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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 0:10
Hello friends and welcome to Episode 495 of the Juicebox Podcast. Today's show is with Hillary, and Hillary is trying to kill me. She wanted to come on the show, then she recorded this episode, and it was terrific. And then she sent me an email and said, I don't think I did a good job. Please don't let anybody hear it. And then months later sent me another email and said, I changed my mind. You could let people hear it. I was like Hilary, I've already deleted your episode, it's gone. But I found it on a backup server backup server. It was backed up somewhere, way, way back. And I'm delighted to bring it to you now. Please remember while you're listening, not to try to kill me, and that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan. or becoming bold with insulin. Hillary Hillary Hillary this show is sponsored today by the glucagon that my daughter carries g vo hype open, Find out more at G Vogue glucagon.com forward slash juice box. The show is also sponsored today by the Contour Next One blood glucose meter. It is incredibly accurate, easy to hold easy to use as a super bright light. I'm going to tell you more about it later. For now just know this, you can find out more about it get started. See if you're eligible for a free meter at Contour Next one.com forward slash juice box. I want to give you a tiny bit of context for this episode before it starts. Hillary came on to talk about how her child eats with Type One Diabetes, it was going to be part of the how we eat series. But when it was over, Joking aside from earlier, she just felt like she didn't do a good job of explaining. But I just really loved the episode. And you know you don't make a good conversation. trumps everything else for me. I thought it was a great episode. She wasn't happy about it in so much as how she described their eating style. So this is not part of the how we eat series. But it is a really great episode of the podcast. And Hillary. I forgive you for trying to kill me.

Hilary 2:46
I'm Hillary. I'm married. We live in Southern California. And we have two children. One is five and one is three. And Joan is a type one diabetic.

Scott Benner 2:58
What do you do for a living? Because you've never used zoom before? That's for sure.

Hilary 3:02
Do I have used zoom before? I am not working right now. But I am I'm I'm teaching kindergarten right now. So are you really not not by choice? not by choice? Oh, California, I'm being forced to teach kindergarten.

Scott Benner 3:22
deputized your major teachers. I'll be right that. No, that's so how many kids do you have in total? to two? And that's it forever? To forever? I feel like that's a smart move. Which one has type one? Joe and she just turned three last week. Wow. Okay, when was she diagnosed?

Hilary 3:43
She was diagnosed when she was 11 months.

Scott Benner 3:45
Who is she named after? Because that's a very traditional name.

Hilary 3:50
Oh, you know what, just, she's Nate. We have a Joan in the family. But we just really liked it. We both were it was hard to agree on a name. And with my son. We went back and forth and with with her. My husband said, you know, how about john? I was like, Yeah, let's do that. Let's just, and we didn't mess with it. I mean, if you agree on something, I feel like you know, just go with it.

Scott Benner 4:11
So I need to know, if you didn't have to make this decision along with somebody else. What would John's name be? Did you have one picked out that he couldn't agree with and vice versa?

Hilary 4:22
No, no, no. Well, he was thinking about Ruby, but I think I that wasn't a name that I really liked. But no, it's just it was just easy. We just both thought you know, Joe,

Scott Benner 4:34
I think Ruby is a woman who sang in a 90 minute 19 speakeasy somewhere. Well,

Hilary 4:40
it's like country music. My husband likes country music. So anyway, I did

Scott Benner 4:49
this down if they like country music, it's fine. I'm just joking. I'm really just trying to say stupid stuff to loosen you up so we can start talking about the diabetes. Yeah. So how old again? Was she when she was diagnosed? 11 months, 11 months that's really young.

Unknown Speaker 5:07
So Young,

Scott Benner 5:08
are you would you describe yourself as just on the emotional edge or things going? Okay.

Hilary 5:14
Um, I would say they're going okay, now most days, but I don't think I mean, I was actually just perusing pictures while I was waiting for you to call. And I was looking back, so I couldn't remember because he's looping. I was like, I wouldn't I couldn't remember when she started looping. And so I was looking back at pictures. And I was just seeing pictures from that time that first year when she was really young. And my son, you know, was just turning four when she was when she had been diagnosed. And it was just really hectic and hard. The first I was crying, like, all the time. Yeah. And it was just I remember driving one time somewhere, and I was just like, I should not be driving like this is, you know, because I hadn't slept it was just out of control.

Scott Benner 5:58
I so I think, what's yours? What do you say? I said, I think my life was similar to yours back then.

Hilary 6:06
Yeah, I mean, I really appreciate you being so open about like, just going, you said that you went up to your, when your wife brought Chinese food home and you just went up to your shower, and you just started crying because it's like, you feel like that sometime. It's just like, you know, are you just trying to keep it together? You know, it was really hard, but I feel like lately, you know, it was the first year was I feel like, you know, it took like a year and a half, I'd say I mean, I feel like it takes a while I think it's gonna take a long time to really get where I felt like to also get where I want to be where I don't see a number and kind of like clench up or take like a breath, you know, like just, you know, have that poker face which I'm excited about a psychologist kind of coming on and talking about like the effects of like, like how to help yourself maybe some tools with you know, higher emoting you know, yeah, you try not to I know I don't like you don't do that. That's why I love listening to cuz I'm like, how you can just like, you do what you need to do. And then you're you don't think about it again, it's to me very inspiring, because I would love to get there.

Scott Benner 7:17
Well, it was a process because for quite some time, I felt like I was doing that. But my wife said that my face gave me away that even if I get if I get hold it in verbally, she's like, it's just coming out through your face. She said, you might as well just look at us. And you know, say what's your thing? Yeah, I used to I've said on here before, but it was like a knee jerk reaction when something didn't go the way I wanted it to, I'd say out loud for some reason, like just under my breath a little bit. And my wife's like, that's hard on on us to hear like her and I and everything. I said, Okay, well, I wasn't doing like I wasn't like, you know what I'll do? You know what? You don't my Fingal Bay? It wasn't like, you know, it wasn't like that. It was just like, was it? You know, just or you're thinking

Hilary 8:05
I messed up. I mean, you're thinking that you messed up not anybody else. That's how I feel.

Scott Benner 8:10
It's a compounding too. It's it's you feel like you screwed something up, you feel like you're hurting their health. You feel like you're messing up the next thing you think you feel like you're letting them down. You feel like you're keeping them from eating. And it just hits you at once. And you're just like, gosh, like, I don't think there's anything like anyway, apparently, it's not good for people around men who are in what I guess you would call us. Like, I don't even know how to talk about sexuality anymore. There's so many different words like, Is there a word for when you're married to a woman? And you're a man? That's the traditional? Is that traditional? I don't even know what to call that. Anyway, I think I think men will know that I'm a large complaint from your spouse is usually tone. Right? Because this guy's just don't think about that. We say what we mean, we don't mean anything more or less than that. And the tone really, you probably shouldn't even infer anything from my tone. You know, I'm not even thinking that far ahead. But, I mean, it's going to be the rest of my life trying to figure that out. Because I know, you know, just the way things are said or impactful on people. And that probably sounds crazy coming from me because I do do a good job on the podcast talking to people the way I the way I would perfectly like to speak to everybody but the key is that I'm not sitting down quietly in front of a microphone having every one of my personal conversations and I'm not centered all the time and think you know, things are going on around you and you're unfocused or running around or tired and just happens, you know? Yeah. Well, I feel for you and it sucks to because the people around you who aren't taking on the lion's share of the responsibility don't really completely understand what it feels like either. Yeah, yeah, it's not great. But anyway, what is Joan using? Is she have any gear? Is she MDI? What's she doing?

Hilary 10:05
Um, she has been looping since she was 14 months. So we've been doing it for a while. And I worked with Kenny. I was like, reached out to him because on Facebook, he always chimes in. And I mean, he changed everything for us. I felt like I was about to give up because I was like, I just feel like we're not really looping. I mean, it's a big change. Okay, I have to back up. When we first when we first started. It was like, my husband described it as like, we've been living without running water. And it's like, turned on now. Like, we have water, because it just felt like a safety net. Like, you know, someone's already working on it. Or like Jenny says, a little grim. Is it good? Or did you want the Gremlins anyway? Someone said something about little Gremlins cleaning up and like, taking care of stuff, you know, while you can go about your life. So, you know, I feel like it's taking care of the highs and lows, but my settings weren't right. And they weren't completely off. But you know, like, for me, I started like fidgeting, and then I'd fidget a little more. And then it was something else. And then by the time it was, you know, a year later, I just felt like, gosh, I just still don't I still not grooving with it, you know, all the way would help, but not as much as other people I would see out there. Yeah. So that's when I reached out to Kenny and I said, you know, can you help me and he lives in Southern California. So we got together. And I mean, man, it's insane. I'm like, You're like a wizard. So that helped a knife, though. I mean, it really works, you know, and he also has so many good videos now on the so called bloopers page, and the, like, the videos that he's done, where he explains nightscout and really goes through everything, and it's really helpful. He's gonna come back. I, I'm glad that he is. Because I just find that he's who I've gotten so much from. And yeah, he's, he's been great. So it's,

Scott Benner 12:02
it really is interesting. You know, for people who don't loop or, you know, use some sort of an algorithm, there's a number of settings. And if those settings aren't correct, it just doesn't work very well. And you can also get the settings close enough that it works well away from food, but near food, it's kind of a disaster,

Hilary 12:20
or one setting could be making up for another. So in some situations, it's working really well, half the time, but the other half it doesn't work, which I think was what was happening with us. But we did one basil rate, which I had, like, I think I had like maybe six or seven basil rates. Yeah, I mean, because on a traditional pump, I mean, I I remember when john was first diagnosed, and we were on, we'd done the Omni pod and T slim, we tried a few different ones. And now we're on Medtronic, because of looping. They didn't have the Omni pod when we first started doing it anyways, but but with the T with a tea slim, we would call in to you know, the the nurse would say adjust this, adjust this change your Basal rate? Oh, it sounds like you need to step down your baseline. And so I had all these different ones until Kenny said, don't you just need one? Especially with I think with anything? I don't know, I bet it just smooth things out.

Scott Benner 13:20
Yeah, I agree that we're basically to Basal rate situation, there's a slightly lower one overnight, and there is during the day. Yeah. And, you know, someone like Kenny, who can see the real mathematical cause and effect of things. That's a, it's just, it's, it's fascinating to me that he can look and say, this is happening. So that means that this is too great, but then he can look at the you know, at the other setting and say, Well, if you make this one weaker, that one has to be stronger, and vice versa, like he just knows. And it's funny, I know now, like I can look at the settings and just change them. But I don't have any of the cognitive thoughts that he has to get to it. I don't even know how to do that. I just know that knob is gonna make this happen and that knob is gonna make this happen.

Hilary 14:13
Yeah. And I think it's interesting what he said about x strep that he used that for MDI and that he had even tighter control us just looking at the data coming back from that. I was like, how are you doing? You know, he really does understand

Scott Benner 14:25
and I've said it before, and I've said it to him too that he also has a younger child and as Do you and so we tried the the just like his idea for just one basil rate. And it worked great away from hormones. And then when hormones existed his settings were useless. Like they weren't they wouldn't work so I so I totally makes sense. I now think of Arden is like three different people. Yeah, and that fixed it. It just it didn't i didn't fight it. Like I hear people say all the time, like you can't figure out like hormones and you know, talking about periods pretty special. difficulty. And I just decided one day, I'm like, she's one kind of person in this, this space, she's one kind of a person in this week, and this week, she's a different person. And so her needs are different. I'll meet her needs. And then the next, you know, the next thing you have to do is figure out like, when does it happen? So, after a couple of weeks, you just see it like, okay, when, when this starts to drift up, these are the settings and when it begins to drift lower, then you go back to the other ones, and you get a little more aggressive with meal boluses in the for art, and it's the handful of days before the actual event begins. Which I say that way, because in my mind wants me to say it before she bleeds, and I'm pretty sure that's completely insensitive and correct. So I end up saying the event or something like that. Yeah, whenever Mazel Tov happens. So it really is interesting, but how is how, how are the outcomes now that you're all set up?

Hilary 16:01
I feel like we're good. It's, yeah, we we just kind of, I mean, there's days when she spikes and you know, I just kind of take care of that, but I feel like her car pound everything's, you know, right. And, you know, I try to keep her. I try to keep her under 130. I mean, usually, if I see a 130 I'm going to Bolus and I feel like we sometimes maybe have a little bit more like a feed insulin a lot, but I'd rather she snack so much. I mean, she's always eating I feel like so I know, there's gonna be a meal coming up anyway. So I would rather just make sure that there isn't a spike, even if I think it'll probably slow down, you know, cuz she's so young. And I have complete control because she's with me all the time. So I just think, give her the best care I can right now. Or you can Yeah, yeah, I do feel like Luke does a good job. I'm not just gonna leave it to loop to knock down something that's that if I miss if I miss time, something you know, which I feel like happens all the time. I don't know how you do it. I feel like with the the lunch that you give Arden and then she can you can just extend, you know, like put in the loop. what it should do. And it keeps like all of it comes in and works at the right time. Like I just feel like that's so hard to do.

Scott Benner 17:28
You're just basically fooling it into being in ludicrous mode the entire time, the foods, you know, just keeping everything turned up, meaning that there's real active Bolus and real active basil. And it's just happening. It's just fighting. I think of it as two flame throwers in a cartoon hitting each other. I don't I my I just there's pictures that pop up into my head. And so the food The food's just trying to, you know, it's trying to get to the other side and you're just trying to stop it. So you just you meet you meet force with force is how I think of it. Yeah, you know, and I do that with, uh, you know, different absorption times. Just tell what

Hilary 18:07
absorption times are you putting in? Are you doing because I do like chili like fruit and some sort of like meat, cheese things. But the fruit I found I thought that the fruit would hit like, all really fast. But sometimes it doesn't like sometimes I over Bolus up front was what I was noticing was happening. And then she would go kind of too low and they would cut off basil. So I started splitting the Bolus, but I still feel like that's not really right, either. So I don't know what I'm doing wrong. But I feel like the timing is still confusing to me. And I don't know if it's because of other foods she's eaten. Because there's not much time between meals, it's like two hours between meals. I do

Scott Benner 18:49
find that it's incredibly easy to overpower simple sugar. And even if it's there count wise, it might not need the same power. And if Yeah, if that makes any sense. Yeah, I mean, so I'm trying to pull this up right now so I can look for an example. So about a half an hour before you and I began, we decided to change Arden's pump. And, and she had been sitting on our CGM, oddly, and nobody noticed. So she didn't have a signal for like half an hour or so. So the loops now not engaged, and her blood sugar's going up and there's no loop. So she gets this like 190 blood sugar that just none of us notice right away. So now it's a 190 blood sugar, it's time to change the pump. So we put on a new pump and make us you know, make a little bit of a Bolus. She announced that she's going to eat something. And I said, Well, I have to go upstairs. So just Bolus 10 carbs now and then figure out what you're going to do and put the rest of it in. I just I don't know what you know, what else am I gonna do? And then I get a text message a little while ago. What is now about 40 minutes ago, now. And the text message just says, I'm having a big potato and reheated macaroni and cheese. No, that's great, you should sprinkle some rice overtop of it. Sugar because that rice has no flavor. And so I said, Okay. So what I did was 80 carbs, 40 carbs for four hours, 40 carbs for three hours. And I opened the loop, because I don't even want to mess with it. Because it's a new pot. It's a new pot. It's a new pump site. And I don't know how well it's gonna work or not. So I don't want to get into the intricacies of basil rates being taken away right now right now. I just want insulin. And you know, that's where we are. She's 187. So I think

Hilary 20:49
how often do you open the loop a day? No, not every day. No, no, no, no, no. I never open the loop. I never do it. But I maybe maybe I should if I get into a situation. So like yesterday, John's blood sugar went really high. And I think it was adrenaline. And it was just up and then it finally came down. But I mean, I Bolus she's on diluted insulin. She's so it's you 25 25% of one unit. And I mean, I gave her six units. And it was finally came down. It was so bizarre. Well, it was almost like a like she was getting sick kind of you know, yeah, amount because I usually don't have to give her it would be you know, just a couple units if she was like at 180. To get her back in range.

Scott Benner 21:41
I have a sort of a concept about high blood sugars. And it's something I use in my own life, but it turned it started as kind of a teaching tool. I guess while I was talking to people. And you know, it's it's nice if you if you have time to listen to the podcast, it'll come to you. Alright,

Hilary 22:01
Scott, wait, I've listened to every single episode. Every single episode and and many several times. I love your podcast. I'm like the probably your biggest fan I think, Oh, thank you. I absolutely love it. And I tell everybody about it. I've told her info about it. I can I like just think it's the best thing because it's taught me I wouldn't have I mean, it. I can't believe they let people go out of the hospitals without giving them like some direction. You know what I mean? Yeah, and without finding your podcast, I mean, I'd be in the weeds.

Scott Benner 22:37
That's very nice. You didn't have to say that. Although I'm glad you did. And because it makes me feel good. And it gives me a nice break in the conversation where I can put the ads.

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What I was gonna say is before you were so kind is that when I'm talking to people who have not listened to the podcast the way you have, right who were coming into it in full freakout mode, you know, so I see I see it a lot on the Facebook page, like some people are just like, Hey, I'm here to listen to the podcast. And then they do it. That's just really cool. As a matter of fact, the podcast just had its best month ever. And this month had more downloads than the first two years of the podcast combined. Wow, crazy. That is awesome. So I appreciate you telling people because the word is definitely getting around. But But anyway, sometimes you get these people and they don't have all the ideas, and they still are having such bad outcomes that you want to try to get them somewhere stable to start over. Right? Yeah, so I have an idea about high blood sugars, the way I think about a really high blood sugar is crush it, stop it, get it stable. Because if you crush it, it's going to fall. And you have to stop that drop without causing another high because I just because you have to write so you know. So it's crushed it, stop it, get it stable. That's it. And I employ that for my own mistakes. Because I think it's almost impossible for most people to disembark the roller coaster while it's moving. I can do it. And I'm sure you'll be able to do it at some point people listening. But when you're first starting out to turn a 250, you know, into an ad during a meal is is a ninja plus level move. And like I can do it I could Bolus for a 200 give my kid a baked potato and and macaroni and cheese not be in the room not count the carbs not weigh the potato and end up at a good blood sugar. But, but most people can't What they need is the ability to start over with. And and so when that happens on loop, I just use the same concept. But you have to you have to open the loop to do that. So it doesn't take away the basil.

Hilary 29:09
I wonder if that was the issue because, you know, I'm also like, I feel like I can he's always said you know, don't trick loop don't tell it you're doing like don't put in fake carbs, you know, things like that. And so I'm like, I'm not going to be a fake Carver. And, and so I think you know, but also it's like the the nature of diabetes. Sometimes you're like, this takes this amount of insulin and you just I feel like sometimes I just beat my head up like yesterday. I was like, well, it doesn't take this much. It takes this much. You know, after you've done it a few times you think you know what, you know, which is something you say but then yesterday didn't work. It was weird. I don't

Scott Benner 29:43
know. Well, that's not fake carbon, though. Yeah, that's a dressing glycaemic load of food, right. So there can be I know that at some point, people are gonna be like, please stop saying this, but it's really important and nobody pays attention to it. So you know, you Get 10 carbs worth of baked potato and 10 carbs worth of I usually say watermelon because they're pretty diametrically opposed, right? And those two things are going to impact your blood sugar differently. So so whatever ratio you have set up for, you know, say your one unit per 10 carbs, that one unit might handle that watermelon perfectly, it may, in fact, handle a number of foods perfectly. If you actually had 10 carbs of it, it doesn't mean it's going to work on the baked potato. So if you know that the baked potato needs the insulin equivalent of 15 carbs, that's not fake carving. You don't that's not lying about carbs. That's being honest about need. Right, which is, you know, I don't even think that's splitting hairs. I just think that's a setting that the pumps and algorithms don't have, you know, I wish that they did one day they might but for now, they don't. You know, for sure. But anyway, yeah, that's, that's what I like to do. And it's so instead of the old fashioned way, you know, prior to an algorithm of crush it, stop it, get it stable. I do with a loop. I do crush it. figure out exactly when to turn the loop back on. Let it get stable on its own.

Hilary 31:22
See, I should have done that. I should I never open the loop. Like I said, I never do it. And that and I probably because I'm trying. Yeah, I probably should have yesterday and

Scott Benner 31:30
it's a different spot for everybody. I would imagine but Arden's about 140. Diagonal down. If you reengage the loop right about there, it gives it enough time to catch it.

Unknown Speaker 31:40
Oh, that's good. Yeah.

Scott Benner 31:42
And keeping in mind, too, this is important. I think most of our ties don't go much over 200. So it's not like we're, but it's still a fair amount of insulin, you know, that I'm talking about? Yeah.

Hilary 31:53
I mean, anything over 120 I feel like it gets a tax, you know? What do you feel like when it's over money, I get the tax, you know, gets a, because if you ever want, it's like so easy to bump in nudge, like you always say, you know, if you're, you know, in a really nice range, it doesn't take much insulin, but once it starts creeping up, it just takes more and more and more.

Scott Benner 32:14
Yep. The higher the higher, you get the you know, the I see people think of it as your insulin resistant, but I prefer to think of it as you know, it's a number you just didn't hit correctly. So now you have a deficit. So you I think of it as a deficit of insulin, some people call it an insulin resistance. I don't know that they don't, in theory and function mean the same thing. But right, you know, it's just the, it's just the way I prefer to think about it's the way that works on my brain. To be perfectly honest with you. I just want to I just want to understand what I'm doing. So you're on to talk about low carb eating, aren't you?

Hilary 32:53
I am low carb not very not not extremely low. We're low ish, low. It only

Scott Benner 32:58
took me a half an hour to get to really getting good at this podcasting thing, but I was enjoying our conversation. Wait, oh, people who like tune in because this one's gonna be called how we eat lowish carb. And then people are going to listen to us talk about stuff for half an hour, and then we're gonna start talking about carbs. And I'm like, this could have been upfront and to you, I tricked you. You're still listening. No, just kidding. No, no, I like having a nice conversation first. So we know, kind of what your situation is, and put people in a mindset. Yeah.

Hilary 33:27
I mean, I felt like the the situation was that she was diagnosed so young, too, you know, so that was part of the, the low carb approach was that the in the hospital, they were like she needs to eat. I think they told me 50 carbs per meal. Like, okay. And then I like put together a meal and I was like, like, how was she going to eat? She was also like she she had because she got sick. She had RSV at six months. And I noticed sort of that she kept on getting sick and different illnesses, a lot of ear infections. And and so that

Scott Benner 34:11
was RSP because I thought of Ruth Ruth Bader Ginsburg,

Unknown Speaker 34:14
when you said

Hilary 34:16
was like, wait, what is she sorry, RSV. It's like a respiratory infection. babies get sometimes end up in the hospital. So I think that's kind of what triggered things because after that, it was just like a slow decline of just her getting Yeah, take her to the doctor. Oh, I don't you know, she's just an ear infection. Okay. And then, finally, I took her in that last month, every single week and I was like, something's wrong with her. Something's wrong with her. And then she finally saw her pediatrician. But she was in decay at that point and had thrown up that day last she was instead of 19 pounds, she was 17 pounds. And like, you know, it was just those are

Scott Benner 34:56
those are Arden's exact weights. 19 pounds 70 I

Hilary 34:59
know I've heard you say that. Yeah. And it was funny because I don't know if it was, it's funny now, when we're, you know, in the house, and we were in a doctor's office, they did the meter, the nurse, you know, gave her a blood check. And it just said, you know, hi on it. And I was like, as you thought, Oh, that's so nice. It's it, you know? So that that made me laugh when you said that, because I thought the same thing was like, What a great, you know, little instrument.

Scott Benner 35:26
You know, only older people would have that thought who had really crappy electronics as a child, just like, Oh, look, it comes on and says, Hello, this is lovely. Yeah.

Hilary 35:38
Yeah. They told me so we went to the hospital after that, obviously. And then they were like, yeah, give her you know, I think it was like 30 to 50 carbs per meal. But I remember it was a it was a lot. It felt like a lot. And you know, we live in California, I eat pretty healthy. We, you know, we didn't really I mean, I don't know, it just, it just was. I think that's just how we ended up there. Because I was giving her Luckily, she was on diluted. And that was that made a huge difference. I felt like with just the not having a ton of lows and highs but she was on, you know, the level here at night, which was, you know, she would have you know, lows at night. It was it was tricky when everything first started, but it felt like, well, we can kind of do small meals, do like 15 carbs per meals and snacks throughout the day, then that kind of makes my life easier, in turn makes me happier and my family happier. So that's kind of how we got there.

Scott Benner 36:38
Alright, so I've like a layered question here. But first, I want to point out that you said, you know, we live in California so we eat healthy, which is why a lot of people don't like people from California in case you're wondering. You're like obviously I'm a healthy person. I live in California.

Hilary 36:54
I just went there's a lot of options. Right now actually, because we're escaping the fires. So we drove here with my fit like me and my kids and my husband drove to Texas. That's where we're from. Okay, cuz you're totally

Scott Benner 37:06
not from California. You said a word early on and it made me think to ask you where you were from. Originally, I made one. I made a note to ask where you're from originally. Now. I can't remember what word triggered me. But we're in Texas. We're about not exactly where because people will come and find you, Dallas. Oh, yeah. I'll tell you, Texas is I'm leaning on my wife about Texas because I feel like I could find no snow and no humidity somewhere in Texas.

Hilary 37:34
Now, it's so humid here, everywhere. But about Austin. I don't know, man. It's it's very buggy. There's so many bugs here too. And I'm not I'm not scared of bugs. I don't mind bugs. But I mean, I came back and I my ankles like everything's eaten up by running very buggy.

Scott Benner 37:52
Let me just believe this exists. Because as I get older, I don't want snow and I don't want humidity. These are my goals. They're very small goals.

Hilary 38:01
Sounds like the West Coast. Why don't you go to new or New Mexico or Arizona? I don't know. Everybody loves you in Salt Lake City. Right.

Scott Benner 38:09
I'm huge in Utah. I know. Sure. I could be the next leader of the church if I tried. I'm serious. I don't know if that was insensitive. And if it was, I apologize, but I think it's true.

Hilary 38:24
I mean, they like you. They're just like, it's beautiful, too. I've never, I've only driven through but it looks amazing.

Scott Benner 38:30
Someone sent me. Someone from Utah heard me say this and sent me a town. They're like, go here. And I looked online, and I was like, I'll be damn, I would like to live there. It was just really beautiful. You know? Yeah. Anyway, so. Okay. What I was gonna say is, you're kind of interesting, because of the timing of Joan's diagnosis in history. I mean, but you're almost gonna you're almost like a person who, you know, 10 years from now is gonna you know, you'll you'll meet somebody who bought a car that runs on gasoline, and you'll be like, oh my god. Wow, where'd you get that? And like, you know, your kid had diabetes for three months. And you put her on an algorithm. Yeah. And was she lower carb that whole time?

Hilary 39:13
Wait, it was more than three months because we did some things before it she she was diagnosed at 11 months.

Scott Benner 39:19
He did some things like he robbed the bank. What are we talking about? You did something

Hilary 39:22
Wait, I'm thinking maybe she was 17 months then but it said porch. I mean, I looked at my pictures this conversation has been a lie believe it No, no, but I mean, I look back at my pictures and it said for it was 14 months it was in February. So yeah, it was really quick after

Scott Benner 39:39
maybe your computer doesn't know what month it is. But that's not the point. Quick No,

Hilary 39:42
she didn't do MDI is very, very long. At all. You also with she got the the G six. Also when we left the hospital, she had a Dexcom she was wearing one from California. Say everybody leaves with the Dexcom from California.

Scott Benner 40:04
Hillary do not ruin my joke. I set that joke up masterfully sorry. Honestly, cut me a break. Okay, let me know though. No, but that's that's so far that's how did you talk them into a Dexcom? How did you even know to ask for one

Hilary 40:19
might well, my husband when she was diagnosed just like he was like we, you know, he's he just wanted to figure out the best things that we could get for her. And he's like, we need to get a pump, we need to get a Dexcom He's like, like the Omni pod. He was just had it all figured out. I was in the hospital just like, not able to talk pretty much like laying in the bed with Joan, you know? Yeah. So he figured it all out. And he's like, the tech guy, and that he does like all the research and all this stuff that we need to he set up our loop. And then I do the settings, which I think, you know, it's usually one person. I don't know, a lot of people I know, because it's a lot to take on setting it up. Well, I mean, people do it. But for me, it seems like a lot.

Scott Benner 41:00
Yeah, I don't know what I'm doing still. Like, there's, they're like, right now people are like, oh, there's a new version of the loop. And, you know, you have to rebuild nightscout or something like a No, thank you. I mean, it's still work and don't have to do it. You know, when I'll do it, by the way, is when I force Kenny to help me or anyone else, I'll just go online. And I'll, I'll I'll exchange some of my goodwill for help because I'm really confused by all that stuff. It's, it's, it's it's not dissimilar, by the way then how I make adjustments on pumps. I just, I just know turn that knob or click that box like I can get through the setup, but I have no tangible idea what I'm doing. Right. I just know where to click. It's Yeah, I must be infuriating to people who, whose minds work differently. But it's the best I can do. Yeah, it really is terrible. So what does lowish carb mean?

Hilary 42:03
Well, for me it it's just like, I'll, I'll I'll give her we'll try things. You know, I'm not I'm definitely if we're, you know, out and somebody has brought something to the park Well, well, not these days, but maybe in the future. You know, well, boys experiment with stuff. But I mean, when we're eating around the house is just, you know, as many lower carb options is sort of what I'm offering. And then I do like to make sure she gets you know, 10 to 15 carbohydrates. At least with the breakfast, lunch and dinner, and then snacks also if she wants, so it's like for breakfast, she had yogurt and berries. But the yogurt was sort of like a more high protein. Yogurt, which is not easy to Bolus for because you have for me because she is low. Like we all kind of eat lower carb sheet, especially with her being little like she's like a little kid, her body can produce ketones, right? So I don't want her to ever have high ketones because of her diet. So I that's why it makes sure that we check ketones, that she's that she's getting enough carbohydrates to kind of flush them out too. So you're trying she's also getting a lot of protein.

Scott Benner 43:20
Jenny explained this to me one time so there are ketones that come from eating and ketones that come from not enough insulin, they're not the same thing. And they and they don't and I ketones might be the wrong word. Because I remember complaining during that episode that there were so many words that sounded like each other that meant something different. But so it's you're just trying to avoid it more because she's such a tiny person. It leads the weight loss to right like

Hilary 43:47
Yeah, right. Yeah. But she hasn't had she's only been gaining weight and she's like, I don't know at a third 70th percentile which she's always been so she's I mean we eat a lot of so she eats like yogurt berries for breakfast or like she had I get this like low carb bread called sola. And it like with Walden farms jam on it in the morning or she'll eat bacon with fruit like usually berries or apples with like walnut butter. She also has like she has some allergy stuff going on or she's allergic to eggs and to soy and almonds so it's been tricky like just with some foods that she can't eat but we do a lot of nuts though even though she's allergic to almonds and we do a lot of nuts for snacks and about lunches. lunches. Sometimes like just leftovers from the night before if it's like chicken and vegetables asleep the chick she's usually She's like a little kid so she's I always I tried to offer vegetables to my children but they don't always they almost never eat them. salami is pretty easy cheese is she loves the least chocolate. I know they were a sponsor at some point or they still are you still

Scott Benner 45:12
have a switch over at the company and then we're going to get back on track.

Hilary 45:15
Okay, cuz we're I'm also obsessed with the chocolate like we buy so much Lily's chocolate. Because you know, it's like olives and lilies chocolate are like the two things I do not have to ball Bolus for everything else. I have to definitely give her insulin for I make what I make waffles out of, like, hurt out of, you know, alternative sort of nut flowers and stuff, right? Yeah, so I mean, there's a lot pretty much and especially with like the keto craze, and people like thinking, you know, doing like low carb diets, I feel like it's so much stuff now you can buy. But for me, it's just easier to do like, lots of different fish and meats and offer those and there's this stuff called moon cheese and like the parmesan, cracker kind of things that I mean, if she wants other stuff, and we're out, I'll also do that it's just, you know, she's here day to day. Yeah, with also my let me know, with my, I have a five year old, you know, trying to wrangle them and all that I just feel like it was putting in so much insulin, and getting the timing right and not getting like, you know, forgetting this or that it just felt like a lot of pressure and stress.

Scott Benner 46:35
So is can I ask you is the is the lowest carb diet a, a, an actual decision about nutrition? Or is it more about making bolusing easier, and the rest of the family just went along with it

Hilary 46:50
felt like it's both because I always have sort of eaten. I mean, always kind of ate this way. Anyways, we didn't eat a lot of bread. And then but my husband did. He was like, eating pizza and all kinds of stuff. And he always has. But ever since john is diagnosed, he stopped eating all of that kind of stuff. And he only eats like meat and vegetables now.

Scott Benner 47:12
Do you believe that during the day when he's not at home, he's just sitting in this car? I

Hilary 47:15
do I do. He's really he's he found also the rebel ice cream. So that's like his thing. He'll have like a pint of rebel ice cream at night, which Joan also can have, which is very cool. But I just feel like there's so many alternatives. And, like right now that it's it's easy enough

Scott Benner 47:37
just to stay on the lower side of carbs.

Hilary 47:39
Yeah. Because then, you know, we can just, like go to the beach, and I don't have to worry about how much insulin she has on board. And I have friends who, you know, it's just, I see the other side. And I feel like, gosh, that looks stressful. You know, because when we're at the park, the most unit she has on is maybe three and that's you know, she's so that's really only point seven, five, because it's diluted, you know, I mean, sometimes it's more but it's it's a it's where I could give her one card and she would be back at where she's supposed to be you know, so and I don't get the spikes and the drops. And so I feel like for right now her being so little and us just all being together as a family for the most of our days, it's especially in quarantine right now.

Scott Benner 48:24
You don't need extra things to be worried about or anything. And by the way, I not that you need my approval. But it sounds completely reasonable to me. And it sounds like it's working really well. So I mean, do you think there'll be a time? Where if she were to come to you and say like, Look, lady, I had pizza at a party? I don't know what to tell you. But I want more of it. Do you think you'd be able to handle bolusing it or do you feel like like so I guess what I'm saying is, is that being lower carb for managing insulin? Some it strikes me like it's sort of like setting the video game to beginner. And you know, so that it just, you know, everything's a little a little more forgiving as you're going which is terrific. It's it's an amazing idea. Obviously. My question isn't, you know, do you think you can sustain this? I don't think like that. But like, say it happened. say she's just like, I'm gonna eat this now. Would you need you'd need some practice, I would imagine, right?

Hilary 49:30
Yeah, I mean, I think with any I mean, we've we've I Bolus true pizza before. And one time, it was great. Another time. It wasn't another time. It was good. You know, like, so it's like, yeah, everything just takes practice. But I think because she's so little Like, right now it's just easier if she's not asking for something than to just do low carb. But if she does ask for something, then I certainly want her to be able to try it and you know, yeah, but you know, we went out to dumplings the other day. Like when I say the other day, it was probably a year ago because we've been inside with each other for six months now. But um, and she, I thought she'd be totally into them. And she like, picked up one dumpling when we finally got our food and she was just like, oh, and she only ate the meat inside. And I was just like, Oh my gosh, you fooled me, you know?

Scott Benner 50:25
She needs a fresh piece of white toast with some butter.

Hilary 50:29
Yeah, actually, I use these for if I do give her food that she doesn't eat, I have the date bars with cashews in them. They're just dates and cashews. And they're so good. They're so easy to Bolus for and they're like 30 carbs. For one bar, I think or maybe they're the what is brand is that a ham what brand it is, but they're just dates and cashews. So I split one and a half, and that's 15 carbs. And so it's like, we miss something. She doesn't want it. It's there you go. And it's so study, and easy. But yeah, I think when she gets older, I have friends who I have. Like this one mom said her, you know, they were even like, very low carb. I don't know if they used our insulin, but they were very low carb. And when our son was diagnosed when he was really young, and then he got older, and he wanted to have pizza and God is friends and have burgers and things like that. So she, you know, he does that now. And she does that kind of work together and do their best. But you know, yeah, it's I say whatever. Well, I mean, the thing is, yeah, it's kind of for me, I think of it in like chunks of time of like, okay, for the next year, what are we going to be doing? And this is, so it's just so much easier the day to day to not have to, but I wouldn't, I wouldn't like it if she was upset that someone was eating something. And she was and I wouldn't want that situation at all. So if that was the situation, then I would say, okay, you want to try that? You know, let's do it.

Scott Benner 51:59
It's very possible that it'll never happen to her, she might just be very happy with how she eats. And that'll be that and,

Hilary 52:04
well, we've been out and she definitely has done that. So Oh, gotcha. It's okay. It's okay. You know, like it. It The thing is, is that we eat like this at home. And so when we are out and if things go sideways, I don't feel like I just think that the day to day of it would be for her age. And for me and like you said, this is like almost like the studying it on like a like a computer game to the beginning level. Because I am a beginner, I've only been diagnosed 11 months, and she just turned three. So we haven't been at it this long. So I feel like it It works great for that. So and there's just so many options, you know,

Scott Benner 52:42
yeah, no, I there obviously, obviously, is a ton of things that you can buy, and that tastes better than anything has in the past, etc. I was gonna say that, um, yesterday, an episode went up with a mom of a really young kid with diabetes. And she just threw herself into understanding how to Bolus for regular foods. She sends me something on Instagram every day, and food that the kid eats and the kids graph. And she's she's a rock star name's Tori. And she's amazing at it. And I just wonder, like, I would love for her to like I said, I'm having this Daydream where you like babysit her kid for a while. And she babysits yours for a while. And I see. No, they're on the east coast. So you'd have to FedEx them. And I think that's illegal. So and I don't know why it should be. But it definitely, by the way, if anyone's listening, I think it's illegal. It'll ship somebody in a box. But especially children, you think the The point is, is that she somehow figured it out. And and I don't know. Like you both listen to the podcast. So like, I'm just fascinated by that. Like, it doesn't matter to me, like, I genuinely mean it when I tell you, I don't care how anyone eats. And I'm going to end up saying this sentence probably on every episode of how we eat. But I just want people to understand how to use insulin. And from there, they can do it with whatever they want. And it sounds like you understand it really well. Now, it's just when you add more carbs, it's it's harder for you. And there's something in there like there's you're not bolusing and not for your your botching the timing or something like that. But it's doable. It's just not. It's not necessary. You know, I'm not arguing for or against any of the ideas of how people eat. I just interviewed a guy yesterday that was a vegan, and not for moral reasons, just just to eat vegan, and it's better for his body and he feels better. And I think that's cool. I actually think whatever people do that works for them is really great. I just want to sort of give voice to all the conversations. So

Hilary 54:51
I think that that's what I appreciate about your podcast is I don't feel like you have an agenda and you are genuinely just interested in people and their journeys. And I think in the type one community, sometimes I get nervous about talking to friends on either side, because it feels like there is like a divide or a stance that you have to take. And for me, you know, even saying like, we're low carb, like, it feels a little bit like, you're gonna be judged.

Scott Benner 55:18
You're not, you're like, you're like, you wouldn't be low carb enough.

Hilary 55:22
Oh, no, I think either way. Yes, yeah. Anyway, yeah, I do feel like and that's why I said low carb ish, because I didn't I didn't want someone to think that I was, you know, representing, because I'm not, you know, but it's, it seems like, just for me, it just makes sense to do what works for you. But I do think that's an interesting point that you bring up about, about the timing and that someone is doing it who has little kid and I sometimes I wonder, like, Am I am I not? Am I like scared? Because sometimes, recently, you ask somebody that like, are you just scared to give that amount of insulin? I was like, Oh, that's a good question for me to ask myself. Am I just scared? You know, of giving that much insulin? Or am I just trying to make it easier in my day to day life? Because if I give that amount of insulin? I would have? I mean, it seems like I would have to try it. Like at least seven times, I think to get things right. But with I feel like the little kids. She's always eating and it's so hard to like really get a good idea of Did you get the Bolus right or not? You know,

Scott Benner 56:32
I hear you. So what's the answer? I don't know. I don't know. Do you think about it for a second? I don't know. I'm what do you do you think you know? Yeah, of course. I know. Yeah. It's It's It's a mix of both. It started out because you because you were not having success? I would imagine.

Unknown Speaker 56:51
Yeah. And

Scott Benner 56:52
then it became easy. And now it's easy. And the further away from doing it. You get the harder it seems about right? I think it is. Yeah. I'm like, I'm almost a genius. I understand. I barely understand anything, Hillary just so you everyone listening understands. I'm good at watching people and, and knowing how to use insulin other than that. It's pretty much a mixed bag after that. But, but no, I would imagine that that's it based on what I've seen, you know, countless other people go through, I can tell you right now, if I come down to Texas and get my ankles bent a little bit, we can give Joan whatever. She wants to eat a bowl of soup for it and we'll be alright.

Hilary 57:36
We're going to be in California Scott. not staying in Texas.

Scott Benner 57:39
wasn't coming to Texas. So you know, it was more of a hypothetical, but I could do it. I also wonder too, how much does she weigh? Again? 31 pounds. How come you still diluting the insulin?

Hilary 57:51
We planted the loop until she's I think I'm four or five is what the end of said no, I think you get I mean, for me, it seems like tighter control because you don't have to. I mean, sometimes I wonder I don't know. I mean, you just her basil rates are, you know, some? Some of them are. You know, so little.

Scott Benner 58:20
How little how small. Like point two five? What would it be if it wasn't diluted?

Hilary 58:27
Uh, I don't think you could get it small enough. Right? Well, because it's, it's one unit is

Scott Benner 58:36
point two five doesn't make sense. It's point two five diluted, but she weighs 30 pounds. Let me look at what her setting. What's her a one say? Okay, would you tell me that? Yeah, it's a 5.5. I mean, it's working. I wouldn't change it if it's working. But obviously, I would just think at 30 pounds she could handle point two of regular at a regular strength. Yeah, I don't know. What's experimental. You're kidding. I'm just kidding.

Hilary 59:10
I mean, that's the only way to do it. That's the weird thing about type one. It's like, I remember when we first started on like, you know, can you tell me how much and then you realize it's all just you just experiment and see what happens you know, we I mean nothing really bad. No, if you're just if you're just trying things and poking around and not you know being too crazy nothing's gonna happen.

Scott Benner 59:31
I just the reason it's striking me is because I just released a person into the wild who I was helping privately and their their kid was like three years old and weighed like 40 pounds or something like that and, and the kid needed like ended up needing it. It's I don't mean it insultingly the kid and it I just said the same sentence. I'm just trying to avoid saying him so I don't get out of here. And instead I'm just being terrible. I'm like that thing that we were talking about. Anyway, the boy He's getting like half a unit an hour.

Hilary 1:00:04
We have sir her basil rate for the whole day is 4.8.

Scott Benner 1:00:08
Hold on. And that's the looted?

Hilary 1:00:11
Yeah, sorry, I don't have this info. I don't have her phone on me. I didn't know we're gonna talk about this. I thought we're talking about food. We are

Scott Benner 1:00:18
talking about food. So that's she's getting point two an hour of diluted insulin. Yeah, I see what you're saying. So that's probably, what's the dilution? How do you do one? Part Two? What one part?

Hilary 1:00:34
It's called diluent. So it's a I think some people use sailing. And then some people use dill, you went with different kinds of insulin.

Scott Benner 1:00:44
But is it like, Is it like a certain parts of insulin to a certain parts of the dilute? Brilliant? Yeah, yeah. What is it? How many parts? To what? Um, it's. So what do you mean? How many parts? How do you mix it? How do you do somebody mix it for you? Or do you mix it? I mix it? Yeah. Tell me how you mix it. As long as

Hilary 1:01:07
you want me to take you through how I mix it, I take out 250 units of insulin, right. And then I put in 250 units of Sorry, my kids are now walking into the room.

Scott Benner 1:01:26
Tell them we're doing something very watch a show. Yeah, watch a show, or find some pornography on their phone or something to leave us alone. So it's half in half. Basically, you're having it. So point two of this is equal to point one, I'm guessing have regular strength. And your pump will do that. Yeah, we're out. Yeah, we're on the Medtronic. Yeah, you're probably you think that we should move to to just not diluting anymore? Well, keeping in mind that I'm a dumb ass from New Jersey, who just bought a microphone and has an idea of how to get his voice onto the internet. I mean, I

Hilary 1:02:04
don't know. What do you think will happen if we don't dilute? Why will that be better?

Scott Benner 1:02:09
I just think you'd have more control over the insulin. What I might be wrong, you

Hilary 1:02:15
feel like do you feel like the diluting is is making it, like, diluted? I was thinking that it was making it not, like precise or something. That's what I fear is that, you know, because one little drop can make such a big difference, you know,

Scott Benner 1:02:34
so keeping in mind that what I know about this could fit into a thimble. I mean, that seems reasonable to me, but I could be 100% wrong. But I would try it for fun one day, I could try that. I would just make I would make her basil rate point one use, like full strength insulin and see what happens. Interesting. I never I never would have thought of doing that. I mean, if she starts like, you know, dropping drastically I might go Ah, that didn't work. Yeah. But doesn't the pump do like point? 052? Also?

Hilary 1:03:08
Yeah, that's what I like about the Medtronic pumps

Scott Benner 1:03:11
totally doable. Yeah, yeah. Here's a good time to say again, nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. I really, I genuinely mean I, I'm, I'm just thinking of this in a fanciful way. I don't I have no idea what I'm talking. But what's the point of it just that you don't have to dilute it anymore? What's the point of deleting it?

Hilary 1:03:36
I don't, I don't know. Cuz I was told, I don't know. I don't ask questions like this. I don't know. I was, I was thinking, Hillary, you're just

Scott Benner 1:03:43
making me upset that I didn't marry somebody who's more like susceptible to authority. And constantly arguing with my wife about every last thing. She's got a goddamn opinion about everything. You're like, I don't know, someone told me.

Hilary 1:03:55
That's like my husband. My husband's like, he's the one who was kind of like spearheading the more lower carb, sort of, he's like, how are we feeding her all this crap? This is crazy. What they're telling us, you know, and I was like, I don't know. They're telling us. I'm just following what the doctor told me to do. And he's like, you need to stop it.

Scott Benner 1:04:10
If I had to guess about that. 50 carbs a day at a meal thing? I would when you said that the first time what it made me think was they know a ratio in that doctor's office and it's based off of 10s. Right, and they were just like, well, she's little half it, give her five. Like, I just that really struck me is such an arbitrary thing.

Hilary 1:04:34
It's so arbitrary. So much of what they had told us, you know, it was they told us to give her 15 carbs to treat her. She was going low. And I was doing it and I was like, This is crazy. You know, she's 300 and now we treat her with one you know, one carb is usually what she needs. It's just it's it's unfortunate

Scott Benner 1:04:55
here sips of a juice box. Just a little bit. Stop just like that. Yeah, yes. Especially when they're that small. Well, I can tell you that six days ago, I met a lovely woman named Patricia. And that's not her real name, but she'll know that that's funny when she hears it, and her son, few years old, I don't remember now, which will probably make her upset. Little kid, blood sugars kind of all over the place. I think it took me maybe 12 hours to get the kids blood sugar stable. And then a couple of more days to teach her how to Bolus and a day after that to tighten up his his basil and get them right. And I just unfollowed her yesterday. And she's, she's doing great. So it and the only thing that's there is she had a willingness to learn something new. And she she I can't believe I'm saying it like this, because I don't mean it this way. She listened well. Like she spoke up when I said something crazy. But I told her in the beginning, if I say something that seems completely out of line, please say something because I'm not there. Like, if I'm saying something that just makes you feel like that's not something we should do, then say that otherwise, you know, we're going to make some adjustments, turn some knobs, see where he gets high, and when he gets low, and then you're going to Pre-Bolus and learn the difference between the impact carbs have and that's it. She I never, I've never spoken anybody privately who's picked it up as fast as she did. It was really interesting to watch happen. She even inside of that week fought with her doctor's office, because they saw the data and said, What are you doing? She's like, I'm keeping my kids blood sugar from spiking all over the place. And they're like, no, that's gonna hurt him. And she's like, No, I think you're wrong. Like she fought back. And yeah, in a week, she's is amazing. Like, she's the quickest turnaround ever. It was really, really interesting. And I'm simultaneously talking to one other person who won't believe what they see. So they just keep throwing themselves into the same problem every three hours. And it doesn't matter what I say, they're not going to listen, so I'm probably gonna suggest to them that no, we shouldn't talk because it's just not worth anybody's time. Yeah, and that's fear, in my opinion.

Hilary 1:07:15
Yeah. Fear is a big thing. I think with the just, I think I think I have had that. And I still do, you know, because but I think it's now mentioned, like we were talking about just, it's just easier this way. Sure. You know, but I also, you know, she's going to preschool and I started thinking like, Well, you know, I don't they can't operate her pump like, she's going to be going just a few hours. So there's, I don't know, when they're this little, it just seems so much easier because it's a one car will raise her blood sugar 20 points. So if you get a miss timing of something, which is also easy to do when they're this little, I feel like I have a lot of nose noses. I feel like I know, I'm on the podcast right now. But if I was listening to it, I feel like I know what you would say. Next, almost. It's really funny to be on it. But what do you think I'm going to say? I think he would say like, I think there's I think that I'm like, there's obvious fear, you know, of, of just like letting her like this, you would have so much insulin on board, and that it's a fear thing. And that I should just try it.

Scott Benner 1:08:26
You know, you're making me think that therapy is such a scam. So I just, I just get somebody in a room and then charge them money to make them say things out loud. They already know. But they haven't said. Yeah, but it's very helpful. I don't know. Yeah, I just, well, let's submit this your insurance to see if I can get a copay for mental health. And

Hilary 1:08:46
you should be I feel like your podcast would be awesome that it should be submitted to insurance, you should be getting some sort of like, payment for this because it really is. Okay. The whole timing thing is I think the part that's hardest, because, you know, the protein rises, you know, there's things that come later that can have so much power and one day, there'll be a certain amount and then the next day they won't, that's where I I was getting frustrated, I think at the beginning, because I would try something three days in a row for breakfast and every day, it would be different.

Scott Benner 1:09:22
Sir, any chance that that has something to do with using diluted insulin?

Hilary 1:09:27
I don't. I don't, I don't know. I wouldn't think so. I mean, I know a lot of people who use or looted insulin and it works okay, or not a lot. I mean, I know. Well, what

Scott Benner 1:09:36
about the idea that the the lower carb options? Do they have a lot more protein in them sometimes?

Hilary 1:09:47
A lot for protein, but that also can be a timing thing. So it's kind of funny because I'm like, I always think about that like when I deal with like a protein rise that I missed on and I didn't hit it like because with Lou I found that I can't really set out a three or like a four hour absorption to hit. And it won't, it won't hit it hard enough when the protein rise happens like that two hours later, or an hour half later, okay, so I have to put in that she's eating carbs. And it's a three hour absorption an hour and a half after she eats to get the protein rise, not to rise, but if I forget, or whatever, I feel like a lot of this has to do with just me being absent minded and not paying attention. Then it messes up, you know, and then I've missed it.

Scott Benner 1:10:37
Are you absent minded? You don't seem absent minded.

Hilary 1:10:40
Very absent minded. Yeah. I get distracted pretty easily. Yeah. Yeah. Like, shy?

Scott Benner 1:10:47
Or like, how bad?

Hilary 1:10:49
No, not that bad. But you know, I just, you know, it's like two kids, you start playing and you know, then you go on to the next thing. And then it's like, oh, I gave you insulin, those a Pre-Bolus. I forgot. Oops, that kind of thing. Yeah, it's like, it's just one less thing to worry about, well, I guess the truth comes out. I'm just trying to make my life easier here. While

Scott Benner 1:11:08
you were being self taught you were being reflective just now what I was really going to say was, it sounds like it's working really great for you. And I wouldn't change it. I was just, it was just fun to talk about. I mean, there are people with children, your child's age at your child's weight that are using pumps that with insulin is not diluted was really my only point. But if it's working for you, then whatever, I just don't want you to get to the point where it stops working one day, and you're so far off of center that you don't even know how to restart.

Unknown Speaker 1:11:36
Yeah, you know,

Hilary 1:11:37
you know, it's interesting, because I mean, that's just protocol at the hospital that we're seeing that that if they're under three, they get diluted insulin that you as the parent gets to mix up every couple of weeks. And it's just part of the process. I remember when they told me that I was like, This is crazy. I can't mix up medicine. What am I chemist? Like? Are you kidding me? This like more stuff?

Scott Benner 1:11:59
What if I forget in the middle of me mixing it up what I'm doing?

Hilary 1:12:02
My husband did that. Like he was supposed to be the mixer for me. And he I came home and he was like had Crazy Eyes. And he's like, I don't know which one I put it in. If it was like diluted if it's the Kimball auger that diluted and I can't. I was like, Okay, stop. Just give me I'm gonna do this job. So,

Scott Benner 1:12:19
episode of Breaking Bad ever. Guys, shoot anybody? You're still money? No, no. Well, you're in Texas. Now you can shoot anybody you want. That's not true. You can't just shoot anybody in Texas. I just need to say that I think. Well, that's a listen. I appreciate you coming on. And I didn't, we didn't talk about what I expected, we would talk about as much. But I feel like we did at the same time. I feel like we talked about I feel like we talked about something that happens to a lot of people, especially people who are probably parents of younger children are people who just struggle out the gate. And the and when they don't figure out how to use insulin, the next very reasonable step is well, I'll limit the carbs then. I mean, I think that's completely reasonable. I always just have a feeling that I don't want you to, I don't want you to eat any certain way. Because you feel like you can't figure out the insulin. If you want to eat that way. I think that's really terrific. I genuinely believe that. But I don't I I'd be sad if I thought that every day you were making a plate and thinking, I really want an English muffin. But I don't know how to Bolus for it. That's all, that's all. And I think you could figure it out because other people have and they couldn't. And like I said, if you FedEx me that kid, I'll get her some pizza, get her all set up. But send a note with her because I don't think you can transport children over a state line like that. I'd probably be capping or if that happened. But But seriously, like, you know, just don't be do what you do. Because you want to do it. Yeah, I guess that's what I'm saying. And it's cool to know that there are a lot of low carb options. And it was interesting to hear you go over some things that she eats, that she enjoys a lot. But it was also interesting to hear you say that she has seen other food and been like, hey, Mommy, how come? I don't know french fry? You know? So

Hilary 1:14:22
right. I mean, I tried to do it when you know when we're out. And if she does want something, I feel like that's really reasonable. But if she wasn't happy with options at home, I think I would rethink things. But I think it's just she also was when she was diagnosed, she was just starting to eat finger foods because she had been sick for like a month before that, you know, and so it was just all everything was kind of skewed from there.

Scott Benner 1:14:52
I think bottles get used up to about like two years, right? It's not about that. It's about reasonable like breastfeeding or bottle feeding.

Hilary 1:14:59
Yeah. I was breastfeeding at the time. And I did stop that because that was it seemed really stressful. And then I found out I mean, I've heard from other people you've had on your podcast that they kept going and they just kind of rolled with it. It was pretty inspiring

Scott Benner 1:15:13
on a Bolus for

Hilary 1:15:15
Yeah, but it's I think, mainly I just want her to feel healthy day to day. And for our family to be happy. And, and not. I feel like when I went, you know, sort of, without knowing that she's definitely going to eat something to give her so much insulin, it gets tricky. Yeah. Do you ever did you feel like that beginning with Arden? Yes, like

Scott Benner 1:15:39
100%? Yeah, yeah. But what I figured out to do is what I tell people to do on the podcast now, which is juicebox, or pick, pick an amount of food you just for sure know, they're going to eat and that's your Pre-Bolus even if it's five carbs and Pre-Bolus, five carbs.

Hilary 1:15:54
And what happens when the timings off on it? So you're, then you're dealing with like a 200, or 250?

Scott Benner 1:15:59
I don't do that. What are you talking about? So you put in the five carbs, right to get some sort of a Pre-Bolus. And the minute the second, that you see that there's more food going in you Bolus. You don't wait till they're done eating, you go, okay, five carbs are in I've got a nice Pre-Bolus things are moving my direction. Also keep in mind, my daughter starts a meal at a reasonable blood sugar. It's not like I'm Pre-Bolus Singh, five carbs on a 250 blood sugar. It's right, you know, she's more around 100 somewhere, one, one side of the other of it. So you would get a little bit going, let it work as a Pre-Bolus give her the food. As soon as five carbs go in, and it's clear, she's gonna keep eating you Bolus for the rest. And that's it. And then that way, there's enough in there to make up for the timing. That's what I didn't. I mean, that's what that's that's what most people do, I think, who have little kids. And it's interesting. I think I've said it on here once before, but somebody contacted me privately once who had gastroparesis, who wanted to Pre-Bolus and we talked on the phone for like a half an hour. And at the end, I said like, I'm sorry, I can't think of what to tell you. Like, I don't have any, even like Fs suggestions here for you. I said, Oh, except you could Pre-Bolus the way people Pre-Bolus for infants was like, just give yourself a little and then once you see that the insolence impacting the way you expect, then give yourself the rest because the problem could be is that they could eat no digestion happens. And so the so the the you know, the glucose is not being pulled up by the blood. Now all that insolence in there, it's gonna, it's gonna kill you. And so once but once they see that digestion is happening, then add they need the insulin right away. And so they did the same thing.

Hilary 1:17:41
Yeah, I guess mine is just more of a timing thing, because I feel like I want to keep things under 180.

Scott Benner 1:17:47
Yeah, no, I know. But you definitely could. But it takes practice. But Alright, so this was good. I enjoyed this. Did you have fun? Did we not talk about anything that we shouldn't have that we should have that we know

Hilary 1:17:59
I think everything was good. I've got my whole family in here. Now. They found me

Scott Benner 1:18:03
as Jonah. Like, can we like pinch her so she cries so we can hear or something like that? Is that? JOHN, you want to say hi, john. He's trying to hear you, Joan. Hello, sweetie. How are you? Yes, Joan. Casey, hi. Hi. Hi, john. How are you? You know how good bread is? Oh, she's gone. Nevermind the turtles. Oh, that's really sweet. She sounds sweet. Yeah, she's a lot of fun. You didn't say that with a ton of conviction? Well, we've been we've been together for six months now. Yeah, she's fine as far as children go. Every day, same thing. That's great. Yeah, yeah, I hear ya. I really do. Alright, well, thank you so much. I appreciate you doing this. Yeah, that's fun. Cool.

A huge thank you to one of today's sponsors. g Vogue glucagon. Find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL Uc ag o n.com forward slash juicebox. I also like to thank the Contour Next One blood glucose meter and remind you to go to Contour Next one.com forward slash juicebox to learn more about Arden's blood glucose meter. I also want to remind you to find the Facebook group for the podcast Juicebox Podcast type one diabetes.

Thank you so much for listening. I'll be back soon with another episode of the Juicebox Podcast. Please don't forget to leave an amazing review wherever you listen. tell a friend about the show or a stream I don't care. If you have to stand up on a bus and start talking about it. You need to do your part. Okay? I make the podcast, I get it to you doesn't cost you anything, the least you can do is stand up on a city bus, where there's about 60 people, I don't want you to waste your time with just three or four and say, Hey, anybody here have diabetes? I got a podcast for you. And say it out loud. If they seem confused, show them how to use their phone. Really, this is all I'm asking of you. Just public displays of affection for the podcast. And if you're an endocrinologist, or someone that works in the practice, and you've been suggesting the podcast to people, let me say thank you. That was really very kind of you. I appreciate that. All right now I'm really done.