#945 In the Loop
Mike has type 1 diabetes and he knows a lot about Looping.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 945 of the Juicebox Podcast.
Today I'll be speaking with Mike He is an adult living with type one diabetes who is very involved in the looping community, the DIY, do it yourself, looping community, Mike and I are going to speak about loop and Omni pod five for a little bit today. If you're interested in algorithms and insulin pumping, this one's for you. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're interested in building a foundation for better health, check out my link for ag one and it's a new link. Drink ag one.com forward slash juice box. When you start with ag one with my link you'll get a free one year supply of vitamin D and five free ag one travel packs with your first order drink ag one.com forward slash juice box and get 35% off your entire order at cozy earth.com. When you use the offer code juice box at checkout. There are links in the show notes and links at juicebox podcast.com to 81 Cozy Earth and today's sponsor. This episode of The Juicebox Podcast is sponsored by cozy Earth. I am right now this second on my way to a movie as soon as I record this ad I'm gonna do a movie with my family. I just pulled on my cozy Earth joggers because it's the most comfortable thing I can think of to go hang out that movie theater with I'm going to have on the sweatshirt from cozy Earth. I'm going to pull on the joggers. I'm going to watch me a film. And when I get home tonight, I'm slide into my bed with my cozy Earth sheets. And I'm going to take a shower and warm and dry myself off with my cozy Earth pals. I am not making any of this up. They are really cozy, cozy earth.com use the offer code juice box at checkout. The podcast is also sponsored today. By touched by type one touched by type one DoD word. They have a big event coming up in September that I'll be speaking at. I hope to see you there touched by type one.org. Why did I get the VIP? Oh, let's Did you because I was out of days? Oh, yeah, I just I was literally. So the um, so every year, I might leave this part. And just so you know, every year, I consciously think don't don't book the show so much that you can't add somebody like I have this real like, don't do it. Scott Don't you know. And so I start every year out very carefully, I put out a link at the beginning of the year, I say, Hey, we're gonna we're gonna book like the first six months right now. But then I'm not gonna book the next six months until, I don't know, June or something like I'm gonna wait a little bit. And so many people reach out with so many great ideas and stories and from different walks of life. I just keep going. Yeah, yeah, like, sign up for that sign up for that. And in three weeks, you can't get a recording until like October. And so by the time March or April rolls around the years full already. And then people reach out that I still want to have on the show. And I'm like, alright, well, I mean, I don't record on Mondays, except for with Jenny or something special like that. So go ahead, just take this special link and go ahead and take something on Mondays. And then before I know when I give away Fridays. And then before I know that I'm recording the podcast every day, five days a week and getting to the point where I did somebody on Saturday night the other day, because I just I don't know how to say no. So I want I want that problem. Yeah, I love that. I love making the podcast. So anyway, you ended up with the VIP link because I was out of days. But also, you're a VIP, like hell. Well, thank
Mike 4:05
you. Yeah,
Scott Benner 4:06
whatever your mom told you about you being special is 100% true. You go ahead Introduce yourself whenever you're ready.
Mike 4:14
Hi, Mike. I've been type one diabetic since 2003 How old are you? I am 32 You're 30 No 31
Scott Benner 4:29
You're 31 When will you be 33 that that confused you?
Mike 4:33
Oh no, I am 32
Scott Benner 4:35
Nevermind 32 Okay, my whiteboard is already a mess.
Mike 4:42
Like my birthday is in 90 So like the last digit matches like my your age, but only before after the birthday. So I got to think like right is it before after my birthday?
Scott Benner 4:54
You were born the year after I graduated from high school. Well, that doesn't make sense. So if I had 19 add to this. Oh, baby, let's make sense. 1011 Carry that it's the one I wasn't carrying the 1345. Yeah, that makes sense. That makes sense, meaning that simple math holds up yet again, like, I want to see the proof. Well, if I took a picture of it, then everyone would know how bad my my penmanship was. And I don't want that, either. So, when you were diagnosed, was there like, Oh, I'm definitely gonna get this because all my brothers and sisters have her or have seven uncles that have diabetes, or was it a surprise?
Mike 5:34
No complete surprise. There's, like at the time, I don't think there was any real autoimmune known in my family. Now, my grandmother passed. About a year ago, she had Alzheimer's. And then also type two, which I guess isn't connected. And then my cousin on that side also has lupus. And my keep going, my grandfather on my dad's side has rheumatoid arthritis or head. He's also past the past year. All
Scott Benner 6:15
right. Okay, well, yeah, you were one of you was gonna get something lucky, you might.
Mike 6:24
But I think all that happened after I got diabetes. So we didn't, didn't have the warning. So
Scott Benner 6:29
all of that happen in meaning that you realized it, or she developed Alzheimer's late. Lupus happened since you had type one. I mean, your grandfather's had arthritis his whole life, but they diagnosed it as RA or what do you what do you mean by that?
Mike 6:49
I just made like I was, I had diabetes. First before anyone else was diagnosed with anything.
Scott Benner 6:56
Okay. Well, then you will. I mean, I also
Mike 6:59
I didn't know that the autoimmune connections until listening to your podcast.
Scott Benner 7:03
Oh, okay. I see. So there would be even you might even know, my grandfather's got, like, arthritis really bad might be how people think of it.
Mike 7:14
Yeah, and I don't know if he actually had a diagnosis or not. I just know, that's what my parents had said is that he had Ra. And my brother might have it, he might not. He's got some joint issues that he's trying to work through right now and figure out but the doctors keep running in circles. Yeah,
Scott Benner 7:31
that's what happens. I think that everybody, honestly, it's a shame. Have you heard Jenny talked about how she manages it with her diet?
Mike 7:41
I think I remember like, she doesn't eat, like dairy. Eggs or RA or something
Scott Benner 7:47
is some nightshade things and it's in her she's an episode about how she eats and she talks about it in there. But I wish her brother luck. It's not. It's not fun, that's for sure. Okay, but you just type one. And when you're diagnosed, how I mean, I could figure it out, but just telling me how old you were when you were diagnosed?
Mike 8:07
1212 That's like, sixth grade. Yeah.
Scott Benner 8:13
Was it a situation where the management of it was given to you or did your parents handle it?
Mike 8:21
It was like, they they helped me in the beginning figure stuff out my mom's a dietician. So like she helped lift helped me with carb counts and figuring all that early on. Of course, I didn't know until listening to your podcast about fat and protein and other things that can affect it. So it's just counting the carbs but you think it was pretty much but yeah, me for Well, I guess. I think in the beginning, it was more so like someone else would figure out the dose or like my mom for the first six months while I was still on injections. But then as soon as it moved over to the pump that was just putting the carbs press Bolus, eat your food
Scott Benner 9:03
in the cars and so there's no Pre-Bolus thing there was no adjust no adjusting after meals if blood sugars got higher or did you even test afterwards to see where they were?
Mike 9:13
I occasionally test after and like if I was high I would like I'd put the number in the pump and if the pump said correct I'd correct
Scott Benner 9:22
okay, well that's something did you hate it as a child? Did you not mind it? Do you remember?
Mike 9:29
Um, I I'm pretty good at ignoring things. I feel like I did an okay job. Like Maitland sees I was looking back through and it saw like consistently in the sevens. I think the highest was like 8.2 the lowest was like 7.1 so it just kind of like shifted around in there. I feel like it would have been a lot lower had had been told the Pre-Bolus But yeah,
Scott Benner 9:57
how did you feel growing up like physically Did you feel healthy?
Mike 10:02
Yeah, I didn't, I didn't notice any problems. I wasn't like a super athletic kid. I was, you know, I'd play sports and stuff, but not very athletic, up until like high school where I could get out of Pe by joining band.
Scott Benner 10:20
Like, I just want to dig into that for half a second. What does it mean that you played sports? But you weren't athletic? Were you the, were you the guy that we all looked at? And we're like, I mean, we like
Mike 10:29
yeah, I was I was the one dancing in the outfield. They're like spinning around in circles and the ball get hit and be like, oh, there's a ball, I should go catch that.
Scott Benner 10:37
We like bikes, and we're going to tolerate this, but he's not going to be here long term. That was the feeling.
Mike 10:42
It's neighborhood organized sports, you can't kick a kid out.
Scott Benner 10:46
You'd be surprised, Mike, but I hear what you're saying.
Mike 10:50
Maybe for being a nuisance, but not just for not being good. Can't
Scott Benner 10:53
you just make it very uncomfortable for them until they leave?
Mike 10:59
I'm also kind of like a pleaser. So it's like, you know, my parents like sports or so they think baseball is important. And I did not. I'm kind of like, I can go with the flow with things a lot. Like even if I don't really enjoy something like, I didn't hate going. Can I Can I ask if I had the opportunity to leave?
Scott Benner 11:19
Yeah, let me if I had the opportunity to leave, I'm just getting the hell out of there. If I might, I know this is not really why you're here. But you and I talked before you came on, we might not actually have a reason for you to be here. So I can talk about whatever I want. Can you tell me a little more about that? You understood? How that baseball as example was important to your parents? They told you or they were just big fans of it? Or how did you know?
Mike 11:46
I don't know it like my dad's just always thinking, watching sports. Like, you know, you'd be excited for me to go play baseball, or I don't think it was also like they would encourage just because, you know, it's better to have your kids go around play sports get energy out, rather than sitting on the couch,
Scott Benner 12:07
or cooking math or something. So as 12 year olds tend to do. So she they wanted you to be active. Do you think they picked baseball? Or do you think you did?
Mike 12:21
I don't really remember it was more like that started in like T ball. So a failure. It was probably just like, hey, there's a team. Go join that.
Scott Benner 12:31
scale of one to 10. Mike, how good were you?
Mike 12:35
Oh, probably. We'll give it a two. Okay. Okay. All right. I could catch a ball and throw it but you know,
Scott Benner 12:41
do you ever remember a coach looking at you with disdain?
Mike 12:45
I don't remember. But I'm sure even if they did, I just went right over my head, you just wouldn't
Scott Benner 12:50
have cared. I'm really like now, I'm not trying to be amusing. I'm trying to like trying to gauge whether it's like as a young child, if you were taking yourself to this place and thinking, Well, my dad likes it. And I don't hate it. And I you know, I'll do it like, and if you ever looked up and thought, oh, this person doesn't want me here. So you didn't have any of that feeling like you weren't great at it? And didn't. It wasn't something you were excited to do. But But so then my question is, what's your remembrance of it? Like, how would you characterize playing baseball? I don't know. Is it a good? Like?
Mike 13:31
A neutral?
Scott Benner 13:35
Okay, I'm asking like, I'm asking you an uncomfortable question, because I want everyone who is about to force their child to play a sport that the kid doesn't want to play to hear that in hindsight, this was what you call it wasted time. Because there was there it was there something you could have done at that age that would have been better for you.
Mike 13:52
No, I mean, in hindsight, I think it was good. Like I said, it kept me kept me active kept me moving.
Scott Benner 13:59
All right, well, then they heard it from you, Mike forced your children to play sports even if they don't want to. That's what you said, right? Yeah. Keep them moving. I'm encouraged by that because I've met I know you you know what I mean? I don't know you I know kids like you. And I sometimes wonder about that. I think oh, there's two seasons where this kid just I mean, obviously, I think everybody but their father could not have cared less about this thing did not want to do this and got brought there every day. And it makes me happy to think that somewhere that kid has grown up and and not devastated by the experience hopefully using you as an example. But then you said you joined the band but what did you play an instrument?
Mike 14:45
Yeah, drums. So like marching band counted as Pe
Scott Benner 14:52
How was that for hookups marching band?
Mike 14:57
Uh, I mean, I was just a freshman year of highschool, and then I moved overseas, my dad's in the Air Force. So we moved around a lot. And every high school I went to three different high schools, and each one got smaller and smaller, and the bands got worse and worse.
Scott Benner 15:12
Did you stop going?
Mike 15:15
I kept playing. I really didn't like the last my senior year, because it was like super small schools like 200 300 kids maybe. And the band teachers spent most of the time talking about like Broadway or something nobody cared about. And I was the only percussionist so there'd be like, here's seven different instruments that are supposed to be played. And I'd be like, How many can I play at the same time?
Scott Benner 15:40
You kids don't know this, but I was the dog in a production of my fair lady in high school. By the way, is there a dog in My Fair Lady?
Mike 15:48
I don't even I don't think I've seen that.
Scott Benner 15:50
I don't know either. I just made that up. I feel let's just roll with it. Pretend there is now there. Damn. Right. As everybody's listening. It's like it's fine with me. There was a chihuahua running around the whole time. Well, that's interesting. I mean, it's interesting that that it's an it sucks a little bit that you found the thing that you liked, and then because of moving around, and dwindled on you, so you're not a drummer anymore?
Mike 16:12
No, I still drum. Oh, nice. But like, drum set, like in bands and stuff. Oh, it's
Scott Benner 16:18
excellent. You do play you play in bands? Yep. How does that
Mike 16:22
not at the moment, at the moment, I'm in between bands, but COVID kinda ended things like make things a little more difficult for a while and that band ended but yeah, I'm in for a new one.
Scott Benner 16:33
Nice. You off to college then after that?
Mike 16:37
Yeah, yeah. Went to college straight out of high school. And they were still in Germany. So and then I went in Florida to college.
Scott Benner 16:45
Did you feel any pull towards the air force or pressure?
Mike 16:51
Well, I was diabetes, so you got out of it. So in the Air Force anyway.
Scott Benner 16:55
How about your brother? Is he in?
Mike 16:59
No, he considered it for a bit but ended up not?
Scott Benner 17:02
Do you think your dad was more disappointed that you guys didn't go in the Air Force or that you couldn't play baseball?
Mike 17:08
I think he's pretty happy with this no matter what.
Scott Benner 17:11
It's a very healthy answer. Mike Good for you. I would have chosen if you gave me if somebody threw a bullshit which is what I just did choice that me I would have chosen I would have been like, I would have thought about it for a second and pick one is very healthy
Mike 17:25
weight, which was a see all the above is very healthy
Scott Benner 17:29
choice was excellent. I'm so thrilled that that's how you answered. Okay, great once you go to college for
Mike 17:37
I started electrical engineering and then the first semester I changed to computer science.
Scott Benner 17:44
And are you able to employ that education in the in the adult world.
Mike 17:49
Um, I worked at a place developing or like taking other iPhone apps and like keep updating them or for about a year, two years, maybe after college, and then I switch to another job where I print and scan stuff for lawyers. You enjoy that there's a lot of it pays the bills and it's it's something different every day. Like, I've been there like six, seven years, and there's always something like new that'll come in and be like, alright, I don't know how to do this. Let me figure out a way to do it easier quality or
Scott Benner 18:26
problems not it's not it's not just repetitive it's, it's something you can actually employ your brain with. Yeah, it's
Mike 18:33
like a mix between repetitive and not because some days you'll go in and you're literally just feeding paper into a scanner for like the entire day. Oh my god. But then the next day, it'll be something completely different. So
Scott Benner 18:45
here's my next, my next false choice for you the job or we're having to play baseball again on the schedule of a child which would you prefer right now?
Mike 18:56
What's much rather be at this job than play baseball.
Scott Benner 18:59
That's what I was getting. Okay. Alright, so you manage your diabetes? Sounds like pretty much on your own. Were you doing that MDI with a pump?
Mike 19:11
mph for the first six months and then as soon as we could get to a pump, we got a pump.
Scott Benner 19:16
Okay. Do you have a CGM now present day?
Mike 19:21
Yeah, I do now. I think I started maybe senior year of high school, maybe freshman year of college. I can't remember when I first got to CGM, but um, I was Medtronic up until a year and a half ago. So it was basically I treated it more like a don't die alarm. Like if it beeps look at it. If it's super high, then start adding corrections because I think you know, my it probably didn't beep until 200.
Scott Benner 19:48
How would you describe your your management in that time? Your management style like were you on top of it? You know, were you a person who was like I'm not, you know, 200 is my number, you can't go over 200 when it got to 200. Were you worried? Or did you feel like an intensity about how to handle it? Or just was it just part of the day and you just did what you did and didn't think about it?
Mike 20:14
Yeah, it's kind of just like in the background. I tried not to focus on it too much. But like, you know, if I thought something was wrong, if it beeps at me and says, I'm Hi, then I'm going to Bolus but then I probably won't look at it for another couple hours or until it beeps again. I see. And I'm pretty good about changing settings and stuff. Like if I'm, I noticed that I'm consistently going high after dinner, I changed my ratio, change basals and stuff. So a lot of times, that wouldn't be until like, you know, every three months, you'd have your endo appointment, and then I'd look all over the stuff like right before the appointment and wait that three months. And then I change it all and then go in and they'd be like, oh, yeah, that sounds good. You can change it to that. Or you could move this a little bit.
Scott Benner 20:59
Not incredibly helpful. At the end of this office.
Mike 21:07
Yeah, no, I mean, like a little bit, but I never really found too much use out of and two appointments. Yeah, like now I go. About once a year, a little more frequently, like nine months.
Scott Benner 21:19
Get your scripts. Yeah, basically do anything. When do you find the podcast?
Mike 21:28
Well, I just looked in the in the app. Not too long ago, we needed that Spotify end of the year thing? Yeah. Because I was on Apple podcasts. And it said, I listened to the first one in January 18 of this year.
Scott Benner 21:41
Oh, so you've just the year for the podcast for you. Yeah, interesting.
Mike 21:46
I swear, I heard the fatten protein episode in December, like a couple of like a month before that. But maybe I listened to it like on the website instead of podcast. Right?
Scott Benner 22:01
So you see, I mean, 2003 2022. So for a long time you live the way you live? And get did finding the podcast change? I mean, if it changed anything for you, what were the things that you adjusted?
Mike 22:21
Well, I found thinking like a pancreas first. And then, so like I learned like Pre-Bolus and a lot of good stuff from there. And then listening to the podcast just reinforces that a lot. As well as add a lot more stuff like the crush it and catch it. While I've you know, kind of done that before. I didn't really think about it as much. You know, it's just like more of the rage Bolus, and then you go low, so then you feed sugar. Whereas now it's like, okay, I know I can just give a massive dose and then like, so loop now. So I can look like right now I need to put in the carbs now. And then it'll even out before I get low. And let
Scott Benner 23:02
the loop jump in. How long have you been looping?
Mike 23:05
Since almost two years now, years, which is when everything, Eric actually I guess the first big switch was getting a Dexcom. Like I was, I remember watching seeing commercials for it on TV commercials kept coming up. And then it kept telling me like, you don't need a finger prick. And I'd be like, bullcrap, I know you need a finger prick, because I have to ferment Medtronic, like he still got to do it once a day. Like it's better than having to do it as much but. And I just kept ignoring the commercial, because I kept thinking that like, they're quite right. When I finally looked into it, working from home and COVID. So, a lot more time on my hands. I looked it up and I was like, Oh, you actually don't need to calibrate this thing. So then I got that. And then I was I also hesitant to get it because I wanted. I like like I've always been trying to get the next best thing, but it's always a Medtronic. Up until recently.
Scott Benner 24:05
Is that just what your doctor's office gave? You? know, it's
Mike 24:09
I mean, that's what it's, well, no, it started out. I remember I think my mom picked the like, she went to a thing and they had the Animus ping or the whatever the Animus one was and a Tronic. And like she thought the the only perk of the Animus that she saw was like it said pizza in it. And then the Medtronic said square wave for dual wave, right? And she was like, well, he can figure it out either way, and the reps seem to like Medtronic better. Yeah, I got with that stuck with that a while. And actually the last Medtronic I got the dreaded six seven D. My endo tried to convince me not to get it. But I was like, No, this is this is the new best thing. This is going to be auto mode. This is going to figure everything out. It's going to be easy sailing. And I was very wrong.
Scott Benner 25:01
All right, we're gonna dig into a couple of things. Here I have notes. My first thing is I want to, I want to say, I know a lot of people because of what I do that, you know, work behind the scenes that companies like, you know, Dexcom. And in places like that, and a lot of those people who make those television ads and whose job it is to try to reach people and and send the message to them that they might want to check more of it out. And I think any of them that heard what you said a second ago are still banging their head against the desk. They're working so hard. They're like, Hey, listen, just come check this thing out. Here's what it does. And you're at home gone. No, it doesn't. wires. Exactly. What I said, is people crankies people, Mike are killing themselves, trying to make people just learn about a thing. So they can decide if they want to do it. And I guarantee your answer just that it ruin their whole day. They're just like, I Why am I trying? Why do I give up? I actually, you might have seen this online. But I just put out an episode the other day with Jake Leach. And this is going to be six months later after people when people hear this but Dexcom G seven got FDA approval. And I hustled my little butt around getting Jake on to talk about G seven and go over all the questions that I had, you know, people gave me through the Facebook page, I had a couple questions on my own. I put together this really tight 30 minutes with just rapid fire great questions. His answers are super clear and valuable. We'll help you make decisions about what you want to do or what you don't want to do. And then the next part is I put it online, and then I have to support it through social media. My job is repetitive too. So I you know, put a post on Facebook, I put a post on Instagram, put a post here and then I and then I involve myself in conversations with people and try to answer questions and point them in the direction of the things they want. It's a bit of a, it takes a lot of time. And in the end, what I want is for people to listen, I made a thing. I think it's helpful for you. If you think it's helpful, I'd like you to listen to it. The other side of it the business side of it is I need people to listen to the podcasts that they hear the ads so that maybe they click on a link so that somebody will buy another ad again the following year so that I can continue to make the podcast It's the circle of life kind of thing. If people don't click on the ads, I lose the advertisers. If I lose the advertisers, I have to go get a different job, you understand. And so, so every time this happens, and I never say like I never speak out loud about it goes on for years, you put up a link. And inevitably, or three or four people come into some sort of a commenting thread and say, I don't have time to listen to this. Just tell me does it do this? And when I see you know, where does it do that. And I see that it crushes my soul. So like you don't know the way the SparkNotes Yeah, I don't want to listen to your little podcast thing just now. I don't want to just give me the answer. But put it here so everyone can see it. So no one has to listen to the podcast. And and what you don't realize about that is that I spent my entire day on Friday getting that out to you in a timely fashion. I did not eat dinner with my family because of that.
Mike 28:17
We posted those questions and it was up like the next day.
Scott Benner 28:20
I hustle Mike, you understand? I grew up a sheetmetal shop. I take that attitude. I applied to podcasting. So I'm a hard working like person. And then it just I don't I put up this what I thought was a funny post about like, are you people I put it up as a poll. Are you people trying to kill me? Oh, I
Mike 28:37
am not trying to kill you. I think you might accidentally voted for yes. Because I wanted to see who voted for yes. And I was like, Oh, wait, no.
Scott Benner 28:44
Well, overwhelmingly, I think there's like 500 votes that people were not trying to kill me. But not the point. I'll
Mike 28:51
take this one. Yes, though. Once successful, yes, we'll do it.
Scott Benner 28:56
You mean to get me dead or just to make me feel badly about it? I don't, because I don't feel badly about it that you should know. i It's to me, it's like, Oh, you shouldn't it's all in fun. You know, and, um, but I did. It is an exam, it is an opportunity to, to let people understand kind of the back end of this thing, which is, you know, if you like the podcast, I'm happy like, and I want you to like it. I am trying to help people. If you heard me speak privately, you know, this is the time of year where I mean, this is the time of the year where I'm renegotiating with all the advertisers. And inevitably, in every meeting, I say every year, I can't believe how lucky I am I do this thing that I really enjoy and love. It actually helps people and it pays my bill. I have bills that get paid because of that I can like send my kids to, you know, the grocery store. And I feel very lucky about that. And then somebody comes along a person who, you know, has been around for a really long time. And it was like This is all about money to you. And I was like, what? In the hell are you talking about? Like, if this was all about money to me, I would have put this ad, I would have put this this episode together slowly over days and given it to you sometime next week, which, by the way, is what everyone else will do. They don't they're not in a rush and released it on Patreon or something. Yeah, right, or, you know, put it here and there. And we're charged you to do it or do it some shows do which is give you like, 10% of the information and then push you towards a coaching service or something. And I was like, That's so not me. I'm so transparent. And anyway, I just don't know, it's, it's not easy to do. The marketing of your content. It's not as easy as it might look from the consumer side. We're like, oh, I you know, I, this guy on YouTube, I really love he talks about cars that I drive and puts up an episode every week, and it's well produced, and you just kind of take it for granted. But that person is probably spending. I mean, I spend 70 hours a week making this podcast. And then you know, and then we're like, stop pushing your links. And I was like, Look, if you don't click on these fucking links Mike Marino podcast, like, like, I don't do not understand how the world works. Like, I can't just, I got a family. You know what I mean? So anyway, I don't know, like, I was trying to,
Mike 31:23
I think I think Dexcom should start putting you in their commercials be like, This is our product. But if you want to know how to really use it, check out that Juicebox Podcast? Well, I'll tell you on the positive, you can get a put out to whoever watches TV. Well, on
Scott Benner 31:37
the pod made the three on the pod five episodes with me this year. That was yeah, those are good. Yeah, it was a lovely, like partnership there between those. I think, if I'm being honest, I stay on the periphery of that space. Like, you know, companies don't put my face on things. But it makes sense to me, because I don't I don't have diabetes. Like you can't you imagine the backlash they would get if they were like, Hey, this guy follow him? You don't I mean, like, Does that bother you at all that I don't have type one?
Mike 32:12
No, not at all. Because of all the content that I get out of it. Like, I don't really care who's telling me as long as it's good information.
Scott Benner 32:20
I mean, that's makes that makes sense to me. But I don't know where people's sensitivities lie, you know, and they overall, it hasn't been a problem for me. I just imagine. It's my imagination that people sit in the room in a meeting and they go, who do we want to put on this? And somebody goes, that podcast is very popular. And then someone else says he does not have diabetes? And I bet you that puts a stop to it every time. You don't I mean, I feel like
Mike 32:43
it's it's almost even better that it's that you're the caregiver rather than the diabetic, because I feel like a lot of the times are, it seems like some parents are like, super into taking care of their children like you. So it's like, focus on every detail, make sure everything's right, figure this out. Because you're hearing about another person, whereas like, for, like, in my case for myself. Up until like two years ago, it was just kind of like, well just try something if it works, it doesn't just try something else.
Scott Benner 33:15
In that vein, like it's not as fine tuned. Yeah, in that vein of thinking, what is what was, I guess, like, go back a couple of years. When you think about managing your health, around diabetes, specifically, what's the goal? Is it a daily goal, a yearly goal, a lifetime goal.
Mike 33:40
I mean, like, ultimately, the goal is just to live without complications as long as you can, or to minimize the complications. And then, but then there's, there's so many different data points now, especially now that I have all these different naps and Dexcom. And so like, now I like every day, there's a goal to hit for like your time and range or, and then you can shift that into different ranges be like, your 70 to 140 range should be some number and your 70 to 180 number should be a different percentage. And then there's a one C there's standard deviation. There's a lot of goals now.
Scott Benner 34:24
Yeah, well, there is do you think of your diabetes as a in the moment thing? Is it a big picture thing? Is that a blend?
Mike 34:37
Me I think it's got to be a blend, because your sugar affects you now, but it also affects you later?
Scott Benner 34:43
Well, yeah, it definitely has to be but how do you think of it? Like, like, overwhelmingly what is most of your time spent doing? Like don't get low right now? Don't get high right now. I want the week to be good. I want the day to be, you know, in range or like, you know, I'm trying to figure out out, help, it's probably
Mike 35:01
more immediate, like what's going on right now? Or like, what's go? What's about to happen? Or what just happened? Like, the next hour in the past hour? And now? Because you can't really change stuff for next week. I mean, I guess you could, like bagels and stuff like overall, but
Scott Benner 35:22
yeah, I you don't even know like so is that you brought up that, um, you know, the parent of someone with type one and my my role changes drastically as she gets older, right. But my vision of it, my perspective on the issue is completely different than hers. Because I hold all the perspectives at the same time. I want her blood sugar to be stable and steady and low now. And I'm worried about her future. Both in the short term and long term, I'm worried about how she'll deal with this while she's in college, will she keep focusing on it? Will she not? Will she give it away at times to do other things, which I expect? Will that translate into her her young adult life as I got away with it in college, so I'm not going to put too much effort to it now does that go into her late 20s That she started having problems when she's 30? Like, when I when I think about Arden's health. I think of it the same way I think of my son going to college and meeting people and maybe having a relationship and looking for a job like I see the whole like, Mike, you don't do you have kids? Yeah, no, you worry about the entirety of everything when you have children. I don't think of it as worry. For me, I think of it is concerned, it's considering I'm always considering the whole thing. But I don't think that as an adult living with type one. That that's the same for everybody. I mean, I've spoken to a lot of people. And I think overwhelmingly, that's not how people think of it. I think it would be too much to think of it that way. I could see why you wouldn't. But I also think that a certain amount of that is what leads to these outcomes that you want. So it's just interesting for me to hear from an adult about how they like conceive day to day of diabetes. That makes sense. Yeah. Yeah. Okay.
Mike 37:24
And, like I said, for the, like, the consideration also changed a lot once once I got Dexcom, because then it's on the phone, because like, even when it's on the pump, like I'm not looking at the pump a lot. Like I said, Whenever it would be, I'd look at it. But now that it's on my phone, it's on my watch. Like, I can see it a lot more often. So it's a lot more. There's a lot more management or like things to do. Yeah, but I'm trying to say,
Scott Benner 37:53
but that stuff helps. And that's what I want to know, like, being able to see it more readily on your watch, for example, not having to dig into even an app or do a blood sugar test or pull out a meter or something like that. Having it there helps. Having goals helps having an app that says hey, you're in, you know, we're our time and ranges, you know, 60%, and it's 40% here, and we're low 5% of the time, or whatever the numbers are, like it gives you something that you can kind of quickly focus on. But then do you adjust after that? Like when you see it, if the numbers not where you want, do you consciously think oh, I've been high too much this week? That's probably because I ate out a number of times, I didn't have a lot of success boasting for my meals or like, do you give it that much thought? Or do you just think, Oh, I've been high a lot, I don't want to be high as much.
Mike 38:43
Yet. Now I do. So now like about once a week, I'll look back at in Nightscout. Like, I'll look at like the daily reports and kind of see what the trends have been. Like, if I'm more consistently higher or lower in a certain timeframe, then I'll adjust either basil or carb ratios or ISF
Scott Benner 39:05
I'm excited for. But then I'm
Mike 39:09
also like tweaking those in the moment too.
Scott Benner 39:13
Yeah, like when something just goes the way you don't expect it to you you're in the moment helping it and then big picture, you're looking at it as well.
Mike 39:20
And I'm I'm a pretty competitive person too. So like having, like having all these stats to like, when I zoom out, I look at my management now. And I'm like, Oh, I'm doing pretty good. I'm like, you know, 91% between 70 and 180 75% between one and 130 or 70 and 130. But then when I zoom in and like the day to day I feel like I'm always like, Oh, am I again? I'm messing up fix it. I'm low again messing up fix it. But like when I zoom out then I'm like okay, overall it's it's going well
Scott Benner 39:59
yeah, it's I think of it the way I do because you're 100%, right? If you look at any 24 hour graph, most of the time, you're gonna be like, Well, what happened there? You know, and then you look back over a month ago, the month was good. So if that day existed within that month, you think, Alright, well, the month was good. But there's things happening during the day that I'd like to have a better handle on. And which one, I think the problem is that the people can just then go, well, the 30 Day was good, I won't worry about a spike to 240 that lasted five hours. And so that's why I think like thinking about it super simply, it works best for me. I'm not, you know, I'm still in the middle of trying to get Arden to think the same way I think about it. Or if I can't, I'm going to have to find a way to take the way she thinks and apply it to diabetes and adjust that, or she's going to have to find that maybe more specifically, right? Because for me, give me you've heard me talk about a million times, like just, you know, one of the big people are like, what are the rules of diabetes as far as you're concerned, and it's Pre-Bolus, don't let a spike happen. Understand the impacts of your food. But then right after that, when I say like, stay flexible. I think what I mean by that sometimes is like, you know, kind of go with it just okay, this happened. Let me keep working. But it half of that is Don't stare at high blood sugars. Like that's the biggest thing. Like, I watched art and try to do something yesterday. And she's home from school for the holidays. And I kept she's like, I have this, like, let me do it. And I'm like, that's fine. So I let her do it. But four hours into it. I'm like, I could have fixed this two hours ago. You know what I mean? Like, and I see what she's doing, but it's, as she's doing it, am I good? I ain't gonna work. And so I kind of find a time to walk into a room and I was like, Hey, listen, you know, I've seen what you've been trying to do. And I understand why he did it that way. I'm like, that's not going to work, you're gonna have to do this. And she loops and I said, You got to open the loop. You got to make an aggressive Bolus. And then we got to close the loop again to stop the low, right. So she does that she actually Bolus more insulin than I would have done. She created a fall inside of 30 minutes. And I kept an eye on it was later at night. And she was up and I sent her a text. And I said, instead of saying, like, close the loop, I said, What do you think? Does it look like it's time? And let her decide. And then she closed the loop off the loop, the algorithm kicked back and shut off the basil caught the blood sugar. And she was like, I mean, I can look. But she was super stable overnight. Yeah, so the drop happened. It fixed itself around 230. And she's been like 90 for the last 10 At least eight hours. Anyway, it's everybody's got to find their motivation, and their style. And you know, and then just, I think then the hardest. It's all that sounds hard. But then the hardest part is after you figure all that out, it's applying it over and over again, without getting just burned out by the whole thing. Oddly, it's like your job really is right? You just keep feeding those papers and that scanner, like, alright, I don't want to do this today. But this is the job and then you do it. And then you look for ways to be engaged by it. Is that right?
Mike 43:32
Yeah, yeah, I think so.
Scott Benner 43:35
All right. Well, if we could pay everybody for diabetes will probably make them more engaged. Do you think just get it? There you go. I get behind that get a nice hourly salary for taking care of yourself.
Mike 43:46
24/7 365 jobs. So
Scott Benner 43:49
like, do you think that would work?
Mike 43:53
Think about probably not, well, no. I mean, even when I was a kid, like I remember my mom giving me like a list of like, it was like a packet of meals that I had to go through and like calculate the carb counts of everything. And I think it was like, I don't know if it actually was, but I think she told me it was like something for her work. And she was like, Oh, I'll pay you to do it. And I feel like the real mastermind plan behind it was like if I could just, you know, pay him to learn more about carb counting. But the money wasn't worth it. Or not not worth it. But
Scott Benner 44:28
Mike was the juice not worth the squeeze?
Mike 44:31
Yeah, there's the idiom. I love that one. That's one
Scott Benner 44:34
of my favorite ones. Why do I love that one because it was taught to me by Charles, this big, very Italian man that that whose son played baseball with my son when they were in high school, not for their high school, but for their travel team. And we spent a number of years together. Standing in the outfield watching our kids play baseball, and he would say stuff like that all the time. He's from from, from the city from one of the boroughs and he'd be like, pow, let me tell you, the juice ain't worth the squeeze. And I it's not what he sounds like, but I'm just approximating it for you. And it's just delightful. It's so wonderful guy. I'm going to tell some story here. That is because you're on and because of what you said earlier. I've never been mean to a child on purpose Mike.
Are you in the Orlando area and looking to meet a ton of people living with type one diabetes touched by type one.org? Why am I sending you to that website because when you get there, you're gonna go to programs, then you're going to click on annual conference, then you're going to see that on September 16 2023, touched by type ones annual conference is happening in Orlando, and yours truly will be speaking at it. I'm doing a big talk in the main room. I'll be talking to the kids and doing a lot all day with everyone who comes I hope to see you there. Head over now find out all the details. And if you have a company you'd like to sponsor the event, you're still taking sponsorship. What a great way to support a wonderful organization and a fantastic day. Now otherwise, just check it all out. Get ready to come. I believe registration opens on August 1. Don't hold me to that but however over the bed, head over to the link to find out for sure. And you can check out what else they're doing it touched by type one while you're there. Their awareness campaign Casino Night a dance program at dancing for diabetes shows beautiful, they have a golf outing. This D box they send out to newly diagnosed people. They really are doing wonderful work at touched by type one.org. I have just surfed over to cozy earth.com to see what's going on. As soon as I get to the main page, I see that cozy Earth has been on Oprah's Favorite Things list for five straight years. If you love Oprah rush over and get something if you don't like her. Don't hold that against anybody. This stuff's amazing. I see here the bamboo jogger pants were on Oprah's list in 2020. I'm about to go slide mine on in just a second. The lounge socks the waffle towels, were on the list in 2022. I just dried my bottom with those waffle towels about three hours ago friends, and my bottom is happy. I got a happy bottom. You want a happy bottom cozy earth.com You want a happy wallet? use the offer code juicebox at checkout to save 35% a mind blowing 35% off of your entire order. If you spend $1 You will save 35 cents $2 Right, you're following this then it's like 70 cents, and so on and so forth. $100 $35 You know how math works. Cozy earth.com Head over there. Now don't forget the offer code juice box at checkout. It lets them know that you came from the podcast. And it lets you keep money when you're buying sheets. Towels. Women's up Goodness gracious. They got everything from like scrunchies to robes loungewear tops pajamas. Make your ladies happy, my friends. And if your men are always wearing janky clothes and you think they look garbagey give them some great comfy stuff that they'll love it cozy earth you can do it travel sets bamboo hoodies, the viscous bamboo hoodie, you don't even know you don't even know I'm gonna go put mine on right now I am going to look. I'm gonna look good. My my drip will be right when I go to the movie today. I don't know if I use that word correctly. Anyway, you're probably old too. You don't know either. Cozy earth.com use the offer code juice box at checkout. Links to cozy Earth touch by type one and all the sponsors are in the show notes of the podcast player or audio app you're listening in right now. Those links also exist at juicebox podcast.com. I share that with you because when you click on those links, you are supporting the production of this podcast you are keeping it free and you're keeping the heat on in my house. So I really appreciate that. Let's get back to Mike lots more up talk to go loopy loop
I've never been mean to a child on purpose Mike. Except for once to get started. And and I want to be clear, this was never to the kid's face. And the kid never knew about this. Never. But my son played baseball with a kid. And again, I've never met a kid that I like it's hard to dislike a child. Do you know what I mean? Like it's just it just it is and and um probably started knowing this kid at the end of middle school, so I don't know how old they are, they're like, ninth grade eighth, ninth grade right there, and all through high school right into going into college and actually, still was tangentially aware of them in college. And the and the, the kindest thing I can say about this person was that he was a dick. He just someone told this kid, I assume, hourly, how wonderful he was, and how everyone else around him was subpar compared to him, either that or he had a significant mental issue, I don't know. But this person believed in themselves in a way that was unwarranted, and, and cruel, to the point where my son said one day that he could hit a ball and got thrown out trying to stretch a single into a double, which he would frequently do get thrown out trying to make a double into his triple A single to double the gauges, just always cocky. And anyway, the kid gets thrown out doing this comes into the dugout, everyone's pretty quiet. Because I mean, it was an obvious situation where this was just a single, like, you would never go to second on this. And he comes in, and he takes off his gloves and his puts him in his helmet, slams his helmet down, turns the everyone in the dugout, and goes, I'm better than all of you. And then just walks away. And that is but one small example of the dickish pneus of this person. This happened constantly, I once saw him hit a legitimate double. He's running the third even though the third base coach, he just has his hands up going stop, go back, like this is not a triple you and boom gets, you know, gets thrown out at third, I swear to you after the fourth time that happened this summer, the kids slides into third gets tugged out. He stands up and the coach goes, What are you doing? And the kid goes, you like like this was the kid, right? So one year, the kid decides that he's so good, he's gonna go to this out of state camp where he's obviously gonna get drafted from because this is how he feels, which by the way was never gonna happen. But he goes to this thing, it's one of these things you pay money to go to, it's not a special thing. It's if your mommy and daddy have money, then you can do it. And he went and did it. And he came back with batting gloves that had the American flag on it. And that is when myself and the other parents started referring to him as Captain America. And then Superman. And then one night, on a Friday night when we got stuck with the last game of the day. And it's 11 o'clock, and the kids are still playing. And we have to be back again at like seven o'clock in the morning. He comes to the plate. And one of the guys pulls out their cell phone and plays the orchestral music from the first Superman movie, Dan, Dan intentar. And like no one knows, but us it's just we're literally we're out in right field. There's no one within 100 yards of us. We're just hiding watching this game. And we just start snickering like little girls. And then it became a habit where we would find big important music to play as this kid walked to the plate and then like children, we would laugh. And I believe that the the the Olympic music, the thrill of victory and the agony of defeat was the funniest one for some reason. They're dead and dead and just have to imagine his kids just you have to you don't know him and I can't but he would stand up so straight, like two straight. And he walked with his chest out. Like like that he just anyway, he was just a deck. He was he was a child that was a deck and I always thought like, Oh, I hope this like not I hope he goes to college and, you know, maybe finds himself or relaxes a little bit. But no lie in my son's senior year of college. They ended up playing him. Same attitude. Same person just kept going. And I was like, wow, that's who he is. It's fascinating. He's a deck. So I don't know I just at some point that had to be put on the record somewhere. So here it is. I just put one kid in the I've never met another kid I didn't like and it's not even that you don't like him. You just you can't root for him. I don't know if that makes sense or not. But um, he's like his worst his own worst enemy or something. Anyways, the opposite of you. You seem delightful. Alright, so hey, I
Mike 54:41
got a delightful.
Scott Benner 54:43
You are delightful. I want to dig a little bit into the Medtronic thing. So you said you got 670 G right, the automated version you're using their thing. It didn't go the way you expected. Why is that?
Mike 54:58
I'm not a very cool sistent person. So having it like an automated black box, change all your settings and do everything. Like if I'm active one week, go into the gym bike ride. And then the next week I'm sitting on the couch like the algorithm doesn't know how to handle that, or like, one day I'll have 300 carbs the next day I'll have 30 carbs. So like if your Basal is more like, not where it actually should be, but because like you can't actually set the Basal on that one, like it takes care of itself. So if you're eating more fatty foods, and not putting the fat in to the cart Bolus, then it's thinking that you're going to need more basil. And then the next week when you're not eating as fatty foods, then you have too much basil. Okay. And the sensor also just, I don't know if it was, it might have been a problem with me not calibrating it correctly, like not calibrating it at a flatline. But also, it's hard to have a flatline a lot of the times, so like it's always going up and down. But with that, when you have to calibrate it, then it's not like you can wait until you get a certain line, it yells at you at three in the morning. And unless you just turn it off.
Scott Benner 56:16
I have to say that anything that is set up to wake me up at three o'clock in the morning, do something doesn't seem well thought out?
Mike 56:22
Well, it may just because like it has an error or something. Or, you know, it's got to be like every nine hours and like if I don't time it right, or I think it was like every 12 hours, it claimed it was every 12 or 24 hours, but it was always way more than that. Like it would say you have 12 hours until your next calibration and then like six hours later, it'd be like, You need to calibrate.
Scott Benner 56:45
Do you do you find the experience with Dexcom to be better or different, or
Mike 56:53
what insanely better, okay, but it's also like, because I started with like Dexcom. As soon as I got that I was like, because I was a little hesitant getting it because it didn't work with my pump. And even before the six, seven D they had the, I forget what they call it, but like it stopped to your Basal if you go if it thinks you're gonna go low. And I like typing that safety feature in it. Of course, when the six seven D, like does calibration errors or overnight or like, it'll just turn that you'll it'll kick you out to auto mode, and it won't turn on that safeguard. To stop your Basal.
Scott Benner 57:26
Yeah. So you think you have to say that you have to safeguard your mind. Like I'm sleeping, at least it'll like sort of like control IQ had Basal IQ first, where are they? Yeah, it was just Its goal was really just not to let you get too low. And then but um, but the problem is the Medtronic would kick you out of automation, if it didn't like where it was. And then this protection you thought you had didn't exist.
Mike 57:48
Yeah, but so as you know, it has a tint going over your Dexcom because like I wanted it to talk to my pump to prevent me from getting low. And I realized, you know, Dexcom can't do that. But then I started looking at I was like, alright, well, how do I at least see the graphs of everything like side by side. So that's when I found tide pool. And then from tide pool, I found loop. And loop it's like, you know, what you tell it to do? It
Scott Benner 58:15
does it shows you everything that it's thinking it's, it shows you like this is what this is how we think your blood sugar is gonna go in the next six hours. Yeah, you don't like the way you're talking? You can fine tune everything. You the way you're talking makes me think to say something I've never said before, which is loop feels like automation, that you're a partner? And if Yeah, if you want to be I mean, you can set it and leave it if you want. But if you want to be a partner in it, you absolutely can be.
Mike 58:45
And you can also go back and like look to see kind of why it made a decision, it made a decision. It's not just this little black box, like you can't even I don't think you can even see like what the basil is we're
Scott Benner 58:58
okay, yeah. And on the pod five, it's a similar idea where they want it to be very automated, and kind of happening in the background. I think it works for who it works for. You don't I mean, and
Mike 59:09
I think if you're a consistent person that it probably works great. But if you're not,
Scott Benner 59:14
I also have to hope. I don't know. I mean, I'm not a computer engineer for certain, or software engineer, but I have to imagine that these are really the first generations of these things. And it does make me wonder what it'll look like in five more years. You know, like, will it be able to, excuse me? Like, will it be able to sense something and just ask you on the screen, like, are you inactive today? Yes or no? Like something simple like that. You know, I'm noticing like, you would think the algorithm could see that you need more or less.
Mike 59:53
And I like how like, I haven't used Android APS but on there like it'll tell you like if you're You're more sensitive or less sensitive than you are previously, so then you can look at it and be like, Okay, I need to increase things or decrease things. And it'll do some of that automatically, I think.
Scott Benner 1:00:10
Yeah, I mean, that's, that's the stuff I'm talking about, like, I mean, they have to let
Mike 1:00:15
you know, the FDA gets involved in and then pushes, like anything they wanted to do, like, you know, tide pools coming out with their, their version for I'm assuming it's still gonna go on me pod if that ever happens, but like, I think the I think the app that they're trying to push through the FDA is like what Luke looked like four years ago. Like they can't put like, I'm using LWC dev now. And like, they can't put remote control in or a bunch of other stuff. Yeah, God Oh, Bolus and like, they got to taper it down enough to get it through the FDA. And then it just, you know, the whole hashtag, we're not waiting movement
Scott Benner 1:00:55
started to wait when it got to the FDA. We're not waiting tide pools, like we're gonna take this and we're gonna go through even when they settled, I was like, how's that gonna work? Okay. I thought, good, go do it, you know, but now, like you said, it's been years. Right? And it, it's not here yet. And I'm Arden's not using the same version of lupus, she was back when they made that. So they have to take some version of the app and say, This is what we're going to send to the FDA for them to judge. You can't keep adjusting what the algorithm does. While you're in that process. Once you're in that process. That's that. What version of
Mike 1:01:34
30 have oh, sorry, go ahead. No, I just didn't like because like, you know, Dexcom g7. Like it's going to be from your episode. I think he said, like, mid 2023, like mid next year for tandem. And like a little later for Omni pod, whereas it already works with loop.
Scott Benner 1:01:51
Doesn't really seven, I didn't even know. Yeah.
Mike 1:01:56
Well, you like it's got to be looped up at like one of the more recent ones. And I think you have to go in and do a little more tweaking, but but you can get it to work.
Scott Benner 1:02:05
Yeah. And and more quickly than you imagined, it will just one day, they'll put out a version. And they'll just they'll be like, here you are using the GSX or the g7. You just tell it and that's it, and then it works. Well, that's the idea of I mean, that's what happens when you put software engineers on to something. And they have to make sure it works. But they don't have to send it out to somebody else to say yeah, you're right, that works. So what what version are you using right now of loop?
Mike 1:02:32
I'm using loop Dev, but the one in the build the fixed. Fix Dev, build script, Nick, it's called?
Scott Benner 1:02:40
Is it? So like? Good?
Mike 1:02:43
So Luke three. And then I'm also using John facets patches.
Scott Benner 1:02:50
Why did you choose those,
Mike 1:02:52
just because I like a lot of the features they have in them, like it'll switch between, like, depending on what blood sugar you're bait, or what your blood sugar is, like, if you're if you set that to 110, you can have it anything under 110. It'll just do auto boat or auto Basal, anything over 110 it'll switch to auto Bolus mode. That way, it'll kind of be a little less aggressive when you're at a lower and you don't have as much time to catch like too much insulin. Oh, I
Scott Benner 1:03:18
love that.
Mike 1:03:20
There's also a Basal lock feature so you can have it so like if you hit whatever you set. So if you set it to like 220 that means it won't cut your Basal off. If it's above that number. It'll just keep it on and like once you're under that number, then it'll cut it off.
Scott Benner 1:03:34
You know, I feel like I just got an email from him the other day his kids using Omni pod five now.
Mike 1:03:39
Yeah, doing really well on it here. Yeah,
Scott Benner 1:03:42
it's funny. This is the that I'm aware of I'm sure it's happened more than this. But then I'm aware of like a handful of times where somebody has been very involved in the looping community and really helping with it, you know, and then control IQ comes out one of the people's like, Hey, listen, I'm putting my kid on control IQ. And then that and then that's it. That person like kind of disappears out of the community. And then I mean, I just set John up to be on the show, I think. So to come on and talk about it. But But But what you just said is amazing, like switching between Otto Bolus and like basil instead, depending on the the blood sugar is kind of genius. Because like one of the problems we have. What in the hell excuse me, Mike, this is unconscionable. Why would that happen? Thing Nevitt I've owned this phone a long time and I don't know how to use it. One of the problems Arden's had you know it happens a handful of times a year as you can get into this situation where you're fighting a low and you got it and then it starts to come up but it's been one of those days where you've just been low, you know what I mean? Like you just don't need as much as usually need. You finally get the blood sugar to like kind of stabilize and it rises up a little bit and hits, I think Arden's thresholds are like 90 or 95 on loop. And then you get to 95. And it sees a rise, and that Bolus is in auto Bolus. And you're like, No, like, don't do that. Not now, not today, you like
Mike 1:05:16
it with with the patch two, there's another feature that helps out with that a lot called negative IO B factor. And you can go into the settings and tell it to only count like, whatever percentage of negative iob that you want. So like if you stop your basil, if your basil leaves two units an hour, and you stop it for a half hour, your iob is a little less than negative one, like at the end of that Temp Basal. Okay. But if you set the negative IB factor to 50%, your negative iob will only be negative point five. So then it won't try to give you as much insulin.
Scott Benner 1:05:51
Yeah. Well, I What I've learned to do in that scenario is just say like, like turn off micro boluses. Without carbs, until you find some stability, then we'll put it back on. And that
Mike 1:06:02
free APS has that setting. Yeah, which isn't in,
Scott Benner 1:06:05
right. Yeah, right and aren't using free abs. But the truth is, at this point, there's so many different versions, I don't even know what to do anymore. Like, wait, maybe there's a better version I could be using, I don't even know how to know that at this point. So you're using it on the pod or using it with what kind of pump.
Mike 1:06:24
I will I started out with a Medtronic because I had one in my drawer that I worked with. The nice thing about having met tronics for 20 years. But then I switched to Omnipod. More. So just because I was worried about the warranty situation. Like if this pump breaks, I don't have a replacement for it, I can't get it repaired really. So then I started using arrows, and I didn't really think I'd care much about the tubeless feature. But then like six months later, Thanksgiving came up. And it was like I kept hearing people talk about the tunneling, like for too big a boluses. And like, Alright, I'm gonna put my Medtronic back on. And those were the most annoying three days of like, my pump going everywhere and having to take it off, put it back on. Getting caught on things. Yeah. And like, I guess, like, well, when it happens for 18 years, you just kind of deal with it, you don't really notice it. But then having six months without that, and then going back to it, it was like, Oh, this actually is a huge improvement. I've tried dash and I like like, I would like to move to dash, but it's billed as pharmacy instead of DME. And my insurance, the way it works like it's way better for DME for me.
Scott Benner 1:07:34
I'm at the point now where I'd like to move out into loop with Dash. And
Mike 1:07:40
you can keep using free APS with dash right now. It's a different version of it. But it's still free P for APS, it should look almost exactly like what you're using now.
Scott Benner 1:07:52
Is it a stable bill? Yes. Yeah, I might have,
Mike 1:07:56
it's the exact same thing, just with Dash added. I think there's a couple other bugs that are fixed or something. But
Scott Benner 1:08:03
I don't want to send her back to school with a prop with something that she wouldn't know how to deal with. But at the same time, this is
Mike 1:08:12
I posted a Dr. We tutorial thing a while ago. Yeah. So like you can remotely install it on her phone to I've actually got even when she's in Georgia, like you can just remotely update it or
Scott Benner 1:08:25
Yeah, Mike, we're supposed to say Chicago, she goes to school in Chicago. That's what,
Mike 1:08:30
that's what I said. Right? Yeah.
Scott Benner 1:08:32
And interestingly enough, Kenny just sent me that same thing. And he any and he's like, you know, you can just do it remotely now. And I was like, really? Like, that's crazy. Yeah, that sounds good. So that's what I want to do. I just need to find the time to sit down. And I mean, I am assuming all I really do is just rebuild the app and then restart a pod with dashboards. And that's it. Yep, yeah, it does. What do you know about? So here's the thing. I put up a post the other day on Facebook. There's two things I want to talk to you about before I let you go. I put up this thing on Facebook. And I was like, tell me something you don't know. This is like the most popular thing I think I've ever posted online. It's just been seen by Oh, your Heroku thing? What? Yeah, yeah, because I don't understand it. I know I have a Heroku app or page. I know I pay for it. For the life of me. I don't know you do. Really? Yeah, they made me start paying for it. For the life of me. I don't really know what it does. I know it's, if I if I didn't have it, I wouldn't have Nightscout. I do like Nightscout. And so like, I don't know, like I don't understand. I've never done a thing I don't understand before as much as this.
Mike 1:09:50
So like Heroku is basically it's the website that hosts your Nightscout app. And then do you have another Yeah, MongoDB like on another website holds all the database. So Heroku or the Salesforce that people who own them, they decided they can't keep the free tier anymore. So then they had to, like now it cost $5 A month is the minimum you can do. So the easiest way is to just pay that $5 a month, and then you don't have to do anything different. Heroku just keeps working with your NetScout. or Now there's also as soon as like the Heroku started, like announced that they were going to start charging $5 A lot of people started to look at other websites that could host it instead of Heroku. So like I've moved mine over to Google Cloud now. So that'll that'll just be free. And then I also with Google clouds, nice because you don't have to go back and clean up the database. Because like, with Heroku, or with the Mongo DB, you're limited to half a gig, I think. So once you have like, you know, every six months or so you gotta go back in and clear the data. ON CLOUD one, I don't even know you really not do that.
Scott Benner 1:11:12
Yeah, I'm fascinated that you're saying that. I was like, Oh, is that a thing? I'm supposed to be doing that I'm not doing too. Even I don't
Mike 1:11:18
if underpinning if it's working, then I guess it doesn't? Doesn't matter. Yeah. But under penalty
Scott Benner 1:11:23
of death. I've seen the word like the word MongoDB. before. And I even feel like I know that if I tried to log into it. I have a way to save your password somewhere. Yeah, but I don't know what it is. And I, but but I don't know, I just listened to somebody. They told me like, do this. I did it. And it works. And it works amazingly. But I mean, that's the part of it. Like all of that is where this gets like sketchy. Like for people coming in trying to like, Oh, I'll try it. But then you're like what you just said, I know makes sense to you. But as you're talking my brains, like, I don't know, it sounds like there's an app. That's Nightscout. It has to be put somewhere. It has to exist somewhere. And then I think well, how come I can't just build it in the Apple Store, like in Xcode like I do with the app for the blue. Like, why is that not okay? And then
Mike 1:12:18
it's got to be, it can't run on your phone, it's got to run like somewhere in the cloud. And like it, if it's an app, it's got to someone, like, if someone put it in the app store, they'd have to pay for their own big giant server for everyone that runs Nightscout. Okay, so this way, like you're just building it yourself. That way someone doesn't have to hold everybody's like, there are some websites that, like, there's a couple. What did you call them like monitored? That's not the word. It's got it set to like, are just for web or just for Nightscout. Like, so you can set it up, and they take care of all the database work stuff behind it.
Scott Benner 1:13:00
I mean, you think, Well, if you switch to this, because people have come on people like go to rail, is it railway?
Mike 1:13:05
Yeah, railway is nice. It's probably the easiest one to switch to.
Scott Benner 1:13:10
And then I'm like, I don't know, like, what what if that company goes out of business? Or what is it like, you know, you like?
Mike 1:13:16
And then you got to switch to a different one or Yeah, that's also why I didn't go with real quick, because I'm not really sure what the future of it is where Google's not gonna go away. Like, I suppose they could get rid of the free tier. But if that happens, I'll figure something else out.
Scott Benner 1:13:29
Yeah. See? That's because you understand it gives you Well,
Mike 1:13:33
I know where to go online to find other people that understand,
Scott Benner 1:13:37
oh, well, that's probably better than understanding yourself. I, I just feel bad. When I ask people questions. I'm like, I don't know what to do. Can you help me? Like I feel badly about it? But I think you know, in the end, I do talk about it on here. So it does, it does get the word out. So I guess it's a fair trade. But I just I keep thinking about in the future. Like, you know, I mean, this aren't going to have a Mongo DB when she's 30. I bet she won't. So anyway, I like the way that it's progressing. So So you're telling me right now there's a version of free APS for dash that stable?
Mike 1:14:17
Yes. The problem is that free APS like it won't keep getting updated. Like it'll, right now it's at a point where, like, they'll keep like, when a new version of iOS or Xcode comes out. Maryann will go in and do like, she'll try to keep it updated so that it continues to work and stuff, but there won't be other features that like it won't improve at all from here on out. And if something happens with the new version of iOS that breaks it, like not going to spend a lot of time to fix it. I see. So really, I mean, it really I think most people including you should just just move over to the well, like like, by the time this comes out, loop three will should be out on Last year, hopefully,
Scott Benner 1:15:01
you think that's the way to go. Loop three.
Mike 1:15:05
Yeah, which is what loop Dev is.
Scott Benner 1:15:09
But right now, if you if you like, go to the if you go to any if you'd like Google loop three right now, don't do it later because like I said, this will be six months later. But it the way it reads on the, on the on the GitHub document, it's like it says right now, like this is being tested by experienced loopers right now. Yeah. So it's still in the in a beta phase.
Mike 1:15:33
Yeah, but I mean, I've been using it since March, I think, okay. And I haven't had an issue with it. But I also like, I keep tabs, like, I'm always in the loop group, and I'm part of the loop and learn group. And then I'll check the zulip Every once in a while, where it's like more than the actual developers hanging out there. So but then also like, like, it probably won't really matter, because it'll be six months in the future. But there is a version in loop docs called fixed Dev, I think, where it's where Marian like, froze loop dev at a certain point. So she's like this, look at this version right now, like is fairly stable. Like working well. So then, that's the version that you'll download just from that. It's like a build script works the same way that the master build script does. And you're so then you're like, Oh, I'm sorry, you won't keep getting the new update stuff like so when they keep putting new stuff in. And they're like, because if you just take the very newest version of loop dev every time, you don't know how much that's been tested, you don't really know if there's something that might break the app that gets added to it. But if you use the fixed Dev, then there's nothing added to it anymore. Like that's just where it stops for some time. They're unstable. Yeah. So and if something comes in, and like a bug comes out, and they're like, oh, this actually does affect the, that version too well, then they'll both go in and look at the options and update that script to download a version that that bug would have been fixed. And
Scott Benner 1:17:09
but even if that happens now with this new like, I forget what you call it earlier, what Kenny was telling me about but But if, yeah, if so if something happened to the app, and it just crashed, or it had a problem, it's now as easy as putting a link on like a cloud server, sending it to art and having her downloaded to her phone, click on it. And it just rebuilds the app right on our phone. Yep, that's insane. How come we haven't been doing that the whole time. Like, that seems amazing.
Mike 1:17:39
And the one caveat is like it has to be a phone that you've already plugged into Xcode and built loop to
Scott Benner 1:17:44
write you can't just install it fresh with that
Mike 1:17:47
with like, if if she threw her phone off the bridge, and like needed to get your new phone, you like there are ways to get around it to add that phone to your Apple account without actually plugging it into your computer. But it's a lot more clicking around online. And like kind of a roundabout way to find like the specific number of the phone to enter. So it is possible, but more difficult. It's
Scott Benner 1:18:12
interesting. So I'm gonna put you in charge for a second. Should should Artem be using loop Dev. The loop three.
Mike 1:18:22
Yeah, I think as long as I mean, as long as you're active in the diabetes, like online community for loop blooped. And like so if there there is a bug or something catastrophic that comes up like you would see it. Other than that, like I for you, I would say yeah, like, you know, look well enough, like, better than anyone else really. So like, if something's not working right on it, I feel like you would see it and realize, but like I said, since March, I haven't noticed anything really.
Scott Benner 1:18:54
So you haven't rebuilt the app in nine months?
Mike 1:18:58
Oh, no, I rebuild that a lot. But, um, the well, the version I'm using now, I think is from like, two months ago. Okay, that's when it stopped getting updated. For the fixed one.
Scott Benner 1:19:09
Yeah. And so you do you think it's getting close for them to say this is a like a stable version?
Mike 1:19:16
I hope so. But I'm sure it'll probably go to like a release candidate where like, they're like, this is the version we think passes all the tests, and then that'll sit there for a little bit. And then though, as long as they don't have any problems with it, then we'll move that to master.
Scott Benner 1:19:30
Yeah. Hey, can I can I move her to a version that supports dash and then four months from now remotely move her to loop three?
Mike 1:19:47
Yes, Inchon Yeah, you can do that. It'll be a little more difficult to move her back to free APS from three. But I think it's just basically you have to make sure everything's uninstalled on the phone.
Scott Benner 1:20:02
Just like to take the app off it completely.
Mike 1:20:05
Yeah, there might be another step or two that you have to go through. But that'll be in like loop docs, he could find that or message me and I'll figure it out.
Scott Benner 1:20:15
Interesting. So if so if I went through a version right now that was dash compatible, but wasn't loop three, which version would I be looking at?
Mike 1:20:27
If you don't want loop three, you still use the fix dev build script. But that script has free APS dev in it. Okay. And that's step B, which basically what you're using now free APS, except with Dash support added in,
Scott Benner 1:20:42
got it. And that one's pretty people seem pretty happy with that right now. As near as I can tell, from people talking online.
Mike 1:20:51
So yeah, well, I think like I said, we're like the people running loop docks and like, trying to push people more toward like, if you want to use dash, especially if you're an experienced user, or Looper to move towards the loop Dev, just because it's, it's what everyone will move to, to and hopefully, once it's released as master, it's interesting. Three, APS will eventually die out.
Scott Benner 1:21:18
I think that very few people listening to this understand what we're talking about.
Mike 1:21:25
That's a good chance. Because I also tried to, I tried free APS X. And like, February this year, and it's so like, it runs off the same as like the open APS or Android APS, like off that same base algorithm. But developed by Ivan, the same guy who created free aps that you're using. But it was still pretty early on in the development. So it was neat and interesting. But then as soon as the Russia stuff happening, he can't really update it since then. Right. So it's just been kind of sitting there stagnant. So like, once that, like, once the rest of the situation kind of figures itself out, or like once he can start pushing updates to it. I might try that one again.
Scott Benner 1:22:14
I feel like we should smuggle him out of the country and get them here. Seriously, every time I talk to somebody, I'm like, I don't know who Ivan is because someone hire him, please. What are we doing? Go get them all from a job for God's sakes. All right. Okay. Is there anything we haven't talked about that you want to because I have one last thing for you?
Mike 1:22:39
Oh, maybe I mentioned a new bus. Have you heard of that? A new bus, a new bus. So it's made by it's made by people in Australia. And it's a Dexcom transmitter that they've like, drilled into and modified the firmware on. So that sensors don't end. So like you can just keep it running. You don't have to restart it, really. And then it also puts the warmup time down to 15 minutes. And it comes with a battery that lasts. I think I got mine in like sometime early this year, and the battery is still going like I think the battery is supposed to last six months instead of three months. But then you can take the battery out put a new one in
Scott Benner 1:23:24
that I've seen people do I've seen them like dig into it, pull the battery out put another like put like hot glue over top of it to hold it in something like that. Is that the kind of thing you're talking about? Yeah, basically. Amazing.
Mike 1:23:38
Then you can just have one transmitter, and that'll just keep working. And then the restart thing is what's really helpful then, like I had a sensor on that lasted 30 days, and was still like within 10 points.
Scott Benner 1:23:50
It was just what I use. Sometimes it was just one
Mike 1:23:53
drawing like normally I get like 14 days and then it starts getting noisy. So then I pull it. I really wish g7 just lasted 14 days. Like I can't wait until they get to that point.
Scott Benner 1:24:04
I thought it was going to I thought that early on. That was the chair and
Mike 1:24:08
then I think there is something with like the adhesive like they had problems getting it staying on everybody for 14 days without making the adhesive too crazy. Yeah, but libre has been doing it for a while. So I don't know why.
Scott Benner 1:24:22
I imagine it comes eventually. So I don't know. Okay, my last thing for you. You left a review for the podcast. That was the it was the most like thoughtful and lovely and then cake made me cringe and it made me laugh and I just I very much appreciate it. Thank you. I've never read something that took me aback. It's only a paragraph and I'm started reading it. Now I got to Google. I don't know who this person is, like Google. I'm like, alright, that's who that is. And then you said something that I was like, Oh, I don't like don't don't Don't compare me to that. Like that made me feel really? Yeah, I don't know. It's just so funny. But I there was
Mike 1:25:06
a lot of parts of that. I was like, oh, I should take that. No, maybe I'll leave it in, like I almost rewrote, or like, deleted that and read it a couple times. So I'm glad I left it there.
Scott Benner 1:25:15
Yeah, no, I'm glad you did too, because I feel like most people who read it, we'll just pick I don't know what this means. Exactly. But I, I was, I was just very, it was heartwarming, and, and it made me feel weird at the same time, which is how I know I liked it. But I appreciate you. I appreciate the podcast being valuable for you in a way that made you think to write that. So
Mike 1:25:36
I think I've got 105 episodes left. And then I'm all caught up.
Scott Benner 1:25:40
I'm thinking of giving out an award for people who listened to all of them. Now, it'll be it'll be a digital real award. I will not be sending a trophy to your house. You know, the trophy might that you never won playing baseball.
Mike 1:25:54
Are you the trophy?
Scott Benner 1:25:56
Am I the trophy? I am nobody's trophy that's for sure. No one would get me and go. Oh, I feel very accomplished right now. No, I just, I mean, it occurs to me, especially as the as the podcast gets into the eight hundreds as far as and nine years. Like in a couple of weeks. I started that ninth year, but I saw this podcast the other day. So funny. It's been out for like three years. And they're like, we're in the season nine. And I thought to myself, No, you're not. Like, stop it. You can't make a season 10 episodes and then tell me you're that's a year, that's a month. That's two weeks for me. Like I think that episodes in a half a month. And they're like we're in season nine. I'm like you just started in 2000. And like 20, like, What are you talking about? But, but anyway,
Mike 1:26:45
I just we're going back through the podcasts and because of how, like you started off, I think like once a week and then moved it up and up and up. And now it's like four times a week. So like going back through the podcast, it's like the last half of it is like the last two years. Yeah, may not pass. But a good chunk of it is just like since COVID. And then like, as soon as I hit the point that was like, pre COVID. It was weird. Well, COVID
Scott Benner 1:27:08
changed it for me. Because Because I saw overwhelmingly if people heard this already, they can probably you could probably shut this off now. But overwhelmingly podcasters I thought made the wrong decision at COVID. They, they they were saying, well, people aren't going to be in their cars as much. So they're not going to listen as much. So they started making like less content. And I it just struck me the complete opposite way. I was like I'm gonna make more, because I think people are gonna have a lot of time. And that for you? Well, except for me, I'm the only one that didn't get the cruise through COVID. And, and by the way, was up all night on Friday getting you the Dexcom g7. So just listen to it. But that's not the point. The point is that and I also stopped thinking my I stopped thinking of myself as a podcast. I mean, it's a podcast, obviously. But you know, once a week, or some come out twice a month or something like that. I started thinking about who who is successful in the space of delivering audio to people. Like I looked at those people, those people don't put out an episode a week, they put out three or four a week. And when you listen to it, you might not always be interested, you might like log on on Tuesday and go I don't care about this interview. But I love the one on Monday, and I might like the one on Wednesday. And I looked at that and I thought that's the model for me. I'm going to put out a lot of good content, you're not going to care about all of it maybe and it's there if you want it. And that's just where I went when COVID switched and to your point a minute ago, this year 2022. The podcast is just by a hair's breadth gonna miss 5 million downloads in 2022. So is a big number for people who are not in podcasting this show I don't think I usually say this on the show. But I'm in the 96th percentile of all podcasts that exist. As far as I know all like not even just health. All not just in health actually today in health. I actually have this in front of me because I pulled up I was pulling up your review today in health. The podcast is 134 in health and fitness which is the parent category and that is that's high they only track the top 200 shows to begin with. Like your your charting if you're in the top 200 So I have I have a parent category health and fitness which I'm 134 in today and it pretty consistently stays in the top 200 all year long. But in its in its subcategory which is health and fitness medicine. I'm number 12 Today in and there's some Pretty big podcasts ahead of me, like, like stuff that has, you know, dozens of people working for them. And they are a part of a media company. And like I read down from the top, Peter Atea, who is just a huge help body has Mark Hyman, Rhonda Patrick. Paul Saladino. Like, you know, these are the people Peter McCollum, these Matt Walker, they're the only ones really out of me. And then it's me today. And I guarantee you that they don't make that podcast by themselves. So it's pretty cool. RFK is there too, but I'm not sure of what it is he's peddling. So I didn't. I haven't looked too deeply. I've heard people on two different sides of him. So I'm staying away from that one. But, but yeah, the podcast is popularity is measured by downloads and by new subscribers. So the one great thing about charting is, if you're not constantly getting new subscribers, you don't chart no interest. Yeah. And that's the big deal about being in the I think in the medicine category. I've I've been pretty consistently the top 20 for like the last three years. So anyway, I just want I put content out and if you want it, that's great. If you don't want God, I got it. Like you don't I mean, so you'll be like the one that I
Mike 1:31:23
just don't go look for a summary of it online. Yeah. Because what the, well, the crazy thing, too, is like, your transcripts are on the website. So if they really wanted to just read it, they could just skim it there.
Scott Benner 1:31:35
I also don't think that these people are like bad people who are like, please just tell them like, I just need to know this. Yeah, they don't know my and that's why I I thought, I thought in a joking way, like and and yet, like very like, I don't know, honestly, I was just trying to say like, please understand my side of this. If we all give away what's in the podcast, and nobody has to listen to the podcast, then there won't be a podcast. Like that's it unless you want me to start charging you for the show. And, you know, the truth is, if people did that, I'd make a lot more money, like a significant amount more, and I still don't think it's right to charge you for the show. So I don't do it that way. I guess.
Mike 1:32:17
You'd be making more money, maybe, but you'd be reaching less people.
Scott Benner 1:32:21
Exactly. And I don't want that. I don't want to limit who gets to hear it. Because you can say something. I mean, think about it. The 5 million downloads. What if I charged 10 cents an episode? Just 10 cents? I don't know the math on that because I'm not smart. Okay,
Mike 1:32:38
but I spent $80 This year then, right?
Scott Benner 1:32:42
You're one person. So if I take 5 million? That's a lot of zeros. Okay, so I take 5 million. you to help me on this because I might be wrong. That's 500000. Wait, is that wrong? Six years 50823456 5 million. And I say times point one. That'd be 10 cents, right? Yep. Ah, yes. I would have made $500,000 this year. I want you didn't know I don't make $500,000. So. So just every other year well now. So now think about that. That was 10 cents. What if I just made it 20 cents a download, I would have made a million dollars this year. And instead I take ads. And I let the advertisers pay for it. And you guys don't have to pay anything for it. So it because of what Mike just said like your smart person. Like Like, even if you charge 20 cents 20 cents for something, it will eventually eliminate some people. And then what happens if that's the person who doesn't know how to Bolus fat. And then they spent their entire life with a seven and a half a one C when it could have been a five and a half a one C if they only would have known to put in some more for French fries an hour later. I don't I don't want to. I don't want to think that I'm limiting people from getting good information. Just to make money. Although now that we did that with the calculator, I really would like to charge 20 cents for each episode. I've been thinking about it for a little while. And it's gonna make me a little sad inside but I'm gonna be okay. I'll be like, I'll get past it. But anyway, I just think it's I think it's a it's a it's an endeavor that I like being part of I like trying to help people in mass. And I I'm not telling you that one day maybe the advertisers will dry up one day and you'll hear me get on here and go look, the podcasts cost 20 cents an episode now. You don't like it don't listen, there's nothing I can do about it. But for now I'm I've been able to keep it for eight solid years 800 app episodes, I've been able to keep this podcast free for people. And, and still, my house is heated, you know. So that's my goal. Although I guess maybe I should take a swing at the end. Right, Mike? What do you think? Like the last year go completely dirty, just curse through the whole thing charge like 25 cents and
Mike 1:35:20
oh, I think if you just made a separate one that was unedited, not edited, but like uncensored. Yeah. And then just charge for that one. I think people might buy that you think I could
Scott Benner 1:35:30
do that just curse like, what am I going to record? Jesus holiday time, I might have to get an editor. Let's make enough money that that can happen. Although I also need to, like, I have these people, these wonderful people who help for free with the Facebook page. And that's important too. I need I need more money all the advertisers have to pay twice as much. I gotta I have to start paying moderators online. That's it. I'll call them right now. Let them know the price is doubling. You think they'll be okay with that?
Mike 1:36:01
I think there'll be okay with whatever you tell them.
Scott Benner 1:36:02
I don't think they will. I think they told me to go to
a huge thanks to Mike. Hey, a huge thanks to Mike for being on the show today. And for all he does for people living with type one diabetes. I also want to thank cozy Earth and remind you to use the offer code juicebox at checkout to save 35% off your entire order. And of course touched by type one.org. Go check out the event. Find out the details. And while you're at it, why not find them on Instagram and Facebook and give them a follow. At the end of the music. I have a little note for you for Mike to add on to what he said here. I will read it in just a second. Thanks so much for listening. If you're enjoying the show, please share it with someone else. And give it a follow or subscribe in your favorite audio app.
If you're looking for community around diabetes, look no farther than the Juicebox Podcast on Facebook, a private group with 40,000 members. There's a conversation happening right now that you want to know about Juicebox Podcast type one diabetes on Facebook. I don't care if you have type one or type two. Lada doesn't matter to me. I don't care if you eat keto, if you eat a bunch of hotdogs or potato chips doesn't matter to me how I eat doesn't matter to me, but you do matters to me that you know how to use insulin and you feel supported Juicebox Podcast type one diabetes on Facebook. Mike sent me a note the other day that said Hey Scott, I mentioned I might switch back to free APS X when I was recording your episode. So could you please update people that I did switch back, except now it's called AI APs. Anyway, about a month ago, he switched back and he's loving it. He said I opened the app far less than I used to with loop. And now that I switched to loom Jove, which is a faster acting insulin. I'm sitting 98% of the time in my target range of 70 to 180. Prior to that, he was sitting at 90% Since he switched to Dexcom and loop to two years ago for two years. He was Dexcom and loop two. Now he's using something called I APs and see him better time and range. And Mike just wanted to let you know. Alright, everybody. This was a good day. I'm feeling good. I'm gonna go check out my movie. I am seriously gonna go put on my joggers. And I'll let you know how the movie was later. Even though I didn't tell you what movie it is. You guys can wonder what movie I went to say. Hey, go follow that Facebook Group. Subscribe and follow the podcast in an audio app. Share the show with somebody else and except my thank you for doing all of that. I'll see you very soon. When I'm back again with another episode of The Juicebox Podcast
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#944 Bold Beginnings: Treating Low Blood Glucose
Bold Beginnings: Treating Low Blood Glucose Originally aired Oct 27, 2022. Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
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 944 of the Juicebox Podcast.
Hello, everyone, and welcome back to another episode of the Best of the Juicebox Podcast. Today's episode is from the bold beginning series. This episode features myself and Jenny Smith. It originally aired in Episode 780. That was back on October 27 2022. And it's called Bold beginnings treating low blood glucose. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you want to check out Jenny, you can hire her at integrated diabetes.com. And if you want to check out the entire bold beginning series, it's available at juicebox podcast.com. Go to the menu at the top click on bold beginnings, you'll see all the episodes there. It's available in your podcast player, any audio happy listening. And if you're looking for another list, but you don't want to go to the website, you can go to the feature tab in the private Facebook group Juicebox Podcast type one diabetes
this episode is ad free. But please remember to use the links if you have the need. They're in the audio app you're listening in right now in the show notes. Those links are also at juicebox podcast.com. Or you can type them into any browser. I appreciate you thinking about the podcast, when you're making purchases, when you support the podcast by using the links, if you're keeping the podcast free and plentiful. I'm gonna hit record gently to tell you this little preamble bit that I normally would have said ahead of time, but what we're done, you and this is the last one the not yay, I should say, oh, no, we're done. We're done with the bold beginnings, then we will move on to the long list of things that I have to do with you for next year. So but I'm gonna throw a little curveball in here. So you and I were going to talk about insurance. And then we were finished. But I'm going to bring somebody else in to talk about insurance. Cool. So because otherwise, it would just be you and I, you know, talking about our experiences with insurance, which might not answer some of the people's questions.
Jennifer Smith, CDE 2:37
No, I think that's great. Because I think there are quite a number of people that definitely no more about the navigation. And I think in terms of this topic, it's more how to really nudge yourself into insurance and get what you need, and get to be able to talk to the right person about it. Yeah. So I think that's great. Yeah.
Scott Benner 3:01
So you and I would have done, we would have had fun. And I would have told stories about yelling the F word into phones to get art and things and stuff. But I can do that with someone else who can also hit the technical sides of it for us a little awesome. So instead, you and I are going to add our very last episode to the bold beginnings series together about how to treat low blood sugars. Oh, right. Because you get diabetes. And nobody says to you, hey, you might get low. And the low might be slow. And it might be fast. And it might be harsh, and you might be dizzy. They just say if your blood sugar gets low at 15 carbs, wait 15 minutes.
Jennifer Smith, CDE 3:43
And then it might respond really fast. Or it might not resolve for a couple of hours. And you're thinking Where did the food go?
Scott Benner 3:52
So so so I want to kind of talk through a number of scenarios. And I know, I know, I'm dropping this on you out of nowhere. And of course I don't Is that is that anything new? No. But I don't have any notes whatsoever. Like we've been doing bold beginnings off of people's questions. So, you know, we might have gotten lazy because we're like, we don't have to drive this conversation. I'll just wait and see what this person said.
Jennifer Smith, CDE 4:14
Well, I'm sure there are probably lots of questions that have come in about low blood sugars.
Scott Benner 4:18
There may have been but they were not. They were not called together for me for this situation. So we're just going to fly by the seat of our pants, which I think will be fine. Not like before. All right. So let's think about this. Your newly diagnosed and I guess the first thing we can consider is that you might be honeymooning, still true. All right. So if that's happening, if you're getting help from your pancreas that you don't expect, you might see protracted I saw somebody online the other day whose kids blood sugar was like low all day. And she's like this has to be a honeymoon because, like we're not doing anything different than we've done in the past. So I guess if you're MDI, and you start experiencing low blood sugars that seem like they're being, I guess, impacted by your pancreas still, you can't cut off your your Basal insulin because you've probably shot it already that day. Correct. But you could start limiting, I don't know, would you limit
Jennifer Smith, CDE 5:23
limit your Bolus insulin, right? Right, or you could look at for that day, making your insulin to carb ratio, more conservative. You know, if you're floating around at a ratio of an in honeymoon, I mean, kids, and even some teens might be a one to 30 ratio, right? You could suggest one to 45 or one to 50. Or right, if you know that you're floating, pretty stable when there's not food introduced, but the stable is low, and you're having to give it a little bit of carb to keep it from like, dipping, then it would be the Bolus is that would be the easiest to adjust in that day. And in looking forward into the next day thinking, this might be what it is, you could downplay your basil that day, whether it's morning or evening time dose, you could take it down a little bit, and see if then the next day floats just slightly higher, and leaves you without having to add so much extra carb
Scott Benner 6:31
to treat. And on the day that you get surprised by it and your basil is already in. You can kind of feed the basil a little bit for the day. Yeah, right and spread out and spread out carbs to cover the timeline. But so this is where you need to understand the difference between like a faster acting car, but a more sustainable impact, right. And so if you're being drugged down constantly over hours and hours and hours, a couple of skittles might stop it for a minute. But the minute you bounce back up again, and this extra Basil is there that you don't need, you're gonna get drugged back down again. So you need foods that are slower to digest. Right? You start you start reverse engineering your problems from diabetes and using your problems as solutions, right? Like, right, if you ate pizza, that might take that might sit in your system for hours and hours and hours impact you. So what a great opportunity to have pizza, a little bit of pizza. Or what are
Jennifer Smith, CDE 7:30
pleading some proteins with some carbs. Right, you might want to treat if you're dipping or lower already. And if you do, then knowing what you just said you want some sustaining power after that to not drop yet again, you could do something that incorporates some fat and protein in it to hold things level because again, the other consideration that if if it is a honeymoon based, like drop in blood sugar, it could be that anytime your blood sugar does nudge up from what you treated with simple sugar. It could be that your betas are also like oh, look at that. There's a rise in blood sugar. Let's give some help. And it doesn't really know that you've got basil injected, that's also there.
Scott Benner 8:15
That's see you know, isn't that interesting that you brought that up? It didn't occur to me that I've always just thought of it is like you're getting help from your pancreas, but your pancreas seeds the carbs and attacks them while the insulin you've learned the manmade insulin you've put in is also drawing your blood sugar there. Wow. So you have dumb insulin and smart insulin working at the same time.
Jennifer Smith, CDE 8:37
Correct. And common time for that. And honeymoon is overnight for a lot of people actually, where they may have corrections that work pretty well in the daytime despite them being really tiny, you know, miniscule amounts of correction. But I've got person after person that says I can't correct unless my blood sugar's 300 At night, because if I correct with just a minor half unit of insulin, I'm sitting at like a 60 blood sugar.
Scott Benner 9:06
And this is the reason we're newly diagnosed people.
Jennifer Smith, CDE 9:09
Correct. It's specifically more honeymooning. I mean, you can even see it on nights where blood sugar is going up. You don't correct the high blood sugar because you have the hindsight to know what's coming. Blood sugar could hit 202 20 and it downplays you wake up in a beautiful number. That's that's not injected Basal that did that. Your body helped you?
Scott Benner 9:33
Yeah. Okay. So that's one kind of low you could experience now another one might be activity, right? I'm trying to think of I'm trying to put myself in a newly diagnosed person's situation right, like they go back to their life like I have diabetes. diabetes isn't gonna stop me and then they go play tennis, and then their blood sugar falls really quickly. There we need fast working sugar are correct something that's going to hit you very quickly and stop this freefall. So if you're in a freefall, for whatever reason, you can't eat. That's not the time to have a slice of pizza.
Jennifer Smith, CDE 10:12
That's not the time to have peanut butter cups, the slice of pizza, the nacho meal breaks, not
Scott Benner 10:17
because that's because you're gonna keep crashing before it has an opportunity to start digesting and to stop you. You're looking for simple sugars. I mean, in emergency situations, I know, I know, people don't seem to talk about glucose tablets anymore. Like they've become persona non grata, right. Because they taste achy,
Jennifer Smith, CDE 10:37
they're not the greatest. I mean, they are they are okay. I think the greatest thing about them for me personally, is that I am never going to over treat with glucose tablets. Right? I mean, they do their job. They're doing the job that I want them to do. But they're not like a bag of I don't know, licorice, like licorice. I like black licorice. So you might be like, easy to keep eating with a low blood sugar. Well, that
Scott Benner 11:04
is one interesting thing. There's a plus for for glucose tablets, you will you won't eat them for fun, that's for sure. No. Gel. I mean, I don't even know Do people carry that still, they should, right?
Jennifer Smith, CDE 11:16
We should and or it's easy, especially if somebody needs to help you. Because you can just get it into kind of the gum line and sort of massage it in it. It does work really quickly. So if you don't love the taste of glucose tablets, that glucose gels might work really great. There's a nice liquid glucose, that I just heard about two that I really liked.
Scott Benner 11:39
Okay, so, but in but in general, juice boxes, people are gonna use Skittles gummy bears stuff like that. Right? Correct.
Jennifer Smith, CDE 11:47
Exactly. But the another good thing as you bring up glucose tablets, glucose, or dextrose is the simplest form of sugar, right? So your body doesn't have to go through this breakdown of the structure of of sugar, if you will. And so it gets absorbed really fast. So if you're looking for candy, specifically, you really want to look for candy that has glucose or dextrose as one of the first two or three ingredients. Because it's going to have the fastest impact on a low or really quick drop that you want to stop.
Scott Benner 12:21
Yeah, the timing. So super important. Because I know a story about a person, I won't say their name, but they're an adult. And diabetes for a long time, felt themselves getting low knew it, ate a bunch of carbs passed out, and then just turned back on when the carbs hit them. They were just like, hey, I'm back. And so so there's an it's an example of having the timing wrong. Like you're falling at a certain degree of speed or rate of speed. And you need that sugar to come in and to slow like a parachute almost to parachute that that number fall down and to stop it. You know what a nice level sponsor don't go too low. So things need to work the way you need. I mean, that really is the message of this episode, right? Like if you're one if you're 120, and you're wearing a CGM, and you see this gradual fall, and you look back over at 90 minutes going down, geez, like I Bolus for this meal, it clearly looks like it's too much insulin, I'm going to get low a half an hour from now. Well there, you could just add some more carbs to your meal or have a couple more bites. Correct. And you might stop that. But if that same 120 was falling quickly, you're in a different scenario, you need to use different carbs.
Jennifer Smith, CDE 13:38
You need to use quicker exactly the simple carbs on a quick drop. If you've got a gentle sort of glide down something that's a little more complex, like crack, you know, something like peanut butter crackers, I hear a lot kind of get used because there's a little bit more to the cracker with the peanut butter added to it. Right. So something like that could use it down. But if you're really really dropping then sugar,
Scott Benner 14:06
yeah. And you have to in the beginning, it'll be hard not to overeat a low but that is a skill you need to learn. Because otherwise the bounce comes and then you're like I don't know what to do. I was cheeky of that fear from you've just been low. You don't want to Bolus like you get caught in that. That bouncing rhythm. You don't want to be in that so maybe you'll learn at some point to look at your situation and say half a juice box here. Or you know, take a couple of sips just have two Skittles you know I say to people all the time just because you open the bag doesn't mean you have to eat all of them. Right? Yeah, just eat what you need.
Jennifer Smith, CDE 14:43
All right, which is also why those little tiny bags I mean this is a popular time of the year for a lot of people to end up stocking up on simple car because we have Halloween coming up. Whether you celebrate it or not. It's a great time of the year to find really little packets of somewhere between eight and maybe 15 grams of carb, simple sugar, Candy really prepackaged. So the whole bag of Skittles versus the tiny little packet helps you to contain things a little more. And if
Scott Benner 15:17
you're not lucky enough to have a CGM in the moment and you're just leaning on your, your finger sticks. How frequently do you tell people to after they think after they've identified a low or felt it and treated it? How often do you stick your finger and look, I find myself, you know what I mean? I use a lot more test strips in that moment than you do sometimes for the whole week
Jennifer Smith, CDE 15:41
you do. But you can expect that even simple sugars going to take a little bit of time for digestion, right? So you're really not going to see much shift. If you do a finger stick, confirm your low, treat the low and five minutes later, you're doing another finger stick, you're probably not going to see not much of a difference, right? So that's where old school was that 1515 rule. 15 grams, 15 minutes while you might not need or take 15 grams to treat this low that you have. Waiting about 15 minutes to retest will give you enough information to say, well, I treated it. It doesn't look like it's come up, but it hasn't also fallen. So that should give you enough to say it's not dropping. Clearly, digestion is happening. Well, let's give it another 15 minutes and test again.
Scott Benner 16:33
Yeah, you know, I have two thoughts. So one of them I'm going to make a note about and then the other one I'm going to say if you are wearing a CGM. Sometimes it will not register as quickly. So you can see like a like, Oh my God, my blood sugar's 50. You know what I mean? And you take a bunch of carbs and, and then there's this way to look at the arrow with the Dexcom. At least I don't know how it works with libre, you'll, you're stopping a low blood sugar, let's just say it's 60. And it's the arrows diagonal down, and you take some carbs in and the next reading is 55. And the arrows still down. And then all of a sudden, the arrow will like sometimes disappear. Like almost like the algorithms like I don't know what's happening right now. But the number stays the same. Or sometimes the number or the number will get lower, but the arrow changes. And do you know what I mean by that? Yeah. And so your whereas
Jennifer Smith, CDE 17:32
if you were testing in a look, then it said 55 with an angled arrow down, you've treated it. And now you can see it has a horizontal arrow, but the number is reading like 51 or 50. And you're thinking well, what that really indicates is the system has found a stability, even though the number has slightly nudged down yet, it's not dropping, what you've done is actually making some impact overall. So it's not really time to treat with yet another like whole box of juice.
Scott Benner 18:06
It's so weird. It's a weird moment because the CGM is a little behind. And what you did with the carbs is maybe more in the now, but you can't see it. And so there's like, there's like multiple things happening at once that the technology has, has difficulty showing you. But you can see that something's happening. And so that's when that's when I say to myself, Okay, now this thing looks stable. And we've gotten to, you know, readings in a row that say 50. But I want to know what's really going on, because either the CGM seems confused and I didn't do well. And we're lower than we think. Or we're higher than we think. And I don't want to treat more. That's the perfect time to do a finger stick to me. Absolutely. You have to. Right,
Jennifer Smith, CDE 18:51
absolutely. Especially for those those numbers where you're treating I say at a number less than 60. Honestly, if you're varying at all and decision about whether I should do a finger stick or not. If you're less than 60 and you've treated it and the numbers on the CGM just don't necessarily add up. Or you're mentally not quite like with it enough with a low blood sugar like that. Just do a confirmatory finger stick, because at least that's going to show you real time right now. Where is your number? Yeah,
Scott Benner 19:29
yeah. And I know we're trying not to over treat. But if you get caught and you don't know, like, this is the time you're going to hear me say I'd rather I'd rather just Hi. Yeah. Because Because what you're saving yourself from or saving another person from we don't talk about very much like in diabetes in general, even on the podcast very much like it just doesn't get talked about very much. You're talking about becoming incapacitated. You're talking about having a seizure. You're talking about death, like you're talking about out. There's a lot that happens between 40 and then I don't know how low anybody's ever been right, you know, but while they were still alive, I saw Arden's blood sugar. I saw Arden's blood sugar 22 wants on a finger stick when she was really little. And she was okay still. And I was just like, keep eating, eat, Yeah, II keep going. And then all of a sudden, it was 30. And I was like, Oh, I might have tested, I might have tested her blood sugar 10 times in seven minutes. I was like, but But I mean, it's the truth, right? Like you, you have to learn to do this. Because you use manmade insulin and your blood sugar is going to get low. I just don't care who you are, it's going to happen. So you need to know how to handle it, or how to handle it for somebody else. And you need to know how to handle it without causing a problem in the future. Whether that problem is a high blood sugar, or calling an ambulance, like right, you're it's not. I guess we don't talk. It sounds scary. It's probably why people don't talk about it, huh? Yeah, yeah. So
Jennifer Smith, CDE 21:03
it's absolutely it's it's more around how to treat. There's not even an emphasis on like the overtreatment. It's just treat it. But why, right? Why is it so important to recognize a low sooner than later or deal with it sooner than later? Or stop it from happening? sooner than later? Because there is that scary factor of? I don't know. I don't know why some people can have a blood sugar. I might the lowest I was ever was 26. I don't I was fine. My mom actually thought the number had to be bad. I mean, it was really old. I mean, this was like 1988. So clearly, the meters were not what they are today. But she's like, that's gotta be wrong. You feel good, right? We were camping. Did it again, it was like it was pretty much the same. Just like you need to eat. Here's the juice. Where's it? Where's the regular soda? You know, why could I be there? And fine, when somebody else could be passed out, have a seizure, need an ambulance need assistance? When their blood sugar is 61 and low?
Scott Benner 22:10
Right? Right. Yeah, everybody's going to be different. And so. So let me let me say a couple things here. I use a football analogy, because it's football season, right? You can't like the reason they offensive linemen are these giant blobs of people is because they're trying to stop this insane force that's coming at them. Right? Correct. You can sometimes put carbs in. And you've made such a mistake earlier in the day with insulin or, you know, there's just so much power on the side of the insulin. It's like the carbs aren't there, like you might as well not have anybody blocking because it runs right through them. Right? That's a panicky situation. The first time that happens to you, where you take in a juice box, and realize that it's, it's like you didn't drink it. If you're enjoying the Juicebox Podcast, and you would like it to remain free. Please support the sponsors. Today's sponsors are Dexcom G six dexcom.com, forward slash juicebox. And Omni pod, both the Omni pod five and the Omni pod dash are available at Omni pod.com. Forward slash juicebox. It's a hard moment, you know what I mean? Because this is what you know is going to work. And now suddenly, it's not working for some reason. And you're like, Oh, God, what do I do? You can't find yourself in those scenarios. Wondering what's in the cabinets? Or what's in my bag? Or what do we have in the car, like you have to be prepared? Correct all the time. Just all the time. You know, anywhere you are. There are fast acting carbs. I don't give a crap if you don't use them for six months. I don't care if they get stale, throw them out and replace them. If the juice, you know, when the juice box gets some spongy from being in the car in the heat, throw it away. Put another one in there. Like just don't. Don't ever find yourself in a situation where you're like, it'll be okay.
Jennifer Smith, CDE 24:06
Right? Yeah, right. I mean, It's fall now and I were just like rotating through. We don't really have summer jackets, but like into fall into the winter jackets. We're kind of rotating them into the mix, right? So I bring up my winter stuff. And absolutely in at least like one if not two of my, like fall into winter jackets. They're old, nasty, bad glucose tablets. Like they've gotten the like crystallized sugar like dots, though and like if I had to, I would still use this. So like that juice box that's like nasty and squishy. If that's all you got, you use the squishy juice that
Scott Benner 24:45
you could spread them around your life like your grandma's spreads around her reading glasses. Do you know what I mean? There's just a pair in this room and over here. You need to be listening. You can't be it's a weird scenario. You can't be scared. You can't live your life scared If you don't want to live your life with a 200 Blood shirt, because you don't want this to happen, because also, that's not any safety from not being low, right, as a matter of fact, that might put you in a situation where you're alone more frequently, but, but I like to say about diabetes, that you don't learn these things, you don't prepare for these things so that you can stop a problem. The problem is always going to sneak through somewhere, it's never going to be where you think it's, you know, because if it was where you think, then you'd get ahead of it, right. So you have to be ready for when it happens. And then the last bit of this is, if all else fails. I mean, please be carrying glucagon, you know, with you, like not, it's in the cabinet in the kitchen, but we don't take it, you know, anywhere. I left it in the car when I went pumpkin picking like it needs to be with you. Right. Yeah, exactly. So well, this is a fun conversation.
Jennifer Smith, CDE 25:51
Harder, I think it's a harder conversation than you think about before. Because there's a lot of, there's a lot more on the back end of not taking care of a low well enough. That is actually scary. Yeah. And it doesn't get talked about. We always try to like smooth it out, like not to worry about it so much, and whatnot. But in order to not really worry about it. Preparation is needed. You have to have things in your purse or your car or your backpack or, you know, at your friend's your friend's house that you go to all the time, or whatever it is. I guess it's like being a girl scout or a Boy Scout be prepared
Scott Benner 26:33
how to be prepared. Yeah. You know, when Artem was younger, she spent her whole day in one classroom, right? Or she went to art or something like that. So she had a bag and she took it with her when she hit middle school and high school and she started having English in one room and math in another room. When that started happening. We put supplies in each room. Like we didn't say to ourselves like she should be humping this stuff all over the place constantly. Let's put a little here there was a couple of juice boxes in every room. You know, it's interesting. It's when you learn about your management to how come we're always restocking the English class. And never the math class. What's the time? Yeah, it's the time of day we're doing something that's making a low around this time of day, it's actually an interesting way to learn a little bit about your management is where am I grabbing my supplies from? You know, do you think that? Do you think that every low is different? Because there's there are questions here from people that are like, you know, after I stopped a low with a fast acting, should I put a protein in every time afterwards? But not necessarily, right?
Jennifer Smith, CDE 27:38
Yeah, no, I mean, the idea. Again, it's kind of an older concept. It's sort of like the 1515 rule, it's 15 grams, 15 minutes, and then you essentially may need to follow that up with a snack. But again, there's lack of enough information about why the idea really was simple carb will typically help keep your blood sugar up for about 90 minutes, give or take. Now, again, a variable in the picture is why was the low there. If it's excess insulin, you may actually need to treat with more than what you thought you would need. But the other idea is that the simple carb to keep your blood sugar up is it's meant to sustain you for that time period, before you might eat again. So if you treat a low blood sugar at, let's call it three o'clock in the afternoon, but you don't typically eat dinner until seven or eight o'clock at night. Lows can bring on another low they can. And so if you treat the low, but there's something in the picture that's keeping you lower, could be honeymoon, it could be excess insulin, it could be more movement in the day, whatever. You may actually for longer than two hours before your next meal. It may be beneficial to have a handful of nuts a spoonful of peanut butter a piece of string cheese a boiled egg, whatever it might be. The the idea there is that that's a little bit more sustaining and or a snack that might have a little bit more complex carb to it long with some protein to sustain things. So you're right every low is not the same
Scott Benner 29:20
right art in tried art in psychology right now. She tried to use a falling blood sugar as a Pre-Bolus for her lunch, but it just didn't like she didn't time it well enough. So like at 60. So listen, for anybody who's listening. Here's how I did it. Arden's in another state. She's 13 hours away. I'm able to look at her phone and see where it is. Right so I use Find My Phone to see. Okay, she's in the cafeteria, so at least I know she's right. So now where she should be near food. I text her Hey, what are we doing about this? Because she's got this like seven One day that became 65 pretty quick. And then I looked at the arrow and then I looked at the line and I thought this isn't stopping. Like this is not a low that's going to stop right like this is this is going to be negative 15 If we don't do something about it, right. What are you doing? I'm trying to like Miss like, you don't I mean, I don't want to be upper asked Jenny. And at the same time, I don't need her dropping dead. It's College. Like, I'm trying to find the middle. I'm like, Hey, what's up? And nothing. Now I know she's with the food. So I'm like, you see this? Nothing. Art and I really need to know you're okay. I'm eating now. I'm like, okay, like the food's going in your mouth. Yes. But Jenny 6060 560-560-5550 5540. I'm like, Are you eating now? Yes, I'm eating. I told you. I was What are
Jennifer Smith, CDE 30:49
you eating lettuce leaves. So
Scott Benner 30:53
what's happening? Like, you're eating like handfuls of sugar, right, like, and so, but so I texted her to test her. So then I sent a text to test her cognitive, like, where she was cognitively. Right. And I'm just like, how do you feel? And she's like, I feel fine. And I'm like, Okay, have you been eating for a while? She said, Yes. So I said, Okay, I got it. There's food in there. It's working. The CGM hasn't caught up yet. But I had to stand there. for like three go rounds. That CGM watching that 42 Just sit there knowing she's not really 42. She's in the mid 60s already. I know. I know this. But I only know this from
Jennifer Smith, CDE 31:35
you. Because you've lived with her. You've dealt with it long enough. You knew the questions to ask. You knew how to get her to respond and whether or not she was going to answer you the right way. And that it takes learning Oh, it's
Scott Benner 31:48
yours. Because otherwise I would have been like drinking juice. I don't care if you don't drink the juice. I'm bringing you home. I'm not paying for college. Like I don't you know, like, you know, because the number because we've done everything's over come home and live in this room for the rest of your life. Because the because the number was so scary, right? But I was able to pick together enough information. I swear to God, that CGM. One more time went from 42 to 66. And I was like, Okay, I was right. But I'll tell you, you're like, God, what if I'm wrong, you know what I mean? Like, I don't want to be wrong, but I might be. The next thing I think we should bring up about lows. Because we're in a we're in an algorithm world now. Right? Control like you on the pod five, that thing that Medtronic makes i What is it? Which one is that? Let me learn the number. Medtronic, don't they have an algorithm right now?
Jennifer Smith, CDE 32:39
Say, do they've I mean, they've had an algorithm for a long time I use as a their CGM, right. And I don't know that their does their algorithm have a name like Omnipod, five, six, so their new their new one and the ISC, that number is what you're looking for seven, seven DG. And I know some plays I don't know if it's here. I don't think it's here yet. Seven. ATG I know is available in some places in Europe already. But 777 80
Scott Benner 33:11
I just I feel like they buy they buy ads for in pen. So I figure I, I owe it to them to learn the name. I just can't keep saying the thing that Medtronic has they're gonna be like, How about how about if you're not the podcast that we sell the embed on anymore? Like? Alright, so the 770 GE, right. So yeah, so whether it's one of those algorithms, we all live in a new space now, where the algorithm sees a low coming, and it takes away and takes away and takes away your basil and takes it away. But it isn't, it isn't always going to get it right. And so you might end up treating a low after a prolonged amount of time of not having any insulin. And then your blood sugar shoots back up very quickly, because there's nothing to stop it. And what is the algorithm do when it sees the higher number gives you more it gives you more insulin, sometimes sometimes can happen. That's what I'm saying. It can happen that's a better way to and when that happens. Here's what I know for certain Yeah, gonna be low again later. Because because, you know, they, you know, when you're taking, you know, sugar and for a low if you take in the right amount, you've been getting on a regular you know, on a regular pump or on an MDI you've still been getting your Basal the whole time. So you're, you're correcting that low more in real time. When you do it right algorithm. The algorithm thought it was going to stop you. It does not expect these carbs. And now you jump up and it Bolus is the number or it's pushing basil at the number that the other night. I guess I should have listed lupus one of those Arden had Jenny I think it was around her period and she was tired. She's rundown and she's getting her period at the same time. We had this whole day where she was a little too low. And it persisted into overnight. And so around eight or nine o'clock we fixed the low and I said Listen, take these carbs, go into the settings and shut off micro bolusing without carbs. I was like, where this thing's gonna hit your, your correction, right? And it's gonna push it back again. And she did that we went through the night really nicely. It was a nice learning experience for her because then she brought it up the next day. She's like, should I put the micro balls back on again? And I was like, Yeah, everything looks good now. So, but anyway, you have to be aware of that. So, I mean, I don't know what you do. Me. I mean, there
Jennifer Smith, CDE 35:29
are other you know, for other systems, you can certainly also navigate something like that. If you've treated a low, you know that you've overtreated it, but the system is going to give back eventually, and you know that it's going to be too heavy, similar to your scenario there. The other systems do have, I guess, adjustable targets or different targets that would be higher. So then it would adjust less if you adjust the target up and say, Hey, I'm aiming for this now. So as my blood sugar is going up, it's okay. You don't have to give me as much because I want to be higher
Scott Benner 36:07
anyway. So like an example with Omnipod? Five, you might tell it to shoot for the higher range. And that's correct. And yes, with I'll tell you what, in that exact scenario with art, and I said, I asked her what did you take for the low? And she's like, Oh, I had gummy bears. They hit her really hard. So I was like, Oh, crap, she's gonna jump straight up. But they don't hit her and hold her. They hit her. And then they disappeared on her. So I was like, oh, no, no, don't let that thing Bolus. Yeah. Anyway, this probably all sounds much more confusing than it will be you have diabetes for a few months. It's all gonna make sense. Don't
Jennifer Smith, CDE 36:41
maybe know very well, yeah. There's still some things I throw my hands up. And I'm like, Well, clearly, like Venus is not in the right place in the orbit of something because I, I just I don't know right. Now,
Scott Benner 36:57
you're maybe just said Good. Luck is what I heard.
Jennifer Smith, CDE 37:01
That was so not the case. That's not the beginning of this is what you want to hear. Yes. Forget the maybe nine I shouldn't say maybe should be like the point 1% of the time. You know, it doesn't take much to learn, especially with CGM is in the mix. These days, it doesn't take much to learn how much is needed. And as you were sort of, you know, talking into the effect of algorithms, you'll see, well, gosh, I was used to using this much, I probably need to use a quarter to a third of what I used to use to treat when I didn't have a system that was helping me
Scott Benner 37:37
You know, I saw a woman yesterday say, I don't know the exact numbers, but the gist of it was on control IQ, I needed 14 or 15, carbs stop below and on Omnipod five, I'll need four or five carbs to stop below. Interesting that interesting, I found that incredibly interesting actually. So especially
Jennifer Smith, CDE 37:53
system to system, given the fact that they're both doing a give and take of insulin, but they are they are very different algorithms. Yeah. So that it does make sense.
Scott Benner 38:03
Alright, so check me on this. You need to know how to stop a low they're going to happen. You're not going to stop a low from never happening. You need to understand the different impacts that these different carbs are going to have on your low blood sugars. After a while teaching yourself to stop a low without creating a high is a great tool to have.
Jennifer Smith, CDE 38:22
Yes, if you it will happen. Yeah, yeah. Oh no,
Scott Benner 38:25
you're gonna rebound high until you until you learn how to do it in a real panic situation. Screw everything else save your life. Correct. And that's it right? Have glucagon with you have snacks with you. Don't go anywhere without ways to treat Lowe's, the people who love you and are around you should understand how to help you if you're unconscious or unable to help yourself.
Jennifer Smith, CDE 38:49
And I think another thing as you mentioned, caregivers or loved ones or you know, whoever. I think within that for Lowe's is recognizing the like what you mentioned about cognitive when you're doing kind of a check with Arden the people that are around you enough should be able to tell whether you're responding or or talking or whatnot, the way that you normally would. And in the case that your CGM is off, or you aren't using a CGM or technology, somebody who knows you well should be able to kind of chime in and say, Hey, are you okay? You know, and don't be angry at them for that. It's just a it's a checkpoint to be able to keep you safe. So
Scott Benner 39:38
yeah, also for I guess caregivers, low blood sugars could leave you with people who are difficult to yes help, right? They could become combative or and that's a real concern, especially as they become adults and I There's one story that sticks out in my head all the time of this woman whose husband got low and she just wasn't big enough to overwhelm him. Do what he needed, you know? And she had to call 911 because of that. But yeah, I mean, the people around you just need to know. And people should be following you. If you have CGM, like I don't know if liberi has follow like Dexcom does, but it doesn't. Okay. Arden is in a suite with girls. And the girl in the next room follows her on Dexcom Oh, wow, that's awesome. She only has a 55 alarm and nothing else. But we explained to her I'm like, if this thing's beeping, please go find Arden. And make sure she's okay. That's all. Yep. And it just, I don't know, especially for adults living by themselves or kids off at college, like somebody, you know, has your back because it also not everybody hears the alarms to like I had a low last night. It was only like 65. But I was sleeping. And in my sleep. I thought did I hear something? Like that was all I thought, right? And then I'm like, I woke up and I looked, and I was like, huh, yeah, I'm gonna watch that for a second because the being honest with you, it was a real slow drift. The loop had been taken basil away. I'm like, I think this is gonna bounce. Like, I think it's okay. I don't want to wake her if it's not going to be okay. And it waited and waited and waited. And then I was like, Oh, it is gonna be okay. It went back up again. But I talked to her this morning. And I was like, you know, you're a little last night. She has no idea. But since she had that seizure more recently, if you listen to her last episode, she'll tell you about it. If she has a she experiences any kind of a quick fall while she's sleeping now. I don't know. I don't know how that rewired her brain. But she's boom. I'm up. I drank juice. I'm good. Hey, Dad, I did this. Do you think this is enough? Like she never used to wake up. And now I don't know if she's feeling the fall while she's sleeping right now. Which has only happened twice since she's been away. But anyway. Alright, Jenny, did we do it? We did it. I think so. Yeah. Yeah. For us then.
Jennifer Smith, CDE 42:00
Okay for us. Awesome. Thank you. Oh,
Scott Benner 42:02
I guess we should say something like thank you for listening to the beginning series. And I hope you found it like, helpful.
Jennifer Smith, CDE 42:08
Absolutely. Especially in the beginning when everything is so new. So
Scott Benner 42:11
let us know if you want us to add to this series. If you go back and listen to it and find something that should have been in there that wasn't please send me a note. And Jenny and I will we'll add it if we think it needs to be added? Absolutely. What are we doing? What are we busy or something?
Jennifer Smith, CDE 42:29
Got nothing else to know. Right? But just hanging around?
Scott Benner 42:38
Well, as I mentioned at the beginning, we've already found more stuff for bold beginning. So this was not the last episode. Let me thank Omni pod and Dexcom. While I have your attention on the pod.com forward slash juice box, see if you're eligible for a free 30 day trial of the Omni pod dash. Or if you're interested in the Omni pod five. For full safety risk information and free trial terms and conditions, you can also visit omnipod.com forward slash juice box. And of course, thank you to Dexcom for being a longtime sponsor to the podcast dexcom.com forward slash juice box see blood sugar in real time, the speed direction and the number right there on your iPhone, Android, or on your Dexcom receiver. There's so much more I want to tell you, but I'm on about day seven of this illness that I have. And to be perfectly honest, editing the show together almost killed me. So I'm gonna go take nappy, and I'll see you next week with another episode of The Juicebox Podcast. Hey, everybody, it's me. I hope you enjoyed the episode. I want to remind you about the private Facebook group Juicebox Podcast type one diabetes. I don't know if past Scott said that in that episode. But future Scott, or I guess President Scott wants you to know about it. Juicebox Podcast, type one diabetes on Facebook. It's a private group that now has 40,000 members. And there are conversations going on night and day. Doesn't matter what country you live in. That group is always jumping, you have a question, somebody in there is going to answer it for you. You need a link, somebody in there will find it for you. There are group experts that will help you find episodes of the podcast that can help you. And I'm in that group every day. So please just stop by and say hello. That's pretty much all I have for you today. I hope you enjoyed this episode. I'll be back very soon, with much much more. Thank you for subscribing, following sharing, telling a friend telling a doctor whatever you do to get the word out about the podcast. I really appreciate it. Keep it up. You are helping the podcast to grow
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
Summary
Intro to the show. 0:00
Welcome to episode 915 of the juicebox podcast.
Nothing on the podcast should be considered medical.
Understanding insulin action and time of action. 2:49
Fear of insulin is the biggest sticking point.
Insulin action and time of action.
Tug of war analogy, insulin and carbs.
How blood sugar works in the body.
Take insulin and start to eat. 8:37
Rapid is a misnomer for insulin.
Rapid insulin is 100% in most settings.
Continuous glucose monitor, dexcom, continuous glucose monitor.
The story of a 17 year old boy.
Timing and amount of insulin. 12:12
Timing and amount is the first step to insulin use.
The importance of visualization.
Dexcom g6 continuous glucose monitor.
Share and follow features for android and iphone.
How to make good decisions. 15:38
Omnipod headquarters in massachusetts.
Request a free experience kit.
Dancing for diabetes and dancingthenumberfourdiabetes.com.
Making the first move is the key.
Diabetes is a science experiment. 19:22
Diabetes is a daily science experiment.
The pre-bolus piece is 80% of control.
I don’t count carbs. 21:28
Don't get mad, don't count carbs.
No accurate insulin to carb ratio set up.
The importance of the arrows in dexcom.
The least important aspect of dexcom is the direction.
What is pre-bolus and pre-basal. 24:54
Temper basal is a fraction of the basal rate.
Pre-bolus time is 20 minutes.
The importance of pre-bolus and extended bolus.
Pre-bolus vs extended boluses.
Trading bolus for basal. 28:08
The concept of super bolus.
Never suspend basal insulin.
Pre-bolus and multiple daily injections.
Sponsor, better help. 10% off first month.
#943 Campfire Stories
Nancy's daughter has type 1 diabetes.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 943 of the Juicebox Podcast.
On today's episode of The Juicebox Podcast, I'll be speaking with Nancy. Nancy is the mother of three, one of her children has type one diabetes, the others have other issues that we'll talk about briefly. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Don't forget to check out the private Facebook group Juicebox Podcast type one diabetes, there's over 40,000 members and the conversation is happening right now that you may be very interested in. You can get five free travel packs in a year supply of vitamin D. When you go to my link athletic greens.com forward slash juice box. That's right start with ag one today and get those five free travel packs and a year supply of vitamin D at my link athletic greens.com forward slash juice box and you can save 35% off your entire order at cozy earth.com. Just use the offer code juice box at checkout. bath towels, bedding clothing cozy Earth has it all. 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. betterhelp.com forward slash juicebox to get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit for any reason at all. You can switch to a new therapist at no additional charge. 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.
Nancy 2:47
I feel like I'm meeting a celebrity. Oh, well, you
Scott Benner 2:50
obviously are. You're not meeting a person who just went downstairs and had to mop up dog urine because because this dog is 15 years old. doesn't know when to give up. That's not what's happening here at all. Yeah. Now. You're not talking to a guy who was just in his kid's room shaking or going. You said to get you up. You said Yeah, yeah, I'm famous.
Nancy 3:16
I'll say this year I get to talk to you last year. I got to meet Dr. Stephen ponder. Did you really? Yes, yes.
Scott Benner 3:22
Were you in Texas or was it somewhere else?
Nancy 3:24
No, he actually came and spoke to a group in my area. I live in Georgia. Okay. My Endocrinologist, Dr. Hutchins is in Macon, Georgia, which is about middle of the state. And she did some just sort of a family day with some vendors. And he came in he was our speaker and had some activities for the kids and things like that. And he was there. So
Scott Benner 3:48
Oh, that's lovely. Jessica, right. Yes. Love. Dr.
Nancy 3:51
Hutchins. She's
Scott Benner 3:52
wonderful. Okay, well, I apparently my children live on either side of
Nancy 4:00
that. Yes. Yes. I kind of suspected I know that you I didn't feel like in any of the podcast or your post. You're real specific. But I kind of guessed that. Your daughter was kind of in my vicinity.
Scott Benner 4:11
Yeah, yeah. I'm supposed to say that. She's in Connecticut. Okay, so or Chicago or something? That's
Nancy 4:18
it's pretty hot in Connecticut this time of year. That's where she is. Chicago.
Scott Benner 4:24
But my son is in Atlanta, but he's, he's trying to get out pretty quickly. So,
Nancy 4:30
yeah, well, my town is uh, we're almost the southernmost town in Georgia. So I'm about an hour north of Tallahassee, Florida. Oh, wow. So I'm all the way at the bottom of the state. So which is geographically challenging with a type one diabetic because they're rare and big town so especially in rural Georgia, harder to find somebody. So the nearest town Hassey Jacksonville Savannah, Macon Atlanta. So
Scott Benner 5:04
are they great once you get there? Dr. Hutchins is
Nancy 5:07
yeah she is but previous one that we used not so much and unfortunately I spent way too much time with her.
Scott Benner 5:15
Oh, yeah, that can definitely happen. Well speaking time I have perfected the Georgia to New Jersey 14 hour drive.
Nancy 5:21
Oh my gosh. That sounds gross.
Scott Benner 5:24
It's horrible. It has moments where it's worse. To name those moments. South Carolina.
Nancy 5:34
Savannah is a really neat place. That was part of my my husband's honeymoon. We did Jekyll Island State at the Jekyll Island Club then went to Savannah and Charleston.
Scott Benner 5:44
Oh, that's lovely. You know, so Arden was there for a year. And we were picking her up. We're by the way we're recording Nancy. Is that okay? Okay. We were picking her up at the end of her first year. And, like helping her like we actually went and visited our son and then we went to get her and helped her brain, like put stuff in storage and like it was our first time everything. We went to help her out. And Arden has a car at school. So Kelly says to me, I know this is hokey, but let's take like a trolley tour of Savannah. Yes, I was like, okay, so Arden's making fun of us. She goes those tour people just stare at us, you know, and I'm like, I'm like, why won't stare at you already know who you are. And we're on the trolley tour. And Arden's got one more class. One more class to go. And my phone rings. And I'm on the tour, but it's art and so I pick it up. And she is pretty hysterically crying. And she's going Dad, dad, a man, a man, dad a man hit Oh, no, like and I'm like, wait a man hit you on like, wait, what's happening? And she's really upset. Arden's not like real flammable. So I was like, yeah, what's going on here? And now I'm worried that someone's like, like, physically attacked her. Yeah, I'm like, I'm like, calm down. I'm like, what, what's happening? And she's like, I was stopped at a red light. And a guy on a motorized bicycle hit me. I'm like, Okay. And I'm like, are you alright? Yeah. And I'm like, is he alright? She was, I think so he stood up and yelled at me for a while and then ran away. And I'm like, Wait, what happened? Like, so I'm like, calm down. I'm like, if you're, you know, like, you're, you're off the road. She's like, I pulled over and I'm like, okay, and I hear talking to somebody, but I don't get a lot of context for that call. Anyway. So she says, you know, there was this guy on this old busted up like, bike that was, yeah, rised. And he was driving really slow. So like a block or so back. She went around him, she stopped. She stopped at a light and was stopped at the light for a bit and looked in her mirror and thought, but he's coming at me quickly. And then she kept looking and thinking, Oh my God, he's gonna hit me. And she's like, I tried to just like, should I like, pull out into the intersection like swerves. Yes. And a red light or cars next to me. I couldn't really do anything. And he kind of veers the last second and catches the back left corner of her car. But what had her so upset was that he flew through the air pass. Oh, that's her driver's window. And I think that was it like the human body flinging made her really upset. Yeah. So she gets out. She's like, are you okay? And he starts yelling at her. And she's like, wait, what? Why are you yelling at me? Like, what happened just now? And he goes, You can't do that. And she goes, what? And he goes, Stop at like a yellow light. And she goes, you're supposed to Yeah, and he goes, Well, you have to know the brakes on my bike. Don't work that quickly. Well, how are
Nancy 8:52
you supposed to know that?
Scott Benner 8:53
I don't know. That's what she wondered. So then they start yelling at each other, like a little bit. And then he just gets flustered and she's like, are you okay? Like, let's make sure you're okay first. And he gets flustered picks the bike up, throws it down a hill on the side of the road off an embankment and runs away into the city. So she pulls over to talk to me. And later she says to me, I pull over and she does that. Like if you want to know what it's like to be a pretty girl and I'm like, okay, she was like, pull over. And I'm very upset. I'm I have a person in my car with me who I don't know that well. Well, I'm just taking taking her to class. She's like, can I call you because I know you're here. And as I'm getting you on the phone, she goes an honest to god crackhead comes up to me and goes, Hey, you from New Jersey. And she's like, not now buddy. So he's, he's like he's hitting on her in a park. Yeah. A
Nancy 10:01
lot of panhandlers in Savannah. And we call them the woohoo girls, all the girls there.
Scott Benner 10:09
Because you yell woohoo app. Or they're yelling. Yeah. So anyway, she's like, and then I just calmed her down. And then I pulled my parenting hat on. And I was like, listen, you're okay. The car is okay. I'm like, you have a class to go to. It's your last class. You're presenting your project. You to pull yourself together and go to that class. Yeah. And I was like, and when you come out, I promise I'll be standing in the parking lot. Yeah. And so I just, you know, couple hours later made sure I was there when she came out. She told us the whole story. He was laughing. But anyway, you visit Savannah?
Nancy 10:47
Yeah, we used to go almost every year, like whether it was for our anniversary or Valentine's Day or special trip or whatever. We haven't been in a while. The drive from my town to Savannah. While it's not 14 hours, it's long, boring. Nothing to look at all the way there. So it's kind of a boring drive. I'm
Scott Benner 11:07
just gonna tell you that. 18 months ago, I had only ever been to Atlanta or to Georgia. Once in my entire life, maybe twice. And now I feel like I live there. So yeah, yeah. Anyway, it's a it's a nice area, I guess. Yeah. My son does not like Atlanta.
Nancy 11:24
I could understand that. My son interned at Atlanta Athletic Club. I guess it's been three summers ago. And the Johns Creek area lived up there. And his fiancee because he they offered him a job after graduation. And his fiancee was like, I don't want to live in Atlanta. No, thank you.
Scott Benner 11:43
I'm not usually a person to talk like this. Because I live in the northeast and I love driving fast and recklessly at times. But Atlanta driving in Atlanta is
Nancy 11:53
Yeah, yeah. It's a sport. contact sport. Sometimes
Scott Benner 11:57
I've seen to hit and runs, and I've only been to Atlanta three times. Yeah. Anyway, okay. So Nancy, we already know you're Nancy. Yes. You are the parent of a type one or you have type one yourself.
Nancy 12:10
I'm a parent of a type one. Elena.
Scott Benner 12:14
Yeah. Tell me about Elena, please.
Nancy 12:15
So Elena is birthday, ironically, is today Happy Birthday, Atlanta, she turned 17. Congratulations. We just celebrated her 10 year diversity. She was six when she was diagnosed. So I guess, diagnosis story, how we figured it out? Well, are just about her.
Scott Benner 12:38
Like how you're going into like how you're thinking of the big round picture. Let's let's start with, are there any other autoimmune issues in your family?
Nancy 12:46
Yes. So my oldest son who will be 23, in a few months, two years ago, was diagnosed with Crohn's disease. My grandfather, my paternal grandfather, had celiac disease. Both my dad and his dad, paternal grandfather. I know my dad has type two, I've always been told my grandfather had type two. He was insulin dependent, before he passed. And I've often wondered with him having celiac. Was it a misdiagnosis? Or just,
Scott Benner 13:28
you know, was it a late in life diagnosis? Celiac was yes, but his diabetes required insulin was longer. The requirement
Nancy 13:37
of insulin didn't happen until later. So it could have just been I guess the progression of type two was my dad nor my grandfather are overweight, big people as a stereotype we talk about a lot as parents, but I just remember as a child, seeing him with the syringes and some insulin. Not knowing Yeah, blast to the future that that would, you know, be us. But so type two, he had celiac. There's been a few times that I've wondered if my middle child my other son had some gluten issues, but we've not done like true tests, but sort of tried to eliminate diet and stuff. But yes, my oldest has Crohn's.
Scott Benner 14:31
That's a pretty rich history of of issues, I would say.
Nancy 14:35
Yeah. And yeah, I always laugh and tease that my husband and I just created these great medical anomalies. Our oldest has Crohn's, our middle son who's 20 has epilepsy. My daughter who's the youngest seven team has diabetes, and she has seizure disorder as well.
Scott Benner 14:54
Oh, no kidding. How's your dog? My dog? See, okay, Yeah. I didn't know if maybe you guys were like the epicenter of something.
Nancy 15:04
Yeah, no. Whenever David and Elena started having seizures, my mom was like, There's something at your house. You can't go back to your house. There's something going on there. Because Ironically, when their seizures started, it was days apart. So we we both Yeah, I can see how we thought it was environmental. But Elena has not had a seizure in over two years, which is never, in my opinion, diabetic related. She had on a Dexcom I could always see her blood sugar. No testing has ever told us anything about her seizures. We've done MRIs, CTS, the was an EEG, that's the brain. I always get that. But worn monitors, we've done DNA testing, David's they can diagnose and see right where it's happening on the brain, hers not so much. So it's been over two years. And one of her last appointments they are discussing weaning her off her seizure meds, maybe it was the column psychosomatic, not that she's faking them, but there's no, there's physical or physiological. I know what the right word would be reason that they can see why she's having her seizures. So David went through a lot his junior and senior year of high school, and has a lot of mental health struggles with the seizures. And so we're holding off until she finishes her senior year to titrate her off the seizure meds because I don't want her to miss out on senior year if stuff starts happening, and
Scott Benner 16:40
are there side effects of the medication? Yes,
Nancy 16:43
Elena, thankfully has never experienced any side effects that I know of. Dave David, yes, we've had to change a few times he had what they call cap rage from Keppra gives you rage issues. Some of his medicines have caused weight gain, and just the disease itself. And the side effects from some of the seizure meds is a terrible tornado of mental health. grossness, so.
Scott Benner 17:16
That's a lot. How old are you?
Nancy 17:19
I am 48.
Scott Benner 17:21
Okay. Your daughter's diagnosed at Did you say six at six? And how does that come about?
Nancy 17:29
So we just, uh, I can't remember how long we'd had our camper. We were tent campers as a young married couple and then started having our kids went on a few tent camping adventures. And then we eventually got us a little camper. So met my parents at a campground for the weekend to camp the weekend. Elena had had her field day on Friday. And then when school's out, we drove over and went to the campground and noticed that she was going to the bathroom a lot. She was thirsty a lot. But I was like, oh, maybe it's just because we're in the camper. And maybe it's just because I'm having to walk all the way to the bathhouse and I'm just, I'm more aware of it because we're not at home and shit. You know, I'm more involved in your bathroom visits. And then by the second day, like she'd ride her bike, she go down to my mom's camper, which is not very far away. We're a state park. Thirsty, haven't used the bathroom again, back in ours thirsty, haven't used the bathroom again. And my mom and I sat around the campfire. When my brother was younger, one of his friends was diagnosed with type one very similar symptoms to Elena. And my mom said, You know what the sounds like and I was like, Yeah, I was like, but no. Well with my dad and type two, I was like, Well, does he have his meter with him? We can pray? Well, he didn't. My uncle was there. He didn't have nobody had a meter or couldn't prick her finger. So we're just there Friday, Saturday, Sunday, came back home Sunday. And at that time, we lived in Middle Georgia. And I was a ParaPRO and a kindergarten class. My kindergarten teacher my class used to be a nurse and went back and got her master's in education. So I called her and I was telling her the symptoms and she was like, let's just hope it's a UTI. I was like, Yeah, but a UTI. You don't go to the bathroom. You just feel like you need to go to the bathroom. She's gone to the bathroom. Yeah. So we got to school Monday morning. And I asked the school nurse I said can you just dip her urine and see if she has a UTI. And so she dipped her urine and the glucose part on the strip, turned colors. So she pricked her finger, and she was 365. And she's like, You need to call your pediatrician. I was like, okay, so I went out to the car almonds are the school and I was calling the pediatrician I was on hold, telling him the symptoms on hold whites. And she started getting nauseous. And our stomach started bothering her everything. And that's when the doctor told me like, you just need to hang up and go to the ER. Well, even though I'm rural, where I live now, I was very, I mean, I was an hour away from pretty much any hospital 45 minutes to an hour. But all of my co workers, I mean, the principal, the school immediately was like, what do we have to do, she's gone and gather and somebody to drive me to the ER, they're getting my purse, they're getting the latest things. And the next thing I know, the teacher that I worked with, is driving us to the ER my car, and I'm in the backseat with Elena, and she's just reassuring me the whole way there. This is going to be fine. You're you're super intelligent. If any parent can handle this disease, it's you. God knew what He was doing. Whenever he gave a line to you, as a parent to manage this disease, you're going to be fine. So that was the pep talk. I got all the way there may I'm just like, What are you talking about? I have no idea what I'm going into. So we went to the hospital, where her pediatrician is, and it's a smaller hospital. And then I have a I would call it like a sister or like a cousin hospital. They're not affiliated but a bigger hospital nearby that he also has. He can see patients. Yeah. So we went to the first small one because it was the closest and I went to the window and I said I'm here with my daughter. She's starting to feel nauseous. I think she has diabetes. I need to have somebody look at her. She's like, I can't admit you to the ER, just because you think she has diabetes. I'm gonna need you to tell me something else.
Scott Benner 21:51
Okay, I want saw big foot while I was like, outgoing. She's like,
Nancy 21:57
that's just not something I can. Oh, okay. She's nauseous. She's throwing up, she doesn't feel that's what got us in the ER not scared that we have type one diabetes, which is very dangerous. Now I know that 10 years later, it was she's throwing up.
Scott Benner 22:12
That's what what's the tree to human ratio where you are? The what? The tree to human ratio. There's lots of trees, okay, I'm just trying to figure out what I'm talking about here. So you had to drive an hour to get to someplace where nobody knew what they were talking about?
Nancy 22:28
Well, what's the pediatrician that called him from his office and he came over. And my husband's still taught us about this. I don't know if it was a student, or a medical student or a nurse or whatever. I mean, our heads are spinning, we have no idea. We didn't know anybody with type one diabetes, I don't know what I was getting into. She just came up to us. And she said, I just feel really sorry for you. And walked out of the room. And I was like,
Scott Benner 22:55
what? Wait, this is a student nurse. I was either a nurse
Nancy 22:59
or a student doctor, someone on the medical staff. It was not just a random person in the hallway, it was actually a hospital medical staff. And that's nobody has yet even said, this is the diagnosis. This is what's going on. And
Scott Benner 23:15
can I say something? You've motivated me? Hold on a second. Okay. Like we've ever done this before. I want everybody listening to picture 30 people that they know. And then tell yourself, like, go through them. And tell me how many of them are really, really bright people. And let's keep that in mind. While we're discussing how all the things you go to get your tires changed. You need new tires, and the person you're talking to you're thinking like, Oh, God, I'm like, I'm afraid to let them touch my car. Or, but But you know, there's a there's one person at the tire place like you've been there before you like, you know, there's one there that knows what they're doing. But where where is he and you're looking around and you don't see him? You're talking to this one instead? You're like, oh, no, no, no, no, they're definitely gonna mess my car up. Or when you're in a clothing store, and the person helping you seems to be staring at a wall or or you're in a hospital and someone says something to you like that. Like, yeah, I I think we all need to stop being so surprised by this. Yeah, that's all. And I'm not saying I'm brilliant. I'm not saying that. I'm not saying that. There are people out there. I just think there are there are levels of understanding people, people, you know, have different levels of of understanding. Have you ever noticed when you talk to somebody that you can't go sometimes more than like three thoughts deep before use them? Right.
Nancy 24:43
Yeah. And I tell a lot of people through the last 10 years with diabetes. Before that diagnosis, I help medical people and I apologize to anybody in the medical community that's listening. I used to hold them at a higher regard than I do. Now, I absolutely go into a medical situation, especially at an AR, or non endocrinology environment. I go into the environment with the assumption that everyone in there is ignorant of diabetes, and I'm the smartest person in the room with about diabetes. And you're not going to tell me what is right and wrong to do. I'm the boss of diabetes. Also my shut up and let me manage until
Scott Benner 25:28
someone proves otherwise, I'll give you exactly. Because so far
Nancy 25:31
99% of our experiences at a hospital or that type of environment that's not endocrine, they're ignorant. And I'm using that word not in a derogatory way in the uneducated. Oh,
Scott Benner 25:46
it's yeah, I want to say something. And I mean this like, sincerely. I know and love people who are not like, people who can think two or three steps into a problem. I'm not saying I'm not saying there's anything wrong with you, if that's how your mind works, or, like, I'm not saying you're better, if you can think six levels deep into a problem. I genuinely genuinely don't think that I think people are lovely, like, yes, you know, yeah, but there's a lot of jobs to fill. Yeah. And very often, they get filled by people who in an ideal situation wouldn't hold that job. And then you don't know who's who, because you're in the tire store. And your, your assumption is, well, everyone here must know about wheels and tires, right? But that's not always the case.
Nancy 26:36
Right? Yeah. Well, just like so whenever we got transferred to the larger hospital, and our pediatrician was still caring for us. One of the things another just so like, blew my mind. There pricking her finger, we were there for like six or seven days, staying in for obviously getting our blood sugar regulated, but they let us stay for education. kept us admitted to the hospital for that. And one nurse that was our nurse for the evening. When she'd come in to prick her finger to check her blood sugar. She'd put a bandaid on our finger, like stop putting a bandaid on her finger. Like she's gonna have band aids all over. Stop and she would keep putting the band aids on her finger like what do you do and I don't draw blood. You just pricked her finger. If she goes through life putting a bandaid on her fingertip Every time she's testing her blood sugar, we've been covered. I am not bashful. Again. I forgive any. Forgive my edit. Please apologize for my attitude. I have fired doctors and I have fired nurses. In the midst of medical care. I have told nurses to leave our room. I have told doctors that I do not trust their medical judgment and that I do not want to see them anymore. I have told nurses and doctors, I don't think you know how to care for this. I want someone higher than you. I want someone to call my endocrinologist call somebody else. Elena several years ago, broke her leg. And we had to have surgery for it. And in the ER that's all I kept panicking about like you're not even checking her blood sugar. And she didn't have a Dexcom at the time. So it had to be a fingerprint. I understand you're gonna take care of her broken leg. But what about what? The last time I checked it was when we're flying here in the car, and I checked her blood sugar to see where she was. When she was in recovery, her primary care doctor called while they were given him the update and everything and they came to the door in the waiting room. They're like the doctor wants to talk to you on the phone. Okay, and I picked up the phone and he's I understand you're a little nervous about the diabetes care. I said I'm very nervous. I mean, nobody's even paying attention to it. He said how about I write in the records that you make all diabetes decisions and they can't do anything without your okay, I said that would be perfect. And that's what we did for that hospital stay.
Scott Benner 29:07
I want to say to this is not me being like a geography snob I've been in I don't want to say where because they're lovely people, but I've been in some more in a really prestigious medical institution. Where I'm pretty sure that if I would have listened to those people, Arden would have been lucky to have an ad one say yeah, and they are shiny and smart and have degrees from places you would be impressed by. And still that was it. Like I'm not saying it's because it's in Georgia and I know I joked earlier about the tree to people but I just really just looking for a title for the episode. And and but but uh, but seriously, like in any place in anytime and listen, you can go through I mean, you look at all the trouble we seem to have sometimes with policing Yeah. And yet I know police officers that are just salt of the earth, people who do a really great job all day long. And I know we get focused on the people who don't do a good job, right? More often than not, and there's reason for that, obviously, it's important. But if you can get into, and those are the positions, you said it earlier, right, like you held people in the medical field in very high regard, but really, for no reason. Just Chairman just like me. Exactly. But you just assumed well, they went to more schooling than I did. Yeah, they do a hard thing I don't understand. And so they must be smarter than me.
Nancy 30:33
But if you're just a general practitioner, if you're just a general, er, staff nurse, yeah, I mean, you can do trauma, and stuff like that. But I mean, when's the last time you counted carbs? When's the last time you did you know, a corrective factor for insulin? When's the last time I doctors I know that they're not super medical, but eye doctor years and years ago, she was getting her eyes checked. And he said how she checked her blood sugar today.
Scott Benner 31:03
That happens constantly to people.
Nancy 31:05
I'm like, Huh? Like, of course she did. Right? Well, what was her blood sugar when she checked it? I posted this and I think you mentioned it in another podcast, or I don't know if it was Jenny or somebody. Y'all are talking about my comment. I was like, which blood sugar testing? Do you want the one just before walked in here? The one on the way here? The one at launch? The one after her snag the one this morning was? I mean, she's on index calm? Yeah, yeah, we check her blood sugar. If we didn't, we might make a terrible decision. And she would die.
Scott Benner 31:36
Let me now I'm going to stick up for the other side. This is my favorite part about talking. I love taking all sides of ideas. You said something earlier? That completely explains why an eye doctor who's? Who's really just trying to say are you I see you have diabetes? I don't really know anything about it. I hope you're paying attention to it because diabetic retina, right? Like that's what's in their head. Right? Right. And why why is that something? So first of all, we can expect the eye doctor to understand type one diabetes, that will correct. And you went camping with two people who had diabetes? Who didn't even bring a meter with them. Yes, that's true. That's true. So you're now making have already previously made the point of the physicians who are just like saying things like, Hey, you check your blood sugar once in a while, right. And so you get put in this type one world, where it's, I'm being honest, if people manage if a person's managing their type two diabetes properly, they'd have as much knowledge of diabetes as you do as a person with tight like managing a time person, right? Where would that fall short? Is there a lot more people like your your family who like went into the woods, and it's like diabetes, not while I'm camping? And you don't have that luxury? Because, you know, she has type one, not type two.
Nancy 32:59
I will say that for my dad since a lightens diagnosis. And as he's gotten older, I think but I don't know, I'm gonna guess. And I have no idea if my parents will listen to this podcast. But I want to guess that having the experience of what we pay attention to. He's always been, I mean, a fairly healthy eater. He pays attention a little bit more to Well, what was my agency? And what can I do better? You know, before my next checkup, and he does monitors blood sugar a little more frequently than the camping trip era. So I don't know if it kind of opened his eyes to and we'll talk sometimes like even though they're different, but you know. So I think it's made him more aware of if he is more in tuned with his then possibly he'd have better results. I
Scott Benner 33:57
think that's completely common, right? Somebody just shows you the things like I don't think people are nobodies. Most people there we go. I don't believe I don't believe that most people are willfully ignorant of things. Right. I think that your you know, father's doing what he thought he was supposed to be doing. And type two doesn't kill you quickly. So it's hard to know why it would be important. I'm up, I'm alive. I'm doing my stuff. Like, I have type two diabetes, but I'm okay. Yeah. Nope. It's it's because I just don't think that people in general understand. Yeah, they're their bodies in many different ways, like so to tell them like the your blood sugar's higher. It's not good for you. So we want to keep it lower. Is not, it's not the full picture. The full picture is if you have diabetes, I don't care what kind it is. And you're not managing it in a way that your body can do. deal with, you will eventually die of something related to those high blood sugars. Right? It might, you know, it might say heart attack, it might say seizure, it might say stroke, it might say all kinds of things on your death certificate. But in general, it's going to be because the level of sugar in your blood was too high for too long. Right? You know, and just the same as you see, I mean, my favorite example is people smoke their whole lives. And they'll always be like, doesn't it's not getting me like, I don't know what they're talking about, I'm fine. And then eventually, they die of respiratory heart failure, which is directly from their, their smoking. But there's also people who won't get up and exercise who eventually will die of not doing that, and, or eating like foods, such a great example. You and I can go out now to a fast food restaurant, and eat it. Yeah. And eventually, that fast food will come out the other side of us. And we'll be like, Wow, we have completed the cycle. Everything is fine. But it's not really fine. Because you have slightly degraded the your body by doing that. Not enough to die in the moment, right? It's not poisoned, you don't like you don't eat the whatever you just bought, and you're just body just because it shuts off. But if you think of yourself as being at 100, the day you're born, you know, on day 3000 When you have a chicken nugget that was made in oil, that's probably not chicken, your number moves down a slightly little bit. But yeah, there's gonna be a full point, but you are taking away from your body's ability to stay alive. Yeah, right. And, and life is already trying to do that. So not a lot of reasons to help it is what I'm saying. That's all Yeah. And you know, I'm a hypocrite like everybody else. Yeah, we all Yeah, but I'm not. I'm not saying like, I'm not saying it to put paint out a picture that if you all would just be I just said, y'all, I've only been talking to you for talking to me a little bit. And I'm already I'm about to find a banjo. But, but but I'm not saying that saying like, you need to be perfect or you're going to die. I'm saying you need to understand the impacts of the things you're doing. Right. That's pretty much it. That's all and I think the disease of diabetes forces you to think about those persons. Yeah, it's your understanding.
Nancy 37:30
Yeah, just so. But then for type one, my, not my initial goal. I mean, I had some mentors reach out to me whenever Elena was diagnosed, and as I don't want to talk to anybody, but eventually I did connected with some other moms and support groups, local support groups and online support groups and things like that. And when I met Dr. Hutchins, she's the one that introduced me to the Juicebox Podcast and listen to that. But my goal for wherever I am, wherever Elena's participating has always been to be a voice and an advocate. Our school system has some great nurses, we have a great nurse coordinator. I've never been disappointed with Elena's care at school. I've never been scared or nervous. When she was diagnosed, we were in the middle of relocating. So we were relocating from Middle Georgia to South Georgia, where we live now is where I grew up. It's my hometown, were moving back here after I'd been gone for 20 years. But where I lived, we had been there for a while I knew the school nurse personally, I knew all the teachers, and I'm fixing to be thrown into a new school system that I know, no one sure I might bump into somebody I went to high school with to have a talk to him and 15 or 20 years, I was going into a panic, I was like I should homeschooler I'm not going to send her to school. I don't know these people. I did not do that she went to school. But my goal has always been to be an advocate and to be a voice for diabetes. Wherever we go, whether it's school, or extracurricular, or family or friends or wherever, because the more everyone knows that's around her, the better people are going to care for her. If something happens, the more that people know, the more educated I educate two or three people, you educate two or three people then they educate three or four people and so on and so forth. Maybe some of those stigmas and the the misunderstandings or just all of our type one kids can have a better quality of life, socially. If more people understand what this disease
Scott Benner 39:48
is, yeah, you're putting up those little signs around the world that when you see them you think why is this necessary, but at one point, it was I saw a sign once on a an overlook with like a little bit of water below it, and it just said, don't jump will cause that. And I was like, wow, they had to put a sign here to stop people from jumping off of this. Like who they weren't trying to kill themselves. They were like you could jump off this and live, right? It happened enough times that somebody in power was like, I have to educate people that they can't jump from here. And so when that when that needs to be done, like this is, I mean, you're doing a good thing. You're just out there. I think of it as like being Johnny Appleseed like you just you a little information behind, and hopefully a tree grows. And you know, you don't stay to watch the tree grow. You just go on, right. Yeah. Hopefully this happens.
Nancy 40:43
And I've been excited to watch a lineup grow into it, because when she was young, she didn't want people to see her prick her finger. She didn't want people to see her given her shots and stuff like that. And fast forward to the last several years. She's become her own voice, her own advocate. Now, she's not one that gets super butthurt over diabetes jokes. There's a few that she's like, Come on, guys, come on. But she's not too bashful that if a teacher or an adult around her says something. She's like, Come on, guys. You know, that's not true. Yeah, I didn't eat a lot of like, you know, I didn't do she'll correct them politely. So she's, and there's been a few times that her and the school nurse maybe didn't see eye to eye because I know school nurses manage it a little bit differently than we would at home. They're more cautious. I get that. But as she was finding her voice, and you know, if a nurse is like, Oh, you're 85, you need to correct she's like, correct. Why would I treat at 85 like that. That's a great number. I'm gonna, she's learned to have her voice. I'm super proud of her. She loves showing off her devices. Couple of years ago, she started modeling for a local former workshop. And she's purposefully tried to have her Potter Dexcom exposed when she's modeling, so that she's an advocate for other teams. And she's even said some adults that don't want to show their devices. She has a little Instagram that she posts every once in a while. She's not like the super influence or anything but everyone smile Omni pod has. She just did what we taste as a media blitz for her die aversary With Omni pod, and she was interviewed by a local TV station and several newspapers and articles about her. So she's much more outspoken and willing to somebody comes up to her and says, What's that on your arm? She's like, Oh, well, let me tell you about it, and blah, blah.
Scott Benner 42:48
Can I tell you what Arne just shared with me while she was meeting, so all of her girlfriends are home, right? But they all went to different colleges. Obviously, they're back now for the summer. And she was in this scenario, like on a big video call with a bunch of friends from one of her. One of her friends colleges. And they all sort of know each other because they talk about each other. And you know, they don't really and Arden's like talking, she's on camera, bunch of this big group. And someone says, not with any sense of irony, they weren't joking. And they weren't being cruel. Like they just they they said the thing out loud that they thought, You know what I mean? Yes, all her pod on her arm and said, Hey, what's that on your arm? Is that for autism? Well, I've never heard that one. And Arden goes wide. Any and I didn't know that you could wear a pod for autism? I don't think you can is the point. I mean, I'm not a I'm not a what you would call like, an absolute person who knows everything about autism, but I'm gonna just go out on a limb and say, yeah, the kid was probably that pretty wrong. Right? Yeah. And, but Arden didn't like she goes, No, she's like, I have diabetes. And this is where I get my insulin from. Right. And then all the other kids kind of made fun of the kid like, What are you talking about? You know, but But honestly, honest statement. That back, Carolina's been asked if it was a nicotine patch. That even makes a little sense. Yeah.
Nancy 44:20
Was it a birth control? Patch? Interesting. Sometimes little kids, you know, and she says it's difficult with younger kids, because you know, how detailed do you get? How vague, are you? She teases sometimes that she's a robot, and that's part of the parts of her robot. And she has we're Apple people. So with the Omnipod five, we have to have the separate controller. And people ask why she has two phones and she's she has all these scenarios. She's like, Oh, I'm a spy. And that's my contact phone. That's how they contact me or Oh, that's my business line. That's how so she has fun with it sometimes. So I'm glad that she's here. From the beginning, from diagnosis, we've always respected the disease. But we have never ever made it a big scary monster to her.
Scott Benner 45:10
Yeah, Arden didn't make a big deal out of it, she explained. And then they moved on. And she didn't break the kids balls over. Right?
Nancy 45:17
Yeah. And that's sort of Halloween, he handles it. And she can have fun with it and not be totally offended and a guest that, you know, yeah. So I'm glad that she's old enough now and embraces that and understands. Just like, I know, there's a ton of memes out there that say this. But the day before Lennon was diagnosed, I didn't know either. So why should I assume that everybody else does? Yeah,
Scott Benner 45:43
it's a weird thing to put on somebody. There's, I say all the time. There's plenty of medical issues. I don't understand. I wouldn't, you know, and I wouldn't be mad at somebody for not understanding my life. Right? When it becomes like that feeling like you had with a broken leg like, well, your ignorance is going to cause me a real problem. That's when it the panic kind of sets in. Right. I need you to understand this right now.
Nancy 46:06
But I will, I will say that took care of her way we did fine, didn't manage well, they let me count carbs and calculate. You can ever think you found
Scott Benner 46:15
the guy who understood the wheels and the tires, and he got it all set up for you to pick through the shop a while till you found him I will just
Nancy 46:21
I just would want if a parent is listening, that if you're ever in a medical scenario, you know best how to care for your diabetic child, do not let the intimidation factor of someone with a degree tell you otherwise. You take care of your kid. But and if they're being if they object to that, ask for someone over them. Ask for a patient advocate ask, you know best how to care for your diabetic child, not them. Yeah,
Scott Benner 46:51
it's not rude to expect somebody No.
Nancy 46:53
You know, I mean, we would do it in other scenarios. Yeah. Well, 100% I mean, if you order your food, and it's wrong, what do we do? We we question and we say, This isn't what are ordered, or this seems a little undercooked or whatever. Why wouldn't we do the same thing for our children? Some people
Scott Benner 47:10
eat it? That's true. Yeah, that's so I heard you say something that surprised me a second ago. Cellphones made all the way to where you live. That's fantastic.
Nancy 47:20
We have running water and indoors. That's crazy.
Scott Benner 47:23
But speaking of technology is what I was going for. You is your daughter using Omni pod five?
Nancy 47:31
Yes. So we started Omni pod five. I'm gonna guess we've been on a little over
Scott Benner 47:36
a year. Okay. And how are you? I love it.
Nancy 47:40
I love it. Love it. We have to reset the controller with the replacement they sent us We haven't done that yet. We're doing that at the next pod change. But I want it. I heard something a podcast the other day. Our Basal to Bolus is right in that sweet spot of almost 5050 5050. So I don't want to start over from square one. Just I mean, nobody does. I don't want to put the old settings in there. It's been a year we stay in automated mode all the time. We don't use manual. Sure we're in limited sometimes during a warm up. But we're an automated all the time. And we have been from day one. So those bezel settings are way out of date. So Dr. Hutchins helped me calculate what we needed to put in for current Basal rates and everything. The first thing I saw right away was we weren't dealing with Lowe's as often. Excellent. It was very, very good. Right out of the box for Lowe's, and my time and range clarity report. Typically, there's nothing reporting. You know, it's like that less than 1% thing at the bottom and the low and very low. Typically, that's what our charts have been since we've been on Omnipod. Five. We're anywhere from I'm gonna guess ballpark 60 to 80% and range. Even at summer camp the other week, she was 75% on range at summer camp on on the pod. I've been happy with it. Did we have some highs at the beginning? Sure. While it learned her and from what I took from the community was correct every high. That's what we did when she was high and it wasn't doing very much I would have her put in the Dexcom and have it calculate and give a correction. I would tell you know, put in the CGM reading on the algorithm and we just did that over and over and over and it took us some days. I don't remember how long but
Scott Benner 49:48
we've been very pleased with it. Excellent. That's what
Nancy 49:50
we started with. It was ironic we had a checkup just before we started it, so I knew her I want see And so Dr. Hutchins and I were like oh this will be interesting because we're just We're starting it and then we have a checkup in three months. We'll see her Awan see when we started Omnipod. Five was a 5.9. We were on dash before that 5.9 went back for the three month checkup. 5.9. Wow. Fantastic. And then the last checkup it was 5.3. So I'm pleased, I'm not disappointed.
Scott Benner 50:21
Yeah, I don't see how you could be.
Nancy 50:23
I mean, we don't micromanage it. You know, there's her, her range is 80 to 180 on the decks calm to alert me. I learned that from the podcast, gives me time to react before and I could probably tighten that. But I just, I'm lazy, and I didn't. So if it's alerting me to at least pay attention to it, see what's going on. So we can catch that before it becomes a problem. If it's one at like, where are you going? Let's fix that before it gets really hot. And then we're chasing it all afternoon. I say we respect the disease, and we do but I'm pretty laid back about it, too. I mean, I don't I don't know. I don't feel like we micromanage it. Yeah, sometimes we ask her like, Did you Did you forget you have diabetes? Like just get from the dinner table? I just said like tonight? We don't have that. I mean, you know, we joke about it that. And I feel like with Omni pod font, I certainly do not think about it as much. And I don't feel like I get as many Dexcom alerts as I did. That's great.
Scott Benner 51:25
And our use house sleeping going better, worse. Same.
Nancy 51:29
Same for me. Unfortunately, I my body has gotten accustomed to the Dexcom alerts. And I've tried to change the sounds but my phone I don't know if it's because it's a dinosaur. I must sounds I can't get adjusted. I sleep through alerts.
Scott Benner 51:46
How does that make you feel when you wake up in the morning, you see that you slept through why?
Nancy 51:49
I'm angry and scared and frustrated myself. But I will say the other morning just a few days ago. And I think it was a compression load. But my husband handled it and so he didn't prick your finger. But I would be interested. I really think it was probably compression. Like I woke up and I see that it had been alerting that she was 40 I was like holy cow. Like I slipped through that well. But he gave her a juice it came. I said but I really think because she had been in range been in rain, she drops and then she comes right back. Probably, I think I don't know. But yeah, I feel like a terrible parent if I wake up and it's been alerting, alerting, alerting. However, she's 17 she's a senior, she is going to be going away to college in a year. She's learning to wake up herself. And there's been times that I've slept through. She's heard on she's gotten up. She's handled it go back to sleep. And excellent, fine.
Scott Benner 52:44
That's good. Well, I'll try not to beat yourself up. And yeah, yeah, I mean, when those new phones when the good speakers get to you, I'm sure you'll where they come through the Suez Canal. How does that work? I don't know. That part of the world.
Nancy 53:00
Savannah port, the international port in Savannah.
Scott Benner 53:03
Oh, you know, I get to watch those big boats come in through there. While we're visiting with Arden. It's amazing to see a container ship close up is ridiculous. Yes. How big it is. It's it's really something if you've never seen it. I mean, it's amazing one time it's not. I'm not gonna tell you it's like not like seeing a unicorn where you're like, oh my god every time this is amazing. But you know, just see it once you go out I think is huge. I don't how is that floating? That's crazy. And then how long does it take to get from wherever it came from? China to Georgia? Yeah, months, I'm assuming. Yeah, no, I don't know anything about that. Yeah, no idea. Okay, so we're doing by the way, first of all, I know what I'm gonna call the episode. What is that? It's nothing you said or that I said, but it's the vibe that the episodes gives me and a little bit about what we talked about the beginning. I'm going to call it campfire stories. Okay. Yeah, I feel like that's what we've been doing a little bit. Yeah. So I'm down with that. Is your daughter going away to college?
Nancy 54:13
What she's choosing to do right now, she'll be only about an hour from us and is actually in a town, my son and feature daughter in law will be living there. So she's not going to be terribly far from us, but enough to have separation, independence, I guess you could say. She doesn't want to go to a super big college. And right now she doesn't seem interested in going very far from home and not because she's scared of it. But she's still trying to decide what she wants to do to so that could change this year, her senior year that if she finally the light bulb goes off, and she says Aha, I mean, that could also change where she goes, but right now she'll probably be only about an hour away from us.
Scott Benner 55:00
Okay, but she'll be. She's not driving it. So she'll be living there. Right.
Nancy 55:04
Right. That's she would live when she teases my son. The duplex that they've gotten. They have an extra bedroom and she's like, this is my bedroom. I'm gonna live with y'all while I'm at college. I was like, I don't know if newlyweds would really enjoy that. But
Scott Benner 55:20
whatever. Yeah, I'm staying here where it's free. That's what I was. Yeah. So that's what
Nancy 55:25
they all joke about. But probably yes, dorm dorms. And I think everybody should get to experience living away and learning some independence. And yeah, I'm not there to wash your clothes and change your sheets. And it should a class and stuff like
Speaker 1 55:44
that been good for my kids. I can tell you. Yeah, I didn't do that. But I we were so honestly, I was so broke as a college. How do you pay for that? I just like I somebody once told me. Well, you get started like a local community college. And I was like, How can I afford to get to it? Right? Like you don't know what it's like to be broke. I can tell ya. I don't have $10.
Nancy 56:10
Last year, whenever my oldest, my oldest just graduated from college. So Elena takes college classes like dual enrollment. They have that through our high school. So she takes some college classes now during high school and gets college credits. My husband's getting his master's, my boys are in college. And I used to tease I'm the only person in my house. It's not taking college classes there for a while. Yeah, no care to go back.
Scott Benner 56:35
Please. Do you think there are people right now who are like, wait, I'm listening to a podcast about diabetes or somebody didn't go to college? You absolutely are. You're listening to a podcast run by somebody who barely got through high school. So
Nancy 56:46
hey, you know, life experiences sometimes or teachers? Books that we were just talking about the degrees don't matter. The degrees don't matter. It's your experience with taking care of something?
Scott Benner 57:01
Yeah. Okay. There's definitely some people are like, I'm not turning this back on. I'm gonna tell you right now. i When I graduated from high school, I sat there and I thought suckers definitely shouldn't have given me that diploma. That was ridiculous. I have I Nancy, do you listen to the podcast with any frequency?
Nancy 57:21
I do. I live at a small town. So my commutes are not very long whenever I drive to town. So sometimes when I listen to an episode, I have to then pause it and then listen to it again later. Oh,
Scott Benner 57:33
that there's that that's the proper way to handle that I listened to. So I don't get
Nancy 57:37
through them. Quick as quickly because I'm having to listen to him. But I will set up posted the other day. And I was listening to the snake oil episode. And when he talked about the coffee enema. Oh, I was rolling. I was driving down the road and laughing out loud because your commentary on that was hilarious. Yes, I listened to him. And I'm gonna
Scott Benner 58:01
break I'll tell you why. Like, because I'm not sure if I've ever told the story of the fact that I missed on purpose, to go to work 52 days of my senior year of high school. I didn't missed school. I was absent 52 days in my senior year of high school. Wow. So I used to go to the technical school alongside a regular high school, which was part of this high school scam. When I realized that you can't go to the way I got through high school I think of as a high school scam. Okay, but they used to have it set up where two weeks of the month, you went to a regular like books school. And then two weeks a month you went to a technical school, I didn't actually have any interest in learning a trade. I had an interest in only going to high school for a year and a half instead of three years like that was. So I just took up a trade in high school to get out of going to school. So you made a visit to the technical school like to try to decide what you want to do. I mean there I mean, literally, cosmetology right. Engine Repair, like there's a sheetmetal shop there was like this school did a lot of everything. And what I did is I walked around, I found the class with the prettiest girls, and then I decided that's what I was going to do, which I thought was a rock solid way to make that decision.
Nancy 59:21
So what was that? What was that? Well,
Scott Benner 59:24
I'm a hell of a baker now.
Nancy 59:27
That makes sense. With all your stories about your cooking and everything.
Scott Benner 59:30
I can make bread, you know, 100 pounds at a time. Like forget. Look at what skills that gave you even though I got a job in a bakery out of high school. I kept it for a week. I was like I'm not working overnight. This is ridiculous. And I quit. So but point is I'm old. So back back then. Computers. Were really just starting to be a thing. Yeah. And the internet really wasn't a thing. Right. So the computers at the height school didn't talk to the computers at the technical school. So I learned that you could, I found out that you could what the maximum days were that you could miss. And I missed that many days at each school. And they never reconciled and I graduated. Nice. Yeah, it was lovely. And but I would go to work like for all of you are thinking like, Oh, great. Well, Scott was smoking crack. Scott went to a sheetmetal shop and broke his ask for $5 an hour because he was poor. But but it was. I don't know. I just I didn't even go to high school, I think is what I'm trying to say. Yeah.
Nancy 1:00:37
But you learned to bake? Well,
Scott Benner 1:00:40
that is for you all,
Nancy 1:00:41
but I don't know. I mean, sometimes when you talk about I have a recollection in the podcast talk like hearing you talk about cooking, or maybe it's on the Facebook page or whatever, talking about meals and everything and all your meals always sound so. Great. See, well,
Scott Benner 1:00:57
I don't know when the war of 1812 was though. Well, I think it wasn't 1812. But I'm maybe I can't be 100%. Sure. And that's concerning. Gosh, you said something that made me want to say something else. And now I can't remember I had two thoughts in my head. Here's a little secret. My whiteboard is full. I had two thoughts. Normally, I would have jotted them both down then told you the first one. But I didn't. And so now I don't know what I wanted to say. It's okay. Don't worry. Okay. You've been delightful. I wondering if there's anything we haven't talked about that we should have?
Nancy 1:01:29
I don't think so. I think I enjoyed the conversation. And I feel like I got to share our story and brag about my daughter how awesome she is. And she's going to conquer the world and she's not afraid of going out there and taking it on herself. So excellent. I think I did okay, in that chapter.
Scott Benner 1:01:57
Okay, sounds like you did better than okay. Also, because we've been having such a good time. We've now all forgotten that each one of your children has an issue. And so two people in your family and that's a lot to deal with. It's usually I usually ask, are you okay, like, what do you do for yourself?
Nancy 1:02:12
Ah, not much. I have a favorite saying that. Just because I look like I carry it well, doesn't look just because I make it look easy. Doesn't mean that it always is. So check on your friends. There are days that are pretty tough. I mean, I've gotten phone calls when David was in college, that they that he had had a seizure and I had to whisk myself away there. You know, watching the Dexcom Elena's on a overnight trip with she's an FFA which is it used to be stand for Future Farmers of America. They don't they just call it FFA now, but she does horticulture and she learned welding and stuff this year. But she goes on field trips for competitions and everything overnight. My son, he's older sort of caring for himself with his Crohn's, but you know, headed to the ER, I'm having a flare. So, I do juggle quite a bit. And I probably do not care for myself quite as much as I care for others. And that's probably not a good thing. But yeah, my kids are the most important thing to me. And I have been blessed with a husband that allows me that I work very part time so that I can be very available for our children at any time that they need me.
Scott Benner 1:03:40
Well, I will share with you and and I'm sure you know this but I think there's probably a way that you could do some more for yourself and, and still instill hope your kids. Yeah, there is Yeah. Plus you painted a picture of some pretty independent children. So they're gonna get sick of you pretty soon anyway. Yeah,
Nancy 1:03:56
no, soon I'll have an empty nest. And then I can I did ask for a little small greenhouse for my birthday last year. And so my husband, a mother in law, and my sister in law got me this little small greenhouse. It's not really big a smaller than like an outdoor shed. But as I started that little hobby, growing some stuff I've always had, like little, like might do vegetables or something. But I started doing flowers because I thought Oh, how fun would it be to just go and cut up okay, in your yard and have fresh flowers. So I've told myself, I need to pick up some hobbies because when Elena leaves to go to college, there's not going to be anybody but the dog or my husband to take care of. And that's all I've done for 23 plus years with kids is so yeah, I need to find some hobbies to
Scott Benner 1:04:43
I know how you feel. Yeah, yeah, it's it's a stark moment. And when that happens, you'll it'll hit you right in the face. Like, oh, no, I'm only good at this. I don't need anything else.
Nancy 1:04:56
Yeah, somebody had asked me you know, if you take away wife, mother, you know your career. Who are you? And I was like, Oh, I don't know.
Scott Benner 1:05:09
I'm the lady who might want to grow flowers. Yeah, seems shaky. Who lives two hours from anything?
Nancy 1:05:17
Ya know?
Scott Benner 1:05:19
How leaving to get the seeds? Do
Nancy 1:05:22
you drop them with pigeon? The
Scott Benner 1:05:24
Oh, yeah, because the helicopters can carry. Yeah, yeah, what happened? Yeah. I have one last question. I'm gonna let you go. Sure. Why is there no diet drinks in the South? Why are there no diet drinks in the south? We have diet drinks. They're very hard to find once you get below North Carolina.
Nancy 1:05:46
Elena loves Diet Dr. Pepper that's her go to and if they don't have that, or there's some machines she's learned fast food that the mixture doesn't make it taste right. Not the freestyle but like they don't mix the soda and syrup. Right? She'll order a Diet Coke but we have
Scott Benner 1:06:03
all right drives feel like I can't find them. It feels like you people just want to drink sugar is what I'm saying. I'm in the wrong places then. Yeah. All right. Nancy, I really appreciate this. I also appreciate that your sound is so clear. I don't have to edit this episode. We did. Oh, wow. Verse. We didn't say anything ridiculous. That has to be cut out. Okay. And the sound is you just saved me two hours of my life by having all your wealth and bake some bread. I don't know how the hell you got them to deliver that thing to wherever you are. But I really appreciate it.
Nancy 1:06:40
My middle son's gaming headset and gaming microphone. I'm in his bedroom at his computer. Well
Scott Benner 1:06:45
thank him for me because I really do genuinely appreciate it. Hold on one second for me. Okay, okay.
A huge thanks to Nancy for this really terrific conversation. I really did enjoy it. And thanks to you guys, for listening. Don't forget to check out the private Facebook group Juicebox Podcast type one diabetes 40,000 members, conversations about everything happening right now type one type two doesn't matter. Kido full time karbi just salads. Doesn't matter. Everybody's invited Juicebox Podcast type one diabetes on Facebook. I want to thank you very much for listening. And remind you that when you click on the links for the advertisers, you are supporting the podcast and helping to keep it plentiful and free. tell somebody else about the show. If you're enjoying it, won't you? Hey guys, just jumping in to remind you that one of our sponsors better help is offering 10% off your first month of therapy when you use my link better help.com forward slash juice box that's better. H e l p.com. Forward slash juicebox BetterHelp is the world's largest therapy service. It is 100% online boasts over 25,000 licensed and experienced therapists and you can talk to them however you want text chat phone or on video. You can actually message your therapist at any time and schedule live sessions when it's convenient for you. Better help.com forward slash juice box save 10% On your first month.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!