Scott Benner 5/15/23 Scott Benner 5/15/23

#909 Diabetes Myths: Series Launch

A brand new series examining the myths surrounding diabetes.

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

Scott Benner 0:00
Hello friends, and welcome to episode 909 of the Juicebox Podcast.

Today I'm introducing a new series with Jenny. This one's called diabetes myths. Oh, that's right. Those things you hear from people like cinnamon and you know that. Anyway, Jenny and I are going to break down a bunch of myths, misnomers and other falsehoods that listeners of the podcast shared, some of them might actually not be that crazy. We'll find out. 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, or becoming bold with insulin. Do you have type one diabetes? Are you the caregiver of someone with type one or a US resident? Well, if those things are yeses, you're perfect. Head to T one D exchange.org. Forward slash juice box and complete the survey when you do this. You are helping type one research to move forward and you're doing it right from your phone or your laptop or your tablet, whatever you got there at the house. You don't have to go anywhere. So what I'm saying and you can still help it takes like 10 minutes, T one D exchange.org forward slash juicebox. Head over help out. This episode of The Juicebox Podcast is sponsored by touched by type one. You looking for people who are doing great things for type ones are you because if you are touched by type one, those are your people you're looking for touched by type one.org Find them on Facebook and Instagram support what they're doing by picking around on their web page. You might even find some information about when I'll be speaking next at their big event. The podcast is also sponsored today by us med us med is where Arden gets her diabetes supplies her on the pods and her Dexcom and you can get more US med has the libre three, the Dexcom G six and G seven. They have Omni pod dash Omni pod five. They've got tandem stuff they got what you're looking for us med.com forward slash juice box. Why would you go to that link to get your free benefits check. And to get started today with us med. You don't want to go online you can call 888-721-1514. But what's wrong with the Internet? Us med.com forward slash juice box. There are links in the show notes of the podcast player or audio app you're using right now. endlinks at juicebox podcast.com. To us med touched by type one and all the sponsors. Hey, Jenny, what's up?

Jennifer Smith, CDE 2:51
He's got that much. It's raining. Is it raining? It's raining. It's a nice rain. It's one of those rains where like, I wish I just had a free day to sit down in a cozy corner of my couch with a really good book and a cup of tea. And like just sit and read that kind of rain, you know, go

Scott Benner 3:13
and make an hour for you. Oh, no. I imagine it would be difficult to get up and start over then after that. Yes, yeah. Well, it rained unpleasantly here last week. So Oh, cozy rain. Sounds much nicer.

Jennifer Smith, CDE 3:27
Cozy rain. Yeah, we had a really pleasant it was beautiful weekend.

Scott Benner 3:30
Nice. Oh here as well. I did all the exciting things that you imagine your favorite podcaster would do over the weekend. I pressure washed a lot of sidewalks and a patio.

Jennifer Smith, CDE 3:42
Yes. My husband loves doing that. Like it's, it's almost like a therapeutic sort of like he gets done. And he's like, look at the driveway. And like it looks great.

Scott Benner 3:54
Here's what it made me. It made me think this is how you ever watched some of those documentaries where they'll show you like if we all just cease to exist. This is how a city would get covered over right? Like yeah, like there's a thin layer of whatever grinds lime grind nastiness on there. And I kept thinking like, if if nobody cleaned this off for 20 years, 1000 years like this would all just disappear under this.

Jennifer Smith, CDE 4:21
Right? It would just be grass and then if it's made of wood or any type of particle board or anything it would just decompose would essentially decompose, right?

Scott Benner 4:29
And even after I don't know how long because I didn't do the math on it. But let's say a half a million years there's there's a foot of dirt on top of the concrete and stuff would just start growing in it and it would be going Correct. I was like, Wow, I'm saving the planet. That's what I thought when I was pressured. I keep I'm keeping society alive. That's what I'm doing is awesome. All it did really was make the middle of my back a little tight from the bending, but I'm okay. It's called exercise, you know? So I know that and when I got done and I thought I'm not tight. I just used the muscle I haven't used in a while, and I completely ignored it and it's loosening up. So

Jennifer Smith, CDE 5:06
that's awesome. Yay. I have to tell you something, please. So I had to drink the Kool Aid, so to speak. After listening to a couple of the podcast episodes, I listened to one on a run on Sunday or Saturday morning, and I kept getting your advertising for the greens. And I was like, God, darn it. I'm just going to try this stuff. Because I kept hearing them and hearing them and you're like, I feel great. And I like this stuff better. Maybe, like have wings or something.

Scott Benner 5:44
That's gonna happen. But I appreciate you supporting the podcast. By getting he went, I'm assuming from athletic greens.com forward slash juice boss.

Jennifer Smith, CDE 5:53
Yes. I used your link yesterday when they you know, they asked, they're like, Well, how did you hear about us? And I said podcast, and then they asked which podcast? Type it in? I made sure to give you

Scott Benner 6:04
prompts as everyone should, because that's how you get the podcasts for free. Yeah.

Jennifer Smith, CDE 6:09
Anyway, I just I had to tell you that. So I don't know when it will come. But I have greens that I've liked for a really long time. And I've used them. So we'll see comparison wise,

Scott Benner 6:20
I tried one that you set me up with and I couldn't get it past my tongue. I was just oh, it's not happening. I kept talking to it. I was like, go in and it wasn't

Jennifer Smith, CDE 6:30
one go in. Oh, this one does. So clearly.

Scott Benner 6:34
Thank you. Okay, so let's take a minute, we're going to set up a new series of episodes. I wish I knew who to give credit to this for I'm sorry that I don't. But someone in the Facebook group said you should do a series about the myth around diabetes.

Jennifer Smith, CDE 6:55
Yes, I remember you mentioned it a while ago, actually. So I

Scott Benner 6:59
put up a post. And the Post said What are your favorite and or most despised diabetes? Legends? misnomers lies half truths or stories. I want to hear everything. And if you're up for it, also share why the story stuck with you. And now Jenny and I are looking at a How long is it 54 page document?

Jennifer Smith, CDE 7:18
Yes, it's it's long. It's the longest document ever received from you about topic ideas and whatnot, which again, I when we start chatting, I have no idea what we're going to talk about. We always have like a background idea of topics. But you're always like, Hey, Jenny, we're going to talk about this today, like great.

Scott Benner 7:40
So the way I see this coming together, is shorter episodes more like defining diabetes, probably where we go through the topic. So I thought in this inaugural episode, we could tell people about the topics. And then you know, the following week, they'll get them so they're broken down like this. miracle cures for your diabetes. These include

Jennifer Smith, CDE 8:07
all of the normal things and cinnamon is in there multiple times.

Scott Benner 8:11
But also prickly pear pills and cow urine. I can't wait to get to that.

Jennifer Smith, CDE 8:19
I have not heard the cow urine one. I've looking through this. I've I've seen many of these but the cow urine.

Scott Benner 8:27
That one I thought was No. diabetes can be reversed. Reasons Why You got diabetes. Let's see my there are so many there for that. It's contagious as part of it. diabetes will disappear, stabilize or get better. Another topic will be diabetes care is easy. It's no big deal. The people really hear that from people. Keep asking my son if it's stable. Now people keep asking my son if it's stable. Now, what did you feed him? And that's lovely. That we have diet restrictions so that people with type one can't eat certain things. That complications are inevitable. That altered mind is a lie. That highs and lows don't really impact people. There is a cure. Oh, this one's This one's huge. There's a cure already. It exists. It's being hidden by the man. That there is that there

Jennifer Smith, CDE 9:30
is I don't even want to go down that rabbit hole. Well, we're going to

Scott Benner 9:33
one of the episodes Don't worry. That there is that there are strict rules to follow like do's and don'ts and people listed a lot of things that people say to them about that. Oh, that their pump will fix everything. Oh, yes. confusion between type one and type two. Only children can get type one adults can't be diagnosed with type one that kind of stuff. Oh, the bad type is a topic Oh yes, at least it's not the bad kind of type one can't possibly be Oh type ones can't be overweight. Type twos are definitely overweight. That's going to be that'll be a topic that type two can become type one or vice versa. And let's see, insulin is bad for type twos. These are all topics that then have tons of stuff under them. Insulin for low's a pump is a oh, here go. You remember, the pump is going to fix everything. How about this one? A pump is bad for diabetic people shared the

Jennifer Smith, CDE 10:38
good. Wow, that's interesting. I've never heard that one. Although for the other one, that the pump, like take care of everything. Honestly, if I had money for every person who's made that comment, as they've noticed, you know, a pat on the back of my arm or my sensor or something. Oh, you've got that great technology and let's make it so much better now just takes care of it. Right. And I'm like, Yeah, we do have a couple hours. I could give you some education about that statement. You know, I mean, it's you could hang out with me for just a little bit of time.

Scott Benner 11:17
By the way, no one's technology works at any part of their life. They're always complaining about their computers my phone doesn't work this app doesn't work the thing in my car won't play and but that thing that must be perfect that must be its perfect

Jennifer Smith, CDE 11:29
technology that it never fails. Never yeah special kind

Scott Benner 11:33
Dexcom stories well, I don't know this one. Thank you to Isabel by the way for putting the list together for me. Um Oh, there's just a lot of things that like Mithy type things around CGM that we are doing drugs or we are drunk. Why? Well now so I see this as a heading and I think that's weird. That doesn't make any sense. But under this heading, there's 12 things I'm not I don't know I'm just scrolling. Let me give you one of them. I had the cops called on me as a kid. My dad was already in the restaurant. He almost went to jail over this never saw him that mad before. I thought he was going to take out this little old lady they call the cop I guess the lady saw her inject something called the there's way more alright we'll get to that health care professionals know all or no the best whoo there's my gosh. My fingers gonna get tired scrolling through this one. This will not be a short episode. I don't think oh my god, we might have to talk for hours about what's on this

Jennifer Smith, CDE 12:50
list. Which which app is which cut topic is this?

Scott Benner 12:54
Hold on. I have to scroll back to it. So I read it to you correctly. Scrolling scrolling that healthcare professionals know or know best?

Jennifer Smith, CDE 13:04
Oh, well, that's the I mean, it's that's it. It's a generalized statement

Scott Benner 13:18
us med people. You I just confused myself. Let me start over. I'll do the whole thing in one take you ready? I'm ready. 123 Here we go. today's podcast is sponsored by us med now us med accepts over 800 private insurers and Medicare nationwide. They offer 90 days worth of supplies and fast and free shipping. US med says they'll do it better for you better service, better care. And A plus rating with a better views Dimiter business behind it was my one shot. US med has us med as an A plus rating with the Better Business Bureau. They've served over 1 million people with diabetes since 1996. And they carry everything from insulin pumps and diabetes testing supplies to the latest CGM like the FreeStyle Libre three and the Dexcom G seven. What about that they got the G six through the libre to Omni pod five Omni pod dash. They're the number one fastest growing tandem distributor nationwide. I mean, what number one distributor for FreeStyle Libre systems nationwide and get this. They are the number one rated distributor index. com customer service satisfaction surveys. I mean, what else you want? Number one, number one Number one, a lot of number ones. If you add them all up, you know what you get? 888-721-1514 That's the number you call to get your free benefits check. If you don't want to use the phone. Go to the internet us med.com Ford slash juice box art and gets her supplies from us Med, you could too. They come right to our door. As a matter of fact, when she went off to college, I made a quick phone call. I said, Hey, you're gonna send art and supplies? Can you please send them to her school instead of here? And they were like, Yeah, sure. And then that just happened. I love us Med, I think you might to us med.com forward slash juicebox. One, take Scott day, call me he only messes up six times. And that take, hey, The podcast is also sponsored today by touched by type one, head over and check them out. It's all they're looking for touched by type one.org. Check out their website, see about the events they have coming up. I'm speaking at one of them this summer, which is getting closer and closer. And they've got a great presence on Facebook and Instagram to really check them out. They're doing wonderful stuff for people with type one diabetes. And they'd like you to know about it touched by type one.org links in the show notes, links at juicebox podcast.com. When you click the links, you're supporting the sponsors. When you support the sponsors, they come back and then you get more free podcasts. It's a circle of life kind of thing.

Jennifer Smith, CDE 16:11
I think across the board for many, many conditions, honestly. But in we're we're talking about diabetes, obviously. And I think that that will be a large topic of discussion.

Scott Benner 16:25
I can't just leave it there. I can't even scroll listen to the very first thing out of the gate says I found that most of the myths I've heard about diabetes have come from my health care professionals. By the way, this is going to be a lot of fun for me, I'm making air quotes because I don't know if you've noticed or not. I can't pronounce myths. Myths, it gets stuck in my so my wife and I are sitting around the other day. I'm like I have a problem. And she goes well. I said I am going to start a topic on the podcast with a word. I don't say correctly. She's like, wait, what? And I said, myths. And she goes, What are you saying? And I'm like, I don't know. It's getting stuck in my mouth myth. Am I saying it wrong

Jennifer Smith, CDE 17:03
myth? I don't think so. Myths. Do I sound like I'm saying it right myth. So

Scott Benner 17:07
Jenny, I can't tell. It feels weird. Like my mouth pauses when I say it myths. Myth. Like,

Jennifer Smith, CDE 17:14
you know, you say water funny too.

Scott Benner 17:16
I definitely say that I'm comfortable with that there's a missile. I know

Jennifer Smith, CDE 17:22
it doesn't sound weird to me.

Scott Benner 17:25
Think about it. Yes. A ton of miscellaneous topics. Oh my goodness, this goes on forever and ever. Alright, so we're gonna be able to put together a nice series about the myths I'm gonna say misnomers about diabetes.

Jennifer Smith, CDE 17:39
I like one of them. Underneath this health care professionals know all or know best. Because I've had this question. I can't say it's exactly from this person says my doctor asked my daughter if she had checked her blood glucose that day. I have. I have had that question before from totally, like, on unknowing health professionals. Absolutely. Unknowing, like going in for an exam or something. You know, where maybe I had to tell them whether I had taken medicine that day. Well, you've checked your blood sugar, right? And I'm like, Oh, my God. Really? Again, do you want the three hour discussion? Because I'm I'm happy to spend time but

Scott Benner 18:26
that's that's insane. Jenny, we're gonna pause for a second and just chill together while the trash truck goes past my house.

Jennifer Smith, CDE 18:34
Fantastic. I can't. I can't hear your trash. I

Scott Benner 18:36
can't think about anything but it is dipping in my ear.

Jennifer Smith, CDE 18:41
Is Monday always trash day for you? Because it's trash day. For us. It is

Scott Benner 18:44
yes. Once a week, the trash picked up once or twice a week.

Jennifer Smith, CDE 18:48
Our trash gets picked up once a week. And then recycling is every other week.

Scott Benner 18:51
That's what we get to. I don't like that, by the way. I hate that. I feel like I'm the waystation for the recycling company. Like I'm piling it up. By the way. Now if the kids are gone, it doesn't matter. I am having that old person thing I like take out half a can of garbage. And I'm like, oh my children left is all I think when I take out the garbage. I drag it down. I go Yeah, cuz I'm old and my kids aren't here. So there.

Jennifer Smith, CDE 19:15
There's a point at which I will get to that then because right now I go grocery shopping. And two days later, I feel like I look and I'm like, where? Where's the food? Like, I spent this much money and had like 40 bags were like, where did the food go? That's all

Scott Benner 19:33
good. No, no, I don't have that feeling anymore. And by the way, as soon as my son started paying for his food, he started eating much more responsibly.

Jennifer Smith, CDE 19:40
I'm sure he did.

Scott Benner 19:42
I get a call from him. Every two weeks. I just paid my bills. I think he's very proud of himself, which is cool. Like he paid his rent and all that stuff. And then he spent a minute or two complaining and that's the end of it. Okay, so Alright, so this is what we're going to do. We're going to go over these topics. We're going to break them into however It ends up working out if we have a conversation about, I don't know, doctors or the bad type or whatever, and it goes longer. I'll break it into two episodes. But I'd like to try to keep them a little shorter. But God knows, I don't know if I'll be able to or not. There's so much stuff here. So we need a place to start. You got to put these in order.

Jennifer Smith, CDE 20:21
Sure. See, and bring it back up. That's it faded off of my screen.

Scott Benner 20:30
I don't think I want to start with this. Yeah, I don't think I want to start with the silliest ones, which are, to me miracle cures, I think I want to hang on to that for a little while, because,

Jennifer Smith, CDE 20:41
and maybe clear up some of the more real well that like true myth type of questions. And then we can be silly in between maybe?

Scott Benner 20:49
Well, I'm just what I'm concerned about is that, what if we get into this list of miracle cures? And we actually find something that's valuable for somebody? It's not going to cure you. But it's not without? Maybe we'll find something that's not without merit? Didn't I mean, correct? Because

Jennifer Smith, CDE 21:04
there are as I'm, as I'm scrolling through them, just quick, eyeballs on. There are a number, a number of these things that are certainly not they're not cure alls. But they are things that could be beneficial in terms of overall glucose control. Yes, right.

Scott Benner 21:22
Yeah. Like tell, for example, I have no idea of drinking apple cider vinegar is good for you or not? Maybe it is, it's not going to make your type one diabetes go away? I don't think it can make your type two diabetes go away. But what if it's, what if there's, I see, my expectation is this is that all of these things start from somewhere. And then just like everything else in the world, they get, like, mostly understood, then exploded and then passed on and kind of understood. And then before you know it, people say things like, I think diabetes can be cured with cinnamon. I've heard that, like, people don't say that, because they know, right, like, and yes, some people are.

Jennifer Smith, CDE 22:04
It's because they've read something somewhere. That was a lot of these, I think, maybe not a lot, but maybe 30% of them, they may start as some type of a ratio, a research study, essentially, because somebody saw some effect of something in a mouse in the lab, because the most drink somebody's apple cider vinegar drink, and well look at what happened because they were monitoring it for something else. And they were well, let's test this. Let's see, you know, I mean, there is certainly some good value to things like apple cider vinegar. These are not cures however, at all, whether you're type one or type two, they're definitely not cures.

Scott Benner 22:50
I just think that it's there might be some, maybe we can mind these things that people say and find the value in them if there is any, or maybe, maybe find where this may have come from? Yes. Because because in the moment, I forget where I saw it on this list, I understand when someone tells you, Oh, your kid has type one diabetes, you just need to do Reiki over their feet, and they won't need insulin anymore. I get being pissed about that. Yeah, yeah. But it doesn't mean that there's not something else on this list. I could have value. So here's a good example, right? My kids physical education teacher sent me videos about curing type one, type one diabetes with a plant based diet. So you can I can read that sentence and see how a reasonable thought gets commingled with the wrong thing. And then with whisper down the lane, and then all of a sudden, did you know that if you just need just vegetables, you won't have type one anymore? I can see where that the craziness comes from. All right, okay. Sorry. So we got to put these Oh, border. So miracle cube. So, here's what I'm gonna do. I'm gonna, I'm gonna grab all of the topics and put them at the top.

Jennifer Smith, CDE 24:11
That's one of the Reiki on the founders. It is totally making me laugh. Like I mean, not let it I mean, the funny thing is the fact that this that this parent really had like, some humor type of response to this person's, you know, expression of hey, if you do this is clearly going to take care of everything he wrote. That's a funny one. Yeah.

Scott Benner 24:40
He wrote underneath of it. Oh, it's time for ice cream. Take your shoes off or

Jennifer Smith, CDE 24:45
better take your shoes off. You just had more ice cream.

Scott Benner 24:49
By the way, why wasn't the magic work through the feet? Through the shoes, I mean, if we can get through my foot can't get through my shoe.

Jennifer Smith, CDE 24:58
I don't know it's I In the energy of the airwaves that you move around your feet obviously have to be exposed to the movement of the air rather than

Scott Benner 25:08
the canvas is that at fault here,

Jennifer Smith, CDE 25:10
Canvas is at fault blocks, it blocks the energy waves from getting in. Yeah,

Scott Benner 25:15
I want to say to for people listening, if at some point, you don't think you can handle me giggling about your essential oils, you probably shouldn't listen, because I'm gonna. And that's pretty much.

Jennifer Smith, CDE 25:28
And I use essential oils, I will tell you that none of them is a cure for type one or type two or any kind of diabetes. However, they do have a therapeutic benefit to, to some degree, if you use them in the right way. My daughter

Scott Benner 25:41
has a diffuser in her room, and she will absolutely tell me sometimes she gets like, anxious or like, upset, and she puts it on she said, it really is relaxing. And I have trouble in the world with that, obviously, I paid for that thing. But if you're gonna start telling me that mixing the lemon with the this is going to make your lumbago go away, then I don't know what to tell you. I don't think I'm going to agree with you. That's not to say you shouldn't do it. And I think that about all this stuff, too. I mean, honestly, like the next find yourself, which one did you find?

Jennifer Smith, CDE 26:15
daily coffee enema? Oh, like, really? Come on. I just

Scott Benner 26:22
Well, I mean, listen, here's the question.

Jennifer Smith, CDE 26:24
This is, this is really where like, you really do you know, you teach kids like when you're growing up like this awareness of pay attention to what comes out, like Think before you speak. I think some people move into adulthood, and have never applied that at all, to what comes out of their mouth. Really.

Scott Benner 26:47
I saw that. I was just like, oh my god, that's amazing. Like, like, you know what my thought was? If I had type one diabetes, and I could get rid of it by giving myself a daily daily, daily coffee enema. Yeah, I might just be like, You know what? It's alright.

Jennifer Smith, CDE 27:07
Take the give me the injection. Give me the needle. I am not doing

Scott Benner 27:13
every day. Where Scott Well, upstairs giving himself a coffee enema to keep his diabetes away. I would Yeah, I don't know. Like, I'm like, it's funny. Like, part of me thinks it's, like, funny. And part of me thinks it's a real like, like, a real conversation like, so let me just put it to you while I'm putting this list together. Jenny, if I could make your type one diabetes go away. But you had to do a coffee enema every day when you got off? What do you think? Think you would do it? No, you don't think I would?

Jennifer Smith, CDE 27:47
I would. I would keep my type one diabetes. I really I honestly, I mean, and again, this is like I'm a week away from living with diabetes for 35 years. Yeah. So maybe I'm at the wrong point of asking that question. Because,

Scott Benner 28:03
right, I will be giving you whatever it may

Jennifer Smith, CDE 28:05
be in the beginning. And I didn't even I wouldn't have even known what an animal was when at that age of diagnosis. Right. So what I've been like, really sure, and then I find out what it is and be like, can you? Can you just give me the syringes back? Because I don't think so.

Scott Benner 28:21
Um, at least this needle wasn't going in my eyes. So well, so it's funny about like, these kind of bizarre. You know, like, either or like this or that thing. I'm going to find something for you in a second that someone posted online. Actually, I don't have to find it. I can explain it to you. So there was in the Facebook group is a younger guy. And he put up kind of this cartoon, right? It's this. Like, in one panel, on the left, there's a guy standing looking at a big red button and the same on the right. And on the left button. It says Arden never gets diabetes. And I and the idea is I push that button and Arden ever gets diabetes. But then nobody gets the podcast. And he asked, like, would Scott, what would Scott do? And I jumped in and I said, Hey, Scott, without pause or hesitation would push the button that doesn't keep my ends up with my daughter having diabetes. And I said as soon as I read this, I thought this is a younger person that wrote this or a person who doesn't have children. I said, I told him I said your parents would drop me off a bridge to protect you. Yes, and I would drop them off one to protect my kids and wars have been started over protecting loved ones. And I get the thought exercise you're trying to get involved in here but you're barking up the wrong tree. You know, I Yeah, you know, I there's not much I wouldn't do to help my kids. So absolutely, yeah, right. Any But it was interesting like this kind of this. I think we're gonna see a lot of false equivalencies in here, a lot of like this or that, or you're just going to be like, no, like, I'm not making that choice. Alright, I have them all out. It's only it's only in my document for now. I'm sorry, but I have miracle cures diabetes can be reversed reasons why you got diabetes. That might be a good starter reasons why I would agree. Yeah. Right. And then

Jennifer Smith, CDE 30:30
and then maybe diabetes can be reversed after that.

Scott Benner 30:36
I think I agree. diabetes cares. Easy. It's no big deal. Like they would? Yeah, I'm moving that one up.

Jennifer Smith, CDE 30:46
And maybe I do the one that what was the one I just said, the diabetes reasons why you got diabetes? Number one, there was there was another one in here. What was the one after the reasons

Scott Benner 30:58
for why you got diabetes and diabetes can be

Jennifer Smith, CDE 31:01
reversed. Reverse. There's another one in here similar to diabetes can be reversed. It

Scott Benner 31:05
is miracle cures, diabetes, diabetes will

Jennifer Smith, CDE 31:09
disappear, stabilize or get better? I think that one kind of goes right along with it could be reversed.

Scott Benner 31:15
All right, we'll put it next to each other so we can consider as we're doing it. Let's see, we have no doubt that we have diet restrictions. I like that one towards the top. Then we'll throw in miracle cures, because it'll be about four or five weeks into the episodes. We'll have a little fun. They're not that I think all these are going to be kind of humorous. Along the way, complications are inevitable. Altered mind is a lie that there is a cure. I so I have that one as bombastic. I'm gonna slide that one down a little farther. That there are strict rules to follow.

Jennifer Smith, CDE 31:54
I think that one kind of goes, it's kind of almost the opposite of the earlier one. Something about it's easy to manage. Yeah, they kind of are similar ideas. But

Scott Benner 32:10
yeah, I think a couple of the type one type two ones might be as well. Oh, insulin for a low I finally understand this one now. Do you understand it now? So this happens to us. There are people in our lives. Yes, when Arden's low, they're like, do you want me to get her insulin?

Jennifer Smith, CDE 32:27
Right? I'm like, well, and unfortunately, it has been. I can't state the programs or the shows. But there have been a couple of poorly stated things in TV shows or movies that have been almost the same thing. Like get the insulin. I'm like, What what are you gonna kill a more?

Scott Benner 32:52
Faster?

Jennifer Smith, CDE 32:54
speed this up with a little more insulin for the 50 blood sugar like, right?

Scott Benner 32:59
It's getting boring watching Shelby die slow in the hospital. Let's fix it up. Yeah. That alone, the amount of times I never thought I would hear about Steel Magnolias so much in my entire life. And it just comes up constantly. And I get the idea like I think contextually, right, like people's children are diagnosed. And then there's this movie where someone has type one who and they eventually end up passing away. And I think that just I guess that must be so scary when you're first diagnosed.

Jennifer Smith, CDE 33:29
Yeah, absolutely. Yes. You know, I've, I've only seen steal Amanda magnolias, like, twice. And I didn't see it until I was an adult. And knowing what I know, there are so many questions that I have. I mean, the story is very, it's very glossed over in terms of her diabetes management. And what led to the events that ended up happening there because my educated or educator brain kind of goes to I want to know the backstory. I want to know what led up to all of this.

Scott Benner 34:16
So yeah, no, I have I've so it's funny when people will say something to me, like, what do you think this means? I'm like, Well, what did you eat three hours ago? Like, what does it matter? I'm like, it's all that matters. I need to know everything that happened before so we can figure out how we got here. Yes, no, I mean, drink the juice. They got that. Right. Right. She was low. They gave her juice. Yeah. You know what the problem I just had an interview with someone whose kid is type one. And he's a producer of like, children's cartoons. Oh, wow. So he, he, we were talking about it. He used a few type one actors to do voices. But I think might have hired some type ones. Oh, I like in the show, like writers maybe if I'm if I'm remembering correctly, but when I asked why not put type one into the, into the actual like program he's like cartoons to Nishi like people will understand it. Like it's nice for the people who will see it but you're trying to reach this many people and you know, it's it's a very fine thing like to you it's your whole world maybe but to most people now you're taking them out of the story to try to explain a thing to them that they don't understand already correct. You know,

Jennifer Smith, CDE 35:33
that makes that's interesting. That's an interesting perspective on

Scott Benner 35:37
Yeah, yeah, it just was it was something else. Alright. So I have reasons why you got diabetes, diabetes can be reversed. diabetes will disappear stabilizer get better. diabetes Care is easy. It's no big deal, that we all have diet restrictions that we have diet restrictions, excuse me, I don't know why I keep reading that incorrectly. miracle cures for your diabetes, that complications are inevitable. Healthcare professionals know all or know best. A pump is bad for a diabetic altered mind is a lie. That there are there are strict rules to follow do's and don'ts that a pump will fix everything that we are doing drugs where we are drunk. confusion between type one type two, there is a cure and it's being hidden. Insulin for low the bad type type one can't possibly be overweight. Type Two definitely is overweight. That type two can become type one or vice versa. Insulin is bad for type twos. Dexcom stories, and then miscellaneous. I think I'm gonna move the Dexcom stories up to come after. I'm going to put it after people think we're doing drugs or we're drunk. Alright, that's it. That's what we're doing.

Jennifer Smith, CDE 36:49
Awesome. I'm curious about the Dexcom stories. I wonder if it's similar. Yeah, I'm curious about

Scott Benner 36:56
the Dexcom we need to get recording so we can find out

Jennifer Smith, CDE 36:58
what they say. Yeah, absolutely.

Scott Benner 37:01
I know. So we're gonna pause this and we're gonna jump into the first one.

Unknown Speaker 37:05
Awesome. Hello.

Scott Benner 37:14
Well, I've pored through the myth list that you guys all sent in. And I have to say I think this series is going to be a lot of fun and maybe thought provoking. I want to thank us med for sponsoring this episode of The Juicebox Podcast, reminding you of course that by calling 888-721-1514 Or going to us med.com forward slash juice box you can get started with the company that provides my daughter's diabetes supplies, of course, touched by type one.org Don't forget to visit find them on Facebook and Instagram. And Jenny if you love Jenny and you want to work with her she does this diabetes thing for a living at integrated diabetes.com. Looking for a community around diabetes look no farther than Juicebox Podcast type one diabetes on Facebook, it's a private group with 40,000 people in it 40,000 Sounds like so many people but all that means is there's always someone there to answer your question or to hang out Juicebox Podcast type one diabetes on Facebook. You don't just have to have type one by the way. Type Two lotta you know, whatever. You got diabetes. You're welcome. There doesn't matter how you eat by the way. You are keto. Come on over. Eat a bunch of food. That is not keto. I don't care. I don't care if you're a vegetarian. If you're a low carb, high carb, mid level carb. Everyone is welcome in my podcast group. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast and look for more diabetes myth episodes coming weekly. Myths. Does it sound wrong to you? myths, myths. Myth it's i gets lost in my head. myths. Myth. Just my lip getting in the way. I'm gonna hold my bottom lip myth. I can't do that. Myth now. Myth, myth. Myth. I lose it as I tried to say it just goes away. myths, myths. Alright, wait, I'm gonna really concentrate myt HS myths. Is that mother? Or is that wrong? I can't tell. Alright, well, it's gonna be called diabetes myth. But listen for me to say misnomers a lot.

#908 From Loop to Omnipod 5

Jon Fawcetts daughter has type 1 diabetes and recently switched from Looping to Omnipod 5. Jon is a font of diabetes infortmation so don't miss a moment.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 908 of the Juicebox Podcast.

On today's show, we have John Fossett. Now John is the father of a child with type one diabetes a teenager. In fact, he is the creator of sugar pixel. He's helped with loop. And he's here today to talk about how his daughter went from loop to Omni pod five. We're also going to talk about a Frezza. I mean, all this is a management heavy episode, like if you're interested in taking care of diabetes. If you're especially interested in algorithms like loop and Omni pod five, or just hearing two people talk about diabetes like a couple of dorks, this one's for you. 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, or becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please consider going to T one D exchange.org. Forward slash use Box and completing the survey. T one D exchange.org. Forward slash use box you can help to move type one research forward in just a few minutes by completing that survey. This episode of The Juicebox Podcast is sponsored by Omni pod makers of the Omni pod dash and the Omni pod five. Learn more and get started today at Omni pod.com. Forward slash Juicebox Podcast is sponsored today by better help better help is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapist who can help you with a wide range of issues. betterhelp.com forward slash juicebox. To get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit. For any reason at all, you can switch to a new therapist at no additional charge betterhelp.com forward slash juicebox that's better help h e l p.com. Forward slash juicebox. Save 10% On your first month of therapy.

Jon Fawcett 2:49
Hey, I'm John Fossett. I am the creator of sugar pixel custom type one and also a lot of the loop patches for DIY loop. My daughter Lily is 17. And she's the type one in our family. So I've been thrown into this. Just like all the other parents having to learn and figure out settings, you know how insulin works and all of that. And that's transition me into doing this basically full time to spend all day learning new things, figuring out new things. She used DIY loop for three and a half years. And she's been on Omnipod, five for five months now. So still learning and every day is a new learning, but hopefully we can, you know, discuss a lot of those things to to help other people out there.

Scott Benner 3:41
Okay, well, that sounds like a good plan. John, I don't I'm trying to think of the first time I had some sort of contact with you. I think it was if you stopped me if I'm mistaken. But I think that something along the lines of your sugar pixel was being shared so much on my Facebook group that you thought that I must think you were spamming the Facebook.

Jon Fawcett 4:06
Yeah, I've had to apologize to most of the Facebook group admins. I can't stop people from sharing it when they get excited about it. I mean, you know how that goes people. People share Juicebox Podcast links all over the Facebook groups as well. It's a similar thing to that. But yeah, that's how we first got introduced through Kenny Fox.

Scott Benner 4:28
Yeah, well, you didn't have to apologize to me. I have a very, I have a very simple rule about the end. The rule, I think just exists in my head. If people are really excited about something, or they find it helpful or whatever reason, like it doesn't matter to me if it's another Facebook group, if it's a book, it can be a different podcast. It can be a way of eating that my daughter doesn't have it could be your sugar pixel. I don't care if the only time the only time you get in the way of that is you know, I don't know if you know this Johnson Some people or they have nefarious instincts, and they'll like, have like an affiliate link where they make money every time somebody clicks on it, or my favorite one is, look at this great t shirt that my sister made for my son. And it says something about diabetes on it. Isn't it great and someone else comes in, and it's only got so great. And then somebody else like, I wish I had a shirt like that, where'd you get it? And then they put Oh, I don't know, I found it here. Here's the link, well, you dig around a little bit. And what you'll learn is the person who put up the picture, the shirt is selling the shirts, the first person that came into the post to say, Oh, my God is so great. They are the same person. And then they start this fake conversation until it draws real people in. And then they sell their T shirts that way, or what have you that I don't I'm not okay with everything else I couldn't possibly care less. So

Jon Fawcett 5:56
in the last few days, this is like playing whack a mole on some of the Facebook groups where it had to have only been a few people started joining the groups, they were fake profiles, join the group immediately post, not only the G six for sale, but the G seven for sale. Like they have all this extra stock of Dexcom G seven that just came out. And it was every five minutes a new post would pop up. I couldn't imagine being the admin trying to deal with some of these scammers that do that.

Scott Benner 6:28
Yeah, that goes on forever. Anyway, my point is, you did not have to apologize. And I would be I mean, John, what kind of a horrible hypocrite would I be if I stopped people from sharing things in my Facebook group? Because I mean, I don't want to brag, but the podcast is shared about every 18 seconds somewhere. And it is, and I get the other side of that, by the way, because you have a thing. And you're trying to spread it like my thing just happens to be free to the people who listen. But even if I was selling a t shirt, I sure I need that money to pay my bills or, you know, sell mine. Yeah.

Jon Fawcett 7:07
This transition pretty quickly to my full time job, I don't know how long it took you to have juicebox sort of become what you do every day all day. But once it hits that point, you know, there is this sort of competing, been competing mentality of well, I need to generate sales to pay keep my electric lawn. But I don't want to come across like a spammer posting links all over the place. So I kind of take the approach of I just try and stay on all the groups to help people also not just, you know, not just take take take but yeah, try and help as many people as I can through questions that are posted and things like that.

Scott Benner 7:50
I stay out of other people's groups, because I think generally speaking, they don't want me there because they just see me as like, mining people. But in my own group, I'm there a lot, you know, that, that fire to get another click or another like or another sale, I liken it to the time I spent after the first time I had sex trying to get to the second time I had so you're like, Oh my God. That's a good analogy. Yeah. Could this happen again, I have to work 24/7. But seriously, people get this. It's just a fire. You know what I mean? Like they sold their T shirt, and they made $9. And they're like, oh my god, what if I sold 100 of them? That's I know exactly how their brains work. Like I could keep this going. You know what I mean? So

Jon Fawcett 8:38
yeah, and one of the things for me those the the entire mentality of it is I created it because it's like Lily's at the time. 16 She never wakes up to her alert. So here mom and dad are waking up to any alert that goes up overnight, because she doesn't hear her phone. And with my background in hardware and software and electronics, I was like I can create something that can solve this. So I created it, really, to help not only us, but other people. So it wasn't I never set out to be, hey, I need to make a profit and you know, grow this gigantic company from doing this is yeah, I'm selling a lot but I'm still doing it because I just want to help people. And I think that's also why people are posting it so much is they realize how how much of a need there was for something that pretty much gonna guarantee you're going to wake up in the middle of the night with how annoying The alerts are.

Scott Benner 9:40
Oh, John, you make that's the same thing that I find is that you just, I mean, you don't start a podcast thinking it's gonna become very popular. You just You just don't like and if you if by the way, if you've just done that, you're silly because it doesn't work out most of the time. And you're doing it because you think you'll reach a few people and that will help them and then You notice that help them and you think, Oh, that's great. You know? That was what I wanted to have happened. You didn't you just? I mean, I don't know, I take your point, I guess so you make sugar pick? Well, that's not what I want to ask you. What is your background? Like, what do you do in college? What would you do for a living kind of stuff.

Jon Fawcett 10:19
I actually dropped out of college after my sophomore year. I was working in doing engineering consulting, and got so busy and so overloaded with actual work that I was like, I need to cancel all my classes, because I can make a lot more money doing that. never figured that I wouldn't ever go back, but I never went back. Okay, so I kept down that route. And you know, that's to give away my age that was 28 years ago, or something like that.

Scott Benner 10:53
I was gonna say, in the 40s. John, everybody didn't need college. Yeah.

Jon Fawcett 10:59
So at some, at some point is like, well, at this point in my life, it's not worth it to go back. But 13 years ago, I launched a company on Kickstarter, making iPhone accessories. So we made I came up with just a stupid, simple idea to wrap an iPhone cable in metal that was flexible. And throw it on Kickstarter. I was like, I think this is a cool idea. I'd been designing products for other people. And, but then they always took them and did the marketing side and the sales side. In engineering consulting, Kickstarter gave us the chance to hey, we can now do it direct, take this idea and see if people like it. Fast forward, then. So that was 13 years ago, over the last 13 years. That company was named one set number 172. On the inc 500, fastest growing companies in the world. We had sales in like 60 countries at one point where we were in retail stores all over the world. And then right in the middle of that we're actually in the middle of a lawsuit against I'll just say the world's largest retailer, I won't name names there for for selling counterfeits. So this little company started here in Akron, Ohio selling largest retail are suing the largest retailer in the world. Right in the middle of that lawsuit, which took like three years to resolve was when Lily got diagnosed. And yeah, so I'm dealing with depositions. And just, it was absolutely insane. Dealing with this lawsuit from from this, when you get hit with, you know, a life changing diagnosis. And I sort of came out of that. And I had, you know, combined with those two things sort of lost all passion for that business, you know, just the corporate America sort of greed type of how everything runs. And I slowly started doing you know, I had I had all kinds of 3d printers, all of the computer CAD software, like all the tools needed to make our own stuff at this point. So I started making custom 3d printed cases for Riley lake. And then later for Orange, like we're all the DIY loopers little storage gadgets and knickknacks that made life with type one easier, whether it be you know, simple clips to hold insulin pens on the side of the fridge out of the way or thanks to better protect Riley link. And that just kept growing and growing. And it kept growing them to the point where I was like, why I could probably take on this sugar pixel concept that had been bubbling in my head for three years at the time. And all of a sudden, you know, life flipped. You know, you go from running this hugely successful electronics company to now complete shift where you're dealing with medical regulations and FDA requirements and all of that type of stuff in this world. Right? But, but the nuts and bolts of it is the products are all pretty much they're just electronics, whether they're iPhone powerbanks or blood sugar monitors, they're just electronics.

Scott Benner 14:44
I tell me a little bit about your daughter. How old was she when she was diagnosed? Your I know you said the timeframe. But how old was she?

Jon Fawcett 14:52
Yeah, she's 17 and I'm not good at math. She's 17. Now she was diagnosed but she was she Just after her 12th birthday, okay, so she's been diagnosed now for five years. And while I'm talking, I'm actually double checking that my math was correct. But

Scott Benner 15:11
what was the possible you're not good with math, John?

Jon Fawcett 15:15
Yeah, I don't, because, you know, my teachers in elementary school in high school said, Well, you gotta learn this math, because you won't ever have a calculator in your pocket at all times. And then now I have a computer with the entirety of the world knowledge in my pocket at all times.

Scott Benner 15:32
They were always I bet on that too. Back then, John, I was like, I'm sure I can get a calculator if I needed one.

Jon Fawcett 15:39
Yeah, so she was diagnosed in 2008 teen, January of 2018, just after her 12th birthday,

Scott Benner 15:46
about five years ago,

Jon Fawcett 15:48
but five years ago, so she was she was MDI, for the first year ish, and that it's sort of amazing looking at people now that come out of the hospital with Dexcom MPs. She was MDI with just a meter coming out of the hospital. And it was six months, I think, before the endo wanted her to have a Dexcom. You know, the endo is always were like, You need to learn how to do this without the technology. I'm kind of torn on whether that's true or not, you know, the best approach or not? Yeah, the the one the one reason, I think, or the one thing that I think helps going through that is learning, really learning more than just, I need to divide this number by this number. And that's how much I does. It's learning the why. And I think MDI can help with that. And especially so, so we did quite a bit, basically sugar surfing through that. She used an eye port for probably six months before she got her first pump. And the eye port, let us essentially sugar served without her complaining about it, because it's one shot every three days when you throw in the pork. Yeah. But what, what you learned by going through that process that I think might be missing now from some people, when it comes straight out of the hospital with a Dexcom. And a pump even is sort of how insulin actually works. You know, DIA is da duration of insulin action. It's five to six hours period, you know, a lot of people see this setting on a poem, and they're like, Oh, I'm gonna set it down to two hours, because that works better. That's just tricking. It's just tricking the Bolus calculator to be able to dose more sooner, when in actuality the insolence still in their system and working. It's just their carb ratio isn't aggressive enough, or their correction factor factor isn't aggressive enough. So those are the types of things I think we learned by being forced to be on MDI for a little bit longer than I think some people are now and then loop further enforced a lot of those underlying concepts, sort of the all the underlying math about how insulin works, how carbs work, and all of that. Yeah.

Scott Benner 18:26
Can I make an assertion? i Yeah, I've spoken to a lot of people. And what I can tell you is that the way people answer questions, there's based on what they think and their experiences. So when you say to someone, you really should use MDI for six months or a year before you get a pump. That's how you'll learn. The rest of that sentence is, that's how some people will learn. And some people won't learn that way. There are other people who a year from now they're a onesies will be 11. And their blood sugars are pink piling all over the place. And they've given up already. And had you put a CGM and an algorithm on that person? Yeah, they probably wouldn't know how it worked. But they'd be healthier. And I just think it's such a funny thing. Because this is an argument that, you know, is as old as time and diabetes, right? And, and it just, it doesn't, you can't answer it for sure for anybody. And, you know, and what are you going to say to someone? Are you are you inquisitive? Are you good with math? Do you does your brain like to figure out puzzles? Oh, well, then you'll probably do great on MDI. Do you bump into walls? Do you not know what to do frequently forget it's Thursday, we better get you on an algorithm. Like, you know, no one talks to you that way. And by the way, just because you don't understand diabetes doesn't mean you bump into walls. I'm being bombastic but I mean, yeah, it's just it's ridiculous. To think that everyone's going to have the same experience. And yeah, and

Jon Fawcett 19:59
for for So it was our step by step through this is, was ended up being the best way for me to learn, of course for my daughter to learn. Yeah, for other people, I completely agree it might not be the best. But underneath all that is still the learning about sort of the the, not just how to manage, but why and the, you know the details about not just here's my carb ratio, and it is what it is. But why would I need to consider changing that? Why would it be odd? The first time we got to scale, my mind was blown in just one little detail of oh my gosh, the printed serving size. For instance, one cup of Cheerios is like 30%, off from weighing the same Cheerios. Yeah. And so those types of things, those span, whether your MDI, algorithm pump or traditional pump is those underlying details, so tell how someone's going to best learn those types of details in

Scott Benner 21:10
1,000,000%. And you know, what I know, and you came to a completely different way than I did, because our brains are different, this whole thing is timing and amounts using the right amount of insulin at the right time, the right amount is your Basal, your insulin to carb ratio, your, you know, other, you know, whatever else. So insulin sensitivity, like it's those three things. And it's knowing when to put it in how to time it and understanding. When the insulin starts to work, when it hits more aggressively, how long it lasts. If you know that, then you're on your way, then you start learning about the different impacts of different carbs and how, you know, 10 grams of this and 10 grams of that sometimes don't need the same amount of insulin and how fat slows down your digestion. Like you can keep growing your understanding. But at the at the core of it, it's how insulin works. It's the exactly it's everything. Really, it's how the algorithm decides everything the algorithm doesn't know from fat. And that's why it struggles with it. And you don't you mean like it, but it does everything else? Pretty damn well. Fascinating. Yeah, yeah.

Jon Fawcett 22:18
And I'm a firm believer, there's also no empirical settings that can span across different systems. And that plays into this because you go from MDI to where you're taking long acting to a pump, where you're basically short acting, or that a pump, traditional pump to an algorithm pump, even from loop to Omnipod, five, or to control IQ. Your settings aren't going to transfer so it's, it's becoming less about, here's your carb ratio, and here's your Basal rate and more about how can I make whatever numbers I can adjust, achieve the best results?

Scott Benner 23:02
Yeah, I want to talk all about this with you, actually, because you sent me and you had been, I guess, kind of booked on the show, or we were trying to get you booked. And I don't even know why you were coming on in originally other than I was like, You should come on the podcast. And then all of a sudden I get this what I would consider from you as and we don't know each other super well, John, we spoken once before this, you explained sugar pixel to me, I got it. I thought it was really cool. I couldn't figure out how to set it up. And I haven't looked at it since then. But that's not. But I also got waylaid by the fact that my daughter's dorm room. Their Wi Fi is like you can't get anything on Wi Fi that isn't like an iPhone. You know what I mean? So that I was like, I'm not gonna be able to use it anyway. not the point. The point is, is that at some point, you sent me a very what seemed to me to be an excited email. And I seriously, which is if you've really looked back, if you could find 20 year old view, and be like, one day, man, you're going to send an email to another man, it's going to be very excited and you're going to say something like hey guys, just jumping in to remind you that one of our sponsors better help is offering 10% off your first month of therapy when you use my link better help.com forward slash juicebox. That's better h e l p.com. Forward slash jukebox while we're taking a break here and I put the ads up front and this one because the conversation picks up and just really starts rolling and I wanted to kind of break it up with the ad before before the flow. Anyway, Omni pod now Omni pod makes the dash. The dash is a tubeless insulin pump that you will just love on the pod also has the Omni pod five. Now Omni pod five is an algorithm that works alongside of your Dexcom G six continuous glucose monitor, maybe you're interested in the dash, maybe you're interested in the five, maybe you haven't decided yet. Either way, all the ways, Omni pod.com forward slash juice box will help you to move forward. If you already know what you want head over there now and get started. If you're still deciding head over there now and pick around a little bit figure, do the reading, you know saying, you know, I'm saying, you know, I'm saying, you know, I'm seeing I'm not seeing anything, it's late at night, I'm woozy. You know, I'm saying you head over there, you figure out what you're looking for dash or five and if you're not sure, you can contact Omni pod right through my link Omni pod.com forward slash juice box. My daughter has been wearing an omni pod every day, every every day, since she was four years old. Arden will be 19 this weekend. And I don't think you can make a better decision than to check out the Omni pod whether it's the five or the dash Omni pod.com forward slash juice box. Both the dash and the five are going to offer you the freedom of showering without disconnecting jumping into a pool running out playing sports, going to do your machinations. Whatever you do there during the day, go to the grocery store, no tubing to get caught on like doorknobs and handles in the cabinets and stuff like that. It doesn't matter what you pick, you're gonna get all that then it's up to you to decide, do I want to make some of the decisions, I want the dash, do I want the algorithm to make the decisions, I'm gonna get the Omnipod five, you decide John's daughter's using the Omnipod five, they love it, you might to omnipod.com forward slash juicebox the links in the show notes, links at juicebox podcast.com, to Omni pod BetterHelp. And all the sponsors. When you click on these links, you are helping to support the podcast. And I very much appreciate it. Now I'm gonna get you back to John. So we can really start to geek out about all this stuff. My daughter switched from loop to Omni pod five. And it's amazing and people need to know how to use it.

Jon Fawcett 27:02
Yeah, I was I was a little giddy. Yeah, you

Scott Benner 27:04
certainly were actually and I don't know you well enough to make that assertion. But that's how getting you in the node as I figured you were. So what version of AMI loop was your daughter using before she moved to Omnipod? Five?

Jon Fawcett 27:19
Well, you could consider it loop three. Now. She was running the dev version since last February. So it was about nine months that she had been running that but for the last two and a half years, I've been customizing loop. So a lot of people using loop have seen the loop patches. Those are the ones that I've written. So they they were just my ways of trying to figure out and force the algorithm to fix things that I didn't think worked optimally. Okay. So for instance, I wrote one where if blood sugar was under a certain value loop would automatically switch to the Temp Basal strategy. If it was over that value, it would switch to the more aggressive automatic Bolus. A lot of people with loop have experience rebound lows where you have a low you take some carbs and loop sees this quick rise from the carbs and thinks you're gonna hit 400, when in actuality, you're going to hit 105. So this helps, that helps prevent those rebound lows, and I just kept adding more and more like I made one tear at the end of our time using loop that I called Basal lock. If your blood sugar was over a certain amount, we use 200. Loop would not cut basil. So loop has this habit of sticky highs where you you get too high and something wasn't correct with your carb count or whatever. And you kind of plateau and you're just riding at 200 for hours on end until you add in quote unquote fake carbs. So that's what we were using with loop was sort of this the new loop three. At the time, it was called dev but with my customized patches running alongside it.

Scott Benner 29:13
Yeah, that's what that's what Arden's using right now, by the way.

Jon Fawcett 29:18
Okay, so she is she using dash.

Scott Benner 29:20
Now? Yeah, she's using dash loop Dev and those two patches that you refer to.

Jon Fawcett 29:27
Great. Yeah. So how how did she so I noticed she was on Omnipod. Five for a while also right.

Scott Benner 29:33
Yeah. So what happened to Arden with Omnipod five is kind of simple as that it added a device and she was kind of like, out from the beginning. She just, she's like, I don't want to carry another thing. That was the thing that really got her was the PDM like I think if Omnipod five would have come out with like an iPhone control right away. Then she would have been like fine, this is fine. I wish people understood A Arden doesn't care. Like I hear other people come on and say, Oh, my kid bought this or my son wanted that or my but Arden doesn't Arden doesn't care. Like she just wants it to work. And I'll tell you what she's an interesting use case for what I believe is one of the like more valuable things about loop is that you can kind of see where insulin is going in and where it's coming out. And I learned a lot more about insulin looking at Nightscout. I mean that that really fast forwarded my understanding even beyond where it was of insulin, just seeing it take insulin away and give it back and those things. It taught me a lot about how it works. Arden doesn't even pay attention to that. She's just yeah, she just she's good at bolusing for her food. And she can make adjustments. She knows when something sticky, she'll do use overrides. If she thinks she's gonna get low, she'll override the other direction. If she doesn't do it very frequently. I'll tell you what. She's been sick this weekend and not really sick. She got a she pulled a muscle in her neck and her shoulder. And it was so bad. She ended up at urgent care while she was in college on Friday morning. And they gave her muscle relaxers. And if you guys have ever heard me say like, I don't drink or I've never been high, like stuff like that. My, my daughter doesn't do any of that either. And so the muscle relaxers hit her hard as she is what would be, I think colloquially called a lightweight. And so she was asleep for swath of time, like 12 hours at a time where her blood sugar is just super stable. I mean, they just it's she slept yesterday till three in the afternoon. And with no intervention whatsoever, and her blood sugar didn't go over like 105 the whole time.

Jon Fawcett 31:51
Yeah, that's fabulous. And that's that's actually, those times to me, are where loop has the most advantages over Omnipod. Five from what we've seen is, if you're steady, it's going to keep you really steady, especially if you're you know, most people are trying to be under 110. With lube is it can keep you in that nice steady range at those times.

Scott Benner 32:22
Also, if you've got I'm sorry. Well,

Jon Fawcett 32:25
I was gonna say for Lily. She didn't like the extra device with the controller and she's not about to switch from iPhone, but it it took a purse to bribe her into giving it a shot. So we found a purse that would fit her car keys or her driver's license everything plus the controller perfectly. And so I think that's, you know that that's made it so she doesn't mind so much carrying the extra device. But she does like that her iPhone is not dead at three o'clock in the afternoon. She always had it connected to a battery charger when she was using loop just because she's on Snapchat and whatnot all day long anyways,

Scott Benner 33:13
oh, yeah, I would say Well, anyway, so the other thing that was going on with Arden at the time that we tried on the pod five for and we used it for a long time, actually, but is that she was having hormonal problems that we hadn't figured out yet. And so we were in this weird thing where we tried to go from loop to Omni pod five Arden's insulin knees were wonky. And as odd as the sounds, as I am the person who hosted the three, you know, on the pod, on the pod five, I went pro tip Series overview, settings and connectivity, which I made along with on the pod. I hadn't made those yet when she started. So, you know, sometimes you hear me say like, the podcast helps me more than it helps you sometimes I was at a loss still when we started on the pot five. So I had initially the problems that a lot of people were not a lot of people, but some people seem to have, which is I don't think I got the settings for Omni pod five, right when I set it up. And so yeah, you know, between that and the hormonal stuff. And she was we just like fought with it for a while. And then we finally got it like, right, and it was working the way we wanted it to. And I was like, see, this works great. And she's like it does. And I was like, okay, and we used it for a while and like she had no trouble with it at all. And then one day, she's just like, I don't want to, like, you know, I'm going to college now and I don't want to carry this thing around anymore. She's like, can I just go back on loop so I don't have to carry anything. And I was like, Sure. So I think Arden ends up on Omnipod five at some point.

Jon Fawcett 34:55
Yeah, and when the iPhone app is available, I think that It's gonna change a lot of people's opinions on wanting to switch, I see that everyday you see somebody posting that they don't want an extra device? Or when is the iPhone version coming out?

Scott Benner 35:13
Yeah, and I'll say this from the other side, if you if you're starting now, that's not a reason not to do it. Because you won't know any different. And I know that's a weird thing to say, but like your kid won't care about carrying the controller. My daughter just had 10 years of, you know, not carrying it. And then suddenly, we were asking her to do something else. And she's like, I don't wonder she was more of the mind of like, I don't understand why we're switching. Like, I'm okay. Yeah, you know, and I was like, No, I know. And I gave her the other reasons, which were, you know, do you want to learn how to build a loop app in case something goes wrong? She's like, No, I was like, well, then here we are. You so it'll, it gets Yeah. But I I'm really super interested. And I want to spend the rest of the time talking to you about how you went from I mean, because you didn't just go from loop to Omnipod. Five, you went from a version of loop that you basically tailored for Lily, with your own paths. You don't I mean,

Jon Fawcett 36:14
yeah, exactly. Well, and there was a lot of learning going into Omnipod. Five. So let me, you know,

Scott Benner 36:27
lead you in? No, no.

Jon Fawcett 36:29
But at this point, I feel like we know the system inside and out and how it's going to behave and why it doesn't behave. At times, the biggest thing that I did was I looked at TDI, total daily insulin from Nightscout reports. And look compared to that, divided by 48, which is essentially what Omnipod uses for its adaptive Basal. So the 48 comes from 24 hours in a day, but then it uses half of half of your total daily insulin for Basal, so divided by 48. And that your hourly Basal rate that the system uses, and I compare that number to what her Basal rate was at loop, and it was within maybe 5% 10%, actually went with the slightly stronger setting than what the TDI would have been based on for the Basal rate. And it also identified five doesn't care day or night. All it cares is basically what's your TDI and what's your iob you know, it doesn't care about carbs, or anything like that. So, if you have five different Basal rates, though, if you're coming from a manual system, or even a loop, those have just been built up over time, usually to solve other issues, not just basil necessarily. And so we put one basil rate in 24/7, because it doesn't matter. And I'd actually that's my suggestion to people I talked to is, if you've got a ton of different Basal rates, it's really difficult for for a person to calculate what their actual total Basal is for the day when your Basal rates are fluctuating throughout the day. So I OB from Basal alone, if you have a fixed Basal rate is times 2.1. So if you have a one unit Basal 24/7, you always have 2.1 units of insulin on board, from Basal. So that's not to be confused with iob, that loop might show you aware that the Omnipod five controller might show you, but that's just to say that's insulin that's in your system at all times. And using a single Basal rate, I think helped us sort of grasp that. Here's how much she uses for the whole day. Split that across, you know, 24 hours, and here's a fixed Basal rate every single day. So the Basal was the first thing is in starting, and I think you see, most people that I see posting, they're frustrated because it's too high. Their their blood sugar is too high, and it's not correcting enough. And it's it's sort of a myth that iPod five has learning. It has history would be a better way to phrase it. And it only has a history of three, four pots, right? And it's taking a TDI average and it's a weighted average. So the most recent days TDI is the highest portion of the average. And that's all it uses. And it updates that during PUD changes. So if, if you're running super high and you're frustrated by it, it's because your TDI is too low. And it's not covering your Basal needs enough. And so the options are either just slowly keep correcting little by little, you know, in every day, you might be adding an extra half a unit or whatever to TDI, or do a restart and restart with more appropriate settings so that you are getting there quicker.

Scott Benner 40:44
When you said add something to total daily. And so you mean just by making extra Bolus to try to bring down a high number?

Jon Fawcett 40:52
Well, yeah, so the people that say like, after three months, it finally started learning me. In most of those people, it's the ones that I've looked been able to see their actual, like gluco data some people have shared it with me is you might be doing a correction. And you're, you know, you're getting half a unit or quarter unit. It's not correcting, it's not driving up your TDI customer to where you need to be. So if, if all your settings, you started around 20, but you actually need to be at 25? Well, it might take two months of just normal, correct when you're high type of strategy for it to start getting that average up from 20 to 25, or 20. To 30.

Scott Benner 41:40
Yeah. Oh, okay. That makes sense. Hey, let me ask you a question about that makes sense? It does actually, let me ask you a question about only pod five that, even though I've had people tell me directly from the company, I see so many people online saying the opposite that it even makes me wonder if I understand what I'm saying. Once you set up on the pod five, on the on day one, you tell it this is my Basal rate, this is my correction factor, these are all the things that's asking blah, blah, blah, go into auto mode. First day, it uses your settings. And then after that, it's it's doing what it wants to do. If I go back into my settings and change my Basal or my insulin action time, or my carb ratio, that that doesn't touch automation, right, that you're just changing your settings for manual, is that correct?

Jon Fawcett 42:34
Correct. And we've been fortunate myself and a few others who did another Omnipod five video with the loop group loop the learning group, we've been fortunate to have a lot of discussions directly with Omni pod. So we asked a lot of these questions of their chief of medicine. And there's no speculation on that one is target is the only setting that changes automation. Now, it can feel like some of the other settings, fix things. For instance, if you artificially lower duration of interaction, from four to two hours. But the reason it feels like that's improving things is you're essentially faking the Bolus calculator into thinking you need a correction sooner. So it's offering a manual correction sooner, it could be if you just click to do a correction, or it could be added on to a meal dose. And that not only brings you down at that time of that dose, but that also increases your your total daily insulin right over time. But the one dilemma there with trying to change some of these other things that may not need changed is that if you're using a lower de dia, once your total daily insulin is where it needs to be, that can actually cause lows or rollercoaster effect, from right having too, too strong, too much corrections going on. Once the system gets you figured out, so if you if you actually look at the insulin action curves, like from the clinical trials, they're all six hours. But the reported iob on the controller and the D at the DIA that's used by the user setting is actually a straight line. It's a straight line insulin decay of the insulin action rather than this smooth curve. And what I've seen is that somewhere between four to five hours makes the reported iob using the straight line most accurate to the actual curve which is you know smooth curves, not a straight line. But but that target setting is the only thing to do. And all these others just affect like either the iob you're seeing or other things like that with the Bolus calculator.

Scott Benner 45:14
Yeah. Also you put yourself at risk for when you do switch back to manual mode, your settings are way too aggressive and will make you low then as well. I can't tell you how many times I've seen somebody online say, Oh, I figured out how to make an adjustment to blah, blah, I changed XYZ. And now automation is working better. And I'll come in and I'll say, the changes that you made did not change automation. That was the only changes to your manual settings. No, no, you're wrong. And I'm like, No, you're wrong. What am I going to do now? I'm on Facebook going not on out of somebody. So I'm like, listen, that's not how it works. You might be seeing Yeah, way but but by the way, every, not everything. A lot of people see ghosts in diabetes all the time. They think they're seeing something and they're not they're misconstruing one thing for another, it happens constantly. And, and we're learning it here. You mentioned that earlier, going from MDI to a pump. It's not apples to apples, you can't just take your MDI settings, put them in the pump, and they're absolutely going to work, you can't take your pump settings and put them to an algorithm, they're absolutely gonna work, can't take your Omni pod five settings and put them in a loop, or control IQ or whatever the Medtronic thing is called, you can't do that. Like, that's not, they're not all the same. And what happens is what you alluded to earlier with the basil is that people get started, their settings are all messed up, they start having problems. And then they make adjustments to settings that fix the problem they're seeing, but don't fix the original problem. It's just patches over top of patches overtop of patches. And before you know it, you're having success. And you don't know why. You don't know how it's working. It's just working. It's it's somewhat akin to when I bought my first house, and we found one day in a dark corner in a hallway that someone had taken masking tape covered a hole and painted over very quickly. Yes, the wall looked okay, from a distance. But it wasn't right, John. And so and that ends up being that, I think, is why you're here on the pod, the company saying so strongly to people, this is about total daily insulin, this, you know, and start around 5050, please, you know, take your total daily insulin, split it in half, half of that is going to be your Basal. Like, just because that's how the algorithm is going to have the best chance of figuring it out. Like the part that's not being said by anybody is you're probably doing this wrong. And you're wrong. You know what I mean?

Jon Fawcett 47:50
Yeah, and there's, there's not necessarily anything wrong with

Scott Benner 47:54
no, because it's working at the end, it only becomes wrong when you try to go into a into into something like an odd like an automated system that that needs it to be accurate. Yeah, yeah. Yeah. So yeah,

Jon Fawcett 48:07
anyway. And one thing that's you mentioned, the basil stuff, as I was called it, Basil creep, is usually the first answer you see from if someone posts Hey, my, you know, I'm rising at this time. Raise basil. Like, historically, with traditional therapy. That was usually the first answer out of anybody's mouth is Basal needs changed? Well, when you start looking at algorithm that that's tracking more things, and and I have reviewed loops algorithm, the results of on the pub fives algorithm, I can't actually look at the math, and I've even done consulting work for a startup that has a different algorithm, where I've seen some how they're approaching approaching this. I really believe that most people, their Basal if they're coming from a traditional therapy, whether it be pump or MDI, their Basal is probably covering at least 20% of their carbs. Yeah, and there's not necessarily anything wrong with that, because it works in that system. It's easier in that system to just sort of smooth out the fat and protein and things like that, or carb miscounts with a higher Basal. But then when you switch that and try to apply it to an algorithm, it just blows up and it'll blow up loop and it'll blow up Omnipod five, just the same. And I do feel like Omnipod five makes it easier though. By that system. You said just focus on TDI. Don't worry about if you have a rise in the middle of the night or beat out For whatever, as long as you focus on TDI, it should be able to handle those types of fluctuations.

Scott Benner 50:06
John, I think this is a great example of the past still impacting the present. Because this all goes back to if you talk to old endos, right? They they would over basil, people who wouldn't, wouldn't consistently be injecting for their food. And so the the people were always seem to have uncovered food in their system. So they're like, well, we'll just jack the basil up to try to take care of that. And the person who made that decision for that person on day one was probably a good decision, you know, but then over time, it just becomes how things get done. And nobody, nobody remembers back to the first time, like, why did we do this, because bill wouldn't inject for his lunch. That's why you know what I mean, but like so becomes, it becomes the way things happen. And then before you know it, you go through a generation of doctors and a generation of people. And that's just what happens, like, what you're, we are seeing right now, the remnants of people not understanding how to manage insulin, you know, all the way back into the late 80s. And, you know, and now it's still impacting things, and we're still having trouble explaining it to people. And algorithms are just going to make it more present. Now and obvious that everyone's most people settings are not right. And you can, it's fast. I mean, it's not fascinating. It's exactly what I expected. But this is this is the next problem, right? Like, are you going to teach people? Which seems impossible? Or are you going to come up with an algorithm that one day just is so good? It doesn't matter? Do you think that's where this is headed? Like when people talk about one day, you're off the boat, like putting your carbs?

Jon Fawcett 52:02
I think it has to be headed that way. And one of the big reasons and I was floored when I started researching carb counting. There's so I found quite a few studies on carb counting, just I was curious is, is it even accurate? Even if we weigh measure percent precision, is it even accurate, and it blew my mind that. So one study, they were only with in sort of the acceptable tolerance 44% of the time on their carb counting. So the acceptable tolerance was like, if you look up what an apple, a medium sized Apple will be, it'll be like, plus or minus three grams from this. So it gives a range. So even with that, though, so 44% of the time, they were within like, three to five grams of what the actual carb count was. And I don't know what everybody's carb ratios are. But for Lily, that could be a whole unit. And a whole units the difference from ending a meal at 200 versus 100. At times, depending on circumstances. Another study. It was adolescence, and this is piqued my curiosity because we're going through this phase where Lily, we're trying to let her do everything on her own and only intervene when things go off the rails. Only 23% of adolescents were within 10 grams of the actual carbs. And when you look at that, and you're like, Okay, we're basically as human beings not capable of accurately counting carbs. And it's not just because people are, you know, guessing wrong. Not trying things like that. It's because yeah, all these variables going into food and like a bowl of Cheerios, you could easily be off by five to 10 grams every single time. So I think we have to get to the point where the algorithms are smart enough to start dosing on the rise, and some are already headed that direction. You know, Android APS is already headed that direction with unannounced meals. And I do know some people who don't enter carbs and use those systems and use them. Probably better than we use a system where we we Bolus for meals.

Scott Benner 54:48
Yeah. I've already interviewed him. I can't think of his name. I just haven't put it out yet. I can't. He's an Australian guy. He's the one it says person you're thinking of?

Jon Fawcett 55:01
No, just what I'm thinking. Yeah. Somebody?

Scott Benner 55:05
Yeah. So yeah, listen, if if I took a whiteboard right now, and I said, John, let's you and I go through all the variables that might make your Bolus wrong, I think we'd write down 50 things by the time we were done. So that's absolutely, yeah, that's why people who listen to the podcast who are not using an algorithm, you know, are just out there working on their own trying to figure things out. It's why they have so much success after they listen to the podcast, because I say, I don't care what the carb count is, I care how it's going to hit. And then you'll learn historically, this plate of food is, you know, eight units of insulin for me. And it doesn't matter if you count it up and come up with seven units, or you count it up and come up with something else. You've eaten this before. It's taken eight units, let's go with eight. It's why my daughter's successful because she's, she's aggressive. Like the, like, it's, she's She doesn't look at something and go, Well, this is probably 10. But it could be 12. She's just like 15. So and, and you're not Pre-Bolus incorrectly anyway, so you probably need a little more to begin with. And you know what I mean? Like, it's all like, you just there is a vibe to it, like you can get through life with a five a one C just vibing with how to Bolus for things. You just have to be right about it.

Jon Fawcett 56:26
And you know, a funny thing about the agency also is we don't worry about it as much as we used to. And I know a lot of people are going more towards focusing on time and rage and stuff like that. But I, I was talking with a colleague about why the GMI shown in clarity used to be called an estimated a YC. Now they call it GMI. Why is that? Usually so far off for everybody? For us? It's usually half a point higher than what her actual who wouldn't see is. And I was shocked by some of the stuff I learned. A one C is so weighted towards the recent yet the last week can shift your agency by half a point. So there is some there is some truth to all I have an endo appointment next week. I better start, you know, yeah,

Scott Benner 57:24
carry myself, I was gonna say because yeah, people sniff the endo appointment coming up, and they start paying more attention all of a sudden,

Jon Fawcett 57:30
that could drop your agency from six to five and a half. Yeah. The other thing I learned was that the actual lab agency tests that are used in the hospitals can be off by 6%. So that's a range of like six to 6.4 or 5.7. Yeah, so we don't worry about oh, gotta hit 5.8 or whatever. You know, if it's like, if she's coming in at six, I'm thrilled because that in a healthy range, no matter what that spread is. So we're we're really shifting more towards this approach of kind of goes along with the carbs what you said with carbs is you don't need all this exactness. There's too many variables and in the world in physiology to be able to get any of this exact

Scott Benner 58:24
you so you do not want to be in a situation where your your last day when he was 6.2. And the next one was 6.4. And you're running around for three months go and I failed. Like it's just, it's nominal. It might be meaningless. And yeah. And it could

Jon Fawcett 58:41
have actually been better when it said 6.4 Because that day the test was running at the high end of yes, the tolerance was allowed by the

Scott Benner 58:49
FDA, John, one of the most difficult things you'll wrap your head around when you have diabetes. Or you're caring about somebody who has diabetes, is that your meter when you test your blood sugar and you like, oh, it says 85 That your blood sugar is probably not 85 Yeah, it could be 95 or 73. Or like, you know, wherever in the range that the meter you're using, you know where its accuracy is, you know, any well

Jon Fawcett 59:21
because the FDA allows 20% on meters just like they do on on Dexcom

Scott Benner 59:28
right. So you test your blood sugar, it's 80 it could be 100 might be 60. It tested it's 100 it might be 120. It could be 80. And the day you give yourself up and go I can't worry about that. I'm looking for stability. I am looking for stability I am looking for not a bunch of ups and not a bunch of downs because these it I got a long day for John Day for my daughter had diabetes. And the girl the girl that made me sound old. The nurse came in the room. The nurse came in that room He did make that really did make me sound old. The nurse came in the room with our new meter, which was this like freestyle thing that I've described in the past as looking like it came out of a bubblegum machine, which is now not a good description, because I don't think you'd get bubblegum out of a machine anymore. And, and it was just just janky little plastic thing. And she brings in this giant thing that the hospital owned. And she tests Arden's blood sugar on the hospital thing because she's got to write it down. And then she goes here, now you do it with this meter, and I tested with a meter and the hospital thing, and the meter they gave me were nowhere near each other. And I was like, whoa, wait. I was like, What do I do? And she's like, just use that meter. I'm like, but it's like, 30 points different than what you just did. And she goes, it'll be fine. And I realized, now, she didn't know what the hell she was talking about. She was just like, Look, man, what she wanted to say was, this is the meter you got dude, good luck. Like, you know, like, like, make the best of it. When I cuz university people test with one meter then test with another like, what am I supposed to do? I'm like, I always tell them pick one of the meters. Because because of what you've been explaining. And that's a it's just, I think that's brilliant. I have to tell you, my daughter is often college now as a freshman. And her a one C went up like point. She went from like six, one to six, four or something like that. The last time but she's been doing exactly what, what Lily's telling us. We do not intervene at almost at all. Like, there are days I don't even think about our diabetes anymore. Like, you know, I the last time I thought about it was when she was sitting down doing homework, and her site was getting old. And I can see the algorithm Bolus and policy and policy and I couldn't move her off this number. And I was like, aren't you got to stop what you're doing for a second change your pump, you know, and then she fought with me about it for felt like hours. And then she finally did it. But you know, there's also the psychological component in there. Like, I don't want her to just not want to listen to me anymore. So there was a reason why I'll tell you what went through my head the other day, when I was going through this. There was a reason why she couldn't get to it. She's not ignoring it. I know she isn't. And I had just spoken to a person who has had diabetes for See, I'm gonna say 30 Some years and you're all gonna think it was Jenny, but it's not. But a person who has had diabetes for 30 Some years who probably lived with a one season the nines for a long part of their life. And that person was like, a little like, I love it when I see people like worried about their six five a one sees, you know, yeah, like, that's gonna be okay. And, and it was, but I take everyone else's point because you'll hear other people say, Well, why can't I get normally one seems like a person without diabetes, say you can't if you want to just, you know, you're gonna work at it more.

Jon Fawcett 1:02:58
And what concerns me with that? Last comment is parents with kids transitioning and we I felt us starting to get to that point transitioning from where Lily's at now. Just about done with her junior year of high school to wear Arden's that, in her freshman year of college is that transition to me felt like oh, my gosh, we should have started preparing for her to handle this fully. much sooner.

Scott Benner 1:03:30
Yeah, we've been doing it's like her junior year of high school.

Jon Fawcett 1:03:33
Yeah, and my concern is when your your kids little, and you're controlling absolutely everything, you know, you're fully measuring every single meal for carbs, you're exactly Pre-Bolus saying all of that type of stuff. Well, that just goes out the window when they start having their independence. And Lily does fabulous at managing on her own. But she's still a 17 year old kid. So there's times when she Bolus is as she's eating, you know, for BOCES after she's started eating, and I worry about burnout from both parents and kids. When you're so focused on this, you know, exactly when see number or an exact time and range, or exactly counting every single card literally has actually been using a president for the last about a month now as a supplement, because sometimes she she actually goes to two different high schools and drives from one to the other right at lunch. So sometimes she doesn't even have time to Pre-Bolus By the time she gets there. So she'll just take a little bit of a Frezza to offset and doses slightly less on the pump. But again, it's not it's not being specific about exact amount of carbs, it's okay it's going to be about this and you know at Adding this one cartridge of a Frezza will help to cut out the rise from not Pre-Bolus thing but we don't know how many carbs. She doesn't know how many carbs that actually was. Just how many units did she take?

Scott Benner 1:05:14
Yeah, do you know that art and figured out how to over Bolus meals that she couldn't Pre-Bolus For just by watching me do it. I don't think we ever spoke about it. Like, I don't think we ever ever spoke about it. And she just one day, I was like, Hey, that was a big Bolus. I texted her at school. And he was he I, I couldn't put it into I sat down. And I was like, oh, and she's like, Well, I'm just Bolus waiting for the rise. It's gonna come. I was like, Ah, I was like, wow, she didn't even.

Jon Fawcett 1:05:43
Yeah, that's the great thing about the algorithm pumps is you can steal basil from the future, right? To help prevent that rise from eating. I have noticed Omnipod five, you gotta go a little less than you do on loop loop would cut basil immediately. And, you know, it dried out much easier. But with Omnipod five, I've noticed we dose a little bit less of that sort of extra upfront, because it'll keep basil on for longer.

Scott Benner 1:06:17
Yeah, okay, that's good to know. You know, I, eventually I will get a email from someone's like, you know, why don't you talk about MDI more. I'm like, I already talked about it. I know how to. The way you use insulin with a pump with a regular old pump is the way if you want to have those outcomes, you would do it with MDI. I'm always interested when people are like, well, I want more tricks for MDM. Like, while there aren't a ton of tricks for MDI. But

Jon Fawcett 1:06:42
my biggest trick for MDI would be to get an eye port because it makes it easier to do all those extra doses. Right? Because you're not taking that extra shot.

Scott Benner 1:06:52
Exactly. And I and it's not lost on me while we're having this conversation like we're talking about I mean really think about what we're talking about right if you're talking about on the pod five and you have insurance that pays for on the pod five you're you can afford a Dexcom you know you have likely have a cell phone like that's a lot of money Yeah, and and even like with like you just said something so off handle you just like I'm like literally supplementing with a Frezza you good luck go into your endo and Telenor you'll also want some inhaled insulin for red is gonna be like, yeah, get away from me. So it

Jon Fawcett 1:07:29
Yeah, it we had to get prior authorization to add it. And even then it was that extra tear. So our, our prescription copay on that was even more, but because she's supplementing it is. It's not nearly as much as like her Novolog. Yeah,

Scott Benner 1:07:49
she's not using as much of it. As much as I'm not coming down on you. I'm saying that it's, you know, we're in this, we're in this moment where care is shifting, right. Like, let me just say, I'm not a soothsayer, I can't see the future. But if we could get a CGM and an algorithm on everybody who had diabetes and needed insulin, the vast majority of these people would be better off health wise. And today, right, and so you have good,

Jon Fawcett 1:08:22
although there's something coming up that has had us thinking, it's, to me looking like the one week basil might be released this year, finally. And if you look at a one week, basil, that, you know, keeps you steady, for your long acting for the whole week. If you were to combine that with a Frezza for your meal dosing, but a Frezza, from from what we've seen in the month of using it is, it is so much more forgiving. You don't have to carb count it's is this plate small, medium or large. That's essentially your carb counting that the combination of that might actually be drastically better than even the algorithms at least today. And to be honest, it's something we might try once once that's out, we've actually chatted about it on whether that might be a simpler way to manage them than using an algorithm pump. So what we'll see but nobody knows until it's out.

Scott Benner 1:09:35
Yeah. How did you get over because you seem like a bright guy. So this went through your head, I'm guessing how'd you get over the idea of inhaling it? Like that's a that's a leap, right?

Jon Fawcett 1:09:48
Yeah. Well, I had a zoom call with their CEO. He convinced me he had a lot of data on a Frezza. And I mean, it's just from everything I've seen about it. You know, the results are undeniable for it. The action time is as fast as the human body's insulin. Okay. So that's why it's such a game changer. If, you know we can get sort of the combination of how to best use it with long acting or with a pump that's just sort of an sort of a reverse untethered, you know, you're doing your long acting and slight adjustments. But the, you know, the inhaling part itself. Lily was a little apprehensive at first, but she got the hang of it. And, you know, the only thing I had to do is I had to email her school is giving them a heads up that, hey, if she shows up in the office, from a teacher center down there for vaping, that she's just take your insulin, that was the hardest part about the inhaled part of it.

Scott Benner 1:11:10
I mean, it's really just saying, I don't even mean that I just mean, like the idea of taking something into your lungs over and over again, like that is off putting to me, that's all like, based on nothing other than I hear that, and my brain goes, we should probably be worried about that. And I don't know.

Jon Fawcett 1:11:26
So there were, so there was a one from I think it was Pfizer. I think it was from Pfizer, it was exubera was the first one. And they pulled it from the market. But there was a lot of there was a lot of misinformation out there on why it was pulled. And I even heard doctors say it was pulled because of lung issues. But it was basically pulled because they did a horrible job with the inhaler. It was like a foot long. What am I gonna do? I mean, it was gigantic. It was like holding a bike pump up to your mouth. To do it, where the the new one is, you know, maybe two inches long the one from from mankind for a president. And so there's no studies out there that say it's harmful or anything like that.

Scott Benner 1:12:29
No, I'm not saying there is by the way, I'm just saying like it strikes me is like worrisome like and I bet could be based on nothing. I just, I wonder if that's not a hard thing to get over. I also keep wondering why someone hasn't just bought the company yet.

Jon Fawcett 1:12:46
Maybe they're maybe they're not for sale? You know, maybe they don't want to I don't I don't know those details. I will say so you do you do need to do a pyrometry Spire, I don't know how to pronounce it. Basically a functional lung test before you start. So you go in, you basically blow in a tube like five times or whatever. And then they they gave her I don't know if it was a stair na steroid, but almost like an asthma inhaler type of breathing treatment. Yeah. Then once that sets in, you repeat the test. So they make sure that your lung function is what it should be. And also that, like if you take an inhaler, it doesn't improve drastically, because that would indicate you have some issues, I say. So you do that at the beginning. And then after six months, and then they recommend yearly after that. And that's just to make sure that long term you don't develop any issues, but I think the bigger the biggest reason for that seems to me like it's you know, somebody who had asthma and maybe didn't even know it, or it got worse in the future, things like that. You know, it can not necessarily be the right insulin to take Yeah, I'm not smart COPD

Scott Benner 1:14:15
Yeah, I'm so I'm so worried that like by me playing devil's advocate that I come off like I'm against, I'm not against, I'm not against it at all, like I I can see a world where Arden would try it as well. And I've spoken to people who swear by it, like really are just doing what you're talking about. They're injecting their Basal insulin and using it for meals and having like, wonderful success with it. So I'm not against anything by the way, like I whatever's best I want you know what I mean? And I want everybody keep trying, I want all these companies to keep pushing and trying to figure out something better and new and

Jon Fawcett 1:14:54
yeah, well and even whatever's best for each person because I'm your top fives not going to be the best As for everybody looks not going to be best for everybody. Some people would manage best with complete MDI.

Scott Benner 1:15:09
Yeah, and for for variable reasons that you that are hard to figure out at first, like, why is worked better for me? Or if this does?

Jon Fawcett 1:15:18
Yeah, all I mean, the first thing that pops in my head is, a lot of people have adhesive reactions, you know, to the pumps and stuff, is, I'm thankful that Lily doesn't have bad skin reactions to those adhesives, like I see some people posting, because that would probably ship us out of out of using Omnipod. Yes, she was having really bad skin reactions, there's all kinds of reasons. But the end result is, whatever system you're using, your settings need, tweaked, to best, get the best results out of that system, and even then is the best results are trying to hit an exact 5.8. It's getting in a good range on a good range over time, you know, not fluctuating everyday, throughout the day, all day or even over months.

Scott Benner 1:16:17
You know, I listen, you made a point earlier, that is not lost on me, which is you can be doing an amazing job for a young kid. And I'm not saying you shouldn't be, but that person is going to leave your house at some point, if you're if you're doing a good job, they're gonna move out, which is the weird part about being a parent and, and they're gonna go live their own life, and they have to be able to, they have to be able to intersect with new responsibilities and stresses and all this stuff and still be able to do their diabetes thing. Like that. Yeah, not and that's not as simple. That's not simply as it's not as simply done, as it is said, it just a lot of stuff happens to them. Like I, like I think this about any number of things like you know, if you're eating like super low carb, and that works for you, I think that's terrific. I also think if you think you're going to go to a college and eat on campus and be super low carb, you're in for a shock. Because a lot of colleges don't offer foods that might might help you with that. And so now you're there. And what do you do? Same thing as if you're always controlling the insulin pump for somebody, and then they get the school and now they're there. And what do they do? Like, it's you know, it's got to be a transferable skill.

Jon Fawcett 1:17:36
And that, even if it's, even if your kid is, you know, highly data, statistics, and all of that loves just digging through those numbers. As a parent, all we're dealing with is looking at, you know, this data to figure out what to do. When that transitions to the kid, they have to add that on top of and I think you sort of hinted at this, they have to add all of that back end, sort of management, on top of actually doing the management. Yeah, taking the insulin, changing their pump sites, refilling prescriptions, and that's a lot to put on a 1718 year old.

Scott Benner 1:18:15
Yeah. And that that's, that's an a scenario, John, we're, we're, we're, we're imagining, like, a kid just being like, I'm gonna take care of myself and actually going and doing it, it's still hard. One of your kids might end up drunk all the time at school, or one of them might end up high as a kite all the time. Or you don't know what's gonna happen. I know everyone thinks they know, they think they're like, Oh, I know how it's gonna go. Yeah, I've interviewed too many people, John, who will tell me like, it was a big shock to my parents when I ended up in rehab. But you know what I mean? Yeah, and I'm just, again, I'm just going to the extremes here. But you don't, you don't know what they're going to what they're going to have to deal with, when they get there. You also don't know how much anxiety and stress they have from diabetes right now that they can't wait to leave the house and try to forget about. And, again, you just need to put them in a situation. And like you said, for some people, you throw on the pod five on the kid, and the kid doesn't pay much attention to it, and it's still going to work out for them. Or, you know, you can't put a loop on somebody who doesn't want to be, you know, responsible for the things that come with that. I've seen. I've seen people on tandem control IQ think it's the greatest thing since sliced bread, and I've seen people that thing doesn't work. And I don't know if that's true, or if they just aren't using it right. But when it happens, it won't matter. Like the reason won't matter if your things not doing what you need it to do. You're going to be in a weird situation where your kids 1000 miles away, and suddenly their blood sugar, sugar 300 And you feel like there's nothing you can do about it and they feel like there's nothing they can do about it. And eventually everybody gives up and I just don't want that to happen. That's all well and

Jon Fawcett 1:19:58
that was So that perfectly explains, one of the main reasons we switched to Lilly to Omnipod. Five is there's less, less thought that has to go into running the system, once it's running smooth, you know, not having to modify basil, or even ever do a basil test, it's basically there's only thing she essentially needs to change in it is carb ratio. If all of a sudden she starts running lower or higher after meals, just change the carb ratio. And through throughout the month, there'll be times when we don't even need, we don't even change the actual setting. She's running low, it might say, those 10 units for the carbs you put in, she'll just those eight, instead, it's about knowing how, how the insulin is going to work. And that, oh, I don't need as much this time, as I normally do, because I've been low today. So for us, it was it was about simplifying the system for her to try and give her the best chance of success based on her personality. And, you know, her how she goes about her day to day and for other people that for other people loop might be the best for that or control IQ or MDI. You know, it's it's all individual, individual to individual.

Scott Benner 1:21:25
Yeah, yeah, for a number of different reasons. It's funny, I would think I haven't I haven't thought about this while we were recording, but I'm thinking about it now. Like, I would think that if the companies that make the different products that we've talked about heard this, they'd all be upset. They'd all be like, No, don't say that. Don't say that. Don't say that. But you know what I heard today, I heard that the guy who figured out patches for loop that I'm using for this kid on on the pod five to me, that's, that's very telling, you know what I mean? And it's not telling that there's something wrong with loop three, or it's telling that these things all work for, for people in certain situations. And that, you know, 10 years from now, you might be on something else. For me, if Arden couldn't use on the pod, we that would be an issue for us. You understand? I'm saying like, if the loop only worked with a tandem pump, I'd use Omnipod. Five, I just wouldn't carry in the thing just shut up. And she and she would agree with that. And for somebody else, they don't care about tubeless. There are other people like I've heard people say, I honestly don't care that I'm attached to my pump. And, and good for them. You know, they mean? Like, what?

Jon Fawcett 1:22:43
Yeah, Lily, Lily would be Lily would choose MDI over a two. So if she couldn't use Omnipod, she would be MDI.

Scott Benner 1:22:51
Exactly. Right. So there's, you know, there's what it is, it's just all I don't know, John, it well, that is confusing as it sounds to people who don't understand. I think people who really know what we're talking about are like, yeah, there's, you know, there's options here, here, here, you just pick the one that's right for you. I'm just thinking that, you know, companies are like, well, please use our thing. But that's just, I mean, and they even know, by the way, you've you've had conversations Yeah, no, it's not for everybody, you know. So?

Jon Fawcett 1:23:23
Well, I have seen, you know, I've been trying to figure out like, when LOOT might be better for someone versus Omnipod. Five, I don't, we've never used to hand up. So I can't speak much to that. But it does seem like the me. Loop is going to be better for the people who have loop not better. Let me back that up. Loop has the ability to achieve better results. For people who are low carb. And people who have pretty consistent lifestyles, you know, they get up, they eat, they do the same thing pretty much every day. Omnipod five, is going to be better for people who either don't know how to manage, tweak their settings or don't want to, or don't have time to write people who just basically want something that works without having to think about it as much. Now obviously, the caveat in there is you have to get your TDI up to the point where it is working like that. But then also, I've seen people with low insulin needs have a difficult time with Omnipod five. So, you know, some of the really young kids is I've seen some of them, but I've seen others who have success in it. So I don't know enough to know if you know it. Is there something about the algorithm that Under certain TDI I can't quite achieve as good of results, I tend to think there is and I think the same in loop is, you know, if you're delivering point one units per five minutes to be your Basal rate, which is like 1.2 units per hour. But point one you can do increments up or down and point 05. Every five minutes. Well, if somebody only has a quarter unit Basal per hour, they're only getting one click of that point, oh, five dose like every 15 minutes that you can't really take that much basil away. There's not as not as many increments, right to transition smoothly up and down to the lower insulin

Scott Benner 1:25:52
people, I would say that with the exception of what you just mentioned, there's people with that low of need. My takeaways always been no matter what the system is, is that if the system's egregious ly working, if it's that far off, if you're experiencing a ton of highs or a ton of lows, that boils down to settings and your understanding of how to use insulin. Like I just, it doesn't work that badly. None of them. Like none of them are that bad. You know what I mean? Like and I'm, that's the wrong phrasing. But if you're like crashing low all the time, and jacking up super high and crashing low, you can't point to the algorithm and go like that's that fall, it's the it's the control, like use a probably your, that thing's not set up correctly, but you don't know how to use it. Same with Looper on the pod five, if you're having like, if it's all over the place like that, the worst thing you can do is step back and go the thing doesn't work. Like it's, you know, yeah, it's it, you don't I mean, you something's wrong, that could be adjusted.

Jon Fawcett 1:26:54
And for the most part, what I see, with people posting out with Omnipod, five is they're, they're starting settings, we're basically what they were using before, which doesn't work lilies, lilies, carb ratio, got 30% more aggressive. So she went from one to seven and a half, or six and a half throughout the day, she is now one to four and a half. I mean, that's drastic change. And that's coming from loop, which is also an algorithm, you know, so even from loop, it needed a drastic change. So for Omnipod, five users, it seems to be they're not increasing the carb ratio. If they increase their cart, or make it more aggressive, right out of the gate, even if their TDI was too low, that would get them in line much quicker. So they wouldn't be riding in the two 5300s all the time, they might be at 200 Until TDI catches up. But it'll be catching up much faster. Two or three pods in. Yeah. And then for, for systems that use basil in the algorithm, I think it's people that don't have a grasp for sort of how insulin works and how basil works with, you know, sort of like the phrase I mentioned before is the first response was always all increased Basal? Well, it's normally fat and protein. In my experience, like, I'm going to say it's fat and protein until I'm proven, until it's proven that it's not fat protein. That's really my take on that actually had quite a few loopers, who look at this, you know, like midnight to 3am rise. So I'm sure you've seen the graphs for that. And then point to several studies that will show that, oh, there's a typical growth hormone rise at that time. So you raised basil at that time? Well, what I the test I tell people to do is don't have any carbs, or don't have any fat or protein in your meal. Within six hours of going to bed, and anything you after that. Make sure it's at least three hours before going to bed and it's 100% carbs, like a bowl of completely dry cereal is just pretty much zero fat or protein, right. And you know what happens every single time

Scott Benner 1:29:30
that the rise goes away? Yeah,

Jon Fawcett 1:29:32
there is 00 Rise and they have a perfectly flat night. Now it is growth hormone. You can say it's growth hormone. But growth hormone is triggered by gluconeogenesis from the fat and protein. So it's, you know, I mean, the culprit is actually the meal. Yeah,

Scott Benner 1:29:52
it's fascinating how, how infrequently we talk about things like digestion nutria Certain things like that we tend to want to treat diabetes, like a math problem always, like there's 15 carbs. That's all. It's 15. That's a that's three units for me didn't work, something else must be wrong. Could it be? Yeah? Could it be that those that you ate something that's laying in your stomach like a brick, and you know, can't be digested very quickly, because people aren't supposed to eat a half a pound of mozzarella cheese?

Jon Fawcett 1:30:29
Well, and to add on to that is, the conversions for fat and protein from your meals, they're not going to always be the same. For the most part of carb is a carb? Obviously, it's not, but it's pretty close. But if you had lower, what is it, glycogen or something like that stores, your body's going to replenish those it's going to use potentially use more fat and protein to replenish those. If you have a high carb meal with high fat meal, it's going to convert less fat than a low carb meal with fat and protein. You know, all of those you can't just you know, I know we started with that. I forget the the book reference that everybody uses, but you know where you do the 25% at this time and 50% at this time for the fat and protein. But the more I get into it, the more I realize it's, I mean, you might as well put a blindfold on and throw a dart and just guess so it's more insulin now. Yeah, so now we're like, okay, take a unit or take two units. It's, that's, that's the math we do is yet you need another unit, or you need another to unit yeah,

Scott Benner 1:31:50
I've made quite a few people. situation better by dumbing it down to if your blood sugar is high, you don't have enough. And if your blood sugar is low, you have too much. And that really ends up just being true. You know, like if your blood sugar is going up, and it's going up and up and up, we can all sit around and talk about like, well, maybe I didn't Pre-Bolus Or my insulin to carb ratio might be off or there could be fat or protein in this and I didn't account for it. But here's the real truth. Blood sugar is going up, you know, what makes it come down? Insulin, lets go. And so yeah.

Jon Fawcett 1:32:24
And you see, you also see so many people that post like, Well, can I do a correction? Now, you know, things like that. And my first thought is always it's only stalking, if you don't need the insulin, right? So you figure out how the insulin works. And then you can know just almost gonna say, you know, by gut feel, but really that gut feel is the billions of pieces of data your brain has already processed, you know about how much you need to take, based on that. Blood sugar,

Scott Benner 1:33:00
if you want to know the uphill battle that we're all against. I saw a post the other day that asked the very serious question, how did you correct a blood sugar two hours after the meal and not have child protective services called on you? And they weren't kidding. Like they were they were talking about something from their life. So you know, there's always a thing at school where the kid you know, Bolus they missed. And they had the nurse add on extra things. And the person asking the question was seriously thinking, I don't know how to Child Protective Services not get called. And I'm like, wow, that's in someone's head. None of you have any chance. Like

Jon Fawcett 1:33:45
we've, you know, we've corrected while she's still eating. we've corrected 15 minutes after the meal. But yeah, that was definitely not enough. We know already, after 15 minutes,

Scott Benner 1:33:57
there are times when the pump is still pumping, and I tell Arden go back in there, add 10 more carbs. So she's like, I have to wait till it's done. I'm like, I will wait till it's done and then puts up our carbs on that, because that's not going to be enough. But my

Jon Fawcett 1:34:12
Lily Lily obviously hasn't gone to the nurse in years. She's been independent at school. But when she was we actually had it written that the nurse calls the parent for meal doses. So the nurse wasn't allowed. Now she started in middle school. You know, so it wasn't like a tiny little kid, but we would talk to her on the phone and we would tell the nurse what to dose

Scott Benner 1:34:37
but just imagine that statement. So the person making the statement is living a life where they don't even understand how to manage their diabetes. They think they do but they don't. The nurse doesn't know what they're talking about. And obviously someone has called the state on somebody at some point for doing the right thing and being told it's the wrong thing. Fast.

Jon Fawcett 1:34:58
Yeah, and the problem is it, is there anybody up that chain? All the way to CPS and doctors or whoever? That would actually no,

Scott Benner 1:35:09
no that no John, they would be doing the right thing. Somehow it's a guy who started making a living selling iPhone cables. guy who was a stay at home dad, and some lady who blah, blah, blah and this person over here and you know, and whoever the hell Ivan is? And like you don't you mean like these are the people who understand how insulin works? Yeah, Jenny. Yeah, people who understand how insulin works, and none of them are, it feels like are in a position to help anybody. Like and that's why, you know, when you stop and look at like the like, the incredible success that the podcast has had, it's because it actually has a way to reach people. Like so

Jon Fawcett 1:35:57
Laos, it allows average people like you and me to share our experiences, but not. Not basically say, here's what your medical advice is to do.

Scott Benner 1:36:12
Without some nerd Nick riding in on a sheriff's going like nothing says three hours. Like what a great you don't know what you're talking about. No one knows what they're Listen, you're lucky when you bump into a doctor that knows what they're talking about. And now I'm expecting just random people to understand who are in some bureaucratic chain. I don't know how I've gotten off on this thing at the school, like because it's fascinating. But the point should be you should distill down everything that was just said into this idea. There's no rules. It's what works. Like Find What Works and do what works. And if it's not working, then keep looking. Don't just throw your hands up in the air and say like, well, that's just diabetes. Like he just gets high at 3am. It's, it's not it's not that easy. I mean, listen to the high at 3am thing from like the fat and protein. Here, how many people are on and acids and explore and experience heartburn overnight. Right? You're going to bed with a stomach full of food that you probably shouldn't have eaten to begin with. And your digestion slows down while you're sleeping. So it just sits in there. And that's what happens. You're gonna get Berets. You want that get don't look. Okay? You don't want that. So like just don't, don't don't eat a slab a beef with cheese on it and spaghetti sauce at 9pm. Like eat that earlier in the day if you're gonna eat that, like the good

Jon Fawcett 1:37:44
that that reminds me of you see the posts of why am I gaining weight? Now that I started insulin, and you see people saying, oh, insulin, you know, insulin, it's known that insulin can make you gain weight. And my just find non my non medical brain is like exploding over here saying no, it's you gaining weight for the basically the same reason that anybody gains weight calories. Except, yeah, except having high blood sugar is coincidentally a nice diet to lose weight.

Scott Benner 1:38:18
Because it's also an eating disorder and a really unhealthy way to be. And so yeah, but Right, yeah, I know, okay,

Jon Fawcett 1:38:25
your glucose isn't getting into yourself. Now it is, and you're eating too much so that glucose is getting converted,

Scott Benner 1:38:33
but see where your brain and my brain says so obviously, blah, blah, blah, there are other people's brains who go so if I don't take insulin, then I'll never get I'll never gain weight. They don't think about like, what's going to happen to them, you know, five years from now. And that's and, boy, you know, what, if this conversation is revealed one thing, it's how many patches there are, it's going all the way back to your basil like because you said about basil, what I would have said in the beginning, if you've got five different basil rates, you're just covering up other problems. Like this is the hole, you haven't figured out something magical. You have other problems that could have been fixed that you've put a patch on, but so much of it, care through school. It's all everything's being patched. Like that's the problem with diabetes care, and probably about everything else in the world is that we've been around so long, that we don't know why we're doing what we're doing anymore. We're just, we just started with a thing. The next decision was wrong, then someone patched it, then the next decision was right, then two decisions in a row were wrong. Then somebody threw a patch on it. Now you're 50 years later, and you're you're riding this motorcycle that's held together with duct tape, but it's running. And so you're like, yeah, it's all good. But then you start making decisions based on what you're seeing and what you're seeing isn't right. It just works. But I don't know if that'll make sense to everybody but trust If you step back far enough, you can see, everything's, I don't want to sound like a conspiracy theorist here because I'm, but society is being held together with luck and spirit. And so as your diabetes, but it doesn't have to be, you can get one of these systems get good setting start over and have success based on on what it's supposed to be based on. I don't know if that makes sense or not. But

Jon Fawcett 1:40:30
it does. But it's it I don't know if this is, I don't know if the statement is in agreement with that are in disagreement. It's a lot more black magic than science, if you will. So it's science, don't get me wrong on managing, but we are looking at, take Omnipod five, I can change basically, five settings that control what the pump does. And only one of those controls the automation, the others just control the Bolus category. Five things, there are probably 5 million variables. Physiologically, environmentally. When I say sort of like, emotionally which ties into physiologically like stress or whatever. And even technologically, how you know, is the cannula at a one degree angle from where it's supposed to be? That causes that drip to just be slightly less. So we're looking at five variables to try and manage something that has millions of individual things that can completely make it go off the rails, right? Yeah, that's why so much like your comment before about sort of not worrying, is it? 30 carbs or 35? carbs, it's, it's worse or whatever? Yeah, it's what works. Because the reasons that I chose for the same thing today that I did yesterday, and yesterday was perfect. And today, I'm 250 The reasons are those other 495,000 variables or whatever, it's that oh, the the temperature was one degree hotter, and my skin was slightly warmer. And so the injection didn't quite absorb in the exact same manner. As it did yesterday. Yeah.

Scott Benner 1:42:37
Oh, no, 100%. I just meant on the setting side, like, like getting like that stuff can be right? It can be or at least better than you have it. Like if you've been patching and patching and patching. You don't know what your basil is anymore. Like you said your daughter's insulin to carb ratio was what one to four and a half. Yeah, and I bet you many people are like, Oh my God, that's sad. You know, we know why I didn't say that John, right, because that's about my daughter's but ratio is and, and so it's just, but her Basil is also not like, you know, super high. And so like it's end, and she's got an algorithm working for it. But the one thing you said earlier that makes, I'll tell you, if you ask me why an algorithm is great, it's being able to steal basil from the future, the way you put that, yeah, I love that about about being able to use a loop to just say like, Look, she's about to eat something, we're not Pre-Bolus thing, right, it's going to hit her so hard, you can literally put in like two hours of basil into the Bolus. And if it's too much, then the algorithm just keeps taking the basil away. And it's the only way I get to help people to like imagine in their minds, is like, if you like a scale of justice, like a big scale right on two sides. And the algorithm is just is just faster than you can think about it. There's carbs on one side and insulin on the other of the scale. And the algorithm is just like, takes all the it takes all the insulin off of the scale. And as soon as it sees it starts to go the other way to here, take the insulin back, and then it keeps it balanced. Too much too little more or less. And it just it's it's adjusting in the moment. And and

Jon Fawcett 1:44:29
that's why it's also important to know that 2.1 times number for basil iob because like a loop loop shows negative things. Which is drives me crazy because it's just a made up thing. Because if your basil is one unit per hour, when Luke when Luke showed zero, you have 2.1 units on board. If loop shows negative one you still have 1.1 units on board. But knowing that number of at any time if the algorithm has been cutting my basil, well, I know that my basil is keeping me right about 2.1 iob at all times. Well, that tells me approximately how much I can add in even from what had been cut from the last hour. For instance, like last night, Lily was like, at five for four hours, probably from like, 7pm until 11, or something, came home wanted to eat before bed, and I just said, look and see if basil has been cut. And if it has, you probably want to add an extra unit. Because I knew that you know, the IRB it or system from the Remove basil before would need to be added back. Yeah. And that would make that meal hit harder she think

Scott Benner 1:45:57
about in our own because that's something Arden doesn't track still.

Jon Fawcett 1:46:01
I'm I'm trying to get her to do that more. So I'm just doing reminders. And then not but but not necessarily following up. To make sure she doesn't like our newest thing is she she goes to bed way later than we do. And she usually wants to go eat half of the kitchen at midnight. So our our newest thing is just telling her head Check, check where you're at when you're falling asleep. And if you're still rising and not coming down from that food, you need to consider how much more to add, because we all know it's going to start slowing down as soon as she falls asleep. And that's going to make make her rise more. So she's getting there, not fully, but she's definitely getting there with that type of Yeah,

Scott Benner 1:46:53
I knew it was gonna get high this morning because she had class at 8am. And her blood sugar's been like 90 for 24 hours. Like she's just been super stable for like a whole day. And she spent the whole day in her room doing homework, you know, she had a couple of meals, but they were smaller. And she's gonna get up this morning, she's gonna go to that horrible cafeteria at that. Pool, John. And I don't know what they feed them. And, you know, she's she made a big Bolus she she was on top of it for the first few hours this morning. It was working. But then she ate again on top of it. And I was like, Oh, here we go. Like so she's gonna go to like, 190 200 it's gonna sit there for a little while, and it's gonna come back. And yeah, it's funny, because I think a lot of people listening to that are like, really, this is what you're worried about. You know, that's not so bad. And I don't think it's I don't think it's, I don't judge it as bad or not. It's just where she's at now. And her understanding of the impact of the food she has, what her schedule is, like, like all that stuff. But if she would have thought the way you just said, like, Hmm, I've been super stable for a long time, let me look to see if my basil has been cut back. Because when I go to Bolus here, I'm going to have a deficit. And I'm not going to be covering it. That's the next step. Like I don't know when she'll get to it. But we're moot like, same thing with you. Like, I'll mention it once in a while. And I figure one day, she'll figure it out.

Jon Fawcett 1:48:18
Well, and that's what's been nice with a Frezza. So Lily went out to get coffee this morning. And I just said, you probably want to take at least one cartridge of a process. So we only have the smallest cartridge, which is 40 units, but it's actually conversion from Nova log, it's like two and a half, two and a quarter units of Nova logs. So what she's started doing at times like that, when you know, she knows she's going to have a quick rise for whatever reason, if she'll take one cartridge over Frezza, at the same time that she doses the rest on the pump. So the Frezza helps them knock down that first hour while the Novolog is getting started. And that's that's actually been pretty amazing to see how it is able to stop the rise with that combination of interests, sort of replacing that replacing that missing Basal but doing it with a Frezza because you know, everything's hitting from, you know, 60 carb, Starbucks, you know, death drink.

Scott Benner 1:49:25
I'll tell you I would I I don't know if Arden would be up for it, but I'd be up for trying it if if she was just the idea.

Jon Fawcett 1:49:34
I don't think you should necessarily try it yourself. Oh, no, no,

Scott Benner 1:49:37
no. I mean, I mean, just I'd be up for like, like trying to figure it out with her if she was interested in doing it. You know, although, you know, it's interesting. You're kind of talking about biohacking a little bit earlier. I was watching this woman online last night she I think she's using the Lilly version of one of those objects injectables that was first brought bought out for type two, but it's been I guess FDA approved now for weight loss and you're seeing a lot of people use it. I don't know what the lily ones

Jon Fawcett 1:50:07
Yeah, the awesome pic or whatever it.

Scott Benner 1:50:10
Honestly I don't know what it's called. But I mean she's this this. I'm just kind of watching this woman on Tik Tok. She doesn't have diabetes or anything like that. She's lost like 42 pounds in a month. And I'm like, I'm so I'm sitting in bed last night with my wife. I'm like, why is that happening? And she's like, well, it quells your because your desire to eat. But I'm like, but there's got to be something else going on. Like she didn't lose 42 pounds from like cutting back on food in a month. Like, that doesn't make sense to me. I'm like, I want to understand that better. That's like, and yeah,

Jon Fawcett 1:50:43
so one pound is 3500 calories. Yeah, that's 150,000 calorie deficit in a month. That's like, you'd be dead. Yeah, it was just cutting down cravings.

Scott Benner 1:50:55
That's what I said to my wife. I'm like, it's not. That doesn't make sense. It's just crazy. She's like, Well, I think it's about how the insulin gets used to. And I'm like, Okay, and so I'm like, I'm gonna figure it out. And then I'm gonna go on to talk about, you know, what

Jon Fawcett 1:51:07
I think I saw when you said that it clicked something in my brain. I think what it's doing is it's actually dumping the glucose through without it getting into your cells. So it so some of the glucose just gets dumped straight through your digestive system. Interesting. If that's the one I'm thinking of, because there was one that I was reading about that.

Scott Benner 1:51:37
I don't know what it's let me take a look. See if I can figure out what it was called. You're saying it's mon Jarrow or something like that? Is that what you thought?

Jon Fawcett 1:51:49
I don't remember which one. But there was one I was reading that was seemed really unusual how it worked. At least part of how it worked.

Scott Benner 1:52:00
Yeah. Now I'm going to find out I'm going to talk to I listen. I'd love to talk to somebody about it just to understand what it's doing. And I mean, it's it's a significant, like, I mean, 42 pounds in a month, and she doesn't look unhealthy. She doesn't look like I don't know, I'm not there. But I mean, like, she's not like, she's not pulling herself on the desk like Gollum going, Yeah, I'm okay. It looks like that's really sound like something's going on in there. Like that's not allowing this to get stored. The way it would normally without it. And I don't know, I just thought it was interesting. So I'll try to find out about it. Anyway, John, is there anything? We haven't talked about that we should? I thought this is a great conversation. And yet I'm not 100% Sure what we talked about. So

Jon Fawcett 1:52:43
yeah, we talked about a lot. So I don't know, I think we talked about everything we should talk about. Oh, no. One more thing. We didn't talk about the single most important thing for Omnipod pipe. So I started counting. How many times a day, I was posting this exact same response to people. They put a new pod on. Patrol, it says it can't find the CGM. So basically the pod isn't connecting to Dexcom. And this goes all the way back to G five restarts. And then you had to do it a lot with loop in the early days, where what was happening is the pod that you just deactivated is not correctly disconnecting from Dexcom. So because the pod is taking the place of the receiver and Dexcom can only be connected to one receiver and one phone at a time. You pull your old pot off, throw it in the trash, it's still connecting with the transmitter even though it's supposed to be deactivated. Okay, so what we do every single pod change, Lilly deactivates the pod as soon as it beeps deactivated, she throws it in the microwave. Don't turn a microwave on by the way, throws it in the microwave. Prime's the new pod starts it connects perfectly every single time because the microwave has a Faraday cage that blocks Bluetooth signal. So you're basically blocking the old pod from continuing its connection to the transmitter. So that's, that's the number one tip I post that more often than anything else to people, because it seems like everybody runs into that we were at 50% of the pods were having connection problems. Since we've before we started doing that, since we started doing that, we've not had a single one that is not connected immediately and reliably.

Scott Benner 1:54:51
Go over it again step by step.

Jon Fawcett 1:54:54
deactivate the pod, pull the pot off and put it in the microwave. And then prime and pair and start up the new pod. And it will connect an app only after it connects. So on the controller, when you see the actual CGM Val value showing, only after that happens, pull the old pod out and throw it away. Okay? So leave it in the microwave that whole time.

Scott Benner 1:55:20
And I'm just gonna say this for people who didn't hear Faraday cage and go, Oh, I know exactly what that is, John, because you're fancy. But it's, it's used to block electromagnetic fields, right? So a microwave has one because if your microwave didn't have one, my, gonna say my testicles would be burned by now. Exactly. But that's,

Jon Fawcett 1:55:40
that's the the little grid pattern you see in the microwave window. That's the Faraday cage. It's just the wire mesh. And for some reason, a wire mesh causes signals to not be able to escape.

Scott Benner 1:55:53
So if your CGM is still improperly connected to the old pod, putting the pod in there basically makes the pod disappear off the face of the earth for the CGM connection.

Jon Fawcett 1:56:03
Yep. And, and we saw about half of the pods having trouble with the connection. And before we started doing that, and once I started doing that, it's not a single one. And all the other things that like people say, reboot the controller, delete the transmitter re enter it, all those types of things. They're all just getting lucky with something with specific timing of maybe when it's trying to ping, the solution is that you have to get that signal, no longer connected to the decks. And the easiest is throw it in the microwave. You could also just throw the pot out down the street, it was gonna

Scott Benner 1:56:40
say I'm laughing and how many people like open their back door and just thrown it into the yard.

Jon Fawcett 1:56:47
That'll do the same thing. I mean, it's about 50 to 60 feet if you have clear line of sight. So you could connect,

Scott Benner 1:56:56
you get a really good arm. So anyway, oh, well, that's great. I appreciate you adding that in here. Thank you very much. Yeah, listen, let's, I don't normally do this. But let's pimp your thing. So the sugar pixel is at custom type. one.com. Right? Yes. Okay. It's really it's a terrific device. Like, it's absolutely amazing. I thank you, I find it to be on the level of glucose as far as like how valuable it was. Because I did. I did run it while Arden was here. And it was terrific. Now that Arden's gone, I need to set it back up. And I haven't yet but I kind of need your help a little bit. And, but for the glucose is the same thing. Like it almost just trains you. Like I woke up in the middle of the night last night. And I fixed my eyes on where that little glucose thing was. And it was green, and I went good. And I shut my eyes again. And I did the same, the sugar pixel when I had it set up, okay, you open your eyes, you're like, Okay, I didn't have to pick up my phone. I didn't have to unlock my phone, all that kind of wakes you up. You don't I mean, like all the machinations with the phone and everything, when you don't have to intersect with the phone, and you can still get a tiny bit of like, a feedback about blood sugar. It's very helpful, and it doesn't break your sleep as well. In the same way, I mean, so anyway, what do you sell anything else that custom type one.com Or just sugar pixel.

Jon Fawcett 1:58:30
That's the biggest thing we sell is sugar pixel. And evidence, we actually have ideas for other products. I have a this Christmas past Christmas, I actually had on my own Christmas tree, a fully functioning version of sugar pixel driving my Christmas tree lights. So that might be something you see in the future is a Christmas tree version of sugar pixel. But yeah, the biggest. The biggest reason I made it I said earlier was Lily wasn't waking up to alerts. And it could be for any number of reasons. She left her volume too low. She left it on vibrate, you know, all kinds of stuff. She's just sleeping harder. And even then it's like, even if everything's perfect. The alerts just the tiny iPhone speaker. So I put a giant speaker in it compared to what you have in the phone. And then also have a vibration puck that you slide under the pillow. So you can get audio and vibration. And we just recently added I think, what has been the most popular feature. We added emoji screens so there's like six or eight different displays you can choose, depending on if you have one user or two users that you're following. But one is emojis. So for little kids that might not be able to rejects. Yeah, we could just have a, we have a single color display. So a kid could No, green is good, red is bad. But we've also added these emojis. So there's Smiley's that have all different smiley faces to indicate the big range. And then there's also icon so like the urgent low is a lollipop is one of the icons. Urgent high, there's a dumpster fire is one of the icons, which is my personal favorite. And then even unicorn, unicorn icon. So you know, little kids get excited. They they hit their perfect number and a unicorn icon pops up on the screen with it.

Scott Benner 2:00:40
Can I set what my number is for my unicorn?

Jon Fawcett 2:00:43
Yes, that was you know, everybody ever about any, you always see the posts of 100. But I know a lot of people that use a different number for their unicorn. So we want to make sure that that was set up.

Scott Benner 2:00:58
That's excellent. John, that's terrific. of sugar pixel is that custom type? one.com. And the word and one is spelled out o ne? So yeah, check it out. Yeah, it really is terrific. It's is it? Is it? Is it still? Like, are you you're not printing them on site? Like how do you make them? I guess, is my question. Are they manufactured somewhere?

Jon Fawcett 2:01:22
It's, it's a lot of custom work. So we are, all of the plastic components are now injection molded. You know, the first one, you bought it within like the first month, we, I didn't know if there were going to be 10 people that wanted this or 10,000. So I couldn't, I didn't have the money to invest to build injection molded. So we were three printing the housings originally, there now injection molded. The then we would purchase all the individual components from, I think, five or six different places. And our circuit boards are manufactured here in Akron, Ohio. And then we do all the finished assembly here, no matter where the parts are coming from. So we have parts coming from all over the world. For it, but everything is finished right here, which I like. Because, you know, it lets us lets me run down right to the factory there. If we have to update something, or, or fix something, make changes, things like that. John,

Scott Benner 2:02:25
how many employees do you have making sure every pixel?

Jon Fawcett 2:02:29
So employees in quotes, there are exactly two of us with custom type one. But our you know, we basically rely on outside contract factories for the various pieces parts. So like our LEDs have, like, comes from a place that has probably 500 or 1000 people that are making LED panels. And our circuit board manufacturer, I think they are probably about 20 people. Yeah, as far as the actual company. You know, if you send a, an email to our support, you're gonna be talking to me. And yeah, and it's, we're just a small place, which, which is good and bad. It's good because we connect, we, you know, I personally can connect with almost everybody. And, in fact, because that can sometimes be overwhelming. Yeah,

Scott Benner 2:03:25
John, you and I are doing about the same thing with a different product. But people I love getting an email, there's like, Hey, can you tell Scott, I'm like, Oh, you think there's another person here? I am Scott. Yeah. Yeah, the guy is the guy. There's no other guy. So

Jon Fawcett 2:03:44
yeah, the the funniest ones are the ones that you'll every now and then get somebody coming in with a raving and ranting message that is acting like we're this, you know, multibillion dollar global conglomerate company that they're dealing with

Scott Benner 2:04:05
a CEO that All right.

Jon Fawcett 2:04:08
Well, I'm just like, I've actually replied before, I've replied to people before, you know, thanks for your patience. I'm sorry. It took me so long. I was up all night with high blood sugars. And so I'm running out a few hours asleep. So that's why I'm deleting replying. I think that's the price is people that, you know, hey, we're, you know, we're the same as the people that are using our product. So there's gonna be days when we might be extra tired, and it takes us a little bit longer to reply to emails.

Scott Benner 2:04:40
I remember when was it Athletic Greens reached out to me because they wanted ads, and they were like, you know, can we talk to somebody in your marketing department? And I was like, that's gonna be me. She goes, Well, after that, we need to speak to somebody in like, you know, accounting and I was like, yeah, that's gonna be me. To my eye, it's me. And she goes, but you chart with like, huge, like podcasts like the large companies running them. And I was like, Yeah, it's me. Like anything you need us my dress? Yes. Why don't you hire people? Oh my god, how much money do you think I make doing this? People hire people? I'm barely paying my own bills. What are you talking about? So yeah, anyway,

Jon Fawcett 2:05:26
well, and that that actually is funny because we, when we were looking at pricing sugar pixel, I wanted it, my main goal is to help people with it, it's a happy benefit that I was able to make it my job. But without cutting corners on the actual product. Like I look at every single penny that goes into it. And I'm like, okay, to offer phone support, I would have to charge everybody, every single person, like an extra 50% of the cost just be to be able to hire people to handle phone support. Right? And is that actually worth it? Probably not. Because I'd much rather it help way more people and the handful of people that might need a little extra help getting it set up, you'll figure it out. Maybe it takes an extra day over email. But that meant that all these other 1000s of people still have an extra $50 in their pocket,

Scott Benner 2:06:28
right? Well, I understood your situation, because when I got one, you're like, I'll send you one. I was like, well, I'll pay for it. John, like, I'm not You're not gonna just send me one. Like, I know, I know your situation, you know, like, I mean, it's, I live it too. And yeah, I you know, so I say to people all the time, like, I just need you to click on the links for the subscribe for the for advertisers, like if you if you listen, if you want to buy a Dexcom do me a favor and buy it through my link if you don't want to buy one. I mean, don't buy one just to support the podcast, just use the links if you're going to you know, and yeah, and I every once in a while. And it's not bad. But somebody will come after me that like you just this is all about money. I'm like, You don't understand what you're talking about. Like if people don't click on those links, by by podcast, like, the podcast that you love so much that you're texting me about how much has helped you like, I actually had a person who's told me these words, this podcast saved my life. And you shouldn't have advertisers. I'm like, Well, you need to pick one. Because that's not how the world works. I, I live inside of a place and my kids go to college, and I eat food and electricity, etc. Like, I can't just make you this podcast, like I'm, I'm an actual person. You know, like, I have things I need to so like, do you want to pay for the podcast? Like I sent it to person like privately? I was like, Look, if you want, I can just charge you like $20 a month to listen to the podcast, and we're all good, then you want to do that? Oh, no. Oh, you don't want to do that. Okay, so you don't want to pay for it. And you want it to save your life your words, but I shouldn't make money. How's that gonna happen? Then? Yeah, so.

Jon Fawcett 2:08:10
And that's the hard part. I mean, it's, it's, um, you know, we all spend way too much money managing this disease. But it, you know, everything can't, can't be free. It's not how the world works, it would be great if it could, the whole night Scout issue with Heroku. Everybody started initially, they discovered railway was working. And they started initially pushing everybody over to railway. And I looked up railway, and I'm like, they're a 12 person startup. And we're going to, as a community push 10s of 1000s of free users onto them, they're going to shut that down, they won't be able to afford that service, if too many users, right. Just all of a sudden start taking their free service you know, so it's it's a line on how you deal with all of that. And I think your approach is the most elegant because it is the the big corporations.

Scott Benner 2:09:30
Yes, someone else just wanted to tell the person Hey, just say thank you. Like, like, I figured this out, like I got you the information for free. Thank you and I'll go you're very well. Yeah, it My pleasure. Like you know, not not like hey, you're pushing ads. Like yeah, do you want the podcast? Like I wonder if people think like after I record with you, you know, if it wasn't for advertising, I it would take me three minutes to go to the front of this and be like, Hey, everyone, welcome to episode blah, blah, blah, the Juicebox Podcast today Jon's gonna be on the show, we're going to talk about sugar pixel and loop and Omni pod five, you're gonna love it. John's daughter, Lily, like I could do that boom, at the end, say thanks for come and see you later, check out the Facebook page. Instead, I spend hours getting each episode together to put ads on them. So that hopefully you'll click on one of the ads if you're gonna buy an omni pod or a G voc hypo pan or whatever the hell you're gonna buy. And so that those people will then send me money, which, by the way, I don't keep much of because I don't know if you've heard about taxes. And then and that is no overhead. I'm a podcast. So like, there's no right or like, like, if you want to know who's like supporting the, all of you through taxes. It's me. Okay. And, and so then that all happens. And then at the end, I just like, like, I mean, my God, like, if you want to contour meter, could you just click on the link? Like, I'm not telling you to buy a contour meter, I guess I got pushback from somebody recently. Like, I don't like athletic greens, and I responded, I was like, don't buy it. When you think you're under like some like, you know, like, it's not a law, if I have an ad, you have to buy the thing, you know, like it's okay. And like, I'm like, I respond back. I said, don't buy it. Other people like athletic greens. And those people who use it, if they buy it through my link, you get the podcast for free. Like, do you really want the podcast to go behind a paywall? Because that's the other option? Yeah. And then how many people to your point about sugar pixel, that how many people don't get it if you make it more expensive? And I'm like, I don't, I don't want to do that. So, and

Jon Fawcett 2:11:42
well, with a podcast especially is, you know, that's along lines of it's mobile, sort of mobile first is a podcast because you're getting it through your phone through the app. And it's just like all the stuff in the App Store is you've put it at $1 next to an app that's free, and nobody's gonna buy the dollar done. Yep. So it's almost like it's almost a you can't put a single, a single dollar amount on on the podcast, without losing probably the majority of your

Scott Benner 2:12:17
life. I had a company come to me one time and said, Hey, let's you should put your your podcast behind a paywall. Because, you know, how many listeners do you have? And I said about this many, how many downloads you have about this money? And they said, Well, if you just charged 99 cents for download, this is how much money you would have? And I'm like, yeah, that wouldn't happen. I said once it's 99 cents, nobody would download it. Like sure they would I'm like, not all of them. And she goes, Well, let's say that I'm sitting at this meeting, I'm like, Oh, my God, I gotta get out of this, you know? And, and they said, they said, well, let's say you lose three quarters of the people, you still have a quarter of them. And by the way, the number was impressive. Like if I lost three quarters. Yeah, listeners, the amount of money would have been apparent, like trust me, I could have made the podcast for like two more years. And then like off. And so I was like, but I said, but the podcast helps people with their health. And she's like, Yeah, and I'm like, Yes. So you're telling me that three of every four people who are now being helped by the podcast are no longer being helped by it for the love of 99 cents. And I was like, You don't understand what I'm doing. Like, I'm helping people, she does know you have a very popular podcast you can monetize the hell out of and I was like, I don't want to do that. I was like, I was like, can you find a way to monetize it? We're all for people are helped with their health, and they doesn't cost them 99 cents. And she goes, Well, you need an ad revenue for that, as I guess I already have that. So you're no help to me at all? And she's like, No, and I'm like, Okay, we're done. Thank you. And that's the last one of those calls I've ever taken. Because by the way, they come constantly. And what I've come to realize is is that she wanted a piece of the pie too. So, you know, like, you know, I was going to make X amount they were going to take 20% of it. And I was like, well, that's the other people that come to me. You should set up a class and charge people $50 for it. And she's like, they would pay that and I was like yeah, they would, but they can get it in the podcast for free. And she's like, you're not making enough money. And I was like, I don't know what's enough. Like I do. Okay. Yeah, I mean, like, I'm not over here struggling, like what are you talking about? Like, how much am I supposed to make off of this? You don't I mean, like, it's all just very, I don't know, but

Jon Fawcett 2:14:36
it's just so opposite of, of capitalism, basically. You know, I mean, it's the opposite. But it's, it's not going to the nth degree to make every single penny you can because it's not entirely about just making a living at this. It's also because we're helping people, you know,

Scott Benner 2:14:56
people that I tell people all the time. I have the It's a triad. I help people, I enjoy this and I pay my bills. You go back two years ago, find me and say, Scott, one day, you'll have a job that helps people that you'll enjoy that will pay your bills. And I'd go like, Sign me up. What is that? You know, like, who's lucky enough to have that? And so, I'm just I don't know, I'm not going to wring every red cent out of everybody. Like, it just seems. It's 30 seems wrong. And by the way, I'm okay. Like, you don't I mean, like, it's not like, I'm not over here. Like, yeah, like, how are we gonna pay the water bill? You know? So? Yeah, anyway, by the way, I don't care. I'm sorry, John, I don't even think about it right up till you get the one email from one person who's like this. You just want money. I'm like, Oh, you have no idea how much money I can make out of this. And and that I'm leaving on the table, you've son of a bitch.

Jon Fawcett 2:15:52
It's your, your, maybe more polite than I am. I just I get those emails. And I'm like, Oh, my gosh, I just, I can't even reply.

Scott Benner 2:16:02
Well, I don't know. Like, I'm not trying to, like, talk everybody into liking me. But I mean, there's, here's my next thought. I've said this before, like, you can't like the reason you don't tell people like I don't understand this, this thing. And in society now where people brag about what they have. I saw somebody in the diabetes space do it recently. And I thought, why in God's name, would you show anyone that car? Like, like, what are they like? What are they going to think? Like, I know what I think when I say it, I think, wow, you're making a lot of money. And, and you're telling me you're helping people like so let's say, John, that this person's making, like a massive amount of money, but they're still helping people, then okay, I mean, good for them. Right? Like, I don't have a problem in the world with that I live in America. I'm okay with that. What about but what I think about is the people who see that are put off by it and stop taking the help. Like, yeah, now you've like, you've hurt someone else's health, so that you could show them you had a fancy car? Oh, just enjoy the car. No one needs to say. Yeah. And that I really do think about that. Because people can get put off by that. Like, if I made. Listen, if I made $30,000 a year off the podcast, and somebody making $15,000 a year is gonna look at me and go, Oh, my God, look at this guy. Like, just, you know, I'm not gonna listen to this, that that person. And I understand that. So like, I wouldn't want that person to think, to not know how to Pre-Bolus because I'm making 30. And they're making 15. And so I just think that's a private thing. You just keep that quiet. Because no matter how little or much money it is, you're going to end up pushing someone away. Anyway, that's like back well, and

Jon Fawcett 2:17:51
so we, that reminds me, I just got a booth at both rents for life, and ADA in San Diego in the summer. Okay. And in doing that, I was like, Oh, my gosh, I have to think through how to make the booth look nice, but not too nice. Yeah, you know, I mean, because I, we can't come across like, oh, my gosh, they they're so this way too much because of how nice their booth is.

Scott Benner 2:18:25
See, these are the things that people in your in my position have to think about that other people don't have to think about. And if they got put in this position, they would very quickly understand it. It's not Yeah, it's not that easy to make something that actually helps people and doesn't offend their sensibilities and all the other things that people can rub up against. I feel it every day on the Facebook page. Like sometimes there are people who are just like, I'm like, You're not like you're not getting this like you don't mean like you're being nasty, you don't realize that. And then it's my job to tell them that except I'm the guy on the podcast. So I don't want I don't want them to like stop listening because a it'll hurt the podcast and be because it'll, because they're not going to hear the thing next week that we talked about that might really help them. And so it's always this balancing act. I was like, I'm gonna be the bad guy. I'm like, I don't want to be the bad guy. But but you're not the bad guy. You look they're like they're out of their minds. You know?

Jon Fawcett 2:19:24
The majority of the people look at those posts and are like, Oh my gosh, this guy this guy did put it like Scott put them in line.

Scott Benner 2:19:31
And it's funny because people will say privately, we'll just block them and again, I think the same thing I'm like no like the like they're having some sort of an issue right now. They'll get through it and they still deserve to know how to take care of their blood sugar's like one bad moment on Facebook doesn't you shouldn't get exiled for that. You know, so anyway, well,

Jon Fawcett 2:19:51
other than other than all the people posting G seven Kenya accounts scammy

Scott Benner 2:19:59
people are Doug, I'm not okay with. Anyway, John, you're really terrific. I appreciate you doing this very much. And

Jon Fawcett 2:20:06
yeah, I had a lot of fun doing it. Good, I'm glad.

Scott Benner 2:20:14
Hey, I want to thank John for spending so much time talking about Omnipod five and looping in the present all the stuff today. Thank you, John. I want to thank Omni pod makers of the Omni pod five and the Omni pod dash and remind you that you can learn more and get started today at Omni pod.com forward slash juice box and of course, save 10% On your first month of therapy at my link betterhelp.com forward slash juicebox. Can't remember the links to type them in the browsers. You can find them in the show notes of your audio player or a juicebox podcast.com. We talked a lot about the Facebook group today. You can find it online Juicebox Podcast type one diabetes fantastic group 40,000 people in it right now. Going Strong. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Don't forget to subscribe or follow to the podcast in the audio app you're listening in right now. Apple podcasts Spotify, Amazon music wherever you are, hit follow or subscribe whichever your app offers. A huge thank you to one of today's sponsors better help. You can get 10% off your first month of therapy with my link better help.com forward slash juicebox that's better H e lp.com. Forward slash juice box. If you've been thinking about speaking with someone, this is a great way to do it on your terms betterhelp.com forward slash juice box

#907 Type Two Stories: Karen

Karen has type 2 diabetes and a lot of stories.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 907 of the Juicebox Podcast.

Welcome back everyone. This is the fourth installment of my type two Story series. We've already heard from John, LeAnn and Michael, and today Karen, a person living with type two diabetes. 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. If you have type one diabetes, or are the caregiver of someone with type one, and you're a US resident, please consider going to T one D exchange.org. Forward slash juicebox and completing the survey. Every completed survey helps someone with type one diabetes, it may help you and it definitely will help the Juicebox Podcast T one D exchange.org. Forward slash juicebox. juice box podcast listeners save 35% off their entire order at cozy earth.com when they use the offer code juice box at checkout and you'll save 10% off your first month of therapy@betterhelp.com forward slash juice box just by going to that link. This episode of The Juicebox Podcast is sponsored by the Dexcom G seven dexcom.com forward slash juice box get yourself the continuous glucose monitor that my daughter has been wearing for years. dexcom.com forward slash Juicebox Podcast is also sponsored today by the contour next gen blood glucose meter contour next.com forward slash juicebox you need and deserve a blood glucose meter that is accurate and easy to use. I had an extra contour next gen at the house that I just gave to a family friend who was concerned that they had pre diabetes on the very first day woke up fasting blood sugar 119. Now they know what they're looking for. They're going to be testing all week and writing down their numbers. You could too contour next one.com forward slash juicebox.

Karen 2:26
My name is Karen and I am 69 years old. I used to be a teacher and retired as of 2006. I'm a type two diabetic. And I guess that's a good start. Because Scott last meal I think

Scott Benner 2:46
it's a perfect start. Thank you. Okay, while you're 69 And how long have you had type two?

Karen 2:55
Well, do you want to count? prediabetes, but um, basically my diagnosis with insulin was 2009.

Scott Benner 3:05
So you've been using insulin since 2009? When right? When did you start having to doctor for this? When was it? When did it begin?

Karen 3:14
Um, about five years before that? Okay. 2004.

Scott Benner 3:22
Wow. 18 years ago. All right. What is the first? Well, were you working then? You teaching? Yes, you were Yes. What did you teach?

Karen 3:38
Mostly elementary physical education.

Scott Benner 3:41
Nice. Well, that sounds like fun, actually. Or is it not?

Karen 3:44
Well, people say, oh, there must be a lot of fun. But really, if I'm playing with the kids, I'm not doing my job.

Scott Benner 3:53
So the fun parts not there, do they? But that was a long time ago back then you let them throw balls at each other and everything right, like dodgeball?

Karen 4:03
Well, occasionally, but we usually use firewalls, so they didn't hurt.

Scott Benner 4:08
I don't think they let you throw balls at each other anymore.

Karen 4:10
No,

Scott Benner 4:12
I don't think so. I don't think you're even like that.

Karen 4:15
I don't know if you can even get hugs anymore. I used to get like 40 or 50 hugs a day. Really, but yeah, but the thing that Well, I had mostly kindergarteners, but the thing that I missed the most was if I dropped something like 24 kids would die to pick it up. Or if I lost something, I can't find my needle race to get it for me. Karen I

Scott Benner 4:49
don't want to be creepy but I could have used a couple of those kids to put my socks on this morning. That would have been a go.

Karen 4:54
There you go and they would have been happy to do that If he would have fought me would have fought to do.

Scott Benner 5:02
Mr. Scott's back hurts. I've got the left one. Okay, so what's the first? Well, since it's funny, type two is different than type one my questions. Alright, so prior to 2004 You live in a life had you had children? No, no. Okay. Would you consider yourself in shape out of shape? A good eater, a bad eater? Like, how did you think of yourself as an adult?

Karen 5:32
I was a pretty good eater, sometimes not. But you know, we all do that. And I've always fought with weight. But at the same time, being told that I created my type two really irritates me a little because the incidence of type two is anywhere from 11 to 17%. From what I've seen, and that's a small amount of fat people who have diabetes, and there's a lot of others who are fat who don't have it. So to say that they're still the cause, because I'm not sure is really fair.

Scott Benner 6:16
Karen, I like your math on that. You're like, listen, there's 10 of us here. Two of us have diabetes. We're all fat. Yeah. So is there. Type Two in your family line? No, no? Okay. Well, okay, you start You shocked me there. Okay, that's fine.

Karen 6:39
And some great grandmother had type two. Well, that's a great grandmother. Well, that's. Well, yeah, but she had 10 children, too. So gak in the 30s. You know,

Scott Benner 6:51
Karen, what are you saying? She used herself up and everything came for? Kind of 30 she had? How many of her? Do you know much about her? Did any of the children not survive?

Karen 7:04
No, all of the children survived except one who was killed at age 19. In the war? No, he was killed on a train track in the Upper Peninsula of Michigan. Oh, my gosh, I can't believe you know, in a snowstorm

Scott Benner 7:21
in the snow. Well, you

Karen 7:23
know, you know how families tell story. They share a lot of things.

Scott Benner 7:28
It's interesting. I I always wonder how accurate any of those old stories are that have been passed down? You don't I mean, like, I'm talking to my mom, and she can't. She's not getting right. What we did last week, and I think, yeah. Tell Tell me the story about your uncle again. You're sure about live.

Karen 7:48
I've had more than one, you know, story about that. And he was he is probably drunk at the time. And snowstorm on the train tracks. And, um, you know, I looked it up online. One time when ancestry he had a free thing, and I saw his death certificate, so I'm pretty sure that was accurate. Because he had, he had been asked to go to play with John Philip Sousa is banned, but he was only 15 years old at that time. Oh, yeah. Like when can that? Really? Yeah.

Scott Benner 8:31
Okay. All right. Well, that's great. Oh, sorry. Sorry. We're getting too far away. No, that's your great grandmother had type two diabetes that we

Karen 8:39
and 10 kids

Scott Benner 8:41
and a really tired vagina imagine so.

Karen 8:46
And she she and her husband were immigrants. So

Scott Benner 8:53
wow, from where? Finland and are so you are? Are you finished or part finish? Half finish. Very nice. I appreciate you saying that. So we can title the episode.

Karen 9:11
Well, I'll have a friendly Anders in the up we'll be happy about that.

Scott Benner 9:16
I'm just wondering right now how many people know who John Philip Sousa was?

Karen 9:21
Yeah, that's true. I was impressed when I was in in orchestra. So

Scott Benner 9:27
Oh, I love it makes sense. Okay, so you in 2004 start experiencing symptoms. What are those symptoms?

Karen 9:37
Well, it was mostly my blood tests showed that my glucose levels are a little high.

Scott Benner 9:43
So you're just in your, in your yearly physical or whatever. And the doctor starts talking about like, Oh, you're pre diabetic, that kind of thing.

Karen 9:53
Exactly. Okay. And he put me on Metformin.

Scott Benner 9:56
And did that do well first of all, do you remember what Pre diabetic meant back then what were they telling you a one C was?

Karen 10:03
I really don't know. Okay. I don't know, back then if they really set a one, see

Scott Benner 10:10
if that was the measurement or if they were doing were they do fasting? Were they doing like a fasting blood glucose maybe

Karen 10:17
more or less to to be diagnosed? I think I did that. But that was right away. I should I would do my fingers check and have blood glucose of 115.

Scott Benner 10:34
And that pretty regularly regularly. So they put you on they put you on Metformin. Wow. Did you experience any weight loss from the Metformin? No, no. Did you experience a lessening of your blood sugar? Did it help with that?

Karen 10:51
I don't think so.

Scott Benner 10:52
No. And how long did they leave you just on Metformin? Five years? And you don't feel like it did anything for you? Not really

Karen 11:00
well, it gave me diarrhea.

Scott Benner 11:05
Karen, you and I are gonna have fun I can tell.

Karen 11:10
I mean, yeah, it was, you know, I found that found more bathrooms people must have sensed like in stores or whatever, where they said no public bathrooms. They must have sensed urgency in my eyes or face. Because they would let me use bathrooms. I have seen bathrooms that you would not think

Scott Benner 11:31
existed. Yeah. What's behind this sheet in the in the clothing store? Oh, my goodness. All right. All right. This is where they keep the mop bucket. Okay. Absolutely. So you had you had stomach pain and loose stool? To say the least? And yeah, but no, but no. improvement. So what was said to you, as best you can remember as long time ago, but as best you can remember what was said to you about? I'm going to use Metformin. And then when you'd go in subsequently for other visits, what was the conversation like?

Karen 12:13
Well, just, you know, that I was doing okay, it was my primary care physician, who had been with me for a while I started with him. I hadn't had a real physician for a while. And when he started practice, I finally had some pain in my chest kind of more or less at the top of my stomach, you know, like a reflux thing. So, you know, I'm thinking heart, whatever. So I went in to him, and he's, he's been my doctor ever since. And now his kids who were about to at the time are adults. And through college, and so on. So it's been a few years.

Scott Benner 13:03
And so you're with this guy for a very long time. But for five years, you don't see. Well, I guess there's no, there's no worsening of it. Is that right? Right. So they're so in their mind, I'm guessing what that meant was, you would have gotten worse without the Metformin. So therefore, the Metformin is helping. I guess so. Yeah. But, but my point, Karen, is that there's not a lot of conversation around a lot of explanation, right, you're not right, you don't leave there feeling like you really understand what's happening to you. Right. Right. Okay. Right. Did the stomach problems ever go away with the Metformin? No, it's stuck with you forever.

Karen 13:48
But I also had reflux diagnosed separately, you know, right. Without taking the Metformin. So, later,

Scott Benner 13:58
let me ask you this 2004 is Oh, god, what's 2022? Give me a second. For give me a sum on this. Alright, so, um, so one, that's the one I'm accessing 818 years ago. That's not what I want to know those 69 minus 18. That's one. You were 51 when this started, okay, so,

Karen 14:24
but I should tell you something, go ahead. When I was 44 I had bad hemorrhoids. I had a hemorrhoid ectomy. internal external fistula, a whole smear, no bleeding problems. My mother has bleeding disorder that was discovered in Finland. So I was tested for it. Yeah, false. The doctor who tested me for looked at my hemorrhoid ectomy results and said, Oh, you had a very bloody sir GE no problems. You don't have von Willebrand disease. So,

Scott Benner 15:06
okay, hold on, let me carry on. Let me go slower here. Hold on a second. I think I have this. So, and again, we're having a good time. So you had very bad internal and external hemorrhoids that had excised somehow. And, and your mom has van Wilbur brands,

Karen 15:25
buying Willow brands, as do I Okay, but it's a bleeding disorder. Yeah.

Scott Benner 15:31
But the the doctor who examined you, I'm guessing you're getting ready to tell me just looked at your surgery and said, What? What were they? What were they inferring from the notes from your surgery?

Karen 15:44
He said, You had a very bloody surgery, and you didn't have any bleeding problems. So along with your testing, I don't think you have been well grants.

Scott Benner 15:58
Okay, because he thought that a bloody surgery would have led to something that would have indicated this.

Karen 16:04
Right. Okay. Now, two weeks before I saw him. I had quit taking birth control pills, because of my painful periods because I had had and Demetrius Okay. Okay. And well, I had the hemorrhoid ectomy. I was taking birth control pills to try to control the

Scott Benner 16:26
pain. Yeah, the pain not the bleeding. Monthly. No. Okay.

Karen 16:30
No. In fact, the only symptom I ever had was nosebleeds when I was a kid. And even then, it was iffy. You know, I had nosebleeds and yeah, it happened after I had a tonsillectomy. So before I had the tonsillectomy, I hit your eggs every night. But after I hadn't had select me, I did have to go back in for some clotting in my throat. But then I was fine.

Scott Benner 17:03
How old? Were you around the tonsillectomy? Like regular age? Four. Oh, really? Okay. Can I go backwards for a second to ask a question? Certainly. Did the removal of the hemorrhoids help with your issues?

Karen 17:18
While it was very painful, and I couldn't sit very well, I could stand but I couldn't sit very well. So yes.

Scott Benner 17:26
So So by the time you had gotten to the, to getting the, the procedure, you were not able to sit at that point.

Karen 17:36
Not very well, well, I kept shifting or you know, like, if I went to a movie, I was constantly moving. You know,

Scott Benner 17:45
was there bleeding with the hemorrhoids or just paying?

Karen 17:49
Very little bleeding? Okay, but he gave me some nitroglycerin ointment that worked. So that helped with the pain and the bleeding travels. zere.

Scott Benner 18:03
Interesting. Okay. So you weren't losing blood from the hemorrhoids? No. Okay. You were just in pain. And when you sat down, you were tilted one way or the other. Right? Yes. Okay. The endometriosis was being treated. I guess I'm making air quotes with a birth control pill was well, hopefully but it didn't really help. I was gonna say it didn't really help much. Right. Right. Okay.

Karen 18:35
So in February, I had a diagnostic laparoscopy which showed that I had endometriosis. For sure.

Scott Benner 18:47
Do they do something for that? Or? Well,

Karen 18:51
the next thing was a hysterectomy. In April

Scott Benner 18:58
How old were you then?

Karen 19:00
44 Okay. Oh no. 4535

Scott Benner 19:04
And you did you did this to me?

Karen 19:07
Yes. Yeah. Total complete. Self Pingle Oh for correcting me, et cetera.

Scott Benner 19:16
Wait, what did you just that's the

Karen 19:18
whole whole surgery name and got a whole you know, 20 letter. Description.

Scott Benner 19:27
I'm looking this one. I mean, you said oh, it was like you said nitroglycerin pills at one point. So I was like, what is happening here?

Karen 19:38
Was it it wasn't pills. It was anointment ointment. Excuse me. That's okay.

Scott Benner 19:43
I don't see the hysterectomy other name for it? Well, they

Karen 19:47
probably don't list it because it's my it's on my sheet.

Scott Benner 19:55
Wait, no hold on my diagnosis. Is it an offer? To me, overarching Yeah, so I won't be gone this far. Hold on a second Karen let's figure it out.

Karen 20:08
I think so Pingle refers to the fallopian tubes or something.

Scott Benner 20:13
It says the total hysterectomy is the surgeon removes your uterus and your cervix but not your ovaries. total hysterectomy is most common type hysterectomy with Oh, for ectomy, the surgery moves your uterus, one or both of your ovaries, and sometimes your fallopian tubes. Okay,

Karen 20:32
I don't have any of it. They just, it's gone anymore. It's all Yeah, it's all gone. And I had an appendectomy at the same time because my one ovary was bound into with scar tissue with the app, appendix. Holy

Scott Benner 20:49
crap. Karen, or do you have any brothers or sisters?

Karen 20:53
Yes. Brother,

Scott Benner 20:55
does he have any significant health issues?

Karen 20:57
Other than bipolar? No?

Scott Benner 21:00
Interesting. You sound like, it's so interesting. I don't want to say what I was gonna say. I'm waiting till we talk a little longer.

Karen 21:06
That's what I that's what I always tell my doctors I'm I'm always interested.

Scott Benner 21:13
That's for sure. So you're so your brother hasn't had his butt cut open or anything else like that? Okay,

Karen 21:18
no. All right.

Scott Benner 21:20
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Karen 24:44
My mom had hemorrhoid ectomy TWICE,

Scott Benner 24:47
TWICE. She loved it so much. She went back Yeah,

Karen 24:51
sir. In fact, my doctor at that time said this will be the worst pain you'll ever have. worse than childbirth or, you know, which I haven't had but

Scott Benner 25:06
take his word for his right. Yeah, five stars. Five stars. I love it will return. You tell me about the pain. How long did it last afterwards?

Karen 25:18
Well until you could really pass stool, it was bad. Because you're, I was afraid to push it off.

Scott Benner 25:27
I bet you know, days weeks,

Karen 25:31
probably at least a week

Scott Benner 25:33
and pain. Pain medication slows down your bowel motility. So I assume you don't want too much of that either. Right?

Karen 25:40
Right. But I still did.

Scott Benner 25:44
Heroin? No.

Karen 25:49
No. But he he had a step down. The surgeon was very good. I liked him a lot. He had a step down procedure. Like after a week or so I called and said, I'm running out of pain pills do How can I have some more? And they said, No, you can't have any more of those. But we have something else. Well, it all worked. As he stepped me down. It worked. So he obviously had it figured out

Scott Benner 26:16
and they didn't return. Is that right? No. Oh, good for you. That's excellent. Did you change your diet at all in in? Like, go with more fiber or like that kind of an idea?

Karen 26:28
Um, yes, but not just because of the hammer deck to me. Just just because I've always been fed tend tended towards him.

Scott Benner 26:38
I don't know what to say. I don't think I'm supposed to say that. But it's okay for you to like it's okay. I know what you're How tall are you?

Karen 26:49
I heat six.

Scott Benner 26:51
And how much do you weigh now?

Karen 26:52
Right now I weighed about 270.

Scott Benner 26:56
And through your whole life around that weight? No, no. How so? Where were you say in your 40s?

Karen 27:03
Um, well, depending on when but after I had the hysterectomy, I had lost way beforehand. But I was very, very thin because I bled all day, lost a lot of blood had to have blood products. And I was so thin. Yeah, people said I was anorexic. And when I was the ASEAN, I weighed 139 pounds because I tend to be very large bone. So, you know, I'm not saying large boned in the sense that some people say I'm saying I really am. I've never, ever had a boyfriend whose hands were bigger than my

Scott Benner 27:49
shoulders, things like that. You're saying? Yes. Okay, so when did you find out you had von Willebrand? I mean, you knew your mom had it. So

Karen 27:59
right. Well, after I bled all day with a hysterectomy, I was I had a hysterectomy. First thing in the morning. And then last thing at night. I went back in just before midnight to have a hematoma evacuation. In other words to take out the blood and clotting.

Scott Benner 28:21
Okay, that sounds terrible. I'm sorry, that just shocked me for some reason.

Karen 28:26
It was kind of serious. Yeah. Right. Yeah, that the doctor that I had had been my OBGYN residency supervisor, he does have some time in his office. And so they knew each. And this doctor also knew my mother. So he was familiar with von Willebrand and he was an ontology specialist. So he knew quite a bit about federal grants.

Scott Benner 29:00
And how do they help you with that? Or Can't they?

Karen 29:04
You can't give me too much after the fact. So he gave me a packed red blood cells. And I felt great.

Scott Benner 29:12
Really? Do you have a lot of them through your life? A lot of that what I would describe as like low iron feeling tired gaining weight, like from the from the iron?

Karen 29:24
Well, I do but not necessarily from that yet reason.

Scott Benner 29:29
Why do you think you do?

Karen 29:32
Um, I think from well, I have depression, bipolar. I'm fighting thyroid right now, which is why my weight is up, I think, because I can't seem to follow anything. And I'm, you know, I just think there's other things going on. Yeah. Go ahead. I'm sorry. Plus, the meds I take make you tighter,

Scott Benner 29:57
right. Thyroid you've learned about recently in your Life.

Karen 30:01
Yes, I just had an ultrasound on Tuesday.

Scott Benner 30:04
Are they calling it Hashimotos? or hypothyroidism?

Karen 30:07
I haven't. I haven't heard anything but I'm taking levothyroxine

Scott Benner 30:12
you're taking that? Said helping?

Karen 30:15
Yeah, somewhat but I'm on 50 micrograms. Okay, slowly. Yeah, slowly increasing, hopefully

Scott Benner 30:25
good. What what point did you realize you were depressed?

Karen 30:32
This would be after the, the. The history.

Scott Benner 30:40
Oh, I was gonna say the first time somebody dug into your butt because that would have depress the hell out of me. I would have been like, I mean, no,

Karen 30:47
that was like

Scott Benner 30:51
that's an indication of how bad the hemorrhoids were if they were like, so you're gonna put a speculum where and then cut? What sounds good. Hey, get in there, buddy. Okay, so after the hysterectomy. Had you had no indication of, of depression prior to that?

Karen 31:10
No, not really. Worrying. I was always super active did 1800 things? Yeah,

Scott Benner 31:17
yeah. Do you think it was a shift in your hormones that cause that? No, no. Was it the loss of the idea that you could have a baby? Did it depress you that way?

Karen 31:28
Well, that was a little bit depressing. But I already knew that. At age 44, you're kind of you know, thinking that yes, that anyway. And if you don't have a boyfriend or a husband or whatever, I don't think it's a wise thing to necessarily have a child. And

Scott Benner 31:46
did you want children?

Karen 31:49
Of course. As an elementary teacher,

Scott Benner 31:54
that might be enough kids. You know what I mean?

Karen 31:57
Yeah. I wouldn't have taken them home.

Scott Benner 32:02
Unless you never did illegally. That's nice. Oh, no, I wouldn't do the I didn't think you would kind of second. second ago. You just listed off a bunch more things. So I'm picking through them. So your your brother's bipolar. But you are? At what age did you realize you were

Karen 32:22
this would be at 44?

Scott Benner 32:24
Everything sort of happened at once? Hmm.

Karen 32:27
Yes. That's why I kind of interrupted you and went ahead and said, Wait a minute, but there's one more surgery

Scott Benner 32:34
that year, which was a gallbladder gallbladder took it out again.

Karen 32:40
Yes. Okay. And at that time, because of my reflux, they did something called a Nissen fundoplication. Where they wrap a part of the fundus, from the stomach around your esophagus to make like a false fails. Okay. It doesn't really work. But there is one plus I cannot lie.

Scott Benner 33:07
You can't finally, something happen on the positive side.

Karen 33:12
It sounds like a really weird. Plus, but you know, it's like, Oh, well.

Scott Benner 33:19
Aaron, I have to tell you, because your story is going to be part of the type two Story series. It's just going to be called type two stories and then Karen, but if it wasn't, I was gonna call it no fun. Does.

Karen 33:33
That would be good. Thank you. I wouldn't mind.

Scott Benner 33:37
It's so. Okay. I have sort of a big question for you. Yes. At some point in your life, do you just think, well, I got it. I gotta shift body. Like, like, I have way too many things wrong with me. And there's a lot of stuff here. Like, I mean, listen, it's easy to look in from the outside, right and see a person who's overweight and say, Oh, they don't try hard enough. Or they whatever. Exactly, yeah. But you have but I don't feel that way. No, I don't you have a good attitude? I don't imagine you do. But I'm just saying like you have so many things wrong with you like medically, that I'm starting to lose track of it where I'm writing it down. Because I had some notes I had to keep so I was like, Oh, this this is just the type to interview. I won't need my whiteboard. And now I'm writing in the gaps.

Karen 34:32
Thyroid I told you I told my doctors I'm always interested

Scott Benner 34:35
Well, no kidding. Gallbladder reflux, thyroid, endometriosis. Hemorrhoids that require surgery, bipolar, and depression and I missing anything.

Karen 34:50
Um, well, I also have some more autoimmune type things like I have localized psoriasis.

Scott Benner 35:00
Psoriasis I forgot one little brands. Okay, what else?

Karen 35:06
Um, I think that's about it because the thyroid we already covered. And when I went in to see the, the endocrinologist last month, because before that my PCP handled all of the diabetic problems or insulin prescriptions and that kind of thing. You know, I said to him, Am I really a type two? Because I listened to the Juicebox Podcast. And you're always asking him about this thing? And he said, Oh, yes, you definitely are. Well, I still question some of that.

Scott Benner 35:48
Karen, I have to tell you like as you're speaking, I kept thinking like, we sure she doesn't have type one diabetes. And not because not because we haven't even talked about your diabetes yet. But because right because the the bipolar and the thyroid and like, and the endometriosis and like it all feels like you're telling me is you just feels like you've come on as a type one and you're telling your story. Have they ever done testing?

Karen 36:14
No, not really. Um, I don't know why the cuz I've only seen him once. I don't know why the endocrinologist said that. Exactly. But I will ask him feature.

Scott Benner 36:27
I would I would love for you to get tested.

Karen 36:31
Yeah, I would do. I mean, if I say yeah, I want you to. Now bear in mind, I have been tested, I had so many blood tests. I had 16 tubes filled for four different doctors. Last time I went, got my blood drawn. So that was quite a bit.

Scott Benner 36:54
There was this one time, Arden was sent in for a diagnostic thing. And the the phlebotomist was like, oh, excuse me. And she left the room with this little tray and came back with more. There wasn't enough tubes in the room, Martin within. Arden looked at me and she's like, that that's a first and I said, Yeah. And she's like, Oh, and this lady just, I mean, we were having long form conversations. While this ball was coming out, it just felt like it wasn't going to stop. So. So you've never been tested for antibodies?

Karen 37:30
No, boy, that would not that I know of anyone.

Scott Benner 37:33
That would be I mean, that seems obvious to me. Because, well, go ahead.

Karen 37:38
Do you have any just seen the endocrinologist once though? You know, hasn't been on time to ask a question.

Scott Benner 37:48
Right. Okay. So let's do the rest of this. So, okay. Yeah. So you are eaten Metformin for five years in 2009? Somebody gives you insulin for the first time? Uh huh. How does that go?

Karen 38:03
Um, well, it was the day of a wedding of a friend and I missed the reception because my blood sugar was low. I hadn't expected it. I was taking Lantis and didn't really understand what I was doing, you know, so I thought, well, I better do that before I go to the reception and eat food and so on, but didn't really have a lot of instruction.

Scott Benner 38:29
So they just gave you Lantus and you would shoot it once a day. Yes, and nothing else at the time. No. Okay. Not then. And so without good direction you ended up low. And do you go back

Karen 38:44
super super low now that I know what that is, but at the time low?

Scott Benner 38:48
Why imagine for the first time any low feels scary as hell? Right? You know,

Karen 38:53
so I was afraid to drive 15 minutes to go to the reception, etc.

Scott Benner 38:59
Given me character driven memory, but

Karen 39:04
yes, I did. Okay. But I didn't know about Lowe's. Okay. So and the, the whole reception was full of EMTs I probably would have been okay and nurses

Scott Benner 39:17
out there. But, but tell me about that a little bit. So they give you this Lantis but they don't explain anything to you. You're just it's handed to you like a pill that you shoot with a needle. Is that right? Correct. Just take this now we're gonna do this.

Karen 39:32
Take this much. Do this. Yeah.

Scott Benner 39:35
No training, understanding what it's going to do what might happen or not happen what you're looking for with your meter. Nothing like that's described. Right? Okay. How long do you go on just doing Lantis?

Karen 39:49
Oh, I'm probably a year,

Scott Benner 39:53
a year. And then do they move you to a mealtime insulin as well?

Karen 39:57
Yes. Which I got moved to Novolog for fast acting and Novolog myth 7030 For long term.

Scott Benner 40:08
Okay, so just the Lantis was not doing anything for you. Right? Not doing enough, right? So now you're going to shoot it meals? What's the description from them about how to do that? What is your understanding of what you're about to start doing?

Karen 40:24
Um, well, I just followed directions, you know, the, how much I was supposed to take. And what times and then before meals, I had the sliding scale thing. So, you know, did the finger sticks. And, you know, of course, my problem with that is when you do finger sticks before your meal, you don't necessarily know how much you're taking, you know, as for carbs during the meal, and you don't know if afterward, you've really accomplished that, because they don't tell you to take your blood afterwards.

Scott Benner 41:05
So they would tell you to test at your mealtime and probably use some sort of a ratio they gave you that involve your your current blood sugar. And then you were supposed to say how much? How much how many carbs you were gonna eat? And then shoot?

Karen 41:21
No, nobody said that. How many carbs? I was going to eat just these just shoot

Scott Benner 41:24
this amount, and then don't look again after that. Right. Gotcha. What part of the country you live in? Michigan? Okay. It doesn't matter anymore. I get I give up. I don't trust anybody. It doesn't matter.

Karen 41:42
I will tell you this, that it is true that most type twos don't have a clue.

Scott Benner 41:49
Yeah, we're doing this.

Karen 41:52
You know, it's it's much easier to find things on Juicebox Podcast or on the Facebook group than it is for any type to group. Yeah. I've tried to find out.

Scott Benner 42:08
Current Tell me about that. So you're saying that you joined type two groups. But they weren't helpful? Not really, is it? Because it's full of people who are all lost and don't know what's happening?

Karen 42:21
Currently? Yes.

Scott Benner 42:23
Well, that's a shame.

Karen 42:25
Currently, yes.

Scott Benner 42:26
And I mean, you're not getting any. Listen, nobody told you what the Metformin was going to do what what their goal was, nobody's telling you what the insulins goal is, it's just do this. Thanks. Do you think? Can you step out of this as your as it step out of it for a second? Don't think, okay, as your story for a second, just look back at kind of look back at it? What, why? Why would someone not explain it to you? Do you come off? I'm being really like, serious now. Like, do you come off as somebody who just wouldn't understand? So it's not worth my time?

Karen 43:00
Now, I think I come off as somebody who already knows,

Scott Benner 43:03
okay, and so do you think that they think, Oh, I don't need to explain to Karen she understands it? Like, is your confidence? Maybe stopping them? Or do you think that this is just what happens?

Karen 43:16
I'm both. Okay. Partially both. Because I do know a lot about the physical body. If you're a physical education teacher who's not just moved into a position, you've had to take anatomy and physiology, you've had to take kinesiology, you've had, I have three physiology classes in college, you know, undergrad, that's not even the graduate. So, you know, I do understand a lot. So I think it does seem like that. That's a possibility. And also, in my family, I happened to have physicians, and about eight nurses. You know,

Scott Benner 44:03
I always feel like they're not they know something that they're not telling you. But But you're making me wonder if they don't know. And they're just like, Oh, good. She knows.

Karen 44:12
Yeah. Or she'll find out

Scott Benner 44:15
oh, yeah, but such an odd thing, isn't it? Like, especially with insulin, which can make you so low, dangerously low? If you lose it rock, use it wrong? And the idea is they'll figure it out is, uh huh. I don't know, the whole thing is just free

Karen 44:31
and my agencies were horrible.

Scott Benner 44:35
So it wasn't helpful. What were your agencies? 19 Oh, my God.

Karen 44:40
Well, yes. Then I brought it down each time. 19 then 12.

Scott Benner 44:48
Karen, let me ask you a question. I only ask you real serious question here. I don't know and I haven't been doing the types of stories conversations long enough. I don't have a real like slick way of saying this yet. Was So I'm just gonna say, are you eating your way to a 99? One C? Or is your body like just so incapable of handling it that any food drought drives? You highlight that? Probably both. Okay.

Karen 45:12
So is that what you eat? You know, but at the same time, then I happen to run in after a few years, went into a program nearby. There's a couple, they call themselves chick pea and bean and they have a foundation, that's 501, C three, and did meetings and so on. And they had a thing for diabetics for how to become vegan. And the reason that I did this is because the husband Mark reversed his type two,

Scott Benner 45:53
by being vegan. So you thought maybe that would be helpful.

Karen 45:57
Right? And, you know, I'm not looking for perfection. I mean, I don't exactly think that, I'm going to totally reverse it. But if it does a better job, you know,

Scott Benner 46:09
you could lose then and your agency would go down, and you'd feel better overall, you're not trying to be a Tiktok star or anything like that. You just want to write Yeah, you feel better. Did that not work for you?

Karen 46:21
It works great, but I couldn't keep falling it.

Scott Benner 46:25
Tell me why. So first of all, what endemic? So what does it work? Great mean? You were losing weight?

Karen 46:33
Oh, yeah. How much? I I lost at least 50 pounds. Oh, my God, I had to have another sleep study for my apnea. Because you know, it was over treating at that point. So yeah.

Scott Benner 46:51
You lost 50 pounds, just eating vegetable based, right meals. And then what what about the pandemic stopped you from doing that?

Karen 47:02
Well, my mom lives in a very small town. She's now 91, close to 92. If you're living alone, during the pandemic, that's no fun. So I moved back home with her, partly to you know, have somebody to be with but also to help take care of her a little bit. And my small hometown doesn't have a lot of possibilities, you know, and I was lacking in energy. I think the thyroid was getting me back then. Three, four years ago, and couldn't really do a whole bunch of things that I would like to write. So there you are, you know, Karen,

Scott Benner 47:51
she is it fair to say that you grew up? I don't know. I should be asking. Did you grow up in like an economically depressed situation? Like, did people not know about food? When they were raising you that kind of stuff? No, no. So so they didn't know about food? But you had money? I'm sorry, I shouldn't have mixed those questions.

Karen 48:15
No, that's okay. Um, when I was a kid, we didn't always have money, but we always knew what we're doing. But things have changed since I was good. I was born in 53. You know, used to be a good dinner to have fried chicken. How long it's been since I've had fried chicken, you know, I mean, we use polyunsaturated oils now is supposed to be good. Like, you know, you want to do that, you know, so,

Scott Benner 48:46
so just in general, people's understanding of nutrition was lacking. And so this is really interesting. Hold on a second. I said, cough. Sorry. We've been sick here for months. Now. I don't even know how I'm getting this podcast at this point. But I am not gonna cut that out. I swear to you, I had to start doing situps the other day because I think my wife's on her way out and I might have to date. So he's been sick for so long. It's just It's that good. She got the COVID that translated into bronchitis that seems to have gone into a third thing. She's been sick for like two months almost. And really beaten the hell out of her so but every day I know you've said that before. I mean, nothing like this has ever happened before. So we're it's kind of got the house on a is she 44 Karen, you're hilarious. Yeah, make me cough. I think I spilled something on my chest. So you grew up in this place where it In time, not not a place but a time when like you said fried chicken was good. You were loves that nice, hot, healthy, tasty meal and with throw some potatoes with it and their sin, and everything sort of goes in that direction. So were you heavy as a child?

Karen 50:18
Um, I thought I was, but I wasn't really okay. Um, again, I'm, I have a big frame. And I always seen my friends would be, you know, like little, you know, five, five foot people who were tiny anymore a size six, you

Scott Benner 50:37
know? Yeah, you're saying if you were born in 19, let's go further. If you were born in like, 2000, you would have just been on the girls rugby team in college or something like that would have like, kind of that kind of a built right. Alright, okay. So. But my point is, is that you're out of a generation that just doesn't know what food is supposed to be. And listen, we're all guessing right now that we're right now that we're correct right now, but 330 years from now, my kids might be on whatever our podcast is. 30 years now go and listen. We were eating like this. And we thought it was good. You know? Yeah. So I take the point that we kind of went from the Depression era, where those people, they didn't have anything. And then things got better and the 50s happen and Leave It to Beaver. And now we're all gonna live in houses and smile and everything and, and one person's working in one person's not there's plenty of food moms at home cooking, and making these big meals. And that's the that mom grew up as a child, probably not even eating every day. So that changes the psychology of around food there. And I mean, you already know like food pyramid, which I think is basically been debunked. Yeah. And like you said, like, they were coming up with these. Well, there's that whole thing right where I don't want to dig into it, because I don't know enough about it to talk about it. thoughtfully. But I think the the sugar lobby put out this report to make oils look bad or oils to shoot, I don't know it was one of the other and

Karen 52:18
when and then the, you know, like pork, the other white meat, they hired surgeons to cut the fat out of those meats that they tested.

Scott Benner 52:30
Right like things things like that were going on. There was a marketplace. tomfoolery going on for like sugar was like, Hey, listen, it's fats fault. That was like it sugars fault. And like, you know, and, and then one, one idea takes hold, almost like the like almost like, you know, VHS and Betamax. There's this argument in public and one of them wins. And then we go in this direction. And so we acted like sugar wasn't a problem, even though sugar stored as fat. So, you know, if you ever had gone to like a water ice place, or like an Italian ice place, and there's a sign up that says no fat, like this, like you're eating, it's sugar. And as soon as your body gets it, it's like lost or this as fat. If you didn't intake any fat, but your body turned it into fat. And right. And so now they're coming up with the idea of like, well don't eat red meat, because it'll give you a heart attack or this and we're going to come up with other oils, canola, vegetable, like all these other words, these are going to be healthy oil, which is I've said on here before, if you've ever deep fried something, fill them fill the pan out, deep fry it, and then look and see how much less oil is left in the pan when you're done. That oil is in the food. Right? But if I scooped out a cup of that oil and said Here drink this, you'd go no, no, I would. I would never do that.

Karen 53:57
I've just been watching Life in Alaska in the Arctic Circle, I think it was called. And they're, they're eating fat because they need it to stay warm and to be healthy. Right? Wow.

Scott Benner 54:13
My greater like rambling point is, is that you could just be a mix of wrong place wrong time. crappy, crappy genetics.

Karen 54:26
Now, let's also add in the point that I've done four times, fasting weight loss programs under medical supervision through our hospital and lost weight each time but can't keep it off.

Scott Benner 54:40
How much did you lose doing the fasting?

Karen 54:44
Oh, 75 pounds the first time 100 pounds later, you know?

Scott Benner 54:50
What was the most recent time you did that? How old were you?

Karen 54:53
Um, it was I'm trying to think probably 20 Some years ago, while maybe more like before the hysterectomy, maybe, because I had done that right before and I was doing it during the time that my doctor told me that when I had the hyponatremia from gallbladder surgery, I couldn't keep doing that, because I had gone back down to my lowest weight. I see. You can't, you can't see me diet anymore. You need to get more calories more, you know? Well, you don't tell a fan. Sorry, you can't do it anymore. Do

Scott Benner 55:39
you think you have a psychological attachment to food?

Karen 55:45
I think I have some, but I don't know anybody who does that.

Scott Benner 55:50
Right? Do you just think you over eat more than than the average Overeater. Now I really know it. But that's interesting. I'll tell you something, Karen. I have I don't know if I've ever said along here. But I am the fattest person who doesn't eat that you'll ever meet in your entire life. Like I don't, I'm not a big food person. i There's, there's times in my life where I thought maybe I'm just not eating enough. Like maybe my body thinks we're starving. And it's like holding on to fat.

Karen 56:17
But yeah. Especially when some of these thin people say, Oh, I wish I could gain some weight. If I eat more, I lose. Well,

Scott Benner 56:31
you're way though, like the funny part of that statement? That doesn't make a good point. Like some people's metabolisms just run differently. I think that's pretty obvious. And at the same time, underlying other underlying medical issues could be keeping weight on you like your thyroid or stuff you might not even know about, right? You know, I get through this illness. I think I said this recently, but I had to take a steroid pack to get rid of my bronchitis, they gave me an antibiotic, right? And, and for the 10 days, I'm on the steroid, I'm like, This is amazing. Like, like, the first thing that happens is my like, the, the liquid in my body like regulates, like IP, like crazy for like 20 hours. And if you Google, it'll tell you like steroids raises your blood sugar and some people urinate that that is not what's happening to me. Like, like, my back stops hurting. You know, I, I lose five pounds of water weight, my back stops hurting, I feel terrific. Etc, etc. As soon as the theory is gone, you know, the the water weight comes, I've retained water my entire life, like I'm pregnant. I mean, there's just no other way to put it. Like I my body retains water. And I mean, in a world where we can't get a doctor to explain what Lantis is going to do to you. I don't have a lot of like, serious Yeah, yeah. Like, like people like you should go to a doctor like for what? So they can go try sit up through this, like, you know, nobody knows. Like, great. You have

Karen 58:08
to find the right doctors. I'll tell you I'm I'm very encouraged right now. Because back years ago, I went with a friend that I met online, had COPD, and was trying to quit smoking. So she went to a quit smoking clinic at Mayo Clinic. And I learned a lot about Mayo Clinic then. And my new hematologist is from Mayo Clinic. And he called me firstly, I saw him and then went down and he had bloodwork done. I'm at home and he called me said your blood glucose was 67. And I wanted to make sure you were okay. He called me not a

Scott Benner 58:56
nurse, right. Somebody helped and cared and was concerned and understood what to be concerned about. Well, how did you

Karen 59:04
different from from Mayo Clinic, that's kind of how they work. And it's like, wow, and he's called me again to discuss what my bloodwork is because you look at just my blood work. I don't have von Willebrand disease. It's interesting, but there's another component to the diagnosis, which is experience. Actually, that got the experience

Scott Benner 59:31
and everything else so so tell me something you you get this you get this incident 2009 That's still a long time ago I didn't start the podcast till 2015 So what was your What was your experience between then and when you found the podcast?

Karen 59:49
Ah, bleeding for mean for the fan will advance

Scott Benner 59:53
no need for the diabetes now like for type talk? What was your What was your life like? 2009 until one Whenever you think of it as getting this

Karen 1:00:01
kind of random, you know, I was trying, but I didn't seem to be doing anything effective. I had the high a onesies and you know, didn't know what to do and I kept bringing it down, but at the same time, the lowest I ever got it was nine on my own. Then I started listening to while my doctor said, you should get a CGM. Okay, so he wanted me to get libre to. And I called the talk to the DME who I cannot say enough goodness, about this DME, but they said, Well, I said, I'm worried that if I wear it on my arm or leg or something like that, I'll knock it off. And they say, Well, if you want to wear it on your abdomen, you have to get the Dexcom. So I got the Dexcom. You know, and the G six is wonderful and that I brought my eight onesies down to it first it was 6.6, then six point you now below six. And I've gotten to the kidney specialist and the endocrinologist and they've all said, Keep doing what you're doing. You're like, Okay, I'm doing better. But what am I doing?

Scott Benner 1:01:30
Is is the addition of the CGM just allowing you to see I mean, it's pretty, it's pretty obvious, right? It just allows you to see where your blood sugar is, how you can more effectively move it and what and what food is doing to you.

Karen 1:01:45
Exactly, that's it. And it allows me to adjust a little bit like if I find I'm going high, for example, if I'm sick, or if I've had a vaccination, my blood sugar might be higher. So then I increase a little bit on my fast acting. Yeah.

Scott Benner 1:02:06
It taught you you can see basically, you can see inside of your body now and it teaches you how to it teaches you how to use insulin, right? I mean, it's funny because I think people might expect some bigger epiphany. But that's it. Really, if you can see, I didn't know you're using a CGM. But if you can see your blood, you can use insulin correctly. And that stops spikes and lows. Have you lost weight on a CGM?

Karen 1:02:36
No, no. I've gained you've gained weight, believe it or not? Well, and I think that goes to the thyroid. Oh, okay.

Scott Benner 1:02:44
Yeah, you do have a lot of different components. So your goal right now is to get your thyroid medication dialed in. Right, if that doesn't start to help you, what about going back to the vegan stuff? Karen, how come we don't do that?

Karen 1:03:00
I'm going to do that. I went to an online class, but chickpea and Bing did, and they're very supportive. They live near me. So we haven't been able to do anything that online for the last few years. But I'm hoping that we'll be able to go in person, I'm better in person. If I see people in person, I'm better off to get knowledge or to better, you know, yeah. catch on to things.

Scott Benner 1:03:34
Are you still ahead? I'm sorry. Good.

Karen 1:03:36
I'm sorry. I had to take a class once. Couldn't get it any other way. And I had to do it through by mail. You know, the correspondence courses? Yeah. It was the worst class.

Scott Benner 1:03:49
Are you are you able to exercise at all?

Karen 1:03:53
Yeah, somewhat. Okay.

Scott Benner 1:03:55
So, do you live with your mother still?

Karen 1:03:59
Somewhat? About 50% of the time maybe.

Scott Benner 1:04:03
Okay. And that's the whole power. Yes, yeah. Okay, is there anything it's hard?

Karen 1:04:11
Hard to do my own thing though. She's very resistant to it. And she grew up on a farm with up you know, during the Depression, they always did have enough food because he lived on a farm. And you know, it was a dairy farm so if you're talking beef or dairy boy, my mom's really into that. Yeah.

Scott Benner 1:04:38
Not so much into tofu or something like that. No, no, that at all. And, and you don't have any trouble. When you're vegan, you're, it's easy. It's easy for you when you're doing it or do you struggle to

Karen 1:04:52
know it's easier? It is much easier. I can eat as much as I want. First of all, Secondly, I'm full from eating more fiber and so on, I think more so than I was when I was in the fasting programs and then adjusting to eating again. And I had dieticians, counseling me, and, you know, all meetings and everything to support but you know,

Scott Benner 1:05:27
in the end, it's, it's calories in, that's what it is, right? It's, it's you have to write even amount of calories for you right now you're trying to lose weight. So you have to be at a deficit so that you lose weight. And then once you get to the weight you need to be you need to be at a don't go back into a surplus so that you can maintain the weight,

Karen 1:05:45
right? But being vegan, you can pretty much eat whatever you want. And you're not going to kind of go over that you don't reach this is the easiest thing I've ever done. Wow. And let me tell you, I, I fought so hard with the fast food programs. One time I went to a store, and I was trying to find something like most women will experience this if they had a period, you know, that you just get where you want to talk about eating kitchen, you just want to eat anything, you know, and you're looking for something that will satisfy you. And it's pretty hard to find it. I did the grocery store. And these are following me. Because I think they thought I was trying to steal things. And I was reading the nutritional labels to find something that was going to satisfy me, but would not be too much of a calorie load. Yeah. No,

Scott Benner 1:06:53
no. Oh, my gosh. So you are managing your diabetes right now just like a type one does. You're on a basil and pretty much are you planning to use the pump?

Karen 1:07:03
No, no, no, I would like to be in a way. Okay, I think

Scott Benner 1:07:09
you're shooting a Basal insulin and covering your meals with fast acting. Correct. Okay. And you learned that on the podcast? Yes. I'm happy for you that this is going well.

Karen 1:07:22
I mean, I still, I still do what my doctors have said, but I've added a little bit from the podcast to help you. And from the the Facebook page.

Scott Benner 1:07:33
Oh, and the Facebook page is helpful for you even though you have type two because you're using

Karen 1:07:37
it right. And because I was on a Dexcom page and Facebook, someone said go to choose backs. It's for type ones. But you'll learn things that will apply. Yeah. So that's how I got to the page and then to the Juicebox Podcast.

Scott Benner 1:07:56
I'm glad. Well, that's excellent. I'm happy that it's helping you. Thank you. Oh, no, please. It's my pleasure. All right. Karen, hold on a second. Yes, there was way more to remember about you than I thought there was gonna be I keep waiting for, by the way, not one of these has gone the way I expected so far. Which is good. Because I thought well, let me do stories about people with type two. You know, see if we can't get more people with type two to step up. I do think there is there is some theme, which is no, no really different than any other illness for some reason, which is Nobody tells me what what's happening. I just you have this take this pill you have this inject this, like that kind of stuff. Nobody really explains and I'm beginning to believe that they don't know. You know, so

Karen 1:08:47
I don't know. But with the bleeding disorders, the Hemophilia Foundation, which I don't know if final brands is really a haemophilia or not, but it's covered by them, ego to support meetings, and they have sessions where they teach you about various things. They have camp for the kids that it's all run by the Hemophilia Foundation in which I don't feel like the diabetic kids are getting seems like there's, there's more individual or something that people are going to different states or you know, I didn't really understand that. So that might be my problem. But to me, that's much more supportive. And I learned much more about being a fleet disordered individual than I have about having diabetes. And there's more people with diabetes, even tied to walk pin.

Scott Benner 1:09:50
Karen, I believe I, I'm starting to believe, like I have like short term goals for the podcast, long term goals for the podcast and you know, The size of the podcast I keep, I think about like, well, the podcast helps people because I make it, it keeps it out in the world, new people find it, they can mine it for information. But if I just stopped making the podcast, it will wither away and die. Like that's how people's minds work. Like you don't I mean, like, people complain that all the new movies suck. But no, but nobody goes back and watches, you know, bullet or something like, you know, they, the old stuff is old. And so to keep helping people, you have to continue to make the thing. And I keep thinking like, how is this going to like long term? Like, how do I get it to a point where it can long term help people? Because this is not, this isn't crazy, right? Like, some doctors don't have a good job of explaining your diabetes to you. We hear those stories from people and don't, and those people's lives are worse for it. And how are we going to get to a point where that's not the case? Like what's the answer? And there are times that I think that in the current model, that answer doesn't really exist. Like there's no like thing, like, there's no magic thing that people aren't doing that if they just did it, everybody who had diabetes would be doing better. I think I think maybe what the podcast is teaching me is that this is it's sort of a virtual meeting. Right? Like they might you can go to on your own schedule, fight. And I I'm almost thinking there are days when I think that's what it is. It's almost like it's almost like AAA, on some level, and, and with management talk mixed into it. And I don't know that there's a better way right now like that, with the technology that exists for reaching people. I don't know if I don't know that there's a better way than this, this idea. So hopefully, someone comes up with it. But I don't think it's not a brochure. It's not a video you watch online one time. It's not a you know, it's not a checklist, like these things have all been tried. They don't help. So, anyway, I found it.

Karen 1:12:15
I do think that the Hemophilia Foundation has found a way to do that. I don't know if it's because it's a smaller population, if it's because they've started getting drug companies involved, which he didn't used to when I first started going to their things. You know, that money is helping, but at the same time, you know, gee, where's the support? How come nobody knows anything? Um, it's also loosey goosey.

Scott Benner 1:12:46
I don't think they know how to deliver it. And I think that this is, I think, I think that I found the most successful way so far, to help people understand diabetes. It's this, and it's not just make a podcast, because trust me, after I made one, a lot of other people tried, and it's no disrespect any of them. I think it's wonderful, but I can see who listens to podcasts. And those other podcasts are not listened to on any great. Like, with any great amount of, I don't know, a big, it's not a big level. And so, so there's something about the information, the format, me, the people who come on, like, you know, all that mixed together is just working, and there's no way to take credit for it, but generally means like, it's like a it's like a TV show that's on for 15 seasons. It's not it's not like they sat down on day one, and they're like, let's make a let's make mash. You know what I mean? Here's what it's gonna be, it's gonna last forever, people are gonna love it, blah, blah, blah, it's gonna, you know, you don't plan something like that. I just got lucky. Like, whatever this is, however, it occurs to me to do it. It just seems to work. And

Karen 1:14:01
yeah, but you're Alan Alda. You have a perception of people, and what they think and feel that is unusual. And I think yeah, it pays off.

Scott Benner 1:14:14
You know, it's funny that somebody said to me, I don't want to say who I talked to when I said this, but I told them I said, I think part of my job is kind of counterintuitive to how people think like people go out into these spaces, they like well, the people will tell you what they need. And you know, we'll just we'll we'll give them what they want. And to some degree, I give you what I think you need. I don't stop to think about I mean, I'm not I'm not I'm not unfeeling about people's feelings or anything like that. Like I'm not harsh, but we don't like if we didn't you and I, for example, didn't spend 20 minutes talking around the fact that you weigh what you weigh. You don't like we didn't nice it up and we didn't You've called yourself fat and we just started talking, that's an honest conversation. And is it gonna hurt someone's feelings? Like, I hope not, but maybe it will. But what I can tell you for sure is that if you went on, you know, a podcast run by like some big diabetes organization and started calling yourself fat, they'd never put that online that nobody would this would get cut up or you know, diced up. This is a real conversation, you're 69 year old lady who's got a ton of health issues. And I don't have type two diabetes, although I really want you to go get an antibody test. And, and, and this is this is your life, like you just laid it out for us? Nobody does. everybody's worried about it's going to hurt someone's feelings or it's going to be perceived incorrectly. I don't care about that. Like, I want to figure out why people with type two diabetes. Don't get help. Yeah. Why don't they? And my big question around it is why don't they understand what they have? How come every person I talked to with type two? Doesn't know what what's happening to them.

Karen 1:16:05
That's what I want. Why I wanted to talk to you. I mean, when you invited me it was just not a good time at that point. And then I had to have knee surgery and then my reading became up.

Scott Benner 1:16:19
Can we put effort into getting you on this podcast? We really did and I'm glad that we did. I'm glad we did it. Seriously.

Karen 1:16:26
Thank you so much. And I really appreciate you being flexible because once I bollocks stuff don't trying to put it on my calendar.

Scott Benner 1:16:36
Don't even think twice about this is well worth it. By the way. I have to go because I have to record with Jenny and a little bit. Okay, but John Philip Sousa wrote Stars and Stripes Forever. Yes. He's, uh, he was uh, he wrote a lot of like, what I guess we'd call like patriotic music back then. Which is Stars and Stripes. Hold on one second. All right. Is the stars destroyed forever public domain. Old enough to be in the public domain. So all you need to perform a song isn't okay. It is. Oh, that means I can play a little bit of it at the end. All right. I'm gonna go I appreciate you doing this. So much. Hold on for one second for me. I want to talk to you just before you go. Okay. Okay, thank you so much. Thank you

first, a huge thanks to Karen for coming on the show and sharing so honestly, and of course dexcom.com forward slash juice box head over and get yourself the Dexcom G six or Dexcom G seven continuous glucose monitoring systems. Don't forget the contour next gen is that contour next one.com forward slash juice box. super accurate, easy to use. And lovely to hold in your hand. Contour next one.com forward slash juice box dexcom.com forward slash juice box. Fill out the survey AT T one D exchange.org. Forward slash juice box. Want to save 35% on your entire order@cozier.com you can with the offer code juice box 10% off your first month of therapy@betterhelp.com forward slash juice box. And of course, get a free I didn't even mention this the beginning. Get a free five travel packs a free year of vitamin D with your first order of athletic greens from athletic greens.com forward slash juice box. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast but just let me say this before I go. If you have type two diabetes, and you're looking for a place to talk to other people with diabetes, check out the private Facebook group Juicebox Podcast type one diabetes, but don't let that name throw you. It's for everybody who has diabetes Juicebox Podcast type one diabetes is a private Facebook group with over 40,000 members. Actually here at the end, I'd like to throw in a plug for the type two Pro Tip series that I did with Jenny Smith. You can find it in the featured tab. On the private Facebook group. There's a list of them. You can also find them at juicebox podcast.com or search your podcast player for juicebox type two pro tip