#735 Bold Beginnings: Pre Bolus
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.
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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 735 of the Juicebox Podcast.
On today's episode of bold beginnings, Jenny Smith and I are going to be talking about Pre-Bolus simple concept that not many people learn about. Don't forget the bold beginnings series is all about things that listeners of the Juicebox Podcast wish they would have known in the beginning. While you're listening today, don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you enjoy Jenny Smith and you'd like to hire her, she works at integrated diabetes.com. If you're liking what you're hearing in the bulb beginning series and want to expound learn more, you're looking for the defining diabetes episodes, and the diabetes pro tip episodes. There are lists of them at the Facebook page Juicebox Podcast type one diabetes. In the featured tab that's a private group with over 27,000 members. If you're not on Facebook, check out juicebox podcast.com or just search in your favorite audio app.
This episode of The Juicebox Podcast is sponsored by in pen from Medtronic diabetes, take the right insulin dose at the right time. The right pen is a reusable smart insulin pen that uses Bluetooth technology to send dose information to your mobile app. Offering dose calculations and tracking in pen helps take some of the mental math out of your diabetes management. You can get started right now within pen at in pen today.com. Or perhaps you're ready to talk to a healthcare provider about m pen. Again, in pen today.com. Head over there now to hear about the app that has current glucose on it meal history, dosing history and much more like dosing reminders, carb counting support and that digital logbook, lighten your diabetes management load with in pen from Medtronic diabetes seriously, in pen today.com. Just head over now and check it out. impendent is an insulin pen that you may pay as little as $35 for offers available to people with commercial insurance terms and conditions apply. But $35 for an insulin pen that talks to an app on your phone and keeps track of things. Not unlike an insulin pump. This sounds like something you want to learn more about in Penn requires your prescription and settings from your healthcare provider. You must use proper settings and follow the instructions as directed. Or you could experience higher low glucose levels for more safety information visit in Penn today.com. And just like that, I've gotten the ads out of the way for you. So you can listen straight through to Jenny and I talk about Pre-Bolus. Jenny, our bowl beginning series is going along well. We are making our way through so far we have recorded and put up honeymoon being diagnosed as an adult terminology which came out in two parts. Fear of insulin, the 1515 rule, long acting insulin, time and range like what range is shooting for and food choices. today. We're going to talk about Pre-Bolus Oh, yes. So I hope you're ready. I'm gonna scroll down to people's,
Jennifer Smith, CDE 3:43
I'm always ready. I never know what we're topic going to kind of address here like here, this is today.
Scott Benner 3:50
Like you're like You're like a member of my gang. You're like we can do it. Let's just go out right now. Always ready.
Unknown Speaker 3:56
What's the plan?
Scott Benner 3:58
Nevermind. We'll figure it out as we go. So the first person just says, I wish we had been told about Pre-Bolus Ng and I'll have to tell you, I'm reasonably astonished when I see people who for days, weeks, months, and sometimes years of their lives using insulin, run into the idea of Pre-Bolus in one day, and they just go I've never heard of this before.
Jennifer Smith, CDE 4:21
Correct. I've gotten multiple comments like that. And the assessments that come in for the people that I get to work with. That's one of the big things there like I had somebody just told me about this, or the emails that I get, you know, asking about, like working together. Nobody had told me about Pre-Bolus thing I've been you know, I've had type one for 40 years and nobody told me
Scott Benner 4:44
like, I talked to somebody recently diabetes for 50 years. And I said how do you handle your meals? You're like, you know, I just sit down and I Bolus the night. And I was like it was like like a Pre-Bolus No, I mean, just you know, just do it at the same time. Why do you not do it earlier? Why would I do that? Right? Well, what about this? And they're like, Oh, that makes sense.
Jennifer Smith, CDE 5:06
Well, and usually, I think the first piece of that comes with the rapid acting that we have had around for a number of years already has the idea that rapid means rapid. So when it's prescribed to them in terms of what the doctor or educator has given them an information it's take the insulin, start to eat your food, this is a rapid acting insulin. But we've talked about for rapid is not rapid, I think still needs time,
Scott Benner 5:39
especially for people who've never used to CGM or worn one, that you can't really see how food impacts blood sugar, and how long it takes for it to start moving. And you can't see the differences between different types of carbs. And so if like, you're saying, if somebody says, well, it's rapid, I couldn't take my rapid insulin 15 minutes before I eat, because sounds like I would be in trouble. I don't want to get low, and they've probably seen themselves get low at some point. And then it then some, you know, probably not for the same reason. But then anecdotally, they believe I couldn't possibly ever do that. So the next person says, it would have been nice, if someone would just would have explained the importance of Pre-Bolus thing. So I think we should. So if you're newly diagnosed, someone's giving you insulin, and they're telling you probably count your carbs, you know, this formula will tell you how many you know how much insulin for this for this amount of carbs. The thing you need to understand different, I think, big picture is that the impact of the carbs happens over its own timeline, just as the impact of the insulin kind of happens over its own timeline. So if you just sort of like picture in your head, you know, a flat line going along your blood sugar at any number, it doesn't matter where 8590 110 200 Wherever you start eating at, you have like some stability, and then all the sudden the food starts to push your blood sugar up. There's sort of a bell curve that happens, they're going up yep, at the same time, the insulin tries to push your blood sugar down. So there's a bell curve going down, you need to line up the the impact of the carbs and the action of the insulin so that they're fighting with each other instead of just working unencumbered, I guess it's correct way to say, All right,
Jennifer Smith, CDE 7:22
yeah, you want to time them appropriately. And I think they're in brings, I think, brings in another piece, potentially, to timing, from initial diagnosis. Most people are told, you don't have to change a thing that you're eating, you don't have to change a thing that you're going to feed your child or your teenager, just remember, you have to take insulin for whatever is eaten. Yeah, well, if if that's the case, then in they're not really transitioning at all from what they had been eating, which may be very high carb or very high glycemic types of foods. But you're also told rapid insulin, just take it before you start eating. As you just said, the timeline there of action is going to be very displaced. And you want to, you want to line those up or overlap them, almost overlay them so that the insulin and the foods start to work better together.
Scott Benner 8:20
I also think that it's possible that the statement from a doctor, you're not gonna have to change how you eat is true. But if they don't give you more context about how insulin works, that's not going to be very helpful, because it will seem like you have to change how you eat. My point is that I believe, I believe that if a doctor says you don't have to change how you eat, and here's how you use insulin to make that true. That's one statement. But you are also going to run into doctors who are trying to soothe your soul with with that, right, you know, they're, they're just trying to they're trying to say, Look, I know that you've just found out that you or your kid has diabetes, this is all very shocking. We're talking about insulin for food. But don't worry, you don't have to change how you eat like, you know what I mean? Like that's more it makes
Jennifer Smith, CDE 9:06
it it makes it easier, right? Like, there's one easy piece it's a comfort to know, well, I can keep eating, you know, Froot Loops for breakfast.
Scott Benner 9:15
Well, and that's the other thing is they don't ask you how you eat, you know, they just like don't worry, you won't have to change your over and they're like, Wow, this is great, because I eat Popeyes for lunch. And I have this and I love it crispy chicken sandwich. Oh, it's gonna be like, and so it's a lovely thing to say to somebody and I happen to believe it. You know, I think you can manage insulin for different eating styles. But you can't just tell somebody, oh, don't worry. You don't have to you don't have to change how you eat, but not give them any more context than that so correct that Pre-Bolus thing. I mean, I guess the last thing I'm going to say before I move on to my next thought is that we did the these episodes are in an order for a reason honeymooning happened first because Pre-Bolus thing if you're honeymooning This is gonna look different than if you had diabetes for a while to, you know, so you have to be careful about that. Because you might have, I mean, you see people worrying about it all the time, go back to the honeymoon episode if you don't know what we're talking about. But if your pancreas is still making some insulin, you don't want to like, be out ahead of the charge, don't like, Don't worry, I'll take care of it too. Now we got everybody trying to get your blood sugar
Jennifer Smith, CDE 10:21
down. And the reason that concept of Pre-Bolus in comes after we've talked about the impact of food becomes even more beneficial than it sort of adds a layer to understanding, oh, I guess this discussion around like nutrition intake or food intake. Looks like I really do have to pay attention to insulin, and oh, look, Pre-Bolus is the next thing to really bring into the picture along with what I choose to eat. So
Scott Benner 10:47
yeah, I mean, there's, listen, there's a level of of proficiency, you need to Bolus for more difficult foods, right. And yours. And Pre-Bolus thing is a big part of it. This person says here, I was really confused on whether I should Bolus before or after a meal. It's interesting. She says, they made this sound like a preference and not what would work best. It took me five years into diagnosis to learn about Pre-Bolus Singh. And I only learned because of the podcast. So no one, no one really told me about told me that insulin doesn't work immediately that it has a lag time, whether I'm injecting it or pumping it,
Jennifer Smith, CDE 11:28
which is really interesting, because it Pre-Bolus thing is not it's not a new concept, by any means. When I was initially diagnosed, and I was using our insulin, regular insulin, which is short acting, takes a longer time to get moving in your system that was told to my parents and explained very well from the beginning. If you're going to eat at noon, Jenny needs to have her insulin by 1130. At the latest in order to make sure that it's moving along with the food. So this concept of Pre-Bolus is certainly not. It's not just because we have rapid acting insulin. And we it's it's been around for a long time. But it seems like there's a disconnect in terms of who teaches about it, or who doesn't.
Scott Benner 12:21
I think you're you've I mean, for all of time, you're you've been trying to balance the action of the insulin against the impact of the food, it's just that the amount of time that it takes for insulin to begin working has changed over the years change. Right. Right. And so it's the same game. It's just different parameters. Right? Yeah. It's just It's fascinating that I mean, it's somebody could get five years into this and have to find a podcast to learn about it. Because guess what they fall into is that, well, this is just diabetes. This is what diabetes is I eat my blood sugar goes to 250. It stays there for a couple of hours. I mean, it comes down rap, and it comes back down again. Yeah. And that must be what this is, because it happens every day. And so that's that. Here's a great, but yeah,
Jennifer Smith, CDE 13:06
and those are also the people that ended up getting sort of hand slapped at visits with the doctor, for why are your blood sugars not like more contained, let's add more insulin probably in the wrong place? Because of the mismanagement of insulin specific to food. That's unfortunate. Yeah,
Scott Benner 13:27
it's that concept of Listen, I'm not trying to be funny here. But if you're married, you know the concept of moving the goalposts, right. Yeah, yeah. You're told that the goal is here. And then you start working towards that goal, and someone comes in and goes, none of the goals over here now. So no, no information about Pre-Bolus thing. And then it's your fault. Your blood sugar's high. Well, what are you doing? What are you eating? This, you know, and when you start getting questions like that, my opinion is you're either with an under skilled clinician, or a lazy one, one or the other, who's putting it back on you. They either don't know or they don't want to try. It's one or the other. Because if you knew how to use insulin, your blood sugar would knock up to 50. FDA correct. Just wouldn't tip here from this person Pre-Bolus thing ahead of time, like when I'm finishing cooking, so that it doesn't feel like I'm waiting forever to eat. So this is a big part about Pre-Bolus thing that we never talked about. There's a little beautiful post this cute little like cherub face girl on my Facebook page the other day, she's like four years old. And the moms video is showing us a video of her and this girl is just like, I don't want to wait.
Jennifer Smith, CDE 14:44
That's so cute. It's cute, but it's sad.
Scott Benner 14:48
It's both things. And so it kind of sucks because yes, you do sort of have to Pre-Bolus ahead of time and think about it like when you're driving to the restaurant is That time, or is it when I get out with a car at the restaurant? Or is it when I order you know, because I don't know how long it's going to take for the food to come. And that's one problem. And when you're cooking at home, it's one busy cooking. And so I don't I didn't remember to do this. Now what am I gonna sit and watch the food get cold? I'm not going to you do have to think ahead. I'll tell you. There's all kinds of strategies if, if we're on our way to a restaurant, and Arden's blood sugar's terrific. Then I don't nothing right heart, right. But when we pull up, I know the restaurant a little bit. I know we're going to be eating 20 minutes from now, or 30 minutes from now, and about what she's going to eat. What are we gonna have? I might be like, Hey, why don't you Bolus like five carbs 10 carbs now then after she eats, we check again, put in a little more, I'll tell you with that strategy. We went to a place the other day, Arden had her period. I haven't said Arden had her period in the podcast for a while. So I think it was about time. We're going into this diner kind of place where she is going to get something not good. Like, like, quality wise, this is going to be a French toast and real syrup. And or a macaroni and cheese situation. She's just juggling the possibilities in her head on the way to the place. Right. And on top of that she had a little ice cream while we were waiting to leave. And so she missed on her ice. I said did you Pre-Bolus This ice cream? She goes look at my graph. Does it look like I did? I said no, it doesn't. So heading up 141 50 We're trying to Bolus it. And we roll into the place where already bolusing in the in the parking lot because this one, it's 170. Now like she totally just booted the the ice cream, and her blood sugar leveled out at 200. But still, with all that Pre-Bolus thing, we she ate a massive, I'm just gonna call it a pile of macaroni and cheese like all kinds of cheese. And within a two hour window, she went from not Pre-Bolus and ice cream to eating macaroni and cheese to back to 95. Right. And it's because of where we thought to put the insulin correct nothing else. It's I mean, well, and
Jennifer Smith, CDE 17:10
where to put the insulin with a little bit of good information or attention to the information you have. Right? Had you only had finger sticks, that would have been harder to do? Oh, of course. Right? We we have access to where our levels are trending now because thankfully, a lot of people have access to using a continuous monitor. Right. So that's a teaching piece in terms of Pre-Bolus. And the idea behind it and a comfort level around starting to do it if you've never had that, you know, in your habit before for food is where's your blood sugar, like you said, if it's level coming in or on the way to a place you're going to eat. Maybe you don't Pre-Bolus until you get to the parking lot or until you actually get seated especially you know, if it's more of a sit down kind of place, you have this waiting time. Whereas, you know, if your blood sugar is already heading up, you're going to do something about it, even if it's just the corrective insulin that you take right now. So that you can get some things leveled off before you actually sit down and Bolus for the food. So there's a lot that you can use your CGM in a high level way to learn how to put insulin in in the right place.
Scott Benner 18:26
That story is a collection of my I mean, 14 years of knowledge having a CGM, knowing how to Bolus for foods not the first time she had macaroni and cheese. You know, like there's all kinds of stuff that I knew about that it is not the story about the time we Pre-Bolus in the parking lot of a restaurant and then walked in and found that no one brought their wallet with them. Oh, that's fine. Yeah. So we were like, just back in the car, just hammering home, trying to get some food before the Pre-Bolus word still worked out. It was just a little more stressful.
Jennifer Smith, CDE 19:00
My strategy would have been like, somebody goes home to get food, get the wallet, the rest of us go into the restaurant and order. And that would have been my strategy
Scott Benner 19:09
with me and kids at that happened a long time ago, I would have been abandoning small children in a restaurant, but which by the way, they probably would have been fine. I mean, look where they ended up with my help. So this person says, Oh, this is about timing of a Pre-Bolus. And I'll tell you, you know, this is the next step. When somebody wraps their head around, I'm going to Pre-Bolus They want to know how long, five minutes, 10 minutes, 15 minutes. And to me, I mean, it that has a lot to do with where your blood sugar is at the moment. What it is you're going to eat next. And then you got to practice. I mean, right. You know, if you have more to add to that, go ahead, but I haven't been able to figure out any more than that in all these years.
Jennifer Smith, CDE 19:50
No, I mean there is there's an assumed strategy to get going with again, a lot of it is relative to the content of the meal and You know, if you're sitting down to a chicken caesar salad, you're probably not going to have a really long Pre-Bolus Again, depending on where your blood sugar is sitting. But even then a meal like that being lower on the scale of glycemic index comparative to a big bowl of rice and grilled chicken. There's a difference there, you know.
Scott Benner 20:22
So well, Jenny, somebody said something I want to pick your brain about, they said, there's a rule of 10 that they were taught. It said, take the blood sugar you have now and divide it by 10 for your Pre-Bolus time. Have you ever heard that?
Jennifer Smith, CDE 20:41
I have not. That's an interesting concept. So if your blood sugar is 180, you should have an 18 minute Pre-Bolus
Scott Benner 20:49
s3 Pre-Bolus a half an hour before? So I
Jennifer Smith, CDE 20:53
guess. I mean, to a degree on the lower end of blood sugar, it still tells you, you still need some whatever. Pre-Bolus you know if your blood sugar's 70. That's still a seven minute Pre-Bolus time.
Scott Benner 21:05
Yeah, I that's the one thing I still can't hammer through Arden's head, like without me there. Going back to the ice cream store. I said, Why didn't you Pre-Bolus The ice cream? She said, Well, my blood sugar was 90. And I said, that don't matter. You still need to Pre-Bolus
Jennifer Smith, CDE 21:21
good blood sugar,
Scott Benner 21:23
good blood sugar. We're trying to keep it here. And right. And she just was like, okay, and then that was it. But she's 18. And, you know, yeah. But anyway, Pre-Bolus your meals? Like, I'll tell you right now with no, I have nothing scientific to back this up. You start Pre-Bolus In your meals, I think you're a once he goes down a point. I just think it does. You know, I think if you wonder why you can't get into the sixes, and you're not Pre-Bolus eating meals, that's probably a large reason why
Jennifer Smith, CDE 21:54
this, especially if you're a one C is if it's under eight, but not quite where you want it yet, let's say in some range of five and a half to six and a half. If that's your pie in the sky kind of place to get to. If you're higher than that. Pre-Bolus I would agree with you. It's a lot of the reason that that a one C tends to be higher is the post meal time period that's left higher than you want it to be. Especially if your overnights are really solid value that's in target and right where you want it to be. If you're having post meal excursions, getting those contained with just the concept of a Pre-Bolus If you hadn't been doing any at all will likely bring your agency down.
Scott Benner 22:38
I like that you've been saying excursions lately?
Jennifer Smith, CDE 22:41
Oh, yes. I like that word.
Scott Benner 22:44
My new favorite. It's my new favorite thing. I don't know why exactly. We left anything out here. Are we good?
Jennifer Smith, CDE 22:53
Um, I don't think so I think from a base level, it gives a good idea of the Pre-Bolus concept. I mean, there's certainly a deeper dive into it. But other than that we've given a good,
Scott Benner 23:05
right click go head over to the, to the protests to learn more, but I'm just going to tell you right now you got to Pre-Bolus your meals, like there's situations where you can't if you're eating when you're 60 I get it if you'd be scared. But generally speaking, please Pre-Bolus Your Meals
thanks so much to Ian pen from Medtronic diabetes for sponsoring this episode of The Juicebox Podcast. Check it out at in Penn today.com. If you can't remember that there are also links at juicebox podcast.com. And links in the show notes of the podcast player you're probably listening in right now. And if you're not listening in a podcast player, I mean, can you please subscribe and follow on a podcast app and helps the show and honestly it's easier for you. The episodes come right to your phone and the Phone is right with you constantly. Mine's right here. See, I just picked it up. Everyone always has their phone or just blood sugar's 126 In case you're wondering. So let me just tell you again, because I know there are a lot of episodes of the podcast if you're looking for the defining diabetes episodes, or for the diabetes pro tip episodes there of course, right in your podcast player, just go to all episodes and you scroll around and you can find them or search and find them by searching for something like diabetes, pro tip or defining diabetes. There are also lists available in the private Facebook group, which by the way, is completely free Juicebox Podcast type one diabetes, so not only you're going to find a Facebook group with 27,000 members in it, people just like you who are sharing experiences and ideas. But at the featured tab at the top, you'll find all the lists of not just these series but all of the series It exists within the podcast and there are many. There's even a special website diabetes pro tip.com, where the defining diabetes and diabetes pro tip episodes are, even if you just needed to see the episode numbers that correlate with each episode so you can go back to your podcast app and and look for that episode. I may have just made that sound more difficult than it is juicebox podcast.com diabetes protip.com Juicebox Podcast, type one diabetes on Facebook, or just scroll through your podcast app or use the search feature. The defining diabetes series is amazing, as is the diabetes protip series you don't want to miss it. If you've been enjoying these bold beginnings episodes and you want to dig down deeper, those two other series. Those are the place to go. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Test your knowledge of episode 735
1. Why is it important to have individualized diabetes management plans?
2. How should blood sugar trends be interpreted and responded to?
3. What are the benefits of incorporating physical activity into a diabetes management plan?
4. What are the different types of insulin and their uses?
5. How should high and low blood sugar episodes be handled?
6. What role does a balanced diet play in managing diabetes?
7. Why are regular check-ups with healthcare providers significant?
8. How can staying informed about advancements in diabetes care help?
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#734 Balaboosta
Ali's son has type 1 diabetes and is preparing to live abraod.
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
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 734 of the Juicebox Podcast.
Today's episode of The Juicebox Podcast is with Ali. She is the mother of a 19 year old with type one diabetes who is preparing to live abroad. And while he's preparing, so as Ali, please remember while you're listening 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 healthcare plan or becoming bold with insulin. If you have type one diabetes, and are a US resident or you are the caregiver of someone with type one, and a US resident, go to T one D exchange.org. Forward slash juicebox to take the survey when you complete the survey. Your simple answers to simple questions about type one diabetes will help other people living with type one, they'll also help you and me. T one D exchange.org. Forward slash juicebox. completely anonymous. Absolutely HIPAA compliant only takes 10 minutes. Go answer those questions for me, please.
This episode of The Juicebox Podcast is sponsored by touched by type one. They're an organization doing great things for people living with type one diabetes. And all they want is for you to find out more about them touched by type one.org. You can also follow me on Facebook, and Instagram. Today's show is also sponsored by in pen from Medtronic diabetes. If you're looking for an insulin pen that does more than what you expect. You're looking for the in pen in pen today.com To find out more.
Ali 2:09
And Ali, I am a mother of currently 19 year old who is on a year abroad in Israel. And he was diagnosed the three and a half years ago.
Scott Benner 2:24
19 years old three and a half years ago. He is not currently in the country, even he
Ali 2:30
is not in the country. He is really really far. We're texting diabetes, different time zones, kind of not able to get texts sometimes it's fun.
Scott Benner 2:44
Interesting. Let's go back a little bit to the beginning. So okay,
Ali 2:48
very beginning. So we're religious Jews. So there's a lot of like very specific holidays and things. So we had Rosh Hashanah, which is our new year. The whole family, you know, was together in one house. And he was very similar. That, you know, he had a sore throat and he was throwing up. So I got him some antibiotics. And we said, okay, so you know, we'll be home in a couple of days, we'll take you to the hospital and take it out there. And he was okay with the first day. He had lost weight. And my mom was like, so excited, took him shopping, and she got some new clothes. She was like, so excited. And that summer, we hadn't seen him in a long time because he was in a sports camp. And then after the sports camp, he went to hockey camp. So it wasn't like a long Oh, he doesn't feel good. Right? Um, so I guess could get a sore throat. So he's like sitting on the couch. It was his
birthday. The 16th birthday, we got ice cream
cake, and he didn't eat it, which is typical ice cream cake. And it was just like on the couch. And and then when we finally took them to the doctor, yeah, I went to work. And my husband was in the doctor. I was like, get a strep test. So he goes to the doctor and he's like, he's like, we're going to the hospital. So, you know, so he got his diagnosis. And I was like, like, I definitely did not believe it. I was like, these people are idiots. They didn't even do a strep test, you know? And then, you know, when I came here, my husband was with him the whole time. You know, he stayed with him. And it was it was I was convinced eventually. So he's nobody, there was nobody no Nobody in our family had any kind of diabetes and even he only had one marker. So the last time you went to Endo, she's like, Well, I'm not going to change your diagnosis because your markers didn't come up. But, you know, maybe there's a different marker. We're not testing, like his one marker that it took him a long time to kill his pancreas.
Scott Benner 5:21
Okay, so, alright, so at the end of his 15th year, he's off at a couple of sports camps. He's gone for a while you don't see him, he comes back. It's a holiday, you're around family, not at home, and he's sick. You think he's got strep, which makes sense. Here. Your mom is on a different path. With like, Oh, it's a great time to buy new clothing. And, and then you get this diagnosis. So how, how long was he in? Was he in the hospital? Did they ever admit him?
Ali 5:56
Yes. So we went to the pediatrician, he said, like go to this hospital. We went to Hackensack instead of the local, you know, the local one. And they have a Mali center for diabetes, which is, you know, pretty extensive, and it's associated with Jocelyn, and it's like a good place to go. Of course, you know, whenever other people told us, no, you got to go to Boston. You got to go to Philly, you got to go to New York, you know, but we were you know, we're in Hackensack pretty happy. And I was kind of picking the doctor. So every five minutes, a different doctor comes in. And there's one doctor that he was like heavy his I put them on the list, Javier Eisenberg, he's like, cool, and a guy and he's got like, you know, big curly hair. And he was like the head of the whole department. So I'm like, okay, that's the one. And when you call him to make the appointment, they're like, Oh, well, we don't have any problems with him. But you can have our nurse practitioner that graduated last year. Do you want that? So we got, you know, eventually got in. It's also like, a little specific to Jewish people as we have this thing called beaker holing, which is people visit sick people. And it's like, you know, it's a big thing. And they also have a setup in the hospital. So the bigger home room, which is, I guess they pay the hospital to have a room. And that room is stocked with like all this kosher food and like, people bring it in all the time. And the restaurants donated. And so we had like, somewhere to hang out. And we had cooked food. And then people start calling and like the first person that calls is rabbi, because, you know, he hears somebody tells him and he hears and you know, what do you want when you want? So Mike, so it gets my kid on the phone, and my kid says I want French fried pizza. So we're like, Okay, enjoy pizza. So like, you know, he comes over and he brings it up. And he's like, he gets on the phone with me. He's like, is there anything you want? I'm like, Just Just bring some vegetable soup. Okay. Just give us something that's somewhat normal. I No, pizza is hard. I don't know anything. Right. So, you know, but I'm going on all the little Facebook groups and somebody's got a friend and the friend calls me and they you know,
Scott Benner 8:34
fascinated that you found a Jewish doctor from Buenos Aires. I don't know how you did that. Right. His name was Javier Eisenberg. And I was
Ali 8:48
kicked us out when he was 18. But last two years. Well, yeah, I
Scott Benner 8:52
mean, pediatrics. They move you on? They move you on when you're 18. For sure. Yeah. Yeah. Well, tell me about. I mean, I'm interested because I sort of know where your story goes to some degree. So I'm trying to pick apart a little bit. So let's find out next. When do you find the podcast and this process?
Ali 9:12
Pretty pretty early. Okay. Pretty early. We, cuz I was on Facebook groups, like the first thing I did was like, very specific good. You know, Jewish mothers in New Jersey, diabetes, the very specific groups. And then yeah, and then somebody new you and was on your podcast. I don't think you've had a Facebook group yet.
Scott Benner 9:34
It was not if it was a few years ago, I think. Yeah, that thing's coming up on two years. So yeah,
Ali 9:41
yeah. And you know, if you're if you're on it, you definitely know I'm on it. I love that group. They're so great. And yeah, so we we stayed in the the we stayed for that weekend. To the Shabbat, and they have an apartment and they, you know, you stay in their apartment, the bigger home people. And you get these, like little gift box then with a little note in it, and my daughter wrote the note, like months and months before, because any, anytime, you know, one of our friends is like, Oh, we're packing boxes, and my all day is I go over with a couple kids and a couple of nieces. And we're packing boxes, and my daughter was the one that wrote the note. So I was like, Oh, that's so
Scott Benner 10:32
cool. So you're so so people understand. So there's a community support at the hospital. And volunteers make up gift boxes. You had done that in the past and your son, and yeah, I think it's hilarious. It's very funny. He listened any chance they kept him in the hospital for eight days and eight nights?
Ali 10:56
That would be cool. I
Scott Benner 10:56
think, just for fun.
Ali 11:01
No, but it's holiday season. Right? So we were scared that he would be he was there that Shabbat but we were scared he was going to be there, you know, three days laters Yom Kippur, which is like a very, very big holiday. And it's a fast day. That was his first basil test was Yom Kippur. So, you know, thank God, he was out. And we were able to do that. But you know, at least we were out.
Scott Benner 11:27
Well, how was his blood sugar super high at diagnosis or no?
Ali 11:32
So he was he was he was 13.
And a sugar was 330. Okay. So and then, by December's the next time they took it, it was 6.8. And it was seven after that. Right. So he was pretty controlled right away. We got a Dex Right, right away. The first appointment, we had this fabulous nurse and the deck the six had just come out. So she was like, you want the six. But it might be hard to get because it just came out. So you know, so she's prodding us, like, is there any reason that I can tell the insurance to expedite it? Like, does he go to school? You know, further, I'm like, yeah, he goes to school, New York, you know, like, and does he play sports? And like, yeah, he's an athlete. He's an athlete. Like, he played two varsity sports, but like, it's yeshiva league floor hockey, you know, like,
exactly Major League here. But
you know, that's gonna bring his blood sugar down. Pushing Yeah, we got the ducks right away. And then the pump, they require you to do training. It's not that they didn't want to order it. But there's, there's some training,
Scott Benner 12:46
they had rules they wanted. Yeah.
Ali 12:49
First of all, everybody's there, I'm there, my husband's there. He's there. You know, I'm trainers and everything. And a whole bunch of wooden fruit, vegetables and twit the smallest bowl of rice you ever saw. And a little potato and a big apple, you know, and they want you to be able to figure out what 15 carbs is. So each thing is 15 carbs. So,
uh, so that was kind of cool. I like that.
And then the next visit already, they're showing us pumps. And they wanted us to be not they want us but like they were pushing the Basal IQ, because they're like, this is safer. We're gonna do the Basal IQ. And that or, you know, some teenagers really like the AMI pod because it's, you know, simpler and it doesn't have tubing and stuff. So my, my son's a one look at it. He's like, I'm not having wires coming out of my body, you know? Like, he's just like, not at all interested in the quad if it was a better quality or not, not okay. So it turns out, it's great quality. You know, we're very happy with Omnipod. And we're, we're in for the five to come out. Yeah. He also wouldn't he also wouldn't loop they, they wouldn't let us loop but he would not do it because we started on Eros. He wouldn't do it. Because it's like, you know, it's not FDA approved. I don't know. But
Scott Benner 14:28
I try. My daughter said what is this? Is that gonna kill me? And I was like, I don't think so. She's like, alright. Whatever the shot then. Yeah. Okay. So would you how would you characterize his first couple of years with diabetes? In a couple of different regards. Was your the health part of it where you want it to be? Was it a struggle? Did you figure it out? And how did he handle it emotionally? Was he you know, did Did he kind of mesh with diabetes? Or did he brusque against it? How did all that go?
Ali 15:06
So, he is a very, like, chill, kid. Like, he's nothing really fazes him. So he wasn't, he wasn't like a stick to nothing. And in the beginning when he's, you know, testing blood sugars and MDI, he had a huge box, this time pod box, and he would bring it like, all over the place and be like, Hey, you want to you want to eat a pie pot, you know. And he was very proud of his, I think it was very proud of his amount of needle district
Scott Benner 15:50
is keeping his like old like syringes. And in this tie pod box.
Ali 15:56
Yeah, that was our that was our sharps container. Nice. And he would like offer it to people to eat. Yeah. So like, he would really like he's very, very social. So he would go to these events and like NCS, why is the use groups that they're in? So they have stuff every week that has stuff every Shabbat? And you'd be with a group of people, you'd be like, Hi, I'm diabetes, you're not like, I don't know, he was not. He was not particularly fazed by it. I would say in the very beginning, he missed a whole month of school, because the doctor is just like, alright, let him Let him get used to it. And in the fall, there's like school every one, two days, you have like, at the most two days a week because all the holidays. So they're like to stay home until the holiday season is over. And then he'll come back. So he goes back to school. And his friends were like, we thought you got kicked out. Why didn't you call us he's like we made this wasn't, I'm gonna call you and say, Hey, I gotta diabetes. Like that was the very beginning. And then by the end by like, two months in. Yeah, he was like saying hi on diabetes. Like, it was not something that he was at all ashamed of.
Scott Benner 17:13
Right? You know, when you guys are on holidays, we all just sit around in public school or like, Thank God for the Jewish people and all their holidays.
Ali 17:23
I wish we got all of them off in public school.
Scott Benner 17:26
I don't know what this Yom Kippur thing is. But I got the whole day off baby.
Ali 17:32
Yeah. You can eat too. It's like amazing.
Scott Benner 17:37
And I can eat too. Yeah, it was a whole free day for us.
Ali 17:42
I don't know I have I have Muslim patients and they got a whole month. They get a whole month and not eating. And the kids do it. Like the older kids do it.
Scott Benner 17:52
They can stay a month they do it. Yeah.
Ali 17:55
Rather than is a whole whole month. Like there's six days a year. Six days. That's quite the basil test.
Scott Benner 18:02
I sometimes forget to eat. I don't know if that counts. Yes or No. for a whole day. It's totally totally it. Exactly the same. I don't feel compelled by any religious reasons. When I do it. I just forget. So she you think he's laid back? He's doing okay. But then, you know, I become, I mean, aware of you, but the, you know, through the Facebook page, but I don't really know you. I mean, to this moment, I don't really know you, but I didn't really speak to you until you reached out directly. Because your son was going oh, why don't you tell people what did he What did he want to do and what were your concerns?
Ali 18:44
Well, he was going for his year in Israel, which pretty much everybody else? Well, I I'll say that and then I'll back up I guess. He was going for his year in Israel, which pretty much 90% of the kids in his school did are going to and it's a yeshiva year, which is like a religious stuff, but it's also traveling and it's hiking. And it's, you know, just learning to be a grown up and having a great time as friends and it's a great year. And my older two girls did it and he's not, he's not staying home. There's no way that you know, this is keeping him home. So I was a little worried because the last time you went to Israel, which was only for a month, he came back with a 9.7 and he had kidney stars and he was a disaster on his own. Okay, so that was a year after diagnosis almost a year.
Scott Benner 19:50
So a year after diagnosis. He went for a month. Right then he came back and it's a once he had gone up significantly while he was there. Alright, so now you're now you're getting back, I assume things get back to the way they were when he was with you. But now you're looking at him being gone for a year. Right? Okay. Okay.
Ali 20:13
So I'm Alou. You. So I'm trying to stack the odds. So there's two other type ones in his particular school. There's more in the neighborhood and in different schools, but his school has three this year. I don't know who's older, but this particular history, so he's living with one of them in the room. And then the third guy in the room is this very good friend of his, that's an EMT. And the Israel tour that he did for the year for the summer was the EMT tour, which you get to be an you get a certificate as an EMR. And it was a great, great experience for him. He actually saved a life and they, they make a very, very big deal about it, they gain a medal from the State of Israel, that he saved a life and, you know, they, they have this big celebration, and he's called up to this big celebration. So it was like a really good experience for him. And I also was like stacking the odds picking that tour, because the other toy he wanted was surfing. So I was like, let's do the one with the medical profession. You
Scott Benner 21:35
know, I, I just had this whole image in my head, that they get the kids over there, and then they stage a medical emergency and let them pretend that they saved a life so they feel good.
Ali 21:48
I think I know, there's a lot of Jewish lawyers in Israel, but it's just not as litigious society, because they're letting 16 year old do all sorts of stuff. You hear
Scott Benner 22:07
I'm dying, what I need as a 16 year old boy, he's just left his mother for the first time to help. Not exactly. That Exactly. Comfort. When you
Ali 22:18
know, I mean, what do they told him pushing her and he pushed here, you know, like they had the machine on telling you
Scott Benner 22:25
the whole time. They were actors. No, no, I'm kidding. When so when you reach out to me, what is your like, what were you looking for that day? Because I remember speaking to your son on the phone and thinking he was not thrilled to be on the phone.
Ali 22:41
Oh, yeah. I'm sure right. Yes. So
he, I mean, his agencies are fine like this. Here's like 6.6 and it was 5.9 is 5.8 6.16. In Israel. He was six this last time, November, which is his own. I would say that's his own a onesie. But his variability is horrible. He is not a straight line guy. He's a don't Pre-Bolus enough and go away in the sky. And then just keep hitting it until it comes down finally, and get his up louder down and then catch it and then, you know, eat again, five minutes later and yeah, like it's he he's variability in his like, waves
Scott Benner 23:30
are bad. So so he's not, he's not really. He's not managing. He's, like, just stopping bad things from happening. But more important that's happening pretty constantly. Yeah, okay. Yeah.
Ali 23:45
He, yeah. If if the Dexcom like runs out of numbers and gives you words that that. Okay.
Scott Benner 23:55
So he shows us that. Yeah. No, runs out of numbers. But what so you're he's jumping up to 400 at times? Yeah, yeah. Oh, yeah.
Ali 24:05
He's up. He's down. He's all over the place.
Scott Benner 24:07
And you have no, now I know, that's not what you want. So, but you're having trouble impressing that upon him?
Ali 24:15
Yes. So I am a podcast listener and I listened to all of your podcasts, which I really enjoy as everyone should. Everyone should. But he's not. So it's going through the filter of me and I'll tell him like, you know, bumping, no, I really hit it a little bit, hit it a little bit hit Did you know, or this one, you should you know, hit it harder. Or remember, I can't tell you, if you looked at the text chats. I can't tell you how many times I've written the word Pre-Bolus in the tech chats, like, Will and he'll say he's doing it, you know, but then we'll have meeting with the, you know, with the endo or the CD or whatever. And then Okay, so your practice seems to be rising a lot. You know? What are you? You know, what are you doing? Are you people listening? And he's like, oh, yeah, totally. Just like, okay, good. So what do you eat it? He's like, eating three bowls of cereal in a 10 minute Pre-Bolus. And that's what he thinks is a Pre-Bolus.
Scott Benner 25:28
When it doesn't, when it doesn't work, and it goes, I mean, he knows. He knows it's wrong. Like, I mean, going forward, I'm assuming he doesn't feel well. Is there? No, there's no, no indication from him that he's like, Oh, I maybe we shouldn't do this. Like he just doesn't, I don't want to say doesn't care, but he doesn't care.
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Ali 28:21
I would say he's trying. But he's really not that good at bolusing. Like his Basil is if he doesn't eat and he's in bed all day. He's got a beautiful line. It's nice and straight settings. Yeah, I don't know if there's a maybe as cover ratio is bad. But he's mostly just winging it. So sometimes the other day he's taunting me. And he says, a four pieces of pizza. Did you see it? And I didn't. And I was like, Oh, okay. Yeah, he figured out pizza. But yeah. Last night, he that all the boys do these like little side gigs to get spending money. So his side gig he decided is going to be making general child's chicken. So he doesn't cook. Split sides get to know learn and he and his friend. He's got a recipe he's going to like okay, so fried chicken with cornstarch and flour, bathed in sugar sauce. That's gonna be like, can you be the protein shake guy?
Scott Benner 29:39
That's gonna be him.
Ali 29:42
No, like, No, it was really good. Like, yeah, I'm sure.
Scott Benner 29:46
So prior to prior to him leaving for this year, was this happening still like were you involved? And you were you were making Pre-Bolus this happen or was it same situation just he was in the same country.
Ali 30:01
Um, I'm gonna say his desk a onesie was those six weeks, I was home for COVID. And he was in his room. And I would just like go in there and do it. But I can't like honestly say I'm better at it than him, because he's doing it all day. So, so you've never been, but you have to get it right. And sometimes he doesn't.
Scott Benner 30:23
Yeah, but you've never been the main person taking care of it?
Ali 30:28
No, no. Anytime he eats, he's the one that puts it in.
Scott Benner 30:32
Alright, so you wouldn't say that you're any? Are you any better? Like you don't even know, I guess if you're better at it than he is.
Ali 30:42
I know that I'm not gonna ignore it and just hang out.
Scott Benner 30:47
But about the timing and the Pre-Bolus thing and things like that, like you?
Ali 30:51
I don't know, I don't know. card numbers of things. I would look it up. But I certainly know. All of the rules. He knows. Also, he knows about that routine. He knows about how long, you know, something's gonna take to hit him.
Scott Benner 31:09
Right. But I don't think we're talking about understanding. And I think we're talking about the will to do it. Yeah, right. That's yeah.
Ali 31:16
So if he was, so how do I give him the
Scott Benner 31:17
will? No, no, no, I'm asking. I'm asking first. Do you have it? Like if we magically made him six years old? And you were just in charge? Is that like, who you like? I'm trying to find out if you and hear the same person, like so like, Oh, you don't? I mean, like, are you? If you were in charge, do you think you'd be like, Oh, I forget the Pre-Bolus. And we end up chasing it around all the time. Like, do you think you'd be him? Oh, oh,
Ali 31:46
I need for my own health. I, I personally eat a very low carb diet. Okay. And that's, it's mostly for weight. But hey, I was expecting this question. And you didn't get a chance to answer this question. How do you know? So I don't really talk, a good step on the
Scott Benner 32:10
alley. Every Jewish mom is gonna listen straight through it, everyone else is probably turning it off. But you go ahead, you keep going. You're fine.
Ali 32:19
But if they want to hear Scott,
Scott Benner 32:21
no, no. But do you see what I'm saying? Like, at what you've described, is basically about three years, where you you haven't been, anytime the primary caregiver on the insulin, and he's chasing it around, and you want him to be better at it. But like, you don't know what to do about it. And I don't and I'm trying to ask the question, if you were in charge of it, would you be better at it?
Ali 32:51
So I don't have the data of my body. But you know, the other day, I see like, a double arrow down, right? And he's like, you know, 60, double down. So I'm texting him and texting him and texting him. And then he gets to the ello w. And then and then I found out later when I told him, they had a push up contest. Okay, then it was like, well, we'll why you know, you know what to do? What are you supposed to do when you exercise? Turn it down, turn it off, turn it down an hour before you know have something to eat before he's like, sick. That's not how it works. Like I can't, you know, go with the guys and be like, well, story. Can we have the Push Up contest in an hour? I need to turn down my Basal. Like, he's not doing that. Yeah, but
Scott Benner 33:39
what about, what about that situation where he's like, Oh, geez, we're about to do this. I'm gonna I'll take in a bunch of carbs. Now to avoid the low instead of experiencing the low and then taking in the carbs, because he's gonna He's gonna end up doing the same functional thing, right? It's just one situation, he would avoid a problem. And the other situation he's steeped in it. But but so seriously, though, hold on. You have not answered my question yet. If he was six years old, I
Ali 34:04
better than him.
Scott Benner 34:06
No, no, no. If he was six years old, do you have the personality? Like, let me give you a different example? Two days ago?
Ali 34:14
Yeah, I think I could do it with all of the information that I've taken in. I think I could do that. So because I would like weigh the food and look, type it in and figure it out. And, you know, extent he extends boluses he just doesn't
Scott Benner 34:30
always do it. Right. But would you Pre-Bolus Because Pre-Bolus things as you would like, for instance, the other day, Arden's like they kept them home from school again. So she's the middle of the day, she's done school already. She's hanging out where Kelly works, and they get lunch together. And then they got a dessert to go with lunch, but they weren't going to eat it right away. And a couple hours after lunch, I was walking through the kitchen and arms like hey, I'm gonna have that that dessert. Now I was like, Oh, well, you know, go ahead and Bolus for it. And she, she, she Bolus and I was near it. So I kind of put it on a plate and I brought it to her. And I set it down. And she reached out for it with these big excited eyes. And I went No. Right? She's like, What am I, you've got to prove you gotta let this Bolus work first. I was like, just don't look at it, do whatever you're gonna do. But we're not eating this for at least 10 minutes. And like, do you would you like, I don't know what the I can't figure out what your relationship?
Ali 35:37
Can I force a six year old to do it? I can't force a six year old to do it. Okay. Would you be able to? I don't know if I can force a 19 year old to do it.
Scott Benner 35:43
Right? By No, no, I hear what you're saying. I could just bug him.
Ali 35:47
I could just like Bugan Bugan, Bugan Bugan. And so he you know, whatever.
Scott Benner 35:52
Still doesn't listen to me. I'm not sure how this is gonna sound like so. I don't think like when I do it, I don't believe that I'm badgering her or bugging her. I don't believe that. I'm, I think I'm reminding her. And then I have the, the wherewithal or the strength to stand in front of her while she ignores me and tell her not to ignore me. Like, I don't just like, you know that thing. We're parents, like, don't do that. And cause like, go to hell. And they're like, all right, and then it just happens anyway. Like, I'm not, I'm not uncomfortable in the uncomfortable part. Like, I can stand there and be like, listen, we have to wait 10 minutes, you just you just really can't eat this. But I don't know that a lot of people are comfortable with that. I guess I'm asking if you are.
Ali 36:41
I, I'm comfortable with it. But my work on him. Like I'm not with him. And I'm not on him.
Scott Benner 36:47
So So why like, that's so that's my real take
Ali 36:51
on texting and texting and like, Do it, do it? You know?
Scott Benner 36:56
What I'm saying the deal? How do I the difference between like bugging him and actually making it happen? Like, he's 19? Like, you know, you have recourse? Like, here's one, you can't go to Israel, if you don't Pre-Bolus Like, you know what I mean? Like, I'm wondering, like, where I'm wondering where that is? Or if it's just not your relationship? Like, I don't know, I'm not judging it. I'm just trying to figure it out. So but I'm not sure. I'm not sure if you know, even like sometimes things just grow the way they grow. You know, like, would he not? Like, is there no world where you'd say to him? Listen, man, this is a significant issue for your health. And I don't care that you're able to see comes back in the sixes, you know, your blood sugar has been three and 400 over and over again. And you're catching dangerous lows. Like at some point, this isn't going to be okay. This can't be your path forward. Big because I mean, you know, I don't know, it feels like we all know where we're at. And we're kind of pretending like we're not there. Does that make sense? I bumped out, I bummed you out? I didn't mean it bummed me out. I'm
Ali 38:01
sorry. No, no, no. We're so another thing we're like trying to do is sort of the get to the right answer the wrong way. And like he, he, so in that in that breakfast scenario. For the 45 minutes before breakfast, he's in the services. So he's like, I'm not, I don't want to take out my phone and do something. And so I'm like, just put in a couple units. Like, how hard is that? It's like, No, I can't do it. You know, it's in the middle of services. I'm not going to do that. So we put it in the basil. So I put two units in the basil that just goes in automatically a half an hour before his breakfast and dinner times. And at lunch, he has a longer lunch. So he can you know, he can do that. But you know, he's got like a flat 1.2. And then at nine o'clock, he's, you know, that our, his Basal is fine. And then it's 1.2 again, so
Scott Benner 39:06
and that's it. You compensating for not Pre-Bolus thing, right? Yes,
Ali 39:10
yeah. And he's a little bit like, Okay, I don't know what I'm gonna eat. So I need to, like, I need to see it, right. And then I had a half an hour, you know, they don't give you that much time, who you know, breakfast is a half an hour, and then you go to class, right? So,
Scott Benner 39:26
like, I'm not on, listen. There's plenty. Yeah, there's plenty of times your arms like I'm hungry, but I don't know what I want. And then she'll do that thing where she's like, Well, I'm not going to eat because I can't figure out what I want to eat. And, you know, it happened like last night, like late last night. She's like, I'm hungry. I was like, alright, eat something. And she's like, I don't know what I want. And I'm like, Well, what about this and you start playing that game? And then they're like, no, no, no. And then you get to there's, there's nothing in the house. I'm like, sure. I spent $600 at the grocery store. There's nothing in the house. You know, so It's it's us and I'm not unaware of the fight. I'm just saying he's in a unique situation. Where because of his, his traveling, he's got the real ability to ignore you if he wants to.
Unknown Speaker 40:13
Yeah. Jay Yeah. She kind of,
Ali 40:20
but Well, I mean, I don't know, like he wants to, he wanted to stay for army. And he's gonna stay for Army because he's not controlled. Right. So, you know, they're, they're doing a ton of hiking and jumping around and all kinds of stuff. And the food is whatever the food is, you don't have a kitchen that you can start grilling chicken. Yeah. So yeah, I don't know if he's gonna do that. I mean, we'll see. But we got to figure it out.
Scott Benner 40:53
Yeah, that was one of the things that you had mentioned to me back then was that he wanted to you wanted to do a year in the service in Israel, right?
Ali 41:00
Yeah, yeah. And my, my niece is doing it now. Like, it's a really, like, it's a great thing for them. They really, you know, they, they get strong, they feel powerful. And it's a it's 1,000,019 year olds running around together. And she wanted to do I think, like a social work one, and he wanted to do he wanted to be in a hospital, like a field hospital or something like that. Be getting medical training. But yeah, they they do some cool things. But then he could also be the guy given our boots, you know, if he's, if he's not controlled, and they see that he's not up for it, they're not going to give him good job. So do you think you know, not that the guy giving up boots is not an important job, but
Scott Benner 41:53
he might not be doing? What do you want? What he's, that's not his goal. Yeah. And does he see those things as connected? Do you believe, like getting to his goal? And I don't know. Yeah.
Ali 42:05
I don't know if she said she's connected. I little bitty, like day to day. You know, I don't feel good. Well, hey, I could tell you why you don't feel good.
Scott Benner 42:16
When you put me on the phone with him. i He. My interpretation was he resented it happening? I thought he did. I thought he wasn't happy about it. But I wasn't on that end. What did you think on your end? I think he thinks he knows everything. Okay.
Ali 42:34
He doesn't need he doesn't need advice, because he already knows. And he's handling it just fine.
Scott Benner 42:42
Gotcha. Yeah, no, I mean, look, that is the basic vibe that comes off of every young adult that I've ever spoken to who's kind of lived past this part and then looks back on it. They'll say, Oh, I thought I knew everything. My blood sugar's were all over the place. I was fine. I didn't care. Somebody tried to help me, I ignored them. But then the last thing they always say is, I wish someone would have just pushed me harder. But they say that they say it in retrospect. So I honestly can't say what would happen in the moment, if that's what happened. I just know that in retrospect, every older 20 year old looks back on themselves at the time we're talking about with your son and says, I wish my doctor or my mother would have tried harder, you know, or sets. But I think what they mean is, I wish they could have gotten through to me. But I don't I don't know if you know the same mind you make that statement with when you're 25 is the same mind you have when you want to go, you know, to Israel for a year when you're 19. It's a weird situation to be in. I mean, have you ever tried? I'm just wondering now as we're talking like, because it's such a big part of your life. Have you ever tried explaining this to a rabbi and having the rabbi talk to them?
Ali 44:01
Hmm, that's interesting. So the rabbis in the program, I'm one of them did talk to him. Just about, you know, and he doesn't know specifics, but he knows if you're missing class, because you're sick. And you know how to take care of yourself. You know, do it. Right. That you have to take better care of yourself. I think that the loop is definitely going to be a game changer for him. Well, but he could still Bolus bad.
Scott Benner 44:41
Yeah, the algorithms aren't. The algorithms are not going to get in front of you not Pre-Bolus thing. They just they can't and not at this moment, like can they one day in the future like baby but for now? It's still it's still not gonna work that way. Like he's got a Pre-Bolus
Ali 44:59
Yeah, And how long do you say a Pre-Bolus is or it's just different for every food,
Scott Benner 45:08
you know, it's different, it's different depending on the food you're eating, how quickly your insulin works, and what your blood sugar is to begin with, right? Like, you know, when you're at five, your Pre-Bolus is different than if you're 120. And is different than if you're 150. And to be honest, if you're 150, you're not really Pre-Bolus. And you're correcting and bolusing at the same time, you know, so, I don't know if there's a if there's a time to it, there's a, I would say this, if he's doing none at all, you know, even just getting him to commit to 15 minutes would be a big deal. And then, you
Ali 45:44
know, he thinks a Pre-Bolus is 15 minutes. But this because that's what he will do. Well, it's not worth it. Sometimes he'll split wrong. Like he'll give a 5050 split. But he really needs almost all of it upfront. You know?
Scott Benner 46:03
Yeah, maybe the nuances, well, maybe that tool is too advanced for him. Maybe he shouldn't be splitting, splitting his boluses unless he really gets it because maybe he's applying extended Bolus is where they don't belong. I mean, that's possible. I don't know, I haven't seen the data, or anything like that. But those, that's one of the things that I see people do, sometimes they get excited, they're like, Oh, I found out about extended boluses, then they try to use it everywhere. And you know, it's they're not appropriate everywhere. So and then. So now you think you're putting in seven units, but you're really putting in, you know, three and a half, and your blood sugar's shooting up while this other three and a half is trickling in, and really not doing much good except holding you under 300. You know, that could be it. Maybe he's outsmarted himself, you know, in some situations, because but being 400 and needing to correct afterwards. I mean, that would seem to me to that it's just not enough insulin for the meal. Maybe either the ratios off or he's eating something that's wildly more glycemic Lee heavy than than his ratio is prepared for that would be my guess. But I don't know how you explain that to him. If he feels like he knows everything. You don't I mean, it's a tough situation, I feel for you, I feel what everybody
Ali 47:22
takes advice, he takes advice. And, you know, a lot of times, they'll just be like, just even it out. Like, just give a little bit, give a little bit and he'll be like, by the power of Grayskull. And he'll like whack the damn thing down. And, and then he'd be like, no, too much. Write and then you know, and then it's low. And you'd be like, like, Okay, this is, you know, you're you're at it, you're, you're it's 60 you need you need 20 points, like 20 points is not that much, you know, and then he'll be like, Okay, I'm just gonna eat, you know, a granola bar, spoon, peanut butter and a little bit juice in there. Like, you're like, you just ate like, 50 carbs? Like, that's not good.
Scott Benner 48:13
Do you have hope that
Ali 48:15
too much? Like the
Unknown Speaker 48:18
person who takes these smart
Ali 48:19
kid and he takes the time to think about it. And sometimes he does, you know, if you take the time to think about it, then he will definitely get it. The Caring is, is hard to give him. Um, but I mean, obviously, the goal is I, you know, I paid him to listen to your protests. I paid for protests. I gave him like 20 bucks and a full day of mom not bugging you. Was what you got paid for protests. And it wasn't a great deal. That's a really good deal.
Scott Benner 48:57
I take it, did it work? Do you think? Or do you think you just gave
Ali 49:01
out 10 of them? He started with exercise. And he did all of the shorter ones, regardless of the topic. So I'm gonna say if you're redoing pro tips, put out some little ones diagnose the defining diabetes are all really short. Right? And and the variables are all really sure. Yeah. So maybe I'll try to get them on those. Be like forget the pro tips. Just do that again. Very
Scott Benner 49:37
well. Maybe it was too much for them all at once. You know, like and that's actually true to like, you know, I don't think you should dive into the pro tips at exercise. If you don't understand the rest of it. You know what I mean? Like the basics. It's just like anything else, like you got to lay down a foundation of basic concepts and then you can build into these you know, more intricate ideas I guess it's just I don't know. Listen, it's it's really tough. It makes it. It makes me I don't know. I'm pretty happy. I have a daughter, not a son that
Unknown Speaker 50:13
I got three daughters. Yeah.
Scott Benner 50:16
They listened vine, right.
Ali 50:17
They love him. They cooked dinner for me. They all guys and stuff.
Yeah, he's good. I hope he is able, like what I'm worried about is that he won't be able to do the things in life that he wants to do. Yeah, no. Too busy ignoring the things he has to do.
Scott Benner 50:41
won't get through if he wants to visa. Yeah, I mean, to me, it's like, he's
Ali 50:46
just like, Okay, I don't you know? Yeah, yeah, diabetes, whatever. But he's not gonna be able to do what he wants to do. Right? If he doesn't?
Scott Benner 50:56
Does he not believe that? He doesn't believe. I don't know. What's tough. Does your husband get involved in this?
Ali 51:06
My husband is like, awesome. He wants to like all the educators things and stuff. But he's not like the day to day, I'm gonna text you if your blood sugar is 180 I'm gonna text you, guy. Like, he's got a job. And he's more big picture.
Scott Benner 51:25
He's doing his thing. You do your thing. Yeah, he'll
Ali 51:27
talk to him. He'll be like, dude, like, What the heck are you doing? Like, just take care of yourself. I'm not gonna tell you how to just do it. And I'll be like, you know, put in 3.2 right now, you know, that's, that's more of my vibe, or I'll, I'll send him when he was on, Basil Glar. Like in the very beginning. He's on basketball. And he's supposed to take 10 units at 10 o'clock. So they like did it so he'd remember. Right? Right. And then he doesn't, you know, then he falls asleep on the couch, or he just forgets or whatever. So his alarms on and I my lines on? And, you know, the first couple of times, I'm like, go downstairs, go find him go. Yeah, you know. And then, you know, we'd be like, Hey, get off the TV, you gotta give a shot. And then I was like, Okay, we gotta like, get creative on this. So I started downloading, like, hundreds of pictures of Basler discs, and mythical creatures. and I were like texting one of those at 10 o'clock every night be like, I'm, like, just a little bit of a different vibe. That is like, that's not because I'm bugging you. It's just, I'm a weird person sending you weird pictures of basketball discs, obviously, like it kinda reminds it like, I'll very often I'll like wake up in the morning and his blood sugar's stinks. And I'll be like, you know, I'll take somebody like, Hey, good morning, how's your day? You know? And it'll be like, Oh, is it takes for mom, I guess I better look at my blood sugar. So he knows he'll fix it. Well, that makes him fix it.
Scott Benner 53:04
Okay. So just being told, like, directly. Yeah, I kind of helps.
Ali 53:13
I, I think so he might feel like I'm still bugging him. But I remember one time you were talking about, you know, if you're, like, just parenting in general is like, you can't always lead with diabetes. Because then they think that that's like, the only thing that you care about. So I try very often lead with diabetes. But I tried to be like, Oh, how's your classes? How's this? How's the Trump has a you know, to just talk to him about other things? Um, yeah. Yeah. I don't know. I want to ask you about like, Basal versus Bolus ratios. Because his Endo, she wanted to increase his climb rate. She wanted to increase his basil, because his percentage was like 20%. And she wanted it higher, because basil percentage. So she's, she's got some rule. That makes sense. She's like, his Basal should be higher. So then he raises basil. And then he was like, always going, Whoa, and it didn't work. But his highs after eating were not as high. But he was always, you know, if he wasn't eating then he was always fixing Lowe's. So it was sort of just like, at putting a blanket on top of it. But he still had to, like, I don't I don't think it was the right basil. Yeah, because supposedly the basil is supposed to keep you know, keep you flat if you're not eating. So it didn't, it didn't really do that.
Scott Benner 54:55
Okay. So all right.
Ali 54:58
It sort of how helps it sort of helped in its own way.
Scott Benner 55:02
Okay, you know what I mean? Give it to me one more time. Just real bare bones. What happened one more time.
Ali 55:07
Okay, so he's up and down, up and down. Yeah. And a lot of times when you see an up and down chart, you're like, Okay, more basil. So she just said more basil, witch, and she was going off of this percentage that endocrinologist use that says, your Basal should be 40% of your total daily insulin. And because he has to correct a lot. And because he's eating a ton of carbs, you know, his, his Bolus ratio is too much Bolus. So
Scott Benner 55:46
well, so I don't know. Yeah, I don't know if I agree with that completely. So up and down, up and down. But it would I would ask, I wouldn't even bother with that. Like, what I would ask first is when he's away from meal, insulin, and he's away from food, by three hours, let's say where does he sit stable? Like is his blood sugar like when it finds stability? Is it stable? 85 versus stable? 160.
Ali 56:17
Okay, so when was the last best day?
Scott Benner 56:24
Even overnight, you see stability overnight.
Ali 56:28
He's up overnight. He's up and eating overnights awake, and running around and doing stuff like there's not a specific time that he's sleeping. I don't think I mean, maybe from three to five. He'll be you know, three to seven or eight. They the schedule is they get up. They started eight. Yeah. And then I'm gonna find it. Any what day was the last day? Can you look up the dates? It's on your phone. Great. About a month ago. I'm just going to look at the at the clarity line. Thank you and see what it was.
Scott Benner 57:11
No, I mean, I'd love to talk about it.
Ali 57:15
Yeah, I mean, it's good to get into the into the grit of it helps people. You want to do falafel while we're waiting? Do I? How would you falafel?
Scott Benner 57:25
How would I eat
Ali 57:26
food? He just started eating it, too. It's a it's a fresh pita. Which is less bulk than two pieces of bread, but it's just flour and water. No preservatives or anything. Right? Was it? December 14. Can you find it and you just scroll up enough? It's chickpeas, fried, like chickpea they made again and that was mush and then they put five falafel balls in and it's fried and then on top is like salad and sometimes there's like a couple of French fries. And then if there's a paste there's like a sauces are chickpea paste and sesame paste. So he ate it. And he had no idea how to booze for it. But you know,
Scott Benner 58:10
the internet says knock it out. falafels about five and a half carbs for a patty. That's approximately two and a quarter inches diameter. Okay, so I don't know like, I mean, what would you do? I would treat it like bread. And I mean the first time I did it, I would just go with this. And I would treat it like bread at first and then I mean it chickpeas,
Ali 58:32
salad, some carbs and some protein and then you're crying.
Scott Benner 58:37
Yeah, you're frying it and then you're saying sometimes there's french fries on it?
Ali 58:43
Yes, you go to a good place there's a couple of
Scott Benner 58:46
good places fries. That's funny. That's
Ali 58:49
only like five because I gotta shove it in that thing.
Scott Benner 58:54
So I mean that's what I would do I would start with just a simple carb count and and then I would see what happens and try it again.
Ali 59:08
So just the pita and then do the coaching later. I'm looking
Scott Benner 59:11
online right now hold on a second. So we got the carbs for the falafel let's try chick peas. Chickpeas have a fair amount of carbs Hold on a second
yeah, there's a fair amount of carbs.
Ali 59:40
So like it's it's hard sometimes. Well, here's the thing as pizza. Okay, what do you got over
Scott Benner 59:45
half a cup of chickpeas is 27 carbs. Okay, so So chickpeas are our 7.8 grams per tablespoon. So if he had if this falafel was legitimately two and a quarter inches around and he had two of them, and it had chickpeas and then we're looking at 510 1118. I mean, and then french fries and fat and everything. I mean that falafel could have been. It could have been 25 or 30 carbs. Really?
Ali 1:00:19
Okay. Would you put 30 carbs up front?
Scott Benner 1:00:23
Yeah, I would. I don't I don't split insulin until something proves to me it needs to be split.
Ali 1:00:30
Oh, yeah, I mostly put everything upfront. Yeah, I
Scott Benner 1:00:33
don't, I don't split insulin until it tells me until, until experiences telling me otherwise. And even then, with the things that Arden eats, it's more like, it's not even like splitting it as much as it's like a fat and protein rise later. If that's going to happen. It's almost a secondary Bolus.
Ali 1:00:55
Okay, you know, okay, so his flat line, it was December 14, but his flat line at 1.2 Was I could send that your screenshot, but was like hovering around 80, it went a little lower, and a little higher, went a little lower, went a little higher and a little lower. And then at the end, he was low. He said he was walking to get food. So so it hovered around eating. It's a little, a little higher. But that's,
Scott Benner 1:01:27
that's the bigger picture is that in the last 30 days, he's had one time when his blood sugar was stable at 85. Oh, no, no,
Ali 1:01:35
but the next day trying to figure out if it were at a nice, a nice flat day, you know,
Scott Benner 1:01:41
but I'm trying to figure out if the basil works, because the up and down might have nothing to do with the basil.
Ali 1:01:47
Yeah, I That's December 19 was a nice flat day, I could send you 90 days. I mean, I could send you 100 days, but
Scott Benner 1:01:57
you see what I'm saying there?
Ali 1:01:58
It was a nice day, you know, whatever. If he's not eating, he's great at time.
Scott Benner 1:02:05
So if not,
Ali 1:02:06
I almost brought him home for a grilled cheese. Because he was so high. And for so long. And finally, and he you know, he fell asleep. And he didn't answer the phone. And finally, he gets to me. And he's like, Oh, I put in a turkey sandwich. I should have put in a pizza. Because that was keeping him higher, longer. And it's different, that he knows turkey sandwich. He eats turkey sandwiches like 100 times, you know, he he's eaten Turkey on right 100 times. And he basically knows that food, I think he needs to like pay attention to specific foods he eats. And then like learn it. I told him like, if you learn, you know, whatever, come down, you know, whatever chicken you want. If you learn general Tao chicken, and your blood sugar doesn't go up to 300 every time you eat it, then, you know, fine, right? It's not the best food, but I'm not gonna bug you about it.
Scott Benner 1:03:11
I mean, listen from your explanations of what you're seeing. My best bet is that he's not putting in the amount of insulin that the food requires when it's required. And I don't and if you know, fair enough, he's 19. And you know, so when but you know, so there's going to be off eating and things like that, and weird sleeping patterns. But if when he is, you know, fasting, his basil works that well, I wouldn't be looking at the basil for these other problems, then. I'd be thinking about
Ali 1:03:48
a week later. He with the new like, higher basil. So it was the week that they take him to Poland. So it's it's a very, very hard week. It's like a lot of a lot of stress and a lot of walking. Was he he was low a lot. Yeah, it doesn't mean I right. It doesn't mean it's wrong, because he's walking.
Scott Benner 1:04:11
Well, no, but it doesn't make just based on what you told me. If you told me he was spiking at meals, and when he was fasting, his blood sugar was 85 What do I do? There's no way I would have said to turn off the basil. I would have said that the meals are your issue. Right? You know, and that doesn't mean it doesn't necessarily mean ratio. It could be his interpretation of how much each meal needs so he's maybe he's
Ali 1:04:43
know that he's actually using a ratio
Scott Benner 1:04:47
wagon but I mean, he has one of the settings his settings have Yeah, yeah, that's true. Yeah, one unit or how many units per how many carbs like that's his ratio. That's what I mean by that. I mean, he's not he's not coming close to getting The carbs right on staff is what it sounds like. Yeah. I mean, that's my, if you made me just after this conversation tell you what I think is wrong. I don't think he's anywhere near getting his carbs, correct. That's what that's it because he's doing a 15 minute Pre-Bolus. Fair enough. You know, with a 15 minute Pre-Bolus If you've got the right amount of insulin, you should not be seen seeing three and 400. So it sounds like he's significantly under estimating how many carbs are in what he's eating? Right. You know, that's, and
Ali 1:05:27
he's not, I don't want to put it like too badly. He doesn't, you know, sometimes you do it right. I
Scott Benner 1:05:32
understand. Yeah.
Ali 1:05:35
You know, he's okay. Yeah, I'm
Scott Benner 1:05:38
not saying that either. I'm saying that in the situations when it happens. This is what I think is happening. That's my best guess.
Ali 1:05:46
And just don't split the dose. Try to put it in earlier.
Scott Benner 1:05:51
I mean, when you're eating things that are, you know, 4050 6070 carbs. I mean, I don't mess around with splitting the dose I gave Arden. So yesterday, I said, Yes. Jonah, what the hell was she had, she put her pod somewhere where I was like, Don't put it there. It's not going to work well there. And she's like, You didn't tell her what to do in my body. And I was like, Okay, put it there. And Nike 24 hours later, I was like, Hey, your blood sugar is sitting at 120. And it's hard to get down. She is that's an okay, blood sugar as a it's 45 points higher than I think it should be. And B, I don't care about the blood sugar as much as I'm telling you that the site is not acting the way it should. I was like, we've tried to correct this 120 A couple of times, it's taking too long for it to come down. And it's finding its way back up. Again. This is the site. And then she goes and has some concoction of like rice and chicken and beans and all this stuff for lunch. And I said you should change this pod before you eat this food. This pot is only like two days old and it's fine. And there's plenty of insulin left in it. And then six hours later, when I couldn't get her blood sugar under 180. I was like, are you ready to change the pod? No, I don't want to change the pod. I was like we're changing the pod, we changed the pod. And two hours later, I had her blood sugar back down at 90 again. And I said to her, all I said was you got to stop putting the pot in that spot right now. Like that spot needs a break. And, you know, so I let her live through listen, I let her live through the entire thing that I knew was going to happen, just so that nine hours later, I could say please stop using that spot on your stomach, just turn it put it in a different place, whatever. Yeah, and hopefully shows, you know, but I don't think that's the end of it. I think now I have to follow up. Like the next time she changes a pump. I'll say again, hey, listen, you know, let's remember this spot here, we're gonna give this spot a break for like four months, like don't put anything here for a while. Like that kind of thing. Like it needs a break. And she's like, it's just one of our favorite places. So, you know,
Ali 1:08:03
he has a lot of arms and legs for the pod. And I don't know, maybe it's the spot.
Scott Benner 1:08:11
Now Arden likes her legs. They don't work as well as some other places. But they're not bad. She has to be kind of cajoled to do her arms. And then she'll do it. But she won't choose it on our own. On our own, she'll pick the her thighs or her stomach. Yeah, but Amy was just that that entire thing. I don't know, like, it's not the last time I'm gonna have to say it to her. And hopefully one day, it'll just sink all the way in. And she'll just give up I do think there in that part of it's a very, you know, very reasonable part of adolescence and growing up where you're trying to push back against the authority and against your parents specifically, it's just, you know, because our kids have diabetes, they get to do that instead of like, you know, I'm going to the movies or I'm going to talk to this girl, I'm not telling you or whatever, it's, you know, I'll put my pump wherever I want to so kind of sucks. Yeah, you know, I would just tell him to spend right
Ali 1:09:11
so eventually she's gonna have to figure like, like, tell herself because she's gonna be in France, painting or whatever doing design.
Scott Benner 1:09:22
Might be Manhattan.
Ali 1:09:23
She's She you're not going to know where it is. Like, she's gonna be like, Hey, did you use that stomach thing again? That's yeah, that's the wrongs that like, you know, she's gonna she's gonna have to do it. And I don't we're not there. I'm sure Arden is way way way better than my kid because she's been straight for so long. I don't know she's got a good blood sugar for a long time,
Scott Benner 1:09:47
but I don't know that she's that much better. She's, you know, a little younger than your son but they have the same. I mean, kids that age all have the same vibe. Like to some degree, you know, and it's that, you know, guess She's working on something as a part of her portfolio for college submission. And I was upstairs working, and I came down like 45 minutes later to get something to drink. And I looked at her blood sugar and I was like, am I the only one that sees the lecture? You know, like, is it just me? I didn't hear it. I pick up her phone. I'm like, your phone's muted. That's why you didn't hear it. Yeah, you turned off the muting. That's why, you know, like, she knows fine. You know,
Ali 1:10:29
we, we made it, we made a little bit of a deal that his alarms are really narrower. And then mine are wider. But it doesn't really work because I checked my phone all the time. But he, you know, in order to have mommy not bugging me all the time and be able to do it myself. His alarms are, I think they're like maybe 7120 or something like that. 130. And my alarms are, you know, my alarms don't go off until it's too late. But but I'm still bugging him. Because I remember one time I was listening to that the NASA engineer, just like, oh, I have action point. It's 117, you know, and he's already 130. And I'm like, texting him. And then finally, like, 45 minutes later, he's like, I was in pre, I was in calculus class, like, leave me alone. I'm 130.
Scott Benner 1:11:27
No, I see that too. Wow. All right. Listen, if you if you pass one thing on to him, okay, I would,
Ali 1:11:35
I'm gonna tell him whatever you say that. I don't. I don't care. If you listen, I think you should
Scott Benner 1:11:39
put I think they should put more effort into making sure that he understands how many carbs are in what he's eating, excuse me eating. And I don't think he should be splitting boluses unless he knows it's a meal that he really understand that the the split balls is going to work for. Those are my two takeaways from this. Okay, all right, more. Yeah. Well, no more carbs. Make sure he knows how many carbs. And don't, don't split boluses for things. Like if he knows it works for pizza, then great. But if he's splitting a Bolus, because he just thinks he should be splitting a Bolus and he's getting high, I would stop splitting that Bolus and see what happens. Okay, those are my those right? Those are literally my management.
Ali 1:12:26
I know we've been going for a while but do you want to do dentistry?
Scott Benner 1:12:29
do dentistry? Oh my god? Well, it's so interesting. You already had one actually just interviewed a dentists last week. Oh my gosh, really? Yeah. But, but that's your professional, correct? Yes. Well, give me give me your high level look at what people type one should be doing in regards to
Ali 1:12:51
all right, I'll tell you stuff that they don't necessarily tell you. I mean, my practice is a kids practice. And I'm like, if the number of rotten teeth in your mouth exceeds your age, that's me. So like, I get like two year olds with you know, they got six teeth. They're all right. Yeah, I get like, they and I gotta you know, I gotta deal with so a lot of people don't know about like, I never had issues with the iron the liquid iron vitamin. That's only before you have to once you have teeth you don't want because it stains them to get stuck. And then um so you know specifically for back for diabetes like it's a gummy bears gonna stay there forever. Right? And juice. If you'd have juice in them water then you're good. And then I would just say you know from from your people that you know, follow you all the time. Just try not to feed the insulin. If you're trying, you know, if you're always juicing, then you got to you know, figure that out. But as far as what happens in diabetes, oh, so prevention, you can do a fluoride toothpaste that's like higher fluoride. And you can use a fluoride rinse and I always say like an electric toothbrush. But you can ask for a fluoride mints. Ketones are acid. Like they they produce acid in your mouth, which is why you get all those sores. So people get like when they're first diagnosed, you get sores and it trashes your gums. But that's not specifically for kids as much. It's more like you get mouth sores. And he some people feel it in there. Like people have said on the podcast before that they feel it like a tingling, if they have ketones. That's you know, that's in the gums. And that's where like when you have acid produced being produced, that's when you use a base like The, like the, you know, there's specific toothpaste does that have a bass in it? That's a,
Scott Benner 1:15:09
you know, soda or something that yeah,
Ali 1:15:11
like a baking soda toothpaste, that's when you would use that if you're high all the time and you're and you produce ketones more, then you would use a baking soda and your toothpaste. And then if you're lower more, and you're always juicing, then you need fluoride, you know, I mean, everybody needs fluoride, but, and then I would say like gum disease, they have, like your little tiny blood vessels everywhere, your little tiny blood vessels in your feet get messed up and your little tiny blood vessels and your fingers get enough. So the little tiny blood vessels in your gums get, they get messed up. So that's when they like start bleeding. So as far as gum care, there's like, there's a perio rinse that you can use. It's like paradox, it's called. Yeah. And then like for kids with braces, like the water pack, and you can do a special scaling and a cleaning. And then doxycycline is a low dose antibiotic that they give people if they're, if their gums really bad, okay? But like they don't give it, you know, preventively. Just
Scott Benner 1:16:13
if I just had a deep clean. I found it lovely. Yeah, yeah. That's lovely. Lovely. It was, I was so worried when I got there. Because they were like, we have to numb you for the deep cleaning. I was like, I have to get numbed for this. And then I got there. And she just put this gel on it to numb my gums. And I was like, Oh, you guys should have been more specific. When you said Nami. I said, I thought I was getting injections for this. But it was, I thought it was nice. So basically, like really like, like high level for people. You don't want sugar sitting in your mouth. And you don't want stuff stuck in your teeth. Yes, right. A Raisin
Ali 1:16:50
is going to be worse for you than a big bowl ice cream.
Scott Benner 1:16:55
Right? Because that'll wash out with your saliva at some point, but duration, right. And so but a raisin could get stuck in a crack or crevice and sit there for until you brush again if you're lucky. And then and then that's where rot begins. And so when people use juice overnight, simplest thing is to just swish with water afterwards. Yeah, yeah. That
Ali 1:17:18
just I mean, don't give them Skittles when they're sleeping. I mean, that's that's not exactly high level. But
Scott Benner 1:17:25
so what is that? Or
Ali 1:17:27
just turn it down? If you got a drifter. And you're, you know, whatever. 765 Drifting if you can
Scott Benner 1:17:35
catch it, so maybe don't use it. Yeah, see if you can catch it with basil if it's going so slow enough. So give it but seriously, like the high level, you don't want sugar sitting in your mouth, and you don't want things stuck to your teeth. And it doesn't have to be something sugary stuck to your tooth, like a chewed up piece of a potato chip stuck in a in a crevice. And your tooth is just as bad for you as a raisin. Right? Like things stuck to your teeth is bad.
Ali 1:18:00
Yes, thanks that cue sheets is bad, but potato chips will go out eventually. Okay.
So bacteria is sugar.
Right? And it produces acid. So and the acid is what dissolves your teeth. So you take a baby tooth, you throw it into Canna Coke, it's gone. And like, a couple of days, it's gone. So it's, but there's no bacteria. So sometimes, if people had acid and not bacteria, you'll see like a white film on the teeth. That's like the teeth turn, like really choppy. And that's like acid without bacteria and that you could definitely see with ketones if you're you know, if you get ketones or if you have acid reflux or if you drink a lot of lemonade or whatever that you know that kind of stuff. And the the bacteria is it's interesting because the kids are kids are not born with bacteria in their mouth. They usually get it you know, from Mommy Kissing. Don't kiss your babies. Now they say that's where he got it from. So there are people that don't just don't get a lot of cavities because they don't have those bacteria.
Scott Benner 1:19:20
So you're saying I have if I ever had a cavities because I guess my wife
Ali 1:19:26
somebody? I don't know, maybe maybe he ate some dirty lettuce. I don't know.
Scott Benner 1:19:33
You just sit in a hermetically sealed room after birth, we'd be fine.
Ali 1:19:40
And then the other thing I would say for the appointment I would ask for an early morning appointment. Because a lot of things in dentistry, you're either not supposed to eat beforehand, or you're not going to eat afterwards. And you know, you don't want to You can always drink juice, they'll always let you drink juice. But, um, you know, but as far as you know, if you're not, don't, you know, don't go to the dentist, like after breakfast having a big meal kind of thing. Because you, you might just, you know, just say,
Scott Benner 1:20:16
I don't want that in your in their throat, right? Like it's yeah, I didn't impression you might see it later, I had an impression on what's the guy's like, are you going to be okay? And I was like, why would I not be okay? Because you'd be surprised like a little bit of this impression material hits people in the back of their throat and they just they can't handle it. I was like, Yeah, all right, you know? So yeah, I got what he was saying.
Ali 1:20:40
Yeah, I mean, if you if you have a deck, you'll see it. But like pain, if you have pain, you know, your blood sugar is gonna go up, and not eating is gonna make it go down. So it's hard to, it's hard to necessarily predict beforehand. But if you're having like, a lot of stuff done, and it might be painful, then that's something to consider as well. It's hard. Yeah, it's something it's hard to tell up or down because you're also not eating if your Basal is solid. And if you don't eat it's nice and steady. Then maybe you would need more if you're going to be in pain. Or maybe you just see if it happens. And then correct.
Scott Benner 1:21:21
Yeah, yeah, there's some people that say the pain doesn't affect their blood sugar. Some people say it does. It's hard to know if that's what I'm saying. Just be aware of it. And but I take your point earlier in the morning, people's blood sugar's are a little more difficult early in the morning anyway. So if you're trying to avoid a low because you're going to the dentist, then that that makes sense to me. Very nice. Cool. And what? What do you do like you'd like you basically, you work on kids with some real tough problems.
Ali 1:21:49
Yeah, yeah. Yeah. I mean, we we definitely drugged them. We had laughing gas. Yeah, sedation, you know, if you're, like, you know, like four or five years old, and they need like, six crowns. Or more than that, you know, you need a little help. Wow. But, but basically, after eight years old, they're fine. They're, like, kind of hang they can sit and take it and as long as you don't, you know, hurt him. Then they're
Scott Benner 1:22:22
cool. Little kids get crowns.
Ali 1:22:25
Oh, yeah, man. It's targeted. So I don't know. Some people don't know. It's good to know. You because You have a lot of kiddo. You got a lot of pregnant ladies. Um, some people don't know that. Even, you know, even nursing has sugar in it. And bottles have short, you know, formula has sugar in it. So, they'll give their kid a bottle all night and all day and it's just bathing there. And and when they're asleep. They don't swallow it. So it just, it just soaks sucks and sucks. So they'll Yeah, they'll ride it out. It's not fun. It's not fun. I know. On that note, wasn't that fun?
Unknown Speaker 1:23:09
To come to the dentist.
Scott Benner 1:23:13
Well, I really, I really do appreciate you doing this and, and sharing like, and it's so fun. And I'm glad I know.
Ali 1:23:22
I love love your podcast, and I love the group. Thank you. Because it's great. Everybody's like so, like, helpful and supportive and terrific. And even when they're snarky. I like it. Yeah, somebody the other day was like, my aunt had pancreatitis, and what kind of diabetes does she have? And like, and then like, nobody answers LLN she eats an O and she eats low carb. Like so like 50 people get on there and they're like, she doesn't need to eat low carb. She just needs to take insulin. And then like finally one person's like, she see three this is from the website.
Scott Benner 1:24:03
Yeah, you get enough people together you actually get answers to dammit. I went on
Ali 1:24:09
Google for you. You could have done that
JDRF set for you and I'll do it for you. Okay, and then like, fight like she kind of kind of carb shamed somebody who was like no, you don't have to eat low carb. And it wasn't even the person like somebody who's and had this question and then and then he writes like, fine do whatever you want if you want to eat you know if you want to just eat sadness all day. Like I personally eat keto just because car like I am definitely carb sensitive. I have a I have PCOS, which is like they say that you might get type two. That's what they want. They like it's it's actually too much insulin your produce thing. So if you keep producing too much insulin, then I guess eventually your cells are like too much and then they shut it down and your absorption goes down. So I just, I don't take anything. But I, but I just tried to watch my carbon cake keeps me thinner.
Scott Benner 1:25:23
Listen, I not hard, not hard. I'm 50 you know?
Ali 1:25:28
Yeah, right. But my keto brownies have definitely been shamed many, many times by my children and everyone else who tries to eat them.
Scott Benner 1:25:37
They don't. They don't.
Ali 1:25:39
Except for my African friends. And they're like, these are fantastic. I was like, Yeah, I've tasted them. But I like Oh,
Scott Benner 1:25:47
that's amazing. All right. Well, no, I can't thank you enough. Hold on one second for me. Okay. Okay. A huge thanks to Ali for coming on the show today and sharing her story. And thanks to Ian pen from Medtronic diabetes, for sponsoring this episode of The Juicebox Podcast, learn more and get started today at in pen today.com. I'd also like to thank touched by type one and remind you to go to touched by type one.org or find them on Facebook and Instagram. long episode today. So just let me say this. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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#733 Newly Single Mom
Lidset is a newly single diabetes mom.
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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.
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Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!