#1203 Ask Scott and Jenny: Chapter Twenty-Two

May 21, 2024Scott Benner

How do I support someone who was recently diagnosed but in denial of their new life responsibilities? How do you help someone you love who isn't ready to accept help, but is hurting themselves without realizing it?
What do you do if your doctor won't prescribe a certain medication that you need? Or if your insurance won't cover it?
When you've been focusing 24/7 on diabetes management for a long time and then things start to settle in, how do you get yourself out of feeling like you still need to focus on it 24/7?
Scott got a chameleon!

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends and welcome to episode 1203 of the Juicebox Podcast.

Today, Jenny and I are back with another episode of Ask Scott and Jenny. And if you'd like to hire Jenny, you can at integrated diabetes.com. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please do me a favor and go to T one D exchange.org/juicebox. and complete the survey. That's all I need you to do. It'll take about 10 minutes and your efforts will support type one diabetes research. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box and don't forget the 40% off offer at cosy earth.com is gonna go away soon. It's gonna go down so cozy earth.com use the offer code juice box right now to save 40% off of your entire order. But in June of 2024 I don't know what that offer is going to be. Get yours now cozy earth.com use the offer code juice box. This episode of The Juicebox Podcast is sponsored by the ever since CGM. Ever since it's gonna let you break away from some of the CGM norms you may be accustomed to no more weekly or bi weekly hassles of sensor changes. Never again will you be able to accidentally bump your sensor off. You won't have to carry around CGM supplies and worrying about your adhesive lasting. Well that's the thing of the past ever since cgm.com/juicebox. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us med this show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash juicebox. Jenny we're back doing another ask Scott and Jenny episode. And I've been on vacation for like 10 days. So I just joked with you. Let's see if I can remember diabetes. Yeah, the truth is even though I haven't been recording for you know, over a week, I was actually with Arden. So a lot of like hands on diabetes stuff happened this week. Actually, I think I have kind of a theme question I'm going to start with because I don't know how much of this it's going to take up. It's a bit deep for Monday morning. But how do I support someone who was recently diagnosed but in denial of their new life responsibilities? How do you help someone you love? Who isn't ready to accept help, but it's hurting themselves without realizing it? Let's just jump right in on that one.

Jennifer Smith, CDE 3:24
Gosh, that that is that is deep. This is a Monday? No, that's that's a really hard one. Because I think it also depends, it sounds like they're talking about somebody who is an adult that they're trying to support to this isn't it doesn't sound child? Because that's a little bit different. Obviously, you're you're the main supporter, and you essentially tell your kid what to do. Adults. I mean, you can support as much as you can, but also being the dictator isn't going to help, obviously being the one that says you have to do it this way. And did you take your guns? I mean, all the reminder statements that you probably would love to say they're only going to make them sort of retreat farther. Yeah. So Acceptance comes with the person's own ability to, to find what really matters in life to them, I think is a big piece. You know, you really like going golfing for four hours Saturday morning. Well, you know, this happened. And this happened. It would probably be a little bit better if you did some of the things that you know, to do at this point. But even those statements are more of a blame, right? That sounds like well, you caused it and that's not really what you're trying to get across. It's you're trying to show, if you took some of these steps, you could do many of the things that you really want to be doing. And this could be less of a burden, but it's hard to get somebody to reflect that way when they truly just hate what's going on. So

Scott Benner 5:01
while you've been talking, I'm sitting with my whiteboard in front of me writing down the names of people that I can't get to take care of themselves. And I think if I could sit here longer, I'd probably be able to write down more names. So I wonder sometimes, I mean, I don't think it's as cut and dry as you're either going to do it, or you're not going to do it, some people are going to fail, and some people are going to thrive. There's people on this list, who eventually listened. There are people on this list, who listened, and then didn't have the tenacity to make it through the treatment. I guess, if that makes sense. And then back down. And I see a lot of people here, actually, you use the golf reference, and I wrote someone's name down. Oh, actually happened to them. They couldn't play golf anymore. And I thought, Oh, they're going to take care of themselves now. But you know, instead, what they did as they start playing golf. Yeah. And, and then I have the names of two people here who are just acting like it's not happening. And you know, and then of course, I have my friend Mike, who, you know, would never listen to me, you know, and he would actually get angry. If you tried to talk to him. And I wonder back now on whether or not that was his blood sugar sometimes, you know, sure. Yeah. Yeah. So, so listen here, someone says, Listen, I couldn't come up with a question for ask Scott and Jenny. But I want to say that I'd like to hear more about this too. I have type one, but my partner has typed to and won't do anything except take Metformin. They won't test their blood sugar won't ask for a CGM and won't will not change anything about how they eat. It can be hard sometimes to see someone care that you care about not take steps that you know would help them think you should talk about this topic. People would benefit from a great I don't know what we know to say about it. My brother was this way and now is suffering consequences. Now he's suddenly interested in being more healthy, but his kidneys are shot. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, G vo Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you store G vo Capo pen and how to use it. They need to know how to use G voc hypo pen before an emergency situation happens. Learn more about why G voc hypo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma visit G voc glucagon.com/risk For safety information.

Jennifer Smith, CDE 8:15
And sometimes it comes to that point during you know your life with diabetes or many other health conditions to that truly need to be well taken care of via lifestyle or you know, I guess less cumbersome medications that don't really require more than just taking it but lifestyle changes that go along with that medicine doing what it should for you. It really is it's a personal thing. It's the reason that we that's the reason that everybody can't just get along. Like, like if we could really help to change somebody to the positive without making them feel like we are offering you know, what we expect are the solutions to the problem. And sometimes I think is you take it from the side of the person who has the condition or diabetes? Well, you're not living it. So sure you can come up with all of these solutions for me, but I'm the one who has to apply them. And in doing that, it almost like I said it comes for some people down to a matter of what really matters and getting that as a kind of a hit point of Oh yeah, I guess I could feel better by doing this or adding this. Sometimes I mean the example of somebody who's living with type one and has a significant other, you know, with type two, that's an interesting living dynamic, because clearly I would expect that their partner with type two see is how they take care of themselves with type one, right? They see the actions of the person they're living with, and yet still are very resistant. To making any changes for their own life. So that's an interesting dynamic.

Scott Benner 10:06
Yeah to live with. I met a young person recently who has type one who doesn't use a CGM doesn't use a pump and doesn't know what their a wands he is, but he's perfectly sure that they're doing well. How are you doing? I'm doing terrific. And I was like, Oh, that's great. What's your one says, I don't know. You have a CGM. Now to get low often not that often. You know, Mike, I mean, I don't think you could be lucky. And but if if you're getting low and getting high and don't know what's happening, like it's, you know, until it's until it's too late. That's the first time you're gonna I mean, if you're not looking, you can't see it. It's

Jennifer Smith, CDE 10:40
called it. I mean, it's called denial. Yeah, yeah, there's a word. And that's, that's the hard part of being the person seeing this happen. And not wanting to say something that, again, is placing blame, right? You want to you want to be able to tell the person, you're completely in denial, you have to face up to the fact that one, this isn't going away. And to be better if we just hand in hand navigate this together, I'm happy to be here. I'm happy to help you. What can I do for you? How can we do this together? If we're going to change our food structure or activity structure, whatever it is, I'll do it with you. I mean, these people are asking because they want to be a partner.

Scott Benner 11:17
I mean, what this really boils down to, like you said, it's personality, but psychology, and you don't just make people do something that they're not going to do the last thing that I read about the person's brother, at the end of her statement, I think it's a statement by the way, it's from a woman I think, by the way it's written, it says, maybe showing him the consequences of people who didn't manage well, and she lists amputees, retinopathy dialysis, maybe that would help him. And all I can tell you after interviewing 1000s of people is it helps some people and doesn't help other people get and it actually pushes some people away, because it just it pushes them deeper into their denial. That's not going to happen to me. I always use the example of like, people smoke. They know what smoking cigarettes does, like, we all know that it's not good for you. But people are like, ah, and my father was all out. He'd come up with a doctor doctor said I'm good. I'm like, yeah, oh, yeah, I'm fine. I'm fine. And my dad dies of COPD or congestive heart failure. I don't remember congestive something from can smoking. Right? And like it'll eggs, like, and he's, you know, I'm good. I'm good. I'm good, right? Until he wasn't. But your point about it being somebody that you care about. I think the the irony is that if, if Jenny, if you had type one, and weren't taking care of yourself, and I loved you, and I knew to talk to you about it, and you were like, leave me alone, you could also look over at me and go, you have things you could fix in your life, buddy. And then like, you know what I mean? Like, what's that? Cast the first stone to I don't know, I didn't read the Bible, but like, you know, like, there's something in there. Right? We're caught in an age old human conflict, right, like, so this isn't just I got diabetes, and he doesn't want to take care of it. I mentioned it to him three times. He didn't want to do it. So screw him. Like, that's, listen, I will say this, and I'm happy to use my brother's name. I don't know if I've ever said Brian's name on here or not before. But Brian has type two diabetes. And I parented my brother, you know, but very kindly and not, not in a way that he would feel parented. And he knew what was happening, but I was never like insulting about it. He and I don't live anywhere near each other. Actually, he could probably walk to Jenny's house, but you know, it would take me 15 hours to drive to

Jennifer Smith, CDE 13:24
him. It would take him a couple of hours.

Scott Benner 13:28
I don't know that the whole place. Anyway. He had type two, and he was carrying weight. And I'd say Hey, Brian, what are you doing? You know, how's it going? My onesies in the sevens? Oh, my God, what are you gonna do for that doctor wants me to are you going to? I think you should, you should try. Let me know if I can help you. And I'm going to tell you years. It took me years. And finally, I have to be honest, I think what really got him is I stuck a CGM on him when I saw him one time. And then he was like, oh, hell, and I was like, right, he goes, so I eat this and my blood sugar goes right up. I was like, yeah, he goes, I didn't realize that. Okay, so then he started to do it again. And I thought, Oh, this is it. And he started, he died a little bit. And then it went backwards again. Anyway, back and forth, and back and forth. So then I said, Hey, Brian, I think you should talk to your doctor about a GLP. You think so? Yeah. It took me a year to get him to do that. You know, but now Brian, say once he's in the fives, and he wears a CGM, and I think he's gonna be okay. And he lost weight and like everything, you know, but I never want to beat him over the head with a stick about it. It was always just I care about you. I hope you do something about this. I didn't try to scare him and he picked it up eventually. I also think that very possibly could have not worked, you know? Correct.

Jennifer Smith, CDE 14:42
And I think what you said there is like you didn't try to scare him and that scare tactics never work. I mean, that's something that age old a lot of practitioners do. I think without thinking about it. I don't think their goal is to scare but I think their goal their their idea is well if as the the person stated But they just show them the complications or if you talk to them about these and make it very forceful in explanation if this is going to happen, you know, some people may take it upon themselves. Well, you're right, I have to do something. There's that's a person that's very willing, and probably already in the stages of like contemplating a change, yeah. willingness to accept some information. But the other type of person is going to say, well, it's going to happen anyway, I guess. So. Why should they care? Just keep doing what I'm doing. Because essentially, they're missing the point of action now means prevention. They're completely just skipping over to you while you're telling me about all these things that are coming. Well, crap. I'm just going to enjoy doing what I'm doing the way that I do it right now. And I'll get these anyway. So what does it matter?

Scott Benner 15:50
I used to hate ordering my daughter's diabetes supplies. I never had a good experience. And it was frustrating. But it hasn't been that way for a while, actually for about three years now. Because that's how long we've been using us med. Us med.com/juice box or call 888721151 for us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omni pod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996. And they always provide 90 days worth of supplies and fast and free shipping. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and Dexcom G seven. They accept Medicare nationwide and over 800 private insurers. Find out why us med has an A plus rating with the Better Business Bureau at us med.com/juice box or just call them at 888-721-1514. Get started right now. And you'll be getting your supplies the same way we do. How many times have you thought it's time to change my CGM. I just changed it. And then you look and realize I got it's been 14 days already a week, week and a half. Feels like I just did this. Well, you'll never feel like that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings, giving you more convenience, confidence and flexibility. So if you're one of those people who has that thought that I just did this didn't know why we're gonna have to do this again, right now. If you don't like that feeling, give ever sense a try. Because we've ever since you'll replace the sensor just once every six months via a simple in office visit. Ever since cgm.com/juicebox. To learn more and get started today, would you like to take a break, take a shower you can with ever since without wasting a sensor, don't want anybody to know for your big day, take it off, no one has to know have your sensor has been failing before 10 or 14 days. That won't happen with ever since. Have you ever had a sensor get torn off while you're pulling off your shirt? That won't happen with ever since. So no sensor to get knocked off. It's as discreet as you want it to be. It's incredibly accurate. And you only have to change it once every six months. Ever since cgm.com/juicebox. I've seen people treat health just like it's money or social status to like, like generations where you've been broke for generations. I'm not getting out of this. You know what I mean? So I'll just take my crappy job and I'll do my thing. And that'll be it. You know, I'm the I can't, I can't get out of this house. I can't do that. Like, look around me. This happened to my brother. It's my mother. You don't think it consciously but you look around you think this is my lot in life, like this is what's gonna happen, you know? And if everybody's got diabetes, then you know, it's colloquial. Like I, we got the sugars, you know, my family's got the sugars, it's gonna get us and I'm like, oh, geez, that's not right. You know what I mean? Like, yeah. And so anyway, all right, good conversation.

Jennifer Smith, CDE 19:22
We don't have like, I still want to like have an answer. I so want to be able to say, hey, just do this for the person that you're trying to support. And it'll get them to turn around. But unfortunately, that's just not it's not human nature. And I wish there was an answer.

Scott Benner 19:38
You have to not give up. If you really want to help the person I think you have to not give up and you have to assess who they are like what keeps you in their life to keep saying Hey, check it out. And by the way, in this one statement here, you can read where people get frustrated. My brother was that we heard this already but my brother was this way and now is suffering consequences suddenly interested in being more healthy. There. sarcasm and suddenly, you know, suddenly they're interested like, Yeah, well, my dad stopped smoking when he got heart failure to, you know, like, until then denial and hope mixed together is pretty strong. I won't I probably not gonna happen to me and especially with diabetes where it's not happening, smoking is the same way. It's not happening right now while you're doing it. It's not like falling. You don't I mean, you don't go on bleeding. I'll try not to fall again. It's very simple.

Jennifer Smith, CDE 20:27
And I think there's a difference here too. I don't know. I mean, the grand majority of your listeners definitely have type one diabetes, right? Yeah. But in all of this, nobody sort of blatantly said type one. Right. And so what we may be able to also understand is that with type two and with some of the meds that are not as directly impactful on blood sugar, like insulin, right, you take it, you can see what it does this way, this way, whatever. Whereas with type two diabetes, and some of the oral medications and the other kinds of things, sometimes it makes it a little bit harder to make a change, because along with lifestyle, those medications, they sort of require a partnership. And then you start to see results, they may not be as immediate and so somebody who is trying to make a change, may be making it and may not have the right medications to help with what they're doing. So they're not seeing any results in there thinking well, what's the purpose like

Scott Benner 21:32
taking a vitamin or exercise? You know, I did a sit up where my where my abs? Like, I took this vitamin D for a week, I don't feel any different, like, oh, okay, I'm gonna try a little longer now. Like it's, you know, but I agree. Like, it's just it's a tough scenario to be put into, because if somebody hasn't already made you believe that even though you're not seeing it, it's incredibly important, then you're the person I met earlier, who's like, oh, I don't have a CGM. I don't know what my blood sugars are. But I'm good. Like, you actually don't know if you're good or not, you're living like it's 1980. And you have type one diabetes. And I don't think it matters. By the way, if it's a type two or type one, I actually think we could have this conversation, take out all those words, and you could insert the one that's impacting you could be diet, exercise, diabetes, you know, saw the same conversation. Alright, let's let's, let's go to something a little more a little easier light. I don't know how light this one is, what do you do if your doctor won't prescribe a certain medication that you need? Or if your insurance won't cover it?

Jennifer Smith, CDE 22:35
Well, I think the doctor side is potentially a little bit easier. I don't love using the word easy in many places. But I think that is if you're in an area where you have multiple practitioners to pick from, and allowance on your plan involves a bigger network of people or, you know, doctors to choose. Absolutely, you could switch doctors, right, because if you need a medication, that someone is not willing to prescribe, and you've brought in enough information to support your reason for believing this medication could be to your benefit. And the doctor is still not willing to discuss, right? I mean, working with any healthcare practitioner, it's a partnership, you both should be putting something into this effort at your health. Yeah, it's not one sided. And so if the doctor is not helping, then find somebody who will write the other side of it is a little bit harder, honestly, I mean, insurance coverage varies based on the plan that you have the type of coverage you have for prescription versus durable medical equipment types of product, sometimes it can be gotten around with insurance coverage, where the doctor writes a letter of medical necessity, stating reason as to this product versus that this medication versus that I mean I myself with using a pump for years and years, one type of rapid acting insulin, I can use it as an injected injection, but if I take it and infuse it with a pump, I get a really hard not under my skin. And so I can't use that particular rapid insulin and so my doctor has written over the years when I've had a preferred for that type of medication or that type of insulin. My doctor has written a letter that says but this this in this happens, my patient needs to have this alternative rapid insulin and so I still I pay a little bit out of pocket but it's nothing comparative right to what would how many little

Scott Benner 24:37
things you don't realize until stuff like that, like Arden's using the GLP through a pen right now and she said that the needles that come with the pen hurt but the BD like the there's another type of needle she gets she gets doesn't hurt as much and I'm like oh cool, or you know, she shoots V ASP. We tried V Aspen a pump, and she would get like what she would call it felt like bruising. So I don't know why it made I feel like it might be the additive that speeds it up. I don't know I will do they usually vitamin B or something like that? I forget. I listen, I'm not a doctor for sure. But like, you know, fee asked makes her site feel Bruce she could talk through it if she wanted to. But she's like it hurts. Whereas loom JEV because we tried everything that she can. Maybe the pumps on for an hour, she's like, this has to come off right now. Like she just yeah, it burns and she can't take it. You know? No vlog works. Okay for her, but not great. You know, so we use a pager, a pager works terrific. It's in her, it's in her notes. Like we had a doctor like note her her her account like that. Her account her chart, I will say this, this is gonna sound a little cynical, perhaps you can find a doctor to help you. You just?

Unknown Speaker 25:47
Absolutely, yeah,

Scott Benner 25:49
they're not all like, you know, what do I want to say? Okay, just, you know, I think this will help in some doctors, if they don't think it's gonna hurt you. We'll go. Sure. Let's try it. And you know, and that's not a bad thing. There's also some, I don't think you should push your doctor around. Because, oh, there's a there's a high chance you're wrong, too. You know, like, but with the things you know, about like this insulin is better for me that kind of stuff. But you know, you know, Jenny, we're going to live through this. This GLP not being covered thing for type ones for probably another year or two. I would imagine, even though the studies are happening now. And we're seeing it already, like you, you're seeing you work with people are paying out of pocket for it, right? Absolutely.

Jennifer Smith, CDE 26:28
Yes. People who are paying out of pocket people who are actually paying out of pocket but going to Canadian pharmacy because it's less expensive and less cumbersome to actually get it. Yeah. So

Scott Benner 26:40
I had to do that for Arden. So Arden just got an ozempic pen that was oh my god, you shouldn't see how it works. You call a company that's based in Canada that I'm pretty sure I'm not talking to a Canadian. Then the pen comes from, oh, God, maybe from Taiwan where I know Taiwan, like something like that, like it's on this long peg. It's crazy. Like it's absolutely crazy. But she doesn't use very much of it. So out of pocket. It's not. It's not cumbersome for us. If I had to buy that pen every few weeks, like I couldn't afford to do that, you know, and her doctor wants her to have it. And it doesn't matter. The insurance companies like it's that right now. They're hiding behind. It's only approved for type twos, right? Yeah. But then I have a, you know, my weight work. So I can have that bound? No problem. I literally don't pay a penny for that. Right? Yeah. But I can't, I can't give a dart and it's measured wrong. And it's just it's a disaster. So change doctors to find somebody with a little bit I'd like to add on to that is don't just pick another doctor and have the yellow pages. Rack tall ahead, have a conversation with the office manager, make sure you're not wasting your time by going to a switchable place is not going to help you either.

Jennifer Smith, CDE 27:54
And if they're not, you know, some of the medications or even some of the things like CGM, sometimes if you have a really good primary care doctor who you've had a really good relationship for a while already, some of those could be written by primary care if they're willing. Right. So that's another source of sort of securing a prescription for something. Now, some of the, let's call them fancier meds that are very specific to diabetes, your primary care is very likely not going to do that for you. But again, just as a potential options, some some will,

Scott Benner 28:32
I'll say to if you can afford it, or, you know, a concierge doctor is a good way to go. You know, for those who think, Oh, am I paying a doctor cash, that must be crazy. I use a concierge doctor, but our insurance covers it. So we see her, we pay out of pocket, she sends us a bill, I submit the bill, I get almost all the money back, they just for some reason won't cover it the first time I don't I don't even care why,

Jennifer Smith, CDE 29:00
you know, sometimes those are relative to how it's written. Sometimes I know that insurance will be very willing to reimburse if you can provide the fact that you're in network providers will not provide the same type of service, or the same type of education or care if that's not available in one of their in network providers. Many times they will reimburse. Yeah.

Scott Benner 29:25
So eventually that's going to change to by the way, because I hate to say this, but like, doctors are doing this more and more. Yes. You know, like it used to be like we'll all get together in a group and we'll pull together and now they're all running from that. So you're gonna see a lot more of this kind of shared stuff. But, you know, the other problem here is we're talking basically about this issue from our perspective, you know, correct. Plenty of you are gonna have crap insurance and it's not going to matter what you do or who you beg. They're just going to Stonewall you the whole

Jennifer Smith, CDE 29:54
way. Right. And I won't even get into Medicare. That's a whole nother like, box of worms to open up, quite honestly, in terms of what they cover, how they cover it, how things are written when lab tests are done and going over a certain time. There are so many rules and regulations within Medicare. It's astounding.

Scott Benner 30:16
Yeah. All right. Let's go. Maybe the next one is going to be upbeat when you it's not just asking us questions when you've been focusing 24/7 on diabetes management for a long time, and then things start to settle in. How do you get yourself out of feeling like you still need to focus on it? 24/7 I have. Oh, wow. Okay, this is apparent. I have blood sugars readily visible in every room of my house. Should I turn some of those screens off? Yet? You? I think you definitely. Yeah. Oh, Am I destined to forever be watching this? I know if you put it on every screen in the house, you are destined to be watching it forever. But like, look, I sit in front of two computers all day. And on one of them up in the corner, there's a little number from sugar pixel that tells me what Arden's blood sugar is. I don't think I ever look at it. As a matter of fact, when I need to know what her blood sugar is, I frequently forget it's there. I do have the glucose globe. I do too. I have one in here, because I'm working and I and all my alarms are shut off. So if Arden has like a flashing red problem, I won't know because I'm recording. And I have one in my bedroom. Because when I wake up at night, it's easy to just look and go, Oh, it's green. I'm okay. Like she's fine. And I don't think about it again. I think it's a really terrific tool. Now if I had one in my hallway, so I wouldn't miss it. If I was going from my bedroom to my office, then I'd be worried about myself. Yeah. And I see people do this all the time. Like some ingenious there's always some ingenious engineer dad, who turns like the wall clock into a CGM or some you know, it's really cool. But

Jennifer Smith, CDE 31:58
I think it boils down to how much data do you need? Right? Are you I guess I look at it from Are you in a time of trying to figure things out? Are you making a lot of adjustments? Are you trying to watch so that you can see whether the changes you made have made a difference? Or are you in a time where as this person states, things have been pretty good, and I just can't step away? Yeah, it's a you have to consciously then step away, right, turn off half of the rooms with the sugar pixel or whatever, you've got glowing, right? Turn half of them off, right? Because they're not needed at this point when something shifts and changes. And again, you're trying to put in adjustments and make sure that they're working rate

Scott Benner 32:45
or vigilant. The difference between you're trying to assuage your fear, and you're trying to help yourself make a good decision. Like I think you're right, like when you're first learning something or dialing something in, you do have to be a little hyper aware of it, because you're making those kinds of decisions. Like, I don't, I don't know if I talked about it on the podcast or not. But you know, my kids got me that chameleon behind me for Christmas. And for the first four weeks, I was staring at the thing waiting for it to, you know, like,

Jennifer Smith, CDE 33:13
you gotta poop, can you eat the worst

Scott Benner 33:16
thing? Or she right? And then like, but no kidding, like, Listen, this is neither here nor there. But the way you can tell if that poor thing is hydrated correctly, is when it goes to the bathroom, you have to assess two different things that happen. And once you have those things, right, then she's healthy. And but that stuff comes from humidity, and misting, and how long you do it and what time of day you do. And you're like, oh my god, like so I'm turning knobs on humidity at 2am to see if this comes right out on Thursday. So for a while, I started giving a lot, like but but then I figured it out. And I don't do that anymore. I check in once in a while now. Hey, you know, right.

Jennifer Smith, CDE 33:57
I mean, it as far as you said, you know, you've got your little sugar pixel notification, you sort of, it's when something is around enough that you really don't pay much attention to it. Yeah. Unless it's blaring noise or an alarm or something at you to pay attention to people ask me, Well, how often do you look at your blood sugars? And where are your alarm set and whatever. And I mean, I have my stuff turned off. When I'm working with people unless I get an alarm for something. My phone is off my you know, all of that is it's turned off. I used to when I first got my glucose, which I also love. I think it's a fabulous little tool. I carry it around because I thought it was kind of fun to have it like in different areas and be able to see rather than even like open up my phone or look at my watch to see where my number was. And now it lives in our bedroom on my bedside table because like you said, it's a nice way that if I wake up I can easily glance I see a color and I'm like great. I don't even have to open up my phone to look at or

Scott Benner 34:56
whatever. Right I agree. Yeah, you Come

Jennifer Smith, CDE 35:00
to feel a confidence. And again, unless you need to adjust something, you're really trying to pay attention to a time of day. And maybe open everything up for a time of day that you're having problems with. But don't open it up. 24/7 Yeah,

Scott Benner 35:13
you can't always be looking and staring at it like that, like, you know, the feeling, you know, the feeling is like my kids about to die. I got to make sure that doesn't happen. Here's my best advice on this. And I, I'll stand behind this segment like 100%. If you're just diagnosed, listen to the bowl beginning series. Once you understand that, maybe at the same time, listen to defining diabetes, so that you have all the terms down, you understand the words. Once you've understood all that you're ready to move on, listen to the protests. And then about six months from now, you're going to be good at this. And then set your alarms where you know, you want to catch them. Right, Arden's low alarm is at 70 Because I know from her settings, if we make it to 70 and it's falling, she may be is going to keep going. Like that's just what I know from you know, history. And then I like my phone to be but 120 And I like hers to be but 130 going up. And and that honestly is getting less and less important as the algorithms get better and better. But my rule of thumb is if that thing doesn't beep don't look at it. Right after you know that you're making good decisions where you're not vacillating up and down wildly now if if I don't know, what's a good example, I just told you about it. Art in Mr. GLP. For I told you about before we started Yes, Arden spinales came up she Mr. GLP for like three days. She just didn't shoot it. Of course. Now the setting she has are not heavy enough because without the GLP her her insulin needs go up. So her insulin needs are going up. But Arden's using Iaps. So I EPS is getting more aggressive as it's happening. Then she shoots the G. So they're I'm fine. I let her go. Because she's finals like she was seeing 180s and two hundreds, but it was after meals, they were coming back and she wasn't getting low. So I'm like, literally let's let her get through her finals. You know, I don't want to like I'm not gonna bother right now barred her? Yeah. As soon as she shot that GLP again. I mean, like, almost as soon as now suddenly, the algorithms being aggressive on the pod five people are gonna know this too, right? Like if you're super active for days, and then suddenly you're sedentary, you might, you know, yeah, you might see a shift in in how your settings are less valuable after you had a big change. And so she shoots it again. And now I pay closer attention to it. Because now it's not a 180 Blood shirt or for an hour. Now it's 55 if something gets sideways, right? Right. And so then I paid more attention to it. I actually looked at it. And I was like I was with her, which I hadn't been for a while. It's like I'm gonna turn a couple screws here. And this algorithm, you mind if I move things around a little bit, and changed her by the way her insulin sensitivity is now like one loser 90, from from one moves her 43 Where she started before GPS, and I made a couple of adjustments. I watched it for a day and a half. And I was like, Alright, this is good. And then I stopped looking at it again. So I mean, I think that's what you and if you can't do that, I talked to a therapist, not you know, I wouldn't ask me, you know, because it sounds like you might have gotten yourself into a into a bad pattern, maybe.

Jennifer Smith, CDE 38:18
I think technology adds a bit to it as well. Because technology allows us all of this information and makes you then think, well, goodness, if it's giving me information every five minutes, I really need to pay attention every five minutes, it could absolutely change. It could. But it doesn't necessarily mean that you have to react to it. I think technology has brought in a world of benefit. But it's also brought in a lot more reaction versus sit back, watch, make an adjustment and watch again, the reactive nature of managing any slight blip up or any slight blip down ends up creating a lot more roller coaster when truly with a lot of the algorithms that we now have. The algorithm needs time. Yeah, to accommodate for any slight rise or slight fall, you have to let it work. And again, you have to work with it

Scott Benner 39:21
because the algorithm is working on its own timeline. And your timeline is not the same as it so if you step in, you are most certainly going to mess it up in the future. Unless your settings are so bad that it needs intervention. That's the thing you need to know not just guess about because you know otherwise, and you can use it and like Arden got low overnight last night. And what I mean by low she went to 65 So she hit 65 So I get an alarm because it went pretty quickly from like 75 to six o'clock and alarm I woke up was like four o'clock in the morning. And I'm like I looked at it. I was like Oh, I wonder if she'll hear this. And then I was like I don't want to wake her up. If she's going to like I don't want to call if she's already taken care of it, right? There's a lot that goes on into this all the sudden is that dynamic here, you it's tough. You know, if she's already done something about it, I don't want to wake her up. I don't want to not to wake up if it's a problem, and it's still falling. So I would look at, I know this is a little unfair, but I have Nightscout. Because Arden is using Iaps. And I look back, and this thing did not think she was gonna get low. It had not been cutting basil like she was coasting really well, but also hadn't Bolus or made any like, pushes with her basil. And then I looked at insulin on board, and I'm like, she shouldn't be low here. I wonder if she's laying on this thing. Maybe this is a compression low, right? Like, maybe let me wait a minute. And

Jennifer Smith, CDE 40:43
especially since you said it changed pretty quickly between five and six. Yeah, but

Scott Benner 40:47
it had happened. So I woke up so quickly that I didn't have I couldn't look back. And because you can see a compression low after they happen. But as they're happening, you can't 100% Be sure. And so I'm watching it. And then it did this thing that I know means she's laying on her sensor. So it was 65 stable, then all of a sudden it was 59. And it was diagonal down. But then on the next time it said 62 Diagonal down. And I went, Oh, it's trying to figure out what's going on. Yeah. And I don't know how to explain to you that. I know that that's what that means. But I just know because I've seen it a couple of times. I stayed up watching of data. That's all I watched one YouTube video about chameleons. And then I went back to sleep. I'm still trying to learn things about chameleons. Don't, Jenny, let me just tell you why right now. And then we'll do one more question. Oh, God, this is not part of our satin Jenny. But

Jennifer Smith, CDE 41:42
my kids get me fun information.

Scott Benner 41:45
My kids get me this. I love this chameleon. It's fantastic. I've wanted to chameleon my entire life. I'm sure I'll talk about on the podcast. It's

Jennifer Smith, CDE 41:52
like boys love this Lobo videos, you text me some

Scott Benner 41:55
Chinese boys slomo videos of it eating and it's a lot of fun. But I've always I like how slowly they move and how specific they are. I like that they're difficult to take care of. And if I'm being honest, I miss taking care of my kids a little bit. So like, so this is a nice thing for me to put that caregiver energy into I mean, I put most of it into you guys, but it's a hairless child. So we're the kids in airborne. Oh my god. So a couple days before Christmas, we were standing around talking about things that we wished we had done or won't want to do in our life. And I went around the room I had the kids say something my wife dies for some friends over. And then they asked me and I very quickly blurted out, I want to keep a chameleon as a pet. And everyone looked at me like I had seven heads. Because I've never I'm 52 in my life mentioned this to anyone, right? It's just the way I felt since I was a kid. Oh, my family lovely. They go out and get me a chameleon. But that's not it also

Jennifer Smith, CDE 42:54
means up to that point. They hadn't gotten you a Christmas gift.

Scott Benner 42:59
Oh, finally, just something for this jackass. Because I didn't know what to get him. But yeah, by the way, I'm the dad. I get like T shirts. And like thing. My wife got me a Squatty Potty for Christmas one time. I was so getting mad. And can I tell you something? I love that. aleria held it I was like, this is a Christmas gift. She goes you're gonna love it. I'm like, I don't care. Don't give me this for Christmas. Like anyways, but one of the best Christmas ever gotten in my life. This is neither here nor there. So anyway, the thing is, there's a lot of different kinds of chameleons. And if I'm being honest, this is not the one I would have chosen. But it's fantastic. And I love it. And honestly, it's a good starter because it's a little more forgiving with its health and stuff like that. But there is this kind that I want. They're expensive. And they're very, very rare. And they're hard to find. And so what I thought was, I'm going to take care of this one, this one will live six, seven years. If I do a really good job with it. I'll really understand this then. And then I'm going to get the next one. I started to get worried because I'm 52 and six years from now I'll be 58 and the one I want could live 12 years. And I started going 60 Do I want to be taken care of a chameleon when I'm 70 years old, like I don't know, you know what I mean? Like maybe and maybe not. And so like, you know, and maybe

Jennifer Smith, CDE 44:19
you'll put it on Pet Carriers and put it under your seat when you travel on the air.

Scott Benner 44:23
Imagine and so like, you know, it's so soon I'm like, tell people this is my it helps me when I get nervous. But did they call that? I don't know. I don't

Jennifer Smith, CDE 44:34
know. You're like little lifelines. Yeah, I

Scott Benner 44:37
don't know. Some people have ponies. I didn't like a million. Anyway. So I look into it. I find that there are really only about three people breeding these chameleons anymore. The one that I really want, right? And I Okay, identify who they are actually make a little note on my computer, and to myself, like four years from now, go check into this. But as I'm looking into it, the guy who'd like breathe Some of the best is like, I'm not doing this anymore after these, and I'm like, you have to be kidding me. And I was like, I've been doing this for 20 years. But this is the last clutch I'll ever do. I'm like, Can you wait a minute? I just figured this out, you know? And so anyway, I bought another one. I even had two big Yeah, he's on his way. I'll be here in like a week and a half.

Jennifer Smith, CDE 45:21
How do they come given that? I mean, you've explained enough to me, like the humidity and all of that kind of stuff, how do they overnight

Scott Benner 45:28
mail pill, put it into a box packaged a certain way with, like, I guess just moist towels to keep enough humidity in there. And he goes to the post office at the end of the day, and it will be across the country from I'm going buying it from California, I'm in New Jersey, it will be at my post office at 10am the next day. So you pay a really hefty, like amount of money to get it moved quickly. And the guy told me he goes, you'll open it up and it'll just be like, Hey, what's up, and it's not gonna, it's crazy. He's like how well they ship like that. So anyway, I have another chameleon coming. So at some point, this tank behind me will actually be slid over that the other one could fit behind me. And then I'm gonna feel ridiculous. But it really is. It's the only thing that I was like, I don't want other pets, our dogs are older, like this is gonna be good. At

Jennifer Smith, CDE 46:19
some point, I will only be worried about you. If I sign in at some point, and you are surrounded by jungle leaves, and I can no longer see you, then I'll be a little bit worried. The

Scott Benner 46:33
breeder says to me, I got a nice female too. And I went, are you upselling? Me? I was like, No, that's okay. Oh, you want to hear something crazy. The breeder this, this chameleon, I speaking to him on the phone to set the whole thing up. And as he was talking, he was so knowledgeable about this thing that just is not. It's not information. It's out in the world really, like, the certain kinds of breeders for the certain they're very private, they don't Okay, share their information really? Well. I and he's like, um, so, you know, kind of said, like, you know, I'm gonna stop doing this. Now, I'm worried that you know, what's going to happen to the population of these things. And I said, you want to make a podcast, and just dump all your knowledge into it about breeding them and put it out in the world. And maybe somebody will pick it up and figure it out. And he has a podcast. And I was like, yeah, he should like, you know, I said, I make a podcast. And basically, I do the same thing. I have a bunch of information that a lot of people don't have, and I let it out through conversation. I said, Hell, man, I'll host it for you. I'll interview you. And you know, you can get all your stuff out and put it up online. And I don't know that he's interested or not. But he says to me, what's your podcast about? And I said, type one diabetes. And you know what he said? My daughter has type one diabetes. And I was like, Oh my God, how old is she? And he's like, 20. And I was like, Oh, my daughter's 20. She has type one diabetes. It's the weirdest thing.

Jennifer Smith, CDE 47:47
That is weird. That's the universe. I don't know what it is. You can like you cannot. You cannot. I don't know, I always feel like you can't believe that. We're just randomly like sputtering around the universe.

Scott Benner 48:01
Odd that there's a handful of people like dishing out good diabetes advice in the world. And there's a handful of people talking about this specific community chameleon, and like, both of our kids have diabetes, and we're talking to each other. And then he, by the way, texted me later. And he goes, Hey, my daughter says she's heard your podcast. And I was like, well, then I thought, of course, but no, no. Who hasn't? Any? That's not the point. I mean, that was obvious, right?

Jennifer Smith, CDE 48:26
You're like what you give me an extra chameleons for free? Discount?

Scott Benner 48:30
He said no. So I even asked, I was like, What about cash? Is there a cash price? Because cash the same as everything else was like, okay. But I understand it's a two year process. I think by the time he sells them, I don't even know that he makes any money on it. Like it's, you know, it's a labor of love. Like he's doing it to help people. It's really kind of nice. Anyway, we're low on time. So let me tell you this. Yeah. I, of course, didn't know anything about your this is going to be about diabetes, I promise. I didn't know anything about chameleons when I started and it was a bad idea to get one and not know, I just want to caution people. These are not impulse buy items, I had to put an insane amount of time and a fair amount of money into doing this correctly. So don't just jump into it. But once I was in because my kids were like, surprised. And I was like, oh God. Like once I was in I had to figure it out quickly. And it was not dissimilar to being diagnosed with diabetes and not getting any information i and that hit me right away. I'm like, Oh my god. This is what people do when they find my podcast. So my first thought was, my Facebook group is so helpful to people. I'll go find Facebook groups about chameleons. Well, that was less than helpful. Because they were a little judgmental. So word I'll use and then I thought, oh, that's why people like my facebook group because we're not in there. Not each other and being judged and everything like them. They call it's interesting. And then I watched how they talk and then I finally found a guy with a podcast. Esther who had really good information and was good at expressing it. And that's where I started getting my chameleon information from. And then I started hearing him talk about community and I was like, Oh my God, he's having the same conversation about people helping people that I'm having. Yeah, I'm not just adding a little bit. It's exactly the same. And then I'm like, oh, people are the same no matter what situation you put them in. There's gonna be a couple of nice ones. There's gonna be a couple of assholes. There's gonna be it's all going to be the same every time. Fascinating. Absolutely.

Jennifer Smith, CDE 50:29
No, is he the one that told you how to look under the chameleons leg and look for bumps and horns and whatever?

Scott Benner 50:37
The sheer here, so Jenny, me on the back of their back legs, I have a Veiled Chameleon right now a little bump on the back leg means I think it's called a tarsal. Maybe is a male without the bump is a female. Also, they have that kind of cast on their head, the ones that kind of stick up in our larger generally males, but when they're younger, it's really hard to tell. And there's no bits and pieces to look for. You know what I mean? So it's her name still,

Jennifer Smith, CDE 51:01
Princess.

Scott Benner 51:02
I've been calling her big mama. Big Mama. Yes. My wife is pushing me very hard to name her after the character from the movie Sing. I'm concerned that my wife is 50 years old and really loves that animated movie where the animals are singing, but nevertheless, she wants me to call her Miss Crawley, which I won't be doing. But she calls her that. My son's girlfriend calls them calls her one thing. My son's girlfriend calls or something. Kelly calls or something. I call her something my brother's wife calls her Kanye. That thing's got like 75 names. So I gotta be honest with you. It's a chameleon. I don't think it needs a name.

Jennifer Smith, CDE 51:41
It's actually my husband, I had this conversation one day we're sitting just, you know, pets are are what they are. Right? And we're talking like just about how creatures like, we inherently know that we're human. Right? Because we have the intelligence level and the understanding at a certain degree, whereas we're looking at our dog who just is I mean, he's the greatest Chocolate Lab. Right? And Nathan was like, you know, he's a dog. That was like, no, no, he has no idea he has no, he knows what he is from an evolutionary like all the things he's supposed to sniff and whatever, but she has no clue that dog means him. Yeah, no,

Scott Benner 52:27
please. We made that word up. First of all, yeah, we're frontal lobe and thumbs are we're probably in that dog situation, pretty much. But ya know, I mean, it's not like if I was like, Hey, Big Mama, the thing would turn it Look at me. Like, it does the same thing. Every time I get close to it. It goes, is this thing gonna kill me? And then it goes. I don't think it's gonna kill me. And then she calms down a little bit like it's, you know, her life is avoiding. She's programmed to avoid being captured by birds and snakes. And does she

Jennifer Smith, CDE 52:58
react differently though, in a learned way? Yeah, you versus your wife?

Scott Benner 53:04
No, she's now good with people, but not fast movements. You can reach into the tank slowly, but you have to come from under her. And there's like a meter like this little box that I need to test the light with to make sure that Jenny to make sure she's getting enough like ultra violet be like Jesus, you've no idea. And so like, and so if you reach in there with that meter, she gets defensive. Like she puffs herself up turns her head a little opens her mouth makes a noise to make. Like that kind of thing. You I reached in the same exact way without the thing in my hand. She'd be okay. Interesting. Yeah, she this type of chameleon are they're very difficult to hold like you, they probably won't even ever probably never, like be on my hand ever. So the other one that I got will probably be more handled by sale. I know. They're very, very, very slow. Like just it's incredible. I love them. They just look like dinosaurs.

Jennifer Smith, CDE 54:02
So yeah, they're I love them. I think my favorite thing is their eyes. Yeah, I love the way that their eyes move. I just it's so cool. Super cool. If

Scott Benner 54:11
you approach her from the back, her eyes turn completely around to look backwards. I know. All I want to know is what does that look like to her? Like, I would love a video of that. I know you can't do that. But I would love that. Alright, well, she's a lot bigger now than the last video I sent you. So I'll get you one today and send one over for the boys. Cool. Thanks for doing this with me actually, the chameleon thing. I didn't just talk about my chameleon because I wanted to I really wanted to say I've just been having this overwhelming experience watching a chameleon community work the same way as the diabetes community does. And I said I've seen I've seen good examples of it work well, and I've seen good examples of it worked poorly. And I've seen the exact same thing and diabetes. It really is. If you can find somebody that can be valuable to you that won't be judging you. You just have to look around for it a little bit. Right. So anyway, Alright, thanks so much. I'll talk to you

I want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast and invite you to go to ever since cgm.com/juice box to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer. And that way you'll know if ever sense feels right for you ever since cgm.com/juice box. A huge thanks to us med for sponsoring this episode of The Juicebox Podcast. Don't forget us med.com/juice box this is where we get our diabetes supplies from you can as well use the link or call 888-721-1514 Use the link or call the number get your free benefits check so that you can start getting your diabetes supplies the way we do from us med. A huge thank you to one of today's sponsors G voc glucagon find out more about Chivo Capo pen at G voc glucagon.com. Ford slash juice box. You spell that? G v o KEGLUC. Ag o n.com? Forward slash juicebox. You have questions Scott and Jenny have answers. There are now 19 ask Scott and Jenny episodes. That's where Jenny Smith and I answer questions from the audience. If you'd like to see a list of them, go to juicebox podcast.com up into the menu and click on Ask Scott and Jenny. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.