expect.
Deciding, and the Side Effects25:00
And so... And then I talked to my wife, and then and we decided, let's just go ahead. That sounds sounds like the risk is is worth the reward. And so in the end, I I had very mild side effects. I I had significant fatigue.
I would get, like, the feeling of I need to take a two hour nap, like, right now about an hour after infusion Mhmm. In that first... Mostly from, like, halfway through the first week. So they start at a very low dose, and then they double, double, double, double, double for the first five days, and then you stay at that higher dose. And...
But I never had any of the nausea. Like, I I actually... You know, they gave me prophylactic. You gave me a bunch of Zofran. And on day three, I was like, I'm really constipated, guys.
And they're like, oh, that's from the Zofran. And I was like, okay. Please let's not...
But stop doing that....
Taking that.
Yeah. I'm gonna be I'm gonna I'm gonna be nauseous for another reason soon.
Yeah. Correct. Correct. Correct. So I actually didn't take Zofran after day three, and I was completely fine.
I just... So I just had this fatigue. And then once once the infusion was done, I I felt completely, you know, back to normal. There was no no other side effects.
Okay.
Yeah. And now it's now it's kinda wait and see. It's so it's so weird. You know, people are like, how are you how are you doing now? I was like, I'm doing the same.
Like, it's... Basically, I have a I have a eighty percent chance... Before Tzield, I had a eighty percent chance of of being diabetic in the next five years based on how many antibodies I have or are positive four... Am positive four. And...
Wait Five Years and See26:43
So if I make it past five years and I'm not on insulin yet, it probably worked. But I'd have to wait five years to see that. So in theory, the shorter term, my a one c could go down or at least stabilize. So this is what the one woman that I that I talked to, she said her a one c went down, like, to... Maybe from, like, 5.8 to 5.6 or something, And now it's just, like, set.
It's just stayed there instead of slowly climbing, which you would more... Is more likely to happen.
Expect to happen. Well, so what are your... Like, forget what everybody said because, you know, they... I don't think anybody really knows yet. But expectations or your hopes, I guess, for having done it?
A Third Still Off Insulin27:32
I I will say I reached out to... Other than this... The... This woman I spoke to, I... My...
We have a a kid actually who plays ultimate Frisbee with us, who's also type one, and this kid's stepbrother is also type one and had Tzield. This... The stepbrother's mom works for Sanofi and worked on the trial. Anyway, so I got connected to someone that was pretty deep into the trial, and she... We emailed back and forth a bit.
We talked on the phone, I think, as well. People were actually very, very nice and very willing to talk to me and... Without saying I I had to pay them. I will say that. And she said that a third of the people in the clinical trials...
So the trial, I believe, started in 2015. So it's 11 later. So people that were early on in the trial that got the treatment, there are a third of them who are still off of insulin, so ten, eleven years later.
Wow.
So my hope is that I'm one of those one third, one of those thirty three percent of people. Mhmm. But, you know, if it if it doesn't work, then I will slowly be becoming more of a diabetic, and I will figure it out as I go along. And it is what it is.
Feeling Like the Reason28:58
What was your daughter's reaction to this?
Yes. She she didn't have a big reaction. I I will... I definitely initially had some feelings of guilt. Obviously, not because I, you know, I didn't I didn't want her to have diabetes or give it to her.
Right? But but once I found out and then I read, you know, the data is, if if if if the father of a child is is diabetic, their chances go up, you know, significantly compared to when the mother is a is a diabetic. And so there were definitely some feelings of guilt that that, you know, I was I would... I'm the reason why she is a diabetic. But not...
I I think I think I've dealt with it.
It's interesting. That's not what I was thinking you were gonna say. I was wondering how you felt about being able to get Tzield, but she wasn't able to get it.
Oh, yes. No. That that is not... That wasn't a... There wasn't a big reaction.
I I I think she understood that it was never an option for... She also was diagnosed before. I guess it was... They were running trials at the time. Mhmm.
But I didn't I didn't sell Tzield to her as some... As a, you know, as a risk... As a as a treatment that will guarantee that I will not become diabetic.
Didn't feel like you didn't feel like she didn't get a chance to do this. I don't deserve a chance to. You didn't have that feeling? No. Okay.
I don't It's rather think we healthy, John. It like that. Yeah. Yeah. I I I don't know that you should.
I don't think you should, and I I didn't know that you would. But I was just wondering because there's that idea of, like, well, she didn't get the chance. Now, like like, what if you never get it? You know what I mean? Like, you...
You'll be moving forward without diabetes and feeling like, oh, I got to do this. She didn't get to do this. That's the that's the part I was wondering about, actually. I wouldn't
Yeah. Yeah.
Sorry. Did I put that in your head? I apologize.
No. No. No. No. No.
You didn't know. No. I... That that... That's...
That is just not the way that we think, I think, in our I wouldn't family.
I wouldn't either. I just was wondering. So Yeah. Okay.
No. It's not... It it it wasn't a consideration. It wasn't a consideration.
Good. Good. Good. Well, I...
You know?
First of all, knock on wood for you. I hope that works. That's gonna be a third of a third of people.
Yes. Yeah. So that's not a that's not a small chat. No. Then I've been I've been doing some random finger sticks.
I I used to wear... I wore CGM initially because I wanted to get an idea of my trends and what foods really, you know, mess with me or mess with my blood sugars. And so since since the infusion, I've done done random finger sticks at times where I thought, okay, I could be a bit high now. And I've seen one I've seen a one sixty, and I've seen a one forty in the last two weeks, and the rest have been lower than that. So I'm kind of cautiously optimistic that things might have started to move in the right direction.
But I'll get a a one c c in the next about two months, which will... So my last a one c... So I one done right after Tzield, which was 5.9. And so we'll see see what it is in the in the winter.
Do you find yourself eating differently, trying to just not tax your system?
Sinus Surgery and a 27032:50
I... Well, so I also had sinus surgery earlier this year. Scott, 45 to 46 has been has been Shock. Been a handful.
Shock you already?
Yes. No. I'm alright. I'm alright. But it's it's been, like, really, it's it's been a thing.
Yeah. So I had, like, sinus. I had really bad polyps for a long time, and and so someone finally convinced me. And it's actually been a very successful surgery, but I was on a lot of steroids after the surgery. And my blood sugar one day went to two seventy, which I'd never in my life seen.
And I emailed my endo. I was like, what am I supposed to do? And I'm supposed to be on these steroids for, like, two weeks. And she's like, well, emailed, yeah, I emailed her, and she emailed the the ENT, and he said, okay. Let's just half...
Just cut the the the prednisone in half, and that really helped. But my endo was honest, and she was like... And this was prior to the infusion. She was like, this might push you over the edge. It might push your pancreas over the edge.
The stress might be too much, and the and the t might... You might not end up qualifying for the Tzield. Like, my my a one c in this period could have gone up Oh, yeah. Significantly Yeah. Enough.
And so over that period, I definitely ate kinda low carb, and I tried to to not stress. I couldn't really act... I wasn't supposed to exercise, so the only thing I could change was my diet. Yeah. And I did...
You know, I could... I I could walk, and I did a bit of walking, but I... But but I... Very shortly after I went off the steroids, things started looking better and then got got back to baseline. And so I was very thankful because it it apparently didn't have to go that way.
I have to tell you, modern medicine is really... It's just a absolute marvel. As you're talking about, like, that... I had that nose surgery, the same thing you did. So I I make a podcast.
I talk... I almost said I talk a lot, but then I I hear the people listening go, yeah. We know. Don't worry, buddy. But, I was getting to the point where I was holding my breath while I was making the podcast because I couldn't move air through my nose at all.
And and I finally went... And the guy's like, your septum's deviated in two different directions. He's like, at the top, it's going one way, and further down, it's going another way. And then you have all those polyps. He's like, I...
You're not moving any air through your nose really at
all. Wow.
Yeah. To the point where after the... Right before he did the surgery, I said, how am I supposed to breathe when it's over? Because I realized I was only breathing through my mouth. Right?
And Yes. And I actually... I said to him the most naive thing. I said, hey. Is the right way in through your nose out through your mouth or in through your mouth out through your nose?
And he laughed he laughed, and he goes, well, peep... People do it all kinds of ways. And I and I I was like, oh, I was like, oh, I thought there was, like, a way, and I wasn't doing it. And he's like, no.
Well, I think there's a way. I think if you teach people, with, like, asthma or something to breathe that's in through your nose out through
Well, I thought so too. But, like, I think he was just stunned by the question. He's like, oh, jeez. I... Maybe I should check him for a head injury while he's in here too.
You know? But he cleaned that out, and my god, that made a big difference for me. But as... But also, the big toe on my right foot was, like, frozen in pain. I had to have that cut open.
They had to do this needling thing so that, like, the ligaments or whatever would grow back to the bone. I had to have my my right knee cleaned out. I mean, if you've listened to this, the the podcast enough, I had to have, like, internal hemorrhoids, like, because, have you heard that episode?
Yeah. I think I did. Think I
heard that a while back. Yeah. They had to go had to go in through my groin with, like, like, the wire and, like... And they had... I think it was five different arteries inside of my body had to be, like, shut down because
I remember that.
Yeah. Yeah. Yeah. And and and the GLP, you know, like, fix so many different things, like, listing them all here would feel silly. Without all that stuff, I'd be limping hard on the right side, bleeding from my ass, unable to breathe, and, like, a nine other things.
And so when I hear people talk about, like, well, I don't know if I trust it. I'm like, you're out of your mind. I was... Yeah. A hundred and fifty years ago, you'd be, like, leaned up against the saloon half dead, and someone would shoot you because they felt bad for you.
Just go take the... Just go do it. Like, what are you doing?
Yeah. You you know? Yeah.
I don't know. Whatever. Good good luck to all of you. I'm in a much better situation because I did all those things. But to your point Yeah.
You hit a certain age and your body's like, yeah. That's gonna break now.
Yeah. So... Yeah. No. That's how that's how I that's how I feel.
Your shit's breaking all over the place, Jacques.
No. I'm I'm... I have I have said I've made a deal with myself. There will be no big medical issues in the next at least twelve months. That's my that's my deal myself.
You see how that'll work out.
Yeah. Well, also, they're hard... They get harder and harder to rebound from. That's Yes. That really is true.
My my wife had a surgery this this summer, and she's still dragging her ass about it. You know? So Yeah. It ain't easy.
Yeah.
Yeah. So, nevertheless... Well, I'm glad you're finding answers. And, you know, it's funny. I should...
I I can't believe I asked you about South Africa because I heard you say Kaiser early in the conversation. And and in my mind, I thought Kaiser is in South Africa? That doesn't
sound right.
No. But I didn't make the I didn't make I didn't make the leap there. Yeah. Well, that's really been... Look at you.
You should go. So... Alright. So the hope is you're a one in three coin flip for this just to, like, push it out for a decade, which would put you into your
Yep.
Mid to late fifties. That'd be awesome.
Yeah. I'll take it.
Yeah. No kidding. Isn't it interesting how, how quickly your desires can get adjusted? Like... Because if I find you a year ago and I say, hey.
You don't want type one diabetes. You say, no. I do not want that. And then when it becomes a possibility, you think, well, I'd love to be able to push it off ten years.
Yeah.
Yeah. Your line will change
pretty quick. You have to just... You just have to roll with the punches. It's a... I mean, I'm very much a a realist, and I I I I think, you know, health care...
Perspective From Rehab39:27
Working in health care really gives you perspective. Mhmm. And I've I've seen I've seen so many people in such really terrible situations, scenarios with... I I feel like cancer is the one that always comes up. I...
I've had I've had so many cancer patients in in rehab of of all ages. I mean, I had a patient with cancer. He was, like, 14 who passed away a few years ago. Like, just, like, horrible. I just...
You know, so so I I I don't wanna... I'm not gonna minimize the effect because there are days... I'm not gonna minimize the effect of diabetes because there are days where, you know, it just frustrates the heck out of us, you know, as a as a family or just my daughter or just me or just my wife. But I would certainly... This is honestly my perspective.
I would certainly choose it over some other options.
I... Yeah. I was just made aware of acquaintances of ours who... One of their children played sports with one of our children, and they're not older people. Like, you know, they're maybe late forties.
And Yeah. The father has a has a brain cancer just out of nowhere. Yeah. You know? And just fine, fine, fine, and then one day not.
And, you know, I don't I don't know a ton about it, but the looking into what I did, I... I mean, it's, you know, it's it's a thing that's gonna end his life at some point. And Yes. Yep. Yeah.
I... You know, any opportunity to stay above the dirt, they say, is is worth taking. So...
Yeah. Yeah. I know. And and, you know, kid having diabetes doesn't mean that something else doesn't come around. We listen to all these episodes of people with multiple autoimmune disorders and how that affects their life.
Like, if you, you know, you can't you can't eat gluten and you can't eat dairy and then you're also diabetic and... Right. That's... It... Things can get very complicated.
Just because something's gone wrong doesn't mean something else couldn't too.
No. No. Which which is a very bleak... It's a... It sounds like a very bleak thing, but it it is also true.
Like, I'm... It's really just... I am... I try to be thankful every day that I have and that that we have and and keep that perspective every day.
Yeah. No. You have a great attitude. You... I mean, through the through the story.
I I... There's this... I don't know if it's a folklore or not, but I think there's a rule that once you get a speeding ticket, can't you get another one the same day or something like that. It'll... And if that's true, I don't know if it's true or not, don't go out speeding to try to find out.
But I... What I always took from that, whether it's true or not, is the idea of, like, you know, you got... We got you once. Like, fair is fair. Like, let's let you go sleep and wake back up again and not have this happen to you again.
And I do think our my... Our minds work that way. Like, well, my kid has diabetes. Nothing else bad is gonna happen. Yes.
Yeah. Like, that... Like, that's the thing that's gonna happen to us, but you Yes. You could... First of all, I think there are things, you know, happening to more people than you know.
People are very Yeah. Very private about stuff. I I have a a a friend right now who's trying to find out stuff from her parents about, like, health stuff, and the parents won't share it with them. They said that's private. Like Wow.
Like, what... It's like... It's just, like, extended family stuff. That's private. I can't tell you that.
Like Yeah. Oh, okay. So, like... So when when the world works that way and people think like that, you know, you think, well, the bad thing happened to me now. It's not the case.
You could you could have a car accident today and rent a car and drive out in the right of the car and get hit again. That that could happen. Yeah. You know?
Yep. So Yep. No. It's... No.
No. There's not... Nothing's guaranteed. I tell my patients often when they get kinda down down about their situation, I'll say, you know you know when you are somewhere and you you look at people, and I I do this, and I watch people walk or run or do something and they look they look... They have a spring in their step and they look very healthy.
I... And then I just I just say to my patients, do not do not think that you know what is going on in that person's life or in that person's body. Like, you cannot look at a person and say, oh, they, like, they don't have pain. They don't have something going on. It's...
That's a completely false narrative. You have no idea.
Yeah.
We have no idea. So so don't don't don't woe is me. There's there's no value in being woe is me because woe is often to other other people too. You just don't know about it.
Yeah. I say go till you can't go. And Yeah. Yeah. I don't know.
It just doesn't seem... I had a a person on the other day, and she shared that when she was diagnosed, she promised herself that she wouldn't complain in her head. Like, she wouldn't she wouldn't complain to herself.
And Yes.
I thought, well, that's a simple but very thoughtful idea. Yeah. So Yeah. Well, anyway, I really appreciate you coming on and sharing all this with me. I love...
It's funny because you you have sparse, you have sparse notes, and they're up off to the side. I didn't really look at them, but I did glance by them once and it said Tzield. Then Mhmm. But then you told the story of your daughter's diagnosis, and I thought, well, there's no Tzield in that story. I wonder if he's just gonna bring it up because it's been in the zeitgeist lately.
This Guy's Story Has a Twist45:13
I did not think you were gonna say what you just said. Wait. Because Arden texted me. She goes, hey. Where are you at?
You're late. And I said, this guy... I texted her back. This guy's story has a twist. And so I, actually, you should see our texts of, can you come rub my leg?
I said I'm I'm recording, then I can come. Okay. Are you done? Then randomly, she says, Friday smells like a Subway cookie. That's her dog.
And then she sends then she sends me the sad face because I haven't come quickly enough. I don't know if other people's children tried to guilt them with that sad face. Then a little later, I got, are you alive? And then I said, this guy's story has a twist. So, I don't know what to call your episode, but it could be in that text somewhere.
I'm not sure.
That... Yeah. That that sounds good.
Seriously, Jacques, I really do appreciate you coming on and taking the time. This was awesome. More people more people
should reach out. Given the... Given... Getting the chance. No.
It's... It was actually quite good. I... This is random, but my wife and I met at a summer camp, and the director of the summer camp... I'm not...
He's not from... You're from New Jersey. Right?
I... I'm from Pennsylvania outside of Philly, but I
live I live in I live it.
I live in New Jersey now though. Sorry.
Okay. Okay. No. But but you and and him, I think if I if I recorded the two of you, two separate recordings, you sound like a really similar, not just your voice, but like the the how of how you speak. Mhmm.
So it's... That... That's been kind of enjoyable. I... And and time I listened to the podcast, I'm like, oh, this guy sounds like...
Scott sounds like Greg.
I prefer to think that Greg sounds like Scott, but I I appreciate what you're saying.
Yeah. That that... No. That's what I meant. I'm sorry.
I said that the wrong way. Just like just like you said it the wrong way to your wife this morning Yeah. Yeah. Or last night.
Vince Vaughn47:10
Question. Do you ever think that Greg sounds like Vince do you ever think Greg sounds like Vince Vaughn, the actor?
Oh, yeah. Maybe... Well, so now that you said that, you sound like Vince Vaughn too. I think you're probably like a clone between Greg and Vince Vaughn.
I... So I get I get Vince Vaughn a lot from people.
But I I Yes. No. That's that's accurate.
I think it's the the... It's interesting how you put that. The how of how I talk, I think it's the how. I don't think I I don't think I audibly sound like Vince Vaughn. I think he and I, like, speak in a similar pentameter maybe.
And and Yes. That that really might be the case, because I've had... I've told these stories before, but there was a stretch of time in my life where the the people would turn just absolutely exhilarated in my direction thinking they were about to meet the guy from some movie that they enjoyed and then to see me and be just wholly disappointed. But but I've had... I've literally...
Oddly enough that... I I I... This is such a strange thing because Arden said the dog smells like a Subway cookie. Mhmm. She means the sandwich shop.
And I was in a Subway once. The... Not a thing I do often, which is really interesting. And I was, seated talking to somebody, and a child in another booth said to his mom, that man sounds like Santa Claus' brother. And it took me a while to realize...
Yeah. He meant the movie Fred Claus.
Which is is Which is Vince Vaughn. It's Vince Vaughn.
Yeah. Oh. And and, and that's... I've... I had one time, like, like, a a group of girls, like, in their, like, late teens, early twenties, were sitting next to me at a diner.
And Uh-huh. The one girl just, like, stops, turns in the booth, puts her head over into our into our booth, and, like, just to find me. And I looked at her. I said, sorry. It's not...
And she goes, I thought you were Vince Vaughn. I said, no.
I know you... I know. I I know
I know what you thought. And she just looks... She looks so disappointed. I can't be... I can't tell you.
She's like...
That's... Yeah. That's really funny. I don't think I sound like anybody.
Well, I don't know about that. I just... Maybe I... You just... Maybe you just sound like somebody I I...
I'm not acquainted with yet.
Yeah. Maybe.
Yeah. It's... But it is interesting, isn't it, that that, you know, I I... When people ask... Because there's plenty of people who come to me and say, like, you should go on one of those business podcasts and tell people about how you make the podcast popular.
I'm like, yeah. Don't know. Maybe one day. But there's a a lot of people who like that kind of content. And I I will tell them privately.
I was like, you know, I do have a deep voice. It's a Yeah. It's an important component to all of this. And and it it does make me wonder, you know, Vince Vaughn's famous. And may...
Maybe there is just something about the speech pattern or the depth of the voice or something that grabs people's attention. Like, it it might have much much more less to do with me than you think. So...
Yeah. No. That's a chance. There's a chance. I mean, there are other, successful podcasters with deep voices for sure.
Gotta be. I... Listen. I there's... I've listened to podcasts where I've liked the content and can't take the person's voice.
And so... And often those
Oh, yeah. Yeah. Yeah. Same. Same.
Yeah. Like, pitched or... And I don't just... I don't mean female specifically, but, like, higher pitched or their register's weird. You know, like, I can't deal with this.
So...
Yes. No. No. That's... I I fully agree.
Alright. Well, Jacques, I'm gonna go rub Arden's leg apparently.
Okay.
And Sounds good. You'll go live your life. Hold on one second for me. Okay?
Okay. Thanks.
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#1997 This Guy's Story Has a Twist - Part 1
This Guy's Story Has a Twist (Part 1)
Jacques's daughter drank ninety ounces of water in one day. Days later her blood sugar was over a thousand, and that evening she did cartwheels in her hospital room.
Jump to a moment
- Nothing looked like illness. His daughter's weight gain slowed and then dipped by about a pound, and the pediatrician said they would keep an eye on it. Over the summer she became, in Jacques's words, the best water drinker in the world. There was one bedwetting accident, which had never happened before, and the weekend before her diagnosis they tracked her intake for a day: ninety ounces.
- They sent a message through Kaiser's portal on Sunday, she gave a urine sample on Monday, and on Tuesday — her little sister's first birthday — the results came through while his wife was driving her to the appointment: ketones four plus. The meter read HI, the pediatrician called an ambulance to Children's, and her blood sugar was over a thousand. The doctor put her about twenty-four hours from DKA. That evening she was doing cartwheels in her hospital room.
- His wife read Dr. Bernstein and Think Like a Pancreas and found the Facebook group and then the podcast. A few hours there taught them more than thirty-six hours in the hospital — more nuance, more hope, and permission. The discharge instructions said to wait three hours before correcting a high. Hearing kids with A1Cs in the fives, Jacques's reaction was: why would I do less than that?
- Food is deliberately not restricted in their house. His wife was firm about it, because girls and eating disorders go together too often. Instead they plan around it: when his daughter goes to a party, Jacques sits in the background holding her phone and handles the boluses, so she never has to pick it up.
- He quit his rehab hospital job in the summer of 2021 to stay home with the baby — his wife is a teacher and was going back in person mid-COVID. Within weeks the older girl started first grade, switched to a Spanish immersion school, got quarantined for COVID, and then was diagnosed. Kaiser has since switched her from Humalog to Kirsty, a biosimilar that works a little slower but that she needs less of.
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Every word of the conversation
Welcome and Sponsors0:03
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Meet Jacques2:27
Hi, everybody. My name is Jacques, and I am the father of a, almost 12 year old daughter, who is a type one diabetic.
How long has she been type one?
She was diagnosed, at age seven, so in 2021, on her sister's first birthday, which was kinda sucky. So almost just about five years.
My father-in-law, who's gone now, had a heart attack had a heart attack on my son's first birthday.
Wow. Yeah. Yeah. That's that's like... Come on, people.
Time it better.
We bought a cake. What are you doing?
Yeah. What are you doing? I'm I'm having a heart attack. Yeah. I Just...
It was it was a rough a rough first birthday for my daughter, my youngest, and also, obviously, a rough day for my
For your family.
For my oldest. For the family.
Yeah. Yeah. And do you just have the two?
Yeah. Just the two. Yeah. So almost 12 and almost six.
I was gonna say, I bet having a kid diagnosed on your other kid's first birthday makes you go, maybe we should get into gardening.
Yeah. No. We we started a little bit late too, so I don't know that we had significant plans. But, yes. Two is two is good.
Two is good. I agree. Yeah. Well, let's let's find out a little bit about that. Yeah.
So give me the run up to... I mean, if... Already, if if your one child's having medical issues while you're in the middle of raising a one year old, I imagine it's hard to see what's going on, but go ahead and tell me what happened.
A Super Healthy Kid4:01
Yeah. So super healthy kid, you know, absolutely no issues, never never had any... Even, like, infection. She went to day care, never really got very sick. So we were like, you know, we we we struck it lucky.
And then in... There was a there was a doctor's visit, I think, in May 2021. And so my daughter's... She's almost 12, and she's five eight and maybe, like, 95. She's like a very tall kid.
I'm six three, so she
Mhmm.
She goes after me. But there was a a period between November, I think, of twenty twenty five and May 2026 where her weight gain had slowed down. And then... So this is May, and then July of that... Of twenty twenty one, she had another visit, and she had actually lost weight.
And... But not like a lot, maybe a pound, or maybe she didn't gain. Something like that. It was it was a very kinda subtle. And so the doctor was like, oh, it's fine.
You know, we'll just keep an eye on this. And she didn't have any other real symptoms. But over that summer, she became, like, the best water drinker in the world. Like, she... You know, kids are like, oh, I don't wanna drink water, blah blah blah.
But she just became like a really good at drinking water, and she was always thirsty. And initially, it was like, oh, she's, you know, she's really realizing the value of of being well hydrated. And then it got to be a little bit crazy, and and she she she had one way... A bedwetting event, which she'd never done in her life. Yeah.
Ninety Ounces in a Day5:41
And we're like, okay. This is this is kinda weird. And then I think the weekend before she was diagnosed, we we tracked her water intake one day. She, like, drank, like, 90 ounces of water.
Oh, gosh.
Oh my god. That's not that's not normal. And so we we we kinda, you know, that... The Internet was already there, and we were looking looking at things. And we're like, yeah, it might be type one diabetes, the bed wetting, and the the thirst, and lots of lots of drinking.
Really had a hard time being away from... Like, not not being able to be close to a bathroom. She would just have to go to the bathroom all the time.
Well, couple of pieces of it... A couple of pieces of advice here. First of all, when you think your child's learning something, something's already wrong. You're wrong about that. You've you've made up an excuse in your mind.
You're like, you know, I think she's she's really starting to understand the value of it. And then you should have went, oh, no. Something's direly wrong, and that can't be what's happening.
No. Not not at seven years of age.
No. No. No. I I...
I was giving her the benefit of the doubt. But...
I had I had a good I had a good conversation with my kids last night. They're 22 and 26. And as we were talking, I thought, oh, they're starting to really come into their own here. This is awesome.
Oh, okay. Okay.
So I should I should be a little bit patient.
Well, yeah. Yeah. Yeah. Yeah. Seven's not gonna do it.
That's for sure.
Seven's not gonna do it. Yeah. But... So, you know, there was nothing else that we... She wasn't, like, acting sick or lethargic or vomiting or anything.
Maybe she had a bit of a bellyache. But there there was this... I remember the weekend... So she was diagnosed on a Tuesday, I believe. And so this weekend, we were with with friends at some, like, little town festival, and we had ice cream.
Right? And and we walked there from their house, and she barely made it back to the house to get to the bathroom. I remember that. And and then the Sunday, we reached out to her doctor. So we...
Like, through the portal, were with Kaiser and, you know, we we reached out and the doctor ordered, like, urine analysis for us.
Mhmm.
And she went in on the Monday and and did the... Like, got the urinalysis. And then and then she had a visit with the doctor on a Tuesday morning. And so my wife took her in. So this is my daughter's...
Ketones Four Plus on Her Sister's Birthday8:10
My youngest daughter's first birthday, but these two are on their way to the doctor's office. As they're driving to the doctor's office, the labs come through ketones four plus. And I was like, oh, crap.
Yeah.
So I I knew I knew immediately.
Well, you guys knew days before, it feels like.
Yeah. But we... Like, and I'm in health care. Right? I'm a I'm a physical therapist, and I I try and be on top of things.
I'm, like, the only person in both my wife and my... No. Actually, my sister-in-law is is is also in health care. But let's say I'm on my side, I'm the only person in health care. And so my family members always ask me questions, so I'm always the one that goes to look up stuff.
And so, yeah, maybe maybe we knew, but maybe we were in denial. But not not not like in... I don't know. Maybe denial is not a conscious thing.
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Maybe it could be it could be conscious, but that was very much unconscious in this case. Like, we just... We didn't we didn't... I I won't say I was thinking I don't want it to be true. Because once I saw the urine labs, I was like, okay.
It's true.
This is it. Yeah.
So so I knew, you know, before they got there. And then, you know, they did finger stick and the machine read high, and the cutoff on the machine is, 700, 600, something like that.
Mhmm.
Over a Thousand at Children's11:16
And so the pediatrician said, we're calling the ambulance, taking her to Children's. So we live in the DC Metro Area. So I went to Children's Hospital, and I believe her her blood sugar was over a thousand. So the first time they could actually get a reading on it.
Mhmm.
So she was... The doctor said, you know, twenty four hours from DKA. So we, you know, we kinda caught it caught it just in time.
Well, they say it either... You know, when when we brought Arden in, they were just giving us credit for her not being in a coma because she was two. They were like they were like, good job.
This
is really good. You don't know. This usually goes much worse than this. So we were like, oh, like, you know, this doesn't feel like a good job scenario, but thank you.
Yeah.
Yeah. Well, good good job. Shock, wait a wait
a Yeah.
Yeah. Wait to get it done.
Cartwheels in the Hospital Room12:06
No. I mean, in in, like like, later, I think that evening... So she was admitted that morning. That evening, we're in the hospital room, and Anya's doing, like, sorry. Anya's doing cartwheels, my daughter.
You know? So she wasn't, like, feeling particularly sick also by this time.
It was all it was all about the the water intake and out... And and output at that point that was really what had you. Okay. Well
Yeah. Yeah.
Yeah. So back through your family line or your wife's, are we looking at any other autoimmune issues like celiac or thyroid or anything like that?
Type 1 on His Wife's Side12:41
Yeah. So in my my family line, absolutely nothing. Like, nothing. My wife's family line, she had an aunt who had type one. She was diagnosed at eight who has since passed away.
And I spoke to my mother-in-law recently, and apparently, there are other... There's some other type one more distant family members, but... So definitely on my wife's side.
Yeah.
And then and then my wife has a cousin who has celiac, which is also on on her mother's side. So so there's definitely some things on on that side.
Mhmm. Okay. Yeah. Well, I guess that wasn't in her Tinder profile. No.
No. She she she wasn't telling people. Isn't it funny that she have no way to know until it happens to you? You don't think, oh, well, of course, I have a distant aunt with type one, and I have this. And my child's obviously gonna...
It... You know? And, you know, the the first seven years of your daughter's life where you're like, she doesn't even get sick. You don't you don't think it's because her, you know, her immune system's turned up to, you know, a thousand. So it's really, it really is...
I mean, has it changed your outlook on how you handle things? Is it... You you said you got started a little later. So for context, how old are you now?
46.
Okay.
So she was born, so my wife and I are a week apart, and the kids are six years and a week apart, so that's kinda cute. But... So, yeah, we... So she was born when we were both 34, and then my second child when we were 40.
Okay.
So... Yeah. So that's... I mean, nowadays, lots of what they call geriatric pregnancies. Right?
But I think having a child at 40 is still on the older side.
Yeah. I would tell you less common... Less uncommon, but not... You know? Yes.
But that but that was my point. My point was is that, like, you know, you've been through life a little bit at that at that juncture. So has the diagnosis revealed anything to you about yourself, about the world, about life, or do you not even have time to think about that when all this kinda gets thrown at you like that?
No. That's a very good and deep question. I really like it. No. I I...
So I... My health care background, I definitely helped. Right? Because I worked, started in a rural clinic in South Africa where I grew up, and then worked in a a big hospital practice with a test to outpatient clinic. And then I've done...
Comfortable in a Hospital15:27
Worked in inpatient rehab settings. And so I'm very comfortable in the hospital setting. So, you know, the first time I see see my daughter after diagnosis, she... You know, she's in a hospital room. The hospital rooms don't intimidate me.
Like, my... I'm sure my wife will tell you she would rather never see a hospital room again. But to me, it's it's like something that's that's familiar to me. And we're very practical people, so we were basically... It was...
This is what it is, and we are... Like, what can we learn to make the best of this? So my wife went very hard on her research. She read some books. She...
I think she read the book by... The low carb book, doctor Bernstein maybe.
Mhmm.
And she read Think Like a Pancreas. And we we found... I don't remember how we found... My wife's research found the podcast or the or the Facebook group. Maybe first the Facebook group, then the podcast.
Okay.
Nuance, Hope and Permission16:35
So that, you know, that made a massive difference as people often tell you on the podcast, and it's not... You know, we're not buttering you up. It it is it is by far... The the amount of information that I... That we learned in the thirty six hours that she was in the hospital compared to what I learned in, you know, listening or looking at the Facebook group for for a few hours or listening to two or three podcasts.
There's just so much more so much more nuance, so much more hope, I would say. And hope... And and, like, and and permission because they give you very basic basic information. Like, you... This is your...
Gonna be your basal insulin. You're gonna give it at this rate. You're gonna give boluses for meals. If a blood sugar goes high, you're gonna wait for three hours before you correct. Mhmm.
Why Would I Do Less Than That17:29
Like, all of those all of those things. And we very quickly decided that we can do better than than what they offered us because, you know, listen to the the podcast and kids are, like, having a one c's in the fives. I'm like, oh, if that's possible with with this technology, then that's what we're gonna strive for. Why would I do less than that?
Yeah. Well, it... That's...
So we're... Yeah. We're just practical problem solving people.
Right. So you you problem... Problems here, this is sad, but let's keep going. We'll figure it out. Take good steps.
Learn maybe that what you're being told isn't everything, and then, you know, I guess, swallow the swallow the red pill and go find out what's really happening.
Yes. Yes. Basically.
Okay. Yes. Well, that's... I'm I'm very happy to know that it was there and that it it helped you at all. So I I appreciate it.
Absolutely. Yeah. And then we got really fortunate. We got really fortunate with having a very compliant child.
She she didn't argue a lot?
Not about diabetes.
I was gonna say. Yeah.
She she is... Yeah. She has been really good about doing what needs to be done, and I... And it's... No.
I can compare it with all of the other stories I've listened. I haven't listened to all the episodes, but I listened to a lot of the podcast.
Okay.
And I've read a lot of the posts, and people that say, you know, there are kids that stop, they just don't care and just let their sugar sit in the three hundreds. That is not my daughter, and and part of it is because we help her manage still. Mhmm. But, you know, she... Has she bought at a few part changes or a few Dexcom changes?
Sure. But overall, her compliance has been amazing.
Okay.
And we're really thankful for that. And also, I'm really proud of her that she has been able to handle it like that.
What... How does... Where does she get her understanding of the how and the why? Is it... Obviously, from you guys, but how much do you tell her about the why?
Why is this important? Why are we doing this?
No. We tell her, I mean, I guess, age appropriate amount, but we... We're pretty open kind of parents. I'm not gonna gonna show her a video of... Or a picture of someone with a amputation and be like, this could be you.
Right? But I... Because I work in health care, again, I have also worked with many patients who are, by chance, they're not in the hospital for or they're not my patient as a PT for diabetes reasons, or although they might be. They might have an amputation, and they have to learn to, you know, to walk before they before they can get a prosthesis or whatever. So...
But I I can say I have seen firsthand the side effects of not taking care of diabetes, and we want you to have a happy and healthy life. And there are ways to do it. And there are more than one way. Right? You don't have to be on this pump.
You can be on shots. You can... We can try a different pump. You can take a break from... You know, we I guess what I'll say is food is a big topic and a big issue for a lot of people.
Not Making Food an Issue20:55
So when we kind of... She eats like you let Arden eat. We're not very restrictive at all Mhmm. Because it... That...
And that's I think something my wife was very serious about because of, you know, statistically girls and eating disorders are are good friends, and and my wife says, like, we're not gonna make food an issue. And and that that takes a bit of that takes a bit of learning because some foods are hard to dose for, and then you, you know, pay the price afterwards when blood sugar don't wanna come down. And so... Yeah. That's...
You know, we we... We've we've tried to to say, you know, these are these are... This is the reality, but let's not make it harder than it has to be. Okay. And hard...
Very thoughtful.... Harder than it has to be is is like is like, still... Let's let's enjoy food. Let's let's put exercise in a positive light. You know, let's make a plan for if you're going to a party, how can we how can we make that work?
Holding Her Phone at the Party22:10
Can I come with you to the party and sit in the background and just take care of the? You know, just keep your phone with me and I'll do the bolus thing, like, and I then get involved. You don't have to pick up your phone. I'm I'm in charge of that. And and for now, you know, that works.
Mhmm. No. She's younger. She probably really... I mean, listen.
I think a lot of people would appreciate it. But but I think that's fantastic. It sounds like you guys are are are working in tandem. It sounds like you're doing a great job. It sounds like she's going with it.
Obviously... Look. I'll... I'm gonna tell you that whatever this is right now, it's gonna be a new thing more times than you can count the next ten years. So, you know, I would just say keep that attitude and and try not to fight too hard to stay in the part you're in now when she tries to move forward into the next part, which will happen over and over again.
But I feel like you'll be fine about that. Yeah.
So Yeah.
That's awesome. Who's the main caretaker of you and your wife, or is there not one?
So... No. No. So, we are, I would say, equal partners, but I am the main caretaker simply because you and I actually have more in common than than you know. I...
Quitting to Stay Home23:26
So let me let me give you a back... A little bit backstory. In August 2021, July 2021, I quit my full time job to become a stay at home dad. So I was working at a rehab hospital full time. We had my youngest daughter and my wife...
This is like COVID time, so my wife's a teacher. So my youngest was born October 2020, and then she had maternity leave, and then she went back to to work for, like, four months teaching, like, online. And my daughter was on her lap for those four months with her teaching. Mhmm. And then in the summer of twenty twenty one, they said, you're gonna go back to teaching in person.
And so we were like... So this is, like, heavy COVID times. Right? So so my so my oldest went to day care for four years and then went to school. And so we were like, well, do we do day care again or do we...
No. We've thrown the idea of me staying at home and starting my own thing. We've thrown it around a little bit, but not a ton. And and so it was, like, decision time. And so I said, okay.
I'm gonna I'm gonna I'm gonna bite the bullet. I never thought as a younger white man from South Africa, a pretty patriarchal society, that I would be a stay at home dad. But fortunately, I am... You know, ended up being... Have more flexible mindset than than maybe I I could have had.
And so I said, yeah. Let... Let's... Well, let's do this. And so I started taking care of my youngest.
So for that first year, she was home all the time with me. But... So this is... So so I quit my job, went to visit my family in August in South Africa, came back. First grade started.
My daughter goes from her local school to getting into a Spanish immersion program. So she goes to a local school for a week, goes to... Then gets into the Spanish immersion program, now goes to that school where she has to get on a bus. We have a nine month old baby at home. Within the first week, there's COVID in the classroom.
They get quarantined. And then, like, two weeks later, she gets diagnosed with diabetes. So that's how it started. That that was... I mean, it...
The fact that I was... Then I stayed on that was obviously so fortuitous, like like, to an insane level because we just could not have done that.
Did People Talk26:01
Can can I ask you in your in your community or or even your family, was it seen as odd? Do you see p... Did people talk behind your back? Or because I I mean, I did it a long time ago now. I...
02/2000 is when I left my job.
And
Yes. I... Openly, people would question what was happening. And behind my back, the the muttering was that I was taking advantage of my wife.
Mhmm.
Did you get any of that?
I... Definitely not openly. I could I could guess that behind behind my back, some of that might have happened. I think my family is pretty pretty open minded. Yeah.
I don't I don't really know. And I... Maybe even even if I did, I don't know that it would have bothered me. I... It was it was kind of a...
It was quite a practical decision.
Yeah. Oh, I wasn't bothered. I wasn't bothered by a jock. I I wanna be clear about that. Yeah.
Yeah. But Yeah. Yeah. It was... I I can recall, like, years into it when my father-in-law, like, proclaimed out loud to the group that I was very good at taking care of the baby.
And and maybe even by then, it was Arden and Cole. Yeah. But it was... I I remember it happening at some event, and I thought, oh, this is this is a a purposeful signal. He's telling everybody it's okay.
Scott's doing it. And I I thought, oh, that's hilarious that he thinks he's in charge of all this, but okay. Like, you don't let it be. Yep. Then twenty years later, you know, as he's at the end of his life and and and they're older, he comes to me and and he says...
He's like, look. He's like, you know, in the beginning, I just... I thought... And I was like, I know what you thought. Don't worry.
I was... You don't have to tell me. And, and he... And and then he said, but I gotta tell you, he goes, just a fantastic job. He's like, the kids are just they're fantastic.
And I was like, I know, man. I said, you should have tried talking to me back then instead of just assuming I was gonna, like, have a have a a Pabst blue ribbon in my hand in
the middle of the afternoon, not know where
the kids were. You know what I mean? So Yeah. It's it's... But it's it's impactful because people look, they talk.
Although I'll tell you one of the greatest things about... I found around that time... The world's different now a little bit, but I spent a lot of my daytime time around women because because they were moms and we were in, like, similar situations. I really think that helped me, you know, growing up, actually. So anyway...
Yeah.
No. It it... I I think I think the fact that it was COVID times, I think the... That was a bit of a buffer. Like, people like, oh, we we get...
Maybe people said you... We get why you're doing this because the the options are... You know, people are jealous, I think, of have... Of other people having options.
Oh, yeah.
But, like, if you have... Right? You you... In in in where we live, like, most families, both parents work, and most of my my kids' friends go to aftercare because school gets out, you know, before they're done with work. And that just doesn't almost ever have to happen in our house.
Well, listen...
And so people are jealous of that.
Yeah. Yeah. Old men... The the number of men who would pull me aside and go, hey. How'd you pull this off?
Yeah. No. I think people are honest with themselves. Right? That that is really...
They would... Some some men would would much rather do that than some desk job they're stuck in.
I... It's been very rewarding. And, and so much so that I I still feel badly sometimes that my wife didn't get to do it. It's, there... There's something really great about it.
Although, I did joke with her last night. We're talking about... I mean, we're not ready to retire. We're retiring, you know, in a decade or more. But, you know, you start you start trying to plan and talk about things a little bit.
And last night, I said, I think, you know, this is the age you could probably retire at. This is the age I could probably retire at.
And I
think I think I said it backwards. I meant that I was the older age and she was the younger age. She goes, why why do you get to retire before me? And I and I and I thought that's not what I said. Like, you know what I mean?
You know, every... By the way, no one wants Alexa listening. But if someone would come up with an app called, hey. Who was right? And it just replayed the last thirty seconds back.
I think it would be a big seller. But, but, you know, you... How many times you and your wife stand together and you're like, I... You just said this. She goes, no.
I didn't. And and just... You want somebody to be able to tell you for sure because she always thinks I'm wrong, and I always think she's wrong. And that can't possibly be true. So No.
Yeah. Yeah. So, so I'm standing there, and and before I knew, you know, what she was saying, I just pivoted to joking. And I said, well, you know, like, with being a stay at home dad, I just thought I'd be like a stay at home retired person first and figure the whole thing out before you jumped into it. And she looked at me like, are you serious?
Because I'm not doing... I was like... I said, no. I think I must have misspoke. But it's No.
It's been a great experience. It really has.
Yeah. Yeah. No. My my wife is definitely jealous of it. My wife really appreciates the aspect of of teaching, you know, summer breaks.
She's not the type that takes... You know, gets the summer off and puts her kids in summer camp. She wants to spend the whole summer Yeah. With with our kids. Like, that is her attitude.
So she there... There's definitely, you know, feelings of... Like, if if you're... This is... Being being a stand on dad is not some kind of burden.
Okay? This is like a real privilege. Yeah. And make sure you you take... You know, you make you make the best use of it.
A 100%. Well well, I wanna learn about... So if that's the situation and that's the setup, You are... I mean, it sounds like your wife found the podcast or the or the Facebook and the podcast first. But do you do you need it for community?
Do you need it for direction? How do you use it as a tool?
Taking Notes on Pizza32:37
I I like to hear people's stories. I listen to the podcast for the stories. Like, there's not... No. I I shouldn't say that.
They they are... Few months ago, I think we had pizza or something and I... That that went poorly again so many times before. And I'm like, come on. I I have to figure out how to bolus for pizza.
This is dumb. Really frustrated. And so I went on and looked for the Bolus 4... I don't know if it is specifically pizza, but maybe it was pizza. I went to a Bolus 4 episode.
And it was... It's with Jenny. Right? Yes. That you do those.
And I, yeah, I listened to it and there was just one or two snippets in there. And I was like, okay. Because I I think, you know, the longer you stay in it, you just you just swag everything. Mhmm. I...
To me, like, I don't I don't really count carbs and... But it was a really good reminder, like, this is what this thing will do. This this this carb will hit when and the protein will hit here and the fat. And I... In the back of my head, knew it, but it was it was a really kinda clear picture.
And so... And and so... And the time after that pizza went much better. And I made some notes about what I did because not particularly good at that. Like, oh, yeah.
I remember what I did the last time, and then I totally don't do what I did the last time. So I actually took some notes that I can go back to because that's a smart thing to do. Right?
I don't know. I'm a boy too. I I wouldn't even know how to quantify that. I just... I'm just following my nose.
So I... You know what I mean? But but that's great. So... But you like to hear the people's stories.
What do you think that does for you?
Yes. Sorry. I
You cut out?
I got... Hi. Sorry. Can I can I? I need to text my daughter quickly.
Can I do that?
Do what you do. I'll pause here. Go ahead.
Alright. Thank you.
Yep. Oh, actually, now I gotta tell you to hold on. Hold on one second. Okay?
Okay.
A Call From the Vet34:53
I'm gonna I'm gonna keep recording, though. Hey, doctor. It's Scott Benner. Weird thing. I make a podcast.
You don't know that. I'm recording right now. But if you don't mind, I really don't wanna miss this call. So, I'm calling about Basil. He's just got discharged from his eyes, and he suddenly doesn't seem to be able to hold his urine the way he wants to.
So we've been going through this process as he gets older. I I don't wanna tell you what to do, but, like, it feels like he needs an antibiotic, but I'm not sure.
Okay. I mean, with his history, I would say, really, the best thing is for him to come in.
That'd be great. Could you see him today?
Yeah. We should be able to. Let me... If you're okay with him, I'm just gonna have, Melinda upfront pick up.
That'd be great.
We should be able to see you.
Yeah. Do appreciate it. Thank you.
Yeah. Of course. Give me a second. Yep.
Sorry.
We appreciate your patience while
we help another pet parent.
Okay.
Please note for the month of August...
I'll take that off the speaker for a second. I gotta make this appointment. My older dog is just, he's struggling this week, And Okay. We've been trying to get ahold of the, the vet, and they're like, we're on vacation. I'm like, how...
You know how to go on vacation?
No. Of course not. What are you talking about?
Vacation. Anyway, I took it the speaker because in in any second now, they're gonna say the address of the place, and then you guys are gonna know where I live. So, you know, just hold on one second.
Okay.
Jack, do do a good job of remembering where we are. Okay? Because this might be the, this might be the end of my brain power to be able to remember what we were talking about and take it. And, also, where the hell is Melinda? Melinda, come on.
Omnipod Melinda? Omnipod five.
Omnipod five. Okay. I'll hold that thought. Yeah. I'm sorry.
I'm still on hold. No.
You're all good.
She's telling me about...
What's going on and offer treatments that bring relief. For ear infections, we even have an office options that last. No at home meds needed. Ask us a... Hi there.
So doctor Princeton said that we need to have people come in today.
Yeah. The only
appointment I
have is
at 03:50. Would you be able to
make that?
03:50. I'll be there.
Alright. We'll see you then.
Thanks so much, Wanda. Alright. You're welcome. Bye bye. Bye bye.
Yeah. I'm gonna tell you. Sometimes I'm thrilled. Hold on. Did she say 350?
Like, I'm asking you. Let me write that down.
350. 350. That's what I
heard. Okay. Vets and dentists are going the same way in America. I don't know about... You're in South Africa.
Right? I don't know about there.
But No. No. No. I'm here. I'm here.
Oh, you're here now? Oh, okay. You're from South Africa. Okay.
Yeah. I'm from South Africa. Yes.
So vets and dentists all have different, like... I don't know. They're... I don't wanna say, but I... I've never received so many sales emails from a doctor before, but vets are just like...
They bombard you with, like, we're having a sale on this. We have that. I'm like, it's a... It's health care. Like, what do you...
I I... What? And and, and my dentist all the time. We gotta do this. We should run a test.
Let's run as a a... Let's see what what? Maybe there's some bacteria back there. I'll I'll send out a $50 test to find out. I'm like, I've been alive for fifty five years.
No one's changed... Ever tested the bacteria around. I'm like, what are you talking about? You need a tray. We have to fit it to your mouth.
Put this gel in it. Okay. I get the tray. I got the thing. You know, next time I go back, he says, oh, the tray is really working.
I think to myself, I haven't used that tray one time. Son of a bitch.
Oh, dear.
Yeah. Yeah. The other... The the... And now I do it...
Like, now I feel like I'm being cheated on. So, like, I do the things I would do if I was dating and wasn't sure if the girl was being faithful. So, my last three months... Like, also, they wanted to clean my teeth every three months. I'm like, I I don't know why you think they're that dirty.
And
Yeah.
So the last three months, I stopped using the rubber picks. Right? Because they're so about... Use the rubber pick. You...
I stopped. And he looks at my teeth and says, hey. You're doing a great job with those rubber picks. And I thought, you mother... Unbelievable.
Anyway...
No. No. I know that. I know that. I know the guy.
I I will say as as someone who works in health care, the the the need to pivot to aspects of health care that keeps paying the bills, there's definitely a pressure there.
Oh, sure.
And so... Right. So... And I'm not I'm not justifying anything. I'm just in in...
Even in physical therapy and and where I work for myself now, just have a single person practice, you know, and I'm part of groups where people is all about how do we... If reimbursement is going down, where where else do we find money? What else what else can we sell? What other skills do we have? What is, like, content and products and and things?
And I think it's the same it's the same there.
Too Much Content39:55
Yeah. Well, I'm gonna just say this, to all of you as a person who's been in this, in this space for... And I don't mean diabetes. I mean in, like, creation content, that kind of stuff. I've been doing
this for
a really long time. You're all flooding the world with this stuff, and it's gonna backfire. So Mhmm. Everyone is gonna look up one day and go, there's too much in front of me, and they're gonna zone out. And maybe it'll be good for the world because they're gonna go back outside, but you guys are just like it...
It's not working. Like, you're you're overwhelming people, and now instead of consuming a few things or picking and choosing, they're either consuming eight... Literally, at this point, the average watch time Instagram Reel is less than six seconds. So Yeah. You're forcing people to not do anything, and it will backfire.
So we're on our way. You're you're you're saturating a market that can't be saturated. People's attention is not limitless.
So... Yeah. No. Absolutely. I I I feel I feel that personally.
I, there are days where I I I turn it... The radio off in the car, and I just... I drive in silence, and I, you know, I I gotta just switch off. There's there's too much coming in.
I I find it's... I I don't
want it.
I find it's ruining music for me. I used... I I I used to think music as a relaxing thing, and now it feels like noise when I can't have noise. And that's No. A 100%.
I've...
Just these last few weeks, I've had that, and I hate that because I love music.
Terrible. It's really... It's a it's a... Anyway, you're all ruining the world. It's...
You don't have a sass.
Yeah.
You don't have a a a surefire idea to make $10,000 extra a month. Just let it go. Okay? Go get a job. Yeah.
Jesus. God. I am a podcaster. You all can't do this. Okay?
Jesus. I beat you to it. I'm sorry. Oh, Jesus. You did.
You did. Yeah. It's not my fault. Like, you can't be mad at me, Jacques. I I didn't know.
I wasn't... Also wasn't doing it for a business. I was just doing it because I thought it would be helpful way to, like, spread my my blog more. And Yeah. Yeah.
I was... Look. There's another thing coming. Go find out. Instead of trying to make...
The Juicebox Hub42:05
Instead of trying to be a YouTuber, try to figure out what you can do with AI or something that you couldn't do before because your little brain couldn't hold it together. Jacques, the other day, before we get back to Omnipod five, which I'm so impressed with myself for remembering, let me let me tell you that, I was I was... I don't know what I was doing. I was making breakfast and and listening to a video about, some new update to Claude. And the the person who was explaining the update just said something that clicked in my head, and I thought, oh, you know what I could do with that?
And then I, like, had a fully formed idea. And thirty six hours later, you can now go to juiceboxpodcast.com/hub. Yeah. And when you get there, you will find, the... Right now, it's a fork that can send you to two different places on the on the on the website.
I fully imagine it will send you to many more places soon enough. But there's something called pro tip practice, which is a twenty one day kinda guided self reflection that only takes a few minutes a day. And k. That's been there for a little bit, but I'm making it public now, after over a 100 listeners have demoed it behind the scenes. So I'm not just throwing it out there for you.
And now I I put something else out, which I'm gonna say here because I want people to go try it and and, you know, please get back to me if it didn't work or there was something about it that was, like, glitchy. But, basically, you... It's the pro tip series, like, split up into labs, like, into 27 different... Because that's how many episodes of the pro tip series are. So you open up the first one, and right there, it...
You'll be presented with 12 different sort of, like, learning opportunities inside of that episode. And you just drop the drop the first one down. It it says, you know, there's a little a little blurb. It's not a it's not a real thick paragraph. I know you're gonna have to read.
And and then a quote from... It happens to be from Jenny from this drop down for number one. In two seconds, you can click on a button, and right there in your browser, listen to the four minute clip where Jenny says what she says So you can kind of, like, get get the idea together, get an example of it, move on to the next thing, do all that. At the end, it'll give you a little quiz. It'll keep track of the entire thing for you as you go through every episode.
And then... And if if you pass at the end, you get, like, a little digital certificate and everything like that. And it's a way to help people go through the pro tip series who think differently or learn differently.
Yeah. No. That's awesome.
It's a 100% awesome. Guess what? It's also free. I wouldn't possibly I'd never think to charge you for it or turn it into, like, a... You know, for just $5, you can get into the hub or...
I'm... None of that. I don't I don't care about any of that. That's all... That's been possible for years, and I've been thinking about it for years.
But I couldn't I couldn't make it happen as I'm one person. And I don't know if you've been listening to the podcast or not. I... I'm not that technically adept. And finally, anyway, yesterday, when, you know, Anthropic was like, well, here's what we have now.
I thought, oh, I can finally use it to do that. And thirty six hours later, it's online.
So Yeah. That's... That is incredible.
Well... But, also, keep in mind when someone, will now approach you with stuff like this in the next six months and say, hey. It's just $20. Or for for a thousand dollars, you can join our three month course, or you're gonna start getting you're gonna start getting hit with that a lot. Yeah.
Yeah. So... I know. I... The the problem for those people are that in the in the PT private practice space, the the guy that I found who's...
He's not he's not a coach. He's not a business coach. He just has had his own practices, and he started a Facebook group for people that are interested in in doing this... Doing private practice and maybe combining private pay therapy with some with some insurance based pay or Medicaid pay, and he does he does all of this similar stuff also for free. Yeah.
And so I've been completely spoiled by a guy who's who's willing to do that same as you. And and, you know, he's he's... And he's an entrepreneur, so he just comes up with other ways to to make his money. He's like, I'm not gonna charge people for this. This is like a community.
Yeah.
And I'm thankful that, you know, that this community can, through advertising, you know, can pay you to do it so that we don't have to pay.
I appreciate that. Yeah. I just said to somebody online the other day, I said, listen. I'm an American. I made a thing.
I created value, and I sell ads on it like a good American. Yeah. That's exactly
it. That's exactly right.
Let somebody with money pay for it. Okay?
Yeah. You could. Yeah. Exactly.
It shouldn't be you guys. Like, that's... I... Listen. I'll tell you that fifteen more years ago, my wife said to me, hey.
My company is offering business coaching. I'm gonna do it. And I was like, what? I... First of I'm looking at my wife like she's she's really, like, adept and smart and good.
And I'm like, well, you don't need business coaching. She said, well, they're offering it. And I was like, okay. So I happened to be around a couple of times for these calls, and I'm listening and listening in the background. And she gets off she gets off, and I said, you should be coaching him.
I was like, I don't... Wait. What is going on right now? You know? And Yeah.
She goes, yeah. I'm not getting a lot out of us. You're not getting a lot out of it because he doesn't know anything. And and I was like I was like, I don't understand. Like...
So I went back over it with her again. This guy sold this... His business coaching to a big corporation. He's, like, on a three year contract where you could sign up, you know, and he would jump on with you. So he didn't work for the company.
He was, like, an outside contractor. And when my wife told me what they paid him to be available for three years, I almost swallowed my tongue. I was I was like, how did he trick you into that? Like, trick them into that. That's really...
I was like, ugh. But, anyway, I I take your point. Like, people have to make money. And Yeah. The world the world is, you know, pivoting, and people are trying hard to keep up.
And it's not lost on me that everybody would try stuff like this. I get it. Like, I really do. But you gotta stop and look at all the people in your life and ask yourself, how many of the people I know would I pay to tell me what they know? I bet you the number's small.
Yeah.
Yeah. Yeah. So... I... Yes.
Yes. I know a lot of nice... I lot... I know a lot of nice people. I I ain't asking them for advice.
So, again, that's what I do, Jacques. I'm already... I've already taken that job. It's done. The...
You you don't need you don't need 50 of us. I'm good.
Yeah. We we do.
Back to Omnipod 549:03
Sorry. Omnipod five, my thought was, twenty seven years ago, I... My thought was, is her insulin... Are her insulin needs going up because of the adrenaline or excitement of a new school year? And then the pod maybe started giving her a little more.
Now she's calmed down, and the pod might still be on that that old bend from the
first week. Yeah. I mean, like, yesterday morning, she didn't have the same breakfast, but I I have, like, a rotation of maybe four breakfasts for her. And yesterday, she she needed more, like, quite a lot more than she normally needs. And then this morning for...
She... This morning, she had a yogurt parfait, which normally spikes her because of the granola and somehow
it didn't. It just didn't.
So, you know you know, all the all the the 101 factors that you have to consider. I I definitely... Like, if she runs above... If she eats... I don't Her sugar is above one fifty and she eats, like, the the difference between one fifty and one ten, The response after with with everything timing and amount of insulin the same is is is very significant for her.
I I really have to have to be careful with that.
Yeah. So her resistance changes significantly in that in
Absolutely. That Yeah. Yeah. And then we're and then we're fighting at the top. She...
Kirsty, a Biosimilar50:25
They're also... Kaiser switched from Humalog to to... Is it called Kirsty? I think it's the insulin. It's a it's a fast acting, but it...
I think it's a little slower than Humalog. But she also seems to overall need it a little bit less. So it... Even if it's a bit slower, it works a bit better for her. What's it called?
What's it called? Think. Oh, I'm
looking at it. French.
No. I got it. Is it
Kristy or Kirsty? Think it's Kirsty.
K I r s t y. Yep. Yep.
That's it.
I have to be honest with you. I've never heard that one. It's a... Oh, it's a biosimilar. Rapid acting insulin first interchangeable biosimilar approved for FDA as substitute for NovoLog.
I had no idea. You're gonna see a lot of biosimilars in the next couple of years. I don't know if you'll all recognize it, but they're coming fast and furiously in diabetes and in a of other spaces. Yeah. Yeah.
Today's show was sponsored by Tandem Diabetes Care, the Eversense three sixty five, and Touched by Type one, who you can learn more about on Facebook, Instagram, and at touchedbytype1.org. Head now to tandemdiabetes.com/juicebox and check out today's sponsor, Tandem Diabetes Care. I think you're gonna find exactly what you're looking for at that link, including a way to sign up and get started with a tandem mobi system. I'd like to thank the Eversense three sixty five for sponsoring this episode of the Juice Box podcast. And remind you, if you want the only sensor that gets inserted once a year and not every fourteen days, you want the Eversense CGM.
Eversensecgm.com/juicebox. One year, one CGM. If you or a loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the bold beginnings series on the juice box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years of personal insight into type one. Our series cuts through the medical jargon and deliver straightforward answers to your most pressing questions.
You'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the JuiceBox podcast. The bold beginning series and all of the collections in the JuiceBox podcast are available in your audio app and at juiceboxpodcast.com up in the menu. Thank you so much for listening. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple Podcasts, please do that now.
Just hitting follow or subscribe really helps the show. And if you'd like to go a little further and leave a review in Apple Podcasts, that would be fantastic. But most of all, sharing the Juice Box podcast with someone you know or someone you think can be helped by it, that's the biggest thing you can do for the show. I'll be back very soon with the next episode, so don't forget to check your apps.
Read the full disclaimer
© 2007–2026 Juicebox Podcast. All rights reserved.
#1995 Dental Pamphlet
Dental Pamphlet
Samira is a dentist whose husband and daughter both have type 1. She left the hospital with brochures on eyes, kidneys, heart and feet — and nothing about teeth.
Jump to a moment
- Half her family has type 1. Her husband, also a dentist, was diagnosed sixteen years ago in his thirties — first told it was type 2 and handed metformin, until somebody finally ran antibodies. He has vitiligo. Their daughter was diagnosed four years ago at eleven, caught at close to 400 because a kid who sleeps through anything was getting up three and four times a night. Both dentists, and all either of them had ever been taught about type 1 was that beta cells are destroyed by an autoimmune response. Everything else in dental school was type 2 and gum disease.
- The mouthwash story is the one to remember. A mom, pleased with herself, had her son swish a blue alcohol-based mouthwash after overnight lows because he liked the taste and wouldn't drink water. Water sits at a pH of 7; that mouthwash is 5.5. Cavities need three things at once — sugar, an acidic environment, and specific bacteria most of us already carry. She was supplying the second one on top of the first. Doing nothing at all would have been better.
- Diet soda doesn't rescue your teeth either. Scott looked it up mid-conversation: Diet Coke runs about 3.1 to 3.3. The preservatives that keep anything shelf-stable — ascorbic acid, citric acid — are acids by definition. And xylitol, which dentists keep recommending to type 1 families, does nothing for a low, because it doesn't raise blood sugar.
- Her four asks of dentists, none of which make a dentist any money: sip water after treating a low and check what's actually in your mouthwash; come in every three to four months rather than every six, because salivary testing shows the bad bacteria are only starting to repopulate at three months and are fully back by six; the less sticky the sugar, the better; and look for dry-mouth products with glycerin, because blood sugar swings reduce salivary function and leave the mouth with less buffering capacity.
- Two things worth knowing if you take a GLP: she says they are starting to see reduced saliva production, which concentrates everything left in it — minerals, bacteria, and glucose. And whitening powder is an abrasive. It works immediately and it works by putting micro-scratches in your enamel, which then stain faster, which sells you more powder. A peroxide gel does the same job without scouring the surface.
- T1D Oral Health Foundation — Samira's nonprofit — the questionnaire she is using to build the first real data set, plus a family brochure
- ADA Takes Up Type 1 Education for Dentists — Her resolution was referred for study, with a report due back at the ADA House of Delegates this October
- Beyond Blood Sugar: Type 1 in Dental Practice — The course she teaches to dentists — CGMs, pumps, dental emergencies, and how type 1 and type 2 differ in the chair
- Dexcom G7 — Now in ten and fifteen day wear, with a twelve hour grace period and up to ten followers
- Omnipod 5 — Tubeless automated delivery, updated with a new 100 mg/dL target option — free starter kit at the link
- Small Sips Series — Listener-voted takeaways from the podcast in short episodes
Every word of the conversation
Welcome and Sponsors0:03
Hello, friends, and welcome back to the Juice Box podcast. On today's episode of the podcast, there will be nothing that you should take as advice, medical or otherwise. So please, please consult a physician before making any changes to your health care plan or becoming bold with insulin. I've got two OG sponsors for you today, Omnipod five and Dexcom. That's right.
The episode that you're about to enjoy was brought to you today by Dexcom and the Dexcom g seven, the same CGM that my daughter wears. You can learn more and get started today with my link, dexcom.com/juicebox. And this little slice of podcasting perfection is also brought to you today by the Omnipod five. The Omnipod five is a tube free automated insulin delivery system that has been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections. You can learn more and get started today at my link omnipod.com/juicebox.
At that link, you can get yourself a free starter kit right now. What did I just say? Free. Terms and conditions apply. Eligibility may vary.
Full terms and conditions can be found at omnipod.com/juicebox. You'll find those links in the show notes of the podcast player you're listening in right now and at juiceboxpodcast.com.
Meet Samira2:02
Hi, and thank you for having me. My name is Samira Chafay. I am a general dentist. I am a mom to a type one diabetic little girl, and I'm married to another dentist who has type one diabetes. We have a son and a daughter.
So fifty percent of our family is living with type one diabetes. So teeth and diabetes, sugar is our life, and so that is my story.
Interesting. Well, I'm sure that's just the beginning of your story. So when you
met I know. So
Yeah. When you met your husband, did he have type one?
No. He didn't. So we met at UCLA School of Dentistry twenty five years ago. I graduated in 2001, so literally twenty five years ago we graduated. But he was actually a year ahead of me.
He graduated twenty six years ago. And, no, he did not have diabetes. The only thing we got as far as our education and physiology is type one diabetes. Your beta cells are destroyed by an autoimmune response, and that's as much as we got. In dentistry, we got so much information on type two.
Type One Was Basically a Blurb3:09
Type two in dentistry with periodontal disease, gum disease, all those issues. Type one was basically a blurb. Mhmm. And years later, sixteen years ago, actually, we had a little rambunctious toddler. So my son was about three, four years old.
I was very, very pregnant with our daughter, and we were working out of a smaller practice, and we were building our kind of our forever practice. You know how people build their forever home? We were building our forever practice from scratch scratch startup, the construction, all of that. And while life is happening, he just was not feeling well. And he kept going to the doctor because that's what a person does.
And they run tests, and they tell him he's fine. And, you know, at at some point, somebody did a test, and they said, oh, your blood sugar is high. You have type two diabetes. And we're all like, okay. That's fair.
Life is stressful. He's in thirties. I... Like, we can accept that diagnosis. But, you know, exercise more, eat better, here's some metformin, and we'll check-in with you.
Mhmm.
Then They Found Antibodies4:18
And he just was not feeling better, and he was just really just... He was struggling. And at some point, somebody decided to do a little bit further testing, and they can... They found out he has antibodies, and it is actually lot out, you know, autoimmune and not type two. So when he got the diagnosis, I I was about to give birth.
You know? The toddler is still super, you know, rambunctious. The construction on... This is going on. Excuse me.
Take your time.
And and there was just so much going on. You know, we're selling our office and then moving into the other place. I'm not at the... And he's still showing up every day to see patients. I still have no idea how.
He's amazing. Right. And, you know, mad respect. And so, you know, he had to learn to do what his pancreas does on his own. He had to learn to manage that, and I was absent from that.
Mhmm. Well, I
Fast forward.
Dentists Make Perfect Podcast Guests5:18
Yeah. I wanna say, I just realized something. Dentists are the perfect podcast guest because you guys are completely custom to having a conversation where the other person doesn't have to be involved he don't want to. It just occurred to me. Was like,
I love that.
Yes. Thank you for feeling. Yeah. Yeah. Every once in a while, I, I have this feeling when I'm interviewing somebody that I could push the microphone away and leave and come back, and I'd be and I'd be like, oh.
And then they'd listen back and think, that was a great podcast. So... But it just occurred to me that dentists have, because you guys are absolutely insane the way you start conversations while you have your hands in people's mouths. Because you... There's a compulsion when you're sitting in the chair to respond.
Yeah. But you can't.
You can't. You're like, does she want an answer to this, or is this, like, rhetorical? What's happening exactly?
Oh, we learn how to, you know, understand understand nods and mumbling, you know, early on. That's funny. That's really funny. It's an occupational benefit.
You're... So let me make sure I understand. You're pregnant with your child who is... Will one day have type one diabetes while your husband's being kind of miss... Misdiagnosed and better diagnosed and then fumfering through the whole thing because you think his direction was terrible.
Can I ask you, do you think they gave him poor direction because he was a physician or because that was the how it usually works?
You know, I really don't know. He had he had a good care team. We live in Southern California, so I don't think access to care is an issue. He he saw multiple providers. And I think at just...
At some point, somebody said, Let's look at it with a different perspective.
Yeah.
And I think, you know, you kind of sometimes accept what they tell you. They tell you you have type two diabetes, and you're, you know, you're fitting into the mold. You... You're not gonna argue about that, especially if you don't know too much about type one. We don't know anybody who has type one in our family.
Right. Like, this came out of nowhere. And so, you know, when he got the correct diagnosis, it was a little bit of a shock. Like, are you sure? Is this...
Oh, okay. Let me go learn about that. You know what I mean? Mhmm. And, again, by then, I...
You got a brand new baby. You know, the other toddlers running around moving a whole practice. It's not like moving your house. I mean, you're moving patients, you're moving charts. It's it's quite an undertaking.
And then somebody had to take over our old location, you know, you have to sublease the other thing. It was it was a lot happening. And so, you know, I'm sure the stress of that probably triggered something that was brewing. But, I mean, you think back, and you're like, oh my god. We...
Did we really go through that? But... You know?
Did... Can I ask, is there other autoimmune in his family? Aunts, uncles, brothers, fathers, the... What are
they what they have? So he's always had a little bit of vitiligo, and the more I'm learning, there's a lot of... Just in our support group around here, we see a lot of kids with vitiligo that also have type one. So I don't... I I haven't really looked to see what the, you know, comorbidity with those two are, but that's as far as we've seen now.
You know, you know, somebody has a little bit of, you know, eczema. So we haven't seen, like, too much.
But but but...
I do think there's an underlying autoimmune gene somewhere.
Yeah. So eczema, how about Hashimoto's or celiac? Any of that?
We haven't seen celiac. We haven't seen Hashimoto. Arthritis, I know rheumatoid arthritis is autoimmune, but I feel like that's just so common. That wouldn't necessarily trigger a... Oh, you know, we better be on the look...
On the lookout for that.
You see anemic? Any anemic people?
Not that we know of.
And how about on your side of the family?
Not that we know of.
Okay. Okay. Yeah. And other type of
Again any I haven't... You know, sometimes people don't share.
The Dexcom g seven is sponsoring this episode of the Juice Box podcast, and it now comes in ten and fifteen day wear times. So you can go two weeks on one sensor. That's pretty great. It also has a twelve hour grace period. So you can swap your sensor when it's convenient for you.
All of 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. The Dexcom g seven comes with way more than just this. Up to 10 people can follow you. You can use it with type one, type two, or gestational diabetes.
It's covered by all sorts of insurances, and this might be the best part. I I promise you this really could be the best part. Alerts and alarms that are customizable so that you can be alerted at the levels that make sense to you. Dexcom.com/juicebox. There's links in the show notes and links at juiceboxpodcast.com to dexcom and all the sponsors.
When you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful. Dexcom.com/juicebox. And can you believe the number one prescribed automated insulin delivery system is now even better? Omnipod five is now stronger than ever with algorithm updates, including a new lower one hundred milligram per deciliter target glucose option designed for more time in range and with fewer interruptions for more time in automated mode. That's right.
The number one prescribed automated insulin delivery system just got better. You can request a thirty day Omnipod five trial today at omnipod.com/juicebox and experience the enhancements firsthand. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox.
And what luck. You were headed there anyway. Omnipod and Dexcom are both longtime sponsors of the juice box podcast. If you're interested in learning more about either of them, using my links really will help the show. Thanks for listening.
We're gonna get back to the show. Oh, no. Yeah.
The other part of it. You know? Maybe it's his second uncle and, you know, or my, you know, second... I... If they don't share.
You're never gonna know. They're
taking a
pill in the morning or something like that. Yeah.
Exactly. Exactly.
So so he teaches himself... This is, you're saying, sixteen years ago he was diagnosed?
This is sixteen years ago. So keep in mind, no iPhone.
Yeah. No.
Sixteen Years Ago, No CGM11:31
Right? He started out without a continuous glucose monitor. And keep in mind, as dentists, we're seeing patients. Like, you're, like, focusing on people and with, like, a, you know, a drill that's going, like, you know, thousands of RPMs an hour. So, you know, you gotta you gotta be really self aware.
I I
Your highs, your lows.
I have to be honest with you. My... I... It took it took me a while to find a dentist. I...
I've probably said this a couple times. The first dentist I had as an adult, I now look back and think he must have been on meth the way he ran around from, like, room to room, like, working on multiple people at the same time.
That's terrible.
Yeah. It... And and now I I have a great dentist. But my goodness, does he have a very specific personality that Uh-huh. That lends itself to this kind of fine detailed, like, like, aggressive but fine at the same time work.
You you know what I mean? He's Yeah. Yeah. Every time he's ever numbed me up, I, like, I get done, and he goes, you okay? And I'm like, I I...
I'm like, you're a you're goddamn magician. Like, I I... I don't even know that you just did anything.
That is so sweet.
Yeah. Yeah. He's just... He's he's so good at it. Right?
And... But I'm taking your point now as you're talking, like, if if you're funfering through figuring out type one diabetes, your blood sugar gets high or low or something, you're trying to do that work, that must be incredibly, like, I guess, just challenging is the word I'm looking for.
So one thing about my husband, he is... He's an incredible dentist. I mean, we both work together. We both went UCLA. I feel like I'm a great dentist, but he is above and beyond.
I mean, this man should... I mean, he he has an engineering mindset. I'm a big picture person. I'm the one that's going through their medical histories. I have...
I'm, like, warding any cavity. I'm the big picture person. But he's the one that... He's, like, making your tooth bionic. Like, he's thinking of, like, the best bonding agent, what's the best material.
Like, he's an engineer. Right? So he... With his OCD personality, we always joke. I'm like, you were made for type one diabetes.
Like, he's all about numbers and stats and how many... You know what I mean? So he... When he was diagnosed and he didn't have all the tech, his management was incredible because he was so self aware, and he was also so OCD about making sure it might work. It has my stamp on it.
I need to do a good job.
Yeah.
And so, again, kudos to him. You know? How many people can say that? But, yeah, it was
a different How did he manage in the beginning? Was it injections, pump?
Yeah. No. No. No. Injections.
You know? I mean, yeah. No. Everything manual. Okay.
But, again, it's... It it was a learning curve. Right? It was a learning curve. And I'll share with you.
Injections Until Four Months Ago14:13
He actually did not use a pump until probably four months ago.
Okay.
He was still on injections.
How
long? Just doesn't... Didn't like the feel of the pump on him. He's... Even right now, he had...
He's using one of the one of the tube pumps. He'd like... You know, it keeps getting stuck on things. He's just, you know, he's cursing it out all this time. But, but, I mean, he was okay with the injections, and, you know, he's like, I just don't like having something on me.
And it was working for him. And, again, his time in range is great. His a one c was great. So, you know, as long as...
I'm sorry. Why do you think he switched?
We... Well, that's gonna come on my next part of the story, but also out of convenience and, you know, just a lot of bruising. You know, insulin absorption starts getting a little impacted when you have a lot of callusing and bruising, and so it was more for that. And he did start the pump as a role model for our daughter.
Happens a lot. Also Yeah. I I mean, I've had a... I'm starting to realize I've had an odd number of conversations with people specifically about diabetes, but it's... It it leans a lot towards the father too.
Like, when I hear the stories over and over again, it's a lot like I was okay. I felt like I was alright, but I wanted to be a role model. Type one parents to a newly diagnosed type one child, I do hear the story more coming from men. It's... I don't understand why that is exactly.
Interesting. I'm just... I'm a 100% sure it's right. So Yeah. How long ago was your...
It's your daughter, right, that was diagnosed?
Her Daughter, at Eleven15:46
So my daughter, was diagnosed four years ago at the age of 11. So almost four years ago, not quite. But she finished school, like, you know, end of end of end of May. Like, I think it was, like, June 3. June 9, we were in the hospital.
And it was, like, a Tuesday. I'm looking at her. I'm like, gosh. She's drinking a lot of water, and this kid, like, will not... She will she will sleep through a bomb.
I mean, she does not wake up. She was waking up three, four times to go to the bathroom. I'm like, how is this possible? And, you know, your mommy instinct kicks in because you've seen this before. And then, you know, it was...
You know, we we already have the, you know, the finger stick, you know, do a little blood check one day and, you know, she was, I think, close to 400. And we literally got in the car and went to urgent care, and then I'm like, well, I kinda don't wanna go inside urgent care. There's all these sick people. So so I went... I was telling the receptionist.
I'm like, this is what's happening. I'm pretty sure this is what we need to do. So a wonderful sweet pediatrician that was on call that kind of saw us in a separate room with his nurse who looked like she was nine months pregnant and was supposed to go home, but she stayed behind for us until he called the endocrinologist. And then, like, you know, the... Or the closest pediatric endocrinologist who could see us was an hour away.
He called an ambulance, and they took us over there. And you know the rest of the story of how the diagnosis goes. And then she was diagnosed, and that was that was a big shock. And the difference for me as a mom is when he got diagnosed, you know, I was the spouse. I was taking care of the kids.
He did this on his own. But when the child got diagnosed, like, she can't do all the PKS stuff herself. I have to do it for her.
Mhmm.
So, yes, I kind of knew, but now you really, really have to know. And a big a big, like, kind of a, you know, look at... It was, like, something that, you know, like, light bulb that goes off was when it was at the hot... When we were at the hospital. So we had...
Yes. Of course, pediatric endocrinology came in, all these other subspecialists came in, nutrition came in, all the... You know, everybody comes through. Right? Do you know how to do this?
Do you know how to do that? Do you know how to curb count? And, you know, we even got, like, an avalanche of brochures. Like, right, I still... I think I have a picture somewhere with, like, how much information we got over a course of three days.
And it was, like, your eyes, your kidneys, your heart, your feet. These are all chronic issues. Right? And as a dentist, I'm thinking, okay. Well, she's waking up at 02:00 in the morning, having a sweet something because her blood sugar is low.
Where's the Dental Pamphlet18:28
Like, this is an acute problem. This is not a chronic problem. Like, where's the dental info?
Yeah.
Where's the dental pamphlet? Like, why why do we as dentists not do this? And so then, you know, you come home and you start seeing the twenty four hour exposure. I mean, literally, this is... Sugar is her medicine, and we dentists are like the sugar police.
How do we not have guidelines? How do we not have advice to give to families? And then, you know, I did what all the good moms do. You know, you join a bunch of Facebook groups and, you you know, you contact your local, you know, little support group or whatever. And, you know, you're reading all these things that people are writing, like, probably even in your juice box, you know, Facebook group.
Like, at least every day there's two, three people asking dental questions. Yeah. You know? And so I go back. And one of the things I will share as part of the California Dental Association, and I'm in Orange County, so Orange County Dental Society, kind of like the American Diabetes Association, there's the American Dental Association.
Yeah.
Oddly enough, they're both ADA. But... Side by ADAs. So I've always been involved with advocacy efforts. I've gone on, you know, when they cut, you know, benefits.
I I do a lot with them. So I already had captive audience, and I'm like, hey. This is happening. What are we doing? And it was like, Diabetes?
We already cover that. I'm like, no. No. No. No.
We're Covering Type Two With Gum Disease19:53
We're covering type two with gum disease. My kid is not at risk for gum disease when she's older, which she is, but I'm not worried about that right now. I just don't want her to lose her teeth. What are we doing? And it's like, I don't know.
Why are you giving your kid sugar at 02:00 in the morning? Why is she not waking up to brush her teeth in the middle of the night? And I'm like, my husband is type one, and he's not getting up to brush his teeth at 01:00 in the morning.
Like... How about no one's doing that? No one's doing that. Yeah. Yeah.
I just
go to... I gotta go to work. She has to go to school. Like, what kind of advice is that? And I think this is where, you know, it really hurt.
It felt personal because, like, you know, here's my own profession, and they don't understand. You know? I mean, in dentistry, like, when a patient comes to me and they say, you know, I smack... Smoked... I smoke, like, two packs a day.
I already know. I learned this. This is all the questions you asked. This is the guidelines. These are your, like...
You know, are you worried about oral cancer? Like, it's it's already set. Like, it's a formula. Right? And why is there not a formula for type one diabetes?
Yeah. Just a little There are many people with type one who don't even have a single cavity, but there are also people who smoke a lifetime and never get, like, lung cancer. You know? It... It's it's still a high risk.
It doesn't mean everybody gets it.
There's a
But there's
I'm sorry. I get a number of people who tell stories about going to the dentist, and the dentist is literally clueless. So they'll say something like, hey. You know, I'm worried about their, you know, their blood sugar falling while they're in here. And Yeah.
Then the dentist does not know how to accommodate that. I I will tell you... I mean, it's a long time ago now, but Arden had a lot of cavities on her baby teeth that... And some of the teeth needed to be, like, taken out and, like, work done and all this, like, stuff when she was little. And our dentist would only do it if it was in a hospital because because he was like, I don't know how to, like, have her out for thirty minutes and, like Yeah.
You know, and and manage her blood sugar. So... But the other thing you get is that once you start that conversation at the dentist, it's the exact same thing you just said over and over again. People will... They'll say, well, like, you know, well, my child has, like, juice in the middle of the night or we have to do this, that.
And the dentist's only advice is don't do that.
Yeah.
Yeah. You're like
That's stupid.
Awesome. Well, she'll be dead and not have cavities. I'm not sure what to do next.
But I think... You know, I I... And I and I do wanna preface that. I don't think they mean to come across as condescending. No.
Is condescending, but I don't think they mean it to. They think they're giving you good advice, but it's because they don't know. Like, I went to UCLA. I had an incredible education. I don't...
I mean, I... I'm good at what I do. Right? Mhmm. But I only got a little blurb.
And so I think it's just missing in the education part of dentistry
Oh, for sure.
Because nobody's talking about it. And when somebody is talking about it, it's because, well, you know, you should brush and floss every day and you should... And so, you know, okay. Well, how do we do that? So as part of my advocacy groups efforts with American Dental Association, California Dental Association, hopefully, we'll be expanding that.
I'm trying to say, hey. There is a little bit of a blind spot here. We need to do something.
Yeah.
And so they've been very receptive. Actually, just last night, I did a webinar for a group of dentists. Like, last month, I did another one. And so I... I'm actually...
Next weekend on the tenth, the American Dental Association scientific session is in Indianapolis, and I'm gonna be presenting in person. And so it's an honor to be able to present in person to the American Dental Association Yeah. And a scientific session. How do how are you? Incredible.
What do they give you? About twenty minutes? You get a half hour? How long do you get?
I get one hour and a half hour. Oh. Ninety minutes.
That's amazing. So what's your That is amazing. Oh, it really is. So Yeah. Let me tell you.
At a lot of the diabetes stuff, your presentations, you're lucky if you get twenty minutes even when they're asking you to present. So how are you gonna lay this out? Like, what's your
messaging? Messaging? And And So So you you know know what what mean? The reason... So the way I...
We started this. So after that kind of light bulb moment, after we came home with my daughter from the hospital, my husband and I looked at each other and we're like, this is stupid. We gotta do something. We can't possibly be the only dentist parents of a type one. You know what I mean?
Like, why is nobody talking about this? So we... We're like, we're gonna go to our local chapter of breakthrough and, you know, and, you know, our our children's hospital, and we're gonna talk to the people, and we're gonna be, like, super involved. And then we go there and, you know, and it... It's a little bit of kind of the similar thing.
Well, my dentist told me this. And I'm like, okay. Well, we can't just do this in our local area. We need to do this on a wider audience. So I established a, nonprofit with the state of California.
Starting the Foundation24:51
We called it t one d Oral Health Foundation. And with the help of, some amazing people we know in our community, we set up a little questionnaire. And the questionnaire is currently on our website if any of your listeners wanna go fill that out. And the questionnaire asks, did your endocrinologist talk to you about teeth? What does your dentist know?
And there's a... Just like there's five questions, and then has a little box that says, tell us your story. What do you want us to address? And when the responses came in, it wasn't that we as dentists need to talk to the public. We as dentists need to talk to the other dentists.
Because if the other dentist doesn't know, then, you know, that... That's kind of where the where the where the gap in in education is. Right? So when we got all the data from our questionnaire, I tabulated it. I wrote it up as a abstract.
I actually submitted it to American Diabetes Association. I haven't heard back. I submitted it to the International Diabetes Federation. Is that what it is? And so nobody has data.
You can even put it in PubMed, type one diabetes and, you know, dental health, like, minuscule amount of studies come up.
Yeah.
And so I'm really hoping that I can get people to fill out the questionnaire so I can publish this as a proper, hey. We need to do something about this. Somebody needs to study to figure out what do we need to do to close this gap. But but to that... So when people fill it out and they answer these questions, one of the first things that you see over and over again...
Xylitol Doesn't Raise Blood Sugar26:23
My dentist says instead of sugar, take a Xylitol. Xylitol is a sugar substrate that does not cause cavities. But Xylitol does not increase your blood sugar.
So not help.
I was just, like, blown away how many people said that.
Are you
blown away?
Are you really blown away? I'll... I'm gonna tell you.
I mean
I have a very, very close friend who's a pediatrician. His father is a dentist. We worked together one time, and I called his father doctor, and he goes, he's not a doctor. He's a dentist. And and and and they're laughing at each other, and he looks back at his son and goes, you're a pediatrician.
And they... And and so there's this, like, you know, already felt like there was, like... In between them, they're like, yeah. Like, we do the thing we do. Like, we're, like, kinda tacticians of a thing.
You know? And and when you hear people going to endocrinologists who don't get great direction about their type one diabetes, I mean, you can't be surprised that the endo bring up your teeth, and you definitely can't be surprised that the dentist doesn't understand your endocrinology issues. So Well, I
I contacted an endocrinologist. Actually, he was... He's not our endocrinologist. He's, like, the head of Children's Hospital here. And so he was really kind.
He actually, like, got on the phone, like, on his cell phone and started talking to me, and he's like, yeah. I've always wondered where the dentists are around here. He's like, I had one mom whose daughter was diagnosed with type one, and she wanted to sell toothbrushes at my office. I'm like, oh my god. That's really sad.
This is where this is where everybody's mind goes. Right? Let's capitalism.
2026. Like, I'm... I'll I'll start an Instagram. I'll get a... I...
Passive in... I'll get passive income. That's how everybody thinks it.
Are you serious? And I think that's why I kinda went to the American Dental Association because what I'm doing, I'm not making money off of this. Right? You know, creating awareness. Yeah.
Yeah. I'm trying to get a message. I wanna... I I... It's important.
My profession is important to me, but my child is also important important to me. My husband is also important to me. And I think everybody should have good functioning teeth. I mean, yes. I...
You know, it's it's like your kidneys, you need it to live. You don't need your teeth to live. But, you know, the psychosocial component of type one is so great. Like, if you can't smile, if you can't eat proper food, you know, what does that do to your psyche? So it is part of the equation.
Yeah. How about just, like, how about I'd like one less thing to be worried about or one less thing to have to pay for or to mess with or go to the dentist for? So so all you want is for dentists to know, like, here type one diabetes, and then kind of go through a checklist. Not any different than, by the way, when you go into, any health care at this point now. They ask you if you're feeling depressed.
Like, that that idea. Right?
Exactly. Exactly. And I'm using the data I've gotten off of the feedback people have filled out on our questionnaire to kind of navigate that. So I will tell you, I went to speak at, like, a little parents' group here. And you know how when you have a low...
You know, you take whatever, you know, whatever your preferred sugar source is and go back to sleep. Right? So I was telling the families, I'm like, you know what would be great? If you can just sip a little bit of water. Just dilute the sugar up.
He Loves Mouthwash29:27
And this mom is, like, super excited, and she tells me, you know, my son doesn't like to drink water. He gives me a hard time, but he loves mouthwash. So he... She has a little mouthwash and a little cup, and he'll swish with the mouthwash because he likes the taste of it and spit it out and go to bed. And initially, I'm like, oh, that's kinda sweet.
That's a great idea. But then, you know, you start digging into this. And she's using... Again, I'm not gonna use brand names, but Big Blue Bottle. You can find it at Costco and Target, you know, really tart taste mouthwash.
Right? And so those mouthwashes have alcohol in them. When you add alcohol to a liquid, it brings the pH down. So if water is at a pH of seven, that mouthwash is at a pH of 5.5. So cavities happen because when you have sugar, when you have an acidic environment, which means pH is below seven, and then the third one is a specific bacteria in your mouth.
We all have... You know how we have good bacteria and bad bacteria or natural biome? Their... Our mouth is the same way. That's why some people, like, never brush their teeth and never get cavities, and other people are, like, brushing all the time and they get cavities.
They just happen to have, you know, a disharmony of the good and bad bacteria. So there's a bacteria, streptococcus mutants, there's a couple of lactobacillus, those bacteria cause cavities. So if you have a little bit of those bacteria and then you add sugar and then you create an acidic environment You're getting a cavity. Either having... Then you're having a...
Then you're gonna get a cavity. Yeah. So this kid is taking... Is correcting his low blood sugar. So he has...
And he already has naturally the bacteria that cause cavities in his mouth, which majority of us do.
And then they're lowering the pH.
Then you're lowering the pH.
Makes it a perfect a perfect...
So doing nothing is better than that. Do you see what I mean?
Yeah. Yeah.
Wait. Yeah. Anybody with type one... Or actually, I kinda tell all my patients, please do not purchase any mouthwasher, any dental product that has a lower pH. And with...
You know, now with ChatGPT, you know, wherever you go, put it in your ChatGPT. What is the pH of blah blah blah whatever you're purchasing?
Right. But even as simple as what you just explained, like, I don't know that, and I would never think to ask about it. I mean, how would I... Like, can you imagine me sitting around going, oh, I wonder if the... I'd...
I'm not creating a perfect harmony of, like, you know, in my mouth to make a cavity big. That... There's no way that people would think the mouth... They definitely gonna think the mouthwash is the thing that fixes the whole thing.
Right.
Yeah. Yeah.
Right. Marketing.
Yeah. Marketing.
Exactly. It's capitalism. Marketing. But this is this is sometimes why, you know, I I kind of get a little cringey because people just read whatever that's on label or whatever is in the twenty second little reel they hear. Oh, this will fix.
No. You you need to understand the science behind it. So for cavities, sugar plus p eight... Low pH plus that specific bacteria. And some people have more of it, some people have less of it, and that's where your risk is high or low.
But
So
if you are
I have to ask one question. Would it have been better for that person to switch with Diet Coke than with mouthwash? Is it... Like, you know what I mean? Like, it really wouldn't be great.
This is what... Yes. So it's... Yeah. It's terrible.
I think... I don't know what the pH of Diet Coke is. I think it's probably around five, if not lower. Yeah. I mean, I I would hope, you know, mouthwash is higher than...
Now you've got me wondering what the pH of everything I drink is. I don't like the way I'm feeling while I'm thinking about it.
So this is the other conversation I have. Okay. You know, when you go to whatever your favorite store is, like Target, Walmart, Costco, whatever. Right? When something is sitting on a shelf...
And I'm not just talking about your regular shopping shelf. I'm talking about the truck that brings it over and it sits in the warehouse before it gets, you know, it gets sold.
Right.
It needs to not go back. Right? So when something does not... You know, what do they add? They add preservatives.
What are the common preservatives you think of?
Oh, got
it. Ascorbic acid, citric acid.
Oh, a... Right?... Things acidic.
Uh-huh.
Okay.
Do you see what I mean?
Uh-huh. Yeah.
Yeah. So a lot of times, know, what we find over the counter that we... Like, we're reading the... Oh my god. This sounds amazing.
Well, I have tell you.
I didn't chat too. I'm...
Diet Coke Is a Three33:38
So I'm wrong. Diet Coke is typically between three point one and three point three, making it strongly acidic. So it has a low pH.
Yeah. That's why drinking a diet drink is not gonna save your teeth.
It's not gonna save your teeth either. No.
Wow. Wow. So you what I mean? Like, people drink a diet drink thinking it's better for my teeth. But if you're having Diet Coke with a hamburger, well, the hamburger is your sugar substrate, right, because it's carbohydrate.
Oh, you're try to get people to understand that. Now... So, like
But I'm still still gonna go to In N Out. You know? You gotta go play.
Skip pivot. Well, not a... I I have two questions here. So my first question is is, like, I like the idea of, like, getting a dentist to, like, message you correctly in that situation. But as a person who just went to urgent care with their daughter, like, three weeks ago, the person at the intake didn't ask her if she felt depressed.
That person told her she didn't. Like this. Here's how the question was asked. You're not depressed. Right?
That's how it was asked.
Jeez.
Yeah. And I hear that happen all the time. Like... So now you're like... You know, now the...
I mean, listen. The person in urgent care is doing the intake is an intake person. They're not a doctor or a nurse or they're nothing, really. They're they're a person running them. They're them.
But, like, you know, they don't have a medical background. And people get bored of it because they... When you ask somebody to do something over and over again, I think it loses its desired intent at some point. And I've seen that in more places than just with that depression question. So my first question is is, like, how do you get the messaging the ninety third time that they've said it, like, to actually feel valuable?
That's my first question. And my second question is, at the dentist office, you've you've mentioned capitalism a couple of times. I know my dentist and like him. Just in case he hears that, I want him to know that. I think he's a fan...
He's a fantastic dentist. He's a wonderful person. He's a good friend. Yeah. But every time I look up, it's have you tried these trays with the gel?
Have you done this? Have you done that? We were thinking of doing a test on your saliva to see... It feels like I'm being upsold at the dentist a lot of times. And the the reason why it here's an example.
Okay? Mhmm. I'm not a good dental patient. I just wanna be honest. I'm honest with him when I talk to him.
When somebody says, you know, do you do you floss? Do you do this? I tell them the exact same truth. Right? But the last time I was there, they're measuring pockets and doing things with your cleaning and everything.
And, oh, your pockets are deeper. You're gonna use those trays and definitely use your rubber sticks. And I'm like, okay. Okay. Okay.
And I get back Yeah. And all my pockets improve. So he comes and he goes, it's really encouraging to see that you're doing the things I asked you to do. Can I be honest with you?
You're not doing
the do one goddamn thing he asked me to do. Okay? And so I brush my teeth the way Jesus intended when I learned in the seventies. Okay? And I don't really do a whole...
And look. I gotta tell you differently. If something gets stuck in my teeth, I take it out. Okay? But I don't eat and then turn for my for my pics.
Or... And I'm not saying I shouldn't. Don't get me wrong. But the minute they tell you how important it is and then you have an improvement without doing that, you start to question the whole thing.
Absolutely.
Okay. So that you gotta... Trust me. I'm trying to help you with this dentist associate. You guys gotta fix that because
Oh, you're absolutely correct.
I know.
No. No. I mean, keep in mind, you know, dentistry is not any different than medicine, endocrinology. I mean, you know, the the dilution of, you know, private equity and corporate involvement and, you know, everything is not numbers is is gonna have an impact on all our health care. Right?
You know, beef... With the days of, you know, you would hang your shingles and you would have, you know, one girl help you and you would set up your own little office and just, you know...
That's
Those days are over. And it's not because I don't want that. It's because it just costs so much to run a business. My little dinky practice has to abide by the same rules in California that the giant hospital has to abide by.
Yeah. No. I understand.
You know what I mean? And these things, they... It cost money. Money. But, you know, you know, some people, yes, I have wonderful...
Many, many colleagues who have larger practices. They sell their toothbrush and the tooth... And the water pick and the gel trays. I personally don't sell anything at my office. I just don't have time for that.
I'm so involved with so many other things. It's it's fine. I just love doing the dentistry. But but I get it. You know?
It costs money to run a business. At the end of it, it is still a business, but it doesn't mean it can't be beneficial, like, directionally. It goes both ways.
Just tell me, are the gel trays any value at all?
Well, it can be. It depends on what you're trying to do.
I feel like I just heard you say no. But... Okay. So what...
No. It is. I mean... So here's the thing. Like, if if...
I'm assuming the gel trays, you're talking about the whitening trays. Right?
No. No. They're for, like, to get, like, this peroxide gel down between your gum and the line. I don't know exactly.
For... Okay. Well, there's different gel trays, so it just depends on what kind of gel it has. I mean, the tray is just the mode of delivery.
Yeah.
Yeah. Yeah. So there's there's ones that are peroxide based that are... You know, they're basically anti... Antimicrobial.
Remember we said we have good back... Good bacteria.
By the way, that's that's the word. Antimicrobial. Go ahead. Sorry.
Yeah. So there's there's, like, good bacteria and bad bacteria. So that what you're referring to is probably trying to address the bacteria that are specific for gum disease. So if you have deeper pockets, that mean... You know how your gums hug your teeth?
Right? Yeah. Yeah. Gum disease is when your gums don't hug your teeth so well. And if you let it go, they keep falling down, falling down, and that's how...
You know, back in the day when nobody paid attention to gum disease, this is how they... Everybody lost their teeth. It wasn't because they had too much candy and chocolate. It's because their gums, at some point, just weren't hugging their teeth because so much bacteria would cause the detachment to happen. Yeah.
We don't see that as much. Right? Because we're flossing, we're going in for cleanings, we're a little bit more mindful of that. But, you know, whether that gel is the one specific for you... I'm not sure.
I haven't examined you, and I don't know what's in the gel.
Let's start. I'm 55 years old. I don't appear to be having gum disease. Like That's awesome. Yeah.
No. That's awesome. Of course, it's awesome. But I'm saying I don't need those damn trays. I clearly don't need those trays.
And it's like...
And we're good. Well... Yeah.
Well, they're good. I own the damn thing now. Now it's like, oh, I'll take a mold. It's a thousand dollars. Buy this stuff.
Like, by the way, even that, like, I don't... By the way, don't remember what it cost. But it feels like... I'm an adult. Everything feels like it cost a dollars at this point.
You know,
like Oh my god.
You know what I mean? Every time you look up, I I I looked the other day, my lawnmower was like... I'm like, I might need a new lawnmower in the next couple years. I went and looked at how much lawnmowers cost. I was like, I'm gonna buy a goat.
I didn't realize lawnmowers were so expensive. So... But but fella. Yeah. Yeah.
Thank you. So my point is is that, like, I love your idea, and and I like where it's coming from. Like, you know, you guys have a real expertise. You saw a real need. It's something I know is is is truly a need because I hear people talk about it constantly.
But just like everything else, I don't know how you're gonna get it into practice. It's... Know what I mean?
So, Michael, just with our foundation, with our efforts with, and this is gonna be kind of the basis of the talk I'm gonna give at the American Dental Association, the dentist. Here's four things you can tell your patients to do. I'm so sorry. It's not gonna come... It's not gonna make you money.
Four Things to Tell Your Patients41:09
But these are, you know, what a good health care professional should do. And the first thing I tell them is number one, like we talked about, sip some water. Make sure you don't have the blue alcohol based mouthwash.
Mhmm.
Have them literally whatever they're using, whatever that's on the, you know, bathroom countertop, take a picture of it, put it in chat GPD, what is the pH? If the pH is low, that's not a good product for you.
Mhmm.
Okay? So that's the first thing I tell them. The second thing I tell them is, you know, how your insurance... You know, you have Delta Dental, you have Aetna MetLife, a lot of these common insurances and, you know, let's it. A lot of people are, you know, kind of use what insurance guidelines are as this is what I need to do.
Your insurance doesn't have your best interest in mind. The average person without gum disease, without cavity risk, that's a low cavity risk person goes in once every six months. Mhmm. Considering type one diabetes has increased risks associated with it every three months. Come in every three months for a cleaning.
It doesn't cost that much. I promise you. Just going in for a cleaning cost less than it cost me to color and, you know, cut my hair. Okay? Literally going every three months for a cleaning.
Not only it'll... Every time you go for a cleaning, you know how to scale your teeth and all of that, it removes the biofilm. It disrupts that little matrix that's forming on the teeth that the bacteria can attach to. They use that at the little, you know, little nook to propagate in numbers and cause problems. Even that one little extra cleaning, even if it saves you from one cavity, it paid for itself.
So I usually tell them, instead of going twice a year, try to aim for three to four times a year. So every three months or every four months instead of every six months.
I'm glad you said that because I also thought I was being shaken down on that. So it's... Because they're like, we'll see you in ninety days. I'm like, ninety days. You know me better than my wife does at this point.
Like, so... Alright. So that is a good
I I think it's... It it controls your risk factors. Right? Mhmm. They're removing...
I mean, I'm not saying, like, buy, you know, buy good gels or get all the episodes. Literally, just go in for a cleaning every every three to four months. And, also, if a cavity or something is starting and it's super small, they can catch it.
Well, that is incredibly valuable. Like, to not let a cavity get out of control is
Right.
Is great.
How about It's... If if if your mouth is a little bit more acidic as type one, and this is, like, a whole other segue here, but when they... One of the things that... With the up and down up and down blood sugar, the salivary glands are impacted. They don't function as well as they used to, so you have less food lubrication.
Mhmm. So your mouth just has less buffering capacity. So I don't know if you've noticed this, but a lot of type ones, they say, not so much that they have dry mouth, but just things stick to their teeth more over the years.
I... My teeth are, like... They're they're horrifying. I mean, I've got those big incisors that are... I could easily be a vampire if I needed to be.
And and then I have the ridges in the back that, like, you know, it looks like they were built to hold Doritos in. You know what I mean? Like, that whole thing. So I'm not allowed I'm not allowed to chip now, you know, because it'll get stuck and
Stuck. Yeah. And... But but, like, think about yourself. Like, years ago, did you feel like food gets stuck in your teeth as much as it does right now?
Two Hundred Dollars, In the Chair44:30
I mean, can I tell you something horrifying? I don't... I I wanna make... I'm gonna do my best to get the number right. I don't think I went to a dentist till I was, like, 20 years old.
Mhmm. Like, I grew up, like, pretty broke. And I only ended up at a dentist because I was having pain from... Well, I probably tell this to every dentist I talk to, but here, you'll enjoy this. I I think I only went to a dentist originally because I had wisdom teeth pain.
So I got to the dentist. I did not have insurance. I also didn't have any... I was actually just telling Arden the other day. She was asking me, how much money did you make when you were my age?
And I was like, $4.50 an hour. Aw. Yeah. Yeah. And so so I go in.
Dennis says, I need to refer you to the oral surgeon. They're gonna have to take out your wisdom teeth. And I said, how much will that cost? They told me, and I said, well, that's not gonna be happening. So I said, what are other ways I can manage it?
And there were not a lot of other ways. And I just looked him in the face, and I said, what do you get for an extraction? And he said, $50. And I said, pull him out here. I'll give you $200.
Yeah.
So in the office with a dental assistant over top of me, both hands on my forehead, holding my head on the chair, I I had my wisdom teeth taken out in the office like that. And and then I never went back again because I just couldn't afford That's
a horrible experience.
Well, I'm I'm 55 now. This was Yeah.
I mean Yeah.
The the end of the eighties. There were other horrible experiences going on. I don't know if
you heard about it. Exactly.
And stuff like that. But, but Yeah. But but...
So Different times.
Yeah. Yeah. I take... So I don't think that people... I think there are some people who still just don't go to the dentist.
I don't I I don't imagine
Yeah. Yeah. And keep in mind, you know, and I and I hear this. Like, diabetes is expensive. Right?
Your glucose monitor is expensive. You gotta pay for insulin. You gotta pay for the pump. You... The...
Diabetes is expensive. And I I do get if, cost is a factor, if you are struggling, if you're... You know, if it's between buying diabetes supply and going to the dentist, I'm pretty sure most people will choose to stay alive than going for a cleaning. So this is assuming everything is level. Do you know what I mean?
Yeah. Yeah. And so, yeah, dental is gonna is gonna suffer. But having... That's why it's important to have good advice.
And on our t one d oral health foundation website, we have a brochure. Actually, I need to upload the updated version. But it has it has little... It has these little tidbits. You know, look at the pH.
Go in a little bit more frequently. And I know these days fluoride is a little bit controversial. I get it. And so... But I do still believe in it.
I still... I think within limitations, there are alternatives. There are mineralizing paste. Like, one that you see... You hear a lot about is called hydroxyapatite.
Have you heard about this?
No.
So the matrix of your tooth is made out of different things, calcium phosphate, you know, and this other thing called hydroxyapatite. So now, like, if you go to Whole Foods and you'll see it online, they sell hydroxyapatite toothpaste because hydroxyapatite is remineralizing your teeth, and that is true. However, it has a little asterisk. Hydroxyapatite is not very stable. It has to be in a specific shape, like, you know, molecules, like, it...
It's it can be a rod shaped. It can be circular. It can be cone shaped. It comes in different shapes. It has to be in the right shape for your tooth to absorb it.
And that shape is hard to manufacture, and it's not very shelf stable. You see what I mean? So if somebody's telling... Selling you a $5 hydroxyapatite toothpaste and that hydroxyapatite is expensive to make and it's very hard to keep stable, well, is it really the correct hydroxyapatite?
Oh, jeez.
Do you see what I mean?
What see is that everybody's got their hand in my pocket, and I don't know what to do. So can I ask a phone? Can I ask a question for myself?
Sure.
Whitening Powder Is a Brillo Pad48:26
You know the powder that you brush with to whiten your teeth? Is that dangerous? Like, is... You you never seen, like, a powder you put on your toothbrush and you just brush your teeth and it whitens your teeth almost, like, in two brushings?
Oh god. Please don't use that.
Really? Works so well. What what is it doing to... I know it can't
be done. Your enamel needs to be nice and glossy. Think of it like, I don't know, like the surface of a countertop.
Mhmm.
When you use something that's abrasive that has silica or anything abrasive on there, Essentially, it's like you're taking Comet or you're taking something, you know
Oh, yeah. That's exactly how it works.
Really pack... So even though it whitens it, it's creating micro scratches. It looks great. Right? But if you were to put in a microscope and zoom in, now you have all these micro scratches.
Well, guess what? It's gonna stain... Restain faster.
Can I use it like?
Are you gonna do? You're gonna go buy more of the stuff.
I don't know. So... Well, yeah, I know. But, like, four times a year, I speak in public. Is it not okay just four times a year?
Like, how often do I need, like
Go back to your go back to your countertop example. If you have a beer countertop as a stain on it, do you take do you take a Brillo pad, or do you put some bleach on there?
It depends how long do I... How long am I gonna live in the house. You know what I mean? So I But
but when you use a chemical, like a safe chemical to... Like a gel to whiten it, it doesn't create micro scratches. It's just blending it out.
Oh god. Does the peroxide gel whiten my teeth?
It does a little bit. Yeah.
What... So I should be using a gel, not... Listen. I wanna be clear.
Not a powder.
I have not used it with any frequency. But there was this one time I was like, something's odd is happening. I couldn't do anything about it. I tried this powder. I mean, I gotta be honest with you.
My teeth were immediately. And and that... But I had the same thought. Was like, oh, I am, like, barkeepers friending my teeth right now. Exactly.
Yeah. Yeah. Okay.
Short term, looks good. Long term, you're probably causing... You know? Yeah.
How come we can't reenamel our teeth? Why don't you guys come up with that? That'd be awesome.
I... I'm still waiting for somebody to regrow teeth in the lab. Feels like they've been saying we're working on it for a very long time. Stumps up. Haven't regrown teeth.
You can grow it in a cyst. You can't grow it in a lab. That... That's... Have you ever seen those cysts
that have
teeth in them?
I know. But you haven't been... How are you gonna put it back in somebody's mouth?
Listen. I'm not I'm not a genius. I don't know.
So I... And I think there's so many other body parts that are worth regrowing before we get into teeth. So Teeth.
Teeth is super interesting. It it... It's also... It's interesting not just what they are, how how you need them, how you have to stay on top of them. Even the history of dentistry is amazing.
Like, it it was almost ignored even back then. Right? Like, because it's, Yeah. More like... It was, bartenders were...
Because they had booze so they could No.
Yeah. Barbers.
Barbers. I'm sorry. Yeah. Yeah. Yeah.
Yeah. Yeah. That's that's amazing. Like, it... They were...
It's funny.
Yeah. Physicians wanted to take care of teeth, and then the barbers are like, well, they're there for their hair. We're gonna take care of it. And then I don't know. Somebody must have duked it out so the health care side got the teeth.
Mhmm. But, yeah, it's it's interesting. Have you seen the little model they have of George Washington's teeth?
I might have, actually. Yeah.
They're like Yeah. You should you should Google it. Yeah. It's it's kinda fun.
It's like braces behind it and all this stuff and and he had a mix of wooden teeth and and human teeth. Like,
oh my god. Jesus. Where he lost his teeth, yeah, they... It looks like the little pegs in there.
That's crazy.
They were creative.
Yeah. They were creative. Alright. So if so if you have type one diabetes in the... I mean, listen.
This is what we... Know, it's what I tell people on the podcast is a swish of water you treated a low blood sugar overnight at any time, honestly. Great idea. My question always is, though, if I keep a bottle of water next to the bed, like... So what if I don't drink it?
What if it becomes my swishy bottle? Like, how long till there's bacteria growing in that, and I shouldn't be using that anymore?
I mean, biofilm grows pretty quickly. Mhmm. So, you know, grab a new glass every night if you can, if not every two nights. Okay. But, you know, the other thing that I...
And I haven't seen too much research on this. They sell these little dry mouth sprays, and it's great for the elderly. It has Xylitol. It has glycerin. Almost like...
Imagine if you have dry lips and you put a stick, it feels kind of nice and hydrated.
Yeah.
So they sell these little, like, dry mouth sprays. And so the pH of that is runs around an eight. So the other thing that I was kind of, like, brainstorming in my head... Again, nobody has done studies, so I don't know if this is true. But they come in, like, different flavors.
They even have, like, pediatric versions of it. So I'm like, okay. Let's say a kid doesn't wanna rinse with water or drink water. I know sometimes I get pushed back on, you know, on that from my own child. It's like, sleepy.
Leave me alone. I don't wanna drink water. Mike, you know, it's like a little spritz, you know, like the old old school, you know, fresh breath spritz. And so you spray a couple of that. It seems like it would bring the pH down.
Okay.
Yeah. Others are... The pH up, not down. Mhmm. And then the other thing I was kind of brainstorming was, you know, alkaline water.
I know our Costco brings alkaline water now, and that's, I think, a pH of eight eight point two, I believe.
Oh, okay. I
thought drink water, then why don't we try alkaline water?
I thought that was just a thing that, hippie white ladies did. But the... There's, like, a real value to that?
Well, I mean, when they're talking about your... You know, drinking it as your tuba water, it seems like once you... It passes your stomach acids, it kind of, you know, neutralizes it. But in your mouth, I can see value in that.
Alright. I see you thinking about this. Do you think there's... I... What's your hope, like, leaving...
When you you leave after you give your talk, like, what would you call a success? Do you know I mean? Like, how are you gonna measure how well the talk went and how well your advocacy is going?
What the Dentists Said in the Chat54:21
Well, you know, last night, I gave a webinar on this. And I don't remember how many people were in there, but it was quite a few number of people. And, you know, when you do a Zoom webinar, there's, a little chat box. And I was, like, reading the comments on there, and it was like, oh my god. I never knew what a lived experience of a type one was.
Mhmm. And so that kind of made me think. I kinda want people to understand what the lived experience is, what the twenty four seven hour, you know, twenty four hours a day, seven days a week looks like. Not just, oh, your pancreas doesn't work. Yeah.
And so if they can understand that this is, like, around the clock problem that you can't just fix by, like, floss more, then I feel like, you know, at least having that compassion, being able to... You know, understanding that, you know, that sugar is gonna be part of your life. You can't tell them don't have candy. You know? You can't just...
The old the old little, you know, do this, do that is not gonna work. I mean, if they understand that, I feel like I did my job.
Right. That's awesome. And it also makes me think that maybe every, I don't know, every different kind of discipline could use an explanation from a group of people about what their... Maybe that would help more than... Because like you say...
We always say, like, you can't teach them everything in medical school. Right? And... Yeah. And
so There's so much.
Yeah.
And and that's the other thing. Like, some people... Like, I've had a couple of people say, I can't believe my dentist doesn't know about type one diabetes. I'm like, do you know how much information you need to learn in a short period of time? And, you know, type one diabetes is not the only disease.
Yeah. There's so much to learn.
I am always stunned by that too. I tell people, I'm like, I don't understand anything that doesn't impact me. Like, what... And do you and do you? You you know, that's that's sort of the...
That's the pearl clutching a little bit. Like, they should know. Like, who's they, and why should they know? And Yeah. And who's gonna tell them and, you know, etcetera.
So
Exactly. I mean, there's there's a lot of there's a lot of, like, chronic illnesses that impact you twenty four seven. And I think, like, for for us in dentistry, you know, if you pair it down to five, six major diseases that are super common, that are super impactful on your oral health, and you really get a clear understanding of not just the physiology, but the lived experience of what that person is going through, you're just gonna be a more compassionate caretaker for that person.
You'll have more context, and it... It'll be easier for you that when you reach for what you think is just throw away common sense, you won't say something like, well, just don't drink juice overnight.
Exactly. Right. Exactly. I mean, flossing is important, but, like, you know, you you can't... You can only say it so many times.
You know what I mean?
Mhmm. Also, I find it valuable to say in this situation that sugar is sugar. It doesn't matter if you give your kid a a banana or, you know, I don't know, a piece of candy. Like, there's still sugar in your mouth at that point. So Exactly.
Yeah. Now Exactly. Now now I would say... Here's the thing I think that I hope... I'll I'll check with you if I'm right or not.
I do think organic stuff washes out of your mouth easier sometimes, but it also can still get stuck. Right? So, like
Well, I've had I've had people say, oh, I don't give my kid, like, Starburst, but I give them a lot of, like, cranberries and raisins. I'm like, well, that's not any better. It's still getting stuck in the grooves of your teeth. I mean, know? So, like, you probably, you know, going with juice might be a little bit less sticky.
But, again, nobody has studied this. Like, for a type one diabetic kid at night, is it better to give them sugar? I mean, to give them apple juice versus, you know, like, I don't know, like a Starburst? Like, this is not something that's been studied. So everything I'm saying is me...
I'm kind of logic in my way through this. Do know what I
mean? If I did the same thing after talking to you, I would say go try to find something that's liquid and not acidic. And that
would So that is one of my... On the website, that is one of the things we write. I'm like, less sticky, the better. Right. And keep in mind, like, you know, yes, sugar is sugar, but, you know, glucose or dextrose.
But then you have the fructose, you you know, there's, like, different kinds. And certain ones tend to be more cariogenic. Remember I said we have good bacteria and bad bacteria? So the bad bacteria, some of them that cause cavities, certain ones use certain kinds of sugar for substrate. So depending of what your bacterial population is, you might be more susceptible one way or another.
Okay. And you
So that's where your dentist doing a salivary testing comes in, but salivary testing is in its very, very early stages.
So not a thing....
Why not everybody's doing it. The the... I mean, it's getting better, but it's also very expensive. And once you have the data, okay, what are you gonna do with the data? The best thing that I saw on salivary testing is that...
What... You remember I said going every three months for a cleaning? Mhmm. It's like, Monday, we're doing the salivary testing every three months, it showed all the bad bacteria was down. Whereas if you wait, like, six months, like, you're repopulated again.
Oh, really?
Yeah.
Okay.
So let's say, like, this is the bacteria that causes gum disease. This is bacteria that's... So you do the salivary testing after the cleaning. Oh, look at all these numbers. We've got really good numbers.
All the good bacteria are thriving. All the bad bacteria are gone. Right? So you do the testing in three months, and they're just starting to repopulate. You wait six months, they're all back.
Oh, well, you are gonna make me go. I do go every three months, by
the Do
you see
what I mean? Like, you don't need the salivary testing to tell you that, but this is what salivary testing has shown us. So, yes, go in every three, four months.
I... I'm still... It's okay if I still complain it, though. Right? It's almost like
You're absolutely allowed to go. I'm a dentist, and I complain when I get my dental work done.
I walk in. They're like, hi. I'm like, we have seen each other too frequently. And hello. I know more about the girls that work in my dentist office than other people in my lives.
I'm not even joking.
You know, if you have a fun office, isn't that the best?
They're lovely, actually. Yeah. Yeah.
This is why women like going... Getting their hair done. You know? Once you find a girl you're comfortable with, it's the same with your hygienist.
I make them tell me that I'm their favorite patient. I don't imagine it's true. But then I'm like... Like, I walk in. I'm like, it's me.
Right? And they're like, well, there's a couple that are better than you. I'm like, that's insane. Who?
Oh, no.
And then one day, I was there leaving, and this woman was like... She was checking out in front of me. And every... Everyone's, like, kind of, like, half laughing, half smiling behind the desk. They walked out.
I was like, what was just going on then? And they and they got all quiet, and the one goes, that's the woman we like better than you.
Oh, no.
And I was like Oh, no. You get
the stuff of your day now.
I made them tell me why. I was like, what's it about her that you... They... It's so... But but I thought they were lying to me because...
Obviously, I was joking at first, but then I realized I was onto something. They do have... Like, they do like patients on different, like, levels. You you know what I mean? From their experience with them.
It's not... I don't think it changes how they're how they're managed or helped or anything. But... And and then one day, just joked. I'm like, well, I must be the best one.
And they're like, well, not really. And I was like, oh. And I... So they they gathered together. Like, we think you're in, like, the top seven.
I was like, that's not bad.
I don't think top seven.
But then that one day, they're like, that lady, we like... That's the that's the lady we like the best. And I was like, I knew there was a favorite.
We take him some treats next time we go in.
Yeah. They say my wife... My... And then my... They like my wife.
And then my... Every time I come home from my dentist, my wife goes, did they mention me? Oh. And even if they do, little bit of doctor. Even if they do, I go, no.
Nobody brought you up. Oh.
Well, it sounds like your dentist is taking wonderful care of you. It's a blessing to have a health care provider in any any field that you feel comfortable with, that you can trust, that you know they have their best interest in mind.
No joke. Really a wonderful experience, honestly. Save me because my teeth were in... But, obviously, I got a late start to dentistry. They weren't in great shape.
GLP-1s and Dry Mouth1:02:18
You know, I had to have a number of root canals, like, in the beginning to get things, like, back in line again. And I I I do have a personal question for you. I would tell you that I think my dental health has been better since I've been on a GLP. And do you think that's just metabolic health, or do you think there's something to the the
So there's definitely... You know, with inflammation, just systemic inflammation, oxidative stress, all of that stuff, it does play a role with it. We are slowly, slowly starting to see some oral health impacts with GLPs, just more like a decreased salivary function. Remember our saliva is the buffer... Has the buffering capacity.
It's the lubricator in our mouth. And so with GLPs, we're seeing that there's less saliva being produced. So I would encourage you to look at products that are specifically geared for dry mouth even though you might not feel like you have cotton mouth or dry mouth. You know, people say I have dry mouth when they're, like, their cheek is dry and sticking to their teeth, but that's, like, severe dry mouth. Mhmm.
But what if you're only producing, like, 10% less saliva? Would you even notice it?
Oh, I would, and I am, and I do. So... Yeah. Yeah. I, a 100%, since I've been on a GLP, have a harder time keeping my mouth feeling wet.
And and so so much so that I... There's... I use... When I'm recording, I've done it, like, three times. I I touch my finger into, like, a tiny bit of just petroleum oil, and I put it on my lips when I'm recording.
Because if I don't, like, I'll start... I'll smack my lips. And I'm always some level of thirsty to quench a thirsty mouth, and that is definitely since the the GLPs. But my oral health has gotten much bigger.
So, you know, keep in mind, again, think of the preservatives, things that have acidity. Because if your mouth is dry, that means there's less water. So our our saliva is not like filtered water. It's like tap water. Right?
It has other stuff in it. It has minerals. Mhmm. So if you just have less water, then that means everything is more concentrated. That also includes glucose.
Right? So if your blood sugar is high, and then there's more sugar in your saliva if everything is more concentrated. But it also means you have more minerals, the bacteria, everything is just more concentrated just like anything else. There's less H2O, less water. So when you are choosing dental products, make sure you use things that have glycerin that are indicated for dry mouth, things that help with production of saliva.
I have tried those... The... There's, like, a gel in a tube that works really well, like, just, like, a tiny dollop of it, like, before I begin. That'll help. But I don't always have that.
I'll tell you. I'm gonna... I'll I'll come clean on something. The only time I drink diet soda is when I'm recording the podcast because it quenches my mouth and keeps it moist longer than water does. And I've never understood why that is, but I'm gonna ask you if you know.
I mean, I would guess it might be just a bubbly nail. So have we tried just using bubbly water?
I can give that a whirl. I I... Because it's It
might it might just be the carbonation.
Yeah. I use it when I'm recording because it keeps my mouth from getting dry while I'm recording.
I mean, you gotta live your life. I mean, you know, it's it's
I made it this far. I'm
not kidding. Yeah. It... It's it's a... It's one piece of a larger, you know, picture, so you gotta do what you need to do.
Yeah. But but I I do encourage you to look at the products that you're using. Sometimes what is right in front of us is not the best thing, and I definitely have recommendations thing I... Things I use in my... For my family.
But there... There's there's a lot of bad, and then there's a lot of good, and there's a lot of snake oil. And it's just so hard to figure out, you know, what is the one that I need to use.
Yeah. No. I appreciate you talking with me about it. Hey. Tell people...
I mean, if they're in dentistry, where can they go to find your your foundation?
Where to Find the Foundation1:06:02
Our website is t one d oral health foundation dot org. We also have an Instagram account that, honestly, I don't post a ton on, but it's t one d oral health foundation. We're on Facebook, t one d oral health foundation. Whenever I see somebody on your on your Facebook group, I try to respond, so I might show up here and there. But, you know, I have my cell phone number listed.
I have an email number listed. Just... You know, have them email me or reach out to me. I'm happy to share. Again, my next presentation is gonna be at the American Dental Association in Indianapolis.
I have a couple more webinars coming up for dentists to listen to if they would like to, or they can just honestly reach out to me if there's a study group or a study club or even a local dental society. I'm happy to get on a Zoom with them and share my experience because this is what it's about. You gotta share your experience so everybody learns, and then they go and share it along the way.
Right. I'm happy you're doing it. I I appreciate doing it too. I I find that every person who has, you know, some little bit of, I don't know, professionalism or, you know, a way to get their voice out about stuff like this, everyone helps a little bit to increase, you know, the the overall knowledge around type one out in the zeitgeist people's lives. And you never know when it's gonna, you know, intersect you and and be valuable.
So I I
100%.
More people should do it.
Yes. 100%.
I really do appreciate your time. Thank you very, very much.
Thank you, Scott. It was a pleasure chatting with you today.
Oh, awesome. I'm glad you had a good time. Hold on one second for me. Okay?
Sure.
Heck of an episode today, wouldn't you say? Let's thank Dexcom and the Omnipod five for sponsoring. That's right, my friends. We were sponsored today by the Dexcom g seven. Dexcom.com/juicebox.
Head over there right now. Look into that fifteen day Dexcom g seven. Fifteen days a long time. It's like half a month. Don't check my math, but I'm pretty sure I'm right.
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Omnipod.com/juicebox. You want some tubeless insulin pumping? Yeah. You do. By any chance, have you tried the small sip series?
It's curated takeaways from the juice box podcast voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Take a deep dive, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com and then go... Oh, actually, we changed the website.
Let me see. Go to juiceboxpodcast.com. And from there, there's these two little lines on the right side top. That's the menu. Then click that.
Then click series. Then there's pro... There's small sips right there, pro tips at the top, all beginnings, bolus four, asks that. There's a lot of them there. There's actually a little search there too.
Could you just type small sips into the search? Oh, wow. That search works great. Look at that. And then you could go right to, like, all results for small sips.
Oh, and that takes you to the FAQ. You should check out the FAQ page too. I think that's juiceboxpodcast.com/jbfaq. Seriously, that thing's amazing. Amazing.
Actually, whole website is... I mean, have you, like, seen it? You should you should go check out the website. The website rocks. It is a potpourri, a never ending of support for you and your diabetes journey.
That's right. It really is. What else we got over here? Oh, I don't like the way that works. I'm gonna fix that.
Note to self. Change the change the masthead on the frequently asked questions page. Yeah. I don't like that. Fix that.
Oh, Claude. Oh, hell. I forgot to say thank you. Thank you so much for listening. I'll be back again very, very soon.
What is that noise? Stop it. Stop. Can you hear that? It's my chameleon squeaking.
Are you squeaking? What are you rubbing the branch against the... Don't tell people I have reptiles. They'll think I'm weird. Thanks so much for listening.
I'll be back very soon with another episode of the juice box podcast. Look at me. Get all deep in there with another episode of the juice box podcast. You can hear it. What was that?
Oh, I'm getting alarms and alerts on my phone. I was gonna get real deep and tell you about the juice box podcast.
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