#232 A Journey of a Thousand Miles

Amy comes full circle……

Insulet’s Community Manager Amy Drauschke is not just an employee, she’s also the mom of a pre-teen Podder! Amy and Scott chat about being bold with insulin, not being a diabetes defense attorney, and creating great content that helps people manage their type 1 diabetes.

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

Scott Benner 0:00
I just finished recording the opening for the show and it was perfect, but was it perfect? It didn't flow exactly the way I wanted it to. So I'm just gonna blow through it right now. top of my head ready? Welcome bold people to Episode 232 of the Juicebox Podcast. Today's episode is sponsored by Omni pod Dexcom and dancing for diabetes. You can go to Miami pod comm forward slash juicebox dancing the number four diabetes.com dexcom.com forward slash juice box or if you want to see them all in one place Juicebox podcast.com. That was good.

On today's episode of the podcast, we're going to be speaking with Amy. Now Amy is the mother of a preteen named miles who has type one diabetes, but she's also the Community Manager for Omni pod. Amy reached out and she wanted to interview me for the Omni pod blog. And I being incredibly lazy, and not having the time to write out my answer. So why don't you just come on the podcast instead? So I tricked her. Because I could have written out the answers. I just I really didn't want to. Anyway, Amy and I had a really wonderful conversation. And we covered so much about her son miles and type one diabetes, that I've named this episode, a journey of 1000 miles. While you're listening to Amy and I please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And always consult your physician before making any changes to your medical plan. We're becoming bold with insulin.

Amy Drauschke 1:44
My name is Amy Drauschke, and I'm a two MD mom of an 11 year old boy, his name is miles and I live in New Hampshire. I also work in diabetes, and the consumer content and Community Manager at insulet Corporation.

Scott Benner 1:58
Amy, I know you because you work at insulin. Is that correct?

Unknown Speaker 2:02
Yeah, that's how we got connected. Exactly. And

Scott Benner 2:04
so tell me what you do there.

Amy Drauschke 2:07
So I work on the marketing team. But I'm the content and community manager which means that I deal with a lot of digital content, which is we have a blog, we have social media channels. I get involved in some website, any type of communication that's online. My primary role is to be that connection to the diabetes community and to the potter community, which we call our Omni pod customers Potter's it's sort of a dual role of community manager and writer slash editor of, of online content.

Scott Benner 2:40
I understand. That's excellent. And you guys have been branching out in that space a lot in the last year and a half, I would say like you have an Instagram now that just didn't have before that's doing well. And you guys put Instagrams up for like different parts of the country like, excuse me different parts of the planet, like different countries and everything. And so you guys are kind of, you're moving in that direction more. So how long have you been at insulin?

Amy Drauschke 3:04
I've been in slept for two years, I started out primarily focused on the blog, Potter talk is our blog, which I'm hoping everybody will check out and then I'm going to share our interview on there. But the blog is, it was just basically supposed to be stories about people with diabetes, not always necessary people, not necessarily people who use Omni pod, but just inspiring stories as well as helpful information about living with diabetes. And I started out as that being my primary focus, and I was really part time, but then about six months later evolved into a bigger role with the social media channels. And I also attend conferences and get involved in some of the local, you know, jdrf events and ADA and things like that. So I'm sort of a connection to the patient community, both in person and online.

Scott Benner 3:58
The first time I ever took money from Omnipod was to write on their blog. Actually, was it actually now I take it for the podcast, but it was really valuable because they gave me a lot of freedom when I was doing it.

Unknown Speaker 4:11
Oh, yeah. So

Scott Benner 4:13
when I first started, cobbling together the thoughts that we now discuss on the podcast, one of the big ones everyone knows is just the idea of not being afraid of insolent not being afraid, in general. And I resigned my contract, which sounds so fancy, trust me was not a lot of money. And I resigned my contract with the pod one year and I and they were like, Well, what do you want to write about this year? I said, I'm gonna write a six part series about fear. And there was dead silence. I'm like, wait, what are you doing? That's like, trust me, it's gonna be fantastic. And I said, it's, yeah, and it's not just content for you. I'm gonna run it on my blog, too. And they're like, wait, we're gonna pay you to write for our blog, but you're gonna use it on your blog. I was like, Yes, those are the terms of my of my new contract. And they were really cool about it and did it and it just helped me It helped me formulate a lot of the thoughts that I share now. So

Amy Drauschke 5:02
Oh, that's a no When was that? Do you never remember

Scott Benner 5:05
years ago? I don't know it. I mean, honestly, had to have been four or five years ago. It was a long time ago.

Amy Drauschke 5:13
Yeah. Because there's been a lot of change and a lot of, you know, different focuses. And, you know, I'm constantly trying to get my head around what we want to put on there. So that's really interesting. I'm gonna have to have to see if I can go check it.

Scott Benner 5:24
Check it out. Find out the history. Amy's like, that's interesting. If you tried that nowadays, we wouldn't let you do that. Well, anyway, so you've been interesting. You know, you're on the show today for a couple of reasons. You're on the show, because you're the mother of a child with type one you said Myles is 11. How old? Was he? When he's diagnosed? He was six. First grade five years ago.

Amy Drauschke 5:48
Yeah. So five and a half years ago, it was the fall of 2013.

Scott Benner 5:51
When he was in first grade, yeah. Okay. So you have that you've got that part of your life. And you work for Omnipod. So you're going to actually, during this conversation, kind of slip in a couple of questions for me. I'm going to expels which now I just have two people just tuned up I go Scott's going to talk a lot in this. And but um, but you're gonna interview me a little bit here and there as we go. And maybe put that up. I guess it's going on for Father's Day on your blog. Is that right?

Amy Drauschke 6:18
Yeah. So um, I really have always wanted to. It's funny, a year ago, I think I had you down as somebody I wanted to interview and put on the blog. And for some reason that time got away from me, and it didn't happen in time. But I I'm really hoping to share your story and how, you know, being a diabetes dad has morphed into this amazing role that you have in the community. And obviously, we have a partnership with Omnipod, and that you're an Omnipod customer. So that's, you know, I think it's a perfect story to tell. And I'd love to be able to take this interview and share it on our social channels as well as the blog.

Scott Benner 6:51
I'm not just the spokesperson, I you

Amy Drauschke 6:54
and I'm the thing I you know, I'm in that same boat. So I was my funniest Omni pod before I ever went to work for insolate. So it's a great, I feel like it's something really cool that you and I have in common.

Scott Benner 7:05
It's excellent. So and you have a third thing that that we're going to kind of dive into today, which is interesting is that you and I spoke privately, I'm going to say a month or so ago. And I did I did one of those, like, information dumps about my diabetes management ideas into your brain, which I know is overloading and we probably did it for like 45 minutes or an hour on the fun. So we're gonna get to find out how that's all struck you and how its hazard has not helped you in your life.

Unknown Speaker 7:33
Oh, wait,

Scott Benner 7:34
let's let's start with a little simplicity right. Myles is diagnosed in kindergarten, how did he present?

Amy Drauschke 7:43
It was actually first grade. It was the very beginning of the school year. So he in my in our town where where he lives. We don't have full day kindergarten. So the first time you go to school for the whole day is first grade. And so this was September, October time, he had just started school going all day. And you know, he was showing signs of fatigue he was wetting the bed, all of a sudden, that was the biggest sign. And he had never, you know, I have two other kids who were in pull ups for years. He was my one kid who never had trouble with nighttime bedwetting or needed pull ups or anything. He just immediately was toilet trained when he was little. And that was it. So when that was happening, all of a sudden, I was like, That's weird. All of a sudden, at six years old. He's He's wetting the bed. But I had, of course, you know, I feel like a lot of parents, you chalk it up to something else, they find another reason why it's not a big deal. And so in my head, I was like, well, he's just started first grade, he's going to school all day, he's exhausted and his body is just not waking him up. So that's how I talked myself out of being worried about it.

Scott Benner 8:48
How long were you able to talk yourself out of it?

Amy Drauschke 8:51
I feel like it was probably maybe two or three weeks. It didn't go on too long. Thank goodness, we did catch it early. But it was really more of a convenience thing I had he had a well, well child checkup, normally scheduled annual checkup with his doctor. And you know, they always say Do you have any questions and the time his dad was the one who took him to the appointment? And I said, Do you think you could just ask him about the bedwetting and see what he thinks? Yeah, what

Scott Benner 9:19
we're where we could get a reasonably priced mattress was like six of them.

Amy Drauschke 9:24
Exactly. Um, but at the end of employment, I said, How did it go? and his dad said, Oh, fine, everything's fine. And so did you. Did you ask him about the wedding? And he said, You know what, I didn't want to embarrass him. But didn't. And I was like, Ah, so that was a Friday.

Scott Benner 9:40
Good luck, because now I'm gonna embarrass you can we step in this room privately?

Amy Drauschke 9:45
So, um, I don't know why that was just an that was his decision. But on. just coincidentally on Monday, that was a Friday and on Monday, I had my own appointment and we go to a family practice. So I was back in the same doctor's office for my own. appointment. And I just kind of mentioned it to my nurses that, you know, I, my son was here Friday, and we didn't we had one more question that we didn't get answered, can I just leave a note for for Dr. Ariane and see what he thinks. And so I wrote my note, and I had my appointment, and she came back in the room after my appointment and said,

Scott Benner 10:17
Amy, you should check out dancing for diabetes.com it's dancing the number four diabetes.com Oh, and they have really great social media on Facebook and Instagram. That's really what she said. I saw.

Amy Drauschke 10:31
She came back in the room after my appointment and said he read your note about the bedwetting he has a couple more questions. And it was questions around, you know, is he excessively thirsty? Is he hungry? Is he tired? And I was like, Oh, he is pretty sick. And he's busy. And he's tight. You know, he's gone to first grade all of a sudden, and he's running around. And so all the questions they asked me I had reasons why it was not a big deal. But he knew immediately like that was something he wanted to check was his blood sugar. So, you know, I think it was a very quick couple of appointments that day later that day, and as well as maybe the next day, where they just wanted to check his his urine and his blood for glucose levels. And like I said it was it wasn't totally out of control. I think he was maybe in the 400. But he was like, yeah, I'm pretty sure this is this is what it is.

Scott Benner 11:19
And that was it. So I'm really, really grateful that I had that appointment myself and I and I followed up because if not, we probably would have waited a few more weeks and not really thought much of it. Gotcha. So so the bedwetting and the other thing is just the tired and lethargic stuff. That was just that was it. You never got to any of the kind of worse stuff which Yeah, did he honeymoon at all? Or were you was it pretty much I need insulin right away? and it stayed like that?

Amy Drauschke 11:45
Um, yeah, I mean, when people say honeymoon, I think of that as and I'm in my experience honeymoon was he didn't need a lot of insulin, but he definitely needed it. And we definitely had to start doing injections right away and checking blood sugar right away. So yeah, he definitely honeymoon, probably six or eight months. And then it just, you know, he needed more after that.

Scott Benner 12:03
Were there ever moments when he flatly did not need insulin at all?

Amy Drauschke 12:08
Not really. No. And I mean, we were so new to it all. It was kind of a roller coaster. Okay,

Unknown Speaker 12:14
yeah.

Unknown Speaker 12:16
It really shakes you up

Amy Drauschke 12:18
any other endocrine problems in your family line that you know of? He had some relatives on his dad's side that had celiac and lupus. Actually celiac and his preterm on his dad's dad's side, and then his dad's mom's side, someone had lupus. So I feel like autoimmune diseases sometimes come together. But nobody would die. No one with Type One Diabetes. Gotcha. Okay, well, you know,

Scott Benner 12:44
how did it start for you? You said you've been using on the pod prior to working for them? Did you go right to a pump? Or did you start with injections? Or what was the process of getting to where you are now?

Amy Drauschke 12:53
It's funny, because you know, when you are in that doctor's office, and they start talking to you about all this stuff, and you have absolutely no familiarity with it. You know, I remember in the endo office, when he was a, you know, in the hospital, when he was first diagnosed, they said, you know, we typically wait six months to get people on a pump, but we could probably advance that up to a little bit and get you started sooner. And I didn't even know what an insulin pump was, you know, it was like, Could somebody back up? Someone back up and tell me what that means. But yeah, so lo and behold, we did get started with a different a tube pump an animist pump at the time, probably, it was probably closer to a year, almost a year later, I think it just took time to, to get trained up on everything, and then to choose the one we wanted. And we changed clinics in that time, too. So

Scott Benner 13:45
a lot of different a lot of different reasons. Yeah. So

Amy Drauschke 13:47
I think we were just getting comfortable with everything. And then we went to the pump in September that following year, and so he started on the animals. He was so he was seven, he's birthdays in August. So he was just a little bit after seven and definitely made life easier. We picked that one because it had the remote, and you could Bolus like across the room or not have to find it on his belt. And I liked that. Of course Omnipod had that same ability. But for some reason, we didn't think that he'd like to have it stuck on his on his skin. And at the time, we didn't have a dexcom yet. So I think it was that idea of like, I don't know if he's really going to wear something on a skin. So we'll try this one first.

Scott Benner 14:29
And you have a dexcom now,

Unknown Speaker 14:30
yeah,

Scott Benner 14:31
using the G six.

Unknown Speaker 14:32
Yes, yeah.

Scott Benner 14:33
You said you were interested in interviewing me, but that's kind of professionally But personally, were you aware of the podcast and did you listen to it or no,

Amy Drauschke 14:41
not at first. So I actually before I worked for insolate. I worked for two nd exchange in Boston, which is a type one diabetes nonprofit research organization. And I had a similar role there. I was the content and Community Manager for their online patient community which was called glue.org and so it was there that I think I started to be more connected and aware of all of these different resources and blogs. And, and I think I had definitely heard about Juicebox Podcast through that. But I don't think we ever worked together. I don't think, you know, there was never an opportunity to have content connection. But I just remember hearing Juicebox Podcast and seeing your little logo with the, with the picture of art and on the jukebox, but I wasn't really into podcasts. In general, we actually had our own at at TNT exchange called diabetes speaks.

Scott Benner 15:35
I crushed it, I crushed them all.

Amy Drauschke 15:38
I had a colleague who was I'm just kidding, I had a colleague who was working on that. And he was so passionate about podcasting. And I was kind of like, I don't really understand, like, when would I listen to this? And what? And why would I listen to this?

Scott Benner 15:51
I understand I I really do. I am. I don't I did not know that they had a podcast. I really was just joking. I didn't I didn't want I did not find out they had a podcast and set out to destroy

Amy Drauschke 16:03
that a couple of seasons. And then it just didn't get you know, the funding that we needed to keep it going.

Scott Benner 16:09
Yeah, I understand. Okay, but so you want to listeners Well, here's what we're getting at. But and so when you and I spoke a month or so ago? How would you? How would you characterize how you were doing with miles, like as far as his blood sugar's go? And as a one season and your goals? Were you reaching them? Were you struggling? Did you realize like, Where were you at?

Amy Drauschke 16:30
When we first spoke recently? Yeah, I think all along, we've been kind of on this roller coaster up and down, up and down, up and down. You know, you have good, better periods of time. And then you have others that are harder to manage. But I think when we when I, when we spoke, I was very skeptical because I had started listening to the podcast. And I just couldn't get my head around what you were saying versus what his doctors were saying and telling us to do what is every three month appointments. And I'm a rule follower. I'm very, you know, a type like, I'm not going to, I'm going to do exactly what somebody tells me to do. And for some reason, I started listening and feeling like maybe I should give this a try if all of these other people are trying it. I know he's not a doctor. I know he's not my doctor. But he can't argue with the numbers. So maybe I should listen to what he has to say.

Scott Benner 17:25
Was that difficult for you to kind of set aside a part of your brain that tells you I've already got a doctor, they're telling me something, even though it's not going anywhere near what I expect or what I wonder what I need? Yeah, yeah. How did you do that? Did you just yeah, I

Amy Drauschke 17:38
think that was exactly it as I was kind of like, okay, so we go to these appointments, and they tell us not to correct within three hours. And I don't really understand how they can say that, and then look at his numbers. And, you know, is a one C has always been, I'd say, between seven and a half and eight and a half. I don't think it's ever gotten below, maybe a couple of seven and a half, like once for like three months. And that was it. And so I started to think like, that's all fine that they're telling us to do this, but they're not really helping us to get this number down. And they're not saying it's bad. And I guess it's you know, it's this scale, you know, it's not as bad as it could be or as high as it could be. But I would like it to be lower. And if I'm hearing that you are having all the success and other families are having, you know, much lower a win season much less of a burden of diabetes taking over there every moment, then maybe I should put aside the Yeah, at the end of directions and take a look at this.

Scott Benner 18:35
Well, let's just say that we would never ask you to put aside your endos directions.

Amy Drauschke 18:39
Right? Exactly. Right. Right. But maybe incorporate it, maybe just incorporate some other insights. Yeah,

Scott Benner 18:46
gotcha. But that's really, I mean, it's honest of you, I appreciate it. And it's valuable for people to know because I'm sure that it's off putting to be on social media somewhere on Instagram On Facebook, and everybody's like, you know, somebody comes on and says, I can't get this this down, or this won't work for me. And then some people come and go, you should listen to Juicebox Podcast, you should try this go to this episode. Try that. Then you get there. And I'm saying things you've never heard anybody say before. And and you're just like, wait, what that's completely different. And somehow in the spot where you ended up being where you were like, Look, I've seen this eight and a half a one see enough. Now I'm done with this. Let me try figure something else out. And some people aren't in that spot yet. I listen, one of my best emails is from someone who's like, I started listening to the podcast, and I hated you and everything you were saying. And then six months later, I picked it back up again. And I was like, let me try this. And now here's my a one c 6.8. Yay. And and I was like, great. That's wonderful. I'm glad that it like struck you at some point, you know. So for the people listening who have heard the pro tip series so far. Basically what happened to Amy is that in less than an hour on the telephone, I condensed that 10 that that now I guess nine part series, it's up to now. And I jammed it into Amy's head. And when it was over, she sounded dizzy even when she wasn't speaking.

Amy Drauschke 20:14
Well, to be fair, I, I had listened to the pro tip series as well.

Scott Benner 20:20
But yeah, love to hear like all jam like that, or was it clarifying in ways? Or did it just make more questions?

Amy Drauschke 20:26
No, it wasn't too bad. I mean, I took notes and I think it's funny we we work with Kate Hall, the amazing track long jumper I don't know if you if you know about her, but she held the high school record for a long jump. And she's also an omni pod where Omni Potter,

Scott Benner 20:43
I feel like she might be set up to be on the show. I'm not sure.

Amy Drauschke 20:47
Oh, yeah, she's just really great. And she had given a talk at the jdrf summit in Boston this past winter, about sports and managing type one. And what she's, there's something she said that always struck me is that with her diabetes, and with her long jump, you know, her track, and now she's a professional track athlete is that she wanted to you know, she takes goals, and she just picked one thing that she could be doing better. So you had given me a lot of things to think about. But she said, You know, there's always going to be a million different things, you could do better, but just pick one thing at a time. And she started doing that with her training. And and also she thought, you know, she said, that's a really good way to look at diabetes. So you would give me, you know, ways to use bazel ways to, you know, the bump in nudge corrections and things like that. And I was just kind of like, Okay, I've got all this information. But even if I just do one of these things, that's gonna be better than than none of these things. So that's kind of how I took it in.

Scott Benner 21:47
That's excellent. That's, that's I think that's smart. You want to hear something funny? It is may right now, right? In 2019. Is that correct? Yes. Yeah. recording with Kate Hall on December 3 2019. And she'll Oh, wow. She probably won't go up until like, I don't know, maybe four months after that. So I'm set up the

Unknown Speaker 22:08
lady. Yeah.

Scott Benner 22:10
I need to push her off a little bit. My kit, my scout my calendars. pretty sad. So

Unknown Speaker 22:14
so I have to say,

Amy Drauschke 22:16
I also like her because she's from Maine. And so she's from New England, Northern New England here where I'm from. So we have a lot of time I

Scott Benner 22:24
can stay alive in that. In those temperatures is tough, except for. I love that at one point where you're like, I just thought my son was overwhelmed by like, starting like full day, like first grade. I was like, oh, gosh, I was like me didn't think the kid was tough for a minute. She was like, I can't hack it. He's very sleepy after first grade. Right? Okay, so you see, you've done that. Now you chose something and you're like, Well, let me start with this idea. What did you pick to start with? Before I start the army pod, do you wanna hear something hilarious? The Kate hall that I'm scheduled to record with? Is not the Kate hall that Amy was talking about? I know, right? Oh, Mind blown. The Kate Hall I'm recording with is a famous soap opera writer. But that's for later, for now. Um, the pod baby, the only two bliss insulin pump in the world and you want one. You know how I know because my daughter Arden has been using one for over 11 years. And it is fantabulous. You do not have to take my word for it. And that's the really kind of amazing part about the pod. All you have to do is go to Miami pod.com forward slash juice box and request a pod experience kit. That's right, a peck ami pod would like to give you a pack, they'd like to send it to your house for free. So that you could try a pod on yourself and wear it and say to yourself, hmm, that Scott guy on the podcast said I'd put the pod on then I wouldn't notice it after a little while. And that happened. And look how small it is. And it just holds the insulin and no tubing and inserts itself. That part you can't figure out what the demo of course because it's not really good to insert it's a demo. But the best part is this after you've decided that you love the Omni pod it is completely simple just to get back in touch with on plenty. Let's keep going. Maybe I want to be a potter, my omnipod.com forward slash juice box, get a pod experience get today, wear it or let your child wear. See what they think. Get started at your own pace. Get it today, summer's here you want to swim without having to disconnect from your insulin. You guys we talked about all the time you want your basal insulin working for you. You don't want to disconnect again in the shower, go swimming, my omnipod.com forward slash juicebox with the links in your show notes or Juicebox podcast.com

Amy Drauschke 24:41
those biggest things in my head without even looking back at my notes. We've definitely been doing the hat like I think when you said if you see the arrow going up even if the algorithm and the pump or whatever says don't correct, you know, because you've got too much insulin on board just to a half a unit just to slow the arrow down. I've definitely been doing that. A lot. lot like just do a half a unit or a point to five units just a tiny amount. And that's, that's been helpful. I mean, sometimes it's not enough, but at least you feel like it's something you can do to take action and you can see if it makes a difference before you then make your next decision or while you're waiting for that, you know, okay, I really shouldn't do much I should wait it out a little bit. Yeah,

Unknown Speaker 25:22
I people are starting. That's something

Scott Benner 25:25
that and that's working. So you're you're stopping the arrow, or I think Jenny called it to Jenny called arrow tax at some point while we were talking like there's an arrow tax, somebody said an arrow tax on and I don't know, it's popping up on social media now, like something that that stuck in people's heads.

Amy Drauschke 25:40
But the other. Yeah, the other thing is, we struggle with Pre-Bolus, saying, I know that you're supposed to and I know how much of a difference that makes, and I understand the science behind the speed at which insulin works versus your food, hitting your bloodstream. But he Oh, he's very, in the moment, you know, doesn't have a lot of patience. So when you said there was a bit about, like, add to that amount, you know, add to your Bolus to cover that spike that will come because you didn't Pre-Bolus that made a lot of sense to me. And we've been doing that as well.

Scott Benner 26:12
So you've been over bolusing the meal to make up for the lack of a Pre-Bolus. And that's working. Yeah, that's

Amy Drauschke 26:18
working pretty well. Yeah. I mean, it's, it was a little tough, when it's a meal, that's, you know, you also are extending and you're figuring all that stuff out. But I had a pretty good sense of extending Pre-Bolus before so this piece was kind of like, a like, light bulb over my head when you said that, like, Oh, that makes total sense. And it makes me feel like it's not always an immediate failure when you can't Pre-Bolus

I was gonna say, it's so hard to figure out bazel so that, you know, I feel like it's constantly like, you've no idea what bazel is the right amount. And that and I remember you said that, too, was like, well, none of this matters if you don't have your basals. Right. And I just feel like that's a constant struggle is increasing and decreasing and changing bagels. And then you're like, Oh, no, I did it too much. He was low all day. And it's hard.

Scott Benner 27:07
Yeah. If you're not thinking about basal insulin, in the, in the, in the framework of timing and amount, just like I'll tell you like when I say everything's timing and amount, I mean, the Bolus and the Basal, like, it's always the right amount of insulin at the right time. And that could mean, it could mean a lot of different things. I saw a person online today, who showed a graph of like their kids blood sugar, who had gotten high during an activity. And I said, That's bazel. And they're like, No, no, the basal is right, because a couple hours later, it went right back. And I'm like, Yeah, but the basal wasn't right during the activity. Right, just because at the at three, three o'clock in the afternoon, the day before the kids blood sugar was stable. You added something else till you added? Right? another variable, right? That hit him with some adrenaline probably and pop them up. And but it's funny when you say there's not enough bazel there, the default in their head was no, no, that's always That's right. I know. That's right. And so they skip over the actual answer, and then start searching for something else that must happen. And the things they come up with are always amazing. It's like, no, it's more bazel. And they're like, No, no, here's what it is. He bumped his knee on a thing. And I'm like, I don't know what you're talking about more bazel. And it is, it's just great. It's great to hear you say that you're that you're figuring out. So it's only been like a month or so. But do you have the clarity app? I was gonna ask you. Like, um,

Amy Drauschke 28:27
I probably I probably do, but I haven't set it up. I should look and see if I have it while we're talking. But I used to use gluco. And this is probably I just have we switched to dash. And I haven't figured out how to hook up dash to glucose. So I just feel like I'm a little bit in this place where of all the times I should be looking at it very carefully. I'm in this transition.

Scott Benner 28:51
I'm dying to know what the estimate of your a one C is for the last like 30 days.

Amy Drauschke 28:54
Well, yeah. So that being said, I have the sugar mate app. And that's what we use. And that has, we've been keeping our eye on that. And actually, that is something we can talk about this more to but like behaviourally, that's something that motivates miles is to keep his eye on that. And so if I look at the 30 day estimated through sugar mate, it's like 6.9. And what was it? What was it at your last but I believe it was, I want to say 8.20?

Unknown Speaker 29:21
Well, that's Yeah, significant reactions. Yeah, that's really exciting. It really is exciting. I

Amy Drauschke 29:30
mean, and that's a that's an estimate. And it's, you know, you never know if it's accurate, but it's definitely gone down a lot. It wasn't 8.4.

Scott Benner 29:38
So yay. Imagine if a month later, you're like it hasn't moved at all. This is just the god the podcast guy. And now I get to talk to him. I pretend I care, but my agency hasn't moved at all, but 6.948 and a half

Unknown Speaker 29:50
is nuts. Like try now on 30 days.

Scott Benner 29:53
I'm gonna go try to imagine where you're gonna be in 60 days.

Amy Drauschke 29:56
I know. It's exciting. And I guess one thing I'd say is like, I Right now I'm literally looking at it. And he's 360. And he's at school and we struggle a lot when he's out of sight because he, you know, he's definitely in that like, preteen mode of like, I'm gonna ignore my diabetes and his, but his school nurse is not always able to be on top of it. So I kind of have to look at it, like we do the best we can with doing these techniques when we can, but it's not all the time. And it's, you know, it's definitely not perfect, but it's enough that it's making a difference. It's making it Oh, can

Scott Benner 30:30
I ask you a question? And please don't feel judged. Just for the conversation. Can you not text them right now and be like yo Bolus?

Amy Drauschke 30:40
I could. So it's funny, he, he got a text. We have like a group text between his school nurse and his dad night. And the school nurse had texted him and, you know, texted all of us, but said, you know, milestone needs to correct and this was at 937. And there's no response. So it's a little hard. I never know whether I should jump in and also ask or, you know, call her and say So did he he's also had lunch since then. So we're still, you know, we struggle a lot with like, how to manage him in middle school when he is on his own. And the school nurses not right there with him all the time. And I'm not right there with him. But yeah, I probably could. Yesterday we had a day where the three of us has stepped out his dad and me all texted him to ask if he had corrected and I found that out last night and felt terrible, you know, so

Scott Benner 31:27
I would send is using an iPhone. Yes. Yeah, I send what I do is if I don't get a response in a timely fashion, and it's important I send the Find your iPhone tone, which is a deafening and incredibly embarrassing tone that the phone makes and that

Unknown Speaker 31:41
really fine

Scott Benner 31:42
then Arden texts me right back after that happens. So I'm I'm less concerned with her. What's the word I'm looking for? Happiness. No, no, that's not the social calm, like, like I don't I listen. It's not every day. It's not even every week. And it's not every time like don't get me wrong if Arden's blood sugar was 120. And I'm like, hey, let's, you know, bolus point four here. And I don't hear back from her. I'm not gonna bother her. Like, that's that silly. But, but if she was climbing or rising, or if it was an hour before lunch, and she was 200, and I thought we have to get this down before we Pre-Bolus for the food, and she wasn't answering me, then I would, I would. And I don't By the way, you sort of said it a second ago, and I want to reiterate, miles isn't doing anything wrong. He's 11 Arden's for, like, you know, I'm happy. My daughter's not running around constantly thinking, I have diabetes, I should be doing something. I don't want her thinking like that. I don't want to, like, invalid. But but she has to know, I think that there are times when I don't really care. You know, like, she told me one time she's like, you have to she's like, Don't text me right now I'm taking a test. And I actually texted her back. And I said, knowing math won't help if your blood sugar's over 200 all day. And so I don't care about your math quiz. I care about your blood sugar. And then I care about your math quiz. There's a pecking order health is first, the rest of it comes later.

Unknown Speaker 33:04
And I think that's a dad thing.

Amy Drauschke 33:07
I think that's a perfect segue into our conversation about parenting, because I feel like I get accused all the time. By my husband of you know, you're too soft on him, you're too worried about how he feels about it all in his, you know, emotional state, you know, he's lying to you, or he's ignoring you or whatever. And he's like, you've got to punish him for that, or you've got to get him to understand and I'm like, oh, but I feel bad. It's not as salty as diabetes.

Scott Benner 33:32
Just be a little jerk about something else. If he didn't have diabetes, probably. I've told my wife throughout the years, you're not his defense attorney. That's what I tell my wife about my son. I've never, I've never once seen her defend my daughter, the way she defends my son. First is interesting. Oh, my God, are you kidding? The minute the boy was born, right? He came out, the doctor grabbed him, I cut the cord. And then it was like an alarm went off in the room. I said, What's that bell and Kelly goes, Oh, you're not my boyfriend anymore. Now that kid is. And so you know, you're just here. You're just here now to make me and my new boyfriend happy and comfortable in any way you possibly can. And so we'll tell you what to do. You'll do it and then quietly sit in the corner and wait for a new task to come. And it does happen to mom sometimes. And I do think especially with boys, and I don't know why I don't understand the psychology behind it. But my children are aware that if if they were to ignore me on that level, diabetes and diabetes, I would show up in their school I'd be like hi and I'd bring like I have to just go talk to my kid for a second and then once you pull them up here and they pull them up I'd walk assign ago have been texting you have an answer, man, it's gonna be a problem if you don't do it, and then that would be it. Yeah, that's it. You're, you're from New England. Take them out in the cold without his clothes, making friends for 15 minutes, break down with diapers, find out, bring them back in and be like, do you want that to happen again? Of course you don't because your toes are blue. Now miles, let's say so what do you got? What are you going to Do so if people tell you about it, and you kind of seem to see it, what stops you from doing? I think that's the real, like joking aside, that's the real question, like, what stops you from being like, hey, you're 360 I don't care if you've been talking to the nurse, this isn't Okay.

Amy Drauschke 35:15
Um, I mean, I get to the point where I'm like, Listen, like you, this is unacceptable. There's certain times a day when you have to pay attention to your diabetes. I know this isn't your choice to have this condition in your life. And it wasn't mine either. But we've got to, there's certain times a day when you've just got to do what you got to do. And it's, it's not negotiable. That being said, if you do that, then I won't be texting you. And I won't the bothering you, because we'll be keeping it in check. But it does, it gets to the point where it has to be like, a really kind of high day, like really high, you know, and I'm like, okay, it's not just a little high, it's really high, and it's not good. So here's my suggestion, maybe,

Scott Benner 35:53
maybe You scared the life out of him in a different part of his life, not the diabetes part. Like for instance, have you ever taken every piece of anything that brings any joy to your child out of the room and locked it into a closet for a month? Have you ever done that? Because it's exhilarating, when you take the television down, and they're looking at you like, Oh, my God, my TV? And like, Oh, yeah, everything's gone. Yeah, you just have to assert yourself.

Amy Drauschke 36:19
It's funny. That's what it basically came down to. Recently, we had one of those days, and I and he had a baseball game that night, and baseball means everything to him. And I said, you know, what, not only can I sit here and tell you that you're not gonna play well, and you're gonna let your shame down. But like, I might just not let you play. If this happens again, that day, you know, on this, you know, you can't be at school all day and be off the charts and ignoring your diabetes, and then come home and expect to go to baseball, like it's just not. And I think that scared a little bit, you know. And I think that, that we have to find that thing that he cares about, but he could lose, and it's hard, because I again, I go back to the emotional part, like, I don't know, if psychologists would agree, like, you shouldn't punish your child for anything related to diabetes, you know, you should incentivize them and reward them, but don't punish them. It's like, it's like anything with parenting, diabetes or not, you know, it's there's just different techniques, and some people feel strongly about about different ones. So I definitely struggle with that. And I definitely have, you know, I have a, my, my ex husband and my husband both involved, and we probably all have different opinions about that. Which makes, which makes it interesting. So

Scott Benner 37:27
so let me say, I've joked around a lot here, but let me be serious for a second. So. And I was serious about some of it. I you know, I think that there's, I agree with you, I don't punish Arden related to diabetes, right, I speak to her clearly about it, I make sure she understands the pros and the cons and what could go right and what could go wrong, and why some things are important, why they're not in other aspects of her life, though. She knows, and I'll just bleep this out later. She knows I'm not. So there's an invitation, that that knowledge translates to other things. And you don't have to say it. Yeah, that's good point. And so I'm gonna give you the benefit of my, of an experience. So most people may or may not know, listen to this, but I have been a stay at home father, since my son was born and my son, tomorrow, I'm going to go pick my son up from his last day of his freshman year of college. So that's how long I've been a stay at home dad, right. And in that time, in that time, I've learned a ton about what women bring to parenting that men don't in instinctively bring to parenting. And I've tried my hardest to incorporate some of those ideas into myself. And I've done that because I thought my children deserved it. You know, we had this role reversal. And I realized my wife would have done things said things felt things that I'm not experiencing. And so I need to understand what those things are. Because my children are at the moment being robbed of a maternal influence in their day to day life while my wife's at work. So I'm a bit of a blend and now of, you know, a traditional mom and a traditional Dad, I think, yeah, but the one thing, the one thing that I've noticed over and over again, that I am grateful for, for being a stay at home father, is that in those moments, I am not conflicted by any of the things that you brought up. Like it's not fair to them. Or they didn't ask for this, like those feelings. They never popped into my head. Like, not once, I would never in that moment. I have a simple packing list. I've prioritized it in my head health comes before everything else. And so I'm a guy. I'm like, a, like a rock with a pulse. Right? I'm not I don't think that Yeah, I just I just I set out on my course I follow my list and I go, okay, health is first. I don't care if you're taking a quiz. We're going to Bolus now. You know, I don't care if you're talking to your friends. That's meaningless to me. You know, I know we've texted more today than we do normally, and it's annoying and trust me, I'm annoyed too, but let's just do it. We have to do and move on. And that has served me well, in the bigger picture, because my kids and I do have a relationship where we can be at, you know, for the lack of a better term parenting odds in one moment, and then it shifts right back again, like, no, there's no hard feelings. People don't, aren't mad for hours at a time after I've had to assert myself as a parent. It's, it's expected. Next comes taught me how to expect something. You want to know what it is rock solid data about my daughter's blood sugar, the direction it's moving, and the speed it's getting there? Is she 102? and headed up, headed down or staying stable? That's the incredibly important information. Forget that she's 102. I don't know if she's one of the two or 80 or 130. I mean, I do but you know what I mean, it's more important to know how fast she's moving, and where she's going. It's incredibly interesting to see, I ate dinner at 6pm. And my blood sugar just never moved, right until 640. And then, oh, it started to go up. That kind of information makes me think, hmm, is there a way I can change my Pre-Bolus or an extended boluses are a way to put my son in a different spot to help that rise? To not happen? How about three hours after I eat, it's my blood sugar going down. Maybe my insulins gotten unbalanced, right? Maybe the food's gone now. But the insulin remains behind. I wonder if I would have slipped my Pre-Bolus forward five more minutes or done a different? I don't know amount of insulin would that low have never come. It's interesting information to have. That's how you think about your diabetes. at another level. You want to be a ninja with diabetes, you need the information you need to know when to react. Right. I'm not Yoda. I can't close my eyes and see stuff coming at me. I need to know what's happening. So I can react so that I can get out of the way or get in the way.

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Amy Drauschke 43:00
I definitely had some some new ideas, though about like, well, maybe I should do this differently. Or maybe I should do maybe I should show up at the school. I'm lucky enough that I get to work from home a lot. And I literally the other day had this thought that if no one else, if he's not going to pay attention to this and his school nurse can't or isn't. I'm going to just bring my laptop and sit at the middle school all day one day and do my work from there and check in with him when I need them like that would maybe that would turn him around quick to have mom in the hallway with her left.

Scott Benner 43:27
Not just the helicopter mom, but an attack helicopter

Amy Drauschke 43:29
mom, like I mean, literally, there's Wi Fi there, right? Like what else do you

Scott Benner 43:34
see, I've told this story in the past. I haven't told him in a while. But when I think of that, I'm obviously nowhere near the parent. My father was in the 70s. Right, like in the 70s in like outside in Northeast Philadelphia. I don't think he once thought about anything about what I cared about or was concerned with, right. But I've told the story before that I got sick one time. And the doctor gave us pills and we got the pills home and they were huge. I mean, like really big, not just because they were monstrous. And I took it out. That's like I can't take this somebody that's like, Oh, don't do that. Just take the pill. And you know, and so I put it in my mouth. And I was like, I can't do this. And he said something like, those are expensive. And if you spit that out and he didn't even like get the finishes thought and I thought okay, I really have to smallest so I went to try small and I couldn't. And the next thing you know, a man who could have just broke me in half if he wanted to was about six inches from my nose and he was like, swallow the pill right now. And you know what I did? Amy I swallowed the pill. And it's better than the perceived beating I was about to take. And I don't think he really was going to do that. But I mean, he pressured he pressured me to swallow that pill and I did it. And I'm not a serial killer now. I don't have any weird sexual fetishes that I'm not

Unknown Speaker 44:52
no no.

Scott Benner 44:52
I'm not broken in any meaningful way. Yeah, so lean on that kid a little bit. That's that's my

Amy Drauschke 44:58
I know. Yeah. And I definitely think I was talking about this. At work yesterday, we had a retreat, and we were all socializing, and somebody was talking about chores and allowance and that kind of thing. And one of the people in the conversation that doesn't have kids, she was she's younger than us. And she was like, but I don't understand. When I was growing up. I just had my chores, and I had to do them. And that was it. There was like, it was just this expectation. I don't understand what you guys are talking about struggling to get your kid to do what you want them to do. And we were like, it's just a generational thing. Like kids just, they don't have that same fear of their parents for that same.

Scott Benner 45:33
My kids are still afraid.

Unknown Speaker 45:37
Maybe it's because we're too soft on them. So

Unknown Speaker 45:39
it's the it's the it's the winters and it's an ongoing battle.

Amy Drauschke 45:42
And I have to say, when I when I listened when I used to listen to you before I started these techniques, that's, that was always kind of something I've skeptical of as I was like, he must be bothering her all day long on her phone, and she must hate it. And I don't know if I could do that.

Scott Benner 45:58
It's 11 o'clock here. She left the house at seven. I haven't spoken to her today at all. So that's awesome. Yeah. And she will talk while we're be she will text while we're talking about her about her lunch about our lunch bolus. But that's it. It'll go back and forth real quickly anyway. And I get to imagine if you start listening to this podcast on the day where I'm joking around about, like, you know, pressuring children to swallow pills they can't swallow or stuff like that. If that was your first episode, you'd be like, Oh, my God, but I don't know. I should call I should call somebody. Well, this guy said in his pockets, but it's, you know, it's an it's an idea. It's an overarching kind of like feeling in your life. Like, I don't, I didn't grow up feeling like I could assert myself too much with my parents. I could tell them what I thought. And when they told me they didn't care, I was pretty much done. You know, I didn't get to. I didn't get to appeal to a higher court. I couldn't turn to my mother or father, depending on who I was talking to. There was just that was it and they were nice. They were blue collar people and they did not have time for my BS. So yeah, it was this is how it is and and do it. And so the other day, I took on a big project at my house, I regraded a portion of my lawn. And I had to rent like a small machine to move a significant amount of topsoil around and when it was over. And Arden came home from school, she's like, can I help? And I was like, Yeah, sure. Get a broom. And we're gonna hose off the driveway, you can broom the mud into the grass as I'm doing it. Right? Yeah. And she comes out and she's like, Alright, and for some reason she was into helping, I didn't know why. So I just let her help. And she says, I should get paid for this. And I said, you know, no, something I agree with you. I said, I will give you 10 American dollars for this work today. And she said this is that's not enough money. And I said, That's all I'm offering. And and then she was like, okay, since she starts doing shoes, my sneakers are getting muddy. If they get dirty, I'm gonna need new sneakers. I said, Well, you better hope you can buy them for $10 because that's gonna make on this job. And so she kind of like laughed, and I was like, Don't laugh. I'm not kidding. And and, and she just had these sneakers only cost $20 I'm always thinking about saving your money. And I said, Okay, I said, Well, if they get ruined, I will buy you a new pair of sneakers up to $20. She's like, Oh my god, I'm gonna get a new pair of sneakers and $10 Oh, no, you can get the new or you can get the $10 you can't get both. Right, right. And, and she looked at me like maybe I was crazy. And then I was like, do you want to try to drive the the little loader that I ran into like the bobcat? And she's like, really? I'm like, yeah, sure, try it. So I let her drive that around in the driveway. And, you know, taught her how to drive it. And it took her a couple minutes to figure it out. And then she was like toying around with it. We got everything cleaned up. She put it back. And I said, was it fun driving the thing? And she said, Yeah, I said, I want to charge you 10 bucks for driving that. But I won't because I love you. And I think you did a good job working here. So then we get in the house, my wife because you're gonna pay her I'm like, No, let her come to me. And she's like, well, I don't like I'm not giving her the money. So she asked me for it. I was like, we don't pay for 90 days here. That's our, that's how we handle it here. I send my invoices out for the podcast ads, I don't get my money back the same day. I was like letter, letter done letter done me a little bit later coming after like, but seriously, like, give her some responsibility and then a little bit. So we were joking around. But I think that's just the general vibe here is that we're in charge. They can have their opinions, we totally let them you know, we're not like my dad. You know, my wife's parents were they're allowed to voice their opinions. They're allowed to argue with us, they're allowed to show us why they think we're wrong. And in the end, if we say no, that's kind of where it ends.

Amy Drauschke 49:31
But i well i think that's I was gonna say I think is related to diabetes. When I when I when my son was first diagnosed I very quickly got into this business as a you know, as a professional, and I found myself connected and getting to know adults with diabetes who were diagnosed as kids. And I had this constant you know, information about what that was like and them saying what it was like when their child when their parent wouldn't let them go on the on the overnight school trip and what it was like when they had to eat the same amount of goldfish every day for snack and and so I think I just early on got that like sympathy bug where I was hearing from these adults about how hard it was to have parents all over them about their diabetes. And so I'm not I don't do as well with the like, it's, I'm in charge, It's for your own good. You can have an opinion, but it's really, you know, I'm not interested. So it's just tough for me, I think and I think in this community, that's something that's so different is the people who have diabetes versus the parents who are managing it for a child who has it. It's such a different experience. And you can never know what it's like to be on a on the other side. And I, you know, I've had brainstorms and wishes around, like, how could we connect more people like so that that experience that I had with my co workers? Like, how could we get the general community to have that, like, have a relationship with somebody else who could give them that insight in case it would be helpful, I don't know if it would be helpful for adults who have diabetes to hear from a parent, but I think definitely parents could bet could benefit. You know, maybe even you I don't know, from talking with an adult who was diagnosed at six and hearing all those stories, so it's like, it kind of sucks when your parents texting you or it kind of sucks when you can't do things that you want to do? I don't know. I'm just Well, let me tell you, I'm thinking out loud.

Scott Benner 51:17
Let me tell you my experience from from recording the podcast. So there are 230 episodes up. And I've recorded 40 more, and I will do hundreds more in the coming years, I imagine. And if you have had that experience, and I've heard I've heard from those adults, and I've heard what you got, which was it stunk being like somebody up my butt all the time, and blah, blah, blah. And I've also heard from people who are on donor lists waiting for kidneys telling me they wish their parents would have been more Yeah. And so and, and everywhere in between, like, those are two, two sides of the of the, you know, of the rainbow. and everywhere in between my parents helped a little, they helped a lot. Sometimes they didn't know, but they wanted to be valuable. What I got mostly from most of them was that it was comforting to know that they cared. That was that's that's most people's takeaways, whether they were harsh and didn't know what they were talking about. Or at least I knew they were interested. The people whose whose parents just don't talk to them at all about it in one way or the other. They seem devastated. Just leave it to them. Right.

Unknown Speaker 52:18
Yeah. And so I can see that. So I,

Scott Benner 52:20
I take your point, 100%. But I would want to I would want to add to it. I wonder how those people who you spoke to back then would have felt if their parents were more involved and had valuable information for them. Right. So that's the goal of this pod. And that's what you

Unknown Speaker 52:37
Yeah, yeah. And

Amy Drauschke 52:38
we've come so far, you know, now versus them. So I Oh, you know, of course, there's that, you know, I'm talking to a 35 year old talking about her experience in the 80s is obviously going to be very different. Yes,

Scott Benner 52:47
when she was taking regular an MPH, and her meter was the size of a break. And it didn't leave her house,

Amy Drauschke 52:53
right. And she had to eat the same food every day. And there was no wiggle room,

Scott Benner 52:57
right. And that, and that's what was in her parent's head, which was, you know, either they were doing carb exchange, right where it was like, You have to eat this certain amount of carbs. And so some so so imagine some doctor who had a 1980s idea of type one diabetes, I mean, imagine that versus the idea you hear now. And still you talk to doctors, like God, these people understand this at all. So, so so they had that 1980 idea of it. And they're like, Look, at this time you put in this amount of insulin, and you make sure to eat this many carbs and do it. Because if you don't balance out, yes, if you do this exactly like this, everything will be okay. And if you don't, you're gonna, you know, someone's gonna have to cut your foot off one day, or whatever, like scary thing. They told Gary Yeah, right. And now that parent every time they have that meal that's in their head three, three times, at least a day, for years and years and years. So it probably gets boiled down to, hey, eat that right now. Or make sure that's 25 carbs, or that kind of thing. Where I would say to them, Listen, you know, are you going to snack on that, that's fine. Start with three units, and we'll readdress it if you snack longer than you think you're going to. And that's a freedom Arden loves because the other day, excuse me the other day, I had to go to the dentist in the afternoon. And she I'm leaving, and I was in a rush. And I'm like, I gotta go. And she's like, I'm really hungry. I want to have some of these like little Ritz crackers or something like that. I was like, all right, do me a favor, because I'm leading count them out. So we know how much we're doing. And she was like, I don't want them then. Like if I didn't count these crackers, I don't want to eat them. And so that shows you how much the freedom of snacking means to her. Like Like she you know, we have set up this world where you know, she can have a little bit of insulin snack and then add more if she needs more insulin later. When I said to her account, these all make sure you eat these and put in the sense on she's like, I don't want to do this. Now. You might think Oh, that's interesting. I wonder what Scott did next. What I did was I said just count the crackers out. Put the insulin in, I gotta go. I'm late for the dentist. Okay, I'm not interested in your conversation here about your thoughts about these crackers. You're hungry, I see that you're hungry. This is not the time to take some sort of a stand. We'll deal with this later. And you know what she did? She counted the crackers. She gave herself the insulin, everything was fine. So

Amy Drauschke 55:18
that's a good, that actually leads me to a question. So Arden was diagnosed when she was a baby. Right are two very young

Scott Benner 55:27
just a couple of weeks after her second birthday. Yeah.

Amy Drauschke 55:29
Yeah. So my question to you is, you know, my my thought is the other day I was trying to get miles to understand this is that he came into this world, right when Dexcom was coming out, it will not coming out. But like the g4, I think was the first one we had Omnipod was available, he has all of these tools. And we're fortunate enough to have access to them. And he doesn't realize how flexible life is for these tools.

Unknown Speaker 55:59
He looks at it

Amy Drauschke 56:00
as like, I don't want to put my ducks on center on. I don't want to Bolus like, it's all a burden to him. But when I think about someone like Arden, you know, you must have really experienced it. You know, before we had such flexibility, maybe not as much as like my my friend who's 35. You know, she didn't have any flexibility. But the fact that all of these devices and tools that that we are fortunate enough to have access to make our lives easier. I wish I could get him to understand like, this is not that bad. Like if this had been 10 years ago, it would have been totally different. So I was just wondering if you you know, if it was when she was obviously as a toddler, that must have been difficult for different reasons, but just the devices alone make it easier.

Scott Benner 56:42
I think it's an ongoing conversation. And it's one we've had over and over again, you know, in different strengths based on how old she was and how mature she was. So the other day this came up, and I said, Arden, we really need to add a fifth and sixth location for your on the pod because Arden is left over naval right of her naval sort of up and down and thighs, right. But I really want her to periodically put them on the back of her arms. Is it FDA approved for the back of your arms? Yeah, so

Amy Drauschke 57:12
actually, I will say as the marketing person. Everybody always shows pictures of the arms. And I'm always trying to remind people you don't have to just use your arms. There's other places so that's awesome to hear she she's not an arm of a lot of people, you know, love the armors or think that's the only place

Scott Benner 57:29
so she hates the idea of it being on her arm now. Now here's why she hates it. She said Okay, so we're good now so I'm quitting my my messaging app. So she she hates the idea of her arm based on an experience she had when she was like six where she worked on her arm had to go to softball One day, she threw it and all she crawling arm, you could feel it moving around. And that sticks with it all this time.

Amy Drauschke 57:50
So I said, well, miles won't won't wear it on a stone at all, during baseball season.

Scott Benner 57:55
Yeah, exactly. But she somehow had it as has an aversion to it now, but I'm like, Look, we have to start using your arms more frequently. And she kind of like pushed back. And I told her look, if we ruin your sites, on your stomach and on your legs, or they're done, you're done. If you want to go back to injections that fine, but I'm thinking for what we do, you're going to get about 15 of them a day, and you're gonna have to, you know, is that what you want to do? If that's what you want to do? I don't care. I was like, but, but just understand that, you know, some of the food decisions you make aren't gonna work out as well anymore. And, you know, and you're gonna get injections a lot more. So do you want that? If you do, I'll do that for you. Yeah, she's like, no. And I said, Okay, well, then we're gonna try your arm, just get over. Like, it's not it's not the worst thing in the world. And, and we've had versions of that conversation, you know, a few times a year for years.

Amy Drauschke 58:48
And what I say to like, when when he doesn't want to say, miles is the thing about the sensor assertion, you know, even with the JSX, he still winces and says, it hurts. And so he procrastinates or he says, Can I have a break? And I and I have that same like, well, it's your choice, it's your body. However, if you don't worry, CGM, we're gonna be checking your blood sugar with your finger every hour, or every half hour or whatever. And I'm like, I don't think you want to do that, do you? But if you do, then yes, but if not, let's just put the sensor on. And usually He's like, all right.

Scott Benner 59:22
Of course, the truth is if we get into a time machine and go ahead, you know, 50 years, and the G six is the size of a hair and it's a little tiny pill and you have to swallow and they're gonna complain about that. Like well, because it sucks because because Amy everything anything excuse me anything you have to do beyond what normal situations ask of people is extra an extra an extra things but it doesn't have to be a fight your entire life. Like at some point, you just have to say like this is this is my life, like this is this is gonna go and I'm I'm going to just accept that move on. Listen, my son is finishing up a college, I told you and we were facetiming with him last night. He's got like one paper left. And it's in. It's in a class, he doesn't particularly enjoy that I don't think he's as strong as mine doesn't sort of work in that way. It's a philosophy class. And I got to write this paper. And you know, we were talking to him a little bit, he was bouncing some ideas off. And right before he went, I said, Hey, I need to tell you something real quick before you go. And I said, I'm at the moment, you're thinking about this paper as something that you have to do to get a grade. I like you've decided it's work. And I was like, I really think that this next 10 hours with this paper would go a lot easier if you just tried to do your best. Like if you read this stuff, and instead of thing, I have to read this, just think like, let me try to learn this. Because it's all just your perspective, one way or the other, you're going to read all this material, you're going to write all the things you're going to write, and you're going to hand it in, this is not going to change. But it's it's you that you could change, you could change your attitude about this situation. And if you did, that, this could end up being a pleasant thing. And not only that, but the outcome is going to be better. I said, I promise you if you stop thinking about this as a chore, and start thinking about it as something that you're going to do and try to do your best and try to enjoy. It will you'll feel better when it's over. And I watched a real look on his face of like, Alright, that that makes sense. And he said, I'll try and I was like, Okay, I'm like, just chill out, man. Like, just read that. Read the thing and write what you think. And yeah, it'll be it'll be better. I promise. I think this is all the same thing.

Amy Drauschke 1:01:38
There was a we have on the on the blog, a series with Sean Busby from writing on insulin, he had done some video interviews with people. And they were all you know, a lot of them were folks that are in his writing on insulin organization. And one of them was this, this kid, I can't remember his name, I want to say his name may have been Dan. But he his story of when he was first diagnosed, as he said, I think he was maybe a teenager. So he was a little bit more, you know, cognitively mature. But he said there was a sign in his kitchen that his mom had on the on the wall, and it said, whatever you are be a good one. And when he read that, he said, Well, if this is what I've got to deal with, at least I'm going to, I'm going to do the best that I can and be a good teacher, I'm going to be a good diabetic, which I know diabetic is not a label that people always like to use, but he said it himself. And I think about a lot. And I think that's similar to what you're saying is like if your hand you dealt this hand, you might as well play, play it the best you can.

Unknown Speaker 1:02:36
You know, it's funny, man, I

Amy Drauschke 1:02:37
think that's a good thing to remember.

Scott Benner 1:02:38
I think that's it's perfect. It's not just about diabetes, or parenting. It's about life like you just yeah, you know, I mean, your situation is your situation, complaining about it or feeling bad about it. I mean, if you're chemically Listen, if you have a chemical imbalance, and you can't stop yourself from feeling depressed about something, that's one idea, but for the rest of you, just stop dwelling about like your perspective, like I tell people all the time, like you can't be dramatic about diabetes and be successful with diabetes. Like if you're always running around yelling, oh, can you believe this happened? Can you believe that the pot, you know, my infusion bag fell out. It's so irritating, or, you know, the next time needed to be reset for two hours? I can't believe it. Or, you know, this stuff always happens at the worst time. Like there's a good time for your, for your sensor to need to be replaced, like what's the

Unknown Speaker 1:03:27
right, exactly. It's so bad

Scott Benner 1:03:29
when you want to be dramatic about things, then it's always a problem. Or you could just accept it, this is it and do it. And that's just that's how I do it. And but again, I'm a boy. So I mean that like detrimentally about women, I just mean that I lack I lack the ability to think about

Unknown Speaker 1:03:49
just like

Scott Benner 1:03:51
it's that old thing. Like, you know, a kid gets hurt on a on a sports field and all the moms jump up and the dads don't even notice it happens there.

Unknown Speaker 1:03:57
I said

Scott Benner 1:03:58
to my wife, like he could really be hurt. And I said, Well, if he's dead, there's nothing we can do about it. Like, like, but if he's not dead,

Unknown Speaker 1:04:07
these are nothing great. Well,

Scott Benner 1:04:09
well, beyond that, though. If he's not then these couple of minutes will read Don't rush out to him like his nursemaid are gonna build character. So he's either dead, he's not dead. And if he's not dead, then let's do something positive for him. And if he is dead, we can be sad in a minute. Like, like, like, you don't need to just sit here it's worth sitting here for a second just let him live in it for a minute. And I don't know it just seems like common sense to me.

Amy Drauschke 1:04:36
I think that's that's a good It's also a good segue to um, you know what I wanted what the one question I had for you for just our conversation is I feel like what you're doing on the blog and what are you know on the podcast and what I'm trying to do on our content and in I also do freelance writing articles for other diabetes sites. is like not always trying to be Susie sunshine, but to show That positive aspect and to show that, like, he can struggle with certain topics and certain things, but here's the tools that can, that can help and can make it better. And, and I think that that's an important thing for, you know, I don't know how involved everybody with diabetes gets with being connected to the community, but I think if you do have that connection, and you can read and hear about other people's experiences, you know, that's, that's impactful. And I'm really grateful to you for this podcast, because you know, as I'm driving to Acton, Massachusetts, 90 minutes each way, when I do go to the office, you know, I have something to listen to, that helps me at the end of the day with my own management of this, and however you absorb those experiences and that information, you know, I do think that can change people's perspectives. Otherwise, when you're alone, and you feel like no one understands and nobody else gets it, you can wallow and you can be very negative. So I'm particularly proud of, you know, both of us for being in this community, and in this world of giving people some information that hopefully helps, even if it helps one person, you know, it's the one more than zero.

Scott Benner 1:06:04
Yeah, I appreciate that. And I appreciate that, that you're trying to do, you're doing the same thing. I'll tell you that my perspective on it is, is pretty simple. So there are a when you say, the diabetes community, I hope I hope that you and everybody else knows who's listening that right now. I just said those words, and close to 10,000. people heard it, okay. And, and to the main thing to them, they don't care about the diabetes community, they care about connections, they don't care that there's this thing in place, like Like, for instance, I like that when I go to my faucet, water comes out of it. But I don't care about I don't care about the water company in my local municipality, right? I don't I know it's there. And I know there are wonderful people, they're doing good work, and that's why I get the water, but I really don't care about it, I care that I have the benefit of it. But that's the as much as I think about it. Most people don't think about the diabetes community, the way people who create content, think about it. So what what you all might not know when you're listening is that there are people writing blogs and, and doing other things. I know those people, most of them, and they know me. And sometimes we have private conversations, I had a really wonderful private conversation with Mike Hoskins from diabetes mine the other day where we talked about how to help people, right, like, like, hey, and so there's more going into it than you might think sometimes. And, and if you're lucky, you're talking or listening or reading someone who really cares about you, I genuinely do. And there's no way for you to know that except to listen and decide for yourself. There are also people in this world, there are also people in this community, just trying to make money off of you and your diabetes. And you have to figure out who those people are as well. And I can't, I can't tell you, but you need to figure that out, too. What I can tell you, what I can tell you is this. Some people are trying to give you the benefit of their experience in a way that will make your life healthier, lighter, happier, more full of joy, more free time for yourself and your family. And there are some people who are trying to keep you scared, and anxious and worried. Because that brings you back to click and read and come somewhere. I've always said, I hope you listen this podcast forever. I hope I make it entertaining enough that you can keep listening to it. But if there's a moment where you get your like, my a one C is six and a half. I never think about diabetes, and I don't really need this podcast anymore. Nothing would make me happier. Yeah, seriously, and don't feel bad about leaving, because 17 more people are coming right behind you people get diagnosed all the time. And yeah, but but the point is, is that I am not going to do something for clickbait, I am never going to try to make a person feel scared or angry or anxious, or put a worrisome thought in their head. I'm also not going to treat them like a baby. I'm not going to hide things from them, I'm not going to tell them what they want to hear. I'm also i'm not i'm not that person who's like I speak the truth. You know, those people sometimes those people are mean you got to speak the truth when the truth is eligible to be accepted by somebody. Right, right. Like you don't run up to somebody on fire and start telling them about how if they would have been more careful with matches have happened, right? Those people need water thrown on them. So some of you some of you listening need the water thrown on you and some of you need the safety talk about the matches. And I'm trying to put this podcast together in a way where it is entertaining, light hearted. And yet all of those things are happening for you. And it's my goal that they happen to you for you in a way that you almost don't know what's happening. And so, to kind of bring it full circle, I mean, that's how I parent like I I don't, I don't grab my kids and sit them down and go here's the lesson for today. I try to involve them. conversation, let them see things that move them in the direction that I'm hoping to direct them. I told somebody recently, I may have said it here, I don't remember anymore. Somebody asked me like, What's your job as a parent? Like, how do you say it? And I said, Well, I think of my job as a parent as having to say the same thing 1000 times, but not be irritated by having to say it 1000 times and trying to find 500 different ways to say it, and trying to build it into conversations about other things, and other people in other situations. I'd like to think that my son thinks about how to treat his sister through a conversation we've had about politics, or that he's considered about how to vote in an election based on a conversation we've had about how to treat a sister. You know what I mean? Like, I think I think it all builds together. I think that when you preach it, people, it doesn't work. But I also think there are moments when you need to be told, shut up and swallow the pill. Right. And so that's what I'm trying to do here. And I don't know if I'm doing it or not, but that's my goal.

Amy Drauschke 1:10:58
Well, you know, I, I will be honest, and say, My first reaction to to your podcast was, like, this guy's got it all figured out. And he's bragging and telling everybody that he's got it all figured out in the end. And then I started really listening and realizing, wait, you weren't just about that, you were saying, I've got this figured out, and I want to help other people figure it out. And I needed to be open to the fact that like, you know, maybe I needed to listen and do some things differently. And I think that that's my initial defensive, you know, I am the kind of person who, when my son was first diagnosed, they said, go to this parent support group at the hospital. And I went, and there was a bunch of moms in the room all talking about what they do and how they do it. And I left thinking like, Well, I'm not doing with those things, what those moms and dads are doing. So I must be a total failure at this diabetes thing. And I never went back. And so it's a weird, like, reaction I have to hearing other people's ways is that you can take the information and then decide for you whether it's helpful or not. But you don't have to feel like you're always comparing yourself to them. And I think that's something over the last five and a half years, but I've evolved into thinking about is like, it's not there's no one way, there's different ways, and there's different things you can try and tweak and no one's perfect, and no one's got it all figured out. But some people, you know, really might be able to help you with with some little tip or some little piece of information. And so I'm always listening to as well as writing and, and putting content out. And you're right, like there are people that are newly diagnosed every day, and they know nothing. And so I might feel like I said the same thing a million times through my writing or through the blog or through social media. But then it's like, no, somebody may have just joined for the first time. And I think, as I write for tea, when everyday magic, I don't know if you know that site, it's specifically for parents. And they asked me to write a lot about the diagnosis experience. And a couple times I wrote, you know, they'd give me a topic, and it had to do with something around diagnosis. And then I turned it in. And I see I there was one article, I forget what the topic was, but at the end, they said, Can you end it with something that gives people you know, some hope and some feeling like it's gonna be okay. And I was like, I guess like, I don't think I felt that way at the time of the story that you're asking me to write, but I can spin it that way. And it's like, that's what people do need at that time. So, you know, it's all just, it's so interesting. And it's so much, there's so much going into it. You

Scott Benner 1:13:25
just gave me so many different thoughts. So first of all, the first thing I thought was, there is an incredibly popular diabetes blog that only talks about bad things. It seems like no matter what you do, it's something scary or something that went wrong or here. Yeah. And then, but don't worry, I'm persevering. And I'm like, Okay, great. Like I get that's a good message, right? Sometimes things go wrong, and I'm persevering. But at some point, the person writing that blog realized this sells. Yeah, so everything you do is Oh my god, can you believe this happened? But I'm not giving up? And I'm like, Okay, yeah, great. And people don't not need to hear that. But that could be every once a month, it doesn't need to be every day or every time. Yeah, that's right. Yeah,

Amy Drauschke 1:14:12
I read blogs like that, too. And I've been turned off because I'm like, I don't need to read about the terrible bad negative stuff all the time. Like I get it that have bad stuff happens to us, too. But maybe it's that I'm too much of the glass is half full, I don't know. But But you're right, like those people get. There are people that are making a lot of money in this business by speaking at conferences, and being on every keynote, you know, every agenda of every conference and every patient event because of that.

Scott Benner 1:14:36
For those of you who reach out to me and say, I really want you to come to like my jdrf type one nation event. And I don't end up at the ones all of them. You should know that the ones I end up that are run by progressive thinking people because when I get on a phone with them privately, I'm not like Oh, I'm so thrilled that you want me to come talk. First of all, I'm irritated. Because I live in the northeast. I've got to go I got to go to a horrible airport. And then I've got to park my car. somewhere that when I walk away from it, I think that's probably not gonna be there. When I get back and I get to fly somewhere I'm missing time with my family. I don't want no to this place, right? It's not something. I'm always amazed like, Oh my god, I got here people like, I got to go to Ohio tonight, nothing against Ohio. But it's an airport with and I go to a hotel, it's not a big deal, right? I love meeting the people and exciting people, but everything else about it is a horror, okay. Except for that. And so I tell them if I'm going to come, I'm going to explain to people how to use their insulin, I am not there to tell them a sad story. I'm not there to tell them a sad story that turns into a happy story. I'm not there to shake. I'm not a cheerleader. And I'm not an I'm not gonna whip them into supporting your you know, your cause I know you're trying to raise money. But if you let me come and discuss with them how insulin works so that they can have success sooner, and get rid of anxiety and stress and fear, then I will tell them how great you are. Yeah, and and some people say, well, we're not comfortable with that. And I don't get to go to those places. But you're not if I'm speaking where you are, you should know I'm saying exactly what I wanted to say when I got there. Because if I wasn't I wouldn't have gone. Yeah. And and there are too many people who get stuck in the situation. You just got in like you wrote something you felt and someone's like, can you happy it up at the end, they're like, you know, by the way, I've written for them a couple of times, but I don't like the way they pay. It's a very irritating to get your money. And so when I got to the point where I thought I would rather not do this and get paid for this blog, I was like, Well, I'm never doing this again. And so I stopped but but point point is you need you need to follow people who have your best interest at heart. And, and my mind for me, it's simple. I spent two years thinking I was killing my daughter every five seconds, and crying in the shower, and just mortified about what our life was. And then I started finding little pieces that made sense. And slowly. And I've said it before because of writing on the blog, I got to sit down and thoughtfully go through like this seems important. I'll write about this, this seems important. I'll write about that. Yeah, one day, I was able to step back and go, Wow, I put these things together. I kind of have a system here. And and then I just couldn't get past it didn't matter like you eight and a half, eight, one c couldn't I was stuck like that wouldn't work, realized, Oh, my fear of insulin got passed it wrote about it. And then boom, it all started like downhill. I was like I just started finding it and honing it and fine tuning and seeing the bigger picture and writing about it and sharing it. And if that sounds egotistical, try to understand that I'm trying to make this fun before if this you do this podcast was medicine. And I was so careful about every word, I said, you wouldn't have had that initial thought. But then again, you wouldn't have kept listening. Because there have been a lot of diabetes podcasts that have come and gone. And you have to ask yourself, why did they stop? or Why do people listen to this one in such greater multipliers than the others. And the reason is, is because because they found a way to make it fun at the same time. And the downside of that is is periodically I say stuff that's stupid, or that's overblown or sarcastic. And sometimes you don't hear the sarcasm when you're in a situation where you're like, buddy, I'm I'm here for life and death. You got to tell me how to get my kids a one c down right now. And now you're making funny, like, like, and that strikes people wrong sometimes. I'm thrilled that you came back. I really am. Like, because I'm sure well, no,

Amy Drauschke 1:18:44
I definitely. And I wasn't saying like when we do content it on the blog at Omni pod is what I find through you know, analytics is that I also send out the email newsletter. So if anyone's not a customer, and you're opted into email, you get like a monthly newsletter with all kinds of links to blogs and information. And definitely, it's the helpful resources and the helpful tips and information that people click on the most like, they don't need to read a sad story or hear a sad story. I feel like that's the stuff that's more for the general public's awareness of how serious Type One Diabetes is. But that's not the the diabetes community and that's not really going to help somebody in their everyday if you really do have to give them information that will help them and so I think that's definitely what you're like I said, I know it's not you know, you're kind of Rogue and you're This is what works for you and you're sharing the information but you're not a you're not a doctor and you're not a CDE but at the same time, so much of this disease is managed on an everyday basis by people who don't have degrees and you do kind of have to lean on your your peers to figure this stuff out on a daily basis. So isn't it I've learned that through listening to you and you know, I thank you for that. It's been really helpful and we'll see in a couple months which is I very much appreciate that and

Scott Benner 1:19:57
I'm in and I'm I'm compelled to say Isn't it? Isn't it fascinating that that the word you considered was rogue? Like if something in a roadway and all I all we're talking about here is using the right amount of insulin at the right time? Like, how is that rogue?

Unknown Speaker 1:20:15
I know

Scott Benner 1:20:16
how well that's different from what people are taught, but it is.

Amy Drauschke 1:20:20
That's the rule follower part of me that had a hard time with that at first, because I was like, what I don't understand what how this can be right? Because this is not what I'm hearing in other areas. You know, and I don't know if it's, I don't know, I don't know if it's the system or if it's the education or if it's keeping up with the times and you know, the technology is advancing faster than the the medicine medical community, I'm not sure. But it's, you know, I do have the Dexcom I have all these tools that you have, why not? Why not use them in a different way?

Scott Benner 1:20:50
I appreciate that. And and, you know, when you hear me say or when anyone hears me say like, I'll say like, Oh, my daughter, say once has been between five, two and six, two for over five years solid, no, no food restrictions.

Unknown Speaker 1:21:01
Yeah.

Scott Benner 1:21:03
Imagine if I didn't say that. Imagine, imagine if I said, Hey, I have this way of thinking about insulin that's completely different than what your doctors told you. I won't tell you my results with it. Right?

Amy Drauschke 1:21:14
Or when you say no dietary restrictions, like I would assume if you didn't say that, I would say Oh, they must be you know, on a keto diet, because there's plenty of people that are out there pushing that agenda. You know, it must be that she never eats carbs,

Scott Benner 1:21:25
right example in that. And that is I hear that from people all the time. I saw you online, and I thought, Oh, yeah, sure. This guy's done eating carbs. And then realize you weren't, I was like, Oh, let me find out more. And so it's important for me to say this is the a one c range, there's no diet restrictions. And Arden doesn't have protracted or frequent lows. Like that's, that's the important part. Yeah, having to say it over and over again, in different ways, is where sometimes you might hear me and I might just say, I might say it like it's a throwaway or like I'm bragging, or you might hear it that way. And not what I'll tell you mostly is that when people are struggling, when they hear about people being successful, it turns them off immediately.

Amy Drauschke 1:22:06
Exactly. That's how I definitely agree. That's how my reaction was that I was feeling frustrated in my own kind of failure. And I was didn't want to hear about someone else's success.

Scott Benner 1:22:15
And so what I was gonna say to you, but luckily, you said it anyway, as if I may, you weren't mad at me. You were mad at yourself.

Unknown Speaker 1:22:22
projecting, I was projecting.

Scott Benner 1:22:24
So if I have to be that for some people, I'm okay with that. Did you know to me, like I don't mind. Like I didn't get to actually feel the moment when you were in your house going, this guy's a jerk. I'm not listening to this. And so I didn't, you know, and so but but if I have to be that for some people, that's fine with me, if you want but what I want you to think of what I what I hope people think and I try to repeat enough without making it, you know, too repetitive is that when you hear about somebody doing, let's just say better than you were their diabetes, you should see that as hopeful not as something to be angry about. Like if if I can do it, you can do it.

Amy Drauschke 1:23:01
Exactly. And I think that's what you do. Like when you when you tell me like what she hasn't her lunch. I can't tell you how helpful that is. Because I'm like, Oh, I can't get you know, my kid isn't gonna sit there and eat cauliflower crust and protein shakes. I've tried it all I've tried all of the like less carbs, higher protein and he is who he is. He's I look at it. Like he's the total carb King and the fact that you don't have any diet restrictions and you list off all the things kids love to eat in her lunch, and it's still okay, that gives me a lot of hope. And let me just say this Amy, if you do want cauliflower crust pizza, you go to a real good foods calm, that's

Scott Benner 1:23:37
real good foods calm and use the offer code juice box, you'll save 20% of your entire order. And there's free shipping

Unknown Speaker 1:23:44
on cauliflower crust pizza. I just wish he did. So I will definitely I'm both

Scott Benner 1:23:50
joking and trying to keep my advertisers happy at the same time. And so I appreciate that. Because I hear that from so many people that just and by the way that was by mistake. That's a function of laziness. I the first time I did ardens Bolus while I was recording the podcast, I was just like, I'm just gonna leave that in because I don't feel like editing it out. And then as I went back and did the Edit, I thought oh, this is kind of interesting. I'll leave it in. But I wasn't a mastermind. I didn't say to myself Oh, people are gonna love to hear this but it is one of the most like commented upon things in private messages. I love hearing you do Arden's Bolus.

Amy Drauschke 1:24:31
Well, I remember when you you did it on the interview with Brett Christian Christiansen from Omni pod and I remember he was asking you about it. He was like now what are you doing right now? are you texting her? Are you looking at it on a

Scott Benner 1:24:42
screen? You know, and I thought that was really great. It's a different way of doing things that listen, we're all in the same situation. We all get diagnosed by a doctor who tells us to count our carbs. Push the button, eat the food, push the plunger down, eat the food. wait three hours test. Correct. Do it again. Keep doing that till you drop that, like that's pretty much what they tell you. And then and then if you're a one sees nine, they'll say, Well, what are you doing wrong and you're like doing wrong. I did exactly what you told me to do. You know, like, how what's your diet like and then then you start feeling bad. I spoke to a young girl last night through a messaging. And she was thanking me for the podcast, she said, she felt like a quote, bad diabetic. Because she's a she's not a, she's a bigger girl. She She described herself as a bigger girl. And she said, because of her diet, she needed more insulin. But when she dialed up the insulin, if she got too, too much, she felt bad about it. So she was eating the food, but not correcting with the insulin, because the amount of insulin made her feel bad about her weight. And so now, not only was she eating poorly, but she wasn't using enough insulin and causing yourself a different problem. She said, she found the podcast threw away that idea, or a one sees already coming down. She's got her blood sugar, so she's starting to exercise think differently about her diet and everything. And that's from someone speaking to her honestly about this, instead of trying to make her feel good about it, or tell her it's okay or don't worry. And by the way, don't worry. But don't do the same thing over and over again, that's causing a bad outcome. And then not worry about it. That's, that's called ignoring it. And I don't worry, Arden's blood sugar's gotten upside down a couple of times this week. I didn't spend all day upset at myself. I was like, Alright, I did this. And that happened the next time. Let me do this. And let's see what happens. It took me a couple days. And now I figured out I mean, how long has it been since we Bolus now a long time, it's maybe 25 minutes, 35 minutes, and she bolused she'd been eating for a while. Her blood sugar 71 still. So this insulin is now it's now active, we have a perfect balance between that insulin and her food. And so we're gonna ride this I bet you for the whole afternoon. She's gonna come home from school two hours from now. Two and a half hours from now. And I don't think I don't think your blood sugar's ever getting over 80. Yeah, it'll probably be right around 80. That's amazing. Right in there. Yeah. With a big, biggest bagel.

Amy Drauschke 1:27:17
I still struggle with though like, does he need more than a different carb ratio at lunch than he does at dinner? And is this you know, are the bases, I just feel like his days are so unpredictable. But it is. It's all. It's just so hard to think of all the variables and all the things. So I understand that today is not going going so well so far. But we'll get a handle on it. He did, he did text me back and say I can't, you know, I have seven and a half units on board. So we're going a little bit of a waiting pattern right now. But I think that's the hardest part for me is being being in this in this role and talking about diabetes all day long at work and managing it at home. And like when he's not with me and I can't do anything about it in the moment. It's so hard to not be able to just fix it is really hard.

Scott Benner 1:27:59
And you're in a different situation to because you've just obviously you're remarried and you have a you know, you have an ex husband who's obviously involved with miles and and so there's now three or three people trying to make a decision. And I think there's a story about like too many cooks and wives how the cake doesn't work out. But you know, like, yeah, you're in a different situation. And so you do your best with that. Can we before I let you go, can we talk nuts and bolts about this high blood sugar right now for a second? But miles has had I'm sure. Yeah. Okay, so. So you said he was I mean, you I think you said 360 earlier, and that was probably 45 minutes ago. Is he still there?

Unknown Speaker 1:28:37
Um,

Amy Drauschke 1:28:38
yeah. So I'm looking at it right now. It's updating. He's at 375. straight across. And he said he had seven and a half units on board around when he at 1109. So it's been

Unknown Speaker 1:28:53
40 minutes since then.

Amy Drauschke 1:28:56
What's your ex only I did, I asked him to increase bazel 75% for the next two hours around 10. So he he has a hard his mornings are tough because he goes to middle school, he has breakfast before he leaves the house around 630. Then they have snack at nine o'clock. And then they have lunch at 1045. So he has like three meals or three opportunities to eat in a very short period of time. And it always messes us up.

Scott Benner 1:29:22
So me you you just thought about those food options. There's opportunities completely backwards from how I would have thought about them. So because he's leaving the house at 630, but he's going to get food again. What time at nine. Yeah, that that's an opportunity for you to be super aggressive with the breakfast because he's gonna have food to catch it if you go wrong. And then again, and then again, you can stay foot on the pedal at the snack because lunches come in an hour and a half later. Like you have so many opportunities to address insulin. So instead of thinking about how the insulin affects his blood sugar or how the insulin affects the carbs, flip it around and think about how you can affect the insulin with the carbs. Like so instead of the insulin pulling his blood sugar down, how could you be as aggressive as possible with the insulin with the safety net of more carbs coming in two hours? And again, an hour and a half?

Unknown Speaker 1:30:16
Yeah, that's true. So

Scott Benner 1:30:17
you could so if you have a heavy enough, I know it's tough in the morning, and you're talking about he, it's tough for him to Pre-Bolus the morning, it's tough for anybody to Pre-Bolus at 630 in the morning, like, let's be honest, right. But if you if you're super aggressive with his 630, and just spread the insulin out a little bit, you know, maybe a broken like an extended bolus or something like that. And then so really keep your foot on the neck of the blood sugar, like don't let it up. And then that insulin is going to come together in three hours, two and a half hours, you're going to have food, though. So say, say he's at two and a half hours later, who cares? He's about to have a snack. And so now you can. And now when you bolus that snack without much of a Pre-Bolus, it probably doesn't matter because you still have active insulin going from the, from the breakfast to some degree. So do you see what I'm saying? like yeah, always he's kind of right, he's always eating ahead of when a low is gonna come.

Amy Drauschke 1:31:19
Right? And so you don't have to worry as much. So you would just do more insulin? Like, would you double his breakfast and spread it out over the 90 minutes until he has snack and then do the same thing at snacks?

Scott Benner 1:31:29
First of all, the answer is almost always more insulin.

Unknown Speaker 1:31:32
Right?

Scott Benner 1:31:34
What I mean, I don't know, like the exact like thought of it. But if you can tell me like so how many carbs does he have in the morning at? And what time does he eat them?

Amy Drauschke 1:31:43
So this morning, he had 20. And we Pre-Bolus, probably 15 minutes. And he was at. I'm looking at it right now he was at, like 140 when he woke up, okay. And so he had his for even with a Pre-Bolus and 20 of 20 carbs, he went up to about 200 by 730. So an hour later, then it dropped pretty dramatically, but not not well not dramatically dropped from 200 to 150. Again,

Unknown Speaker 1:32:21
by eight o'clock,

Amy Drauschke 1:32:22
but then he went up again, you know, he started rising pretty dramatically, even without more food. And then by nine o'clock when he had his other snack, he was 260. And this is the part where I cannot wait for Omnipod for the for the apps to come out because I can't see a fee. I can't confirm he actually bowls for his nine o'clock snack because that's been a struggle sometimes with him is that he just doesn't. But without knowing whether he had insulin or not. He's you know, he's almost at 400 by 1130. And he does eat lunch at 1040. So and he gets a Pre-Bolus of 30 minutes before lunch. But when he's already 300 going into that Pre-Bolus it's like, you know, he just keeps he's just gone up, up, up, up up all morning. So okay,

Scott Benner 1:33:07
so what I would say is you said at one point in that breakfast, you said he went down, but how far did he go down?

Amy Drauschke 1:33:14
Um, so an hour after he had the breakfast, he went from 200 to 150. Oh, so but he's standing right back up again.

Scott Benner 1:33:24
So a little bit of it is changing how you think about it. 150 isn't down. So high, right? 150s 70 points higher than 80.

Amy Drauschke 1:33:33
Right? It just what I meant is he's been on this upward track all day. But there was one instance where he blipped down a little bit, but then kept going up.

Scott Benner 1:33:40
So that's that, that that dropped down to 115. At some point that insulin peaked, and it overwhelmed the food for a second. But after the peak was gone, the food was still there, and brought him back up again. So you needed more insulin, spread out a little more over like maybe 90 minutes. Okay, and so if he ends up at 260 later, I mean, how much insulin did you use for the 20? carbs?

Unknown Speaker 1:34:08
Do you remember, um,

Amy Drauschke 1:34:09
I think he's at like an eight to one ratio. So pi two and a half years.

Scott Benner 1:34:13
So I would suggest to you to ignore whatever his ratio is. And just think about it in terms of how much insulin Do I need. So what really would have worked here, so it doesn't matter if you use it, you know, it doesn't matter. Say you use two and a half units. And let's say that that snack didn't exist at nine o'clock. And so at 930 He's 260. How much would it have taken to correct it to 60 back to 100.

Unknown Speaker 1:34:39
And

Unknown Speaker 1:34:43
what was that 160? You know,

Scott Benner 1:34:45
so you're doing the math.

Unknown Speaker 1:34:48
three units about how many

Scott Benner 1:34:50
how much do you think it would take forget what the math says? I think about 260 back to 100. If I just said you right now you can't there's No Bolus calculator. You're on your own Amy, how much insulin is gonna give you? 100 right now?

Unknown Speaker 1:35:06
Probably for you. Okay, so

Scott Benner 1:35:08
probably that meal that you gave him with, like two and a half units was probably more like five and a half units. Okay. Right. And so you could have taken this five units and spread them out, you could have put, I don't know, it sounds like he didn't go up for the first hour. So maybe you could have put like 30 or 40% in at the beginning and the balance over an hour. And that would have stretched it out, you know, then you would have had some peaking. You know, in that hour range, you would have had some peaking in an hour and a half range, there would have been some in the beginning more over time, like I don't know the exact answer. But what I'm saying to you is, is you have to figure out how much insulin and where it needs to be on the timeline of that food.

Amy Drauschke 1:35:50
Do you typically extend very frequently, like because when I when I learned about extended Bolus Originally, it was always like I only used it for the heavy fat, long, long digestion foods. But what I think I'm hearing you say is that you can use an extended bolus only over 30 minutes or 60 minutes and have help but give more insulin as a total bola right.

Scott Benner 1:36:13
Yeah, so like in some people, like people on injections, I'll tell you sometimes I inject some now and some and a half an hour, sort of the same idea, you know, 35% 40% up front, the rest over an hour. The fourth the first 40% goes in when you push the button and then incrementally this other 60% is being jammed in over the hour, over a half an hour. You know, I know that most people think of extended bonuses is how to spread insulin out over four hours for pizza, right like that. But you can manipulate the insulin with the extended boss you can manipulate it with Temp Basal. You could if you were scared that five and a half units was too much. What's his basal rate? If he told me how much he weighs? I might be able to guess it. How much does he weigh?

Unknown Speaker 1:36:52
You know what I was below it, but I don't know how much. I was one in 10. So is his basal rate like 1.1? Like point nine? Yeah, it's probably a little low too, by the way.

Unknown Speaker 1:37:01
Really? Okay.

Scott Benner 1:37:02
Right. So so you know if so you could have doubled as bazel to make a unit. And when done four and a half Annabelle, so say four and a half and a bolus and a double bazel for an hour. And that way, if that's too much insulin at any point, you can just cancel the Temp Basal. Yeah, and like and get some of it back again, it's all about manipulating the insulin to be where you want it to be.

Amy Drauschke 1:37:22
It's funny, because when you said that about the 50%, up front, and over an hour, that's what we did yesterday. And it's what my husband did, I wasn't home. And he texted me later. And he's like, I figured it out. This is what we need to do for when he has those french toast, things. He has this french toast sticks with like

Scott Benner 1:37:39
disgust or maybe poison. I know what you mean,

Amy Drauschke 1:37:42
pancake wrapped around a sausage. He's like it's 50% up front over an hour. And he's looking at work. And I was like, great.

Scott Benner 1:37:50
Later, no, two or three hours later.

Amy Drauschke 1:37:52
No, yesterday, he had a great day. Oh, okay, interesting.

Scott Benner 1:37:55
Just think about it that way about how to put the insulin where where it's needed stop. So stop thinking about what the pump says. Because all the pump says is the arbitrary numbers that your doctor put into the pump. Right when the doctor did that they weren't thinking that you were gonna find a way to wrap a sausage in a pancake. They were just they're just like that. But I do think again, like I said before, it all comes back to it. You got to figure out if it's Basil's right first. And because if he's point nine, and he should be 1.2. So that's every hour, he's not getting a third of a unit of insulin that he needs. Right. And then that happens all morning long, like while he's sleeping, he gets up and then you give him two and a half units for something that, by the way, probably was more like five units, and one of the units is only going to replace the bazel over the next hour. Yeah, so you're right. There's no deficient in. You have a deficit of insulin at that point.

Unknown Speaker 1:38:50
Yeah, that's it. No, I

Amy Drauschke 1:38:52
mean, that's, that's really good. I've been trying to figure out the bezels for, you know, days. And then it's, of course, the like, do you give it three days and wait and see? Or do you play attack it every day? That's what

Scott Benner 1:39:03
people say, I'm more of a three hour kind of girl. Like I put it in? And if it's not working more, it's much less? Because Yeah, you have access to the Dexcom right away. So like, use a pretend Do you have time we were going on forever? Do you have to go?

Unknown Speaker 1:39:20
Um, well, I

Scott Benner 1:39:22
think I have a little bit more time. So. So think about this about adjusting bezels. Right. Say your base will set it at a unit say it's set at five units. I don't care where it's at. And your if your blood sugar is not resting at 90 without food or insulin, then your basal is not high enough. And so, right you know, well. Okay, Scott, well, my basal is resting at one my blood sugar rests at 180 how much more I don't know how much more but definitely more. So say you're at one and you're you rest at 180 I would push it 20 or 30% and see what happens. It's not like it's not like you're gonna put your bazel up 30% for an hour and he's gonna be dead 90 minutes from now. Like you You're just gonna see his blood sugar coming down. And so maybe it only comes down to, I don't know, 150 and then it sits at 150, well then try a little more. And just keep trying a little more until you get where you want to be. And now you're down to where you want to be. And maybe you'll end up getting too low. So bump it back the other way a little bit. Just, you know, yeah, mess with it until it's making sense. And now when you're close, you know, it doesn't have to be perfect. But when you're close, now you can start making adjustments.

Amy Drauschke 1:40:30
I think the hard thing is like, it's that resting with no foods, like he just so rare that there's no food in a system and no exercise and no anything in it. I mean, so I look at nighttime a lot as like, like, last night, he,

Unknown Speaker 1:40:45
you know, he

Amy Drauschke 1:40:46
slowly rose up after being like, 100, he ended up at like, 180. And so I'm like, okay, so clearly the bazel I always think of nighttime is like, it's definitely bazel because nothing else is happening. But it is. And then I wonder if like, is the base of the same across all 24 hours? Oh,

Scott Benner 1:41:01
it's not the same over every hour. Yeah,

Amy Drauschke 1:41:04
it's so that's really hard to figure out is like, Well, does he need more in the morning? I left sir.

Scott Benner 1:41:08
But but that but here's why. It's here's why it's not. Because more. Because if you're not if you're not 90 more, if you're 180. Overnight, more, if you're 180 overnight. You're right. There's less happening overnight, although there's still body functions and growth and stuff. But you're right, more happens during the day. His eyes are open, he sees things. They make him anxious. They make him excited. They make him angry, he eats food. So if you didn't if you needed more overnight, you probably definitely need more during the day. Right, right. And then yeah, so just more, so I get him down. You know, I'd get him down from this high get him home from school. And I do a Temp Basal increase of, I don't know, 20 or 3020 20% 30% for four hours and see what happens.

Unknown Speaker 1:41:54
And you because what you're gonna when he comes down? You mean once he's back?

Scott Benner 1:41:58
Yeah, right now I'd have his bazel double till I could get him back.

Unknown Speaker 1:42:01
Yeah, right.

Scott Benner 1:42:02
Because you're fighting with a high blood sugar and food that wasn't counted wasn't covered correctly with insulin right now. And when you look at that insulin on board, when you have a 270 blood sugar, and your was a 270 was at three, seven, I forget now. It's 37. So you're looking at 370 blood sugar, and you're like, I have seven units on board. I'm going to tell you, if that was me, I wouldn't consider those in those units at all. Because if they were doing something, they would have done it. Yeah. You know what I mean? So I think it's more

Unknown Speaker 1:42:32
to do add a couple more units, like, keep bumping it. I mean, in addition to the bazel It's tough. School,

Scott Benner 1:42:39
right? But I mean, I would I would Bolus, get it down and catch it with juice later if I had to. But But sitting and staring at it's not going to help you like and the other thing is to your insulin action time, is where that insulin onboard number comes from. So do you. Do you know what the insulin action time is set for?

Amy Drauschke 1:42:59
I do I believe it's two and a half hours. That's where I like to keep it. Okay. Hold on. So I think originally when we got the dash, it was defaulted to three hours. And I changed it right.

Scott Benner 1:43:13
So the point is, is that you if you tell it two and a half hours, three hours, four hours, whatever you tell it that's affecting what it's telling you the insulin on board is and you're saying, Oh, that's definitely in there that amount? Well, if you went into his pump right now and changes insulin, it was action time lower, higher, it would all of a sudden tell you he has less insulin on board. Because it does the calculations is Oh, we must have used it up because she told me it was only going to take two hours for it to use up or write you know, you know, she told me for

Amy Drauschke 1:43:40
me, I know what that right amount is?

Scott Benner 1:43:42
Because if it was the same for everybody, no, but if it was right as blood sugar wouldn't be 370. So so you'll figure out what his insulin action time is, by when you one day get his blood sugar to not go up while he's eating. And at this point in the recording, I suffered a massive computer failure. So this is the end had been some time it's almost two hours long. Last thing I was gonna say was that when she gets the insulin right, she'll one day get his blood sugar to not go up while he's eating and not to get low later. All right, people if you made it this far hour and 45 minutes of this show, you're a huge fan of the Juicebox Podcast and for that I am eternally grateful. Thank you so much for listening. Thank you to Omni pod Dexcom and dancing for diabetes for sponsoring the show you guys rock go to my omnipod.com forward slash juice box to get started today you get a free no obligation demo of the Omni pod to try for yourself and@dexcom.com forward slash juice box you can find out how to get started with the Dexcom g six continuous glucose monitor. And let's be honest, if you're listening to this podcast and you don't have a Dexcom I mean let's go right here we go get on it. All right, the music's gonna stop in a second, you're gonna go to dancing for diabetes.com that's dancing the number four diabetes.com. And you're gonna like them on Facebook and Instagram. I mean, you know, please saw all of your new reviews and ratings on iTunes recently. Thank you very much. And I would like you to know that this show is now available on radio.com. They have their own app radio.com. If you're using the radio.com app, and you'll want to listen to the podcast there, you absolutely can. But if what you're doing is working, don't feel any pressure to switch. I'll be back next week. Thanks for listening.

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#231 Diabetes Pro Tip: Variables

Diabetes Pro Tip: Variables……

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

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

Scott Benner 0:00
Hello, and welcome to the next episode of my diabetes pro tip series with CDE Jenny Smith. This one's called diabetes pro tip variables. The episode is sponsored by Dexcom real good foods and dancing for diabetes, you can go to dexcom.com forward slash juicebox real good foods calm and use the offer code juice box to save 20% of your entire order or dancing the number for diabetes.com. To find out more. There are also links in the show notes of your podcast player, and at Juicebox podcast.com. In this installment of the diabetes pro tip series with Jenny Smith, Jenny and I are going to be talking about variables those things that you know, change, but impact your blood sugar. The stuff you don't always think about, like are you taking a medication? Is it allergy season? Has it gotten warmer outside or colder outside? Do you have road rage? Stick around Jenny and I are going to talk about it all. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And always consult a physician before becoming bold with insulin or making any changes to your medical plan. Can I take a second to share something with you that I believe you have an incredible impact on. I'm talking about the popularity of this podcast. I'm looking right now at the total downloads for April of 2018. Versus April 2019. Back in April of 2018, I was incredibly impressed with how many people were listening to the show. And last month, three and a half times more downloads than the previous year. And as I'm editing this, and getting ready to put this up for you in May, I'm pretty confident that this month will be the most popular ever.

Easily surpassing April of this year, which as I said, is three and a half times more popular than April of 2018. So as we approach the 1 million downloads of the Juicebox Podcast, I have a small favor to ask of you that I really have no right to ask because you're already listening. And I love that. But could you just do me a tiniest favor, find one person who doesn't listen right now who's not a subscriber, a person that you believe would enjoy the show and introduce it to them, show them how to download a podcast app on their phone. Show them how to subscribe. And perhaps you know, just share with them a couple of your favorite episodes to get them started. My goal, of course is to limit the struggles and suffering of other people. You guys know how it felt before you found the show. I'd like it if you could help somebody else to get to where you are now. And with all the ads the asks and the excitement of the 1 million downloads out of the way. I think we should start the show. Hey, everybody, this is Jenny from integrated diabetes services. I understand a lot of you have been contacting me privately, which I think is a fantastic idea for any and all of you who are interested. Jenny, of course, has been doing the diabetes pro tip series with me. This was supposed to be the last episode. But I think unless Jenny has changed her mind, we are going to continue to add to this series throughout the year. Yeah, excellent. Jenny. I'm very excited about that. And today's topic is. So you guys don't really understand how all this happened. I wrote down what I thought were the tenants of the podcast. And I sent them to Jenny. And she put them in a different order and made changes to them. And she's like, I think this is how that this will work. And I was like that's great. And then we were supposed to Oh, well. You know what I was thinking Jenny's? We were supposed to record basically a like a menstruation episode but i think i but i think it fits really well into your idea for today, which is variable. So I think we're going to combine the two of them if that makes sense. You agreed? Excellent. Okay. Why don't you tell people what made you reach to me and, and suggest this

Jennifer Smith, CDE 4:05
the word variable brings in the whole topic of discussion, right? I mean, we're taught from the get go there are three main factors that really you know, you get educated about is impact on your overall blood sugar control. We've got an I kind of call them like the triangle of management of what you're told about to look for effects. Exercise, the medicine, you take and type one of course insulin Sometimes though, with the changes in some of the medicine now for type one use could be other medicines. And then you know, the third one is food. So you got exercise, medicine and food and you know, if you contain all of those, you're going to have diabetes success, right? If you just learned about all those little pieces when they're only three, so you're going to do awesome. Well, that's like baloney.

Scott Benner 4:57
I think there's so many more factors. To consider so many more variables or like icebergs, right? That can kind of come through the course of your day. I mean, some of them, you can sort of head off, you may know that they're coming if you know, to look for them, and that they could have impact on blood sugar. Again, the short list that I kind of came up with just to talk about today, cuz I know, we don't have like, four hours to discuss everything, I think I came up with, like 10 or 12, you know, variables that I could really think, affect most people, and that you really should consider. So, you know, I'm sure that you probably have some variables that you know, just with what you've seen with your own daughter's management, right? Absolutely. And, and to kind of tag on to what you were saying, I found myself this past Saturday at the dancing for diabetes touched by type one event standing in front of people telling them that insulin timing is the seed of the tree, that is your management. And as long as you know, we can always go back to that as the base is the root, right? But then eventually, you know, that seed grows a trunk and the trunk grows, branches, and the branches, grow leaves. And all of these different parts of the tree can affect your blood sugar and will sometimes, but you can't get caught in a problem. And staring at the leaf on the 77th branch and wondering what is that leaf doing to me right now, even though it is doing something to you, it's I like to look back afterwards and say what happened there and try to figure it out. But in the moment, as we say, here on the podcast in the moment, it just means you need, you know, you need to change, yeah, adjust, right, maybe that means more insulin maybe means less. The idea that bazel insulin is insulin too, and we always forget about it, everyone wants to set their bazel. And then think about Bolus, which just doesn't work, you know, you have to think about the timing of all of the insulin. And when one of these bazillions of variables comes into play, some of them being more constant in your life than others. They have requirements. And they require of you to, to resist, right? Like you can't just, you can't walk through a day when you're premenstrual maybe the same way you walk through a day when you're not. Oh, right. And so go ahead. Give me your first one. What's your first good one off your list?

Jennifer Smith, CDE 7:22
Cool. My first good one actually takes into account the three that I mentioned, right? exercise, medicine, and food. Each of those seems like a simple like one topic blurb word, right? It's if I figure out the medicine, but you brought in a good factor, it's the dosing the timing, the consideration of the medication itself. And again, with more medication being added to the list of potential use, especially with type one, you bring in more variable there. And so with the dosing and the timing, it takes evaluation, so that that variable can be I guess, better known for you. Again, you know, we all have your diabetes may vary, right? We all have our n of one life with our insulin that we use, and we learn how to dose it, learn how to time it. So that's, you know, one and then the other two, exercise has a lot of variables to it, you get the blanket statement from a doctor who says, just take your pump off or just, you know, do a zero bazel if you're gonna go and exercise. The world of exercise is not that simple with diabetes, but if anything, there are a million variables within just the topic of exercise if you consider you know, slow movement, like when I take my dog out for a 20 minute walk and he stops me pees in sniffs everything. My blood sugar could drop 50 points from just a dog sniffing walk.

Scott Benner 8:50
sniffing walk not to be confused with the brisk walk

Jennifer Smith, CDE 8:53
with a brisk walk. Exactly. So I mean, you know, things like that are all you know, going to like Disney World to walk around all day, that slow, consistent movement, you wouldn't count as exercise not like going to the gym and huffing and puffing and sweating to death. But it's a variable that in my experience, I've found I need to reduce my Basal about 20% for the full extent of the time that I expect to be at like a Disney park or someplace similar.

Scott Benner 9:23
Can I ask you a question about that? Yeah, we always say that and then we never sort of not not you and I just people in general, we always say like, you know, exercise can bring my blood sugar down. In I don't want to go too deep into it. But why? My question is, when my body starts moving, what does it do that makes my blood sugar fall? Is it using the insulin more effectively? Is it speeding up the like, that's what I want to understand real quick. Those of you looking for a diabetes organization to support should check out dancing for diabetes. That's it, no big sell. I just think you should Dancing for diabetes.com that dancing the number four diabetes.com. I was at their event, a couple of weekends ago, I heard Elizabeth talk about how she started the organization. Her words just made me so proud to be there and to be supporting what she was doing. And I think you would feel the same. Just check them out dancing for diabetes.com. That's dancing the number four diabetes.com.

Jennifer Smith, CDE 10:25
Yeah, so the exercise piece, if you consider I like to refer to it exercises like free insulin, really, it's some types of exercise again, you know, the low slow to moderate intense exercise, you really looking those cells, doors on them have, you know, little locks, right, for the most part, we used to use insulin to unlock the door to get the glucose to enter. When we exercise, the body is sensitized to insulin, and those doors open freely, because your body wants to incorporate the glucose into the cells to get used and to energize the body to keep performing. So if you've got and this comes into the first, you know, topic of medication and the timing, when you're looking at exercise, the timing of insulin is very, very important. And the dose and what you're coming into that x active phase with onboard, that's just it's huge. You know, so if you're looking at going into a five mile slow Temple Run with five units of insulin on board from the Bolus that you just took, think again,

Scott Benner 11:37
sizing, I just spoke to an adult woman this weekend, who still play soccer, and she said, you know, the advice she got from her doctor was to take her pump off, and she said, but then my blood sugar goes sky high, and I can't play. And I don't want to do that. And I didn't have much time to talk to her. But what I said was, I said in a very basic way, that everything I say on the podcast, works for activity, you have to wrap your brain around it. But in the end, if you're using the right amount of insulin at the right time and taking into account that this exercise is going to happen, that's it. And it's simple to say, well, you just turn your basal back an hour before and during or something like that. And that may be the answer in there. But there's an answer in there. And that is you have insulin needs. During the soccer game, you have less insulin needs. So don't give yourself the dog sniffing insulin when you're playing soccer.

Jennifer Smith, CDE 12:32
Right. Exactly, exactly. So yeah. And then you know, so then we, you know, take into consideration the adjustment for exercise, but there is also exercise on the opposite side that may require more insulin. Yes, because of adrenaline seems like you know, those who lift or do a lot of resistance training, or do HIIT workouts, you know, the high intensity interval training, where you've got a little cardio but these really like short bursts of intense exercise in some of my first, I guess, personal informative about intense burst exercise for my blood sugar control was when I was starting to train for my first half Ironman and my training routine had some of the running as sprint Hill sprints, where I'd literally like fly up the hill and then sort of jog back down and fly up the hill. Well, you know, I adjusted assuming that I'd have the similar responses other exercise where I would adjust the insulin and whatever, man I was high. I was like, you know, but adrenaline, you know, research adrenaline is kind of a component there to consider. The weightlifters that I work with, tend to find that they need to dose insulin before a heavy lifting session, they might need to take a unit of bolus insulin, they may need to do a temporary bazel increase those kinds of things. So exercise isn't as simple take your pump off and go and exercise. That's not it.

Scott Benner 13:54
That's the do. No, that's do not die advice. That's advice that won't kill you. It's definitely not going to help you. Right, right. Exactly. And the example that I use over and over again, in my talks in here is the idea of Arden showing up for basketball at a great blood sugar and then running around which makes you think blood sugar would fall but then would go up. And then we figured out that she was competitive and she wanted to win the basketball game. So her gitelman spiked up

Jennifer Smith, CDE 14:22
and difference there you probably found from her game to her practices. Yes. Which is very common for any athlete who is in a competitive anything. I mean, I found that with my running races, I could go out for my nice runs and for my training and have great management knew what I was doing some of my first five K's man, I was astounded at the rise in blood sugar as soon as I got in the car to head out. Yeah,

it was like a drift off. It was like

Scott Benner 14:53
play competitive sports or have been around it this this might make sense to you. My son always echoes this back to me that it's true. He said, it's kind of impossible. They always tell you to practice like you play. And he said, it's kind of impossible to do. Because when you're practicing, the game's not there. Like, right like there's these the same intensity is not there the same desire is not there. You can't You can't duplicate the feeling a feeling like you're going to lose, or let someone down or lose your spot on the field or some something like that is like you can't you can't make that up in your head while you're practicing. No. So your your insulin needs will be different because your brain is thinking differently about what you're doing. Wrong. It's very interesting.

Jennifer Smith, CDE 15:37
Yeah, yeah. So those are, you know, all even the time of day for exercise could make a very big difference for how you strategize adjustment. I know my morning adjustment for exercise is very different than my mid to late afternoon or evening exercise. Very different just based on again, the sensitivity and all of that kind of stuff.

Scott Benner 15:56
So, and Arden, as an example, closes her eyes to go to sleep and her blood sugar goes down. It happens almost instantaneously. So it's not a huge job. But that girl goes to sleep and the I don't know what you would call it the day life. Right? The anxiety and knowing like a release of Yeah, she relaxes. And when she relaxes, her body's not forcing her blood sugar up in the same way. And it starts to drift down. Yeah. Wow. Okay. Jenny, let's on that list. Now.

Jennifer Smith, CDE 16:27
The next one, again, of the three, the third one was the food, right? And we think okay, and we talked about this in one of our other, you know, just master carb counting and you've got it like figured out you've got it totally nailed, you'll be clear and beautiful post meal blood sugars, right? Well, again, I kind of Kanan takes into consideration, type, amount, combination of food, what went into the meal, if you sit down and you eat, like, you know, a three cup jar of peanut, versus a three cup plate of white rice. carbs are there in both pictures. The coverage of them, however, is very different. So those variables that kind of come in with food, we know now, thankfully, in the past, I would say five D, maybe even 10 years, we've become much more aware. and educating people a little bit better about it's not just carbs, it is the fat it is the potential protein. And with some of the I say newer, they're not technically new, they just have gotten a lot more media is things like the Paleo kind of diet or the keto diet, those kinds of path plans or you know, eating habits, they require you to figure out the impact of the food in a different way than just carbohydrate.

Scott Benner 17:49
I know I think I've said here before, but I was with a person eating no carb at a meal. And we went into a restaurant sat down, hi, Vicki, Vicki ate food. I feel like we sat there for a half an hour and talked, we got in the car, we're driving away, and she pulled out her PDM for her ami pod and gave herself insulin. And I was like, what was F word she goes, the protein is gonna hit me. So that's it, that's it. I don't think she ate one carb while we were where we were. So different ways to wrap your head around different things. And I have it, you know, again, I just this is fresh in my head because I just got back from a talk. But there's a slide that goes up that says all carbs are not created equal. But you have to you have to write you have to believe that 10 unit, you know, 10 units away, I cannot talk about grams, 10 grams of rice and 10 grams of watermelon or grapes are not going to impact you in the same way or for the same amount of time. Okay, if you don't know that, then you'll struggle. You know, you can't just you can't just count your cars, put your insulin and eat your food and go away. If it worked like that. Well, then you're and this probably would need this podcast

Jennifer Smith, CDE 19:03
would be perfect for all that's exactly right. Well, and then the other factors, you know, that will kind of, I'll touch on as we sort of go on here. But factors of food impact, you may get many of your common things figured out as I think I said in one of the previous ones, you know, if you figure out the 2025 most common foods, meals, things that you eat, that's like 80% of your management, if you kind of nail those, figure them out from the protein, carb fat impact, awesome. But then we bring in all of these other potential variables, like you mentioned, initially, you know, the menstrual cycle for women. Well, you may have all those wonderful things figured out and then in comes the three to seven days before your period is supposed to start. And if you haven't been told that there is an impact on blood sugar, and you just think that gosh, it must be my insulin or it's a bad site or something crazy is going on, you get really annoyed and confused. And for women, that could happen every single month that you're getting annoyed and confused. And unless you start to track things,

Scott Benner 20:12
you'll remain annoyed and convenient. I try so hard to tell people, I don't want you too. I don't want you to completely forget about the possibility that your insulin went bad, or that your infusion site suddenly stopped working. But if your blood sugar was at all day, and then all of a sudden it jumps to 150. And it won't move. It's probably not your insulin, you know, but you see so many people, they hyper focus on the physical things, they think they can see that they that they can they can believe might be the reason, right? And I you have to be able to kind of look back a little bit and say, okay, it doesn't make any sense that my blood sugar was doing what I expected it to do. Suddenly didn't, why am I thinking of the pumps at fault? Like why am I thinking the insolence of fault that insulin has been working for a day and a half, you know, or that vials been working for two weeks, or whatever it ends up being? You really sometimes just have to think it's probably the stuff I can't see. And then I think and then I always think too, and then don't spend too much time on it. Bring it down, drop it. Yeah. And here's a great variable, say your candle is loose and you're leaking. And you're not getting as much insulin as you believe when you push the button. Still, in the end? The answer is, you're not getting enough insulin. The reason is mechanical. But the idea is still the same. If you were getting insulin, your blood sugar wouldn't be that high.

Jennifer Smith, CDE 21:38
Correct? Absolutely. And when we take into consideration, you know, cycle changes, if you start to track things as a woman, and you do have a cycle, and you're not on birth control that completely, you know, cuts your site off entirely, and you just don't have it anymore. If you're having a cycle, start to track things, because that's a good way to figure out some of that variability that a woman will have has nothing to do with the male at all diabetes management strategy. So if you're a woman listening, and you're within the time period of potentially having a cycle, and you're not postmenopausal, or anything, start to track your cycles and evaluate, usually, for most people, they see a rise prior to their cycles starting, as soon as their cycle starts usually needs dip back down, up until about oscillation for women can be anywhere between day 11. And day, like 18, give or take. That could be another rise in hormones, it's usually shorter, it's only about two or three days. And then things kind of drift back down again, typically before that three to, let's say, five days before your period starts again.

Scott Benner 22:49
So we have this continual roller coaster of hormones through the course of a month. And if nobody's kind of clued you in to pay attention to it, you may just feel like there are variables that you just don't know what's happening. It just seems random if you don't think I'm not aware that that's an impact. And they're, by the way, they're fantastic. I happen to know, trackers like different apps you can get for your phone to track your period with it's it was only a period tracker, there you go. And it was only uncomfortable for me like the third time I asked her Can I see the app that tracks your period real quick. You know, she said she was like, Okay, take it. But it really is spectacular. And in the end again, you need more insulin, you need less insulin, you need the regular amount of insulin, you know, once you recognize that it's happening, and you don't spend a day and a half wringing your hands wondering what's going on and you just stay fluid and do what it asks, then then then it's not a burden anymore. It's just I need more insulin, but our brains get stuck. You know, you and I talked about this before we started recording. But Arden's looping now and I'm seeing with her bazel, that how much more basal insulin the loop can use. And I thought back to when I used you know, I had ardens bazel, before the loop set up at like 1.4 an hour and to double it to 2.8 to me seemed like all the insulin in the world. And now I'm seeing the loop do it too, sometimes four or five, six units, and not for a full hour. But it's still it's I realized I was stuck in the number the idea of the number and that can happen to you too when your period pushes up your insulin needs. And you think that's crazy. Let you know on most days, I use 20 units all day between Basal and Bolus 40 is going to kill me. Well, it's not that day because your needs are different.

Jennifer Smith, CDE 24:35
She needed it. Right. Right. Absolutely. Absolutely. And that I think you bring into, you know, you lightly touched on, like the site or the pump or you know, those as being variables, but they certainly are. I mean, you have to know when to definitely address it as a potential site issue. You know, if you're in the time period of, let's say, your mom or your man and you shouldn't have hormone issues and you've got you been floating along beautiful for, you know, weeks and weeks and weeks. And now all of a sudden you've got this like, high blood sugar, you know, you're usually up to like 140, maybe after your breakfast, and now you're at like, 300. Clearly, that's not normal if another variable isn't there, right? So, you know, you address things you say I'm Hi, let's address the Hi, but why is it happening as well? Could it be the site, check your site? You know, those kinds of things? Could it be the insulin think about, you know, if it's brand new vial, probably not. But if it's a vial that's getting close to that, like, end of life, like it's almost empty, or you've, you know, you don't use very much insulin, so you're getting to kind of that 30 ish days, especially this time of the year and through like fall, where if you keep your open vial of insulin out of the refrigerator, temperature changes will affect insulin. So it's really an important piece to consider, maybe you just need to change the insulin out. So those as you know, potential site issues, the other site issues would be the site itself. Have you used this site over and over and over and over? And finally, it's gotten to the point of just you can't use me anymore?

Scott Benner 26:13
Why would you switch to a new site expected it's possible that you need lesson so and then you needed prior on the old practice? Maybe that sites working better? Correct. And for all my talk about don't beat yourself up about it's probably the pump it's probably the pump once you decide it's your it's your site, it's you know, it's the pump. And nobody bails on a pump site faster than me once I believe it's the site, you know, I'm like, okay, off gone. And that's that, you know, and you if you're newer to this, by the way, this all seems I try to bring this up on small talking about things on the podcast is an exploded view, right? Like you're really stretching things out to see in your regular life. It's not going to take the last five minutes a Jenny and I talked about this for you to make that decision. You know, you've heard me say before, like about cgms. People, like how do you know how you can trust your CGM? Like you can tell. They're like, What do you mean? Like sometimes it's 30 points off, which by the way, you know, 30 points off a 10 year old meter. I don't know why we're believed in the meter before we believe in the CGM, but neither here nor there. My point is, is that if you have some experience with this for a while, you know what's real, and what's a ghost, you know, and you can, you can look and say to yourself, alright, this is clearly the site, this is going, you can look at your CGM and say, I don't think it's possible. My blood sugar has been at three for six hours, maybe I ought to use my meter to see if that's right. And those decisions become very easy over time. You may be thinking, but Scott, you just got done saying that diabetes technology is not perfect all the time. Why would you put the ad for Dexcom? Right here? Are you aloka? No, I'm not crazy. I'm confident. And I love the Dexcom g six continuous glucose monitor. It is of course, at the very core of all of the good decisions that we're able to make moment to moment, day to day, week to week, year to year, we're helping my daughter live well with Type One Diabetes, nothing is perfect. But Dexcom is as close to perfect as you can currently get. The only thing that's ever going to be more perfect. Then Dexcom g six is whatever the next version of Dexcom is. I mean, that's my guess. Here's what you need to do. dexcom.com forward slash juicebox that's how you get started. You want the Dexcom because of its predictive nature, because it can tell you not just what direction your blood sugar is moving in sure it's going up. Yeah, of course it's going down. But how fast is that happening? Am I falling so quickly that I need you know, an emergency infusion of juice or some sort of a carb? Or is it just kind of drifting down? Am I maybe able to watch it for a second see what's gonna happen? Is my blood sugar jumping up right after a meal? Maybe I didn't, you know, use an offense on the things that you're wondering while your blood sugar is doing what it's doing the next context the Wonder out, it shows you it replaces wondering with wonder, like wonder like, you know, fireworks like whoo like that. Our results are ours and yours Of course may vary but my daughter's a one C has been between 5.2 and 6.2 for over five years, largely because of the information that we get back from her Dexcom g six, go to dexcom.com Ford slash juice box to get started today.

Jennifer Smith, CDE 29:30
You know another one that

is this time of the year in consideration of like insulin and viability and all that stuff. Another one that a lot of people don't realize is this time of the year of could for many people bring in the variable of allergy.

Scott Benner 29:48
Okay, how would so right just because because that's almost an infection

Jennifer Smith, CDE 29:54
causing yeah causes kind of like that histamine reaction in the body which causes an inflammatory respond, you know, that's the reason you get all Flemmi. And you know, bleary eyed and like whatever is coming out of you desperately to push out

Scott Benner 30:07
the dust

Jennifer Smith, CDE 30:08
push out the nastiness, right, exactly. I mean, unfortunately, my husband has nasty allergies in this time of the year. He's just like full of sneezing and like runny eyes, and you know, that kind of stuff and it stinks. But when you consider diabetes, insulin needs with this as a stressor on the body, we talk about stress as a variable to allergies could be a stress variable. And so your insulin needs may very well go up in this time of the year. Because of that type of, you know, setting now, if you use some medications to help deal with the allergies, it's always important as a medication kind of component or variable, check the label, or ask the doctor, make sure any of those medications that you may take for, you know, an allergy won't necessarily have impact on blood sugar, some of them have a steroid base to them. And steroids, as we know, will usually raise blood sugars as well. So you could have kind of double impact and medication impacting as well as the allergy itself impacting Do you have pain on your list? plan would be another stressor within that like, kind of body sort of? Yeah, absolutely.

Scott Benner 31:21
People don't think about but I've seen it happen so many times that you can't not trust I saw Arden get hit in the knee with a softball once. And her blood sugar immediately started going up and stayed up. State her insulin needs remained high for days while the pain in her knee subsided. It was a significant pain. Yeah. And so let me ask you if I have a headache, would that push up my blood sugar?

Jennifer Smith, CDE 31:45
It could if it's a if it's a bad enough headache, especially those who may have like migraine issues absolutely could be a variable. Sometimes too, you know with that as as effect. Sometimes if you notice the rise in blood sugar, you take medication to offset the pain itself. If the pain isn't felt anymore, blood sugar's should or could very well come down. And so you do have to be kind of cautious with the adjustment in insulin. If you're doing something to cover the pain, you may find that correcting the high blood sugar drives it down more than you expected, because you're not feeling the pain anymore. So

Scott Benner 32:23
funny. My next question was going to be to say I'm in a road rage situation. And because I'm all dialed into my diabetes, and I've got a dexcom I see my blood sugar goes from 80 to 140. I don't want a bolus right away, right? Because my bazel because that that burst of adrenaline is going to go away quickly. And then my base, my Basal is going to crush that number again, most likely,

Jennifer Smith, CDE 32:45
most likely, I mean, Basal never meant to essentially bring blood sugar down. But once the stressor is gone like that a quick impact kind of thing. Typically, your blood sugar should start kind of coming back down. And if it doesn't, it just means obviously that you are thinking about it and continuing to like dwell on the problems right? You have extra road rage

Scott Benner 33:05
is when

Jennifer Smith, CDE 33:06
you have extra road rage Exactly. Go home and you tell every neighbor about what happened on the way home and you know, you continue to perpetuate the issue. Bolus Ford

Exactly. Yes, exactly

Scott Benner 33:18
is a quick burst of adrenaline the same as a lollipop. In that it is it does hit you but that it can't sustain the rise. Is that a similar idea?

Jennifer Smith, CDE 33:29
kind of similar idea. It's kind of a good way to

Scott Benner 33:32
know something, you know, doctors used to and I I'm sort of against the idea of talking about free foods. I don't I don't really think there's free foods in general. But But I have seen it with Arden and I've always wondered, is the fact that like she put a lollipop in her mouth and her blood sugar went up a little bit and came down is that because a lollipop is a quick hit that goes away? Is it a free food? Or is it because I've got the balance over insulin so wrong that it's able to handle carbs? I haven't like haste to think about that when she was younger. Like Am I really like did that really not have an impact or like, you know how we talked about if you know, I was explaining to people this week and I said look you have to Pre-Bolus you can't be scared of it like insulin works the way it works. It does not work the minute you put it into your body if you Pre-Bolus and two minutes later your blood sugar starts falling the Pre-Bolus did not magically start working you probably

Jennifer Smith, CDE 34:25
were falling already

Scott Benner 34:27
yes you were falling already or you did something hours ago that is impacting now that you're unaware of. And I always wondered about that like when we'd give our like little bits of candy my jet was I just premature like what I just holding up a low that was coming anyway.

Jennifer Smith, CDE 34:42
Could be the factor and that's also a kind of brings up a good point while it's not really a variable but it might be if you consider it. Lows when you treat a low we recommend treating with simple sugar, right? When you treat with simple sugar, that simple sugar is really, its potential impact lasts an hour to 90 minutes. And thus the age old recommendation, if you have a low blood sugar, treat it, it comes back up if you're not going to be eating a meal or a snack within the next two hours, treat or follow up that carb sugar with a snack that includes protein. And the reason was to sustain the blood sugar than because that quick glucose like you just said, it goes in it does its job, it gets things up, but eventually the bazel it's there that's supposed to be right. That's sugar, it will overpower it. There's not enough laughs really, if it's working the way it's supposed to. So yeah, absolutely adrenaline and a lollipop.

Scott Benner 35:46
So the numbers not really the power without the way it's just a simple sugar, you have to give it a protein or a fat to actually add the, the weight to that number that

Jennifer Smith, CDE 35:59
so that knowing something slower digesting you know, if you consider something like you know, keen raw or like a piece of sprouted grain bread or you know, something longer sustaining. It's got the carbs, probably more than the lollipop does. But you're going to get the rise it's going to be a lot slower, but it's also going to be a lot more sustained.

Scott Benner 36:17
Jenny, you're not from where you live. Are you? Like were you born where you live? Like Jenny's? Like I'm from the Midwest. And still, I'm still you said qinhuai as an example of that was really interesting. Oh, by surprise, I was like, Oh, we get fancy Jenny must have been burned somewhere else that moves where she lives.

Jennifer Smith, CDE 36:39
Oh, no, not at all. I'm just you know, I am a dietitian. Oh,

Scott Benner 36:43
okay. See?

Jennifer Smith, CDE 36:44
all the fancy foods I guess I

Scott Benner 36:46
should know about right. I haven't I haven't read your bio in a while. I don't worry. I just I usually do it before the episodes when I'm putting the episodes together. You can well I got me by surprise. If this was a regular episode. I would totally title this episode. Keane was just so you know.

Jennifer Smith, CDE 37:02
Funny,

Scott Benner 37:03
so many people. So many people came up to me this weekend and said, Can you put any more effort into making the titles match what the episodes are about that is like No, probably not just listen, you'll figure

Jennifer Smith, CDE 37:13
you can title it the variable of keywords that

Scott Benner 37:20
attract what's next on your list.

Jennifer Smith, CDE 37:22
The weather. As we consider temperature changes, I've got you so many people in I noticed myself I've got really good friend who notices as soon as March hits. And you know, here in the Midwest, March may or may not be warmer than the winter has been. But she's like, as soon as Marcus, it's like a switch in her body goes off. And it's like, it's spring, hey, let's dial down the insulin needs. And she literally has about a 20% decrease in her basal needs, from March all the way through, like, you know, October ish, when it starts getting a little bit cooler out, then across the board rule. For the most part, the warmer the weather, the more and the more time you might spend in the actual warm of the warm weather. You know what, what is warm weather do it increases the like, your body needs to cool itself off. And so your vessels come closer to the surface of the skin. So you can cool yourself by sweating a little bit more that like increase in in the vascular nature of the underlying tissue brings vessels closer to insulin, and you absorb faster.

Scott Benner 38:31
Plus and this isn't physical but physical in terms of inside of your body. But you probably become more active when it gets warmer to

Jennifer Smith, CDE 38:38
right. Absolutely do more things. I know myself I you know here and my husband talks about it all the time. He hates the winter weather and everything and he's like, let's just move someplace much warmer all the time. So we can always be outside. And quite honestly, if that was the case, I probably would have lower insulin needs throughout the whole year because warm weather comes I'm consistently at the park with my boys or and go and doing my normal exercise. I mean, I don't even consider that exercise that's just part of our normal daily when it's nice outside. So yes, we become more active.

Scott Benner 39:12
When it's nice enough to be active more often outside. I think what Jenny's saying is if you're thinking of relocating to a warmer place, and you feel like you can't afford it, don't forget to deduct your savings and so on. Right, there you go. You might be able to afford more rent because of a go. All the diabetics are gonna live in California now.

Jennifer Smith, CDE 39:33
Right, right. And the opposite of that, you know, the cold weather, you need to stay inside more oftentimes, cold weather means you're eating a little bit harder your food, you know, to kind of sustain and back up or kind of plump up almost. You eat more like stews and things that might be a little bit more protein and fat Laden, just heavier meals in general. I mean, nobody eats well, maybe some people do but nobody eats like a rockin hot. chili, dinner in the middle of July summer. at certain times, no,

Scott Benner 40:05
I get that you're more sedentary in the in the winter anymore

Jennifer Smith, CDE 40:08
more sedentary. Exactly. You may get your exercise, but it may be shorter, you know the, though it's not as light outside anymore in the wintertime. So all of those kinds of things as far as the time of the year allergies, whether cold, warm, they can all be a variable. So I have a variable for you. Is it possible? It's more of a question that you may be able to tell me to shut up? But

Scott Benner 40:33
do some of our bodies react differently to Calculus than others? Like Like this? Might this gives a possible that? Because you're because that candle goes in? Right? It's seen as a foreign body immediately. Do some people see a third day on an insulin pump less effective, but some people can make it longer or shorter? But yeah, okay.

Jennifer Smith, CDE 40:56
Yes, absolutely. And I think that's part of the reason, you know, Omni pod, especially did their 72 hour or up to 80 hours of, you know, exploration, essentially three days on the pod, because the studies have actually shown that longer than three days with a site inserts to impact the absorption at the site. So if you think of the consistent drip, drip, drip, drip, drip, and then these big boluses, I mean, if you don't use a lot of insulin might be two units. For every Bolus, if you are some of the team guys that I work with who are eating, you know, 100 plus grams of carb per meal, and the ratio is a one to three, you've got huge 20 unit bolus going into a site and that site gets, it gets saturated, it can only absorb for so long. So some of it may not necessarily be canula. Some of it may be how long and how much is going in at the site. For the people that are sensitive to different candles, though. It could be the angle, some people do much, much better with the angled type of canula. Other people do much better with the 90 degree canula. I myself found no issue with Omni pod at all. I mean, I was a long time user before I started looping about a year and a half ago. But once I started looping with my Medtronic pump, I actually found the angle candles were horrible for my skin, they did not work. And I found the 90 degree plastic canula also wasn't something that my system seemed to really like. Whereas the steel canula that goes in in a 90 degree angle. It's kind of like a foam tap. You just pop it right in. That's awesome. It is like my go to set now. It's fabulous.

Scott Benner 42:38
Just t slim have steel and plastic. They do. Yeah, I see people a lot talk about the people who struggle on the T slim move to the steel Canyon that sometimes helps.

Jennifer Smith, CDE 42:52
Yep, the one for t slim is called True steel. And the one for Medtronic is called the shorty. Okay, they're both steel, they both they work. Lovely. I would say for most people that I've encountered who have that kanila kind of issue. Yes. And you know, as a variable, those may be things to evaluate and say, I know it's not the darn insulin, I can give an injection with the same bottle of insulin and my blood sugar moves the way that it's supposed to, let's change the site. It's not necessarily the site, it could be the canula, we change the canula. magically, things look better, sometimes we even need to go down in the insulin needs because you're responding better. So

Scott Benner 43:32
I would have to say at this point that when you buy a pump, you're going to get instructions from the pump company about approved sites to use. Keep in mind that the pump company had to get the pump through the FDA process. And every site they wanted to test took more time. And that took away time from them getting it to market for you. So had they decide had they had the luxury of more time, they may have tested more sites and the FDA may have said hey, this data proves that you can use it here too. I'm now not saying anything else about that. Other than you should consider that. Correct. That's all.

Jennifer Smith, CDE 44:15
Yes. And even some of those approved FDA sites don't work for some people at all.

Scott Benner 44:21
Just because it doesn't make them good for you.

Jennifer Smith, CDE 44:23
Doesn't make them good for you. That's exactly right.

Scott Benner 44:26
not approved doesn't make them not good for you. All we always take into account the photograph on my blog that Chris Freeman, the Olympic skier allowed me to use of him wearing his pump on his pictorial. I believe the man has the same body fat makeup of this metal microphone that's in front of me. Yeah, I think

Jennifer Smith, CDE 44:48
many women use jet fighter as well, even though they don't technically have. They've got pectoral muscles. They're just hidden underneath a breath. I

Scott Benner 44:55
love when someone shares like a cleavage picture with their pump on them. My daughter and she's like, never, never. And I'm like, Okay, I'm just saying this lady says it works really great. I can't wait for me.

Jennifer Smith, CDE 45:06
Right, right. Again, all those variables to definitely consider.

Scott Benner 45:12
You know where else variability exists in the foods that people enjoy eating. Some of you, for instance, just rocking it eating as many carbs as you can jacking up that insulin going crazy, but some of you are like, Hey, you know, I would like to have a slightly lower carb option without sacrificing taste or choice. And luckily for you, this is an ad for real good foods and they have just that not only do they have it, but they're offering you 20% off with the offer code juice box. Let me tell you more. First thing you do is go to real good foods calm there's a link in your show notes. But if you type it in your browser, it's all the same. Then you go to their products. Chicken crust, pizza, cauliflower crust, pizza, breakfast sandwiches, both sausage and bacon, and geladas 3d different flavors. Italian entrees have been added. And of course the poppers that everyone loves. Those of you who are already enjoying real good foods, they have a VIP text club list for exclusive offers. All you have to do is text RGF 2474747 to be added. Are you kidding me? You love texting people? Wait RGF 474747 you can do that. But you got to go check them out. Their foods are low in carbs and high in proteins and delicious. It's amazing what they've done. They've taken you know, the treats that you love and made them fit into your low carb lifestyle to amazing without sacrificing taste and I don't honestly know how they do that. It's probably Voodoo. I'm not a very like food sciency kind of guy so I'm just gonna go with it's possible there wizards real good foods comm use the offer code juice box at checkout to save 20% on your entire order. And considering their free two day shipping. That's a great deal. What do you see how it shows up? Like they send you an igloo in the mail or something very cold, chilly. Ooh, where

Jennifer Smith, CDE 47:06
are we talking about location here, I clearly had location for a different reason being a variable, location, being like travel. Travel is a variable. If you notice, changes in your blood sugar. When you are flying or traveling long distance, we usually find that over two hours of sedentary travel will usually require more insulin because of the sedentary nature and the potential bit of stress that travel brings in.

Scott Benner 47:42
We on a three hour flight. We always have to Bolus our two hours into a three hour flight. I never thought of it before. But it's constantly that

Jennifer Smith, CDE 47:50
Yep, yep. So I personally have found that I use about a 20% bazel increase. When I fly I get to the airport I turn the Temp Basal on so that by the time we get on the plane, it's already like circulating at a higher level. I continuing until we get the notice of descent and then I cancel it. And that works really well. For me I do the same thing on long travel and when we lived in DC, and we would drive back to the Midwest to visit family. That's a long drive lots of sedentary sitting in a car, the stress of driving on the road and everything I would need a Temp Basal increase for that. So traveling it of itself can be a variable for those on tube pump. The variable could be the pressurization in flight. Many people find and there's actually some really good I guess, blogs on what people found with the tube pump in flight. So the recommendation now is to disconnect before ascent. Check the tubing Once you're at cruising altitude check if there are any bubbles, purge them out with a priming bolus and then reconnect. Same thing for descent disconnect once you land look at the tubing clear the bubbles if there are any. Some people have noticed that they get a bit of insulin bolus that won't show up in the pump because of pressurization of the pump and the reservoir and everything. Some people find that they've got this huge air bubble in their tubing. And so if they didn't look at it, they would get a huge missed amount of potential diesel or Bolus the next time their pump pumps out and that's something

Scott Benner 49:22
with the change of Evo elevation.

Jennifer Smith, CDE 49:26
Yeah, it has to do with the pressure pressurization within you know, the cabinet. Unfortunately, there's not a lot of In fact, there's nothing that I've seen in any of the tube pump companies that they talk about doing that, but it's something that we know is common

Scott Benner 49:43
to happen to

Jennifer Smith, CDE 49:45
an army pad obviously there is no tubing. I've had a random couple of people who've noticed that in flight they have these lows, having not bolused having not done anything different having sat at the airport for like an hour or two before their flight took off. Again, no boluses or anything, and they are low through the course of the flight. So I potentially I guess it could happen even without the tubing component there. I mean, the pod still have a reservoir. But I've really primarily heard it with tube pumps. I always wonder about

Scott Benner 50:18
you. Some people get like, like, we all most people have the same reaction, right? Nervous upset adrenaline, blood sugar goes up, but you do see sometimes, like people have the complete opposite reaction that you expect from them. And it's that's their norm, right? Or, like, here's one, how come when Arden has a head cold, it's like she doesn't have diabetes anymore. And other people say when I'm sick, my blood sugar goes through the roof. Arden gets sick, her blood sugar goes to 80 and sits there for days. It's far right. And it's just so the other variability that we haven't spoken about yet is you? Are you right? So your response? Yeah, your response to all of these things. So you know, the variables may treat you differently than other things.

Jennifer Smith, CDE 51:04
Similarly, I have my friend, who I have done races with in the past, not recently, but she actually has a considerable drop in her blood sugar once she gets to the race day.

Scott Benner 51:15
Okay, that's it. She doesn't have that adrenaline spike, she had the opposite. I mean, there's adrenaline there, but whatever reason it's causing her to drop. Yeah. And so for Jenny's friend, the the point here is, don't say, Well, I heard on a podcast that you know, when adrenaline hits your blood sugar goes up, and everybody online says it, but mine goes down. Don't don't bang your head against the wall. Just accept it. That's what happens to you and address it accordingly. Correct. There we go.

Jennifer Smith, CDE 51:40
Yeah, exactly. The other travel one was altitude. Many people don't consider altitude. And if you are someone who goes to Colorado skiing or somewhere fancy in Europe, and you go skiing, or whatever you do, you could notice that going to altitude, I noticed it when my husband and I took a trip to Peru, and we hiked the Inca Trail, which is we got to Cusco and we were like, Oh my god, can we just pleat the it like the altitude was like crazy, we felt like we had never exercised before. And my insulin needs go up about 30% for about 24 to 36 hours, once I get to altitude, and then they come back down. It's like my body just needs this like adjustment period. And then it kind of comes back, you know, to my normal. But that's a pretty common one to consider.

Scott Benner 52:32
And that is incredibly common. And even though it is incredibly common. There are three people that I know of right now listening to this that are thinking, I it's the complete opposite of what happens to them. I correspond with people who live in Colorado and are afraid they're going to die because their insulin just crushes them. They use the tiniest bit and if their blood sugar's falling constantly, they don't know why pumps injected doesn't matter. They just the elevation, that altitude just it wrecks them. So yeah, that's their that's their normal, you know,

Jennifer Smith, CDE 53:02
that's their normal. That's right, absolutely. So you know, all those, I guess, all those things to consider. You know, they're all there are lots and lots and lots of variables. What else is on my list? I have

Scott Benner 53:15
Jenny prepared for you people, I hope you appreciate that. I did.

Jennifer Smith, CDE 53:19
I did just because I was like, gosh, there's so many of them, I need to like make sure I get the primary ones that I talked to people about considering, you know, a variable I know we've talked about previously, when we're talking about like being bold with insulin is high blood sugar itself, like extreme high blood sugar can be a variable in how you expect your body to respond to insulin. Typically, when blood sugars are higher than about like that 250 Mark, which, huh? You know, they recommend testing ketones anytime you're higher than 252. Right. So along with that comes the consideration. You've got it all like squared away, you know, your bazel you know, your sensitivity to boluses to correct blood sugars, or carb ratio is all dialed in, and you feel like things are working and, wham, you're high now. And you take your correction and you're like, well, that looks like I've put water in my body. And it did literally nothing. It was sugar. So we've got this like, like this toxic state almost like they actually call it glucose toxicity that comes into play when you've got extreme high blood sugars, where you'll need more insulin than your sensitivity factor would normally cover. And

Scott Benner 54:37
that's what people commonly say, I'm insulin resistant when I'm high. That's the that's the common way that people talk about. So if you have that feeling in your head, this is what Jenny's talking about. Now, from my very non scientific perspective. I learned years ago and we've been talking about here forever, that bringing a high blood sugar down and coming in for that landing that you're hoping for And not a crash, right? it you have to In my opinion, it's a mix of Basal and Bolus. JACK, you don't just, if you're thinking, in my mind, if you're thinking it's two units to get this 300, back to 100. I like to find a good portion of that insulin from Basal. And I don't know why that makes more of a difference, but it certainly does. So

Jennifer Smith, CDE 55:24
it's also a, I call it a, let's say a safer way to also manage potentially, because if you've got a Temp Basal increase, going along with a part of a Bolus that you've used to address that higher blood sugar,

Scott Benner 55:40
the bazel can be canceled, right? You can always bail on Okay, once you see the

Jennifer Smith, CDE 55:44
movement that you want, you can bail on the Temp Basal, whereas if you've taken your rage bolusing you're like, it's telling me all you need two units, man, I'm gonna nail it, I'm going to get it down with like eight units and you like nail? Well, once it's there, you can't get rid of that eight units, it's, you know, whereas

Scott Benner 56:00
you just Pre-Bolus for your next meal, you better eat it at the right time.

Jennifer Smith, CDE 56:03
That's exactly right. So you know, if you do some of it as Bolus, like you said, and some of it is this Temp Basal insulin, you can cancel that town, you may need to cover a little bit, but at least you're gonna drift down better without a huge crash. And

Scott Benner 56:17
also, you can also cancel it and go back to it, which I found myself doing before, right? You're, you know, 300, it's now it's 280 is 250. And then you're like, Oh my gosh, it's two hours down, I'm shutting the bezel off, then all the sudden 220 levels out like, Oh, she left the bazelon. And you put it back on again. But at least you're in control of it to a degree, right. And you and you didn't just put in this giant like, you know, mallet full of insulin that you can't stop. It's hard to walk when you're done with it. Yeah, I want to say too, and this maybe doesn't fit here. But when you find yourself in those situations, I think it's incredibly valuable that when you cause that fall that that the sent in blood sugar, and you have to eat some food to stop. But at some point, I know everybody thinks of that as like some failure. But there's so much to learn from watching the food go in and watching how it affects your blood sugar on the CGM, that that that experience of stopping up drop like that will inform a lot of what you do in the future. Because just like you can see, oh, wow, I was 152 hours down. So I ate this. And I came in at at that knowledge. And I can't really explain to you how in the moment right now how in this example, but it will inform your understanding your greater understanding in a way that will help you in the future. It's absolutely very neat to see how the food affects the insulin.

Jennifer Smith, CDE 57:40
I see. So awesome. Yesterday, I talked to somebody who she worked very hard, you know, with strategy management, we knew something was kind of going on in the evening for her. So we said let's do like an evening bazel test, let's see what's happening truly behind dinner without the dinner, you know, being there. So she did this awesome bazel test, we saw the drift happened that we kind of assumed was from bazel. We, you know, could counter it, but she ended up having to treat the drift down and she didn't want to eat at 10 o'clock at night. So she just treated the low. She had three glucose tablets to treat it. And she thought, you know, all we're getting out of this is the bazel test. So we know where to change things. You know what? So we could actually get the evaluation of what the carb intake she did, how much of a rise did she get with it from it, because there was no other food, there was nothing I mean, the only other food she had in her system was from lunchtime at noon, at 10 o'clock at night, there is no impact of that whatsoever. She had no exercise, we treated the low it came up, we saw how much she can use, I pointed out she's like, wow, we got like more done than I thought we got done. She was so excited that she could actually see. And it was simple sugar, right. So she didn't treat with something that had the fat or the protein that would have later potential impact that you couldn't figure out. It was just glucose tablets.

Scott Benner 59:05
So there's so much to learn to learn if you just step back a little, and widen your vision. And and you know, and you have to get rid of that I failed or this is a mistake or a problem feeling. It's just data coming back like look at it and really accept what it is instead of being upset with yourself. Because you can't because I said it this you know, I say it a lot. But this weekend, I was really pointed with a pretty large group. I said, Every time something goes the way you don't want it to go. And you don't use that as a as a moment to collect the data and make decisions and, and and further your understanding. You wasted that moment. And you're going to have to have it again now because you didn't pay attention to what happened. It's just like, I mean, what's the saying right? Something about history doomed to repeat it right? I don't know the exact thing. Right? All of you who know it now are repeating it in your head in your car. But that's the idea. The idea is it's happening. Learn from it. Don't just read Your hands like I can't believe that happened. That sucks. I bet at this, you know, right. All that's true, but isn't going to help you the next time. So right, cool. Jenny Kiki, anything else? I mean,

Jennifer Smith, CDE 1:00:13
I yeah, I had two other one was something that I think is not addressed. Usually not addressed at all, unfortunately, health factors, I guess that we don't really want people you know doing really it's things like smoking. If you're a smoker, I'm sorry, but you know what smoking can have impact on on on blood sugar and some of the research that's out there that can actually show that smoking can have an impact by causing some insulin resistance, because cooking is it's suggesting inflammatory responses in the lungs,

Scott Benner 1:00:50
that make sense.

Jennifer Smith, CDE 1:00:50
So could have impact blood sugar wise, the other one would be drugs. Drugs can have impact potentially, on your diabetes management. You know, depending on the kind of drug that you're,

Scott Benner 1:01:03
you're telling me that if I'm sitting at home, really trying to figure out my insulin problems, and I'm not taking into account my heroin addiction, I make I'm leaving something out that's important to think about. Absolutely. Which which might be, which might be reasonable like that. I think that people compartmentalize their thoughts sometimes. And you really sometimes don't see where the impact is actually coming.

Jennifer Smith, CDE 1:01:25
Yeah. And as a variable, you may not be considering all of the things that you could be doing for your diabetes management. If you are utilizing a drug and it's, it's really your main like focus, right? Because diabetes isn't going to be a focus for you, then are you gonna say drinking next? Because I have one I

Scott Benner 1:01:40
wanted? Yeah, I'd say alcohol.

Jennifer Smith, CDE 1:01:43
Yep. Alcohol itself drinking, it's a big one that I discussed with, you know, my teens and my college. Because it comes into the picture it does. Learning how to do it safely, is an important thing, because the impact of the alcohol itself, you may have your fancy sugar, you know, juice sweetened beverage, the alcohol in it, however, is going to have impact later on your blood sugar. So what we find is that hours later, if you've had enough alcohol, it could cause a drop in your blood sugar.

Scott Benner 1:02:17
And and not for nothing. But when you're really loaded, you're probably not doing your diabetes, math as well as you probably could be wrong. Oh, is it fair to say maybe have a buddy with you explain to them why you don't just need a sober driver, you might need a sober bazel tester to watch these things just made me think of, because I just did an interview with somebody who's like clinically depressed and has type one. And to watch the cycle of how it hit this person over and over again, was just like, it's crushing, you know, to see, but for them to have to live with. So now I'm thinking, if I'm on a depression medication, is that affecting my blood sugar? Is it making my blood sugar higher? Giving me anxiety more that it's higher end, making me feel more anxious about you having to use extra insulin in what about just the, the, the physiological, and maybe you don't know, but experience of being depressed? Like does that have an impact on you?

Jennifer Smith, CDE 1:03:20
It's, well, depression as a stress, right? So it could be it could go various ways, if the depression isn't being managed with, you know, assistance, whether it's counseling, or use counseling, and medication or whatever it might be, you know, that in effect could be enough of a stress that it is bringing your blood sugar levels up. It depression can also mean that you're just, you're just not eating. So it could very well maybe bring insulin needs down because you're just literally not taking in anything through the course of the day. Now, some of the some of the medication, some of the oral medications will make you feel so much better, which is a purpose, right? That's the purpose. But some of them also increase appetite. If it increases appetite enough, and you're not cognizant that that's what's kind of happening and kind of rein that in, you could have weight gain that could impact your influence sensitivity.

Scott Benner 1:04:19
I'm gonna add a thought to this, because I had a conversation with somebody online, told me something I never considered. So this person was overweight. And eating was more than they wanted it to be. And so when they counted their carbs and went to give themselves insulin, they wouldn't give themselves all the insulin they needed, because it reminded them that they were eating more than they wanted to be eating. I know that's a real interest. You have to wrap your head around it for a second, but they were disappointed in themselves for eating that much. And one of the ways they pretended that it wasn't going on was to use an amount of insulin that a more normal meal would have been Yeah. So there's a lot of things I wrote, you know, as we started this conversation today, I wrote down life because the variable really is life. Right? Like, it's your living, and there are different things happening to you. And whether you're, you know, addicted to drugs, or you're depressed, or you just don't have your bazel, right, or, well, all the things that Jenny's brought up here today, really, it's just, it's, you're alive, and you have diabetes. And so they're going to be variable. So are there any more on your list? You're looking at the

Jennifer Smith, CDE 1:05:28
only other one was a

growth cycle?

Scott Benner 1:05:34
Oh, growth, are you?

Jennifer Smith, CDE 1:05:36
And I think, you know, I mean, that is a it's a broad topic. So I bring it out as a variable. It may need full nother discussion, potentially, but it is it's, and people ask, and I work with a lot of kids, lots of ages. I mean, a little younger than two is my youngest person. And kind of up until like, the 70s is my oldest and but the kids have these variables of growth that just drive parents crazy. Because become, you know, we've got things smoothed out and beautiful in the biggest things I tell people is the needs will change. We'll get them figured out. They'll probably look like they're going along pretty nice and that you know, little Johnny is gonna burn up, you know, a half an inch and so for the next couple of nights, they may get these like, like you said, aren't goes to bed and her blood sugar, kind of like drops off in a growth spurt. Many kids go to bed as soon as their head hits the pillow pillow and they're snoozing, man, it's like a rocket ship to the moon

Scott Benner 1:06:42
blast off blood sugar is the worst part about growth hormone and children is that it happens while you're trying to sleep. That really I have to give Arden her balls really quickly. This one's gonna be easy, though. Because Arden's doing the loop right now at carbs. taco. That's it. Time 10 minutes from now

at carbs taco time, change time to 10 minutes from now, that isn't gonna make sense to you guys yet, but it will one day when Jenny and I talked about that and and Katie de Simone comes back on and tells me all the things I did wrong while I was setting up my Ardennes loop. And how good and how I could have avoided them.

Jennifer Smith, CDE 1:07:35
Yes, I get it. That's great. Cuz that was like laying last little tidbit of variable, which is a total different discussion. I'm glad you're going to have it with Katie. But you should discuss with her the looping variable. Because these all have different if you are using a looping pump.

Scott Benner 1:07:55
Jenny, this is going to come out before I talk to Katie. And so I'll just tell you now and then you guys can all hear it. Now then hear me talk about later with Katie. Every every thought I had trying to set up the loop was wrong. Like like you don't mean Up, down left, right? Like everything. If you asked me, you know, yes, though, I'd say yes. And you'd like to know, you know, I send genic effects. I'm like, I'm seeing this, should I move this up? She go no down. I'm like, how do I get that wrong? It's just it's so so all of us. Right now everybody who's listening. If you're being bold, if you're following along with this podcast, obviously, it works fantastic. And there's no you don't need to change. But if you go to looping at any point in your life, or into a closed loop system, the variables, the settings that allow the loop to think are counter intuitive to what we're all doing. We're not looping, but I am putting myself through this so that I can explain it to you all better. Because if you guys want to move to a closed loop in this future, I think that's not a bad idea. And I want to make sure you understand how to transition from being bold with insulin to being I don't know, bold with a blue,

Jennifer Smith, CDE 1:09:08
or how to maybe let loose Be bold with itself.

Scott Benner 1:09:11
Yeah, yeah, there's a way but trust me, I still only understand that about 65%. But by the time I'm done talking to Katie, and by the way, now that Jenny has been kind enough to say that she's going to continue coming on like this. I don't think we'll be putting them out like three at a time, but maybe once a month, or as often as Jenny can do it. And trust me, we're going to get about that as well. So thank you so much for doing this.

Jennifer Smith, CDE 1:09:33
Thank you.

Scott Benner 1:09:36
Wherever you are right now, I imagine you applauding for Jenny just a slow, deliberate and lovely clapping. That's how I feel every time she's on. Hey, how about that great news. Jenny is going to keep coming back on the show. The diabetes pro tip series is going to go on into the future non stop pro tips. Just for you guys for listening to the Juicebox Podcast. Don't forget to check out Jenny at Intuit. To diabetes.com there's a link to her email right in the show notes. Don't forget dexcom.com forward slash juicebox get started with the G six today, dancing the number for diabetes.com. And of course using the offer code juice box at real good foods calm. I love getting all of your ratings and reviews on iTunes. Thank you very much every time someone leaves a great iTunes review for the Juicebox Podcast. I don't know if you know this or not. An angel is completely unaffected, but I am incredibly happy

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#230 Bri Not Brie

Lilah's School Aide also has Type 1……

Bri has so many different connections to type 1 diabetes.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello and welcome to Episode 230 of the Juicebox Podcast. Today's episode is sponsored by Dexcom. makers the G six continuous glucose monitor by Omni pod, the only tubeless insulin pump in the world And who could forget dancing for diabetes. Find out more about all the sponsors at Juicebox podcast.com in the shownotes located in your podcast app, or by going to these links, ready, dancing the number four diabetes.com dexcom.com forward slash juicebox my omnipod.com forward slash juice box. Today's guest has a ton of connections to type one diabetes. I'm not going to spoil all of them here in the intro, but I'll give you a little taste. Remember when Lila's mom couple episodes ago talked about I was an aide at school? That's Breanna. That's right. Bree is our guest. Laila aid, embryos connections to type one diabetes don't end with Laila. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before becoming bold with insulin, or making any changes to your medical plan. Hey, did you know you could follow the show on Instagram at Juicebox Podcast on Facebook at bold with insulin. And that podcast app users on iPhone can just scroll to the bottom and rate and review the show right there. That's right. If you wanted to give the show, say a five star review and say something glowing about it, you could do it right in the podcast.

We have to get going sooner quicker, like quickly get started because now there's more story to tell than there was before. So, so before this, I'm going to leave all this and before I asked you to introduce yourself, you told me your name. You started telling me about your diabetes background, but instead just tell me your name. And how old you are then let me go two different directions. So go ahead.

Bri 2:15
My name is Bri and I am 26 years old.

Scott Benner 2:18
Okay. Now, Bri has type one diabetes, I would have let her tell you that. But that's not important anymore. Because what's important is that she and I tried to record this a couple of days ago, had all kinds of technical problems. And she went out and got a headset just to do this. So thank you very much.

Unknown Speaker 2:34
You're welcome.

Scott Benner 2:35
And on top of that, um, I don't know if you can imagine I record this at my house. So like today's Friday, my wife's working from home, my son still home from college. And everyone's just kind of like in a swirl in the house trying to grab food, get their laptops run up to their bedrooms and hide so I can record the podcast. And as that's happening, I get an email from Barry that says, I've locked myself out of my apartment and I'm waiting for a box.

Bri 3:04
Yeah, that happened this morning. That happens to me very often, honestly. Yeah.

Scott Benner 3:09
Put it What? How many times? Have you been locked out of your apartment?

Bri 3:12
This is like the third time in the past couple of months. So hopefully it's the last time Can we unpack

Scott Benner 3:19
this for a second and find out why are you secretly wish you were home living with your parents or

Bri 3:25
my daughter has like multiple locks and they all require different keys. So I only use one deadbolt key. And then I leave the rest of my house. So this morning I went to take my dog and I was like half asleep and I left the one of the door doorknobs locked all over the keys on my keychain, which I should have done a long time should have done at the first time but so

Scott Benner 3:49
you're all set now you've made the adjustments. I am

Bri 3:51
good. I am in my bed with my dog. I'm good. Yeah. Okay.

Scott Benner 3:56
Well, I'm fantastic. I'm glad. I'm glad you're never gonna be locked out again, hopefully. Oh my gosh. Okay, so let's just, it'll be a little clunky. But how old were you when you were diagnosed with type one?

Bri 4:11
I was 24. About to be 25. So I'm so yeah, it's been like a year and a half. Pretty much. Yeah, exactly. A year and a half

Scott Benner 4:18
is this is it? What month were you diagnosed?

Bri 4:22
I was diagnosed in June. June 16. of 2017.

Scott Benner 4:29
Yeah. Yeah. It really is a year and a half. Okay, so um, so expected like everyone in your family has type one and you were just like, this is gonna happen to me eventually. Or I don't

Bri 4:41
know. So yeah, no one in my family has it? Um, yeah, I went into the doctor. I just thought it was like lacking a vitamin or something. And I was like, I just need like, you know, some extra vitamin B in my system. And then they took my sugar they couldn't even read it because it was so high. They came back. They're like you have diabetes. I was like, Oh my god, this is so embarrassing. Like, I'm too young to have this. I must have ate too much cake the past week, like, I'll get rid of this not gonna tell anyway, like, no big deal. And then obviously, like, all the information started coming in, I was like, Oh my god, like, this is just like, totally life changing. Like, this is crazy. I thought only kids could get it right. To super educated as most people are on the subject, but um, yeah. How it happened.

Scott Benner 5:30
So that's interesting. Are you in the doctor by yourself? I assume you are. You're old enough like you.

Bri 5:33
I mean, I was like, literally on my way to work. And I like just walked into the doctor because I felt like crap. I was peeing all the time. You know, I had all the symptoms. And I don't know why I google everything. I'm like a total health freak. And it was like one thing. I didn't really go like all my symptoms. So Otherwise, I would have known

Scott Benner 5:52
that yeah, it was like crazy. So you're really just lacking vitamin insulin. So that Yeah, well, but it's such an interesting like, process through your mind, right? Like, I must just be you're young. So you're like, I must just need a vitamin of some sort. Because when you're young enough, and in your mid 20s counts at this age, you don't imagine anything can go wrong with your health, right? So you're just like, if something's wrong, it's got to be something like minor and weird. And then when you heard the word diabetes, you thought type two right away. And then when someone told you it was type one,

Bri 6:23
yeah, well, I didn't know that there are different types. I thought type. Well, I thought type one was like, the pre pre diabetes that you can, like, get rid of, you know, like, how that happens with type two, like, the doctor will be like, oh, like, you know, your blood sugar's looking a little high. But if you eat well and get your act together, you know, you can be okay. That's what I thought it was. That's what I thought type men.

Scott Benner 6:48
There'll be a moment today when you're staring at your phone, and you desperately don't want to go back to what you're doing. But you've run out of apps to check. That's when you go to dancing the number four diabetes.com and find out all about what that fantastic organization is doing. That's dancing, the number four diabetes.com. No kidding. So So for a couple of moments, as the doctor was telling you, you really were just thinking like, Oh, this is so embarrassing. I've like I've let my health Get away from me.

Bri 7:16
Yes. And I was so confused. Because I'm a total health freak. I work out way too much. So I was like, just totally like, What is going on? You know? Yeah,

Unknown Speaker 7:27
I know.

Scott Benner 7:28
Well, so you're in. You're in grad school right now? Yes. Do you can we say what you're trying to do with your life?

Bri 7:35
Yeah. So I'm in grad school for clinical psychology. So I'm getting my hours right now to become a marriage and family therapists.

Unknown Speaker 7:43
Okay, great. Yeah.

Scott Benner 7:44
And so how did you end up so now? Bree has a really interesting, here's how I'm gonna make sure I understand how you got to me. You work for the woman who contacted me. Is that correct?

Bri 7:57
Yes, Alina.

Scott Benner 7:58
Yeah. And she she was trying to tell me about how great you are because you're helping her to care for her daughter while her daughter's at school. Is that am I getting this? Correct? Okay, yeah. So let's do that first, because because you have another job, too. But but this one, but this one first. So what does that look like day to day? How do you how do you help this little girl?

Bri 8:18
Well, I go in during right before she eats pretty much. So she eats at 1130 i Pre-Bolus at 1115. And then I'm there until 230. So right after snack, that's just like three hours a day.

Scott Benner 8:30
So so but this is at school. This is a school aged child, right?

Bri 8:34
Yeah. So I don't work for the school. I work for the family. This is a first grader, okay.

Scott Benner 8:40
So you just you just roll up in the morning and be like, Hey, what's up everybody at the front office, go find her, give her insulin and then hang out not with her. But behind the scenes.

Bri 8:51
Well, I usually sit with her at lunch because she you know, she needs to eat all of her food. And she's a little chatterbox. So I that's usually my job for the most part is to make sure she's eating everything on her plate. And then after that I'm I'm in the so it's kind of complicated. Actually. The nurse has a phone and iPhone, I have my phone and then the teacher her teacher also has a phone, which stays in her like little diabetes bag. So everyone is kind of in contact with each other. So it takes a village. It's like we are you guys now. You know, give her a tab do this do that. So it's kind of like, you know, we're all able to communicate effectively, which is super helpful.

Scott Benner 9:30
Okay, and so she has she's using a glucose monitor.

Bri 9:34
She knows she has a dex comment Omni pod.

Scott Benner 9:36
She has Dexcom what do you do? Well,

Bri 9:38
I have ducks comment on the pod as well.

Scott Benner 9:40
Cheese. And okay, so there's no ads this week. Just everybody gonna dex commented on the pod. Yeah. There's links in the show notes. No, seriously. So, so she's a first grader do Witkin. I don't know how freely you're allowed to speak. But when was she diagnosed?

Unknown Speaker 9:57
I believe she was two or three

Scott Benner 10:00
And so is this a situation where they were having trouble at school or where they were trying to set something up that would work in the, you know, before trouble could arise? How did you how did you? How did they come to look for you, I guess I

Bri 10:13
started working for this family, when Laila the little girl started kindergarten, so she was like new to the school. And I think that they tried out, just having the nurse, you know, her going to the nurse, but it's like, She's so little. So she wasn't she's like five years old at this point. So like she needed like someone to walk her to the nurse, which is all the way across campus. It's just a total pain in the butt. And she does have a lot of lows. Some days, though, is just like totally complicated. So I think I don't know who suggested maybe it was the nurse who told the mom, maybe you should look into hiring someone you know, to be at school and kind of be her shadow. So that's kind of where I think she reached out to jdrf. And then jdrf, it must have been like a blast email or something to like, you know, people in their 20s or teens or something of you know, this mom needs a babysitter who has type one. So I reached out with like, hey, like, I'm in grad school. Like, that sounds like a good gig for me. So um, so yeah, I reached out. And that's how that

Scott Benner 11:16
you can tell me Is this something that's common at at her school? Like is it you and like, 12 other 26 year old people, like hanging out with like, the kid who needs an inhaler. And the kid is or like, like a ninja in the corner keeping peanuts away from one of the kids.

Bri 11:32
This is like, just you. Yeah, it's just me. Um, and that was the problem is the nurse also has the whole school to take care of. So if God forbid, there was an emergency, and you know, the nurse has like, 10 kids in her room, like she wouldn't be able to give Laila the highest care that she should be having in that moment. Okay, though. All

Scott Benner 11:52
right. So I'm trying to imagine this from everyone's point of view, who's listening, like I'm trying to, like, I'm putting myself in the, in the shoes of like, a 55 year old mom whose kids like 30 now, and she's thinking none of this is necessary. And like, and like somebody who's had trouble with their kid, you know, with Lowe's, and they've been really scared, or they're just general where people have not good nursing or whatever. And I can see, you know, I can see it from all the different angles, I think, if it's needed and valuable, that it's needed and valuable. Right. So how long have you been doing this with her?

Bri 12:24
So last year, I was full time I was there every day. And then this year, I since I have clients now, I'm with my, the counseling center that I work at. I'm only there a couple times a week, and then I switch off with another girl who does the same thing.

Scott Benner 12:40
is the plan for the family. And you might not know, but is there a plan to transition away from this? I mean, the kids not gonna be like 15 hanging out with a 35 year old you, right?

Bri 12:49
Right? No, that's definitely the plan. And I'm really, really, really close with the other shadow. And we're like, super diabesity BFFs outside of our job as well. So we've kind of been working on transitioning Laila to, you know, giving her on boluses. And putting in her own cards, checking her finger, you know, so I'm kind of like, in the, I feel like she's in the training stage right now. Because eventually, she's gonna be like Arden, where, you know, the mom can just text her and say, you know, do this, do that, and she'll just punch it in herself.

Scott Benner 13:20
So that's what so this is, this is a stop gap between. So this is a person trying to kind of do what we talked about in the podcast. But because their child's so young, there's not enough. There's that you can't have you can't feel like Oh, she's gonna just see my text or not forget or not push the buttons wrong or something.

Unknown Speaker 13:41
Yeah, very cool.

Scott Benner 13:42
Now, what is this? I don't know what I want to know about this. It pays well enough for you to do it. Because you live in LA, right? are out in California.

Bri 13:55
Yeah, I live in LA, it's like 10 minutes from my house. Like, it's super easy. I get to do my schoolwork there, which is awesome. So you know, after lunch, and I make sure sheets are food. I kind of just go hang out the teachers lounge, get a lot of work done. If she has a low I text the teacher tell her to give a tab. So does she I mean,

Scott Benner 14:14
does she ever like a cool like, you're not there like you walk in and she ever just like, give you the shoulder like, Oh,

Bri 14:19
she runs away from me. And she thinks, oh, funny when the Omni pod doesn't connect to her.

Unknown Speaker 14:27
She's like, like, the wall and like, she's five.

Scott Benner 14:31
You must seem old to her. Like I just realized, like you I'm talking to you. And you're like, I'm stopping myself from calling you a kid. And, and she she's probably like, Oh, this giant, tall old lady comes and takes care of me.

Bri 14:44
The other day the kids were like, how old are you? Because I sit with all the kids at lunch and I was like, What do you think I am? And Lyla goes, I think maybe 60

Unknown Speaker 14:57
That's excellent.

Scott Benner 15:00
Further, I asked about where you live, because I just was trying to think about like commuting time, but it's close to your house, but commuting time and like, like, how much would I have to pay somebody to make this valuable to them? Because if you said to me, I had to go like, I'm not a grad student, but I have to take three hours of the middle of my day to go hang out with a, like a five year old and have lunch with them. I'd say, Oh, sure, I could do that. It costs a million dollars, you know, because I wouldn't want to do that.

Unknown Speaker 15:25
Yeah, but this

Scott Benner 15:26
is like a good side gig for you. Like it makes a little money.

Bri 15:28
Good. Because I'm just like the kind of person I get so distracted doing work in my own house. So I usually like end up going to a coffee shop or something. So it's just like, it's perfect, because like, I would normally just be somewhere else doing my work as well. So

Scott Benner 15:42
you might you might try spending some of your free time hiding spare keys around the neighborhood.

Unknown Speaker 15:47
Oh my god, I know, right?

Scott Benner 15:52
Yes, let's take a side trip for a second. How many times do you have to lock yourself out before you start thinking, Oh, my there's something wrong with me.

Unknown Speaker 16:03
This morning, I was like,

Bri 16:04
Oh my god, I can't believe

Scott Benner 16:07
I'm sorry. It's the most genuine laugh I've had on the podcast in a while. Know when you close the door when you came back?

Bri 16:17
I knew the moment I closed and I said a curse word. And I was like, oh god, my neighbor public just heard me and

Scott Benner 16:22
had to walk your dog which in by the way your dog appears to be in your picture on Skype. Is it a golden retriever?

Bri 16:28
Yep, I have a golden retriever Sawyer

Scott Benner 16:31
very cute. So you had to walk Sawyer the whole time go into yourself? I'm locked out my

Bri 16:39
I had my car keys with me it's just like that one key I did. I haven't like a my junk drawer because I never lock that.

Scott Benner 16:46
So yeah, you and so you're hung out in the car until the

Unknown Speaker 16:50
tree store

Unknown Speaker 16:51
did you do I'm sorry.

Bri 16:52
We went to the grocery store. I got I was a little productive during that show.

Scott Benner 16:58
I might have gone back to sleep in my car. I might have been like, I don't deserve to be inside even. So. Okay, so you have this this one job are you do you basically go in you? You know it's funny. You're I don't even know what to call you're like you're not even a like you are sort of a pancreas. Well, let me ask you that. How? How autonomous? Are you with her? Is it all on you? Or do you and the mother talk?

Bri 17:21
Sugar is dropping, I'll usually get a text from her and she'll say like, I'm paying

Scott Benner 17:26
you don't kill my kid.

Bri 17:28
She'll be like, is this low treated? Or you know, just confirming pretty much or if I see that she's dropping, and I'm like, Oh, you know, Lena might be getting nervous right now let her know that she's eating because I do like try to hold her back on eating before. You know, I try to wait till she's going down and insulin is hit. She's on fiaz.

Unknown Speaker 17:46
Okay, so, um,

Bri 17:47
I guess that's supposed to hit a little faster?

Unknown Speaker 17:50
I don't know. But I say that for sure. Yeah, yeah, I

Bri 17:53
don't know that. But but okay. I was like, 30 minutes before

Scott Benner 17:58
but but on a normal day, if you roll in there and her blood sugar's 120. You give her her Pre-Bolus you decide on what that is based on her meal and everything.

Bri 18:06
Yeah, yeah. And then I kind of am able to also dictate like, what she eats first. So I'll say like, save your food for last because I don't want her I don't want that hitting her at that moment. So

Scott Benner 18:16
that's always I gave up on that with Arden. I was just like, it's like, you know, sometimes you the heavier carbs first. She's like what? I said, the heavier like that. Nevermind. And just eat it. It'll be fine. I'll create. I'll create this big blanket of insulin that nothing can get through. And it's funny because it now to you. Before I tell you why it's funny. Do you listen to this podcast?

Bri 18:41
Yes, I do. I actually like put, I gave this podcast to like aleena. And she was totally into it. And then the other shadow and I told the nurse listen to it. Because I actually messaged you on Facebook. Because when I was first diagnosed, I was like, Oh my god, there's so much to learn. And so I literally like listened to your podcast, like in the hospital bed? And then, yeah, so that was me. And yeah, just like religiously listened. And it's so funny, because I'm the kind of person who never really talks about my diabetes. It's kind of just like, I don't want to be a burden on anyone. And I kind of just like, keep it to myself, because I'm an adult. And, you know, that's how that goes. I realized over the holidays, and I wasn't really listening to the podcasts like my diabetes, like my sugars were going higher. And I think it's because like I wasn't, you know, it wasn't like an active area of my brain being exercise, if that makes sense. It's kind of like, I don't even

Scott Benner 19:38
know it's kind of awesome feedback I've ever gotten like,

Bri 19:41
that's like I have to listen to you in order to keep my numbers.

Scott Benner 19:46
Everyone who's listening. That's a good point. You have to listen to the podcast every week or something horrible will happen to you even have to market it if everyone's scared then that everybody will get up on Tuesday. I have to download that show. Meanwhile, do I always put it out on Tuesday? I feel like I don't. Sometimes it's like later Tuesday or Wednesday, sometimes like, you know, Monday will be fine. I'm really not as well planned out. It's like you might hope. One thing that helps me not worry so much and not have to plan as much as maybe other people do is Dexcom. While some of you are busy, you know, counting your carbs down to the last half carb and figure out your ratios and just wringing your hands making sure that next bolus is going to be exactly right. Sometimes I just put the insulin in and you know if I'm wrong, I adjust. How do I do that? Well, I use the information that comes back from Arden stacks comm g sex continuous glucose monitor, because Dexcom tells me when Arden's blood sugar is on the move. Is it rising or falling? And how fast is it moving? Dexcom knows. And it tells me through its share and follow features. See Arden's at school right now. And her blood sugar is let me turn and look 101 she's actually been eating lunch now for about 25 minutes. But if that bowl is we did together doesn't quite work, and our blood sugar starts going up, we'll know before it's too late, and there's time to do something about it. Same if we kind of got a little aggressive with that bolus and later Oh, falling blood sugar. Don't worry, we'll find out way before it becomes a problem and address it with some fast acting carbs. Now, these are my results, and yours may vary. But I find Dexcom to be an indispensable tool in our day to day life with Type One Diabetes. And I think you would to check them out@dexcom.com forward slash juicebox. Start today with the G six have a completely new experience with your type one diabetes. You can find links in the show notes of your podcast player, or at Juicebox podcast.com. Okay, so that's amazing. So you found the podcast, listen to it, pass it on to Alina, but so she didn't know about it prior to us starting to work with her daughter at school. So Alright, so let's let's kind of like go a couple different ways. And if I've asked you questions about another person that you can't answer, just say, Scott, that's not my business. I can't say that. But so are you so far, you're using an omni pod index calm. And and I want to just say, while Bri has not said specifically she bought them because of the podcast. I do think I deserve more money for the ads, because she did buy them. So but but but no. But so you have you have you have a Dexcom and you have, you know, a pump? Or what was the first thing that you took from the podcast that made a big difference for you?

Bri 22:47
And I think just having the the CGM and was I was like, I need that. You know, why don't I have that? Why don't they give that to you? straight out of the hospital. You know, I understand like getting the pens out first. And you know, knowing how the insulin works and being more hands on. But I mean to CGM, like why would you not, you know, it's like, you're.

Scott Benner 23:14
So you got to you got to CGM. And then you could see what the insulin was doing the kind of apply what you're hearing on the podcast and what you're seeing in your real life. And if I can ask, Where are you at with all that? Like, what, what's, uh, what's the name one see that you're kind of getting kind of comfortably at this point?

Bri 23:31
Yeah, well, when I was first diagnosed, I think it was like 13 something. And then after that three, just three months later, it was already a 6.2. So I was like, on top of it, but I was also honeymooning as well. And also, I just listened to the episode The other day about insurance. And I just turned 26, which means that I got kicked off of my amazing parent's insurance where I didn't pay a penny for any of these things. Sure, I was kind of having some anxiety of not having insulin know of when I'm going to have my next insurance and all that stuff. So I wasn't using my, my pump during over the holidays. So that was really difficult because it's like all the extra food and all that stuff. But um, so I haven't been to the endo, so I don't even know what my wins. Right now.

Scott Benner 24:22
What was your last one that you remember?

Bri 24:24
It was like it was higher than than usual is like a 7.2 or something which I wasn't too happy with.

Scott Benner 24:31
anyone see, but I hear what you're saying. So are you I didn't expect to talk about this. But are you? How long will it take you to find insurance? Like what's your plan?

Bri 24:40
Well, yes, today is actually the last day to apply. So after I get off this, I need to figure that out. Yeah, because I want to stay with all my old doctors and stuff, which is like huge for me. Um, so I just need to find a plan that I can stick with everyone and that, you know, Omni pot Dexcom works with to

Scott Benner 24:58
you so you're still a student. And I guess this isn't we can't out you on the podcast, but I mean, you're not you're not working for a company that offers insurance is what I was gonna say.

Unknown Speaker 25:10
Nope. Yeah.

Scott Benner 25:13
Okay, let's do this by you There is so much about you that I'm going to talk about and yet there's details here. So I'm looking at my clock to make sure we're okay. Okay, so, so the little girl that you help at school, do you find it motivating, like, like, it's not I mean, like, I'm assuming there's a standard that, like, if I had, I have a job, I've had jobs in my life, right. And I show up in the, you know, to my to my work, and there's a standards and expectation, I have to do so many things, put so many things away, whatever it is, I have to do. And if I don't do those things, my employer looks at me and says, You're not cutting it. So I'm kind of guessing it's similar. Whereas if the mother sake, look, we're paying you you're coming to the school, I want my kids blood sugar to be, this is our goal. And if it doesn't, I want you to get it back. Like do you feel like that about it? Or do you feel how does it strike you?

Bri 26:06
I mean, it's just diabetes is so unpredictable, as you know, so I feel like, that would be so much pressure. If the mom was like, Oh, my God, like, you know, why is this not happening? Or right? You know, Why is her number still at this? I mean, I just, I do what I need to do, like I give corrections when needed. I'm triolo. I mean, that's what I'm there for. I'm not like an endo.

Scott Benner 26:29
Right. So I just wanted to I wanted to understand like for people, like, it's not like you show up and they're like, Look, if the kid's blood sugar goes over 140 we're not paying you for the last hour.

Bri 26:40
No, mom and I are super close. So we, we communicate effectively.

Scott Benner 26:46
Yeah, you're you're a comfort and a safety and a communication. person. Okay. All right. Excellent. And and so when you see her, when you see her blood sugar, and it's like stable and yours isn't? Does that feel weird that you were able to keep one person's but not yours? Like, I'm trying to figure out what that feels like to like be managing it. Let me tell you why. So two weeks ago, I was approached by a mother of a small child about a four year old and they said they just kind of, I forget the word she used, but there was desperation in her note to me. And she said along a CGM graph that went from like, you know, 60 to 400. Over and over again, like that. And I don't know what it was. But there was something about our note that just I couldn't, like, I just couldn't send like, Hey, good luck or anything like that. I just, I want to look, you can call me. And we talked for 45 minutes or so. And, and then I did something I'd never done before, which I almost shudder to say here. But I followed her kid on Dexcom for a little bit to help her, like, kind of adjust things more quickly. And that was a Tuesday. And by Thursday, she sent me back her first six hour period that wasn't under 70 or over 100. Oh my

Unknown Speaker 28:05
gosh, wow.

Scott Benner 28:06
Right. And she's so happy for him. And then I you know, I said look, you don't even you know, let me go away now. But there was a moment during that, where I missed on one of Arden small losses. And Arden's blood sugar was like 200 and a little, a little kids blood sugar was 110. I was like, Whoa, I got that one. Right, but that one wrong? I'm related to that one, you know, like, so. It felt first split second, it felt weird. Like I was like, like, does it feel like a lot when you're sitting there and your D? Is your diabetes on kind of cruise control? or?

Bri 28:39
Yeah, yeah, pretty much on cruise control. I'm really aggressive with my insulin, which I am with her too. But sometimes I'll come in and the nurse has just overtreated Alo by accident or something and she's like, Hi. And that it's like, I'm I have to deal with that. Like she's about to eat, I have to, you know, Pre-Bolus and crank up per Temp Basal. So it's nice because I kind of just get to do my own thing on, you know, what my gut is telling me to do? Because it's like, if anything happens, I'm there. Like, if I give too much insulin, which I'd prefer, then not give enough because it's like a whole battle field that I'm there to treat below. So it's like, I like

Scott Benner 29:17
listen, I think it's great. I think I think it's possible that you know, someone could hear that and be like, Wow, that's a that's a nice to have, you know, like like it really is but but I get it like I I was in that position where Artem was diagnosed when she was two by the time she was for a full year before she started kindergarten. And not with any of the good gear that you know we have today with Dexcom and Alibaba and stuff like that I was in a panic. I was like, I don't understand how I'm gonna send my kid to the school like she was little she weighed like 20 some pounds and she was like this little you know, and um, and it really did panic me and that's I back then. Back then before even like texting was a big thing and all that I just put it in there. 504 plan like every time they tested her blood sugar, and they had to do something, I made them call me.

Unknown Speaker 30:05
Mm hmm.

Scott Benner 30:06
And that was not something they were thrilled about. And it was, it was a small school, so it was reasonably doable. So I get this, especially out there where I'm assuming this is a large school with a lot of kids in it, right?

Bri 30:20
Um, it's a private school. It's not too crazy. Not Yes. Not like overwhelming. Okay. All right.

Scott Benner 30:26
So you do what you do. Now you have a nother job because you are a hard worker. Tell me what your other job is.

Bri 30:33
So my other job is working with a family who they are total workaholics and they travel a lot for their job. So I stay overnight with the girls. Both of them have type one. So that is a lot of a lot of work. One of the older one, they're older too. And the younger one is 11. She has a pump. No CGM, which is terrifying. And I hate that. And the older one is 16 just got her driver's license. And she has a dexcom and no, no pumps, she does MDI, but she hardly ever even wears her Dexcom. So it's so funny. It's not funny, actually, it's interesting, because the family that I work for with the daughter at the school, the first grader, those parents are so on top of their daughter, you know, they care so much about their health. And then the other family, you know, it's just like, totally lenient and laid back, the girls is the girl, the girls, a onesies are always very high, and then nines, 10s. It's, it's crazy. So it's interesting going from that, you know, like, the first dynamic to the second, sometimes the same day where it's like the same disease, but you know, they don't care about it all

Scott Benner 31:52
feels different. And so so this is super interesting. So maybe a we shouldn't use your name in the beginning of this. And but but but so now, I guess what I was gonna say is like, don't care or just so busy that they're, they've kind of left it to the kids and the kids are managing it as best people their age can do. Like, yeah, what do you think? I

Bri 32:18
think the mom cares. It's not that she doesn't care. Maybe the kids don't care. The mom cares, but I don't think that she understands the, you know, the locks. Yeah, but the complexity of it and the future repercussions of it. And

Scott Benner 32:34
so by not understanding so they have to understand on some level so do you think it is it down to like, I just don't imagine that there's anything we can do to affect this? Like it's, it does what it does, and I'm just along for the ride desert? Yeah.

Bri 32:51
Yeah, it's really strange. And it's like something that I don't want to, you know, step into when I'm, when I'm there. I'm on my butt about it, which they hate my text. Because I have it on my phone, the Dexcom and she's wearing it, but she'll just be like, Hi for hours. I'm like, What the hell's going on? And so my text her like given sling given sling given slid. I'm like, Don't make me Shut up to your school and like, step up, and

Scott Benner 33:18
I want to make sure I have my head wrapped around this. The older one has a pump, but no dex calm. The younger one has a dexcom but no pump and I get that backwards. Opposite opposite. Okay. Yeah. The older one has MDI index com, the younger one has on the pod. No. Dexcom. Okay.

Bri 33:36
Now she has a Medtronic.

Scott Benner 33:38
Oh, she's using a Medtronic pump. Yeah, okay. Well, I'm not saying that's the wrong choice. But

Bri 33:45
I it's funny, I used to I tried that pump out for a for a bit. And I did not like I went from the no tubing to the tubing. And it was like, it was not okay. Like, my dog was chewing on the that time I woke up from a nap. I was like, Okay, this is this is gonna work.

Scott Benner 34:03
Well, well. So I have a couple of things that happen to me recently that I'm going to share one of them here I did a talk. I can't You know what, I can't even say that. I'm gonna have to scrub that out and go back. So recently, I spoke to a person who has connections with a hospital. Okay, so they have, you know, can look at me trying to talk around so, so bad at talk. This is how you know, I'm being honest the other times because my words come out so easy. Let's say there's a medical person who sees people with diabetes. And they told me that as much as you would like to hope that parents all are, hey, let's take care of this. You know, I'm here with you. That there are some parents who just really don't want to be bothered and And, and we'll just, they they said that it's kind of sad because what they see them do is they give the kids the big talk, like, you know, this is your disease and you have to own it and everything they said, but if you ask me, what they really mean is I don't want to be bothered with this.

Bri 35:17
Wow, that is so interesting and not

Scott Benner 35:20
like my expectation. Isn't it funny how you, you just sort of everyone imagines that the world is the way that it is for you like, right, like I, like I know how I feel about parenting. And I know that I have made choices in my life to put my kids well before much before me and I sort of just assume that everyone's doing that. And to have to have a medical professional stand in front of you and tell you that is not the case. For me. It was shocking, a little bit, I guess. Yeah. And especially when you try to put it on a kid who then doesn't have good tools, even if they wanted to do it. Well. I mean, how would they accomplish that? You don't I mean, without anybody directing them, or helping them or showing them the way? You're so interesting for you because you have you are sitting, smack dab in the middle of two completely opposite worlds.

Unknown Speaker 36:14
Yeah. Wow.

Scott Benner 36:15
I didn't even realize that when we were talking. When we were talking about getting together and doing this. This is amazing. You're You're like the Oracle you can see all over. And so. Okay, so let me let me ask you a couple questions. Kids who weren't that interested? Or don't have the direction? Do you feel like it's not your job to help them because, you know, you know how to handle this better than they are? So do you think it's not your job? Have they rebuked you and you've tried like, what's that setup? Like?

Bri 36:45
No, I am. Like I said, I am like, totally on their bite, which I feel like sometimes they dread when their parents are journaling, because they're like, Oh, God, Bree is gonna be here. Like, I'm gonna have to get my act together, just because like, we'll sit down to eat and I'm like, oh, did you give insulin? And then they'll just look at me. And they're like, oh, oops, nope. And yeah, this was like, the first week that I was stayed with them since since last year. I guess I'm a new year. And I was like, oh, like, do you guys not have diabetes? Like in the new year, which is that your resolution? I'll kind of like mess with them joke. You know, I joke around with them a lot. But it's like, dude, if you're insane, like what is going on?

Scott Benner 37:24
And so it's just an apathy? No. Can I ask you? Are they apathetic about other aspects of life? Or is it specifically the diabetes?

Bri 37:31
No, it's just the diabetes. The older one is very embarrassed about it. None of her friends know that she has it actually. So that's, that's me. Yeah. How

Scott Benner 37:39
long has she had diabetes?

Bri 37:42
She's had it for I think, two or three years. So she was like, at that weird, you know, adolescent transitionary. teenager phase when she was diagnosed?

Scott Benner 37:53
She the first diagnosis the family the second?

Bri 37:55
No, the second.

Scott Benner 37:56
She was probably thinking she got away with it for a while, right? Like, you're like, you don't mean like, Oh, hey, got her, not me. like a like a bad horror movie. You're like, Oh, my friends dead. But I'm leaving. And so no, I well, and so you feel terrible, right off the bat? Because it's so like, have you ever tried to? And I don't know if you don't think this is your place? where maybe just flatly isn't your place? Like, have you ever said to them? Look, if you listen to if I told you tomorrow, we were going to eat at six? Could I get you to you know, start thinking about your blood sugar an hour before dinner just for a minute. Like you tell him like that's like that's a tool that would would keep your blood sugar down. And like, he hit him with the like, you know, highs and lows, lows. And once you're high, it's hard to get down and like you, and you just kind of bounces off.

Bri 38:43
I mean, I feel like they just don't care enough to even absorb that information. Like it's so irrelevant to them.

Scott Benner 38:49
Hmm. Just does one have a better grasp of it than the other? No, no, they're pretty much in the same boat.

Bri 38:57
Yeah, yeah. And it's interesting what you're saying about what the doctor said, because I feel like parents lay the foundation of the kid's relationship to diabetes, or, you know, or just any topic. It's like, you know, you need to care for yourself. And it's, it's a team effort. You know, it's like the family I work for at the school. Like I said, Everyone has a phone. And everyone makes an effort to take care of this little girl's health. And it's like, the other kids don't even understand anything about it.

Scott Benner 39:30
So it's a willful misunderstanding, because it's not that they don't have the, I mean, these aren't. I mean, their parents travel a lot for work, and they're paying you to watch them. I'm assuming there's a couple of dollars rolling around the house where they could, you know, go find things out if they wanted to, they can afford to go to the doctor and that sort of thing. So yeah,

Bri 39:49
yeah. It's so funny. These those families have the same doctor.

Unknown Speaker 39:53
The same stuff. Interesting.

Unknown Speaker 39:57
I thought that was crazy.

Scott Benner 39:58
Oh, and not uncommon. Good in an area I there's people around me who are like gay have the same doctor. So, huh? Wow, okay, hold on, I got a little like I got thrown there by that a little bit I did not expect you. I mean, in fairness, I never expect anything from anybody because I do no work before we sit down and talk, which is on purpose for anybody who's new to the podcast, I like the conversation to be organic. I just did not expect you to tell me what you told me. So it's, it's weird to imagine I'm imagining the situation that you're in with them. Because, again, you by the way, you've only had diabetes for a year and a half, these kids are probably longer than you could probably like, Listen, you don't know what you're talking about. You know, there's probably part of the things where you get to where I'm at. You'll you'll see how hard this is. And then there's this other part of my head who thinks I'm thinking back to the person I talked about earlier met him on a Tuesday, blood sugar's all over the place, Thursday, blood sugars, not over like, a 45 minute phone call and a couple of follow ups, and the more they got, and it makes me feel like, Oh, I could do that with that kid to where somebody, somebody could do that with those children. And, and you know, but it does take, listen, I'm gonna say something that will sound like I'm speaking for myself first. I can, but I'm not I think if I'm good at one thing. It's not, I guess I have the information. Having the information is one thing, I think I'm good at explaining the information. And so I don't think I don't think I'm the only person that can do it. And I don't think that it works every time. But I do think that it's uncommon for me to tell you that I can talk to somebody for 45 minutes and help them understand their insulin better. But I've I've done it enough times now that I'm comfortable saying that it is true more often than not. But if you but how does one doctor, get it through? So So I guess it's the parent, right? Like, I guess it's the fact that, right? You have a child who's too young to make its own decision. So the parent gets to decide, we're going to be proactive and take good care of this. And I'm going to figure out how to do that. And put time and effort into that. And it's working for that little kid in that little kindergartner. And then you have the other side where the family is not saying that they're saying, Hey, here's your stuff, go take care of it. And the kids don't have success, which if my interviews in the past, have taught me anything. Those girls don't want to be in the situation they're in that they don't know what to do about it. And like because there's plenty of interviews with people in their 30s who had diabetes through those formative like teen years, and they'll tell you, I just needed someone to help me. I wanted my mom to tell me Hey, I'll help you with us. We'll figure it out together. Something like that.

Bri 42:45
Yeah, I think everyone wants that. Anyone? Yeah. When I was first diagnosed, I had a boyfriend. And he was just like, not very supportive of my diabetes. We were together for five years broke up over this past summer. And there would be times where I'd be like sitting on the couch so low. He had my dex comment with literally say, like, blow arrow down. I'd be like, I can't move. Can you get me a juice? And he'd be like, you can get your own juice. So it's like

Scott Benner 43:13
tough love a seizure.

Unknown Speaker 43:16
Gotta love it.

Scott Benner 43:19
Five years, Marie, come on. There is no one better than Kim. Is he really handsome?

Unknown Speaker 43:25
I'm not really.

Unknown Speaker 43:29
Oh god, I'm

Scott Benner 43:31
wrong to name this episode. Brees, ugly ex boyfriend was a jerk. But see, interestingly enough, again, what you're describing is a person who doesn't understand and isn't willing to take the time to understand.

Unknown Speaker 43:48
Exactly, exactly.

Scott Benner 43:49
Can I ask you this? This one's going all over the place. And I'm gonna lead you a little bit with this question, because I can't imagine your answers otherwise, but fairly heartbreaking to find out a person you'd been with for five years didn't care enough about you to figure it out?

Bri 44:03
Yeah, um, yeah, I mean, that's an aspect with a lot of my friendships too. I've kind of realized like with since I've been diagnosed, like who came to the hospital to be with me, who, you know, my, one of my best friends is on my dexcom share, like she's, she cares. And she's important. So it's kind of like, allowed me to like filter out people in my life in a way. Just because, you know,

Unknown Speaker 44:28
luckily,

Scott Benner 44:30
I met a person recently who experienced the gap in their insurance coverage. They had medical insurance, they had decks comment on the pod, and then they lost that happy to report they have it back now, but they also have a perspective that they lacked previously. I want you to know how impactful it was to me to stand in front of someone who is literally crying tears of joy. To get their insulin pump back again. This person was just standing there holding their PDM and just grateful to have it. And I thought here is someone who really understands what the Omni pod brought to their life and knew what it felt like to have it taken away. Now for those of you who don't have an omni pod right now, you have nothing to compare it to. But if you would have been there with me, and seeing the just absolute gratification on this person's face to have this back in their life, I think he would know what it meant to them, is incredibly powerful. And so you know, we stand here and talk about Temp, Basal rates and tubeless nature and you can swim with it. You don't have to disconnect for sports, but it's more than that. So take a minute, go to my on the pod.com. Get yourself a free, no obligation demo the only pod today, and find out what that person knows what I know, life with Type One Diabetes really is better when you have on the pod. I know this seems like a fairly melodramatic story, and you might have trouble believing it, but it is 100% true. Just in case you still can't believe me. Just know that that demo that you can get from Omni pod is free, it has absolutely no obligation and allows you the opportunity to wear a pod and try it for yourself. Miami pod.com forward slash juicebox. Listen, I want to tell you this. years ago, I I interviewed some people, and and i they're married. And they told me a little bit about their courtship and when they met and how one of them found out the other one had diabetes. And, and I can't remember if it was the woman, I think it was realized the guy was just such a good guy. And she had been through so many guys prior to that, who were not supportive of her diabetes and what she needed to do. And she realized, I think pretty immediately she was going to marry the guy. And I thought that the the tone of that episode really the takeaway of it should be the when you find the right person, you'll know and then you'll be great. You'll be grateful for not having been with the others. You know,

Unknown Speaker 47:01
that's

Bri 47:03
Yeah, dealing with diabetes, like at my age is like so weird, too. Because it's like, some people will say the stupidest things like I was on a date with this guy. And he's like, do you have the good kind of the bad kind? It's like, Oh, my God, like, this is so annoying. So it's just like another component of like, being added on to the burden of having diabetes and having to work with it every day. But like having to introduce that to a new person is like, kind of scary, you know?

Scott Benner 47:30
Because how are they going to take it?

Unknown Speaker 47:32
Wow,

Scott Benner 47:33
are they gonna understand? But do you ever put yourself back in that spot you were in in that doctor's office where you were like once like pre diabetes, and I'm away with a setup, like so. But I guess at some point, it gets tiresome right to explain it.

Unknown Speaker 47:47
Yeah.

Scott Benner 47:48
Okay. What are you gonna do there, you're gonna start a dating app for people would type

Unknown Speaker 47:53
out. That's really, that's a good idea.

Scott Benner 47:59
So that they know what they're, you know, like, it's no different than if you like, like, let's say you had a fetish where you love the bridges. You wouldn't want to spend time with people who didn't also love bridges. Because that would just be a waste of your time because a person who didn't love bridges would look at you at dinner and go, Wait, did you want to go after this? And say No, thank you. But no, I mean, I wonder if there's a way to, I guess there's not really like dating such an odd thing to begin with. Right? Like there's this whole this whole, like, just blanket of humanity around you and who of them are someone you'd be attracted to visually, someone you'd be attracted to emotionally intellectually, like all these things that whittled down whittle it down whittle down that start from this big pile of people moving around? You're getting down to the few that fit these categories? And then you got to find one who doesn't hear? Oh, you have diabetes? Is it the good kind are the bad? Can you imagine if you would, Did this happen to you? Was this a guy you thought was like a good a good choice?

Bri 48:58
Did I mean obviously, I explained it to him after that. But yeah, and then there's just been like, other people are like really interested in it and like, want to learn all about it. And going back to like, what you're saying about how parents kind of like, build the foundation of the relationship with it. Same with me, like, I feel like my ex boyfriend made me feel like any partner will feel like it's a burden and like, I shouldn't talk about it with other people. And I should just like, keep it to myself. Really. Right. Exactly. So it's been like interesting like meeting other people and like learning Oh, it's like people actually are interested about it and like, want to help me and it's okay. And come out of my shell about it.

Scott Benner 49:39
So as someone who is, I guess, I'll just barking out noise fine as someone who is probably pretty close enough to being old enough to be your parent. Right? But probably not. I mean, it would be creepy. I would have been like 17 or something like that one. But you know, it would have been, you would have been on my little mistake in high school, but just the point. The point is, I still am old enough to tell You can't build a personal relationship where you feel like you need to hide stuff. Right? It will, it will encumber you in a way that I don't even think you'll understand until it's too late. You can't hide you don't I mean, please, I don't want to find out everybody. Listen, this podcast got divorced next month, because they all ran home. And they were like, hey, there's something I haven't said. So, but so if you've been hiding something long enough, just keep hiding it you're doing fine. But I mean, you don't want to is what I'm saying. You would prefer

Bri 50:31
for the other person?

Scott Benner 50:32
Yeah, no, you don't need that you're you have enough you have diabetes. You're a grad student, your your you multiple jobs, you're working hard. You're gonna start hearing other people's problems as a part of your, you know, your your life as I already

Bri 50:45
do. I got my whole clientele. Exactly. Well, the story is he was just uneducated about all of it, and didn't care enough to do any research

Scott Benner 50:53
or come to you and just say, look, we've been together a really long time. And I think I'd like to ask you to marry but I'm really concerned that you can't have a healthy baby, is that true?

Unknown Speaker 51:06
About thing?

Unknown Speaker 51:07
And also could have googled it? You know, like, which? You did? Well, to get rid of that one. You're so good. Absolutely. Oh,

Scott Benner 51:17
my gosh, that's exhausting to hear. And, and so for people who are listening who have younger children, who think oh, my God, is this what my kid has to look forward to in dating, there are also plenty of gaps. There are plenty of episodes that don't go this way with people who find great people. And so don't worry, plus, there are plenty of people without diabetes dating jerks to

Unknown Speaker 51:38
everywhere.

Scott Benner 51:42
Okay, let's take a breath for a second. Okay, you know what, I'm gonna put an ad here. I just got back from Orlando where I attended dancing for diabetes touched by type one event, I was able to meet a lot of you. And I really appreciate you making the trip to come out and talk to me about what the podcast has meant to you. And I also got to speak with new people who had never heard about the podcast. This is all thanks to dancing for diabetes, and what they're trying to do for people living with type one, take a minute to check them out. Dancing, the number for diabetes.com. We're also on Facebook, and Instagram. I don't know where I want to go with our last 10 minutes because I don't want to pick too far into other people's private stuff. I don't want to put you in a position to talk about other people. And at the same time, you've only had diabetes for a year and a half, which is both a lot a long time and a short time. Yep. Are you excited? Will you you have next comment on the product? Will you move on to horizon artificial pancreas when it's available in a year or so? Or what's your thought about artificial pancreas in the future? Oh,

Unknown Speaker 52:54
oh, yeah. Yeah,

Bri 52:56
I should. Like I said, I had the Medtronic and like that. I was like, what was it that a goal thing is like 140 MB of blood sugar. Yeah, I hated that. Yeah. So is it is it I was listening to that podcast episode last night actually with the guy from Omni pod. He did say it is user definable. Right. And

Scott Benner 53:15
they said that's their goal. They say that every time that I tell them, I mean, I guess it's still going through the FDA review process. I guess it comes down to what they can prove they can make work and work safely and make, you know, yeah, so. But it sounds like that is their goal. I think that any pump company who's trying to make a closed loop system, who doesn't see that as a shortcoming of the first ones that are on the market is not paying attention? I think the pods paying attention. So yeah, because right, what's the point? If you're keeping your budget, like if you have an A one C with it's an average blood sugar of 110? Why would you want to switch to something?

Unknown Speaker 53:51
I'd rather just put in extra work,

Scott Benner 53:53
but at the same time, those girls that you're talking about that you that you work with, they would really benefit from something like they will. Right, right, right. So there's a lot of value in it for everyone. It just depends. It just depends on what your what your definition is, I guess, and how much work you're willing to put in otherwise, because I have to agree with you. If you told me that it was going to keep Arden's blood sugar at 140, I'd say well, I guess I'm not interested that, you know, I mean, I would love the overnight. Now, if you told me you could throw into auto mode overnight. And I don't know, maybe that would tease me enough to try it and then like do it manually otherwise, but I don't know if it's gonna have manual modes and auto modes. We don't know enough about it yet to make that decision. But I'm excited. Like I think it's

Unknown Speaker 54:38
Yeah, me too. Yeah. Yeah. I

Scott Benner 54:40
think that I think the future is, is now for the lack of a better Yeah, unless cheesy phrase, but but i think i think it really is. And it's only going to go and get better from here. Should you live you live by yourself right now? I do. What's that like? Because you said you're pretty aggressive with your insulin but you live by yourself. How do you? How do you do that? Like, how do you keep yourself from worrying?

Bri 55:04
I'm dexcom share. I mean, I have my mom on there. I have my friend who lives down the street from me. And every time I go low, I mean, my phone is blowing up. I

Scott Benner 55:15
can't avoid it.

Bri 55:17
Like I just ate like they don't understand either. Like, it takes a few minutes to kick in, right? Like Jesus, like I just had a juice like give it some time

Scott Benner 55:24
happened to us last night Arden's blood sugar went to like, it got to 70 so it alarmed, it's like four in the morning. And, and I was like, I got up, and I'm pulling myself together. And I'm like, What am I gonna do about this? Like, am I gonna do some, so I looked at the trend line. And I thought, Okay, I think this is going to continue down. So I gave her a little bit of juice, and I didn't want to shut her bazel off, because I know she's getting up in two hours. And you know, four o'clock getting close enough to, you know, her kind of witching hour where her blood sugar starts to kind of creep back up again. So I didn't want to cut bazel. So I just gave her some juice. And I got back in bed. Same thing, like I figured three revolutions, the Dexcom, maybe 15 minutes or so. And I'd be i'd feel comfortable going to bed. Every time it'd be between that and we'll ended up being 20 minutes later, when I was comfortable going back to sleep. My wife barely came out of her sleep. And she'd go, she was like, three minutes, just three minutes. I was like, what she's okay. And I'm like, she's okay. It's okay. I've got it. Okay. And now, you know, now I'm like, I'm online. I'm trying to read the news or just keep myself awake for 10 minutes, you know? Five minutes later, BP? Hey, there's three. There's three. Like she didn't say like, Oh my god, I'm like, go back to sleep every time for four times. And finally it rose up over 70 and I don't know if I was more relieved that Arden's blood sugar was going up or that my wife is going to stop half popping out asleep, like talking about how many times she could hear beeping. Yeah, I was just like, but but so that's really interesting. When so when people text you or call you, you respond, you hear it? Yeah. Okay. And some people don't. So what what number? What number do people start calling you at with your jet low? Only? Under 55? Yeah, okay. That's cool. Look, I it's a great support system to have.

Bri 57:15
Just, they just want to make sure I'm awake. cuz sometimes it's happened. Like if I'm taking a nap or something. So

Scott Benner 57:20
yeah. And how frequently do you get under 55? Do you think it happens?

Bri 57:25
Often I usually just like turn off my, my bazel if I'm at like, 60. So it'll like start creeping back up.

Scott Benner 57:32
Yeah, I like the way you're doing this. I can't see. And so you pick that stuff up from this podcast?

Bri 57:38
Oh, my God. Yes. And you know, like, no one, I wouldn't if it worked for you. Like, I wouldn't have even known any of this. You know, like the endos in the hospital, like, Oh, you give you give a shot when you like before you eat? And it's like, don't you don't do that like that. That screws you up?

Scott Benner 57:53
Wow, that's so cool. I'm so happy to hear that. Like, I really don't. I have enough contact with people that, you know, I get emails. And by the way, you guys have been writing a lot more lately, even then you had been in the past, which I really appreciate. If I don't get back to you right away. It's just because I'm like a one man operation over here. But I get back to everybody at some point. But to hear someone say it is it's nice. Like I don't know, another way to put it to hear you say that is really just I feel good about that. So it's really cool for you to share that with me. And yeah, and everything you're doing really I mean, like look it in one way or another you're helping three other people with diabetes besides yourself. Do you ever feel with the the two older girls that you that you work with? Does it ever bother you? Do you ever feel badly about it? Like I sometimes take on guilt from other people? So if I if I try to help somebody out and they can't figure it out, it makes me feel bad? And I don't know if that's me? Or like, Do you ever feel like that? Do you ever wish you could impose yourself on them? or teach them faster? Or better? Or like, are you pretty good at keeping it separate?

Bri 59:04
Yeah, I feel like I'm pretty good at keeping it separate. Just because like with my therapists job, like I seem with that, like I have to keep like the, you know, the slaves like here and they're separate from my home life as well. So it's kind of like seeing what that job like I have to keep that separate. I can't carry that burden with me. But um, yeah, it's it's tough when the kid does not have a CGM. And you know, it's on me like I am the caretaker. So it's like, I'm setting my alarm, you know, every two hours to go check her sugar because I'm so paranoid about it. I don't like that. I don't like I can't see where she's going. So I would love for her to get a dexcom at some point.

Scott Benner 59:43
Do you give her insulin when she's sleeping without her knowing?

Unknown Speaker 59:47
Yeah, through her pump. Yeah. Okay.

Scott Benner 59:49
So there's that kind of comfort level between Yeah, sure. They're not looking to be that involved anyway, so anybody that's helping is probably Oh yeah,

Bri 59:56
they would love if I could just follow them around everywhere. And Do it.

Scott Benner 1:00:01
Well, I'll follow them on the next common I get them going. I figured out it takes me takes you out three days to teach somebody how to do it, but they still look. But they have to listen though they can't say why. And they have to wrap their head around the ideas. And so I it's interesting too, because there's a boy named William that was on this past year. And he was 15. At the time I talked

Unknown Speaker 1:00:26
that listen to that light, but

Scott Benner 1:00:28
he is just it's funny how it sounds like he heard the information. I'll try this right? I'm going to try it. Yeah. Oh, my gosh, do you ever try to? Could you get the older one to like, just listen to the podcast to see if they would connect with it or not? Or do you think

Bri 1:00:48
I can talk to her about it? And I just don't? Yeah, I think she just had such a weird age right now. And I hope that she'll care more as she gets older. And maybe, and I tell her, you know, maybe it might take a health scare of something happening for you to realize how important it is for your numbers to be more consistent and more study,

Scott Benner 1:01:08
it's so hard now to talk. It's really difficult to know what to say to somebody like, do they need to do they need? You know, some people need a kick in the butt. Some people need a pat on the back, like that whole thing like and how do you know who is who and, you know, back then when you go back and listen to somebody who's 36 tell you that when I was 15, if my mom just would have done this, that would have meant the world or that or you know, been there. I've talked to people who want to help their kids it is to some degree, you know, not to some degree, it's completely about how available the child is to the information like right, like how much are they resistant or want to listen. And I always tell them the same thing. Like you have to, you have to like sit down and just say, look, obviously we haven't done really well at this so far. But I've got some new information and I need a month to put it into practice and to to get a cut me a break for a month, like for a month I'm going to say Bolus and I need you to do it when when we say because yeah, and you'll learn what's happening so that we can make because that's that really, to me, that's the heartbreaking thing is that if they understood the things that we talked about here, that diabetes really would be less of their day, if they they just knew what to do, and and kind of did it in a timely fashion. And they're being overwhelmed with it. It's probably constantly on their mind, you know, even though they act like it's not.

Bri 1:02:31
Yeah, and I actually went to um, was it connected in motion? The diabetes camp?

Unknown Speaker 1:02:36
Yeah. Yeah, my

Bri 1:02:38
my friend that I was telling you about her, and I went, and there is a diabetes psychologists there. And he kind of made a good point. He's like, if you're in denial about your diabetes, like you're thinking about it more, and it's being more of a burden in your life, or is it just like, you give insulin for your food, that's like a routine thing. It's just like an added step that we have to do. I was

Unknown Speaker 1:02:58
like, Oh, my God, like, I

Bri 1:02:59
don't want my CGM to show or like, I don't want, you know, anyone to see me pulling out my PDF, because it's so bulky and embarrassing. Like, that's how the older one thinks, like, she has that mindset. And that must be like, so hindering to her. Yeah. And, you know, a huge weight on her shoulders versus, like, open about it.

Scott Benner 1:03:18
Yeah, always heartbreaking like to hear about them is, is really kind of crushing. And I think that's a, it's what we say it's what I tell people all the time. Like, I know, I say to them, like, Look, you have to Pre-Bolus a little bit that, hey, if he tries to go up, you can nudge it back down, like and people are like, Oh my god, you must be involved with this all the time, like no, barely, ever, you know, like, like, once you get on a roll with it, you understand how to do it, it really requires much less of your time, effort and your attention, which then can drift off and think about other things. And not worry about anything. And like I just said to somebody the other day, I'm like, the first thing I need you to do here is move the high alarm down in your next calm. And then people always say something, it's gonna beep all the time. I'm like, No, it won't. It's like if you if you and I talk about this a couple times, it will not be bought the time, I promise you. And so yeah, okay, well, obviously, it's difficult to know, you know, how much you can impose yourself into another person's life. And it's, I'm not telling you you need to be doing it or that you know, that you're, you're certainly not letting them down. You're doing them a huge, you know, a huge thing already by being there for them the way you are. I was just I was more just wondering how, like, how you found their availability to ideas and to help.

Unknown Speaker 1:04:32
Yeah,

Bri 1:04:33
I mean, I tell them, you know, like, instant doesn't hate you for a while you have to Pre-Bolus you have to give insulin before your meals. And it's just like, what, it just goes in one ear out the other like the 11 year old is in her own little world of like

Unknown Speaker 1:04:46
slime. Like,

Bri 1:04:49
like doing her own thing. She doesn't care. She doesn't understand the older one though, like she would be able to understand if she actually, you know, was open to the idea.

Scott Benner 1:04:58
So here's my thoughts. Like if I was in your spot, and I was with them, based on what I know, and based on what you know about your other job with the kindergarten aged child, what if you What if you approach it with them as Hey, listen, you guys are about that the greatest weekend of your life, because I'm going to take care of your diabetes for 48 hours in a row, and you're not involved, you're not going to be it'll be hard on you, you'll be devastated. You know, like, you'll be crushed, like, at the end of the two days. But I wonder if two days would be enough for you to get them into a better range, so they could start to feel better. And say to him, Look, this is what this took. Now, you know, why don't we do it together? and get you to a point where you can do this on your own? Like, I wonder if it's something you could show them? Because, yeah, you don't mean because trying to get them involved in it is going to be nearly impossible, because first of all, their blood sugar is crazy high, they're probably aggravated to begin with. And and they already don't understand it's already probably a sense of shame for them. And so like, what if you came in and just reset them? Like just hit Control, Alt Delete, which I think by now is our old reference, right? You don't even like said, Look, let's start over. I'm gonna take care of for a couple days, I'm going to show you what I think you could do pretty easily. I don't know, like, and they might tell you to go to hell, like I have no idea. You know, but I just it just, it runs through my head. And it seems like such a, I don't know, it's hard.

Bri 1:06:29
The hard part is is that they go to their dad's house over the weekend. So I watched them during the school week. So when that school, you know, they're not giving then they're gone. If they say they do they say they give insulin but especially with the older one who has MTI is like how am I supposed to tell? If she is

Unknown Speaker 1:06:47
Yeah, cuz she's, you know, yeah,

Scott Benner 1:06:48
cuz she didn't have a pen, right, that measures that or tells you what she's used or,

Unknown Speaker 1:06:53
hey, yeah, it's

Bri 1:06:53
like, I have no idea. Yeah, right. Yeah. So I don't know. That's, I can do that when they're at home, though. Like, and show them. Because also like what you were saying on some of their podcasts, I was listening to the other day, like, totally Enjoy your day. But you're saying like you want Arden to like be her most authentic self? Because it's like, like you said, like you're moody and irritable when your blood sugars are high, and you're not being your normal self. So that's like a component of it as well.

Scott Benner 1:07:22
Yeah, you just, I mean, it's so crazy to think that somebody could be having reactions and feelings that aren't really the ones they'd be having if their blood sugar was lower or higher. You know, that's just such an odd, there's a ton about life, I don't find fair. But the one thing that I don't find fair, that kind of really makes me angry is the idea of wasted time, like wasted time really makes me upset. And to think that you might, that those kids might be living a day or a week, where it just, it's not who they would be at. And it's also, by the way, unfair to put you in a position at your age, when you're not related to them to feel in any way responsible for that. But I was just, I'm just wondering, like, if you could just kind of take it from them. Let them just relax, not think about it, but have good outcomes, and then say, look, now let me like all together, we can we can do this together?

Unknown Speaker 1:08:16
You know, that's a good idea.

Scott Benner 1:08:18
I don't know that. If you did that. You could, you know, you could definitely ask for a raise after that. You'd be like, hey, fix your kids blood sugars. And nobody broke into the house. So I'm gonna need some, you know, an update to the pay.

Unknown Speaker 1:08:33
Yeah.

Scott Benner 1:08:35
Really delightful. I appreciate you so much coming on. We're over an hour. So let me just ask you if there's anything that we didn't cover that you wanted to that I might have missed?

Unknown Speaker 1:08:46
Not that I know of. No, we covered a lot.

Scott Benner 1:08:48
I know. There was so much there. Just think you have there are three things that we spoke of. We could have just talked about you the whole time, which would have been reasonable. We could have talked about you in the kindergarten. I just was trying to hit on everything because

Unknown Speaker 1:09:01
what a perfect Yeah,

Scott Benner 1:09:02
super interesting. So okay. Well, thank you so much. And I appreciate that you that you put so much effort into being on I'm glad you got rid of the boyfriend who doesn't care about you. dog is adorable. Please keep in touch. I'd love to know how things are going.

Bri 1:09:16
Yeah, thank you so much. It's great talking to

Scott Benner 1:09:19
you as well. Have a great day. You too.

Unknown Speaker 1:09:21
Bye bye.

Scott Benner 1:09:23
I believe we can all agree that Brianna was very open and honest and a lot of fun to talk to. And I think we could agree to that. We want to find out more about Dexcom on the pod and dancing for diabetes, bring good into the show notes. We're going to click on the links. We're going to go to their web pages dancing for diabetes.com dexcom.com forward slash juicebox in Miami pod comm forward slash juice box. Let me take a moment to thank you for all the great ratings and reviews have been popping up on Instagram for your emails and social media notes. And in general for sharing the show with other people. This again will be the most common Popular month in the history of the podcast. That's because everyone out there is sharing. So thank you for that and get yourself excited because next week Jenny Smith will be back. We're going to talk about the variables that come up in life with diabetes, and how those variables may change your management decisions.

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