Scott Benner 11/28/22 Scott Benner 11/28/22

#798 Chicken Thighs

Kristie has type 1 diabetes and she just made a human being.

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Scott Benner 0:00
Hello friends, and welcome to episode 798 of the Juicebox Podcast.

On today's show we're going to speak with Christie. She is an adult living with type one diabetes, and she's going to talk to us today about her journey through pregnancy. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. You're on the internet constantly clicking and tapping and swiping. I just need 10 minutes from you. Head to T one D exchange.org. Forward slash juice box join the registry complete the survey. They're looking for people living with type one diabetes, who are US residents, or who are the caregiver of someone with type one. This is all you need to do. There's a great episode about why this is so important but you're going to be helping people with type one. You might be helping yourself you're going to be moving type one diabetes research forward and supporting the podcast all by filling out a survey. T one D exchange.org forward slash juice box

this show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash Juicebox Podcast is also sponsored today by ag one from athletic greens. Every morning I wake up take a scoop of delicious ag one and I'm on my way, when you use my link athletic greens is going to give you a free one year supply of immune supporting vitamin D and five free travel packs. Visit athletic greens.com forward slash juicebox. If you're looking for a great type one organization to support check out touched by type one at touched by type one.org.

Kristie 2:14
I'm Christie and I was diagnosed in April of 2020. With type one, it was actually at the height of the pandemic. It was just a few weeks after the whole world shut down. And I can just dive right into my story if you want me to

Scott Benner 2:33
Well, yeah, let me just make sure I understand the timeline correctly from when we're doing it now like are you just up on your two year anniversary?

Kristie 2:40
Just about next week is my two year anniversary.

Scott Benner 2:43
Wow. Cool. That's excellent. I mean, cool in that you're ended up on here at a anniversary. It doesn't matter. Christy what does it matter what when you're doing this? I just I found it interesting that it's been like kind of exactly two years. So yeah. All right. You seem excited to tell me what happens. happened?

Kristie 3:00
Yeah. So my husband and I got married in 2017. And we wanted to start a family in 2019. And after a couple months of trying and not being successful, we decided to go to a fertility clinic. And this was again, kind of as COVID was breaking out was during our first appointment. So he said we're just going to start with some blood work and kind of see if we can see anything from that before we actually have you come into the office. And so I went in for bloodwork and my fasting glucose was 305. They called me and said do you need to see your PCP and find an endocrinologist and figure out what's going on. So that kind of put all the fertility on hold fertility treatments on hold, and really got got to learning about what even diabetes was. So I was originally diagnosed with type two, which is very common to misdiagnosed at the beginning. Especially not having I didn't go into diabetic ketoacidosis I just had the high blood sugars. And so when I first saw my, my PCP, he just kind of walked into the office, you know, again, it's COVID petrified to go anywhere. Double mass walked in, and he's like, so I hate to break it to you, but you have diabetes. And I was like, okay, he's like, so do you know what a carb is? And I chuckled, I was like, yes. You know, I'm relatively familiar with nutrition and I had done the keto diet in the past and knew what carbs were. He said, Okay, avoid those and you'll be fine. And here's a prescription for Metformin, and kind of set me on my way.

Scott Benner 4:45
I have a couple of questions. Yeah, let's start with one that you can't really answer. Who do you think? thought let's call primary care physicians PCPs, also known as Angel Dust, a didn't I mean like Don't? Don't you always wonder like who comes up with stuff? Like, why is there no one in the room? Here's what I think. I think in every room where something gets named, you need a person like me, who sits there and goes, I think PCP also means Angel. Das, we probably shouldn't use that. You know, instead of people just think, oh, primary care physician. Yeah, that sounds right. We'll do that anyway. Because every time you say that, what I hear is, every time I hear Angel Dust Angel, my other question is, when you decide to have a baby, you want to try to make a baby. I'm being serious. What happens first? Do you get tired of having sex when it doesn't happen? Or do you start worrying that hey, this should have happened by now? Like, what was your first like, were you like, I'm being serious? Like, which? Which came? Yeah.

Kristie 5:45
I really just expected it to happen so quickly. So I'm the youngest of five. And my grandma, my parents had 18 grandchildren from my other siblings. Oh, my goodness. So I was like, Oh, this is gonna be so easy. You know, I'll be pregnant the first month. And so when we were about six or seven months, and I was like, Okay, maybe we should just get things checked out. And kind of did it just as a precaution. You know, most people say it takes at least a year, but I was impatient. And I'm very type A and wanted on a specific timeline.

Scott Benner 6:19
Are you like sitting in that room going like you get me pregnant right now? This is what it has. No pressure at all right? Yeah, yeah. So a lot of fun. You are okay. Okay.

Kristie 6:32
Yeah, so then when it wasn't happening, that's when we decided to check it out. And that's, that's what kind of changed my whole course.

Scott Benner 6:40
Even from his perspective, do you? Do you ever walk like in that process? Did you walk into the bedroom and go, I can't believe we're doing this again? Like it? Did it? Did it get it get? Clinical? I guess, is my question.

Kristie 6:53
Oh, definitely. When you're trying for that long. It definitely it's like, you know, you have all the apps and you're tracking everything. And every morning, I was checking hormones, and it's like, it's like, okay, like I do it again.

Scott Benner 7:05
Okay, so Is it as bad as someone's like looking at their phone while you're having sex or not quite that badly.

Kristie 7:12
It's not that bad. You still get to enjoy it. All right.

Scott Benner 7:15
Excellent. i So wait, tell me again, your grandparents made like, like most of the people under the state my parents.

Kristie 7:23
So I was saying my parents have 18 grandchildren, your parents have 18 grandchildren. So between my four siblings, there's 18 kids. I see.

Scott Benner 7:34
So just even more specifically, your brothers and your sisters have no trouble knocking out the babies. Correct? How much is this? All sisters? Okay, how much of this? Well, I'm probably skipping ahead. Oh, look at me. I almost asked the question that ruins the story. Okay, go ahead. You got so they put you on Metformin. And then what happened?

Kristie 7:56
So I ended up going to Amazon and getting a glucose meter and was taking my blood sugar kind of, you know, a couple of times throughout the day and sent an email through the portal to my doctor saying, hey, you know, I'm still seeing blood sugar's around, you know, 275 300. And he wrote back, stop obsessing about your blood sugar. It'll take a few weeks for the Metformin to kick in,

Scott Benner 8:22
kick in is that how drugs work?

Kristie 8:27
So I again, being type A impatient called Joslin diabetes Center, and just said, you know, I got bloodwork done, my agency was, I think, 11.9. And my fasting again, was 305. And so the operator was like, we will see you tomorrow, we'll get you in right away. And they were able to do a virtual visit and correctly diagnosed me and that day, I had insulin in my body. So it really took kind of advocating for myself and realizing that it just, you know, there was a difference between type two and type one and it just didn't fit the profile of type two.

Scott Benner 9:06
You know, Was I too harsh earlier? Were you calling your primary care physician PCP because he was actually on Angel Dust. You know,

Kristie 9:14
I quickly I quickly dropped that doctor and found a new one right after

Scott Benner 9:18
stop worrying about your health so much.

Kristie 9:21
Well, I think the best thing was the day that he had diagnosed me with type two and put me on the Metformin I said, you know, we're trying to get pregnant with this affect my ability to get pregnant, or does Metformin safer pregnancy. And he said, Oh, diabetes, you should just look at adoption. But that was the most heartbreaking sentence I'd ever heard.

Scott Benner 9:42
This was still the PCP guy. Yeah. Wow. What a bedside manner on him. Hmm. Right. It was a guy, right? There's no way a woman said that to

Kristie 9:51
you. No, it was definitely a guy.

Scott Benner 9:53
I figured. Okay. Wow, how many people do you think right now we're like, I don't know what PCP or Angel Dust is. And I don't understand why they're talking about so much. What age do you have to be to understand that lingo? Do you think?

Kristie 10:06
Probably, yeah, probably 25 plus 30 plus?

Scott Benner 10:09
Yeah, I think if you know what, Molly anyway, I don't know. Listen, I'm a funny person talk about this. I only know these things from television shows I watched as a child. So okay, so you got away from the bad doctor? Who told you not to worry about your who gave you Metformin, not even a meter sent you home? And then when you checked on your own health, told you, please stop paying so close attention to this. And by the way, you probably shouldn't have children. Yeah, so no good information came from this doctor whatsoever. No, not at all. Geez. Hey, did you know if you go to my link contour next.com forward slash juice box. There's a place there where you could actually get a meter right through Amazon. Just wanted to throw that in for people because apparently you guys are buying stuff on Amazon. So please, you could still use my link. I know that was inappropriate. Let's move on. So you get to Jocelyn and I assume they give you I mean, they they to appropriate testing to find out that you have type one diabetes. Yeah. So

Kristie 11:11
they diagnosed me with Lauda with the we had an episode on late and autoimmune diabetes and adults. So I was 30 when I was diagnosed, and when they looked back at bloodwork, I had had a relative Lee higher fasting glucose a year prior. And my great PCP hadn't flagged it or really done anything about it at the time, but it was evident that my pancreas was slowly losing its function.

Scott Benner 11:42
I assume that Dr. Just thought you had had a sandwich before coming in. So yeah, that's fine. She probably had something with bread. Don't worry about it. Well, what a what a go getter. Jeez. Oh, yeah. Does it make you look back at the other things that you had seen this doctor for in the past? And do you like wander through all of them?

Kristie 12:03
Well, luckily, I had only seen him for about two years before. So I had just moved to my village back to my hometown. And so I just started seeing him.

Scott Benner 12:15
Is this a case of a small town doctor or an older person?

Kristie 12:20
Very small town rural hospital.

Scott Benner 12:24
Okay, like the only doctor there? Yeah, yeah. Like if he if he doesn't kill like half of you. It's a good thing. He's like, I saved half of what do you want for me? Like that vibe? Yeah, I gotcha. Do you pay him and chickens? How rural is? Well, not that well. Okay. So he took money and everything. You didn't have to bake a pie in exchange for like a thermometer or something like that? Which doesn't that sound better? By the way?

Kristie 12:53
It does. I was just gonna say, with all the baking I was doing in March of 2020.

Scott Benner 12:58
All of all of us are inside. Like, we should bake something, cook something I was making potato chips for a while? And do you have any idea how much time that?

Kristie 13:09
Well, that was a big one. He diagnosed me as type two. I was like, Wow, all the bread I made the cakes and the cupcakes like I really killed myself. That's just, you know, I had that assumption that that's how you cause diabetes. And of course, I learned so much more of the last two years.

Scott Benner 13:26
So how long did it take you to? I mean, it sounds like you're the type of person who's gonna dig right in. So you know, what was care like in the beginning.

Kristie 13:35
So at the beginning, definitely was a little bit more challenging, because of everyone's telling me to restrict carbs. But you know, everybody said, the long term complications of type one. And I immediately was like, I'm only 30. I want to live a long life. And I wanted to have, you know, that flat CGM line. And so I'd say the first couple of months, I definitely really struggled with food issues. It was really hard to kind of go into the summer with the world kind of opening up a little bit. I live in a resort town. And so it was summer and the beach and everything was fun. And I was sitting there like, oh, I don't want to have ice cream. I don't want to do any carbs. I need to keep my sugar's under control. And just kind of it's just said those first couple months, like mentally were really challenging because I knew I wanted to prevent long term complications, but thought that the only way to do that was to restrict and that was not how I want to live the rest of my life.

Scott Benner 14:37
Yeah. So what were you when you were really restricting what were you eating?

Kristie 14:42
A lot of eggs. A lot of eggs and bacon. And like chicken thighs and veggies vary keto based, kind of 3030 carbs 30 to 50 carbs a day,

Scott Benner 14:54
right. chicken thighs that was so specific. Christy.

Kristie 14:57
I hate to compress so much. Coming to

Scott Benner 15:02
you from the south. No, northeast. Northeast but you like you like a darker chicken meat? Yeah, a little greasy. Look at you. How'd you how'd you prepare it? I don't. This has nothing to do with anything. Just in the oven baked in the oven. Yeah. Interesting. Look at you. You're You're a different kind. Christie, I like you. Okay. Christy wants the thighs. That's for sure. Like chicken breasts. Oh,

Kristie 15:33
it's so dry.

Scott Benner 15:34
It's what eat this garbage. So funny. I don't know why I was so amused by that I was really taken by that as like, because most people would have just said chicken. You don't I mean? Yeah, like chickens. chicken pies, dammit. Don't give me any of that white meat. The stuff that people say is healthy. I don't want that at all. That's excellent. Okay, so Alright, so you have a skewed vision of what you're supposed to be doing at first, I understand it, by the way, because for five seconds. I've said this on the podcast before but somebody. It turned out my iron was very low. I was just unhealthy. But my dentist looked at me one day and said, Are you sure you don't have type two diabetes? And I was like, I don't think so. But even in the 24 to 48 hours that it took me to get to a physician. I had trouble making myself eat. It was interesting how it impacted me. Like right away. I became I don't know just paranoid about food. Yeah. And that, that. So I do. I think I understand what you're talking about a little bit there. How long did that last? That process of just eating chicken thighs and eggs?

Kristie 16:47
Um, so that was probably till about July or August.

Scott Benner 16:52
How long was that in months? Do you think?

Kristie 16:54
Oh, like three months? Okay. So I had amazingly gotten my agency down to 5.5 in July. And that was really just through that restricted eating and really not having a fun life. And then I specifically remember the day in August, when I went to work out. And I've made kind of a home gym during COVID and had a low blood sugar. And it was just like feeling really defeated. Like this is just too much to conquer. I, you know, not eating what I want to eat. I can't work out like I usually do. And I went on to Facebook to find a support group. And they recommended listening to the Juicebox Podcast. And so it was literally that day in my gym, I started to listen to the podcasts and was like, wait, I can eat cars, and have a normal life and have a normal agency and not have these long term complications. So that's really kind of when everything kind of turned around for how it was managing and kind of not having to have this food restrictions and fear food. Lifestyle.

Scott Benner 18:02
How many chickens have I saved?

Kristie 18:05
A lot of chickens?

Scott Benner 18:06
I have right? I am. Yeah, I've liberated chickens. Oh, now I'm feeling good about this. Okay, great. I was gonna call this episode thighs and eggs. But I might now consider myself the great liberator of chickens and the episode. But so the podcast? Well, what happened to me you started thinking, maybe this this guy voice notice something about using insulin like I could figure this out?

Kristie 18:34
Definitely. And I think one of the biggest things was hearing about the Omni pod. And so when I first was diagnosed, I didn't even want the Dexcom I didn't want anything. I was like I don't want to wear anything on my body. I didn't want anyone to know I was diagnosed. I should also backtrack and say I had a lot of kind of like work stress going on. So I was the president of our Chamber of Commerce, the executive director. So helping businesses get through COVID. And at the same time, I serve on my town Select Board, which is kind of like a city councilor. So trying to save the town trying to save all the businesses and also trying to learn how to save my life and deal with diabetes. And so I didn't really want to be wearing anything was nervous or, like what people would think that I had this perception that people would think that I couldn't lead having this complication. Oh, wow. And really, yeah, I think just mentally I just thought it again, just kind of thought it was going to interfere with kind of the perception of me, which I now realized it I think it makes me stronger and more badass, but I can handle everything and you know, monitor my blood sugar's daily. Yeah, maybe

Scott Benner 19:46
we'll save that belltower. Exactly. Isn't that the theme of like, half of the movies in the 80s, right, like a town has to sell save a bell tower or something like that. What's that back to the future? We're getting off the subject here. Hold on. That is really well it's it's not surprising I guess that you would think I don't want people to know especially being diagnosed so late and you make a good point about all the different stressors fit in the one you left out was that you? Did you still think you couldn't have kids at that point?

G voc hypo penne has no visible needle and is a premixed autoinjector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to Jeeva glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or pheochromocytoma. Visit G voc glucagon.com/risk. Today The podcast is also sponsored by ag one and I began taking ag one because I was concerned that my diet didn't include all the vitamins that I needed. Now every morning I wake up take one scoop of delicious ag one. And with that scoop I get 75 high quality vitamins, minerals, Whole Foods sourced ingredients, probiotics and adaptogens. These helped me to start my day, right? This special blend of ingredients supports my gut health, my nervous system, my immune system gives me more energy recovery and focus. And ag one is lifestyle friendly. Whether you eat keto, Paleo vegan, dairy free or gluten free. And did you know it contains less than one gram of sugar, no GMOs, no nasty chemicals or artificial anything's. Tons of people take some kind of multivitamin. But it's important to choose one with high quality ingredients that your body can actually absorb. And don't forget that when you go to my link, athletic greens.com forward slash juice box, your subscription comes with a year's supply of vitamin D, which is also so important to add in these winter months. So go ahead and check it out athletic greens.com forward slash juicebox. There are links in the show notes of your podcast player and links at juicebox podcast.com. To G voc ag one touched by type one and all the sponsors. When you click on my links, you're supporting the show. And before we get back to Christie, if you're looking for the diabetes Pro Tip series, the bowl beginning series or any of the series within the podcast, head over to juicebox podcast.com Go up to the menu and they're all broken out there. They have their own page each one. And if you're on the private Facebook group, and you should be those same lists can be found in the feature tab at the top of the page Juicebox Podcast type one diabetes on Facebook.

Kristie 22:57
So at that point, it was actually one of the first podcasts I listened to was somebody. They were talking postpartum about their pregnancy. So I was like, okay, I can get pregnant with type one. And that's really why I started to kind of look into it and research and I switched endocrinologist to somebody who specializes in pregnancy, but type one. So trying to get that ball moving as well. Nice. Yeah, it was really being put on the Omni pod is what helped me because my insulin doses were so small at the beginning. And I don't know if this is common with everybody, but they started me off on the sliding scale. Where if your blood sugar's you know, say above 150, you take half a unit of insulin when you go to eat, but they don't account for any of the carbs that you're eating.

Scott Benner 23:48
Yeah, so the good old sliding scale.

Kristie 23:51
Yeah, so I'd be like, okay, my blood sugars are under 150, I'm not gonna take insulin, and then I eat what I wanted to eat. And I would, you know, go through the roof. So none of that made sense to me. And it was kind of listening to the podcast about, you know, your example of tug of war and like, the insulin has to get in your body and be able to compete with the carbs. And then I realized you actually had to take the insulin for the number of carbs. So I ended up meeting with my endocrinologist in September and was like, I think I know my insulin to carb ratio, and this is what it is, and I want to be on a pump and like, can you set all this up for me? She was like, Okay, nice to meet you.

Scott Benner 24:29
Hey, everyone, Christine here, and she doesn't need us so much. How did they How did the doctor accept that? Was that excited for them? Were they like, oh, great, this person knows what's up. Let's just double check it or is it off putting to them? How did you

Kristie 24:44
know she was really excited? And I think it makes their lives easier when they don't have to do as much work or, you know, constantly over explain, like I feel like they monitor my first appointment. They again always go into it with a longterm The impacts are and all the complications and she kind of started off with, you seem to already have a good control on this and as long as you kind of keep maintaining it, you know, you'll you'll be in the clear.

Scott Benner 25:13
I'm feeling like I deserve some money from these appointments now because you're right, she got paid that day. What do you think your insurance probably paid her a few $100 Don't you think?

Kristie 25:24
Well, that was the thing during my pregnancy. You have to meet every couple of weeks and she'd be like, Oh, I'm not gonna make any changes because you already did is like yeah, I already did all this. I don't even need an endo.

Scott Benner 25:35
Don't forget to pay us on the way out and then Scott, anything yeah, basically I this baby. Let's just jump to the this this baby named Scott. Yes, sir. No. Dammit. Okay, that's fine. Did getting your blood sugar's under control, make it easier to get pregnant.

Kristie 25:53
So we ended up still going through fertility treatments. But we were successful in April of last year, getting pregnant regulations.

Scott Benner 26:02
So because I was wondering, like the whole time you're telling the story. I was like, I wonder if her blood sugar gets back in range if she gets pregnant, or if it just makes the IVF possible. So I wasn't certain where it would go, how many rounds did you have to go to get pregnant?

Kristie 26:17
We did two rounds. And we ended up being successful with an IUI which is kind of the precursor to idea. Oh, can you? I don't know what that

Scott Benner 26:25
is IUI. It's

Kristie 26:26
an intra uterine either.

Scott Benner 26:30
You don't know what it is.

Kristie 26:33
Uterine insemination, I think. And intrauterine insemination.

Scott Benner 26:41
So what is they just like? Is it like turkey baster time? Is that what they just took the boys and jam them? Yeah, I gotcha. All right. I feel like you need a lot of big words for that. So it doesn't sound like what it is. I understand why they. So what's the difference? Can I ask like, what's, I can't believe this? What's the difference between your your husband's penis still in it? And whatever they use? Do they take it more to the source or so it doesn't have to travel this far? Yes.

Kristie 27:08
Yes. They have the two posts a little bit deeper. So

Scott Benner 27:13
drops it right on. So they don't walk first. Right. I gotcha.

Kristie 27:22
And so that ended up being successful, which we're about to start IVF. And we're very lucky.

Scott Benner 27:28
Yeah, well, yeah. It sounds like it's a nice if not easier, but maybe easier, but also probably less expensive. And a number of other things, no drugs, right.

Kristie 27:38
We still use drugs, just to try to increase the number of eggs to I'm sure that it will be successful. But I would say typically, IUI is of a very low success rate, people do a couple just to try before they go to IVF. So I was very lucky to be successful. And I really think it was I had kind of everything in line with my blood sugar's I had gotten diagnosed with Hashimotos in the fall, and had to kind of get my thyroid under control. And so it wasn't till about January. So that was kind of 10 months, eight to 10 months after being diagnosed with type one that we were able to start resuming the fertility treatments.

Scott Benner 28:19
Oh, and the Hashimotos came after the Typhon

Kristie 28:23
Yes, so probably the two were related, but nobody tested my thyroid

Scott Benner 28:27
at the time you think maybe they they both might have Oh, interesting. I have more questions now. Anyone else in your family like all those those girls that you're related to the sisters? Did they have any autoimmune stuff?

Kristie 28:40
No other sibling but both my parents have hypothyroidism

Scott Benner 28:45
interesting. And there's 18 grandchildren

Kristie 28:50
and all of them are fine I won the jackpot with the auto autoimmune diseases the

Scott Benner 28:55
listen I'm what I'm hearing is I've got 18 more possibilities of people that could be on this podcast one day, so I don't want to jinx anybody but you know, let's keep them aware of the show because I'm going to need content moving forward. I mean, that's really going to be interesting for you I obviously don't wish any ill will on anyone but 18 people descended from three are sisters you gotta like I mean I wouldn't bet on it but maybe I would like it maybe I'd start like a like a raffle thing or somewhere you bet money on the kids or i It seems wrong let's take that back. I don't mean that but I do think it will you know when you pick the squares for the Super Bowl right? I don't think you should do this but it's a delightful I don't know why I'm amused by this idea. I know I shouldn't be but yeah, you put all the kids names on a little chart and people lay money on it and then somebody wins the pot one day

Kristie 29:48
that would be right chose me they'd been big.

Scott Benner 29:51
Okay, then you have to already you have anything else coming? You feel anything coming on? Or? Or is it been pretty good since then?

Kristie 30:00
No, it's been pretty good since then, with pregnancy, I was definitely at risk for preeclampsia. And with that, they think that's also an autoimmune and I ended up with postpartum preeclampsia.

Scott Benner 30:13
They think preeclampsia is autoimmune.

Kristie 30:17
They're starting to dig into that. And yeah, that's what my OB was talking to me about. And I was confused as to how they were. They were monitoring throughout the whole pregnancy for preeclampsia. And I ended up with postpartum so it's three days postpartum, that my blood pressure skyrocketed.

Scott Benner 30:37
And I ah, article here is preeclampsia an autoimmune disease from Wow 2009. Numerous recent studies have shown that women with preeclampsia possess antigen tensin receptor agonist I should not be saying these words auto antibodies that bind to and activate receptors instruction of these auto antibodies in pregnant mice. Look at that. I'll be done. And that interesting. We'll learn a lot here in this generation of doctors, not your PCP. He was an idiot. He's out there doctors seem to sometimes understand what's going on. Wow. So how was the pregnancy? Did it go pretty? Well, it sounds like you're really whelming tamed as far as your blood sugar's go.

Kristie 31:28
Yes. So I really got to experiment with insulin with all of the insulin resistance. And I, you know, very thankful to be able to have Dexcom and Omni pod. And I worked with Jenny from Integrated diabetes services, and was just be able to have a very successful pregnancy may when she was under 5.1, the whole pregnancy. And then I did deliver at 37 weeks just because my blood pressure started to increase.

Scott Benner 32:01
Okay, was that does that cause any issues or No?

Kristie 32:06
Nope, they were able to induce me. And after 31 hour labor, I had my son. It was fun. I actually didn't find out the sex during the pregnancy. And so it was really fun for that surprise, but I really, it was a long lever. So it was a good surprise at the end.

Scott Benner 32:26
31 hours a very long time. You were like in just 31 hours later. Just a day or so later, the baby came? Well, yeah, definitely wasn't done cooking yet. You were just done baking him. That's all. So yes. How much did the baby when

Kristie 32:41
he was six pounds, eight ounces.

Scott Benner 32:43
Nice. And at any point that we consider naming them Scott.

Kristie 32:47
Unfortunately, now

Scott Benner 32:48
wasn't ever joked about. Did you ever think of it in the back of your mind for a split second? Hey, the guy on the podcast is probably gonna want me to name this baby after him. Maybe really? All right. No, you didn't think about it like fine. That's how it's healthy for me to know you didn't think about it at all. I appreciate that. It actually it's good for me. I and even if you did think about lying to me is the right way to go. Because it makes you sound like a really so nice, healthy, baby. Everything's been good. How long did you give birth? Oh, he's three months. Wow. So new. Yeah, you're making me sad. It's been fun. Yeah, it's the best time really. It's, I'm just my son's finishing up college and you're making me sad. You to make me sad. Don't hold on us. Like a little air on my face here. I don't want to get all likes my kids. You know, he's in his last few weeks of college. It's his last few weeks of college baseball most likely unless he goes and plays a grad year somewhere or something like that. So since a lot of things coming to an end of my life that I thought of is what my life was about. You know what I mean? So Oh, yeah, try to

Kristie 34:06
I just went back to work and just dropping him off. We're lucky. Both grandparents live in the same town. So the grandmothers are watching him and just dropping him off at daycare. It's like a huge adjustment. We cried. And he's like, Well, this is just one phase and we're gonna cry kindergarten drop off and high school and college and everything else. Yeah, I

Scott Benner 34:27
cried. When Cole got on the bus for kindergarten the first time. I went back in the house and basically fell apart. My wife's like, are you okay? Then she laughed at me for a while. It was not pleasant. But I was very upset. I had been with him like every second for five years, you know, basically. And then all of a sudden I just put them in like a giant like tin can missile with a lady I didn't know and I was like, here you can drive them away now and it was very upsetting. I will tell you that. I know everyone's gonna say it to you and You're going to think you're hearing it. But it goes by way faster than you think it's going to. It just I, there's no way to prepare you for it. Because days feel like they take forever and weeks feel like they take months and months feel like they take years. I know that that like while you're living life, you can't tell the passage of time. But it is absolutely shocking how quickly it happens.

Kristie 35:23
So, yeah, trying to enjoy every moment. Yeah,

Scott Benner 35:27
do your best is. It's the it's the one thing I wish I could fix. Which is time passing. And I don't think I'm gonna figure that out. I figured out the diabetes thing pretty well. I wouldn't look for a Scott stop stops time podcasts coming anytime soon. I don't I don't think I can. Although I guess if I figure it out. I've got all the time in the world. But that's not the point. Yeah, I haven't been working on that as what I'm saying. If I do I will. I think I know exactly. Some of the days I'll go back to it just sit around and stare at for a few years. But anyway, are you thinking of more children? Or are you going to like stick with the one baby situation for a while.

Kristie 36:06
Just one for a little while. With having the postpartum preeclampsia. I think that was a lot. So for anyone who doesn't know that's high blood pressure. And it was just like one more thing to manage. So I became a new mom was managing blood sugars, and then all of a sudden had to take my blood pressure a couple of times a day. And, you know, just be on the lookout for all the different symptoms of higher low blood pressure. And it just is a very overwhelming experience to kind of be thrown at everything at once.

Scott Benner 36:40
Was your husband working? Were you on your own during it? During the day?

Kristie 36:44
He had three weeks of maternity leave?

Scott Benner 36:47
Okay, it's still you're you've done it for over two months. How long? Does it take the preeclampsia or has it not? resolved?

Kristie 36:55
It has not resolved yet.

Scott Benner 36:57
Wow. What's the expectation?

Kristie 37:00
They say it can take days, weeks or months?

Scott Benner 37:05
Well, that's a polite way of saying we don't know. Yeah. Christy, you know, all the measurements we have for time could take any of those. So well, what what's been your experience so far? Is your blood pressure elevated or lowered? Or does it bounce around?

Kristie 37:24
About the first six weeks it was elevated and then it finally did stabilize but I'm still on medication. And now it's it's pretty stable with the medication. But looking forward to not having to take one more medicine a day.

Scott Benner 37:38
You're comfortable that your Hashimotos is well maintained.

Kristie 37:42
Oh, so postpartum, it flipped and I got thyroiditis and had hyperthyroidism. Like I said postpartum was like it was a beast. So as much as I loved pregnancy, and I love my son, I'm not sure what to do postpartum again.

Scott Benner 37:58
Hey, listen. Whateley drawers on the wall, or takes a crap on your floor or something like that. You'd be like, yes, was fine. Once good. Okay, so you had so tell me about this. So the baby comes out we and then you? How long until you your hypothyroidism turns to the hyperthyroidism.

Kristie 38:20
So I'm not actually sure and they didn't diagnose me until 12 weeks, but every time they checked, my TSH, it was extremely low. And they just kept reducing my medicine, check it again, extremely low, reduce my medicine. So finally at 12 weeks, they said, Well, I think we can tell you that it's postpartum thyroiditis, and it should stabilize shortly. Again. Good a good time measurements.

Scott Benner 38:48
Yeah, you know, weeks, months or years, perhaps even days. Did Has that happened yet?

Kristie 38:55
It hasn't happened yet. So they're still just adjusting the medicine.

Scott Benner 39:00
So are you taking any Synthroid, are you on Synthroid? Yes. I'm still taking How much do you know how many micrograms?

Kristie 39:09
75 five days a week.

Scott Benner 39:12
Oh, I see what they're doing. Okay, that's still 70 fives not I mean, that's a fair dose for an adult sized person. So and your and your TSH is still like, is it what is it? Is it in the ones is it lower?

Kristie 39:26
Lower like point one.

Scott Benner 39:27
Wow. Why are they giving you any at all then I wonder? You know, I was wondering the same thing. Like because you could just move on because you're not going to know when it flips back. I mean, how many blood tests have you had in the last couple of weeks?

Kristie 39:41
It's like every three weeks we've been testing it.

Scott Benner 39:44
Yeah, cuz that's that's the problem is that they probably think it's just going to stop and then they don't want you without the medication when it actually stops. Right. How is being hyper different from being hypo?

Kristie 39:58
You know, they're very similar like It's a lot of fatigue, which I was like, Oh, my new mom, of course I'm fatigued. The only big thing that I noticed was the heart palpitations.

Scott Benner 40:10
Oh, okay. They're scary too, aren't they? Yes. Yeah. How often? Were you having them?

Kristie 40:18
At least every day? Fun times?

Scott Benner 40:21
Are they gone now? Or no? Yes. Okay. Well, that's good. I, you don't? I mean, how many things do you need going? Are you breastfeeding on top of all that?

Kristie 40:35
Oh, yeah. So there would be days where I'd be like, Oh, I'm having heart palpitations. We're gonna check my blood pressure and my blood sugar. Oh, and I'm in the middle of breastfeeding. So my husband come in like one arm. He's taking my blood glucose, the other arm? He's taking my blood pressure?

Scott Benner 40:51
How? How has that been on your relationship? So far?

Kristie 40:56
It's been good. I mean, I really lucked out. We've been together 11 years. And he's, you know, he's always been my best friend. But he really has like, taken all this on and, and just been such an amazing support person. And, you know, I think it's challenging having a son now. Like, when we were in the hospital, it was like, Oh, my gosh, do I, my son had a low blood sugar when he was born. So I was like, do I go to the NICU with him or stay with you? Because I had a postpartum hemorrhage. And he's like, I'm so used to being the caregiver. He didn't know which way to go. Obviously, with my son. It was I think he's really, he's thriving in the role.

Scott Benner 41:33
Excellent. So hold on a second. So I have to wrap my head around your situation here. There's many, many things happening here. What what Tell me again, why did you have to go to the hospital?

Kristie 41:47
Oh, when my son was born, he had a low blood sugar at delivery.

Scott Benner 41:53
Okay, all right. Okay, that hasn't been a problem.

Kristie 41:58
No, no, it was just one and they attributed it to him being born at 37 weeks and a 31 hour labor.

Scott Benner 42:06
Okay, he was just cold, hungry. He was stuck in there. He was he was on that slip and slide way too long. It was like, Listen, I'm wet and I'm cold. And I haven't eaten anything. This lady How did your blood sugar's react after he like during that long? Delivery? Like so? Did you still need the the jacked up insulin that you needed in the third trimester? And then how soon? No, you didn't not during the delivery or not in the trimester,

Kristie 42:34
not during the delivery. So during the delivery, I ended up cutting back because I was induced. I was on Pitocin. And I couldn't eat anything. So Pitocin helps speed up the delivery. And so without eating anything, I just cut back my basil. I think like 20%. I was this is a great tip that I got on Facebook was I used the sugar main app to have my blood sugar's on display. So wherever I was in the hospital room, I could still see all my blood sugar's were. So we could kind of see if they were rising or falling pretty quickly. And didn't have to pull up my phone every five seconds, or have the nurses prick my finger.

Scott Benner 43:18
You and your husband were kind of managing that in conjunction with the health care team or just on your own.

Kristie 43:22
On our own, we actually were fighting very hard to manage my own blood sugar. So that was something that was really important to me.

Scott Benner 43:28
Was it a was it a fight? It was they didn't want you to do it?

Kristie 43:34
No, I gave birth at a big hospital dimensioned them in a rural area. So they couldn't I couldn't deliver a high risk pregnancy here. So in in Boston, they were not happy to have me manage my own chippers.

Scott Benner 43:51
Can we talk a little bit about that? How long was that process of you? badgering them into doing what you wanted? How long did it take you to get? Get that on your, you know, set up the way you wanted it.

Kristie 44:01
Um, it was probably like, three or four hours of going back and forth and then having to, like, I just like signed paperwork and say everything of like, they want to know every time I gave myself insulin, I was like, Oh, I'm on a pump. And they were like, Well, every time you give yourself insulin, let us know. And I was like, No, it gives me like every hour is a basil. And they were like waiting to write it down. I'm not gonna write down every hour while I'm in labor.

Scott Benner 44:27
Every hour, by the way, it's broken out of over the hour. You'd be yelling like, I just got point. Oh, four. I just got point. Oh two. I just got no algorithm for you. Right? You're just using Omnipod straight up. Yes. Okay. And he sounds like so, how did you get? What is my question here? How did you get so proficient about your diabetes in such a short amount of time?

Kristie 44:55
Um, I think as I mentioned being type A and then I My background is in data analytics. And so I kind of looked at Dexcom and was like, Okay, here's where I see trends, how can I fix it? And obviously, it just kind of being COVID in the world slowing down a little bit. I had a lot of time to do research and listen to podcasts. Yeah,

Scott Benner 45:16
I understand it time really is the time to look at it, and enough understanding to make sense of what you're saying. Right. That's it.

Kristie 45:26
Yeah, and I think it just really helped some of like, things that I had early on, you know, I had worked with a nutritionist who had type one. And she was telling me how important it is to Pre-Bolus. So basically, the first day that I started using insulin, I was Pre-Bolus thing. And then I was learning that other people were like, Oh, I don't Pre-Bolus And I was like, No, you have to like that's, that's how I was taught to use insulin. So it just, it wasn't difficult for me to start introducing it. As soon as I think I'm gonna have a snack. I take insulin, and I set a timer for 15 minutes.

Scott Benner 45:59
Wow. Good for you. It's a It's that easy. Not all the time. No, I was gonna say also nothing about this story is really easy. I mean, you had trouble getting pregnant, you had trouble getting through to a doctor, you. I mean, you get pregnant, there's issues with your pregnancy. Your Hashimotos is, you know, morphing in and out. Like a bad sci fi movie just turning from one thing to another. You're managing that along with the preeclampsia along with being scared. I mean, honestly, how scary was it when the baby's blood sugar was low? Oh, super scary. Yeah, my wife, my son didn't warm up for a couple of hours. And I remember just being scared about that. They're like, we can't bring you the baby yet. He's not warm enough. And I was like, what? And you know, there was a knot as umbilical cord when he came out. And something like you don't know what you're doing. I remember I know I've said this on here before but the I cut coals umbilical cord, and they are holding the scissors. And he comes out and the doctor's like running though the umbilical coordinate this not an IC the not I point to it, I go, is that a problem? And he holds up the baby, indicating to me baby's alive. And he goes, apparently not cut it here. And you know even that you're like, Well, isn't the thing how he breathes? Like the cord is not where the air and the like I pretty sure I learned that in health class. Like so there's this stuff you don't know. And all of a sudden you care about something more than anything else in the whole world. And you're trying to you're trying to make sense of it. I would think that low blood sugar thing. I mean, did you wonder for a second, the baby got insulin through you?

Kristie 47:44
Oh, there were so many things running through my head and the so mentally gave birth at a big institution. And so they had you know, 100 doctors and as a teaching hospital and everybody's in the room, it was great. Not really. They are like, Oh, it's because that the moms diabetic that the baby has a low blood sugar. And you know, in that moment, like very much like I'm blaming myself and crying and my blood sugar's had been between like 80 and 110 throughout the whole delivery. And I just kept saying like what, you know, what did I do wrong? And I was very lucky that I had hired a doula who also had type one. And she very quickly was like, Could this also be because he's cold? And, you know, he was having trouble warming up? And they said, Well, yeah, that's that could also be a factor. And it was like, they just immediately jumped to it because I was diabetic, they get a low blood sugar. And it was, you know, traumatizing for me as well. Like, you know, I just spent nine months growing this human and I felt like I had failed right off the bat.

Scott Benner 48:46
I heard somebody say recently, something that I've thought, kind of privately most of my adult life, I've never, I don't know how much I've said it out loud or not where I'm being recorded. But, um, medicines a thing, we're still figuring out. You know, we don't, we don't know everything about the body and about medication, about surgery and about procedures and all the stuff that goes along with being alive and the things you need to stay alive. You know, all the things that have to happen so that you don't die along the Oregon Trail when you're 17. You know, like, my appendix needed to come out and stuff like that. I mean, we know a lot and doctors do an amazing job, but there's still a lot more to know. And they're not perfect, and they don't certainly know everything. But we hope they do or act like they do like I don't know exactly, but that um, oh, the mom has diabetes. I heard blood sugar. That's probably because of the diabetes lady right here like they don't I guarantee you the person that said that out loud. Didn't know that as a fact. They just put two and two together and set it out loud. Yeah, the problem with human beings is we don't know everything. So but we act like we do, and write good on So if we didn't know, I mean, how would there be any podcast? I know. And I'll just be mine. I mean, all of them. Were everybody's like, here's what I think. Great. So are you? I mean, I think we've heard here you're thinking just one baby, which I'm on board with, by the way. But overall, glad you did it still.

Kristie 50:22
Yeah. Oh, yeah. Yeah. I love being a mom. That's excellent.

Scott Benner 50:27
It's just it's, you know, it's an important question to ask, because there could be people here, all that and go. I'm not doing all that. I mean, not that some of the things that happened to you are going to happen to everybody. But know. Your parents pretty proud. I imagine that you got Hashimotos to just like keeping the family tradition go. Oh, yeah. We're how aware of their Hashimotos they've Hashimotos. Are they not autoimmune? Do you? How aware of that with your parents were you like growing up?

Kristie 51:07
Not aware at all, just, you know, I remember my mom actually had her thyroid removed at one point. And she's kind of I was in college, and she called, she's like going into surgery. And I'll call you when I get out. And never really thought that much about her having thyroid issues, that it would impact me. So I'd never had ever researched it, or new signs to look out for it. And I look back, and I'm like, I'm pretty sure I've had Hashimotos for like, five years before I got diagnosed.

Scott Benner 51:37
Can I tell you that that part that haunts me about being a parent, with my daughter having autoimmune issues. I don't want my kids to waste time or to have poor health and not know why. Like, like, I constantly think about like, should I just sit down and write down everything I know? Or would that freak them out? Like maybe I'll just stay alive and call them every six months and ask them how they're feeling? You know what I mean? Like, but you know, I'm saying like, if you had this for five years, you look back now in hindsight, you see how it impacted you? Right? Yeah, like and isn't that does that sorry, looking at your posts, you're still just had a baby? I shouldn't say anything sad do But doesn't that make you sad? A little bit?

Kristie 52:21
It really does. And, you know, I look at kind of like my quality of life. I was always fatigued, always, you know, exhausted. And I just always chalked it up to the fact that I was busy. Now I had a really high profile job. I had ran for public office, it was like I was always on the go and doing things. So I was like, of course, I'm tired. You know, I'm working a lot. And it's, it was so much more than that. And I kind of felt that when I got diagnosed with type one, it was my body saying like, please just stop doing everything you're doing. I ended up quitting my job. And I just kind of got a new job. That's way less stressful. And I really kind of dived into my health. And previously, I'd always kind of been, quote, healthy. You know, I was a runner, I was a spin instructor. I ate healthy. And so like, outside, I looked healthy, but I felt like on the inside. My body was just kind of overstressed and overworked and just kind of helps me stop and reevaluate life, which I think COVID did for a lot of people, but it was really kind of this diagnosis that made me pause.

Scott Benner 53:27
Oh, yeah, there's a ton of people every thought thanks. Because I can't go into any store now and get service with any kind of expediency. People are like, we don't have enough. There's not enough people working our it's my first day. I'm like, Okay, I'm just I'll stand here. Just yeah, everyone lost their will to make money. I need you ball out there. Again, get out there. I didn't stop making this podcast, you don't get to stop going to work, then, you know, just live the American dream. work yourself into the ground and die. All right. I need my Nuggets. Or whatever

Kristie 54:03
it is. Like I said, I am in a resort town. So it is challenging. We have we have no workers and with the paws on J one visas and h two BBSes we've had a very challenging two years and it doesn't look like it's getting better anytime soon.

Scott Benner 54:19
Yeah, well, listen, everyone's gonna run out of money pretty soon, and they'll go right back to work. Don't worry. You know, listen, it's nice to talk about in that kind of like, you know, real progressive way and I agree with you, like we shouldn't work ourselves into the ground, you know, etc. There's too much stressed with work, but what really is the alternative? Because the alternative sounds like no money and no place to live. So, you know, I think you got to get into this is I mean, you want to try to change society, okay. But for the moment, like this is how it works. And, you know, people have been working themselves into a heart attack for many generations in America. It's a tradition so Keep up the tradition. Do your part Christie.

Kristie 55:06
Or you can find the happy medium. Yeah, a bit less stress and some time to be a mom.

Scott Benner 55:10
That's excellent. That's really great. So are you working every day of the week? Do you work from home? Do you work out of place of business you have to go to.

Kristie 55:19
So I'm working from home, which has been really nice to kind of ease back into it.

Scott Benner 55:24
Nice. That's excellent. I don't think Kelly's ever leaving. I said, I was like, why don't you go back to work? The Office everybody's okay. Now they say you don't even have to wear a mask on an airplane. Get out of here. Yes, silly kid. It's just like, I get more done here. And I'm like, I know. But

Kristie 55:42
yeah, it's so my husband's the same. He's been able to work remotely, since COVID. And now, everything's opening back up. And he's still remote. So it was definitely interesting with both of us being home for the past three months. And trying to get work done and just being in the same space as much as we've been.

Scott Benner 56:02
Yeah, a lot. A lot of office buildings that aren't being used right now. I keep wondering what anybody's gonna do with them.

Kristie 56:08
Like, well, it's like malls are not as much use anymore.

Scott Benner 56:12
Yeah, yeah, no, I was at a mall recently. They're very sad. Used to be a bustling place. And now you're walking and you're like, anyone else here. I feel weird.

Kristie 56:24
Just there to get some exercise,

Scott Benner 56:25
I just need to walk around and go to the Apple store and look at the things I can't afford that I'm gonna leave out of here. I need a pair of sneakers. That's really something, you know, so at the beginning, you said you love telling your story? Have I let you tell it? Or are you not gonna do anything? We're doing good?

Kristie 56:42
No, that that was? Yeah, that was just No, I think the the education out there. I always tell everybody, you know, how I was misdiagnosed, and how you have to be an advocate for yourself. And I feel like, that's what I've really learned over the past two years from everything from as calling Jocelyn myself and getting an endocrinologist. And then throughout my whole labor, and pregnancy, just I kept having to advocate for everything that I wanted. And I feel like this is kind of like not enough people know that, that they're in charge when they are at hospitals. And they think that the doctors know everything, which they do know more than us. But a lot of times you know your own body a lot better.

Scott Benner 57:23
In fairness to your statement, Christy, everything that happened to you was met by misinformation from a doctor. I mean, they got the baby out, but also took him 31 hours. So Well, I think that's just nature. I know. But while we're busy blaming them, let's blame them for that as well. Yeah, maybe the 31 hour thing? No, but everything else from the Pete from the original PC. I guess? You were pretty happy with your OB, right?

Kristie 57:54
Yes, I did luck out with a really great OB. Good.

Scott Benner 57:58
Okay. But I mean, they brought everybody it sounds like everybody in Boston saw your hoo, ha, right? They brought everybody into the room, and then made you feel bad. Oh, yeah.

Kristie 58:08
And they were, they just kept telling me, it is medically necessary to get this baby out. And like, one sentence I heard the whole time I was there. Now I was like, I think we're okay. Because, you know, I had gone in really wanting a different birth experience than I had. And I wasn't excited about being at a big hospital. And so I pushed back on every single thing. And every time I pushed back, it was like, it is medically necessary. It's like, is it really? Is it life or death right now? Once you reach life or death, I'll give it but until that point, I'm going to keep advocating

Scott Benner 58:40
for you. That's really something that's great. What else? Is there anything I didn't ask you that I should have?

Kristie 58:49
What can I can think of?

Scott Benner 58:53
I feel like we did such a good job. I'm just looking up and it hasn't been quite an hour. And I'm like, we did it. But usually it takes longer than this. Did I not talk as much is that what happened? I feel like I've talked a lot. Thinking people are like, Yeah, well, here's what happens. Got you shut up and let her talk. And that's how we got the story.

Kristie 59:11
No, but I'm only two years into it. So

Scott Benner 59:14
yeah, that's right. You don't know enough yet. I didn't have enough to ask you about. Well, what about? There's a couple of things for me to ask you about. So did you find the episodes of the podcast where we talked about pregnancy? The pro tip did you go through the one person who I interviewed at every step along the way? First second trimester all that stuff. Did you hear all was any of that valuable for you?

Kristie 59:40
Oh, definitely. And really just hearing experiences and yeah, it sounds so cliche, but like you, you don't understand things a lot of times until you can see it in somebody else. And so I felt like even when listening to the podcast of that first episode I listened to it was a very similar story. You're talking to somebody The who had gotten diagnosed at 30. And kind of how she was navigating, like a few change jobs and trying to navigate that. And it was like, Hey, here's somebody kind of like me going through the same experience I am and they're okay. And I'm going to be okay. And then just hearing successful pregnancy stories was like, okay, I can do this too. And I was very prepared at every step when I would know when the insulin resistance was going to hit. And now I was able to look at my Dexcom data and be able to evaluate things. You know, I didn't want to be looking in the rearview mirror constantly of like, what was happening the week prior, but I would say, I'd also know, okay, I remember that either hitting, you know, week 32, the resistance was going to kick in a little bit more, and so I would know what to expect. And also be able to look at what was happening.

Scott Benner 1:00:51
Oh, that makes me happy. I'm glad. I just think it's so cool. Like, really, you didn't need to lay the baby after me. I was teasing you. But I'm just, I'm just happy that you, you had a better experience because of this thing we put together here. You know, it's

Kristie 1:01:05
definitely really cool. I think about it. I was like living this life of not eating carbs. And yeah, I know that some people choose to do that. And there's a lot of days where, you know, if I've had a roller coaster day, the next day, I'm like, I'm gonna go easy on the carbs today. But I like having the choice of, okay, I can go easy on the carbs today, or it's my birthday, and I'm going to eat all the cake. And I just now I know how to dose for it. I have the tools to be successful.

Scott Benner 1:01:30
Yeah, no, it's so I'm genuinely like, I have so many feelings about it. That I can't, I can't even I can't get them all out. I'm tickled. Like I'm happy. I'm happy for you. I'm proud of myself for making the thing like it really does like it. It's awesome probably end up saying it over and over again till the end. But I didn't know when I started this that. You know, Christie was going to not have to eat chicken thighs and have a baby and stuff like that. You know what I mean? Like it's, it's cool to reach people and to and to help them. It's hard to put into words. Anyway. If I was on PCP, I could probably be more eloquent. What is Angel Dust? I mean, Christy, don't you feel like we have to find out now because I really don't know. Do you know your big Angel Dust fan? As a child? No. You don't strike me as a drug user at all, by the way. No, fence like Ledeen? Okay, here we go. Then cycling or Fen LIS cycle flicks. I don't know. Pepperdine PCP, also known as Angel List, among other names, is the disconnect of hallucinate. hallucinogenic drug use for mind altering effects PCP may cause hallucinations, distortions, perceptions of sound, and violent behavior. Is this like when they talk? Oh, you can smoke it. snort it? Look at this kid stop listening. Looks like Oh, wow. There's all kinds. It is not a good thing. I'm not saying that. Nobody do nobody do Angel. Schizophrenia. What happens here? Wow, can you get flipped into being a schizophrenic by by smoking the Angel Dust? Definitely don't do that kids. No drugs. I want to say right now, Christie, who is delightful doesn't do drugs. And I've never done drugs either. And you can actually believe that I just know. I just know PCP is Angel. That's that's all I know. That's the extent of my knowledge. Will you stop your child from smoking the weed 20 years from now when they try?

Kristie 1:03:42
Oh, they're gonna have to try if they want to.

Scott Benner 1:03:45
Okay, it's completely Lila. Did you hear cops can smoke weed now? Really? I swear. Christine, do you mind if we take the end of your episode to look up things that I've heard but haven't had time to look into? I think in New Jersey Okay, in New Jersey, the Jersey City Mayor says cops who use marijuana even if they're off duty will be fired. But that's not what I heard. I heard New Jersey cops won't be banned from smoking weed. So I guess you made it. Oh, it's going back and forth. It's turning into a political thing. So I guess they made it legal. So how do you stop somebody from doing something illegal right like vodka is legal so cop can go home and have a gimlet if they want to. Right so if you make the weed legal why can't they go home and have an edible or smoke and now the governor's like he's open to banning off duty hops from using marijuana. Interesting. This is gonna go back and forth forever. Watch New Jersey mess this up. They mess everything else up in New Jersey. By the way, it's just a bunch of banks and pharmaceutical companies and a big highway. There's nothing else here. Don't don't visit we have nothing

Kristie 1:04:59
you where I am, we get a lot of visitors from New Jersey. So we don't like the people from New York or New Jersey?

Scott Benner 1:05:05
Ah, well, you would like me. Although I would drive very fast through your town that would be irritating to you probably. Yeah. And I'd stop and want to use your facilities and stuff. And then I'd spend money while I was there, though. So I need a drink. side of the road kind of a thing. Let's see, what does your husband do for a living?

Kristie 1:05:28
He works at a bank? He does. He's a credit analyst. And does mortgage evaluations.

Scott Benner 1:05:34
Nice. So like a nice little family? We get you are? What are our hopes and dreams for this little baby? What do you plan on being serious? Do you want it to grow up to be relaxed and happy? Or do you want to be a go getter? Or because you you've kind of seemed like you've had both in your life? I mean, you were out there, like doing a lot at one point. And now you're thinking the other way. But how do you think about the baby? Like, what should the baby do?

Kristie 1:06:03
Yeah, it's really interesting. I've never thought about it. But you know, I think I just want him to be happy. I definitely don't want to put as much stress on him as I felt like, I had a lot of stress. I was the first in my family to go to college and graduate, and kind of be this star child. I feel like I don't want to put that pressure on him, especially if he's the only kid. But I think it's more so I just, I'm looking forward to having fun with him.

Scott Benner 1:06:31
Yeah, that's the way to think about I approve your message. Christine, what do you think of that?

Kristie 1:06:36
And I really hope he doesn't get type one. But yeah, if he does, then I have the tools to help them.

Scott Benner 1:06:43
The podcast, you meant the podcast right now. Yeah. Like you'll make him Listen, please. I need the listeners, Christy, I

Kristie 1:06:48
gotta keep this guy. That's all he's done his first three months of

Scott Benner 1:06:52
listening to this. So Oh, my gosh, I I was just interviewing somebody the other day. And I brought this up. So it'll be six months ago, people you might have heard it before. But this this kid, this mom shared this, this image online of this child kind of drew himself as a robot with things on his shoulders talking to him. And one of the things was a juice box, telling him that he could eat whatever he wanted if he balls for it. And she said she couldn't believe like, he's a little kid. But he's hearing the podcast ball. She's listening to it and helping himself that way. I was so like, I thought that was really kind of like adorable. But yeah, I mean, listen, I, I don't, here's where I'm at, if anybody cares. I don't want my kids to live with me for the rest of their lives. Not because I don't like them. But because I don't think it would be healthy for anybody. I want to, I want to be able to die thinking they can take care of themselves. But I do just want them to be happy. But I also think there should be somebody making the nuggets. So I'm very conflicted. I want them to get out there and work and be happy at the same time. Is that possible? Can you work and be happy? I think so. Yeah. But everybody can't have a YouTube channel. Christy. Somebody's gonna have to actually go make the french fries. You know what I mean? Yeah, somebody's gonna write.

Kristie 1:08:14
It's gonna, it's gonna equal itself out and balance itself. I think soon.

Scott Benner 1:08:20
You think so you think like one day, we'll all just have like little tasks that we do and money will be free and you won't need it or something like that? Or what do you think?

Kristie 1:08:28
I don't think I don't think it'll go that far.

Scott Benner 1:08:30
But you're just gonna get all Star Trek,

Kristie 1:08:32
I think that we're starting to figure out ways to balance. I always say like, work life balance, but there's no such thing. But, you know, I think things that have come out of COVID like being able to work from home. Yeah, I think I would have quit my job. Honestly. You'd have to go back three months after giving birth. It's a lot, but being able to ease into it is something that is gonna make me keep working.

Scott Benner 1:08:57
Can I go out? I'm gonna give you a hot take. It's gonna go the other way. Right. I think the working from home thing is ruining people's work life balance, not making it better.

Kristie 1:09:07
Oh, yeah,

Scott Benner 1:09:08
I can see that too. Yeah, I think that it's easier to start working. So you start earlier, you probably go longer. You start to get this feeling. There's nowhere to go. So I might as well do this. If I'm not doing this. What else am I going to do anyway? I think they're getting free work out of us by working from

Kristie 1:09:24
home. Yes, I definitely saw that at the beginning of COVID. It was like 24/7. Non stop. Yeah, it could be alright. There's nothing else.

Scott Benner 1:09:34
I sat down the other night at like 11 o'clock. It was like a Friday night. And I was like, I'm gonna edit another podcast. No, I mean, it's a you know, it's a business I own. So I mean, I obviously didn't have to do it if I didn't want to, but I'm just saying like, my wife was out somewhere. And I was like, I have nothing to do. I'm not tired. I mean, I'll go to work. If I had to go into an office building. I would not have gotten in my car and driven to a Building at 11 o'clock to edit a podcast. So, I do think there's I think there's good and bad as with everything we're gonna see. But my heartache is before long we're going to be opening those office buildings back up. People are going to be thrilled to go back to work. Yes. How many people do you know that got divorced during COVID? Do you know any? Yeah, quite a few. Yeah, quite a few. Yeah, of course you did. I did. I, I had a guy told me. I swear to God, beginning of COVID. Everybody's like, oh my god, COVID We're all gonna die, blah, blah, blah, it looks me in the face. He goes, Oh, I'm getting divorced. I was like, what he goes, I am going to end up getting divorced. And I said, What do you mean, he goes, the only secret to keeping my marriage going is that we don't see each other very much. I was like, yeah, and he also for sure. Six months later didn't live there anymore. Wow, divorce now.

Kristie 1:10:52
We see now

Scott Benner 1:10:53
older people. Like not like, you know, 29 year old or somebody who's like, you know, it's just like, Yeah, whatever, like, spent a good life together. And, and he knew, as soon as COVID came while everyone else was like, I don't know, I'm gonna get the COVID I'm gonna die. I'm gonna do this. My grandma. Like, all everybody's thinking about all that stuff. He's like, Oh, I'm getting divorced. happened, like, Oh, my goodness, it

Kristie 1:11:19
was it was really something he knew the key to success was not being

Scott Benner 1:11:23
his key to success was going to work. And I don't know why, like, I don't know, his particulars, you know, they could have just talk to each other. You know, what I'm saying? But, but he knew where it was headed. So really interesting. All right, Christine. You're too nice. And we're just talking at this point. So I'm gonna let you go. All right. Thank you very, very nice. Did you have a good time? I did. I feel like a hostess in this situation. Like, if you didn't have a good time. I worry about my skills.

Kristie 1:11:54
Now, it's, it's funny, because I listened to you so much. It's actually nice to have a conversation back and forth.

Scott Benner 1:12:00
It's nice when you can talk back to the voice makes you feel more safe. You know, I had a, I said, we're gonna stop. But one more thing. I clear my throat though. Sorry. This morning, I was talking to a business associate Who's moving on from a job. And we were saying goodbye. And we'd done a lot of stuff together for the podcast. And at the very end of the conversation, she said, just want to tell you what, it was a great pleasure working with you. And I said, thank you. And but part of me is like, why, you know, but I didn't say why. But she just went on into it. And she said, You're such a great facilitator of good conversations. And then that got in my head. Because then we got on and like, 15 minutes into this, I started thinking, Am I doing a good job in this conversation? Because I can't tell like, so the secret is, is that if I am a good facilitator of conversation, it's not something I'm setting out to do. It's happening. Does that make sense? Right, and so then I got into my head and I was like, Am I doing the thing that makes me good at this right now? Like, I actually, like, had my son I was a little twisted up in the first like 15 minutes we talked because I had her voice in my head telling me you do a good job at this and I was like, what does that mean? So

Kristie 1:13:12
anyway, freaks you out like stage fright.

Scott Benner 1:13:15
I got a little freaked out. Hopefully no one will notice.

A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juice box, you spell that g v o k KEGLUC AG o n.com. Forward slash juicebox. 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, and of course ag one from Athletic Greens head to my link athletic greens.com forward slash juice box to get a free year supply of vitamin D and five free travel packs with your subscription, athletic greens.com forward slash juice box. If you're looking for a community around type one diabetes, the Facebook page for the Juicebox Podcast has now over 31,000 members at it Juicebox Podcast type one diabetes on Facebook. If you're looking for the afterdark series ask Scott and Jenny algorithm pumping bold beginnings defining diabetes to finding thyroid diabetes Pro Tip series, the diabetes variables mental wellness and more. Head to juicebox podcast.com. Look up top in the menu and you will be able to find everything that you're looking for. Once you know what you're looking for. It'd be super simple to listen right there online. We're searched your podcast player for the episode that you want. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#797 Island Adventure

Paola's daughter has type 1 diabetes and was a guest on episode 467 'Come Together'.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 797 of the Juicebox Podcast.

On today's show, I'm gonna be speaking with payola. She is the mother of a girl who's been on the podcast before. As a matter of fact, her daughter and her friends who all have type one diabetes were on together. If you remember that episode, this is going to be the mom of one of those girls. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician. Before making any changes to your health care plan. We're becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry, fill out the survey help people living with type one diabetes, help yourself move diabetes research forward without getting off your sofa. There's so much you can do in just the 10 minutes that will take you to complete that survey, T one D exchange.org. Forward slash juice box. If you're looking for the diabetes Pro Tip series that defining diabetes series bold beginnings or any of the series within the podcast, they are now listed at the top of juicebox podcast.com. Just go to your browser, and they're all right up there. If you're on a phone, hit the little menu icon, and then you'll see the list this episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes. You don't want an insulin pump, but you want some of that good functionality that an insulin pump has. You're looking for the in pen in pen today.com today's podcast is also sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitoring system. You want to see your blood sugars in real time. Watch this. I'm going to turn my head. I now know Arden's blood sugar. I just looked at my phone. That was how quick I did 103 and stable. What do you think of that? You can do that to artists not even here actually are in the state right now. dexcom.com forward slash juicebox.

Paola 2:15
Okay, my name is Paola and I live in the Cayman Islands. My daughter is a Mayan. She's 18 years old and she's our type one diabetic daughter.

Scott Benner 2:26
Okay, was was my on the show before?

Paola 2:31
Yes, as a matter of fact, she was she spoke to you maybe a year ago, she was with her other type one diabetic friends on the island. And they interviewed with you. Yeah,

Scott Benner 2:44
okay. Oh, that's I still have such a fond memory of talking to those girls. It was, That episode was so much fun. I had a lot of fun. So, and you guys are the reason I am the number one podcast on the Cayman Islands. So thank you very much. It's our pleasure. Also, with five other people would start listening to one podcast, I think it would knock me off, but it's not a huge population.

Paola 3:09
Um, no, it's a very small population. As a matter of fact, I have shared it with a few other diabetic kids as well as adults. I'm not 100% sure whether they've been listening as well. So I wouldn't be able to tell you know, that's

Scott Benner 3:25
okay. I just know that when I look at my stats, I am always crushing the game in Ireland. So I'm excited. That's awesome. Yeah, you guys are you guys are moving the needle over there for sure. Well, what made you want to be on today?

Paola 3:40
Well, for one, I wanted to share my diagnosis, her story and also as a teacher, I wanted to share a few tips that teachers can do if they do have a type one diabetic student in their classroom.

Scott Benner 3:55
Okay, cool. Well, first, let me see if I can figure out what episode The girls were on. So that sure, do you remember what it was called?

Paola 4:04
Ah best? No, I wouldn't. I can text them. Yeah, and asker I'm sure

Scott Benner 4:15
it'll be more fun to see if we can figure

Paola 4:19
I think it was around the 404 20s. Maybe if I'm not if I'm recalling correctly.

Scott Benner 4:25
Okay. You know, the number.

Paola 4:28
I I could be round though. Well, that's more in

Scott Benner 4:31
the let's find out if you're right. Nice try. No. All right. Well, we'll figure it out as we go. Okay. So my is how old when she's diagnosed.

Paola 4:46
Maya was seven years old. She was diagnosed on May 8 2011. And first grade,

Scott Benner 4:56
first grade. Were you guys living where you are now at the time?

Paola 5:00
No, we were actually living in Ecuador. So prior to her diagnosis, um, I did, in fact, lose quite a bit of weight. But I didn't see any of the signs. I mean, all I knew was a she's always been a very active child, and she was running around and doing all sorts of sports. And I didn't pay attention to the weight, I feel horrible about it, because I didn't really pay attention to it until it got really, really bad. And then because we had a long weekend, the pediatric, our physician told us that we could run a blood test, we got the results, but there was nothing, nothing out of the ordinary, I guess and what he saw. So call them again and ask them there's something really definitely wrong because the Maya was super lethargic, she was laying on the couch, and it was very hard for, for her to stay up to stay awake. And, and that was normally not our child's I mean, she was always active playing with our dogs and things. And so we thought this was really weird. So we quickly ran another set of bloodwork. And as soon as we found out that our physician called us and told us, You have to come right away to the, to the hospital because of my is about to go into into a coma. Oh my gosh, yes. While she was extremely high, very lethargic, her head was falling down completely, she could not hold her head correctly, her arms just went down. It was it was really scary. So when we got to the hospital, we had lots of physicians, nurses poking her testing this and that, and it was, nobody was giving us any answers. All we knew was what they were doing. And it was very hard for us, as parents. And finally, a few minutes later, the pediatrician came out and told us well, I Maya has type one. And we were just shocked.

Scott Benner 7:12
Wow, it's crazy. You said that you felt like you ignored things. But what specifically did you see that now, you know, in retrospect, was a sign? Well,

Paola 7:21
yes, I'm glad you asked me that. So now I know, for example, the constant weight loss, the thirst. Going to the restroom at odd hours. But we have always been a family that drinks a lot of water. So to us, it didn't really become strange that she was more thirsty than before. You know, it just wasn't strange to us. And so when I learned about all the symptoms prior to that lead to the diagnosis, then I was just Oh, my goodness, I should have paid attention to this. Yeah. Well, obviously you. You don't know that. Because you're just not informed on a

Scott Benner 8:02
very little way to know how many how much weight do you think she lost?

Paola 8:07
Um, she was, she must have lost about 20 pounds or so. Wow, she was so thin Scott, you could see her ribs. And of course, I didn't notice this, particularly because she was seven years old and she got dressed by herself. She showered by herself. She ate all her her meals. So there was no way for us to really notice anything other than the 24 hours prior to her diagnosis, maybe even 36 hours prior.

Scott Benner 8:38
That's why that's how it happened to us to. I mean, Arden was clearly in hindsight, had lost weight, and, you know, all the other stuff, everything but until it became emergent, like to the point where you're like something's really really wrong. I couldn't I mean, I didn't put any of the pieces together. I also think that looking back on it as the person I am now is not helpful, because back then nobody in my family had ever been sick. I didn't like you know what I mean? Like we were living that life you get up you do your thing, you come home, you go to bed, you do it again, like get it no one was ever there was no illnesses to think about in that moment. Now, of course, like now I'm like, I'm like a radar detector, you know, something changes on like, what's gone? What would was less time moved to the bathroom.

Paola 9:34
Exactly. What happened here and I paid? Yes. And I also pay attention to those types of symptoms or signals and my students, so I'm super aware.

Scott Benner 9:47
No, I'm sure the kids are completely annoyed by it. Right. But I do ask questions like How long was your period? Oh, yeah. How'd this go? When's the last time you went to the bathroom? When's the last time you did this? Have you been eating Okay, how do you feel like the last thing I said to my son this weekend was, how do you feel? And he was like, why don't you need anything before we go? Like, all I was really saying was like, I was trying to signal him, like, think about yourself for a second. You know, because you're busy, and you're a college and you're playing sports, and you're doing a lot, like, stop for five seconds and think about your health. Has it been okay? And he's like, no, no, I'm good. And I was like, okay, but that's all I was really doing. At that point. I was just trying to get him to think about back then I didn't know what the hell was going on. So back then I just thought I was going to work and make some money and buy a house one day, and the kids would get married, and I'd retire. Like, that's how I felt my whole life was gonna go instead. This hell happened. So anyway, so. So there she is in the hospital? How is the health care in Ecuador? Was it okay? Were they able to help her?

Paola 10:48
Well, that's a good question. So we were provided and connected with an endocrinologist, not necessarily a children's endocrinologist or a pediatric. But he was the number one in in Ecuador in the country. And so everyone spoke very highly about him. So he came over Amaya was, was given her insulin through an IV, her meals came in. And she started to gain a little bit more for color and our skin a little bit more attentive, and so forth. And then came all of our training. So this physician would sit with me and would draw these, I'm not kidding you. He would draw these mountains and hills and in it, put formulas, and he would tell me, this is what you're going to do at this time, you're going to divide it and multiply it by this at this time, remember that this formula only works from this time to this time and so forth, then so am I was actually at the hospital for 10 days, because her her body wasn't reacting positively to the to the insulin and so they kept us there for a little longer. And then by the time we were ready to go, I I had more than 20 pieces of paper with different formulas and hills and mountains that I needed to be able to multiply and add and divide. And and all of this was so confusing at first. So confusing. That's it. And

Scott Benner 12:24
yeah, the math is the first thing that made me cry. Well, after the realization, the next thing that made me cry was the math actually. So

Paola 12:32
yes, and I'm not a very good mathematician either. So I thought, How am I going to figure this out? I mean, this is so complex. But so we were with this physician for about a year and a half or so. And then we had an accident took place in our family. And so we I tried to get a hold of them because the Maya was her numbers were really high. And I could not bring them down regardless of how much insulin I was. I was giving her we were using lentils and a Piedra back then we did not have the Dexcom because that technology didn't exist in Ecuador, and when when she was diagnosed, and so we went home with lentils and a Piedra and had to be administered at set times. So we had to go and train, not necessarily trained, but informed the school, the nurse that the school wasn't very comfortable and giving Amaya her shots, even though she's a nurse. So

Scott Benner 13:43
you said something a second ago, I'm confused by or I'm not following the thread on. You said there was an accident in the family.

Paola 13:50
Yes. So my sister passed away. And terrible accident.

Scott Benner 13:56
Okay. And did that have an impact on my care? Is that what you're getting at?

Paola 14:01
Or? Yes, yes. I'm sorry. So yeah. So we had this accident, and my sister passed away. And we were trying to get a hold of the physician and the endocrinologist, but we couldn't. And so when I finally got a hold of them, I asked them, look, these have been her numbers these days. And I have done everything that you've told me and I have not been able to bring her blood sugar's down. And so what do I do now? And he just told me, he just brushed me off saying things like, don't worry about it. Let her numbers run high. This is a hard time and your family don't worry about it. Just keep on giving her insulin Make, make. Make your meals weigh up told you and nothing more. or, and when I got home, I thought this can't be right, there must be something that we're doing wrong, right? Because her numbers were so high, she was constantly above 250, rarely below 180. And the more that I read online about the different things that I could be doing as a mother, when you have a type one, I would share that information with a physician. And he would just brush me off saying, Oh, no, that's the way they do it in the US, we do it here differently. Don't worry about that. Just keep on doing what you're doing here. What's interesting

Scott Benner 15:36
is so that he had one idea of how to do this, and no other interest in looking into it. Beyond that,

Paola 15:44
nothing, nothing, no other interest. And so after that position, I thought we can't continue with it. So immediately, I started looking for another another endocrinologist, we found another person who works closely with a nutritionist, and we thought, oh, this would be great. Because finally somebody else will be able to guide us with carb count and a proper balanced meals and so forth. And so we thought, okay, let's go with it. We lasted with this doctor for about eight months, because every time that I went with Amaya to have her checkups, he was so rude. So, so rude and his way of treating me Why Why don't you understand this? Can't you just figure out you're multiplying, you must be dividing and doing something wrong? How come her numbers continue being so high? And so I felt very threatened by his way of talking to me that I thought I can't continue like this, because it's not healthy for me. Therefore, I cannot help my daughter

Scott Benner 16:54
when you there. When you look back on that? Do you see a situation where he was covering for his lack of knowledge? or D?

Paola 17:04
Absolutely. Absolutely. He knew nothing. He he was basically giving us the same guidance that the first endocrinologist gave us, but then adding a twist, which was the nutrition factor. So he would say, make sure that she's got these items, certain meals, so that you have a better balance of of your food. And we thought we were doing okay, but every time we went to him, it was my stomach would be in the knots. I would get so nervous. And it wasn't healthy. Yeah.

Scott Benner 17:44
Oh, and you weren't gonna get anywhere either. Plus, it makes you crazy because you see a problem. And you know, there has to be a fix to it. And then the person who's in charge is telling you, you know, this is fine. You know, this is okay. Or you're doing it wrong. One or the other? And

Paola 17:58
yes, yeah. And constantly, the blame was on me. So I was doing something wrong. It wasn't a my, yeah, he never checked on a maya never. So it was always me. I was the one that was doing something wrong. I was making mistakes here and there. And so I felt I could not continue with him either. And so we were lucky enough to find another endocrinologist. And she was very interested in the background knowledge that we had with numbers and the nutrition and she so she made a few twists to a Maya's doses of both lenses and a Piedra and number started to get a little bit better. And we thought, okay, this is great. You know, so we're on a better track right now. We thought, This is fabulous. In those days. And as the years went by, Maya went through all her elementary years. So she finished school, she had great teachers. Her second grade teacher was fantastic. And so she was she had our phone numbers on the classroom phone right above it on a post said, she tried to help my as much as she could with, we're making sure that she was asking that she drank water that she was eating what she was supposed to be eating. And so she had a lot of she gave me a sense of security, which was very important as she was coming new with with diabetes into a school and to a school that had never had a type one diabetic students.

Scott Benner 19:44
Wow, that's lucky right to find somebody that that's willing to get involved and, and to understand what was your level of understanding of that point as you're as you're sending her into school, and you're having these problems with the doctors and not sure like, what's her or health, like at that moment? Are you still looking at 250 blood sugars? And you wondering what's going wrong? Or had you had you made a leap yet to figure this out on my own?

Paola 20:09
Well, I'm glad you asked me this, because prior to, while we were with our first two doctors, everything I heard from them was, oh, you can't continue doing it, you have to follow these rules. And make sure that Amaya takes in her insulin at the set times. And she's got to eat this amount at this time with this amount of insulin. So it was very rigid. And so that didn't allow us a lot of flexibility. And when we went to our third physician, she twists I allow my head to have more flexibility. She doesn't need to take her insulin at this time. If she's not hungry, she does not need to eat, you know, so it gave us a little bit. It broke away from the from the constraint that we had before. And besides that, I was reading, I was researching about the technology that existed in the US. And I thought, how can we don't have this here? I mean, I would question them.

Scott Benner 21:14
Yeah. Let me ask you a question. Did anyone in the beginning tell you you were doing sliding scale? They were used, that I was doing what? Using a sliding scale? Sometimes when I stepped on a scale, I wish it would slide away from me. But that's a different story. How would you like to use the in pen from Medtronic diabetes? You might be saying to me, Scott, what the heck is that? Just an insulin pen? Oh, no, no, it's not just an insulin pen. I think you and I need to visit in pen today.com together to learn more. I've clicked on it already. Have you know you haven't, you're on your phone, probably. But I'm here. So don't worry. In Penn today.com. This is where you're going to learn about what is this thing asking me to do? Do I want to take a survey now right now I'm making a podcast. Hold on, we'll do that later. Here's what you get with the pen, you get the pen, which is terrific. It's a pen. And then you get an app that connects to the pen. Now you see what's happening because that app is going to show you your current glucose. You can see your current level After pairing your continuous glucose monitor Oh, oh, okay. What else meal history, dosing history. Activity Log. That's right, you can see a list of the recent actions including doses meals and glucose readings in the activity log. How about if you push that Reports button reports can be generated for up to 90 days of data. It will and the impact is going to show your glucose history your active insulin remaining. That dosing calculator, I don't think you need to know anything else. If you don't want to pump. I mean, you have to look at the impact. And that's just my opinion. But I think you might agree once you go to in Penn today.com. When you're ready to try it fill out the form and you get going. There's videos there to learn about the in pen. testimonials from users, you can find out about their 24 hour technical support their hands on product training, online educational resources and learn about this offer that says you may pay as little as $35 for the event offers available to people with commercial insurance terms and conditions apply. But it's definitely worth you head over to Impend today.com. To find out more in pen requires a prescription and settings from your healthcare provider, you must use proper settings and follow the instructions as directed, or you could experience high or low glucose levels. For more safety information, once again, in Penn today.com. Dexcom is going to give you the power to manage your diabetes with confidence, make better diabetes decisions in the moment with the Dexcom G six. At the beginning of the episode, I told you that my daughter's blood sugar was 123. I think I'm looking now it's 109. It's drifting up slightly. I'm able to watch that with my phone, you can to Android or iPhone. Arden has her phone with her. It's feeding the information into the cloud. And then it drifts back down into my iPhone. I don't think that's technically how it happens. But the cloud is how it works. And you can see, speed, direction and number. That's amazing. Actually up to 10 people can follow a Dexcom user, anyone you want. That could be a teacher, it could be I guess you could be your priest. It can be really anybody. I don't know who you're wanting to do it but I mean probably use your visual mom or your dad or your husband, your wife or something but you know I'm saying dexcom.com forward slash juicebox. See the speed, direction and number of your blood sugar in real time on your phone or on a Dexcom receiver. You have no idea how valuable it is. It's everything. Every decision we make. Every card we cover, or don't. Every time we use insulin we first Look at what the Dexcom is telling us about what's happening with Ardens blood sugar. You will love it dexcom.com forward slash juice box Do not delay, you may be eligible for a free 10 day supply of the Dexcom G six. Go to my link to find out more

they ever used those words like you shoot this amount of insulin and she has to eat this many carbs?

Paola 25:36
They then say it and but I'm assuming Yes, they did. In Spanish. It's it's it's called something else. But yes, it is the same ideas there.

Scott Benner 25:45
Okay, so. So did you see? So interesting because you're being told one thing, and then you're online, you're like, seems like people do it a different way. And so you get to this new doctor. And they're basically you're telling you now count carbs use insulin for carbs? Correct? Okay, great. How long was that since her diagnosis?

Paola 26:07
Um, it was probably in my first four or five years.

Scott Benner 26:12
Wow. So for first four or five years, you're doing sliding scale, and then maybe 2016, you start counting carbs?

Paola 26:21
Correct. And so just to give you another idea of how bad our situation was with her man with our management was a minus a one C was always above nine. I could not bring it down. Was that because I didn't have the tools?

Scott Benner 26:39
Can you talk a little bit about how that made you feel? Personally,

Paola 26:45
I was heartbroken because the more I read about the care that you should have, the more that I wanted to make amends to what we were doing with with our daughter, and I had no support by the doctors. And so whatever, whenever I went to them, and I said, Hey, I read this article, I wouldn't even print it out for them. Look at this. Can I do this? And they would be like, no, no, no fallout, this is the way we do things. Ignore that. That's the way they do it in the US don't pay attention to those things.

Scott Benner 27:21
That sucks. I really does. Well, okay, but you got away from it. How did you so the new doctor helped you move away from it?

Paola 27:28
A little bit? Yes. So she made a few changes. But this is the best part. Am I yeah, we're in fifth grade. And because we, we? Well, my husband and I both work at American international schools. And am I as is a student in in those schools. We had a family who came from Canada. And they their youngest child was a type one. And their middle child became is best friend's in grade five. So their friendship led to us becoming very close to this family and learning from them. So it was my first time seeing a Dexcom it was my first time seeing the different types of snacks that you could have for in case you're low. It was our first exposure to to making corrections when you saw certain numbers. It was the first time that we heard about Pre-Bolus ng we had not heard about it before. Okay. So it was there was a lot of new things. And so we this family was amazing to us. And they shared even the friends for life conference in Orlando. And so we we thought, okay, we're gonna go. And so the two families, we left together from Quito, and we arrived to Florida, and we were in the conference together. And, gosh, it was just like, I cannot believe I am listening to all of these things that I have been wanting to do, but I have been unable to do it. Because the physicians wouldn't allow us to make those changes, would you? Would you ever

Scott Benner 29:23
would you have ever considered just going against the physician? Or do you do you think that's not something you would have been capable of doing?

Paola 29:32
I don't think my first years I would have been capable to do it. I would have been very hesitant just because I feared that I was playing with the insulin. I wasn't 100% sure that I could make those changes on my own. Sure. And so I was very hesitant. No, I

Scott Benner 29:51
understand. I just I want people to hear that. That it's that even in the face of I mean your own common sense, or your own ability to look added more information and say, I don't think this is right. Or at least I think we could be doing this differently, and maybe be having some better outcomes. And I mean, my goodness, like there certainly was room for better outcomes. Let's just say what he wants. He was that whole time. eights, it wasn't

Paola 30:14
the nine nines, late eights, nines, 10s. I believe we even got to 111 at some point.

Scott Benner 30:24
So this is how we do it in Ecuador, is is nines. And we're okay with it. And, and that person would have, I'm a little angry that person would have just let your daughter live like that her whole life until she was probably in her late 20s When she started having some sort of side effects from high blood sugars. And then they would assess like, this is what it this is just diabetes. It says, you know, that's it. Wow. That's it terrible. Absolutely. So meeting so meeting this other family really was by the watershed moment for you and hearing them say, yeah, right.

Paola 31:04
Absolutely. Absolutely. We're still in connection with them. Both Amaya and their daughter have gotten together. They're constantly chatting with each other. And so our connection with them is very, very strong as they've been wonderful to us. And because we were able to go to the friends for life conference, both my husband and I attended two different workshops. And in one of those workshops, we learned about Dexcom. And we were dumbfounded by this, oh, my gosh, what is this thing? And so we attended the whole workshop, and we asked them, a few families, what would be the most important tool if you were able to get one of these tools? Whether it's the pump? Or the Dexcom? Which would be your first Yeah, and everyone said, The Dexcom? Everyone said the Vex, I

Scott Benner 31:56
understand. Yeah, I mean, being able to see it is it's just the best part, right? Like, I mean, honestly, after you see it, then you then you want a pump immediately, then you're like, oh, okay, well, now I know what to do. You know, but first step, seeing things go on understanding them better. Seeing what you can do with the insulin makes such a big difference. It's just, it is I hate to say a game changer, but it really is.

Paola 32:22
Oh, absolutely, absolutely. So we looked into it, we called our insurance, we found out we were not going to get coverage for the Dexcom. But we thought you know what, her health is far more important right now. And as teachers, we made the huge sacrifice. So we bought six months supplies of Dexcom when we were in Orlando, and took them with us to Quito. And we also bought I had not heard of these, the glucose tablets.

Scott Benner 32:55
Okay, what were you doing? We have, how did you manage low blood sugars?

Paola 33:00
Um, well, this is this is the other crazy stuff. In Ecuador, the physicians, both physicians told us just give him a little bit of soda, if she's low, and we are a family that we do not drink soda at all. Just give her some oranges. And so what we did was, I would give her a little bit of fruit juice, any kind of fruit juice, and that would bring her up again. Okay, but it wasn't glucose tablets or anything like that. Yeah. So

Scott Benner 33:26
everything that was handy that she could carry with her and, and things like that. Exactly.

Paola 33:30
Gotcha. Exactly. Yeah. So we we arrived with the Dexcom. With, with glucose tablets, and right after we went to see the endocrinologist and we were so excited to show her the tools and provide her with some of the information that way she may also guide other other patients with it as well. And we showed her the glucose tablets and all of this. And she just sat there. Oh, Scott, it was so horrible. She just sat there. Let me talk about all of these things and said, Oh, Allah. We don't manage diabetes that way in Aquitar.

Scott Benner 34:13
Still, still that's the answer. Okay. That was

Paola 34:17
her answer. Was her answer.

Scott Benner 34:20
Is that about when you were done? Were you just like, yeah,

Paola 34:23
we waited we waited until she until we had another bloodwork. I believe we waited about six more months. We saw her twice after that last time. And that was it. Yeah. Because in the US in order for you to get Dexcom you need a pediatricians. What do you call it? The prescription from a pediatrician and endocrinologist, pediatrician that can give you the prescription for it. So we were able at the friends for life conference, meet several people electricians and we found this amazing doctor. And she made immediately examined Amaya. She did some blood work for her. And immediately right after she gave us the prescription and we were order we were able to purchase Dexcom.

Scott Benner 35:16
Wow. That's great.

Paola 35:17
She did it for us.

Scott Benner 35:19
Maybe because somebody else you?

Paola 35:21
Absolutely. And with with this doctor, we stayed until we came. Well, we we've been with her ever since. Yeah. So that means that we have had to travel to the US and get a Maya to see her endocrinologist and in Orlando, get blood work. We take us we do as much as we can with bloodwork and Ecuador. But then we would take the results and whatever other checkups that she needed to have done, we would do those in the US.

Scott Benner 35:56
So just to kind of back up for a second. You and your husband are both teachers. Is that correct? That's correct. Yeah. And so you just Where are you from originally? I'm from Ecuador. You are originally from Ecuador. Okay. And your husband as well?

Paola 36:11
No, my husband's from Venezuela.

Scott Benner 36:13
Okay. Did you meet him? Because he came to Ecuador to teach.

Paola 36:16
No, I actually met him in St. Michael's College in Vermont.

Scott Benner 36:22
Of course in Vermont. And

Paola 36:25
I know I know how you feel about Vermont?

Scott Benner 36:28
I'm just saying we're all the Ortiz's meet in Vermont. Yeah. So common. So okay, so you were in school in Vermont? He was from Venezuela. You were from Ecuador. You met there. You guys obviously got together. He came with you. And did you ever consider going to Van as well? No. Girls always win those conversations. Okay, so maybe your house basically. But you don't? Where have you lived since Ecuador?

Paola 37:00
Well, I was born in Ecuador. But I grew up in in Boston. And then I finished my elementary and middle school in Vienna, Austria, right. And then I graduated, I finished high school and Pennsylvania, and did College in Pennsylvania and then went to Vermont, and then Ecuador. And now Cayman Islands. Well, in between we've done Costa Rica, Colombia, Ecuador, Cayman Islands now

Scott Benner 37:30
do you just go where the jobs are where the teaching jobs already you pick places you'd like to work in, or like to live and then find work?

Paola 37:37
Um, it's where the jobs are and the experiences. It also has to do with how much we're gonna get paid. And so

Scott Benner 37:49
then, how did this happen to you when you were a child? Were your parents doing something similar?

Paola 37:55
No, my dad was secretary general of OPEC.

Scott Benner 38:00
Oh, that'll move you around. Yes.

Paola 38:04
So my dad was a diplomat for a good number of years. And so that allowed my sister and I to go through several international schools. And that's why I love that type of life. I have friends from different parts of the world. And so when the time came for us to choose a school for our Maya, I thought she has to enroll, we have to enroll her in an international school because they're so great.

Scott Benner 38:31
Wow, that's really cool. So I now remember teasing my about what her dad did for a living, because she was talking about how she wasn't Ecuador. But now she was here. And he was from like a perspective of a younger person. And I said to her, if I'm remembering, right, I said, my Are you sure your parents are teachers, but if they're like, international gunrunners, or something like that? And she said, she goes, they're not. I said, How do you know? And I just so enjoyed the pause after I said, How do you know where I know her brain was like, maybe they are lying to me. So it's just it's such an interesting life to be able to move around like that. And very, yeah, it's excellent. Actually.

Paola 39:10
It is it is. We're hoping to move in about two more years after we've been here for five years and Cayman Islands then travel elsewhere, just because it's your best way to get a real feel of living in a country taking in their culture, their traditions, the music, the food, and learning as you're working. So we love it.

Scott Benner 39:33
So you think I'm sort of after the girls after my is done, ready for college, then you guys might move somewhere else?

Paola 39:40
Yes. Well, am I coincidentally Scott, Maya is in the US right now. Because she's visiting the college that she has accepted. Oh, yeah. That's about I'm sorry.

Scott Benner 39:53
That's exciting. I just did this with Arden. Kelly and I just took art into a number of schools, and she chose one then we spent a few days and, and and got the feel for the place. And it was a it was such a good time. It's very good for her. What is she going to study?

Paola 40:08
Um, she wants to do something in the sciences and biology, but she's still unsure. 100%

Scott Benner 40:15
sure my son is about to graduate, he's still unsure. So it's off. He's, wow. He's like, he's like, I don't know, do you want to get a master's degree? And he's like, Oh, no. What do you want to do? He goes, I'm gonna take a break. He's like, I'm tired of school. Oh, well, there you go. Yeah, that makes sense. But that's very excited. Good for her. That's, that's yeah. Tell people nowadays, what's my agency?

Paola 40:41
Oh, so before we spoke to you, three months ago, her agency was 5.5. And about two weeks ago, she went, we went to the doctor and her agency went up a little bit. She's at 6.0. And we blame schoolwork. Because it's been very hard for her to, to manage the stress that she's dealing with. As a high school student, as a senior. There's lots of work and exams, and she's doing the IB. And it's very draining. There's lots to study. And so it's been harder for her to manage as tightly as she was doing before.

Scott Benner 41:27
Okay, that that I think is, I think, pretty common. Is she? Is she managing it more by herself than she was in the past?

Paola 41:38
Yes, yes. So I've tried to let go of the reins a little bit just because I need to get her ready for college. And so so that she becomes more independent. She's really good about bolusing prior to her meal, so that is that is a huge plus, she's really good about that, um, counting carbs, or predicting or estimating how much is her meal is a little harder, just because sometimes she'll forget, oh, the fats. Oh, I need to add this for the protein. Yeah. And so that's where she makes her mistakes. And then that raises her numbers a bit. It's interesting.

Scott Benner 42:16
This is right where Arden is right now to like she's taking more and more of her, her care over. And she's having these like experiences like I did before, where she's trying to figure out, you know, what is this meal going to do ahead of time and get getting it right sometimes and getting it wrong sometimes and missing things like fat and protein. And you know what day of the pump, it is that kind of stuff. I still I'm doing my best to just slip in once in a while, you know, like I'll say like, I think maybe you should change your pod before you go out to dinner. She's like, Oh, no, there's still 30 units. And I'm like, I know. But if you look at your blood sugar, your blood sugar over the last four or five hours, it's been drifting up and you've been bolusing more, it's a good indication that the site might be done. And, you know, a couple of times chickened out, and it'd be fine that she comes home and she's like, I have to change my pot. And I was like, I know. So it's watching her figure it out now, but it's going pretty, pretty well actually. And it sounds like I mean, listen to six a one save for as a 17 year old girl, as it's really good, you know, so she's getting it and so will so am I right?

Paola 43:27
Yes, yes. I'm thrilled that she's so independent with it. So at school, she'll just change it. She's got her supplies at school. And prior to this trip to visit the school that she's going to go to in the fall she took all her supplies with her she was ready we had the the doctor's letter indicating what she was taking with her because when you travel with all of these items, they set alarms they they stand out because it's not your common Mm

Scott Benner 44:03
hmm yeah, so she's got the letter that's like I have diabetes and the stuff is my equipment all that stuff. She buyers Yeah, yeah by yourself right now she fly to the states on her own?

Paola 44:13
No, no, she actually went with her dad my husband took her I couldn't go just because I have a friend visiting so we had to divide and conquer. Gotcha different place. How many kids um, is our only daughter.

Scott Benner 44:27
Is there any other type one in your family?

Paola 44:30
No, so am I is our only type one but my mom has Hashimotos and rheumatoid arthritis. Yeah. And her for oh, this is something I forgot to tell you about. A Maya was misdiagnosed with fibroid and therefore for her first five years she took levothyroxine

Scott Benner 45:00
How do you miss diagnose her with it?

Paola 45:03
Well, the doctors just run these tests. And immediately they must have seen that the numbers were a little off with her thyroid. And so therefore, they gave her this medication. And she had to take it daily until we went to the US. And we met this other endocrinologist, she did the blood work and immediately said, Wait a minute, this is just wrong. Take this out, you are not going to take levothyroxine anymore. And and let's see what that's going to do to your system and about six months. And so we ran tests after that. And she confirmed Amaya, in fact, does not have a thyroid issue.

Scott Benner 45:44
Hold on a second. Let's pick through this. This is interesting. So do you remember the numbers back in Ecuador? Like what was the TSH that made them made them think she needed the thyroid replacement hormone?

Paola 45:56
I believe? Probably, if I'm correct, could it be three, four? I could be wrong, though. Three

Scott Benner 46:05
or four number? And then what is it now without the without it? anymore?

Paola 46:14
Yes, they do. But I don't have her latest results.

Scott Benner 46:18
So I would say to you this that they'll call any number. There's a big wide range where they say it's in range. I think that thoughtful endos will keep your TSH under about 2.1. Right? They want it to be under there, but it's a lot about symptoms. So does she have the symptoms? Does she have tiredness or weight gain hair loss problems with her nails? Constipation, moodiness, does she get cold or hot? Like that kind of stuff?

Paola 46:55
Well, now that you mentioned that, that is exactly what's happening right now, in the last two years, she's been feeling a lot of those symptoms that you described, and her endocrinology was on island hasn't given her any medication because her number her range is 182 to one I believe.

Scott Benner 47:14
So it's very close. So I would say this. Very similarly. It's interesting, very similarly to a lot of things about diabetes. The, you know, the the range that they quote unquote, say is is normal is not what's important. So with thyroid, it's symptoms, like you should treat the symptoms. And don't worry about what the blood test says so much. I think it's very possible that unlike diabetes, the way they do it on Ecuador, about thyroid might be right. The doctor might have got the thyroid piece, right and the diabetes piece kind of wrong. So if she's having if she's having those symptoms, that thyroid replacement hormone could take care of it in just a couple of weeks. She could feel better. Oh, okay, isn't that interesting?

Paola 48:07
Oh, I should run those tests. Again, I would replay there's a couple

Scott Benner 48:11
things you can do here. Hold on, I'm gonna look over at another heater monitor for a second. So there's a whole series on thyroid that I just did. Called the finding thyroid, I would listen to those. And I would listen to episode Hall a second. You would think I'd be better at knowing my podcast than other people. But that's not the truth. Episode 413 thyroid disease explained, is a long thoughtful conversation with the woman who manages my family's thyroid problems. My wife, my son, my daughter, so she's not an outside of the box thinker because I don't like that term, but she's just more in tune with with managing a thyroid problem. So where as a some doctors will say oh, your TSH is three or four that's in range, you're fine. A doctor like Dr. BENITO who you'll find it episode 413 will tell you I think her numbers like 2.1 or something like that showed Matt she'll medicate over like 2.1 If there's symptoms, and my both of my kids thyroids are managed like right out to the end of the earth and they and they don't have trouble with them. And she even supplements their T three a little bit, which is definitely more outside of the box thinking but like for instance, Arden's thyroid if she just managed that with a T for replacement, which could be lever thyroxin or Arden uses terrorists and there's a couple of different drugs. Her thyroid numbers are great, but she's still very tired. But if you add a tiny bit of cider mill to Ardens regiment which is T three, then the tiredness goes away. So it's, it's really it's you got to find somebody who understands it. But I think I think that you got good information the first time. And then you got to the states where they just said, Oh, this isn't rain. She doesn't need this. But I think I think, yeah, I think it's possible. Well, I mean, from what you're saying, but I definitely think it's worth looking into it if she's having the symptoms right now.

Paola 50:24
Yes, now that you mentioned those symptoms, I will definitely call on our physician and see if we can get some blood work done. Just that, you know, and Aquitar. Thyroid is the most common ailment, really? Everybody has it? Yes. One we live in altitude. So the altitude has a huge factor in it. And in addition to that, there's our salt has less sodium than your regular salt, and therefore those may be causes. Yeah.

Scott Benner 50:56
You guys use a lot. You guys use a lot of sea salt on your foods? Not? Not regular table salt. Oh, isn't that interesting? You'll hear about that. And the episodes to be talking about that a lot. Yeah, so people, you saw that you see more goiters jump started, you see more goiters? In Ecuador.

Paola 51:14
Yeah, you probably do. Yeah. Interesting. For sure.

Scott Benner 51:18
Not crazy. Sure. You know, as you and I have been talking this whole time. You You really helped me and you don't know why I'm gonna tell you in a second. I recorded this episode back in October. It's April now. So it's a while ago, with a with a boy, young boy as type one who lives in Ecuador. And oh, wow. Yeah. And I kept thinking, My goodness, that episode should have been in my editing queue by now. Like, why have I not edited that show yet. And it was, I looked while you were talking. And it's a simple, just a file management problem. It got moved into a completed folder, and it's not completed. So I just slid it back over. I may have never noticed that I didn't post it. Had you not said I grew up in Ecuador. So thank you so much. I really appreciate it. My pleasure. Yeah, it's um, it's a great story that kids got crazy and sundry. I don't want to ruin it for people because it'll be out before they hear yours. But it's, it's a really great story. And you saved me from never putting it up. So thank you very much.

Paola 52:24
Oh, my pleasure. My pleasure. Well, I know now, for example, that you can get T slim and Ecuador. So that is that is that's a major plus to any type one diabetic that is diagnosed. Yeah. Maya was like,

Scott Benner 52:43
Oh, my gosh, the availability of all this technology is just very important, you know, and the companies they think move it around the world, I guess, as fast as they can. But there's so many different health systems and insurances. And but, you know, the way things get paid for it's just, it's incredibly difficult. There's plenty of people in all kinds of different countries that come on the show and, and do what you do, like have to leave the country to pick up supplies. It's, it's, it's pretty common, actually, if people can afford it. They're doing it all the time.

Paola 53:12
Yes, yes. And so that's why am I was able to get the ducks calm. That's why we use the Dexcom before we even went to the pump. Because we know for sure, we were battling issues to get coverage for our Dexcom. And so we knew that if we tried the pump that that was going to even be a steeper hill to climb, and we knew that was impossible. And so the insurance company said to us, okay, what we'll do is we'll cover 50% of the Dexcom because it is a medical need. And then you guys can cover the rest, but we cannot cover your pump.

Scott Benner 53:50
That's something Well, yeah. What now? She's gonna be on your insurance for a while, obviously. Yeah. Everything else. Okay, but at least she'll have better access when she's in the States, right?

Paola 54:04
Yes. Well, as soon as we moved, and we took this post this job and Cayman Islands, we were assured that the insurance company would cover a mic as am I as needs and so we got the pump. Four months after we arrived.

Scott Benner 54:23
Okay, pretty quickly. That's it hasn't been has been Omnipod. Yeah, it hasn't been the same issue there as it was prior.

Paola 54:30
Gotcha. No, no. Yeah, actually. It's been wonderful.

Scott Benner 54:33
Yeah. The three girls that were on together, including your daughter, were they all using the same pumps? Or no,

Paola 54:39
they are yes, they all use the Omnipod. They all use Dexcom. The only difference is that one of them is looping. The other one was looping but something happened to the Reilly link and therefore she stopped looping and now she's back to regular pumping. Regular pumping gas

Scott Benner 55:00
Chess played something. I just it's for people who don't know is these three girls that are friends. They're not even particular. They're not even Exactly. Similarly, age, they all met through, you know, through having diabetes and living on cayman islands like that. And, you know, Maya was one of the three girls. They were just really delightful. That's excellent. Cool. Yeah. Well, yeah. What else have we? What have we not covered that you want to talk about? I want to make sure we're getting it everything.

Paola 55:28
Oh, thank you. So may I talk about teaching a type one student? Yeah, please. Okay, so, in when I was first diagnosed, I had never had the experience of having a type one students. Um, I was diagnosed in May. And then in September was, as we started school, I got my first type one diabetic student. She was from Brazil. And she came with no technology tools. Mom was a complete wreck. If I thought I was a mess. Because I thought I was a mess. This mother was by far, messier than I was completely. She came to school every day with her daughter's lunch, she, she waited at the school, she was she was making sure that she had her insulin thing, this poor woman lived the entire school year on campus. And so this, the students that I had, she was very shy, very quiet. She didn't want to engage much with with her peers. And on top of it, she had had such a horrible diagnosis in Brazil, that it made her not want to share her diabetes with anybody other than just let me know how she was feeling. So it was very hard. Okay. And as I tried to train the next year's teacher that she would have, because she was going up another grade, the family heard that they were getting transferred. So she left. And so the summer comes, we start back up in September again. And I hear that I'm going to have another type two student. And so I get my students, she had a little bit more knowledge about type one mother was very supportive was diagnosed at the same age as Amaya. But she didn't have any technology either. And she managed with the same more or less the same formulas that I was seeing and that I had been using with Amaya. The same story, we finish the school year, and this child leaves the school and the summer comes. And then again in September, I get my third type one students. This was three, three years in a row, right, three years in a row. So I was I was looking at this and saying, thinking to myself, what what's happening here. I'm not an experienced mother as a type of a type one. But yet, I'm getting all of these students and I'm trying to learn from them and get the best experience that I could from them. Now my third student came from the US was a mom from from Boston, she was doing some anthropological studies in an Exeter and he came with a pump with the Dexcom. It was the first time that I had seen the Little Red Book of the American Association of diabetes, the one that has the carb count on it. It was the first time I had seen that little book, I had never seen it before. And his pump was wired. So I'm assuming it must have not been the Omnipod. So we had it was with this particular student was my first time that I had that I had used the glucagon. I had never used the glucagon before nor the will nor did I know how to use it. But mom when she came in at the beginning of the school year to let me know about her son. She taught me how to use it. And that was my first time with it. And I had never seen it before. You didn't need

Scott Benner 59:22
a student though. I beg your pardon. Did you have to use it for the student or you? You were just trained on it?

Paola 59:28
I was trained on it. And a few months later, I believe it was after Christmas. My students had an episode and so I had to give them glucagon. Wow. Okay. Yes. And that to me was a shock.

Scott Benner 59:45
Yeah. Was that a common thing for that boy or do you not know?

Paola 59:49
Um, I believe that wasn't common because he had we had had a sports morning and so he had done a lot of sports, I believe. And so Oh, probably he hadn't eaten what he was supposed to and his blood sugar just went,

Scott Benner 1:00:04
wow. Wow, Was that scary?

Paola 1:00:07
Super scary. I had never experienced that before. In the meantime, I had my students wait outside for me while I was taking care of this particular student. I had some of the some of my colleagues also there with me, they were all giving me all sorts of positive energy. Paula, you can do it. If you can do it. You can do it. You know, it was just like, oh my god, that but I wasn't 100% Sure, because I've never administered glucagon before.

Scott Benner 1:00:32
Sure. And at this point, at this point, Maya has type one.

Paola 1:00:36
Yes, I am I already had. Right. So

Scott Benner 1:00:39
you're probably like, great. Is this gonna happen to her? Yeah, exactly. Right. So exactly. So these three kids in a row? Did you learn something new from each one of them?

Paola 1:00:51
Yes, I did. So I took on about little bits and pieces from their management. And I tried to tweak that with with Amaya. But then I would share that information with the physicians and they would bring it down again. So it got to a point where I stopped sharing, but I was I was doing a little bit of the things that I would learn from these three students. Although the two first ones were managing exactly the same way as I was. Okay. Okay. It was just my American students that managed it completely different because he had the pump.

Scott Benner 1:01:27
Yeah. Hadn't had more knowledge and more technology. Yeah. And then okay, yeah. Did you ever figure out why they kept leaving? were you driving them away? Or was that just happenstance?

Paola 1:01:37
I know, you may think it's that way. But no, I'm all of these families, because it's an American International School, they get transferred quite often come and go. And so they all left. And this the my last students, they, they were actually supposed to be in Ecuador for two years, but the mom was able to get all the data that she needed for her research. So they left

Scott Benner 1:01:58
Okay, now, the fourth year, was there another kid? Or is that there?

Paola 1:02:01
No, no, no, that was it. That was it. And so currently, I have a type one students. She is She was diagnosed in first grade like Amaya in May. And she's on the Dexcom and the Omni pod lived in the US was diagnosed in the US. And then they moved to Cayman Islands, for her to start grade one. And when she came, no, I'm sorry, grade two. And the second grade teacher did not get involved at all with her management. She did not follow her in the Dexcom nothing. And so mom was a little worried about her schooling, primarily because she had had a very negative real conversation with the school's nurse. And so that didn't go very well for her. So she was hesitant to allow the nurse to manage her daughter. And so that was that was very difficult. So she would come to the school to change her pods to administer any other insulin or any other food that she needed. The teacher wasn't engaged at all with her management. And so when, when, when it came to her being in my classroom, mom asked specifically that she'd be placed in my class. And so before school started, I had been following her on the Dexcom. So I follow Amaya, and my students and all of a sudden I've got alarms, beeping, her alarms, my alarms, I've got cases for low blood sugars. In the classroom, I make sure that my students has a possibility to engage in every single activity that I do in the classroom. She if we're gonna have snacks, I make sure that she Bolus us for the snack prior to having her snack if we're gonna have a celebration. It's exactly the same way. I've never put her on the side. She's made short videos about her diabetes and tried to teach peers about it. It is lovely to see how the students are so aware of her needs. When they hear an alarm. They immediately come and ask me Miss Paula was that Amaya or is that Emily? And so they are aware of her alarms they they know how she feels if they see her laying down a little too much or or babbling or sometimes she'll start sweating. Then they'll let me know this Bala. I don't think Molly feels okay. And so immediately I'll go over, I'll check on her. We've done meter checks in the classroom, we've done pod changes in the classroom, anything that she needs and to help her feel as comfortable as she possibly can as another student, right, not as a type one student, but just as another student.

Scott Benner 1:05:25
Yeah. Is it? Is it common that if everything's sort of out the open and comfortable for all that all the kids are comfortable with it?

Paola 1:05:36
Yes, well, so. So like, I as a mom, who is going to monitor Amaya, I've always told my students you're going to hear these alarms, this is what this means. I teach the students I give them many workshops on what the type one is. And so they're aware they're more informed. And so when I had Emily, I did the same thing with the with her peers. And so she's, she's feeling super at ease in the classroom, she feels comfortable, if she's hungry, she'll just get her snacks we Bolus sometimes it's wonderful I can, I could see her numbers really going on, on a relatively straight line. And I'll tell her before lunch, don't Bolus until we're in the cafeteria, and then you Bolus. So the kids are hearing all of this vocabulary. And so they're wondering, what is that? You know, they ask questions,

Scott Benner 1:06:35
how old right down to your current student? How old? Are those kids?

Paola 1:06:39
They're in grade three,

Scott Benner 1:06:40
three. Okay, that's excellent. I'm super excited that you're doing that. You're spreading your awareness around and helping and, and learning at the same time and just, you know, absolute treating people like people and, and not like problems or illnesses. It's just, it's a wonderful way to think about it. And and you can see that if you didn't have the experience you had you very well may not know how to do any of that. Just like, you know, you spoke about with a student where the teacher they had last time they're like, look not you know, this one's not really engaging. This teacher doesn't engage with her on about diabetes at all. That's really what

Paola 1:07:15
exactly, exactly, so her mom is super i We chat all the time I let her know, you know what we had a birthday, I'm going to we're going to have this snack, I'm going to Bolus this much so that she knows so well, mom is Mom is constantly informed of whatever changes I've made, whatever boluses I've done corrections have made and even when I've given her a juice, if there's a need. Now, I do that all the time with her now that we're getting to the end of the school year, and mom is a little concerned about what's going to happen in grade four. You know, I don't know if she wants me to continue, continue following her on Dexcom, I would be more than happy to do it. But I don't want to interfere with whatever's happening in that classroom as well. So I want to make sure that the teacher is well informed not that she would be able to Bolus because just I was talking to two of the grade four teachers. And they both said, You know what I would prefer if it stayed in your hands, I don't want to have anything to do with it. You know, because they don't feel comfortable managing the PDM and inputting all of this data and if necessary, so some of them feel comfortable. Others don't feel as comfortable,

Scott Benner 1:08:31
right? And then that's just what happens, right? It's the luck of the draw, you get a teacher who's like, I'll give it a try. Or you might get a teacher, it's like please, I don't want to be involved in this. And however that is does the school not know who's who, with who the teachers are? Like, couldn't you put the student with somebody who might be more amenable to learning?

Paola 1:08:50
Yes, yes, I believe so. So that that meeting should come in early June, where we gather as teachers and we put specific students in specific classrooms, just one out of a request of a parent for a health need. And in this case, my students will have a health need, therefore she needs to be placed in a good classroom. Nice. Well, that teacher that is going to be willing to make the changes that that she would need, you know, make adjustments,

Scott Benner 1:09:18
right. That's excellent. Yeah, well, pal, I thank you. I have a couple of recordings today. So I have to bug out. I can get to my next one on time. But I want to make sure that we're that were you feel comfortable about what we did today.

Paola 1:09:33
Yes, thank you so much, Scott. I really appreciate it. I wanted to, to talk to you to share my experience as well as what teachers can do in the future for when you get a type one students you know, it's so common, so common nowadays. That if you get one or two that that know how to how to manage it. Gosh, what an what a Comfort it is for a family to know that there's, there's somebody that can help.

Scott Benner 1:10:04
Well, I think overarching ly, your through your conversation, what I took from it was to be open minded, because you ran into a number of people who weren't. And it stifled your daughter's care for years really. And then then you, you know, you were open minded but they weren't and that blocked you. And then you get, you know, you get later on in your story. And you find out that there are teachers who are some of them are, again, more open minded to being involved in something that they're not comfortable with. And, and some aren't, some are, some aren't. And even how thoughtfully you were taking from other people like sort of paying attention to like, well, this students doing this thing, we don't do that. Let me examine that. Is that something that we could maybe integrate into our lives and make our situation better, and then giving back to them? It's just it's communication, open, mindless call, whatever you want? That's what I took from your conversation. So thank you very much. Yeah. Yeah, sir. Oh,

Paola 1:11:04
thank you, Scott, I really appreciate it. I hope that more families in Ecuador hear the podcast, I have been suggesting it to a few that I know that are families with type one, so that they also listen to you and learn from you.

Scott Benner 1:11:21
I hope everyone learns how to balance the insulin that they need against the carbs that they're taking in, and, and learns how to, to, I was gonna say, fight back, but advocate for yourself, when you notice something happening in your life or your health. That just doesn't make sense to you. But somebody in a position of power is telling you, it's okay. It's very important to continue to question that, and to try to get your own answers. So

Paola 1:11:49
yeah, I believe so I believe that I am an advocate for that. Because otherwise, then we can all learn, we can all make changes to better our health, and it's the health of our kids that is at stake. If we don't learn and don't question,

Scott Benner 1:12:05
you don't want your life to be stuck in the spot where somebody else randomly puts it because of their lack of understanding. So Correct. Yeah, go get it. Absolutely. Excellent. All right, hold on one second. Of course, I could turn the recording back on you. Go ahead. We were saying goodbye. And you said you wish we were recording. So what did you want to say?

Paola 1:12:24
I just wanted to say that your podcast has been our lifesaver, I have learned so much from the stories of different moms and dads dealing with this condition and making the changes and questioning physicians and at the same time learning about all of those pro tips, the the ideas that are behind the a better care are so important for every single family to, to take into that to make those changes to to make sure that we provide the better health for ourselves. And you do it so naturally. And so Well, Scott, so thank you from the bottom of my heart,

Scott Benner 1:13:04
thank you for telling me that to turn the recording back on because I did not want to miss that. And you're very welcome. I genuinely appreciate the kind words and I hope that other people find similar outcomes, listening to the podcast. So I mean, you guys are doing terrific. It's really It's inspiring, so well done for you seriously. I mean, thank you so much. Of course, I can say it as much as I want, it doesn't mean everybody hears it and puts it into practice. So it's very, very exciting. Okay, now we'll stop again. I mean, if you unless you're gonna say something else nice about me, then I'll let this go a little longer. But

I want to thank my guests for coming on today and sharing her story. And of course, I'd like to thank Ian pen from Medtronic diabetes and remind you to go to Impend today.com to get the insulin pen that does more. And of course, Dexcom, makers of the Dexcom G six, they'd like you to come over and see if you're eligible for a free 10 day trial, the Dexcom g six@dexcom.com. Forward slash juice box. And if you don't need the trial, just want to get going. You can do that on my link as well. links in the show notes of your podcast player, and links at juicebox podcast.com to Dexcom in pen and all the sponsors. When you support the sponsors, you're supporting the production of the show. And for that I think you among other things there are a lot of series within the podcast that people listen to that kind of standalone items and I've put them all in one place. You can find them at juicebox podcast.com. At the top of the page you'll see home episodes other stuff right but then you'll see after dark asks gotten Jenny algorithm pumping bulb Beginnings The finding diabetes to finding thyroid diabetes, pro tip diabetes variables meant For Wellness, they're all there. If I see you guys using the links and enjoying them, I actually have a couple more things I'll put up there for you. So if you're in a browser there at the top of the page, if you're on your phone, you have to hit the three lines, that means menu and then it'll drop down and show it to you. So I'm just going to click on one to give you an idea I'm gonna click on bold beginnings, takes you to a page says if you were just diagnosed with type one diabetes, the ball beginning series, did you bah bah bah. And it lists all the episodes honeymooning adult diagnosis long acting insulin. So there's a ton of them there. I'm not going to read them all to you. Right there. There's an online player you can list the all the episodes there are you can launch links to Apple podcasts, Spotify, I heart podcast, Amazon music, you can of course, go to your own podcast app and search for bold beginnings Juicebox Podcast there, you scroll down a little more, and you'll see links to defining diabetes, the thyroid series, algorithm pumping diabetes variables, s on and on. They're all right there. Just watch it. Here's the afterdark I click on that. Now I'm on a different page for afterdark it's amazing how the internet works. You know, the internet. It's magical. Anyway, you can find all these in the podcast player you're listening in right now. But I wanted to make them accessible and shareable on the website. And that I've done and now I've told you about it. And because of all this and that and the other thing, I'm not finished. I'm dizzy. I've done five of these tonight. I hope you guys have a good weekend. I'm gonna go to sleep

#796 REPLAY: Turkey Tutorial

Prepare for Thanksgiving—or any day—with Scott as he applies all the core principles of the podcast to this potentially anxiety-producing holiday. He discusses tried-and-true concepts like being bold with insulin, bumping and nudging, using increased temp basals and extended boluses to provide a “blanket” of insulin to help make the grazing and unusual mix of food associated with the day easier. Episode first aired on November 25, 2020 as episode 412.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 796 of the Juicebox Podcast.

On Thanksgiving morning in 2020, I woke up with this idea of how to talk people through Thanksgiving. And I recorded it and put it up for people to listen to. It got a great response. I see this episode shared online quite often actually around days like Thanksgiving where there's going to be consistent food throughout the day, you know, grazing, not some kind of set meal times. People seem to love it. They share it with each other. But there are so many new people listening to the podcast and I thought anyone not on Facebook are lucky enough to see it on Facebook isn't going to know it exists. So today, I'm going to replay it for you. If you've already heard it as Episode 412, you're done. There's nothing for you to do, you can leave. But if you'd like to hear me talk it through sadolin while you're making the gravy, I will talk about how to Bolus on a hectic day like Thanksgiving. There aren't going to be any ads but I will list the advertisers before the program starts. Please feel free to use my links if you ever have the need, as it supports the show great like I'm going to say this here just quick even though I think it gets set again on the recording but 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. The Juicebox Podcast has been sponsored for a long time by some great companies on the pod makers of the Omni pod five and on the pod dash Omni pod.com forward slash juice box by Dexcom. Makers of the Dexcom G six continuous glucose monitor. See if you're eligible for a free 10 day trial to Dexcom g six@dexcom.com. Forward slash juice box use the most accurate and easy to use meter that I've ever held. The Contour Next One at contour next one.com forward slash juice box. My daughter carries G vo glucagon and you can find out more about it at G vo glucagon.com forward slash juice box. One an insulin pen that does more. You're looking for the in pen from Medtronic diabetes in pen today.com We get our diabetes supplies from us Med and you could as well. Us med.com forward slash juicebox would you like to see an organization helping people with type one, all you have to do is go to touch by type one.org and ag one by athletic greens is the drink I drink every morning. You could go to athletic greens.com forward slash juicebox get yourself some ag one. All right, let's find out what I sounded like two years ago. Hello, everyone, and welcome to episode 412 of the Juicebox Podcast. Think of today as a pep talk for Thanksgiving. Today we're just going to talk about how Arden is going to manage on Thanksgiving Day. Which if I'm being honest, really is about how we manage every other day. Just that people seem to get very nervous around these holiday situations. Can I understand why there's probably more grazing and snacking. There's also a lot of variables in what you're eating. We'll break it all down. Talk about how I'm going to attack it. See if you can find some good ideas in here for yourself. 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 changes to your health care plan. Becoming bold with insulin or stuffing your turkey and that's not some weird euphemism actually think when you stuffed the turkey. You can like mess it up and cause a problem is it trick and Gnosis botulism? Botulism that sounds like something to do with a can. Alright, so before we get everything else, let's just figure out what undercooked poultry does to prolong cooking you're stuffing in the turkey they're calling that a mistake to avoid I can tell you personally, I used to put my stuffing in the turkey but it slows the cooking time way down and doesn't allow an even heat to go through the bird and I don't do it anymore. I prepare my stuffing and actually make it by hand I bake the bread tear it up days in advance let it become stale almost and then combine it with a whole bunch of different that's not the point I make my own stuff. Make the stuffing and I put it in a pan and bake it in the oven. Because I found when I put it the stuffing in the bird took too long to cook and I wasn't getting a cook through the way I wanted. So now I'm drying the outside of the turkey took took the internal portion what Hold on a second uncooked. I know we'll get through the rest of it. Just give me a second Turkey causes Wow. Raw and undercooked meat and poultry can make you sick. Most raw poultry contains Wow can't be low Baxter can't be low back there needs a better name. It also may contain salmonella, Clostridium perfringens and other bacteria. Raw meat may contain salmonella, E. E stands for EU in this situation. How long does it take to get? I'm falling down a rabbit hole here. How long does it take to get food poisoning from Turkey? 12 to 72 hours the symptoms usually lasts around four to seven days. Wow. Cook your turkey. You know poultry it has to be cooked to 165 degrees, right? Hold on Turkey. Done. 100%. Right. Yes, 165 degrees. A whole turkey is safe when cooked to a minimum internal temperature of 165 degrees Fahrenheit, as measured with a food thermometer. Check the internal temperature in the innermost part of the thigh and wing and the thickest part of the breast. All right. There's our little turkey tutorial. Whoo, I just found the name of the episode by mistake Turkey tutorial. That'll be fun. Alright, I'll do that. Let's talk about some other stuff. Everyone freaks out around holidays. Oh my god, we're gonna be snacking all day. There's food in the house. There's bowls of food on the cabinet. There's grazing, I hear you. Maybe this COVID Thanksgiving might not be exactly the same as most but still, it's here, right? You're gonna get up have a breakfast, there's going to be a big launch or a big dinner. grazing in between pie. I'm assuming cookies. gluttonous extravaganza. Here's how I think about a meal with insulin. First, I wonder how long does it take for the insulin to start working? How long till it effects the blood sugar? And how long will it last in the body? That's my first thing. How does the insulin work? And Arden first thing to consider? Second thing? What is art and eating carbs? How many? Yeah, that's easy, right? You count the carbs. Everybody's like, no, no, it's not easy, Scott. Because stuffing. And it's pretty easy. You don't I'm saying handful of stuffing ish is probably a piece of bread and a half something you got to you got to wing it a little bit. Just didn't mean weighing it because of the turkey. You got to just kind of like roll with it, you got to look and guess be kind of aggressive. But still, the most important thing here is Pre-Bolus thing, getting your insulin in and working so that it can time itself up with the impact of the food. So what we're talking about here is timing. So that the insulin kind of comes online, at the same time that the food comes online, meaning while the food is pulling up on your blood sugar, you want the insulin to be pulling down, you want them to get involved in a tug of war that no one wins. That's how you keep a stable line. You know, when you see people's lines are super stable on their graphs. But they have food in there. And they're like, Yeah, but you can't find the bagel, you won't be able to hold on work. I'm sorry, I've been sick. How do you not see the bagel on the line is because that as the food impact is trying to push the blood sugar up, the action of the insulin is trying to pull it down. And so it just creates this stability. No side is winning the fight. So you have to Pre-Bolus your food, you can't let the carbs get ahead of the insulin. And to understand Pre-Bolus thing better, you can check out episode 217 diabetes pro tip Pre-Bolus. Now the next thing to consider is the impact that the food or the drink you're having is going to have on the system.

And it's not as easy as saying this is 10 carbs, because 10 carbs of Hawaiian Punch will impact your blood sugar differently than 10 carbs of macadamia nuts. I don't know how many carbs are in macadamia nuts. But imagine you've eaten 10 carbs of them. The punch will hit you quickly and harsh right your blood sugar will shoot straight up while the macadamia nuts which by the way, I've checked on and one cup of whole or halved macadamia nuts have 19 carbs. So if you have a half a cup of macadamia nuts, which is probably what like a handful, you've got 10 carbs, but they're not going to hit with the same exuberance that a simple sugar like a juice would. So keep that in mind for a second you have 10 carbs worth of impact on your system. If it's something liquid, like the juice or something sugary, it's gonna happen very quickly. So you need the insulin to be working when the Hawaiian Punch goes on. I have no idea why I picked one punch. I've never drank wine punch in my life, nor do I know anybody that drinks it, but that's not the point. The point is, you may need a longer Pre-Bolus so that you can match the action of the insulin up to the impact of the Hawaiian pot. And now for something like the nuts, you might be able to Bolus with the carbs, wait a couple of minutes and start eating. Because as the insulin slowly comes online and begins to work, the nuts are slowly coming online and trying to push your blood sugar up. Now the key around these bigger days, I think, is understanding there's going to be a mix of foods, a mix of impacts. Pumpkin pie is sugar, and milk, right, there's like, like milk in it, I think. So there's some fat, but then you have the flour from the pie. So you have two different impacts, you have the sugary filling impact, and the karbi flour impact. Same with a cherry pie, apple pie, sugary and carby. At the same time, it's not dissimilar to Chinese food, where you'll get the slower carbon pack of rice, but the quicker sugary impact of some of the sauces. So imagine that for pumpkin pies and example, you'll need enough of a Pre-Bolus that you'll head off the sugary spike. But you still need enough insulin over the timeline that the pie is going to impact your system to keep down any slow risers. So there's two things in there, a more fast acting carb and a more slow acting carb. If you're pumping, you may use an extended Bolus, a Bolus that we put in a portion upfront and drag the rest of it out over time. I'm also a big fan of manipulating Basal insulin. top line idea being that if your Basal is set to keep your basic body function stable, and now all of a sudden, you're adding a whole lot of carbs over many, many hours. It's reasonable to think that the Basal insulin you're using on a normal day might not work as well, on a carb heavier day. To learn more about Temp Basal increases and decreases go to Episode 218, also part of the diabetes Pro Tip series for Temp Basal. While we're at it, you're going to want to look at episode 263. It's about how fat and protein impacts your blood sugar to things that you don't think of as being impactful on your blood sugar, but they are fat slows down digestion, slower digestion lengthens the time that the carbohydrates impact your system and protein. As your body breaks it down. Your body turns protein into anybody. Glucose and glucose is anybody. sugar and sugar makes your blood sugar go up. So all those proteins people like those are free carbs, those are free carbs. Are they diabetes, pro tip, Episode 263, fat and protein. Some people who aren't MDI multiple daily injections who are injecting their Basal insulin and not manipulating it with their pump. Find on days like Thanksgiving, a little little extra basil might be the way to go. The idea being your Basal insulin, again is only supposed to keep you stable at a number and stable. So if you're super stable all day without food and your blood sugar's 200. My opinion your Basal is not strong enough. But if you're super stable all day at 95. Without food, Basil is probably right on. But what if you put in a tiny bit extra, it would be holding your blood sugar down a little farther. But if you're planning on grazing all day, and eating that may again be necessary. All we're talking about is manipulating the insulin to put it where you need it. My goals during the day are really simple. Yours should be to I'm trying to maintain the steadiest blood sugars as I possibly can. And I want to avoid spikes and significant lows. After food. I don't want Arden's blood sugar to go over 140 and in a perfect situation, I'd like Arden's blood sugar not to go below 70. But you know, if it hits 65 for a second, it's not the worst thing in the world my opinion. I follow a few rules around this. First one is, it is far easier to stop a low or falling blood sugar than it is to return a high blood sugar to a safe range. Right? So stop a fall with a little juice, get it leveled out, start over again, or have a 300 blood sugar that you're fighting with all day. Which scenario would you rather Bing for me? I'd always rather be on the other side. But don't get me wrong. I'm not trying to make a low blood sugar. I'm saying that they're easier to fix without a rebound. How do you stop a high blood sugar from happening if you've messed up the Bolus? Well, I'd look into bumping and nudging a little bit. That's going to be in Episode 225 diabetes pro tip, bump and nudge. Basically the idea is this. I think of type one management as driving. There's lines on either side of the lane and I I'm trying not to leave the lines. That's why I have my daughter's Dexcom CGM set at a high alarm of 120. A low alarm of 70. If she should drift under 70, we bump it back up with a little bit of juice. The idea being, the less you use in carbs, the less likely you are to overcorrect up. So I'd like to know sooner, so that I can kind of bump it back up. Same thing with the high blood sugar getting over 120 legit back down again. Again, the idea being the amount of insulin that it takes to turn on 120, that's rising into a 90 that stable is far less insulin than it would take to turn a 200 into a 90. And you know, once you start getting up 151 8200, you start using more and more insulin, which eventually causes a low later. And then should you miss address the low now you're on the roller coaster and you're up and down. So I like keeping what feels like tighter tolerances, so that you can just make small adjustments to stay in your lane. Over time, that turns into better bolusing. Better correcting, you just get better at it. In general, before you know it, you don't really leave the 70 or 120 or whatever range you said, that's been my finding. If you're interested in learning more about the Dexcom G six continuous glucose monitor, go to dexcom.com forward slash juice box. There are links right there in the show notes of your podcast player, and at juicebox podcast.com. Now I think it's important to remember to Bolus for what you're eating. But all of that infers that your settings are good to begin with. And for many of you, this might end up being your Achilles heel. What do I mean? Well, many people I find have Basal insulin that is not well dialed in. So either your blood sugar's are always on the higher side. And you're making these very aggressive bonuses at meals because you don't realize that but when your Basal is off, well then your meal Bolus is off to here's what I mean real quickly. Let's say that your Basal insulin should be one unit per hour, but you have it at a half unit per hour. That means that every two hours of the day, you're missing out on a unit of insulin. So if you're at a half, and you're really a one, you're 12 units deficient over a 24 hour period. So you're trying to make that insulin up somewhere, you're very likely making it up with your meal insulin. So if you're not using enough basil, you probably think you need more for your meals than you actually do. Meaning if you had more basil, which would hold your blood sugar lower and more stable, you would need less insulin, mealtime. And vice versa. If your basil is too heavy, you're probably one of those people who's like, oh, I

barely use any insulin at meals. Because you have so much Basal insulin going throughout the day, you're basically feeding the Basal to stop you from getting low. Does that make sense? And if that does make sense to you, but you'd like to learn more, check out episode 237 diabetes, pro tip setting Basal insulin. So back to my original thought here, you need to put insulin in for the food you're eating. If you eat something at 9am, and then at 10am, and 11:30am. And then again at 11:45am. These things all need to be covered by insulin. Now if your settings are right, then put what you put in at 9am is for that food, what you put in a 10 is for the next food, etc, and so on. But if you're too aggressive with your meal, insulin, meaning your settings are way off, maybe what you put in at 9am and 10am was too much for that. So you're thinking oh, the thing is, you know, 1130 that's free? Yeah, it may be but it'd be better to just get your Bolus is down better. So that you can continue to Bolus for the things that you eat. That becomes very important on days like today while grazings in line. Because what happens is you start thinking, Oh, I have enough insulin for that, then you don't then you're 100 blood sugar turns into 150 You know, like it'll come back down. And then it doesn't, you have to Bolus for what you're eating. My opinion is to stay aggressive with the foods that you're eating. Keep after them with insulin, and if you do cause a low later, well, lucky you. It's the most food horrific day of the year, there's something to eat. Again, I'd rather be on the lower side than the higher side. And you might be thinking, Scott, that stacking my doctor told me never to stack insulin. to that. I would say it's only stacking if you don't need it. If you do need it. That's called bolusing if things do go wrong, please do not throw yourself into a tizzy. Don't start yelling about diabetes being unfair and you always knew this was gonna happen and falling into the drama because the drama stops you from learning the lessons because everything that happened is right there in front of you. You can see I Bolus here then this happened. I wanted that to happen next time I should Bolus a little more or a little less or a little sooner or a little later. You don't want to give up the lessons. They're hard fought Right. And you don't want to keep having to have them over and over again just to learn them. So get rid of the drama. Try to figure it out, you can do it, you can absolutely do it. Make your best guesses about carbs. Keep in mind that potatoes are going to hit a little more substantially, then I don't know green beans, right green beans, thought Garza. Um, I think green beans, carbs, I don't really eat green beans. Hold on a second. Yeah, green beans have carbs. A couple of green beans has seven carbs. I don't really count carbs. Actually, I just sort of guesstimate the plate. And you probably can too, if you have enough. If you have enough time in the simulator, and you've really been able to figure it out. You just sort of looked down you go, I'll tell you right. Now, here's how I do a plate I go potatoes 30 piece of bread 20. Turkey 10. Beans, 10. We got here cranberry sauce, I don't know. Little bit of it five. I just roll like that was bang, bang, bang, bang, bang, insulin goes in good Pre-Bolus Get a good fight set up between the food and the carbs. And then correct on the backside. If you have to, you may have to correct with insulin, then you may have to correct with food. I'm not sure. But sitting around and waiting and crossing your fingers. It's not a good planet, I would much rather punch first. That's sort of how I think about bolusing. Because when it this is a sports metaphor. So I'm sorry if you don't get it right off the bat. But you need to dictate the pace. Right? You come out swinging any way you want to think about it. You act first. So that the next thing that happens is because of you because at least that you can measure. Right when you cover your face. And you're kind of hiding and you're just hoping not to get knocked out. You don't know what's happening to you. You don't know why your blood sugar is doing what it's doing. But at least you can say, You know what, I had an eclair. I thought it was 35 carbs, my blood sugar went to 200. And later I had to correct with another unit. So next time I'm going to get that unit into the original Bolus, I'm going to say it gets that ICLEI or maybe it is 35 carbs, but it punches like it's 45 carbs, or whatever. You know, your numbers may vary. But the idea is there. I learned from that and move on. And the next time I have an eclair they do a better Bolus job. That's it. Get out be aggressive. Don't be scared. Do your best test if especially if you don't have a Dexcom CGM test, use your meter My daughter loves the Contour Next One meter. And you can learn more about it at contour next one.com forward slash juicebox. But that's how we roll Arden pumps, I should have said that up front, Arden has an Omnipod she's had an iPod since she was four. And she is 16. Now, as a matter of fact, if you'd like to learn more about Omni pod, you go to my omnipod.com Ford slash juicebox. And Omnipod would be delighted to send you a free, no obligation demo pump, you can actually try it in your home, see if you like it. But that's beside the point, I digress. You have to do what you have to do. Whether you're on MDI and you're going to be a little more aggressive with basil for Thanksgiving, where you're on a pump. And you think yourself yeah, this is the second day of my arm, the pod but my site starting to get a little funky. So I'm going to change my insulin pump the night before Thanksgiving. So I have a nice fresh infusion going on Thanksgiving Day. Those are the kinds of little things you can do to prepare. From there. Don't get behind because when you start chasing blood sugars, it takes a special kind of ninja level to crush a high, bring it down and get it stable again. So as corny as it sounds, you'll never get high if you don't get high. Make sure your base was right. Learn your Pre-Bolus times understand the differences in different glycemic loads and glycemic indexes of foods. Ie how hard and how fast they hit you and go for it. Test when you need to test. Be ready. But don't let it ruin your day. And I'm saying you can have a good day too. And if you're catching this one the day before Thanksgiving, you're like well this would have been helpful last month. The podcast is always here for you will get the guts Get it together for Christmas dinner. Right? doable. It's very, very, very, very doable. For perspective. My daughter has a once he has been between five two and six two for almost seven years. She has no diet restrictions. Her blood sugar's are very stable. Her time and range is excellent. She has the consistency that you want. And the only thing I know how to do is use insulin. Everything else is extra. There's a ton of variables don't get me wrong. A lot more than what we spoke about here today. As a matter of fact, in Episode 231 diabetes proto variables we talked about a lot of them. We talked about it ton of stuff, how exercise impacts things. And there's no doubt that it'll take time for you to understand all the variables in a way that's actionable in the moment. But it is incredibly doable. So if this is your first time hearing the podcast, I hope you jump into those pro tip episodes, and see what you can figure out. They're all available at diabetes pro tip.com are right here in your podcast player. And if you're a longtime listener, you're just looking for that pep talk for Thanksgiving. Go get at it, you can do it. Oh, you know what I should say, if you're gonna have time around family and friends who don't understand diabetes, and you wish they understood it better. Episode 371 explains type one diabetes to an outsider. Maybe then Mom will understand why you're a little agitated. Because all the different pies are coming and nobody told you how many carbs are in them and etc, etc. All right. I really enjoyed this. I hope you have the happiest of Thanksgivings. I know you can do this. And if you need help, check out the private Facebook page for listeners of the podcast Juicebox Podcast type one diabetes. There are over 7000 people in there talking about management. And if you have a quick question, I can't think of a better place to ask. I want to thank the sponsors even though there were really sponsors on this episode, but I slipped them in you know I'm saying the Omni pod tubeless insulin pump, you can get a free no obligation demo of the AMI pod sent directly to your home by going to my Omni pod.com Ford slash juice box. You can learn more about the Dexcom G six continuous glucose monitor@dexcom.com forward slash juicebox. You can also get yourself a Contour Next One blood glucose meter which is the easiest to use and most accurate blood glucose meter that I've ever used for my daughter. Contour next one.com forward slash juice box. Add your voice the type one diabetes research with the T one D exchange T one D exchange.org forward slash juicebox. That's for US residents only.

You know, I cook every year Thanksgiving and the one thing I can't figure out is how to make gravy myself. I am bad at it. And it had something to do with the drippings. And flour. There's whisking involved, but I just can't do it. I don't know what your plan is. This year, I'm going to actually smoke a turkey a smaller one and a pellet grill and make a smaller one in the oven bacon tubers. I'm trying to cook two birds with two ovens at the North. Trying something new but didn't want to mess up and have forever to be like oh great. This sucks. So I'm gonna double up on the birds this year and see which one flies. That was a terrible joke. Mashed potatoes I'm great at going to be some yams, beans, vegetables, cauliflower, making some fresh bread. Like I said earlier, I make the stuffing myself learned from my grandma. I hope you have a great day too. No matter what your tradition is. I think you can do this. I swear you can. Let me just leave you with this. If you told me I could, in two sentences explain diabetes on Thanksgiving to you. I'd say get ahead and stay ahead. And then if you didn't cut me off right away, I'd say you have to get your Basal rates, right. You need to learn how to Pre-Bolus and please understand the different impacts of different foods. That's really the basis of this. That's enough to get you through tomorrow. And those pro tip episodes, they'll teach you the rest. Thank you so much for listening, have a happy Thanksgiving. There's a lot more coming on the show between now and the end of the year. I actually have a doctor coming on next week who is so well versed in treating thyroid issues I just recorded with her today. It's a it's an absolute joy to treat you're gonna love and you know what I'm asked will say here, all the sponsors are back in 2021. And I'd like to thank them Dexcom on the pod Contour Next One touched by type one, G vo Capo pen, T one D exchange. Their support allows the podcast to get produced the way it does. I'm sitting in front of a microphone the day before Thanksgiving recording this for you. Because this is my job. And I get to have this amazing job because you guys support the show and your support leads to add support and add support pays my bills and then I get to sit here and do this. So it's a circle of life kind of a situation for everyone except the turkey.

Well, thank you so much for listening. I hope you enjoyed it. I'm sure you're going to do terrific today or whatever day we're talking about. Maybe it's Christmas or a baby shower or something like that. I hope This helped you get through it. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Don't forget to support the sponsors. There are links in the show notes of your podcast player, and links at juicebox podcast.com. To all of the sponsors. When you use them, you're supporting the show. Don't forget to take the T one D exchange survey and T one D exchange.org. Forward slash juicebox. And of course, share this episode and the podcast itself with someone else who you think might enjoy it. No matter what day you're celebrating, I hope it's a good one. If things aren't going well or you're looking for a little more help, you should head over to the private Facebook page for the podcast Juicebox Podcast type one diabetes, and there will be someone there to answer your questions. The Facebook page is always free. And and this is amazing. And it's inhabited by over 30,000 people just like you have a question ask it I bet you someone answers it might even be me. And now for the next 35 minutes I'm going to do my turkey calls which I've been working on all year

Wait, I gotta get closer to the microphone. Sorry

let me get clear. I got it ready Yeah, I'm just getting alright. Happy Thanksgiving.