#269 Defining Diabetes: Low Before High

Defining Diabetes: Low Before High

Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
Bonus content from Pro Paddle Boarder and Windsurfer, Fiona Wylde.

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

Glycemic Index from Harvard.edu

About Jenny Smith

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com

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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
Defining diabetes is made possible by in pen from companion medical. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And Always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. You're about to hear a snippet of an interview that I've just completed with Fiona Wylde Fiona is a 22 year old professional wind surfer who uses the in pen. So you're gonna hear that little snippet right now. And then Jenny and I are going to come on and define a diabetes term. When Jenny's finished spreading her diabetes wisdom, Fiona will be back to tell you something about the pen that I bet you don't know. To be honest with me, I'm 48 years old, how far would I paddle before I had a stroke? Or an aneurysm? Couple of feet? A couple minutes? How far do you think I'd make it

Jennifer Smith, CDE 0:49
go as far as you want to go? That's the cool thing is that, you know, it doesn't really matter. You Don't you know me, okay, if you were to, you know, jump off the start line and try and go sprinting, you'd probably be out of breath kind of soon. But you can jump on a board, you can go with your friends, your family, if you have a dog and put your dog on the board go cruising around, like, there's all sorts of different things you can do. It's like, it's like a bicycle, you know, you have your people who go out and ride 100 miles, you know, in the weekend, and that's what they do for fun. And then you have some people who have cruiser bikes, or even a bikes that you know, put a picnic basket on the front and go, you know, cruising around paddling is the same in that sense. Like you can, you know, have top line race equipment, go, you know, for speed, or distance, or whatever. Or you can just grab more of a Cruisee board and go have fun, go exploring, maybe you know, paddle into a different place that you've never seen before. Or it's cool to paddle out and look back at what you're looking at every day, and just get a different perspective.

Scott Benner 1:51
I see you're saying this is where people like you who are super athletic, don't understand that other people don't have brains. Like here's your saying I would paddle out to get a different perspective, which does sound neat, except I would paddle out and then have a panic attack that there's no way I can make it back again. Then I would start imagining what giant Canadian fissure in the river that will keep my body when I sink to the bottom. Like that's, that's how it would occur to me.

Jennifer Smith, CDE 2:15
Well, yeah, that just crossed my mind.

Scott Benner 2:19
Wouldn't it be great if if Fiona's entire career was killed today? She can't get over the anxiety of thinking about whether or not salmon could eater? And she's like, I never thought of it before. I can't go back and

Jennifer Smith, CDE 2:33
yeah, okay. Yeah, I'll be alright with that.

Scott Benner 2:37
So first of all, it's amazing. And you said something a while ago already that I jotted down and I don't make a lot of notes and I do this. But did you say that there was a paddleboard race? That was 13 miles? Yeah. Okay, so when when they say go, first of all, I have questions. Does everyone finish you starts?

Jennifer Smith, CDE 2:59
I'm pretty much in the Elite Field. Yeah. Okay. In the open field, there might be a couple that pull out. But it's just, it'd be more like a marathon in that sense. You know, it takes a while. Some people, some people, you know, don't, maybe some people just get tired or fatigued. And then yeah, you have to pull out from but for the most part, and especially within the Elite Field, pretty much everybody finishes,

Scott Benner 3:25
how long does it take to go? Like, like the person who wins? How long does it take them to go 13 miles.

Jennifer Smith, CDE 3:33
With that particular race, too. That's the other thing with water, it all depends on the conditions. If you have 13 miles with wind at your back, and you're going where we call downwind, which you can kind of surf little bumps that the wind is generating the whole time, you're gonna go a lot faster than if you have a headwind or completely flat water. So it depends, but in that specific race that was in North Carolina, around Wrightsville Beach, and that was about a two and a half hour race.

Scott Benner 4:03
So I'm gonna tell you that I'm not 100% certain I could stand on the board for two and a half hours. Like, take all the rest of it.

Jennifer Smith, CDE 4:09
Oh, there's a lot of training. I'm not kidding. Like,

Scott Benner 4:13
your legs like super tired.

Jennifer Smith, CDE 4:14
Your legs are exhausted. Yeah, most people think that all paddling comes down to you know, your arms and your shoulders and all that but there's so much balancing involved, and your legs are bigger muscles, you might as well use them more. So by the end of it, my legs are shot.

Scott Benner 4:33
Jenny and I are going to define a term from the podcast right now. And after that Fiona is going to tell you something else about the impact. I am now going to ask Jenny to define something that's not a real term, right. It's something that was made up on the podcast. So you hear me say a lot that I have these kind of like tenants these ideas that I use day to day while I'm helping Martin with their blood sugar. And there's a bunch of them but I'm now just going to blurt one of them out. And then let Jenny define it from her perspective. So what does that mean to her when she hears it? Because maybe she can add more clarity to it than my oversimplification. So where do we want to start? Because there's a lot of them, I'm going to start with, you'd rather stop a low or falling blood sugar than fight with the high ones. What does that mean to you?

Jennifer Smith, CDE 5:29
Overall, it means that it is, it's easier to navigate carbs in to stop a drop, or to treat a low. For the most part, there are some sticky lows that are sticky and nasty to bring up. But for the most part, a stopping a low or treating a trend down can be easier because carbs work faster, then if you're already high, and at a deficit of insulin, a deficit of insulin is always it's like you're behind the track your way at the end of where you need to be. And so you have to play catch up. And playing catch up takes time, because our rapid acting insulin today is not quite the term rapid it takes time. So it's it's easier even though we've been schooled in this like, fear of insulin kind of thing, because oh, it can cause a low blood sugar lows are easier to treat. And to prevent further dropping, then trying to correct for a high that's rising really fast or stuck high. For some reason.

Scott Benner 6:56
This This to me, I started with this one because this is my getting up in the morning. Thought I'd rather stop a low or falling blood sugar than fight with a high when it has to be your mantra every day I it's there's times it's hard because it feels it can be feel exhausting in the beginning, you know, before you really put all the pieces together and it kind of gets easier. But I partly believe that that's where the idea of being bold with insulin came from me like I thought to myself one day like I just have to be bold and do this. And think bold with insulin. I wasn't thinking in T shirts back then I was just thinking about how to get

Jennifer Smith, CDE 7:30
through the day. Right? But or magnets or whatever,

Scott Benner 7:34
answer buttons, it depends on where you see me. But But no, seriously, like, I think that's at the core every day, like you have to just be in that mindset. Because when you do that, yeah, sure, you might have a couple lows. But I'd rather have a couple of lows a month and have 27 days of good blood sugar's then have you know, 27 days, you know, crap, blood sugars, and three lucky days where it actually works out for reasons I don't even understand. Okay, this is going to be really interesting. We're going to do more of this the next time we talk because I like Oh, I like hearing you can have fun. Tell me what I think you're in Penn app has information from your Dexcom on it. So you open up your M pen app, it knows what your blood sugar is because of your Dexcom do you then just tell it this is how many carbs I'm thinking of having and it tells you it's suggested amount of insulin?

Jennifer Smith, CDE 8:28
Yeah, so I've set prerequisites of okay, you know, this is my carb ratio, and this is what I'm planning on doing. And it'll Yeah, you pretty much put in, you know, how many carbs that you want to do and want to eat? And then you give yourself, okay, you know, it's suggesting this amount of insulin, you're like, Alright, I think that's about right. Or, you know, maybe I'm gonna have a little bit more food than that. So I'm gonna give myself a little bit more. But it's nice, because you can, you know, you can think of okay, what, what do I want to eat? You know, how many carbs are in it roughly. And then it's nice, because I would normally just be like, okay, that for me, that's this amount of units, whereas using that, it definitely gives you more precise. You know, just give me a more precise number of like, no, if you're not, you actually need more insulin than that you're gonna go high. And so that's been a that helps me kind of alleviate a lot more of the like, big swings of up and down.

Scott Benner 9:22
That's excellent. But yeah, that's one of the major things that's missing when you're injecting really, right. Yeah, that whole piece of it plus now. So now the pen app knows how much insulin is on board. So in the same situation, except say you've had a I don't know say you had a snack at 11 o'clock and you gave yourself some insulin now it's just an hour and a half later and you're going to have a meal. We you put in your you know, I'm going to eat 40 carbs. It takes into account the insulin still left from the snack and it gives it gives you a different dose. If that insulin still active, yeah, my gosh and how valuable do You find that information?

Jennifer Smith, CDE 10:02
Well, for me, it's huge. Because, you know, a lot of times I, you know, it's easy to just look at a meal and be like, Okay, that's, I know how many carbs are in here. And that's how much insulin I'm gonna eat. But it's harder when it's like, okay, I already gave myself some insulin for food a little while ago. And I don't necessarily know how much you know, insulin is left or how much has been absorbed. And so then you end up stacking insulin. And for me, well, for anybody really, I think stacking insulin is one of the things you want to try and avoid the most.

Scott Benner 10:34
Now, you do not want to have more insulin than you need in your body, that's for sure.

Over the next several weeks, you'll be hearing a lot more from Fiona. I'll be sharing with you small clips from her interview with me which will go live at the end of this little, this little thing we're doing here with companion medical. And she's going to be sharing tips about how she uses the N pen at the end of these episodes, so you can check them out at companion medical.com But there is of course links in your show notes of your podcast player. And at juicebox podcast.com. I'm not gonna lie if you go through those companion medical No, you're coming from the podcast, which would really help. Hey, you can check Fiona out on Instagram at Fiona underscore wild and wild is Wyl de there's also a link in your show notes for Fiona's Instagram account. She does some pretty amazing stuff for a human being, especially considering she's doing it on a piece of what appears to be Styrofoam over a giant body of water. Thanks so much for the recent reviews that you guys left on iTunes. They were completely sweet and wonderful. Hope you're enjoying the Juicebox Podcast. I hope you've checked out the private and public Facebook groups. And of course, follow me on Instagram at Juicebox Podcast. Thanks so much. Have a great weekend. I'll see you next week

Jennifer Smith, CDE 12:06
Hey, this is Chantel Wilde and the Juicebox Podcast is super crazy.

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#268 DJ Jazzy Jeannie and the Aubrey Tribe

Jeannie is a unique mom of a blended type 1 diabetes family…

Blended, not stirred

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

+ Click for EPISODE TRANSCRIPT

---

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

Scott Benner 0:00
Hello, everyone and welcome to Episode 268 of the Juicebox Podcast. Today's show is sponsored by Dexcom on the pod and dancing for diabetes, you can learn more@dexcom.com forward slash juice box, my omnipod.com forward slash juice box or dancing the number for diabetes.com. In this episode, I'm going to be speaking with Genie. Now genie is the stepmother of a girl named Aubrey who has type one diabetes. She's the foster mother of a girl named jazzy who has type one diabetes. She's the mother of a couple of adopted kids. She's a wife, she's everything. It's amazing. This episode starts with some discussion around what it's like to have a blended family and how to manage between. Well, you'll say what am I gonna do tell you the whole story right here. It's like a game or see a movie trailer, and you get done watching it, you think? Well, no, I don't need to see the movie. I'm just about to do that right here I was about to tell you the whole story. Just listen. While you're listening, remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And always consult a physician before making any changes to your health care plan are becoming bold with insulin. Those of you who have not checked it out yet on Facebook bold with insulin, but there's a private discussion group, just for podcast listeners to help each other and discuss some of the ideas that we talked about here on the show. If that sounds interesting to you check it out. There's 1100 users already. Hi,

Unknown Speaker 1:38
I am live in Arizona with my husband and we have five children. Can I stop for a second? You said Yeah, I am. Then it cut out. And then you said the rest. So I'd have everything by names just start over.

Jeannie 1:53
Okay. Hi, I'm, um, I live in Arizona with my husband and our five children. We have two daughters right now that are type one diabetic and three younger ones that are all adopted, but not type one. Our oldest is my stepdaughter. I bought him was diagnosed when she was 14 to 17. Now, our second oldest is type one. And she's actually our foster daughter who just moved in, in October.

Scott Benner 2:23
So there's so much interesting stuff to talk to you about. So I can't wait. I'm very excited, actually. So tell me first. Before we get started, you should know that I didn't have the heart to tell Jeannie that her name kind of blanked out the second time that she introduced yourself just kind of made me chuckle and I kept it to myself. Anyway. I'm about to ask Jeannie a question. And then the podcast get started. Did you contact me?

Jeannie 2:47
I did. I was asking you. Hey, I'd like to listen to a podcast of another blended family. And you're like, I don't have one you want to do it.

Scott Benner 2:56
I plan Did you write into the podcast?

Jeannie 2:57
I was like, Oh, okay. No, I

Scott Benner 3:00
wanted to listen to one Scott not be on one.

Jeannie 3:03
Right. I was trying to get advice here. Give it so hopefully nobody thinks I have great advice.

Scott Benner 3:09
Well, it is my experience that your experience will be good advice. And our conversation might lead to something that you hadn't thought of before because I might say something silly that strikes a chord. But this is what we're going to do. I'm going to orient myself, because my brain doesn't work as well as it should. Okay, you are married to a man who had children when you married him?

Jeannie 3:33
Yes. He had one daughter. Yes. Aubrey is our oldest

Scott Benner 3:36
Aubrey Okay. And then you came in? Did you make the babies with him?

Jeannie 3:41
A couple of them? No, no, no, I have no biological children. So our oldest is my stepdaughter. Okay. She was three when Matt and I got married. Right? So I've been around forever. And then we have our foster daughter and then our younger three are actually all adopted.

Scott Benner 3:56
Okay. So foster daughter comes second.

Jeannie 4:00
No foster daughter moved in about six months ago. Okay.

Scott Benner 4:03
See, see I'm doing this.

Unknown Speaker 4:04
Yeah. All right. Let

Scott Benner 4:05
me start over. You marry a gentleman. What's his name? Do we say his name? Matt. Matt. we marry Matt. Matt has a three year old daughter. Do you know what I got to get a pen? Hold on a second.

Unknown Speaker 4:14
Sorry.

Scott Benner 4:15
I don't get it. Hold on. Matt. daughter was Aubrey. You're not impressed that I remember Audrey's name from 18 seconds ago, but trust me, I am. Thank you. Then you it. Do

Jeannie 4:29
you adopt one child? To start we adopted? Yeah, we adopted it and then at birth.

Scott Benner 4:35
And how old was Aubrey when you made the first adoption?

Unknown Speaker 4:39
He was seven.

Scott Benner 4:40
Okay, so four years later, you adopt?

Jeannie 4:45
adopt hildon got him at birth. Then you get the adoption bug and you keep going. The younger two are actually biological siblings. We got them at the same time.

Scott Benner 4:54
Okay. How long? How old is Aubrey then.

Jeannie 5:00
She is head.

Scott Benner 5:01
See how I'm just gonna throw everything into Audrey's. Yeah. Okay, so like that. No, yes. As with anyone else, so Okay, so now alberi seven we adopt the baby already is 10 we go, you know, we haven't done in a while adopted a baby, let's get to this time,

Jeannie 5:18
right? For children. Right, and we think we're done.

Scott Benner 5:22
And you're rolling, you're rolling along and you're feeling pretty good about things. And now Aubrey is how old today?

Jeannie 5:28
Today? She's 17. She was 16 when Jazzy, our foster daughter came home.

Scott Benner 5:32
Okay, so you and you took in a foster child last year Jazzy, and jazzy has type one as well. Yes. All right. Everybody's take a breath. We're gonna start start over again. Now we got this all straight. Okay. Okay. And by we I mean, I finally understand that enough to talk to you. Perfect. I don't know how perfect it is. Maybe I could have just read the email. Dancing for diabetes is an annual showcase of Central Florida dancers that has raised nearly one half of a million dollars for type one research. The 19th annual dancing for diabetes show will be held on Saturday, November ninth, at the Bob Carr theater in Orlando, Florida. Tickets for the show range from 15 to $35. Each. Just go to dancing the number four diabetes.com. Click on the newsroom tab. And there you will be whisked away. The exact place you'll need to be to buy these tickets and have a great day. Dancing for diabetes is my favorite diabetes charity. good at dancing the number for diabetes.com. I am adopted. And I am grateful to the people who adopted me. And I think it's a beautiful, wonderful and loving thing you did taking anyone's children and because let's face it, our own children are irritating. And in other people's children, you think God they could end up being irritating in different ways that I'm not accustomed to. Right. It is a big leap. And it is it's an amazingly warm and wonderful thing. So thank you from all of us adopted people for being one of those people who might adopt somebody.

Jeannie 7:10
It's actually been a fun journey.

Scott Benner 7:12
So imagine it has so let's sort of unpack that a little bit. So what's it like bringing an adopted baby into a house for you? Boy, I know that's not the right place to start. Here's the right place to start. What's it? What's it like being a step parent?

Jeannie 7:28
So it's different today than it was when Aubrey was three. When he was three, there was a lot It was hard. Not because of Aubrey Aubrey has always been an easy kid. She's such a good kid. And she always has been. But we just kind of we got married and instantly it was custody battles and arguments. And that was hard because I'm not. I avoid confrontation like nobody's business. So that was hard. But being a stepmom to Aubree she's been great. She is always a sweet little girl. She's grown up to be a good, beautiful young woman. She's like, the day Honestly, I can look at her like, we're just a fun person. Like I really enjoy her company. So Aubrey is amazing. The other stuff that comes along with it, it's been hard. Blended families are hard, I think in every way. And

Scott Benner 8:15
and, you know, we're trying not to I don't wanna hurt anybody's feelings or anything. But I want to understand the concepts. Right. So yeah, there's a custody battle. Does that mean that you're just trying to become apres mother or the father is trying to get sole custody or what was trying to happen right there.

Jeannie 8:31
Oh, when Matt and I got married, he only had three nights a month. Oh, not because he did anything wrong. But he was told that was normal. And I walk into picture. I feel like that's probably not the norm for a dad who's lives in the same city and is a good guy. So we started the process. And now today, we have have to was always our goal. We never wanted to take her away from her mom. She's a good mom, who's in the picture, and we actually get along great now. But at the time, was young and there was a lot of stuff and everybody was still on edge. And you know, Bart,

Scott Benner 9:02
how old was Matt, when you married him?

Jeannie 9:05
I want to say 29 or 30. Okay, so

Scott Benner 9:08
he wasn't he wasn't young, young, but he was no right. And he had a three year old. Can I ask how long? He was divorced from apres. Mother when you met him or when you married him?

Jeannie 9:20
Um, okay. So it gets complicated, right. So we met. We met up in Alaska, actually. He was already friends with my sister and brother in law. So they after that was left and the divorce was happening. They brought him to Alaska. They're like, yo, you need a break from Arizona. Come get a break from Arizona. And, you know, come to our little sister's wedding, not mine, another little sister. And so I was up there like, Hey, your friends Give me my date to the wedding because I'm not gonna bring any of the guys here.

Scott Benner 9:48
And so Alaska, I'm assuming.

Jeannie 9:51
Right? Yeah, he's like, I'm gonna go to Alaska. That sounds like I've never done that. Right. So he goes to Alaska and we keep talking. And so technically, he was still married. While we talked, and the divorce was already in place and getting processed, and so we got married, we dated for nine months, some of that long distance and then I moved to Arizona. So we he had been officially divorced, I think for six months of that.

Scott Benner 10:14
Okay? She's been very careful to make sure that you all know she's not a homewrecker.

Jeannie 10:18
I know I am. I was not in the picture.

Scott Benner 10:22
I just love that you went from Alaska to Arizona. We're just like, incredibly cold, dark place. Now let's go to a bright hot place.

Jeannie 10:31
Right. I know. I am by nature. I love green. And I love Alaska. So all of our vacations tend to be green and mountains and very nice. Get a break from Arizona.

Scott Benner 10:43
Okay, so I feel like I'm understanding and and I get I get your point too, because I've you know, I've been a stay at home dad for 19 years. And if you told me that I could only be with my children 28 days of the month, I'd be very blue. If you told me I could only be with them two days a month, I'd be very upset. Like there'd be no it. I would want them to be with me constantly. I think a person who's not in a divorce situation. Who likes being around their family could never understand. Like, oh my gosh, like, they won't always be with me. And so again, I get Audrey's mom saying no, probably Yeah, right. I I would too. I I could be the nicest person in the world. I'd be like, I don't want no, I don't care. I wanted to be with me

Jeannie 11:25
right now. And then once we had held at home, I it took me a little while I was like, Oh, I get it better. Yeah, of course. Yeah. I'm

Scott Benner 11:31
not giving this kid to somebody else.

Jeannie 11:33
Already super hard. Yeah, I get it.

Scott Benner 11:35
So how long does that take to become comfortable?

Unknown Speaker 11:42
Just the blood. Just know the 5050 split how

Scott Benner 11:45
long until you're not pissed about it one way or the other? No matter which side of it you're on?

Unknown Speaker 11:51
Um,

Jeannie 11:54
it took a few years. I had somebody give me advice. It took us good two years. So as the two year markers like it is not better yet. What is happening? What's wrong with all of us? I think it was probably, you know what I think a big turning point was, at one point, we had all the kids, we had our kids at a private school. And they had their son at the same private school. Well, our boys held in and their son. So Bobby's mom, and stepdad, their son is held in the same class as our hildon. And they're actually in the same classroom. Okay, at that point, we were just bomb. When we did stuff for the boys we do. Plus parties and field trip, and it just had to be okay, like, our boys were friends. Yeah. What do you though, right? Yeah, we just had we we all chose this school. So we just had to be okay with that. And how is I think?

Scott Benner 12:41
I'm sorry. Go ahead. No, I was just gonna say I was gonna ask how Aubrey dealt with it. Was she on a similar timeline? Or did she go more quickly or slowly?

Jeannie 12:50
re was really unaware of any issues that we had, which is what we wanted, we were all actually always really good. On both sides, no matter what was going on about not talking bad about the other one, and respecting the other parents. And if Aubree was saying some sexual I would call her like, Oh, you could not talk about her mom that way. And I think that her mom's the same way. Aubrey was, I hope she describes it as being unaware. I didn't realize there were issues. Until a lot later, you're high, you know, older ages, filler. And afterwards as as things aren't like that anymore. You can give her some historical if she asked me even now try not to asking pointed questions to them. Yeah. But again, is he loves her mom. And she loves her stepdad and her brother over there. So yeah, we don't ever want a recession. But if she's asking questions, she's 17. We can tell her the truth show us she's asking hard questions already.

Scott Benner 13:45
So now, apres diagnosed with type one At what age at 1414. So not that long ago, three years ago,

Jeannie 13:54
coming up on her a three year diversity in May.

Scott Benner 13:56
Okay, so you are in a situation that people ask me about a lot. And, and so, I mean, you're covering, you cover a lot of bases. So, so, the one so you've talked about now how to, you know, share custody in a way that doesn't cause harm? Right. Right. Right. And the idea that it takes time and that you have to be you have to care about what's best for the child and and not not so worried about yourself, which is a difficult thing to do as an adult, my one of the more adulty things that I've had to do is ignore how I felt for someone else. Right? I mean, that's just counterintuitive in almost every way. You know, when your kid goes away to college, it's, you know, here's how I feel, but that's not what's right for him. Oh, you know, and so, there's a lot of that in there. So congratulations on being an adult because it's not easy. But now, here's the next thing. She's diagnosed with a disease that takes an incredible amount of understanding time and management skills. I just hearing from a mom this morning, about I split time with my, my, you know, my child's father and I appear to be a little more, you know, reactive to type one then it is. So I guess the first step is did does that happen? Like, like, how do you I, gosh, where do I even want to start Hold on, let me just like re scramble my brain when the diagnosis happens is are all of you in the room at the hospital

Jeannie 15:38
so that that night actually chaperoned a school class trip to Knott's Berry Farm. So we had Aubrey the whole weekend before. And we noticed things that were I had never heard of type one. So I wasn't connecting that it was that. So we got back. We're like, sort of the doctor. So mom took her mom took her to her local pediatrician. It's the day of her eighth grade graduation, and they do his private school. So they did like a big cap and gown. She was libertarians, big deal. He takes her to the doctor and back gets a text from mom, saying they're saying she has type one diabetes, I have to take her to the hospital. And so Matt, that plays everything down. Because if it's scary, he doesn't know how to deal with it. So he's like, well, I'm sure it's not that big of a deal. Like they're probably overreacting. We don't know. Any type one diabetes.

Scott Benner 16:25
Type One type, like 50 is probably bad.

Jeannie 16:28
Yeah. Yeah. But I've never heard of it. So it can't be that big.

Scott Benner 16:32
I can't even hear my stereo when it's turned off. Right? This is probably fine. Right?

Jeannie 16:36
Right. So he tells me this, I google it. I'm like, you better go to the hospital. So I haven't you know, another kid to pick up. Cool. So like, you go, you need to be there. He's like, Okay, I guess I'll go We'll see. See what this is about. And they get to the hospital. And they confirm, yeah, this is high blood for sure. And they teach her how to do an injection of insulin. Very, very basic information. She was not indiecade thank goodness. And they sent her home. And she graduates from eighth grade that night. And is this looters? torian it gives her speech shot her way, you know, yeah. So that they had contact with an endo who we were eating, I think a couple days later. And he moved appointments around and was able to get her in, I think about the very next day, but the next one and so Matt was out of town, he was out of state already because we didn't know we had this appointment. So for that appointment, and from all the training, it was either me and you know, mom, and stepdad or all four of us.

Scott Benner 17:35
And what do you do when the information strikes you differently than it strikes someone else or you absorb it quicker or slower than the other person like because I it makes me think of a time that Arden's blood sugar was very low. And she was young. And we're in the middle of the night. It's you know, God knows three o'clock in the morning, we have her like in her diaper wrapped in a blanket sitting, you know, seated on the countertop in our kitchen. And there was this I had a food my hand and my wife had a food in her hand. And both of us believe that we had chosen the correct food to save our daughter's life. And we stood there and argued about which one it was. And and either of them would have worked by the way. And yeah, neither of us was right or wrong. But you have this incredible feeling like I've been taught and I know and this is my inclination. So this is right. And if you are disagreeing with me, you are attempting to kill my child. Because you go from like zero to a million miles an hour, right? Like, right,

Unknown Speaker 18:36
right. So

Scott Benner 18:37
yeah, I am interested. Did that happen? Did you guys learn together? Did you learn separately? Um,

Jeannie 18:44
so they gave us training. And we did all of that together. All of us were there learning about glucagon and all that so so we learn all the basics together. And I think at first because mom is a nurse. Alright, so I come back, bro. And Matt naturally does because he's like, it's medical. You know, we'll figure it out, of course. But let's go for the way to just kind of make a lot of the decisions at first because she does. She wasn't familiar with type one. The geriatrics but we're like, but she has a medical background, so it's going to make more sense to her faster. And so we took a backseat to a lot just kind of let her take a lot of those decisions. Obviously she's here. Every was here at the house. We made decisions. We weren't calling mom in the night. Um,

Scott Benner 19:29
but she I think the leader of the diabetes tribe, you're like, let's make that President. Right.

Jeannie 19:35
Yeah, it wasn't even discussion of a natural you guys.

Unknown Speaker 19:41
Yeah, yeah.

Jeannie 19:42
I was trying not to step on it. I'm Aubrey and I love her. I know, I know. She's gonna get the best care. So why would I step on toes make this about me needing to be involved, right. So I did that for a long time would fall for perceptions and just give us half a bill. And mom would make the appointments and we would go and we were involved and we care for her. But we didn't. We didn't really take the lead on anything for a long time.

Scott Benner 20:13
Okay, so so you, you basically did what I suggest a lot of families do in, in, you know, classic situations, which is someone should be in charge, and someone should be learning it. But in the background that you can't have two voices yelling at the same time, right? You very netsy now, it's funny you describe yourself is like, it's confusing, and it's blended. But you guys make a lot of good decisions along the way. Like there's any point in your story. So far, we've been talking for 20 minutes. At any point in the story. If you were, you know, someone who pride a man away from her husband, then you guys wouldn't all be sitting in the room happy together. Right? All right, right. If Aubrey says mom didn't have, you know, a medical background, you guys may have all like, fought for a piece of the pie when it happened. Like many like you had a lot of good luck in this very confusing situation. And you made a lot of good decisions so far.

Jeannie 21:10
Yeah, yeah. I feel like Auburn's gotten the best care possible to do. Yeah, because we do work. We do work well together.

Scott Benner 21:18
It's obvious. Yeah. I mean, it's unless you're lying about something, but I don't think you would be.

Jeannie 21:22
I mean, we don't always agree on everything. Because we're different parents, different parenting styles. But as far as diabetes, you

Unknown Speaker 21:29
guys got,

Jeannie 21:30
yeah, you're on this page, I believe. And it actually wasn't until I started listening to your podcast that I'm like, I feel like we could do better. I feel like we could put numbers lower. I feel like you don't need to be scared of keeping her lower. So and then I'll be nicer talking about it more money. What about this? What What would you what kind of just little older at that point she'd been diagnosed for about a year. She's pretty independent with a lot of it. Because she goes back and forth, I think and, and naturally, she's like, well, I'll just do it. I know how,

Scott Benner 21:56
how did how does Audrey's mom take it the first time you say to her, Hey, I have some ideas about obvious medical care. I learned online from a stranger. Right? Well,

Unknown Speaker 22:05
I actually have it said that.

Unknown Speaker 22:07
Okay.

Jeannie 22:10
I talked to Aubrey about it. Because at this point, opera is pretty independent. I'm like, What would you think about trying to keep your numbers lower? I feel like maybe we were doing the safety thing we were taught. Keep it around. Oh, 170. That's safe. Lower than 80. That's scary. She could die. Like you. They do that because they don't know how involved you're going to get. They don't want your kid to die. So they do teach you the basics. And but from listening to podcasts, and I had to start with certain certain episodes, we'll send her like I would listen to this. But just Aubrey and I texting about it and talking about it. And it kind of has naturally now stepped. I wouldn't say I'm four involved in her mom, but I'm a lot more involved than I was.

Scott Benner 22:53
Because you've changed your management ideas, right? You've gone from like, let's put the insulin in and we'll test again in a few hours to let's be a little more fluid and reactive. And, yeah, that takes and Okay, so you guys are doing it together. You know what, and help me a little bit when you say you split time? 5050 it's, it's weekly. Right? Like there's a couple days here that a couple days. There are week on week off. Oh, it's one week and then one week? Yeah. Okay. Oh, so that's not as jarring as, like three days than two days. And like all those broken kind of

Unknown Speaker 23:29
Yeah, some

Scott Benner 23:30
people's custody agreements are are mind numbingly confusing. You know, ours was sure for a long time. So you learn from that? Did that change? Because you learn from it or because Aubrey got older or what? What's

Unknown Speaker 23:47
the schedule?

Scott Benner 23:48
Yeah, like kind of instead of bouncing back and forth, what made you go to week on week off.

Jeannie 23:51
But actually, when Aubrey was younger, we stopped fighting for custody and fighting because it was about eight. And she was kind of starting to notice that, you know, issues between parents. And so Matt and I decided he don't want to ruin her childhood. We don't want her whole childhood wrapped up in custody battles. And we don't want to keep fighting with her mom. So we actually settled for about a third of the time when she was eight. So it was a really confusing schedule. And you bounced around who's here Wednesdays then every other weekend, but not Thursdays, like it was super confusing. So it wasn't actually until Aubrey was 15 it was just a couple of years ago where she was like, he went to her mom and said I want more time with my dad. I don't want more than you. Yeah, she

Scott Benner 24:29
got to make the decision then.

Jeannie 24:31
It's not that we don't want anymore but we don't want her whole childhood ruined because we had advice. Somebody told us along the way. Hey, yep, Ella hood is so fun and getting as much time as you can great, but they're going to be an adult a lot longer than they're going to be a kid and if you ruin their childhood with custody battles, they're not going to want to be there if they're an adult.

Scott Benner 24:50
Let's not waste any time we're gonna get right to it. request a free experience get today, a free pod experience kit from Omni pod Free and no obligation experience gets the job that it's not like if you have them send out the kit, you're locked in or something like that. Not the case. This is just a demo on the pod is thrilled to send you. You just you know, Miami pod.com forward slash juice box, first name, last name, zip code, email address, preferred phone number type of diabetes, I certified I'm 18 years of age, I acknowledge about the HIPAA policy authorizing requests I get right to your house comes in the mail. I don't know if you've heard about this thing about the mail crazy. You give something to someone give them a couple of bucks like Yo, would you take this across the country? For me? They say Yeah, no problem. And then it happens. bonkers, right? Anyway, you fill out that information with the link. On the pod, it's gonna take your experience kit, your free demo on the pod that you can try on and wear and see how you enjoy. They're gonna take it to one of these male people. These magical people are going to transport to wherever you live, anywhere that you live, right? Actually, is it anywhere? Yeah, you know what? Now I gotta be resting United States anyway, anywhere in the United States that you live, these magical people will bring your free experience kit right to your home where you can try it. My omnipod.com forward slash juice box. I am telling you do it now. It's free, and there's no obligation, even if you get the thing and just stick it to your forehead for fun. What do you care? It didn't cost you anything. Give it a shot. I think I probably have to say here that the FDA does not approve the Omni pod being one on your forehead that was farcical. I hope you understood that. Yeah, forcing a kid to be with you only to turn them into an adult that doesn't like you. It's not a great idea.

Jeannie 26:44
Right? So we kind of took that to heart. And we're like, Okay, so once in time, right. But let's just make that, you know, utilize the time we have and your family when she's here and just keep it you know, we're still even when she wasn't here. It wasn't technically our time, we'd go to the class parties. But it's not like we were absent. And she wasn't here. But it was a super confusing schedule that we were able to simplify just a couple years ago, because Aubrey kind of sided.

Scott Benner 27:07
Yeah, good for you. That's excellent. Okay, all right. So right. There's a lot unpack I know, I'm getting it. Don't worry. And Okay, so let's go to this for a second. What about the podcast made sense to you? Like, what did you hear that you thought? Wow, that's sounds reasonable. I should be trying that.

Jeannie 27:29
I think the first thing that we tried, and it was Aubrey and I talking about what do you think about this idea of Pre-Bolus saying, there's nobody to talk to us about that. And I thought it means, you know, as we kind of, I know, I'm not saying that they because but I actually listened to somebody. I don't know. Jenny, Ellen or Jenny. He said you Well, if I'm this high, I posted. I'm done. This is I wrote it down. And let's start here.

Scott Benner 27:53
It was that with Jenny Smith to see the NHS. Yes, I think it was Jenny. And she kind of just gave like a some sort of a breakdown for what she does. Yes. You thought okay, well, it's a place to start. Yeah,

Jeannie 28:03
I took that. And with that, let's start here and try this. And so that's now our resist school. And she's texting me daily, not just when she's with us, like her and I are texting back and forth is she's like, Okay, I'm at this and I can feel the CGM. Hey, you have lunch in 20 minutes, pretty high. So let's go ahead and give your bolus is this now on even. So we just kind of started from there. And, and, and I will say I'm the only stay at home parent out of the four parents. So she needs supplies to school or she needs something. I'm three miles away. And I'm the one that she would call. Because I'm right here. So naturally, I stepped up more in those things, just but it's just Aubrey and I kind of decided, yeah, let's lower let's lower your threshold. Why are Why are we waiting till 170.

And she'll go home and tell her mom and it's not a secret of a home and talk to her mom about it.

Make sure she's aware of the Hey, I'm lowering my threshold. I'm gonna get my alarms earlier. But because I'll be so independent a lot of times it's just every fixing. Even I try to give her when she was first diagnosed and first got to see him she would have four parents texting her. Are you okay? And she didn't like that.

Scott Benner 29:14
Yeah, it wouldn't either. Oh, my gosh,

Jeannie 29:16
I know. So don't have to learn like okay, face to try and do this before any of us stepped in and now I think it's just mom and I.

Scott Benner 29:24
What, um, what does she running? She has to she have a pump. He has a pub, she has the T slip. Okay? And she's using si XCOM Yep, they're great. I just happened to I was just at the on the pod headquarters the other day, and I got to see some software that's about to come out where they're gonna there'll be you'll be allowed to have followers. So you'll be able to see when the insulin went in and stuff like that. And and how

Jeannie 29:51
Yes, but she was talking her into the army. Yeah, I tried talking to her to the Omni pod when I first picked out a pump and she's like, oh, No, now she's saying it. I can't even get another one. Now she's waiting till next August is for players to get the Omni pod. Gotcha. Look out sometimes they have switching specials where they they kind of help you

Scott Benner 30:11
get out. Oh, yeah. So if that pops up, that's a great idea. Um, I just was just bringing it up because I think it's amazing to now people will be able to see like, Oh, I, you know, I sent a text and said you should bolus this much. And now I can see it actually happened to me, which is great. You know, she's doing well on her own. And long have you been at this kind of new way of thinking about it?

Jeannie 30:37
Maybe a little less than a year. Maybe about a year ago, I kind of was like, why don't we try this stuff?

Scott Benner 30:44
Okay, so what are you seeing in changes and variability like, you know, from highs to lows? And what are you seeing anyone say?

Jeannie 30:53
A one has come down. I cannot Honestly, I tried to send data appointments, cuz that's one of our blended family things. And like, you know, you go to appointments, it just is easier with the personalities, I think, for him to go and just kind of relay the information. See, I sent him so he'll often be on his phone the whole time texting me, okay. They said everyone sees this. Okay. They said this. keeping me in the loop.

Scott Benner 31:17
walkie talkie with the button pushed?

Jeannie 31:19
I know, I know. And this last point, I know this last time I went to actually went because he was out of town. I was like, I don't know, we should probably just do this. It's much easier than you trying to remember what they say. I'm

Scott Benner 31:30
gene said that most boys are just boys. You know what I mean? I know. It's hard to break them of some of their boy things. I know.

Jeannie 31:36
He's a great dad. But he's like this medical stuff. I just don't get it all. So I mean, for sure. Here at the house. I am the one getting up with the girls in the middle of the night. It's, you know, I'm the hands on one with all the diabetes stuff here at our house. So he's like, it just makes sense for you. Maybe because they weren't buying you should just do that. It will be fine to pass it off. So we'll see. Until we're able to see has come down. He feels more confident. And I know she's catching things. She's increasing her. Faisal. She's spending it she's doing you know, she's we're just learning so much more.

Unknown Speaker 32:15
It's good, but she's confident.

Scott Benner 32:17
And she didn't have any trouble. Like, what was her first inclination when you said, hey, maybe we could stop your blood sugar from getting so high? Was she like, yeah, right on or did she?

Jeannie 32:26
She's like, yeah, she's all about slightly competitive. We had all kinds of setback a little too much. And so when I was like, let's try this in this. She's like, Okay, good. I'm glad I'm not expected to do that myself. Because she's back and forth. There's only so much control any of us can really have. Hmm. So I think we had all maybe put it on her a little too much. Yes. It's just

Scott Benner 32:50
my opinion, that interesting. So I've spent a lot of time talking about that recently with different, different people. So a nurse brought up to me it's something I was talking, I was speaking at a thing. And I mentioned that, you know, that there was a question that came from the audience. Well, how involved are you in this? And I said, Well, I'm I think I'm appropriately involved considering my daughter's 14, and she has a disease that requires you to use manmade insulin to keep it common. Like it's, I think sometimes people want to be removed from it

Jeannie 33:22
is a super responsible kid. So it's easy to think, oh, oh, this

Scott Benner 33:25
Yes. It's, it's it's the same. It's the same gear that causes sometimes parents to make this mistake in a larger family. So if you have a kid who maybe struggles with homework, you can't and you have one that doesn't, you give all the help to the one that struggles, and then the one that doesn't, sometimes it's like, I would like help to. Yeah, it would be nice, you can overestimate how well you're doing right. And, and I think that something I used to see online more than I see now, is that people want very much to give their children credit for their bravery, which shouldn't be undervalued. But at the same time, I like to remember that people aren't brave because they want to be there frequently, when you're brave, you're brave, because you are forced to be right you know, so it's fine to say look at them, you know, stiff upper lip, they're doing great and everything but that doesn't mean that it's not difficult or that they couldn't use help. And right, I was speaking just this past weekend with Jeff Hitchcock, who is the you know, the founder of children, children with diabetes, the friends for life conference in all those places. And he was speaking about research that he's seen that says not only should parents stay involved if they want to healthier child with type one, but much longer than you think even into their 20s they could still very much need your assistance you know in some way. I'm not saying you should still be telling them that you know, dinner's six units, but but you can't. It's not It's not the story. thing you should just extract yourself from.

Jeannie 35:02
Right. And I don't think any of us did it intentionally. But I think over time I was like, Well, she's going back and forth between home and and now that if she wasn't low, we wouldn't texted big. Are you okay? Do you mean anything? And I'm still up in the middle of night if she needs a juice box, it was last night. But it was just natural thing. And then when I stepped back in, I almost didn't she never told me this, but I just felt like it was almost a relief. Okay. I'm not on my own yet. Like, it's not all on my shoulders a little bit. That's right. Yeah. So I tried to stay involved.

Scott Benner 35:31
So let me ask you this. When you texted me, or when you emailed me and said, I have questions. I hope somebody from a blended family could come on and answer what were your questions? Have you been thinking to yourself, you know, these closed loop systems are starting to come out for insulin pumps. On the pod is saying that, you know, their horizon system will be out in 2020. And other companies are following suit. That all these systems use the Dexcom CGM, and I don't have one. Have you been thinking about that? Have you considered that the in pen? Even if you don't want an insulin pump? also works with the Dexcom? Or what about just the Dexcom? Right? What about just the continuous glucose monitor that allows us to make decisions here at my house that are astonishing. For instance, Arden went to a homecoming dance on Saturday. We didn't go with her we didn't worry about or my wife actually dropped her at the school and then went out to dinner with a friend. Nobody's sitting outside of the school hoping nothing goes wrong or waiting for a panicked phone call about my blood sugar's low, or what do I do? Nothing. My daughter was free to enjoy the dance. And every once in a while my wife and I just picked up our phones and checked on her. Now my wife was checking on her from a restaurant nearby. I was four hours away at my son's baseball game. We were both watching Arden's blood sugar, so she could free and easy enjoy a high school dance. And we did it with those share and follow features that Dexcom offers that's available for Android, and iPhone, you're gonna want to go to dexcom.com Ford slash juice box to find out more about the Dexcom g six continuous glucose monitor. The diabetes world is moving forward. And it's moving forward with Dexcom. There are links available in your show notes and at Juicebox podcast.com. And I understand that this might be a big move for some of you. And it might be nerve wracking. But please take it from me. Don't be scared. Dexcom is amazing.

Jeannie 37:31
I guess I was wanting to see how another family handles like, oh goes to the appointments, like I told you about like I tried to back off, but really I'm the one involved. I go and ask the questions. So I'm giving Matt nabru questions to relay about insulin stuff. And they come home and they're like, Oh, she said something about that.

Unknown Speaker 37:49
helpful. Do you want me to move it all back to Alaska?

Jeannie 37:53
I know, I was like, could I write you a list and have her just fill in the answers? I don't know. So. Right? So when I went this last time

Unknown Speaker 38:01
to send with

Jeannie 38:04
please give me write down the answers as she says them. So I wanted to see that whose options because we would run out of things and mom would have a ton of it. So had to set up our analysis. Now we kind of set it up where we'll pick up an even months you pick up in the odd months because you're getting plenty like they gave us a huge prescription we will kind of have a stop now. But let's just that way it's not I don't go to fill one in 30 filled.

Scott Benner 38:27
We kind of have a drawer and it's not there or break this balance between these two homes.

Jeannie 38:32
Yeah, who really wants insurances and supply companies like those those things that I was like, the day to day stuff like 30, blended family stuff we've been doing for a long time. But this stuff is new. And I think we've kind of settled into a routine even since I emailed you a little more of one of what what are we Oh, man is the diabetes stuff. I would

Scott Benner 38:54
like to suggest that you people are pretty good at this. You maybe should ask yourselves a little more when you have questions because I actually know a person whose child gets shuttled back and forth a couple times a week and they won't even let clothing go to the other house. Yeah, your kid shows up in an outfit. And when they get there then begins to use the clothes from the one parents house and when they return to the the initial home they came from, they have to return in the clothes that they showed up in because the one person can't trust the other person not to just start hoarding all the clothes and not giving them right. Yeah, that you magic. I mean, jeez, I just, I would just bang my head against the wall continue.

Jeannie 39:35
Oh, that's tough, difficult. And there's I don't know. And I will say we have one of the better blended families. I know there are tons of bad ones out there and it would be way harder. So we are blessed. If I need to I can send mama texts say what I need to make a decision now about play order, right? I just thought recently, hey, this is how much the supplies are. They want me to place the order right now. Do good with that. You know and I'm okay she's okay with me doing that. You guys can kind of just text back and forth and

Scott Benner 40:01
you're in contact and

Jeannie 40:03
yeah, we don't do it a ton. We don't need to do it a ton right? Um, but we can so that needed to accept dad or mom. It's totally fine like we can do that.

Scott Benner 40:12
So back to how you were wondering about who should I send the appointment you just made a decision send somebody to the appointment, you're seeing how you're going now you're considering adjusting it a little bit. Yeah. So is the real advice to people. Just try something and and then stay fluid about it. Like don't don't set it down and keep moving. I guess, though, if

Jeannie 40:33
you just don't know ever since. So different, but I guess I would just do whatever is best for kids. I asked Aubrey, but this last appointment I went to him like, is that a big deal? So because of that if I don't go dad can't go so neither of us go. And it's like we're missing information we need right? She's like, No, you should totally go and it was fine. Like, why would you not go? Now she's like, you should probably just go to all of them. Okay, so

Unknown Speaker 40:55
why what else? Anything else?

Jeannie 40:59
I don't think extra so you don't

Scott Benner 41:02
know what we think? What were you wondering back then? What were you hoping? Oh, flip podcast about hear somebody say that would make you go? Oh, thank goodness, somebody finally said this to me. I can just do it like this.

Jeannie 41:14
That's a lot of it was just the logistics of it. Like I want to make sure I wasn't overstepping. Because she has a mom. I'm not trying to. I'm not. I'm not mom. Right. But in our house. I'm wrong. That makes sense. Like, well,

Scott Benner 41:26
it not only my essence, it leads me to a question. I've been dying to ask you since we've been talking. Oh, come into a child's life when they're three. I assume. While we're not measuring. You love Aubrey just as deeply and thoroughly as her mother does, and probably in the same motherly way. Right. Like you don't.

Jeannie 41:47
Yeah, I love Aubrey, just like all of my kids. Right? Like there's zero. Wait, I don't just think was at all and so that's why we stopped them. Like why are you know, I can do this? Like, I'm not gonna be hard for me to love another case. Look, I do like, No, no, yeah, sure.

Scott Benner 42:01
Let's just keep going now, like it's filling up. But But no, I mean, I want people to understand that like, I mean, listen, I'm 47 my mom's in her 70s. She doesn't treat me one ounce differently than she does her that my brothers who are you know, natural to her. And, and so it is really to be it is really to be understood that you are in an incredibly difficult situation, the same incredibly difficult situation that our mothers and although her mother's, we had to score them, hers might be a little higher since right? She came from her, you know, but still, you're both living with almost the exact same feelings for this person who gets bounced back and forth who's been diagnosed with Type One Diabetes, who you want to take really good care of. And so to show

Jeannie 42:45
Yeah, I think so. I think she would recognize that too. Yeah, at this point, she would agree that I love Aubrey, and we only want what's best for her and we, you know, yeah, totally that I'm, I don't know, I don't know how to describe my role. And like, Well, I'm not your mom. Right. But I do all the mumps stuff.

Scott Benner 43:01
A lot of the time all the feelings.

Jeannie 43:04
Yeah. It's an interesting role. I don't I never pictured myself being a stepmom and I didn't have a stepmom. So I, I honestly have sought out other moms. How do you do this? Because other moms because like it's this is hard to share a kid because like you were describing how long does ownership I didn't either. Like I said what she should be here. Right? In my heart. I wanted her there all the time.

Scott Benner 43:24
Everyone feels like that. Yeah, yeah, that can't be the situation unless you just got way progressive and moved into the same house, which would be freaky. And I would absolutely watch that TV show. By the way, if you guys did that. Let's kind of jump off of Aubrey for a second. Sorry, Aubrey, we're done with your now and and and ask and I hate to skip over the twins, but they don't have diabetes. So yeah, we're not completely skip over them. But how does it come to your attention that there's a child in the foster system who has type one?

Jeannie 43:55
fully random. We have a friend who was a caseworker is not Jesse's case. But she has a caseworker and had met jazzy you know, just through different things. And she in passing says to me, she knows we have adopted she knows as well like, in passing. You guys ever take a 13 year old with type one. She's been in a group home for three years and she's such a good kid and she just wants a family and, and she knows me well enough that I looked at her and said, I think that sounds great. But you know, Matt, probably gonna say no, I'll run it by him. Because I'm all about that's always been like nope, we're done. More is enough. We're totally done. Let

Scott Benner 44:32
me jump on that side for a second. I my parenting style is I begin with no, everything is no if you said to me, Hey, Dad, the house is on fire. Should we get out? I'd be like, no. And then I back down from No, I go through all the bad reasons. I'm uh, I think backwards, I think through things. And maybe maybe this is I don't know if this is consistent with men or Pete. I don't know what it is. But I start with why I wouldn't do something and I get to why I would. End So while while Kelly starts with why we should do something, and well, you know, in the case of wanting a dog never got to the part why we shouldn't. And that's why I now have dogs that I take care of stares at me,

Jeannie 45:12
I think. Yeah, I think Matt and I are similar where I'm like, Yeah, let's do it all in

Scott Benner 45:16
a nice young girl in the group after three years, she needs a family. We're a family. Let's do it, man. He's like, what about the money and the insurance? Like, right? Yeah, yeah, I say I always say By the way, if I was married to someone exactly like me, I'd be really broke, like, because you know, it or not like, because I make good decisions about some things and other things. No, I'm incredibly cheap about some stuff. And incredibly not about other things. Right? Like, yeah, last weekend, I took an incredible amount of pleasure in finding socks that I liked in a Bible and get one free situation. And I mean, to the point where I called my wife, I was, I was away, I was off watching my son play baseball in a, you know, and my wife had to go back a little earlier than I did. So he had a day off. And I sent her a text message. jokingly, this has been recorded around the time that we we find out about the owner of the Patriots and his visits to the massage parlors in Florida. And I said to my wife, I said, Some guys might be out getting a massage, and I put it in quotes. I'm like, I'm out getting buy one, get one free. That's so proud of myself, because I have found socks with just the right bounce and cushion at half the price. And so I but then, you know, if I see something that I think is valuable, I don't stop and think about it. For some reason. My brain is like, split right down the middle,

Jeannie 46:40
you know? Yeah, I can do that. This is an investment. Cape, I believe that this is a testament, but your person's thoughts. So

Scott Benner 46:49
we cannot invest in your purse. Yeah. So okay, so you, I'm assuming, get mad alone in a room and talk him into jazzy right? Is that how you handled it? Well,

Jeannie 46:59
we know I didn't have I come home and I honestly, but I told her I would mentioned it. I Oh, I'm honestly already on board of the idea. But I did not. I did not think I did not think this would get even a discussion. So I mentioned that we were watching the kids swim in the pool. So we're watching the younger three swim. And we're just sitting there. And I'm like, so you know, Ellie mentioned this girl. And you know, she has no group home and she has type one. She's had it for a while. But he starts asking me questions. And he's like, we should ask her I don't like, I don't feel like I should text her questions unless we're considering this. And he's like, well, how can we not she has type one. I'm like, Are you serious? Really?

Scott Benner 47:39
mad? Because that has experienced the change of knowing someone with Type One Diabetes. Like

Jeannie 47:44
he's all alone. Yeah, I'm like, Oh, okay. So we call Aubrey down to talk to you. Like, am I in trouble? No, I'm talking to us. Oh, what do you think about this, and I read logistics of our house, she would have to be the one to share a room. Never. She's never in either home shared bedroom before. She's never had to she's always been the oldest and things so we call her down. We tell her about jazzy. It's like, we're doing it right. I'm like, okay, you both need to stop and think this through. Like, I feel like this is another response I expected from either of

Scott Benner 48:18
us funny how you turned on a dime. And you're like, Hey, you people are being way too reactive right now.

Jeannie 48:25
Because I know I'm all in. I'm like, Aubrey, and like, it's such a sharing a bedroom, you're sharing your siblings, when you're not here half the time, she'll still be here. When you're sharing your grandparents. You are everything dad, nice. She might end up being a better kid than you. And you might slide down the list. You never know. Right? Totally. I think I'm pretty sure Matt says something like that. They're very sarcastic, um, even was like we need it. So I made Aubrey take a few days and spot it. But in the background, Matt and I were talking and asking questions, caseworker, we do. And she's answering questions and telling us more details and as much as she could. And so I was actually about to leave for Africa with our church for 10 days. Like, let's not meet her right now. I don't want to meet her and then disappear. That's not good for her. So we waited till I got back and met her like Lou next week. Right? And and we were introduced, so I already had a couple families fall through that started the process and into their minds, which is heartbreaking. And so we're Palm Desert amazing. And they introduced us as they just they have an IRA type one and they just want to mentor you and just be another person in your life that could help you with your type one. And so we took her out to dinner under that. Oh,

Scott Benner 49:41
sure that that that veil of you know, not not not wanting to put her in a situation where she could get let down again.

Jeannie 49:48
Yeah, totally. We just wanted to protect her and meet her. And I think before we even met her met, I knew we were do this. We knew that this was gonna happen, but we're not gonna put her in prison. You could be hurt again. So we waited a while we visit with us to like our volleyball game and kind of hang out. And at one point we were driving because we had our agency, it was just kind of visits more and more. And we were given a lot of flexibility on Oh, something's happening in the group home, you want to do that great. But if not, you're gonna come over here. Great. And we start flip overs like that. And at one point, we're driving, and I'm like, so that I would like you to bend. And whatever that looks like, if it's adoption, great. If it's, you want us to just foster you. Great. If you want us to help you reunify as moms, this is something we can help mom learn how to do great. What do you think about that? She's like, yeah, I'll move in. really casual about it. And I'm like, Oh, I'm like getting all emotional. This is like a moment. And she's like, yeah, that's fine. I'm

Scott Benner 50:44
like, whatever, lady that sounds good. Yeah. And

Jeannie 50:46
I think now that I know her better. That's just her her way. Even though she was emotional about it, she wouldn't have told me at that point. She didn't know me well enough. So we get to know her and she moves in? Well, gosh, I got that. We met her in September, she was moved in by the end of October. So we rearranged rooms and bought beds and baby town.

Scott Benner 51:09
And how long ago was that now?

Jeannie 51:11
Uh, this past October?

Scott Benner 51:14
Oh, hold on a second. Six months, really? was halfway there.

Jeannie 51:19
Sorry. I thought you might ask. I think I did the math yesterday.

Scott Benner 51:24
Look at you. You actually looked at the you're like, let me look on the calendar and see. And overall, how is it going?

Jeannie 51:32
So I'm great. Yeah, he's a good kid. He's a, if it was easier, I would think taking it like she's a good kid. Not that she's not a 13 year old girl. Because there's all kinds of other just parenting stuff that comes with that. Yes. Um, but even beyond type one, there's stuff. And we're adjusting. And the kids are cyllage. I mean, we changed the birth order. So that's a huge thing for kids, especially adoptive kids.

Scott Benner 51:58
So it didn't you slit in an older person, right?

Jeannie 52:01
Yeah, yeah, we change birth or suggest fits between, you know, older too. And it hasn't been our dynamic, but it's going well, like so with Aubrey it took it's taking more time for them to just get to know each other because she's gone every other week. So she's taking more time.

Unknown Speaker 52:16
So it's a huge dynamic to seven. It is it is

Jeannie 52:19
all of a sudden you're like and you're sharing a room have fun. Yeah. And they're both doing well with it. I think jazzy was more easily 30 are in a room with three other girls. She is federally Alright, find some

Scott Benner 52:31
space. She's pretty good. She's pretty. Yeah,

Jeannie 52:33
whatever the week, she has her own room. That's great. Um, so the younger kids will search them with the idea. I'm pretty sure our youngest honor the six year old. She's like, okay, so witness my new sister moving in. Like just, this is just like, Okay, this is just something mom and dad do just, you know, okay, we're at home and it is perfect. And they moved on.

Scott Benner 52:54
Do you imagine that you'll adopt her eventually, if things continue.

Jeannie 52:59
you're open to adopting her over the age of 12 in the Arizona Foster, as I say. And right now her first choice is to reunify with mom because they have not severed. Right. Okay. Um, and so she still does visits with mom every weekend. And I think it's moving to severance. I I actually am the one that kind of fought for them. Not just last court date, cuz I was like, You guys aren't giving her a chance. We just got her a CGM. We just are getting her technology. What if monkey handled this? Right? I mean, I asked jazzy if I was allowed to say these things. That Yes. And actually, after that court day, when I thought I was doing such a good thing, I thought I was helping her out like we could help her reunify, we just want what's best for her. Of course, if that's adoption, like that's fine. To help mom learn how to finish diabetes. Great, we will do that. After that visit, mom start pushing jazzy really hard to let us adopt her. Because I think she knows she's not going to figure it out. It's been three years. And there's other things like jazz, jazz is not a US citizen. But this would get if we adopted we'd get her citizenship, like things like that.

Scott Benner 54:01
But I don't think mom can provide for her. Is that like her mother might feel like, even though she might want her back. There's a better life for her with you.

Jeannie 54:11
Yeah. And I tend to describe that to jazzy as, hey, look at the younger two, their mom loves them. Their birth mom loves them, but she picked us because she couldn't afford to feed them. Like, that's what your mom's trying to do for you. I think in the best way. She knows how. But you're when you're 13. And you're hearing nothing from your mom. That's

Unknown Speaker 54:29
so hard, like rejection that so hard.

Jeannie 54:33
It's so hard. So you know, we have that stuff and that stuff comes up. So I was shocked. That was the case. And now we're kind of backpedaling, like, Okay, if that's not an option, then yeah, we're open to adopting and we still are but just has it cited basically.

Scott Benner 54:47
So in six months, what kind of an impact Have you had on Jazz's diabetes care?

Jeannie 54:54
Well, so I will say her last endo from all accounts Everything I've heard was not as good as our current endo. we've switched her, okay. That alone I think she would she she would feel like she went to no appointments and got beat up and yelled at for an hour, or 15 or 20 minutes and told she's not doing good enough and then get sent away with a prescription. He never suggested a pump. He never suggested the CGM. She's had this since she was seven. He saw her for three years and never once suggested technology or gave her any praise.

Scott Benner 55:29
Yeah, that seems common for a lot of people. Oh,

Jeannie 55:33
I it makes me so mad at him.

Scott Benner 55:34
You get good or bad some

Jeannie 55:36
that seems to be we kind of in the group home suggested they're like, you know, they don't get he she doesn't like him. So if you have one in mind, I would swear so we just automatically switched her the one that we love that you love. And so we've gotten her CGM is doing MD eyes which I'm he was on board when it was going to be the Omni pod. But her state insurance won't cover the Omni pod. So we kind of switch gears and I'm like, Well, what about the T slim? And now she doesn't want to do it. So I'm not sure why. I'm not sure. And I told her this. I can tell you I think it's a little bit of a control thing. There's a lot of unfamiliar stuff going on right now. A lot of change. So this is familiar doing shots is familiar. And she's doing fine with it. So why why rock the boat

Scott Benner 56:18
would start with the CGM in the situation anyway.

Jeannie 56:21
Oh, holy. Yeah. That was my first thing. Right? Yeah.

Scott Benner 56:24
She'll figure out what she wants to do next.

Jeannie 56:27
Yeah. And so yeah, so we let that go. And even her doctors like I'm gonna push you a little bit for the CGM. But if you're getting insulin in you, and it's going well, for a while, isn't crazy through the roof. The group home did a fairly good job at managing her sugars, but they kept her on a pretty low carb diet as well, which, you know, jazzy didn't like. So we're trying to like, figure out the new way of doing but it's just a it's a new mindset to like, she came home one time from a visit with mom and said something I'm like, well, you're coming home for moms Really? Hi. How can we how can I help you figure that out? She's like, since one of my high and her numbers were 50 and 300. And I'm like, you don't think that's high? Like just her whole mindset? Yeah. Is it's been trained by other people. And now I'm trying to, I don't know that's super high. Like,

Scott Benner 57:14
wait, oh, shells to Wait, are you Wait, are you helper, kind of bring it into a more reasonable range, she's gonna feel it's gonna feel differently. She's gonna be excited, you know?

Jeannie 57:24
Well, she has such a poor immune system. And she's already had her up. She's been hospitalized, I believe in dk 11 times. Prior to the state. He was removed only because of diabetes. There's no, there's nothing else. It's because she kept ending up hospitalized with diabetes. Her mom still has brothers. She says brothers that mom is raising. So it's not a bad home. She's not a bad mom. So be the first one to tell you. My mom is a good mom. She just I just couldn't figure it out. And I think it does a language thing that makes it harder. Yeah, and things like that. So you'd be the first one to defend her mom. And so I will for her. She's not a bad mom. She just couldn't figure this out. And Jessica doesn't open the hospital. And the state's like, we can't do this. Like she's gonna die. Right? At least at least. Yeah. the least bit in one coma. Like it's been bad.

Scott Benner 58:14
So funny how she was in a situation that was so crazy that between 250 and 300, and seemed really, like, I think, an incredible improvement. Oh, yeah.

Jeannie 58:24
You should have seen it. When I said that. That was high. She looked at me like I had three heads.

Unknown Speaker 58:27
I'm like, Lady 500 times.

Jeannie 58:29
That's right. That's exactly right. I'm like, this is high that I've had to kind of back off. I don't want her thinking I'm hounding her all the time. I don't want her feeling like I've moved you in here to fix this. Like, that's not why we brought her here. Like we really feel like she's supposed to be here. And I think at some point, I think at some point, she will change it will decide to let us adopt her. I don't want to form a relationship around. I'm fixing your diabetes. Because that's not it. We love jazzy. Sure. We want her here long term.

Scott Benner 58:57
Yeah, the narrative is the narrative is complete and encompassing. And then she gets to decide from there, you know, what that means moving forward. I mean, who knows? Right? She could pop up six months from now and be like, hey, I need to keep my blood sugar at 120. Now all the time, so I'm gonna go home now. And like, and that could happen as easily, she could say, I've fallen in love with you guys. And I want to stay here or anything in between that, you know, and it's really wonderful of you, by the way to give of yourself like that, knowing that it could possibly go the other way. because that'll hurt if she leaves.

Jeannie 59:32
Well, yeah. And we've, we've hold her like, whether you move back in with mom or not. But no matter what you decide, like, we hope we'll still be your people. I hope you'll still let me manage diabetes, have Mama's understanding it or take you to appointments or be at your wedding? Like if that's what we already that's great.

Scott Benner 59:49
Right. So it is hard, but you have more you have more for her if she wants it.

Jeannie 59:54
Yes, yeah, exactly. We've told her over and over again and everybody would like her to choose adoption, but it's a lot of pressure. She's known us for Six months. So, once more time, we understand that

Scott Benner 1:00:03
I wouldn't let you pick my takeout at this point, you know? Exactly.

Jeannie 1:00:07
Where people, right? Yeah,

Scott Benner 1:00:09
no, I Well, again, amazing because it's a it's a different it's a different gear you have to allow yourself to be open to the idea of being hurt or helping someone that you know may not want it or may not, you know, may not stick around or all the things that could possibly variably happen to open your heart up like that is it's dangerous.

Jeannie 1:00:33
We've only done it with this one kid we got licensed for her. So the people who do this foster care thing all the time on a rotating basis, I have friends who do I actually hold the respect a whole new level of respect since I've been doing this with one kid, and we really don't tend to open our house up to more we have five kids, right? Um, yeah, people who do this say is special?

Scott Benner 1:00:54
Yeah. Okay. Well, we've learned a lot. I usually just say that at the end, but we've we there was a lot in there, I would need to ask you, if we didn't talk about anything that you were hoping we would talk about?

Unknown Speaker 1:01:10
Um,

Jeannie 1:01:14
no, I don't think so. I was gonna say, hey, actually, you I hear all the time on this. Talk to people that like, oh, are in the witless insurance? Well, that wouldn't let us get a pump for six months, right? We found a loophole. And it may not work for everybody. But we got every pump. So they had the six month rule within three months, I think. And it may not work for everybody what we did the Medtronic 30 day trial. That was the first pump, we heard about the 30 day trial. And when we went to go get the T slim. They're like, Oh, you have to wait six months, we're like, but she's already been on a pump for 30 days. They're like, Oh, well, then you're familiar with pumps, okay, and they just let us get it.

Unknown Speaker 1:01:53
That's silly.

Jeannie 1:01:53
I don't know if that will work for everybody. I'm not promising it well, but it's worth it.

Scott Benner 1:01:57
Well, I will give my advice on the subject, I think you should stand in front of your endocrinologist and say them write the prescription for the pump. Right, please. I'm getting a pump, I appreciate that you have a static rule, I don't think it applies to our situation, we'll be fine. Like, you know, please don't worry, give me the prescription, and then stare at them. It's like when you're trying to get a car at a cheaper price. You don't get in any negotiation I want to share. After the ask is made, whoever speaks first loses. So all you have to do is say we want to pump now we're not willing to leave here without the prescription and then have the nerve not to talk again until the doctor talks. Because when the doctor talks are gonna go okay. Because what else are they gonna say? Yeah, right, it's, you just have to, you just have to be a little, a little steadfast, you know,

Jeannie 1:02:52
people that are able to get it and know or because their interest because for us, the end would have written it, it was the insurance that wasn't gonna cover it. So

Scott Benner 1:02:57
people that that have an insurance problem that's different, the endo could then probably write you a letter of medical necessity that would get them around that rule. And if they don't know about that, they could spend five minutes figuring it out. And

Jeannie 1:03:08
we didn't know that right?

Scott Benner 1:03:08
But if but you have to be careful that in a lot of practices, they just have this arbitrary time. And you don't get a pump until you know some date on the clock. Which by the way, at the very beginning of this episode, you talked about the idea that like somebody told you it takes like two years to get comfortable with the mix family. And then when that didn't happen, you were like, Oh, my God, what happened? I got to two years. That's such an arbitrary number. Someone spoke. Yeah, no,

Jeannie 1:03:33
yeah. I had I had clung to that I was supposed to be better by now what is happening?

Scott Benner 1:03:38
I did the same thing with diabetes. I randomly assumed it would take a year for me to understand diabetes. And on the day, I'm not even kidding. On the day of the year. I was like, I don't feel any better. I don't understand.

Jeannie 1:03:51
Somebody put that in your head. And then you know, I really did. I was like, I don't like conflict. This is comfortable. So tears in this is supposed to end. Yeah, I did it. So yeah, no, I feel like I wasn't. I mean, for them it worked into here. So that was fine. But I shouldn't have taken it to heart so much.

Scott Benner 1:04:06
Thank you for you, by the way, too, because I remember being newly married and there was already a lot going on there. If you would have thrown something huge like this into the mix. I don't know how, how I would have handled that. Exactly, you know, yeah,

Jeannie 1:04:18
I look back and I'm like, wow, that was kind of chaos. You're trying to adopt it. Like it's as the customer settles, it's nothing that I do is easy. Like even our adoption stories are crazy. And our stories are normal.

Scott Benner 1:04:30
I will say this I find I find about being married that when you have a common enemy. It's much easier. I always find when my wife and I don't have a common foe. Then we look at each other and I'm like, Huh, I wonder how we could fix each other. I'm like, No, like let's let's focus on this over here we go. Yeah, it's oh my gosh, that's awesome. God I can't thank you enough for sharing. This is one of the more exciting stories. I think that is that's ever been on the podcast. So thank you very much.

Jeannie 1:05:04
Well, you're welcome. And it was I mean, fun talking to you actually briefly met you when you're here in Phoenix. So was I delightful? You were very delightful. Yeah, we were in your class. That was the thing. You just you were just here for it.

Scott Benner 1:05:16
Okay, so I came out to the type one nation event in Arizona,

Jeannie 1:05:19
and Aubrey, Aubrey and I were there.

Scott Benner 1:05:21
I did a panel with a couple of nurse practitioners and someone from the jdrf. Then I did my own build within something in a slightly smaller room where a woman would have made you bold with insulin into a camera. That was not my idea.

Jeannie 1:05:33
Yeah, yeah, we were in there.

Scott Benner 1:05:35
How am I doing there? Be honest.

Unknown Speaker 1:05:37
Oh, you did? Great.

Scott Benner 1:05:39
Thank you did great. Did it actually move you forward? Did having all that information and kind of a compressed time and hearing me say it in slightly different ways was invaluable?

Jeannie 1:05:47
So a lot of the stuff you said I had heard I listen to podcasts. Okay. But Aubrey has all your podcast she has not even close. So it was really beneficial for Aubrey. And I could like poker music. Yeah. I could have been telling you he says that like

Scott Benner 1:06:00
so tell me something because I'm terrible at this. Did we actually shake hands and say hello,

Jeannie 1:06:04
briefly very briefly.

Scott Benner 1:06:06
They yank you around I get you get drugged from room to room. Oh, I

Jeannie 1:06:09
know. You're a lot of people talk to you. So I just briefly said Hi, I'm you're interviewing me next month. I'll talk to you later. And you're like, Okay, talk to you later.

Scott Benner 1:06:15
Remember that? I wish people like I flew in the night before they take you to a dinner. Get now you're in a suit, kind of like you know, just wandering around meeting people. And then you have to say something and then they whiskey back to the hotel. You have to go to sleep because you have to get up incredibly early in the morning. I think I spoke three times in a under a six hour period. And then when my Were you there at lunch when I spoke then or had you left by them?

Jeannie 1:06:42
Yep. No, we were still there. Okay, so

Scott Benner 1:06:43
I spoke at lunch. They took me off the stage. I grabbed my bag. Literally they jam me in a car drove me right to the airport and dumped me out at the departure thing. Yeah. And so I was just by the time I sat down on the plane, I was like, Oh, my God, my head spinning.

Unknown Speaker 1:06:57
So right.

Jeannie 1:06:57
I think you had mentioned on Instagram or something. It's gonna be a whirlwind trip. I don't I can't hang around very long. So I knew you weren't gonna I know. It was a quick trip. So I didn't expect to like a long conversation. I

Scott Benner 1:07:08
told them. I told them, they asked me back. I said, I really I hate running out like that. Like I really do. I always try to make sure that isn't the case. But my son's birthday. And his very first college baseball game was the next day.

Unknown Speaker 1:07:21
Oh, fun. Yeah. So I was running back home for that.

Jeannie 1:07:23
Yeah, no, the whole event was great. ever done it like that before. And we both really enjoyed it. And we'll do another one. That shop

Scott Benner 1:07:31
I thought I thought very nice. I didn't the one that I think of is the sort of the crown jewel of these things at Southwest Ohio. We do an amazing job. But I thought Arizona did did a really splendid job. It was laid out well paced. Well, you know, it was it was really great. We're gonna do another one. By the time this comes out, I might have done it already. So it won't be worth mentioning. But okay. I really appreciate you coming on. Thank you so very much.

Unknown Speaker 1:08:00
Yeah. Thanks for having me.

Scott Benner 1:08:03
And thank you to Dexcom dancing for diabetes and on the pod for sponsoring the Juicebox Podcast. Please go to dexcom.com forward slash juice box my omnipod.com forward slash juice box or dancing the number four diabetes.com to support the sponsors. Those links are available, you know when you type them in at Juicebox podcast.com right there in the show notes of your podcast that thanks so much for listening. I'll see you on Friday with another episode of Ask Scott and Jenny actually, I think I might do a defining diabetes this Friday. I think it's gonna be a defining diabetes. I don't know. And now I feel like I shouldn't have said anything. I'm panicking. I don't know what to do. I'm just gonna

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#267 Ask Scott and Jenny: Chapter Three

Answers to Your Diabetes Questions…

Ask Scott and Jenny, Answers to Your Diabetes Questions

• Let’s talk about standard deviation and target range.

• Let’s talk about Loop and absorption time to better understand food impact, glycemic index and extended bolus.

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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
This episode of The Juicebox Podcast is sponsored by in pen from companion medical. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And to Always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. MDI users, this one's for you. How would you like to live your life less complicated? You can do that within pen in pen is a reusable injector pen that has its own smartphone app. They talk to each other through the Bluetooth. that Bluetooth is magic, isn't it? You know what the app does? I'm going to tell you a lot of battle over the next few weeks on these Friday shows. But for right now, dose calculator dose reminders reporting actually tells you if the temperature of your insulin has gone out of range. Not only that, it connects to your CGM. Ooh, I got you there tonight, an app on your phone that connects to your continuous glucose monitor that connects to your insulin pen. Now you want to know more about indepen don't you? Check out companion medical.com. Welcome to ask Scott and Jenny. In today's episode, I Scott and Jenny Jenny Smith from the diabetes Pro Tip series in defining diabetes. You know Jenny, Jenny works at Integrated diabetes. She's a CDE, a registered pump trainer CGM trainer dietician, she has type one. Her favorite candy is dark chocolate peanut butter cups. And if Jenny was a professional baseball player, she'd be Hank Aaron.

In today's episode of the show, Jenny and I are going to be taking questions from you the listeners. In this episode, we're going to talk even more about understanding standard deviation and absorption times for loopers. Now that absorption time for lupus thing, don't get confused and think if I'm not looping, this doesn't work for me. It's also going to be able to inform you about how to understand your extended boluses. Trust me, it's all about timing and amount.

mirdif asks one interesting journey after we did standard deviation in a defining diabetes. I get this question a lot now. So obviously we there's something we didn't say there. We caused more questions than then

Jennifer Smith, CDE 2:42
then I think I read this one, what three day

Scott Benner 2:45
target for standard deviation? And if you set your targets tightly for alert purposes, will it look like your standard deviation is greater? Will that not affect the value of murder? We did talk about this in the office? Because I've had the same thought. But I won't. Yeah, I'll let me go over it one more time in case we missed something in that episode.

Jennifer Smith, CDE 3:03
Yeah, so standard deviation really speaks to the variance up down. So even if you had your target set, let's say, in your CGM, you have your target set from 80 to 120, let's say a very tight target, okay. But you have this roller coaster that's happening this up, down, up, down, up, down, up down, you know, from, you know, on the low end, maybe in the 50s. And on the high end, maybe up to like the 120s, you're still you're going to have a higher standard deviation, because the variance even within that target that you're still meeting, you're still having a roller coaster. Now the standard deviation is going to get higher. If you have more variance, let's say even if you're your target is that 80 to 120. And you're going from 50 all the way up to 300. And way back down and way back up to 250 and back down, then the standard deviation is even going to be larger than it was with a roller coaster within a target. The aim for standard deviation. I'm always kind of cautious to say we're aiming for a standard deviation of this solid rock, you know, this one number. The lower the standard deviation, the better. That's that's the easiest way to say I mean, if you're looking at a standard deviation of 70, you've got a heck of a lot of variance you do. Your CGM graph probably looks like a roller coaster at an amusement park, right? That's not what we want to aim for. Even within a tight target. You still don't want all of this happening. You want more gentle rolling hills from you know within less or within a tighter range, right? That's going to bring the standard deviation down. So if you have you know, a target range set from 150 to 180. And you're meeting it and your standard deviation is 21. That's a beautiful standard deviation, but your target is leaving you high. Right? So you're doing a good job of keeping things to a minimum as far as excursions, but you just need to ratchet your target down to keep that same low standard deviation. So I hope that makes sense. I'm going

Scott Benner 5:29
to share what we do because it's by no means the rule but it's a place where I've become comfortable with living life and finding a balance. Right. So Arden's target is set at 70. And 120. I'd love to be between 7120 as much as possible, it's not as much a target as it is. alarms for me, like when do we have 120? So I know what to do, right. I love for Arden standard deviation to be lower than it is. But in honesty, I tried just not to go over 40 Like that's like, and that's not great. Yeah, but it's, it's I shoot for more like 35 I try not to go over 40 If you look at Arden's graphs, they're interesting in that 18 hours of the day, her blood sugar is like 80. You know, most of the time, there's two meals that are varying cause a variance Right. And, and she'll jump up usually, it's like 181 60, conventional pumping, I was able to get down a little more quickly. But we're doing now not as fast. But conventional pumping, I didn't have 18 hours of ad that was solid. So in my mind, it's a bit of a trade off, and I'm learning how to do the meals better. I think that you should think about standard deviation more in the context that Jenny put it in. You don't want it to be 70. Not good. Right. But if you're shooting for 20%, or something like that, probably not that realistic. So I've heard under 40. I don't know where I've heard that from is that a reasonable like Mendoza line for

Jennifer Smith, CDE 7:13
under 40? Absolutely. I mean, if you're really it, I usually with the with the people that we work with trying to aim for, you know, the 30s or without consistently running just way too low with little deviation, the 20s can be great, as long as like Arden is kind of hovering at that at with little deviation. Great. That would be awesome. You might be in the 20s. But you know, 30s is kind of where we aim. Overall, with a little bit lower or whatnot. Depending on what situation in life you might be at two, with the women that I work with through pregnancy, we aim lower, tighter overall everything.

Scott Benner 7:55
Let me give you an example because I'm looking at a live grant for art and for 24 hours, right? So in the last in the last one day Ardens a one C has been 5.8 with an average blood sugar of 119 that put our standard deviation at 42. Now if you go out over 90 days, Arden's averaged a one C is 5.6. Over 90 days, her average blood sugar's still 115. But her deviation will probably go up. It does. So it goes it says 45 Over the last 90 days now we are still learning some things and so we have some more prolonged blood sugar's but for instance, in the last seven days, her standard deviations 38. Right. So as I get better at it, you know, over the last 90 days, because you know of this loop thing, you know, you see it come down, I will get the deviation consistently under 40. I think it's going to be more consistently like 35 Once I figured out the meals, but then, you know, I think Jenny's Right. Like once you have the tools in place and things are working. I see standard deviation not as a target. I see it more as See, I don't want to call it a report card, because I don't mean it like that. But I think of that more something you look at later to say, oh, things are getting better, not something right day to day. It's like a comparison

Jennifer Smith, CDE 9:19
almost to say this is where I was this is where I am now. Oh, it looks like it has improved.

Scott Benner 9:26
I would look at if you're looking day to day, I just look at average blood sugar, and I try to keep it lower. And then I look at at deviations like high high deviations. Obviously I don't want a low blood sugar. So I don't have a lot of problems with lows. But I don't want to see big spikes that lasts too long or big spikes. Right. So Meredith, I hope that answers some question and then I'm about to tell you something about in pen. And I think I should first warn you it's possible the information could blow your mind. So I don't know what you want to do put a hat on or hold your hands in the side of your head or something like that, but When you Bolus within Penn say you're having some food, right? And you look at your plate and you're going 10 times, you decide that's 35 carbs, you go into the in pen app, tell it 35 carbs, and it tells you how much insulin to inject, right? Hold yourself tight now because the here's the rest of it. Now pen users, no, you have to prime your pen a little bit. So you prime the Impend, and then dial up the insulin that the app tells you, let's say it tells you a 3.5 units, you inject those 3.5 units, the in pen actually can see the difference between the prime and the 3.5. And it doesn't. So you know, I'm saying like, when it's calculating how much insulin you have, it's not saying like 3.5 plus the priming amount of insulin it know, how does it know? The fascinating, right, like just boom, I don't understand. I mean, for a pen user, or somebody who's doing injections, this is an incredible leap. Your insulin on board is being kept by an app on your phone. And it can see the difference between the priming of your pen and the Bolus. Get out of here. You obviously need to know more companion medical.com. There's links in your show notes at Juicebox Podcast comm. And one more thing, starting I think next week, maybe the week after these ads are actually going to be a conversation within pen user and world champion, paddle boarder, Fiona wild. Fiona is going to tell us what she loves about it. And it's enough of me telling you what I can, you know, read in a PR kit. Let's hear from a real user. I'm wondering about carb types, oh, entering into a loop. I get confused about what to put when I'm eating a combo meal. For example, what if I'm having pizza and fruit or a burger and veggies or, you know, like yogurt fast carbs plus protein? She said I thought maybe since Jimmy was a dietitian too. This might be something she can help decipher how to Bolus for different combinations. So what Matty's bigger question is and how this will work out for the rest of you is she's really asking about absorption time, I think in loop right, to

Jennifer Smith, CDE 12:15
an glycemic index to a conventional pump system. Yeah, in game

Scott Benner 12:19
conventional pump system, it's going to be glycemic index. And the idea of extending boluses or temporary or something like that. So it's, it's crap, slightly different tools, same reason. But to give people context, you don't listen, who don't use the looping system, you will tell the loop Hey, I'm eating 35 carbs now. And then you have to tell it how long you expect it to be in your system, how long you expect it to take to absorb is that one hour, 30 minutes, two hours, three hours, like that kind of thing. If you get that absorption time wrong, when you put the setting when you put the carbs in the loop, it really big causes a lot of high blood sugars when you get it wrong the wrong way. So do you have any thoughts on this? Because I'd actually love to hear them. I'm gonna sit back and listen like a listener for a second.

Jennifer Smith, CDE 13:03
It's a very good question. I think that the icons that are within the fast moderate and slow groupings, if you are a looper and using them are defined by like a glycemic index nature, right there fast ones are going to get absorbed pretty quickly loop says they're two hour moderate or like a three hour really slow, which would be like high fat, really high protein kind of meal would be a slow absorption, right? icons like a lollipop, a taco or pizza. Okay. Now, most mixed meal, she brings up a good question. Most mixed meals that are a content of carbohydrates, and protein and fat and healthy fiber. Good example being something like grilled chicken, steamed veggies, and maybe like quinoa or brown rice or something like that, right? That's a good mixed meal, a three hour absorption would be a good place to start. It's mixed. You've got a little bit of everything. Now, on the flip side of that, let's say you have like a thumb size of grilled chicken, one broccoli spear and a plate full of brown rice. Hmm. Question time there is based on the content, right the content but the portion that's the glycemic load. It's not only glycemic index, but it's the amount if you've got a plate full of high index carb that you're eating, very minimal little other things that's no longer a combination meal. That's more like a two hour that's like it's fast now rice is as an example in this can be a can be a bad example because some people's experience with rice can be longer impacting same thing with pasta. Some people get really quick impact from pasta some people get really like long drawn out. And I mean if I went into it further, some of It has to do with cooking method and again what you eat with it and whatever. But in a simple answer, most combination meals that are not heavy simple carb should be about a three hour absorption for our absorption would definitely be those Merle meals like she's saying, let's say I'm eating a big old cheeseburger and french fries but I'm also having an apple on the side, that's still a fairly long digesting meal. A trick or a tip that might work it let's say you're eating the apple First eat the apple, put it in as a 15 gram you know kar Bolus absorption two hours. And then when you go ahead and Bolus for the rest of the combo meal, or go ahead and rest as the rest as a four hour absorption. That way, you're kind of addressing both types of food and the way that they may be being digested because of how you've kind of eaten them. Whereas the apple at the end of the meal sitting on top of the burger and the French fries and whatnot. Group it in and to for our absorption.

Scott Benner 16:10
I was gonna I was gonna say to rice so at home. I only use a basmati rice. It's okay, and that does not impact Arden nearly like if we were to go to a Chinese restaurant, she was just going to grab like white rice, right? It's just it's easier. You know, bread with no high fructose corn syrup. Great way to cut yourself a break. And pasta, I use dreamfields It does not hit Arden nearly like other pasta does. Both in intensity and time. So there are sort of ways to like cheat around it with certain foods and what you said about about cooking methods I just made I just made another another note for myself about something we could talk about in the future. Because that's really interesting.

Ask Scott and Jenny was brought to you today buy in pen from companion medical, please go to companion medical comm or click on the links in your show notes of your podcast player, or the ones you can find at juicebox podcast.com. For more information. Just think about what it would mean if your insulin pen could keep track of your insulin on board and so many other things. Just like a pump. The impact is fantastic. It's like that little train that just keeps going get any mean climb and Chugga chugga chugga that thing you don't I mean, it's like no stopping us. Now that's not the train. But if the train could sing, you know if the little engine that could could sing I imagine it would sing ain't no stopping us now. What would that even sound like? I'll leave you with that thought. As it fills your head all day long and torments you. You know what? That's not fair. You need to get that out of your head. Do this instead, think about this companion medical.com with links in your show notes for juicebox podcast.com

About Jenny Smith

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com

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