#708 Co-parenting Through Divorce

Jacqueline Stephens Breisch is a divorce attorney and the parent of a young type 1 daughter. In this episode she shares her professional viewpoint on divorce when you have a type 1 child. Her companion blog post on the subject can be found here.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 708 of the Juicebox Podcast

sometimes my voice is so deep, it shocks me. And just now recording that opening was one of those moments, I can hear myself in my ears and I was like Boo, Jesus. Your voice is deep tonight, Scott. Anyway, today I'm going to be speaking with Jacqueline, this is interesting, right? She's a divorce attorney and the mother of a very young type one. So she came on to give us some advice about how to, you know, dissolve a relationship and help a kid with type one diabetes. It's really good information. And we also talked about her life with type one with her daughter a little bit. It's a nice hodgepodge, a little bit of information, a little bit of entertainment, you know how the podcast goes. While you're listening today. Please remember that my voice sounds amazing, and that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. At the end of this episode, I'm going to give you a link for an article Jacqueline wrote for the Juicebox Podcast website, it's going to detail all of her suggestions for you. Should this unfortunate event come up in your life. This episode of The Juicebox Podcast is brought to you by Dexcom and Dexcom makes the Dexcom G six continuous glucose monitor. And that's something I think you want to know more about. So head to dexcom.com forward slash Juicebox Podcast is also sponsored by Omni pod. Now on the pod makes the Omni pod dash and they make the Omni pod five. These are both tubeless insulin pumps that my daughter has worn and we've enjoyed head over to Omni pod.com forward slash juice box. In a few minutes. I'm going to do some ads for Omni pod index COMM And I'm gonna mention some offers they have that I think you're going to enjoy. So look out for that in just a little bit. For now, though, this is Jacqueline.

Jacqueline Stephens Breisch 2:16
My name is Jacqueline, professionally, Jacqueline Stephens Breisch, and I'm a f amily law litigator out of Chicago, Illinois,

Scott Benner 2:25
family law litigators is that a very nice way of saying

Jacqueline Stephens Breisch 2:29
it's a very nice way of saying I'm a divorce attorney. And divorce, of course, isn't just the the act of divorce, but it's all things leading up to that and all things after that, meaning, you know, people will have issues with parenting, and with post decree issues relating to support and whatnot, long after they're divorced. So family law is a nice way of saying that I work not only with with people who are going through the process of divorce, but those people who are dealing with the aftermath of it. So at

Scott Benner 3:02
any point, for example, you could be met with a person who's went through their divorce a number of years ago, but now one of the others not meeting one of their obligations, and so much so that it has to go back to court.

Jacqueline Stephens Breisch 3:14
Absolutely. And that is a that's a big part of my practice. That's, that's more common than probably a lot of people think or understand.

Scott Benner 3:23
No kidding. Oh, okay, what percentage? I mean, less, you have to make up a number because you don't know. But what percentage of your day or week do you think is taken up with divorces that are in progress versus maintenance for ones that have already happened?

Jacqueline Stephens Breisch 3:38
Honestly, at any given time, it probably fluctuates to 5050. All the way up to maybe the bulk of my practice in any given period of time could be dealing with post decree issues. And, you know, particularly for our discussion today, dealing with parenting issues that have surfaced that no one could have really anticipated at the time that a divorce was entered, or maybe in a situation where one party or the other was represented by someone who didn't do a very good job in formulating a parenting plan. And so now there's issues that need to be addressed that, you know, either weren't foreseen or couldn't have been foreseen or just were handled poorly to begin with.

Scott Benner 4:17
Okay. And just for some context, you are the mother of a child with type one.

Jacqueline Stephens Breisch 4:22
Yes, yeah. So my my little one, I have two kids. My son will be six tomorrow and my three year old daughter Everly is type one diabetic.

Scott Benner 4:30
Okay. Oh, well, happy birthday to the older one. And how old How old was Everly when she was diagnosed?

Jacqueline Stephens Breisch 4:37
So she was diagnosed almost a year ago, exactly. January 18 of 2021. And she had just turned to the November prior so she was just over two years old. When we figured out that something wasn't right, and we took her to the doctor, and unfortunately that led us down a path to hospitalization type one diagnosis.

Scott Benner 4:59
You're married?

Jacqueline Stephens Breisch 5:01
Married? Yep.

Scott Benner 5:02
Okay. Were you if you don't mind me just on a flight of fancy for one second, were you married before or after you became a family law? Practice or

Jacqueline Stephens Breisch 5:13
so I might have my husband and I dated him when we were in law school. I'm practicing for about 11 years. And we got married. We've married eight years.

Scott Benner 5:25
So is it scary to get married when you know about all the other stuff?

Jacqueline Stephens Breisch 5:31
You know, it's surprising, but actually, people in my industry have a lower divorce rate. Just because it's, you know, more of what you're getting into, you know, I see divorce every day. And I know, I personally don't want to go through it. And I know that a lot of people probably don't have anywhere near the amount of information that they should when they're contemplating that decision. But I think that if anything, it's just helped me, you know, pick the right partner for myself.

Scott Benner 6:03
Yeah. Do you think that there's a tiny bit of it that if you guys are fighting, he looks at you and thinks she will kill me if we get divorced, I have to shut up right now.

Jacqueline Stephens Breisch 6:12
We've actually we've joked about that in a in lesser arguments, definitely not serious one. But no, I mean, I think a lot of times in doing what you do, whatever your occupation may be attend to just think about it, how it could apply to your own life? And, of course, I do. It's very, very much meta of, you know, when I'm having an argument with my husband about something, and then I have to go defend my client who did the same thing. But no, it's, it's it. Yeah, we definitely have those jokes. But in all seriousness, you know, as it relates to parody issues, in particular, are I mean, he's, he's a great dad. And so I'm very lucky to have a partner, you know, and not just a lot of people still have arcane views of marriage. And, you know, we both work, we both take care of our kids. And we're lucky in that regard.

Scott Benner 7:05
Well, you're a very mature person, I would stand with a stack of my business cards, flicking them. He was telling, I'd just be like, you know, you just said something, though, before we before we kind of dive into all this. Is it shocking to you still, how many people think of marriage as more of a like, I'm assuming what you meant was a purchasing agreement. Like we're together now. And these are the things you'll do for me, instead of like a partnership is that still prevail in people's minds?

Jacqueline Stephens Breisch 7:34
I think that there, there certainly is some level of that transactional type relationship, you know, this is the work I do this is the work you do, whether or not those particular people think that that work has the same value, you know, is kind of what leads to the problems, you know, the traditional model of one parent working outside the home, the other parent, staying home and raising children, and taking care of the household. That still happens, of course, but that's becoming less and less prevalent as we move forward as a society. And so those types of marriages, you know, people have been married, you know, 2030 years, and now all of a sudden, they're getting divorced. Those are ones where you can kind of see where there was some cracks. But again, for some people that works incredibly well, you know, some people like to have those defined roles. I know, in my own marriage, my husband and I talked about how difficult it is sometimes to both work, both take care of the kids. And, you know, when you're burnt out at the end of the day, and you see your partner, you know, cleaning up the kitchen, like, Oh, I really should help but you know, that I'm tired. You know, it's so I don't know that there's a there's one kind of model that I see or don't see, I think it's just becoming now more, I think, in society, that we're seeing marriages that are more partnerships. And, you know, I made a joke the other day, to my mom that, you know, I've never seen my husband like sleeping on the couch when my kids are around. And I remember as a kid, your dad sleeping on the couch while everyone very quiet, you know, like thinking that doesn't happen anymore. You know? So it's just this funny types of things that we're just moving on. And I think, you know, the idea that oh, like you're a dad or you're you're babysitting your kids tonight for your wife, or you know, those types of ideas. Maybe they still happen in some parts of our society, but it's just falling by the wayside and people are recognizing that a marriage takes to with children, particularly a marriage takes two people who are going to put forth you know, significant effort in that partnership.

Scott Benner 9:40
Yeah, I think they asked for the same thing for my birthday every year and I never have the nerve to say it out loud. But I always want to say to my wife, like can we just pretended to 1956 24 hours. I would like to say something and just experience agreeance like no one no one telling me I'm wrong or like, like, I don't know. I know that's a weird thing. But I mean, just imagine being in that dominant position back then, I mean, life must have just been a dream. You don't mean like, you're an idiot, or you don't you don't know what you're talking about. Everybody's just like, Oh, dad works hard, leave him alone. And that's sort of the end of it. I was like, no one's ever once treated me like that. No one's ever been, like, let him sleep, he looks tired. Or even,

Jacqueline Stephens Breisch 10:21
I mean, even just children. I mean, the things that my kids say to me, sometimes I'm just shocked, like, I would have never said this record, and not even in a just respectful way, but more just, we treat them with such, you know, the way that everyone parents, you know, from millennials to Gen X, it's just, it's everyone changes, right, the trauma that we went through, we're now trying to undo with our kids, and we're going to screw up in a different way. And then all of our kids are going to be the same type of parent to their kids, because they were, you know, we're gonna, we're gonna love our kids too much. And they're gonna give be given too much of leeway to you know, ask the questions and say what they want to say.

Scott Benner 11:02
It's like voting. You know, they say, like, very conservative parents raised liberal kids, very liberal kids raised conservative children, like that kind of stuff. I listen, when we were first married, my wife and I, we were really young. And we had call. I mean, we were really young. Not that young. But, I mean, we were in our early 20s, which, to me seems inappropriate to have a kid but whatever. So, you know, I think we both grew up in sort of more of an iron fist like mentality with our parents, like, you know, I'm gonna say a thing now you're gonna do it, don't mention it again, to me, and you know, that kind of stuff. I don't really care about how happy you are. I just, I'm legally obliged to keep you alive. I'll hug you once a year. You don't need me like that kind of stuff. And, and my wife's like, we need to let the kids have their own thoughts. And you know, I was like, Alright, I was like, it seems like a mistake to me. But I think you're right, like so you know, we, we did, and there's still times now, right? There's still times now when something happens. And I'll look at my wife very quietly. And I'm like, You were the one that wanted to give them all this autonomy. I was like, now they're using it. So just sit there and shut up and take it. So it because it's hard sometimes, like you said, they'll say something and you think you don't say it out loud, because I recognize it's not smart. Like, you know, from a developmental standpoint, to say it out loud. But I have thought a couple of times in my life, my dad would have like, backhanded me for saying that. You know what I mean? And not even like vicious, like horrible things, just like any kind of, maybe I'm giving you too much of a look into how I grew up. But like you don't mean like, just disagreeing in public or saying something that would embarrass them or anything like that? Yeah, my dad wouldn't have like, been like, Oh, he's got his own thoughts. would have been like, oh, look, he can't stand up. So not that I think it's okay to hit children. This is not what I'm saying. Jacqueline. Alright. So

Jacqueline Stephens Breisch 12:51
nothing in this podcast will condone corporal punishment? No, of

Scott Benner 12:54
course not. Oh, gosh, do you think no, no one's ever thought I've met that. I just I grew up in the 70s. And my dad didn't like what I did. He hit me. Like, that was just how it worked. He didn't punch me he didn't, you know, I, I got some sort of a whack somewhere. I don't even know how to put that I guess. And, and I, but I do think that my wife was right, to some degree, you know, to a great degree. But I also think that it was smart to mix in a little bit of 1970s. Not like, like a backhand. But just sometimes you have to be, you know, I mean, how to people put it usually, like, you need to be their parents, not their friend like that kind of an idea. But I mean, sometimes, I don't know, like you try explaining to a six year old to sit down in the middle of a movie theater, like sometimes they gotta be a little afraid. Right? Like a little bit like a tiny bit. But anyway, this is not why you're here. Yeah,

Jacqueline Stephens Breisch 13:49
it does, it does kind of go to I mean, that delicate balance that a lot of two parent households are able to maintain because those two personalities of the parents can kind of flush all that out, you know, you can play good cop, bad cop to an extent, kids know when different needs need to be met which parent to go to. And, you know, in the context of a divorce and growing up in, you know, a relationship where you have two parents who don't live together and are co parenting, you know, that that creates challenges in and of itself. So, when you have, you know, the added pressure of, you know, a child with special medical needs, you know, which is kind of the topic of the day, that lends itself to all sorts of problems. And, you know, children are, you know, manipulative by nature, depending on their age, they're learning to test boundaries. And so you have people to people who aren't on the same page, kids are going to exploit that even if they don't mean to. And so it's, you know, it's important when you're parenting children in any respect that you are able to work with your co parent, assuming you have one. And to make sure that you know, everyone on the same page, and there's no ability for the child to just kind of go rogue and go off the rails,

Scott Benner 15:05
I listen, I'll share something personal. There are times while you're raising children, that one of them will do something, and it throws off the delicate balance that you have with your spouse. And then you almost want to pull the kid aside, obviously, you don't do this, but you want to pull the kids side and be like, listen, you're gonna get me in trouble. Do not do that again. You know, like, like, I it took me years to get this lady okay. Like with the things that we're talking about right now. Don't make her think you're not okay with it. I was like, are suddenly it's going to be two against one. And she's not going to look at me as being wrong, Scott, look at me. He's the enemy. Veto mommy, daddy divorced one day, stop saying that. Of course, none of that gets said out loud. But you know what I mean? Third moments. Don't say that kid. What are you doing? Oh, my gosh. Alright, so everybody gets married great intentions. That makes some babies, one of the babies comes out to got an autoimmune disorder disorder, let's say type one diabetes, you know, for the the, you know, for our conversation here. What is? Is it fair to say that most people have not pre planned their divorce?

Jacqueline Stephens Breisch 16:16
Yeah, so in just a couple of points just off the bat. So obviously, I'm licensed to practice in Illinois, every state has different laws as it relates to parenting allocation responsibilities and parenting time. You know, every state has different words and verbiage that they use. So, you know, just as as you just got give your little precursor at the beginning of every episode, you know, nothing that I say should be construed as legal advice, you should consult with your attorney in your jurisdiction for any questions about any co parenting issues that you have. Obviously, I'm I'm here to try to provide some additional information and just a general outline and precursor that, you know, would lead to a discussion with your attorney. And, you know, your particular set of facts and circumstances to the extent anyone, you know, hears this and is, has additional questions should always be addressed with an attorney who could represent you. But, you know, in in Illinois, you know, and I feel pretty confident saying that this is true across the country, you can't do anything in regards to a prenuptial agreement that has to do with children. And when I say that, I mean, you can't pre plan for any financial situations or decisions relative to children, nor can you put into you know, self prenup to say, Oh, I'm going to agree that if we get divorced, you know, mom will have custody? No, no, that's never going to be enforceable. Because you have to find the facts and circumstances as they exist at the time something is happening. So as a relates to children, no, can't pre plan for anything. And so once you know, you're in the situation, where you're deciding that you're going to be divorced, or maybe you're already divorced, and now your child is diagnosed, you know, any situation like that, where you find yourself being in a position to make important decisions, it's just so imperative to make sure that you have these thoughts at top of mind with a child with with type one that we'll go through today. Because, you know, I think a lot of people are, don't know what can be in a parenting plan, don't know what should be in a parenting plan. A lot of people are represented by attorneys who might not have the level of knowledge about not only special medical needs to begin with, but type one specifically. And so, you know, my goal today is to try to provide some insight and information, both from my experience, you know, now being the mother of a type one child, but in the context of what I do for a living, seeing how so many mistakes can be made. And you know, whether they've already been made, trying to rectify them, and if they haven't been made yet, trying to make sure that they don't happen. Okay.

Scott Benner 19:11
Thank you. That'll be absolutely terrific. I'm actually very excited to talk to you about this. And it sounds like a bummer of a thing. But one of the biggest sources of consternation that I see online is from divorced parents. And one and one, one parent doesn't get it either medically or doesn't care, you know, and the other one is just out of their mind, trying to keep a kid healthy, when they're in a situation where they sometimes don't even communicate with the other person. Or anything that gets said is seen as you know, angry whether it is or not, it's a very, very confusing thing. And in the end, it ends up hurting the kid. I mean, we all always say that right? Like no divorce. to pair up, you know, parents fighting hurts the children, but in this situation it's hurting them medically and sometimes in ways that you might not be able to reverse so it's just super important. Let me ask you this. Do do people generally speak well let me ask this first is that is the number true that you know of is it one in two marriages end in divorce two in three marriages end in divorce, if you have a child with a medical issue

I know that was a bad place to cut it, you're all like, am I gonna get divorced, we'll find out a second of Jacqueline knows. I'm sorry, made me laugh for some reason. Anyway, dexcom.com forward slash juicebox Dexcom makes the Dexcom G six continuous glucose monitor. And that monitor shows you blood sugars in real time on an Android iPhone or Dexcom receiver. I just looked at our just blood sugar. Now it's actually late in the evening, and she's out with a friend getting ice cream. And she missed her Bolus. So we're using the Dexcom data to readdress that insulin and get her blood sugar back down without creating a low I can see Arden's blood sugar right here on my phone, and so could up to 10 followers. So that means you, a spouse, a school nurse, anybody in your life that you want to be able to see your blood sugar or your child's blood sugar, they could do that with the Dexcom share and follow features that crazy. Of course, it's wonderful internet technology. Ooh, you know, anyway, dexcom.com forward slash juice box, no finger sticks, that's a nice thing. You get Dexcom, you don't need any more finger sticks. Dexcom works with all the fun algorithm pumps, like the control IQ by tandem. And on the pod five from the Omnipod. Obviously, I should have said me on the pod five, but I'm a little tired. So I'm not going back. Anyway, listen, algorithms are a thing of now and definitely going to be in the future. And Dexcom is a great choice to work with those algorithms, you should check it out@dexcom.com forward slash juice box. And if you don't have an algorithm based pump, if you're just pumping normally, or using the in pen for Medtronic diabetes are whatever you're doing, being able to see your blood sugar, or your loved ones blood sugar in real time is it's just game changing speed and direction with easy to read arrows, a graph that shows you how things are going everything you need to make better decisions with your insulin and your carbohydrates. Now let's go on to Omni pod now I'm going to tell you about the Omni pod dash, it is possible that you can be eligible for a free 30 day trial the Omni pod dash, and you would find that out at Omni pod.com forward slash juice box. At that same link, you can learn about the new on the pod five, which is as I just mentioned, on the pods new algorithm based system, so head to my link on the pod.com forward slash juicebox. There's a little blurb there from me, it's actually redesigned, it's very nice. The people who did this did a wonderful job. You can learn about on the pod five, you can take on the pod dash out for a test drive with a free 30 day trial. If you're eligible, you can talk to an omni pod specialist. There's nothing you can't do at my link, check your insurance coverage. It's a perfect link. I just I just sounded like somebody has fun on the pod.com Ford slash juice box. And by the way, I didn't mention it before, that was my mistake, you may be eligible for a free 10 day trial of the Dexcom G six, find out that little bit of information@dexcom.com forward slash juice box, there's links in the show notes to Dexcom and on the pod and all the sponsors or links at juicebox podcast.com. When you click on my links, you're supporting the Juicebox Podcast. So when you take that extra step, it's a big deal for me. Thank you very much. Let's get back to Jacqueline there's a lot to come up a lot a lot actually. For full safety risk information and free trial terms and conditions. You can also visit omnipod.com forward slash juicebox

Jacqueline Stephens Breisch 24:34
you know, I haven't looked at those specific statistics. I think that also it's hard when you look at oh this many marriages will end in divorce will after how many years and you know I mean so it's it's hard to say obviously having a child with a significant medical issue whether it be you know, something chronic like type one or some thing you know horrible and more like in a moment in time like a cancer diagnosis really, obviously incredible really stressful for parents to deal with, and puts a strain on any marriage whether or not it's healthy. It's something that's that's really, really hard. I don't have those numbers in front of me in terms of like you said,

Scott Benner 25:13
Well, those are the numbers that my endo tried to scare my wife when I when when Arden was diagnosed, so she, Oh, that's lovely. It was for that she goes, You should immediately seek marital counseling. She had met us 20 minutes before. And I was like, at first I thought, what can she tell about us that? Like, we don't know. But then she said, she gave us those numbers one and two, then goes to two and three with a chronic condition. We were like, Thanks. Have a great day.

Jacqueline Stephens Breisch 25:44
Yeah. And all the more why I mean, all the more reason why it's so important to get your ducks in a row. Because if the reason that you are getting divorced, just because your co parent isn't helping doesn't understand type one, you know, is unable to care for your child. I mean, those are those are scary reasons to then get divorced from that person, and then say, okay, like, it's your weekend with our kid, you know, I mean, it's so you know, I think that that's a lot a big misconception people have with divorce in general is, I'm getting divorced, I can be rid of this person. Well, if you have kids, you're not rid of them. Unless they're signing over their rights, you know, moving across the country, you're never going to see them again. So you know, if if part of the reason why you're having problems in your marriage is because the other parent won't take your child, one diagnosis seriously won't help with care. Know that situation that you probably want to work on before you address if it's a bigger issue in your marriage. You know, there's a lot of things that you can do to try to force someone to care. And at the end of the day, they have to care. Yeah, you can't really make anyone do anything, as we all know. So but there's things that you can do, if you're in the process, to force them, maybe you can't force them to care, but you can force them to do what they need to do for your child. And if they don't do that, then you can have remedies with the court to prevent the child from having, you know, extended periods of time that they are under that parents care.

Scott Benner 27:20
Well, it's interesting, you're making divorce sound like you just don't live in the same house and your laundry doesn't get commingled anymore. But other than that a lot of it stays the same.

Jacqueline Stephens Breisch 27:30
I mean, it does when you have I mean, if you have young kids, and if you have a child, I mean, again, the focus of today, of course, is type one, if you have a child with type one, I mean, how many times a day until your child is somewhat self sufficient, you know, if one parent is the is the point person, that's a tremendous amount of pressure on that parent to then just say, Okay, go into mom's or you're going to Dad's, you know, best of luck? No, of course not. I mean, just like you wouldn't send a child somewhere where they could be neglected, just like you wouldn't send a child somewhere where maybe your co parent has, you know, a mental health issue, or that's uncontrolled, or a drug issue that's uncontrolled, you know, you're not going to send your child somewhere where they're not going to be taken care of. And that is, you know, again, looking at the different ways that the laws impact things here in Illinois. One of the situations that we look at, and one of the standards or levels that you have to look at in order to change parenting time, is looking at whether or not something is a serious endangerment, you know, that's kind of what gives rise to an emergency. That's what you would have to prove in order to make a change for or a parenting plan. And, you know, it this is a serious endangerment, I mean, to say, Okay, I see in your Facebook group all the time, oh, my, my kid just came back from moms and you know, their sugar was 300 the whole time they were there. I mean, that's not okay, that's unacceptable. If you send your child to, you know, any other childcare if you sent them to camp, and those numbers were happening, you would have a fit. So why is it okay, just because it's the other child's other parent.

Scott Benner 29:18
So. Okay, so if this is your situation, is any what are my first steps? Let's just say it's happening to me, and I want to do something about it. I find an attorney first. Is that going to be an expensive proposition always or not necessarily?

Jacqueline Stephens Breisch 29:38
Well, I think so taking a step back. I mean, obviously, the first thing is, let's hope that most people who are taking this advice are not divorced yet and can put together a parenting plan that kind of addresses some of the things that we'll continue to talk about. Okay. If you are already divorced, right, so you're already Divorce, you already have a parenting agreement, it doesn't address diabetes, it doesn't address medical care, except as a, you know, little boilerplate blurb. And you're having these issues, child's going to the other parent, their diabetes is uncontrolled, they're not getting, you know, they're not bolusing for meals, they're consistently high. They're having dangerous lows, no one's answering the phone, you know, all these horrible things, right. So a couple of different things. Number one, a lot of people will have mediation clauses within their parenting agreements. If you have a mediation clause in your parenting agreement, then that's the first thing you should do, you know, you should raise the issue with the other parents say, I'd like to go to mediation, I don't want to go to court, I just want to have a third party there to help us walk us through this, let's get some new plans in place. Maybe that means that the other parent needs to go through some type of diabetes education, you know, go back to the drawing board. Remember, when you were in the hospital, when your kid was first diagnosed, and, you know, they're throwing all this information at you. And obviously, you weren't absorbing it. So maybe time for us to hire, you know, a CD and maybe ask for time for us to go back just to you know, the basics and make sure that we all understand what's going on here. Because clearly, you don't understand how serious you know, our child's health is.

Scott Benner 31:19
Generally if I say that, and my spouse says to themselves, mediation, I know I don't do a good job with diabetes, if I go to mediation, this is me getting in trouble, I'm not going to mediation, then

Jacqueline Stephens Breisch 31:32
then then you're going to court, then then then you're hiring a lawyer. And you're going to file, you know, the appropriate pleading with the court to amend your parenting plan. And, you know, here's what's been going on since our parenting plan was entered, or here's what's been going on since our child was diagnosed, depending on the facts and circumstances of your case. You know, if the other parent is brushing off your concerns, you keep documenting it. And again, I you know, this shouldn't be a situation where, oh, you know, we had a bad, you know, pod site change, and oh, you know, child was up to 250. And this was a one time thing. And okay, now I'm going to court, this is, you know, this is chronic pies. This is not, you know, we're not taking care of diabetes. This is, you know, serious. Yeah, you know, you document it in writing, whether that's through text, emails, you know, put together, you know, that information, every time they come back from mom or dad's and their high, you know, keep a log, keep a journal, you know, you've got the log with, you know, Dexcom, if you have a Dexcom, you've got, you know, gluco, if you have a pod or what have you, I mean, you have all of the data at your fingertips to say, look at this was dad's weekend, you know, and look at his numbers or look at her numbers, look at what's going on at mom's house. It's, it's easy for us with the technology we have assuming you have access to that technology to show what's going on, you know, it's it's not hearsay, it's it's proof, it's on a report. So, you know, keep documenting it, and raise it. And if they won't do anything about it, then you have to file something with the court to have the court make a change. I wonder

Scott Benner 33:16
what happens in a scenario where I don't know like making something up, let's say the doctor's okay with blood sugars that are 250. And you're not. So one spouse, or one excuse me, one parent is, you know, not letting the blood sugar go over 250 It's jumping up and down. There's no stability. When you have the kid at home, you've got these more stable blood sugar's but you go back and say, Look, this is I mean, is there really someone there that would understand the difference between like, diabetes ideas like like stability and or do you need to bring in an expert to, to even say, look, the doctors not as on top of this as they should be? I didn't really mean like that. I see that spoken about so often. It's why I bring it up.

Jacqueline Stephens Breisch 34:06
Yeah, I mean, you would you would need your doctor to be supportive, because yes, of course, a judge is not a judge isn't going to have the medical expertise necessary. And you know, you wouldn't be able to testify as to what healthy blood sugar's are but judges can take judicial notice of medical journals, judges can take judicial notice of, you know, those types of, you know, literature that's out there that's medically accepted about healthy blood sugar's about you know, these tremendous swings about high blood sugars. So yeah, I mean, if you've got an endo that's okay with 250. I mean, the first thing is you should get a new endo but, you know, I think that it's it's important that you have some something for a court to look at to say, Okay, what this person is saying is true. And, you know, we've got that literature out there.

Scott Benner 34:58
Is it that easy to switch doc versus if I'm in a divorce situation, or do I have to have the agreement of the other person as well,

Jacqueline Stephens Breisch 35:05
totally depends on what your parenting plan says. So I mean, if you're in the process of a divorce, and there is no parenting plan, yet, you're not yet divorced, then you're kind of in a limbo, because no one has been allocated Medical Decision Making responsibility. So just backing up just a little bit, you know, we always used to use the word custody. That's kind of the word that was used throughout, you know, the 50s 60s and 70s. As we got into, it wasn't just automatic, that mom was going to have custody, in this case of a divorce. And we got through this whole idea of the tender years doctrine of, you know, children automatically went with mom. So now this word custody kind of became a bad word in my industry. And so we started to use the concept of parental responsibility. So it's decision making, and then it's parenting time, those are kind of the two components of what we used to call custody. So in the decision making world, you know, particularly when it comes to medical decision making, you know, usually in your parenting plan, you're going to have this all allocated as to who makes final decisions for medical, a lot of times it's joint, so we're going to keep the same doctors and we are going to attempt to agree utilizing the recommendation of the doctor. And maybe if you know, one parent doesn't agree, they can get a second opinion. And ultimately, if you don't agree at all, you can take it to mediation, you can go to court, you know, with with things like your child's medical decisions, mean, in a perfect world, you're able to work through those things with your co parent, because the two of you have the most knowledge, you'd think about what your child goes through. And for people who don't have children who have any special medical needs, that's not really something that that comes up very often. In this situation, if you already are going through a divorce, you don't have a parenting plan in place. You know, yes, you can go and change your your doctor. And again, do whatever your attorney tells you, you can or can't do. But there's there's nothing in place at that juncture that would prevent or really allow you to do that. So it's, you know, until you're divorced, you're married, and you can do anything that you would do in the context of what you would otherwise do. For your child, you know, in your marriage,

Scott Benner 37:27
I just I find, I feel like what you're telling me is that when that agreement gets set up, that's the land grab moment, right? Like, if you think you're the more responsible one, or the one who understands the diabetes better. That's the chance that you have to kind of swing things in your favor when you're setting it up when you're setting up that agreement. And it's possible if you think you're married to somebody or getting divorced from somebody who doesn't understand or care all that much to begin with, I would think it would be pretty easy to put the responsibility on you almost thinking the other person might want it to be off of them. I know, it's me being a Little Mac of alien, but I think that like, right, there's your shot, does that fair?

Jacqueline Stephens Breisch 38:12
That is fair. And a lot of times, you know, it takes a level of respect for the other parent to recognize that and to say, You know what, you are the one who's better suited. And that's, that's okay, that doesn't mean that I'm a weak parent. But, you know, if, if you've been the point person, and you're going to all the doctor's visits alone, and you know, your child's insulin sensitivity factor, and you know, their carb ratios, and the other parent is clueless, and they're, they've never put on, you know, a Dexcom they don't do a pump change. I mean, yeah, you shouldn't be the one who's who's responsible. I mean, that just makes sense. That's not That's not to paint the other parent in a negative light. Going back to what you said earlier, it's what's best for the kids. And so, if I know, and this is obviously not true in my situation, I mean, my I'm lucky that my husband knows all of this, but I am the point person day to day that does my daughter's diabetes stuff, right? I mean, yes. Does he change her Dexcom? If, you know, we have a failure, and I'm not home, of course, but I'm the one that does it, you know, day in and day out. And you know, with COVID, and only one parent can go to appointments, you know? Yes, I'm the one who typically would take the reins. And so if you know that your other parent is the one who is doing the research and who's, you know, more invested? Why wouldn't they have decision making responsibility? Even if it's kind of a pseudo joint decision making but then if we can't come to an agreement, ultimately parent A is the one with responsibility, right? You're still getting consulted, you're still getting information. You're still welcome to go to appointments. But at the end of the day, The person who has more knowledge is going to make the final decision.

Scott Benner 40:03
Okay? Hold on one second, I had a weird computer monitor issue, and I am fixing it right now. It's not affecting us recording, it's just freaked me out. I'm being honest, well, you are not making divorce sound fun at all, Jacqueline, I just tell you that right now.

Jacqueline Stephens Breisch 40:22
And it's not, you know, you've got to have a good guide to get you through it. But you know, if you're, if you're contemplating divorce, or you're in the process, it is so crucial to include terms to your parenting agreement to provide for a parenting schedule, and decision making as it relates to your child's health, that's in your child's best interest. And of course, that's, you know, whether or not you have a child with type one, I mean, that's, that's clear. But in our situations, you know, if you've got the other parent who doesn't wake up to alarms hasn't managed care, you know, your child's not old enough to take on the responsibility in any way themselves. It might not be appropriate for your co parent to have, you know, overnight parenting time, at first, it might not be appropriate until they can demonstrate that they're up to that task. And maybe that does require some additional education. And you know, those types of things, having those working through that pre divorce will, you know, help prevent issues post divorce. But if you're already in the situation that we discussed, where you know, you've got, you've got a co parent who's just not taking it seriously. That's where now you're going to have to go back in and kind of fix what was not really done right the first time.

Scott Benner 41:38
Yeah, you know, I was just thinking that I was wondering how frequently do people get this right, the first time in these agreements? And how many times does it take seeing the problem, so you can adjust the agreements? Because I'm also imagining, you know, while you're getting divorced, you're probably not in a great frame of mind, you're probably leaning on the attorney, and the attorney probably doesn't have a ton of knowledge about type one diabetes, so even things that might look very normal in a health agreement might not be valuable in a diabetes agreement.

Jacqueline Stephens Breisch 42:06
Absolutely. And I mean, how would they have any knowledge? You know, I mean, for me personally, until, you know, until I was thrust into the situation that I'm in with my daughter, I was completely ignorant about diabetes. And you see that every day. I mean, you know, family members, co workers, I mean, people don't know what how would they know, I don't expect them to know. And I had some background with it, like, my father in law was type one, I had gestational diabetes with my first pregnancy, weirdly enough, not with my daughter with my son. So you know, I had like some base level knowledge. But this is, you know, this is a such a chronic thing. I mean, we don't, other conditions have, you know, flare ups and remission, you know, you have a good day, you have a bad day. I mean, this is every day, as you know, we don't get a break, you know, this is everything they put in their mouth, every hormone, every activity, it's 24/7, it doesn't stop, and it's exhausting. And it wears on parents, whether they're married or or, you know, working separately to try to raise their kids. So, you know, having this stuff in an agreement is not something that's going to just be, you know, second nature or, you know, you're gonna have to explain this to your attorney, and you have to explain to your attorney how important it is. And their boilerplate agreement that they've been working on for 10 years is not going to include this type of language. You have to be an advocate for yourself and for your children.

Scott Benner 43:34
Right. Fund. I was gonna say fun, I'll still say fun divorce question. What's the what's the most common cause of divorce? Is it infidelity or money?

Jacqueline Stephens Breisch 43:48
You know, that's so funny to say there. I wouldn't say it's, I wouldn't say that there is a most common cause. I wouldn't say it's infidelity. I think that it's people who don't want to be married anymore. That's, that's the most common cause of divorce got people don't want to be married anymore. And, and why? It's a whole slew of reasons. I mean, it's so complex, it's, you know, years of, of harboring resentment over you know, roles in the marriage that relates to money that relates to family that relates to how you parent, you know, there's there's so much there. I couldn't say that there's one thing that I say, Oh, yep. See this every Tuesday, you know,

Scott Benner 44:35
do you ever look at people and think, Oh, my God, it's so obvious you should YouTube never should have been married. How did you not say

Jacqueline Stephens Breisch 44:44
you know, it's funny because I don't, it is. It's funny now in the in the world of zoom, where I sometimes don't even physically meet my clients anymore. But, you know, I still rarely get to see the dynamic between the people except in you know, reading there. emails to one another reading their text messages. I don't typically see the two parties interact. So I don't really get to have that level of insight except in a mediation setting where, you know, we're all in a room and we're trying to work through the, you know, what could be an agreement? Yeah. But, I mean, yeah, most it, you never, I never want to become too jaded. Or like, Oh, I've seen this one before. Because that turns into the client, every client is different. I never want a client to feel that way. But, you know, as I go on, I definitely can see the same type of relationships over and over. Things change, there's nuances, but it's, it's the same type of dynamics. And so it's, it's not necessarily like a one issue. But it's like, oh, yeah, I've seen this, you know, narcissistic personality with like, a totally enabling type before.

Scott Benner 45:50
It's funny, I feel very similarly, about not wanting anything to feel blase. I actually only answer my email, from listeners, like monthly, but the ones that are just like, look what I did, or, you know, like they're trying to, like, share their, their excitement with you stuff like that. Because I don't want to get into the point where I'm just dashing back and email to somebody just blindly being like, Hey, good job, you know what I mean? Where they've made some amazing medical leap for themselves. So and, you know, that might sound strange to other people. But if you're in my position, I see it so frequently, that I mean, there are times when I get your emails, and I'm like, Yeah, of course, you did the stuff I said in the podcast here he wants he's five and a half. Now. I told you, it was gonna be like that. You don't even that's not how you want to answer. You want to be like, Wow, this is amazing. Because that is actually how I feel. It's just that when you're busy day over day, so I take your point, I thought that was kind of nice that you don't want to feel that way. When you're when you're when you have people sitting in front of you virtually, or, or actually COVID pickup divorces?

Jacqueline Stephens Breisch 46:58
Well, at first to kind of put everything on pause with with the level of uncertainty that everyone was, was dealing with, you know, courts had to figure out how to go remote, it was incredibly stressful and crazy. And we were getting updates every day and things were changing. And, you know, we're trying to zoom into court and everything. It was just, it was nuts. And then I think, you know, things picked up again, you know, kind of once everybody got their arms around what was happening. And, you know, I mean, hate to say it, but people you know, forced to stay home with someone that you were maybe going to be on the verge of getting divorced with like, it's gonna push you off the edge.

Scott Benner 47:36
Oh, so I had, can we just chat for a second? Jacqueline. There was a person. As soon as this happened in the first time, we all got locked down. I will obviously won't say their names. But I went to my wife and I was like, hey, you know, blank and blank. She's like, Yeah, I'm like, they're totally gonna get divorced this year. And she's like, what I'm like, the separation is how he runs all the infidelity. Like, he's not going to be able to stop cheating, just because they're all together, like, so he's going to get I know it. I know. He's a grown man, but he's gonna lose his mind like a child. And he's going to try to fit this cheating in a lot. And sure enough, boom, just like that. I felt like Nostradamus. When I figured that one out. I was like, there's no, there's no way he's going to stop. And there's no way he's going to be able to hide it. And now he doesn't live there anymore. So I was like, I called that one. My neighbor is an older gentleman in his 60s. And I said, How's it being with, you know, not getting out much. And he's so funny. He goes, I were fine. And I was like, Hey, he goes, plus, I ain't leaving. And I was like, what? And he goes, if she wants to leave, she can leave. And I was like, right, he goes, my house, I bought all this stuff. I didn't going anywhere. I was like, I love that older attitude, like in the 60s, like, I'm too close to the edge. Now. I think. If you want to go, you can go. I'm not I'm not staying here. Like, you know, he almost came at me like, by the way these people get along really? Well. It's not not the point of the conversation. But but his intent was sort of like, like, if she doesn't like me, I get it. But just that, like, I don't know, if we've been at this too long. I'm not leaving this place. And I was like, gotcha. I don't know. I think it's funny how different people think about it. And I think it's interesting how some people treat it. So you know, just kind of like it's almost unimportant. Like, I don't I don't see it that way. I remember saying to my wife when we were younger, and we were talking about what our expectations were for being married. I said the way I see it, it was like, you know, if we stay married our whole lives, I don't know how long that'll be. You know, I said maybe it's 30 years. And I was like if like eight of those years are amazing, and three of them are pretty good. And five of them suck and you know, eight of them are fine. Like you don't even like I said that would make sense to me. Like I don't expect every day to be magical yummy, but I wonder how many people do have that expectation and I hate to be the person to say something like this but as you know, I don't want to say in these times because that really makes To me sound old, but you know, in a world we live in now, where we're grabbing gratification is so readily available. Like, how hard is it to have like a real like, you know, down and dirty, like personal relationship with communication face to face communication when, you know, everybody's texting and looking at their phones and not that really, I mean, my son's still learning how to talk to people, and he's going to be 22. You know, it's just, it's fascinating how, I mean, communication is obviously the key of most of these problems. And, you know, we are not a society of people who are good at communicating to begin with. So,

Jacqueline Stephens Breisch 50:38
right, yeah, you know, that's funny, and we're just chatting at this point, right?

Scott Benner 50:43
Yeah, this isn't like the legal part. Don't worry.

Jacqueline Stephens Breisch 50:45
So we, I just talked about the other day, because, you know, when you think about it, and, you know, I, I was born in the 80s. And when I think about, you know, watching TV, like I was explaining to my son, you know, when I was a kid, you know, you had a certain amount of channels, that's what you had, you know, you have YouTube, you can look up anything you want. And, you know, started going on a tangent. And it's, you know, we all watched the same news, you know, there wasn't all these news outlets, and, you know, these conspiracy theorists and all it was, you know, you watch the news, you watch what was on, you know, must see TV, and you went to bed. And, you know, you watch commercials, and you ran to the bathroom or the commercial break. And, you know, it's Yeah, to be with each other. You know, you're either watching TV, or you were in silence. You know,

Scott Benner 51:34
Jacqueline, if you were a conspiracy theorist in the 80s, people thought you were nuts. And now you have a very popular podcast, if you think that way. So you know what I mean? Like, you're, you're like it, you're a famous person. And to your point. I know, my daughter always looks at me weird because I like mash the television show. And I was like, You don't understand. It's what was on first of all, you know, like, I liked it enough. And I thought it was funny. And I watched it. And I told her, I was like, 100, and like, I think, Oh, God, what was the number like 106 million people watched the finale of mash live, they couldn't timeshift it. You had to be there when it started, you know, and you

Jacqueline Stephens Breisch 52:12
scheduled your life around it. Like you're like, we got to be home to wash mash. Oh, my

Scott Benner 52:17
God, I still have a completely clear view of us sitting in a restaurant on a Friday evening in October. And me being like, you all got to eat faster, man. Like, the Charlie Brown. The Halloween special is on at eight o'clock. It's on CBS. And we gotta go and I joked in another episode, that special is why I can sing the Almond Joys commercial song. Like, you know, because they were always the sponsor of that special. And I made sure to see it every year. You know, what ruined it when they put it on videotape. The minute, the minute wasn't special. I didn't. I didn't care about it anymore. Yeah, because now it's accessible. Anytime, yeah, I just didn't care anymore. So I knew, I think there's something to be learned from that. Not that anybody is actually going to learn it. But I can't see that marriage isn't either going to lessen in in popularity in general. Or, you know, and maybe that'll be helpful. Maybe people will get married when they're older. And that will, you know, have people find matches that are maybe a little better suited, like I am, I'm stunned that my wife and I are still married, because just because of the age of when we met and got together, if for no other reason. It just, you know, like, I think statistically, we should probably not be married. Because of like, I think my wife was like, I mean, was she 21 or 22 when we got married something like that? You know what I mean?

Jacqueline Stephens Breisch 53:45
It's not happening anymore. I mean, you know, of course, there's certain certain situations, but no, that's people are waiting longer and longer, and, you know, probably with better results, but who knows,

Scott Benner 53:56
I'll be dead by the time we know the the outcome of that. So I don't care. Alright, so I do have a question about the, you know, because it seems so obvious to you, because it's your profession, like you just do this, you get an attorney, you do that. But that would seem overwhelming, I would imagine to most people and or they'd be concerned about the finances of it. And then that, to me seems like that would create just inaction. And and then the person who would get hurt that again, would be the kid and their diabetes. So Can these decisions be made in a quickie divorce in, you know, in with an attorney that's maybe not as adept? Like, how would you do those things on the cheap? I guess I'm asking.

Jacqueline Stephens Breisch 54:41
Yeah. So I mean, I think it's the same way that you might look at the type of information you'd want to put into your kids 504 plan, you know, and we're not there yet. Because my little ones only three but we just had her her annual appointment and I was asking her I know about it. So it's just kind of top of mind for me where you've got to think about Okay, let me walk myself through a typical week, and maybe, you know, maybe my child's gonna go to so and you know, other parents house on Wednesday and then for the weekend, or whatever the case may be, what's that going to look like? You know, what's the physical distance? How are we going to communicate? What are we doing to manage supplies? Are we transporting everything? For each parenting exchange? Are we going to have sufficient supplies in each home? You know, do they have, you know, how are we going to manage picking up insulin and keeping refrigerated? And who's going to have it? Are we going to keep a stockpile of both parents houses? Like what are we going to do there? What kind of communication tools are you going to use? You know, are you comfortable just texting with your co parent? Are you going to email Do you want to have something more formal, like a co parenting communication app, where you can actually log things in and put things on a calendar, you know, what makes sense for the kids for their schedule. And, you know, maybe, maybe, Dad's really bad at breakfast. So maybe Sunday night, instead of them sleeping over till Monday, they go back to your house that doesn't take away from dad's ability to parent, but it's just starting the week fresh with you on Monday, because you know, you're going to get them a good breakfast. And that's not going to spike your blood sugar before school. So you know, all of these things, it's just a matter of you, as an individual who's not a divorce attorney doesn't know how to put pen to paper and, and recognize what can be in a parenting plan. Because if you go to, you know, just your regular Joe Schmo divorce attorney, you know, they've got their template that they're going to give you and it's not going to have any of this in there. And, you know, unless what you're trying to agree to is somehow unconscionable or not in your children's best interest. A judge typically is not going to care what you want to agree to as it relates to your children. So you might want to put in a whole slew of information about, you know, time and range, or, you know, having more education, you can put anything you want in a parenting plan, as long as it's to the benefit of your kids, a judge is going to enter it. And so you've got to talk these things through with a lawyer. And if that lawyer is telling you like, Oh, that's not how we do things. You know, yeah, it's it's daunting to think about having to hire a more experienced lawyer, it's daunting to think about what that cost and expense might look like. But it's also daunting to think about what your kid's life might be like, if he or she has four diabetes management, and that has really significant long term health issues. You know, we all spend money on things we don't want to spend money on, and this is your kid's life. So I mean, to me, it's an area that's really really important. You know, if if you can do a lot of the legwork yourself, and you can go to a lawyer and say like, look, I this is a really limited scope. This is what I want your help with, you know, have yourself ready to go and hopefully they can they can help you.

Scott Benner 58:00
I'm going to ask you something that you should feel completely free to say no to it is up to the point where you can tell me please like edit this out so that people don't hear me say no to this, Scott. Okay. But if you wanted to write a piece on this, like a blog post, I would I would be thrilled to host that on my site. Sure, absolutely. Would you really be interested in doing that? That? Yeah. Because you said something at the beginning of, of of that part of the conversation where you're, you know, I, I felt like you were like alluding to like almost the way the podcast helps people with management. Like you should have that kind of information. And I just keep thinking, like, where are they going to get it from like, that is a super specific situation, right? Like, your kid has type one diabetes, and you're getting divorced. And here's some bullet points for things I should be thinking about. Like, where are they really going to get that from, you know, if you if you were interested in doing that, I that'd be amazing. And if you're not, or it's too much work for you, you don't want to have your name on something like that. You would tell me and I absolutely would just like, chop this out. Nobody would ever know I said it to you. But But if you're interested, I'd be thrilled to have that.

Jacqueline Stephens Breisch 59:07
Yeah, no, I absolutely could. I mean, I kind of put something together for today just to keep my thoughts fresh. So yeah, I'd be happy to

Scott Benner 59:13
do that. If you can turn it into something. I will put it out the same time as this episode. That'd be amazing. Thank you. That's really, really kind of you. Because I just keep picturing like, maybe I'm a pessimist. But divorce doesn't seem like a happy time. And I think it's easy to kind of like crumbling on yourself. And especially if you don't want I mean, what if you army we can what if this to death? But what if you're the one who's in charge of the medical stuff, and you're being left and you're emotionally crushed? Like how do you pick your head up to do these things in this moment? And what if we can make it easier for people to just walk into an attorney's office just with a printout of something and say, Look, these are the things that are important in the health portion, because my son has diabetes and etc. It might be a big deal.

Jacqueline Stephens Breisch 59:58
Yeah, absolutely. And yeah, I mean, I think a lot A lot of times too, you know, as unfortunate as it is, this is a contract. This is a negotiation. And, you know, you have to there's give and take when you're trying to come up with an agreement. And, you know, if you're so close to getting an agreement done, and you're your spouse, or your co parent is unwilling to put in certain language, you've got to decide like, what am I going to do? Am I gonna go to court over this? Or am I just going to agree to keep it out to get this done? And then yeah, then you find yourself in a situation where you've got a parenting plan, that doesn't work for you, and that's negatively impacting your child. But that's why, you know, parenting issues are always modifiable, you know, you can't, you can't contract away for something and say, this can never change. Because it always depends on the facts and circumstances that are in place at that time. And so you could always make a change. And that's, that's something that's really important for people to know, who feel defeated, like, oh, you know, I got divorced a couple years ago, and I was right in the throes of, you know, my child's diagnosis. And I just, I didn't know what I didn't think and, you know, it's, it's not too late, just because you did that you can go in and you can change things. And when it comes to the health and safety of your child, like, I mean, I'm sure most people who are listening to this podcast, either listen to it for themselves for their own knowledge or for their child's knowledge. And, you know, you'll nothing's gonna ever stop you. If you're already listening to this podcast. It's because you really care and you're trying to make your kid's life better.

Scott Benner 1:01:33
Yeah. And people should be able to carry that over to this. I would.

Jacqueline Stephens Breisch 1:01:38
Yeah, and, you know, yeah, it's, you know, does it does it? Does it hurt the wallet to say like, Okay, I'm gonna have to go and spend 1000s of dollars in attorneys fees to change this. Yeah, it does. But like, if your kids five, okay, the next 13 years of his life,

Scott Benner 1:01:51
you know, we can aggregate that cost out a little bit. You know, it's funny, I just realized when I first made Arden's first 504 plan, I purposely put a couple things in it I didn't care a lot about so I could give them away in negotiations. And then, and then moving forward every year, there'd always be something in there that became unimportant because art and got older or the school changed or something like that. And I would always make sure if when we got stuck, I'd say Listen, why don't if you can let this go, I can let this go. I always had like a little bit of like, I always thought about that. I don't know, it just makes sense to me. But when you said it, I was like oh, that's smart.

Jacqueline Stephens Breisch 1:02:34
That's the way the world right? Yeah. We call them throwaways.

Scott Benner 1:02:37
My, oh, they have a name. Excellent. My, when I left eighth grade, Jacqueline, eighth grade, the last day of school, I was walking in the hallway. The guidance counselor stepped out in the hall, grabbed me snatched me into a corridor, he was not going to touch me inappropriately at something wanted to say, he pulled me into this little corridor, and he goes, you're going to high school now. I was like, ah, any idea what you want to do with your life? And I was like, nope. And he goes, You should be an attorney. And I said, What? And he goes, you'd be a good attorney. And I said, Thank you. Because you think you want to be attorney and I go, No. And he goes, why not? Well, then I'd be an attorney every day. And I realized, I realized now looking back, like I really did not want to I couldn't imagine doing the same thing every day. In You know, when I was in eighth grade. I always thought he took it as like an attorney joke. Like, because I was like, well, then I'll be an attorney. But I was just, I just didn't want to do the same thing every day. I've always kind of like, rubbed up against that idea. But I do think I'd be graded. Actually, I think Arden would make a great attorney.

Jacqueline Stephens Breisch 1:03:40
She's right. Well, she wants some some pointers. Senator my,

Scott Benner 1:03:43
I still think my son who hates school, so probably won't do this. He argues he's such a good argue or it's just like you can't you can't win. He's just so fact based. He doesn't get emotional when he's arguing. It's just too hard to like, like Jesus, like you're looking for a crack. You don't I mean, you can't find one just but I don't know. I'm sure he's, I think when he graduates he's getting the hell out of college. I don't know if he's looking for more or not, although he talks about grad school sometimes. So I don't think he knows what he's done. Anyway. I needed one of the kids to be an attorney because it's clear Kelly's eventually going to get second me and I'm going to need some representation. You know what I mean? Do you think most married men feel that way? Like they're on some sort of a time clock with like, I wonder when she's just gonna get sick. I mean, this is going to be done. I always tell my kids I'm like, do not. Listen. I worked really hard for you guys. While I was younger, daddy cannot end up living in an apartment above a pizza place. Okay, that's all I want to make sure I just don't want to live above a pizza place. That's the worst thing I can imagine. Anyway, is there anything we haven't talked about that we should have? I know you have a list in front of you. So

Jacqueline Stephens Breisch 1:04:57
yeah, I mean, I think just you know what? Other things I wanted to touch on was, you know, okay, assuming that everything that I've talked about of trying to, you know, put together a parenting plan, okay, that's out the window, you know, we're talking about someone who is facing a diagnosis, you know, they're already divorced, or, you know, they, they put together a quickie parenting plan, because they didn't have the time or resources or the emotional ability to deal with it at the time they were going through the divorce, but now they've realized there's issues. And you know, you've got a parent who's not taking your child's health seriously. I think one of the things you asked me like, okay, you know, you don't want to go to mediation. So what's your option, the only option is really court, you know, there are some other kind of newer and nuanced things that people are doing. You know, like I, like I started the episode out with saying is, you know, you can't, there's nothing that you can do to make the other parent care, but you can force changes in their behavior, by making better be consequences to their behaviors and actions. So whether that's less time with your child, because they just can't keep their child healthy. Whether that's, you know, even doing some sort of parenting education, not necessarily diabetes related education, but, you know, is the other parent doing this, because they're being spiteful, you know, are they I see all the time where there's, there's an issue for one parent, the other parent doesn't think is that big of a deal. So now they're going to downplay it even more out of spite. You know, oh, you know, his numbers aren't that bad, get over it, you know, that type of thing, where it's almost like a gaslighting. And it's very much conflict between the two parents is now trickling down to the child. So a lot of times parenting education, working with, you know, a licensed therapist who deals with these things can actually help the two of you learn how to better communicate as CO parents. Another thing that people do sometimes is to utilize what's called a parenting coordinator. And that is basically like an intermediary step that you don't have to go to mediation, you don't have to go to court, here's this third party, who is typically a family law attorney as well, who's going to listen to what the dispute is, and make some sort of recommendation. And if neither of you challenge that recommendation, it becomes as good as if it's a court order. So, you know, there's other things you can do that are not only more cost effective, but might actually be more effective than a traditional litigation model, where that might just breed more contempt and breed more anger. You know, if you take if you, if you write a letter, write an email, write a text to your other parent, you know, let's say it's a bad weekend, and your child comes back, and they've had horrible blood sugars, and you just say, you know, so and so it was only in range, you know, X percent of the time, and his average blood glucose was why and, you know, we need to get on the same page regarding his care, because, until he can independently manage it, he's counting on us to keep them healthy. You know, if those types of communications that are neutral, and pleasant and child focused, are still not being taken well by your co parent, then that's a problem with that person. And that's where you've got to go in and take action to do something, because you've got to, you've got to be the protector of your child's health. You know, just like you wouldn't send your kid to school, if like their teacher was being, you know, abusive, or you wouldn't, you know, you're not going to send your kid into the fire here, just because the other person is there is their parent as well, you've got to protect your kid. So, you know, starting it off that way, trying to be as as non adversarial as possible, and maybe thinking about some of these other tactics other than just, you know, let's go back to court.

Scott Benner 1:08:54
Can I add something here? I know this because I run a fairly large Facebook group. A lot of you don't write as well as you think you do. And you're not as good to communicators as you think you are, like, I see. I see. And I see people, they think they're having a well balanced conversation, but you can still see the bite the backbiting remarks, and you know, the, the desire to one up somebody or outsmart them. And, you know, I would have someone else read that stuff. You know what I mean? Like, find a trusted friend, not somebody who hates your spouse, too. You know what I mean? If you're if you're in that situation, but somebody who can read it from just a clear third party perspective and say, hey, you know, in this sentence here, this is really passive aggressive, or you're, you're you're blaming the person here, like we don't want to do that, like the one. I'll tell you, one of the amazing skills that I've come out of this podcast thing with is being able to talk to people In a way that I mean, and is neutral, and supportive, like it's a, it's a skill I've built up talking to people online. And it's super important. Like it just it in any situation, I mean, you could be talking about something silly with a stranger, you know, people kind of look to be insulted or angered when they're reading their people are on the defensive, a lot of times they, I don't even think they realize it, their, the way I put it, usually when I'm talking about it privately is people want to be upset. And if you give them any opportunity to be upset, then they get to take whatever it is inside of them, that makes them want to be upset, and they get and they get to put it on you. And so there is a way to communicate with people where it is impossible for them to do that. And if they do, it becomes very obvious that they're the problem in this situation, I think that's the kind of communicating you need. Anyway, that's just my two cents about that. I've, I've talked to a lot of people and seen a lot of people argue, and a lot of people get along, and I can tell the difference between a sentence that's going to go over and one that isn't?

Jacqueline Stephens Breisch 1:11:11
Absolutely, absolutely. And I think that that's, you know, my advice to my clients, when they are responding to a parent, where there is a lot of animosity where there's a lot of issues is okay, draft your response, you know, just like anyone would tell you, right, don't send it right away, go back, try to scrub it out for some of the emotion and respond to facts with facts, and, you know, provide facts where they're necessary, and do your best to keep emotion out of it. Because this is emotional, you know, I get emotional just thinking about my daughter. And you know, when I talk about her, didn't get emotional today, because we barely talked about her. But you know, I even when I've had to explain her condition to, you know, my co workers or my colleagues or what have you, I mean, it's, it's a very emotional thing to think about, you know, if you aren't taking care of your kid, like what that could mean. And so this is not something that is, you know, if you've already have conflict with with the person you're raising your kids with, this is not an area, that's going to be easy, right? And it's going to be taken as criticism, and it's going to put your your co parent on the defensive when you're saying that something they're doing is wrong. And again, not to say that every little thing, you should be putting them on the defensive about, you know, everybody has bad days with diabetes management. I mean, maybe not your Scott with our

Scott Benner 1:12:43
No, I do. You know, Jacqueline, by the way, like, as good as I am kind of professionally talking to people in my own life doesn't always go that well. Because, because I don't stop and think about it. In my own life, sometimes you're just passing somebody in the kitchen, and you say something, and as it's coming out of your mouth, you probably shouldn't have said it like that. And you know, you don't even mean anything by it. Or sometimes you do mean something by it, sometimes you're looking to score points or hurt people's feelings, you know, like that kind of thing. You know, so just because I know how to do it doesn't mean I always do it either. So if you don't know how to do it, likelihood is you're gonna do it, you know what I mean? You're gonna, you're gonna say something that gives somebody and in the end, in the end, the goal, if you just have to keep the goal in mind it none of this matters anymore. You're divorced, you know what I mean? Like, what's the end goal? My end goal is I want this kid to get Pre-Bolus when he's at his dad's house, my end goal is I want them to test the 45 minutes after they eat, because sometimes the kids blood sugar shoots up, the end goal isn't for somebody to like each other or feel good about anything. I mean, you know, just try to take all that out of it when you're talking to each other. I don't know, it just seems,

Jacqueline Stephens Breisch 1:14:00
right, you're not going to convince your co parent to do anything differently by criticizing them, putting them you know, putting them into defensive posture. You know, if they come back to you, and you're like, you know, why was his blood sugar this high? And this, this and that, you know, that's not going to help anything?

Scott Benner 1:14:18
Are you lost? It's over

Jacqueline Stephens Breisch 1:14:19
already. So so, you know, and you don't want to put this on on your kid. And depending on their age, some of it's going to be put on him or her right, because at some point, I assume I mean, my daughter's through researches doesn't do any of her own management except stick a little thumb out to get her finger poked. But, you know, at some point your child is going to be managing their own care to an extent and you want them to have too good models to you know, you don't want them to think it's a free for all at dad's house. And at some point they're gonna think like, you know what, I don't feel good when I don't take care of my blood sugar. So I am going to do it. And again, this also depends on What technology they have available to them? Because it's a lot easier for a kid on a pump than it is for a kid who's MDI, right to try to do it by themselves. But all of that to say, when you are communicating with the other person, if you can keep it as factual as possible, right, like I said, you know, my first example like, okay, they were only in range this percent, like, how can we, you know, how can I help you to get make that better. And then that's really swallowing a lot of pride to have to say that to somebody who you probably don't like very much, and who you think is doing a bad job at managing your kids managing your kids diabetes. But if you remember, like, this isn't about you, this isn't about you being right, and the other person being wrong, because when the other person is wrong, your kids aren't healthy. So

Scott Benner 1:15:48
just don't have what you need. Just now you're now you're like, Oh, I'm right, great. You're right, and the kids blood sugar still 350? What does that help? You know, I'm actually looking for at the moment, I'm looking for some communication experts to be on the show. And I don't even care if they have diabetes at this point. Because I've been around people long enough now online that I just think it's valuable for people to hear how to communicate. It is not something we teach children, we don't teach anybody how to do any of the things they need to do. Actually, you were talking earlier about, like, there's mediation apps for divorce. And I was thinking like, how, how funny is it that divorce is just like health care in America, like we don't, we don't try to treat it before it happens. We just find ways to make it easier after it's gone wrong. Like, like there ought to be marriage apps. You know what I mean? Not divorce. And, and really what we're talking about as a people, listen, here's what I'm saying, Jacqueline. Without society structure and rules, we'd all just be having sex, smoking weed are beating each other up. And so that's what I'm, that's what I'm starting to think. And so you need you need these lanes to keep keep some people in like, some people are going to be lovely, they're going to get divorced, they're going to do exactly what they're supposed to do. But that's not the conversation, the conversations about what happens when it when it goes wrong, or somebody wants to be angry or somebody is, is hurt, or you know, is trying to hurt you back. There's all this kind of interpersonal stuff that's happening. And at least when you have two attorneys standing in between you that can kind of get stripped out of the decisions. I mean, you might not be happy while it's happening. But at least you'll get where you need to be. It makes sense to me, it really does. And let's not forget, if you never get married, you won't have to get divorced. So you know, wear a condom, etc.

Jacqueline Stephens Breisch 1:17:36
But if you have kids, you're still gonna have to develop a parenting plan. I

Scott Benner 1:17:39
said, wear a condom Jacqueline, were you not listening?

know, I know it's Listen, it's show. But

Jacqueline Stephens Breisch 1:17:52
the whole world? We're all just trying to survive. Yeah. And, you know, I mean, it's just, this makes it so much harder, you know, to think I mean, and I think about people who, you know, this is just not something on their radar. And it's just they choose to bury their head in the sand about it. And, okay, well, you know, I was blood sugar was high. So what, you know, his blood sugar was 600, when he was diagnosed, he was fine. You know, I mean, it's like, people just they have, if you're with someone who has no concept, and doesn't understand, you're in a bad spot, and you probably have to take some drastic measures. And those measures are not going to be inexpensive. So you've got to pick your battles. And maybe that means that you just try, you know, try to make things a little bit better and a little bit better. And before you know it, your kid can manage more, or care.

Scott Benner 1:18:44
Do you know how many times I've seen this specific problem where one of the spouses also has type one diabetes doesn't take particularly great care of themselves. And therefore, in this scenario, the judge or the mediator uses the parents health as a barometer. And the other parents like no listen to he doesn't, she doesn't take great care of themselves. We don't want that for the kid to but then the parents standing in front of you. And they seem like they're healthy, because it's diabetes. And you can't really tell if you you know what I mean, when you're just looking at somebody. I've heard that problem from a number of different people, where, where that could happen. And I mean, if you listen to the podcast, you're gonna hear an endless number of people who have type one is adults who have children. And it isn't until their children get diabetes, that they are actually able to even like psychologically, make the decision to take better care of themselves. So there's a lot of there's a lot of psychological and emotional things going on. I mean, your job is really important. Like we joke about attorneys, but your job is very important.

Jacqueline Stephens Breisch 1:19:49
Well, I'm like with this stuff, too. I mean, it's like okay, think about the intergenerational you know, all the stuff you carry all your baggage, all your intergenerational trauma, then you've got this, you know, autoimmune disease that is clearly genetic. That's, you know, I mean, I couldn't I mean, obviously, sometimes it's pops up out of nowhere. But like I said, like my father in law was type one. When I met him, he had just had a kidney and pancreas transplant. Oh, wow. And because I mean, he had a myriad of health issues. And at the time, I didn't realize maybe some of those health issues were diabetes related. And again, he passed five years ago, so I don't, and my daughter was diagnosed, you know, three years later, I don't, or four years later, so I don't ever really want to bring it up with my mother in law. It's, you know, obviously, it's a touchy subject. My husband grew up though his whole life with his dad, you know, going through issues going through lows, and you know, he, he saw it all, but when I met him, he was not a diabetic anymore. I mean, as crazy as that sounds, I'm on my way. I just had such a, I didn't have the level of knowledge. So when my husband would say these things to me, I'm like, Wait, why? What do you mean? Like, I didn't understand that, okay. Your pancreas produces insulin. And if someone gives you a healthy pancreas, it's gonna continue to work for a while until your autoimmune disease realizes like, hey, there's a healthy pancreas in here.

Scott Benner 1:21:09
Hey, so your husband, his feeling about managing diabetes? You You didn't have to? You'd never had to cajole him. He's the one who understood on a deeper level, you killed his father, he is probably how he feels.

Jacqueline Stephens Breisch 1:21:23
Oh, yeah. And he was devastated. Because he was like, Oh, this is this is from me, you know, like, she has it because of my genetics. And I was like, look like, I'm no angel over here. Like my, I've typed to author my family. I had gestational diabetes, it was a perfect storm, you know, she just got a genetic cocktail. And you know, she, she's this perfect little person, I wouldn't change the thing.

Scott Benner 1:21:43
I heard myself joking on an episode recently. And I say that because I, I edit them like six months after I record them. So it's almost like I've never heard it before. There'll be a moment where I hear your my conversation, I'll be like, Oh, my God, that was good. But where I choked where I think people with autoimmune diseases must have little beacons on them to attract other people with autoimmune disease for marriage. You know what I mean? Because every time I asked like, like, is there anything else going on? Like your family's or celiac, or? I don't know, hypothyroidism? Is there anything like that in your life?

Jacqueline Stephens Breisch 1:22:18
Not that I'm aware of. But I mean, now it's like got us thinking, right? It's like, but no, I mean, we've, as far as I know, nothing else.

Scott Benner 1:22:26
It's also stuff people don't talk about,

Jacqueline Stephens Breisch 1:22:28
either. Yeah. I mean, we we mean, again, I type to all throughout my family. My mom had gestational diabetes with my brother, I had it that in with my son. And then when I was pregnant, with Everly, my daughter, who's my type one, you know, I went in for my test, and I was just expecting that I was going to have it again with her. And, you know, like, I chuck the disgusting drink, and they took my blood sugar. They're like, Oh, you're great, you're good. And I was like, Wait, how is this possible? Like, why wouldn't I have it again? And, you know, I've read statistics that like, if you have gestational diabetes, or chances that having type two, it's like, you're 5050 at that point, you know, like, your likelihood just skyrockets. But I don't even know where I was going with that, except to say that there's just, you know, the, the whole the whole notion of, you know, all of these, this slew of issues. And when they're onset and why they're onset, and, you know, we all had COVID in May of 2020. And I'm pretty sure that's what brought on a release diagnosis, or brought on the onset, I should say, was, was COVID. But, you know, when when I was in the hospital, and this, you know, very nice intern, came to see us, and it's, you know, 1130 at night, and I'm trying to get her settled, and it's just a horrible day. And he's like, oh, like, you know, you had coat he's like, oh, yeah, there's probably brought up by COVID. And I'm looking at this guy, like, what? Yeah, what are you saying? Like, I'm like, Are you a medical doctor? Like, because in my mind, I had no idea that this could be triggered by a virus, you know? So I'm just like, I literally, I probably lost it on this poor, sweet intern who was just trying to be helpful, like, just tried to be because I'm like, What do you mean, my coat and like, Are you a COVID? Like, like, Are you like a fake? COVID person?

Scott Benner 1:24:26
Well, I think Ardens was brought on by Coxsackie. So it's a virus to

Jacqueline Stephens Breisch 1:24:31
Okay, so yeah, and it makes sense. I mean, she was really little. You know, I guess I always thought that it was the kind of thing that came on in you know, more, you know, 789 like that. It's just in my head. I mean, what do I but that's just kind of the age that I thought was more of a normal age for onset was, you know, late childhood into teenage years. And so when they told us that when she was two, I was just like, wait, what? And it's so much harder. I mean, I'm sure every age, it's hard. You've lived through every age. So I'm sure

Scott Benner 1:25:06
Yeah, so far, they've all been a ton of fun. So

Jacqueline Stephens Breisch 1:25:09
but when they're so little, and their, their sensitivity factor is so low, like, you know, if she's taken a nap, and she's at 145, I'm hesitant to even do anything because, you know, just the smallest amount of insulin could send her Clomid thing, you know, I feel like if, if she if her insulin correction, if her sensitivity factor was was more if it took more insulin, I can dose her more aggressively. And sometimes, you know, I just I don't because I don't want to have her crash. And, you know, it's just, it's hard. She's, I don't know how much she's gonna eat for dinner. And I don't know, you know, she's gonna want a snack after dinner. And it's, you know, I tried to Pre-Bolus and, and she doesn't want to eat, which she just put in front of her. You know, it's so I'm sure that those things are always there. But it's when you've got a toddler. It's especially difficult

Scott Benner 1:25:57
if you made me choose the worst part so far. I mean, when she was little, I'm gonna guess it was I'm holding out a little bit of a little bit of space in that answer, because I'm thinking College has the opportunity to be terrible. And I guess I won't know, for a little longer. But you're making me think this is a weird thing. I'm sure most people don't think like this. But there's part of me that would like to see how good I'd be at it again, with the knowledge in my head now with a younger person. Like I like if you could take me back. If you could take me back now to when Artie was diagnosed, I wonder how I would do?

Jacqueline Stephens Breisch 1:26:34
Yeah, no, I hear you. I mean, I'm sure you do. Great. But I mean, like, I think about, like, you know, when you say like, oh, with Omnipod and Dexcom, you know, or her agency has always been in this great range. It's like right now ever lose anyone see as a 7.2? Well, when she was diagnosed, it was over 10. And, you know, that's, that's great that we've got it this low, but that still is not great. And it's like, I have like, I don't know how we could do it any better than we're doing right now. Unless I just did it unless I just made her go low carb, you know, which I'm, you know, we've we've definitely reduced and change diet a bit, but I'm not going to make her do that at this point. Right. You know, if if she wants breakfast, so it's like, that's what I don't. It's a hard thing I struggle with is, if she was diagnosed a little bit older, like people will say like, oh, it's, you know, it's great, because she'll never remember, you know, it, she'll always just be used to it. That's so great that I have like, five years of managing this horrible disease without any help from the person I manage. You know, it's like, it's not great. I mean, yes, it's good that she is so brave, and just, you know, puts her thumb out for her finger stick and just lets me put on her Dexcom. And she's, you know, she's gotten used to it. But it's, it's really hard to have a child this young and deal with it. And I can't imagine what you guys dealt with, without the technology we have today, you know, just

Scott Benner 1:27:59
ran around constantly staring at Arden wondering what was happening to her, like, constantly,

Jacqueline Stephens Breisch 1:28:04
like, okay, and within like, at least with I mean, Dexcom like, I think you guys said this, you and Jenny said this, and one of the protests and it was such a game changer to me, but it was like, You Dexcom is not there to tell you the number. It's there to tell you the arrows. Like, you know, if I give her a finger stick and she's 120 Like, okay, that means nothing to me, isn't a minute, she could be 80. And in a minute, she could be 160. So it's like, okay, great. But it's so yeah, when when we were without Dexcom, which was very short period of time. I mean, I learned quickly that I had to get that four, or when our Dexcom doesn't work, which seems to be often which is really frustrating. But we've had a good run knock on wood. So hopefully we're in a better way. But

Scott Benner 1:28:49
is it hard to keep her hydrated? I guess two little kids like, they don't drink as much water and things like that, which really impacts how well the CGM is can work.

Jacqueline Stephens Breisch 1:28:59
Yeah, I mean, I feel like I'm just like pushing water and pushing water. But I think also it's just, it's, there's so much less real estate for us to put it on. And I wonder if maybe she's mean, you know, the doctor just checked her. She didn't have like any significant tart scar tissue. But it's like, if I get it in a great spot, it works great for 10 days. And then like, we've had some really wonky ones. Just like I don't know what the hell's

Scott Benner 1:29:24
going on us and our only does her hips exclusively. And she doesn't really rotate them that much, except they go back and forth, back and forth. Perfect. Sounds work terrific. Like, okay, so

Jacqueline Stephens Breisch 1:29:35
when you say her hips, where do you mean like, like back or the front. Alright,

Scott Benner 1:29:40
so if you reach down your side and find your hip pointer, and then you roll back to where kind of the middle of the roundness of your butt cheek is. There's kind of a flat part in between those two places. And that's where Arden Where's hers? And we just go left, right, left, right back and forth. She's never orange never had a CGM on her stomach her arms.

Jacqueline Stephens Breisch 1:30:03
Oh, okay. And then where does she typically wear her pod?

Scott Benner 1:30:06
stomach, legs and arms? Okay. So, you know, it's Listen, it's all the stuff you figured out even going back to what you said about like people say this is easier, that's easier. You're always going to, you're never going to take those conversations, right? You know what you mean? Because it just they always feel like you're trying somebody's trying to say to you, Oh, you're so lucky that your daughter got diabetes, when she was to like, let them like I ended the way I usually say it is, you know, you know, they told me that it takes 30 years for diabetes complications to come. And that's what they told me when my daughter was two, which led me to add 30 plus two and think, Oh, my God, is my daughter gonna get diabetes complications when she's 32. Like, I got to live like that for a while. I got to live through a time where they told you it didn't matter how higher blood sugar was, because she's young. And it won't affect her. That was a common stance from doctors. Yeah, you know, and none of it. In the end, you need to keep blood sugar's lower and stable. That's what you're looking to do. You know, and the rest of it's up to whatever this all is, it's up to the universe. It's up to God, it's up to whatever you believe in, but low, low and stable, and hope for the best. That's what you're shooting for. Yeah, well, that's

Jacqueline Stephens Breisch 1:31:18
the thing. I mean, like, we mean, we've, we've started to just like, we took her to the movies. And I'm like, alright, what are we? What are we doing here at the movies, like, we get to the movies, and she was like, 120, and steady. And I'm like, Alright, here we go. Rollercoaster. And I'm, I'm like, You know what, we're gonna doser super aggressively. And I bought a ton of candy to just keep in my bag. And I'm like, here's something I know, she loves to eat. So if she starts to tank, we'll just, you know, pump or full of candy. Like I mean, she's again, it's just what she wants to do. And I just, I'm like, Let's experiment. And experiment. And she ended up doing great. She never was above 170, which is great for us. I mean,

Scott Benner 1:32:02
that's excellent. And you'll get better, I can tell you, you'll get better and better, actually, you should probably come back on like in a year or two. And I'll tell you why. First of all, the most fascinating thing that's happened during this hour and a half is that Jacqueline, the attorney, and Jacqueline, the mom of a kid with diabetes are almost two different people, which I really enjoyed. You've said, twice, once in response to me and once and just on your own, which was great. So and you're so new at this, you almost don't know what you're talking about yet. And I think that if you came back a year from now, and I was like, Hey, you remember the lady who gave you the talks about the legal stuff, here she is back, you're a one see for your daughter is going to be, you're not even going to be able to believe it where it is. You're going to be so good at this in a couple of years. If you have your mind and your desire, and this podcast, you're going to be fine. I really I really believe that. Yeah, I can I listen, I talked to a lot of people. And I will say this over and over and over again. Because I believe in it so much. The desire to do well, coupled with good information is pretty much most of what you need. Yeah, you know, and then after that time, is some time. Yeah,

Jacqueline Stephens Breisch 1:33:15
for sure. Yeah. Yeah, it's a it's a roller coaster. But no, we feel so much better now. I mean, I just remember feeling so defeated in the beginning. And like, it just, it was oppressive. And so we're in such a better place coming up on her one year anniversary in eight days. It's,

Scott Benner 1:33:32
I'm glad. This year, I'm glad you feel better as and as much as you think this still sucks. Like next year, we'll feel better again. And, you know, you can assign arbitrary dates to it, like every year if you want to. But the truth is, she'll grow, she'll put on body weight, that will make the whole thing easier, her eating will become more consistent, that will make it easier. You know, all that stuff just in time and your experience is really the part that that you're really waiting for, you're really waiting to, to just start making, I saw somebody leave a review for the podcast recently online. And they said something to the effect of what Scott says is right, after a while I just knew what to do. And I didn't even need to and I didn't even need to be able to like quantify the situation I could just kind of stop and look and think Oh, I know what to do here. But it does get to that at some point where you just you've done it over and over again so many times you stop doing the math and you just start going oh, you know what I see the pitch of this Dexcom line I you know just drink half a juice here or you know, we're gonna have to put in two more units here I can see where this went wrong. It just becomes kind of second nature but it takes time before it gets to that point. You know, you said earlier I don't know what you did with art and when she was so little before the technology and I tried my hardest to find this old blog post that I know I wrote wrote but I can't find it. Where I basically took a pic Sure of art and add all these different blood sugars. And I mean, it was like a match game, you had to like match the photo with the blood sugar. And that came from what one time the doctor said to me that like circles under the eyes could be like, I don't know something about higher blood sugars. I don't even know if that was true or not just people people say things. And I talked about how I stare at Arden constantly just trying to see if she looks like she's high or low, which of course is mostly ridiculous. And then I took these, like few pictures of her where you can't I couldn't even tell you Don't you mean, like I knew the answers and mixed them up. And when I covered the answers, I couldn't tell which you know, you can't tell like and that's all I did. I just stared at her. I was just like, I would just like find her look her in the face. I don't even know what I was looking for. You know what I mean? I was just trying not to have to test her over and over again. But we ended up doing that. I would say already got tested 1014 times a day when she was little.

Jacqueline Stephens Breisch 1:36:00
Oh, yeah, I can't even imagine. I mean, sometimes I test her that much. If that sounds not working, or if I think it's telling me something wrong, you know, because then so with her little like, you know, she's three. So she's like, I really, really low or low voice. And I'm like, Are you low? Like oh shit, like, I'm like, you know, I go back home. So she's perfect. And I checked her and she's fine. I'm like, Hey, honey, are you just want some candy?

Scott Benner 1:36:23
For a lollipop? Are you working me? Is that what's happening?

Jacqueline Stephens Breisch 1:36:27
Oh, God, she loves Dum Dums. You know, and they're not a good treater of lows, because they take too long to eat. Like they're just I mean, I guess maybe if you had like a kind of a stubborn low that you were just trying to slowly bring up. I don't know, maybe that would help if it was just a statement. But she always wants Dum Dums. And I'm like, there's no good way to treat for them. They're just plain straight sugar. They're just total garbage. There's nothing good about them at all. But she loves them. And I'm always like, Okay, if you're like, kinda low, but not really low, and we're about to go do something. I'll let you have one. You know, it's kind of like how I've I've managed to keep them in her diet. And difficult. I'm sorry, go ahead. Well,

Scott Benner 1:37:08
I'm sorry. You think sometimes?

Jacqueline Stephens Breisch 1:37:12
Alright, I think sometimes she just says she's low to see if she can sucker me no one.

Scott Benner 1:37:16
Sucker you and was there a pawn on there on purpose? No. I was just gonna say a little ball of sugar on the end of a stick is like always amazing. So I'm with her. I think I think she's right. Okay. Well, surprisingly, I have a long list of were the words she said today that I have to go back and edit out. I was interesting at 112 Twice. 126 126 44 130. And just now 131 When I mentioned it again, so often. You were a delight. Jacqueline, did you know that? Oh, thanks. God, thank you so much. You feel relaxed? Pleasure. You're good, right? Like you feel pretty relaxed now. Right? Yeah, you were good. Were you nervous at the beginning, by any chance?

Jacqueline Stephens Breisch 1:37:57
I will say I really wasn't. But I think it's just because I we've just jumped in. And I just was looking for your direction as to how to do that. You know, so But no, I mean, this is this is what I do. I feel very comfortable talking about it. The intersection of these two things like couldn't, couldn't be more comfortable and you couldn't have made it more easy. So thanks

Scott Benner 1:38:16
very glad. Now, it's my pleasure. Thank you very much for doing this.

I'd like to thank Omni pod for sponsoring this episode of The Juicebox Podcast and remind you to go to Omni pod.com forward slash juice box to learn more about the Omni pod five, the Omni pod dash, and everything else you need to know about my daughter's favorite insulin pump. After that, of course, you can check out dexcom.com forward slash juice box are you eligible for a free 10 day trial of the Dexcom G six, there's but one way to find out dexcom.com forward slash juicebox if you're enjoying the show, please leave a rating and review like a beautiful five star review. Wherever you listen. Don't forget to subscribe in the app that you're listening to or follow and of course tell someone else about the podcast. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry take the survey help people living with type one diabetes support the Juicebox Podcast. And last but not least, here's the link for Jacqueline's article juicebox podcast.com forward slash blog, forward slash companion 708 it's also right now on the front page of juicebox podcast.com. And by right now, I mean end of June 2022 juicebox podcast.com forward slash blog forward slash companion 708 The links also in the show notes of the podcast player you're listening in right now thank you so much for listening I'll be back very soon with another episode of The Juicebox Podcast

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#707 Printing A1cs

Howie is an adult living with type 1 diabetes and also the parent of a type 1.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends and welcome to episode 707 of the Juicebox Podcast.

On today's episode of the podcasts I'll be speaking with Howie he is a type one himself and the father of a child with type one. And I'm pretty sure that his wife made him come on the podcast. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Real quick, please remember, it would mean so much to me and to people with type one diabetes. If you took the survey AT T one D exchange.org. Forward slash juicebox. Go to the link. Join the registry take the survey takes fewer than 10 minutes can do it from your phone. You could do it on the potty. You know what I mean? Like you shouldn't sit that long. But if you're there, you could do it as what I'm saying. T one D exchange.org. Forward slash juice box. You have to be a US resident who has type one or a US resident who is the caregiver of someone with type one, take the survey support people with type one diabetes support the Juicebox Podcast.

This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox. today's podcast is also sponsored by touched by type one go to touched by type one.org To learn more about their organization, or to get tickets for the upcoming annual event, which I'll be speaking at on August 27. in Orlando, Florida, touched by type one.org. Today's show is also sponsored by in pen from Medtronic diabetes. The pen is an insulin pen that does more than you expect from an insulin pen. I'll tell you more about it during the ads. But for now, you can go to ink pen today.com.

Howie 2:20
Howard's a whoops, don't want that. Take that back. I don't want say my last name. How we

Scott Benner 2:28
just say hey, oh, my name is Howard or something like that. Alright. Hello, my name is how we go. How are you? This is the most uncomfortable start to a podcast so far. How are you a parent of a type one or you have type one yourself? Both. Wow. All right, then now we're on to something. You listen to the podcast? I do.

Howie 2:50
So I've been listening to podcasts predominantly found out my wife. I mean, my wife is the biggest embrace of the podcast. Considering I've been diabetic for 42 years, I probably was a late adopter to the podcast. Most of this in candor has been in preparation. So I've listened to the Pro Series. I've listened to a lot of the recent ones to see and have those interviews or listen to how those interviews have panned out so I can be prepared. So your wife, the listener, she's more of the active listener to be candid with you.

Scott Benner 3:19
Oh, no, no, that's perfect. That's what I wanted to know. So tell me 40 You've been? You've had type one for 42 years. How old are you?

Howie 3:27
I am 44. So I was diagnosed February 18 1979.

Scott Benner 3:32
Wow. Wow. Okay, dude, first of all, you look super young. I appreciate that. To see you right before we started. You do not look. You don't look that and not that you're old. But you look really young. I appreciate that. So you were not my daughter was diagnosed when she was two.

Howie 3:48
I did actually hear that. And I mean, I've heard your journey. And that's pretty incredible that somebody with not that experience and doesn't sound like you're in the medical profession, New Zealand have recognized the symptoms. So kudos to you.

Scott Benner 4:00
I'm definitely not in the medical profession. I was. At that point, I was in the I was in the stay at home dad profession. Prior to that I did. Gosh, I worked in this little credit union where I did their graphic design stuff. And I actually collected debts for them before that. I I was basically a debt collector. I hated it. I was so good at it. And it made me sad to be good at it, if that makes sense or not. And one day their, their graphic designer quit and it was this really small place and I like I marched into the human resources office. I was like, I can do that graphic design job. And they're like, Do you have any background in this at all? I'm like, No, but I can do it. And I and the person had left kind of abruptly. So I I said come here. I went over to their desk. I sat at their computer and I opened up the stuff and I said Tom, I'll make something tell me what it is. And I did and they were like, wow, really? I was like, Look you can pay me less because I'm not qualified. I just wanted to be out of debt collecting so badly. So I was. So they gave me the job. And I worked there, right until my son was born in 2000. And then I've been a stay at home dad since the since the beginning of 2000. Yeah, so I had no medical background.

Howie 5:17
Well, I mean, hey, then you can be a doctor. Since you had no background in graphic design. It sounds like you pretty much could be a physician. So that sounds awesome. No, Web MD.

Scott Benner 5:25
Should I just go to the hospital, walk into your courses and be like, Hey,

Howie 5:29
sit down, watch me. Yeah,

Scott Benner 5:31
you can really underpay me, you're gonna save a ton of money. I mean, it's. But anyway, that's so in 19. Dude, I was eight and 79. That's a long time ago, how was mature first recollections of like diabetes management.

Howie 5:49
So I, I probably could remember going back to 566 years old. And it was mainly from just, I had very supportive parents. They managed it but didn't micromanage. I was never stopped from doing sports, I've never stopped from staying over people's houses. And diabetes in 1979 was much different than it is today. But my first recollection, Verlet recollections were probably lows at the time, because most of them happen at night. So I just remember, probably just low pass out events. And in the middle of the night, my parents supporting that, and sometimes even, you know, police in emergency would have to show up at the house, because like I mentioned, diabetes back then was quite different.

Unknown Speaker 6:33
Regular and mph, or lenti, how far back is 79.

Howie 6:38
So I did have both of those. I actually started on animal insulin when it was made with you know, pig fat. So I had that first, I was on NPH, I was on regular, I was on lenti. And I was on regular insulin for a long time. I mean, one shot a day and pH at night, six hour peak time, I might be wrong on that. Maybe it was 12 hour peak time. And then regular insulin would peak. And that's the thing. It was just you know, spray and pray basically,

Scott Benner 7:03
man, you are you're one of the youngest people has told me they've used animal insulin, I think.

Howie 7:08
Yeah, I mean, it's what's interesting is I actually was an avid injector in my stomach. So I really came, I actually had, you know, about swelling and hypertrophy from that, which actually to give listeners confidence has gone away. So part of my agenda that I actually wanted to at least discuss was my story and evolution of what diabetes is look like, how we found out when my daughter was diagnosed with diabetes, and what that what that has looked like, and then also just, you know, reinforce perspective, what it's like when being a patient of diabetes, you know, because what the parent probably goes through is very, very difficult. I always think that being the diabetic parent is much more challenging than being the diabetic patient. Because you can never opt out. There's not there's no off time. So if you're the patient, it just is what it is. So the parents seem that is much more difficult. So I would probably talk about the perspective since I've had both. So that's really the thoughts that I had, but yeah, you definitely

Scott Benner 8:09
you tried to evolve a lot. You tried to produce the podcast, I relaxed. I've been doing this a long time. I'm pretty good at this. Answer right through all those ideas. Can you let me be the funny one? I don't know. You're gonna you can try. I appreciate it. Okay, so, geez, two years old. 79. Your parents were so so you did get low. But it was mostly Yeah. Ever sleeping? What? How did they know? Would you cease? Or would you like was it sweating? How did how did you know you were low back then. If you were asleep, I mean,

Howie 8:50
so I didn't what's my mom, I don't think my mom has ever had a restless restful night ever. So I grew up on the East Coast. And I just had with Howard. So most of the time, a little bit of a helicopter mom would recognize lows during the day, I and then I was also trained to feel some of those lows. So there was no insulin sensors, the blood machines would take 120 seconds in order to record a blood test, big giant door that would flip closed, they weren't that accurate. So as a matter of fact, we used to actually test blood sugar just on urine strips at the time before we got the glucometers. And I wouldn't I wouldn't know at night. But some of that by the time my mom would come in, I mean, I would I'd be twitching I'd be shaking and then unable to swallow chocolate or juice. So they would have to put cake frosting actually in the side of my mouth. But because most of the time during the day my parents would able to we're able to observe and I was you know, more and more in tune with the feeling so I would manage it at the time.

Scott Benner 9:53
Wow. That's fascinating. You also made me think that I have an episode that's recorded with a tie Your mom and her her younger 20 ish college aged son. And they're from Long Island. And they were together on the episode and it was just, it was fantastic. Because she was just, she was as East Coast and and Long Island as you could. And she's lovely. And the kids like mom, you know, like it was just it was great. I can't wait for that one to come out. It really just like wonderful people. It's a great story too. But nevertheless I can I can really like imagine your poor mother like there's no, I mean, you think about all the information that's available now. And it just was really nothing right? Like you said it earlier, you said would you say spray and pray just put it in and hope nothing bad happens. Right and and try to live?

Howie 10:46
Yeah, I mean, there was no card county there was none of that so and that you take the same dose every day. And regardless of what you eat, or what your activity level was.

Scott Benner 10:56
And that's just the best they could do. And so your mom, your mom basically just hoped until it went, it got upside down. And then she she put it back again. Basically, yeah, but she probably tired. Do you think she still thinks about you?

Howie 11:10
Yes, I mean, both my parents are very involved. I mean, great parents, they supportive of all of their kids. So they are obviously involved in my daughter's situation. So my parents are worried about me nonstop. And what's funny is, you know, when you're on a plane and the oxygen mask drops down, it's always obviously put the mask on first before you assist the little one. So that's what my parents always have to remind me because my default instinct is if my daughter and I are both low is to treat the daughter before I treat myself. But my parents perspective is, hey, you need to take care of yourself. So yeah, they nonstop it's it's a perpetual worry when you're a parent of a diabetic

Scott Benner 11:50
were they like knocked over by new technology.

Howie 11:55
It's incredible. So it's a blessing, I think it might it's also a little bit of a curse. And I'll explain that. So yeah, they think Information is power. So my daughter has a plan that she can obviously have a phone and, and watch at school. So I can see in real time what my daughter's blood sugar is text, the school nurse, the school nurse makes notification that sent my daughter down. So that's incredible. What I think the curse part is, though is people are so reliant on technology that they don't recognize the symptoms. So as someone who like my daughter is getting lower and lower, and she's a new diabetic. So that will come with time. It's she's overly relying on the technology as opposed to recognizing the symptom. And sometimes I think that could be dangerous in the short term. So I think that's a little bit of a minute, a minor curse. But overall, the technology has been incredible. It's what they can do now has been really amazing. And hopefully there's some bright stuff on the horizon.

Scott Benner 12:52
Let me get your perspective, a little deeper on that. Is that a problem that you've actually witnessed? Or a concern?

Howie 13:00
fair question. I think it's, it's probably a concern. I haven't No, I haven't witnessed it enough. Because I do see actually my daughter saying I feel low. And I'm reminding her Hey, what does that look like? What does it see? What do you feel like? Hey, what can you see? What can you read? Because my symptoms I have, they've evolved over the years. And I've been able to recognize things later that I couldn't recognize when I was younger. So I'm programming at least asking, hopefully, asking questions, and my wife is doing the same she's very involved in, in my daughter's care, to be to help encourage her to recognize the signs. So it's more of a concern than then, then something I've

Scott Benner 13:40
seen. The reason I asked is because I remember when my son was younger, I would sit him down and tell him about glorious football games where the Eagles scored 10 points and the giant scored three and they beat the crap out of each other for four hours. And no one ever threw a ball over 20 yards and my kids like I would like to see a 40 to 35 game kind of situation I want to see you know, at points, the ball fly over the place. He doesn't think of football the way I think of it. And when I watched football now I think, Ah, just a catch with a bunch of rich guys are having a catch, like, like, when are they going to try to kill each other. And he doesn't care about that. And I just wonder if it's just sometimes you just get steeped in what you think is the way and then you see a new thing and you judge it as not as good as the thing you grew up with, I guess or something like that. Because I hear people say what you say but I never see it. Like, like I do you know what I mean? Like if we can do a time machine went back to 1979 and gave your mom like I'm like, you know, Hey, lady. I'm here from the future. This is a Dexcom and no way would I

Howie 14:49
ever go back to those days. Yeah, of course not. I mean, this it's way way better. This but let me give you an example. Two days ago, my pump dad had an issue and I couldn't and change the cartridge and basically the pump broke down. And ironically, I have another pump. So I'm able to reset and get that done. So then I sat there and thought about my kit, what would she do? What would I do if she was in Coachella in her pump row? What would I do if she is on a vacation? Is this kid going to know how to then go get to Ceiba mathematically figure or a sorry, whatever insulin law to mathematically figure out how much to prescribe, and then say, hmm, I haven't given a shot and 15 years or whatever the timeframe is, let me go get needles, and now how much so I just don't know. I think that's what I mean. So, but that said, I would never go back. That's a stone age as a diabetes compared to what we have today. So if

Scott Benner 15:44
it makes you feel better, my daughter couldn't give herself a shot. And so my daughter's had diabetes, since she was two years old. She's 17. And she's never given herself an injection. But and if she had, she was five when she did it, just tried it, or not even five, three, and was like, I'll give this a whirl. If I handed my daughter a needle right now. And I was like, hey, guess what, we're going back to needles. She'd be like, whoa, whoa, wait, hold on, slow down. Everybody just like, can't they FedEx a pump? You know, like, what's going on? But, but then she do it? The issue Wouldn't she wouldn't just lay down and die. Like she would do it. But so I think that's the answer. I think that, yeah, your daughter wouldn't know how to do that, you know, 15 years from now, if she's never used it before, but she'd figure it out, or you'd help her or someone would you know what I mean? I mean, 100%? Yeah, I get your point. I just don't think it's worth worrying about, I guess.

Howie 16:39
No, I hear you. But that's back to my theme that a kid can never opt out, of course, a guy but of course, they'd figure it out, because you have no other choice. So that's what I mean. It's like, Hey, you got COVID in your line. And it's like, you still gotta take insulin. But so there's not, there's not there's not an off day. So yeah, of course, they're gonna figure it out. Because the other option is not an option.

Scott Benner 16:56
Well, I want to dig into that because I have a feeling like I know where your will go deeper on that idea. But when you say you can't opt out, when you're the parent of a kid who has type one, versus when you're an adult, do you mean that you can just as a person living with diabetes, make a decision, like, I'm not really gonna pay attention to this today? And my blood sugar is gonna get high or whatever I'm just doing? Is that what you're saying?

Howie 17:18
No, no, not at all. No, I'm saying the kid always. They're a person with diabetes always has to be cognizant of that. That's what I mean. So whether you're sick, whether you're traveling, whether so my preparation for a trip is different than my wife's preparation for a trip, I gotta bring a, you know, a vat of stuff. So that's what I mean is there's never an off day for the diabetic I took whether you want it to pay pay attention or not. Okay.

Scott Benner 17:42
Yeah, I'm sorry. I was I was hearing you backwards. Okay. No, no worries. Yeah. So. But as a parent, you feel like, well, there's another person who could just take over for me for a couple of hours, like a spouse or a loved one, or somebody could step in and maybe give you a hand for a minute. And, like, spell you a little bit let you sit on the

Howie 18:00
bench? Oh, for sure. Yeah, yeah. And don't get me wrong. I mean, my, our journey is relatively good compared to probably other folks that I hear about. And we have a lot of support from family and a lot of support from friends. So there's a lot of people that are vested in my daughter's care. You mean, the school has been fantastic. So yeah, I'm not managing this nearly as much as actually my wife is she my wife is on the follow up, like 29 hours a day. So I'm like, I'm not even gonna have her Hi, alerts on leaving care. Let you worry about those. So no, my wife way manages it more than I do.

Scott Benner 18:34
So that's interesting, then. Do you have trouble? Well, let me see how to answer this question. You've diabetes a long time. How long ago was your daughter diagnosed?

Howie 18:45
August of 2020. So just over a year ago,

Scott Benner 18:49
how old was she then? She was eight. Okay. First question, did you have you been worried about her since she was two getting diabetes or?

Howie 18:58
No, ironically, what's the craziest not only have I not been worried? What's also interesting is I didn't even recognize the symptoms when she was when when she was diagnosed. And that's what's crazy.

Scott Benner 19:16
What were the symptoms?

Howie 19:19
So we want a trip to San Diego and typical vacation. I mean, beach vacation. Kid was not perpetually thirsty. She was not constantly going to the bathroom minimum, not at no weight loss. So the traditional sign that lethargic, I mean, we had a beach vacation, we're up late. Kids are jumping on the bed. She did wet the bed in San Diego. I mean, she's an eight year old. It wasn't obvious, but it's like, hey, maybe there's that would have been the first indication but still not enough that I'd be concerned based on all the other externalities. We drove back from San Diego. I live in Arizona, which is a six ish hour drive. And she only had two bathroom breaks despite what we've done. The volume of you know what, we weren't even drinking that much. So you got to think you have water to on the trip back from San Diego, not going to the bathroom a ton. The next morning, a couple more bathroom trips were like maybe she has a urinary tract infection. We took her to the doctor. And the doctor, were actually fortunate because you hear of a lot of pediatricians that are not that in tune with the symptoms. So she tested negative for the urinary tract infection. They drew her blood or they gave her finger prick, and she was 519. And then when my wife told me that her blood sugar was 590, and obviously we knew that instantly, and they've sent us over to the hospital out here.

Scott Benner 20:39
Wow. Okay, so do you have any other kids?

Howie 20:43
I do have a six year old.

Scott Benner 20:45
Okay. Have you done trial on that?

Howie 20:48
No, we did I know that. I've I have heard that you're a big fan of the sponsor.

Scott Benner 20:54
You well, in fairness to me, I've had them on a number of times over the years and just thought they were great to support and then very recently they asked if they could buy ads, but I would have said trial net whether they were paying all right, also they only bought a short run so it's over all right. So this part is getting cut out right? No, I'll leave it in. I've already spent money. I sent it to my kids college or whatever. So but no, I just think it's not that I think you should or you shouldn't I'm just interested in how people think about it. Like would you want to know if your other child had auto antibody markers

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Howie 25:39
So let me emphasize again, this is just my approach and my perspective and understand both sides of it. I personally don't. And because, and I've heard a lot of different debates. Why? I mean, what is it going to do? What is it going to give me what is it information? There's nothing that I can change. So why sit there in the back of my mind? Is it August 11? Is it a couple kids have been sick and hospital runs are highs? And now? So I don't know if I want to add? Because I don't know if there's behavior yet that has shown enough data that it's that I could course correct. So it's information. I don't want to Yeah, no,

Scott Benner 26:15
I completely. I don't judge people on that thought. I think it's people fall into two camps. And I understand them, I would tell you that trial net would tell you that your child's possibility of going to decay, if they were diagnosed goes down significantly if they're in the trial, and they have a prevention study going on that could hold off the onset of diabetes by a number of years. And I think and, you know, plus data for, you know, Tomislav, which is a drug they're working on. And I don't know if you've ever heard that the gentleman who runs that, that company who's making that drug, but it's a really fascinating interview about how he hopes to change diabetes in the world. It's just I can't go into it right now. But I'm not saying you should. I was just interested in your thoughts. So thank you. I appreciate it.

Howie 27:04
You guys didn't use that for your daughter. Right?

Scott Benner 27:07
My son went to trial that Okay, okay. Your son was second. He did not have. He didn't have the antibodies at that time. And they don't retest if you don't have any. So if he's developed them since then, we don't know. But God, you're gonna bummed me out. Make me wonder if my kid's gonna get my other kids. She's our way to move me. No, I'm just teasing. You were the catalyst. You brought it up. I really did. I apologize. I'm trying to push this trial not on me. No, I'm kidding. I'm trying to make it your your problem that I got sad first. Okay, so when you're when your daughter's diagnosed, you look at the world now. But what is the world now to you? So you're using a pump? Were you using a CGM before she was diagnosed? I was okay. All right. So you've got CGM, you got a pump. You you you know the world now around diabetes. If you're not comfortable with the numbers, you don't have to give them to me. But are you happy with your care prior to her being diagnosed?

Howie 28:12
Yes, so my my I was a three, every three months, endocrinology appointments, written to doctors once a year when, you know, I was had enough diabetes. I probably wasn't the best kid diabetic. What I mean by that is, oh, shoot, I gotten to see the doctor. Let me go write a bunch of blood sugar's down in my logs. So I'm not yelled at my agencies when I was a kid were not amazing. I mean, I was probably printed nines, I probably printed 10s. And I shouldn't say that's not amazing. It's just a data point. So I printed scores that were probably most parents would not be that excited about. Since I've been on a pump in 2005. I've never printed above a seven, my agencies are six to six, five or so. I'm probably stricter, I probably micromanage my diabetes to the point where I'm lowish higher percentage of times on my pump, and most people are, which causes me to snap back on the high side, which impacts my agency.

Scott Benner 29:10
Tell me it's my last. I'm sorry, before you go on. Tell me what low means to you.

Howie 29:16
Usually below 70

Scott Benner 29:18
Okay, all right. So you go below 70. And then you correct are you using an algorithm?

Howie 29:24
I correct with with 15 grams of carbs generally. Okay. And a little bit more potentially on how low I am. Okay.

Scott Benner 29:32
And then you bounce later that does that never make you think I'll try eight grams of carbs.

Howie 29:38
Great question. I've never really thought in him back to my point where I could do better if I made even overcorrect. Because when you're the diabetic kid, you were like, you can't get high enough quick enough. When you're the diabetic parent. You set you set a timer and wait 15 minutes. So it's always a do as I say versus do as I do because I'm 40 There's no way to explain what that feels like to somebody. And I thought about it this whole car right over this conversation in case that came up. But so I overcorrect. But I have I thought about the eight grams of carbs to answer. The question is no, it's a great, great idea that I wouldn't be opposed to trying at all.

Scott Benner 30:16
I want to ask you a question, the feeling that you're trying to get rid of, is it visceral, and it needs to go away? So you just like, do you think the more I eat, the faster this will go away? Because does that really correlate like would aid not work as well as 15? Or

Howie 30:30
100%? It makes no sense. You're absolutely right. I mean, and you're not going to go up right away. I mean, we overtreated my daughter yesterday. So it's, there's no logic behind it. Okay. But the feeling is not it's uncomfortable. I don't think it's like I need this to go away. So I've actually almost trying to come to the point where I can trick myself into appreciating it maybe like, huh, so there's people that drink a lot of beer to get tuned up, maybe I can almost trick myself into thinking I had a couple of drinks, which is not really the right way to approach it. But it's uncomfortable, you're feeling you're coming out of your skin. Like if you ran a turkey trot on the east coast, where it's freezing, and your body's warm after the turn, but then you instantly stop and you get hit by that cold air. Right? That's the way it feels. It's like, wow, I'm really uncomfortable right now. And that's the best way I can

Scott Benner 31:21
describe it. It's just a complete quick change to how your entire system feels and direct you just want it to go away. Correct. Okay, do you think being low stops you from thinking straight about it?

Howie 31:35
I have 42 years of experience. So probably not as much as somebody that's new around and back to a do as I say not as I do. Like, I've probably driven a lower blood sugar than I should and I would never want my daughter or anybody that's listening to do something like that. So I I'm uh, I'm of the camp of I'm so which is actually hypoglycemic unawareness is a real thing. But I still feel low in the ad. So hopefully I can manage it quicker than, than some others. But the initial question that started us down this road is I do I am a very diligent care of my, my care. I mean, I I print low sixes which could be better, of course, I go to see a retina doctor on his scale of zero to 10. They raised me a one for zero being the best, in terms of my mind just went blank. What are those called? A Blasian? are what are they called? The shadows of the eye. So I'm ready to really well, no neuropathy on toes or anything like that. So cool. For somebody that was casual in the beginning, became much more diligent later in life. Had a had a lot of had a good college experience had a great adult experience. It hasn't impacted me to the point where I've seen some of the long term effects that have impacted others.

Scott Benner 32:49
Yeah, I said earlier, you're interesting because you're a dinosaur, but you're young.

Howie 32:53
Yeah, I appreciate that.

Scott Benner 32:54
You usually when I hear people's stories like this, they're usually a little older than you. Just because you were diagnosed so young at the right time to hit all these different changes in insulins and technology. You've kind of lived through a lot of the of the lifetimes that diabetes actually, yeah, when I

Howie 33:12
heard that Johnson only gave out like 50 or metals, and there wasn't a lot of it was like, oh, shoot, send them far away.

Scott Benner 33:19
You might be maybe getting an ad or metal and let's hope so. Yeah, no kidding. Okay, so initial thoughts when your daughter is diagnosed? Shocking. Scary.

Howie 33:33
Oh, I was happy. We lit fireworks was awesome. We had a party you should have seen it was great.

Scott Benner 33:38
Yeah, absolutely. What took so long ganging up on her mom. Now,

Howie 33:42
that might have that might that might have been your best question so far. So I will say that's a good question. Except for that one. No, we were. We were dejected, obviously, but we we were way forward to that loser. Are you still on? Did

Scott Benner 33:55
you hang up on me? No, I'm trying to figure out if your response is the same as people who don't have diabetes, just kids are diagnosed.

Howie 34:02
So I didn't go. I don't think so actually, where the anger didn't get the why maybe we didn't have as much of a range of emotions because you have to spring into action. What I think I could have done better is opening up myself to be educated as well, because there's so many things that you take for granted, having that experience that you could benefit from like I didn't really even know what a honeymoon effect was. I didn't know certain things that were important that I didn't I usually undercut the education that the hospital provides, right. My wife had to go through basic card counting when I just want to get out of the hospital and get her home when that type of stuff is very important. So you had to step back a little bit and appreciate the education and pause to understand that not everyone is up to speed of where I was. So I didn't go through probably the ranges of anger and frustration. Really, I mean, sad. But also, I did feel empowered that that I had the tools to help her

Unknown Speaker 35:08
that in that initial

Scott Benner 35:11
education in the hospitals, Were you hearing things where you're like, I didn't know that, or are you just like, wow, this is I know all this. But it's, it's cool that they're saying it, which I haven't feel Yeah.

Howie 35:22
In the beginning, I normally it's like two or three days stay depending on circumstances. And I wanted to test out my Let me test out of this. I know this stuff, I know this stuff. Before I got, I saw what they were going through in the program and all that stuff, I probably had ego and type a went in. Once I sat down and saw what they were presenting, and the food choices and the food charts. The biggest, the biggest awareness to me was that the honeymoon phenomenon and how little insulin, I couldn't believe what a half unit was, and you mentioned that on one of your podcasts on your daughter, that you can't understand what that is. So I was initially in a rush to get out of there and just get this kid Hall. But I, it was invaluable what we got from just the details. And then what's interesting is she was diagnosed during COVID. And I was the one that spent the night just to watch over and make sure and babysit this thing as it goes on and work with the nurses in the hospital. Not that I was adding any value, but you know what I mean? I sat. So then when my wife had to come in, it's like you have to change places in the hospital and do all those things. So they spent a lot of time with her, which I which I also thought was pretty great.

Scott Benner 36:35
Okay, so now your wife reaches out into the world to find information. She's the one that found the podcast, right? Correct. So what would lead her to do that if you've got type one?

Howie 36:49
Issue, huge fan of different perspectives. And so she I mean, there's so and I also same thing is, I'm not that I don't think there's so much I need to know, and there's so much I still can know. And I think that the hospital education made us aware about fundamental diabetes that I was taken for granted. I mean, I was, you know, 43, or 42. And my, my daughter got it. And I took a lot of that stuff for granted. So I am a big from, whether it's JDRF, or whether it's other diabetic parents in the area, or whether it's, you know, information through podcasts, there was nothing like that back before. So I've always encouraged and she's even, you know, self motivated to find that out and learn as much as she would candidly tell you, and I don't like to paint somebody else's perspective. But she would candidly tell you that I because how he made diabetes look kind of easy, I didn't really have to worry about it. And this was like, Oh, my gosh, I can't believe the depth of what this involves. And all the other impacts. It's not just like, hey, don't eat sugar, or, you know, take a shot. There's so many varying circumstances that has opened her eyes. And because of that she's sought information proactively on her own. That's

Scott Benner 38:05
kind of what I wanted to get to. So are you if she's not involved in your care prior to your daughter

Howie 38:13
involved? I mean, you're you can't be uninvolved, but hey, my bloods logo, can you help me with orange juice? Or there's times that or she's recognized, hey, you're low. Do you need something? Do you need something? But it was definitely, much, much, much more casual. Yeah, but no, she was never involved in my palm, never, you know, none of that type of stuff. And we're just observation. Are you okay?

Scott Benner 38:38
Right. And because that's that part is always like, super fascinating to me, because of my perspective, like, the idea that you could live with somebody that has type one and only have like, a loose understanding of it is, it's just, it's so unlike my experience, that it's why I asked the question, usually, I'm just always looking for answers that, that makes sense to me. But I mean, I get it. I don't see why she would be. I just wanted to know if she was like, I'm wondering like, in my mind, like your daughter's diagnose, like, Does your wife step back and go, Oh, God, like, how are we so bad at this? I can't let this happen to my daughter, or were she like, I don't know anything about this? Like, was it a moment of realization for her where she's like, I really don't know as much about this as I even thought I did. The latter for sure. Okay. Yeah. Is has your health benefited from your daughter's diagnosis?

Howie 39:32
I don't know if I have data or stats to measure that. But I, so, um, I don't think I have enough information as to save so so my agencies haven't changed my, my tanam percentages and lines haven't changed. So I can't say it's gotten better or worse than said no. I because one author thing I want to emphasize is we really really, really like my parents in the old days would say hey, like a normal kid like a normal Kids, and they've really stepped back because they don't want to perpetuate that. So it's the same thing as we want to think of my daughter as a kid first, and you're a kid number. So the diabetes is almost like, Hey, you can eat what you want, as long as we track and measure. And she's never hiding food because of how we let her live. Like my other daughter. And so because of that, nothing's really changed. We don't cut our food, we don't do anything differently. We kind of still eat what we we eat when I've always managed that anyway. So I my care hasn't changed that much. Would

Scott Benner 40:32
if I don't know, um, again, the numbers are you can share them if you want, but I don't care. But your variability, your your agency, your outcomes, would you be comfortable? If your outcomes were your daughter's outcomes?

Howie 40:46
What do you want? Yes,

Scott Benner 40:48
you are. Okay, that's 100%. Okay. And so is it fair to say that she's close to you? Are you having luck managing her that way? Or is it harder with her?

Howie 40:59
Yes, I'll give you a couple of things. And also perspective is the physicians that I see are also celebrating my care for my, my timeframe and my lack of complications. So this isn't just that I've been, I've been really paying, spending a lot of time and managing it. And it takes work, but it's definitely you get a good return. So the physicians have supported that. And I would definitely be happy where my daughter is at. And one other thing to think about is the margin of improvement between a six and a seven. Supposedly, an agency comes with such significant risk of lows, I personally still would rather be a six. So I do try to I tend to try to run low. My daughter hasn't printed above a seven since she's been on the pump. So she still has, you know, obviously, there could be some, some measures of improvement. But she's been seven, since she's been on the pump. And she's only been on a pump for eight months. So I think she went on fully in March of this year, because and which is accelerated, by the way, they let us on a Dexcom quicker. And they let us on a pump quicker. Probably because of my experience. Yeah,

Unknown Speaker 42:06
I would imagine. Do you guys Pre-Bolus meals consistently.

Howie 42:09
So back to the ability to always learn something? I do. Yes. We do her as well. It's actually come back to bite us because she's not eating as much as we put in sometimes. Yeah. So then I have to over treat and say, Hey, you're not eating lunch? But hey, enjoy the Skittles. But I do Pre-Bolus Yes. Okay, and that I've seen an improvement there. Because just like that modest improvement of it tends to tick up. So I do take about a Bolus 15 minutes early.

Unknown Speaker 42:40
Cool. That's excellent.

Scott Benner 42:42
So I have other questions. So the first thing I was gonna say just just to kind of lean into what you just said a second ago, if she's not eating well, you could do an extended Bolus, and then bail on it. If she doesn't eat that interest. That's one way to do it. Like so brilliant. So you could do an extended Bolus, but over only over 30 minutes. So you still Pre-Bolus say her meals, five units, which is probably heavy for her, but I don't know. Say it's five units, you do five units put in, I don't know 50% Now and the other 50% over 30 minutes. So by the time your Pre-Bolus is over, she's got some of it. You know, I mean, you could work with the numbers and the time and stuff like that. But you could get it to a point where she's got some of it enough that the Pre-Bolus is going to work and she won't spike, but that you could bail on the Bolus if she doesn't finish the food. Oh, that's brilliant. That's one way to do it. You could also I mean, you could Bolus some and double her basil and attempt basil to kind of make up the rest and then bail on that if you wanted to. Like there's all kinds of ways to like kind of futz with the the insulin to try to make it to put it where you want it without it making her low later. But what I'm what I'm super interested in is that if your wife's so your wife listens to the podcast, you just listen to some to prep yourself for coming on the show. So it was your wife's idea for you to come on the podcast.

Howie 44:07
Do you want to keep shining a light on that? Yeah, yes. Yeah. No, it's fine. I actually wanted to Yeah, so my I thought of the patient did parent I was like, it's a pretty good story. She motivated, she's like, Look, you

Scott Benner 44:20
got to listen to this. You got to talk to this. There's a great story. So my wife is the motivator to come on here. Yes. And so she wants the story. But do you think there's any part of her that wants you to hear what I think about management? Of course, okay. All right. Okay, because if she's listening to the podcast, and you're saying six, almost seven is fine. I'm going to tell you like my daughter is 17 her a onesies been between five two and six two for eight years. She eats whatever she wants, just like you we don't mess with food. Except I probably just have a different idea of of where her blood sugar should sit stable than you Do that's pretty much it. But I'm guessing as far as the number goes not to say one's right or one's wrong, so when you listened to get ready, you kind of listen to protests and stuff like that. Like, what did you think when you were listening? Do you think you think I was an idiot? Or did you like, like what you heard somewhere in between?

Howie 45:19
I definitely didn't think you're an idiot. I was I was very appreciative of, of the variability of what your topics are. So there's no way that a non diabetic versus diabetic wouldn't find value or information based on the variety of topics. I also thought the information that you're giving is usable. So even if you get if you think in one hour, if I got three pieces of information that's invaluable. And the return on that is great, just what you gave me right now about bolusing and the extended Bolus. So I'm a huge fan of learning and trying to understand information. So I liked one the variability to some of the specific tips with I thought the the fat that with it was bolusing. For it was the pro tip number 430.

Scott Benner 46:07
Yeah, Bolus for fat and protein.

Howie 46:09
Right. So I think that's huge too, which is an extended Bolus feature. Some pumps have more variability or flexibility in that, but the ones that are going to resonate with me are the specific specificity on how can I get better from a six five to a six? Oh, I think that would be that's valuable.

Scott Benner 46:25
Yeah, I'll tell you, there's another fat episode that if you enjoyed that, you'll like I'm looking at the number for you right now. On my, it's weird to do some, it's the 471. It's called bolusing. Insulin for fat. Okay, if you like that pro tip, you should listen to that. Because that'll give

Howie 46:45
it's with you. It's with you and your educator on that one, right? Oh, no, on

Scott Benner 46:49
this one, it's going to be me and a mom from Canada. Okay, writes a blog called waltzing the dragon. And she's, she'll go through exactly how you can count the fat grams and make a Bolus to counteract the fat rise. It's fascinating. And it works really well for most people.

Howie 47:09
Yeah, that's the stuff that I have a hard time with. Certain, you know, Asian foods, that with the sauces, I usually kick up in those chicken. I always miss counts, things like that. So anything that's gonna give me tips and improvement on mitigating highs from foods that I tend to eat all the time? Yeah, would be very helpful. I'm

Scott Benner 47:27
gonna guess. And if I'm wrong, you'll stop me. But I'm putting myself out on the branch here. Your high alarm on your Dexcom set at like 200.

Howie 47:37
Let me even look, I think it's 181 80 was

Scott Benner 47:41
my first guess I should have went with my gut dammit.

Howie 47:46
Yeah, it's 180. Okay,

Scott Benner 47:47
if you set that at 150, you're able and SEO go down.

Howie 47:54
But here's the thing. Am I supposed to then jump in? I don't know what which pump your daughter's on? assuming she's on a pump. Right? I hear mixed reviews? Where? If I'm going to keep jumping in to overcome the control IQ? Will that will that change me to the low? That might you're saying that control IQ will kick in earlier?

Scott Benner 48:12
No, I'm saying you're You paying attention is a big deal. So I know you're using control IQ, and it's what is its target, like 112 and a half or something like that. But if so, if you're setting Well, listen, we'll talk through it for a second. So when you are completely away from food or meal insulin, like overnight, where does your blood sugar sit stable?

Howie 48:39
So this is my daughter, my son, my wife brought this one up to me. It's like, it's perfect. It's like incredible. My wife said that you were talking about this not too long ago. It's at 100 ish. I mean, it's hard to see right now because I'm looking at the pump instead of the app, right? Because I'm on my phone, but it's close to 100 or low 100.

Scott Benner 48:55
Okay, are you in sleep mode? When you're doing that?

Howie 49:00
I don't change anything. My Bolus, my program is changes in the middle of the night. But I don't actually go on to sleep mode automatically now.

Scott Benner 49:07
Okay, so I hear from people that sleep mode can be a little more aggressive. And so if overnight, just think about this for a second, if overnight, your blood sugar sat at 85 or 90, instead of 100, your agency would probably drop like point seven.

Howie 49:24
Like just All right, that's easy. So that's interesting. So you're starting sleep mode or your suggestion is to start sleep mode potentially right before obviously you go to sleep and mine is going to be tighter in the middle of night. Yeah,

Scott Benner 49:33
so my daughter loops, so she has the do it yourself algorithm right now. But we're going to try on the pod five when it comes out too. But the but the control like cue from what I understand from people, so I don't have it. But from what I understand for people sleep mode can be a little more aggressive. And so there's a way that people use it. Some people stay in it 24 hours a day to kind of Like, keep the algorithm, I don't know, tight again, I've never again, I've never done it. But, but so like, overnight last night while you were sleeping at 100, which by the way is magical like, and especially to somebody I should say who's had diabetes for as long as you have who's lived through so many different iterations of diabetes, it must just be amazing to you that there's an algorithm like cutting your basil back and keeping you from getting low, like it must be magical and but the one my daughter's using right now was a little more user defined. So last night while you were sitting super stable 100. Overnight, Arden was sitting super stable at five overnight. And then the next thing I do that you probably don't do is I have tighter tolerances on her CGM, so that I'm so that we're aware of her blood sugar. So the way I think about her blood sugar is, I think, my lowest set at 65. I'd prefer for her not to get under 70. But she doesn't really, honestly, that doesn't happen more than a couple of times a month. And so, but her high alarm on my phone is set at 120. And on her phone, it's set at 130. And my theory behind that is, the sooner you know that you're going up, the sooner you can make a correction. And when you make that correction at a lower number, you use less insulin, when you use less insulin, you have a lower chance of having a low blood sugar later. So instead of waiting till you're 180, and going, Ah what happened here and having to put on a bunch of insulin, which might cause a low later, which might cause you to eat 15 carbs that might cause you to go back up high. Again, why not find out at 120 that things are a little askew, and just nudge it back again. And then it's this one little thing you do? It's over. And then you skip the hour and a half where your blood sugar is going to 180 that you don't know it because you're not getting an alarm, and then all the rigmarole that comes afterwards. So that's how I think of it.

Howie 51:59
You're under reset, right? The issue is, is what's funny, is I actually, when we started I talked about micromanaging diabetes, is because I tend to try to run them before they hit up that high when I was always like, but then I was educated that you should try to let control IQ run its course. But I would rather try to tighten it up myself and front run it, which is exactly what you're saying. Yeah,

Scott Benner 52:22
screw that noise. I mean, I love algorithms. I think they're all terrific. But they need help. Yeah, like it's you know, you take control like you as an example. You go out right now find a feral type one walking around, who's you know, a one sees nine and a half. And you know, they don't know about pumping and CGM. You slap a CGM on them put a control IQ on them turn that thing on, their life gets immeasurably better. And if their blood sugar has to go up to 180, so that the algorithm can work and bring it back down. It's still it's such a an amazing improvement for their life. But if you're a person who's talking about like, I want my a one C to be in the fives, well, then you got to figure out how to work with that algorithm. Like your daughter is going to want to have a baby one day maybe, and her OB is going to tell her that hurry. One scene needs to be five to do that. And yeah, that makes sense. Yeah. And I guess my point is, is that if my 17 year old daughter can have a five, five, I think that was our last one. And I can tell you that in the last four days that she's had a ammos bowl for lunch, if which in your local so you probably know what that is. It's basically Mexican fast food, you know, with a ton of like, rice and sour cream and all these things that are a problem. Last night, she had a salad for dinner, but I think it's because she exercised. So she was like, I'm gonna have a salad. But you know, she's also had pizza gone out for burgers with her friends, like she eats as, as you know, quote unquote, normal as you can possibly imagine. And the only thing that I do differently than other people is we react sooner. And we take advantage of overnight hours. And that's your five a one say like you listen to those protests again. And just adjust your thinking a little bit like I know you think like, it'll there'll be more lows, but I see fewer lows than when my daughter was bouncing around before because the bouncing around to me is where the problem really happened. So sometimes people don't Pre-Bolus Or they don't understand the impact of the food they're eating. So they use too little insulin. They end up spiking up. Eventually they get tired of it. They correct that spike in the middle of the spike working their food digests out of their system. There's nothing left to hold up the blood sugar, they come plummeting down, they panic, they overtrain they go back up again. And then they know some people chase forever. Like no kidding. Like you can see I've had people send me graphs that just go on for days where they just go up and down and up. They just they're out of sync with what's happening. They don't recognize that insulin Use now isn't for now it's for later that kind of an idea. And, and they just chase forever. But once you find stability, and you can dial in your Basal, and that insulin sensitivity and create that stability to lower and lower number it you don't have once your settings are right, how you don't have any more of a chance of being low if you're 85 All the time than you do if you're 120 all the time. But I do think you'll be low more frequently if your blood sugar's frequently go over 160 at a meal.

Howie 55:32
So I'm just going to change my high settings on the on the control IQ to 150. That's what you're saying, That's it, you're out now at least see what that looks like for the next month or two.

Scott Benner 55:41
There's just yeah, there's a really interesting study, there's someone from decks, there's a scientist from Dexcom, somewhere in these 600 episodes, that the tighter your tolerances are on your Dexcom, just meaning that the more you pay attention to your blood sugar, the lower your a one C code drops, and the better your variability gets. And it's just because acting sooner creates a an environment, like I said earlier, where you use less insulin. And when you're, you know, if you don't get high, you know, you won't get high, and then you don't get low, and then you don't chase. And it's just a really simple idea. Really, it's for sure, yeah, the way I think of it, and it's in one of those episodes, somewheres. You know, when you're driving down the road, and you find yourself veering a little bit, you're just kind of drifting to the right, you don't turn the wheel 180 degrees to the left, you just nudge it back a little. You don't I mean, if you were to oversteer, you'd end up in the other lane. And then you'd be like, Oh, God, I'm gonna hit a car, and then you'd be oversteering the other way. And then that's up and down, up and down, up and down, except, you know, side to side, because you're driving. But if you just make these little bumps and nudges to the wheel, if you really think about how you drive a car, most of your hand movements are almost imperceivable, to your eye even, that's what you should be doing with diabetes, is just making the small adjustments along the way. And I think as the algorithms get better, and hopefully all of them like every one of them control, like you whatever Medtronic Scott coming out on the pod five, when it happens, I all these companies like I call on them personally, to go back to the drawing board, create a lower target, and go back to the FDA and get it through the FDA. Because while these things are amazing, and they're going to help a great number of people, they're not going to be as valuable to a person like me. Because if I slap an algorithm on my daughter, I mean, are you telling me I gotta hurry once he needs to go up a full point so that I can have an algorithm, you know what I mean? Like they need to, I think it's imperative for them to spend some money and some man hours and some time all of them to get the the goal target down lower, so that the FDA says, You know what, let's let the user say, I'd rather I'm shooting for 85, or I'm shooting for 90 or I'm shooting for 95, like let the user make that decision. And then the algorithm should support it.

Howie 58:03
So your will be correcting at 150 Just for the sake of the argument to make it easy to you. And then it's going to 180 and it's still continuing up, you're not adding correction then because you don't want to stack Do you let that unit or ish work to bring down or would you correct again,

Scott Benner 58:18
I believe you're looking for an episode about stalking, where I'll tell you it's not stalking if you need it. So if you would have made a great Bolus, you never make it to 150. And so if you made it to 150, your Bolus wasn't right. Like there's a, you know, when you see people's like super flatlines. Online, you're like Jesus like that. Like you, somebody puts a graph up in there, like there's pizza in here. And you're like where they can't even see it. Like that's somebody who really knows how to Bolus for pizza or Chinese or just a regular meal. So my, my assertion is, I'm not shooting for a solid flatline. Like there are people who do that. I'm not one of those people. I think that I've worn a CGM, and I don't have diabetes, and I've seen my blood sugar go up 121 3140 for a meal, I've seen it hang a little bit and come back down again. So in my mind, 140 and it comes back on its own doesn't get low. Sorry with me. I know I could have done better, but it's okay. 160 to me is a high blood sugar. And in my mind, 180 is a spike like I've significantly screwed up if we're 180 or above is how I think about it. So my overall concept around it, and I don't abide high blood sugar. So if a high blood sugar goes up, I bring it back down. I'd rather stop a low or falling blood sugar than fight with a high one. I will tell you that that sentence is at the backbone of how I think about diabetes. I'd rather stop a lower falling blood sugar than then then fight with a high and I think that as you get better and better at bolusing for meals, the frequency of the highs goes away which takes away the frequency of the lows as well. It's all it's all timing and amount. You just have to have the right amount at the right time. So even though your algorithm if I'm remembering control IQ, right, they all work about the same way, you make this big Bolus, and then it leans on the Bolus and takes away the basil. Is that right? Yeah. And so if you mess up, if you don't Bolus enough, if your meal ratio is not heavy enough, then as soon as that basil goes away, you know, the carbs are like cracking their knuckles and like licking their chops to like, I'm gonna win this, and you know, it starts to go up. But if you had a, if your meal ratio was right, and you Pre-Bolus well enough, then that amount that you put in should cover the basil needs and the meal needs. And then the algorithm should be able to say, Okay, now is the time to put the basil back on. So if you're seeing spikes, I would look at your meal ratio. Does that make sense? Like you're you're in for sure. Yeah. And I would be as aggressive with the Basal is like, could be, I don't want lows, but I want to sit as low and stable as possible. Without the, without the algorithm cutting out all the time. You know what I mean? Like you want the algorithm you want the base, it'll be able to run. And for the algorithm to come in when it needs to, and add a little or take a little like, you don't want your basil to be so heavy that the algorithm is always taking it away. So there's a somewhere between insulin sensitivity basil, and meal ratio, there's a balance in there, where you'll find kind of perfection. And then after that, it's it's understanding the differences between foods, it's understanding that you, you know, I don't care if you, you know, pour a bowl of Frosted Flakes, and the box tells you it's 35 carbs you need, it needs what it needs. So there are some foods where you have to ignore the carb count and Bolus, you know, for the impact of the food that you know is going to come and there are some there are some foods that you can rely on your carb count, and it works really well.

Howie 1:01:52
Yeah, chicken foot back to that example. It doesn't matter. I mean, I get like 140 grams is still gonna be

Scott Benner 1:01:57
Yeah, did you guys, I don't, I couldn't even begin to tell you when my daughter was growing up, like, you know, Chinese food, like, I don't know how to count carbs in Chinese food. I'm not measuring it. There's no accurate carbs. Now, what I learned was, my daughter's Chinese meal needed a Temp Basal increase of about about 180%. For three hours, she needed about a 20 minute Pre-Bolus. And it and I had to be and there was a number in my mind, like, I didn't matter. I just knew it was like 15 units. You know what I mean? Like, I never even bothered with it. I just learned from historical like, I go on the idea that people pretty much eat the same every time. You don't I mean, like, you're not like 100% Yeah, it's not like how he's like a one slice guy, one Friday night, and the next Friday night, he's like, I'm gonna have seven slices of pizza, you're like you're a two, or you're a three, or you're a one like, you know, you mean, so you kind of learn the impact of that food. The simple way I think about it is if you Bolus for a meal, and you spike and stay, and then it takes, I don't know two more units to bring it down without making you low, the next time you have that meal, I don't care what the carb count says those two units from the correction belong in the initial Bolus. Because that's what that meal takes for you, aside of what you're setting, say, you know, your settings might work great, and all these other circumstances, but this one meal, they don't. So stop fighting with it. And just it's common sense, put the two in with a meal, and don't have the spike.

Howie 1:03:31
In back your point about the algorithm. It's like, I don't know if this is still the case. But Medtronic, you could change your active insulin or insulin on board. Were Tanna, when you're in control IQ. It's five hours regardless. Yeah, that's even an impact. Yeah, they're

Scott Benner 1:03:43
all different. I mean, look, right now, I haven't used on the pod five yet I am i They're a sponsor. It's not why I'm saying it, I'm saying I really want to use it because loop, you have to use this little connecting device with loop called a like a Riley link or an orange link. And my daughter does not like to carry it, it's an extra part on the pod is going to print the algorithm right on the pod. So you'll literally be able to walk away from the controller, and it'll and the algorithm is going to work fine with loop if you get away from your phone, because the algorithms on the phone, if you get too far away from your phone, or that link breaks, then the algorithm stops working. So I want on the pod five to work for my daughter very badly. And we're going to try it. But it's going to lack some of the user defined ability that the do it yourself system has. And you know, right now my daughter's target for her algorithm is I think it's 85. And so the algorithm is trying to get her to 85. And I mean doesn't always work. It does a good job, but it also works like other algorithms like she's she's been getting this kind of like, I don't know what it is like excitement thing when she goes to school in the morning. And the algorithm kicks in and tries and tries and tries and holds her about at 141 45 which is great. Like you know what I mean? And then She'll when she leaves school and that that kind of like excitement goes away, it comes back down again. But we've been experimenting with different boluses trying to Bolus we're trying to Pre-Bolus the excitement she gets when she goes to school or anxiety. I don't know what it is exactly. But you know, her blood sugar rises in the morning. And so we've been working on different ways to kind of fool the algorithm because she's not taking in carbs. So if you just Bolus for carbs, then it's going to, you know, we're if you just make like a straight Bolus, I should say without putting in carbs, it's going to take the basil away, because it's going to suddenly think she has too much insulin. This morning, we tried to Bolus for a few carbs to see if that would work. It didn't. Tomorrow, I'll try to be more aggressive with it. And try to get ahead of it. But like, in my heart, I'm looking at my daughter's blood sugar right now. It's 142. And it's not upsetting to me. But I'm not just gonna look at it. You know what I mean? Like, we're, we're gonna we're gonna move that number. And so while you and I were talking, I texted her and I said, you know, and and to make a Bolus, and she did. So she. So what we did here to try to like get around the algorithm is we Bolus three times her Basal rate. So her Basal is about one. So she just put it in blindly three units, because I figured she needs about a unit and a half to move the blood sugar. And she needs about a unit and a half to cover when the algorithm shuts off the Basal because we've just put in a blind three units. Does that make sense?

Howie 1:06:30
Yeah, for sure. Yeah. So it sounds like you're mad, it's back to your My question. Your question to me about my wife and me, the care and the attention it's putting here, it sounds like most of the management's relying on you.

Scott Benner 1:06:43
Well, in certain situations, like you're gonna have a hard time talking a 17 year old and thinking they have to Bolus a 140 blood sugar while they're at school. You don't I mean, like, it's, and I don't see it as it's funny. I don't see it as micromanaging. I see it as managing, like I, you know, if if people want to say that, you know, oh, my kids blood sugar goes up to 225 at school, and I don't micromanage them. I mean, all right. But that's like a seven and a half a one C at once he like, that's not micromanaging. That's, that's management. Like that's what diabetes requires. And so what is happening over the years is that while I make these decisions, she's always involved in them. And it's my hope and desire that she's just kind of learning as she goes. And then the next piece is going to be to get her to want to do it consistently. And that I don't think is something you teach somebody like I think that's maturity. So my idea is that she has the tools. She seen them used, she knows when to use them. And now that next piece is, is the hope that she'll want to, because I can't make her. You know what I mean? So if you're saying my art, like, would Arden Bolus for a high blood sugar if I wasn't around? She would. But would she think about it the way I think about it, I think to your point no, because to your point earlier, right, like I I'm her parent, I probably care more about her than she cares about herself. Just like your mom, you know what I mean? For you and you now for your daughter? For sure. Yeah. So I don't know, man, I see it as a slow burn. Like it's, it's gonna, I think the worst that could happen on an algorithm is that if my daughter, like completely flaked in college, maybe her a one C would go to like six and a half. You know, I wouldn't see anything terrible about that. I know, she wouldn't sit around and stare at a really high blood sugar. Like she doesn't want to feel bad. You know. So once she's up at 180, she's not going to feel good. Just like you still feel a little hinky at 80 Because but if you drew yourself down a little a little that would go away eventually, I think. Yeah, I would imagine. Are you having fun?

Howie 1:09:04
Yeah. 100% I was actually going to also ask you the fact is the wife and she also get involved. So that was another question that you asked me,

Scott Benner 1:09:13
oh, my wife is less involved than I am. But her job is more intensive than mine is. So during the day, my wife's like gone in like very confusing, long legal documents and on phone calls, running meetings with a lot of people my job allows me to kind of like look up more. And plus, I was the one who started it out. Like I was a stay at home dad when my daughter was diagnosed. So most of the informations in my head. So I still see my wife like asking questions and then learning along the way. But the truth is, she's a bright girl. Like if I just disappeared like if Thanos snapped and I was gone. It would take my wife about a day and a half to figure this out. And to put everything into practice, plus I left behind a roadmap for so she could just, that would be the ultimate indignity. If she had to listen to the podcast. She would be I

Howie 1:10:09
mean, you're selling yourself short yet to drum up an hour and 12 minute conversation with a complete stranger. No preparation is pretty good. That's not that easy.

Scott Benner 1:10:16
Dude, I'm great at this. But don't tell people. It's seen seems in my list. You don't? Yeah, you don't want to show off? Oh, no, no, nothing like that. I don't want to I Yeah, no, I mean, listen to the way I see these things. As you come on, you are who you are. And then the conversation pulls out the story. And that way, it's a nice, it's a real conversation, like you and I are just getting to know each other. And, and that that's what makes it listener. But like, if you were to come on and start reading a bulleted list, people would be like, No, thanks. I'm good. You know what I mean? Not that you would do that. But to me, it's, it's not smart to have it so planned out that it feels stilted, is usually our authenticity. Yeah, just, you know, just do just do it. Don't be sorry. So is your wife going to be happy with us? Have you done what you were sent here to do?

Howie 1:11:11
I mean, you tell me how many It depends. I mean, how many more sponsors can we sell? Do you think we can do a good job? Let's take this thing to the streets.

Scott Benner 1:11:18
I like Absolutely. I like how I got an email from her the other day like she was your mom. She was like, it was almost like my house is coming on your show. And I want to make sure

Howie 1:11:29
that I mean, I

Scott Benner 1:11:31
figured you picked her and you were like, I want to be ready for this. Like, what do I do? Is that how it went?

Howie 1:11:36
Preparation is the godmother of execution. So yeah, like to the you saw the beginning, like, let me produce the show. You're for the guests. I got the questions. Don't worry about it. Yeah,

Scott Benner 1:11:46
I know. I look like I don't prepare. But I've been preparing to do this for 20 years. So you know, I'm good. The Congress, you

Howie 1:11:54
don't get to 590 shows by not being prepared. So by mistake, at least that's what you're up to. Now, I don't know what you're up to. Before pre production.

Scott Benner 1:12:00
Yeah. Oh, I have the I mean, if it gives you any feelings like you won't come out for six months, at least. Really? Yeah, I have probably 6065 pre recorded shows that haven't been up yet. I record Wow. I recorded like at least three days a week.

Howie 1:12:19
And then I would imagine there's some people that don't make the cut.

Scott Benner 1:12:21
No, never happens. It's so funny. This comes up all the time. I have I think my number I don't know the number even one time in the very beginning of kind of gender fluidly being very public. This person this girl came on and talking about her partner made the partner upset because they were getting ready to travel overseas. And she was worried that someone would recognize her from the podcast, and she didn't want trouble. So that's a great episode nobody will ever hear. I once did an episode with a young girl with type one who in my best estimation had some sort of a breakdown while we were talking. And I I began to talk to her like she was my daughter. I continued the recording so that she could share it with her mother. And so that's never been out. I was I once recorded with a person whose microphone was so bad that it just didn't work. And there was one time in the middle of a conversation that the conversation took such a strange turn that it made both of us very uncomfortable, and we just deleted it when it was over.

Howie 1:13:27
You cut it you're like man, my recording cut out. That actually looks funny. I hope there's no the last one I heard was when you're like I said you were yelling at the lady that had a woodpecker in the back. I think that was the Canadian lady actually yelling at her. What do you do? You're like, Ma'am, can you fix your microphone? And she's like, Oh, I'm sorry. I was like it's pressing against your shirt.

Scott Benner 1:13:46
And she's like, it's a woodpecker. I'm like, it's not a Woody Woodpecker. I would think that was delightful. The last one was really crazy because I was talking with a person, a woman in her 30s and we were having this like loose, happy just like jokey conversation. It was a lot of fun. And halfway through it, she just kind of took this great left turn and talked about a sexual assault like out of nowhere. And I did not it was hard I didn't I didn't adjust quickly enough. And it just got I mean like literally like imagine if you're telling knock knock jokes with people and a half an hour into it. Somebody's like I was date raped. And you're like what, like it just no transition was very, very odd. And the rest of the I tried to pivot. And I thought I did. But even as look at backing on there was a couple of just uncomfortable moments in the middle. And it ended and she's like, I don't want anybody to hear that. I went I agree with you. I was like, I'm gonna delete it right now. And I just did and there was nothing wrong with it. It just was. I don't know how to put it it was it was just very awkward and strange and it didn't do justice to the to the topic. All of a sudden, you know what I mean? Like, in so those are the only ones that I've ever, ever not shared with anybody.

Howie 1:15:07
And it's true. It's like, do I have to report this? Um, I don't know what's going on here. This is not exactly what I was

Scott Benner 1:15:12
prepared for. It was just very strange, you know, like, and it's like, okay, like, I completely agree with you. Like, let's get rid of this. It was nice to meet you. I'm sorry that this went awkwardly, but I don't know what happened. I can never decide. I never asked her. And it was just wasn't appropriate to ask her like, Did Did she just get emboldened and blurted out? Or was it just an in artful, you know, you know, injection of a different kind of information? Or was it that we were so joking along that it took me so by surprise, I don't think the next thing I said was appropriate. Like, do you know what I mean? Because I don't even know if I knew what I was saying at that point, like, so I don't, you know, if you've never made a podcast, it's your brains always a little ahead of what you're doing. Because I'm listening to you. I'm also formulating a question. I'm also trying to imagine where the conversation is gonna go. Like, I'm doing a lot while I'm talking. And I think my brain drifted ahead of the conversation. And we basically went from like one thing to something drastically different. And I just didn't pivot fast enough. And it was just I don't know, anyway, those are the only ones like I've never, I don't hold on. I think everybody's interesting. I love hearing people's stories. You know?

Howie 1:16:27
That's good. I mean, it shows it shows that you're, you do ask good questions. And it's, it's not pre programmed, and you lean into the conversation. So

Scott Benner 1:16:36
I thought that's what you were able to do. Did we miss anything that you wanted to talk about? Is there anything left on that paper over there? That's funny.

Howie 1:16:42
No, I think I'm absolutely happy with hopefully, what we got to share out, you know, I wanted to be cognizant of there is one thing is the, the second kid that is not the diabetic, and being very mindful of the potential not getting attention. And what I mean by that is, so for example, if one daughter is has a low blood sugar, and the other daughter wants to read to me, the tendency is gonna go to the daughter with a low blood sugar. So the perspective of the other kid is very, very important. And I also mean by that is, I've seen my sisters, for example, have to deal with, you know, we got to cater to how we because of circumstances. So it's almost like my sister's adversity is not allowed to be brought up, because it's not as drastic as mine are. So I think that's something that one eight actually add unnecessary guilt to the diabetic, because it's like, no, you can have adverse, so you can have problems, too. It's not a scoreboard. Yeah. So I think that's what it is almost like, you can't convey that your sister or somebody shouldn't have something difficult, because it's not as difficult as what you have. So that's just something to be mindful of, is not reinforcing that as a parent. And being mindful of the nondiabetic kids perspective,

Scott Benner 1:17:57
I like to to how you, you spoke pretty clearly earlier about not wanting to restrict foods or say things are out of balance, I think, a good relationship with food is incredibly important. It's so easy to create a eating disorder around type one. So I love the way you're thinking about that, that we do the same thing here. You know, I don't, I want to say like, I seriously mean this, I don't, I don't care how people eat, like I have a whole series of how people eat. It's literally called how we eat. And people come on and talk about all the different ways that they eat carnivore, you know, flexitarian, you know, all kinds of different stuff. And I just think people need to understand how insulin works. And once they understand I went somewhere, you go, you know, God bless, like, go eat any way you want, you know, but I think it becomes a problem. If people run to an eating style in lieu of understanding how their insulin works. You know what I mean? Like it just absolutely, yeah, that's kind of how I think about it.

Howie 1:18:55
It's the folks that work out don't have the proper diet, don't expect the same type of result. And so you have to understand the impact of the insulin.

Scott Benner 1:19:02
Yeah, you just need to know how insulin like whether you're gonna eat a low carb meal, or fish or all vegetables, or, you know, you're gonna go to Burger King. Like, I just want you to understand how the insulin works. And then once you do that, you should go live your life, you know. But But yeah, but I do. I think that, especially when kids are growing up, like, if you tell them like this, you know, if you scare them, like, we can eat this, you do run the risk of, you know, it's a risky thing to say to a kid, like eating disorders or are not. There been a lot of people on here that have had them, and they're, they're super serious and very difficult to get out of once you're in. And, you know, it's just it's something to be aware of, too, so I liked

Howie 1:19:47
and even short term, your kid may sneak food and not take insulin to cover it. So even if they don't, if that doesn't impact, you know, the eating disorder side, which is obviously very, very, very difficult. It's even the short term issue is like, oh my gosh, Let me hurry up and eat this. For my parents see,

Scott Benner 1:20:01
yeah, well, that's how those that's how the disorder start, like I have to hide it. I can't tell people won't take insulin for it, then when people learn they can manipulate their insulin to lose weight that becomes incredibly dangerous. You know, there's, there's, there's a ton of different reasons why you want to build a very normal relationship with food with with diabetes, for sure. Healthy food, like, Listen, don't get me wrong, if you asked me to make a decision, if you're eating McDonald's every day, I think you're doing something wrong. Like if you're asking me from a personal perspective, but again, if you're eating McDonald's every day, and that's what you want to do. I think you're probably making other health ish decisions that are poor, but I still want you not to have a bunch of spikes and lows later, you know, I mean, you don't, you don't deserve poor diabetes health, because of your eating choice. I know that seems disjointed a little bit, but I think you should eat healthy. But if you're not going to, like, you know, it's not a perfect world, I can't We can't make everyone do exactly the right thing. You know, the best thing for them, so if that's going to happen, they deserve to know how to use their insulin. You know that that to me is just makes sense. But

Howie 1:21:12
absolutely diabetic and non diabetic should eat healthy regardless. So yeah, 100%

Scott Benner 1:21:17
but if you're not, if listen, if you can't visit a reason why you can't I mean, maybe it's money, maybe you're buying processed food, because it's cheaper. Maybe you're you know, maybe have a food addiction, maybe you just don't know any better. You still you don't deserve to be wandering around with a 400 blood sugar because of that. So anyway, that's how I think of the podcast in my heart. It's about using insulin. Yeah,

Howie 1:21:39
no, I appreciate that. That's awesome perspective. And I'm glad my wife encouraged me to, to pay attention and listen, and obviously the dual benefit of one learning something and then to showing the the resources that you provide to the 18,000 plus followers.

Scott Benner 1:21:54
Well, that's just in the Facebook page. I've learned that a lot of people listen to this podcast. So it's the weirdest thing is that apple won't tell you how many followers you have, like how many subscribers? It's the one thing they won't tell you and most people listen on an Apple product. Like a great knowing. Yeah. Is it will Spotify is the next most popular one, I think. No, I mean, it's annoying. You can't get the data. Yeah, I don't know why they won't share it with the the people who make the show. So you get downloads completion, like how I know how long people listen, on average, which I'm in I'm incredibly proud of how long people listen to the episodes. But be a you don't get an exact number of people I did you know, it's funny the other day, Spotify does this like thing at the end of the year where they tell you like your most listened to songs. You're most listened to podcasts and people have been tagging me, you know, like your my my number one podcast and one woman had 12,000 minutes of listening in the last five months. And I was like, Oh my God, that's a lot. And I did the quick math, I was able to divide 12,000 by 60. And she she listened to about 200 hours of the show. So my assumption is let's, let's say she downloaded 200 shows in the last five months. In the last five months, the show's had over a million downloads. And I thought of her as a person who listened to a lot. So then I was like, well, is everyone listening that much? Or they're just way more people listening to that? I think because they everybody can have listened to 200 episodes in the last five months right now, but doesn't make sense. So it's just it's an unknowable thing for me. That's That's it. I don't even care. But I would tell you there's a lot of people listening this the podcast this year 2021 is going to have over 2 million downloads just in the calendar year.

Howie 1:23:47
And it's actually hard to find the old ones. So that was challenging is on at least I'm very inexperienced on just Apple products in general even though I have one. Yeah, so it's even hard to find ones beyond I think past the four hundreds on yours. So scroll,

Scott Benner 1:24:02
scroll, scroll. You gotta go to the setting that says see all podcasts I think and then just scroll like a lunatic.

Howie 1:24:09
Yet for some reason mine stop mine. Unless I'm doing still don't have my wife show me. Yeah. I liked your Hearthstone. I liked the humblebrag 18 Oh, that's just on the Facebook page. That's pretty. I like that. Oh, yeah,

Scott Benner 1:24:19
that's not a humble brag. I'm not being friendly. But I'm incredibly impressed with myself. That Facebook page is actually legit. And it's a really wonderful place. Like I I'm proud of how it, how it operates and how people act in there and how they help each other. It's really cool. But yeah, I just it's interesting, though, because you can look at the Facebook page and think, Oh, this must be all the listeners of the show. But it's not nearly a fraction of them. As a matter of fact, a lot of people on that Facebook page. I don't think some of them you know, the podcast exists. They just know what's a good Facebook page.

Howie 1:24:54
And that was the other way. So when I was trying to get the information on the number of listeners, I actually was podcast first. Then my wife showed me the Facebook page secondarily. So I would imagine the same things happening reverse.

Scott Benner 1:25:05
Yeah, yeah. I think one feeds the other, it kind of goes back and forth. And, you know, I'm trying to do some math here for you real quick. So the podcast is 4.6 million total downloads right now.

Howie 1:25:20
That's amazing. That's awesome.

Scott Benner 1:25:21
If I divide that by, like, just 550.

Unknown Speaker 1:25:26
So hold on a second. 4600123.

Scott Benner 1:25:35
Yeah, so if you think about it this way, if, if, if those downloads represented, say, everybody listened to every episode, there'd be about 9000 people who are listeners, but there's no way that that's the case. Right? Like, No, everyone hasn't listened to 550 episodes. That's just obvious. But from there, I don't know how to do an average of how many people have listened. So I don't know how to do the math, like, you know, is the average 50 band do? Is it 100? You know, like, I genuinely have no idea. So you kind of do that. You just kind of do that math. Like let's say everybody, on average listened to 100 episodes, then there's 46,000 plus people who have listened to the podcast.

Howie 1:26:18
Now it makes complete sense. Yeah. And this one's probably going to generate a couple 100,000. So those numbers should jump up. Ya know,

Scott Benner 1:26:24
I think just you being here, honestly, is gonna make you 100% You're a difference maker, for sure. Oh, absolutely. All right, man. I hope you have a good day. I appreciate you doing this.

Howie 1:26:35
No, thank you so much for the time and attention and the education most specifically for selfish reasons. I really, really appreciate the guidance and and what you're giving me selfishly here,

Scott Benner 1:26:44
I think that you're, you're a person on the precipice of a five, anyone seeking the fives. And I have a soft spot in my heart for people who have had type one for a really long time, because I imagined that it must be very difficult to go through all these different iterations. And because a six to you, I would imagine is seems like the pinnacle because of how you've lived through it. You're right, I'm happy with the six. Happy, are you kidding me? I've been your fireworks coming out of your ass.

Howie 1:27:19
Mom's my mom's like, 74. She's like a six, three. I'm like, at least I'm not like a 74 year old woman.

Scott Benner 1:27:25
I imagine your mom right now looking at your Dexcom

Howie 1:27:30
Thank God, I don't have to follow up. The best is like mine goes in and out of Bluetooth. And my wife looks at it and like she'll tell me stuff. Like just finally, just leave me alone.

Scott Benner 1:27:40
Well, man, listen, I'm not saying there's anything wrong with your management style. Like I genuinely mean that I just think no more there if you want it.

If you don't want it, I understand.

Howie 1:27:50
I love to print the fives and I'm going to show you my chart. So I'm the first thing to do is lower my lower my targets and raise my raise my raise my low, I'm sorry, lower my low and lower my high.

Scott Benner 1:28:00
Here's what you're gonna do when you're done, go to juicebox podcast.com, scroll down a little bit. And there's a section called algorithm pumping. And there are a bunch of episodes there about looping, which is just a different algorithm, I think if you listen to them, and there is one there about control IQ as well. But if you listen to the looping ones, you'll get more ideas about how to kind of manipulate the algorithm a little bit.

Howie 1:28:21
Yeah, cuz when you said my daughter loops, I thought that was like a specific pump that I never heard

Scott Benner 1:28:25
of. No, it's It's literally, you download off the internet, some lovely people, I think the man who made mine lives in Russia, I think you download the code, you build the app yourself. The amazing people online built these like little like Bluetooth links that link the algorithm on the phone to your pump. They mean they hack the pumps, you know, so that the I mean, Omni pod is not something they offer, you know, from the company. It's all do it yourself. I didn't realize that. Oh, wow. But it adds it adds more flexibility for targets is that really the biggest deal and the one we're using has auto Bolus. So like where control like you see should go up and it raises your Basal. My daughter's boluses. So you get a little more instantaneous, you know, you know what I mean? Yeah, that's, that's what I hated

Howie 1:29:18
about Medtronic pump technology, centralized key will give them micro Bolus, but it's still not enough. Usually

Scott Benner 1:29:24
not enough. Yeah. Now these things need to get more aggressive. And, and I and seriously, like, I listen, I have the opportunity to talk to people at a company levels all the time. And I'm always advocating like, I know it's an expense, but you gotta go back to the FDA. And you got to you got to do more testing to prove that you can have lower targets. It's a big deal, like let people have more flexibility with their targets. But you see, the bigger problem is that they have to run a study. That study costs a lot of money, and then they've got to take it back to the FDA and go through the process again. You know, but I just I keep pushing wherever I get the opportunity. So I hope people seem to listen. Seems like your work gets done quicker. Yeah, probably, but I know people listen, like I know. There's somebody really high up at Medtronic that listens to the show. So I know people hear me and I'm telling you that it's really important you have to spend the money and do it

a huge thank you to one of today's sponsors, GE voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. You spell that G VOKEGLUC AG o n.com. Forward slash juicebox. I'd also like to thank Ian pen from Medtronic diabetes for sponsoring this episode of the podcast and remind you to go to ink pen today.com To learn more about that insulin pen, and of course touched by type one.org. Go get your tickets, they're free

hope you're enjoying the show. If you are, please share it with someone else who you think might also enjoy it. And so I want to thank everyone who's ever taken the time to share the podcast with someone else. If you've already taken the survey AT T one D exchange.org. Forward slash juicebox to remind you that if you haven't, it takes fewer than 10 minutes and would be a huge help to me, the podcast and people living with type one. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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#706 Bold Beginnings: Adult Diagnosis

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 706 of the Juicebox Podcast.

Today is going to be the second installment of the bold beginning series. While you're listening to this episode, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please consider going to T one D exchange.org. Forward slash juicebox. To take the survey, the T one D exchange survey benefits people living with type one diabetes, it's incredibly easy to do and will take you fewer than 10 minutes, T one D exchange.org forward slash juicebox. Also, today, you're going to hear Jenny Smith, Jenny is a CDE. She has had type one diabetes for over 30 years. And she works at integrated diabetes.com If you're interested in learning more about what she does.

This episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes in pen is an insulin pen that talks to an application on your smartphone and gives you much of the functionality that you will get from an insulin pump in Penn today.com. Today's show is also being sponsored by touched by type one, I need you to go to touched by type one.org. When you get there, go to the program's tab, click on annual conference and get your free tickets for the 2022 touched by type one Annual Conference, which will be held on August 27. in Orlando, Florida. I think last I heard, I'm going to be speaking, I think in three or four different sessions there. So come on out. Let's talk about some diabetes touched by type $1. Work. So Jenny, here are the questions that adults asked in the Facebook group. And that is, here's a statement. This one says that newly diagnosed those are often treated as type twos for a while, then we get tested and learn why nothing ever quite worked. I think a lot of should be more widely known about. So if you're diagnosed as an adult, I mean, Fair's fair, what I hear from most people is and it's, it's wrong, but doctors look at them. And if they look like they're reasonably in shape and fit, they think they have type one. And if they look like they're not they think they have type two, and it's very common to be to be stuck into a category without anybody.

Jennifer Smith, CDE 3:12
Correct. And that's in a I mean, what you just said is also in an environment with doctors who really are thinking type one thin, normal size looks, you know, like they maybe are an athlete or something like that. I'll actually say I mean, I've got a number of people that I've worked with over the years that are athletes, like I've worked with a couple endurance athletes who were initially misdiagnosed in the emergency department, as type two and sent home with completely a lack of information and a prescription for oral meds that were not going to do anything for them.

Scott Benner 3:54
Yeah. Yeah. You'd be surprised how many people I've spoken to who are dismissed at their diagnosis because the very next statement here on in our questions is, when I was first diagnosed as an adult, I couldn't get in to see an endo for a while because I wasn't quote unquote, critical and I wasn't hospitalized for DKA. And one of their first questions was, how do you even know I'm a type one. And you know, nobody does antibody testing right away for you. And this person says I just wish I would have known to ask for a C peptide test. When this was starting. It is not uncommon at all handful of metformin get home, take these come see us in a month, let us know how you're doing except you don't have type two diabetes. You have type one diabetes, and that's not going to help you. So and then you are in a real you're at a risk then a significant risk. Yeah.

Jennifer Smith, CDE 4:48
Yeah, absolutely. And I think that the issue there too, is adults. We're we're very misinformed when it comes to our education system. All right, we just we really are in terms of many health conditions, but diabetes included, there's still a lot of really good misinformation out there about diabetes. And so as adults, if you have all these symptoms, and you have no knowledge of diabetes, no personal history from family member or friend or anything, you may go to the doctors because you don't feel very good eventually. And then you get diagnosed, we are told your type two diabetes, well, maybe you don't even know there's type one diabetes, or you don't even know that you should ask to say, Well, gosh, this doesn't seem to be what I you know, what, what I would fit into for a diagnosis? I think so I think teaching is important. Yeah, it's

Scott Benner 5:48
important to know that you can be thin and lean and healthy and have type one or type two diabetes. Correct, right? I mean, and there's just so many in here, like I was diagnosed a month ago, at age 55, a week after my birthday. How was that possible? No one in my family has this. I was 50. My first question was, what the this person is obviously shocked. And then the next thing I want to get to, which I think is super important is, and I won't read the whole thing, but diagnosed at 47 years old, full time job, fast paced lifestyle. They can't get started, really, they don't know anybody that has diabetes, they're busy, they get up, they go to work, they're counting. They're I mean, people end up being hopeful, right? Like this person probably lived their whole life, you get sick, someone gives you a medication, you take two a day for seven days, you feel better. That's that, right? What you expect when this happens. And then when that's not the case, they say, look, it's almost five years later, I still struggle with my Basal with my Pre-Bolus times, this person doesn't know what they're doing. And so

Jennifer Smith, CDE 6:47
and I think a big thing of it goes a little further than not necessarily knowing what they're doing. One, I've found, definitely, that adults diagnosed with type one and absolutely with type two, are very poorly educated from the beginning, in terms of what to do, but along with that is they've already had a life and a schedule and a structure to that life, adding in something that they haven't been given the right information many times from the get go. And now they have to disrupt a lot to learn how to fit this in, to what their schedule was. Whereas kids are, they're different. I'm not saying that it's not difficult, but it's different, because who's helping the child

Scott Benner 7:43
write it because when you're diagnosed as an adult, it's on you, it's on you. And when your diet when a child is diagnosed, some person I mean, hopefully, right? A caregiver basically stops the rest of their life to figure this thing out, because the diabetes is really a newborn baby, all of a sudden, correct can't help itself. If you don't know what you're doing yet. And it's a it's a very slow process and a scary process and, and a process where you feel like you're about to drop the baby every five seconds. And, you know, you just sit on the sofa. But, you know, it's funny to piggyback on what you just said, and the next question, somebody said that they got a ton of code, they got a ton of information in their education at the hospital, but none of it's happening in their real life. So what they, they felt like they left completely prepared,

Jennifer Smith, CDE 8:29
which is great to hear that yay for whoever educated you.

Scott Benner 8:35
And then there you go, you shop at home. And there's nothing there, the person actually said I had to start listening to the podcasts and reading posts in the Facebook group, but that they still feel out of control. You know, please do a show for older diagnosed people, a different issues like work pressure schedules, exercise, cycles, evening events, etc, etc, all these things, and it's very liquid. It's very true. I mean, Jenny, you know, like, if my daughter runs on a schedule, I can run her blood sugar, like it's nothing but if you start throwing in a bunch of different problems, ya know, and variables like this adult issues, it changes and I never go ahead and say that, you know, Sam, so no, I

Jennifer Smith, CDE 9:16
was gonna say you're AB you're absolutely right, adult issues are your own to manage to begin with, and many, thankfully, there are a good number of people who have a very supportive, significant other spouse, or a really good friend that, you know, gives them some support or help. I think one of the, not everybody has this option, but I've had a couple of people who've actually after diagnosis, they actually decided to do the best they could for themselves to really get an idea. They took one or two weeks off of work. And they said I am I'm just gonna I mean if I'm going to really nail understanding this as much as I can, and then I'm going to add this other variable back into the picture. I'm going to add work back. Now I'm going to add exercise back. It's but there are a lot of adults who don't have that option, you don't have the time you can take off. So you have to do diabetes, along with what was already in your life. And it adds a layer. I mean, I can say, as somebody who had had diabetes, long time before I had kids, adding kids into the picture has added a layer to my management that is very different than I did before.

Scott Benner 10:28
Yeah, I saw a woman walk out of an elevator yesterday with a libre on her arm, and she was lugging a baby, and had a four year old behind her. And I thought, oh, that's different than just walking off the elevator. It really is. You know, it's, there's this this next person said it this is very interesting, because I brought it up in the honeymoon episode for newly diagnosed but this person says, I thought I was doomed. I was in denial. And I spent days researching articles about potential cores, cures, excuse me supplements to prevent disease progression and everything. So they fell down a rabbit hole. Then they said they went into a depression, hopelessness. And on top of all that, blood sugar is all over the place. Yeah, yeah, let me keep reading, I kept calling my doctor when numbers didn't make sense. And they repeatedly told me it's okay, if you're 180 to 200 for a few hours after you eat, you're not damaging yourself unless this occurs for long term.

Today's episode of the podcast is sponsored by Ian pen from Medtronic diabetes. And I would like to tell you a little bit about it. The pen is an insulin pen. But it's not just an insulin pen. Yes, it has a cap. And yes, it has a needle and a cartridge and a little window where you can see how much you're dosing, little knob twist at the end and a button you push. It's an insulin pen, right, just like you expect. But here's the stuff you don't expect. How about an app on your cell phone that shows you reports easily shareable reports with data that is generated for up to 90 days in pen can do that because it's connected to that app by Bluetooth. The impact app is also going to give you an activity log. So you can see a list of recent actions including doses meals and glucose readings. Your active insulin remaining is right there on the screen. With that in pen app, see how much insulin is still working in your body. And in pen has a dosing calculator to help you take the guesswork out of dosing your insulin. The app uses your glucose levels, and a carbohydrate estimate to recommend the dose that's right for you. That sounds like a thing you get with an insulin pump. It even considers the amount of insulin that's still working in your body to help you avoid lows in Penn today.com. Forward slash juice box. One a digital logbook, in pen has that one carb counting support Oh, well, the pen app can help you estimate carbs based on your meal size. There's also a fixed dose option that allows you to choose the same carb amount for a specific meal each day. seems too good to be true. It isn't in pen today.com forward slash juice box, head over there now get started today. There are links in the show notes of your podcast player and links at juicebox podcast.com. To the in pen. And all of the sponsors of the Juicebox Podcast including touched by type one whose annual event is coming up in Orlando on August 27. And the Tickets are free. Did you hear that at the beginning of the show. Don't forget touched by type one dotwork. In Penn requires a prescription and settings from your healthcare provider, you must use proper settings and follow the instructions as directed, where you could experience high or low glucose levels for more safety information visit in Penn today.com.

Jennifer Smith, CDE 14:06
Right, but how do you stop it now? Like if it's occurring, and it's damaging long term? Well, then tell me what I should do. So I can stop it from happening long term. Yeah, excellent. Right. Like it's

Scott Benner 14:17
like, they feel like they're like, you could do a little math, you'll be alright. But that leads to a meth problem. Right, right. And it really is the same thing. Like I didn't I'm sorry, it's such an odd if anybody has a math problem, I'm so sorry. But like, I mean, it's just like, that's how it seems to me. It's just like, Absolutely, Hey, it's okay. Don't worry about it. But it's okay. Don't worry about we have so many episodes where people say, listen, they told me it was okay if I was up to 180. And then one day it was 190. And I thought well, that's only 10 More than one ad and then 200 was only 20 More and then 250 was only 50 More than 200 and I was okay with 200 Before you know it, blah blah, blah, blah, blah. Right and it's not it doesn't help you in this moment when here you On your house hopeless, alone, feeling depressed, unable to manage diabetes? I think the one of the, you know, I'll tell you a genuine I don't know if I would have said this five years ago, but having that Facebook page really teach me like you have to go find other people. Because for a little while, you need to know that other people live with this, and they do a good job.

Jennifer Smith, CDE 15:23
Because I was gonna do the same thing. Yeah, yeah, hope is incredibly

Scott Benner 15:27
important. And I'm not saying you got to go to some like type one retreat with people or something like that if you want to you can but but just knowing it I, I interviewed a girl this morning. I see if I can tell this really quickly. Last year I ever interviewed a girl from Canada who was allergic to insulin. i Yeah, figured it out. A doctor in Texas heard the podcast, she had a patient who was going through something similar. The doctor called me I put the doctor in touch with the person from Canada. conversations went back and forth. Long story short, the girl in Texas started using a Frezza. And she's doing much better now. During the conversation that I just had with her the girl from Texas, which is in the podcast summer, like go find I think it's called allergic dance on Park.

Jennifer Smith, CDE 16:20
All right. That's my alert that I should have turned off for going to pick my child up from the bus stop, which is not my job this afternoon. That

Scott Benner 16:29
kid can wait, Jenny, we're making a podcast. Wait, tell him to stand there a little longer, he'll be fine. But in the course of interviewing this girl from Texas, the mother spoke about how this is such a rare thing. But that she found a Facebook group with seven people in it who are allergic to insulin. And it was everything to her. Yeah, everything to find those other people, right. And I just think that it's not. For some people, it is not going to be intuitive to go look for other strangers and find comfort in them. But I am telling you, I've been doing this a long time. And not nearly as long as Jenny has been. And it's incredibly important.

Jennifer Smith, CDE 17:12
No I and I wouldn't 100% agree with that I would include for adults specifically too, don't be afraid to reach out for some type of mental health support to there's a lot that you have to navigate and it really helps to have somebody to even maybe help you get some structure or an idea of how to restructure things. I asked an adult as you said from a touch point, I I did not have diabetes friends, really, until I was an adult. I didn't. I had the people that I got to work with on a clinical bases. But I really didn't have anybody I connected with until I went to a diabetes like athletic training camp. Right.

Scott Benner 18:09
And you met people there

Jennifer Smith, CDE 18:10
and I met you it was it was like diabetes disney world to me. Everybody was beeping and buzzing and complaining about blood sugar's and how are you going to adjust before the five mile run? We're going to go on? I mean, it was I smiled the whole time that was there. Because it was exciting to connect.

Scott Benner 18:31
As as crazy as this might sound. I know this is a weird statement. But for you personally, if everyone in the world had type one diabetes, that would be better for you. You'd,

Jennifer Smith, CDE 18:43
right? I mean, the whole the whole world would just, it would just understand it wouldn't be a oh, well, you know, I'm gonna bring that special dessert for you because you have diabetes, kind of like the weird comments that you end up getting, right? No, just you don't understand. So sometimes that is even off putting for you as an adult to try to explain to somebody because there's so much missing that you can't explain in just five minutes of why you could actually eat the regular dessert if you wanted to. You just don't bother and you're by yourself. And then you're by yourself. And

Scott Benner 19:23
listen, I only have the context of a parent but I can tell you that when your child is diagnosed, you have no recourse you're not you know, I'm not I'm not I'm not dropping her in a in a basket or a fire station. She's my kid I'm gonna figure this out right

Jennifer Smith, CDE 19:36
she's not Moses you're not gonna let her go down the street

Scott Benner 19:42
I'm not very religious Jenny So I don't know that whole thing but it did pop into my head about should I say I didn't float it out or stream but I couldn't remember the whole parable. Anyway. The it slowly you understand it? And you don't you don't you give yourself over to it. It's a life change. As much as you won't want it to be at first, and you may do a really good job of giving diabetes, a lower impact in your life, but it's going to have one of the only, like, the only thing I can say is, you know, when you get a bad cold, and for three days, you just the world understands, you're going to lay down, you're going to be sick, and nobody's going to hear from you. And you find a way to make that time you do that when you're the parent of a child, you okay? Well, we're, you know, as an example, we were in the we had just renovated a portion of our home when our son was diagnosed, we'd done it, and we had it broken into two phases. For five years, while I learned about diabetes, my children had to jump out the front door, because I didn't have steps. And that is one, that's great. Yes, that is one of the things I put on the back burner, while we were figuring out diabetes, for Arden. And but when you're going to be an adult, and this is going to happen to you, there's no one there. I mean, maybe you have a spouse if you're lucky, right. But you'll be surprised at how many adults I see who try not to share their diabetes with spouses, which is a personal decision, you know, so you're going to have to say to yourself, I got to look at this 24 hour clock at this seven day, calendar this 30 day month, and find some time in here to just learn about this, and find a way to incorporate it because unlike a bad cold, it's not going away, but it will get you know, if I if I had something hopeful to say I would say that diabetes doesn't get easy. But sometimes you get so good at it that it can feel easy, some days. And those days sometimes grow into weeks, where you just go, oh, this was an All right, you know, you're gonna have to make that time in your life, you can't just put your head down and run through it, because it's not going to work that way. And you

Jennifer Smith, CDE 21:45
can start in from an adult perspective of a major change to your structure or your day schedule. Even if you just start with a basic of kids, then given this medicine called insulin, and I was told to take it, here. And here. If that's where you start, then that's That's it? Yes. Just take what you were told to take. And then moving on, you can kind of build on that. Especially if you've got technology, I would say that's another big one that adults should definitely ask about. I know, parents are definitely the ones to beat down knocked down camp outside the doctor's office until they get the products and the technology that they want. Adults do the same thing. Yeah, I asked for a CGM right away on diagnosis, you know, ask for a pump. And or start the discussion sooner than later, depending on you know, what you think you can handle

Scott Benner 22:46
to, to use a phrase from the podcast or something else, you should dictate the pace? Don't Don't let a doctor say, hey, we'll look at it three months back. No, no, let's do it. Now. You know, I want to get an insulin pump. Let's start that right now. I don't want to talk about it three months from now, you know, the other thing is, too, is you know, I tell people all the time, you might get a clunker of a doctor. Don't, don't don't suffer with it if that happens, right. And it's you know, I have a note here to myself, that children get treated better than adults do in medical situations. And it's because in my mind, it's a business. And if and if I see you treating my kid poorly, I don't want to come back here. So everyone's very nice and accommodating. It's how kids get treated adults, do not get treated that way. And by the way, if you are if your husband's a doctor, or your wife's a doctor, or you're a nurse, even if you're like you know, an OB nurse and know nothing about diabetes, your doctor is going to assume you know all about it. Yeah, and not tell you anything, because you're gonna think other nurse they know. And we know that's not true, too. So,

Jennifer Smith, CDE 23:55
in fact, in hiring my own Endo, or endos, you know, in over the past years as an adult on my own. I think since I've been in the profession of diabetes education. I've had more doctors who seem they seem almost standoffish, kind of scared to suggest and or talk about things. I'm usually the one to bring up the questions or hey, look at this. I'm thinking about this. What do you think about this? And I don't, I don't want that I'm paying you to help me. I don't want you just so you can write my prescriptions for

Scott Benner 24:36
me, I still need help with just a guy with a podcast. And every once in a while I get that I get the like, Well, what do you think I'm like, you saw what I think like that's the best I can do. What do you think? I'd love to hear what you think? Let's collaborate a little bit. It's it's not undoable. And I would I'd want to I'd want to finish this up by saying that I've interviewed you Dozens of people diagnosed in their 30s or 40s, their 50s and their 60s. And they're doing well. It's so possible to do. I would. I mean, listen, I'm biased. I'd find Juicebox Podcast type one diabetes, the private Facebook group and just lurk around and watch people talk. You can learn a lot that way. If you have a question great, if not just sit back and watch. And the Pro Tip series from the podcast that begins at Episode 210, with an episode called newly diagnosed or starting over, I think if you listen to the Pro Tip series that Jenny and I put together, it's absolutely free. I think you could get your a onesie into the sixes pretty comfortably. If you need any help find me and ask and I will absolutely ask. And if you're really, really lost, Jenny works at a place called Integrated diabetes, and it's at integrated diabetes.com. So you could

Jennifer Smith, CDE 25:48
thanks yeah, I was actually going to bring in the the fact that you've got a really wonderful list of endocrinologists. And I think there are even some diabetes educators within the list on the website on your website, right?

Scott Benner 26:01
juicebox, Doc's dot com.com Voc acids a list. It's curated by the people who listen to the podcast, who say that my doctor is cool with how I manage. I manage through, you know what I've heard on the podcast and you know, so other people can find them

Jennifer Smith, CDE 26:19
and you have some pretty good connections in a good majority of the states and bigger cities

Scott Benner 26:24
is getting bigger and bigger. It's not. It's not not worth your time to go check it out. You might find something near you for sure. Yeah. Okay. All right, Eddie, thank you so much. Thank you real quick when you get a dog.

Jennifer Smith, CDE 26:35
Oh, we've had a dog a long time.

Scott Benner 26:36
I know. I thought you have cats. Oh,

Jennifer Smith, CDE 26:39
well, we have a zoo. We have two kids. We've got a chocolate lab who's like 85 pounds. We've got two fish. We got two cats.

Scott Benner 26:48
I'm still recording, by the way, but I did not know your dog.

Jennifer Smith, CDE 26:51
Oh, yes. We've got more hair like floating around.

Scott Benner 26:56
That dog bark and I went, What the hell is Jenny dog sitting? I've never heard a dog barking all the time. I've talked to you.

Jennifer Smith, CDE 27:03
I know. Usually. In fact, I've heard your dog's bark before. And I'm I am surprised that in all the years he has not ever bar

Scott Benner 27:13
I swear to you, I thought you were dog sitting with that happen. I was like, although true.

Jennifer Smith, CDE 27:18
We often we most often do these more in the morning. And usually if we're getting deliveries, which I expect, probably something came and somebody knocked on the door, they usually come in the afternoon. So that could be why today

Scott Benner 27:33
you and I almost never do this in the afternoon, actually, that ever is the big deal. Sorry. Well, it's it's a holiday weekend. So I hope you have a great time. Thank you. New episodes of the bulk beginning series will come out every Friday. Thank you so much to Ian Penn from Medtronic diabetes, for sponsoring this episode of The Juicebox Podcast. Please remember to head over to in pen today.com. If you'd like to learn more about that insulin pen that talks to that app through Bluetooth. I'd like to remind you again about touched by type one, it's touched by type one.org. Of course, Jenny Smith works at integrated diabetes.com and bold beginnings episodes. And all of the episodes of The Juicebox Podcast are available at juicebox podcast.com. And in any one of your favorite audio apps, like Apple podcasts, Amazon, Music, Spotify, and stuff like that. If you need a list of apps that are free to use, by the way, I also have those at juicebox podcast.com, where you can head over to the private Facebook page for the Juicebox Podcast. It's called Juicebox Podcast type one diabetes. There are links there to all the series, tons of questions and answers from people living with diabetes, and links to audio players. If you're enjoying the podcast, please hit subscribe or follow in whatever audio player you're using right now. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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Test your knowledge of episode 706

1. What is the main topic of Episode 706?

• The Bold Beginnings series installment
• Insulin management tips
• Carb counting techniques
• Diabetes complications

2. What common issue do newly diagnosed adults often face?

• Misdiagnosis as type 2 diabetes
• Lack of access to insulin
• Immediate DKA hospitalization
• Over-prescription of insulin

3. Why do some adults fail to get immediate testing for type 1 diabetes?

• Misbelief that type 1 is only for children
• They have a family history of type 2
• Lack of awareness about diabetes
• Early testing always confirms type 1

4. What type of test is often missed at diagnosis for adults with type 1 diabetes?

• HbA1c test
• Blood glucose test
• C-peptide test
• Ketone test

5. What advice is given to adults newly diagnosed with type 1 diabetes?

• Start with basic insulin management
• Avoid all physical activities
• Immediately use an insulin pump
• Follow a strict diet plan

6. What did Scott and Jenny recommend about diabetes technology for adults?

• Delay using technology
• Ask for a CGM and insulin pump right away
• Use technology only if necessary
• Avoid using CGMs

7. What is a common feeling among newly diagnosed adults?

• Denial and hopelessness
• Immediate acceptance
• Confidence in management
• Lack of concern

8. How can newly diagnosed adults find support?

• By attending type 1 diabetes retreats
• By joining Facebook groups
• By isolating themselves
• By avoiding discussions about diabetes

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