#168 Dexcom G6 One Month Review

Not your average product review...

We've been using the Dexcom G6 CGM for over a month and I wanted to provide a review that was more than just my opinion so I invited Jake Leach Dexcom's Senior Vice President of Research and Development to talk through what I've learned since Arden began using G6 about 40 days ago. Type 1 diabetes will never be the same!

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

Scott Benner 0:00
Hello and welcome to Episode 168 of the Juicebox Podcast Today is a special episode, a very special episode of the Juicebox Podcast. And it's brought to you by Omni pod, the world's most amazing list Everest best this tubeless insulin pump and Dexcom, makers of the G six continuous glucose monitor. Today, I'll be speaking with the Senior Vice President of Research and Development at Dexcom. Jake Leitch. You know, is this a review episode? Is it a follow up to G six? Well, you call this one what you want. But Arden has been using the Dexcom g six now for 1234 I think four insertions. So we're somewhere between 30 and 40 days, I have a firm grasp of what the product is, how it's better. And I thought all right, I'm going to do a, you know, a review episode for you guys. And I had the opportunity to have someone on from Dexcom. So instead of talking about the stuff that you can read anywhere online about what Dexcom is, I thought let's talk with one of the people who is the lead of their research and development, we can kind of dig deep on some ideas. here's just some of the topics that we'll cover. How does low predictive alert work? What's the next leap index com? What should we be excited about? Has the adhesive changed? What's the compression low? How does the inserter work? How is it designed? Talk about the auto startup? direct integration with Apple Watch the one with the cellular in it, you know? And how about that two hour warm up period? Is it ever gonna go away? All that and more right now on the Juicebox Podcast who I have to squeeze this in real quick. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making a change to your diabetes care plan. Oh my god.

Unknown Speaker 1:48
Bernie and Scott Benner.

Unknown Speaker 1:49
Hey, Scott, how you doing? Good.

Scott Benner 1:51
Thanks. How are you? Jake, I had an opportunity to talk to Kevin say again. But I asked for you this time, because I thought your background might lend a little better to the conversation. And here's why you guys are in the like iPhone space now. Like it gets a little better every time. But I can't point to why it's great. Because it's been great for a while. But if I go back 10 years, I know why my iPhone is amazing. I do know what I mean by that. So there's not a lot of space for you guys to go is the problem, I think, but maybe you know differently, which is why I thought talking to you might be interesting.

Jake Leach 2:26
Yeah, it's wonderful. It's a pleasure, pleasure to be with you.

Scott Benner 2:29
I appreciate it. So I'm going to start by telling people that this is going to be part of the review episode that I do about the Dexcom JSX. But that if I had to do a review, in all honesty, it would take about eight seconds. So I'm going to try to stretch it out a little bit here by kind of going through it step by step. So we start off with the new insertion process. I wanted to talk about maybe from your perspective, how did you go from what it was to what it is now?

Jake Leach 2:57
I'm sure yeah, so the you know, the whole purpose of the insertion, the applicator devices to get that sensor under the skin as quickly, as painless as possible. And with this little steps, and one of the things we we knew about our G five applicator and the previous manual versions was that there were quite a few steps involved, that the user has to go through to make sure that sensor gets inserted properly. And it also isn't automatic read, you have to go through each step. So the goal of that new insertion system, the one that's with G six was to develop it so that it was as simple as a push of a button, we wanted it to be single handed operation so that it could all be done without needing to use multiple hands to complete the sensor insertion. So it's very similar, the sensor and needle under the skin. It's all the same dimensions as the manual applicator. But we set the development team off to develop a way for the insertion system to insert the sensor very quickly and easily. And so the actual insertion is about 15 milliseconds is all it takes for that sensor to be placed just under the skin tickets.

Scott Benner 4:13
It goes beyond that it's spectacular. So I asked my daughter after we did the first time, I said hey, they said it's almost painless. And she thought about it for a second. And she goes is feel this award because I don't know what happened. And, and so I swear to you stick it on, you know, she's 14, she's, you know, apprehensive because it's something new. And I realized that when I thought about it in the abstract before I held it in my hand, I imagined that the pushing of the button was pushing the needle but now I realized the needles already drawn back almost like a like a harpoon or a bow and arrow and all you're doing is releasing that tension when you push that button so there's not even much of a push involved. It's it's hard to put into words you just touch that button and it's over.

Jake Leach 5:00
Yeah, exactly, there's a there's a number of spring powered mechanisms inside the device that mean when you're pressing that button, it's really just releasing the spring to pull this put the sensor and pull the needle out. And it's a, it's a lot less, we found it's a lot less intimidating than the previous version. Because it's just that much simpler to use and doesn't necessarily look like, like an injection device.

Scott Benner 5:23
Yeah, the last one was a little frightening. But But, but I'm telling you no lie. I pushed the button. Look there in the face. There was no expression on her face. And she was like, it's done. And I said, Yes, she goes, I didn't feel it. And I was like, okay, and that has been she's now worn. I want to say for and she's had the exact same experience over and over again. So kudos to engineers who came up with that, that it really is amazing. Wonderful to hear.

Jake Leach 5:51
glad she I'm glad she's enjoying it.

Scott Benner 5:53
Absolutely. So once it's on, it's simple. That little inserter just kind of like slips off. You know, you, you click your transmitter in. Now, I do have I have to tell you, I'm having hiccups with the scanning of the Is it a QC code? What kind of code is that? The q? I don't know what they call? Yeah,

Jake Leach 6:10
it's a QR code. Yeah, like the code that's on the sensor is actually the first version of our app, the one that we released with this smaller market release, it did actually have a bug in it. So we are just in the midst of fixing that, though, we'll be deploying the fix this week. So give me give it a shot the next time around, and it should work. Yeah, it will both the Android and iOS app should be fixed fixed up,

Scott Benner 6:36
it is as easy as I think it's like a four digit code. And it doesn't take any effort. It's just that one step of scanning. So for people who don't understand what you'll do going forward is you just sort of hold your phone up to the, you know, to the cake, the packaging from the sensor bed, and it just scans it all in. And it's all set. And and you're on your way. Now. Now, the moving forward part, this part is interesting. How did you, I'll tell you the most magical part, you would think it would be the insertion process, but it's not. It's after the two hour warm up, it just starts working. So I don't I never think about it once it's on again. And then magically, it feels like there's just a number all the sudden that pops up. That really is kind of spectacular. But I'm going to ask you a question from listeners. Is there ever a spot in the future where you imagine there is no warmup period? And can you explain the what the warmup period is for?

Jake Leach 7:29
Oh, yeah, absolutely. It's a great question. So the, the warmup period is, like a couple of things are occurring with the sensor is dry, when it's in the package. And then inside the applicator device, once the sensor is inserted under the skin, there's a period of time that it takes the chemistry on the sensor to acclimate to the tissue to the body into the interstitial fluid, where it's measuring the the glucose, there are ways to reduce that warmup period, and we're very confident that our future versions, we're going to be able to reduce it, I think we're gonna be able to get it down to about 30 minutes, maybe even faster. But you, you're balancing a little bit of what's the level of performance. And if we cut it any lower than 30 minutes, we wouldn't want the system to be inaccurate. So we're very confident we can reduce it by at least an hour. And if not even maybe get to half an hour. And we do that through updates to the center, as well as the algorithm that is turning that sensor signal into a glucose reading. The more one of the big things with GS six was, we did change quite a bit of the materials that go on the center. They're all kind of the same base materials as our previous products. But we we've fine tuned it quite a bit both in the design in the process we use to manufacture the sensors. And what it results in is a much more consistent and stable sensor signal. So that's why that's what enables our factory calibration, where users no longer have to enter the finger sticks to calibrate and it's also what's going to enable us to reduce the warmup time in the future.

Scott Benner 9:13
Okay. Okay, so that leads me into my next question which is when Arden put on the G six At first, I left the G five honor we did it for about 12 hours I did it out of anxiety right you would think I might have done it for the podcast somebody I just was anxious I was like I trust how this G five works right so you're going to give me something new. I believe in you guys. So I think it's going to work but I need to see it myself. So I put it on. First of all, the concept of it doesn't work real well on the first day or it's not as accurate as you would like it to be till it's been on for a while that I've I've let go of completely I'm but what I saw initially g five g six was that they didn't exactly match. They were close but they didn't match. And then I realized that I'm calibrating the G five based off my meter. And then we get into this weird world of diabetes, right? Which is, which one of these things is closest to accurate? And what does that even mean? Like, what does? Do you know what I'm saying by that? Like, what is my accurate blood sugar mean? I've gotten to a place in my life where I've just said, I'm going to pick the device that I trust the most. And I'm going with what that tells me. But it is one of those things that if you sit down and think about it academically, it'll make you insane. So how did you how do you how do you guys think about it? Like, because I trust the G six implicitly already? It's It's fantastic. But it didn't agree with the G five. But is that because the G five was making some decisions based off my meter readings?

Jake Leach 10:41
Yeah, it could it could be the the way that we look at accuracy. And you're absolutely right, it can get really kind of mind boggling. The The main thing that we look at is the ref blood reference Are you using to calculate your accuracy. And so what we do for our systems to measure performance, is with something called a y si, it's actually a laboratory analyzer. And we compare our performance our measurement of glucose in the interstitial fluid to what the venous blood glucose concentration is. And so that it were matched to that one of the things that's a little bit different about it, fingerstick meters, it's measuring capillary, it's a finger stick at the tip of the fingers. So you're going to get flight differences between the venous blood and the capillary blood. And so when you're calibrating to the capillary meter, it's still accurate. But it's just it can be slightly different than than what a venous blood measurement would have been. And when we designed g six, it's designed to be coincide with the venous blood readings.

Scott Benner 11:50
So how do you decide I don't even know if this is a fair question, but there's an interstitial reading. There's a reading I can get for my blood. And there's what for the lack of better word God knows my blood sugar is? And so how do I know what gets closest to? Like, how do you how are you? Why don't because it's working? Great. Let me tell you why I think it's fantastic. Because I look at my daughter's clarity reports. And her a one c reports back incredibly close to what clarity tells me, you know, if I look at her her average blood sugar, what it's going to be. So to me, that makes me feel like what I'm seeing moment to moment, day to day has accuracy. But I don't but that just seems like the only way I can tell. Do you mean like what is the what do you guys talk about when you sit down and talk about this.

Jake Leach 12:39
So when we, when we talk about accuracy route, we're always looking at, you know, making the system as accurate as possible. And when we do our clinical studies for the FDA, and when we really are looking really closely at performance, we do look at that that venous blood draw, we actually draw blood out of the catheter and measure it. But the differences between the the venous blood in the interstitial and the capillaries, it's also small, it's it's very rarely going to make any clinical difference, you're not going to make a different decision based on the different glucose readings. So that's, that's how we look at it, we look at it from a Wi Fi perspective, the FDA, that's how they have specified, particularly with the new approval for G six as an integrated CGM. There they they put out some very specific standards for how AGM icdm should be studied, and the performance they need to meet and all of the different aspects that really is what sets cheesecakes apart.

Scott Benner 13:43
But spectacular. Can I ask you a couple kind of rapid fire questions or my expectation? Well, first of all, Arden used acetaminophen yesterday for the first time, it literally did not make a difference. Thank you very much. I don't know what the magic is. But that was really cool. If I told you, you could have something for free, and that giving it to you, in no way bound you to do anything else in the future. Would you take something for free? Have you answered that question in your mind now? Have you said to yourself, yes, Scott, I would take something free if I didn't have to do anything in return? Well, if you have, boy, do I have good news for you? I need you to click on the link in your show notes or go to Juicebox podcast.com and click on the link. You can type it in the browser if you want. Clicking on the link does help. I'm not gonna lie. I don't make money when you click on the link. But it does let the advertiser know you came for me and that does help the podcast keep going. Anyway, what are we talking about? The Omni pod tubeless insulin pump on the pod is thrilled to send you a demo of the pump. They actually send you a pot. It's not a working pod in as much as like you know you couldn't get insulin from it but it has all of the same parts inside. It's the same weight as a real pod. And you know that way you can really To get a feel for it, you can wear it and see what you think. You can hold in your hand and say this thing is pretty Tommy, where's the thing I hook on my belt, you might say to yourself, that attaches to my tubing that attaches to my infusion set. Well, that doesn't exist with the Omni pod. The Omni pod is an all in one device. It's controlled by a handheld, personal diabetes manager, let's take off the PDM. But that PDM is wireless, it talks to the pod wirelessly. It's not connected to you, you don't even have to have it with you most of the time. And the pod has everything you need, and it's on your body. And then once you're saying it's hard to picture, Scott, but is it not really tiny and it's small, it's amazing. And it's lovely, and it doesn't have any tubes. And if you go to my omnipod.com forward slash juice box, or click on the links in your show notes, or go to Juicebox podcast.com and click on a link, you can have a free no obligation demo right in your hands very soon. Arden Arden's about to be 14 years old, she's been using the only pod since she was four, we could not be happier with it,

Jake Leach 16:01
I really hope you give it a try.

Scott Benner 16:03
g five, I thought was really good. But I lost my signal more than I would have cared to. And it took a little time to come back. Now I figured out how to trick it back with like resetting Bluetooth and stuff like that. So I figured it out along the way. But it happened more frequently than I was comfortable with it happening. I am not seeing that at all with G six. How did you fix that.

Jake Leach 16:28
So it's a it's a Bluetooth communication protocol that we use in the transmitter to communicate to iPhones and Android phones as well as insulin pumps, and then also the receiver device that we supply. And so that Bluetooth protocol, when you start talking about mobile phones, it's complex, because on the mobile phone, there's a lot of other systems on the phone that are using a Bluetooth, whether it's streaming music, music, audio, and many times even the Wi Fi chip is the same electronics as the Bluetooth and so their their time slice. So it gets complex on those platforms. And one of the things is we work very closely with operating systems on those phones. And we we do quite a bit of optimization to do to try and limit the amount of time that Bluetooth signals are lost. And I agree with you, it still happens. It just the fact that it happens is something that means that we have more work to continue to do g six, it should be about the same. We made some enhancements. But you still can't experience the signal loss alert on on G six. And but you You got it, Scott, you you basically reset the Bluetooth. And that's often what will bring the signal back because on the phones. It's not it's not a perfect scenario. So sometimes you get great performance. Other times you don't but there is always a way to fix it by by cycling that that Bluetooth

Scott Benner 17:57
crash the app go in and out of airplane mode and then back right away. So that's how it's been working for me hate this. I'm seeing. So every once in a while we see a compression low, which I'd like to get you to explain to me because in my literally untrained mind's eye, the interstitial fluids being pushed away from the wire. And that's how it reacts. But I'm sure I'm wrong. I'd like you to explain what it is when you lay on the sensor for too long or press on too long that it it reports a low that's false. But also Also, I'm seeing much quicker recovery time after I tell Arden Hey, rollover is and I don't know if that's my imagination.

Jake Leach 18:35
No, no, it's a great question the soap compression. Also, in some of literature, it's called sensor attenuation it is basically when you put that pressure on the site where the the transmitter and center are, it can reduce the diffusion of interstitial fluid in that area. So the sensor is still very measuring the glucose in that area very accurately. But it's just as the glucose in the area where the sensor is, isn't reflective of what the glucose is in the rest of the body. And it comes from that event compression where the interstitial fluid is not diffusing into the area around the sensor. When when people run into that I often know they try different locations for their sensors. But but it can happen. And we're you know, there's a number of items that we're always focusing on trying to our goal is to make the system as reliable as possible. And so we'd love to be able to detect those those compression events and so that we don't issue a low alert that isn't valid. So it is another area where we're continuing to investigate and has everything to do with the shape of transmitter and the size and the central location and all those things. So that's what causes a compression. The other part your question about the response time GG six is designed to be more responsive to glucose changes. And so that's exactly what's happening when when ardonagh rolls off, the sensor stops applying that pressure. Look, the glucose infuses back to that area very quickly in G sex detects it. I knew

Scott Benner 20:12
that wasn't my imagination, it was happening so much faster that it just it couldn't have been coincidental. Okay, as the adhesive changed at all in the G section, the

Jake Leach 20:22
G five, not the patch material, the base material itself and the adhesive have not changed, but because of the shape of the new transmitter. The shape of the adhesive is slightly different, but it's it's very similar to the shape of P five, but it is exactly the same adhesive as G five.

Scott Benner 20:40
Okay. Um, let's see, lag time, I'd like you to like, I'd like to understand that when I'm looking at like, I'm looking at Arden's blood sugar on my screen on my computer right now, which is the next thing I'm gonna ask you about. It's 114. Is it 114? Right now? Was it 114? Two minutes ago? What is how does that lag time? Is there like time and how does it work?

Jake Leach 21:03
So a couple of a couple different components to the lag time. So one part is just the time it takes for the interstitial fluid to have the same glucose concentration as the blood. And that's very quick, it's about a minute or two, there's been a couple of different clinical studies where they just are the researchers studied the diffusion of glucose from blood to interstitial fluid, and it's a matter of a minute or two. So you get a little bit of lag, they're not not really perceivable that there is some lag there. And then the rest of the lag tends to come from the system and the measurement system. So the CGM, and historically the CGM is we're a little slower to respond to glucose changes. And so the reading that you were looking at, could be, you know, a five minute average from five minutes ago. But as we continue to enhance the the systems we have, the reading is valid for that five minute time period, there's a little bit of prediction built into it. So it's not just like it's a five minute old value. Okay. So we update the readings every five minutes, but they have a component of prediction built into it. So that we are giving you as accurate reading as we can, because we're always trying to match that. What is the true venous blood glucose reading.

Scott Benner 22:21
So that makes sense to me, based on my findings, and for the people listen to this podcast. And there are a lot of them at this point who do things the way I do, which is I bump and nudge my daughter's blood sugar, I don't just you know, put in a mountain weight if I you know, if I see a 122 diagonal flop, I push a little insulin on it. And some people are like, well, that how do you you know, isn't that number behind, but I'm not finding that I'm finding that I'm, I'm working in relatively real time situation, my expectation for how the insulin works. And my expectation for what the CGM is telling me is, it feels pretty accurate to me, like it feels like it's all happening the way I expect it to. So that that makes a lot of sense. I'm a little bit about predictive. Actually, let me jump to this real quick that somebody asked this. And I have to say, I agree I'm using a third party app on my Mac right now. And I can see Arden's blood sugar up in my bar, and my menu bar, are you guys gonna ever develop something like that for PC or Mac, because it is, I'm being asked a lot by people who are at work, and whose jobs frown upon them having their cell phones out.

Jake Leach 23:22
We we don't have in our roadmap right now to do software for the computers to display glucose. But what we do have is, we're working with a number of different partners that we have right now we have a Data API that's available to partners who want to work with Dexcom. Right now, it's retrospective. So the the data is three hours old. But we're looking at lots of opportunities to determine how to partner on the real time data so that we could enable the ecosystem of developers out there who have great ideas and develop wonderful solutions that maybe Dexcom is not focused on, because we're focused on other pieces of software. But we do really believe in open systems that are reliable. And I think all the different options of displaying glucose is is my vision for how it should be is you should be able to get those real time readings anywhere. You want them anytime in the format that you want. And so enabling the developer community to help us with that is is the way we want to move forward.

Scott Benner 24:34
Right? So if you have a good idea, reach out to Dexcom and get involved. I can tell you right now I'm using gluco gram it's working great on my Mac and last week I was at the Indianapolis 500. Not at the race but at the speedway and I was watching Charlie Kimball race, and I was down in the pit and I could see his blood sugar on their screen in a row. It was pretty cool. Okay, uh, geez. Jake, 30 minutes. Hold on a second a predictive alarm alerts, how soon Am I seeing that predictive alarm you are going to be? Because right now it says something like it expects you to be under 55 in the next 10 minutes.

Jake Leach 25:10
Is that? Yeah, it's, it's Yeah, the way that the predictive, low alert, or the urgent low, it's basically determining, it's trying to give you enough time to deal with a impending low. So what it does, is it it estimates, in how much time are you going to be 55. So it looks at what's the glucose and how fast is it dropping in, it also takes into account where the low glucose threshold is set. Because if the low glucose threshold is going to give you 20 minutes of time, before you hit 55, we're not going to issue their urgent, are they going low, soon alert. But if you're dropping quickly, to the point where you're low alert will go off, but it only will give you let's say five or 10 minutes of warning, we're going to advance that alert in time to give you a little more time. So our goal is to try and give you 20 to 30 minutes of warning ahead of a 55 occurrence. So that's the way it's designed. So that the goal, one of our main goals of predictive alert was not to increase the number of alerts that users receive. Because we know historically, with other systems, predictive alerts can be a little bit of a nuisance, because they're not always that accurate. And so we wanted to do a very nice job of predicting that that low glucose will alert without giving too many false alerts.

Scott Benner 26:38
This next question you might just say no to do you guys have any plans to integrate with a Bluetooth meter so that I people who need to calibrate still don't have to type it in?

Jake Leach 26:48
We don't in our roadmap, we don't. That's not to say, though, that you couldn't, you know, develop a system that took in the Bluetooth meter readings, I've seen some different, you know, prototypes of health kit on the iPhone pulling in the meter readings. And so we don't plan plan to integrate with Bluetooth meter. My goal, ultimately, is to get to the point where the system is not, you know, finger sticks, we can basically retire the finger stick meters forever.

Scott Benner 27:19
That was my expectation of what your answer would be is that we're trying to get away from that. So no, Apple watch that has the cell connectivity. Are we ever going to be able to see our blood sugar on that without a phone involved in the loop?

Jake Leach 27:33
Mm hmm. Yeah. So it's a great question. The your left just told me no, but the core, the core, the core Bluetooth, connects, basically, the functionality that Apple announced last summer, that they were opening up to particular companies, including Dexcom. So they opened it up last, or they announced it last June. And then we've been developing with it ever since. And so we are working on a communication protocol between our transmitter and the Apple Watch directly. But it's still in development, because it is actually a very complicated scenario of the phone goes out of range, and then the transmitter has to switch over to communicating with the watch on its own. And then when the watch comes back in range, you have to switch back to the phone. So both Apple and ourselves are working on a number of different prototypes. So we're, I'm confident we will, we will have a solution there. But it is quite a bit of development still ahead of us to get to the point where it's reliable and works the way users want it to and expect the experience to be so we're developing on on the Apple Watch, and some other you know, the Android systems and we're also looking at doing it with Fitbit as well. So I do think that that's a really important option that we need in the future to have, you know, kind of lightweight, easy, convenient displays where you don't have to have your phone with you at all times. So I think it is it is definitely important aspect of our displays. And we are working hard on and by working

Scott Benner 29:05
hard. I mean, there are three engineers in the room have big clumps of hair missing off of their head.

Jake Leach 29:11
There's a lot here, there's quite a few engineers working on it.

Scott Benner 29:13
Let's see. Ah, is this is my I'm gonna ask you two questions. I'm not sure if you're the right person to ask do you know about like Canada launch and how upgrades work and stuff like that? Or am I better off talking to Kevin about that?

Jake Leach 29:27
You've been talking to Kevin about timing, I can I can mention that. The for the the upgrade that the system if users have the touchscreen receiver from G five that is fully compatible with G six and a Connect, it can just be firmware updated so that when it does come time to transition between g five and G six, all the user needs is a new transmitter in the sensors. And they can upload the firmware right to their receiver from our website. Okay, so we've got a number of G five users who've already upgraded to G six in that

Scott Benner 30:01
And then I think the rest of it's pretty easily spelled out online. If you're out of warranty on your G five, you'll you want to be transitioned to the G six you can be. And it's that simple. Alright, so I'm going to ask you a question that I don't know if you can answer but there's going to be two of them in here at the end, we have four minutes left, restarting the sensor, you can restart a G five, it's against the FDA, you know, protocol, it's not something you guys say people should do. But it's obvious at this point that people understand that you can just, you know, for lack of a better term, check the G five and a thinking that you've put on a new sensor but and restart it. I personally have, I have good insurance. So it doesn't bother me that the new g six only lasts 10 days. And I've been watching machinations online as people try to figure out how to restart the G sex. What I see, I haven't tried, and I don't plan on trying. But what I've seen is that you guys have created a sensor bed, where you can't get that transmitter out of there until you take it off your body and break it is in kind of like like cracking it kind of the sensor, but then the transmitter slips right out. Is someone gonna figure it out? Jake, or is it not? Or can it not be figured out? That's my question. Well, is someone gonna nerd out? Or can it not be figured out?

Jake Leach 31:10
You know, so the sensor restart issue? You know, the question about it was, as we started working on factory calibration, that was a really important part of our kind of risk analysis and all the hazards involved with factory calibrated sensors that get restarted. And so it's actually part of the FDA guidance on the integrated CGM because of the performance requirements, and the fact that there's no finger stick calibration required. It was part of the the approval is to ensure that the sensors could not be restarted. Now, you know, I'm an engineer. And I know there's lots of very intelligent engineers out there and other scientists and folks who can figure things out. And so I'm sure at some point, someone will figure out a way to do it now, is it going to be easy? Or is it something that we would recommend? Absolutely not. But they, you know, it's, it's like any system, if you work hard enough, you can generally figure ways around the design intent. I wouldn't recommend that

Scott Benner 32:15
Dexcom does not want you doing that I say, I report back if you know anything. And so here's my last question that it's really very open ended, but it is genuinely my biggest interest while I'm talking to you. What's next? What should I be excited about? That's coming? Is it something you can talk about? Can you be general McCain? Sure. Yeah. Next.

Jake Leach 32:39
So, you know, for CGM, one of the things that that's coming is the expansion of the use of continuous glucose monitoring past our current users, the most of our customers, and our patients, our intensive insulin users, right? Just like ours, and they're making decisions every day, how much insulin Do I need to take lemon to cover those carbs. And so it's a critical part of their, you know, how they manage diabetes. But as we step into other realms of type two diabetes, pre diabetes, there's a lot of opportunity for that continuous glucose signal to help people live healthier. You know, there's a coaching aspect to it. So one of the things you're going to see is that the CGM is are going to continue to get simpler to use, and more applicable to the broader markets, where folks don't necessarily have all the training that some with Type One Diabetes has, in terms of, you know, doing injections or are using CGM. So one of the exciting things is the the size of the CGM is going to continue to reduce the complexity will be reduced. The connectivity and all the things that come along with the Dexcom CGM, the phone apps, the share apps, we're going to continue to enhance those and make, you know, take advantage of all the new features that come out on the mobile platforms. Every time there's a new iOS or a new version, Android, they, they put in new new features that developers like Dexcom can take advantage of. And so I think there's there's a lot of opportunity to continue to enhance the experience and the basically making diabetes, easier to manage. Whether you have type one or type two, or or just interested in blood glucose, dynamics and living healthier, there's, there's tremendous opportunity, and we're just kind of we're, we're happy where we are with the mobile platform, but we see a lot of runway left still for what we can do and engaging users and giving them more than just you know, the glucose reading and the rate of change. You can imagine helping support some of the decisions that have to be made about insulin or carbohydrates, or exercise, all the all of those aspects. We can Continue to improve and work on.

Scott Benner 35:02
Cool. Can I ask you one last thing before I let you go?

Jake Leach 35:04
Of course God,

Scott Benner 35:05
did you guys ever consider taking a shot at smacking freestyle when they came out with that Libra thing and put because I'm assuming that their product is just it's an aspect of Dexcom. But it's not the entirety of it. I'm assuming you could create something like that Lieber fairly simply, based on we could. Yeah,

Jake Leach 35:24
we could we think one of the you know, there's the there's a couple aspects of Dexcom CGM, the performance of courses are is paramount to the reliability users have learned to trust and and rely on. So the performance aspect of Dexcom is different. But also the real time connectivity. So for alerts, alarms, and powering of closed loop systems, and all of those things, the integrated CGM is, you know, where we think is the right place to focus. And so that's where we are focused. And it's one of the reasons we implemented Bluetooth on our system was so that it could be integrated with more devices. And it's also why our partners are enabling their systems with Bluetooth, so that they can communicate with our our transmitter. So Tana being the first and intellect to working quickly on a Bluetooth version as well. So I think there's a lot of opportunity, and we're gonna stay focused on real time CGM.

Scott Benner 36:25
Yeah, I just I can't. If I can't see it, if it's not always there. It just takes away a big part of what it is. I don't know one other way to put it like when I look at that other that other product, what it looks like, to me is a fingerstick meter where I don't have to poke my finger,

Jake Leach 36:41
which is very similar. Yeah, we don't get the alerts and alarms at night, like when you expect, you know, that's one of the times it's critical for Yeah, monitoring glucose when you're asleep. And so yeah, you don't you don't get any of that functionality.

Scott Benner 36:51
No, that's it. I was just I was mulling around my my house today, thinking about what I was going to talk about with you. And I just kept thinking, I wonder if they thought, Wow, we could do that too, you know, but we don't want to. And so because it ends up being a pricing thing, right? It's just, it's cheaper. And so it's a it's, it's like a bit of it's almost like, if I buy my homeowners insurance from Dexcom in my house burns down, you'll you'll pay me back completely. And if I buy it from freestyle, you'll pay me back like half. And so it's not. And so it's not a bad deal. It's just not as good as it could be. But the price is lower, I guess if you're paying out of pocket, so I don't know that this wasn't for you. So anyway, everyone I had Jake on because Jake knows the r&d. And I thought everybody can do a review where everybody just goes over, you know, the stuff you see on the website. Again, it does this it does that. But it seemed to me like it would be more interesting to understand why it does what it does. And so that's why Jake, I thought I'd have you on today. And I really appreciate you taking the time. For everyone listening, I'm assuming Jake came into the office sat down, and I called him so it is very early where he is and we appreciate you taking the time very much.

Jake Leach 37:55
Thanks so much, guys. Pleasure.

Scott Benner 37:57
Have a great day.

Unknown Speaker 37:57
You too.

Scott Benner 38:00
I'll be sharing my dexcom g six review with you right after these words from our sponsor. It's very simple. If you heard something today about the dexcom g six continuous glucose monitor and you're interested in finding out more, click on the links in your show notes. In your podcast player, go to Juicebox podcast.com, where there are also links, or go to dexcom.com Ford slash juice box Dexcom would be thrilled to get you started right away. And when you use my link, they know you came from the podcast, which is very helpful. It's not financially helpful. Like I'm saying I don't get paid by clicks, which is important to know. But they do know that the podcast ads are bringing people to them, which helps me get more podcast ads, which helps the podcast keep going. Let's go over it really quick. You were a dex comm product, g fiber, the G sex, what you're getting is a real time understanding of your blood sugar, where it is and where it's headed. And how fast is it headed there? Is my blood sugar 80 and is it real stable? Is it 80 and about to be 50? Is it 90 and about to be 120? These things are very important to understand. Here's the next thing that's very important. The concept of sharing blood glucose data. The user, whether it's your child or your spouse, or just a good friend can be wearing the dexcom and sharing their information with others. Imagine what that means no matter where you are right now. You can know someone else's blood sugar. Maybe they're gonna be incapable of helping themselves. Maybe they're just not hearing it. Maybe it's your son or daughter at their sports event. Maybe they're at school. Maybe you're just giving some backup to a friend. But the share and follow functions of the dexcom g six are spectacular. They're available for Android and for iPhone. And they present a peace of mind that is unmatched in the world of living with type one diabetes. Again, go to the links in your show notes at Juicebox podcast.com, or dexcom.com Ford slash juicebox. To get started today, to find out more to switch from the G five, that a G six, use that link for everything.

And now after over 30 days of use with the Dexcom, GS six, this is my very unbiased and honest review of Dexcom latest product. It's fantastic. There you go. That was the whole thing. I'm kidding. I'll tell you more. Listen, we went over a bunch of it just now with Jake, those are my unfiltered thoughts as you can imagine. But I'll go through it step by step for you. Now, it's not going to take long though the honest truth is if you see some long review of this product, people are just using filler, because it is simple to use. And it works. So the insertion process, he take out the insertion thing, the device, the little potty comb, I don't know what to call it, exactly, it's a thing. And it has the sensor bed already installed, and you take it out the package, take off the adhesive coverage, you stick it on, you push the button, you pop in the transmitter, you know, I think there's something you have to do with the phone like push start sensor or something like that, or on your on the Dexcom g six receiver if you're not using your phone, start sensor. Two hours later, a blood glucose value just pops up on your device. That's it, there's no calibrating or testing necessary. If you want to calibrate and test, it actually has a function for you to still do that. But we haven't and we are having no trouble whatsoever. Now the actual process of the insertion is amazing. It's as smooth as silk. I mean, that's the review. The accuracy is better. The first day accuracy is fantastic. The insertion is painless, and easy. There's no calibration necessary. If you experience a compression load, once you take your weight off of the sensor, the accuracy comes back in moments. I've had no issue with connectivity between the app and the transmitter. It's working great. I mean, the last real thing I can't tell you, which is I have to wait for Arden to get an A one see to see how closely it matches her clarity app. You know what what has her average blood sugar been as far as the Dexcom is concerned over 90 days, and does that closely match with what her a once he ends up being? That's the last really measure I can use. And I can't tell you about that for a couple more months. And that is going to be incredibly important. I need to know that the information I'm getting back from the G six is helping me make accurate decisions. But in all honesty, I can't imagine it's going to be in some way not as good as the G five and the G five was fantastic. And I've been managing Arden's agency really well. With the information coming from the G five, I expect it just to get better with G six. So I'll be back to you with that information in the next couple of months. But for now, if you're looking to me for my opinion, if you're able to move from the G five to the G six, or from the G four to the G six, do it for the first time I'm able to actually give advice on the podcast. My advice is use the G six if you can. It's fantastic. It's quick, it's easy, it's painless, it's accurate. You know what it's making me think of honestly, back in episode, I think 158 I did a whole hour interview with the CEO of Dexcom. Kevin Sarah, we did it right around the announcement that the G six had been approved by the FDA. And at that point, I think Kevin called it an evolutionary leap. The G six was an evolutionary leap from the G five. I'm calling that statement an incredibly accurate description of the improvements that have been made. Okay, guys, I hope you enjoyed this episode. Also, two episodes dropped this week. So I hope you didn't miss the other one. Episode 167 is out too. If you got this one and you didn't get another one. Go back and look in your podcast app. It's there. It's a full one hour interview with the mom of a girl with Type One Diabetes, who is also quite the Instagrams thought it's actually a really great conversation about type one diabetes, but we also talk a lot about life low carb and not low carb, which is really interesting. That's Episode 167. Thank you so much. Dexcom for sending me Jake. Thank you Jake, for coming on. Thank you Omni pod for sponsoring. Thank you, Dexcom for sponsoring. Thank you for listening. Thank you. Thank you. Thank you. Thank you. Thank you. There's a lot of factors there. Actually, while we're at it, let's keep going. A lot of great reviews coming on iTunes. Really appreciate it. I love it. I love it. When you guys share the podcast. It is the best and pretty much the only way for the podcast to grow is word of mouth. If you like it, tell someone else. If they look at you funny when you use the word podcast, snatch the phone out of their hand and show them how to listen. People need help sometimes. You could be that person for them. You could be a podcast Sherpa, and official Juicebox Podcast Sherpa. Hey, I'm gonna do something they don't usually do. I'm gonna shout out a couple of people Trish for telling me that she loved when I babbled on at the end of a previous episode. bad jokes and asking while you were still listening. Trish said her hands I think were busy or dirty or something and she couldn't shut off the podcast, or switch to another episode. And that gave her something to do. So for all of you whose hands are dirty right now,

Unknown Speaker 45:12
I'm still talking

Scott Benner 45:14
is another shout out to I don't want to use the name but someone who contacted me recently to let me know that they went to their endocrinologist with a decreased day one C, and they were super thrilled. And the endo treated them poorly about it. You know, the endo gets scared that you don't know what you're doing and that you're achieving some sort of a lower a one C, by having scary lows. This person was not and told the doctor, the doctor said, What are you doing? And she replied, I'm being bold with insulin. I like write that in the email and was like,

Unknown Speaker 45:46
yeah,

Scott Benner 45:46
shout it out loud. Good for you. stick up for yourself. Also great notes from Europe lately, Germany.

Unknown Speaker 45:52
And

Scott Benner 45:53
where else Portugal? Am I am I right about that? I'm writing today from Portugal. A small country in the western part of Europe. Yeah. What's up, Rita? Thanks for writing. I'm going to email you back as soon as I can. Here's the point. The community built around this podcast is worldwide. You are not alone. I am not alone. together. We are. We are each other's support system, even though we can't hear each other's voices. That's really important to know. All right. I'll see you guys next week.

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#167 Juniper Eats Carbs

Junebug eats carbs.... lots of carbs!

Juniper was diagnosed when she was just two years old. Today we hear Junebug's story from her mom Lisa's perspective. They even tried to eat low carb for a while but (spoilers) they switched back. 

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Alexa - google play/android - iheart radio -  or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello and welcome to Episode 167 of the Juicebox Podcast today's episode sponsored by Dexcom and Omni pod, you can use the links in your show notes, or at Juicebox podcast.com. To find out more about both of these great products, you can also type into the browser if you want my omnipod.com Ford slash Juicebox Podcast dexcom.com forward slash juicebox. Quick note, this is Episode 167 168 also went up at the same time. So if you don't have it, check for it. It is my Dexcom g six review with the senior vice president of r&d from Dexcom. Jake Leitch so it's not your average review show. It's way better. We dig deep into a ton of stuff. Just go get it. I promise. It's really good. Today's episode is with Lisa Poole, Lisa's junipers Mom, you might know Lisa from Instagram where she runs an incredibly vibrant and exciting page called T one Junebug. Let me just leave a little silence here for all UT one Junebug fans to maybe Hoot and holler a little bit in your car. Go ahead. This episode is really cool. We're going to talk about a lot of different things about management style and you know, type one diabetes in general, and a little bit of Juniper and Lisa story. But also, Lisa, at some point moved Juniper to a low carb lifestyle and then moved her back from it. So you're going to get to hear about that entire experience being diagnosed, eating regularly, then going low carb then coming back from low carb. Nothing you hear on the Juicebox Podcast of course should be considered advice medical advice. Always consult a physician before making changes to your medical plan. Here is Lisa. Key one

Lisa Poole 1:48
super early here where I am so hopefully I don't sound too tired.

Scott Benner 1:51
What time is it?

Lisa Poole 1:52
It's six in the morning here.

Unknown Speaker 1:54
Well, I'm so sorry.

Lisa Poole 1:55
No, you're good. It's not like we get sleep anyways.

Unknown Speaker 1:59
Oh my god.

Unknown Speaker 1:59
I feel terrible.

Lisa Poole 2:02
No, no, I usually get up at six anyways, but I I got up at five and grabbed a coffee and left my house because it's noisy in my house.

Unknown Speaker 2:11
Oh my gosh.

Lisa Poole 2:13
They're good. I am Lisa Poole. I have five children. My youngest daughter is Juniper. She has type one diabetes. She is five she'll be six in about three weeks. Okay, Jennifer six.

Scott Benner 2:29
How we'll drill a 505 almost six. Excuse me? How old your oldest.

Lisa Poole 2:35
My oldest is 17. I have two boys. 1517. And I have three girls who are Juniper five. Addy is eight. And Penelope is 10.

Unknown Speaker 2:45
Oh my gosh. Very

Scott Benner 2:46
nice. That's a lovely family. Um, I have to ask right off the bat from my experience with the podcast. Are you a Mormon?

Unknown Speaker 2:54
No. Okay.

Scott Benner 2:57
Every time someone comes on here, they're like they have like 9000 kids. I'm like, you're a Mormon, right?

Lisa Poole 3:03
No, we don't live in Utah. We live in San Diego. We had two kids. And then we have three and why not go for four and then. And then we had five and we're like, wow, we are crazy. Like it is total chaos.

Scott Benner 3:18
I think the weather must be nice. There's something you need some another you got some, like depressing months or something like that, where everybody just looks at each other and like no, no, thank you. Right.

Lisa Poole 3:29
Now they are great kids, but they're there's always something.

Unknown Speaker 3:35
Yeah, no kidding. So

Scott Benner 3:35
okay, so Jennifer's, um, she's diagnosed when

Lisa Poole 3:39
she was diagnosed right after her second birthday.

Scott Benner 3:43
Arden was exactly the same. We were about three weeks after her birthday. I think

Lisa Poole 3:47
we were about two months after her birthday. Okay. Wow. Not not on our radar. At all. Of course. Yeah. on anyone's ever Yeah,

Scott Benner 3:56
no one's like, you know what I think's coming this year. We're gonna get that sidewalk fixed and someone's gonna get diabetes. Right. Right. So no, no, I hear you. It was it did it present in basic, the basic ways.

Lisa Poole 4:09
Looking back, it was all very clear sometimes, you know, during, and it was probably like a two week build up where I look back and the symptoms are crystal clear. Yeah. But it was summer it was August. It was really hot out and I was like, Ha she's drinking a lot. And and that just kind of kept increasing. And then she was sleeping in our bed with us so and she would wake up in the morning and her pajamas would just be soaked. Like she would soak through her diapers and I thought Oh, she needs some bigger diapers and she's outgrown that size. That we got bigger diapers and she continued to do it and I think it was the night before she was diagnosed. She woke up just crying for water and drank an entire sippy cup of water like in the middle of the night. And still it didn't quite clicked something serious was going on. The next day I remember we went to Starbucks, because you need a lot of coffee with five kids. And all my kids wanted to get a hot chocolate and June sat there and chugged a hot chocolate, which was another leg. That's weird. And it wasn't until the day the day she was diagnosed, my husband took her out of the house to go visit some friends. And so I had a quiet moment to Google some of her symptoms. And, and that's when it all started to kind of come together. But I still, you know, she was playing and acting healthy and she didn't look sick. She was kind of cranky, but you know, two year olds are cranky. Yeah.

Scott Benner 5:45
Yeah. Well, five kids, you might have thought one of them's gonna be a clunker. personality wise, maybe it's just her. Yeah, she was

Lisa Poole 5:53
always pleasant. But I thought, you know, I wrote everything you can write off as something else, like the crankiness. I was like she's teething. She's not sleeping. Well. It wasn't until the night before we went to a back to school event for my older kids. And she was crying for water, and they had food tracks. And so I'm searching for water, and they've sold out of water. And so they have this, like little juice, soda thing, but I thought, okay, my three girls can share it. And June, just sat there, chugging it, and another lady noticed. And she said, Wow, she is so thirsty. And that's my thought that's, you know, when someone else is noticing that your kid is excessively thirsty, maybe there's a problem. Yeah, so I started Googling and, you know, have that quiet moment. And it's still it just was not on my radar that my two year old could possibly have diabetes. But I called her pediatrician anyways, and I and I told the nurse, I said, these are her symptoms. And, you know, I'm, I don't feel super concerned. But I feel like maybe we should see what's going on. And she didn't seem super concerned. And we were going into a holiday weekend. So it was a three day weekend. And we couldn't make it into the office before they close. So she said, just come in on Tuesday morning. And we'll see what's going on. And thank goodness, the doctor called me back after the office closed, it was about 530. And he said, You know, I would just feel a little better if you would just take her to an urgent care near you. And ask them to check her her blood sugar. And I was like, Okay. And we are still not really concerned. I left. We had just arrived to the pool, because it's middle of summer with all five kids and my husband and I said, I'll be right back. I'm just going to run her down the street. It was literally like a mile away. We're going to get her checked out. And we'll be right back and we'll come swim.

Scott Benner 7:46
And there was still no part of you is like don't put the other four kids in the pool just yet, just in case.

Lisa Poole 7:51
No, they were already swimming up. Like I don't want to ruin your fun. We'll be right back. We arrived at urgent care. And I could tell the doctor there seemed like I was a little bit wacky, like my two year old looked fine. She was not acting sick. But she humored me and said we would check her urine and she was still in diapers. So they they put like a little collection bag in there so they can they can test and she came back and I just the whole her whole demeanor had changed. And she didn't say anything about the test she just said so we're gonna do a finger poke and just see what that says. And so they did a finger poke. They actually did a toe poke. And the meter just read Hi. Yeah. And now they're scrambling around looking for the pamphlet that comes with the meter to see what high even means. Because I don't think they've ever seen that. And I I knew that was bad. I had no idea what a blood sugar reading should be. But I knew it shouldn't be high.

Scott Benner 8:52
Was it? I remember saying on here once and I think I've said it here. But when we did it with Arden's we ran out and bought a meter. And the high was a chai like it was the screen was so small. And I and I I literally when it happened, I thought oh, how cool is that? That they make the meter? Like say hello to you before it tells you what your blood sugar is. And I kept staring at it go now when is the number coming?

Lisa Poole 9:14
So I thought about going to buy a meter but I thought I don't know what a blood sugar. I'm not going to know how to interpret that number because I had no I had no clue. Right? And so at that point, she said so your daughter has type one diabetes, we think we're gonna we want you to go straight to Children's Hospital. And so we I gathered up my kids from the pool who are still wet and dripping and we threw everyone in the car and drop them off at their grandparents house and got her down at Children's Hospital. And they were waiting for us and once we got there I could tell how serious things were. The mood was definitely you know, went from she's totally fine to she is not fine, and her blood sugar was over. For 801, we only got admitted. So yeah, we spent the next four days there, we talked him into letting us leave a day early because there are other kids were starting school and we didn't want to miss their first day of school.

Scott Benner 10:12
But your story is so incredibly similar to ours.

Lisa Poole 10:16
Yeah, I've heard you tell our story and a lot of

Scott Benner 10:20
a lot of similarities. That really is it's a, it's a, I don't it's, it's, I don't know what it made me sad. Like, when you were telling it, but it wasn't for you. It was for me, I usually I'm empathetic, while we're talking about like, Oh, this reminds me of a bad part of my life. And and everything you said, step four step makes sense, like the idea of writing off things that are right there in your face, because it could be something else, that's such a normal thing

Lisa Poole 10:46
to do. And the symptoms aren't talked about, I don't think nearly enough. And so I was, I really had never heard any of the symptoms, or the fact that my two year old could even get diabetes. And I think there's a huge lack of awareness for people who are not connected to the diabetes world somehow that like what sometimes to even look for an a child, which is why I I'm always trying to share and unfortunately, we had a friend who later on was diagnosed and she recognized some of those symptoms, because we talk about them a lot. And try and share and, you know, I just there needs to be a change in the amount of awareness that's out there, and people actually looking for those symptoms.

Scott Benner 11:28
But we did an episode a few weeks ago, with beyond type one, and they're really pressing, to get posters and information into pediatricians offices, and they're having really good success with what they're doing.

Lisa Poole 11:39
Right. I listen, that was, that was amazing. It was really cool.

Scott Benner 11:44
So you get out of the hospital for a couple days, you ship your other children off to school. And what's the next step? Like? How do you begin to be as it's only three years ago, right? Three ish years, maybe a little more

Lisa Poole 11:56
now. So the summer will be four years for her.

Scott Benner 11:59
Right? So what did they send you home with? Did you have a like, was it needles? Was it pens, what did they give you?

Lisa Poole 12:05
So we had needles, they sent us home on three different insulin. She was doing Lantus and novolog, and NPH. That was not fun. So for a two year old, she was on a very strict eating schedule. So she really freaked out in the hospital, like, like any two year old, which he really hated the shots. Like it took a couple of us to have to hold her down and, and do the shots. And it was just, it was horrible. And so they're, I think their thought was with the mph, we can eliminate a couple of shots during the day. And so she had very strict eating schedules. So like she had to eat breakfast at seven, and she had to have a morning snack at 10. And then she had to eat her lunch at 12. And then she had an afternoon snack at three. And then she had her lunch at five. And then she had an evening snack. Break two year old who before this was allowed to just snack when she wanted to. You know, she always would just kind of snack through the day. And it was it was really hard. I remember the first week home and all the other kids went to school and she wanted a banana which she had been able to eat the week before. And I had no idea how to dose for it. And it wasn't time for her to eat. And so she laid on the ground and cried for 45 minutes and I I literally did not know how to make that happen for her. Yeah. So you know, I don't think that a strict eating schedule for a two year old was such a good idea. such a fun idea.

Scott Benner 13:40
No, I was just at something this weekend where people were speaking and some people would had diabetes for a long time. And they this one person described the same idea of like, you know, I had to eat at certain times and certain amounts of food like one starch one car one this like, like it had to be fat in it. There was actually Carrie Sparling, she writes a blog called six until May it's a really popular diabetes blog. And she said that there was supposed to be a certain amount of fat in her diet. And her mom couldn't figure out how to get the fat or diet she would just give her like a tab of butter and make her eat it Oh my god. Because but because of the same thing I think you're describing like that, like how do I make this happen the way I'm supposed to do that kind of like insecure. So not knowing Yeah,

Lisa Poole 14:27
yeah, on top of it, each meal had to be a certain amount of carbs. So each meal was supposed to be 45 carbs. Each snack was supposed to be 10 carbs and I remember telling them in the hospital. This is more food than she eats now. And so we were trying to like add extra carbs to her food and we would dose her before and then she would eat only half and so then we'd have to make it up with juice and I remember being really stressful trying to like we were forcing extra carbs in her Yeah, your whole day. And then when she wanted to eat certain amount of carbs, she couldn't because it wasn't the right time, or it wasn't, it didn't fit into her food schedule. And so after we were home, we did that for a few weeks, and they actually had us calling in every single day. For almost the first two weeks, we would call in at night, and tell them what her numbers were. And then they would make adjustments to her insulin because she was all over the place. And I pretty much figured out by the end of the two weeks, they were just guessing what the amount should be. But they kept lowering it and lowering it, and she was having a lot of really scary lows. I remember our first week home, and she, it wasn't, I wasn't supposed to test her yet. You know, I'm, I'm still only testing her at the times that told me to test her and she, she wouldn't act low. And so she was playing and I decided to test her I think she would tell me when she was that little she would say I so tired Mama. And then I would know like, I better test her. And so she was 32. And she was just playing like nothing. And so very quickly, they rushed getting a deck on her, which was a really good move for us. Yeah. But she had a deck on within within a month of being diagnosed. Well, that's,

Scott Benner 16:21
that's fantastic. But it Yeah, but what you described First, I want to go back to that idea of like, okay, you know, inject this much and give us a call because we don't know what we're talking about. And then and then Hey, why don't you try this? Like, you know, when somebody starts saying, why don't we try this? You're in trouble?

Lisa Poole 16:40
And just guessing Yeah,

Scott Benner 16:41
right. And you picked up on it really quickly, which is good for you.

Lisa Poole 16:45
I still for it took me a while to learn that I could make adjustments and that I could do it, that I would know her better than they ever would. And it took me a while to figure that out that they really didn't know any more than I did.

Scott Benner 17:02
So the barrier to making that decision. Do you think

Lisa Poole 17:06
for me deciding that? Yeah, like

Scott Benner 17:08
what do you think held you back like the first time you had the thought? What do you think held you back from just making the decision and making, you know, adjustments on your own?

Lisa Poole 17:18
I just don't think it occurred to me that, that that's what we could do. I think once I realized that they sounded like they were guessing. And I thought Why? I could guess too.

Scott Benner 17:32
And I'm here, so I might have a little more idea.

Lisa Poole 17:36
But you know, I look back at the stuff they sent us home with like, her ranges, they had her and they didn't want her going to bed unless she was under the shade to be over 180 to go to bed. So if say she was 150 they wanted us to give her a snack before bed. To me, I've never seen blood sugars. I don't know what I'm looking at. I like I followed them for a short amount of time thinking that was normal. And definitely realized at some point that was not normal. We do not go to bed at 180 anymore.

Scott Benner 18:12
And that was just a fear thing. decision.

Lisa Poole 18:16
I think for them, they wanted to keep her safe and and that was safe. But really it's not.

Scott Benner 18:23
Right. Right. It's safe today. Not safe.

Lisa Poole 18:25
Let's say it's Don't Don't let her die tonight, but isn't really healthy for her body. So the interesting thing about her is after about each week, the insulin levels kept going lower and lower. And add up after about five weeks, I ended up taking off all insulin completely. Oh, she had she kept having so many lows, that it just kept decreasing and decreasing until they pulled out all insulin. So no lantis nothing. And like the second they did that I I ran with it and we switch to low carb. And I figured if we can however long we can keep this going. The better like you know for a two year old to even have a few days of not having to get shots that seemed very appealing to me. So we switch to low carb. And she stayed off all insulin for eight months.

Scott Benner 19:25
Wow. So that her honeymoon was really long then. But something it

Lisa Poole 19:28
was long and I think we prolonged it with the foods we ate and yeah,

Scott Benner 19:35
how did you do? How did she do with that at that young age? Like what are some examples of foods she would eat the low heart

Lisa Poole 19:42
so for her she didn't. I don't know that she knew much different. The whole family started eating that way. I would. I would bake a lot of foods we would make stuff like with almond flour and coconut flour and stevia I try and make her treats and like a lot of nuts and few berries, we cut out a lot of fruit at the time now looking back at it, it looks and it feels really restrictive at the time it worked. And to me the trade off was you eat these foods and we don't have to take a shot. So it worked at the time.

Scott Benner 20:24
Well, the whole thing had to be incredibly overwhelming for you, because you're you're describing first of all you have, I think I forget now 43 kids, and and then now you have a lot of children and, and other responsibilities on top of those children. And, and now you're, you know, she's eating at certain times, and that's not working, and then all of a sudden, she doesn't need insulin anymore. And you go to this low carb, and you're baking and you're cooking and did this thing complex most of your life.

Lisa Poole 20:51
Yeah, I pretty much lived in the kitchen, which at the time, it felt worth it. Honestly, I mean, it seems silly now. But everything I wanted to read everything and, and family and friends were sending me information about how the care is like right here. Like, if we can just make it a little further like the cure. Is this any day now? I don't live like that anymore. And but you know, in the beginning, you you kind of hold on to this hope that maybe this won't be your life forever.

Unknown Speaker 21:21
Yeah, no, no, I really understand.

Lisa Poole 21:24
I really don't. Yeah, I kind of had this feeling that if we can keep this going for a while then maybe she'll never have to go shots again. They'll have this cure by the time your honeymoon ends. And it'll just be that easy.

Scott Benner 21:40
I'm so do you. I don't know, how was it crushing when you realize that wasn't what was gonna happen? Or did it just kind of kick you into another year of we need to take care of this in a different way? Maybe,

Lisa Poole 21:56
I think it was gradual. You know, while we while she was off insulin, like low carb was the answer. And yeah, going back to why we chose low carb going out there and searching for support in mind at finding some Facebook groups. And it seemed like there was two sides to the Facebook groups. So you had the one more mainstream where you had people saying I just let my kid eat whatever they want. But then they're, they would show their graphs and the numbers would be insane. And I would think I don't want that. And then I found the low car groups where they were really restrictive. And this is what they eat, and they don't eat, but their graphs were beautiful. Yeah. And so with the information I had, I felt like those were our only two options, it wasn't an option to let her eat whatever she wanted, and have good blood sugars. And so to me, I knew as much as I wanted her to be a kid and eat what she wanted. I didn't want her to have these wild, horrible blood sugars. And to me, I didn't realize that there was another option that she could eat other foods and have good blood sugar at the same time. You know, so you do what you you do what you can do with the information you have at the time. And so those to me, it felt like were the only two choices.

Scott Benner 23:15
No, I understand. So, I don't know. I've never looked into like a low carb option for Arden. But But I did find something online recently where this person was saying, you know, here, look, this is my kids horrible graphs, you know, before we went low carb and here's my kids graphs now, just as you described, Rocky Mountains on one side, the other side was like 86 and perfect the whole day. And I thought, Okay, I see your first of all, probably pick the best graph you've ever had in the worst graph you ever had to make your point. But I understand still the point is valid, right? If you you know, restrict carbs, enough. Your blood sugar is not going to go out much if you're using insulin, but all it made me feel like was like, Listen, if this is a choice, I don't care, like make let me be perfectly clear if you don't eat carbs. I don't care. But But you know, but but don't say this is what diabetes is with carbs, when you clearly don't understand how to use the insulin to stop that from happening. Because then that's that's a disservice to people because then you give them that feeling of either or it's either horror, or it's joy. There are no other options. And that and that's what you saw, right? Which was

Lisa Poole 24:28
Yeah, it's one of those were absolutely It was like those were our only options was have horrible blood sugars and let her eat whatever she wants, or have really good blood sugars and have a very strict diet. Yeah, I didn't see that there was another option really until I started listening to your podcast. And it just kind of opened my eyes to like, hey, maybe we can eat like we did before we were diagnosed and have good blood sugars at the same time because I'm not willing to to put our health That risk just to let her eat different foods. Yeah, we'll see if I can do both like, Yeah, let's do both. Let's eat normally and have good blood sugars. And that's what we do now. Absolutely. Oh, much better I spend much less time in the kitchen.

Scott Benner 25:17
Um, well, first of all, I am glad for you. And, and I'm thrilled that you've you found this out, I'm a little extra mushy about it, because I just got a little I just got back two days ago from giving a talk to a roomful of people. And this is what we were talking about.

Unknown Speaker 25:32
I

Scott Benner 25:33
love that you found it. And I love that it's that it's helping you but I'll say that it's just a sad. Oh my god, Arden just I texted her that I wanted her to bumper bazel and her and Bolus a little bit. And she didn't see it. So I waited like a long time and I reset it again. And she goes dead. A human can't possibly answer in that amount of time. I think she doesn't understand that the there was a large gap of time in between when I said it the first time and she did. So anyway. So yes, a human as she gets older responses get more thoughtfully jabby

Lisa Poole 26:17
I'm sorry, I get my teenagers daily and think I hope they don't get diabetes. because that'd be a whole nother challenge.

Scott Benner 26:26
Yeah, right. Different. A different person's perspective is so different. And, and I know the same thing, like my son's a teen, and even though he's been around diabetes pretty much his entire life. He wouldn't be like, oh, okay, I know what to do. He would be one that would go kicking and screaming. So

Lisa Poole 26:43
Oh, yeah. My my son.

Scott Benner 26:45
Yeah. And I get it, by the way, but

Unknown Speaker 26:47
yeah, totally. Yeah.

Scott Benner 26:49
So but I'm sorry. But to go back to the idea of, I find it heartbreaking to think that you've felt or that other people feel caught in that situation like that, there's because I would do the same thing. By the way, if I thought that I would feed Arden, you know, dust I scraped off the countertop with salt sprinkled over. And if I thought that was gonna keep her healthy for the rest of her life, you don't mean like how some of the foods might taste?

Unknown Speaker 27:13
Yeah.

Scott Benner 27:16
I don't want to say but I've had a couple of those. And wow, Holy God. Unless I could use one less carbs in my life, we all could, I think on one level another. But there's a difference between the lower carb and no carb, like no carb is, like you're talking about like almond flour nuts, like you're talking about stuff like that, like this is a very specific

Unknown Speaker 27:40
diet at that point. Right. And

Lisa Poole 27:44
it limits a lot of your options, like we would avoid a birthday party, because oh my gosh, they're gonna have cake there. And I like it, it got to the point where I didn't even know how to dose for those foods, even if I wanted to give them to her. I think the further down the road, you go of low carb, you're dosing for such tiny, tiny amounts of carbs, if you're even dosing at all. That's a thought of dosing for like a piece of birthday cake. Like I didn't even know how to do it, right. So it took a lot of experimenting in the beginning and and we're still we're still learning, make sure that you know different foods, I try and look at it as like, I remember one of the first not low carb foods, we went out and met some people and she had pizza. And she, I think she might have hugged her pizza. If you could tell it was like the best thing she had ever eaten, which made it totally worth it. But her numbers were not great after but instead of thinking I failed at this, and we're never going to eat that food again, I just took it as a learning experience for what to do differently next time. And most of my learning experiences where I need to dose more. There was a lot of fear in the beginning of dosing such large numbers when we had not been dosing like that before. Yeah. You know, set a dose for five carbs, which might be something we did before now we're dosing for, like 45 carbs, and the despair over

Scott Benner 29:10
Yeah, the disparity between the amounts of insulin was probably shocking. I would

Lisa Poole 29:14
write Yeah, and those first few times felt really scary to dose that large amount. But the more we do it, the more comfortable we are at figuring out what dose works for different foods and how much she needs. And you know, each time we just learn a little bit better how to dose better for that.

Scott Benner 29:32
Let me ask you, how long ago did you start listening to the podcast?

I love finding a suspenseful place to put an ad. Actually, I got this note one time from this one person who was really mad. Okay, I'm always listening and then something gets interesting and then you cut off and put the ad in. I think if you every time I do that. I don't know who you are. I don't remember your name. Remember this suspense bothers you. Alright, that's enough, I used up most of the add on that, I'm gonna have to start the music over, hold on. Today's first ad is all about the dexcom continuous glucose monitor, specifically the G six. In the very next episode Episode 168, you're going to hear a 45 minute long conversation. That's my review of the G six plus conversation with the Dexcom, Senior Vice President of r&d. I think it's really insightful about how and why the G six is, in my opinion, a leap from the G five. But for now, all you need to know is this, if you want to know where your blood sugar is at where it's going, and how fast it's going there, if you want to be able to see that remotely for your loved ones. If you want to be able to make the kinds of decisions that you hear us talk about on this podcast everyday decisions to keep blood sugar stable and low to take away spikes. And if a spike comes make dealing with a spike easier, if you want all of that data, all that information that helps those decisions be so easy and painless, then you really do want the Dexcom g six continuous glucose monitor, you can go to dexcom.com forward slash juice box, you can click on the links in the show notes, you can go to Juicebox podcast.com, and click on the links. But one way or the other, you need to get yourself some more information about the Dexcom continuous glucose monitor. And those are the ways to do it. Most of the things that I accomplished with my daughter's Type One Diabetes with her a one C's, which at this point now are four years of 5.6 to 6.2. I could not accomplish those things without the dexcom and without the Omni pod. But the ad today is about Dexcom. So let's focus on that dexcom.com forward slash juice box with a link in your show notes or Juicebox podcast.com. Do it you will be happy you did.

Let me ask you how long ago did you start listening to the podcast?

Lisa Poole 32:05
maybe a year and a half ago. Okay.

Scott Benner 32:08
And you're still you're still figuring it out? Right? I'm plushy still small. It's, I mean, five or six years old is what would I mean? I'm guessing

Lisa Poole 32:18
piny 30 5038 pounds.

Scott Benner 32:20
Wow. Okay, so she says so little bits of insulin have a big impact on her she doesn't have a ton of body fat to distribute the insulin with and stuff like that. So it's, it's a it's a bit of a slog, right, right, trying to figure it out all the time. But But I love what you said about not giving up and just taking Hey, this is what happened. And now we'll just make an adjustment for next time. I I have to say it made me smile when you said it was like she would almost hug the pizza is like that's

Lisa Poole 32:48
oh my gosh, we if she had an extra piece that she she wanted to bring home with her. And like she had to hold it. She didn't even want to put it in the box to bring it home with her.

Scott Benner 32:59
She's like, no one's taken this from me.

Lisa Poole 33:02
Yeah. But it was at that same time that I thought oh my gosh, I don't want to give her these food issues of like, she needs to hoard her food because she might never eat pizza again. And I noticed that a lot when we first switched over, like she was so excited to eat a certain food that she had never had before, or it had been a really long time since she had. And I don't see her doing that anymore. Like it's just not as big of a deal when we have a tree eater, and she gets to go get an ice cream or whatever, which is what I want. You know, I don't want her to have any kind of food issues. I remember one of the first podcasts I listened to that you had was a lady you came on and you guys discussed diabelli Mia. And I thought oh my gosh, I do not want her to grow up with any kind of food issues or just any issues with food.

Scott Benner 33:54
Yeah, yeah. So that was a big changing point for me of I need to figure out how to dose her and get over being fearful. So that she doesn't think any differently if there's a given taken there. I mean, there's gonna be times where I go through it, you know, periodically, we put a pump on yesterday, that just must not have been a great place for it. And it took a while for it to start working the way I wanted it to. I don't know if it was in a muscle or you know, too close to a muscle or some whatever. And so I adjusted the insulin and we're good now but first number of hours wasn't great. And we came up on a meal. I was fighting like this 150 blood sugar trying to push it down. And then the meal came and I was like okay, I'm pretty certain this isn't going to go well but I'm not going to ask are not to eat this food. So I just gave her you know, I over Bolus then I covered it the best I could and eventually a broken or I got our blood sugar back to where I wanted it to be, but I think it would have been much more dangerous to create a conflict with the food than to let her blood sugar be one ad for a couple hours. Like, you know, that, to me is a trade off, it's worth making,

Lisa Poole 35:07
we run into that a lot being five years old, sometimes she just doesn't have the patience to wait for, for Pre-Bolus like I would like to all the time and, and so it is a balance of like, just eat it and I'll figure out the blood sugar and maybe I'll increase your bazel. Or I'll figure out a way to make it work, but just go ahead and eat it. And, you know, hopefully as she gets a little older, there's a little more understanding of maybe waiting a few minutes or getting the timing better. But it's tricky when you're five and you don't want to wait for that snack. Yeah.

Scott Benner 35:40
How about now how about I, there's a couple you can get away with, you can get away with under Pre-Bolus Singh and over bolusing you don't mean like trading extra insulin for less upfront time. But there are some foods that are just, you know, it doesn't work as well, like you can't, you can't make that trade off with a bowl of cereal. You know, for instance, he you know, that'll cause a low later, you'll have to use so much insulin upfront to stop like, you know, Apple Jacks from from doing something like that, that later you will get low. But

Lisa Poole 36:12
one of the meal I can sneak in the Pre-Bolus before she even know she's waiting, you know, as I'm making the food or after we order the food. And then when it arrives she can just eat and to her. She didn't wait at all right? I got the Pre-Bolus in and it all worked out great. It's usually with a snack, which tends to work out better anyways, without as big of a Pre-Bolus.

Scott Benner 36:32
That's interesting. And you're making me think of a story someone told me this weekend. So I wish I knew who told me this now I spoke to so many people this weekend. But somebody was telling me they had a friend with a like a toddler. And they Pre-Bolus the meal. But one time the Pre-Bolus got out of whack and the kids started falling before the meal was done. So she gave the kid ice cream, like an ice cream sandwich or something like that, right? And then the kid figured out, right? Like, I this is how I can get ice cream. And it became it became like an issue. And so you're saying that you can get away with Pre-Bolus in a meal because you know the meals coming but snacks. If it's just a snack, there's no cooking time for the snack like okay, you push the buttons not give me the thing in the package or the or the banana or whatever it's gonna be. And that's really kind of interesting. What kind of pump Do you have is a pump? It is

Lisa Poole 37:28
we have we are on Omni pod.

Scott Benner 37:31
So she No, but she knows when you're you can't do it without her noticing,

Unknown Speaker 37:36
I guess.

Lisa Poole 37:37
Oh, I can't. Just Yeah, well, that's the currency doesn't really pay attention to what I'm doing. Oh,

Unknown Speaker 37:45
no kidding. Okay.

Lisa Poole 37:46
All right. Yeah. Sometimes I have to ask her to come closer, because she's over somewhere playing and that they won't read that far. And usually, she's not really paying attention to what I'm doing.

Scott Benner 37:56
I wish there was I wish you all could have seen, like, pay for people of Omnipod, just to be with a reasonable distance of the pod to to use the, you know, the PDM.

Unknown Speaker 38:06
Right. And like, we have to be so close. Well, some days,

Scott Benner 38:09
I'll tell you the pump that Arden was wearing last time, I felt like they had to be touching. And the one before that I can stand in my dining room and do it through the floor up into our bedroom. So it's like, you know, some of them are, you know, different. Maybe that's where they're shielded on their body. I have no idea. But what I was going to tell you is that many many, many years ago, we were contacted by on the pod and they were working on the new PDM which at this point now is the old PDM it's about to be replaced. And I got we they asked for Arden to come down and Phil apod and do everything they were just trying to they needed data on little kids using the PDM for the FDA. So Arden goes down and she does it. And the guy setting up the fingers, hey, do you want to see something look what they've done with the distance. And he took the pod walked out of the conference room, we ran down the hall went into another conference room push the button, he said go ahead and deliver a bolus with it. And it was working like 40 feet away. And I thought, oh god, this is amazing. And then when it got back to the FDA, the FDA made him restrict it back down to us to a closer distance. And I was like a

Unknown Speaker 39:16
farmer,

Scott Benner 39:17
but I got to see it for one afternoon. And it's it would have been really cool. I don't know why the FDA made them do what they did. But I have to admit it would have been great if it worked at distances like that.

Unknown Speaker 39:30
Yeah. So

Scott Benner 39:33
anyway, I'm sorry, I got off on a bit of a tangent. Maybe remember this very happy about where you could Polish from anywhere in the house. Because at that distance, I probably could have like set temp basals from my bedroom. And that'd be perfect. That was exciting to me the idea of not getting out of bed but okay. Yeah, yeah. So let me so. So when you look back on low carb in your in your experience, and you look at how happy She has to have things that are not low carb, is it? Is it a flavor thing? Do you think like, what do you think is the difference?

Lisa Poole 40:07
The taste better? You know,

Scott Benner 40:10
white flour. Good.

Unknown Speaker 40:13
carbs is good, you're right.

Lisa Poole 40:19
I think part of it is just the freedom thing of like, being able to go out if we want to or like, hey, let's all go get an ice cream or, like having the piece of birthday cake at your friend's birthday party. Just the freedom to like I'm not scared to dose for any food that she that she wants to eat. You know, within reason I don't let her eat birthday cake for breakfast. But sure, you know, it just the freedom of being able to we're not scared of food. Where I think there was some fear before, like, I don't know how to dose for that, or we can't eat that. And now there's just that new freedom of we're not held back from food or what the food options are.

Scott Benner 41:04
I always worry, like my bigger like concern is and maybe it's unfounded, I have no idea. But if you spend your whole life eating that way, and you know, insulin is just this thing you give in tiny little bits and you don't, you know, to your description, don't really know how to Bolus for other, you know, items with more carbs. And what happens when your kid becomes an adult or goes to college or goes away for the weekend. And everybody's like, I'm eating pizza, and they're like, I love pizza, I think Let me try. And then the they are wildly unprepared for how to manage that food with the insulin in any way. Right? Like, I think you should understand as much as you can about diabetes, because you it's easy as a parent to look at your five year old. And you have more children or you have an older child too. But when you have little kids and just little kids, there is a time in your life as a parent, where you have this very unreasonable expectation that you are building the exact person that you mean to be building and that they're going to launch out into the world exactly as you mean for them to be, you know, and it doesn't really work that way, you know, like you're building a foundation for a human being, they're then going to leave your house, immediately, the bright sunshine of freedom is going to hit them and they're going to start making their own decisions. Hopefully, they'll make them sort of in line with the things you've been telling them. But it is unreasonable to think they're going to continue being your eight year old for the rest of their life. Which by the way, is not something you would actually want to begin with, even though it feels like it's what you want when they're eight, right?

Unknown Speaker 42:34
Yeah, having

Lisa Poole 42:34
a 17 year old, I cannot clearly understand what you just said. Yeah. So yeah, there's, they're gonna become their own person, and they're gonna do what they want. Yeah,

Scott Benner 42:46
and they need tools. Right? So they can't, everything can't be and you can break it down. If you forget low carb, it can be anything. I'll tell you right now my my son's 18. He's gonna leave for college in Gosh, if I cry, don't hold it against me, me. My son's gonna leave for college in less than four months. He's going to go to a school and he's gonna play baseball there. So he's been talking through social media with all the other boys were coming in on the baseball team. And they're all trying to get to know each other. But moreover, they're trying to find roommates. And, and my son comes to me about two weeks ago, and he says, I think the guys are all getting ready to like pick roommates. Like I have to figure out who I want now. What do I know how my son's gonna do? Like, my son's not a drinker. He doesn't run around and party like all this stuff. Like he's a pretty and I know people think oh, yeah, you think that but you're gonna have to trust me on this one myself that this is who he is. And so he comes to me one day after school, when he's texting with this kid. He goes, I think I found my roommate. He goes, we agree on religion and politics, and he doesn't drink either. And I was like that the part of me who thinks that I might be able to launch my eight year old and Phil world exactly the way I want them was like, I'm winning. I'm so winning right now. But still, that doesn't mean that's, you know, I don't mean to say that six months from now my kid's gonna come home with like, a fairly horrible drinking problem and a heroin needle in his arm. I don't think he's gonna go that far. But but to think that he's going to get through college without ever wondering what a beer is, is a little unreasonable, you know, and so I've given him both sides of the conversation, not just the side that I want him to stay in. And I think about that with the low carb, like, you can't not understand insulin. And, and if you're just But listen, I've had days where my daughter is sick, and she doesn't eat. Diabetes is really easy. If you're not taking in carbs. It's you know, it's super easy, actually. And so when you're sick, and then it just sort of that whole curveball of diabetes doing what it wants to do low Can I tell you, I'm very lucky Arden doesn't get low when she's sick. So it's just dumb luck on our side. Like when my daughter gets a head cold, I'm like, oh, four days off from thinking about bolusing. Because she, her blood sugar stays incredibly steady. And she doesn't need as much insulin for reasons that I don't understand in any meaningful way. But

Lisa Poole 45:13
then five days in the hospital because she was, had a tummy bug, and she couldn't keep anything her blood sugar, even if she would eat, she wouldn't absorb anything. So, you know, you don't feel like you're like eating when you're throwing up. But she would be throwing up and then I would have her eat something and she would eat 5060 carbs, and she would still be in the 50s. Wow. So we had her, her bazel turned off by 85%. And she was still like in the 40s 50s. So they had his turn her pump off completely, which was not, I don't think the best idea. And I even told them that. And so we did. And then of course by morning, she had large ketones, and she was in the beginning stages of decay, even though her blood sugar was in the 50s. So we added we spent five days in the hospital where they could have glucose in our IV, and it was the only way we could keep her blood sugar up.

Unknown Speaker 46:10
Well, that sucks.

Lisa Poole 46:12
Yeah, yeah, I'm sorry. She says they have really good chocolate pudding.

Scott Benner 46:18
Can you imagine how easy it is to buy off a five year old?

Lisa Poole 46:21
Like, if we could go next time to the hospital? And I don't get the IV? I'd be totally cool.

Scott Benner 46:26
Yeah, just the pudding. And then we roll in an hour. Oh, I'm sorry. I know that does happen to a lot of people where he just like Arden has bouts where her blood sugar will hit 50. And, you know, it won't come back up. It feels like no matter what you do, but these are a handful of times a year. And it only lasts for an hour or so like we don't have like that kind of. But I know a lot of people do.

Lisa Poole 46:49
That was by far the worst. Yeah. You know, it happens sometimes.

Scott Benner 46:52
Isn't it funny to like the situation that you got put in? Because when they said shut the pump off, you're like, that's not a good idea. We always need insulin, even if our even if. And yeah, and yet you felt like I'm assuming there was just no other option at that point.

Lisa Poole 47:08
Yeah, I think it was like, here's your last option before coming into the hospital. And let's give it a try. I knew it was not a good idea. Yeah. But at that point, I couldn't turn her pump back on either because I couldn't get her out of the 40s even while she was eating. So we couldn't give insulin. So once they got the IV and the glucose running, though we could give her some insulin. Because she had to glucose in her IV. Yeah. Oh, balance down.

Scott Benner 47:33
Yeah, well, maybe that's a little bit a function of her her size too. And her age and right, maybe being a little bigger will help you with that. And plus, you know, there is this other thing to like, you know, we've only ever experienced what I think is it's not it wasn't DK in the way that was told to me by a doctor. But we had a pump failure overnight one time. And Arden woke up in the morning and she gets out of bed and she's like, I don't feel good. And I'm like, okay, and we test and her blood sugar's in the three hundreds, but it's not overly high. But still, I'm like this shouldn't be so I look at the pump and the pump the candle like kinked or something, or I don't remember what it was, but put a new pump on got insulin going. And she was sick to her stomach. And I said, Look, I said to my wife, I'm like, in the amount of time I think this is been, she's gonna have to go the hospital, you know, like this and check her ketones or ketones were were out of whack. And my my daughter's like, I don't want to go to the hospital. Is there anything I can do to avoid going to the hospital, I said, Okay, if I give you a couple bottles of water, I need you to drink them. I'm going to bolus an incredible amount of insulin. And when it happens, and it's going to happen, your blood sugar is going to fall when you're not feeling well still, I'm going to absolutely need you to have to force some food in to catch to catch this. I said if you think you can do that, then I'll try it. And she was old enough to make that decision. Like I will eat sick, you know what I mean? But if she was younger, she would have never I couldn't have even had that conversation with her. You know what I mean? Like and she definitely wouldn't have been able to pass it because drinking the water almost killed her. Like like she was drinking water and she was like, like, Look, we can just go to the hospital. She's like, I'll drink the water and I'm like, Okay.

Lisa Poole 49:29
I actually had a very similar conversation with Juniper.

Scott Benner 49:35
In a life where so much is difficult. Something needs to be easy. Something needs to be an oasis. I think the AMI pod tubeless insulin pump is that oasis in a desert that is type one diabetes, to be able to get your instant delivery to be able to control your rate of basal insulin without being tethered to something to me is huge. I know when people Think about moving to an insulin pump, the first thing they think of is I don't want to be attached to something. And on the pod keeps you from feeling attached. Because there's no tubing, there's no device that you're tethered to nothing that you have to wear on your belt or jam in your bra or something like that. It's just this little tiny pod that just adheres to your skin, and it's got everything it needs right inside. I think that's nice. I think that it's nice for something to be easy and just work. Right? Don't you need that sometimes? Don't you just need something to just do what it's supposed to do? Do it well, and do it without being a burden. I feel like that all the time. Just sometimes you're like, oh, can't something just go the way it's supposed to? Well, the only pod will go the way it's supposed to. And you know what that's saying a lot for a medical device. It does what they say it's going to do, it does it well, and it does it without burdening you go to my on the pod.com forward slash juice box, or click on the links in your show notes. Or at Juicebox podcast.com. And on the pod, we'll send you a free, no obligation demo that you can try for yourself. You don't have to believe me, you can actually hold it and decide for yourself.

Lisa Poole 51:22
I actually had a very similar conversation with Juniper. So she had been sick for about two days before. And each time she would not eat or drink something, I would have to have the talk with her. Like we're gonna have to go to the hospital. And if you can't drink this juice, because you're we cannot get your blood sugar up and she would always choose like, okay, I can power through, I'll drink this, I'll eat this. And it was the morning that we went into the hospital where she just she was like, I can't and I was like, we're gonna have to go to the hospital. And she was like, okay,

Scott Benner 51:48
like, that's how you know, she really can't.

Lisa Poole 51:50
I was like, Okay, yeah, that's, that's the sign we need to go. You know, even being at five she was making those choices. And she definitely reached the point where she was like, I'm done. I can't do it. Well,

Scott Benner 52:01
that's Listen, that's pretty heady for a five year olds. Just be like, okay, I've tried and now I'm done in. Yeah, I guess it proves. I guess they do grow up too quickly, when they when they have diabetes, for sure. Hey, so are you from California originally?

Unknown Speaker 52:18
I am. Do you say what? Well, I

Scott Benner 52:19
feel like I'm saying water incorrectly. When I'm speaking to you, I my kids. My kids have made me completely like mental about a couple of words from the Philadelphia East Coast area. And I'll say it, there'll be like you meet. So I live in a place. It's like a meeting point in between a bunch of areas. And because of the kind of businesses around here, it draws people in from a lot of different areas. So my kids don't have the Philly accent. I grew up with, you know, things like sports, like you know, where I grew up, people watch the Eagles play football. You didn't watch another team play football. But around here, people are giants fans, they're you know, some people like this, they like that they Oh, cowboys and Patriots are like that kind of an idea. And my kids are not thrown off by it. I'm like, you know, as a child, we would have beaten those children for for liking a different football team. And so it's the same with dialects. There's dialects coming in from everywhere. And now my children know to correct my my bad pronunciation and

Unknown Speaker 53:21
no funny.

Unknown Speaker 53:22
I think about it now. And the podcast is fairly good. I'm

Lisa Poole 53:26
sorry. Our kids are only so quick to correct us if we

Scott Benner 53:29
Yeah, it's not nice. And the podcast is incredibly popular in California. As a matter of fact, I think if I had to, if you want to take a detour for a half a second with me, yeah, I think of all the states of the in the United States. It is, I think, the most popular in California. And I don't know, I don't know why that is exactly. It's interesting. But it is yeah, it is true. I'll use just this month or two the last 30 days and I'll look real quick. faraway.

Unknown Speaker 54:10
Maybe

Scott Benner 54:13
I'll see maybe triple the next closest state in downloads. Hundred. I don't know if it's the sheer size of California or if I've always wonder if it's if there's more progressive thinking that, like I can never figure out exactly what it is like when you share your idea with another person with diabetes. If they're like, hey, right on, I'll give that a try. Whereas if that happens somewhere else in the country, people are like, No, that's not what my doctor said. And I'm not gonna do it. I always wonder what it is if it's just the sheer size of the population or, or if there's something more sense a sense of a sensibility that's definitely

Lisa Poole 54:48
and he read it better than me interesting thing, trying to move away from listening to what your doctor suggests and or tells you to do and I think that's that takes a while. To, to figure out that you know, best. We actually had an interesting thing happened when Jane was in the hospital a couple weeks ago. And I battled a little bit with the the night nurse who came in and the things he wanted to do was just not acceptable to me. And he was going to check her blood sugar every single hour with a finger poke. And I was like, she has a dexa on like, why are we doing that? And there was a few other things. And so we, we definitely had some words, and the doctor came in in the morning, and I thought she was going to scold me for starting a nurse. And instead, she came and she was like, that was really awesome. What you did like that is so needed, you have to advocate and you're going to know your kid better than anybody. And in order to keep your child safe in the hospital like this, you have to be a strong advocate for them. And I think that is so important. And something maybe people don't realize that they they're going to know their child better than even the doctor sometimes.

Unknown Speaker 56:01
Yeah, it

Unknown Speaker 56:03
is just right.

Lisa Poole 56:05
Right, anyone, but you know, our kids who need us to be the advocate for them, and we do know them best, we're with them 24 hours a day, and I handle all of her diabetes care. So that was interesting. I was I was glad I was not in trouble for you know, I

Scott Benner 56:23
think Listen, I I advocate for that on the podcast all the time, like you absolutely have to just speak your mind without acting like a lunatic. You know, because it's easy for people to discount you if you seem crazy. So you know. And plus, you have to realize the situation you're in, you're in the hospital because something went wrong with your diabetes, you're like, Listen, I'm really good at this. And the person's probably thinking, are you because you're at the hospital. And,

Lisa Poole 56:47
Christine, when you go to the hospital, at least with the Children's Hospital we go to is every doctor that we end up with, they come in after already looking at all of our agencies. And so they came in and she was like, You clearly know what you're doing, and and everything well, like, we can see the circumstances that you're here for this reason. And you know, we're gonna let you have control of her diabetes while you're here. That's not why you're here. But I do think they see a lot of kids who are not well managed, and then they have to take over. So they could see that we were in a situation where they didn't need to take over her diabetes management. It was just that we needed that little extra help with the IV. And so they they let me still do like i'd handled all the dosing.

Scott Benner 57:27
Yeah. Isn't that it? That's incredibly That's an incredible insight into the process. Because

Unknown Speaker 57:33
Yeah, yeah,

Scott Benner 57:34
because they felt like they had a, you know, prize for the lack of a better term, they had a report on you. And then that report proved out that you must, at some level, know what you're doing. And so they felt more comfortable allowing you to keep going with it. Right. It's funny, because they were they came in and they were impressed with her. All right, when fee, so that was good. I do a similar thing with 504 plans at school. Every every year, we have a meeting, I take a minute to thank the school for their flexibility, because of what it leads to for Arden's health. And I show them, you know, numbers, I'm like, look here, this is, you know, here's, here's normal, here's where she is, you know that this is due in large part to, because you're allowing me to manage her the way we do through text messages while she's at school. And just giving them that idea that that the way they're treating me is benefiting Arden. It makes them they feel empowered, it's because it's interesting, because in the way we do it at school, I've taken all the power away from them, but they still feel empowered by it because the result is so good. Like, I've talked them into believing that their decision is better than their action. And and it's true, but I show it to them. I think you did a similar thing you didn't maybe they checked on you first and you didn't know. But I think it's good for other people to know that you can say, look, this is an anomaly. Most of the time, we're, you know, this is our understanding of it. And we need to be involved in the decision still.

Unknown Speaker 59:06
Right. Yeah,

Scott Benner 59:07
that's a it's a great point. I'm glad that came up, actually.

Lisa Poole 59:12
So while we were mentioning a one C's, I just wanted to tell you or anyone listening that, you know, we managed a really good agency was low carb, but we are now eating anything and everything and still have a really good agency. And so for me, I didn't think that was a possible thing in the beginning. And it is it's just about understanding how to actually use influence, and you can't eat anything. It's just not with the tools that they gave you in the hospital, you know, the tools they give us in the hospital. And then we walk out we try and let her eat normal foods and she would be 400 later and then we can't correct for three hours and it was a nightmare. Having the right tools like the Omni pod and the decks and then having a really strong understanding of how the influent actually works. You can, you can eat what you want and have a good day Wednesday, it doesn't need to be one or the other.

Scott Benner 1:00:05
I appreciate that. Can I ask you and you don't have to give me numbers. But what's the disparity between with carbs and without carbs? They once they like, what's the gap? Like? I don't know, went from five to nine or something like that. But what's the difference? Like the number of difference foods?

Lisa Poole 1:00:21
It's minimal. So her last three months, he's had been 5.9. And when she was low carb, she was about five point out of 5.1. Yeah, so we're not we're not perfect. We were still learning with different foods and mix still. I don't know if it's because the first sighs Yeah, sometimes it's not totally predictable. But we do our best and we know how to correct if things don't go right. Or I've definitely learned to use Temp Basal in the past year or so. Which is a game changer. Absolutely. Yeah, it's huge. Like, we figured out like Pre-Bolus, even when we go out to eat is really tricky with her because she can the timing of it and trying to time the food is tricky. And you know, we've done it before we're, the food doesn't come out in time and then dropping with double arrows. And we've got to like quickly find some other food for her to eat before it gets there and throws everything off. So now we'll use the Temp Basal sometimes. And we'll, I'll like increase the Temp Basal by 100%

Scott Benner 1:01:24
to get her bugs moving without ball, get

Lisa Poole 1:01:26
it to start moving without actually giving her a Pre-Bolus first. And then as it gets closer to where I feel comfortable, like, Alright, the food should be here in a few minutes, then I'll doser but then I feel comfortable that I can I can shut that off. If you know the food takes 45 minutes and she's dropping too quick. I can turn it off.

Scott Benner 1:01:44
We say you, you are my proudest moment. So you really, you really took to the information like really well that's it's such a so commendable. I'm, I have a question for myself, I guess. But two, I have two questions. So going back to what you said first, can you explain to people that while your daughter's eating carbs your graph is not perfectly flat? like it used to be with no carbs? Am I right?

Lisa Poole 1:02:10
It is not funny when we were eating low carb, we had a perfect straight line most of the time.

Scott Benner 1:02:15
But now there's some spikes, you get them back quickly and you still have a one to five line.

Lisa Poole 1:02:20
Exactly, yeah. You know, we we try and keep those spikes down using Temp Basal and Pre-Bolus seen but it's not perfect with with a five year old, like I was saying sometimes she doesn't have the patience or she wants to eat right now. And you know, we work around that and having the right tools like being able to, I don't know how you could do this without a pump. But having the tools like a pump to be able to to do the Temp Basal, so we use Temp Basal every day. And it helps so much with controlling those spikes. Or if we see she starting to trend low we can we can decrease what we use our Temp Basal is every day. And that's, that's been a game changer for us. And I just didn't understand how to use those. And really until I started listening to your podcast, and a lot of it is just experimenting, like not being scared to try it out. And the thing with Temp Basal is is you can always just shut it off. If you feel like it's not going the way you want it to go. I'm a lot more bold with a Temp Basal because I can shut it off at any time. So if I'm not sure about Bolus in a huge amount, I'll start with the Temp Basal I'll do a mix of the two. But now we don't have perfectly straight lines. But you know, if we do spike we come down fairly quickly. Like the other day, we had a huge spike she was playing and she pulled off just part of her pod. And we didn't realize it and she kept rising and bolusing heavy and she just wouldn't budge. And I finally looked and I could see that the candle had pulled out a little bit but you know it wasn't a like crazy panic moment. We fixed it she was got a new pod on Bolus heavy we set at Temp Basal and she was back down in range with you know, within a pretty short time. Nothing there's not such panicky moments anymore. We know how to handle everything. Yeah. And it's just learning to be comfortable with with trusting your skills and and using the tools you have. Like I hear so many people who don't have pumps who don't use 10 basals because they just don't understand them or they're scared of them and that is such a great tool to have and not use.

Scott Benner 1:04:28
Yep, it was my first thought when I got a pump was like wow, I could like be in charge of the basal insulin finally.

Lisa Poole 1:04:35
Yeah, yeah, I mean, like at night we've been using them. Like if I see your start to trend down and I can oftentimes catch it before she actually has to eat something in the middle of the night. Which is huge. I'd much rather just like shut it down and not have to be feeding her in the middle of the night. Yeah, it doesn't always work and sometimes we still have to feed or something but

Scott Benner 1:04:55
I tried last night so I template two examples of temples basals in the last couple of days one was Chinese food where I didn't think Arden looked as hungry as she was. So I thought she needed 11 units for the for the Chinese, right. So I normally would just give her 11 set up in some sort of an extended bolus and you know, work it out. But instead I gave her like eight of the units. And then I doubled up her bazel for like an hour and a half to make up the other three. And sure enough, like 40 minutes into this, like, you know, extravaganza with the Chinese food. I was like she didn't eat as much as I thought she wouldn't have just shut the bazel down, right. And it was perfect because the insulin wasn't in yet. And yet, we were still being aggressive up front. And it didn't result in a spike. And it was really a really good example of using it and then being able to shut it off last night. Last night, I did not I get sick in a very strange way I don't feel well a couple times a year, then I fall asleep wake up five hours later and I'm well again much to the My wife hates that about me

Unknown Speaker 1:05:57
the exact

Scott Benner 1:05:58
so I traveled this weekend, I came downstairs last night, I was doing the laundry last night because that is my job. And I came downstairs at eight o'clock ready to watch the Sixers game which they lost. So luckily, I didn't actually watch it. And I came down to the into the, into the living room where my wife was and I took a blanket and I jam myself into the corner of our sexual and I said I'm either going to be okay in a little while or this is where you're going to find me dead. And I like covered up. And and she's like whatever and whatever, whatever. And Arden had a little bit of a peak when I was when I was out cold. And my wife's not she's my wife's really getting it. But it's she's getting it slower because she's around at much, much less. And so she had a little bit of a peak and she got to come down. Well, when I woke up at midnight, completely healed by the way. I woke up at midnight, I kind of took over and I looked at her blood sugar was 72, which I was thrilled with. But you could tell she had been drifting down over a number of hours very slowly. And I looked at the 72. And I was like, Alright, I'm going to shut her base law for half an hour, I think I can catch this and get her back into like the 78 range. And I'll tell you what a new piece of technology kicked in. So we're using, we have the G six now the G six from

Unknown Speaker 1:07:15
now.

Scott Benner 1:07:16
You should be a little and I'll tell you why. So I shut the Basal off. And it's a little bit of a crapshoot at that point. Like I wonder if this Temp Basal is going to work because I got to it a little too late,

Unknown Speaker 1:07:25
right and

Scott Benner 1:07:26
diagonal arrow down 66 diagonal down. And that's a moment where I still would have gone back before with G five or before I would have said let me wait a little longer. And what would have happened is that little longer would have turned into 61 and then 55 and then a low. But instead instead the decks beeped and said. I forget exactly how it puts it right now. But it said that you will be at 55 sometime in the next 20 minutes. If you don't, right.

Unknown Speaker 1:07:56
I was like No, I was like,

Scott Benner 1:07:59
Oh, this is amazing. So I went in and I gave her like, three quarters of this tiny juice box. And boom 65 leveled off went to 7070 to 80 100 102 I think and it leveled off like 20 minutes later. And I was like, Oh my god, this is amazing. Yeah. And that. So now it's just like another feels like another tool. You know what I mean? Like another weapon to get right with. And it worked. So well. I was like, wow, that's fantastic. So I'm going to talk more about the JSX. At some point when I have a little more time with it, but

Lisa Poole 1:08:35
not wait to hear about it. We've got our order in. We're all approved. We're just waiting.

Scott Benner 1:08:41
I hear June, this will be out afterwards. So I can say I think they're going to start shipping more around June 1. And then

Lisa Poole 1:08:49
yeah, that's what they told me last week coming after that. pretty hot. And looking forward to it.

Scott Benner 1:08:53
It is pretty cool, though, I have to say, I'm actually going to you know, to go back to what we talked about about even when you're really in good control. You see, you see peaks during the day. I'm actually going to put the G five on myself and wear for a while just to see what it looks like when you don't have diabetes because

Lisa Poole 1:09:09
I've worn jeans decks before and it was interesting to see what a working pancreas looks like.

Scott Benner 1:09:16
Did it stop you from eating any specific foods?

Lisa Poole 1:09:19
was no I kind of wanted to challenge it and like see

Unknown Speaker 1:09:22
the challenge your pancreas? You mean you're like can you handle this? Yeah.

Lisa Poole 1:09:28
Let's see what you're gonna do with this.

Unknown Speaker 1:09:31
I'm incredibly amused by that for reasons I don't completely understand.

Lisa Poole 1:09:36
Yeah, it was interesting.

Scott Benner 1:09:39
your pancreas? Yeah. Fantastic. Well, Lisa, we are over an hour. You were fantastic. And I really appreciate you saying this. Because if if the low carb people hear this, they're gonna kill you.

Unknown Speaker 1:09:53
So

Lisa Poole 1:09:55
we've been banned from some low carb groups already.

Scott Benner 1:09:58
Did you did you try Let me ask you before we go, once you saw the other side, did you feel like this compulsion to go back and go, Oh my god, it's not true. And then they kicked you out.

Lisa Poole 1:10:11
They kicked me out before that. I say, see them eating pizza, they are banned. It's a it's a little, I hate to say it, and met some really nice people on those groups. But it's a little cold, like, like, and for a while, it was like, This is the only way but you you'd like step out of that cult culture. And it's, it's not and I I do wish that I could that they would look and see like it is possible to eat and how you want to eat and have good numbers. I think there's a lot of fear and, and dosing such large numbers. And there's a lot of thought that will it's just, it's safer to do it this way. Yeah. And, you know, I feel confident as being her caregiver that I am watching so closely all the time. That that she's not in danger. You know, I can always like you always say I can bump an edge things and I don't feel like she's in a dangerous spot for meeting normal foods, right. It's, it's not a dangerous thing to dose the amount of insulin that she needs. And it just it takes a while to get to that point. But yeah, I've been banned from some of those groups. And that's okay.

Scott Benner 1:11:27
They came after me once. I think I mentioned what was an art is lunch once and then I got hit pretty hard, but I'll say it again here in case you're listening. today. It's a grab bag of Cheetos. A full size bagel, a bunch of grapes. How many? I don't know. Let's see what else Oh, thin Oreos. I don't know exactly how many I just grabbed what appeared to be about two inches of them. And what else is in there? There's a carrot in there. And oh, a mixed fruit cup. But Low, low sugar,

Lisa Poole 1:11:57
some carrot for good measure. There's like counterbalance.

Scott Benner 1:12:00
I also I also Yeah, Cheetos in a carrot. You should see how this kid is she's

Unknown Speaker 1:12:06
covered. She's built

Scott Benner 1:12:08
like an Olympic athlete. She's just little and she's not little anymore. She's getting bigger, but she's very muscular. And I must be doing something. Okay. She's incredibly healthy. So

Lisa Poole 1:12:16
think you're doing very well.

Scott Benner 1:12:18
Thank you. And and so and how much will I give her for it? I have absolutely no idea. I'll just wing it throw some if it's not the right amount. We'll do more. If it's too much. We'll do last. And we'll just stay really fluid with it. And it's going to work out great.

Lisa Poole 1:12:30
Now that is the other thing I have taken away from you that I have to tell you, thank you. We used to measure everything. And everything was so precise. And and you say it still wouldn't be correct. Right? Right. Now it's so much more I don't measure anything anymore. It's all based on like the type of food she's going to eat. Like, how active has she been today? Do I think she's going to eat at all. There's no more measuring. And that's really nice

Scott Benner 1:12:57
for people listening, if you would all just figure out what Lisa's figured out, I could stop doing this podcast, and I would get a lot of my free time back. So everybody, please, whatever she did do it.

Lisa Poole 1:13:08
It's nice to not be so compulsive and, and anal about measuring every single like gram of food,

Scott Benner 1:13:15
hard enough time

Lisa Poole 1:13:16
measure, and then she's not gonna eat it all anyways, or maybe she's going to want more and what did you know, like, especially the five year old, you don't know how much they're going to eat, like, you know, start with a certain amount add more if they eat more, yep, you know, used to be like, I kind of panic if she wanted extras. And like, just you got to be able to roll with it. And having the right tools is, is huge. And being able to do that, you know, being able to just add a little extra insulin or increase the bazel or decrease it. Like if you didn't eat all of our food. It doesn't need to be like a panicky moment.

Scott Benner 1:13:50
I hope that it makes you feel better that the reason I was able to pass that on to you is because that used to be my life. Like I was like, I'd measure something and then she would need it and you were measuring back what she didn't need and then like how do I make up for this? And it's all just nonsense. But yeah, that is really

Lisa Poole 1:14:07
like I measured that out precisely you need to finish

Scott Benner 1:14:10
Yeah, and it didn't work anyway, right? Yeah, it's so I started my talk this weekend by looking out at a really nice group of people. I do have a full room which I was by the way for anyone who was there thank you because I saw some people speak to empty rooms and that's a horror I would not want but but so I started out by saying it's this type one diabetes thing. It's all about understanding the insulin it's all about timing and understanding the insulin once you've got that the rest of it just falls into place. And I'm just really thrilled that it worked out this way for you and

Lisa Poole 1:14:43
and not being scared to experiment and and try it don't look at it as a failure but you know as a stepping stone to doing better next time.

Scott Benner 1:14:51
I'm totally grateful for you coming on and saying this I I hope people understand that I do so little interaction with people who even want to come on the podcast that all I know Like Lisa told me, she's like, I want to talk about life after low carb. And I was like, cool, that'll be good. I genuinely didn't know she was gonna say that the podcast helped her with it. You probably don't believe that, but it's true. And, um, I just thought it was interesting to hear from somebody who ate low carb and then didn't. But this is

Lisa Poole 1:15:18
why I'm pretty sure we've officially been banned from any low carb. So we hadn't group that we had not been banned from before. But

Scott Benner 1:15:24
I have a Facebook group. You can come on, Lisa, it's fine.

Lisa Poole 1:15:28
All right. We have we have our own page. We have plenty of friends.

Unknown Speaker 1:15:33
You'll be okay.

Unknown Speaker 1:15:34
Yeah, we'll be fine. Well,

Scott Benner 1:15:36
thank you so much for doing this. I really appreciate you staying on extra time. I appreciate that.

Lisa Poole 1:15:40
Thank you so much for having me. It's fun.

Scott Benner 1:15:43
Cool. I couldn't agree more. I'm always grateful when someone comes on and shares their story so completely and honestly, Lisa definitely did that today. I want to shout out to Juniper Hey, Junebug, what's up, kid. Thanks for letting your mom come on the podcast. Thank you so much to Dexcom and on the pod for sponsoring the show, my omnipod.com forward slash juice box dexcom.com forward slash juice box with the links at Juicebox podcast.com. Where your show notes and you know what i'm on Instagram to Lisa can't have all the Instagram followers. I deserve some to write check me out for the podcast at Juicebox Podcast and for my type one diabetes blog at Arden's day. But you can also check out what Lisa is doing to and everything that junipers up to. She does a lot of cool stuff for a little kid. I put a link in the show notes for their Instagram T one Junebug. Thank you for listening to the podcast. Thank you for sharing the podcast. Thank you for rating the podcast. Thank you for being a part of the podcast by helping to build the community that the podcast thrives on. I'll be back next week with another episode.

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#166 Patti Makes Me Happy

Patti struggled for decades before finding her T1D groove...

Patti's story is inspirational!

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

Scott Benner 0:00
Hello, welcome to Episode 166 of the Juicebox Podcast. Today's episode is sponsored by Omni pod index calm. As always, you can learn more about the Omni pod at my Omni pod.com forward slash juicebox, or the links in your show notes were at Juicebox podcast.com. And the same goes for Dexcom. Except they spell it a little differently dexcom.com Ford slash juice box and those links in the same places. I got this really wonderful note last year from Patty. She told me a little bit about her diagnosis story and the anger she'd carried for a very long time about her diabetes. She actually said that she was not a very good keeper of her diabetes.

sometime last year after finding out that her agency went up, Patty decided to try to do something about it. She'll tell you more in the episode, but eventually she found this podcast. And a little while later she sent me this incredible note that I'm looking at right now. Well, you know, I had to ask her to come on to tell the story because it was just really special. I want you to know two things about this episode. One Patty's a little soft spoken. So listen closely. And to nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making changes to your health care plan. Hey, guys, listen, I was hoping to have my Dexcom g six review for you this week. But Arden has been feeling a little under the weather, her blood pressure has actually been kind of low. And we're in the middle of trying to figure out why that is. So I'm a little behind. So if you can be patient. I'll get to it as soon as I can. I really like it. I think it's very worth upgrading. But I'll get back to you with some more details as soon as possible. For now,

Unknown Speaker 1:50
this is Patti.

Patti 1:53
Okay, my name is Sadie. And I've been a type one diabetic since 1993. I am a registered nurse, and I take care of the geriatric population. And I have a very spoiled cat that wants to kill me on a regular basis.

Scott Benner 2:13
You're very good at this Patty. Excellent. So Oh, and just as we get going, my daughter wants to do our Bolus for lunch. So hold on one second.

Unknown Speaker 2:22
We're gonna Bolus try to remember what was in that lunch box. Let's just call it 10 units

Unknown Speaker 2:31
and

Unknown Speaker 2:35
extend 60% now and the rest over a half hour.

Scott Benner 2:46
And she's back on our way. Hopefully she'll just say, okay, go away. And

Unknown Speaker 2:54
let's see. Come on. She's read it.

Scott Benner 3:03
Okay, so 1993 Sorry about that. 1993 How old were you in 1993 1111 years old? I want you I told you before we started recording, every podcast, I've almost every quarter I say to somebody go ahead, introduce yourself. I'll ask you a question. And we'll get going. And I never know what I'm going to say. Which is I don't know what kind of a truth that is about the podcast. But nevertheless, I don't I don't pre plan it. But for you, but for you. I know my first question. Okay. Okay. Back in 1993 when you were 11 years old. Tell me why you got in the bathtub at two o'clock in the morning.

Patti 3:47
I thought somehow that would help with how thirsty I was. Um, I don't think I was actually thinking very straight at that time. But I figured why not put on a swimsuit and goggles and go for a swim in the bathtub. And now maybe I thought I was asked Moses it would like, help me feel less be hydrated. But

Scott Benner 4:15
so you were looking for any way at all to feel hydrated at that point. Yeah, yeah. And, and even at 11 which, by the way is old enough to recognize that swimming in the bathtub, too in the morning is odd. So so it's not like you were six and you're just like, you know what might work? So you you climb into the bathtub. I think the first obvious question we don't really need the answer to is did that in any way quench your thirst? No, they did not. And who found you in the bathtub?

Patti 4:45
Um, my brother did How old was he then? He's about probably maybe 17

Scott Benner 4:58
years so he was a number of years older than you without Yeah, okay. Brother finds you in the bathtub. I'm assuming he gets your parents.

Patti 5:05
Yeah, he says, you know, this is kind of weird. Maybe you should check this out.

Scott Benner 5:15
You have the best diagnosis. Sorry. So

Unknown Speaker 5:18
so

Scott Benner 5:19
you're in the bathtub you did have goggles. That's not just hyperbole. You were actually had goggles with you

Patti 5:24
I bottles I was on is all about women.

Unknown Speaker 5:28
Oh my god.

Scott Benner 5:30
Okay so your your goggle up here and your swimming suit, you're in the, in the bathtub, your brother finds you, he goes and gets your parents, your parents, I'm assuming look at each other quietly and think, oh god, this one's nuts. But then ask it but then ask you what's wrong? And what did you tell them? Do you remember?

Patti 5:46
Well, um, I think I was pretty honest with them. I just said I felt like swimming in the bathtub. Um, and I really didn't see a problem with it. Although at that time, I was also starting to hit the cosmos. respirations which I think was freaking them out more than the fact that I was in the bathtub with a swimsuit. Yeah.

Scott Benner 6:11
And so you're panting it's obvious that point.

Patti 6:15
Yeah.

Scott Benner 6:16
Okay, so they they take you to the they probably took you to the hospital, by the way to abandon you there. But then when they found out you had diabetes, they're like, Oh, that's okay. Well hang out with other. Can we take her to a fire station? Is she too old? She'll find her way home again, like what do we do? Right? But but so so you said in your note that an hour later you were you were pretty much being diagnosed with Type One Diabetes?

Patti 6:38
Yeah. Yep. All right, took him to the ER. And the doctor, I guess took one look at me and said, Oh, my gosh, she's diabetic.

Scott Benner 6:50
Wow. Well, that. So now that person knew what they were talking about that that's you don't hear that very often. You don't hear a lot of people going in and just getting the answer right away. Which is, okay, so, but you were pretty far along at that point, because you probably didn't end up in the bathtub purely out of like an 11 year old flight of fancy you were probably your blood sugar was pretty high, you probably weren't thinking very clearly.

Patti 7:14
Right? It was a gradual build up. I had totally forgotten about this. But my mom had reminded me that when I was in fifth grade, I was the only fifth grader that demands of a water bottle on my desk, because I was so thirsty all the time. Yeah.

Scott Benner 7:32
How long did that go on? For? You know?

Patti 7:35
I, it felt like it was a week. And when she had reminded me, then I remembered that Yeah, yeah, actually, I did have a water bottle. Yeah.

Scott Benner 7:46
And that's going back even. I mean, 93. Let's do Matt, why don't we do 2003, then another 10 would be 2013 and 2017. Down to those 14 that's took 24 years ago. So I know, you're impressed with my math, Patti, but just try not to try not to, you know, get?

Patti 8:05
I'm not.

Scott Benner 8:07
So it's quite some time ago. Did you? What kind of tools did they give you in the hospital to try to cope with the type on?

Patti 8:19
To be honest, I really don't. They gave me that many. They really didn't explain what they were doing. I do remember, at one point, I had he on a keto strip. And the reading was large. And I looked at this person, I don't know whether they were a nurse or not. And I just said, well, is that good? Or Ill? What does that mean? And? And she kind of gave me sort of? Well, not really, but it didn't really explain why I was doing it. And also, they were testing my blood frequently, and they weren't explaining to me what was going on really, or why they were doing it. And they weren't explaining to my Mom, why they were doing it. And so my mom was starting to get very angry because of the lack of communication. Um, you know, why they were doing?

Scott Benner 9:18
So they were just sort of handling you but not taking any time at all to explain what was happening, why it was happening or anything like that.

Patti 9:25
Yeah. Okay.

Scott Benner 9:29
So you get out of the hospital, that experience you said, within your note that that experience did not sit well with you, and it stuck with you for a really long time. So let me ask you a couple questions like when so when you got out? Did you feel like did you feel like you knew what you wanted to do what you were doing? Did anyone eventually explain to you did anyone eventually explain it to your mom or you just like, Did they give you the old here's your insulin. Here's your needles. Good luck. What did you get?

Patti 9:59
Well Prior to diagnosed I had been a physician assistant. And obviously, I wasn't going to go see them anymore. And they had me go to it trician that specialized in diabetes, a pediatric endocrinologist. And I remember going to, I'm not sure if you want to call them like classes. It was just me though. And I remember they told my mom to have me go, like, run around the playground and letter. What it's like to have low blood sugar before I go back to school, so, um, yeah, they had me fat. So the

Scott Benner 10:50
two so this class told you to get your blood sugar low before going back to school. So you'd know what it felt like when your blood sugar was low?

Unknown Speaker 10:57
Yeah. Ironically, that's

Scott Benner 10:59
not the craziest advice I've ever heard for 23 years ago. It's not good advice. But it's not. It's not the worst actually. It just sounds like there were people sitting in a lunchroom somewhere going, what can we tell these kids? And, you know, and so, but you went into that class without a parent just by yourself.

Patti 11:17
Um, I think my, my mom might have been in there too. But I don't really remember her. Like being in the same area that I was, or if she just sat in the waiting room. I remember, a played this. It was, I don't know what kind of game it was. But they had me play this game where you had to go through the city, and you had to avoid the sugary foods. And then you had to eat the good foods. And I just remember these bizarre looking bananas that were walking down the street. And if you run into them, something would happen to your blood sugar or something like that.

Scott Benner 11:55
Oh, yeah, that sounds exactly like diabetes, you bump into a banana and everything goes wrong. And I'm sorry, your hospital was on Mars. Where was this?

Unknown Speaker 12:08
Yeah. Okay.

Scott Benner 12:10
Okay, so, um, so, how did this initial experience strike you? What I mean, were you left, obviously, at scale, a leading question that we all pretty much know the answer to, but were you invigorated and excited to take care of your type one diabetes? Or what were the first No, no.

Unknown Speaker 12:30
So much.

Unknown Speaker 12:33
Ah, yeah. So

Scott Benner 12:34
kind of tell me a little bit about those first years and how they hit you sort of emotionally and then that side of it?

Patti 12:41
Um, well, I, I was obviously very angry. Um, I'm not sure exactly if I was more angry at being diagnosed so late, or if I was just angry at diabetes in general. I also knew that I was depressed. And I was trying to convey that message to F. And my parents and nobody seemed to really be getting the picture that Yeah, you know, maybe it would have been good to talk to somebody about my experience in the hospital. As I listen to a lot of diagnosis stories, and I mean, I don't hear too many where the doctors telling you that your blood sugar was 1300 and 76. And you know, you're in you were in cardiovascular shock. And I, if I had just slept it off, like the physician assistant told my mom to do, I wouldn't have been around.

Scott Benner 13:54
Patti 1300 and 76 was your blood sugar.

Patti 13:57
Yeah, and I know, I shouldn't be proud of that. But sometimes, like when I tell people diagnosis story at my desk, and I have the highest reading at the hospital. Well,

Scott Benner 14:05
yeah, I mean, I think that listen, the highest aside, it sounds like you were the closest to being dead that you could have been and you're back from it. You know what I mean? Like, that's the that's a heck of a triumph in there. I don't think you had much more time. Like you don't mean like that. Like you said, You didn't really bring it up here but you talked about the note and we're probably confused as to things but that you did go to a doctor prior to the to going swimming in the bathtub. And and they told you like flu like symptoms, go home, sleep it off that kind of thing. Yeah, yeah. Yeah. Well, you're looking at me here.

Patti 14:40
Really. Factor says that. If I had done that, I would have died that night. And they, when I had interviewed the emergency physician who saved my life, in 2015. He was saying that they were very Worried that I wasn't going to make it, I was fair that they were struggling to get been access because I was so dehydrated. And

Scott Benner 15:12
she said, You went back. You went back to talk to that doctor a couple years ago.

Patti 15:17
Yeah, I did. As I, I really struggled. Except I diabetes. And I've been working with a therapist, Mike who's kind of like a cheerleader. So

Scott Benner 15:34
I can't, I gotta be honest with you. If someone would walk around behind me like doing like little like, Sis, boom, bah stuff during the day, I think it would be here.

Unknown Speaker 15:42
I really want good blood sugar. No, forget that.

Scott Benner 15:46
You can make it to the car, you'll go grocery shopping, you won't cry while you're there. Like stuff like that. But But okay, so you see. So this is, I think the interesting part and where we're really going to talk, which is that you're talking about in 2015, you're still you're still digging away and digging away trying to figure out how to deal with this in your life. Because in all honesty for 20 years, you just you by your own admission, you haven't been doing very well. Is that is that right?

Patti 16:17
Or right?

Scott Benner 16:20
This is the depression? Did it stick with you? Or did you find a way through that earlier? Or would you have considered yourself still depressed about in the recent years,

Patti 16:29
ah, still depressed. It was especially bad in middle school was, you know, the addition to hormones and everything else. And I just never really got over that initial experience of being in that in the intensive care unit and waking up with a IV in my left arm and, you know, I, I'd be upset because my parents would have to go home at the end of the night. Because back then, you know, the parents aren't allowed to sleep overnight with their kids. So, you know, it's like, left in the weight room. You know,

Scott Benner 17:11
it was a real trial. It was a it was a serious trauma for you know, Can Can I ask you, did you have any? Did you have any depression prior to the diabetes that you're aware of?

Patti 17:21
Not that I'm aware of. Okay.

Scott Benner 17:24
Okay, so your diagnosis, you know, for a number of really good reasons was was really impactful on you in ways that didn't lead you into exciting times, we'll say. And so for for literally 20 some years, you've been battling with that place that it put you in? Have you had Are you in that time? Are you diligently working towards your diabetes and not having success? Or are you having success? Are you not? Are you not wait, you know, considered? You know, does your doctor feel like you're doing a good so hard to talk around? Because I know some people don't like to hear the words good job and compliance and management, all that stuff. But let's just save it for the, you know, I'm not judging you. But for the for the terms of the conversation. Would you consider yourself someone who spends time every day keeping their blood sugar and range? Or was that not working for you just wasn't going down? How's your day? Like, I

Patti 18:27
guess? I was probably probably the most non compliant diabetic in the state of Michigan, probably.

Scott Benner 18:36
And what does that look like day to day?

Patti 18:39
Um, well, you know, in middle school, I would, I would make up numbers. You know, what, when I was testing my blood, eyelid Of course, the AMC always paid me into a big fiver. But I would also know, I was also on injections up until 2005 when I stopped my first insulin pump. So

Scott Benner 19:15
it doesn't, you know, are you are you injecting? You were injecting for a dozen years then. Yeah. Okay. And so basically, whenever you tested and the number came up, we were just like, it's perfect. And then you rattle off some number that you thought was great if someone asks you, and did your mom just accept that as you know, would you Oh, no, no. So how did they?

Patti 19:38
Well, I'm in the early years, it was kind of like, the diabetes. Um, you know, they didn't want me to go to sleep overs right away because they're worried about my blood sugar going well. You know, I couldn't go to that guy. I played violin. I wanted to go to Interlachen and like, Well, no, you need to go to diabetes camp first. And I was getting very resentful or angry at them because I felt like, you know, all this, as I'm diabetic and one memory sticks out was when I was in for age, and it must have been some like Christmas party or something. And I remember they were like, all these like, desserts and everything on the table. And then my mom's like, and here's some sugar free cookies and

Scott Benner 20:40
sugar free cookies. Those two words don't go together. Have some tasty kale. Right? Yeah, yeah. Right. So it just, I mean, you got the full like snowstorm of diabetes, like it just every time you turn it around, nothing was going your way, basically,

Patti 21:03
pretty much. And I was also I'm still in denial. Like, I, I figured, well, hey, if I just ignore it, it'll go away or, and that will help me be more quote, normal, unquote. But of course, if that doesn't work,

Scott Benner 21:27
don't worry. Well, we'll read a story in six weeks and on in some raggy newspaper somewhere that ignoring diabetes is the way to take care of it. So yeah, so I mean, obviously, it's a childish thought. But it's also a thought that, you know, comes to people when they're not children, if they're have, they've been so overwhelmed by something that they just can't imagine a pathway out of it, right, you just sort of, you don't want to give up, you don't want to say to yourself, I give up. So you go look, you know, and I bet you this will just be okay, if you know, I don't you know, and you get that feeling in your head, like, like doing nothing is doing something almost.

Patti 22:02
And I was also a very teenager, I'm sure my mom would have sold me to the gypsies if she could have. Um, you know, so I, I remember, I would think I was very rebellious, because I would have like a liter of regular coke in my closet. They're like, Okay, I'm gonna drink this, and not really care what it does to my blood sugar.

Scott Benner 22:31
And that was in high school.

Unknown Speaker 22:32
So that was in middle school in middle school. How

Scott Benner 22:35
did High School go? Did you find any clarity there as you got older and you matured more? Or did it just go on a little more of the same? You know,

Patti 22:43
I think with the dip pression got worse. And I really found it hard to relate to other people. I think there were maybe two or three other diabetics in the whole school system. But I never really acted with them. There was one person that I started to get better once they started later on in high school, and then in college. But I've I haven't talked in a way that I could somewhat relate to But yeah, I was just, I, I feel like, part of it was like, as my being depressed, my depression wasn't addressed, that it made just everything else. 10 times worse. No, I

Scott Benner 23:42
mean, that that makes a lot. I don't, I don't feel like I've ever been depressed in my life. But that does make a lot of sense. You know, I mean, if you think about what depression is, and how it can affect you, and then having it on top of something like that type one, just you know, geez, that's magnified a million times. Constantly all day long, right. I mean, that's had to have been what it felt like is that all day long, everything was sort of conspiring against you to make life difficult, I guess.

Unknown Speaker 24:10
Yeah, yeah.

Scott Benner 24:10
Yeah. And then and how do you fight back with it? You don't have the right you're diagnosed 23 years ago, you're not given great tools. The technology really wasn't there to help you. Your mom wasn't, you know, you know, your mom didn't. It's not like she had a firm handle on it. You just weren't listening to her. Right, like so. Everybody was a little overwhelmed by it one way or another. So I'm stunned, amazed and sort of I don't know I found myself feeling proud for you. Like I don't know how you got through high school like you graduated high school and went to college. Oh, yeah. Seriously, it's a it's a heck of an accomplishment when you're battling against all those things. And but you did you went to college. It was college. I don't I don't want to belabor the point. But was college more of the same or did you find a lighter college?

Patti 24:56
Um, were the same.

Scott Benner 25:01
How do you keep going? Like you have the Constitution of a bowl? Seriously, right? Like your blood sugar's all over the place, you're depressed. And you've still go to school graduate, go to college graduate, you're an RN,

Patti 25:17
I yeah, I am, I originally went to school for composition to experience, I have a bachelor's in music. But then when I realized that I couldn't get a job with health benefits, I decided I need to find a career that would kind of help with that. So my got interested in nursing and gradually tested the waters and found that I really liked doing it and but

Scott Benner 25:48
so you hold two degrees that you got while you were depressed with Type One Diabetes that was out of control. Seriously, Patty, without the depression and the diabetes, you'd be an astronaut. And I'm like getting

Patti 26:03
horrible at math.

Scott Benner 26:07
I'm sure the people who you're getting medicine for feel good about hearing you say that. So I don't know, one to four of these, whatever. But but

Unknown Speaker 26:21
but but so,

Scott Benner 26:23
you know, you're the first person that, you know, I get I get a number of, you know, I get a number of emails, people thanking me for the podcast. And some of them I'm just I'm always just like, wow, like, thank you. That's really great. And each one of them makes me honestly very emotional and, and happy. And but yours. I was just like, you have to come on the podcast and tell people this like you. Because you really were just sending me a thank you note, you told me a little bit about your background, and said thank you. And that's sort of the the reason I wanted to have you on this because this right not that your story is not fascinating, not that I wouldn't just sit here for an hour and talking about you swimming when you were 11 years old in your bathtub, because I'm delighted by that. But but because but because I'm forever trying to get across the people that no matter where diabetes has sort of stuck you in your life and no matter how you're struggling, that I do think there are simple pathways to feeling better, doing better, being more healthy. And in the end, it's just me saying it. I think that people who aren't depressed who aren't overburdened by it, hear that and go Oh, that sounds hopeful to me. But I'm also aware that it could sound to other people like bs like oh, yeah, sure. That's not for me. My life doesn't go that way. That's that's your good luck. You know, you were lucky with diabetes the way you hit you the way it struck you the way you understand it the way you know the tools you have whatever it ends up being. But that's not my reality is that is how I feel like it can be seen by some. But your reality is and let's be honest, Patti about as terrible as possible. And so I appreciate that you're laughing. And and yet, tell me tell everybody what you told me at the end of the email. The new dexcom CGM is here the G six has arrived. You can always know your glucose numbers and where they're headed with the dexcom g six continuous glucose monitoring system. By the way, it's now FDA permitted for making diabetes treatment decisions without finger sticks or calibrations. Guys, listen, I gotta tell you, I am working my butt off here on this ad. And I'm just in the worst mood been worried about Arden. Listen, let's just be honest, for a second, no big voices or anything else. If you were a dexcom continuous glucose monitor, you're going to be able to see where your blood sugar is going how fast it's getting there, you're going to be able to make treatment decisions before you run into problems. The new g six has a predictive level alert can actually tell you that in 20 minutes, it expects you to be 55 that gives you so much time to do something with a blood sugar that's like in the 70s you can set your high threshold line like ours is at 130. So that as soon as you bump up over that number, you can make some adjustments to keep you from getting any higher. So when Dexcom will tell you on their website like you know a one see reductions historically, they'll say like historic results here I'm going to read the historic results based on Dexcom G 4g five systems, a one c reduction. The dexcom CGM is proven to lower a one C and reduce hypoglycemic events. That's what their historical data tells them. What I'm going to tell you is, is that when you know your blood sugar is going up and you do something about it, it doesn't go up. And that's what lower Sherry one say. We talked about it here all the time. You guys know what to do. I just I don't have the energy today to be like, hey, by Dexcom but please look into it. You'll be really happy you did. And I'll be happy if you use my link dexcom.com forward slash juice box with the links in your show notes or Juicebox podcast.com tell everybody what you told me at the end of the email

Patti 30:07
well, that I listen to your podcasts, and your, your Outlook, and the suggestions that you gave, I feel like I got more out of that than any endocrinologist that I've ever been into. And that really is the honest truth. I've, I've been really listening to your podcast pretty much every day. And each one I take a little bit from and I can relate to, and especially the one fold with insulin, I think that had the biggest impact on me. Because I've, I've never been fond of the idea of low blood sugar. And so on purpose, I've kept my blood sugar higher than it should be. Just so I don't have to feel low blood sugar. So it's, you know, it's really made an impact on me and, and I haven't always been good about wearing my dexcom sensor. And I've been wearing it now for about two to three weeks. And what I do is a I've been doing a screen capture of like my breath for 12 hours, 24 hours. And I send it to Mike. You chillier. Yeah, my cheerleader. Yeah. And. And when I gradually started sending these ones, where my mind was, like, being steady at 100. And he emailed me back and he's like, Who are you? And what did you do with Patty's?

Scott Benner 32:08
Well, Patti, I want to tell you that I got your email later at night, my wife and I were in bed kind of, you know, at the end of a day, and I read it in bed, and she looked at me and said, Are you crying? And I was like, the whole night crying. I was crying. tears coming out of my eyes. And and she said, Why are you upset? I said, I'm not upset. I'm really happy and and she said Why? And I told her I'm like, I can't even let you read this again. Like, I can't read this twice tonight. Like if I read this twice, I'm gonna I'm gonna fall apart. I was so thrilled for you. And it seriously just really pleased for you. You know what I mean? And, and I did, she did. My wife did wrestle my iPad from me. And she read it. And then she even said something nice to me. And we've been married for over 20 years. And that never happens, Patty. So you got my wife to say something nice to me. You're apparently my cheerleader. By the way. Thank you very much. And, and but but moreover, I can't believe I'm almost gonna I'm almost gonna just be crappy to myself. It's a podcast. It's just like a silly podcast. And and but it really struck you right? So I think that what I'd love to understand what I'd love for other people to hear and I don't know the answer to this question is, what about this turned you because you are a person who in case it hasn't been clear to people, up until a couple of months ago, your entire 23 years with diabetes has been just as you explained your middle school, your diagnosis, your high school, your college, your adult life, it has been a burden and full of depression and not really trying to take care of yourself in a way that you were you even wanted to. And so I just think whatever came out, whatever you got out of this. I want to know what it was like I want to know how it struck you like what what is it that? I mean? How I'm at a loss, honestly.

Patti 34:15
Well, um, you know, I gotta make a disclaimer that happy pills and therapy every week also help.

Unknown Speaker 34:22
Oh, fine. So

Scott Benner 34:23
I've done nothing. I've right away. Patty's here to tell everybody that if you're depressed, take Zoloft or something and and and go to therapy and then a podcast. So the podcast is useless said Go ahead. Okay, so how long have you been? How long have you been using? I'm using you're using like SSRIs or something like that.

Patti 34:47
Um, I was. But now I'm on. I'm kind of a combination. I've got Wellbutrin and Adderall imboca and look,

Scott Benner 35:04
I think one of those makes your hair grow. I'm not sure. I watch a lot of commercials where they say things about Cymbalta. But I'm just kidding, I don't know. I have no idea. But okay, so you've you found a therapist who sort of gotten you into cocktails, it's, that's a better way. Well,

Patti 35:23
it doesn't prescribe any medications, psychologists, but I do have a nurse practitioner that I also work with. And she prescribed monitors and medications for that. But one reason that Mike has been very effective for me is that I can't bs him, like I have with other therapists. Like, it's not possible, like he totally knows, but I'm being a big favor. So please, I kinda need somebody to kind of call you out. Right? Call me out on that. And, and it definitely has not been easy to discuss. And I'm, can be very good at deflecting the diabetes topic and finding other things to distract with. But luckily, he's very patient with me,

Scott Benner 36:23
keeping you on so so. So I guess the first step was finding someone who would be a strong, you know, ally, and at the same time, somebody who would call you out if you tried to deviate away from the conversation. And that that's been very valuable to you. At the same time, you've addressed the depression with medication, which is also been valuable, I think, and did that. Do you think those two things together made you? Did you did you suddenly wake up one day and think, wow, I want to I want to take better care of myself?

Patti 36:54
No, no, I'm actually was a recent visit to the endocrinologist, um, I, anyone see had gone from 9.1 to 9.4. And, you know, when I found your podcast, this was after my appointment, and I wasn't being totally serious with myself. At first, I'm like, well, maybe I'll just go and see if there any podcasts about diabetes. And, you know, just check it out. I wasn't really expecting to change my outlook very much. But the more I listened to your podcast, the more things started to click with me and make more sense. Especially, like, for example, the Dexcom settings, and, you know, your high limit and your low limit, and it made total sense for me to think Well, okay, why would you set your Dexcom to 250, and then get a warning, because by that time, you're super high, and it takes forever to get back down. And just by, so I decided, Okay, I'm gonna adjust that. And I was starting to notice results, and I started adjusting it even more. And I think by getting that immediate, back, of being in it, trying to do like, micro boluses, and pumping down high blood sugars, being able to see that right away, it really made a difference for me, that podcast where you were talking about that, and it really kind of opened my eyes like, Okay, this doesn't have to be like this. And, I mean, just just the way you talk on podcasts, and, and you have a good sense of humor, and, and you always seem he always mentioned, you know, it's not going to always be perfect all the time. There's no such thing is that diabetes land. But you I like how you say to, you know, take what data you have, and try to figure out how that happened and how to make it better for the next time. And just being able to put that into my technology and seeing those results, because I think one of the tricky things with diabetes is everybody tells you about complications and how, oh yeah, you're gonna lose your foot and an eyeball and maybe throw a third arm or something if you don't take care of your diabetes, but you don't see any of that right. away. And, and so you're not getting instant feedback as to what's going on, whereas wearing my CGM and trying these techniques out, I'm seeing Well, yeah, it is possible that I can get it in the range. That is where it's supposed to be. And yeah, I am going to have bikes and stuff, where I need to figure out what happened or if I didn't do the Bolus, right, but it's not the end of the world. And I, you know, I, I know, prior to this, I really define blood sugars as either good or bad. And, and I realized, well, if I keep doing that, you know, I'm just gonna have bad blood tears all the time, and then I'm not gonna feel good about myself. So I'm trying to look at it more from just, it's a number. And I have this goal, and I'm trying out these techniques. It just, the more I realized it was possible to do that, the more I felt, kind of inspired to and motivated to do what you're doing. And I'm trying your best to pick up blood glucose glucoses table as you can. On a daily basis.

Scott Benner 41:38
Well, Patti, I think what you've just said is that I'm delightful. And thank you, I heard you, not just joking you, because you've made me uncomfortable and being so kind to but, but it was, it was I just I just like listening to you talk just now because it, it made me It made me feel lucky, that the things that we talked about here occurred to me, you know, because I just simply could have been, you know, what I mean, I just as easily could have been a person who didn't get a good lead in and didn't have somebody with me to kind of spur me on and, and, you know, it could have been, you know, I mean, you were getting this feedback, your whole life, but you couldn't process it, and nobody was there to help you process it. And you've ended up just making me feel very fortunate. And, and then I'm glad that whatever has happened to me, and my daughter, and whatever has kind of transpired in our lives and stuck to us as as you know, kind of the ways we do things. I'm so glad that it got back to you and that it found you Yeah, I just I'm really pleased for you. And and I'm excited that you're on a new path because this is a very new path for you at the moment and and just to hear you talk about not you know, to bumping and nudging align around and and and wanting to know when your blood sugar's heading up not being told an hour later after it's already 250 you know, that stuff just makes me like I feel like I'm glowing inside. I'm so happy for you, you know? I'm thrilled. I really am I'm saying nothing of value right now because you were so kind just now and that I can't think which doesn't happen very often here so you kind of shut me up Patty podcast if I get this seriously I'm I'm genuinely thrilled for you. So I guess let's talk you know in the time we have left let's let's talk about like some real like nuts and bolts stuff. So you are you Pre-Bolus savvy podcast listeners heard this ad coming a mile away. Guys, I'm in the same mood as I was when I did the Dexcom ad. I will tell you this Arden's blood pressure has been low for a few days, and there's a lot of stuff going on around here, and we're trying to figure things out. Now, a secondary issue on top of diabetes she would think would be overwhelming, but I really have not found that to be the case. Earlier I spoke about the Dexcom. Now I'm gonna tell you about the Omni pod, two percents on pump. These tools make Arden's management so simple is the right word, that I don't feel overwhelmed by diabetes. And when something else in life comes up, it's not like something's piling on top of something else. Arden's having an issue right now we're gonna figure it out. But it's not like I'm being inundated from all sides. And I really believe that her care that our management which is driven by on the pod, and the decisions we can make about her insulin and the delivery system we have for her insulin. It just makes everything more manageable, simpler. And so when something else in life like this comes And I'm all bummed out right now, because I'm trying to figure something out that I don't have my head wrapped around just yet. I'm not also thinking about IVs. And maybe that's the greatest thing I can say about on the pot, is it it really does make your life simpler, a little less diabetes a little more. The other stuff, links in the show notes, links at Juicebox podcast.com, or my omnipod.com Ford slash juicebox. Find out more today, on the pod sends you on a free demo pod, you'll really be able to get a feel for it from that there's no obligation and it's absolutely free. So give it a shot. I've just talked right past the music don't even care. Here's what I do care about. I did spend the other day editing this episode with Patti, she's a real treasure, by I really hope you're enjoying this the way I am. Here she is again, we're gonna ask her if she's Pre-Bolus thing and some of the nuts and bolts stuff that she does around her day to day diabetes,

Patti 45:54
I'm trying to definitely at breakfast I am on lunch, I'm a little bit forward areas because of the job that I work at. It's there's so a crisis that happens at like 11 2019. And if I Bolus, my lunch is probably not gonna be a good idea for me. I have tried it a little bit. But I'm still kind of working out the kinks and trying to avoid low blood sugars, although that's another thing that I've tried to be more vocal about my diabetes at my workplace. And I have some very, very supportive co workers, fellow nurses and seniors who understand what I'm trying to do, and I've used the Dexcom share app. And so if I go low, then I have a few nurses that get notifications. And I also shared it with my mom too. So you know, I'll get a text or they'll come out of their office and be like, are you eating something?

Scott Benner 47:15
Yeah, you have a lot of cheerleaders. And that's amazing.

Patti 47:20
And, yeah, and so it just kind of makes me feel more comfortable to you have that support. And, and they really have asked and looking out for me and I've explained what I've been trying to do as far as getting my blood sugar's under better control.

Scott Benner 47:41
And, you know, sometimes when if I, I know sometimes when I get low blood sugar, I get kind of crabby. And some, sometimes my females will be like, you need to go test your blood, you're getting crabby. So it's it's amazing that the feature on the Dexcom allows you to have have that option with people to just sort of be able to see it in case you don't see it. And to be able to just show their support for you, it's even more fascinating that you knowing that they have the option to see it is making you more comfortable and more kind of bold with your own care. That's so so in the past, you've just felt like if I should take too much insulin here, I'm on my own, and I'm going down. And pretty much Yeah, yeah. Wow. Yeah,

Patti 48:26
I haven't really been vocal about my diabetes and what I'm trying to do. Also, sometimes I'll post a graph on like, a five hour span of my graph on Facebook, kind of make myself also accountable and say, okay, you know, last night was a good night and babies planned or are starting out a little bit rough today, but in my coworkers will also ask, you know, how, how is your blood sugar doing? But your

Scott Benner 49:05
community then? Really?

Patti 49:07
Yeah, and it helps if you work in health care, because they

Unknown Speaker 49:11
understand a little better.

Patti 49:12
They understand it a little bit better, although they're still you know, some individuals who sure have old ways of thinking about diabetes, but we

Scott Benner 49:21
think you ate too much candy when you were 11. And

Patti 49:27
or they mix up all you need to take more insulin if your blood sugar's low and know you don't want to do that.

Scott Benner 49:34
I know somebody like that, that just can't get it straight. Always bringing the wrong thing at the wrong time. Your low. Here's your pump. Your high have this soda. No. Okay, keep that straight. But, but wow, petits you've had a complete and utter turnaround in your life in the last few months. Are you thrilled Are you excited? Like how does how do you feel hopeful? Like, where are you at?

Patti 50:04
I feel hopeful. I've also noticed that I, I physically feel better course. I'm not as tired as much. I'm not having to bathroom as much. I'm also I know that blood sugar mix definitely affects my mood. And so that's always been an eye has also helped with my mood and keeping that good arm or, you know, reasonable and reasonable.

Scott Benner 50:41
I hope people appreciate that when you said that sometimes when your blood sugar is low, you can get crappy that I did not make any kind of a SpongeBob SquarePants reference at all and call your crappy Patty.

Patti 50:52
Do it all the time at work? Yeah, well.

Scott Benner 50:58
God, Patti, I don't even know what you've really just I'm so thrilled listening to what you're saying that I've now become a listener to the podcast that I'm not hosting it anymore. And I apologize to everybody for that. But I but I hope you can understand I just It's never happened before I just listening to you talk about about what start, you know where you were? And how and I guess maybe it's not even where you are right? As much as it is for how long you were there? And then, because I mean, I'm guessing but 23 years into it. I don't imagine you thought this was ever getting better.

Patti 51:35
No, I can, um, I had a pretty grim outlook. And I would always get frustrated myself. Because, you know, I would tell my things like, well, if I can go to nursing school and survive nursing, why can't I take care of my blood sugar? Like, you know, why? Why can I do one area of my life, but it seems like, you know, the diabetes is always an epic fail.

Scott Benner 52:02
So you even your successes made you feel bad?

Patti 52:06
Yeah, yeah, somewhat, or I would go on these, like, spurts where like, I'd be I'd be really focused on tape, or pouting, or whatever. And, but that would only last like a week and a half or something. And then

Scott Benner 52:24
that's why I don't count carbs.

Unknown Speaker 52:26
It bums me out.

Scott Benner 52:27
So lot of insulin, little bit of insulin that took this much last time, that kind of thing. That Bolus you heard me give Arden at the beginning of a podcast. I didn't. I tried to remember what was an early lunch. And then I was just like, just randomly picked the number of insulin not randomly, but I chose a I chose a bolus and we're What are you and I about? Gosh, we're 15 minutes into this. And I didn't talk about it up front. But Arden's blood sugar was a little stuck today. So it was 140 on our CGM, when she said it was time to Pre-Bolus for for lunch. I gave her 10 units, you know, which is meaningless to other people. It's, you know, obviously, the amount of insulin for the amount of food is different for everybody. But I gave her 10 units with an extended bolus. So I gave her 60% of it or six units right away. And I told the I told her to extend it over a half an hour. So they the remaining four units when and over the next 30 minutes. She didn't stop. She didn't start eating for 15 minutes after the balls probably have to take a drink. I'm sorry. Um, she's 120 now. And she's sort of drifting down. She's done eating, I would imagine and now that I've had time to reconsider there where Brock was in her lunch today was yogurt, broccoli to Oreo cookies, a grab bag of blue Doritos. A half a sandwich with Nutella on it. I want to say there was also watermelon a nice slice of watermelon. A iced tea with no sugar.

Unknown Speaker 54:00
And

Scott Benner 54:05
I don't know if there was something else or not. I think that was probably it. But best guess if I sit here and think about it, the bread probably was, I don't know. 18 carbs. And there was probably what? Eight carbs and atella the chips are probably 20 an hour up to like 40 I know the cookies word another 20. So that's 60 watermelon doesn't seem to touch her. She won't actually eat much of her yogurt. So I don't know maybe another 10 there. And then from there, the broccoli nothing and you know, blah blah blah blah blah. And then a unit or so for their blood sugar that I wanted to come down and 10 but I didn't do any of that math when I was talking to you in the beginning or when she was there just yesterday. It took nine units to bring her the nine and a half To get her at lunch, and she didn't have Oreos, and so I add a little more in some this time. gave her a little more up front I did yesterday. I'm sorry.

Patti 55:09
Oh, one. One thing I'm trying to figure out for me is that my mom makes a lot of homemade things. Take things so well yeah,

Scott Benner 55:22
I understand what you're saying. I just went I did you cut up for a second. I wasn't certain that you said cake things. But I got your homemade cake things. Good thing big cake. I understand Krabby Patty all the sudden, ah, yeah, I'm just

Patti 55:33
so and, and I always have trouble figuring out our content in there. And I saw this. There's this scanner out there where you can scan the food and it figures out the chemical emanation and reflect fight back to it. And then you can figure out how much carbohydrate is in this. And you use the weight of it really figure it out? And it actually is, it has worked out pretty well. You have? I do. Wow.

Scott Benner 56:08
Is it a tricorder? Star Trek reference? I

Unknown Speaker 56:12
don't know how that.

Unknown Speaker 56:15
What's it called?

Patti 56:16
I think it's called. Ah, no, or it's spelled i o si. Oh,

Scott Benner 56:24
look at that. That's amazing. Now I would tell you cut a piece of cake. Give yourself some insulin for it. If it takes more insulin to bring your blood sugar back down next time you have a piece of cake use that amount. Right. But then I wouldn't get a cool laser beam. So you know,

Patti 56:40
if I wanted a dinner date or something, I could take out dinner and

Scott Benner 56:47
you can also see how many cards they are. So what is it? I'm now online, we're now doing the least interesting thing on a podcast. I'm going to Google something so what's it called?

Patti 56:56
Um, it's spelled i O.

Unknown Speaker 57:01
It's about carbs. Let's

Patti 57:06
make an app that goes on your phone and you have to select the category that you're scanning. I'm

Scott Benner 57:18
pulling into question my, my Google foo here. It's not going well. Nutrition guidance si. Oh,

Unknown Speaker 57:28
personal training.

Scott Benner 57:30
All right, you're gonna have to send me a link you have a link that you can share with me.

Unknown Speaker 57:34
Yeah, I don't. I'm telling it right.

Unknown Speaker 57:43
I'm just gonna try to try quarter instead while you're doing that.

Patti 57:46
Oh, it's called diet

Scott Benner 57:50
diet sensor. Which by the way is not as I Oh, hold on the sensor. Diet sensor. Oh,

diet sensor calm. Let's take a look. That's not a laser beam. That's a little bit of a letdown Patty, but Okay, it looks pretty. So personal, nutritional advanced, Hillary. Alright, I'm gonna check it out. I am, why not? Give it a shot. So

Patti 58:17
you just always pretend that there's a laser beam. Oh, don't worry. I

Scott Benner 58:20
will. Though. Don't you worry. Patti. There's gonna be a laser beam when I push the button If I get this thing. I'm gonna check into it. I really I mean, why don't you tell me you put you do it and it tells me how many carbs are in my food. If I know the weight of the thing.

Patti 58:36
Yeah, I can stand up bread and it'll give me the amount for a certain amount of weight but then I put it on sale and I just plug in the number for how much it weighs. And then it gives me the amount of carbs for that and I tested it out on a piece of candy and it was very accurate.

Scott Benner 59:03
Is it expensive?

Patti 59:06
Like 240

Scott Benner 59:08
right I'm gonna look into it nobody go get it. Yeah, we'll try it we'll try it out see if we can find our see if we can get him to send us one and give it a shot. Okay. All right, Patty. Listen, we're up towards an hour you are absolutely delightful. I said earlier I was delightful but that's not true you are and and seriously I just really appreciate you doing this I appreciate your reaching out and the thank you note was just really well received on my end I want you to know and i i genuinely appreciate the getting it but your story just in general just it knocked me over and and now that to hear it you know spoken in your words is even it's a little more than I could handle today. Obviously everybody there's gonna be people are going to people who listen to podcast and be like there was minutes where Scott didn't talk, which must have been bizarre. They must have thought my microphone was not broken. I was just just kept listening to what Patti was saying. And thinking Wow, she's she's come so far and and, and your perseverance is seriously admirable because I've I don't know that I could have like slog through 23 years and still found like light at the end of the tunnel I I might have given up so I it's just amazing what you're doing and I want to congratulate you on it and wish you the best of luck moving forward with it.

Patti 1:00:26
Well, thank you for doing these podcasts. Don't stop

Scott Benner 1:00:31
it I won't stop a lot of pressure for me, but okay. Yeah,

Unknown Speaker 1:00:36
well listen all the time with them so

Scott Benner 1:00:39
well, Patti, you're in luck. And I joked with somebody the other day. So probably somebody who hear me say this twice. But I've sold ads for the year already. So I'm stuck. I can't stop whether I want to or not at this point, I have a podcast. But actually, you know what, joking aside, that's really great. Because the sponsors, you know, make the podcast possible with my time and and that kind of thing. And in the times when I'm sort of like, Oh, God, Do I really have to do this right now? Like, I go, Yeah, I do. And then you know, and it doesn't happen to me often. But there's, you know, you can imagine that sometimes life will get away from me or I was sick when I had to put one out one day, and I was just like, the last thing I wanted to do was sit down at my computer and, and, and put together edit and upload an episode. But I just was like, You know what, like, I've made promises to people. And so I followed through, not that I need that every day, most days. It's just really cool to talk to people like you. But but but seriously, I appreciate it. I don't I need to stop talking because I sound I know I sound foolish today. So thank you very much. I wish you just a ton of success moving forward. And please, I hope you keep in touch.

Patti 1:01:47
I will. And thank you very much.

Scott Benner 1:01:50
Now you're it's really My pleasure. Thank you so much. I hope you have a great day. Oh my god, Patti is adorable. She really is. My mood just got better hearing her voice at the end say you to listen guys, thank you so much to Patti for being open on us talking about her, her sadness and her anger and all the things that she's done to try to get herself back from those feelings. That's really incredible. Thank you also on the pod at Dexcom for sponsoring the Juicebox Podcast, you guys can go to my omnipod.com forward slash juice box, or dexcom.com forward slash juice box or go to Juicebox Podcast com links in your show notes. Please find a way to get these great devices to try. Next week, we're going to do an episode with all you Instagram folks out there T one Junebug. You're gonna like it a lot. It's really great. and with any luck, I'll have a little update for you about Arden and her blood pressure will be back to normal. I'm hoping knock on some wood here. And that's pretty much it. I'm sorry for my lack of enthusiasm during the ads and stuff that I just there's a lot going on here. I'll see you guys next week.

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