Scott Benner 5/20/23 Scott Benner 5/20/23

#915 Best of Juicebox: Diabetes Pro Tip: Pre Bolus

Originally posted on Mar 25, 2019.

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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 915 of the Juicebox Podcast.

Today, we're gonna be revisiting episode 217 From March 25 2019. This is the Pre-Bolus episode of the diabetes Pro Tip series. Today, Jenny Smith and I talked about Pre-Bolus thing. I mean not today, but I don't know, like four years ago, but for years has not made this one any less of a fan favorite. 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 head to cozy earth.com You will save 35% off your entire order with the offer code juice box at checkout one word juice box at checkout at cozy earth.com to get 35% off everything they have joggers, sheets, towels, pajamas, I mean they've got so much great stuff, check them out cozy earth.com Use juicebox at checkout to save 35%.

The 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 therapists who can help you with a wide range of issues better help.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. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price 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. In the episode about insulin, I told you that, that my nurse practitioner CDE told us that fear of insulin was the biggest sticking point for people making good decisions with their diabetes, right. And after I got past my fear of insulin, the next hurdle I had to get past was Pre-Bolus. And I am now years and years later at a time where I will tell you that if you do not Pre-Bolus a meal, the likelihood of success is near zero. And if you have success without Pre-Bolus saying.

All that means is that you gave yourself too much insulin prior to that. And it's just catching up now. And so this is it. We're going to talk about Pre-Bolus And then we're going to talk about how about insulin action, right the action of the insulin and how to balance it against the impact of the carbs or your body function. So tell me, let's go over the part that people aren't gonna find comforting at first, right which is the amount of time it takes insulin to begin working in a person varies person to person and insulin to insulin. Is that pretty fair to say?

Jennifer Smith, CDE 4:07
It's pretty fair to say yes. And insulin to insulin. I would definitely say most of the the rapids on the market should be fairly similar. The rapid acting influence on the market and their time of action should be fairly similar now. Person to person. Yes, that may vary

Scott Benner 4:30
situation to situation as well

Jennifer Smith, CDE 4:32
as situation it may vary. But again, that's the learning part of it. Okay,

Scott Benner 4:37
so person, the person could end up meaning just your body chemistry could mean where your infusion set is right, you know, or your injection site. Absolutely. Say you're a person who gets stuck on I always injected my belly in the same place that spot might not be as reactive to the insulin as if you would just try a new spot. If you went to a new spot it might work quicker than it has been in your old spot. Right? If you're wearing infusion set it could we alluded to it before you could get better action from your insulin on day one than you do on day three or better on day two, then you know, two hours after you've put it on, there's a lot of different variables. But we're speaking generally here to you'll apply them to your variables later. Now, if you've heard this podcast before, you'll know that I have alluded to how insulin works in a number of different ways. So I'm gonna give my kind of cartoony description of it, and then we're gonna let Jenny talk about it for real.

Jennifer Smith, CDE 5:32
Her acuity might be better, as we'll see.

Scott Benner 5:34
So here's how I pictured in my head a couple of different ways. The first way is I think of a tug of war. And I imagine a rope with a with a flag hanging in the middle of it. And on one side of this tug of war rope is insulin. And on the other side is your carbs and your body function. It could be adrenaline, it could be fear, could be anxiety, whatever it helps to drive your blood sugar up. That stuff's on one side of the rope. The insolence on the other side, unlike a tug of war in a schoolyard, our goal is not for one side to win, our goal is for them both to pull and pull and pull until they get exhausted, and they both go, I can't do this anymore, and they dropped the rope and our flags still in the center. That flag represents the blood sugar. You start at when the impact of the carbs begins in my mind. So I'll explain a little more. If you let them both start pulling at the same time, the carbs are generally speaking, going to gain power and momentum before the insulin begins to work. So now your rope is going towards a high blood sugar and you're you're starting to head up. Now suddenly, you're 50 points higher. And what if you started with 150 blood sugar, now you're 200. And now these carbs have momentum. They have speed, they're pulling your blood sugar up. Now all the sudden, 1520 30 minutes later, the insulin is like, oh, no, no, wait, I have a job to do. I remember and it kind of comes online. But now it's pulling, it can overpower the the momentum that the carbs have created. Plus, you now have another 100 points of blood sugar to contend with. And all you have is the insulin that you counted your carbs for. So even if you counted your carbs perfectly, and realize that this meal is five units, once the momentum of the carbs is rocketing your blood sugar up, once you have a number that is higher than you started with those five units are not even going to begin to cover what's happening, let alone the food that you've put in. But if you put the insulin in first, and let the insulin come online slowly and begin to pull down and create the momentum in the other way, then you flip the script. And now the carbs are fighting. So instead of having a fight at 180, blood sugar, you're having a fight at an 80 blood sugar. And instead of your blood sugar falling at 80 It's being the attempt is that it's now trying to be pulled up by the carbs. And that's how when you see people with a stable graph, that's how they're doing it. And so for me, in a perfect situation for me, my daughter's blood sugar is diagonal down when I give her most foods. There's differences you know, food to food, situation to situation, but in a perfect world. To me, that's it, you want your insulin working, your blood sugar trending down, creating some momentum down, when you allow the carbs to begin to pull up. Right now, you'd explain that in a technical way that sounds

Jennifer Smith, CDE 8:37
and most in most settings, yes, that's 100% I mean, insulin, our rapid I've always thought that rapid is such a misnomer. Honestly, rapid indicates like now rapid is like sweating out, click, click, click lights with design, it's working. And it's, you know, still education is take your insulin and start to eat. I mean, even from most endo offices, it's take your insulin and start to eat, it's going to be working very, very quickly. That's not the case. And anybody who has been taking insulin long enough, and you've seen the spikes, and you've seen the issues, despite counting your carbs as precisely and weighing them and everything and you're still seeing these issues. It's the mismatch of insulin timing, it is so rapid take anywhere between about 15 to 30 minutes to really get that active peak, not peak, but that active phase where then when you start putting your carbs in. They will match as you said that carb digestion will start to match with the insulin you'll get a nice gentle curve up and it should then start to curve back down. And there is a lot of there's a lot of education that also focuses On, as you mentioned, watching for that curve down, watching for the curve down to start so that you know the insulin is already moving things.

Scott Benner 10:12
Yeah. And to give you some context that a person I spoke about in a previous episode, who was having trouble, told me, but what am I gonna do, I'm gonna be scared. I said, well try it a little bit this time and then a little more next time and a little more next time and go for it. And, and so I always tell this story somewhere. And I think here's the right place to tell it. Prior to glucose sensing technology being a thing that anyone knew about prior to Dexcom, I was again in the office and the CD says to me, Hey, you're gonna get one of those Dexcom things. And I thought, I don't know what that is, you know, and she starts telling me it's, it's, it's a continuous glucose monitor. And I'm like, Yeah, I again, don't know. And then she tells me this simple story. There's a 17 year old boy in her practice, who loves candy, certain kinds of candy, and he can't figure out how to Bolus it. So he gets a Dexcom, whatever the first one was, I don't even remember anymore. His whole goal was to eat this candy without a spike. So he goes out to the store. And he buys like little grab bags of these candies, and a number of them enough for a week and every day starts on this experiment first day, just like you said, eats, gives himself as his insulin, just like he had been told his whole life, blood sugar goes up to 20, something like that sits there forever. Eventually, he has to give himself more insulin to bring it back down again. Next day, he tries a little sooner, give himself a few minutes, 510 minutes gets a little less of a rise. So the next day, he goes even sooner. And then before you know it, it's a little sooner, a little more, and he starts adjusting it back and forth a little more a little sooner, a little later, until one day, he eats the candy. And his blood sugar never moves. And she tells me that story. And I thought immediately Wow, that means it's possible. Yeah, that was the first time I thought I was like, if that kid can do it with candy. I can do it with anything. Like anything, right? And so yes, give me that CGM place. And I got it. And I and I started dispense with my fear. And I started learning about it. There were hiccups along the way, right? I've given her insulin, and she's gotten lower than I meant to for two when she's eating. But you know, once twice, I'll go back to this over and over again, when something goes wrong. It's not a mistake. It's a learning experience. It's data for next time, right? Right. So I put the insulin in, and she goes down to 70 and sits at 70. While she's eating. It's beautiful. You know, like, there she goes. And then and then then a spike. Even if I really messed up on the amount of insulin, I used a spike takes you to 120. Right, right. Right. Right. It's just, it's all about that timing and amount. And I repeat it over and over again, that you all the things you and I are going to speak about all the things that people hear about on this podcast, if you want to know how to use your insulin, at its core, the very first step is timing and amount. If you get you can use the right amount at the wrong time, you can use the wrong amount at the right time, that it's too much, you have to have the right amount of insulin at the right time, you have to balance the action of the insulin against the impact of the carbs. If I do that, I don't want to say it's easy, because that's insulting to people. But let me just say I don't think about diabetes that much anymore.

Jennifer Smith, CDE 13:27
It's easier, it's much easier if you do that. It is easier. Absolutely. And it's a lot more. It gives you a lot more visual than to understand. Because it's not so much of an unknown Well, gosh, I counted the carbs, I took the right amount of insulin and this is always happening to me. Why. And if you can start to put those pieces together, it's not a wi anymore. It's like turning the light bulb on.

Scott Benner 13:58
Here's how I explain what Jenny just said. The Dexcom G six continuous glucose monitor gives you a complete picture of your glucose showing you where it's going and how fast it's getting there. There can be nothing more important. The Dexcom GS six also eliminates finger sticks for calibration, diabetes treatment decisions, and diabetes management. It also has an automatic inserter. Like it just you know, you stick it on and you push the button and the next thing you know you're wearing it. Now you can use the Dexcom receiver to get the information from your transmitter. But for those of you who enjoy using your cell phone, it works great with iPhone and Android as well. The last little thing about Dexcom isn't so little. How about the share and follow features also for Android and iPhone. Your loved ones can follow your blood sugar anywhere in the world. And if you're the parent or caregiver of someone with type one diabetes, you can be watching their blood sugar as well. You want to know what Arden's blood sugar is right now. It's 82 just glanced up and saw Just like that. Now my results are mine and yours may vary, but my daughter's a one C has been between 5.2 and 6.2. For over five solid years, the decisions we make about how to give my daughter insulin and when to give it to her, come directly from the data that comes from the Dexcom G six. And I don't know if you know this or not, but my daughter does not have one dietary restriction. Those numbers are accomplished through waffles, just as well as through salads, through burgers, just as well as through zucchini, it doesn't matter anything that impacts my daughter's blood sugar, that impact is shown to me by the Dexcom JSX. And then I make good decisions. You want to make some good decisions, go to dexcom.com forward slash juice box and get started today. That's the best decision you're ever going to make. This is a short episode, and I don't want you to have to have to add breaks. So hang on for me for one more second, let's talk about Omni pod. This past week, I visited the Omni pod headquarters in Massachusetts, where they've just moved their production facility. It's about to go live. And I got the tour of the floor where you're on the pods are going to be made from now on right here in America, right in Massachusetts, I want you to know that what I witnessed in Massachusetts on that assembly line, it didn't just renew my excitement about Omni pod, it shot me over the moon, the accomplishment of bringing a production like that into one facility, putting it under your roof that showed me a real commitment to the people living with type one diabetes. Right? This isn't being made overseas somewhere, you know, a bunch of different factories. It's all right there at the Omnipod headquarters, and its state of the art an absolutely stunning. This is a company who is behind you for the long haul. I believe that before but I believe it even more. Now, here's what you want to do go to my Omni pod.com Ford slash juice box or click on the links in your show notes or juicebox podcast.com. When you get there request a free experience kit. That's right, a pack a pod experience kit on the pod is gonna send you a pod that is an exact replica of the one you'll get when you start using the product for real, but this one's non functioning. And so it's safe to wear for you to try out, you'll be able to find out if you like it, where you want to wear it. And you'll notice how after you've had it on for a little while you don't even remember that it's there. Miami pod.com forward slash juicebox. The links in your show notes or juicebox podcast.com.

Last thing, don't forget dancing for diabetes that's dancing the number four diabetes.com. It's the little organization that does a ton of good for a lot of people living with type one, they're on Facebook and Instagram. And at dancing the number four diabetes.com Check them out. Here's how I explain what Jenny just said. I think of it as this equation that it's a mathematical equation that doesn't have any math in it. I did this that happen. So next time I'll do more or less sooner, you know, little less little more, that kind of thing. And I always just I always just keep looking at it like that. I did this and that happen. It's the idea of being in a fistfight and you want to hit first because now you have caused an effect. Right? And if you and so now, you know I've done something. And that's what happened next. Now I can make a good decision about what what I do next, instead of waiting for diabetes to do something to you. And then you're just covering up your face hoping not to get knocked out. Right? Like because you don't know what's happening. You don't know why it's happening. I have no context for what's going on. But when you make the first move, you can be sure that what happens next was impacted by what you did. I put insulin in 10 minutes before you ate 10 minutes before I ate. And my blood sugar went to 150. So the next time I'm going to try 15 minutes. And if it goes to 130 I might try 20 minutes. And you know if I get low then later I might say okay, I might need a little more a little less. Now here's where people always say well, how much Scott How long? You know, give me the time give me the amount? That answer for me. It's always going to be I don't know figure it out for yourself. Okay, you have to

Jennifer Smith, CDE 19:22
this is the starting place. Yes. This is where to start. This is how to start. You have to do your own. I mean, diabetes is a science experiment. It's a daily I feel like every day you're almost given like this new petri dish and you're told, keep the dots growing purple today. Okay, let's work on keeping the dots growing problem is that something green pops in and then these like little horny pink things pop on. You're like, oh, no, but it is it's like it's a science experiment that for the most part when you figure out what does work the timing around the most typical foods that you Eat and whatnot, it takes a lot less thinking out of the equation.

Scott Benner 20:04
Yeah. And while this isn't about Pre-Bolus, and it will come up later, but it's important for me to say, because I think this is impactful when you really stop and think about your, your habits around food. They're pretty similar. Right? So, you know, you're not I always say like this, like, if you're a person who gets a pizza on a Friday night and has two slices, you don't suddenly next Friday have seven slices, you don't go from being a two slice person to a seven slice person, right? Like, and so, so you can start making these decisions about how much insulin and when, and you can make them based on historical knowledge about what's going

Jennifer Smith, CDE 20:41
on? Yeah, I usually tell people as the Pre-Bolus piece, you've got, most people have about 20 to 25 foods that are the most common for you to eat regularly. Yeah, that's at least 80% of your control there, at least. So if you can nail the Bolus timing around those and figure it out, for the most part, you know, variations in setting will happen, whatever, yeah, but for the most part, if you've figured that out, you're also much more likely to be able to figure out food that isn't your norm, because of the similarities to what you've chosen. And what you're usually eating,

Scott Benner 21:27
because you can stay flexible. I call it saying stay fluid, right? So here's, here's where I'll tell people this, don't get mad. I don't count carbs. I actually think about it a little backwards from the VB how most of you think about it, I don't look at the food and say eat away at or measured and say okay, well, that's 25 carbs. And my pump says that, I get one unit for every 10. So that's two and a half units. In honesty, there is no accurate insulin to carb ratio set up in Ardens pump. We don't even I don't even pay attention to that. I look at a plate and I say to myself, that's seven units. I think that if she's going to sit down and gorge herself on nachos and cheese, the last time that happened, it took 10 units. But I think of it as insulin, not as carbs. And of course that takes a little practice, right? It does, it does. And it is a little contingent on you having a CGM. I'm not going to lie about that, right, because I start with a healthy Pre-Bolus. And healthy would mean in amount and time. And then I watch her CGM, and I don't really watch it, I have her tolerances set tightly enough that if she leaves that range, I find out about it. So as an example, if I were to give art in something incredibly carb heavy, I might use a Temp Basal increase, and a Pre-Bolus to try to spread out the action of the insulin across this timeline where there's going to be these carbs, right? If I make a Bolus, and 30 minutes after I do it, she's 121 30 Diagonal up. I look at that line. And it tells me something based on my previous knowledge, it's that I say to myself, ooh, this I missed, like, this isn't enough insulin. And I will give her more I will bump it and nudge it back. It's not a ton more, it's enough to stop the arrows,

Jennifer Smith, CDE 23:25
right. And the arrows are very important to bring up in this in this as well. Because if you are using a CGM, those arrows do indicate a rate of change. And again, that's not something that most people realize. They don't understand that and not understand that it's that they've not been told they've not been told, Hey, these arrows tell you that you're increasing by 30 to 60 points in the next 30 minutes. Okay, if that's the case, and I know what my plan of correction factor is, or whatever, I can say, Okay, I'm going to need this much more insulin because if I don't correct my rising 130 blood sugar in the next 30 minutes, I could be 30 to 60 points higher. I could be as high as 190. I don't want to be 190 I've obviously miscalculated someplace, I can throw in a bit more insulin to counter that expected and stabilize it. Yes.

Scott Benner 24:20
Yeah. It very much. It very much is remembering to like I guess the way I usually say it is that you have to trust that what you know is going to happen is going to happen, right? Yeah, you see, and I think that the least important aspect of what the Dexcom does is the number. It's the direction and the speed, direction and

Jennifer Smith, CDE 24:48
100% I wish more please say that again, is the direction it's the trend. It is not just the number

Scott Benner 24:56
the numbers nice like don't get me wrong. It's a starting point, but You know, if you're 60 and stable, and you haven't had insulin for three hours and you haven't had food for three hours, well, maybe you could get away with like a Temp Basal decrease of 100% for half an hour, maybe you'll rise to 90, right. But if you're 60, and you're falling, well, then you don't have enough time, because as we've now discussed over and over again, insulin doesn't begin working right away. Also, Temp Basal is our insulin. It's funny how people think of bolusing and basil is different. But once you're on a pump, it's the same thing. You can't just turn your basil off, and it starts happening right away,

Jennifer Smith, CDE 25:34
takes about 60 minutes for circulating insulin level to be different.

Scott Benner 25:38
I always write and I always try to think of it a little bit as like Ardens Pre-Bolus time like if Ardens Pre-Bolus time is 20 minutes, well then setting a Temp Basal is not really going to start working for at least 20 minutes. Plus, it's a fraction of the Basal rate if, if you're getting a unit an hour, and I say to her, okay, let's double it, let's double it to two units an hour, that impact of that doesn't begin for 20 minutes or so plus, it's not the whole unit. Actually, it's the it's the fraction of it. So when we talk about basil, we'll get to that. But so Pre-Bolus Singh is really just the idea of balancing, again, the action of the insulin against the impact of the carbs, giving yourself a chance not letting the carbs wash you away. Because here's what happens when the carbs wash you like, count your carbs exactly right. You put your insulin in, you spike up the 200. When that happens, that insulin was only for the food. It wasn't for the 200 blood sugar, and it wasn't for the momentum of the rise. And so when I see that, like, I guess an easier way to say this when when I don't have time for a Pre-Bolus and Pre-Bolus thing to me is never about the number, you can Pre-Bolus a 65 blood sugar, you know, you can Pre-Bolus a 90 blood sugar because still no matter what, if you're stable at 65, the insulin you put in is not going to start working until it starts working. So you have and so don't get me wrong if I see a 65 blood sugar and an artist needs 10 units for what she's eating. I don't put all 10 units in at a 65. I might do an extended Bolus which we'll talk about and extended Bolus but I get some insulin moving, I make sure the insulin is on the winning side of this tug of war to start. But in a situation where I can't Pre-Bolus Let's say I know the meal is five units. 100% certain it's five units. But for whatever reason life, let's call it I can't Pre-Bolus and Ardens. You know, I'm going to start eating right now. I'll give her seven units. Because I Bolus for the food, the five units for the food I knew. And I probe and I'm Pre-Bolus Singh. The rise I know is coming and the end the number I know is coming. So I'm already treating a high blood sugar that hasn't happened yet. Because I know what's going to happen because I didn't Pre-Bolus

Jennifer Smith, CDE 28:03
Right. John Walsh goes into detail about what you're doing in a little bit of a different way. He calls it super Bolus, I call it an over Bolus thing. Yeah. And he calls it super Bolus in the way that you take that five units, let's say in your example. And let's say your basil behind that meal for the next two hours is one unit an hour, you actually take your basil running for the next two hours, and you add it into the Bolus for the meal and you take it all upfront. And then to decrease the chance of being too low later. Because of so much upfront action and the blood sugar staying normal, you actually set a temporary Basal decrease, he recommends starting with 100% Because you've loaded that onto the front to avoid a low but on the back end. Some people find though that a Temp Basal 100% off is too much. They only need a 50% they still call the spike and prevent it. But in the back end, they're not having a low then. So similar kind of concept. Yeah,

Scott Benner 29:07
I consider that trading Bolus for Basal. So So you know, say 120 Diagonal up 3040 minutes after a meal and I go, Oh, geez, I got to stop that arrow. How much do I Bolus to stop the arrow? I usually Bolus an hour's worth of a base of Basal insulin. That way if the arrow stops and I stay steady, and she doesn't go down, I say okay, well obviously I was just wrong on the initial amount. But in those situations where you push the button, you know the unit and a half goes in, and five seconds later the error goes from one to 22 Diagonal out the flat you go oh, I didn't need that. Right Temp Basal off. Half hour. All I've done is trade the Basal for the Bolus. Absolutely. Here's a good place to say this and we'll say this in each of these little vignettes. Never suspend your Basal. It's always temporary basals when you suspend you're shutting your pump off when you shut your Jump off. It does not. You have to remember to turn it back on. Yes. Yep. It's always temporary because you can set a Temp Basal for a half an hour, an hour, two hours, but at the end of that time, it was bad. And I'll go back on and start delivering your Basal. It's always temporary Basil is not not don't suspend your pump. Okay, so I think Do you think we covered Pre-Bolus? There?

Jennifer Smith, CDE 30:20
I think that's pretty good. Good. Yeah, that's awesome.

Scott Benner 30:25
Don't forget that you can work with Jenny yourself. If you want just go to integrated diabetes.com To find out how. Let's also take a moment to thank our sponsors Dexcom on the pod and dancing for diabetes. There are links in the show notes of your podcast player app, or at juicebox podcast.com. But you can always go to dexcom.com forward slash juicebox. My omnipod.com forward slash choose bucks or dancing the number four diabetes.com. I hope you're enjoying the Pro Tip series. This was episode four, where we talked about Pre-Bolus. And don't forget that episode one is for those starting over, or just being diagnosed. Episode Two was all about multiple daily injections. Episode Three, we talked all about insulin. Today, of course Pre-Bolus Singh in the next episode, Temp Basal rates huge and important. And then after that insulin pumping, they're designed to be listened to in order to trust me listen to them in order. I have just a little bit of music left here. So let me thank everyone for the great reviews and ratings on iTunes. Very much appreciated. 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 juice box that's better. H e l p.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 juicebox. All right, I want to thank you for listening to this episode of the Best of the Juicebox Podcast. And I'd also like to thank people who made better microphones since this was made. Those people should be lauded. And I think we're all very, very grateful. Thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast made on this microphone. The one that sounds amazing

#914 Diabetes Myths: How You Got Diabetes

A brand new series examining the myths surrounding diabetes.

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Scott Benner 0:00
Hello friends and welcome to episode 914 of the Juicebox Podcast

a Jenny's here today and we're going to be talking about diabetes myths. Myth. Am I saying that right? You know what I need? I need some. I need some synonyms for myths. Because every time I say it I feel like I'm like I'm butchering it. Let's see, I know what a myth is. I don't need an example of myth, myth. Synonyms folktales stories legends tales, fables, sagas, allegory parable, tradition lore folklore mythos. How come I can say mythos but not myth? Wait, I said myth. Hi, Jenny's here we're gonna talk about myth, myth, dammit. While you're listening today, please remember that nothing please remember, I can't say myths that and also 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 are becoming bold with insulin. Quick quick, right 35% off your entire order at cosy earth.com with the offer code juice box and check out 10% off your first month of therapy@betterhelp.com forward slash juice box by free travel packs and a free year's supply of vitamin D with your first order at athletic greens.com forward slash juice box. This episode of The Juicebox Podcast is sponsored by the Dexcom G seven continuous glucose monitoring system dexcom.com forward slash juice box you want to wear the Dexcom that Arden's wearing, you're gonna have to get the G seven cuz she just switched and it's I almost cursed. It's really great. The podcast is also sponsored today by Omni pod Omni pod.com forward slash juice box you want the Omni pod dash where you want the Omni pod five it's completely up to you both can be accomplished at Omni pod.com forward slash juice box. You want to gear up like Arden you want the Dexcom and you want the Omni pod?

Oh goodness. Well, you guys can hear Jenny laughing we're back to record our first myth. Are you in the topic that we're going to do? Today? Reasons Why You got diabetes?

Jennifer Smith, CDE 2:30
No, no underneath the miracle. I'm gonna have to like,

Scott Benner 2:36
I don't know. Sure. Well, last week. Yes, we will. Alright, anyway. Okay, so let me I'm gonna scroll two reasons why you got diabetes on the master list. All right. So first one says, obviously, I caused it in my kid because I fed her too much sugar. Yeah, oh, you can't cause type one diabetes by feeding people too much sugar?

Jennifer Smith, CDE 3:07
No. 100% Incorrect.

Scott Benner 3:09
Type One is an autoimmune disease. And that's not how that works. So where's the confusion? Is the confusion is that people believe, first of all, that diabetes is the word they know. And when they hear diabetes, they think about I think most people think about older people in their life.

Jennifer Smith, CDE 3:33
I think it comes from honestly, the larger amount of the population knowing. And I say knowing in air quotes hear more about type two diabetes, right. And as we've talked before, about the differences, type two diabetes does have lifestyle component to it, and to diagnosis. It does. But I think people don't realize the very large difference in terms of why you could have type one versus having type two. And so it all with just the broad term of diabetes, it all gets lumped together. And so you know, these people will say, well, they just wouldn't feed them all that sugar or you know, if your kid wasn't eating this for lunch every day, or you know, I've heard from a number of parents who have actually been told by some of the school personnel, well, if you wouldn't put that in their lunchbox every day, maybe their numbers would look better. Like really, really come on.

Scott Benner 4:42
This is caused by eating too much sugar. We've loaded our son with sugary snacks and drinks and that's why he has diabetes, the unhealthy diet. Now here, my uncle said five minutes ago while watching television, a doctor, Dr. Pepper commercial came on and he said that pepper, that stuff will give you diabetes. So this is where I think this is where I think it comes from. Right? Because I mean, listen, forget Dr. Pepper, soda. It's not good for you know, it's just not so no. And health issues. If you drank enough soda, you would have health issues.

Jennifer Smith, CDE 5:24
Yeah, yes, absolutely. I mean, there are so many things on the market today that are not food, right? I mean, no, I don't think hopefully nobody thinks Dr. Pepper or anything of the like, is really food. But it really is not even close to being anything we should be putting in our body anyway. But again, statements like this, my personal is that I've just come to the point of I just brushed it off. I'm like these people, my educated brain is like and what, whatever, I let it go, right, I'm not going to ruminate on it, because that doesn't help me at all. If I could have five minutes with them, I would teach them why that statement is wrong. And it's not funny to many people. But some people really get very offended. Honestly, by a statement like this, that stuff will give you diabetes or, you know, the the comedic types of jokes about diabetes and again, personality wise, I don't, I don't take them in as a personal attack against me. I take it as your a dumb person who just doesn't, doesn't understand even what you're trying to be funny about. So I'm gonna let it fly, whatever.

Scott Benner 6:40
When this would get said to me about Arden when she was younger, I was always amused that the people who were saying it, we're not exactly long distance runners, you know what I mean? They weren't at the pinnacle of health and performance either. Have you looked in the mirror this morning? You know, she's got diabetes, but maybe you might want to skip it too. for other reasons. You don't look well, this year, this year is heartbreaking. My own mother saying to me, this is a quote, you got diabetes, because you ate so many sweets as a child, which I don't know how that person didn't respond. Well, who was in charge of that? Like, What an odd thing to say to me right now? Yeah, like, that was you like, like, not me? Like, I didn't have any money. I'd be like, Oh, my God, that wouldn't have gone? Well, if somebody would have said it to me, I would have been like, I didn't have money. You bought that stuff? Agreed? Yeah, that's been there. That's heartbreaking. And then I mean, like, you can deep dive into the psychology of it. Like maybe what the moms really saying is, I let you down. I feel like I let you down. You could be you know,

Jennifer Smith, CDE 7:50
this is the way that it came out. Yes. Yeah.

Scott Benner 7:53
People don't do a good job of communicating. When I was when my 18 month old was diagnosed in decay, and someone asked me how that happened. When he was so young, did he eat a lot of sugar? So now that see, this is the part this is why it's so upsetting your kids 18 months old. And in DKA. I don't understand why people think this is the time to say hey, do you think you did something wrong? Like Like, it would be like if I came up on a car accident, and you were pinned in the car, and the back of the car was on fire? And I looked in the window, and I was like, Hey, were you driving too fast? Like,

Jennifer Smith, CDE 8:30
did you not use your brakes? Did you not see what was happening in front of you?

Scott Benner 8:33
Yeah, this is your fault. Like, can you help me out the car please? Like, like, like, you know, like, it's just a that's like college, the part that throws me off, you know what I mean?

Jennifer Smith, CDE 8:46
And this is the part that I wish, you know, as people with diabetes, who are the majority listeners to your podcast? They will they will listen, they will think about this and they'll say yeah, you know, who I really wish this could go to. I wish this could be just a podcast for the like the this is the general public's information about when to keep your mouth closed. Honestly, like, if you don't know what you're talking about, please. I mean, what is it? Zipit locket put it in your pocket is like what my kindergartener has learned, right? If you have nothing right to say, or you're not supposed to be talking, close your mouth. Right? And that's, I wish this could go to the general public and just be broadcast as a commercial. Like, if you don't know, don't comment.

Scott Benner 9:37
Maybe people should just if they get this comment, you can just AirDrop them a link to this episode here. I'll tell you what, like, I've now skipped past so many statements that say the same thing. But this one catches my eye. My Type One daughter being asked if she ate too much sugar, and that's what caused her type one. Like that's the thing like now I'm trying to think like you've you think this thing? Why would you say to a kid, I don't understand why you would say to her mom, I really don't understand why you would say to the kid,

Jennifer Smith, CDE 10:12
well, you know, one other place. And maybe this comes up in these comments. But another comment I've heard from many parents along the line of the sugar piece is, well, your kid is eating sugar. Like they say all the time, I guarantee they're not eating it all the time. But it's very likely they catch the child eating sugar when their blood sugar is lower, right. And they then sort of come back with a statement of, well, it would be better if they just didn't eat so much sugar, or it was caused because of that sugar you're giving in on the back end, as the parent, you're thinking, Well, again, I could give you a whole education session on why she's probably eating sugar right now, if you would actually sit down and listen,

Scott Benner 10:58
yeah, here's the other side of it, too. I grew up, I'm older than you. I'm older than most of you. But I grew up in the 70s. And in my refrigerator, was a large plastic one gallon container, they still make them today. And you turn the top and you can pour out of it. That container was always full of some sort of juice. Now I'm making air quotes with juice, cuz it was most assuredly not juice. It was we used to get this big container of a powdered substance. And you'd put like, 15 scoops of it in there. Little warm water to melt it little cold water. And then it I don't even know what it was. But I'm pretty sure it was sugar, and or chemicals. And I don't even use plastic containers in my house. I won't even put I'm pretty sure it was both of those chemicals and sugar. And it was ruminating and like in plastic. And I don't have diabetes, type one or type two. We used to eat it Kentucky Fried Chicken all the time because it was close to our house. My mom did not know the first thing about nutrition. I clearly am not lean because of my upbringing. But that's not my point. My point is, I don't have type one diabetes, and I don't have type two diabetes. And if the amount of sugar an 18 month old could have consumed could put them into decay, then I would have 43 times that amount of diabetes right now. Correct? Yeah. And you absolutely. And here's the interesting thing. I'm talking a little out of school here, if because I don't remember the the test. But I recently went to the doctor and had like a complete physical. And this lady runs bloodwork so much that I had to pay for some of it out of my pocket, like the I mean, like she's testing things that your insurance customers, like, we don't need to know that she's like, I need to know what is B 12? Is it like stuff like that? She said to me, I forget what the test was. But she said, I can say to you with a fair amount of certainty, you're never going to develop type two diabetes. And I was interested, I was like, why I'm gonna get I'm gonna find out about what that was. Yes. And. And she pointed to a marker and she said, Look, I can't say for sure she goes, but this number here tells me you're very unlikely to get type two. And I was like, Okay, thank you. I didn't ask her. We were talking about a lot of stuff. And I didn't remember to ask, I'm going to email her and ask her. But my point is, I'd be I'd be curious. Yeah, what it was, I don't have type one yet. You know, I don't know that I will or I won't. But again, the antibodies is still something very misunderstood about diabetes type one, like for sure. And even type two, like, I just don't seem to be predisposed to it. You know, so I just that sucks when everything else gets caught in the in the way also, I just made a decision about this episode. After we record this. I'm going to send a file of it before I edit it together to Erica, I'm going to let her listen to it. And then we're going to talk about the psychology of why people might say stuff like this to people.

Jennifer Smith, CDE 14:14
That would be really interesting. From from the mental standpoint. Yes,

Scott Benner 14:20
I just it just hit me here. Let's see. This woman says, This person, by the way, I just assumed these are moms. And I could be wrong. That my type one causes diabetes because the diet I had to choose to ignore this talk, because I was gonna throw some hands and I'm not I'm not cut out for jail, it says. So that's pretty

Jennifer Smith, CDE 14:45
funny. Yeah.

Scott Benner 14:47
Candy, the week of my daughter's diagnosis, we went to a scout meeting and at the meeting, the troop leader said to me, Oh, wow, I didn't know she had such a sweet tooth. She said Skinny? Yeah. Yeah. Okay,

Jennifer Smith, CDE 15:05
again, your child has diabetes because behind the scenes, I didn't realize it, but your kid was clearly like, eating the whole bag of sugar. A whole

Scott Benner 15:14
thing had to happen. Oh, here's one. You're a terrible parent, because your child got died. diabetes.

Jennifer Smith, CDE 15:20
Oh, that's so sad again. Dip your lip. I'm sorry. Really like, Joel, you're

Scott Benner 15:30
this. This one's from a deep thinker, probably. Probably a scientist. I fed my child mac and cheese. And that's why they have diabetes that that statement came from a family member. Yeah, there's probably probably a scientist that came up with macaroni and cheese gave your kid diabetes. Oh, jeez, too much sugar cause diabetes. I'm 26 I got diagnosed at 15. Apparently, I'm too young, not fat enough. Or my parents fed me crap. So that's a light. That's, that's 10 years of people saying that?

Unknown Speaker 16:12
Yeah, absolutely. Yeah.

Scott Benner 16:15
Cheese. We moved to Canada from Europe. And my son was diagnosed here four months ago. Very often, I heard Oh, this is because of our Western diet. From considerably intelligent people. They don't know that we're from Canada, and are not from, we're not from Canada, and our diet is Mediterranean. And we don't buy prepared food at all. So this person is not eating the way they think. But it's still what happens. You know? So is there, like, really break it down for a second? And your answer might just be one word. But is there anything about diet that could make your type one diabetes happen?

Jennifer Smith, CDE 16:59
It mean, in terms of diagnosis?

Scott Benner 17:02
Or anything I could eat that would force me to get type one diabetes? No. Okay. I mean,

Jennifer Smith, CDE 17:08
that that we and I say that with the side note of? No. Because again, if we really knew the true, one point cause of type one diabetes, there would be a cure for it. Yeah. Right. So I mean, diet in and of itself, has not of all of the I don't necessarily that say that they're myths, all of the hypotheses about where type one diabetes comes from and why someone may have it versus another one may not within even the same family. There are so many unknowns about that. That you can't necessarily say no to food, but food I don't believe by any means especially just the simple thing of sugar right? is definitely not Oh, you have diabetes, because you ate all that sugar. Wrong.

Scott Benner 18:05
I'd like to point out that I don't think you should eat a lot of sugar.

Jennifer Smith, CDE 18:09
Right? We're not advocating for downing sugar.

Scott Benner 18:13
I'm not saying that we should go back to the country time lemonade and the the punch that we used to get as kids and oh my gosh, popsicles Jenny during the summer, that just your refrigerator just full of sugar.

Jennifer Smith, CDE 18:28
Did you have the little they were called Little jugs. Oh, sure. They looked like little like barrels. They were plastic like white ish. Right? And then you had an aluminum rip tap.

Scott Benner 18:40
Ever try want us an adult? Orange. I tried one as an adult. That's like what the is Oh my god. Like it makes your brain like

Jennifer Smith, CDE 18:50
because I didn't even like them as as a kid. I had. I didn't like the flavor of them. I and I liked like Kool Aid. But I did not like those. They were just not favor.

Scott Benner 19:05
Yeah. But that's a cost thing for us. Yeah, they were like, I know this is probably hard for people to imagine. But you could get like a flat of them for like $2 Yeah, it was nothingness. You know, like, and so your parents bought stuff like that because it was cheap. And they didn't nobody trust me. If you went back in a time machine, and got my mom in 1976 and said, Hey, this lemonade is bad for you. My mom would go lemons grow on trees and pollute and that would have been the absolute end of it. My five year old has diabetes because she's overweight. Oh, but you're so young and look so healthy. Yeah. Lovely. Had a couple times.

Jennifer Smith, CDE 19:53
Yeah, that's one that I've I mean, I've heard it as well. And again, I think it comes from The visual of what most people see as diabetes, which is type two diabetes, and it's even, it's very unfair, even in that line of, you know, type of diabetes, but I've got what you look great, you know, when you, you're running all the time and bah, bah, bah, like, yep, still got a dysfunctional beta cell in my body, though. So I have

Scott Benner 20:23
other autoimmune issues, if I can tell you about what it is listen, from, from an uneducated perspective. It's hard to ignore, you do not look like a person who has something, quote unquote, wrong with them. Like you just you don't. And I know that, like, if I didn't have a kid with type one. And you said to me, I don't know. Here's three people tell me which one of them has an illness. And it was me, you and I don't know, Bill Clinton. I wouldn't pick you. That's a good thing. I think it's Bill and then it's me after Bill, but that lady is definitely just thrown in here to confuse everything. So yeah, I mean, I get where it comes from. I don't I don't understand why you would say it. If you don't know, when people really just think they know.

Jennifer Smith, CDE 21:18
Well. And the thing is, I You said something that made me think that it's you said the uneducated, these are many of these statements don't come from uneducated people. Yeah, they are uneducated, in terms of one particular thing, but specifically diabetes.

Scott Benner 21:39
So the thing that always keeps me focused on not getting upset when this stuff happens is that there are maybe a billion things you could ask me about that? I don't understand. And if you pressed me, and I made a guess, I'm sure my guess might very well be wrong. The thing I don't have that these people have is I have no compunction to walk up to a person and go, Hey, you want me to tell you? What's, that's the part that that's the unplug. Here, though, I want to go, I want to go this one. This is from a I'm guessing from a widowed person because it says, oh, stress caused my type one, if that were true, then every widowed person would have type one. But I caused this the word there. I saw this the other day, people love, it's still very popular to say my I have diabetes, because I COVID. And then they'll say COVID, cause my type one diabetes. But COVID didn't give you type one COVID set off an auto immune response that ended in type one,

Jennifer Smith, CDE 22:43
redirect and forever. Not for everybody does that obviously just like this statement is every widowed person would have type one, every single person that had COVID, or every single person that had the flu, and a really or really nasty fever. Any of those if you know anything about the research being done in type one diabetes is there's a lot of viral research going on about why does one person this virus causes a reaction that shouldn't happen the way that it does, right? So stress is horrid. And the way the body reacts to stress Absolutely. In one person, person versus another could have something happen. But to tell somebody that, you know, well, you're so stressed out. Clearly, this is why this happened. It's

Scott Benner 23:35
it's, I think I think the word cause is where the confusion comes in. Like it's so close to. I don't know, I'm trying to find a simple example, like, stress doesn't make type one diabetes, you don't get stressed out and suddenly have type one. No, but you could get stressed out to the point where your body experiences turmoil that ends up in an auto immune response, that if you already had antibodies for type, one could kick the whole thing into gear,

Jennifer Smith, CDE 24:06
right? I mean, stress causes significant inflammatory response in your body. It does

Scott Benner 24:12
this is this this little misunderstanding between the word caused and like, you know, my daughter had hand foot and mouth disease, which is called coxsackievirus. And then she got type one diabetes coxsackievirus didn't like go into a laboratory and make type one and shove it into my daughter's body. Like it. She's got but she has type one, because she got Coxsackie. The point is, if she doesn't get Coxsackie that day, and just gets a virus two years later, then she likely gets the diabetes then this lady could have it's funny when I hear this statement. I mean, assuming that she was widowed at an older age, I think wow. How lucky is that? She got through most of her Life without getting type one. Like that's how that actually kind of feels to me, which is interesting. This person said I was diagnosed the same summer that I completed three marathons. And I can't tell you the number of people who told me that running the marathons made me diabetic. That's interesting. Is there anything

Jennifer Smith, CDE 25:20
I liked the next day, I started to say things like, yes, instead of a finishers medal, everyone that completed that race got type one diabetes, exactly.

Scott Benner 25:27
There's, there's the thought 1000 People ran a race, one of them ended up with diabetes, and somebody goes, oh, there was the race thing. Instead of, instead of saying 999, out of every 1000, people that ran a race didn't get type one diabetes, they see at the interest, where people's minds are interesting.

Jennifer Smith, CDE 25:49
When I think it begs of it's a it's like a deeper thought, honestly, as what you just said, along with the stress, and like the widowed person is this person without knowing as many people are walking around today without type one diabetes, specifically, right? Nobody just randomly goes to the doctor. And it's like, Yep, I want to make sure that I'm not carrying around these antibodies and whatever, right? These are not tested for factors. Unless you are doing something like trial net or whatnot, because you already know that you have type one in the family and you really want to stay on top of it. The majority of the population has no idea if you're walking around with something that could at some point get I say turned on. Right and or your body reacts a certain way. So you know, this person running the marathons, who knows, was just the point at which that piece in their body was like, Yep, it's time. Yeah. So sorry.

Scott Benner 26:51
Here's a couple of like, I hope people are listening to them, because contextually you can figure out where it comes from. Although this one's just sort of hilarious. I was told that I had not lost so much weight, I wouldn't have gotten diabetes. That's just that's, uh, that falls under the you're damned if you do damned if you don't category. I'm telling you to people. But here's this one's interesting. My two type ones were diagnosed about nine days apart, ran to a friend's husband at Target right after diagnosis. The question was, what causes that diet? And then she's she says, Yeah, dude, I did this to my kids like with food, but I get her feeling. But you understand his question. He's worried. He's like a lady. I know. Both of her kids got type one diabetes, nine days apart? Is that something I have to worry about? Like, that's the question she takes the way she takes it because of her. Rightfully so like, I'm not saying that. But like, I get where his question comes from, like, Hey, what happened here, like somebody told me, so this doesn't happen to me, is what I'm getting out of that. I think this is the case that takes the cake. When I met a stranger at a birthday party, who told me in the first five minutes of meeting him, that I really should research my kids diagnosis more, because it's likely it could just be a parasite, and then no one. And then no less than five minutes later said, I don't really understand how diabetes works, and then wanted me to explain it to him. And then a Dexcom alarm goes off, and they use cake to take care of a low. But again, you know, that can be a parasite. By the way, what is diabetes? Thank you. Thank you for your searing insight. Do you see this one I had a professor tell a lecture hall full of 200 people that type one is quote the one you get the one you're born with. I raised my hand. I said I wasn't diagnosed until I was 13. And then she talked her way out of it by going you know what I mean? shut her down. And so like so but that's another example. Right? The one you're born with means that's in your that's in your body already. Right? You're. But that's not true. either. You could develop the antibodies later in life as well. Yeah, so my God, these go on forever. I cause

Jennifer Smith, CDE 29:23
it's, you know, what's painful is that we live in a very we live in a society today where it's very easy to now get the right information. Yes. Right. I mean, these types of comments. I've heard myself since I was diagnosed almost 35 years ago. Yeah. So it makes me really sad then that people are not learning.

Scott Benner 29:58
Jenny, I heard recent li that you your phone has access to more information than the President of the United States had access to in the early 80s. I would agree. And now you can't like, and still people can't figure anything out. This one's terrible. I caused it. That and that I deserve the punishment. Oh, wow. I don't know who's I don't know what burden you're trying to lift by telling people that but that's horrible. Oh, my daughter was diagnosed because she was born by C section. So this was a myth mixed with mom shaming. So hey, cuz you couldn't push that kid out. It has diabetes. So she hits her on, like, twice. People are horrible. Yeah. Oh my gosh, um, it is my fault that my son has diabetes. Because I had gestational diabetes when I was pregnant with him. My weight must have caused my daughter's diabetes, my weight must have caused my daughter's diabetes, okay.

Jennifer Smith, CDE 31:07
Meaning they is kind of the same as the the one you just read about. Maybe the maybe this person is overweight or herself and was pregnant and overweight at the same time. And maybe that is what they're expecting, cause the daughter to have diabetes, because clearly the body was unhealthy while it was in its gestational

Scott Benner 31:30
age. This this one, here's the whole story is not important. But she does point out that like, people wouldn't even make eye contact with her after her children were diagnosed. That's they thought it was they thought more type two stuff. Just weird that like

Jennifer Smith, CDE 31:49
that. And I think in this, I think some people just don't know what. They just don't know what to say. Yeah. You know, after, after a diagnosis. It's like, I think of any kind when you hear somebody that you have gotten to know, has had something traumatic in one way or another happen. Sometimes you feel like you just don't have the right words. And you're not quite sure. You know, what to say? Yeah. Now, I mean, the response of just not even like approaching or eye contact or whatever, clearly isn't the right way to go about it either. But I don't know. It's sad.

Scott Benner 32:29
These last couple are about contagious. My kids are grown now. But I had to have three with type one. Kids would ask my kids if it was contagious. And eventually they get tired of saying no, and just started saying yes, then fake coughing on everybody. Somebody said, I've been told that it's contagious. But this one, this is the last one on the list. And then we'll wrap up. As a teen. My friend's mom was told diabetes was a sexually transmitted disease. And if her son and I dated, he would get my diabetes. Oh. Did you give it to your husband, Jenny? No. No, no. Well, that didn't work. Dammit.

Jennifer Smith, CDE 33:13
We've been married and together a lot.

Scott Benner 33:16
Jenny and her husband have a sex at least four times. And I got wedding kids and like a birthday. And it hasn't happened yet. Wow. diabetes is a sexually transmitted disease. It Well, that's the end of the list. i My takeaway is, I just always think about this the same way like you can't judge people. On their level of understanding. I mean, there are some things in here in this list that are just confusion. There's some things in here that are ignorance, there's some things that in here stupidly, it depends on who you bump into. But the one thing that I've learned from this list is that everyone believes in themselves to an absolute fault. Everybody's like, I think a thing. So the thing must be right. And then here we go. And your point about being able to look into it. Especially in a world where people spend so much time connecting to information through a phone or a computer. Why not take five minutes to find out something before you say to somebody, like just right, you're on your phone anyway, like,

Jennifer Smith, CDE 34:34
well, right. I mean, at a general, a general party, how many people you know, backyard party in the summertime, you've got a family and you can see that the child or maybe one of the parents or whoever looks like they've got an insulin pump, right. Or they've got a CGM rather than like just spewing words out of your mouth that clearly are not going to be smart because you don't have two clues. You know, whatever. VLC is on their phone at that point, get on your phone, figure it out, look it up and

Scott Benner 35:05
listen. Not to be too clear headed, because I don't want to ruin everybody's stupidity with this. But you could just ask. Just Yeah, exactly. Say, Hey, I'm very sorry to hear about this. I hope you're okay. Do you know what causes this?

Jennifer Smith, CDE 35:24
And I think the other thing that all of these statements also are kind of show behind the scenes is people want to offer you information without understanding your situation. Right? They think that they like, no. They think they know something like, what did you know about this? And I, I saw this famous person and they're doing this kind of thing. What did you ever think about doing that?

Scott Benner 35:57
No, I haven't, but thank you. And so you're saying I just need to diffuse Oak Grove water? Okay. I want it. Thank you something about cow urine? Did you say

Jennifer Smith, CDE 36:10
how we write cow urine? And you know, I'll

Scott Benner 36:12
get right to it. Honestly, like, I really am gonna, like, I'm just gonna grab Erica for like, 10 minutes, that would be great. And I'm just gonna say to her, like, read these. I don't even need to talk. You just jump on here. And tell me what you think. And you guys are gonna hear that right after my voice stops. So awesome. Yeah. Thank you so much, Jenny. Thank you.

Eric, we'll be here in just a second. But first, let's talk about the Dexcom G seven continuous glucose monitoring system. Why do you want it? Well, it's smaller, it's flatter. It's more comfortable to wear, says my daughter. It's easy to put on the new insert II system thingy, boom, like really easy, push it down, hit the clicky. Done. Very cool. I didn't want to get too technical with you there. But you definitely hit the clicky. And then it goes in, you're gonna get what you expect from Dexcom 10 days worth of monitoring out of each sensor. But now like, unlike with the G six, when you're done, you just kind of pull it off and flip goes in the garbage. There's no pulling out the transmitter and then putting the new transmitter into the new sensor bed. And like you'll see I'm already forgetting how to do it because Arden got the g7 now take a look at it, Dex comm.com forward slash juicebox. Don't get me wrong, the G six is terrific. The g7 is smaller. And there's some other good stuff about it too. Shorter warm up period for 130 minutes, pretty great. decks comm.com forward slash juicebox. Of course, you can get up to 10 followers, use your iPhone or Android phone as a receiver or you can use the Dexcom receiver all that good stuff still exists. This smaller package. You know, they say good things come in small packages. I don't know why they say that. But it is say speaking of sayings, here's one for you get it on the pod Omni pod.com forward slash juice box. Why? Well, how about tubeless? How about you can swim with it, bathe with it run around with it? How about you don't have to disconnect to do things. I just saw another story online today if somebody disconnects their palm who disconnects there. I just thought I just saw another story online today of a person who has to disconnect their tubes pump to do an activity and guess what they did? They forgot to turn it back on blood sugar. Right up. It's a quick way to DKA you don't want that. I only bought you leave on omnipod.com forward slash juice box. Your kids can leave it on when they're out playing about and adults. When you do adult stuff, you can leave it on to can you imagine those adults things but without the tubing. You would like that, wouldn't you? Of course you would dexcom.com forward slash juice box Omni pod.com forward slash juice box check out the Omni pod dash. Or if you want that sweet, sweet automation, check out the Omni pod five. That's right on the pod five paired with Dexcom G six is a beautiful marriage. Let those things make those decisions for you. More insulin less insulin, automated baby omnipod.com forward slash use Basal links in the show notes links at juicebox podcast.com. When you use my links to get these items and the other things that are bandied about on the podcast, you are supporting the production of the podcast you are keeping it free for its listeners and plentiful. That's the thing you do. And I'm not telling you to just go by Omni pod if you don't want it, but if you want it Omni pod.com forward slash fusebox. I'm not saying get a Dexcom to support me. I'm saying if you're getting to Dexcom dexcom.com forward slash Tuesday Awesome. You got it. Alright, let's get back to these. Dammit, mythos. Why can I just say it like that? Myth? Myth I can say multiple myth is myth. And that it seems like I'm saying it wrong. It's very upsetting

Speaker 3 40:27
Hi

Scott Benner 40:39
All right, as I promised when I was speaking with Jenny earlier, I harangued Erica into jumping onto this jumping onto this episode too. So Eric already knows, but you know, just to kind of lay it out for you guys. As Jenny and I were speaking during this episode, I found myself wondering, like, what makes people say these things? Like I couldn't fathom? Like, I'm trying to imagine a person coming up to me and saying, like, Oh, my kid was diagnosed with type one diabetes, or I just got diabetes or something. And the thing I say to them back is so I mean, ignorant, I guess for the lack of a better word, and often course, and mean. You know, to give you some examples that you didn't hear from when Jenny, I were recording, you got obviously the you got diabetes, because you ate too many sweets as a child, huh? Except, you know who that came from, to this adult? Their mother, which flipped me out because you were in charge of the food lady, when, when I was a kid, like, you could have made a different decision if you think that was it. People who sit in a room with you. And you know, the example here was like a commercial came on. And they're like, oh, that's soda, that stuff gives you diabetes. And like that stuff. So you're, I'm really first just looking for your interpretation. Do you think people set out to be Corson unfeeling? Or do you just, this is just a gap between their brain in their mouth most times? Or what do you? I don't know.

Erika Forsyth, MFT, LMFT 42:10
I, I would hope that most often people are speaking without pausing or speaking without thinking how their words are going to land. I think sometimes the example you just gave from the mother. Sometimes it's easier to shame somebody else, as opposed to maybe blame yourself, or consider that as an option. And not that we meet, we're looking for anyone to blame themselves or but that could be an automatic response. Yeah, I think the the ignorant comments may stem from their understanding of what diabetes is, which may be from, you know, misinformation like commercials from, you know, thinking, I think we think about cancer, there's so many different types of cancer. And people try and relate to other stories and other family members who have cancer. And I think they think that diabetes is very similar that there's one type of diabetes, and so they speak out, they make a comment, it may be that they're trying to connect with somebody, they might try and share that they have an experience with diabetes. But they don't know they obviously there isn't a real solid knowledge coming in some of those comments you just

Scott Benner 43:29
shared. I wonder too, not just in this topic. But in general, if people don't want to pre absolve themselves from a future problem. And kind of what I mean by that is, if you come up to them like that, here's the person here said that they were just flat out told by somebody else, that they were a terrible parent, for their child having type one, that they mess, their diet up, and all this other stuff. So obviously, knowing that that's not the case. And that's not how you get type one. I always think that there's like this split second decision made in the back of your brain somewhere like this, like I'm standing in front of you, and your kids been diagnosed, my kid doesn't have diabetes, I have to think you're a bad parent. Because if I think this is random, then it could happen to me and my kid. And like, almost like I have to blame you. So that I'm protecting myself. I'm making air quotes, protecting myself from this thing happening to me, because I'm a good parent. So there's no way this could happen. You must be a bad parent, you must not have done the things you were supposed to do. And that's why your kid ended up that way. And I don't think that's to shame you. I think it's to protect themselves from the fear of it happening to them, but I could be way off on that. But that's how I always think about stuff like this.

Erika Forsyth, MFT, LMFT 44:49
Yes, and gosh, I sure hope that is an internal process. You know, I hope that but I know these things are spoken and they do come out of people's mouths. And I think it gets I appreciate that perspective is I'm going to protect myself because we also are always trying to make sense of why it happened. And if we don't know why we're going to either make false assumptions, false accusations, generalizations, and those obviously, never land well. So I like yeah, that's it, maybe it is a protective factor for the person who's making the comment, and kind of rationalizing how they would never get something like that, or do something like that to themselves or their child.

Scott Benner 45:32
Now, here's another thing somebody said, and I will go, I'll say this, like, it's nice to try to understand people, and to be generous with them and everything. But if someone looks at you, and like, you say, Hey, I found out I have type one diabetes. And their first thought is, and I'm quoting here, you're not fat enough for that to happen to you. Maybe surround yourself with smarter people. Like, honestly, I don't know. Like, there seems to me like, there might be an element here of just people who don't know how to how to be, you know what I mean? Like, that's just a who would in your wildest dreams, Erica, in your wildest dreams? Would you ever say, Oh, well,

Erika Forsyth, MFT, LMFT 46:10
but I think so that we look at, and I know, we'll spend time on how to receive these comments. But I think that person who's saying that maybe is really is trying to compliment the person in our way, right? But their assumption is like, Oh, you get diabetes, if you if you have obesity, that's the person's assumption, right? That's how they're speaking out of that. And so they're trying to tell the person Oh, but you're, you're too skinny to have diabetes, and maybe they're trying to compliment. I don't know, listen,

Scott Benner 46:40
I'm not a well educated person. But if you're having that thought it would be my thought to say, you know, that's really surprising to me, because I, you know, I guess in my mind, I, I relate that to this, and you're not like that, like, why not say that instead of? I don't know, learn a couple extra words. So yeah, so my question is now, it is about that, right? Because you I'm assuming you have a couple of options here. You know, somebody says something silly or stupid to you like that. You could keep yourself together and educate them or try. You could get angry and be back, which I don't know if anybody would blame you. And you could walk away, right?

Erika Forsyth, MFT, LMFT 47:28
Yes, I think first, I would encourage you to think about, you know, here's this exchange of information, you've shared, something you've shared, you've been diagnosed, your child has been diagnosed, they respond in a way that is often maybe not helpful, even though maybe they're trying to help they're trying to relate. They're trying to compliment whatever it is, we don't know. Always the person's intent and motivation. But pay it being paying attention. First and foremost, how is that exchange of information making you feel? Are you feeling and that might dictate your next step? But is it? Are you irritated? Are you angry? Are you sad? Are you you know, raging and sigh?

Scott Benner 48:05
A murderous rage?

Erika Forsyth, MFT, LMFT 48:09
Are you? Yeah, so I think it probably depends on a that the environment, the the context, you know, where are you? Who is the person? And that would maybe dictate your next response? Is it a family member? Do you want to spend time educating them? Maybe? Is it someone? Is it a co worker? Who says, gosh, you know, I didn't you have diabetes? You don't eat a lot of sweets? Or oh, can you you know, this goes along with it? Can you eat that treat? I think your response to do I want to educate them? Do I want to be kind of a jerk back to them and be like, You have no idea go, go Google type one versus type two, or all of the different types? Do you want to just check in with yourself and you know what, actually, that's, um, you don't have to express to them how you're feeling. But you can choose to say, Gosh, internally, you're thinking I'm feeling so angry right now. I want to touch this person. Yeah, but it's not worth it to me. I'm gonna say, You know what, actually, that's really that's off base. And here, you can go look at this website. And then and then later, I would encourage you to kind of spend time on that that feeling.

Scott Benner 49:19
You know, one of the what I count as one of the most terrible things that is said to me, or has been said to me in the past about this, and I heard it a more than a handful of times when Arden was so little, I know 100% It's meant well, but I've never come closer to punching someone square in the face than when I've been told, Oh, well aren't got type one diabetes, because God knows you can handle it. And I'm like, okay, so what are you telling me that because I'm a competent person, I gave my daughter diabetes by being competent. So if I was just a big dummy, then she wouldn't get diabetes because it like and meanwhile I know people have died ladies were incompetent. So I understand I understand the message. I even understand the intent of the message. That one, that one was hard for me, but it was difficult. I think it shut my brain off. Because the only thing I could think to say was like, you know me fairly well, like, I would have just eviscerated them if I open my mouth. So I just I like just big eyes and nodding.

Erika Forsyth, MFT, LMFT 50:24
Yeah, and I think most often people are so taken aback. And usually this is in the early stages of post diagnosis. So you yourself are still grieving, you're trying to figure out what does this mean? What, what is type one, what is type two, you're trying to figure this out. So oftentimes, people are deer in headlights, and they they freeze. It's like, I can't believe you just said that. And I don't know how to respond quite yet. Yeah. And so maybe the best response is to just what you just did not with your eyes wide open.

Scott Benner 50:53
I mean, yeah, like I was. Yes, I was like, I could, I could have strangled somebody for saying that to me. Like, because that's the like, you can, you can mean, whatever you mean, from my perspective, I am a competent person, therefore, your God gave my kid diabetes. Like I was like, all right. I mean, that doesn't make like, can you not step out of a thought and break that down for a second go? Well, that's not at all comforting to somebody, you know, but I understand the idea. The idea is, well, if it was gonna happen to somebody, at least x, y, z, which, by the way, that may have been okay, like, I probably would have, I don't know, in the very beginning, I don't know how well I would have received it. But if you said that to me now, like, just recently, someone online, and I've referenced this once already, so I don't want to go too deeply into it. But they were just kind of like posing, it was like a thought exercise. If if we put Scott in a situation where he could like, accept or decline Ardens diabetes, but he knew but you know, but he knew that, like, all these people were being helped by the podcast, what would he do? I was like, well, unequivocally, I would say no, thank you to the diabetes if you gave me the option. But I was able to have that conversation. But if I wasn't me, like, can you imagine saying that to someone else? Like, it just it's a weird thing to say? I don't know. I don't get it. So

Erika Forsyth, MFT, LMFT 52:21
I think yes, people are often they're trying to be empathetic, they're trying to maybe in that moment, give you that compliment. But oftentimes, they're unskilled and how to express empathy that's appropriate. And it's hard to give people the benefit of the doubt when you're in the space of still grieving and trying to get your feet on the ground. Oftentimes, a lot of my claims will say, when they're trying to give the other person the benefit of the doubt of like, how much did I know about type one, or that there were two different types before my diagnosis? Really? Nothing? Maybe usually, you know, most people do not know anything about the difference, or that there is a difference. But then there's still that feeling of but this isn't helpful. This, this empathy, or this compliment that you're trying to give me is not helpful. So then, going back to Yeah, how do I want to respond? By checking in with that emotion? Is it your own narrative? That they're, that it is your fault? Are you feeling guilty about that? Is it touching on something that you were kind of wrestling with internally that you might, that might be and so yeah, sorry,

Scott Benner 53:28
I'll pause No, not at all. I, I just, I wish there was a way to say to the people who are eventually going to be in that situation where they're going to be struck, and for whatever reason, say a thing to tell them like, at the very least, if you can't, if you can't just get better at talking, then ask questions, instead of making leading statements like that's very, that would be a very helpful way around it. Because then at least the person hearing you would say, Oh, they don't know. So you're missing by the way, why would you know, how many diseases are there in the world and conditions? Um, I don't know anything about any of them. I know a lot about this, and very little about anything else. And I don't know why I expect my neighbor that I bumped into at the grocery store to understand diabetes. So he's just it sounds like it would have sounded to you a week before it happened to you, you know, so it's confusing. I think they're, I think they're scared. They don't want it to happen to their kid or themselves. And the unknown is frightening to people. And I think that I think that blaming the other person makes it feel that's my that is my real take. It makes it feel less likely. It's gonna happen to you if you can say, it's the comparison thing that Come on, everyone does it. You want they walk around constantly and like if you if you're uncomfortable about your weight, you find a person who you're like, Oh, well, I'm better off than they are. Or you're the amount of money you have, like, oh, I might not have any money but that guy, the fenders fallen off his car fenders are on my car. I'm doing okay. Like I just think that's I think people's brains rank things to protect themselves, but Anyway, so yes. So if I want to get if I'm really angry, and I want to get out of it, I don't know like to me, to me, I just, I just go with, like smile and wave, like, yeah, thanks. And just get the hell out of there. Because I mean, what are you going to do? You can't you also can't put yourself in the position of educating the entire world, because they're not going to remember they're not going to understand they don't really care, you know, so.

Erika Forsyth, MFT, LMFT 55:32
So you've received the comment, you're feeling the rage, anger? What what is the most effective way to respond? I think, what you could have one statement to say, you know, what, actually, I used to think that way, too. If you did, you know, I totally thought that way too. But actually, it's really different from that assumption, I, and I'd love for you to go check out and you could list any website, you know, Google Wikipedia,

Scott Benner 56:00
that haven't even have an answer in your pocket already

Erika Forsyth, MFT, LMFT 56:03
have an answer in your pocket. I know. Some people like the the etiquette cards from the behavioral diabetes Institute, you can print off a PDF of those, and they actually carry them in their bags. And we'll say, You know what, that's I used to think that way. It's totally actually incorrect. As it turns out in here, check this out. And so have I think, particularly when you're in that really raw grief stage, to have a statement memorized to say back is really helpful. So that you're not having to make that decision in the moment of like, I want to burst out in tears, I want to punch the person. I'm just gonna say this. You know what, that's actually really incorrect. Here you go, go check out this website. Great

Scott Benner 56:45
idea. And it stops you from looking crazy, which, you know, the worst thing is after this, after this interaction, where you, you didn't start it, someone else starts it with you. And then when you walk away, that person is walking away thinking, Oh, you poor thing. And you're back. They're like, you know, pulling your hair out, because they didn't understand and then you tried to hit it happens in the beginning, when you start to explain diabetes to somebody in the beginning. I don't really know this from a parenting side. You sound out of your mind. Like you really do to other people. Like if I get too low, this might happen. If I get too high, this might happen. I just long term complications, and there's needles and insulin and like you just you start rattling stuff off. And you sound unhinged. I've sounded unhinged in the past. Like when I was first diagnosed?

Erika Forsyth, MFT, LMFT 57:31
Yes, yes. But you're because you do feel this kind of gut need to want to educate everybody, because you've learned so much. And you realize, Wow, I did not realize that there was this difference, and I'm staying on that topic. But so you want to then share the information and let other people know. But then that's exhausting. And it's not as you said, it's not your responsibility to have to do that. But then allow yourself whatever that feeling is coming up in the moment to allow yourself to feel that it might not be appropriate, right? Then

Scott Benner 58:03
take take this one step further, then we'll we'll say goodbye. What happens when you get misinformation from a physician? What do you do then? Like how do you like me? Because it's now it's not a one on one. It's not you know, a person you work with or person, you know, but it's somebody who extensively has like a position of power over you. They're saying something incorrect, or doing that thing where people come in, this happens a lot. People, they struggle, they figure something out, they get together super proud, they head to their doctor's office, look what I did, I got my agency to drop a half a point, I'm super, like, stable and everything. And the doctor just immediately says to them, well, you must be low too much. And they're like, No, I fit and they won't even some people won't even hear of it. They'll try to tell you to like I've heard of people's having their pumps taken from them. After finally achieving success, the doctor is trying to turn their insulin down to make their blood sugar's higher. So wow, I don't know, how do you like that was painful.

Erika Forsyth, MFT, LMFT 59:00
I think? Well, as we have all learned, we've become really good at advocating for ourselves and our needs. And in the beginning, that's a new for some, you know, it's a new skill set, right to know what you need and be able to advocate for it. And you can do it in a respectful way of, you know, all due respect Dr. So and So, but this is my body and this is my child's body. And we found great success with this. Thank you very much for your time and your and your suggestion.

Scott Benner 59:35
I've seen a lot of people send me notes. They're like, Oh, the doctor took the palm made changes. We walked out of the room. I didn't even get out the lobby put everything back. And yes, we got going. So yes, it's a weird, weird position that you don't expect to be in but it very well could happen. So well. Thank you. And

Erika Forsyth, MFT, LMFT 59:54
but one more. One more comment of just encouragement. I think it does. comments about not only why did you get diagnosed, but how you should operate as a person with diabetes, those comments do continue right throughout your life. And they do. Either your skin gets thicker or you have all of your statements already memorized in your back pocket. And then you and it's easier to just choose to say, Oh, actually, that's totally false. But it's okay, we can still we're still good, you know, and it doesn't hit you as hard. You know, over time that does that does happen. So I just wanted to give that piece of encouragement, but in the beginning, it can feel like you're just getting barraged with those painful comments.

Scott Benner 1:00:40
Right. Okay. Thank you very much.

We're gonna thank Jenny, we're gonna thank Erica, we're gonna say that Jenny works at integrated diabetes.com You can hire if you want to. You can thank Erica. And you can thank and you can hire Erica, if you live in a couple of states, you can do the virtual with her. Erica forsyth.com Go hit her link up and see if it fits for you. If it doesn't betterhelp.com forward slash juicebox save 10% On your first month of therapy with my link. And of course, Omni pod sponsoring this episode. Thank you Omni pod Omni pod.com forward slash juice box go get the Omni pod five. And Dexcom is here to dexcom.com forward slash juice box to do G seven. Where that G six right at your fingertips at my link dexcom.com forward slash juicebox. Thank you so much for listening. I'll be back again soon with another episode of The Juicebox Podcast. If you can think of more diabetes misnomers and you want to share them, share them with me. On my Facebook group Juicebox Podcast type one diabetes. It's a private group with over 40,000 members. You can be part of it. Find it log on, make a post and say Hey, Scott, I forgot about this one. Maybe one day your example will be on the podcast.

#913 The 5-4-3-2-1 Method

Erika Forsyth is an LMFT who has type 1 diabetes. She and Scott discuss the 5-4-3-2-1 grounding technique.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 913 of the Juicebox Podcast

Erica Forsythe is back and today she and I are going to speak about the 54321 grounding technique. I know you've never heard of it before, and you're like, sounds like counseling, Scott. But there's little more to it. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. At the end of this, if you find yourself saying I loved Erica, I want more you could make an appointment with her at Erica foresight.com. Erica serves a number of states right now. Virtually virtually that's the word right. California, Oregon, Utah and Florida. And she's in California if you'd like to meet her in person, Erica forsyth.com. How would you like super comfy sheets soft and luxurious? And how would you like to pay 35% less for them than other people Bay. You can do that at cozy earth.com When you use the offer code juice box at checkout. That's right, the word juice box at checkout saves you 35% This episode of The Juicebox Podcast is sponsored by the company where my daughter gets her Dex comment on the pod supplies from and you can get that and more from us med us med.com forward slash juice box that's how you get started. You go to the link or you call them at 888-721-1514 us med let me just give you a taste a tease right. US med carries everything from insulin pumps and diabetes testing supplies. The latest CGM is from freestyle, and Dexcom. They also have Omnipod, five Omnipod dash control IQ. That's the tandem stuff. They have so much at us. med.com forward slash Juicebox Podcast is also sponsored today, by better help. Now if you can't get to Erica, but you still want to visit a therapist, check out my link better help.com forward slash juice box, you can save 10% On your first month of therapy when you go to that link. Hierarchy. Welcome back.

Erika Forsyth, MFT, LMFT 2:36
Hey, thank you.

Scott Benner 2:37
I have you here today. Because well, let me tell you why. You've mentioned something to me before about coping grounding techniques for anxiety. I remember you saying it to me. And you just we glossed over very briefly. And very recently, a famous person who I've been following my whole life had what they described as a breakdown. And that they went to get help. And that one of the things at the therapy that that they sought out that was incredibly helpful is something called the 54321 coping technique. You call it that Do you have a word or name for it?

Erika Forsyth, MFT, LMFT 3:23
I can't grounding technique.

Scott Benner 3:25
Okay. I want to just, I don't imagine I'm going to get to talk very much in this, but I'd like you to explain what it is. Talk about the steps of it, and then maybe give me some examples of how to use it in real life.

Erika Forsyth, MFT, LMFT 3:39
Okay. So the grounding technique, there can be you can utilize all five of your senses. Sometimes I also teach my clients just the three to one technique, which I will explain. So grounding, what that actually means is bringing your mind and body and your senses to the present moment. This Do you want me to review it? What it is first? Or why? Why might be helpful?

Scott Benner 4:12
I think I think why? How do you get into that situation? Because what it makes me feel like is that you become a little disconnected from reality. Like maybe you get lost in a in a feeling or a thought or a problem, right? And it's almost like, in my head, it feels like it feels like the visually like if you've ever seen in a movie, somebody's getting sucked out of a dream. Like they're having a dream and then all of a sudden, they they suck them back to where they are. It's almost like to me it's that feeling of I'm away in this dream in this other place and I can't get back to me. Yes. Is that okay? Yes,

Erika Forsyth, MFT, LMFT 4:48
yes. So I would I would encourage someone to use this technique when they are feeling like people describe it as they're spiraling right there. mind their thoughts are racing, they feel like they can't control the experience they're having whether it's physiologically like your heart is racing, you're maybe even feeling like you're spinning a little bit. And your thoughts are just, you're perseverating on something, usually, it's about anticipatory fear, something that you're worried about in the future. But it can also be something that's happening currently. Or it could be something that happened in the past, and you feel like you cannot get yourself out of that moment and added the feeling. And it feels really scary and overwhelming, that often can also, this experience can be connected to having a panic attack, where you, which are very, it's very scary, and other people describe it as feeling like they might, it's as if they're dying, right, that their their heart is racing, they can't catch their breath. The the grounding technique can be difficult to utilize once you're experiencing a full panic attack. So this would be something that it can't be done, but it's really, really challenging. So this is kind of when you're in the space of your, you know that your mind is just going going going going and your heart is racing, and you can't feel like you can't make it stop. So what you want to do, so the grounding technique, again, you can call with your ball, five senses, or three is bringing yourself to the present moment. And sometimes even before, using the grounding technique, it's helpful to kind of check in with your breathing. So two different ways to do that one is just placing your hand on your heart. And you're just kind of getting in touch with your body and you might feel your heart racing, you might feel it slowing down, you're just kind of letting your body know that you're here like you were with your body. Because sometimes people describe when they're feeling panicky is that's the you know, the out of body experience. So you're connecting your hand to your heart and connecting with your body. Another way and this kind of goes with the 54321 technique is holding up one hand and you're tracing the other hand, you're tracing one finger on the other hand, up and down the finger, your fingers, it's might be hard to do without seeing it,

Scott Benner 7:15
I used to, I used to do this when I was a kid, I started my wrist and go around my thumb and then around my pointer finger and then just keep going around the edge of your hand like that.

Erika Forsyth, MFT, LMFT 7:23
Thank you Yes, and then you're inhaling as your as your pointer finger is going up one finger, your thumb, and then you're exhaling, going down. I encourage people to try these breathing and you kind of go through up and down each finger inhaling as slow as you can, and then exhaling as your pointer finger goes up and down each digit to just kind of slow your mind and body down before you do the grounding exercise. There's really no right or wrong way to do it. But sometimes people will tell me, and I know it can be really challenging to be in this headspace of, of panic and say, I'm going to do my grounding technique. It's hard to jump into that. So the breathing exercises kind of helped slow everything down. Okay. Okay. So the 54321. The first one is, look, you're looking in your realm, wherever you are, you could be at the grocery store, and having this experience, you could be driving in your car, you could be at your office, you could be at your child's school, wherever you are, you're looking around in your physical space and identifying five things that you can see. Now what this experience does, is it It forces you to stop thinking about whatever you're thinking, because you're then having to look and identify, Okay, I see this book, I see the layout, I see the desk, and you kind of want to it takes time, but you kind of want it as slow as possible. You don't want to be like okay, see, boom, boom, boom, and blah, blah, blah, next. But again, that's it. So kind of look around and taking it okay, see five things. The next one, and oftentimes it gets confusing of like, which sense do I do? 54321? It doesn't really matter.

Scott Benner 9:10
Yeah, just an hour. I want to get back to what you said. It doesn't really matter what census but but in the, in the idea of like, five things that I see around me. It's, it's not like I see five pieces of paper and I'm done. But do I say it out loud? Do I see I see a pack of paper. I see a camera like, am I saying it out loud? Or am I saying it in my head? Or does that not matter?

Erika Forsyth, MFT, LMFT 9:36
Um, I think it probably depends on your comfort level. If you're alone, it could be helpful to probably say it out loud and then define it like okay, I see the tissue box and it's rectangle and there's orange and yellow and blue print on it. You could say it out loud if you're in a public place and you prefer not to it's okay. Okay, okay. Yeah. But yeah, try as I said, you know, going doubt around the objects slowly identifying them if you can, describing them out loud or in your head, right? So, just you're just slow. You're bringing your mind and body and now first, your vision to what's in front of you. Okay, the next one is for things you can touch. And that's not just like, you know, again, I see my smooth laptop, you're gonna feel it. And you're gonna think to yourself, Okay, this is kind of rough. I can feel my fingertips going back and forth over it. And then the next thing, okay, oh, this is really smooth. The mousepad is smooth, and it's pink and purple, you know, whatever. The next one, three things you can hear. This is quieting, you know, you're you're using all of your senses to quiet your mind and quiet your body. And so you're listening. And this may take some time. It could be you hear your heartbeat. It could be I can hear myself

Scott Benner 10:59
breathing. I can hear. You can hear silence even if you get quiet enough like that. You can hear the room, which is silence. I don't know if that makes sense to people. I wear a lot of headphones. So I think of it that way. But I can hear nothing. If that makes sense. Yes, right. Stillness. Yeah. Okay. All right. So like that five things that I see. I see my I see my microphone. It's on a stand. It's got a long cable on it, like take a minute to describe it. If I already decided to touch that microphone. It's metal on one side and cold and smooth. On the other side. There's a foam cover the foam covers rough and it's porous and to actually touch while I'm thinking three things. Three things that I can hear is an idea of how to get quiet and then really listen. So you're just calming yourself down really right you're grounding yourself. I mean I know that's what we're talking about. But that's it's really fascinating before we get to the next thing where does this come from? Like where did this idea originate?

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Erika Forsyth, MFT, LMFT 14:18
Do you know of grounding technique I imagine it's connected to you know an Eastern philosophy of you know mindfulness being present in the moment I couldn't tell you exactly who created it or where it originated but I imagine it's you know getting to that place of the practicing the art of mindfulness stillness being present with your body. Have you discovered who created it

Scott Benner 14:45
here the National Institute of Health says was first developed by Lowen one one the Madonna of psychotherapist apparently only get one name 1958 between 1958 1979 Oh, one was one of the first body psycho therapists. Okay.

Erika Forsyth, MFT, LMFT 15:04
Okay, well, thank you. We give him give low end credit him or her? Yes, thank you.

Scott Benner 15:11
I'm usually the one that just calls. Okay? Okay, so number two, okay.

Erika Forsyth, MFT, LMFT 15:20
So then two things you can smell. And again, you know, taking your time and this is, it could be your own, you know, something that's in the air, your body, your perfume, your, you know, whatever, whatever is feeling that maybe you don't even have candles or if you if you don't have anything that you can smell, you could light a candle at you know, do if you have the oils, something if

Scott Benner 15:48
it just shows your shirt, right? You probably smell your own hair like anything.

Erika Forsyth, MFT, LMFT 15:52
Yes, yes. Anything. And then one thing you can taste, which is this is tricky. And this is why I go over the three to one. You know, sometimes people get caught up and like, well, what if I don't have like a strawberry in front of me, but it could be also just tasting and being mindful of what is the flavor in your mouth. It could be leftover breakfast flavor, it could be your coffee, you know, that you've had? It doesn't have to be something that you are actually tasting in the moment. But just kind of going back to being mindful. Like what did I have this morning might be your toothpaste, right or your mouthwash that you're tasting in your mouth?

Scott Benner 16:27
I don't need to lick my desk when I get up. That's correct. Right. Right. Right. And by the way, how proud is everyone of me that I didn't say that you could smell what the rock is cooking. Because that did pop into my head. I've never watched wrestling in my life, and it still came to me. So so the taste thing am I actually looking, but my first thought is to put something in my mouth and taste it.

Erika Forsyth, MFT, LMFT 16:54
If that's if you had happened to have something, or maybe you have your coffee or your tea, or you have food in front of you or a snack, but it doesn't necessarily have to be that it can be something like there's a residual taste in your mouth typically,

Scott Benner 17:07
how long? Do you think the 54321 process takes a person? If they go through it mindfully this or not? Uh, this?

Erika Forsyth, MFT, LMFT 17:17
That's a tough? Yeah, I don't I think it can be, it probably depends on as you as you practice, it will probably take longer over time. I mean, you could probably do it in as quick as like, a minute or two. But I don't know if that that might not be as effective. So maybe if you could stretch it out even over five minutes, 10 minutes, I think would be a challenge, but could be done.

Scott Benner 17:40
Okay. So be seated standing doesn't matter. Do you think?

Erika Forsyth, MFT, LMFT 17:45
So these are good questions. I think a lot of times people associate grounding with you know, going outside barefoot and grounding your feet on the grass on the ground and really connecting your body to the earth. You can do that in that process. But I also really want to encourage people that you don't have to be in a special position or environment or place to practice this. So whatever I would say whatever makes you feel most comfortable and focused on the exercise, but if it just means you're at you're sitting in your car at the stoplight, you can do it quickly. Right. And oftentimes, the clients will get it's confusing to think, okay, 54321 What sense am I supposed to say am I supposed to touch five things, I supposed to see three things. And so sometimes it just to remember, three to one, which is if you if you maybe if you're at a stoplight, and you only have a few minutes, a minute, three things that you can see two things, two things that you can touch. And one thing that you can hear that eliminates the smell and that tastes but sometimes that isn't as easy to do. And again, really, I don't find maybe in the literature, it is important to do it in that order. But I think really the the emphasis is grounding yourself to the present moment and interrupting the Thought Cycle and then calming your body physiologically as well through the process.

Scott Benner 19:16
So the first time I heard anything about this was from you. When I was explaining leaving my son for the first time in Atlanta, and that it occurred to me that I should call my brother and talk to somebody and you said, Oh, that you are grounding yourself. And I was like, Oh, I didn't know I was doing that. But it does make sense like, and then it's distracting. The conversation is distracting then even though like we talked about what was happening, even saying it out loud makes you realize like, oh, it's not as bad as I thought it was when it was when it started to happen. I don't if that makes sense or not like almost talking it out loud is helpful.

Erika Forsyth, MFT, LMFT 19:57
Yes, and I think you were also do doing that while you were driving. So you had to be you had to be kind of mindful in the moment as well of driving, bringing you were in the present moment. And grounding yourself can look like yes, you were you were talking to him and talk me through what happened. And then also thinking about what was next.

Scott Benner 20:23
Yeah. I have to say I also find the work of a guy named John Sarno around back pain to be really valuable. And one of the things that I've always taken away from his books that I read years ago the that the idea of that you can tell yourself like, I'm not injured, like yeah, my back hurts, but I'm not injured. I don't have a physical injury didn't fall. I wasn't hit by a car like something's not structurally wrong with me. Yes, I'm feeling pain right now. But I'm not hurt. I'm okay. My back's okay. Like, I used to tell myself that, and it was actually incredibly valuable. So it mean, to the point where I would say that, that the stress could kind of exasperate the, the pain, like so you have the pain, and then you get stiff? And then you start worrying, like, am I going to be able to go up for work tomorrow, and like, you sort of spiral, I guess, same thing we're talking about. And then I would just tell myself, and I would say it out loud, if I, if I had the opportunity to I'm not hurt, my back is not injured. This is okay. And it would actually help. So,

Erika Forsyth, MFT, LMFT 21:31
yes, I mean, that's really effective, you know, with people with chronic pain, right to there's the pain that you experience. And then there's the thought process that goes alongside it that can contribute to even more pain, emotionally, or sometimes even physically. And that's, that's a great exercise of there is the pain, you're not like ignoring it, diminishing it. But the thought process as a result of that you're separating the two, you're not connecting them.

Scott Benner 22:01
Is there a world where I would ground? prophylactically? I'm sorry? Is that a word people know? It I'm sorry. Just for context, it means like something I would do ahead of time so that the thing never happens, like, can I ground myself before I become, like, upset.

Erika Forsyth, MFT, LMFT 22:20
So like, free, like a pretty meditation,

Scott Benner 22:24
right to do something. We're just talking about meditating at

Erika Forsyth, MFT, LMFT 22:27
that point. So front to front load. I mean, I think anything you do that you practice, even when it's not in the crisis moment, it's going to be easier to implement in that crisis moment, or in those stages of panic. So if your mind and body is accustomed to grounding yourself, which could look like meditation, which could look like various, you know, different practices. If you know how to do that, instinctively, it'll just be easier to do. And, you know, post, right, right, when the moment when you feel like you really need it. Yeah. When is that beneficial? i Yeah, absolutely.

Scott Benner 23:10
I guess anything that works for you is beneficial, but like, it just occurred to me like, I wonder if it like is becoming disconnected? A thing that happens, like at the snap of a finger? Or is it something that maybe happens throughout the day? And you don't recognize it until you know, you're you've slipped over the slope at that point?

Erika Forsyth, MFT, LMFT 23:29
That's a That's a great question. I think part of the initial process that when you're becoming a is having that awareness that you are cycling, or spiraling, or per separating, and you're experiencing the anxious symptoms, because oftentimes, you might not even realize you're doing it until you are at that place of having the panic attack or feeling like you cannot function, whether it's momentarily or seasonally. And so, one of the first steps, you know, is to increase that self awareness of like, Oh, I'm doing that thing where I'm, I keep saying I'm using what if, you know, worst case scenario thinking? This is kind of going back to some of the you know, that the cognitive distortions or the lies or the worst case scenario thinking, becoming aware that you're doing that is is really the first step, and then being kind to yourself in that moment. You say, Oh, gosh, I'm doing I'm doing that thing again. Gosh, this is because I'm feeling really nervous about this upcoming event, right? I'm feeling really nervous about letting my child go to school. Okay, I am. So you're being kind of kind to yourself, being aware and being kind to yourself, helps kind of lead you to the end to the next step of whether it's the you know, the deep breathing exercises are the grounding technique.

Scott Benner 24:51
And do you like from your perspective, obviously, this is something I should I should be asking you. This is something you use with people who see you.

Erika Forsyth, MFT, LMFT 24:58
Yes, yeah, yeah. So we've talked about this all the time

Scott Benner 25:01
do people report back with with success? Normally?

Erika Forsyth, MFT, LMFT 25:06
Yes. And I think it can be successful. But the common issue is that it does take practice, right? So it, it's hard to go from the state of panic to Oh, yeah, that's right. I'm feeling panicky, I'm gonna go do my grounding technique. It's really hard, right? And so it does take that practice. And that's why we kind of we break it down into what are the thoughts that you're thinking? What are Are there different distortions that you're believing, being kind to yourself in that moment, replacing those with truths, all the while, integrating the coping skill. So it's hard to go from the A to Z, without some of the steps in between. And then it just, it takes practice.

Scott Benner 25:52
I'm looking around online while you're talking. And because it just keeps striking me that anybody who knows about like electrical work, right, you have to ground the socket, you have to like, and you grounded, you're grounded into the earth. So that if there's not an electrician, but so if there's a surge, instead of zapping you, it were the house, it literally goes down, there's a metal spike somewhere outside of your house, it's driven in the ground and your whole electrical system is is attached to it so that, you know it can ground we're not talking about anything different, really, we need to help people to go outside, walk barefoot lie on the ground. I even see here submerse yourself in water. And then there's equipment to ground yourself with, which I would have no idea about. But my son brought this up to me like last year, he's like, you know, you can get like, like a mat to sleep on that literally is, is grounded the outdoors. And I was like, why would that be? And I can't wrap my head around it. But maybe there's something to it. You know?

Erika Forsyth, MFT, LMFT 26:53
That is such a great analogy. Yes. Thank you. That is good.

Scott Benner 26:57
I like it when you thank me. It makes me feel it makes me feel evolved. Like it makes me feel like oh, Erica Foster, thank me, I must have been really thoughtful just then.

Erika Forsyth, MFT, LMFT 27:10
Well, it was good. That was a good,

Scott Benner 27:12
thank you. I appreciate it also makes me feel like you're way healthier than I am when you do that. Always like she's, she's either so good at this or just way more together than I am. By the way, I want people to know when they hear this first run. This is coming out during I think it's National Mental Health Awareness month in May. It is it is I cannot take credit for doing this on purpose. That is not why this happened. So I saw something in my social media a few weeks ago. And I mean, for clarity. I mean, he's very public about I guess I'd be happy to say it. The movie director Kevin Smith had a mental health crisis. And he put out a 30 minute video talking about what he did for himself. And I watched it. And he was talking about this grounding technique, which made me think oh, wow, Erica brought this up to me. And, and I thought wouldn't that be nice to walk through it to? To share it with other people? So that's how we got here? Um,

Erika Forsyth, MFT, LMFT 28:15
yes. I think one of the beautiful things about it is that it can be done without anybody knowing like a lot of my a lot of students that I work with you maybe have test taking anxiety or, and even even caregivers as well. You can do it without anybody knowing it doesn't have to be this big. You know? Yeah, exercise that is embarrassing, or causes a lot of, you know, public or personal distress in public. And so you can do it. No one even knows you're doing it. And that's the beautiful thing, kind of

Scott Benner 28:49
like opening up your phone to look at your CGM. Like that's right, right. Just Oh, I'm doing your thing. No one knows but me. And that's yeah, that is really wonderful. So practicing it so so not not indifferent, indifferent, not unlike almost anything else in life. Like, don't just reach for this information in the moment where you're actually having a panic attack. For example, like do it today. Do it now just practice so you, you know the steps and maybe it will maybe you can even like because I mean, I'm doing it while you're talking. You can feel like that. I guess centering is the way to go or balance or calm even like it made me realize that when I because I sit in like 1000 different positions while we're talking like I lay back like my microphone moves around really easily. Sometimes I'll sit back I'll sit up, I'll sit forward. But I found myself sitting up straight and and planting my feet on the ground. And I'll tell you, I never considered it before but there's an alleviation of something. When I'm when my body knows I'm in a stable position. I've just I've done it like four times while you're talking. It's happened every time I can pointing exactly what it is. But I feel stable in this position with my feet planted firmly. It's very interesting.

Erika Forsyth, MFT, LMFT 30:06
That is, that is a great point. Thank you for reminding me that, yes, it could be helpful. If you're able, if you are seated to have your feet on the ground, kind of everything at right angles, if you can buy your knees, and then your your hips, your shoulders above your hips, because that is your kind of in alignment. And that can help you focus if your bodies in that posture, it can also you're bringing mindfulness to your body through the guidance. The grounding technique. Yeah, it doesn't have to be. But that is another helpful tip.

Scott Benner 30:43
An arc is the person who slept through high school, I feel weird saying this out loud. But I feel like what I'm what I'm experiencing. I'm just trying to tell you, I didn't do well in science. But I feel like what I'm experiencing is my body is not making a bunch of micro adjustments to keep me balanced. And so it's almost like my body's able to relax. Because I'm in this position. It feels like the it feels like the chair has me chairs under me, it has me it's behind me the way my weight is there. And even when I think to shift, I can't because my feet are firm. But if you stand up, I don't know if we think about this a lot. But you're constantly. Like if you've ever watched like a robot try to balance like when they're teaching robots to walk, and you can. Okay, so you can hear well, you can hear the servos in the legs and the articulations where it's constantly like it's constantly balancing itself, like forever balancing itself. And I just realized that when I sit up and I put my feet on the floor like this, my body doesn't feel like it's, it's working to hold me up. And it's relaxing. So anyway, I mean, it's grounded, because my feet are on the ground. But I think more I think more like it's like an alleviation of like, processes that you don't know are happening constantly. So one less thing your body's doing. It's kind of how it feels. But again, slept right through psychology as a senior. So I did I did a final but did not did not listen, Have I ever told you that story? No, congratulations. Oh, thank you, my, my senior year, we had a half year psychology class. And it came right after lunch. I was always very sleepy during this class. So I would I would sleep through the class every time. The guy was boring. And it's not that I didn't like the topic. I thought the topic was great, but he just didn't deliver it well. Anyway, halfway through the year, it's time to make the final because only half your class. We come in, he hands out the final. I fall asleep. Like let it take I just I looked at the finals. Like I put my head down like went to sleep. My friend woke me up. And he goes, I remember his words. He looked at me incredulously and said Don't you think you should at least take the final I thought as a valid point. And I sat up and slapped myself in the face a little bit and took the test. The next day we came in for the last day of class. This the dejected man at the front of the of the classroom holding the finals graded in his hands. He was so like, it'd be used distraught. And later I realized he was distraught because I think he thought his existence was a waste of time and unnecessary because I got the best grade on the final. Oh, he was so pissed. And he goes, How is this possible? And I said I probably learned while I'm sleeping. Anyway, I found it. I love psychology. I just didn't like the way he spoke about it. But I'm fascinated by it. Otherwise, I appreciate you doing this. Is there anything we're leaving out? Or any?

Erika Forsyth, MFT, LMFT 33:53
Yeah, yes. I think I was just thinking back when you asked you know how to clients report is as effective. One thing that can be challenging is it's easier if you're hearing someone tell you to lead you through the steps. And obviously it can be done independently. And so if you're finding when you're wanting to try this or practice this, either writing it down on a sticky note, you know, 54321 with the different senses. You could also record I'm sure I know, there are probably you know on various apps or even you could YouTube, Google YouTube, you know someone walking you through this. You could record yourself which can be really powerful. Walking yourself through the steps. So if you're finding that it's either challenging or doesn't feel as effective if you're working through the steps internally by yourself if you need to hear someone walk you through that. That's just another I just wanted to suggest that as another tip. Yeah.

Scott Benner 34:56
I don't know firsthand, but I would also bring it Up to the I've heard so many people talk favorably about Transcendental Meditation. And TM is I think they offer like a tiered system to pay for, like to learn how to do it. And I think it's pretty reasonable. If that's ever something that I'm that you are interested in if they charge you by your household income. So if you want to learn how to do TM, I were find another form of meditation that just seems like such a good idea, honestly, like just the idea of sitting quietly. In general. Yes, yes. There's so much going on. Erica, like, I mean, there's a moment today, when I mean, we work from home, you know, my wife's downstairs, she's working, she hasn't been feeling well. You know, Arden's two weeks from coming home from school, we're traveling soon to pick her up. And my son still away, he's by himself, I tried to work, I had an advertiser, like, got a little funky, and I had to work it out. And like, you know, like, there's everything going on, and I come downstairs, and my wife starts telling me something about an experience she had at work today that was really genuinely interested in her as she's talking, the dog has to go outside. And now I'm like, hold on, hold on, wait, I'm pausing her and I let the dog out. And then I get outside and my neighbor's waving to me. He's got a question about something. And then I'm talking to him. And before I know what, it's 20 minutes later, and I'm back inside. And I'm like, Kelly, what were you saying? She didn't even remember, she was talking to me at this point. And all I could think was, there's too much happening. Like, there's just there's too much happening. And I gotta go back upstairs. And I have to edit three of these podcasts today. And I have four phone calls. And I have to set up this thing. And Eric and I are going to record and, and I can understand when people just like, like spiral out like, it's, it's like my life's going well. And it's still a lot, and I don't know what you're supposed to do when things aren't going well. And all these things are still happening. And these are just little things like, these are just momentary things that I find myself bumping into, while I'm going through my day, there are other big ideas going on here. There's, I have a whiteboard next to me is like 50 things written on it that I have to do, and it's already time to pay like my taxes again, and like, you know, like, it's just like, it's, it's a lot, you know, and I don't know, it just it feels like it would be valuable to have a couple of moments of quiet. And whether you're, you know, having an issue or just trying to stay present, I guess is the right word. It's so funny when you say it. When you say present, grounded, when you say grace, when you say things like that. I think these are so like obvious ideas. Like, I don't know why we don't talk about the more, you know,

Erika Forsyth, MFT, LMFT 37:53
they're in there. So they're hard to do for ourselves and internally, like we can offer grace to our children, we can help them oftentimes, you know, we can help them calm down. We can help lead them to say no, it's okay. You can move from school and you're in your child's you know, running around, they've all this homework and their blood sugar's high. And it's, it's easier to maybe help someone externally. Yeah, to kind of pause and take one thing at a time as opposed to in our own body and mind. And so we I, we often talk about, you know, trying to think, how am I going to ground How am I going to calm myself the way I would my child, or my best friend or my partner,

Scott Benner 38:37
I'm going to try this. And because this may sound may sound opposite of what I just said, but I'm having a struggle, like a personal struggle right now. And that is, I'm bored. I don't have enough to do. Like, I have too much to do. But my kids aren't here. Like, I I'm not, I'm, I am not good when I'm not helping people. Like it feels very hot. My Existence feels hollow right now. Like, I feel like I'm getting up and doing the thing I'm supposed to do. And, um, you know, working on losing weight, which is going well and, you know, like thank you. And, and and so everything's moving the way I want it to the podcast is very popular, it's doing terrific. I can't, you know, all that. So there's nothing going wrong wrong. And yet, I keep thinking I'm bored. And when I really stopped and thought about it, like I'm not involved with the kids as much, and I didn't realize how much I would miss that and how much of my I mean, I knew how much of my life it was. But I didn't understand that there'd be a vacuum like that like and there's a vacuum I did not expect and anyway, I just I need to do something because I don't know like i right Now I feel like I'm floating through my life at the moment, if that makes sense. So, anyway,

Erika Forsyth, MFT, LMFT 40:05
maybe a bit a bit untethered from where you found your, your purpose. Yeah, and you derived a lot of value and purpose from that. And so with them gone, maybe there's a little bit of untethering. And that can maybe lead to various amount, you know, think thoughts and feelings, and which are all valid and true. So you get to feel that and in that process, maybe going back to the, you know, grounding yourself and letting yourself feel those feelings of boredom and maybe sadness or loss, I don't know. But that's what grounding can do is, like, also create space for the feelings that might be suppressed, because you're going going, going from one thing to the next, you're getting all your checks off the whiteboard, and then the feeling that is there. Once you're grounded and present, it allows for it to come out.

Scott Benner 40:56
I don't know if this sounds silly, but I woke up the other day, and I had a text from Arden. And she just wanted this special soap, like a bar of soap. And I like ordered that soap and had it shipped to her and sent her the tracking information isn't the best 20 minutes of my week. And I just was so silly. Like I was like, Oh, am I not having conscious thoughts? Like, oh, I'm valuable again. Like it's not like that. It's that I think I actually enjoyed this. Like, like, like, hearing their thoughts and their their things that are going right and things that are going wrong and like having conversation back and forth about it all that stuff is like it's just gone now. But you know, and and then I'm also thinking they don't have somebody to talk about it with. Like my son especially he's living in a city by himself right now. And I feel very badly about that. Like I want him to finish this part and go somewhere where there's more people and I don't know I just anyway, I'm going to try this is my point.

Erika Forsyth, MFT, LMFT 42:01
Yeah, good dad.

Scott Benner 42:04
Sets sappy stuff about myself. Anyway All right, one day Erica. We're gonna we're gonna we're gonna go over you One day One day find out what makes you tick sit these conversations on your on your throne of good thoughts and no. I want to hear it all figured out. I wonder what a mess you are one day I can't be the only one telling stories about sitting around feeling hollow

Erika Forsyth, MFT, LMFT 42:43
What do I appreciate the vulnerability

Scott Benner 42:45
Thank you very much I appreciate you doing this

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