Scott Benner 11/21/24 Scott Benner 11/21/24

#1364 Eversense 365 Overview

Eversense 365 overview with John Bradford.

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Scott Benner 0:00
We are all together again, friends for this next episode of The Juicebox podcast.

John Bradford is the head of Global and US CGM marketing at essenzia, and he's on the podcast today answering listener questions about the ever since 365 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. 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. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com you don't forget, if you're a US resident who has type one or is the caregiver of someone with type one, visit T 1d exchange.org/juicebox right now and complete that survey. It will take you 10 minutes to complete the survey, and that effort alone will help to move type one diabetes research forward. It will cost you nothing to help.

Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it too. So screen it like you mean it one blood test. Can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com for more info. Today's episode of The Juicebox podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate. And waiting for you at contour next.com/juice box.

John Bradford 2:09
Well, hi Scott and all the listeners at Juicebox. My name is John Bradford, and I am the Global Head of Marketing for ever since CGM awesome. I

Scott Benner 2:18
appreciate you joining me today. Thank you.

John Bradford 2:20
My pleasure.

Scott Benner 2:21
What are we gonna talk about today? John, well, we're gonna talk about the 365 right? We guys call it ever since 365 is that how you talk about it? Well, if

John Bradford 2:29
we call it the what we call brand police, right? Scott, we would call it ever since 365 but I'm okay. If you call it 365

Scott Benner 2:36
I'm gonna say three. Okay, thank you. I appreciate that. Sure. And let this be a lesson to other people I work with not to be such sticklers. They know who I'm talking about. But you have type one diabetes as well. Is that? Right? John,

John Bradford 2:49
I sure do. I have type one diabetes. I was diagnosed 55 years ago. I'll actually have my 56th diversary Coming up on january 26 like I know the exact date, all right. Scott, John, how

Unknown Speaker 3:02
old are you? Oh,

John Bradford 3:03
do I have to answer that question? Well, no, no, instead,

Scott Benner 3:05
tell me old you were when you were diagnosed. Oh, yeah. Okay,

John Bradford 3:07
let's back into it. Um, I'm 62 Oh, No, kidding. You

Scott Benner 3:11
have such a youthful voice. Oh, thank you. I know how important that can be. I have dark hair, and I'm 53 I cling to my dark hair like, it's like, it's everything, like, please, please don't go away. Wow. So if I asked you, what you remember about your diagnosis, you're not going to remember anything. But what do you remember about growing up with type one? Oh,

John Bradford 3:30
I remember my diagnosis, actually. So Scott, I come from, yeah, a family with diabetes. I have a an older brother who has type one, and an older sister has type two. So I was the third of eight children, or I was the third of a family of eight kids. Three of us were diagnosed with diabetes. I was the third one to be diagnosed. So I'd already seen syringes, you know, urine test tabs, reactions in the middle of the night, seizures, appropriate food, etc, from the time I was a little kid, wow. So when I started having to pee a lot, my mom and dad took me to the Endo, and sure enough, I was diagnosed with type one diabetes. Are you? Did

Scott Benner 4:13
you start with beef and pork insulin? Yes, I

John Bradford 4:16
did. Wow. I started with beef and pork insulin. My syringes, my father boiled syringes and distilled water every morning, so I woke up to the sound and smell of nice glass syringes boiling and then my father obviously would make sure those were all dried out. We would drop the insulin using pig insulin, as I like to call her pork, and that's what I got my one shot a day. Scott, how

Scott Benner 4:40
long do you think you did that for, until you went to, I'm guessing, really

John Bradford 4:44
long time. Yeah, long time. Clear and cloudy next, then clear and cloudy. Exactly right, clear and cloudy and Scott, it's not even just the instant for me. It's how we monitored our glucose levels. I mean, I started with a test tube. In my bathroom. And, you know, every morning and every night, I had to get into a little cup, put a few drops into vial, and drop in a clinic test tab and see what my residual sugar was in my pee. How was your health today? My health is great. I'm very blessed. So I have no long term complications from diabetes. Scott, I think I just natural aging with my eyes. So I've had no retinopathy, no neuropathy, no kidney disease, no cardia disease, etc. So I'm actually doing very well, and I attribute that really to my parents.

Scott Benner 5:40
How so did they help you with, like, sticking because I'm assuming you ate on a schedule back then

John Bradford 5:45
we ate, that's correct, we ate on a schedule. And my parents were great. So Scott, I'll try not to get teary eyed when I tell you this part of the story. But my father, engineer, brilliant man, very even keel, kind of the opposite of me, very even keel. My father would always say, Hey, kids, the most important thing with your diabetes, it is manageable and it's going to be cured in your lifetime. So the challenge that's put in front of you is, how do you protect your body so that when your diabetes goes away, there was no residual ever. Nobody would ever have known you had diabetes. Scott, that's the philosophy my dad used with us as we were raised. Yeah, take care of yourself, because it will be cured in your lifetime. And you know when it is cured, great,

Scott Benner 6:35
but until then, you're as healthy as you could possibly be,

John Bradford 6:38
absolutely so as I said, grew up in a family of eight kids. My mother and my father are amazing cooks. We just ate so well. We grew up out in the farmland. We ate so well and so well taken care of all. Went to school together. Everything was just great. But in our house, basically we all ate the same food. It was all basically for healthy diet. I mean, Scott, it's so amazing that 55 years ago, what my mother and father did is basically what's being recommended now by all of the societies around treating obesity, treating good, long term public health. My parents basically had the entire family eating well, Sugar was a minimum, salt was a minimum, everything was about good, whole, healthy, fresh food that didn't spike your glucose?

Scott Benner 7:22
Yeah, I don't know where you fall on those eight kids, but are your siblings all like, did they live healthy lives like you? Yes, yes. Like, did it translate? You know what I mean, to like, because it's a that's a big group of people to like, put a an idea into their head. Does that make sense? Oh,

John Bradford 7:37
yeah, yeah, absolutely. Well, first of all, my entire family, it's my passion. My entire family cooks beyond belief. Cooks bakes, everything really well. My family really grew up with the whole thing about great, clean food. I mean, we were, that's just the way we were raised. So it had great impact. You know, now, Scott was not disclosing too much about my family, but I will tell you, it is so interconnected. I have other family members that they don't have diabetes, but they do have other autoimmune Uh huh, diseases that they're managing.

Scott Benner 8:05
What do you got? Some hypothyroidism, celiac, anything like that.

John Bradford 8:09
Exactly right. Crohn's, yep, yep, and others, yep.

Scott Benner 8:13
A lot of people have been saying lupus to me lately, too, when we talk about extended family.

John Bradford 8:17
And that was the that was the next one. Yes, look at me, exactly right.

Scott Benner 8:21
I'm like a soothsayer over here.

John Bradford 8:22
I know, I know you are a soothsayer. Look at you.

Scott Benner 8:25
I just, I just talked to a lot of people have type one diabetes. That's all Okay, so you've got a plan. What I want to talk about, though, is how you transition through technology. Because in my mind, insulin is a biological technology, and then, you know, so you transition through that. What happens? First you get a meter first, like an at home meter, is that, like the first thing you get?

John Bradford 8:47
Oh, Scott, you're making me smile, because, you know, for all of my type one peers out there, I want to say I'm not an early adopter. Oh, okay, I'm also not a laggard. I'm kind of in the middle. I'm a Libra, so I'm kind of in the middle. Scott, okay, I'm not going to be the first one to jump and go, just so you know, all right, I got you. I think the big critical points my diabetes were as a kid, really, underneath the guidance of my family and my parents in particular, you know, going to diabetes camps, eating, well, really, having a good, strong parental influence towards healthy lifestyle and good diabetes management. Scott then, like everyone else, once I became college age, I kind of went off and did my own thing, right? Probably didn't follow the good principles of diabetes management. Had a couple bumps here and there, and finally, had a day of reckoning where I said, You know what, I don't like the way I feel. I don't like some of the things that are happening to me as a result of not great, ideal diabetes management. So I went and found a new endocrinologist, an adult endocrinologist and a phenomenal diabetes educator, and I will tell you, Scott, those two individuals turned my life around. Wow, that's awesome. Big technology fans, of course, and this was. About the time that blood glucose monitoring was taking the forefront, Scott in particular, with the one touch meter. And so I was very lucky. I actually was hired right out of college to work for Johnson and Johnson, their diabetes division, and I sold the one touch brand for many years in my career. So that was my introduction to blood glucose monitoring. Wow.

Scott Benner 10:21
Oh, so you got a freebie at work. Is that how?

John Bradford 10:26
Maybe, no, you know what? Those doctors,

Scott Benner 10:29
right? They put you in into position that's correct. Okay, sorry, go ahead.

John Bradford 10:34
No, I was gonna say, Scott, it's actually great. I mean, I am really fortunate in my life that both my personal life as well as my professional life have intermingled. Some would say, Oh my gosh. Do you really want that? Absolutely, I knew from a very young age that I was committed to the diabetes community. I wanted to be part of the diabetes community. I wanted to help the diabetes community. So it was actually a really easy fit for me, and again, my diabetes educator, my partner, my diabetes educator, my doctor, everybody really said to me, go into diabetes, do it. So I did. I'm really glad I did. Scott, okay,

Scott Benner 11:10
your whole career has been spent around this space. I would

John Bradford 11:13
say, through my professional career, 95% of it has been in diabetes, whether that's blood glucose monitoring, continuous glucose monitoring, insulin delivery, digital health, some exploration and division care for diabetes as well. That's been the majority of my work. Scott, I did take us a minor detour, and I actually got to work in another very interesting space called drug recovery, drug rehabilitation. And it was amazing, Scott, how many people with type one diabetes I met in that community as well. Really,

Scott Benner 11:46
that's interesting. Now, being around that technology at work, did that turn you into more of an early adopter? Did you stay pretty much should I say Libra esque? By the way, I looked up the traits of Libras, just in case I needed them later. I have them right here in front of

John Bradford 12:03
me. You have them to use against me. Okay, I would say I became a little bit more of an early adopter. But Scott, I'll tell you, I'm just fascinated by my friends, you know, who were the early loopers, my friends who were really the early drivers and trying technology. I mean, just it's amazing, I guess, comparatively, Scott, I'm nowhere near close to those people I respect so much. But I think others might say I am an early adopter. There's a nice, vague response for you. The

Scott Benner 12:31
contour next gen blood glucose meter is the meter that we use here. Arden has one with her at all times. I have one downstairs in the kitchen, just in case I want to check my blood sugar, and Arden has them at school. They're everywhere that she is, contour next.com/juice, box, test strips and the meters themselves may be less expensive for you in cash out of your pocket than you're paying currently through your insurance. For another meter. You can find out about that and much more at my link. Contour next.com/juicebox contour makes a number of fantastic and accurate meters, and their second chance test strips are absolutely my favorite part. What does that mean, if you go to get some blood, and maybe you touch it, and, I don't know, stumble with your hand and like, slip off and go back, it doesn't impact the quality or accuracy of the test. So you can hit the blood, not get enough, come back, get the rest, without impacting the accuracy of the test. That's right, you can touch the blood, come back and get the rest, and you're going to get an absolutely accurate test. I think that's important, because we all stumble and fumble at times. That's not a good reason to have to waste a test trip. And with a contour next gen, you won't have to contour next.com forward slash Juicebox, you're going to get a great reading without having to be perfect. Type one diabetes can happen at any age. Are you at risk? Screen it like you mean it. Because if just one person in your family has type one, you're up to 15 times more likely to get it too. So screen it like you mean it. One blood test can help you spot it early, and the more you know, the more you can do. So don't wait. Talk to your doctor about screening. Tap now or visit screen for type one.com to get more info and screen it like, You mean it interesting? Okay, well, I appreciate learning about you, but now I want to learn about the product. So I have to admit, like I got to learn a lot about it over the last year, because you know that you guys have been sponsors of the podcast, which has been very good for me, because I had an outsider's perspective of it. When it started sort of just like, oh, I don't know. That sounds I don't know. Like, you know what I mean? Like, it just, it's one of those things where, like, I'm not sure what to think about that. But then you start meeting people who are using it, and you're like, they just talk about it as normally as could be. So absolutely, yeah, it's, it's awesome. Like, right? Just to see people trying new things and having different experiences. I guess the way, the reason that makes me so happy is because I think that the adoption of new technology and moving forward and staying reasonably current, like I'm with you, like you don't have to be the first one, you know what I mean, but keeping up with things, I just think it's important with diabetes, specifically, to never look up and realize, Oh, I'm doing something the way they did it 10 years ago, and no one else does it like this anymore. Because I equate that to valuable management, I guess, like, I want people to be healthy and and have their best, happiest life. I personally think that comes from knowing where your blood sugar is and how fast it's moving, and, you know, not having kind of the emotional and psychological impacts be as heavy as they could be, I don't know this is kind of the way I think about it. I

John Bradford 15:49
completely agree you gave me goose flush, Scott, listening the way you talked. You know, I always like to draw the analog back to the very first iPod. Who knew we needed that technology? Well, you know what? We are warriors in diabetes, Scott, we've lived through so much, right that I think sometimes we take it for granted that there can't be better. You know, a very good professional and personal friend of mine, Kelly, close, who I think is a very well known name, probably one of the premier diabetes advocates in the world. Kelly is just amazing. And Kelly's whole thing is about we deserve innovation. We deserve innovation every day of the week, because what we have learned to manage ourselves with diabetes the rest of the world isn't having to deal with we are. So why don't we dissolve? Deserve equality, and that's always been Kelly's mantra. And I completely agree with her on that, Scott, and that's why I love technology. Yeah,

Scott Benner 16:41
listen, John, if we make it to the end with time, I'm going to tell you my favorite Kelly, close story, okay, but I love that. Doesn't fit here, but it's an awesome story. I have any favorite Kelly close story, Scott, so get ready. Okay, well, maybe yours will be better than mine, and we'll find out. You know, I asked my Facebook group for questions for you, and we kind of pared them down to some, like, core ideas and things that we could talk about. So one of the things they wanted to know right away was, hey, this thing seems great, but I use a an A ID system. Like, is it going to integrate with pumps and a ID system? So where are you guys at with that,

John Bradford 17:14
right? Well, so the great news for everyone is that we do have I CGM indication. We actually received icgm indication with ever since e3 earlier in 2024 so when we received the 510, K clearance from the FDA for ever since 365 it also Scott came with I CGM. Now, Scott, what does i CGM mean? I CGM means, from an interoperability standpoint, the FDA perceives you to be of superior performance and be able to be a core part of an intelligent system to deliver your insulin. So we have met those standards. Scott, so that's great news for us all right, and we have the I CGM designation attached with ever since 365 Okay, so that's half the story, Scott, the other half of the story, then, is to actually work with the partners, pump partners, smart pin partners, etc, to actually integrate our technology into theirs. And Scott, I just want to give the whole community confidence. We have been working on that for quite a period of time. We're in full negotiations, discussions to make this happen. And you know, Scott, sometime soon, in 2025 I hope to start making announcements on which systems that we are integrated with

Scott Benner 18:23
that's exciting. Now I'd be remiss here if I didn't ask, because you brought looping up early. Is that a thing? Do you think loopers will be able to use 365 so

John Bradford 18:33
ever since e3 was part of a clinical study and published with beta bionics before. So Yes, Scott, there are, there are loopers using our technology today.

Scott Benner 18:44
Wow. Okay, I didn't know that. Hey, look, I learned something today. Finally, no, I'm just kidding. I learned stuff constantly on this podcast. Well, that's awesome when you say conversations with everybody, like right down to islet like, newer devices, right?

John Bradford 18:56
So now, to protect negotiations and discussions, we actually don't have disclosure to say any names

Scott Benner 19:04
publicly at this point. Okay, well, then I will never ask that again. Is that okay if I put just a little roadblock on that one? No, it's fine. No, I don't want to listen. I'm not trying to get I want this to work. I'm not looking for you to get in trouble. Heck yes, yeah. God,

John Bradford 19:16
here's where I have confidence. My boss's name is Brian Hanson. Brian actually came to us. We're really very lucky. Brian came to us from tandem. So Brian helped change the whole course of insulin delivery and also a ID systems. So I think we should have great faith and trust that we have Brian Hanson at the lead, leading negotiations for

Scott Benner 19:38
us. Awesome. Let's get you to break down how the system works, like, from, like, the nuts and bolts stuff, like, how do I put it on? How to, you know, what's the doctor's visit? Like, to, day to day stuff. Because I think it's gonna sound really different to people, and I don't want to butcher the language, so I go to my doctor and I'm like, hey, I want to get this what happens next? I. Absolutely.

John Bradford 20:00
So you want to talk about the process first, then we can talk about the product itself. Does that work? Yeah, please. Sure. So the process is very straightforward. You speak with your doctor. You receive a prescription. We are a prescription product. At that point, you'll be speaking with our diabetes Therapy Associates. They're an ever since expert who will take you through to find the right distributor for you have your benefits investigation done, all of your paperwork done, right? Scott, has CMM, all those typical things that happen with CGM, and then that'll be processed. The product will then ship from a distributor to either your doctor's office or to a designated in searcher. And we can talk about that in just a minute, Scott, they will conduct that brief office visit with you to do the placement of the sensor right underneath the skin, make sure that you then get connected to the app. Everything's done, then off you go to your day to day management.

Scott Benner 20:54
So funny, I forgot you're not Canadian, just because the person I talked to is Canadian about ever since, and I thought for sure you were going to say, and Bob's your uncle at the end of that, which is, I can't believe that's where my brain jumped to. Nevertheless, I find the doctor who does the insertion. And let's be really clear for people who might not understand, right? So I'm going to go to the doctor and they're going to make a small incision in my upper arm below my shoulders,

John Bradford 21:19
correct, right? That's correct. So a small incision is made in your upper arm. The sensor is placed right underneath your skin, and then steri strips or glue are used to seal that. There are no stitches. There are tagoderms placed over the top, Scott, and it takes approximately five days for that site to heal completely.

Scott Benner 21:39
Okay? And now I've got this little pro. I don't know what do you guys call it? Sensor, sensor. Okay, so the sensor is under there and it's reading interstitial fluid. That's what it's doing.

John Bradford 21:50
No, actually, it's using fluorescent technology instead. Scott, it's actually reflecting through light to determine the glucose level. Wow,

Scott Benner 21:58
how come? I don't know about that,

John Bradford 22:02
Scott, it's what I call the secret sauce. Part of the secret of some of the stuff you are going to talk about, why I think the product is so amazing is because the fluorescent technology itself, so it's not using fluid, so it doesn't have some of the challenges that fluid can present, such as compression loads. And we'll go there in just a couple of minutes, if that's okay with you.

Scott Benner 22:21
Oh, please. I'd love to know about that. So, okay, how much technical background do you have on this? Like, what are you what are you talking about? Like, is holding, like a little flashlight up in there, and it's what's it looking at? What's it? How do it know

John Bradford 22:31
that's actually a really, that's a really good I like that visual. Scott, a lot. That's a great one about it is, like a flashlight. So the sensor has what we call redundancy in it. So there's four different circles on that that's resting underneath your skin. And what it's doing, it's constantly looking at the glucose, and then every five minutes, it's transmitting that glucose reading to the transmitter, which rests atop your skin. And then the transmitter is then what actually connects the readings to your mobile device.

Scott Benner 22:59
Wow. Where does the sensor get power from?

John Bradford 23:04
You ask the tough questions. I love it. Currently, the sensor gets its power from the transmitter. So the transmitter both receives the results, moves them to your mobile device at the same time, the transmitter is actually powering the sensor. Hmm, is

Scott Benner 23:19
your dad still with us? He

John Bradford 23:20
is not. Oh, I'm

Scott Benner 23:21
so sorry he must. He would have been thrilled by this. No, oh, absolutely. I'll

John Bradford 23:25
tell you the team that developed this technology. Brilliant, brilliant, brilliant engineers, yeah, brilliant.

Scott Benner 23:33
Who made me think your dad, when you when, when you were talking about how

John Bradford 23:36
I know, right? I, yeah, I, Scott, I have tell you, part of the fun part of my career has been getting to interact with engineers and learning to speak a whole new language. So I speak like a marketer, engineers don't, so it's been a really fun learning for me. Scott, how to translate the voice of our customer people, diabetes back to the engineers. It's been amazing. You know

Scott Benner 23:59
what's interesting? John, I don't want to go down a weird road, but general manager of the Philadelphia Phillies has type one diabetes. Yes, he's been on the podcast a couple of times, and when I asked him to explain his like his job to me, he said, basically, he goes to the analytics department because he's got a I'm pretty sure, of mathematics or economics degree from Stanford, and played professional baseball for almost a decade, and so he took the technical stuff from the analytics department and he turned it into baseball talk yes for the players. So he's like, the in between, right? And I almost like, I almost think of you as like, Well, yeah, you're a marketing background, but you grew up with an engineer in your house. You must be a good in between for that

John Bradford 24:38
absolutely. And Scott, I have to tell you, it is. It's a whole skill about what we call insights, and insights, which I do want to chat with you about, about what I make, think makes ever since 365 so unique and such a tremendous benefit to people, diabetes is really very much insight based. Okay,

Unknown Speaker 24:56
how so? Scott, this

John Bradford 24:58
kind of like a pop quiz. Mm. So four most common complaints, or also another way said reasons why people take breaks from continuous glucose monitoring, which is kind of frightening. Scott, isn't it to think that people would actually take a break wake up in the middle night, low maybe not wake up in the middle night, because they're not being alarmed, right? So I mean, I'm all about CGM and the benefits to me on CGM, but patients to take breaks.

Scott Benner 25:23
Can I guess what the four things are? Well, I

John Bradford 25:25
want you to, because they're both intentional and unintentional. Take a guess. All

Scott Benner 25:28
right, hold on a second. Now, I please for anyone listening, we did not set this up at the let me just think. We did not. I'm gonna go with it gets knocked off. Adhesive allergies, false readings, compression lows, okay, there's a fourth one, damn, damn, hold on a second. Is it? Is it? Just tell me, John, is it the most obvious one, and I've just missed it?

John Bradford 25:56
No, it's actually close to your very first one. Scott, so the four most common, I would say, complaints, or what I call pain points, because the pain points that we experience with CGM, short term CGM utilization, the first is, Scott, that you missed, is the sensor fails before it's supposed to, oh, it

Scott Benner 26:15
doesn't make it the full time. Doesn't

John Bradford 26:16
make it its full labeled life. That's issue number one for people, my sensor, my sensor. People Speak directly, my sensor died before it was supposed to. What am I supposed to I don't have a backup. I wasn't planning for it. Do I go to my doctor's office? Is insurance going to cover it? Do I have to pay $400 out of pocket for, you know, all those things, right? Scott, as you said, the emotional, physical disruptions in our lives that we really don't need when we're trying to manage our diabetes and, as importantly, manage our full lives. Okay, okay, yeah, so sensor failing before it's supposed to. Sensor getting knocked off. And that comes for a variety of reasons, right? Scott, that can be sports, exercise, bumping into a door jam, knocking into a car, a frame construction workers, we hear this all the time from construction workers. I'm an HVAC worker, you know, I'm a plumber. I'm getting into tight spaces. I knock my CGM off, right? So those are the common ones we hear. To your point, this whole thing about I am woken up, or my loved one is woken up in bed, or the people that I have as my emergency contacts to be notified when I'm experiencing a severe low are being disturbed in the middle of light because of a false alert. So Scott, you nailed that one. And then the other one is, is skin sensitivity, right? And how does Scott get giving you quizzes? I know you're interviewing me. Hey, Scott. There was a study done in France a few years ago about type one patients over 800 using CGM devices as well as insulin delivery devices. Do you want to know what the reported frequency was from that patient base? I am experiencing skin sensitivity, skin irritation, skin reaction to my adhesive. You want to guess how high it was. I

Scott Benner 28:02
don't know, but I have to imagine, for people who already have autoimmune issues that skin irritation is not uncommon. But I don't, I can't guess a number, almost

John Bradford 28:11
30% so Scott, one out of three people are reporting frequent episodes with skin sensitivity issues caused by the adhesives off of devices. Yeah,

Scott Benner 28:22
now, and you're lucky if that's not your case, but, and now, how does 365 fix that? It's because, sure, yeah, tell me about that.

John Bradford 28:29
Well, let's go to the four key pain points. Okay, so the first pain point was a sensor. Basically, I use the word dying or not making its full labeled life. So I put something on a short term. CGM, I think it's going to last 10 days. It only lasts eight Okay, so I just lost two days. All right, how does Eversense? CGM, pass it off, Scott, we're actually in the plus 90th percentile lasting the entire life that we publish. Okay, so it means for our one year wear product, we're in over 90 percentile on the sensor making its full life. Scott,

Scott Benner 29:04
how? So, it's amazing. How do you how do you like, okay, I guess my question should be, when it doesn't make it, what happens? Because I'm putting myself in other people's positions, like, if my, if my other, if my other one gets knocked off, and I pick up another one, I put it back on again. But if the one inside my arm stops working, what do I do? Right

John Bradford 29:20
then at that point, we would do a process and have a new sensor inserted for you. But again, Scott, it is so minimal compared to short term CGM, so minimal. Yeah, yeah. If it gets replaced, does it go in a different arm? Yes, that's correct. So our labeling recommends Scott that you alternate insertion sites, so you'll start, you know, whichever arm you pick, and Scott, you just, it's a really simple process for the doc and the patient. Patient reaches across their arm, shows where they can touch their tricep, where they can reach on their forearm comfortably to apply and remove the transmitter. And that's where the sensor is inserted. And then you just rotate. Yeah, now your

Scott Benner 30:00
transmitter sticks to the person too. So how come they're not having adhesive interactions with you? Really good

John Bradford 30:07
question. So let's go back to those pain points. So the second pain point was really skin irritation, as you've been talking about. So Scott, we actually use a silicon adhesive. Okay, so And Scott, we actually have through a two year study, less than 2% of patients ever experienced skin sensitivity issues with our gentle silicon adhesive. Wow. So compare that 2% to 30%

Scott Benner 30:32
I think I know this part like that adhesive goes on like a new piece goes on daily. Is that right?

John Bradford 30:37
That's right. So Scott, I know we're going to jump here a little bit. But what we didn't get to cover is what I like to call my iPod analogy about this. So maybe Scott, what we could do is go back to how the system works. Yeah, however,

Scott Benner 30:49
it's more comfortable for you to talk about because I will, I will jump around. So stick with what you're doing, and

John Bradford 30:54
we'll actually good. So let's do this. We're going to leave and we're going to come back to those next two pain points in a moment. But I think Scott, what's most important for me is the questions that I see online, the questions that I see in social media, all these really engaged people wanting to learn more, I just kind of want to share in a really simple, straightforward discussion. There are four components to the system, okay, the first is the sensor. The sensor is placed underneath your skin once a year. Second is Scott, then you have a gentle silicon adhesive that is changed daily. And what happens on that daily? It's a double sided sticky part of its the one side sticks to your arm. The other side is what the transmitter sticks to, right? And now, Scott, I do want to go to the transmitter, because we're going to need to do some more work here as a marketing team to really make sure people understand how the system works that's on us. Just you know, for your community, that's on us. But thank you for the core questions, because it lets me know what we're not communicating well, Scott and we'll get there. Okay, so the transmitter itself, Scott is fairly small. It's only about two inches in length and only about a little over an inch and a half in width, and it's flat as a pancake. Okay, so that transmitter, Scott, the smart transmitter, is really the brain power that's moving things back and forth between the sensor and your app. What I want to make sure people know is we got to break out of the thinking. This is the iPod thinking. There is no cannula on our smart transmitter, right? So it's held to your arm by the adhesive. That's why, Scott, if ours gets knocked off, for some reason, the transmitter gets knocked off, you can pick it right back up and put it right back on. If you want to take it off, to take a shower, you can take it off, take a shower. You can charge it up while taking a shower. You can peel off your adhesive. You can wash fully underneath that skin. Make sure your skin is nice and lovely, etc. Reapply a new adhesive, and then put that smart transmitter right back on top. So Scott, it has this tremendous flexibility to it that it has nothing that goes into your skin, because it's communicating back and forth with the sensor that's underneath your skin, right? So it's a radically different thought, Scott and you keep talking about engineering, it's a radically different thought, how the transmitter works. I still see a lot of question people. They say, Well, how does it get knocked off? You're not wasting a device. You're not because it lasts for a year, and it just comes riding off with that a double sided adhesive, yeah,

Scott Benner 33:23
knocked off, almost the wrong it's almost like, dropped, like, Oh, it came off. I'll put it back on. What?

John Bradford 33:27
And you can, yeah, how

Scott Benner 33:28
frequently and for how long do I have to charge the transmitter? About five

John Bradford 33:32
minutes a day. Will work. Scott, oh, no, kidding. Okay, yeah. So again, what we find, and I know you've talked to a lot of people who've used the ever sense systems you'll find what most people do is they just plug it in when they're taking a shower.

Scott Benner 33:46
Yeah, and, but if they don't want to, can they swim with it or shower with it? Oh, absolutely.

John Bradford 33:51
We have labeling for the product. Can be worn in the shower if you don't want to take it off, absolutely. And can be submerged in water. We have our designation for length of time, submersion and water for length of time, sure, but same

Scott Benner 34:04
problem being submerged as anything else, right? I'm assuming it talks back to the app through Bluetooth. So water blocks Bluetooth signals.

John Bradford 34:11
Water Blocks Bluetooth signals and correct and Scott, the other thing I want to be really clear on, because I always believe in full fair disclosure to answer people's questions. When you do take the transmitter off, information is not transmitted back to your app.

Scott Benner 34:27
Okay, so the app goes blank. It's not get anything from it, and that's right. And you're going to tell me, as soon as I put how long after I put it back on, do I get information again

John Bradford 34:35
within five minutes? Okay, but it doesn't backfill. Scott, so you you'll have a gap on that data. Okay, but Scott, let's talk about when that might happen. I always say to people, make sure glucose is stable before you choose to take your transmitter off. You should talk to your doctor about that. PS, by the way, Scott, or use your own diabetes management knowledge and expertise, right? We have people that tell us they take it off for a shower. Scott, I'm trying to save this a sense. Positively as possible. We have people who say they take it off for intimate moments. Okay? We have people who tell us they take it off because they're about to speak in front of a public event. We have people who say, I'm at a really spectacular moment, and I just don't want people to bombard me with questions about my diabetes at the moment, so I want to go with just a clear arm, right? So all those things work. And Scott, I always say, negotiate that with your doctor. Know what's right for you and your diabetes management. It's available to do that. But again, that little break I recommend only you know, I would recommend that you align with your doctor about when and why you take it off, what's

Scott Benner 35:40
the accuracy like between that and other popular CGM, between 365 and other popular CGM? Great

John Bradford 35:46
question. So we have exceptional accuracy for 365 days. And Scott, that's what matters. We have exceptional accuracy for 365 days. Imagine that. This is what I call the magic of this product. The engineers were so brilliant that they were able to figure out how to keep it accurate. Scott, we actually have a claim versus other systems. We are the most accurate at low glucose values. What's that range?

Scott Benner 36:10
When you say low, below 70, below 70, most accurate there. Okay, yep. And I mean, obviously, I mean, if you're going to get distinctions where you can use it with other systems, then it's going to fall within the range that's acceptable to the FDA, just like the other CGMS are that work with those pumps. You got

John Bradford 36:31
it. Scott, and again, remember, for I CGM designation, the FDA sets the bar very high for what your accuracy performance needs to be so. Scott, in nerdy terms, that's called marred, although that will be shifting soon from an outside perspective. But Scott, all of our Mard data points are all less than 10% which is considered exceptional accuracy. Oh,

Scott Benner 36:53
okay, not paying for it. Like is this a thing my insurance is going to cover? Sure

John Bradford 36:58
is so ever since 365 is covered by the majority of commercial health plans today, Scott, and it's really easy. You're interested. Your doctor is interested. Give us a call, Scott, into our diabetes therapy team, and they will conduct a benefit investigation for you, and they'll let you know through that what your co insurance or co pay is based on. You know what? Everything that's happened already for your diabetes and other medical supplies for the course of the year. So no

Scott Benner 37:26
different than anything else. If my insurance covers it, it's covered, but then it's yeah, how much my insurance covers is my personal issue, right?

John Bradford 37:33
Bingo. Now. Scott, one difference between us versus other systems on the market, the short term system Scott is that we do require the placement by a trained health care provider. So that's the key difference. The other difference Scott is we do actually have two costs involved with our system. One is the product and one is the actual insertion itself, because typically there is a office visit cost associated with the insertion as well, and again, but those can all be reviewed by our expert team of individuals who have in depth knowledge of this, and confidentially, with the patient's agreement or person's agreement, can go in and look through records and let them know what their exposures are, financially. Oh, it just

Scott Benner 38:15
occurred to me. I don't know why this just occurred to me, there's no waste once it's in the transmitters. The transmitter all year. It's not like I'm tossing it every number of days or weeks or something like that. So there's nothing for me to buy after the initial buy. Is that right?

John Bradford 38:28
That is correct. So Scott, Scott, I'm smiling on my face right now because a couple things I want to make sure I get across. I always use the analogy. And this is through Dr Fran Coffman, one of the most brilliant endocrinologists that has ever lived, just tremendous. Fran always uses the example with me. She's like, so John, she said, just think of everything green. I was like, okay, Fran, tell me more. So Scott, with our system, the sensors placed once a year, the smart transmitter lasts for a full year. And then you have your app. But then Scott, you have 365 adhesives that are provided to you. You can use one per day. So theoretically, Scott, you can carry around with our product. You can carry around a year of supplies in a plastic baggie. Yeah,

Scott Benner 39:18
I don't know why. It just occurred to me like that. For some reason I was like five. I never thought of that before, right? All right, awesome. Let's see one of the questions that people hit me with, and I think it's probably because the past iteration of the product required pretty consistent calibration. But has that changed? That's changed with 365

John Bradford 39:36
though, right? Scott, this is a magnificent change for us, and it's driving tremendous excitement with healthcare providers, as well as with people with diabetes. So Scott, after day 13 from a calibration standpoint, it's just one calibration per week.

Scott Benner 39:55
Okay, so for the first 13 days, it's what

John Bradford 39:59
one. One, and that's to get the system calibrated, what I call personalized to you, to make sure that the accuracy has been optimized to

Scott Benner 40:06
you. Scott. And then, once a week finger stick calibrate. That's it. Once

John Bradford 40:10
a week calibration, finger stick calibration after that. And Scott, if you look at DQ and a which is, I think, the largest registry in the US of diabetes, patients with diabetes, people diabetes, type one, type two. We do know that, on average, patients sometimes question the results are in conducting finger sticks anyway, with factory calibrated products. So we are actually personalized calibrated, right? It's calibrated by you to the system, to the system, and you. So to me, one calibration per week. Really is not any change to behavior that we're seeing with a lot of type one people already who question their results and do a recheck. No. I

Scott Benner 40:50
mean, I have my daughter test her blood sugar all the time. I'm always like, I check that before you do anything. I say that a lot. So that makes complete sense to me. All right, so some questions that are from the group, but I have to admit, pops up into my head too. What about risk of, like, infection, like once? Because that's got to be something people are wondering while they're listening to this, absolutely,

John Bradford 41:10
absolutely So Scott, we have excellent, excellent safety information. So just so everyone is aware, we actually have a study from our previous system, ever since e3 that actually was a two year study around these topics. And actually, Scott, the study for the submission to the FDA for ever since 365 Scott, since it's a one year product, the study lasted about two years. Scott, because we have to follow people through the full year, right? So let me tell you about safety results. Scott, I can say it in one word, excellent.

Scott Benner 41:44
Okay. I mean, how do you is there a way, you guys, yeah, how do you quantify that?

John Bradford 41:50
Sure that's quantified by what are called adverse events, so, or what we call AES. There were no unanticipated adverse events on the two year study with ever since 365 there were no device or insertion removal procedure related severe adverse events, which is an escalation. Scott, so there were no and no skin infection, because I know you had asked about that ahead of time in our post approval studies. Scott, point three, 1% let me say it again. Point three, 1% mild skin infection. That's pretty awesome, actually. And skin irritation from adhesive we talked about it, it's less than 2%

Scott Benner 42:29
well, people who are, like, aware of, like, an omnipotent for example, like, how would you compare the transmitter for 365, to, like, the size of an Omnipod? Oh, really

John Bradford 42:39
good question. Similar in the OmniPods. Most free Omnipod five, yes, okay,

Scott Benner 42:44
similar to that size?

John Bradford 42:46
Yeah,

Scott Benner 42:47
gotcha. Okay. How about weight?

John Bradford 42:49
Scott, I'm holding it in my hand right now as we speak, I'm holding both the sensor in one hand. I'm holding the transmitter in the other. The weight a feather.

Scott Benner 43:00
Do some people put a hold down on it, or put a wrap on it when they're running, or something like that? Or does that not seem necessary?

John Bradford 43:06
You know Scott, I think it's a good question to ask someone that I know you. You've spoken with Chris Rudin as well, who's Mr. Super athlete. So I think it's a great question for Chris. Or what I have observed with patients is the silicon adhesive is enough to keep the transmitter in place securely. I have heard cases Scott, where some people are saying I'm going to be doing something, where I just think I'm going to have tremendous amount of moisture, you know, water, humidity or something. Maybe do an overlay, but we actually don't recommend it. That's actually as needed by the patient. Okay, you know, Scott, there are some short term adhesive. There are some short term CGM that actually in their labeling. They actually part of the system is the overlay.

Scott Benner 43:53
Okay, okay, yeah, no, I know they're starting to come with some things in the box, right? Because they know people. They know people are requiring them. MRI, can I get an MRI, you sure can? Oh, all right. How come it doesn't come flying out? Or is that a CT? What am I thinking of? No. An MRI, right? Yeah.

John Bradford 44:11
MRI, yes. MRI, yes. TSA, yes. Oh,

Scott Benner 44:14
nice. I don't have to get the pad down. Finally. Nope, nope. I'm just looking through, it's so funny. I'm looking through people's questions, like, like, just how they kind of sent them in raw. You've covered this one, but somebody just said, Wouldn't it start to smell? And I thought, Oh, why would they ask that question? Like, oh, because they think that adhesive is on there for a full year. That's the assumption. Oh, I get it now. Until you explained earlier, like, you were so clear about, look, you get one of these every day for 365 days, you take it off, you throw it away. Do another one. Because I kept looking at the list and going like, Why did someone ask that? But now that makes sense.

John Bradford 44:48
You know what? Scott, we get that question all the time on social media, and I think it's a really fair question, Scott, that's just back, Scott, to the marketing team here, Scott, you know what? We're. Truth. We're honesty. We're all about protecting, helping people with diabetes, Scott, we need to do a better job of making sure this is a new technology for people to understand how it really works. Yeah, I would understand why somebody would think, Oh, how gross, stinky, like you're using the same adhesive for 365, days after seven days, mine's peeling up. Smells as dirty as grody. No, you have a fresh one every day. Yeah,

Scott Benner 45:22
I did get an I got a question from a very thoughtful person who says they went through, I guess, let me see, this is for, oh, apparently this was back for your 90 day sensor. But they said that they saw that you can't get a massage near the area. Is that a thing still

John Bradford 45:38
during healing process? I would recommend No, Scott, I know there's questions on dislodgement that have been asked before, which we have not seen evidence, but Scott, would you be okay? Since that's a medical question, if I would check with our medical department, I could send you an email afterwards. Is

Scott Benner 45:56
that okay? Wonderful. I'll put it at the end. That'd be awesome. Yeah, I appreciate

John Bradford 46:00
that these are good, all good, fair questions, and I want to make sure they're answered accurately.

Scott Benner 46:06
Okay, what about age like? How old do you need to be to get this 18 plus. Is that a thing you're working on for younger people? Absolutely.

John Bradford 46:14
So our partners, sensionics, who is the really the engineering brilliance behind the whole ever since platform, they are actually actively involved in studies for additional age groups. Scott, but I don't have that to announce yet, but you know, if you go to now, if you go to study sites, you'll see those where those studies are being conducted. Yeah,

Scott Benner 46:36
no, it's not just the thing you're thinking about. It's you're actively, actively

John Bradford 46:40
involved. Scott, you know what I love you're asking this, I love that. Your listeners, viewers, the community, is asking, we're actually working on, you know, additional age indications. And to your point, we're actually working actively. We already have a clearance for it on the A, I d integration.

Scott Benner 47:00
Oh, awesome. Here's the sad quote everyone will always ask this question, am I ever going to get this in Canada? Poor Canadians never get anything. Is it coming to Canada? Available in Canada? Where else can people get it?

John Bradford 47:10
So sure, currently the products available in seven markets and six European markets as well as the US. Not currently available in Canada. I know there were always some questions in Australia as well, not yet, Scott, really, we are at the point of wanting to make sure we demonstrate tremendous success in markets before we expand. Scott and that, and Scott, I'm partially responsible for that. So you know, Scott, because to me, I want to make sure we're able to have full success before we expand globally,

Scott Benner 47:42
what are the markets that it's in now, though, because I'm pretty worldwide, so can you shout out Absolutely?

John Bradford 47:46
So the second, what we would say the second largest market for many Diabetes drugs and diabetes devices were in Germany as well, Sweden, Switzerland, Spain, Poland and Italy, we actually have a tremendous business in Italy. Scott,

Scott Benner 48:03
awesome. Okay, oh no, it's great. No plenty of i I'm often genuinely gobsmacked by how far and wide this podcast is listening to. So I'm glad you brought it up. And same for those people in those countries. Go to your doctor, ask the question, blah, blah, blah.

John Bradford 48:17
That's right, exactly the same now. Scott, ever since 365. Is currently only available in the US. We actually expect to receive news in 2025 about launching in Europe.

Scott Benner 48:30
So right now, in those other places, it's the six month system.

John Bradford 48:33
It's right, ever since e3 so the six month system correct. We

Scott Benner 48:38
talked about this earlier. I feel like I want to try to ask a more specific question about the cost of the insertion. Does that fall to people, or does it go to their insurance? Generally,

John Bradford 48:47
it depends. Scott, it can go either way, depending upon what the patient's already paid for office visits, etc, for the year. But

Scott Benner 48:55
it's not going to be a thing where they're like, Oh, this is $5,000 you pay this part. It's like, your insurance covers it if it covers it, and then whatever your co pay is, or whatever your negotiated price with your insurance is, is how it goes,

John Bradford 49:07
right? So, Scott, there's two to be really technical about it. Scott, there's two aspects to it. One is the product cost. The other is the procedure cost. Okay, okay, yeah. So they're they're covered differently by health plans. They're managed differently by health plans. That's why, you know they say you've seen one insurance company in the US, you've seen one insurance company in the US. They all operate differently,

Scott Benner 49:28
right? So, so just check and find out what your situation is. Now can find out for sure. Okay, what am I not asking you about this? John, that I should have

John Bradford 49:36
I think for me, you would ask me, what do I see as the four key benefits of the product you didn't maybe ask me that. Okay, good. Well, so to me, we are the longest lasting CGM. We last for 365 days. We are the least system likely to fail. Okay, yeah, number one. Number two, no more wasted CGM, so, Scott, you talked at the very beginning about the. Getting things knocked off. Guess what? You can't knock our sensor off, our sensors underneath your skin. So you knock for transmitter. You simply pick it up and reapply it. There's no waste, and that's a key thing that I say. The other is accuracy, and we didn't really dig into it, but compression low so Scott, because of all fluorescent technology, we do not have the compression low artifact, as that's called, so you can sleep directly on our transmitter, Scott, and not have false alarms caused by compression lows. We are the only CGM system that does not trigger compression loads.

Scott Benner 50:33
I wonder if people understand. I do try to mention this once in a while. So other CGM are measuring interstitial fluid. So if you That's right, you lay on it, it actually disperses the fluid away from the sensor. And so the truth is, is that if your blood sugar is 120 and super stable, and you lay on your CGM, and then all of a sudden it's like, oh, you're 66 it is actually accurately reading the glucose. It's still around the sensor, except you've dispersed so much of it that there's not as much glucose at the sensor as there is actually in your body. So that's what compression loads mean. It's like you lay on it, it pushes the fluid away. The sensor can't read the fluid accurately, exactly,

John Bradford 51:12
exactly, right? You know, the really fancy guys and gals out there that really know this topic. Call it compression artifact. Such a nice engineering work, right? Scott, but Scott, you described it beautifully. It happens with anything that's using a cannula inserted sub q to read interstitial fluid. It's a potential, okay, and it does impact some patients more than others, especially side sleepers, right?

Scott Benner 51:37
No, no, I trust me, I've seen it. I've been woken by it before. I've I've had to teach myself how to visually understand that that's what it is when I'm looking at it, if that makes sense, right?

John Bradford 51:46
And Scott, we all know in the community, Scott, our favorite thing, because we hate to be infantilized, right? Scott, our favorite thing. And I'm saying that jokingly, facetiously, none of us like hearing our CGM alert us in the middle of the night, three o'clock in the morning, right? Waking us up with screaming noises, baby noises, whatever you use to wake you up, to get you out of deep sleep. And you know it's also disturbing your partner in bed and potentially other people, right? When that happens, we want it to be true, not false, right? No. Fair enough. My last one is maximum comfort, and that's our gentle silicon based adhesive is changed daily and cause almost no skin reaction. Scott, I'm making some very decorative statements about our technology. You heard me say, no, no. I mean, these are pretty amazing things to people with diabetes who are experiencing false compression lows. This is really important to people who are are facing skin irritation, skin issues with adhesive these are really important for people who, for whatever reason, lifestyle, etc, activity, knocking their sensors off. And it's really important, Scott, for people who actually, for whatever reason, have sensors that die before they're supposed to. No so I

Scott Benner 53:00
agree. I John, I have to tell you that I have spoken to people privately and on this podcast who had to stop wearing a CGM because of skin irritation, and it was heartbreaking to them. They wanted that data absolutely and having to walk away from it, I hope they find out about this. Is what I'm saying. Yeah, no, for sure, I listen. My daughter's 20. She's had diabetes since she was two. I can't imagine her not having CGM data. It just doesn't like I don't know how to wrap my head around that completely. So,

John Bradford 53:28
you know, Scott, you you said this. And you know, we've heard this through multiple diabetes innovations over the years, with insulin delivery, with CGM, etc, the thing that touches my heart the most, and what wakes me up every morning and keeps me so committed to the our community is when people who use ever since 365, has said to me, why didn't I do this earlier? I'm

Scott Benner 53:51
glad do. Do people continue with it after they try? Do you have data on like, like

John Bradford 53:55
we sure. Do? You sure do 84% continuation rate Scott. And actually, Scott threw that placement underneath the skin, which we used to call a procedure, I just say, an in office, simple procedure, to place a sensor underneath your skin. Scott, 84% of patients there said that, no problem, they would do it again.

Scott Benner 54:14
Oh, that's awesome. And how quick is that procedure? Like, not long, right? It's like, like, what do they give you, like, a little local so you don't feel it, and then you get

John Bradford 54:22
a little local, that's right. And then there's a small point five millimeter incision made the sensor slipped underneath the skin. Steri strips are put right back on Tiger derms laid over the top, so you have a good healing process. And then five days later is about five days later, the steri strips should be out and you're good to go. Awesome. How long does it take? Scott, it really depends. Scott, like everything else, on the patient themselves, but also the provider doing that. Scott, but what I say to people is you can go get it done on your lunch break.

Scott Benner 54:53
Oh, exactly. So it is a quick thing. Okay, all right.

John Bradford 54:56
Scott, this is one thing for me. You know, because in diabetes. We've all been exposed to so many different things. You know, our eye screening processes, our foot screening process, you know, all these things that can sometimes feel very laborious to us. What I want to make sure people know is this is a very proven procedure that can be done very quickly. Okay, very quickly for the person with diabetes, this is not disrupting your day. You can ask, when you speak with Chris Rudin, and I know you've talked to Mary about it, you know, Mary will talk about she goes and gets the procedure done, then she went to the playground with her son. So I just don't want people to think this is like a massive surgical procedure. It is a minor, minor procedure, right? Okay, minor, minor procedure. So we got a break free of the thought of, this is a massive, a massive medical procedure that's going to have me sitting in my chair recovering today.

Scott Benner 55:48
Also, you know what I didn't ask you about, and I want to make an ask, and maybe you guys are doing this already, but so we didn't talk about the the on body vibe. So, like we did not, the transmitter can vibrate to tell you what your blood sugar is without being audible, which I think is awesome, but it's the transmitter vibrating. Tell me when we get to the sensor vibrating. Is that a thing that you could do? Because that would be crazy.

John Bradford 56:11
Well, to be fair, for the audience, you are correct. We didn't talk about on body vibratory alerts, or as I like to call them, on body vibe alerts. The smart transmitter will, if you are experiencing high or a low, will give you a different vibration sequence to let you know it's very quiet. You can feel it. That's really ideal to not wake up a loved one in the middle of the night, if that's what you want. Scott being at church so you didn't, don't disrupt the preacher, right? Or being somewhere else, presenting like you know you do all the time, presenting in front of groups. You don't want a screeching phone sounding at you. So the on body vibe alerts are pretty darn amazing. It is done through the smart transmitter. And to your point. Scott, yes, lots of thought processes about the future. Scott, all the way from having the sensor itself vibrate, Scott, all the way to how do we make the transmitter go away completely?

Scott Benner 57:03
Really? Oh, cool. Yeah, I'm looking Imagine that. No, I listen. I when I was first told about it, I misunderstood it, and then I because I thought the sensor vibrate. And I was like, that's magical. How the hell did they do that? But then I started thinking, like, I wonder if that could be a thing that they're thinking about or working on in the future. Anyway, I always like to say to people like, please keep pushing and trying. And I know everything's not possible, but a thing under your skin is already kind of magical. You know what I mean? Like, it just, it really is crazy. Oh, I remembered my random question from earlier. Is there a limit on how many people can follow a user? Scott, I

John Bradford 57:39
need to get back to you on that. I

Scott Benner 57:40
believe it's 12. Okay. All right, okay,

John Bradford 57:43
let me follow Let me follow up on that one. Scott for you. Have two follow ups for you, okay, all right, perfect. And Scott, what I did want to say is just two things. These are my plugs, guys. These are my marketing plugs. I hope you bear with me. Feel free to go to ever since cgm.com there's really great education. There videos on there, George, we call him, who's great, who shows in real life, what's happening with some of these frustrations, Scott, that we talked about. And the other thing is, if people are so interested, you can follow us on social media, on Instagram, on ever since CGM really great content there from actual users, Brand Ambassador Scott, that are telling you The Good, the Bad and the Ugly on a daily basis. And I just adore their stories, because they're humorous at points, but they're also there the truth about pain points, Scott and I just love our ambassador community and all the work that they're doing to keep us real. I

Scott Benner 58:40
think people should check into it too, but I think John was a little wrong there. Let me just say it's ever since cgm.com/juice box. John, that's Scott, that's right.

John Bradford 58:49
Let me play that back. It is ever since cgm.com/juice box. That's exactly where we want you to go. Yeah. I

Scott Benner 58:57
mean, I want you to use whatever CGM works for you. But I think this is well worth looking into, but if you are going to look into it, let's keep paying my electric bill. That's all I'm saying, John. So I agree. I agree, sir. All right, you want my Kelly close story. Do you have to go? No,

John Bradford 59:11
oh my gosh, I'll probably see Kelly this week. Okay,

Scott Benner 59:15
so she's not going to remember this, although I've said this out loud once or twice, so maybe she's heard it. I was at like a blogging conference with her. There were a lot of people there, and I happened to be seated next to her, and I didn't know her at the time, and she had a laptop in front of her. And we are sitting in a big kind of conference table. There's got to be 20 people in that room. We're having a pretty heady conversation about how to help people with diabetes. And she's, you know, typing constantly, like just typing, typing, typing, writing something, not not just like filling in, like, you know what I mean, like she's writing. And I noticed that through this entire conversation, she's writing, and at some point she has a question, and she asks her question, but to my amazement, while asking her question about this heady idea. And offering her feedback on it, she never stops typing. And I am just transfixed by this, so I very rudely lean over her shoulder and look she's typing about something that has got nothing to do with what we're talking about. And it blew my mind. John

John Bradford 1:00:22
Kelly is brilliant. No kidding, absolutely brilliant. And I'll tell you the coolest office space in San Francisco, an old Victorian home Scott her team of people committed diabetes, many of them with diabetes, many without many planning to go to medical school, they're the future of diabetes. Scott, it's so amazing. It's just, it's my heart is just like, I feel like the Grinch. My heart has grown four times its size just thinking about what she's done for our community. It's amazing. I'm

Scott Benner 1:00:57
just telling you, I have never in my life seen somebody hold a full conversation audibly while typing out something that has nothing to do with it. At the same time, it was I thought, Oh, my God, this lady's brilliant. That's exactly what I thought when I was sitting there. So then I at lunch, I started talking to her. I was like, hey, exactly, my God, you're smart, John. I can't thank you enough for doing this. It really is lovely. I've learned a lot about 365 and ever since, in general, since you guys have been sponsors. And I just, I keep thinking, Man, I don't know if ads are enough to get this through to people. So, you know, I said I'd love to have somebody on the show to really lay it out for you and and even though you're coming from a marketing perspective, and I think people could feel that as selling, I just think you're the right person to tell it, because you know now they can dive in and find out if what you said is good for them or not. But I really think you laid it out very completely in a way that will at least give them a path to to check more into it. So I really do appreciate your time well.

John Bradford 1:01:53
And Scott, thank you and Scott, thank you for all you do via Juicebox and you just you yourself, or all of us with diabetes, we so much appreciate it, and I do want to say a huge shout out, and thank you to your followers. Scott, just such honest, genuine, intelligent questions, and just keep them coming. Guys, let this the only way we're going to keep driving innovations and diabetes. So just keep those questions coming. Be as tough as you want. I can take it, and I actually appreciate it. Scott, so thank you so much.

Scott Benner 1:02:25
It's my pleasure, John. I hope you have a good day.

John Bradford 1:02:27
Thank you.

Scott Benner 1:02:34
Your kids mean everything to you, and you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen it like you. Mean it because if even just one person in your family has type one, your child is up to 15 times more likely to get it. But just one blood test can help you spot it early. So don't wait. Talk to your doctor about screening tap now or visit screen for type one.com to get more info and screen it like you mean it. Arden started using a contour meter because of its accuracy, but she continues to use it because it's durable and trustworthy. If you have diabetes you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour, next.com/juicebox if you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bold beginning series from the Juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginnings series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com. If you're looking for community around type one diabetes. Check out the Juicebox podcast, private Facebook group. Juice box 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. You.

#1363 Caregiver Burnout Series: Part 3

Erika Forsyth provide strategies and encouragement for caregivers to manage nighttime sleep disturbances and burnout.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Here we are back together again, friends for another episode of The Juicebox podcast.

Erica is back for part three of the caregiver burnout series, and don't forget, if you'd like to hire Erica, you can learn more about her at Erica forsyth.com. 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. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com if you are the caregiver of someone with type one diabetes or have type one yourself, please go to T 1d exchange.org/juice box and complete the survey. This should take you about 10 minutes, and will really help type one diabetes research. You can help right from your house at T 1d exchange.org/juicebox, I know that Facebook has a bad reputation, but please give the private Facebook group for the Juicebox podcast, a healthy once over Juicebox podcast, type one diabetes.

This episode of The Juicebox podcast is sponsored by ag one, I start every day with a delicious drink of ag one, you could as well drink, AG, one.com/juice box. Today's episode of The Juicebox podcast is sponsored by Omnipod and the Omnipod five learn more and get started today at omnipod.com/juice box and that Omnipod iPhone app you've been waiting for, it's available right now in the Apple App Store, Erica, we are going to jump into episode three, the third part of our caregiver burnout series. Today we're going to talk about what

Erika Forsyth, MFT, LMFT 2:10
that's right today, we are going to talk about the third burden or barrier to why it's challenging to take care of yourself as a caregiver or find time to care for yourself, and that is managing type one and the experience of nighttime sleep disturbances. Again, this is the third most common burden or issue that parents have identified in all of the research around caregiver burden for children with type one,

Scott Benner 2:41
when it's time, can I read the quote from the research? Yes, I'm gonna

Erika Forsyth, MFT, LMFT 2:45
pass it over. It's time. Read the quote. This is from the parent from the from the research, getting,

Scott Benner 2:51
getting the character. Let's see, I'm sad and tired. Okay, I got it. Yes. I feel unhappy when I think about not sleeping, feeling anxious and feeling tired and moody all the time. So it's rather contradictory, because I'm obviously satisfied that things are well and that my child feels fine at the same time, I may not feel satisfied because I do not feel well, really. Okay. So what this person is saying is, right, like I've got, I got my ducks in a row here. Kids doing good, but I'm up at three in the morning Bolus in a 140 and I feel like I'm gonna drop dead because I'm unbroken sleep might be the worst thing that could happen to you. I used to think, I guess, in the beginning, when Arden was first diagnosed, and I realized, Oh, I'm awake at two in the morning for 45 minutes, and then I'm up again at 430 for 15 minutes. I actually, in the beginning, I thought, I can do this. It's okay. I guess this is what it is. And then as the years went on, I mean, there were times like I one time I woke my wife up and I said, I need you to watch Arden's blood sugar. I feel like I'm gonna have a heart attack. Like I like I was yes, I was buzzing, and my heart was like thumping out of my chest. I was exhausted, but I had so much adrenaline, it didn't matter I was awake. And I'm not that guy. I am head on the pillow. Go to sleep like I don't. I do not struggle to sleep. Prior to ardence, diabetes, I would not have been a person who I thought could have just woken up at two in the morning and stayed awake before stayed awake for 45 minutes or an hour or something like that. I just wasn't that person. But then I was, and I actually tricked myself for a long time into thinking, Well, I'm gonna be okay. This will be all right. This is, I guess, this is how I live, and I'll be okay. And then one day, I thought, I'm gonna die if I don't, if I don't fix this, you know, yes, and then CGM and algorithms came, and it got easier, but, but tell me more about it, please.

Erika Forsyth, MFT, LMFT 4:46
Yes. I mean that that tension between you know, you need to sleep, but just as important, you wanting to make sure your child stays alive and or doesn't have a. Have a low or stay high for hours. And so this is, obviously, this, the state of sleep deprivation is really common in the beginning of diagnosis. And as we've talked about, you know, the seasons of change, particularly from, you know, changing devices or growth hormones, etc, etc. So this, you know, the fear, this is probably one of the greatest fears among parents, at least according to the research. But I would also probably say, from what we hear on the podcast and in in my office, you know, this is the greatest feared outcome. Is your child having a hypoglycemic reaction or seizure. And so then that fear is driving. You're just wanting to monitor whether you're finger pricking every half an hour to an hour, or watching the CGM. And so even, as you just said, parents know and experience you have short tempers over long periods of time of not sleeping, you are not motivated to exercise. You have difficulty making decisions. You have you might have some impairment in your work performance or functioning. You might not make the dietary choices that you are striving for. You have decreased patients and irritability. So you're then stuck in between this tension of, I so desperately want my child to be safe at night, and I so desperately need to sleep, and I and I know that I'm not functioning well, yeah, but yet, as the parent says, but then you feel well because your child's doing okay at night, right? You're

Scott Benner 6:37
proud and exhausted at the same time. And yes, it's funny, because you said hypoglycemia is what people are worried about in the research, I was worried about both. Like, that's the other thing. Like, I'm freaked out when somebody says, Oh, you know, I needed to sleep through the night, so we just put their blood sugar at, you know, 180 and left it there all night, or 200 or wherever you put it. I'm like, Oh, God. Like, don't do that. Don't do the other thing either. Like, that's the to me, that's the that's the push and the pull and the anxiety of the whole thing, which is, like, you can't be low, that's dangerous right now, and I don't want you to be high, because that's dangerous later. And, you know, I'm exhausted, but in my mind, you know, if I go to sleep now and don't do something about this, either you're going to have a seizure or your eyes are going to explode when you're explode when you're 35 and like, and that's how it feels like it just, it feels like, no matter, like I have to do the right thing to avoid both sides of this, you know, Storm and, you know, like in the middle feels so narrow, like the line you're trying to walk, it feels, it feels like a tightrope, right? And you know, just, it's not easy, and then you're exhausted. And everything you just said about what comes with exhaustion, I know I've lived through all that, just, just every, everything you just said happened to me, and it's, I don't think it's a thing you can avoid, all those, all those implications,

Erika Forsyth, MFT, LMFT 7:57
yes, yeah. So this is, it is challenging. And again, can be normal during certain, you know, ages and stages of your child's diagnosis. But what we're wanting to encourage you to think about, you know, if this is now becoming years and years and years, right, of of not being able to sleep, and so pausing and asking yourself, you know, noticing the why, what is going on. And so as we move into kind of the tool, you know, I say take breaks, and we're going to get into that, like, what does that actually mean? But I would encourage you to to start asking yourself, what is the risk and the benefit of studying the numbers? What is, what is the underlying reason that you cannot sleep? And this might feel a little bit similar to episode two of kind of pausing and listening to what is driving the behavior? Is it fear? Yes, it's probably fear of having, if your child up being too high for too long or having a low but what is underneath that? Do you need more education? Do you need more knowledge? Do you need more time? Do you need more trust with the alarms? And we'll get into that a little bit more. So what is, is it kind of general anxiety? Are you feeling anxious about everything, and that's keeping you up, and then you're watching the numbers, so just trying to understand what is is it might be grief also come, you know, in the beginning or at any point, what is it that is driving you to continue to monitor the lows beyond the obvious of what we've already said, Right?

Scott Benner 9:41
Guilt, maybe my daughter is 20 years old. I can't even believe it. She was diagnosed with type one diabetes when she was two, and she put her first insulin pump on when she was four. That insulin pump was an Omnipod, and it's been an Omnipod every day since then. That's. 16 straight years of wearing Omnipod, it's been a friend to us, and I believe it could be a friend to you. Omnipod.com/juicebox, whether you get the Omnipod dash or the automation that's available with the Omnipod five, you are going to enjoy tubeless insulin pumping. You're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an Omnipod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an Omnipod for 16 years. She knows other people that wear different pumps, and she has never once asked the question, should I be trying a different pump? Never once omnipod.com/juicebox, get a pump that you'll be happy with forever. The holiday season is approaching quickly, and I'd like to take something off of your plate. If you're looking for something for a partner, a parent or a friend, why not give them the gift of health. Give them ag one. And right now, ag one is running a special Black Friday offer for all of November. Ag one is a daily health drink packed with nutrition to help alleviate bloating, support sustained energy and whole body health. It's the time of year where we put a lot of different stuff in our bellies, but the one thing we should put in there, my opinion, is ag one. So this holiday season, try ag one for yourself, or even gift it to someone special. It's the perfect time to focus on supporting your body with an easy and surprisingly delicious daily health drink. And that's why I've been partnering with ag one for so long. Every week of November, ag one will be running a special Black Friday offer for a free gift with your first subscription, in addition to the welcome kit and vitamin d3, k2, so make sure to check out drink a G one.com/juice box to see what gift you can get this week that's drink a g1 com slash juice box to start your holiday season off on a healthier note, while supplies last, yes, right? That could get you it's my fault. This comes from my side of the family, that kind of feeling, I think, also either being a single parent or having a spouse who you guys have decided that, well, they work during the day, so I'm the one that does this. Or, you know, I have to be honest, I hear a lot of people tell me, you know, I guess it, I guess it, it could be either side of it. But I hear a lot of women tell me, like, Oh, my husband says he's not getting he's not good at hearing things. So I'm like, Oh yeah, me either. But let's go. Like, so sometimes, I think sometimes in a two spouse situation, you'll find one that just goes, Oh, I'm not good at this. And then, you know, it gets laid on you, or you're the one that does the management, so it feels like you're the one that needs to be doing it. And, you know, people can kind of use that as either like a legitimate reason or a cop out for not being involved overnight, yeah, but at the same time, I don't know, I think you could set to see to me, it seems like a learning thing, like very much like we talked about before, like, if you if you had good tools, not just, not just, you know, CGM and pumps, which you know, would obviously make it easier, I think. But just like good knowledge of how insulin works and you know how to head things off before they become giant, you know, hyperglycemia issues or, you know, or hypo I think those tools will help you. And then maybe you start with a wider range that you're okay with overnight, and then learn how to through actions that happen prior to sleeping, you know, settings and bolusing strategies, etc, you know, learn to, like, tighten that tolerance as you go. I wish I could go back into it that way. I didn't have any of that information, but, but I can see where it would have saved me to do those things.

Erika Forsyth, MFT, LMFT 13:53
Yeah, yeah. So, so, you know that's trusting. You know, can you trust? If you are using CGM, can you trust the alarms? As you were saying, right? Like, and if you can't, what is underneath that? Is that general anxiety? Is it not trusting? Is it too tight? Is it too wide? You know, what is your range?

Scott Benner 14:16
Also, the physical alarm? Like, maybe you just, maybe some people just don't hear it. Like, I know that I just kind of was sarcastic about it because, but sometimes you just don't hear it. I alarm, fatigue is very real. There's a ton of research about it. I don't hear the damn thing, like, half the time, like, you know, I mean, like, I'll hear the I'll hear the den, den, like, the real low one, yeah, but I don't, I don't hear the other stuff. And we actually just realized recently that my wife's phone her high alarm, like it's set where ours is, but she's not really that. My wife's not involved in like, moment to moment decisions about insulin. So I said to her, like, let's raise that alarm up so that if Arden goes over 120 your phone's not beeping every few minutes. I said, because I think. It's, I think we're just hearing it now and not reacting to it anymore. Like, let's put it at a place where, if it goes off, it wakes us up, because we're not accustomed to hearing it. And even though we're sleeping through it, I still think it's causing poor sleep for us as well. Yes, yeah,

Erika Forsyth, MFT, LMFT 15:13
yeah, alarm, alarm, fatigue, not hearing it. I mean, I often, I think I've shared this before. I don't necessarily hear my alarms, that my husband will, but I will feel the vibration. My pump will vibrate. And so I often will feel that wherever it is, you know, in my bed. But there are certainly more, you know, sugar, all the different you know, sugar pixel glow. Glucose

Scott Benner 15:33
isn't Thank you. Glucose gloss is audible. It's visual, but I find it okay. So you want to go over these real quick, yeah, yeah. Let's do it. Sugar pixel has a puck. Actually, I have it right here. That's crazy, a puck that plugs into the sugar pixel and then it vibrates. You can kind of put it under your pillow, right? And hopefully that'll give you some vibration there. I like glucose because it I set ranges for colors, and then if I should wake up in the middle of the night and I look up and there's a soft green glow in the corner. I don't have to open my phone and look at it, because I think, okay. Green, good, back to sleep. Red, Oh, I gotta wake up and see. And it helps you to stay it helps me, at least, to stay aligned with what I'm trying to accomplish without it yanking me hard out of sleep. Now, you know, yes, that is cool. Yeah, it definitely helps with that. Also, if you get too low, if the blood sugar gets too low, it flashes red. Now, visually, I've never been woken by that, because I have it on a it's as dim as I can get it. I use it for just like it makes my wall glow a color off in a corner, and that's how I use it. But the sugar pixel itself that has alarms, and you could set it up to vibrate for yourself. It gets a great tool. I have a sugar pixel next to my bed. Arden doesn't have it because she's at college and she couldn't get it onto the to the Wi Fi like because her school's Wi Fi was blocking it. But I also know there are people who can get around that. Yeah, it's a weird monster. It's so the data so valuable, and the alarms are so valuable, until one day you just like, I don't hear this anymore. And that's, that's the end now, yes, what about the other side of it? If my daughter's low, my wife's cortisol shoots through the roof, and she can't go back to sleep. Like it hits her. She gets hit with adrenaline, even if I'm like, she's fine. She's like, it don't matter. I'm up. So does that happen to people too? I guess, right,

Erika Forsyth, MFT, LMFT 17:31
yes. And, and I think with your different ages of your child, we have, yes, thank goodness we have all this technology if you're if you're able to use it and the the alarms, but also your body, for most, not actually, I don't know what the stats are. I wonder if you do of how many people can wake up from their lows. Because prior to my wearing a CGM, my body would wake itself up from a low now it doesn't, because now, now I'm reliant on my alarms if I go low, so I will not wake up and feel low prior to my alarm going off, but before I had alarms, my body would wake itself up. My brother would never wake up from a low and consequently had some more morning seizures. Okay, so I wonder, I don't know. I've never actually thought through this, but I wonder if our bodies have become more dependent on the alarms, as opposed to waking themselves up, Bolus, I don't know,

Scott Benner 18:27
you can also get, like, hypo, hypoglycemic unawareness and that, well, yes, yeah, which can come from that it described to me when it when your body used to wake you up, what did it feel like? You remember the visceral feeling?

Erika Forsyth, MFT, LMFT 18:40
Yo, yes. Like, it was pretty classic, you know, shaky, racing heart. Those would be the the first I would wake up and feel shaky, wake you

Scott Benner 18:51
up, like, physically pop you open. Or, like, you know, when you're dreaming, and you realize in your dream, you like, I gotta pay, and then you wake up because you gotta pay. Like, that kind of, how does it work? How did it work?

Erika Forsyth, MFT, LMFT 19:01
The shaking wouldn't wake me up, but not like I was seizing, but it would. I would wake up feeling that way, feeling shaky, and would just roll over and pop some glucose in my mouth.

Scott Benner 19:13
Did you stay awake to see if it worked? No, I

Erika Forsyth, MFT, LMFT 19:16
would take three and go back to bed and probably wouldn't even finger prick. Yeah, that was back in the day. Take three and you're good, yeah,

Scott Benner 19:23
three should be it. Boom. Done that. Did you wake up in the morning super high, or was it usually okay? Oh yeah, I'll fix this by making my blood sugar 350 but, but, you know, at a certain age, right in college, maybe, like, just, it's great that you did it honestly now, but you say now, as an adult, your husband's the one that wakes

Erika Forsyth, MFT, LMFT 19:46
you. He'll hear the alarms and think, you know, due to technology, I don't have as many nighttime alarm or lows, right, because the pump will shut off, but if I do have a low I would say. Most often I'll hear or feel the vibrate or the alarm and wake up and then feel low. How often

Scott Benner 20:06
does that happen to you in a month,

Erika Forsyth, MFT, LMFT 20:08
a nighttime low? Maybe twice, okay? And that only happens if I've eaten late and have I have a lot of insulin on board before going to bed, and so that just means I over bullish. But if I if everything is okay, and I naturally go low, my pump will shut off, and I'll never

Scott Benner 20:26
you'll wake up in the morning and say, Oh, I was 65 for an hour and they came back. I was, yeah, yeah, gotcha. That's interesting. Okay, so I'm sorry, back to, back to,

Erika Forsyth, MFT, LMFT 20:35
yeah, it's okay. So I mean, yeah, nighttime. What is driving that fear right beyond the normal? Is it fear? Anxiety? Is it guilt? Is it shame? You know, we've talked about, what, what gremlins? What thoughts are you having as you're watching the arrows? Are you on that roller coaster of fear, of shame, anxiety, as you watch your child's numbers rise and fall. So what do you do? I know a lot of people, particularly in the beginning, and I understand and get it and validate it, but you might spend all day watching the numbers, staring at it, yeah. And then, even if you're in you know range, and you feel like you're in a comfortable space, it's hard. You can't tell your mind to say, oh, it's night time. I'm going to stop looking at the numbers, right? It's hard to make that switch. So if you're Reliant and dependent and accustomed to staring at the numbers for most of the day, it's hard to just turn that off at night. And so when one tool to take an actual break during the day, for example, not looking at at your and this is, again, mostly we're talking to people who are, you know, doing follow or watching your child's number on a CGM app, not look at it for starting with five minutes, if you're if you're looking at it, or if it's constantly up in your screen again. If you are able to function and you feel comfortable and everything is flowing, that's great. But if you are finding that you are riddled with fear and shame and guilt and need to feel like you're fixated on the number and want to take a break, this is, this is something that you could try to say, Okay, I'm not gonna look at the number for five minutes, or an increase to 10 or an hour, whatever feels like wherever you are in that threshold that feels like a challenge initially, and then grow, yeah, and during that time you will that will give you clues as to what's going on. Are you panicked? Are you fearful? Are you able to distract yourself and trust what's going on with where your child's number is and how much insulin is on board, etc? And so during that initial time, it might be hard to be like, what else can I do? You know, whether it's make a phone call, do something positive for yourself, any kind of distraction that is helpful, but noticing in those breaks of when you're not looking at the CGM or the number, that is an indicator of what is in going on inside you emotionally. Does that? Does that make sense? It

Scott Benner 23:13
does. Can I I'm gonna this is not a left turn, I promise you. No, go ahead. Encouraged me while we're talking right. How does social media platforms keep your attention through dopamine hits for instant gratification. Dopamine has another name. It could be adrenaline. So it gives you that a social validation loop. It's another thing that social media does to keep you and you're validating that you you're doing something important. It gives you that feeling of completeness, that you've completed something people love, that it hits you with, uh, FOMO, right? So the fear of missing out on something, there's something called notification triggers. So push notifications come. It draws you back into the app. It makes you feel like there's something interesting happening, like, this whole thing, there's an engagement loop that comes from that. And then there's social comparison, which you talked about earlier. And then there's the kind of the gamification elephant that they use. They gamify things. So you could make a an argument that I've heard people say that they game their diabetes, and they do well because of it, because they take it as like, Oh, I'm trying to keep like, you know, it's, I don't know it's like, Pac Man, like I'm trying to keep the lady inside of the thing without the ghost catching her. Like, I'm trying to keep my numbers here and there. Some people report that that's a really great way for them, not for everybody. And also, you get a lot of emotions out of this too. So it occurs to me that, like, there are a number of reasons why that could help you do well, but there's even more reasons why it could hurt you. But at the same time, we're right back to the idea of like, you can't just put it down. It's not, it's not a game. It's it's life and it's health. But there's a bunch of ways that you could be being impacted by it and not realize it. And. Therefore keep you in that app longer than you need to be, which is why I very just simply tell people you set alarms and you do not look at that app unless those alarms are beeping. Just do not just, you gotta just, you gotta trust something. You gotta trust that if I'm in the range that I set, I don't need to look. That's my opinion. That's what worked best for me, yes,

Erika Forsyth, MFT, LMFT 25:20
if that doesn't work for you, that's okay. And if you're noticing that whatever you're doing doesn't feel sustainable, that's you know, then to kind of pause and say, Okay, what is why can't I trust the alarms? Why can't I sleep? If the fear. And I get it. I really do that the fear you don't want your child to have a low or sustained highs, and then looking at where is that fear coming from? And again, I know, I think I've said this every episode now, but that it does often feel like a luxury, something that takes time and energy to pause, like, what? What is driving my fear? I don't have time to think about that. I'm just surviving. I'm just trying to keep my child alive. And so I think I want to acknowledge that too, that this, hopefully just even by listening again to this, to this particular episode, that you're able to spend a few minutes saying, like, wait, you know why? Why is that so hard? Beyond the obvious of wanting to keep my child alive,

Scott Benner 26:21
right? Well, I'll talk to about the again, about the ranges, because I think this is important. At some point in the in the podcast, you'll hear me say that it occurred to me while I was still learning all this, it occurred to me one day that Arden's top number was set at 200 on our CGM, and that we were very good at keeping her blood sugar under 200 and then I thought, I wonder if this is an expectation game. So I pushed her blood sugar to 180 and then I realized we were awfully good at keeping our blood sugar under weight 80. And I was like, oh, so I kept pushing it down right. What you don't realize in that story is that along the way, I learned other things that were helping us keep her at 181 6140, like on and on and on, and it's a lot about settings and timing and the other stuff we talk about in the podcast about how to use insulin. But as I was learning to use insulin and tightening the range up, I was getting what I was expecting more often. It just occurred to me while you were talking, I don't know what Arden's blood sugar is. I don't think I've looked at it today, so I wasn't certain. I opened up my phone and her blood sugar is 88 but that freedom of like, the settings are good. We know how to use the insulin most of the time. This is going to be okay. Like, the way to get to that is by understanding how insulin works. Is, again, my opinion, like, like, and so if there's a place to put your effort to me, it's, it's learning what you talked about, like your body. It's, you know, like, what it needs, like, what happens, like, how do I get ahead of this knowing simple things about insulin? I know this isn't like an insulin, like, you know, series, but the one thing that I think most people miss out on in the beginning is that what's happening now is about what you did before. And I don't think people think people think about it that way, usually, like, you mentioned it earlier, like, if I get low overnight, it could be because I had a heavy dinner some six hours previous to that, you know. And I don't think that in the beginning it occurs to you. Like, I think you just look at and you go, it's three in the morning. Why did I get low in three in the morning? And you start making changes to your basal and messing up your basal and, like, everything else, right? So that's the stuff. It's where I just think, go listen to the Pro Tip series. Learn how to use your insulin, and then see if a lot of these things don't get not alleviated over time. It's my expectation for you. It's why I made the Pro Tip series. Actually, I can't believe Martin blood sugar is 88 I'm like, super happy. It's like, she's in college. She just ate something terrible, I'm assuming a while ago, because I see a Bolus, like I see a Bolus about about 45 minutes ago, and she did a great job with it, you know. Anyway, I'm sorry,

Erika Forsyth, MFT, LMFT 28:52
no, that's good, I mean. And it is true, like there a lot of it is this education piece, and when you are able and ready to access and apply that is also part of your journey. Yeah,

Scott Benner 29:07
you have a note here too. I don't want to miss about setting a timer.

Erika Forsyth, MFT, LMFT 29:10
Like, yeah. So, so the timer, yeah, we talked about like setting the timer in terms of during the day. The topic is, you know the nighttime sleep disturbances and the fear of your child going low or having long term high, and that if you're watching the numbers all day long, it's hard to tell your brain to turn it off when you're going to bed, and so to practice giving yourself that break during the day. So setting a timer like what you were just saying with the alarms. Don't look at the number at the CGM or test your child's blood sugar for five minutes. It's very

Scott Benner 29:47
worth like, highlighting like, I'll set a timer, and I will not think about this until the timer goes off again. You can teach yourself to like, I know it works, because before all this technology, I used to think I. To check Arden in an hour. And, believe it, I seriously, believe it or not, eventually my brain knew an hour, yeah, like, I would just be like, Oh, I'm gonna test her now. And then my alarm would go off. My taught my brain how long an hour was without looking at a clock. And so you can teach yourself to, you know, to step back a little bit too. I think, I think that's like, a really valuable idea to give yourself some a shot at separation from the whole thing,

Erika Forsyth, MFT, LMFT 30:25
yes, and then hopefully that gives you feedback as to what's going on, to then apply that at night also, right? So what we're trying to do is to want to help you have more sleep at night, ultimately. But it is a hard it's a hard process to get there, and it is normal to have that right, to have those sleep disturbances, but we hope that eventually to get to a place where you can trust what's in place, so that you can take care of yourself and get some sleep.

Scott Benner 30:58
Yeah, because it's it is very hard to see what a lack of sleep is doing to you until it's too late and you're having those fights and those problems that you were talking about. And sleep is just not a thing. You can't bank it like, you know, I mean, like, I can't just sleep 20 hours today and be okay tomorrow. You need to sleep every day. And I know that's the thing. I just, everyone must know, but it's tough. Like, it just, it really is. It's the thing that's come the closest to killing me from diabetes so far. Like, seriously, like, I like, vibrating, heart pounding, like I'm so tired, but I can't go to sleep. Like, it just, it was, and it would, sometimes it goes on for days when you don't know what you're doing, yes, oh, it's hard. It's the worst. And I was lucky enough to be a stay at home, dad, like some of you poor bastards are getting up in the morning and dragging your ass to work, you know, like on no sleep. And then listen, we had a parenting thing the other day here, and I said to my wife at the end of the day, you know, lucky we are that we even work out of our house. I was like, this took a lot of effort and time and focus that I think if we were just leaving the house and going to work, we would not have been able to accomplish this like, you know. And just imagine being, you know, having that implication and being exhausted, on top of all the other things, did we get through? There's a little bit left here. Good. Well,

Erika Forsyth, MFT, LMFT 32:12
we, yeah, I think we got, we got through everything. I think they just, I wanted to end with a little exercise, just because these first three well, they're all They're all challenging and heavy, because what you're doing as a caregiver is challenging. But just wanted to end with a self compassion exercise, because a lot of these things that we've talked about, if shame or guilt or fear is driving some of these behaviors to offer some self compassion and kindness to yourself. And I can't remember if we've already gone through this before, but if you're able to either right now or maybe later, pausing and taking some deep breaths and either placing your hand over your heart and feeling your heart beat, or placing your hand over the other hand, and you can either just hold it or or tap it or kind of rub it as if you were kind of crossing your child's hand, but you're doing this to yourself and connecting with your body in that way, with either your hand over your heart or Your one hand over the other and having offering a positive kind of affirmation to yourself that I you know, I am good enough. I am I'm doing the best I can. I am taking this one day at a time. I am on a journey, and I am valuable. Whatever else is coming up for you. I know this might feel odd doing this right now, but if you are able to integrate it can take you can do it for 30 seconds or a minute throughout the day, of just pausing, connecting with your body and connecting with your mind and giving yourself some positive affirmation, because you all are doing an incredible job. I hope

Scott Benner 34:02
you're happy. Erica, now there's a bunch of people crying in their cars and while they're doing their dishes so but no, that's fantastic. I I'll try that for sure. Thank you. I appreciate it.

The conversation you just enjoyed was sponsored by Omnipod five. You want to get an Omnipod five? You can you want to make me happy? Do it with my link. Omnipod.com/juice box. A huge thank you to one of today's sponsors. AG, one drink. AG, one.com/juice box. You can start your day the same way I do with a delicious drink of ag one. Are you starting to see patterns, but you can't quite make sense of them? You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, you're starting to think this isn't going the way the doctor says. It would I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 when or if you need something that is represented by one of the sponsors. It would help the podcast immensely if you would use my links to look into it or to make a purchase. Those links are available in the show notes of the podcast or audio player you're listening in right now and at Juicebox podcast.com it's a simple and easy way to support the podcast. 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. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.

#1362 Rollin’ with Elizabeth

18 year old Elizabeth shares her story.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Welcome back, friends to another episode of The Juicebox Podcast.

Today, I'll be speaking with Elizabeth, who is 18 years old. She's an athlete into martial arts and judo. She's had type one diabetes for five years. This is her story. 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. 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. Are you an adult living with type one or the caregiver of someone who is and a US resident? If you are, I'd love it if you would go to T 1d exchange.org/juicebox and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa. This is the way today's episode of The Juicebox podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now app no limits. Ever since us med is sponsoring this episode of The Juicebox podcast, and we've been getting our diabetes supplies from us med for years. You can as well us med.com/juice, box, or call 888-721-1514, use the link or the number get your free benefits. Check and get started today with us. Med, this show is sponsored today by the glucagon that my daughter carries, G VO, hypo, pen. Find out more at gvoke, glucagon.com, forward slash Juicebox.

Elizabeth 2:26
Hi, I'm Elizabeth. I am a type one diabetic athlete, and I do judo, which is a martial arts and today I'm on the Juicebox podcast.

Scott Benner 2:36
And a second ago, Elizabeth introduced herself, and I didn't have her track recording, so now it's recording. We're all good. Here's what I learned in the 35 seconds before I realized I wasn't recording your voice. You're 17, you're almost 18. You'll be 18 on July 19, which is just a few days after my 53rd birthday. We're both cancers, but you don't find yourself to be particularly emotional like I do? Yeah. Do you think it's possible that none of that means anything, whether you're like a Pisces or a cancer or something like that?

Elizabeth 3:09
Personally, I think that it has nothing to do with you. You are you, and you be strong as you.

Scott Benner 3:15
I agree. What makes you come on the podcast? What do you want? What made you reach out from previous

Elizabeth 3:22
experiences I haven't really had the chance to meet any other type one diabetes in the martial arts community, and those that I have met, they do not compete to the level that I do. Hold on a second you were hoping

Scott Benner 3:35
what, Elizabeth, you sound like, you might be a little ass kicker. Are you out there rolling with the big boys. What's going on?

Elizabeth 3:41
Well, I would hope so. I actually I compete interprovincially and internationally on Team Alberta. So Oh, my God. Oh,

Scott Benner 3:50
you're Canadian.

Elizabeth 3:51
I am, yeah, oh, I

Scott Benner 3:53
didn't know. I thought you sounded extra polite, but I didn't know. Hold on, a second. How long have you had type one diabetes?

Elizabeth 4:00
I have had type one diabetes for five years this November.

Scott Benner 4:04
Oh, okay, no kidding, so you were how old when you were diagnosed?

Elizabeth 4:10
I was about 11 or 1211. Or

Scott Benner 4:13
12, okay, 11 or 12 in Canada. Always been Canadian. They didn't. You didn't move there or anything like that. Yep, born and raised. So when you were diagnosed that they put you on regular and mph,

Elizabeth 4:24
regular and mph. I'm not quite familiar with the terms. Then you

Scott Benner 4:28
didn't. Then it wasn't you. Some of the provinces use an older form of insulin when people are diagnosed. But you you, what did you start with?

Elizabeth 4:37
I started with basal. Glory and humility, actually. Okay, so

Scott Benner 4:40
you started with more modern Did you know that province? And should I say province or province? Does it matter to you? I don't want to insult you either. Art is fine. Okay, province. There they do it differently from from one to the other. Oh, that's cool. Interesting. So you're in. Let's see either I gotta test myself on this Toronto. Toe would do more modern insulin. So would trying to think of the different provinces. Never mind. I'll never figure it out. Do you live? Do you live where the abominable snow monster lives? Or are you near a building?

Elizabeth 5:13
Well, I mean, I'm in a building, but it gets pretty cold here.

Scott Benner 5:18
Is it an igloo that you're in, be honest, not

Elizabeth 5:21
quite, no, it's, it's a pretty nice house, I'll be honest.

Scott Benner 5:25
I've had, I've had some deep conversations with other Canadians. One was a little girl recently, she tried to tell me that you even have cars in Canada, which I thought was crazy, because obviously you live on a frozen hellscape. There's just polar bears and penguins and everything. But she said, No. She said, like, there's like, towns and sidewalks and everything. So I chose the believer.

Elizabeth 5:46
Are you saying, As shocking as it sounds, that is true, we do have cars.

Scott Benner 5:49
You're representing the same ideas. Okay, that's okay. When did you start? By the way, did you like when I said rolling? Like I knew a little bit about judo? Yes, yeah. It's pretty impressive, I imagine for you first, let me talk to you a little bit about your diagnosis. I want to just kind of get that story for you. So do you remember much about it?

Elizabeth 6:07
I do actually, I was in my junior high years, and I had been sick for a little while. Not quite sure why. I was like, oh, probably just a common cold, like, whatever. But then it didn't really start getting better after about three, four days, I ended up going to get checked out at the hospital nearby, and I ended up admitted that night, and they were like, well, yep, you have type one diabetes. And like, this is something you'll have for life. And I definitely remember being pretty scared because I didn't really know what was going on and what was happening, but I was lucky enough that I had both my parents there to support me. Very nice.

Scott Benner 6:46
Any other family members, brothers, sisters,

Elizabeth 6:48
I do actually, I have three younger brothers, none of which have diabetes, which they're pretty lucky. The

Scott Benner 6:55
word bothers wrong. But when you were younger, did it? Did it make you upset that you were the only one that had it,

Elizabeth 7:01
honestly, I don't think it did. I think the biggest part for me was that, honestly, I was actually really, really scared of needles. Yeah, so I was just a little bit jealous. Were you

Scott Benner 7:10
able to get past that, or do you still have an

Elizabeth 7:14
aversion? I think I'm okay. Now, I look at a needle and it's like, well, this is part of my everyday life. So I think I'm okay. Now, cool.

Scott Benner 7:22
How about other autoimmune stuff for you? Do you have celiac or thyroid stuff, or anything like that?

Elizabeth 7:27
I do. Actually, I am a celiac. Oh, but, but

Scott Benner 7:31
that's probably not a problem in Canada, because you just drink ice water all day, right?

Elizabeth 7:37
As much as I wish that was true, I definitely missed the taste of bread.

Scott Benner 7:41
Tell everybody how to prepare whale fat as soap.

Go ahead. I have no idea. Okay, fine.

So you do. When were you diagnosed with celiac? Oh, I

Elizabeth 7:52
think I was nine before the type one. It was before the type one.

Scott Benner 7:57
You were making a little pile of autoimmune issues, and nobody else in the family with that, even I

Elizabeth 8:03
have a distant cousin who's like, three times removed, who has celiac, but I think that's it. Jeez.

Scott Benner 8:09
Lucky you. Well, Elizabeth, way to just gather all the stuff up for yourself and not share it with anybody else. How about your parents? Did they have anything going on,

Unknown Speaker 8:21
like medical stuff,

Scott Benner 8:21
no, how about that? So did you have, do you remember a virus before you were diagnosed, or anything like that? Yes,

Elizabeth 8:28
actually, I do remember this. So about a week and, yeah, just about a week before I was diagnosed with diabetes, I got a really viral, like disease or sickness. It was called 10 Foot Mouth Coxsackie

Scott Benner 8:41
virus. Yes, that's what my daughter had before she was diagnosed. Yep, yeah. Now you know somebody else who that happened to. So, yeah, we're going to expand your little universe, uh, pretty, pretty quickly with, uh, with this conversation Coxsackie. No kidding, yeah. Arden had it when she was two, and it just didn't go away, and then next thing he knew, she had diabetes. Sucks. Sorry. Well, what a bummer. How do you find the podcast like? How does a 17 year old listen to a podcast made by a 52 year old guy? If you take insulin or so final ureas, you are at risk for your blood sugar going too low, you need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries G vo hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes ages two and above that. I trust low blood sugar. Emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypo pen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store G, vo khypo pen and how to use it. They need to know how to use G. Pen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gvoke, glucagon.com/juicebox, gvoke 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 insulin OMA visit, gevok, glucagon.com/risk, for safety information. I don't know how you guys order your diabetes supplies, like CGM pumps and testing equipment, but at our house, we use us Med, and I'm gonna walk you through the entire process right now. I'm looking at the email from us Med, it says it's time to refill your prescription, dear Arden, please click the button below to place your next order. Then you click the button that was it. Two days later, I got this email, thank you for your order from us. Med, we wanted to let you know that your order and it gives you an order number was shipped via UPS ground. You can track your package at any time using the link below, and then there was a link, and then it showed up at our house. Now I'm going to walk you through the entire chain of events. On the 29th which was the Saturday I clicked on the email on that Monday, the first I got an email that said the order had been sent four days later on the fifth the package arrived. If you can do it easier than that, you go get it. But if you can't us, med.com/juice, box, or call 888-721-1514, get started today with us. Med, get your diabetes supplies the same way we do.

Elizabeth 11:42
So actually, it was my mom who found the podcast while she was doing a little bit of research internationally for other athletes like myself who compete like at high levels and have diabetes, and she recommended the podcast to me. And so I started listening, and I was like, this seems kind of cool, and I kind of applied, or I kind of messaged you on a whim. I was like, well, maybe he'll say something, maybe not. And here I

Scott Benner 12:04
am. Here you are. Well, cool. So the podcast has been valuable for you. Very, very excellent. I want to figure out what you learned and how you apply it. First, tell me, where are you competing you you mentioned, like, how you what's the is it like a, I don't even know what to say, judo, like league or I don't understand,

Elizabeth 12:24
so, yeah, so I'm part of something called Team Alberta. So each of the provinces has its own, like, judo team that represents the province. And to be part of this team, you have to travel interprovincially. So I think I'm visited pretty much each of the provinces two or three times to even in the past two years. Okay, and I go and I compete, and it's like, the more medals you win, the higher you're standing. And it's like, the better chance you have of then competing internationally. So I was actually given the chance this past February to go to Denmark and compete for Team Alberta as well.

Scott Benner 12:58
You beat up people from Denmark. I did

Elizabeth 13:01
a little bit of beating up and then got beat up as well.

Scott Benner 13:05
Tell me how you get involved in judo. Judo in

Elizabeth 13:07
Canada specifically is a bit of a smaller community, just because it's not as widely spread as something like hockey or lacrosse. But there are a lot of local communities that have their own Judo clubs, whether they be fairly small or the same size as my club. My club is the biggest in the city that I'm from. All you have to do is show up to a class. There's nothing more to it. Everyone is there is very friendly. They're very welcoming, and they're there to teach you how to fall, how to participate in the sport, and simply how to enjoy it and have fun. How old were you when you started? I think I was about five, five or six. Really,

Scott Benner 13:44
did one of your parents do it, or is it something you showed an interest in? They took you to it.

Elizabeth 13:49
So my mom actually got remarried a couple years ago, and my stepdad was the one who was doing judo when we first met him, and he was like, you guys, should come try this awesome sport. And I was actually a dancer at the time, and I was like, beating people up. That sounds awesome. Finally, so I went, and I kind of just kept going, no

Scott Benner 14:09
kidding. Oh, that's very cool. What would you say about judo that other people wouldn't know like because you hear people who do it, they're very passionate about it, and I hear them talk about community and mental toughness and and learning moves and being able to feel how things are happening so you can respond to them. But like, what? What about that is attractive to you? Yeah, definitely,

Elizabeth 14:32
I definitely agree with all those things me. Personally, I find that tudo has given me a very strong sense of morals, and it has really taught me things like resilience and determination, and it has given me a lot of grit. It also gave me the chance to connect with people all over the world, and its community, as you said, is very vibrant and it's very welcoming. And even though you might go and you might compete against some of these people that you know on the mats when. You come off, you shake their hand, and you at the end of the day, it's just you did a good job. We had a good fight like, Thank you for coming. Thank you for showing up.

Scott Benner 15:07
What's the goal of a of a is it a match? Is that what it's called? Yes, okay, what's the goal of a match? Are you trying to score points? Are you trying to submit people? What is it you're trying to accomplish?

Elizabeth 15:20
Yeah, so it's, it's a point system, so you can score half points and you can score full points. So a half point is called a wazari, and a full point is called an EPON. And for the ages 1414, and up, once you score a full point, the match is actually over. But you can score that point in multiple different ways. You have your groundwork techniques, which you can do chokes, arm bars, or you can hold a person down for 20 seconds, and then in your standing you can throw this person, and if they land completely on their back, then that is the full point.

Scott Benner 15:54
How scared are you that you're going to dislocate your knee or elbow or something like that?

Elizabeth 15:59
I mean, I have had some experience with injuries in the past. Actually broke my collar bone and my foot on a couple different occasions, but I think that even though I was scared to get back on the mats after that injury, after any of the injuries that I've sustained, I think that it's the most important thing was that I kept going back and I kept persevering. Because even though I was scared, getting back on the mat renewed my self confidence, and it made me stronger in the end as well.

Scott Benner 16:30
Why would you settle for changing your CGM every few weeks when you can have 365 days of reliable glucose data? Today's episode is sponsored by the ever since 365 it is the only CGM with a tiny sensor that lasts a full year sitting comfortably under your skin with no more frequent sensor changes and essentially no compression lows. For one year, you'll get your CGM data in real time on your phone, smart watch, Android or iOS, even an apple, watch predictive high and low alerts let you know where your glucose is headed before it gets there. So there's no surprises, just confidence, and you can instantly share that data with your healthcare provider or your family. You're going to get one year of reliable data without all those sensor changes. That's the ever since 365 gentle on your skin, strong for your life. One sensor a year. That gives you one less thing to worry about, head now to ever sense, cgm.com/juicebox, to get started. So dig deeper into that, like I've spoken to people who played baseball, basketball, football, like, you know, done all kinds of different sports competitions and things like that. You don't hear any of them talk about their self confidence growing from it. It's more usually like, you know, I barely keep my head above water because I'm I feel like I'm failing all the time, you know, because I think sport, generally speaking, is a lot of controlled failure, hoping for a couple of, you know, successes. But so first of all, why is Judo a confidence builder?

Elizabeth 18:07
Well, as a girl, just kind of, in this world, it's, it's nice to always have those kind of self defense skills, right? So even just that, and like, knowing that I know how to defend myself if I get into a tricky situation is really valuable to myself. And then for the self confidence part about coming back after an injury, I can say for sure, there is no better feeling than overcoming that mental block where you think you can't because of an injury, you sustain in the path, and you go above and beyond, and you achieve even more than what you wanted to originally. I think that is such an important part of your love for your sport, and it's important that you continue with it and go with it throughout your life.

Scott Benner 18:50
Yeah, yeah. You can tap out of a match anytime, right? You could just tell the referee, like I'm done. Is that right? I

Elizabeth 18:55
mean, yes, but I wouldn't suggest it, because your match only usually lasts about four minutes, so there's really no point in tapping out honestly. Okay, you want to you want to persevere. You want to push through. You want to do as much as you can in the time that you're given and get the best results you can Okay,

Scott Benner 19:14
and is it more about physical strength or using your opponents like motion against them. Like I hear people talk about that, I don't think I understand that completely.

Elizabeth 19:25
I think that's based on the person you are as a fighter and the person you're fighting. So in my personal category, I'm actually on the smaller side in terms of height. I'm only about 5556, and most of the girls I fight are about 510, 511, some even six feet. So a lot of these times, I can't simply muscle my way through them, because they just have longer arms, longer legs. They can reach their techniques better. So I have to use a little bit of a combination of that strength to get them moving, but then also the speed and technique that I've been developing throughout my. Charge you to life.

Scott Benner 20:00
Talk about the technique is it? Is it as specific as I feel pressure here, so I reach for this hold. Like, it's a lot of holds, right? Like, like, how would you explain what you're doing to somebody who has no idea about it? Does that make sense? Yeah, yeah.

Elizabeth 20:18
So the way that we like to describe how you get someone moving is, we call it action reaction. So if I'm going to do something, so if I'm going to push you backwards, you're going to react and try and react forwards. So as a judoka, we tend to use that action reaction to our own advantage. So if I'm going to, if I want to throw this person forwards, I'm going to get them moving backwards so that their reaction is going to come forwards, and that'll facilitate the throw for me,

Scott Benner 20:45
okay? Then you take their motion, their their forward motion, and you throw them with it. Yeah, got it, okay, and then, and a lot of it's about that, right? Like, technique, like responding properly, and then for you, being fast. Like, is that the idea that you so you're quicker, but some of those longer girls, maybe like, are structurally more I don't know what the word is capable. Is that, right?

Elizabeth 21:11
Yeah, yeah, I would say that I definitely rely a lot on the speed and the the mechanics of the technique that I like, which is called a drop technique. So it's actually one where I drop to my knees and then I continue to roll, which loads the person onto my back and turns them onto their own back.

Scott Benner 21:28
Is this an Olympic sport?

Elizabeth 21:32
It is actually,

Scott Benner 21:33
do you have eyes on that? Or is that not the level you're at? For

Elizabeth 21:37
me, I have not been training to the level where I would go to the Olympics. However, we did just send multiple Canadian athletes, including a girl in the under 57 category, to the Olympics. Oh, cool. From your group. No, not from our group, but she is a Canadian athlete who has trained out of Alberta. Am

Scott Benner 21:55
I using the word Dojo incorrectly? If I say, Are you involved in that?

Elizabeth 21:59
No, Dojo is just the name of the space that we use for our training. For our club, actually, we don't have our own facility currently, okay, although we are getting one for the next season, which, yeah, yes, oh, cool. But we actually work out of a local YMCA. So for Judo, you have the Tommy mats. So they're the mats that you do your the sport on. So every class we have Monday, Wednesday, and we have Saturday, we come and we lay down our mats, and then we teach our younger kids classes, which I also help participate in, and then I also do my own classes, which are the late class in the evening, and then we have to put all of our tatami mats away afterwards. Elizabeth, how

Scott Benner 22:37
do you stop yourself from getting what they call cauliflower ear?

Elizabeth 22:40
So I have yet to have an experience with cauliflower ear. Knock on wood. I'm very lucky for that, but I have had a couple of friends in my sport who have had cauliflower ear. The solution to it is simply getting it drained repeatedly. And while it's a very painful process, or so I hear, it prevents your ear from getting that massive swelling around it,

Scott Benner 23:01
wow, that's just from the rubbing and the grinding on the ear. Is that, right? Is that also, like bacteria from the mat? Or no, yeah, is it, I don't know. Isn't that funny? That's, that's what I want to know about. How does that happen? Because it's, it's frightening when people have it. You know what? I mean? Like, visually, you're like, wow, that's feels crazy, but and I just, I'm thinking of you like you just, you're so young, you know what I mean? And I know you don't think of yourself that way, but I'm like, Oh, my God, I don't want to have a big thing on her ear. Do you roll with men and women, or do women stay with women? Men, with men.

Elizabeth 23:36
So in competition, it is just male, just female. You're competing against a girl if you're a girl, and you're competing against a guy if you're a guy. But in the club, it is beneficial to work with everyone on your competitive team, and it helps you, and it helps them, and it creates better bonds between you and your teammates. So I tend to roll with pretty much anyone on the meds, even the guys who are a lot bigger or the guys who are a lot smaller, just everyone is kind of included. But it is important that me, as an athlete and as someone who has technique and skill, but also some strengths that I modify the way that I fight different types of people. So if I'm fighting a younger kid or someone who's a little bit smaller than me, I'm not just going to out muscle them, out strength them. I'm going to use a little bit more technique try and work with something I don't usually do, but if I'm fighting someone who's bigger and a lot better than me, fingers crossed that they're toning down their strength a little bit, and I'll be working on my specific techniques for someone who is bigger, who is taller than me. Gotcha,

Scott Benner 24:37
do you see Judo as a strictly athletic endeavor, or do you think of it as therapeutic as well?

Elizabeth 24:44
I would say, I would definitely say both. There are some days where I'm like, oh my goodness, I gotta go to judo. But every single time that I get on those mats and when I come off afterwards, I feel like a different person. I could be having the worst day in the world if I go to a judo class I come off. Mats, I'm smiling, I'm happy, I'm joking with my friends. It's such a way to get out all of those feelings that you might not be able to express otherwise. And it's it's just so much fun, like it's hard not to be happy. Once you come off the mats after a good day of like a hard sweat and good training,

Scott Benner 25:17
you have a feeling for what it is that the that the activity releases, or what it's, what it's giving you that you didn't have in your day? Is it just the aggression thing,

Elizabeth 25:26
maybe a little bit. But I find just just getting on the mats and, like, not having to, like, talk to someone while I'm just doing a little sparring match, is just kind of the best therapy, because I'm there, I'm in the zone. It's like, okay, I'm gonna do this, I'm gonna do this, and I'm gonna throw. And then when it works out, it's like, yes, like, I got this. We're doing this. And it's so therapeutic,

Scott Benner 25:50
yeah, so you feel accomplished, too, if you can, like, hold, grip, hold, throw, and you're like, Wow, I did it. Like, I like, I matched their emotion. I I got my technique ahead of theirs, and I kind of won this moment. Definitely, definitely feels okay. That's really interesting. Okay. Now, what about with diabetes? Like, when you first started judo, you didn't have it. Did you notice changes? Like, is it more anaerobic or aerobic of an exercise? Because it feels like it's both. It

Elizabeth 26:18
definitely is both. I found with diabetes, I had to actually tone back quite a bit on the like, the amount of utero that I was doing, simply because I wasn't quite sure how my own body worked in coordination with it. So I had to figure out, like, Okay, how do I do this? How do I manage my diabetes when I don't have insulin running, or this or that?

Scott Benner 26:40
So it took you months, years to figure out how to manage insulin with judo. Or do you still struggle with it? Or is it a thing you understand now?

Elizabeth 26:49
I would say that I understand it pretty well right now, and I'm fairly lucky. I have parents who work in the medical field, so they're really, really helpful, especially in competition. I feel like I have a good handle on what I need to do is sometimes, sometimes it's a little bit hard to do it, or it's like, oh no. There's a moment where, like, I didn't give a Bolus or this, and it's like, I'm still working at perfecting it, but I understand my body a lot better.

Scott Benner 27:15
Yeah, your parents are in the medical field. Yeah. Is it like, can you be in specific, but tell me about like, kind of what they

Elizabeth 27:23
do? Uh, yeah. So my my stepdad, he works, is as a trauma doctor at the hospital here, and then my mom is, she works in orthopedics, so it's like casting and like fixing bones and all that cool stuff.

Scott Benner 27:36
Oh, wow. Oh, is that how they met? Did they meet at the hospital? I

Elizabeth 27:40
think they met at a work related party, but I'm not entirely sure. I'd have to brush up on that.

Scott Benner 27:47
Don't worry. It's okay. Do you meet people to date at judo? Like, new people? I mean, like, you know, have you ever, like, met somebody you've been interested in, like, romantically at judo? Or do those things not mix? I

Elizabeth 28:00
know people who have, but I try to avoid any kind of romantic feelings with anyone on my club. I definitely picture them more as, like, my brothers and my sisters and like those people that, like, I'm really, really close with and I have, like, share a really strong bond of friendship and, like, almost like sibling rivalry with, yeah, I gotcha, but I don't think I could ever see myself romantically interested in anyone at my club specifically interesting.

Scott Benner 28:25
Can I ask, why is it just because you're so close to them, or is it because they're involved in judo? I

Elizabeth 28:30
would say a combination of the two. I'm really close with them, so I don't think I could see myself in a romantic relationship with any of them as well as we're all focused on doing better and improving in judo. Plus a lot of them have significant others outside of judo, so I just tend to stay away from it. I was just

Scott Benner 28:45
wondering if it's a thing you didn't want to mix because of the focus of judo and, like, if you now you're suddenly romantic with somebody, if that maybe ruins what that thing is like, it's because it seems like it's such a specific thing, I don't know. Like, I was just wondering, okay, you wear a pump, or do you inject?

Elizabeth 29:03
So I have a T slim. I am a pump certified, yay,

Scott Benner 29:08
using control. IQ, yes, I do with Dexcom. G6 Yeah. G6 okay. How long have you been wearing that?

Elizabeth 29:16
So I've had the Dexcom, I want to say, like, almost three years now, and the pump just under that, so, like two ish, so

Scott Benner 29:26
you take it off, obviously, to compete. Yes, yeah.

Elizabeth 29:31
So I just for the Tesla. I'm lucky. It's just you can detach it from the pump site, but my CGM stays in. So I actually use something called a co band, or like, vet wrap, and it's basically, it's almost like a tensor bandage that I just wrap around wherever my CGM and my pump side are, and it helps us so they don't get ripped out while I'm competing. Kind

Scott Benner 29:51
of makes it feel like it's part of you, so it can't get pulled on. Yeah, and then do you so you're disconnecting. So do you have the ball? Let's be for you disconnect. I'm trying to decide if the anaerobic, anaerobic things cancel each other out, or if you get high from muscleing or low from movement while you're while you're doing this.

Elizabeth 30:14
So that's actually the fun part. It can go in any which way. There's were

Scott Benner 30:19
you saying fun sarcastically. Elizabeth, yes, okay, yes, very much. All right,

Elizabeth 30:26
but I actually so for competitions, we do actually bullish thing between my matches. So on a good day, I'll have between like four and six matches maybe. So there can be between like five to 10 minutes, or like, three hours between those matches. It kind of depends on the bracket and what happens in the matches, but I always I'm giving small, like units between like one and three every hour or so to keep myself level. But I'm also pairing that with drinking, like my Powerade and having, like, some protein while I'm waiting for my fights, that'll that helps me sustain longer, but the insulin keeps me from going too high.

Scott Benner 31:11
Okay, I see, so see, it's a pretty involved thing for you. So how long does like it the match you said maybe is like four minutes, but then they're sitting around, then you roll again. Or do you roll once a day? Or how does that work?

Elizabeth 31:24
So that depends on how many people you have in your category. For me, I don't usually have more than, like six, so I'll have usually, like five fights in a

Scott Benner 31:33
day. Okay, spread out over how much time I'm sorry, five fights over, that depends.

Elizabeth 31:37
So if I win and I win and I win and I continue to just win, the matches will be fairly close together, but if I win and then I lose one, then I drop down to the rep a charge, which is the bronze medal bracket, and then I have to wait quite a while before those matches actually start. So it can be between like an hour, or it can be between like three hours. You

Scott Benner 31:59
have, like, a little kitchen worth of supplies with you when you go every time. Oh, yeah.

Elizabeth 32:04
Sometimes. I also have younger siblings, right? So we have lots of snacks and stuff for them. Oh, they

Scott Benner 32:09
also are into judo. Yep, my whole family is actually, oh, really, no kidding. You go over there, like, like, The Incredibles, but for Judo, yeah, yeah, I have a question that I feel like you're going to answer in an unsatisfying way, but why are you so mature and smart? Well,

Elizabeth 32:27
I mean, I try to be I'm also the oldest of four kids, so I help look after them as much as I can, and then, like diabetes, right? So I have to be a little bit more mature and able to be able to handle that by myself.

Scott Benner 32:42
So yeah, but that's not, that's not a real answer. Hold on a second. Like, are your are your parents? Like, are they, like, super special, calm people. Were you raised really? Well? Are you making up for something like, what's like? You're uncommonly together for your age. Do you know that about your skin? Well, you're very welcome. But do you know that about yourself?

Elizabeth 33:04
I mean, I've had some people tell me that I'm quite mature for my age. And I'm like, Oh, thank you. I tried always been like that. I definitely was not when I was young. I was I was a little rascal. I was a wild child, actually. So

Scott Benner 33:17
you just said rascal. I feel like we're 75 together. You're fantastic. You're like dating. It'll ruin judo. No. Hold on. You're really interesting to hear because so here, here begs the question, right? When you're diagnosed with type one, do your parents help you with it a lot, or do they just give it to you? Is it a mix.

Elizabeth 33:40
So in the beginning, they helped me a lot, specifically my mom. She she was like, right there. She was like, she held my hand through a lot of the things where I just didn't understand at the time. But over the past couple years, they've given me a lot more, like control with it, and now I primarily do most of the things, although I'm grateful because at competition, my parents are there to help me out when I'm like, running around like a headless chick, and I'm like, Where's where's my belt? Where's this? And my mom was like, take some insulin. And I'm like, it's, it's a really nice reminder when she's there.

Scott Benner 34:13
Nice. Okay, so it started off them, and it transferred to you slowly, and over the last couple of years it's been mostly you, but they still help.

Speaker 1 34:21
Yes, yeah, all right,

Scott Benner 34:24
it's not answering my question, though. I'm trying to figure out, why are you good in school? You get, like, really good grades.

Elizabeth 34:31
I mean, I'm not exceptional. I'm not like a 90s student, but I'm like a fair 80s average kind of person, okay,

Scott Benner 34:38
above average grades, not fantastic. I would say that's just average, but Okay, does it come to you easily, or do you have to work to get to where you're at with your grades? School

Elizabeth 34:50
is not my forte. Test taking is not where it's at. I definitely have to work hard and study lots like all the time to get the kind of grades that I want. I. Even then it's still, it's still really hard. What

Scott Benner 35:01
do you want to do after school? Like the are you going to go to what they call University?

Elizabeth 35:05
Yes, actually, I have been accepted to the University of Alberta in a psychology major. Oh, look

Scott Benner 35:11
at you. I was going to say, what do you want to go for? But there you've answered the question, something you've always been interested

Elizabeth 35:17
in, not originally, originally. I was like, I want to be a doctor, like my parents, like, I'm going to be a doctor. And then, kind of, as I kept growing up, I was like, I don't know what kind of doctor I want to be, maybe this kind, maybe this kind. And then I got diabetes, and I was like, I'm going to be an endocrinologist. Like, Heck, yeah, I am. And then slowly, for sure, I was like, hmm, Kinesiology is cool. Maybe physiotherapy. And then I was like, You know what? No psychology.

Scott Benner 35:43
You're just bouncing around. You don't, you don't, you know, I have to tell you, I just this summer, I've really come to think, like, just how ridiculous it is that we ask 17 year old kids to pick a thing that they're going to do for the rest of their life. It just doesn't, I mean, I understand why you got to get going. You know what I mean? Like, I'm with all that. It's just such an odd thing. Like, how are you supposed to know, you know what I mean,

Elizabeth 36:09
preaching to the choir, man, yeah.

Scott Benner 36:11
And also, you're somehow, like a little mix of a hippie and an old lady at the same time. How did that happen? You know what I'm saying, don't you?

Unknown Speaker 36:23
Yeah, yeah.

Scott Benner 36:25
Does it freak you out when a person who doesn't know you can talk to you for half an hour and start like thinking about who you are?

Elizabeth 36:32
No, no. I mean, I'm not a very like I mean, I would say I'm a little bit introverted when I used to meet most people, but I'm a fairly chatty kind of outgoing person in general. So it is what it is, yeah?

Scott Benner 36:44
But you, you have, like, a, I don't know your vibe is interesting. It's like, upbeat, but old soul, but not crunchy. Does that all make sense? Yeah? Yeah.

Elizabeth 36:57
I'll take the compliment. I'll take

Scott Benner 36:58
it. Listen. Whoever you are is a compliment, as far as I'm concerned, but it's just your mixture is interesting. That's all. What do you like to do, besides judo, so I'm big

Elizabeth 37:08
into, actually, just like physical activity in general. I love, like, mountain biking. I used to be a dancer, so I love dance, just being outside, pretty much just kind of my vibe. But I also do love art, um, I love drawing kind of, kind of anything like that. Okay,

Scott Benner 37:23
so solitary. You like more solitary endeavors.

Elizabeth 37:27
On occasion, I like doing these things, like, with people, like, I'll go and I'll bike with some friends or with my parents, or, like, we'll go on a bike ride with my dog, because I have a lovely little Australian Shepherd.

Scott Benner 37:39
It's interesting though, like, because I guess maybe a lot of stuff is like that. I was gonna say, like, you're doing group activities, but they're singularly focused. Once you're involved in them, you could kind of say that about judo too, honestly, that's what I'm saying. But I think everything's kind of like that. Though, if you stop and really think about it, like, how many things are you actually holding hands with somebody while you're doing? You know what? I mean?

Elizabeth 37:59
Sure true. Maybe, I

Scott Benner 38:00
think I might have just out thought myself in a circle, and then when I got to the end, I was like, oh, dummy, that's how that works. Do your siblings, your younger siblings, know anything about the diabetes?

Elizabeth 38:10
So I have three younger brothers, two of which are, like, fairly young. One of them just turns five this August. The other one is seven. Oh, so, oh, oh,

Scott Benner 38:20
that's right, your parents are, it's a second marriage for your mom, right? Yeah,

Elizabeth 38:24
yeah. Those are my half brothers, yeah. And then I have my other brother who actually lives with his biological father, and he just turned 16. He turned 15. You have

Scott Benner 38:34
a half brother that lives with his biological father, but that's also your biological father.

Elizabeth 38:38
Not quite. Hold on, my mom give birth to me and my brother? Yeah, and he is 15. He lives with our bio dad, okay, but I live with my mom and my step dad and my two half brothers. I

Scott Benner 38:49
got it, okay, okay. I thought there was, like, I misunderstood for a second. Don't worry about okay, so they're not totally they're they're younger, really, is the answer. What's the kids you live

Elizabeth 39:00
with? They're goofballs. And sometimes when I'm sitting there and I'm like, Guys, just like, leave me alone. Leave me alone, they'll be gone. They'll come over and be like, Lizzy, what are your blood sugars? You're being grumpy. I'm like, Guys, yeah, there's, there's silly little goofballs. It's

Scott Benner 39:15
nice. Wait till they get bigger, they'll be silly big goofballs. Oh, definitely. So okay, so after this university psychology, but you're gonna keep I mean, Judo stays in your life for

Elizabeth 39:28
sure. Yeah, definitely, definitely okay.

Scott Benner 39:31
Is it a thing that you recognize that one day, physically, you won't be able to do or do you think you just do it with a little less gusto as you get older so you can continue?

Elizabeth 39:40
I think anything is possible. My stepdad is over 40, and he still competes interprovincially and wins golds and competes internationally and wins medals. So I think I can go for as long as possible, do this

Scott Benner 39:54
every weekend, like every weekend, you get up on Saturday morning and go off to a to an event. So

Elizabeth 39:59
we. Of our trainings, they're weekly. We have three times a week, but our competition season, well, most of our competition season just actually finished after we had nationals, which was about two weeks ago. A little more than that, maybe three. But we probably have about a competition, maybe two a month. And we also have mandatory monthly trainings with the provincial coach.

Scott Benner 40:23
How does this translate into real life? Like, let's say you're, you're out walking, and a lumberjack that smells like maple syrup comes up behind you and tries to take your purse, right? Like, how do you how do you? Like, how do you fight him off with what you know from judo? So

Elizabeth 40:43
again, it's like Judo is the use of your own body mechanics and then manipulating the body mechanics of your opponent, right? So if he's going to come and he's going to reach for my purse, I'm simply just going to grab his wrist and I'm going to turn and throw him, because he's going to be going forwards towards me. So I'm just continuing his momentum, this lovely lumberjack momentum. Yeah, I'm barely doing anything. Honestly, I'm just influencing this momentum. Just a temp, okay,

Scott Benner 41:07
so he comes up to you. He's like, Oh, hey, I'm gonna take your purse a and buy beer. And then you're like, you wait for him to come at you, or you, oh, yeah, well, you would run first, right? Like, you'd be like, I could probably outrun this like, like, like, because he's got syrup on his hands, he'll probably slip and so like, like, but you would, but if you got stuck, you wouldn't attack, you'd wait for the attack. Is that correct? That

Elizabeth 41:30
depends really, if he's coming at me and his if he's coming at me first, and I'm like, well, he's coming at me, time to react to his acting. But if he's there and he's like, oh, like, I'm gonna take your purse, but he's just, like, standing there, and there's not really anything happened, I'm not gonna go for an outright fight. But again, if he, if he comes at me, like he's going to do something, I'm going to take the first move in terms of defending myself.

Scott Benner 41:54
And is this so all in is this also just so ingrained in who you are that even if they took you by surprise, you would react, like, reasonably appropriately.

Elizabeth 42:05
I mean, I would hope so, but like a competition. But

Scott Benner 42:09
what happens, like in your house, if somebody comes around the corner and they're like, boo, are you just like, you already have a hold of them and you're moving them? Do you know what I mean? Or like, how quickly does your body go to that like, that memory, that muscle memory.

Elizabeth 42:22
Have you ever heard the quote, fight or flight, that I'm a flightless bird?

Scott Benner 42:26
Okay, so you're right into it. That's kind of

Elizabeth 42:29
the quote that I try to live by.

Scott Benner 42:31
If you didn't have judo, what do you think you would do with all this energy? Because it feels to me like you have extra energy and that, like, expelling just some aggression and tactile or tactical, like, ideas, seems like it's really good for you. Like, where do you think it would go, though, without this?

Elizabeth 42:50
Honestly, I'm, I'm not too sure. I think Judo has really gave me a level head in terms of just, like, being like a good person. Because, like, I think with more free time, there would have been more chance for me to get into trouble, do things I'm not supposed to, you know, like, go drinking, go partying, which is why I appreciate you, though, because it, like, it kept that level head. It kept me focused on a goal. My goal was winning nationals, and it and I wanted, like, constant improvement. Do

Scott Benner 43:19
you think that that's who you are, though? Do you think like, if, if, somehow, if this man doesn't come into your life and say, Hey, you guys should try judo? Do you think you're out there just like drunk? Elizabeth,

Elizabeth 43:31
I'd like to say that. No, I don't think that's me, but I honestly have no idea where my life would have taken me without something as as moral compass, like as judo. Interesting? Are you religious? No, not really.

Scott Benner 43:46
Is this your religion?

Elizabeth 43:48
I would say Judo is my religion. I would say that, okay,

Scott Benner 43:52
I'm interested because I don't drink as an example. But I think if you I don't, I don't imagine, I can't imagine, what would move me in that direction, like even if my life got bad, I don't think that that's a direction I would go into, because I wonder if you're not giving yourself enough credit for who you are, is what I was wondering,

Elizabeth 44:12
potentially. But I think without my step dad being in my life as well, it would have changed me a lot as a person. Sure, I really look up to him, and I really aspire to be a person as awesome and cool and sophisticated as he is. Wow, so not even just Judo itself, but him not being in my life definitely would have made me a different person.

Scott Benner 44:32
So I don't want to I don't want to discount that. I just want to say that I think it would be okay to give yourself some like credit, like that. You wouldn't be like a person out there, like, just a ne'er do well, like, you know, skulking around in the shadows, breaking car windows and stuff like that. I just don't, doesn't sound to me like that's who you would be. What about him specifically? Are you so reverent about like, what is he? How does he appear to you? If you had to describe him to me? Would you say about him?

Elizabeth 45:00
Well, first and foremost, he is an amazing like judoka. He is incredible at the sport that he does. He holds, like, international titles and like several competitions, and it's like, Whoa. That is awesome. He is, like, a well established man who, like, works in the medical field, and he's good at his job, and he's just like a goofy, outgoing guy, but he also can be like stoic and like reserved, and he's just got so many different contrasts and different angles to him that are so unique and so interesting, and it makes him just a really awesome person as well. He really stepped up as a father figure in my life for a number of my elementary school kind of years. So I really, I really look up to him like that.

Scott Benner 45:45
Yeah, no, I imagine that's lovely. Your mom. She's just okay. I

Elizabeth 45:49
love my mom. I have I share such a special bond with my mom. She is my number one fan. She is my go to girl. She's not just my mom, she's also like my best friend. And it's like the best relationship I could have asked for. Wow,

Scott Benner 46:02
what's the worst thing you've ever thought in your head about another person?

Elizabeth 46:06
There was a girl I was competing against, and I I had won against her several a year before, but in the process, I had accidentally broke her collar bone with a throw, and when she came back the next year. She beat me at the same tournament, and then she slandered me all over social media. I was a little bit sour above that.

Scott Benner 46:27
Yeah, sour. You were just a bit sour. Were you? Yeah, so, so you humiliated her. She came back with an eye on getting even she does that, but then she has to go and do something online too.

Elizabeth 46:43
Yeah, that is disappointing a little bit. It's okay. My, my sweet moment of revenge was I beat her at nationals to win the gold.

Scott Benner 46:54
Oh, look at you. You got her back eventually, eventually, it took a little while I got there. Did you whisper anything in her ear while you were, like, choking her out or whatever you were doing there,

Elizabeth 47:03
no no that the drill maps, the tatamis where you are competing is almost as is a sacred place. Oh, you can't there was no disrespect there. You can't

Scott Benner 47:14
whisper. I wouldn't have put that on Instagram if I was you while you were, like, making her rethink her life. No,

Elizabeth 47:20
no, okay, in a match. One, you can't talk because you'll get in trouble. And two, it is, it is incredibly difficult for a person to come out and compete in front of a huge stadium for like a like a national title, so I do my best, even if I despise someone I'm fighting with every fiber of my being, I'm never going to disrespect them in a tournament match. I will never, even though

Scott Benner 47:49
go I'm sorry, even though she was disrespectful to you, you wouldn't consider being a being disrespectful back to her. Just you'll just try to beat her. And if you can good, and if not, then, okay.

Elizabeth 47:59
Yeah, exactly. Wow.

Scott Benner 48:03
Geez. Are, like, are people in your town, like, lining up trying to get you to marry their son? No, no, no, they're missing out. I would, I would definitely, if I had a 17 year old son, I'd be definitely pushing him towards you right now. I'd be like, Elizabeth, here, meet my kid. No, yeah, you're, you're, you're special. I would actually, if anything horrible happens to your parents, I might adopt you. So let me know if you need anything. Okay,

Unknown Speaker 48:27
thank you. No, you'd

Scott Benner 48:29
be good respect. I you listen. You'd make me look good. That's what I'm thinking. Get it? I mean, they'd be like, Oh my god, Elizabeth, right. I'm like, Hey, I know I taught her a lot. That's what I would say. Like, behind your back. I take a lot of credit for you. Well, listen, as a person who slander is a tough word, because it because I don't know if I would say that, but I've been slandered before. It's very it's infuriating, like it really is, because it goes beyond somebody's opinion, like, I don't mind if people don't like me. I fully almost expect that I don't care if people don't like me, and they tell their people they don't like me, that even makes sense to me, but making something up because it's hurtful and because you think it will damage somebody or make you feel better, or whatever. Like, I have a real difficult time with that, and I never, even though I have the ability to and a platform to do it on, I don't strike back in a way that would damage somebody, and I could, and I've been brought to the brink of it a couple of times, but I've never actually done it. So I applaud you, because it's difficult, and I'm an adult, and I still sat down and wrote something out just to delete it the other day because somebody in a public setting lied about me in front of a bunch of other people, and I could have and I know a thing about them that they did directly, that I was aware of this part. Person's actions are just so despicable, and they try so hard not to to look they try very hard to look like that's not who they can be. And I don't know them well enough to tell you that's who they are every second of the day, but I've seen them be like that a number of times I have like and I could have outed them, and it would have been really damaging to them, and I didn't do it, but it's the closest I've ever come to doing it. So I know how difficult it is to, like, pull yourself back, and you seem very much more mature than I am actually with your answer. But anyway, I want to give you a lot of credit for that, because it would be easy to strike back, you know,

Elizabeth 50:39
thank you.

Scott Benner 50:40
Thank you, of course, good for you. I don't understand still, you're an alien, right? You were dropped here. You're watching us from Mars or something, and you're trying to, like, blend in. What's going on exactly? I still don't buy this. Why you're so nice. You don't do anything terrible. You ever kick a dog? No, no, what? No,

Elizabeth 50:57
I have a dog. I love dogs.

Scott Benner 51:01
Okay? I didn't think so. You ever stick gum under a desk? No, you would never do that. Would you? No, do you take your shoes off when you come into somebody else's house? Yes, get the out of here, really? Oh, my God. Do

Elizabeth 51:15
you curse on occasion?

Scott Benner 51:17
What's your favorite curse word? Say it now, unburden yourself. It'll get believed. So whatever you say, no one's gonna know what you

Speaker 1 51:24
said. I don't know. That's a good question. I don't know. I don't know. Oh, my God.

Scott Benner 51:34
Seriously, like, what's you do? You have a go. What are you? You're walking through. Here you go. You're walking through the room, you don't have any shoes on, and you kick something and you yell, is it? No,

Elizabeth 51:49
damn. You're gonna laugh at me for this one. I would I would stub my toe, and I would say, Mother of all, that is holy.

Scott Benner 51:57
Is that a curse? No, it's just what I would say. But you're also not religious, no, but you would never say Jesus Christ if something bad happened. Oh, no, I definitely say that one. That one you say, okay, all right. Have you ever said Christ on a cracker? I love that one.

Unknown Speaker 52:16
I'm sorry.

Scott Benner 52:17
What you've never heard that?

Elizabeth 52:19
No, it's now in my arsenal. Now, wait, wait,

Scott Benner 52:22
wait, hold on a second. We have a question to be I don't know where that came from. Let's find the etymology of Hold on a second. What is the etymology

Unknown Speaker 52:34
of Christ on a cracker?

Scott Benner 52:39
The phrase Christ on a cracker, is an exclamation used to express surprise, disbelief, frustration, or exasperation, is considered a euphemism to avoid using more explicit or blasphemous language, substituting a mild or less offensive expression while still conveying strong emotions. Christ refers, of course, to Jesus. Christ, central to Christianity, etc. On a cracker, this part of the phrase adds a touch of absurdity and humor, making the expression less offensive than outright blasphemy. It also suddenly refers a Christian practice of communion. That's what I thought, too, where bread symbolizes the body of Christ, overall. Christ on a cracker serves as a colorful and emphatic way to express strong reaction. Please go to that one the next time you stub your toe, okay, I will. And if people say, What did you just say, Go. I learned that on a podcast. I would please tell people that was, by the way, our chat GPT Overlord, who gave us that breakdown of the etymology of Christ on the cracker. Lovely, yeah. Also, I was typing and not looking completely missed on Etymology and chat, G, P, T, still knew what I was asking, so be aware it's coming for you and me. So psychology, you find people interesting. Why they do things interesting? You want to help them feel better. What's the also? I don't think this is what you're gonna end up doing. I think you're gonna change like, 17 more times, but what interests you about it?

Elizabeth 54:03
So actually, we had a Japanese exchange student come and stay with us for a little while. He also did judo, so he was staying with us and training with us at our club, and he was actually doing his studies in sports psychology, and I found it really interesting. And I was like, hmm, that seems like a really cool profession. And then another of the gentleman at our club, he also him and his wife. I'm good friends with his kid, him and his wife. They're both sports psychologists. I was like, I was talking to him about it. He was like, yeah, like, it's really cool. Like, this the kind of stuff you do. I was like, but I also, I have, I have a soft spot for kids, since my brothers are awesome sauce, but I definitely would go into either sports psychology or child psychology. Elizabeth, every

Scott Benner 54:48
time you talk, I just assume you're not a real person. You're so kind and lovely, and everything you say, I'm like, oh my god, this is amazing.

Unknown Speaker 54:57
Thank you. Seriously,

Scott Benner 54:58
you. I'm like, What the hell is happening? All right? Well, terrific. Let's make sure. Did let's go back and make sure. Did we talk about or not talk about anything that you wanted to Did I miss anything? That's my first question, Not particularly, no. Did you cover things that you were hoping to talk about? The other

Elizabeth 55:19
thing we didn't really talk about was there's something I do called intermittent fasting.

Scott Benner 55:24
Oh, I would like to talk about that. I've done that in the past. Go ahead, tell me, yeah.

Elizabeth 55:29
So the diabetes clinic actually does not like it when I do intermittent fasting, but so the way that they like to or how I've perceived the way that they like to help manage, like a diabetic blood sugar, is the constant use of like food and like sustenance, because, like with food, you can give more insulin and so on so forth. But I found that an important aspect of participating in judo, like to maintain weight and just increase my overall performance, has to do with the intermittent fasting on non tournament days, I try to refrain from eating for around 16 hours each day, sometimes 18. This gives me a chance to focus on like my background and my basal insulin and generally keeps my blood sugars at like a more steady rate on the days where I don't fast, which is usually just like my competition days, or the days where I have, like, like those post tournament training camps, I usually start the day off with some protein and, like, liquids, and I stay light on the heavy carbs, because those are what spike my blood sugar really bad, and then it just kind of stays up for when I'm doing judo for the rest of the day. Instead, I eat those heavier carbs later at night to help rebuild any muscles that I might have broken down a bit during the day, and those carbs actually helped me maintain my blood sugar better overnight on competition days as well. Why would your doctors have a problem with that? They just don't like the fact that I'm only eating about two meals a day. What's

Scott Benner 56:59
your a 1c

Elizabeth 56:59
my a 1c right now is, I think it's around seven.

Scott Benner 57:04
And what's your variability like? Do you bounce? Do you get over 180 very often? Well, no, hold on a second. You're in Canada. Sorry about that. Give me a second. Juicebox podcast, calm a 1c and blood glucose calculator. Type in. You got to get a plug in once in a while. You know what I mean, put in 180 so 10, right? You get above 10 very often.

Elizabeth 57:26
Sometimes I find that when I'm fasting, I actually don't get above 10 very often. I honestly stay lower about where, on a good day, when I wake up in the morning and my blood sugars are around six, I tend to hover between like six and like four

Scott Benner 57:41
Okay, so like between 70 and 110 that's really great. So yeah, and you don't have a ton of variability. Do you know what your do? You happen to know what your, oh, God, simple phrase just fell out of my head. A standard deviation is my standard of deviation. Do you know that you have you ever go into your Dexcom clarity app and look at your standard deviation.

Elizabeth 58:03
Yes. I mean, I haven't done it recently, but I have. Usually I stay between about six and, like, eight, nine.

Scott Benner 58:10
Really, I don't know what, why didn't All right, what is,

Unknown Speaker 58:16
I don't understand. Like, do you think

Scott Benner 58:18
it's just one of those situations where that's like, that's just how they do it. They don't know how to support you. Maybe

Elizabeth 58:23
they also told me, like in the past, or whatever. So I've also gone to, like, diabetes camp and stuff like that. Again, they use food to help manage, like, blood sugar. So they recommend eating like breakfast, a breakfast snack, lunch, like an afternoon snack, and then evening snack, and then, like, dinner, and then, like, a bedtime snack.

Scott Benner 58:43
So they're feeding people on such a schedule that they don't have an opportunity to get low. Yeah, yeah,

Elizabeth 58:49
which I struggle with, because in tournaments, like, we have to, like, weigh in for our competition, so we're fighting people roughly our size. Like, that's why I do the intermittent fasting. It helps me maintain, like, a healthy weight and sit at the spot where I want to be at. Yeah, I'll be, Damn It's upsetting,

Scott Benner 59:06
isn't it, that they can't just kind of meet you where you are and see that you're having success and try to support that.

Elizabeth 59:11
I mean, I see, I see why they don't, why they're like, why they recommend that I should be eating more. It works for me, so I'm going to continue to do it? No,

Scott Benner 59:21
you should. Does it make you feel bad? That's my worry for you. Seems so goddamn nice. Like, do you like? Do you sit there and feel badly about what you're doing? Not at all good. Yeah, you got a spine for that stuff. Seriously, you you have a you have a resilience that you said you used to work grit earlier, if you knew that or not, because I was busy going, I don't know why a 17 year old knows the word grit, but, but do you feel like is that A is that a central part of your personality, like that resilience?

Elizabeth 59:50
I would say I think so. Like being a diabetic and someone who does judo and like a female and someone who's like, had like a. Rough childhood, or whatever you want to call it like I think, I think resilience is a pretty good way to I mean, I'm still here, right? So

Scott Benner 1:00:07
tell me how your childhood was rough.

Elizabeth 1:00:09
My parents divorced when I was about two and a half after they had my my brother, so I spent a lot of time going back and forth between the houses, and there was some conflict there, as well as some like Anim. I don't want to say animosity, because that's the strong word, but there was definitely some conflict between the houses. So when my mom started dating and when she got married again, my dad was mad and this and that, and it was like a constant band here between the two households. Yeah,

Scott Benner 1:00:35
that makes sense. Okay, so the divorce is where you feel like you had your first opportunity, where you kind of could have gone backwards a little bit like something could have happened to you, but you didn't like you kept going in the direction that you went, and even though you don't have, like, a firm feeling for where you want to go in life after this, which we both agree, is not something you should probably even know when you're 17. But does that feel like an unknown to you? Like I would say, Yeah, and you deal with it by knowing what it's going to be okay.

Elizabeth 1:01:09
I think I deal with it knowing that even if I don't know where I'm going right now, like my this is going to sound corny, but the adventure towards where I'm gonna end up is one of the best things, right?

Scott Benner 1:01:25
It doesn't sound corny. It sounds like you're 46 and you're fan and you've been through a little bit of but you really understand life.

Elizabeth 1:01:35
I try. Has

Scott Benner 1:01:36
anything really horrifying ever happened in your life? Have you ever lost someone or anything that we would like think of as traumatic as ever happened to you, beyond the divorce.

Elizabeth 1:01:47
Well, I mean, three years ago or three years ago, yeah, this October, my my uncle, so my mom's brother, her little brother, he, he passed away unexpectedly. Obviously, yeah, that that hit my entire family, including me, like a semi truck. Him and my mom were really close. I was also really close with him. We would talk almost all the time. We spent a lot of time together. So that was that was a devastating blow to our entire family.

Scott Benner 1:02:21
How did you guys traverse that?

Elizabeth 1:02:23
It was tough. I think we're still going through a couple of the ripples of the aftermath and stuff like that. I tried my best to stay strong for my mom, because it was, it was her little brother, and I could not imagine losing one of my little brothers, sure. So I just, I tried to stay strong for her and support her any way I knew I could. Definitely went and talked to some people as well. You

Scott Benner 1:02:46
went to therapy, yeah, but then the focus is on being supportive for your mom, like that, doing it for her, like, you'll be strong for someone else. Yes. Do you think she did that for you in return?

Elizabeth 1:02:58
Yeah, probably it's kind of in her nature. Like, that's where I got it from.

Scott Benner 1:03:02
I have a central belief that if people who love each other put each other first, that a lot of things take care of themselves.

Elizabeth 1:03:08
Does that make sense? Yeah, like,

Scott Benner 1:03:11
like, if I'm here for you before me, and you're here for me before you, then we all are supported, and we all feel like we have a like, a greater purpose within our structure, and then it kind of blends out a lot of the problems that come with selfishness and and feeling alone.

Elizabeth 1:03:31
Yeah, that's a really nice way to look at it. Thank

Scott Benner 1:03:33
you. It's a high minded idea I have that I'm not sure that I live up to. Hmm, now that you and I have spoken, do you like me more or less?

Elizabeth 1:03:44
I like you a lot. You're a fun guy. We're

Scott Benner 1:03:48
gonna call this episode Canadian fungus, because I'm a because I'm a fun guy and and you're Canadian, of course, or the Alberta surprise, although that sounds weird, I don't maybe you're you're too young for me to tell you what I thought that sounded like. So maybe we should. We're not gonna say that. Thank God you told me you were 17 before we started, because I knew to like I wasn't sure you come off so adult that I would never in my life have guessed you were 17 if you wouldn't

Elizabeth 1:04:19
have told me. Seriously, that's what I'm aiming for. That's what we're aiming for.

Scott Benner 1:04:22
Why are you aiming for that? Tell me that

Elizabeth 1:04:24
I want to be mature. I want people to go to depend on me and look to me for advice. I want to be there as a good friend and a good person. So I feel like being mature is a good way to start that process. All right. Well, we're

Scott Benner 1:04:36
going to stop the recording here so everyone listening can go off on their day and feel like they are letting someone down compared to you. Seriously, it's not the intent. There are going to be adults all over the world walking around today going, I'm not trying as hard as a 17 year old girl from Alberta. I really got to pull it together. There are also some people who are hoping you end up in prison. I just want you to know that. Oh, okay. They're like, let's see this girl fall in her face. Wait. Oh, something really goes wrong. But yeah, I know I I'm, My money's on you. Elizabeth, thank you. Thank you. I'm gonna put all my loonies, and I think I have four of them here on my desk somewhere. I do, by the way, do I have I somebody sent me Canadian money with the, like, the diabetes, like commemorative stuff on it. Did you do you know that that happened, like, a year or two ago? Yeah? Yeah, I

Elizabeth 1:05:27
have a couple loonies like that. They are loonies because

Scott Benner 1:05:29
I forget if I'm just using the word because I think it's funny, or because they're actually loonies, they might be loonies. They're my desk somewhere. Go through all the Canadian money. Loony, what else is there? Too many quarter I don't know, dime, nickel. Why, in God's name, would they make it Looney and toonie?

Elizabeth 1:05:45
I don't know they're fun. I think it's based off of a Loon, like the bird, but it's like Loon is in one and then toonie, because it's two, $2 Wait,

Scott Benner 1:05:55
is that seriously? A loony is a bird, but a toonie just means two. Loon

Elizabeth 1:06:00
is the type of duck. Go ahead it, yeah, it's just a type of duck. You're like, that shit. Scott, that's

Scott Benner 1:06:07
the whole story. Oh, my God. Have you ever had a Tim bit I have, yeah, and are they any good?

Elizabeth 1:06:19
They taste like bite sized donut pieces. Gotcha. So

Scott Benner 1:06:22
it's nothing special. The chocolate ones, though, are really good. Do you feel controlled by the Queen?

Elizabeth 1:06:29
No, no. We just celebrated our, like, 100 and 52nd year of independence, didn't we? I

Scott Benner 1:06:33
know, but I sometimes I feel like Canadians sometimes have a little bit of that, like, bad feeling left? No,

Elizabeth 1:06:40
I don't think so you

Scott Benner 1:06:41
don't give a crap. Do you? I like you a lot. Sorry. Elizabeth, thanks. All right, I'm gonna go make a baby right now and try to grow it up to be your age, and then I'm gonna send it over to you, because I'd like to see what you could do for it. I also want to point out to my own children that you're not trying hard enough. And Elizabeth is the absolute seriously. You're not even corny.

Elizabeth 1:07:03
You should I'm a little bit corny. No,

Scott Benner 1:07:05
but Elizabeth, you should be, let me be listen. You want to speak. You want to hear some truth right now? Yes, hit me with some truth. You should come off much cornier than you do and you don't, which means it's like it feels authentic. You're freaking me out. I just want you to know that, are your parents freaked out by you? Like, is there a world like, it would have made me feel better if your parents were, like, functioning day drinkers, and they were like, I don't know where she came from, but it feels like they're decent people too, like your staff. You know what I mean? My parents are great. They're great, I know, and I feel like, if they weren't, you'd tell me, right? Yeah, or you talk around it, you would talk around it at least, yeah, like, if your parents weren't really decent people, you wouldn't say that they are would you like, I wouldn't lie about it, right? But you would stay away from it if, seriously, if your mom was a heroin addict, you wouldn't have told me today. Yeah, probably not. I know. I know that about you. I feel like I know you Okay. All right, Elizabeth, you were beyond terrific. I really appreciate you doing this and reaching out. I have to be honest with you, when somebody was like, I want to come on and talk about judo, I was like, oh god, that's gonna be so boring. But okay, and then it wasn't, it was really amazing. So thank you so much. Yeah,

Elizabeth 1:08:22
thank you for having me honestly. This is like a fantastic experience, and I'm really glad that I got this opportunity. Oh,

Scott Benner 1:08:28
I'm glad you feel that way, but, and I believe you, because I know you wouldn't lie to me,

Elizabeth 1:08:36
what was your favorite curse again? What did you say? Mother of all, that is holy.

Scott Benner 1:08:44
But the next time you you stub your toe, you're gonna say, Christ on a cracker. That's right, it's Oh, Christ on a cracker, just like that. And then when people look at you, just go, I learned that on a podcast. Okay, yes, sir. All right, Captain, you're fantastic. Feel free to ask to come back on the show, like when college is over. Okay? Oh, thank you. I would love, I would love to hear how college went for you as a matter of fact. No, don't thank me. As a matter of fact, I'm gonna make a note here for myself. Keep the podcast going for at least five more years so you can hear what Elizabeth did in college. There. You're no no, but I want you to have time to, like, settle in and feel, you know, like reminiscent and everything I am, you're you're now my reason to go on. Thank you very much.

Elizabeth 1:09:30
No, thank you. Seriously,

Scott Benner 1:09:31
hold on one second. You're fantastic.

A huge thank you to one of today's sponsors, gvoke glucagon. Find out more about G vo hypo pen at gvoke glucagon.com, forward slash Juicebox. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, for. Forward slash juice box. The conversation you just enjoyed was brought to you by us. Med, us. Med.com/juice, box. Or call 888-721-1514, get started today and get your supplies from us. Med, one year one CGM, that's today's sponsor, the ever since 365 learn more and get started today at ever since cgm.com/juicebox, and you may be eligible to receive the system for $199 for a full year. There's more details about eligibility at my link, if you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective the bold beginning series from the Juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple podcasts. Please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.