#727 Bold Beginnings: Target Range
Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 727 of the Juicebox Podcast.
Welcome back to another episode of bold beginnings today, Jenny Smith and I will talk about the target that you're trying to keep your blood sugar in that range that we're all hoping to stay in. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Hey, can I bother you to please go to T one D exchange.org. Forward slash juice box join the registry, take the survey, that's all takes fewer than 10 minutes. You just need to be a US resident who has type one diabetes, whereas the caregiver of someone with type one head over there today. It's completely anonymous, absolutely HIPAA compliant, and all you need to do is complete the survey to help people living with type one diabetes. The bold beginning series began back on episode 698. And there is a complete list of episodes available on my private Facebook page called Juicebox Podcast type one diabetes, it's up in the featured section should go take a look
if you're enjoying this series, you probably should head over to the defining diabetes series and the diabetes Pro Tip series to learn more. This episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes. And you can learn more about the in pen right now at in pen today.com
Jennifer Smith, CDE 1:55
thanks sorry, I was late. I was changing a screaming pad.
Scott Benner 1:58
So it's no trouble at all. The fun stuff life. We we were recording so cool. Ardens Dexcom has been expiring at 11:30pm for like, seven months right? Like we just I don't know what happened. You know, we ended up changing it
Jennifer Smith, CDE 2:16
like that like the ad hour like you let it go and or is that like the empty hour or
Scott Benner 2:22
the Dexcom? Dexcom. Not to CGM is Dexcom. Not okay. Now I see. Yeah. So we ride that thing right to it like right till the end. Yeah, I am, too. And every, every time we've changed it over the last six, eight months, however long it's been I might have lost track. I walked to her, she texts me whatever. And we look at each other bleary eyed, so tired. And I realize like, Oh God, I'm up for at least two more hours now. Right? And I look at her and go, the next time this is done. We're just going to change it a few hours earlier. She goes That's a good idea. We should definitely do that. Right. Yeah. This time. I set an alarm. I like told my phone basically. Hey, Siri, in nine days, and blah, blah, blah, hours remind me to chase. So yesterday afternoon, it goes off when I Oh, cool. We're gonna finally do this. And then we forgot.
Jennifer Smith, CDE 3:15
Because you turn the alarm off, right? I do that I turn the alarm off. And then like, Oh, what was that? Again? This was due four hours ago. We
Scott Benner 3:22
had a whole conversation about it yesterday. And I said, Listen, let's change it around five o'clock. That's a good idea. We'll do that. And then next time, we can adjust it into the three if we want her to the seven if we want we'll decide, right? And she's, she's like, Yeah, 1030 Last night, I texted her, I feel bad. I just texted her the F word. She's like, what's wrong? And I was like, we didn't change that. Thanks, God. So we ended up doing it like 1030 Last night.
Jennifer Smith, CDE 3:49
Well, let's do was an hour earlier.
Scott Benner 3:51
You're trying to make me feel better. But that's not
Jennifer Smith, CDE 3:53
ours better than you know. i You try.
Scott Benner 3:56
I'm old. I can't be up that late anymore. It's not good for me. So anyway, today, for the bulk beginning series, we're going to record the topic of range. So, so far, Jenny, I know it doesn't seem like it has been together is so delightful that it doesn't feel like time has passed at all. But we've recorded honeymoon, being diagnosed as an adult terminology would end which ended up being two episodes because it was long. There was lots in there there was we've recorded highs and lows, which basically is fear of insulin. We've recorded the 1515 rule, long acting insulin, and today we're going to do range and maybe we can sneak in food choices if we have enough time. Oh, that puts us only 1-234-567-8910 1112 just 14 more topics away from buttoning the series right up so we're doing terrific. I know as
Jennifer Smith, CDE 4:56
you said the the other than not that today his tactic but the food choices in my head right away flashed this like this like dangerous.
Scott Benner 5:08
We're gonna make people hate us. It's like Oh Please don't hate me. We I think in one of the the fear of insulin we we drifted into it for five seconds and even if we were talking about there I thought some of them's not gonna like hearing this but whatever. But for right now, yeah, range is a nice easy one. Great Yeah, no one's gonna be mad at us for talking about this probably. Okay, so again this series is for people who are newly diagnosed. And the way it began was we reached out to the Facebook group and said to them, what do you wish you knew in the beginning? And here are some of the responses that fit in this topic. What range to be, or to shoot for was really hard to understand. I would have been, it would have been easier to explain that they want him to run on the high side. So let's see right away. This is interesting, because we're getting a look into what doctors say, right? Apparently, they wanted the kid to be higher. But the mom found the online world pretty quickly and decided that wasn't a good thing. So what did she say here? Okay, they wanted him to run higher as his body adjusts for a few weeks was what she initially found out is what they meant.
Jennifer Smith, CDE 6:33
As they said, it probably wasn't explained that way.
Scott Benner 6:35
No, she's like, clearly what was going on is they wanted to figure out the doses. But none of that was communicated whatsoever.
Jennifer Smith, CDE 6:44
Correct. It was a poor communication. See bad pod? Sorry, my noises are going.
Scott Benner 6:50
even heard that one in a while? No, I
Jennifer Smith, CDE 6:53
know, my my high alarm, which isn't really I mean, it's not high. My high alarm is set for 130. Really not high. But it's just telling me clearly. Anyway. Yeah. So you know, initially, she should have been told, Hey, this is what we're aiming for. Here. Because of these pieces, we aren't quite sure how sensitive your child is going to be once we introduce insulin. And as the body starts having like more normal looking blood sugars, the body starts responding or coming out of DKA or whatever, right? And then we're going to transition down to a healthier target range, right. But that's it's not usually clearly explained.
Scott Benner 7:37
And obviously not because the very next statement is someone said, I wish they would have told me that being 200 for a few weeks was okay as the body adjusted, but that we were going to taper down to a more realistic and healthy range. That it may take a while to normalize blood sugars. So yeah, you're right. This is this is the thing that people don't get told. So let's kind of break that apart for a little bit. So I mean, you're diagnosed, I'm assuming most people are diagnosed with a higher blood sugar that's probably been higher for a while. And they even though they get you down in the hospital, you know, it's funny, I say that, like, that's the norm. But how many people have I talked to who go to a hospital or sent home right away, or were diagnosed during COVID and weren't even allowed in the hospital? Right? So what happens is there? I mean, obviously, you don't walk into the hospital with a 700 blood sugar, and they're like, we'll just fix that right now. Like there's a very slow type titration that takes place in the hospital, if you're if you're there is that for safety reasons.
Jennifer Smith, CDE 8:39
It is for safety reasons. You know, if you adjust the body from the idea that you're not quite sure how long blood sugars have been so elevated, right? For kids, it's probably not been that long of a time. It happens very quickly that turnover or that transition. But there is a slow progression of beta cell loss. I mean, if you look at the research in the development of type one, there is this progressive nature to actual diagnosis. But the high blood sugar's aren't really until that very end point near diagnosis, but you still need to be very careful about bringing those blood sugar's down. Because the body adapts pretty quickly to its new set range. And if you've been running at 300 Plus for a week or two weeks or three weeks, that needs to be certainly brought down slowly not to the point of you're waiting eight weeks to bring those high blood sugar's down but in the hospital if you have had a chance to have an inpatient stay, or a closely followed outpatient, you know, diagnosis and, you know, collaborative work with a with a health care team. They will still try to really bring things down slowly because again, once you add insulin into the picture via injection, whatever betas may be left, actually, they get a little bit of a rest, and then that we've talked about honeymoon already, that honeymoon could kind of come back into the picture. So they do have to be very careful.
Scott Benner 10:15
Yeah. And I'm assuming that the wider range is because of that partially. And because of also partially, they're not sure if you're going to get home and get a little, you know, rejuvenation out of those beta cells and suddenly went down. They don't want to tell you, it's one unit for 10 carbs, and then get you home and find out that, you know, it's a half unit for 10 carbs, because you're getting some help on your pancreas. Right? That's, that's, that's the one half of the reason why they would show you a wider range with a higher ceiling. But the other one could be, they just don't know yet. Right? Like, they're not sure what's going to happen. And Correct, right. And so this person here says, one of the most useful things that I learned from the from the podcast was that I didn't have to accept these out of range spikes at meals, just because she had diabetes, that I can make adjustments to flatten those lines, etc. So I'm going to hold hold the half of her thought there. So that's the next part that I think is important, because you said it a moment ago, if it's not communicated to you, well, this is a completely new thing for you. And they could tell you, I don't want your blood sugar to be under 100. Or, and but it's okay. If it goes up to 200. After meals, they might say something like that. I say this all the time. Like if you don't give more context, your statements in the beginning, when you're teaching something to somebody, they're going to assume that's the rule for forever. And that is what I see with people is that they don't think the people who don't make it online, the people who don't find somebody to talk to just assume, Oh, it's 100 to 200. And these are people you will hear from that have had diabetes for three or four years who are treating low blood sugars, you know, air quotes at 110. Because they're trying not to go under 100. And, and it just skews your way of thinking about it forever.
Jennifer Smith, CDE 12:06
Absolutely. In what you learn, in many things, not just diabetes, but it definitely makes sense when I'm talking about a health condition that's so dramatically impacting right now. And kind of forever. What you teach in those beginning stages, becomes almost a very hard rule that it's very hard to clear out of your brain. I kind of think of it almost like when my little one was starting to ride a bike. My husband, and he, he disconnected the front brake. And he taught my son. The reason was because he didn't want him squeezing as hard as he was. And he was like four years old, right? And like any explained, I don't want you flipping over the front. Well, now he doesn't he still doesn't like that front brake connected, because he was taught that he could have an accident in which he flies over. First, right. That was what he learned initially. And it's hard to unteach
Scott Benner 13:04
I also think that with people with diabetes, you see that with where they where their devices, like the the first place they put it is the place they think it belongs, you know, and that happens to kids a lot too. It still happens to Arden I moved Arden's Dexcom for her yesterday's we were talking about in the beginning, which I think will be in the episode. And she wears them on her hips. That's it. And I put it on and she goes, That's too high. And I'm looking I'm like, it looks fine to me. You don't I mean, and if it was higher than the last time it was there, it was by a half an inch, you know what I mean? But she acted like, and she's pretty reasonable. She's like that, like it
Jennifer Smith, CDE 13:42
was on her forehead instead of like,
Scott Benner 13:44
what are you doing? It's under my arm, you know, like, like it was. So it's just in her head. That's where it goes, I think. Okay, so back to this lady's point about I wish I would have known that the blood sugar's don't have to spike up after meal. She also says on the flip side, I would have liked to have known that we that lows weren't a thing that happened. Her main message here is she left the hospital believing spikes and lows were part of it.
Jennifer Smith, CDE 14:13
And we're going to be what she should see.
Scott Benner 14:16
Yeah, yeah. It's funny her description. It's not well written, I'm sorry to the person who wrote it. But But because so reading, it's not going to help you much. It's why I'm picking through it. But the intent of this statement is, it's almost like she's in a bad relationship. But somebody told her this is what it's like to be married. So you just have to deal with it. Like, right? Yeah, it's, um,
Jennifer Smith, CDE 14:38
it's interesting. That's too bad.
Scott Benner 14:40
Yeah. Right. Like, I mean, you know, way back in the Pro Tip series. You know, I said all the time, and I haven't said it enough lately, but it's my least favorite part about diabetes is when people get caught in a situation where they find themselves saying, well, that's just diabetes. That's how it happens. You can't avoid that. And you can and she's like, I wish someone would have told me that it was possible, even if even if I wouldn't have been able to do it right away the knowledge that it was on the horizon would have been a nice idea. Right? Absolutely. Now, I think the reason people don't get told that is that many times, they're with physicians who don't know how to stop spikes and highs and, and that's why you don't get told it's possible to fix.
Jennifer Smith, CDE 15:23
Well, and I think when you're talking about range to range is something that will evolve, so to speak, as you become more comfortable, and comfort comes from learning more, and experimenting more and paying attention to what happens for yourself or your child or the person that you're helping to care for. So that range may tighten, and be different than when you were first diagnosed, or even different than when you were six months out from diagnosis, right. And they may shift through life or through each variable, you might have different ranges that you're aiming for. So I don't think that there's a, there's not a hard and fast range.
Scott Benner 16:10
No, I imagine that you probably talk to people who are older, elderly people, you probably start shooting for a wider range. And, and that makes sense to and younger kids who I don't know run around a lot during the day and you know, get bursts of exercise that you don't expect, you might have a different range for them. But none of that changes. The goal, right should be the goal range, and the places you have to adjust that range for your specific situation. Again, I just think the biggest problem with this, this this piece is that is it, nobody tells you the first numbers I said out loud are not the thing you're going to be doing your whole life. There's some other statements here from people. I wish someone would have told me that everything seems to affect my blood sugar. So the I think the variable series does a good job of shining a light on that if you want to know about some things that that that can impact your blood sugar that no one at the hospital or a doctor's office might bring up. This, the next statement is I would have liked to known what main factors can increase or decrease the need for insulin. And then you know what I mean? So food
Jennifer Smith, CDE 17:19
again, there's variables, that's certainly relative to the variables too.
Scott Benner 17:23
But I think I think that it also it shines a light on the, you know, all carbs aren't created equal idea. Yes. Because the in the beginning, in the beginning, when you you're told that formula, which is what the next statements about them trying to lead into that. And then it you know, one day eat, I don't know, doesn't matter have french fries, the next day, you eat a salad that has some carbs in it, and it doesn't work out the same way. It fries your brain. You're just like, Wait, yeah, it was 12 carbs, they were both 12 carbs. Right? And then you start saying silly things like I did the exact same thing today that I did yesterday. And it didn't work except you didn't see all the variables, and it really wasn't the exact same thing. You know. So this, this person says, What did those numbers and that correction formula even mean? My son was diagnosed, and we were sent home with a mathematical formula. We're told to follow it daily. But I still don't know what the numbers are even referring to. And John, Jenny, as you know, that feeling is what spawned my blog in this podcast. So do you know what formula she's talking about?
So you're using multiple daily injections for an insulin pen, and you want more, but you don't want to move to an insulin pump. That's okay, because the option of the in pen from Medtronic diabetes might be the perfect solution for you. The in pen is an insulin pen. But it does more because it connects to the app that gives you your current glucose readings, meal history, dose history, activity, log dosing calculator, active insulin remaining glucose history and reports for you or your doctors to look at. Doesn't that sound like a lot of good information to have right there on your smartphone? I think it is, too. So how do you get started with the M pen you go to in pen today.com. When you get there, you're going to be able to see everything that I've already told you about and more. Not only that, but if you'd like to talk to somebody about the M pen, right? If you'd like to schedule an online health care provider visit, you can actually do that at my link. And you can also just get started in pen today.com. If you'd like to see how the dosing calculator works, there's a video there. You can click on it and watch it. I just clicked on it now, but I'm not going to watch it because I've seen it already. Plus, you wouldn't be able to see it. Anyway, to go learn More about the dosing calculator dosing reminders, card counting support, and the digital logbook, head over there and watch the videos. You may even be eligible, right? It's possible. And this means here's what this means. There's like a little disclaimer here. This offer is available to people with commercial insurance, and Terms and Conditions apply, but you may pay as little as $35. For the embed, go check it out. There's so much on that link, you can't go wrong in Penn today.com. In Penn requires a prescription and settings from your healthcare provider, you must use proper settings and follow the instructions as directed, or you could experience high or low glucose levels. For more safety information visit, you guessed it in Penn today.com. Hey, this isn't an ad, this is for the podcast, I'm gonna put this in here, I don't usually do this. But if you're listening to the bold beginnings episodes, when they're over, you might want to move up to the defining diabetes episodes and the diabetes Pro Tip series just like I was talking about earlier in the episode, you can find all of them at diabetes pro tip.com, or juicebox podcast.com. When you get there, you're gonna see something that says type one diabetes Pro Tip series from the Juicebox Podcast. And there's a little introduction there from me. And basically what it says is, look, my daughter has had an A one C between five, two and six two since 2014. With zero diet restrictions. This information works for children, adults, and for the newly diagnosed. And for those who have struggled for years, I believe that anyone living with type one diabetes can use these simple concepts to stabilize their blood glucose levels, lower agency and improve glycemic variability. Again, with zero diet restrictions, check out those episodes, diabetes pro tip.com, or juicebox podcast.com. And of course, they're right there all the episodes in a podcast player of your choice, whether you're on an iPhone, or an Android. And please keep this in mind too. All of the content within the Juicebox Podcast is free. And it's always going to be there's no need to pay for this information. I just want you guys to be as healthy as possible, support the podcast in any way you can through the advertisers filling out the survey at the T one day Exchange, or just telling somebody else about the show, will you support the show, the content keeps coming and it stays free
Jennifer Smith, CDE 22:37
I would expect they were sent home with a little bit more of a specific or a precise, I wouldn't necessarily call this a sliding scale that's more of a hard and fast if your blood sugar's in this range, take this many units of insulin right. Where this gives a little bit more precision because that formula gives you a way to calculate a dose just for correction insulin When blood sugar is high. So they may they will give you a target blood sugar. So your formula should say current blood sugar meaning where it is right now whether it's from a finger stick are from your CGM, your current value right now. And then you're going to subtract from that target your target. So if they told you to target 150, great, you're going to subtract your current 250 blood sugar. And then you're going to take away the 150 target, which leaves you 100. Right. But that number looks odd until you factor in what they've given you. And it's called a correction factor. That correction factor is how many points one unit of insulin or for some little kids, they might have said how many points or half a unit of insulin may drop your blood sugar, right. So let's say your correction factor that you've given been given in this formula. Target blood sugar 150 correction factor is 100. So, so we're going to take 100
Scott Benner 24:17
If you had a 300 blood sugar, you would subtract 150, which is your target which would leave you with 150 Correct but in your in your thing you need but
Jennifer Smith, CDE 24:27
and then you have to divide that value by the correction factor they
Scott Benner 24:31
gave you to use. In this example, we're using a correction factor of 100, which means we're assuming all unit of insulin is going to bring your blood sugar down by 100 points. So 150 divided by 100 gives you how many units to take. And that would be 1.5 1.5 units exactly based on all of that and then the problem is that all seems so like specific. And then when that when it doesn't work, you're like, it's impossible. I've got this mathematical formula that gave me all the people in the white coats for like, here's what you do. And they explain it hopefully the way Jenny did, which was very clear. But they don't tell you something in this example, like, when your blood sugar's really elevated, you may need more need more insulin, right? Right. And then you could
Jennifer Smith, CDE 25:23
or if it's right after you finish playing three hours of soccer in, you know the field with your child during a tournament, and now you're correcting a blood sugar that's too high. Well, activity is the variable in the picture now. So you may use this formula. And you may see a really dramatic drop in blood sugar and think, Well, gosh, it usually works. Maybe something's changed and nothing's changed. It's the fact that there's no exercise in the picture that makes the insulin work better. So these formulas are a place to start. Right. And they do need some adjustment. Pretty soon after initial diagnosis.
Scott Benner 26:02
I've also found over the years that having a CGM Arden has the Dexcom that it takes away. I don't think about the the range as much anymore. As soon as I think about, like rolling. Like gentle lines. Yes. Right. That's more how that's more how my brain thinks about it. Now, instead of like, I'm trying to stay under this number or stay over that number. I just think I'm really trying for there not too many sharp falls, or sharp peaks. And they, you know, I don't know like, I don't even think of them as numbers, I think them as lines. Right?
Jennifer Smith, CDE 26:42
It's exactly it's almost like the sky and sort of the ground, if you will, and you have this range that you're trying to fly like a glider plane through, and you want this nice, gentle rolling effect rather than these big JJ like roller coasters is not what you want. It's also
Scott Benner 27:02
really interesting how a visual representation of it changes your feeling about it. Because you know, if your high alarm just went off at 130 Arden's high alarm is 130 on her phone. And it's i It's 120 on mine, so I can react a little quicker to if I guess I have to find or somewhere or something. But it's funny that when you look at it visually, you're like, Oh, my God, what's this crazy spike here. And then you go back and realize it went up to 120. Right, because it visually looks like a crazy spike. But that almost trains your mind to work within the range that you've set up. Anyway, if you're lucky enough to get a CGM, you'll, you'll see what I mean. Last thing here for range, someone says the quicker that you can learn about your glycemic sensitivity and insulin sensitivity, the quicker you can use that information to make broader changes. And this does really affect your time and range. So I'm guessing we've already talked about this, right? But they probably were eating some foods that hit a lot harder than than the ratios, their insulin ratios could handle. Right? All right. So find that in an episode called food choices. That's either out now or will be out very soon, depending on when you're hearing this. Yay. All right, Jenny, take a deep breath. We're gonna do the food choices. Fantastic. So much here too.
Jennifer Smith, CDE 28:28
I am quite sure you got the gamut from one side to the other. And in some of it, I think it's interesting what you texted to me the other day because some people are so quick to latch on to one nutrient being the the the end all be all of this is what solved it for me.
Scott Benner 29:01
Jenny and I are going to continue that conversation in the next bowl beginnings episode called food choices. But for now I'd like to thank in pen from Medtronic diabetes, and remind you to go to in pen today.com To get started right now with an insulin pen that talks to an app on your smartphone, giving you much of the functionality that people have come to expect from insulin pumps. If you'd like to check Jenny out, she works at a place called integrated diabetes.com. Her services are for hire. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Test your knowledge of episode 727
1. Why is continuous glucose monitoring (CGM) important for managing type 1 diabetes?
- It reduces the need for insulin
- It helps in managing blood sugar levels effectively
- It eliminates the need for blood tests
- It is only relevant for type 2 diabetes
2. What are the differences between types of insulin?
- All insulins have the same role
- They are used interchangeably
- Rapid-acting insulin covers meals; long-acting insulin manages blood sugar throughout the day
- Long-acting insulin is used for corrections; rapid-acting insulin is used for fasting
3. How does exercise impact blood sugar levels?
- It has no impact
- It can cause blood sugar levels to rise or fall
- It should be avoided
- It only affects type 2 diabetes
4. What role does diet and nutrition play in diabetes management?
- They are not important
- They play a critical role in managing blood sugar levels
- They should be avoided
- They only affect type 2 diabetes
5. How can psychological aspects of living with type 1 diabetes be managed?
- By ignoring emotional health
- By seeking support and counseling
- By avoiding discussions about diabetes
- By reducing the need for insulin
6. Why are regular medical check-ups and consultations significant?
- They are not necessary
- They help in early detection and management of complications
- They are only for advanced cases
- They should be avoided
7. How have technological advancements benefited diabetes care?
- They have made diabetes management more complex
- They have no impact
- They have simplified and improved diabetes management
- They are only for healthcare providers
8. Why is building a supportive community important for managing diabetes?
- To avoid physical activities
- To manage the emotional and practical aspects of diabetes
- To ensure proper carb counting
- To reduce the need for insulin
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#726 Brusha Brusha Brusha
Trey Perez is a Pediatric Dentist and he has type 1 diabetes.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 726 of the Juicebox Podcast.
On today's show, we're going to talk to Trey Perez. He is a pediatric dentist and he has type one diabetes. So we're going to talk about, you know, his life and his job and what you might want to do to keep your teeth clean, and other stuff. It's gonna be way better than I just described. Gotta cut me a break because all I can think of right now is we make holes in teeth, which is an old crest commercial from I don't know how long ago. But anyway, Trey's a lot of fun to talk to, I think you're going to enjoy it. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Becoming bold with insulin, or making holes in people's teeth. We make holes in teeth. Do you not know this cartoon commercial? If I thought any of you had seen grace, I'd be like, brush up, brush up brush up, but I have no feeling that you're gonna get that reference either. Major is really coming out this week, isn't it? Alright, you're ready to get going. Here comes tray
this episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes. The M pen is an insulin pen, but it does much more. You can find out all about those things at in pen today.com. Today's podcast is also sponsored by my daughter's blood sugar meter, the Contour Next One blood glucose meter. Contour next.com forward slash use box is the link you're looking for. It is small and easy to hold and beautiful. And I'll tell you more about it during the ads. Brush up brush up brush. What is that whole song? Brusha Brusha Alright, hold on a second. I can't even got started yet. Alright, so Greece is a movie. And during the movie, some of the characters are watching television. And a commercial comes on for old toothpaste. But the movie was set in the 50s. So what was it called in Patna or something like that? Hold on. Yeah, apama IPA, Na, it's toothpaste that obviously does not exist anymore. And there was a beaver called Bucky. Bucky had too big teeth as you can imagine. And he would say stuff in the morning ready for my day. I brush my teeth pressure, pressure, pressure, pressure pressure, and that is up and down around and around by the brush my teeth. But anyway, it goes on for quite some time. And like this guy flies in. He wants to like hear your favorite racecar? I don't think I can let you hear anymore without getting in trouble. Anyway, here comes try. Sorry about all this.
Trey Perez 3:20
My name is Trey Perez. I am a pediatric dentist. I am based in Brooklyn, New York. I also have a background in public health. I am myself a type one diabetic. So yeah, so I want to my goal is to you know, promote oral health and promote health in general. So I'm glad to be you know, part of this, and you know, talk with you.
Scott Benner 3:45
I'm very happy that you were willing to do it reached out and everything. So thank you very much. Trey, how old were you when you were diagnosed?
Trey Perez 3:54
I was 35. So it's pretty recent. I'm 37. Now so I just had my my diet birthday a couple days ago, it was actually New Year's New Year's Eve when it happened. So when I got diagnosed, so it's fairly recent for me.
Scott Benner 4:12
You know, it's funny, that would have shocked me had I not spoken to a woman who was diagnosed in her 70s recently. Yeah, yeah. So
Trey Perez 4:21
I've heard a couple people that you've talked to a little diagnose lately or later in life. And I was surprised because I mean, I know about, you know, I know about diabetes, you know, with my background and my education. So we used to be called juvenile diabetes. So we always thought it was happening in in kids and I thought I was when I was experiencing my symptoms. I was like, this is like diabetes, but I'm too old to have type one. My lifestyle was too healthy to have type two. I was I was very confused. I was in denial.
Scott Benner 4:57
Just based off the naming of the Have you been juvenile diabetes? That threw you off that quickly? That's interesting.
Trey Perez 5:04
Yeah. I mean, once, I mean, once I got diagnosed, then I did a lot of research. And actually, my mom pointed out that it's about 40% of people with type one are diagnosed 30 or older. So it's almost half, you know, so that's, it's actually not that uncommon man. And it can happen. And then I realized a little bit more it can happen at any age. You know, just one it does one little naming thing all those years, right, you know, and yeah, it sticks with us for this long. It's
Scott Benner 5:38
interesting. Okay, so how did you I mean, what was your first presentation? Like, what was the first thing that got you thinking something was wrong?
Trey Perez 5:45
Well, it was just classic symptoms. It was textbook symptoms. And it was it was strange. I could tell you the whole story I'm in. Remember, in June of ended June 2019. I went to the doctor and I got bloodwork. And I never get bloodwork because everything's normal, but you know, mid 30s, time to start doing those kinds of things. And everything was fine, like my blood sugar was in the 90s. Totally normal. And then in November, I went, and I did this dental outreach in Nepal. I when I came home, I was really tired, but you know, jetlag, and everything. I just assumed it was that, but then the jetlag seemed to linger for weeks. And I was going to the bathroom all night. No, chugging water, drinking anything I could, I was so tired. I got so weak, and I'm a big fitness person, I would go the gym all the time. And I couldn't after that I was so weak, so tired that I couldn't do that. That really affected me. I lost 20 pounds in you know, a couple of weeks, and people noticed that I looked different. And eventually, I realized something's going on. And I was in denial. And it probably because of that. I didn't go to the doctor as soon as I should have, but eventually I did. And I'm New Year's Eve 2019. That's when I got diagnosed. So the next day started doing the finger sticks and 2020 for me started that way. And then everything else. Everything else that 2020 happened and yeah, so it was a great start, you know?
Scott Benner 7:31
Almost quite literally two years, then.
Trey Perez 7:34
Yeah, two years.
Scott Benner 7:35
Were you sick in Nepal? No, I
Trey Perez 7:37
wasn't. And to be honest, usually when I go travel to places like that, it usually gets sick. So I was really happy that I wasn't
Scott Benner 7:46
maybe yeah, maybe your auto auto immune system was just like, on Yeah, serious overdrive at that point. Just swatting stuff away. Like, you know.
Trey Perez 7:56
Yeah, I think I've heard you say that. When the maybe the immune system gets bored, and it just starts doing what it wants. Because the funny thing is, I hadn't even had a cold and in years, I usually get a cold like every year and so I hadn't gotten sick like that, but I get sick with
Scott Benner 8:14
type one. Yeah, listen, Arden doesn't get sick ever. No. So I have a crazy, like immune system where I you know, if I get sick, like you know, like, something comes over your during the day and you know, five o'clock you're like wandering around. Like, I think I got it asleep like something's wrong. You know, like, I'm out of it. Like something's happened. I'll wake up in the morning, like it never happened. Yeah, that's good to see. You think it's good. I think it's why I'm probably gonna end up with tape on when I'm older. Because my immune system is like is what if it gets confused one day? You know, I know ya never know, I probably should do the antibody test. Actually. Already trial that if you're listening, I'll do it. I think I'm too old for this thing. But, you know, if you make an exception and send me a kid, I'll do it. Anyway, yeah, yeah. So okay, so you're diagnosed? And you're you're pretty far into your practice at that point. Right. How long have you been practicing?
Trey Perez 9:13
I've been practicing. I've been out of residency since 2015. Okay. Oh, that was four years at that time.
Scott Benner 9:20
Yeah. So you did you have your own practice? Are you working somewhere? How do you do it?
Trey Perez 9:24
No, I work part time in a private practice. And I work part time in the hospital, actually the residency program.
Scott Benner 9:34
Okay. How do you make the decision to become a pediatric dentist is it just because you want to see little kids high on gas?
Trey Perez 9:41
That that is very fun sometimes because they do they do some silly things. And that definitely makes the day a lot better. Now, I think I mean, being a general dentist is really hard. I think that's the thing. People who specialize in dentistry, sort of realize that being a a general dentist, you have to do everything. And when you specialize, you don't have to do as much. And so I mean, I like that, you know, with kids, that everything is shorter, you get to see more more kids in a day. It's sort of that instant gratification. Because, you know, with with adults, you have to do crowns, those take several appointments sometimes and with kids, it's, it's, it's a lot quicker. And kids are just people to get it might be hard, but kids are just, they're easier. It's sort of the adults and the parents that that actually make making more difficult.
Scott Benner 10:38
Like you have a lot of stories about crazy people. Yeah. So you know, it's funny that you say that, because you're making me think about my current dentist, who I've had now for quite some time. Is, is an artist. He's just so good, and patient and methodical, but and you know, still has a great personality. And like, he's just the guy I went to as a young adult, we used to joke all the time, that I can't believe I'm saying this, we used to joke all the time that my dentist was on meth, because because he would, he would had four offices. And he'd filled them with people. And he would literally run from one to the other working on people. He'd come in, he'd see you go, I'll be right back, then you'd hear him in the next office. I'll be right back. But then he'd start your procedure. They go, I have to go for a second, then you'd hear him go into the other room and start another procedure. He was working on three, four people at a time. Yeah. And it was just always, like it never felt right. You know what I mean? Like he was in the middle of working on my teeth once and I heard him say, I gotta go, my buddy's bringing over a Corvette for me to look at, he went out a side door, looked at a car, like bought and then came back inside. And I just thought dentists were crazy. And then I moved. And I and people recommended the gentleman we use now. And I remember going once or twice and just thinking, like, oh, like you can be like a normal person to be a dentist or like I was just going off of my young adult like experience with my crazy running in circles, man. So I think it's a really big deal that you fit what you're doing. You don't I mean, because the guy I have now is very suited for this. Like I've had a root canal. And it's just like a walk in the park to him. You know what I mean? It's it doesn't hurt. He's great at the whole thing is I fallen asleep during a root canal. So I think that says something about him. You know, that's good. So I like that you found a place where you think you fit? You know, I think that's a that's a smart move. Not that you were otherwise going to be running in circles like,
Trey Perez 12:42
No, I mean, there's a lot of running in circles, no matter what it is. There's a huge amount of volume of patients that I see a day. Yeah, it's it is it can be
Scott Benner 12:56
kind of do Yeah. Is there truth to the um, I hate I know, this is such a weird thing to say before we get into about diabetes. But yeah, Is there truth in it like is being a dentist towards the top of the suicide list?
Trey Perez 13:10
I've heard that but it's also one of the top of the, the like, those reports about best jobs. Okay. If you look at those, it's like pharmacy and dentists are always on the top of the best jobs. So I've heard that statistic, uh, you know, make jokes about that all the time. But no, I don't think so. It's a pretty good career. Because it's, I mean, you're, it's not like medicine. It's more nine to five, you know, and there's not really there are emergencies, but it's not life threatening emergencies. And the way you have to deal with is not life. I mean, it is in some way life changing, but it's not like life or death. I know. And that's, that's a good thing. And, you know, if if, you know, technically we're surgeons, and I do go to the operating room, and I do surgery there, but it's not the worst thing that happened is not going to be somebody dying on the operating room table, you know, so I don't have to deal with that sort of stress. It's pretty comfortable. I honest.
Scott Benner 14:14
I'm wanting to share a joke. My friend, friend of mine is a pediatrician. And I, we were together once and I referred to him as a doctor and he goes, I'm not a doctor, I'm a pediatrician. And they said, Well, your father is a doctor Tunica. He laughs because he's not a doctor. He's a dentist. And
Trey Perez 14:30
I do that all the time, too. Yeah.
Scott Benner 14:33
It's hilarious anyway. Okay, so what was it like? I mean, at that age being diagnosed, did you have trouble getting started and acclimated or, or how did the beginning go?
Trey Perez 14:46
Well, it's weird. I mean, I sort of think about how my diagnosis and my transition compares to these children that get diagnosed. Um, I know I'm in the health healthcare field and I have a background of master's in public health and I've always conscious about keeping myself healthy. So. So, you know, making myself healthy with diabetes, you know, properly giving myself insulin and counting my carbs and making sure I have enough water exercise and everything. It wasn't too hard for Me, me, it was hard. I definitely had panic attacks when I was first injecting myself because it's not something I'd like to do. But I think I did pretty well with it. You know, adjusting to that is, it's a total 180 from your life, I like, the way I see is I sort of live my life a certain way, you know, for 35 years. And then now I have to change a lot of habits and I can't, you know, eat right before bed, you know, I can't have any late night snacks. I can't, you know, binge I can't just spontaneously eat without thinking about it. So it changed a lot. But I feel sorry, when I see kids that get diagnosed, you know, when they're little babies, and that must be tough. So, yeah,
Scott Benner 16:13
so there's no more like, I'm gonna watch a football game or grab a bag of chips and a beer and sit down and not think about it. And however,
Trey Perez 16:22
it's funny. It's funny that you say that, because I used to do similar things, you know, on Sunday afternoon to maybe just order a pizza. And just like lounge and watch football. You know, I don't do that anymore. I missed that.
Scott Benner 16:39
You miss it. You do, right? Yeah. Yeah.
Trey Perez 16:41
And if somebody you know, brings cake or cookie into work, or something like that, I'm like, I gotta think twice about, you know, eating it. I usually won't need that, you know, of course, I'll have cookies and cake. But it's not like, I have to think about it first, you know, I have to think about I can't just like, Oh, I'm gonna grab that. You know, there's a lot more thought that goes into day to day decisions.
Scott Benner 17:04
Do you stay very regimented during the work day so that you don't have like a blood sugar thing while you're working?
Trey Perez 17:09
Yeah, I, I'm a big fan of routine. And I eat almost the same thing every morning. I try to eat similar things throughout the day. I try to be as accurate as I can. But the routine definitely helps. When I go off that routine, that's usually when I see some spikes.
Scott Benner 17:35
And then you're Yeah, you're kind of stuck in the middle of a procedure, I guess. And has that happened? I mean, do you? Yeah,
Trey Perez 17:40
yeah. I've been scrubbed it in the O R. And then my Dexcom alarm went off. I'm like, I gotta go. So I had to take off my gown and everything and then go into the other room, I had some juice and just had to wait like 1520 minutes. For it corrected itself. Meanwhile, everyone else is in the or the kid is intubated. And everyone's just like twiddling their thumbs. But I mean, everyone's very, they're very gracious about it and patient about it. So that was good.
Scott Benner 18:12
But when you come out and talk to the families, you go, sorry, I know, that took longer than I had to drink a juice box before we start.
Trey Perez 18:19
Now. Luckily, I mean, it takes a long time to do what I do. So you know, a couple of 15 minutes, 20 minutes, nobody noticed. Yeah.
Scott Benner 18:28
Well, so do you tell your I mean, how open are you about it at work? For instance? Like I'm sure the people you work with know, but what about patients? And how does that work?
Trey Perez 18:38
No, nobody really knows what my Yeah, my staff knows. people I work with no, but no, I don't really talk about it with my patients. Now,
Scott Benner 18:48
I don't know why. I'm just wondering.
Trey Perez 18:51
Now if they had it. Then I would have talked about it with a couple patients who are also type one.
Scott Benner 18:57
Okay, so kid comes in with a CGM or something. And you might be like, Yo, I got that to kind of thing. Yeah.
Trey Perez 19:03
Yes. sort of show them mine. Well, then, yeah. So
Scott Benner 19:07
so so let me tell you something that happened to my daughter and, and I'll see what you think. But, you know, in the very beginning of all this, I really didn't know what I was doing very much. There were way more juice boxes than there are now you know, I would say at this point in Arden's life now, she doesn't maybe drink a juice box like maybe once or twice a week, you know, like for some sort of allow, but she was really little and there were no CGM. You know, those things were, they were plentiful. And one time she we were going along, everything was fine. And then one day she said to me, she was tired of the juice boxes and she wanted to switch to something else. So we went to the store and I let her pick something else. And within six months of that new drink being introduced into her life, Arden had like nine cavities on her baby thief. And at first First, I was just like panicked. I thought, you know, you kind of get lost in that my kid has problems. So here's more problems, I guess, I guess this is just how it's gonna be. And then it hit me one day that we switched the juice boxes. And so I switched back, she had the little cavities, you know, filled, and she's never had that kind of problem again, just do you think I'm right to think that it might have just been the switch? Yeah, really,
Trey Perez 20:26
to be honest, usually, like big life changes that like that, or diet changes, something like that, that usually triggers something. So but no matter what, when it comes to tooth decay, it's all about sugar. So and with diabetes and, and tooth decay, it's, you know, it comes down to sugar. So, no matter what I mean, juice, any sort of carbohydrate is can contribute to tooth decay, to carry so
Scott Benner 20:58
so so sugar that, so when you drink it, and then you don't have something else to flush your mouth out, it stays behind stays on the teeth,
Trey Perez 21:07
right? It's all about, like exposure. So for instance, if you have something that sticks to your teeth, the longer is sticking to your teeth, the more likely you're gonna get a cavity or if you have more snacks during the day, then you're more likely to get a cavity. And so with type one diabetic since we're, you know, snacking and having juice, and throughout the day that I think it does increase the risk, you know, for sure to have to, to have done a tooth decay. And I've noticed, you know, one thing that I I struggle with is, you know, if I have a low in the night, I'm really tired. And I'll, you know, have some juice or something. And then I noticed I shouldn't brush my teeth afterward. I'm like, two times. And I'm sure a lot of people struggle with that, too. Now, I brush my teeth before I went to sleep, but now I'm having more sugar in the middle of the night. And now that's gonna be sitting on my teeth till the morning. It's not it's not easy.
Scott Benner 22:09
Is there any value? I've heard a lot of people keep water next to the bed. And after they drink the juice, they kind of swish their mouth clean. Yeah, actually do anything.
Trey Perez 22:17
Yeah, I mean, if you're Yeah, so you're doing a couple of things, you probably rinsing the sugar off the teeth a little bit. And you're also sort of neutralizing the, the bacteria because it's actually to the cake is caused by bacteria. So it eats the sugar, and it ferments it and produces acid. And that's what breaks down your teeth. So it's not the sugar directly. It's, it's the bacteria in your mouth. But also a lot of these juices are acidic. Anyway, pretty much anything other than water is bad for your teeth. You know, juice, soda, they all are acidic, and those break down your teeth just like the bacteria do. So if you rinse out with water, that's good. In fact, if you brush right after you drink something acidic or right after you throw up, then that actually breaks down the teeth more. So doing something like having water is better. Because when you when your teeth are exposed to that acid, than the teeth are more vulnerable. So if you brush with toothpaste or toothbrush, and there's a braces that and those break down the teeth more when they're in that state. So water is good. The best thing is if you put like baking soda, and rinse with that, but that's kind of gross, but water is pretty good.
Scott Benner 23:39
Yeah, I don't find it when you recommend gross things to people. They're like, Oh, okay, let me I'll definitely.
Trey Perez 23:46
But just nobody wants to drink that. Yeah, no kidding.
Scott Benner 23:49
Would you would you you would just rent with the baking soda and water not? Yeah, swallow. Right. Okay.
Trey Perez 23:55
Just rinse it neutralize the acid. And that helps.
Scott Benner 24:00
Yeah, it's interesting, like, I had I know, I've talked about on here enough that people probably understand that my iron apparently was pretty low throughout part of my life. And once and I would have dental problems. And then I figured out that iron thing and got it balanced out. And the problems that I used to have pretty consistently just stopped happening. And I don't know if it's, I don't know if I'm just healthier in general now because of this, or if it was directly related to the, to the mineral, you know, to iron. But it's definitely I'm definitely seeing it, you know, like long enough now that I can believe in it. Like I've had a number of like root canals in my life. And it's not, you know, it's not lack of care. It's not it's just, it just would happen and then all of a sudden, you know, it's actually I don't think I've ever said this. It's my dentist that I spoke about earlier. The good one, not the crazy one who kind of saved me, because I came in just for you. You know, I don't know what I was in there for one day. But a procedure that took about 90 minutes. And inside of that 90 minutes, I got up out of the chair to use the bathroom like twice. And I do remember that I drank a ton of water before I went to the thing. And I, I mean, that was stupid, like, don't get me wrong, but I got to the dentist office, use the bathroom, went into the chair, had to get up in the middle of the procedure to go. And then after the procedure went again. And by the time I got out, the dentist pulled me into his office and said, Hey, my assistant says that's the third time you went to the bathroom since you've been here. And I left and I was like, Dan, do you have the you have the staff tracking people's bathroom habits? Like what's going on? And he goes, you know, man, that that really could be type two diabetes. And I was like, why? That's crazy. Like, I don't have I would know, if I had diabetes. I know what diabetes looks like, you know, and, but I got home. And I couldn't bring myself to eat. It was fascinating what happened because I just like Arden wasn't there it was the middle of the day, I did not have access to a meter. I couldn't check my blood sugar. And I just thought I don't have diabetes. That's silly, but he's like, go get a you know, get a physical get a physical. So he's pushing me towards the physical. And just somebody putting the idea in my head. I couldn't bring myself to have lunch. I couldn't like I'm like, what if I do have diabetes, I can't eat this. Like I started, like, over the next number of days before I can get to the doctor's office, I started eating like very low carb being very strange around food, like kind of in a panic.
Trey Perez 26:38
Well, yeah, that's what happened when I first got diagnosed to I didn't I wouldn't touch carbs for the first week. I was terrified.
Scott Benner 26:45
Yeah, it's because I mean, what was what was the? How did it feel to you? Like what was the thing you were concerned about?
Trey Perez 26:53
Well, once I found out what my blood sugar was, I was just totally shocked. I mean, I said it I was I was in denial. pretty strongly. And, um, when I, when I found out what it was, I was surprised it could even go that high.
Scott Benner 27:22
I'm fighting every urge inside of myself to just not read the in Pana toothpaste that from the 50s. Instead, I'm going to tell you about in pen from Medtronic diabetes, because they're one of today's sponsors. Here's what you get with the in pen. It's an insulin pen that connects to an app on your phone. That app is going to give you a lot of functionality, some of which is the kind of functionality you think of when you think of insulin pumping. Let me tell you more. When you pair your in pen, with the app, you get a dosing calculator, active insulin remaining a glucose history reports that you can share with your doctor or look at for yourself, activity logs. And actually more than that even, I'm not going to read them all to you because you're going to find them when you go to ink pen today.com and look around. If you're ready to try, fill out a tiny bit of information and hit submit, you're on your way to getting yourself an ink pen from Medtronic diabetes. Use the dosing calculator to take the guesswork out of your dosing the app uses your glucose levels and a carbohydrate estimate to recommend the dose that's right for you. It even considers the amount of insulin that's still working in your body to help you avoid lows. People who have insulin pumps call that insulin on board. And now you can to Medtronic diabetes offers 24 hour Technical Support hands on product training and online educational resources for the in pen which by the way, May. And I say May because it's an offer available to people with commercial insurance, but may cost you as little as $35. The in pen, that's right may cost you as little as $35. Head over now to in pen today.com To find out more. From time to time, I have this horrible feeling that this is no way to start to that. But I have this horrible feeling that there's something right in front of me that I'm forgetting or ignoring or just don't know to do. I don't it's not an omnipresent feeling. Don't worry, don't you don't have to worry about me. But I think about it. Sometimes I wonder like, what small changes could I make? That would have a large impact on my life. Hopefully I'm not the only one who thinks like this. But I digress. Here's my point. You use a blood glucose meter every day. It gives you important information that you make important decisions with and yet you have no idea if the meter you're using is the best one available. You don't even know if it's one of the best ones available. All you know is a doctor gave it to you. Well, here's the thing you You can know that it's not a not a, you know, thought exercise like the thing I was talking about earlier floating around the world like, should I go left or right up or down? Should I stay? Or should I zag? It's not that difficult. The Contour Next One blood glucose meter is a really good meter. It will give you really accurate results. You can use those results to make good decisions. Contour next one.com forward slash juicebox. I don't even I have no more to say, I guess. But I have to because there's time left. And I mean, they did pay me to talk about it. So let me tell you this. It's it's the best meter I've ever used. It is the easiest to carry the easiest to hold. It is the most accurate. I love the Second Chance test strips. I can't say enough about it. The Contour Next One blood glucose meter is simply the best meter I've ever used in the 14 years that my daughter has had diabetes. I do hope you check it out. Contour next one.com forward slash juice box. And I just want to finish by saying please don't like worry about every little decision in life. I was just being melodramatic. You know what I mean? Like, have you ever really thought about the decisions you've made? You understand? I'm saying? Although I did mean that, it really mean it would be easy to get a good meter.
Trey Perez 31:19
And it's around 300. And but you know, I've heard it. I've heard stories where it's it's way higher. Yeah. after that. So it wasn't. Yeah, I guess so. But so I think my doctor, he didn't think it was to two eyes. So I didn't go on insulin right away. He put me on type two medication. And that sort of that did not make me feel good. So I was on Metformin engine nuvia like two weeks, I was like, this is not getting better stuff are getting worse.
Scott Benner 31:49
They do a C peptide on you ever.
Trey Perez 31:52
Um, I can't remember. I think maybe I don't know if they did it, though. That time but I think since Yeah, I think it's been done, right.
Scott Benner 32:04
I don't imagine. Yeah, I just I was in a panic, I didn't know what to do. And I couldn't bring myself to eat. I did finally get a, you know, an appointment with my doctor. I've told that story before I was told that I was coming in for a console. They explained to me that I you know, I said I want to get a physical and they're like, Okay, well, you'll come in and see the doctor 15 minute consults, then we'll Book Your, your appointment for the, you know, for the procedures and everything. And I was like, okay, like, that seems reasonable. It was a little odd to me, but I didn't think much of it was like, Alright, I guess that's how this doctor does it. So I show up and like 10 minutes into this conversation. He starts examining me and I was like, I thought this was a consultation before the, you know, before the exam was like, I got really confused. And then like, 20 minutes later, I like my pants are down, like bent over a table. And I'm like, I'm like, so happy that I didn't run here from like, you know, from something else or the gym or something like that just had this consultation with this guy. So I finally said to him, I was like, Yo, man, I'm like, I'm happy. We're doing this. I was like, but that's not what your staff told me. And he goes, Oh, I don't know why they said that to you. It's like, Oh, great. Okay. Thanks a lot. Anyway, I did not have type two diabetes. Of course, they found my iron to be really low. He immediately believed that I had cancer because my iron was so low. It seems like a jump. Yeah, it was a pretty so I suddenly was getting scoped and all this stuff. And of course, it was just low iron. And I had to go through all this rigmarole just to get an iron infusion. And I felt like I was gonna pass out by the time I think my fart and was 13 by the time I got an iron infusion. And what's the normal range? It it's it should be like, it should be not like 100 or, you know, 75 is considered low for a woman of menstruating age. Like that kind of stuff. Yeah, so I was just like, I could barely hold my head up. I was dizzy constantly. I couldn't stay awake. Maybe past like, one two o'clock in the afternoon. It was really I one day want to go back and find the podcast episodes where I'm like, I have to be like obliterated in some of them. Like from just no iron, but I don't know. Maybe I was pulling it together long enough to do them. Anyway. Okay, so what I mean is that is that the bare bones like overnight that's it swish with water after you drink a juice is really a great thing to do. What about throughout the day?
Trey Perez 34:37
During the day? Yeah, same thing. I mean, water is your best friend. I mean, I before getting diagnosed, I didn't drink juice that much nitric. Yes. You know, I have I haven't usually like if I've noticed my blood sugar getting in, down to double digits. I have little swig but you know, I do drink a couple times a week. It's totally, totally changed my life.
Scott Benner 35:04
Yeah. Do you have them in your car and in your bag?
Trey Perez 35:08
My gosh, I found that I found my jacket the other day. Okay. You know you're diabetic when you find juice boxes everywhere.
Scott Benner 35:16
I picked up art and art as like a little clutch that she has now that she takes to school and it has a juice box and I picked it up and handed it to her like over the island yesterday, and I could feel it wasn't heavy enough. And I was like, you don't have a juice box in this. And she goes, I don't know. I was like art. I acted like, you don't I mean, like, I acted like she went rock climbing without safety equipment. Make sure there's a juice box and she's like, okay, she drives now, you know, and meanwhile, they're in the door pockets of the car, too. Oh, yeah. So it's not like they're not plentiful. They're spread around the house like, like, you know, Apple seeds.
Trey Perez 35:52
And the funny thing is this Christmas. My mom and my one of my dental assistants, they both got me juice boxes.
Scott Benner 36:01
How pack? How was that for your mother? When you were diagnosed as an adult? Did she? Um,
Trey Perez 36:07
she Well, I think. I don't know. They seem to be okay with it. I remember visiting my dad. We went we went up to Maine. And when he got groceries, he's like, made sure he got you know, almond milk, nothing with any sugar in it. And he like labeled everything. It was pretty funny. This has sugar in it. This doesn't have sugar in it. Okay, thanks for that. I can read the labels, but thank you for writing it. Oh. They were super supportive. They're trying to help me in their own way he loves Yeah. It's wonderful.
Scott Benner 36:46
They're not very involved. Like they wouldn't know how to help you with any of this like big picture and understand it.
Trey Perez 36:51
Do you have any? No, I'm sorry. No, what do you say?
Scott Benner 36:55
I was gonna ask if you have any brothers or sisters?
Trey Perez 36:57
Yeah, I have an older sister younger brother. But I'm the only type one in the family.
Scott Benner 37:03
How about other autoimmune stuff? Celiac? My
Trey Perez 37:06
dad has. Yeah, it's all sort of colitis.
Scott Benner 37:11
Okay. Interesting. Nobody else though, right? Like, what else would we be looking for even like, like, you know, bipolar cousin. Like, these are the things I'm now I'm now interested in because I've heard so many people say it's so much obviously see, like hypothyroidism,
Trey Perez 37:31
hypo thyroid. My mom has type of thyroid.
Scott Benner 37:33
Okay. Hashimotos is just she just, she's not an autoimmune.
Trey Perez 37:39
No, not that I'm aware of tincher. So if I think it was my mom, and she just really talked about that. I was just home one time. I'm like, Mom, you're on Synthroid, she's like, yes, no big deal. Like, okay, it's, it'd be nice if you told us about your medical conditions, you know, your chronic medical conditions to
Scott Benner 37:57
your people you have, right, maybe I might want to look out for that for myself. Thanks.
Trey Perez 38:04
But you know, their baby boomers are a different generation. And they don't talk about that as much.
Scott Benner 38:08
Ya know, it's very, very true that some people just, it's not even conceivable for them to have conversations about their health with other people.
Trey Perez 38:17
Yeah. Meanwhile, I talk about diabetes all the time. My friends, like stop talking about it. On on the internet, you're talking on a podcast to millions of people. So just stop
Scott Benner 38:29
talking to people about your diabetes. Let's just talk about some other oral stuff, oral health stuff that I think just people in general don't know about that I know about, like, even like, having like a potato chip, right? Like it could get caught in a crevice of your tooth, and it stays kind of packed in there. And that's really bad, right? So what's your people do during the day? She like soft picks? Like, what? Like you don't I mean, like, what do you do if you're not in a place where you can brush your teeth?
Trey Perez 39:00
Yes, if you can get it out. That's better. Like I said, it's anything that's sticking to the teeth. The longer it's there, the more likely it's going to cause a cavity. And a lot of people think, Oh, my kid doesn't eat candy. Why does he have all these cavities? I'm like, Well, you know, I see kids all the time eating, you know, Cheerios, and go fish and chips, crackers. Those are all salty treats, and they cause cavities. People don't realize, you know, there's carbohydrates, and sugars in those starchy things as well. So you read, everybody has bread all the time. So it's any carbohydrate and if you can get it out, that's better. That's it. I mean, it is hard if you're at work or doing something where you can't brush your teeth. But you know, removing anything is going to be better.
Scott Benner 39:53
Drinking water is a big part of it. Hmm.
Trey Perez 39:55
Yeah. So what happens is, if your mouth Have is dry, which it can be if your blood sugar is on controlled, or if you if you just dehydrated or if you're taking multiple medications, you know, dry mouth is pretty common and the wetter it is, the better it is for your teeth. So staying hydrated is super important. When your mouth gets dry, that's when the bacteria tend to grow more and cause more cavities. So it increases the risk.
Scott Benner 40:28
I'm envisioning a day in medical school where someone for the first time introduced the idea that the wetter it is the better it is and everyone laughed is that.
Trey Perez 40:40
As I said that I didn't realize when I'm gonna start using that though.
Scott Benner 40:46
I was gonna say either make a t shirt or stop saying that's hilarious,
Trey Perez 40:51
new phrase.
Scott Benner 40:55
Do people see the dentist often enough? And what about?
Trey Perez 41:02
No, I don't think they do. I mean, our recommendation whether it's a child and adult, you should see the dentist every six months. And that's because things can happen pretty quickly in the mouth. Like if you are if you do have a change of habit, or some sort of change of lifestyle. In those six months, you can go from having no cavities to having several cavities. And it's not just cavities, but there's periodontal disease, gum disease, and there's different levels of that. So in some ways that can be worse. Because you actually lose your teeth and it's can be harder to repair that but every six months no, just to checkup make sure everything's okay. If people are higher risk, they're supposed to come every three months after high risk for gum disease or caries, then they should be coming every three months just to monitor you know, do some sort of preventative treatments just to keep them deeper and worse
Scott Benner 42:03
probings like that but yeah, I'm getting older, I just my dentist basically strong arm me into a deep cleaning recently, and then gave me a tray that I put gel in and and I guess I'm forcing the gel down into my gums. And and I'm doing that because he told me to and I don't want to get yelled at basically. It is a hard thing to try to imagine, though. Like you don't I mean, it's not that I don't think it's that I don't care about my dental health. Like I don't think that's it at all. I think there are so many other things going on in the world, that it doesn't feel like an emergent problem. It's a it's almost the same as I just said this the other day. So I shouldn't say it again, because people here a couple of weeks in a row. But I think that part of the reason why there's more of a community around type one diabetes, is because people are very desirous of figuring it out quickly because it feels like a thing that could hurt you in the moment. Whereas type two diabetes, there's no, there's not as big of a community or hardly any. And you don't hear people talking about it very much. But it also doesn't feel like something to them, that's going to hurt them today. And so it's the idea of it happening in the future that allows you to kind of ignore it, if that makes sense or not. But I wonder if dental stuff isn't like that a little bit too. Because should should children be getting cleanings? Like if I baby teeth? Yeah. Should I be getting them cleaned? Yep.
Trey Perez 43:29
Like, well, just as a PSA, everyone should take their kid to see the dentist by the time they're one year. Okay. And they should be going from then on it should be every six months.
Scott Benner 43:41
Tell the people you're not just saying that because you have a car payment Right? Like you actually no,
Trey Perez 43:45
no, this is the American Academy of Pediatric Dentistry, American Dental Association, it's the recommendation but it's also the American Academy of Pediatricians the the actual, you know, MD Is it to them as well. They have the same recommendation.
Scott Benner 44:02
Track I grew up pretty broke. Yeah, I didn't see a dentist the first time till I was like 20 years old. They could no one ever took me to the dentist. They didn't mention it. It wasn't a part of my life at all. Like it wasn't even like, it wasn't like I thought like, Oh, I haven't been to the dentist. Nobody takes me it was just never brought up. I definitely could have used braces growing up. That is not something anybody could have afforded. I think it was a financial thing. It just nobody else. Yeah, I went because my wisdom teeth were impacted and I thought I was gonna die. So I have you ever heard this story? Not at all. I'm gonna give it to you real quick then because it'll freak you out. So I go into my dental my dentist's office, which is where I found the meth dentist. And I also shouldn't say that I'm sure he wasn't on that but he's actually a lovely guy just very amped up. And I guess maybe it was coke then. Anyway, up teasing I Go in there. And I'm like, I don't know what's wrong, a lot of pain. I'm very embarrassed to say I've never been to a dentist before had to say that to a person I didn't know. He tells me when Western teeth are impacted. And I have to go to an oral surgeon to have him removed. And I stopped him. I said, I can't do that. I said that, that I don't have that kind of money. And he's like, No, you really have to get this done. And I just I told him, I was like, Look, I appreciate your concern can't happen. I don't have the money. And just kind of out of nowhere, while everybody was staring at each other. I said to him, how much do you charge to pull out a tooth? And he said, $50 as long time ago, and I was like, Well, I can come up with 200 bucks if you want to pull him out. And he said, No, he's like, there. That's not how this works. You don't need me. He's like, That can't happen. I said, it's not gonna they're not coming out if you don't do it. So a few minutes later, he's loading me up with Novocaine. And then his partner comes out, stood behind me with his palms on my forehead to hold my head down on the chair, and he yanked out my wisdom teeth in the office. It was terrible. It was terrible. It was like one of the worst. Like, I just remember him pulling in my head trying to pull up and the other guy leaning down on me. And does that horrify you go ahead, tell your story?
Trey Perez 46:17
That I still have it wasn't diesel? I can't relate to that. They're fully in the normal. Just, yeah, I got lucky with that. And I don't deal with wisdom teeth. That's fortunately, that's something I don't have to deal with. Both
Scott Benner 46:34
of my kids have had them out like the what I would consider the modern way you show up at an office, they knock you out, you know, give you a little Jackson juice. And then, you know, you're you wake up 2030 minutes later, and you don't have your wisdom teeth anymore. Yeah, you know. So, but anyway, it just it was I kind of look on it as like a kindness back then I think he really believed me. I was like, Look, I can't, I can't afford to do this. And so he's like, Well, I'll try to help you. They did not come out easily. It was not another thing. But the recovery was fine. That's good. So you know, anyway, I might have gotten very lucky in that situation, if I'm being honest.
Trey Perez 47:09
Yeah, maybe that's something we struggle with, I think as a profession, because, you know, having it is very expensive. But still other surgeries, if you go to the hospital, that's even more expensive. But insurances tend to cover that and insurance tends not to cover dental treatment. And when it comes to insurances that do cover it, that it's limited on what they do. And it is a big struggle, because the patients don't know what's covered and what's not covered. And insurances don't want to pay. So it's a struggle for those who want to help everybody, you know, we want that's most of us just want to help people and some people are chasing paychecks. But, you know, that's why we got into his to help people. And unfortunately, there's a huge money side to it.
Scott Benner 47:57
And so there's just and do you think that that causes people then to ignore things until they're a problem that can't be ignored anymore? So we don't do as much preventative care, which would maybe stop it. Yeah, do the other stuff.
Trey Perez 48:11
I mean, just like in medicine, prevention is the best medicine. And a lot of prevention isn't just getting cleanings and fluoride and things like that. It's about education. And it's, I wish more people thought about their teeth, but a lot of people don't. And there's a couple of things. One is, you know, insurance of what's what people can afford. And it's also people think, like, you know, with baby teeth, oh, they're just gonna fall out. I know, it doesn't matter. You know, just, they're just do whatever I want. Yeah, yeah. And so people think about that about their adult teeth, especially older generations, they're like, Oh, well, my parents had dentures while my teeth are all gonna fall out. I'm just kind of, it's gonna be the same for me. But when I, when I used to work with adults, the denture patients, they're like, Oh, I wish I listened to my parents. I wish I took care of my teeth. Because having dentures having fake teeth, it's not the same. And they miss their teeth, for sure. And a lot of people wait until it's too late. Because they're like, it's just teeth. It's just a dentist. It's no big deal. You know, they don't people think we can fix anything. But it's a lot of things are very difficult. And nothing's as good as your own
Scott Benner 49:25
teeth, you know, and it becomes irreversible at some point. So
Trey Perez 49:29
yeah, yeah, I mean, you can come in, it could be a small little cavity, and you can take care of that. But if you wait long enough, that the whole tooth can be decayed, and that tooth has to come out.
Scott Benner 49:40
I am. You just shocked me a little saying that people kind of pre plan to lose their teeth as adults.
Trey Perez 49:46
Yeah. I mean, there's some people, you know, depending on the culture and the way they grew up, they definitely see that.
Scott Benner 49:53
Yeah, it's unfortunate it is. That's sad. It doesn't have
Trey Perez 49:57
to be that way. It doesn't have to be that my grandfather died. While he was like, I think a three when he he died and in the nursing home is last few weeks. So there he the nurses like wow, he has all his teeth. So you can you can live, you know your whole life and have all your teeth,
Scott Benner 50:17
right? Are you the first one? Actually my father is a dentist. Yeah. That happens kind of that's that's the thing that happens, right?
Trey Perez 50:26
Yeah, he's actually Oh, he's retired or semi retired now, but he was a dentist in a prison for 32 years.
Scott Benner 50:33
Wow. Yeah. Your dad had diabetes. That sounds like an interesting story. My wife says, Honey, I was interviewing a person recently who is a sex worker and has type one. And my wife's like, how much to talk about diabetes. I was like, not that much. And she she goes, this is a podcast about type one diabetes sounds like it's about people who have type one diabetes, I was like, I'm not getting involved in somebody's really interesting life story and stopping to be like, so what's your Basal rate look like? It's like, I was like, We want to hear the, you know, the interesting stuff. I seriously like, tell your dad, if he ever gets diabetes, I should be his first call. Because I want to hear that story. So I mean, big picture. You know, if you want to leave people with a with a message here about themselves as adults living with type one, or people who are, you know, caregivers for children, you know, what are some really big just go over and again, for them? Like, what should they be doing to help themselves with their, with their oral health?
Trey Perez 51:35
Well, it's, you know, managing your diabetes is super important. When it's not managed, well, then, you know, you're you get dry mouth, and you know, your risk for tooth decay goes up. And also, if you are drinking a lot of juice boxes, or juice or snacking, then you have to be careful with that. But people just sort of, you know, brushed teeth aside, and I think the same goes for podiatry. People don't really think about your feet is that important, or, or going to the dentist is too important. But these are things you use every day, use your teeth every day, all day, you use your feet all the time you're walking, and you don't you sort of take it for granted. And, you know, things could be going wrong that you don't see. So it's definitely easier if we catch something early than waiting till it gets too big. So I think we sort of as a society, or as a culture, just, you know, sort of brush those things off that though, they're not as big a deal. And people only want to go see the dentist to the podiatrist when something is wrong.
Scott Benner 52:51
But yeah, checkups are really big deal, because actually, you just discussed Heath the way we used to talk about my little brother growing up, we used to say that Rob has two states of being he's either in trouble or currently getting in trouble, and you don't know about it. So he's an adult now and doing much better. But, but so your teeth are either, like something's happening, and you don't know it. And that's the time to find out not after it's happening. Right, right. Yeah.
Trey Perez 53:19
And tooth decay is the most common chronic disease in childhood is five times more common than asthma. And everybody knows somebody that has asthma. So if you know someone with asthma, that means, you know, every kid almost has a cavity by the time they're five, some not every but it's that's what it seems like sometimes it seems. I think it's about you know, 40 depending on you know, where, where the study is from, but you know, it can be like 25% to 50% of kids will have a tooth decay by the time. They're five years old.
Scott Benner 53:54
Okay, wow, that's I didn't realize that. Simple things. So keeping your mouth wet, dry. So dry mouth is a is an example of something you should be concerned about. I guess kind of a chronic bad breath is probably another thing you you have to pay attention for. Right? Well,
Trey Perez 54:09
yeah. So when it comes to bad breath, that's a big complaint that people have all the time. And usually, if you think about it, things that smell bad, like the garbage or the bathroom or something, it's all because it's the one thing it's bacteria. So if there's a lot of bacteria, and they're growing, they're sort of they're creating this bad smell. So it's and things are breaking down. Like there could be stuff in between your teeth. There's food there, and there's plaque there. That's usually where people neglect it the most. Some people will be great at brushing and I can tell and then but they're gonna start to bleed once I start doing anything and ask them if they floss and they say no, seems like nobody flosses. But if you're not flossing, then you're not cleaning the whole tooth. And it's sort of like I think like, if you're not If you're not flossing, you're only cleaning about 70% of it to. So that's like, to me, that's like taking a shower, but you're not cleaning your armpits and your other areas that might get smelly. It's just, it's those are like the worst spots because that's where all the food, that's where things are accumulating. And that's, you know, where things are breaking down, the food's breaking down, the bacteria is growing. And that's where you get this bad breath. So it's usually poor hygiene from bad breath, if it's, if it's not, if that if the hygiene improves, and nothing. The bad breath doesn't improve in a couple of weeks, because that's as long as it should take if you're doing everything properly. You know, Gingivitis would go away in two weeks bad breath should go away. So if those doesn't improve, then it's usually like a GI thing, but that's pretty rare.
Scott Benner 55:49
Well, you know, I have to be honest, like the you said, the simplest thing today, as one of my big takeaways, and I don't understand why in my entire life, I haven't put this all together. But the idea that it's not, not so much the sugar, the carbs, but the fact that they sit in your mouth, and then they break down and it's the process of it breaking down. That's dangerous for your teeth. Right? Like I yeah, like when you said that I was like, oh, like, I'm surprised. I didn't outloud go. Oh, geez. I just thought like, there was something magical about the sugar. That was bad, but it's not. It's just, it's food for bacteria. And then it's the waste from that process that's really causing you problems with your gums, your teeth, your breath, like the whole thing. Exactly. So just don't leave stuff behind in your mouth. And you'll be okay.
Trey Perez 56:33
Right? I mean, if you leave, you know, fruit, like, if you leave like a banana peel out on your, on your counter after you eat it, then it's gonna rot. There's gonna be flies attracted to it, there's gonna be, it's gonna smell gross. And that's, I mean, if you leave food in your mouth, similar is gonna happen. You're gonna back to your grow. You're gonna it's gonna smell it's gonna be pretty gross.
Scott Benner 56:57
Is this a this thing I'm about to say to you? Is this. Is this bowl, or is there? Like, what about people who pop gum in? In lieu of brushing? Is there any help? Is that actually doing anything for your positive?
Trey Perez 57:08
Yeah, if it's sugar free gum, especially. Because it's stimulating your saliva. So if you have no more saliva, then you're washing things away. And there's a lot of good things in the saliva. The saliva, there are immunoglobulins. So it can that helps. And then, you know, more fluid is good. There's more minerals, you know, that help strengthen the teeth. There's a few of xylitol gum, that's good. Xylitol is a sweetener, but it's not it doesn't contribute to tooth decay. The bacteria don't eat it, and dissolve the tall. It's believed that it helps prevent cavities helps with the bacteria in the mouth.
Scott Benner 57:54
My dentist has small individually wrapped like Chiclets on his countertop, and it's gum made bizarre. I just realized while you were saying yeah, yeah, I thought he was just trying to be polite, but a little bit of both. Yeah, perhaps. Right. So hey, you said you have a Dexcom. Right. But do you have a palm? Do you use pens?
Trey Perez 58:14
I've been using pens. I did try the Omnipod. And I just didn't love it.
Scott Benner 58:20
You didn't like wearing a pop? No.
Trey Perez 58:23
It was an issue for me. I did do it for about a week. Okay. Like a month ago?
Scott Benner 58:28
The adhesive was a problem for you.
Trey Perez 58:31
Yeah, that and I kept knocking into things and couldn't get you started. Yeah, I couldn't get used to
Scott Benner 58:37
it. Listen, it's not for everybody. That's actually you know, as you're spouting off, I didn't mean spouting off bad, but like running through statistics about things that happened in dental care that we don't know about. Actually, far fewer people were insulin pumps than you think. So, you know, it's it's more common for a type one to be MDI, actually,
Trey Perez 58:57
yeah. Yeah. I just wanted to try it. See if I like to. I did meet a guy at the gym a couple of weeks ago, and I see him every once in awhile. And he's a type one, two, he saw my Dexcom and he made a comment and he has the the FreeStyle Libre. And he's doing daily injections as well.
Scott Benner 59:15
Right. How soon after your diagnosis. Did you have a CGM?
Trey Perez 59:20
I think it was a year later. How do you guide? Yeah, I think it was about this time. Last year that I that I started it.
Scott Benner 59:28
Did you honeymoon at all in the first year? Yeah,
Trey Perez 59:31
I did. Like a lot. And then when that honeymoon phase ended, that was tough. I could I definitely saw that happen. And that was that was like February and March last year that it ended.
Scott Benner 59:44
Do you find it easier to manage with the CGM than you did without it?
Trey Perez 59:49
Yeah, okay. And mainly, I mean, for so many reasons. But doing a finger stick, it takes a little bit of time, you know, just to Open up everything, clean your finger, do those stick, wait a couple seconds for it to turn on. And then it takes like a minute to do it. And this is just like on my phone. Yeah,
Scott Benner 1:00:11
it's like, okay, you know, people have had diabetes for longer just heard you say clean your finger and they're like, finger.
Trey Perez 1:00:17
Well, I don't always do that. But
Scott Benner 1:00:20
I know. I just said that because you were a doctor.
Trey Perez 1:00:24
Yeah, I'm just trying to be doing things by the book, Leading by example. Right? I don't always do that. I don't, I probably don't more than I do.
Scott Benner 1:00:36
I would, I would say it's probably been 2012 is probably the last time I bought an alcohol swab. Yeah, we definitely don't use that stuff anymore. But that's, uh, it was around them, sort of what you were talking about, like, you know, we used to, like, clean, Arden's fingers with and you know, her sights and everything with alcohol, and she just started having like skin problems, you know, because we were drying out her skin constantly with alcohol. Oh, yeah, I've noticed that too. Right. I did a little research and I found out that in Europe, that's not the standard of care. The standard of care is warm water. Mild soap, like clean. Yeah, pat dry that
Trey Perez 1:01:18
I heard. I've heard you say that. And since then, I stopped doing that. Because I didn't notice getting some irritation with it.
Scott Benner 1:01:26
Yeah, totally with the alcohol over and over again. Yeah, no, I you know, Trey, I'm not a doctor like you. But that's I'm just saying what we do. I'm just a dentist. I'm just a guy with a podcast. So I think you've got me by a couple of years in college at the very least. Difficult, difficult major. Right? Dentistry? Yeah, yeah.
Trey Perez 1:01:50
Yeah, there's a lot to know. I mean, going through college. I did. I did biology, cellular and molecular biology. So I learned about I started with that. But then when I got to dental school, dental school was like college on steroids. Like I had to. I had no time for anything else. You know, it just had to, that was my my life. In college, I had, you know, jobs and things outside of school. But that, you know, dental school is just my full time job. Yeah. Studying and everything.
Scott Benner 1:02:22
Has dating changed with diabetes at all. Dating? Yeah, seeing people like that. I mean, if you do, yeah.
Trey Perez 1:02:32
It's something I do. Talk about. So I'm comfortable talking about it. So yeah, a lie. Well, I, I mean, I can't remember what was like dating before, but it's something that comes up, I guess, pretty quickly. It's like, oh, what do you what are you doing there? And while I'm injecting something, so yeah, it definitely plays a part. But it hasn't really made much of a difference, I guess.
Scott Benner 1:03:00
Well, you're also showing up with the dentist thing. So they're gonna hang a little longer to see what's. Yeah. Everybody knows the story about like a dentist wife who has a great car, like they're like I can put up with this guy in Jackson's. Yeah, you get a little leeway? I would imagine. Yeah. Do you see you? I mean, you're not hiding it. Obviously, you go out, you're eating people are gonna see it. Do you don't lead with it? I imagine you don't be like, Hey, I'm trying you want to go out? By the way? I have diabetes? wouldn't think it would start like that.
Trey Perez 1:03:31
No, sometimes it would, I guess. But no. Has anyone
Scott Benner 1:03:34
been put off to the point where you think you didn't see them? Again? Because of it.
Trey Perez 1:03:39
Now, I don't think I've got I mean, I haven't been doing much dating, but because it goes to sample sizes, too. Yeah. Just too small for that. How are
Scott Benner 1:03:49
the borough's the city now, in the beginning of 2022? Is it? Are there a lot of restrictions? What's it like seeing patients with COVID?
Trey Perez 1:03:58
Well, that's, that's been difficult. I mean, I have to wear a lot more PPE than I did in 2019. But I've gotten used to it. It's just, you know, how we practice now. It's probably how we should have practiced before because we're looking in people's mouths. And, you know, kids come in, kids are always sick. If you've seen like 2030 kids a day or more than, you know, you're more likely to get sick. So I'm comfortable with the by now people. It's sort of fluctuated with the volume that we've seen. Lately, I think people are a bit more nervous to go out of their houses because this Omicron variant but overall, like we really haven't missed a beat me it's slow down here and there. Now in the beginning, we everybody had to get shut down. But you know, summer of 2020 everything was, you know, back to 100%.
Scott Benner 1:04:57
Did you realize or did you lose people or There are people that didn't come back.
Trey Perez 1:05:04
Yeah, I'm sure there were some people moved out, a lot of people did move. And then people, people are a little bit nervous to go out. But overall, you know,
Scott Benner 1:05:14
I was talking to an emergency room physician who told me that some of the problem they're seeing right now with crowding has less to do had less to do with COVID. In the moment when they said this to me, and more to do with the fact that people had ignored their health for so long because of COVID, that it was kind of catching up to everybody. At the same time, people are having a bunch of emergent problems, things that they tried to ignore to stay out of doctor's offices with COVID, which I thought was kind of fascinating. And I didn't wonder too, if it creates a malaise, like, you know, you go a year without getting your teeth cleaned, all of a sudden, like my teeth aren't falling out. I'm good. I don't have to do that anymore. Like if it if it kind of falsely tells you. This is something I can ignore, when it's when it's obviously the opposite.
Trey Perez 1:05:59
Yeah, I've seen a few cases like that where people have come in, and I didn't want to come in because of the COVID and spend two years and yeah, now this is just really hurting me. I want to get this fixed.
Scott Benner 1:06:08
Arden's getting her teeth cleaned and a couple of days and she she said again, she's like, this is okay, not that she's done it a number of times already in the last, you know, year and a half or so. And I've have I've had dental work done and everything and I said to the, to her kind of the same thing you were just talking about, I was like, I think that dentist office might be one of the safest places around I was like, these poor people are wrapped up like, you know, frozen food at this point. Like you can't even say, you know, yeah, yeah, that's been shielded.
Trey Perez 1:06:37
Yeah, it's hard, interacting with people because having the bedside manner chairside barrier is important, and they can't really see me smiling or, you know, talking and so that's been difficult. The communication has been a little bit more difficult. So, yeah, I missed that. And, hopefully, I mean, who knows what's gonna happen?
Scott Benner 1:07:02
I have no idea. Honestly, there's part of me that thinks that this is how things are going to be for a while. And yeah,
Trey Perez 1:07:07
I think so too.
Scott Benner 1:07:09
All right, I'm gonna let you go in a second. I have. I just want to know, like, Tell me some of the craziest things kids have said when they're on the gas. Like, have you ever heard something that like, put you back cursing, weird sexual stuff, anything like that? Oh,
Trey Perez 1:07:23
no. One time this kid when they're sedated, it's funny. When kid was like singing frozen, it was really cute. The one kid had to wrestle him a couple of weeks ago. And he he, after he got in the chair. He said, I'm sorry, I punched you. I was like, Don't worry, you didn't punch me. I dodged it. VTT definitely get you keep he was swinging. Yeah.
Scott Benner 1:07:54
I stopped losing. I stopped my son from like popping a lady trying to give him a flu shot when he was about seven years old. I just, I saw it happen. I reached out and I grabbed his arm was like, It's not her fault. Yeah. So. So when Arlen had all those cavities, and I talked to you about back then, you know, we went to a pediatric dentist and a guy that we, you know, trust and had used in the past once or twice with my son. And he was so uncomfortable with the idea of, of making Arden incapable of drinking juice, because she was little when it happened, like she was really little, that he said, You know, I need to do this in a hospital setting where they can regulate her blood sugar if something should go wrong. And just like you said, our insurance did not want to pay for that. The way I finally got around, it was just dumb luck. My wife's company is large enough that they actually, I don't know if people understand how insurance really works. But when you're, you know, when you're with a bigger company, the insurance company really is just sort of managing the billing and the price settings and things like that. But your company just writes a check at the end of like, every quarter for how much money they owe the insurance company. It's a weird thing. It's just my my wife's company is one of those. So I appealed to her company. And they just said, okay, and gave us a waiver for it. It was like a $14,000 procedure, because of the hospital when all was said and done. And we were looking at trying to pay that ourselves, which was not going to happen, like we weren't going to come up with 14 grand for this. And I went to the company and explained what was happening. And we went through a little bit of a process and we got a call one day and they're like, Okay, you can book it, we'll pay it. And so basically, it was just the company telling the insurance company, let them do this, we'll pay for it. And that that's how it worked out. I'm not certain you could get that accomplished every day on everything that you want to get done, but it is how it worked for us in the situation. And then we got to the hospital. And it was well before we didn't I have a CGM she was really little. So they, you know, they hooked her up and had all this stuff ready to manage your blood sugar with and got her through the process. And you know when it was over, he said, You know, I feel bad that we had to do this I was just scared. But then moving forward, she had to go to the dentist's maybe a couple more times for to see him to, you know, have a cavity filled or something like that across the years. But then once we had a CGM, I was able to say to him, Look, I can manage this here, without her needing to take anything in her mouth. And I was doing it back then with like, Temp Basal. Like I was taking her insulin away, making sure she wouldn't get low during the procedure, stuff like that. He was completely comfortable with that. Nowadays, like when Arden goes to the regular adult dentists, like, I mean, she's using a loop system, we don't even really think about it, to be perfectly honest with you, I just take her it's usually kind of fine. But it's been a it's been a long process. diabetes has touched. Everything we've done over the last 15 years. And going to the dentist was, you know, was definitely one of them. It was scary. I can remember being really frightened back then about the finances, about her health thinking we couldn't afford it. And, you know, if I wasn't who I am, I don't even know that I would have thought to reach out to the company and do what I did. I'm just very. I don't know, this push it. Yeah, I'm not sure. It's,
Trey Perez 1:11:25
it's good that you did that. Because insurance companies, you know, if you if you push them enough they can they'll do things like that.
Scott Benner 1:11:31
It turned out it wasn't the insurance company I had to talk into the insurance company said, Look, we said no to this, because that's not covered. That's not part of the plan that we agreed to with your with your employer. So I just went to the employer and got them to change the thing for art and one time that they would agree to. And that was that was that was really weird. To be perfectly honest. I'm still struck by how strange it was, all these years later. I basically went to a company and said, like, can you please pay for this? And they were like, Yeah, sure. So.
Trey Perez 1:12:03
So how old was she when she had that?
Scott Benner 1:12:07
For four, five, maybe like she was really young, she had a bunch of cavities. And they came all at once out of nowhere. And I think they were from this iced tea juice box that she was drinking. Yeah, very likely. It sucks. But I mean, she's good. Now her dental health is great now. But she also doesn't. She doesn't have as many lows. And she doesn't, you know, she's not snacking in the middle of the day constantly. She's not drinking juice or taking in a bunch of sugar, you know, at random times, and she takes good care of her teeth otherwise, good morning and night. Or should people be brushing in the middle? Be honest, like what do you do versus what do you tell people?
Trey Perez 1:12:45
I, I do what I tell people. That's something that I've always tried to do, you know, practice what I preach. So you should be flossing once a day. I usually floss at the end of the day, you know, to clean off all have food in the plaque in between my teeth. And I usually brush after that. And brush twice a day for two minutes should be like the last thing you do before you go to sleep. Make sure your teeth are clean before you go to sleep, because if they're not then all that stuff that's been on your teeth all day. You're just sitting there and the bacteria is commenting and just breaking down your teeth. So the most important time is that night. And then if you can do it any other time after you eat, then that's good bonus. You just want to clean your teeth off anything. Like we've said it's anything that sitting on your teeth is is not good.
Scott Benner 1:13:39
Flossing, wax floss the best just the there's it doesn't
Trey Perez 1:13:43
matter. It's like whatever works for you. Okay, like whatever you use, that's gonna be best that I've had. I think I've waxed floss because sometimes just easier to slip in there. And so whatever works.
Scott Benner 1:13:56
Gotcha. Okay. All right. Did we not say anything that we should have? Have I left anything out?
Trey Perez 1:14:01
No, I think that's pretty good. I think I got everything I wanted to talk about.
Scott Benner 1:14:05
Are you amazed that we talked for this long? Because the beginning you were like, I don't know what?
Trey Perez 1:14:09
Yeah, and it came up more naturally than I thought. So. I'm pretty good at this tree. Don't worry about it. Yeah, I know you are.
Scott Benner 1:14:18
I know what to do. The whole time. I'm just thinking like, maybe if his dad worked on a person prison that had type one I could make that count. I'm telling you like a prison dentist sounds like a badass job to me with like a lot of crazy stories.
Trey Perez 1:14:33
He didn't really talk about it much so. But I'm sure he did have some stories. No, my dad's pretty reserved guy, so
Scott Benner 1:14:43
yeah, all right. Well, then I got it. I don't need him. I need more people like the sex worker. But yeah, when I pause this, I'll tell you the word that I had to bleep out of that episode The most before I let you go, but I'm not gonna waste it here. People are gonna have to listen to the episode to find out. But Trey really I appreciate this man. Thanks very much for coming on and talking about all this. Yeah, my pleasure. I'm happy to do it. Excellent. Have a Happy New Year. Happy New Year to you too. Thank you so much to Trey for coming on the show and talking with me today. And thanks to Ian pen from Medtronic. diabetes. Don't forget to go to ink pen today.com to learn more. I also want to thank the Contour Next One blood glucose meter. Make your next existential decision at contour next one.com forward slash juice box. I want to thank you so much for listening and remind you to go to T one D exchange.org. Forward slash juice box and fill out the survey. I'll be back very soon with another episode of The Juicebox Podcast. Are you enjoying the show, please share it with a friend or a stranger. I don't care if you know them. And don't forget to subscribe and follow in your audio lab. If you're looking for community around diabetes, check out the Juicebox Podcast Facebook page Juicebox Podcast type one diabetes is a private group on Facebook with over 26,000 members, you can be one of them. People talking about life. Insulin, they're drilling down on ideas about how to bolster things. And just having regular everyday conversations that nobody but people who live with diabetes may understand Juicebox Podcast type one diabetes, as a matter of fact, at the top of that page, there's a featured button when you click on it, there'll be lists in there of different series within the podcast. So if you've been having trouble finding the day, the day that the diabetes Pro Tip series, or the defining diabetes series, the variable series how we eat any of the series throughout the podcast, you want to check out the afterdark episodes for instance, but you don't know where to find them. Go to the Facebook page, go to the feature tab lists a plenty are there
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#725 Teacher Mama
Christina is themother of a type 1 and a teacher at her school.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 725 of the Juicebox Podcast.
Today on the show, we'll be speaking with Christina. Christina is the mother of a child with type one diabetes, and she's a teacher. So we're gonna get her teacher mom perspective today. While you're listening, please don't forget, just don't forget, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. I'm gonna say it again, because it has to be said, if you're messed up. I'll try again. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry fill out the survey answer the easy questions. It's completely HIPAA compliant and absolutely anonymous. When you answer these questions, you'll be helping other people with type one diabetes you'll be helping the show and you're just might be helping yourself. Go see Wow. P one D exchange.org. Forward slash juicebox.
This show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash Juicebox. Podcast is also sponsored by touched by type one head to touch by type one.org to learn more. And today's program is what my grandmother would have called it a program. I don't know why she'd say I'm gonna sit down and watch my programs. I mean, I don't know she was from a different time. Anyway, the program is also sponsored today by us med. US med is the distributor of diabetes supplies. It's where I get our hands on the pods. And it's where I get Arden's Dex comps, you can get your things there as well. Go to us med.com Ford slash juice box or call 888-721-1514 To get your free benefits check. Thanks so much for supporting the sponsors. Now let me get you to the program. You know, in my mind now expect the mandrill sisters to come out and sing or Lawrence walk or something like that.
Christina 2:39
Seattle Aquarium.
Scott Benner 2:40
Oh,
Christina 2:42
and yeah, it was really active. It's like climbing all over the glass. So it's my favorite animal.
Scott Benner 2:47
There you go. I was in Seattle. This year. I didn't know that. Yeah,
Christina 2:53
it's not huge. It's okay. It's you know, it's important, but I wouldn't say that you need to like go back specifically to see the aquarium.
Scott Benner 3:01
If you enjoy them and you're ever in Georgia, the Atlanta aquarium is is quite spectacular.
Christina 3:07
Okay. All right. All right. I will tell ya,
Scott Benner 3:11
well, good plans on leaving I for Georgia soon or No,
Christina 3:15
I don't. But now I'm just gonna go just for that
Scott Benner 3:18
feels like a hollow promise to me. But I want to say I was there with my son when he was like 16. And he was playing baseball. At the end of this very long, very hot day. We had this little gap of time, it was the only time we could go to the Atlanta aquarium. By the way, if you've never been there, their traffic is horrendous. So, the CRAM is pretty close to the hotel. And I'm like, Look, we have to go. You know, we're gonna go We're here. We're this close to it. And he just he did not want to he fought it. He's like, No, I'm tired. I'm hot. I just wanna take a shower. I don't want to do like the basically like looked at the floor the entire time we drove there we were caught in horrendous traffic turning what in any normal place would have been like a 15 minute ride until like a 45 minute ride to you know, get in there. And when we leave some hours later, he says to me in the parking garage. I'm glad you made me come to this. Oh, that's good, nicest concession he's ever made to me in my life on something like that. So
Christina 4:24
that's awesome. That feels good as a parent you need those moments brought this
Scott Benner 4:27
up to him recently. doesn't particularly remember it.
Christina 4:33
That's great. Sorry, the he'll probably have similar experience at some point when the tables have flipped.
Scott Benner 4:40
Or I'm wasting my entire life.
Christina 4:43
Yeah, I have those moments. Those thoughts too. It's apparent like why am I spending so much time on this?
Scott Benner 4:48
You kept that like these most like, I kept thinking of it as like he'll never remember it when he was little. But it'll it'll be the building blocks of who he is. He's got Throwing up and sometimes I'm like, I don't think that worked.
Christina 5:03
Yeah. Well, it's like my daughter just lost to her first two teeth. And, you know, it's like, do you what do you because our parents kept ours, you know? And I'm like, I don't, I don't, I didn't want my teeth. Like, it was really strange when my parents handed me my teeth. And we're like, Here you go. And I was like that that's, that was my part of my body. And that's just really weird. It's just one of those things where you're like, I don't think this is going to be important to you.
Scott Benner 5:31
I need to tell you that I've been recording the entire time and starting to think I'm leaving this in. So I'm going to tell you something right now. All right. I don't know why. But Kelly kept the kids teeth. Okay. Okay, I didn't even know it was happening. And when I found out, I found it a porn. And then she told the kids one day, and they, they shunned her. So.
Christina 5:59
So I made the good choice of throwing them out into the garden, basically, although that could be creepy for someone else, and they buy our house and find little baby teeth.
Scott Benner 6:08
You throw them in the garden?
Christina 6:10
I did. I don't know why, but it was like, it feels less abrupt or like less crude than throwing them just in the trash. I don't know why I was like, I'll put them in the bushes. That was like my middle ground, I guess.
Scott Benner 6:29
Yeah, if we lived in a small community in the 1800s, my children would have made Kelly move just outside of the tree line after they told her that. Right, exactly. That's disgusting. And then she showed them and they were like, no, no, no, we don't care about this. Like, why are you showing this to us? Yeah. I can understand. I think I took that opportunity afterwards to go, you know, some of the other things that you're saving to give them later. They don't want that either.
Christina 6:55
Right? Yeah. And there's like, if you save everything, like where do you possibly even put it all? You know, we have to actually hide when things when we when we, you know, purge, we have to hide them from my daughter, before we throw them away because she wants to keep like everything. So maybe she would be the one of the people that would want her baby teeth. But I really got to work on her right now about this because she's going to be like a hoarder. If I don't, it sounds
Scott Benner 7:18
like you're judging her. But you threw their teeth into a bush. So I'm not certain where this fault lies. Exactly. True. True. I will finish by telling you that my mom is 79 now and she just moved out of her home to a place where you know, somebody can be with her a little more frequently. And she has this candle. It's a Christmas tree. And it's maybe, I mean, no lights, maybe about 18 inches high. It's the most realistic looking candle I've ever seen in my life. And I remember it throughout my life. You know, like it's always been around as a decoration at Christmas and my whole life. I've thought, why don't we ever burn that candle? So we're cleaning up her apartment, she's there. And I'm like, you know, there's a lot of stuff she had to get rid of. She just doesn't have the space for it. And I said, Mom, what's the story of this candle? She goes, That's my mom's and I flipped on the bottom. The label on the bottom is actually made out of cloth. And it's just, it's really old. And I said to her I'm like, okay, she's, you know, like, Well, what do you want to do with it? She was I don't want any space for it. I said, I'm gonna take it home. I said, but I'm gonna burn it. But only on Christmas. Yeah. And she goes, Okay, I said, so I'll have it for years, you know, we'll burn on Christmas. So she was at my house on Christmas. I set the candle. I'm like, Mom, I'm gonna light the candle. Is that okay? Like, are you alright with this? Because most of what I'm thinking is the candles neat and everything. But, I mean, if I if I turned to my kids 25 years to now go, Hey, this candle belonged to my mom and it belonged to her mom, they're gonna throw in the garbage.
Christina 8:53
It's like you might as well just enjoy it.
Scott Benner 8:55
That's exactly how I felt. I was like, why don't we just burn the candle and just enjoy it. And by the way, however long ago that candle was purchased, they made candles a lot better because it didn't drip. It didn't smoke. It burns slowly. We have apparently as Americans forgot how to make candles or we don't make them here anymore or something.
Christina 9:14
Right, right. That's not surprising, unfortunately. But that's really cool. That'll be a really fun tradition.
Scott Benner 9:19
Yes, if I can remember the damn candle is next year.
Christina 9:22
We'll see. The other challenge? Yes. Anyway, Christy,
Scott Benner 9:26
you should probably introduce yourself.
Christina 9:29
Yes, yeah. So obviously, my name is Christina and my daughter Annie started kindergarten in August at the school where I also teach fifth grade. So I was hoping to kind of share a little bit about the start of her year in kindergarten and kind of what we're working on challenges that we came up against in the hopes that might help others prepare and get a little window into what to expect.
Scott Benner 9:53
What if I said to you, I don't want to talk about that. I want to talk about candles and aquariums for the rest of you
Christina 9:57
could probably do that, ya know? No, no, please. I could,
Scott Benner 10:01
but you could.
Christina 10:03
I probably could. I'm a chatty person. So especially if it involves aquariums because yeah, I do like marine biology, but I guess we'll give other people a break.
Scott Benner 10:15
Yes, for sure. I will tell you I think that what's sold my son on the Atlanta aquarium with the beluga whales.
Christina 10:20
Oh my gosh, I've never seen I've never seen those.
Scott Benner 10:23
I think that might have been what did it and pretty amazing. There's also like a main tank in there that is so large that it's hard to wrap your head around. Oh, okay. But that's not the point. The point is, you made some babies. How many babies did we make?
Christina 10:39
I've got two. So Annie is the oldest and then Jack is plays a year and a half. A little bit. A lot more. She'll be two in April. Put it that way.
Scott Benner 10:47
Okay. And how old Danny again?
Christina 10:50
She will be six in June. So she's five now diagnosed when she was diagnosed at two and a half, three years. Yeah, we just celebrated this last September. We just celebrated kind of like the tipping point, you know, where she said diabetes in her life longer than
Scott Benner 11:07
not? Would you do fireworks?
Christina 11:13
You would think I would remember what we did for her diversity. But it's kind of weird because of COVID. You know, like the her last couple of diversities have been pretty toned down like the first year we went really big. And we went to Canada. And we had like a three day weekend. And then after that. It was a little bit more scaled down. But I think we just kind of went out. We always go out to dinner and have lots of desserts. We do like a weekend type of thing. So we have lots of dessert that weekend and she gets a little little present and stuff and we just kind of make a big deal of it.
Scott Benner 11:43
Cool. That's excellent. Well, you live in Seattle. I wasn't sure maybe you took over a city block and moved into a bank or something like that.
Christina 11:50
Right? Yeah. Yeah. And we we actually live further north we live in Bellingham area.
Scott Benner 11:58
Christina trying to distance herself from craziness. She's like, I don't really live right there.
Christina 12:04
Okay, Seattle is amazing, but it's actually worse than he was born. But there's so much traffic, it's, uh, you know, crazy. It's just you lose like hours of your day and traffic. So we couldn't do that.
Scott Benner 12:17
Do that, that's for sure. Okay, so any other type one or autoimmune issues in your family?
Christina 12:24
No, you we have type two runs on both sides. I'm pre diabetic, but not type one. It was definitely out of the blue. When she was first showing symptoms. We didn't know what they were. We just kind of she had gotten sick. And we she started drinking a lot of water was the logic you know, those common things and we just chalked it up to her kind of recovering. She had never, she's always had a really strong immune system and had never been to the doctor before ever before being admitted to the hospital. So we just thought that her body was doing what it needed to do to recover from being sick. And then she kept drinking more and more water. And we had luckily caught it before she wanted to ketoacidosis so we, you know, call their doctor and like she's drinking a lot of water. She's wetting the bed, which at that point, she was, you know, potty trained and all that jazz. And so it was abnormal for her. And, yeah, my, it was a kind of a dramatic event because my husband took her into our doctor. And it was like, right at the time when school started for me and the kids. Were starting to come into the classroom and I got a phone call from him saying, you know, he was very calm about it. He's been like, he's been an EMT and a firefighter. And so he like very calmly using his, like, firefighter voice told me on the phone, you know, what was up, like, we need to go to Seattle Children's Hospital. They're saying that she has diabetes. And it was just this very crazy dramatic thing where like, the kids are coming to my classroom and I'm like, running against the tide of students to the off office. And I was like, I have to go now. It was it's always like imprinted on my memory like trying to get down that hallway of students. So but we did catch her early enough to where it wasn't dramatic. She didn't have to be in the ICU or anything. And I feel like overall, you know, our experience with it was pretty smooth as far as being, you know, she wasn't helicoptered out or anything like that.
Scott Benner 14:18
Right. Okay. So some would argue maybe her immune system too strong.
Christina 14:23
Exactly. I know. Seriously, and actually, my, my son has not gotten sick yet. Like he's really I mean, he may, you know, every once in a while he'll have a low grade fever maybe. But it makes me nervous now.
Scott Benner 14:37
Yeah. Ya know, when he like rubs his face on the glass door, and you're just like, Oh, he's fine. Doesn't matter. He's looking handrails. Nothing happens. And
Christina 14:44
yeah, yes. So well. Yeah.
Scott Benner 14:47
Let me say this. No, I'm not pushing this on you. But trial net is in your general area of the country. Like there is the home office there. So if you want to do that with I don't know if home office is the right verbiage. But your hub? Yeah, I don't know. Listen.
Christina 15:03
Yes, we once he, we actually have it in our notes at Seattle Children's that once he turns to we're gonna go ahead and go through that program.
Scott Benner 15:12
Cool. All right. So, very specifically, we're going to talk about your professional expertise and how it's intersecting with your parenting and then maybe some ideas that you might have wrapped around both sides of it. So how long have you been a teacher?
Christina 15:29
Okay, I think I know the answer this question off the top of my head, but I have been a teacher for 11 years now.
Scott Benner 15:36
Okay. And you you said you were teaching fifth grade at the time do you still teach with
when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. G voc hypo pan is a ready to use glucagon option that can treat very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to G voc glucagon.com. Forward slash juicebox G voc shouldn't be used in patients with pheochromocytoma or insulinoma visit G voc glucagon.com/risk.
Hey, yo, what's up? It's me again, Scott. I'm here to tell you about a place where you can get your diabetes supplies that might be you know better than where you get them now. You s med us matters where I'm getting Ardens Dexcom and Omnipod supplies from I switched to us med from the place that we were using before the same way you will I went through a link on the internet us med.com forward slash juicebox having said that I could have called a phone number 888-721-1514 You have your choice. I just sneezed unexpectedly Don't worry I edited it out it would have blown your ears out sorry. Wow. I'm dizzy from it. Anyway us med number one distributor for FreeStyle Libre systems nationwide. The number one specialty distributor for Omni pod dash number one fastest growing tandem distributor nationwide, the number one rated distributor index com customer satisfaction surveys. Oh my goodness, could there possibly be more Scott there is. With over 1 million diabetes customers served since 1996. US med wants to give you better service and better care. They're going to do that by always providing you with 90 days worth of supplies and fast and free shipping. They carry everything from insulin pumps and diabetes testing supplies to the latest and CGM like the FreeStyle Libre two and Dexcom G six us met accepts Medicare nationwide and over 800 private insurers. Are you having trouble finding a place that has on the pod five? That's where I got on the pod five from us med. Need to know more? Us med.com Ford slash juicebox links in the show notes links at juicebox podcast.com. When you support the sponsors, you're supporting the show. Let's get back to Christina. Yep, stuff. I wonder if the kids remember the day you weren't there? Probably not there. They probably don't remember anything
Christina 18:23
I know. It's probably like your son. They're like, What are you talking about? Like this massive life event? For me? It's probably like,
Scott Benner 18:28
can I just check with something real quickly when you are absent one day or you just take a day off? Absent? Like you're not an adult? Let's say you just take the day off? What do they do with your kids? Do they bring in someone to teach them? Or do they put them in a closet for the day? How do they handle it?
Christina 18:44
Yeah, you have to get a substitute teacher. And it's actually a lot of work. So teachers don't often, you know, this year is kind of different with COVID. But you know, that's where you get teachers coming in. They're sick. They're coming in, like, at death's door because it's almost just more work to make sub plans because you have to like, write out every step of like, every minute that a guest teachers in your room what they do prep everything. It's a ton of work.
Scott Benner 19:11
Okay, my daughter's High School now doesn't even bother with it. Which I find disturbing. Interesting. So if your teachers not there that day, they send you to a common area and you sit there and stare at something for an hour.
Christina 19:24
That's bizarre. Do they have subs, like shortages or something?
Scott Benner 19:28
I don't know. There used to be subs and a few years ago this started happening. Weird. And now the teachers tell the kids like hey, I'm taking off tomorrow.
Christina 19:35
Oh, that's that's, that's interesting. Oh,
Scott Benner 19:39
it's not interesting. It's this. It's the feeding. i We I'm paying the property taxes here for that school. And yeah, but that's a different system. I have not heard of that. Yeah, this is how it's being handled how the teacher can't come. That's okay. Just sit there.
Christina 19:52
So interesting. I don't know why. I haven't heard of that. No, that's not a common practice over here.
Scott Benner 19:59
Okay, so So, all right. I want to start I guess with so your daughter's going into school now into kindergarten? Yeah. Okay. And let's start from your perspective as a mom, like what was there to do as she went into school around diabetes.
Christina 20:18
So we, first of all, I started having a lot of anxiety, I think I'd want to, I think I want to start with that, because I, you know, Annie has a really strong, confident young lady has always made friends really easily, I've never would have worried about her socially. And even with that, around like, three months before kindergarten started, I started having just not, you know, waking up at night, worried anxiety about the transition. And I think what I was most worried about was, you know, her, I had these like images of her going in her alarms going off and being kind of like kids kind of judging her being wanting to separate themselves from her excluding her because of her diabetes. And so the first thing that I did when I started experiencing that was I reached out to our team at Seattle Children's, and I asked them to connect me with some families whose kids had gone through kindergarten. So that I could kind of ease some of that and get a more realistic picture of what other experiences were, which is also one of the reasons why I wanted to come on to the podcast, too, because it was really helpful when I was able to reach out to some of those families and say, Hey, did they did your child experience this, and the overwhelming response that I got, and I'm not saying this is true for everyone was that it was, you know, as far as the acceptance socially, was very smooth, there are a lot of other kids who have special needs and classes and kindergarten, everyone's just kind of on even playing field. So that made me feel a lot better. And I would recommend that any other families who are experiencing that also kind of reach out, we don't have a huge community up here. In Seattle, there's a big community, you know, type one community but appear not so much. And so it really is kind of like, a little bit lonely like Annie didn't, we actually just recently met some other type ones her age, but up until even a month ago, you know, it was just kind of so I didn't really have anyone to compare to. So after I kind of worked through that a little bit, in June, we met, I met with over zoom with the nurse and we started setting up some preliminary information to start getting the 504 going, so that she could work on it, write it up. And then we also needed to as part of that we needed to get our paperwork from Seattle Children's that has what they call standing order. So you know, what, kind of directions for how to address her needs at school. But it has to had to come from the, from them. And all of that gets it worked into the 504. And then we met again, in August, before school started to go over that written plan to sign it, etc. So that's kind of like the quick little overview of the setup. So you know, check in the, you know, before the school year yet and prior to start getting that ball rolling is what I would recommend. Yeah, you
Scott Benner 23:13
know, it's funny, as a person who's now had a kid with diabetes go completely through school like Arden's a senior now, and she started school with diabetes. I like my first inclination is almost not to laugh at you, but to be like, Oh, it'll be okay. Don't worry about it. And you know, like, I know you're going to but then I remembered that I think I went into the school like nine months before Arden school year started the tried to get a 504 plan. Yeah. And they were like, Why are you here? Well, they looked at me very strangely. Yes. And they didn't kick me out. But they were like, no, like, we don't do that now come back
Christina 23:48
into, especially right now, because school nurses are so overloaded with COVID. I'm really glad that we and she had reached out to me because of that reason. You know, there's just a lot going on for school nurses in their world right now. I don't know how she's amazing. That's all I have to say. So it helped to just get the Getting Started a little bit earlier.
Scott Benner 24:12
Okay. I am, I would have to say that. I guess I'm interested. Let me just change my my, my thought here for a second. I'm more interested in now that you've seen the whole thing be set up? How many times have you been handed a 504 as a teacher?
Christina 24:27
Oh, frequently.
Scott Benner 24:30
What really happens? Like do you just kind of like listen, do you just kind of like Look at it go, Oh, my kid got asthma. I think you stick it in the drawer. Do you really read it or like how valuable are they?
Christina 24:41
I think it depends on the severity of the diagnosis. So for instance, because if I before is is used for a large range of things. What I most commonly use see fiber force for are like learning disorders. So things like, you know, if a student has ADHD or something or something along those lines, it could be asthma related. Yeah. And in general, in, I would say, in fifth grade, it's a little bit different, because fifth graders are much more able to manage themselves. So for instance, if a student has asthma, it's, they're much better about saying, I need to use my inhaler right now. versus, you know, if you are in a kindergarten class, and the kid is unaware that they need their inhaler, and might be like wheezing, you know, get to a point where they're using so. And when it comes to learning, you know, accommodations for learning. That's where it's nice to have that copy. You know, I have like a binder that I use, it's right in front of me. And I have students who, you know, every year who needs special education services, and they have accommodations, and I think it depends on the teacher, perhaps, but I'm constantly kind of flipping back and forth to those to make sure that I'm following them. So even even when it comes to like, when I'm making a new seating chart, you know, making sure that I'm following that plan, and if there's like preferential seating, following through, but that being said, I teach fifth grade, I have one group of kids. And if I, you know, was teaching middle school or high school, you've got a lot more kids. Yeah, it's a lot harder to manage. And I think it's really important to teach kids to, to advocate for themselves, even from a young age. And we're already teaching Annie that as well.
Scott Benner 26:28
I bring it up, because one of the things that I kind of see online frequently is newer diagnose people send their kids off. Ooh, hold on a second. Yeah, I don't, I'm not sure just what happened there. Sorry. I'm trying to get some water while I'm trying to hold on to my idea. So I see newer diagnose kids, right, and their parents have set up this 504 plan. And then something doesn't happen in the 504 plan. And they kind of lose their shirt a little bit. You know what I mean? Like, and sometimes it could be I don't want to say inconsequential things, but sometimes it's smaller stuff. You know, like, it's not like, I mean, don't get me wrong, like I want the kid tested, you know, blood sugar tested, you know, alarms being treated properly, you know, blood sugars being handled, like all the like the like Do or Die stuff, obviously can't get ignored. But when it's some like little weird thing, you put in your 504 plan, and they didn't do it, and then they start running around, you know, yelling about like, we could sue over this. I was like, I don't know what this is doesn't seem important to me. You know what I mean? Like, sometimes, you know, I've only spoken about this a handful of times, probably on the podcast, but my thought process going into the school Saans the first time when I went in like a year before Arden was going to be in kindergarten was I guess I realized in that first meeting, they looked at me like I was out of my mind. And I thought I don't want to be the crazy parent. Like Like, because, you know, once you leave the school, they're just they're people at their job. And, you know, when I walked out my imagination told me that they stood in that office, they're like, What is wrong with that guy? You know, and, and I thought, I don't want this to be the case. I don't want it to be adversarial. And I don't want them to think of me as like reactionary and overreacting. So I'm cognizant about, like, keeping the 504 plan thoughtful, but simple, and followable. And then I just realized at one point, like you can't, like even if you read it, it's not like it means anything to you. If you don't know about diabetes.
Christina 28:40
Yeah, and it's such a, it's such a complicated disease, right. It's not, it's not like, you've taken inhaler, when you have a symptom. It's, you know, it's, it's such an ongoing management throughout the day. And I agree with you, like, even when I even with frequently looking at this stuff, there's absolutely times where I'm gonna forget, because I think one thing that's really important to remember is that it's such the classroom is such a dynamic space. And you have kids who are in the room that have all kinds of needs, and it's not always it's not always physical, right? So, especially, you know, this is a great example, we have a lot of kids who are experiencing trauma, anxiety, depression, you know, who were already experiencing those things and then put a pandemic and isolation on top of it, it's, you know, really, really traumatizing and then and then so you're trying to manage all of their needs, their academic sides, but you're also trying to manage the whole child and think about what they need social emotionally, in order to be just like a good person in society. And so you're trying to meet those needs in addition to the layering on top of needs that are in a 504 and then every day is just really different. It's the thing that I love about teaching is that you go in and your day yesterday is not going to be the same as the one that you're having today. And sometimes that's great. And sometimes that really is challenging. But it? It does, there's so much variability that again, I think it kind of, I think what you're saying is spot on and that you got to be careful about. You want to think about the battles, what you're what you're kind of highlighting most are the battles that you're choosing. And, and that that was one of the things that I was going to talk about too, is just that, we've absolutely had to change some things from how we expected them to go. So Right. So for instance, I can kind of tell you a little bit about how we have it running and then some of the challenges we came across.
Scott Benner 30:41
Can I I do want to hear that. But I want to say first, you got to like when you went to college, you're you have an undergrad and what what's your undergrad?
Christina 30:51
So I have a bachelor's in English and comparative literature. And then I have a master's in education, and my multiple subject teaching credential and my single subject teaching credential,
Scott Benner 31:02
nursing classes. I No. No, pre med. No. How about Psych? Did you take any psychology classes? No, no. So are you trying to say that a bunch of children are coming together that have a lot of needs that, you know, nobody's really qualified to help with like, you're, you're qualified to teach them, and then they they show up with all these other needs. I think it's just very important for the parents to remember that you're not sending your you know, I don't know you're shy kid to a psychologist, you're sending them to an education major. And there's, you know, and you're not sending. And by the way, too, how often do we talk about on here? How nurses don't get any training around? Oh, my goodness. So. So you think they tell teachers about it?
Christina 31:49
Right, or, you know, or even like, it's very rare to find a school where there's a full time nurse just dedicated to that one school. So their caseload is usually spread across several schools. You know, and that's that itself is a challenge. They're not always on your child's campus.
Scott Benner 32:07
I think the last thing I want to add before you move on, is that we are in a really wonderful time around diabetes where everything is obvious to you like I can pick up my phone right now. And I can swipe up and tell you that Arden's blood sugar's 91. That looks pretty stable to me. And like, I know that in the blink of an eye, but hundreds of 1000s, if not millions of children, before your kids went to school with diabetes, and they didn't have a CGM, or some of them didn't even have a meter. You know, and, you know, maybe their long term health won't be the greatest compared to yours. But they did live through fourth grade. So, you know, I think there's a way to, there's a way to what do I want to say here, Christina, I don't want to be too antagonistic. Sometimes, you got to not want to be upset. Because that makes sense. You have to want to not be upset, like, it's sometimes it's too easy to want to want the fight. And yeah, and that's it. That's just my opinion, my opinion, is you're looking for harmony, and as much understanding as you can get, given the situation? I don't know.
Christina 33:20
Yeah. And I think we, you know, I think we're used to having to do a lot of fighting, especially with like insurance and, you know, pushing back against, you know, like, I know that we have done a lot of push back with even just her diabetes care team around her higher blood sugars and said, like, no one, you know, we want to get them lower that kind of thing. And so I think, I think I think, too, we're just we're that's our kind of our natural trigger. And it does take a while to kind of bring it down. And I had to work on that this year, too. And it was kind of good that I knew, you know, I'm obviously, my, they're my colleagues that I'm working with. And so it was kind of nice to have that because I was able to kind of stand back and tell and, you know, remind myself, this isn't just the school nurse, this is so and so I know them, I have a history with them. I know that their hearts in a good place. I know all of these things. And I'm able to kind of step back a little bit more. Yeah. And trust.
Scott Benner 34:18
So you think it's easier, it might be easier for a stranger to look at the school nurse and think she's trying to screw us. Whereas you look at the school nurse and you're like, that's Pat, you and Pat's a decent person, and I've seen them work very hard at their job, and I know they're not trying to mess up with us and you have a little familiar outtie so everyone, you know, I think you have to just assume that in all these situations until it's proven over I'm not saying look there are people have horrendous stories about school. I'm certainly not lumping them into this right little bit of a conversation here.
Christina 34:51
But your times to be upset. Yeah,
Scott Benner 34:53
I'm pleased and I you know, at some point in this conversation will tell you about you know, when I got very upset and did something, but I'm just saying, like don't want the fight, like want to want it to go well. And if they don't get it right away, I wouldn't take that as being as them being adversarial. I would take that as I'm not understanding. That's my point. Yes, absolutely.
Christina 35:17
And I, I think that's a huge point that I want to drive home to is like, it's it's Boy, oh, I guess I'll wait to like go through our process. But I do want to talk about that, for sure.
Scott Benner 35:28
Tell me about the process used?
Christina 35:30
Okay, well, I'll tell you kind of how we decided that, you know, the system that we decided to try out, and then I'll tell you like, the challenges that we came across. So how it goes for us is last summer, before COVID, like delta got all crazy again. But Annie went to this science camp. And I was I wanted to do that, because I wanted to just practice her being away from me, with a team that doesn't know anything about IBD. This just to see how it would go and went really well. It was great. But the system that we had with them was that they would just take a quick little picture of our pump and text it to us before snack or whatever. And then we would give directions or if an alarm went off, we would they would take a picture and send it to us at that point, we were using Medtronic. And they're, you know, we could follow her. But there's always a huge delay. So sometimes up to 20 minutes, you know, if she goes low, or something we wouldn't find out on our phones until like 20 minutes later on. So we use that system. So it was little more real time for them. And we actually came up with that, because I remember the episode where you were talking about how you had this realization that you could just text Arden and she could, you know, text you back what her blood sugar number was, or whatever. I was like, Oh, well, let's try that. So we use that same system at the school, we have like a group thread going that has, you know, parents, the teacher, school nurse. And then she also has some individual parents who are like, support people to school who, you know, check in with her at key parts every day, when things are a little bit crazy for the teacher. And he's got a lot to manage just to as a check in point. So yeah, what what happens is the teacher or whoever's checking in with her will take a picture of her phone, which isn't as necessary anymore, because we were now on Dexcom and Omnipod. But I'll get there. And they send it to us. And there's a snapshot of the phone and we give dosing advice, or, you know, so might say okay, go ahead and have her put in her number and dose for 15 minutes before eating or something like that. They do the same if there's an alarm, we'll say Alright, go ahead and give her the applesauce or something like that. When we sent her to school, her lunches and snacks have like a little sticky note on it, that have the carbs. And then for her lunch, we'll actually write down like how much each item has so that they know how much to make up type of thing. So she doesn't eat or carrots are something which wouldn't be that big of a deal. But if she didn't eat her carrots, you know, they we would know that she gets make up like two grams or something. And then we keep extra supplies at the school like, you know, all of her extra be, especially since I'm there, you know I've got insulin in the fridge, I've got slight changes and stuff in my room. And we I definitely have had to do that so far at school. And then of just, of course, extra snacks and juice and stuff. And the interesting thing is that Annie has to be the one to push any buttons in her pump. And this I have heard is different across schools. I don't mind it, it's fine, because Annie is pretty savvy. And she does you know, she does little things here and there with her care and I know that on crease. But she you know, they supervise her but they can't push anything into her pump. She has to be the one to do it. So another thing too is that they're not comfortable doing any kind of temp Bolus. So like if I want to do a temp Bolus, I've gotta like, go in there, have them bring her over and set it.
Scott Benner 38:58
Alright, so that's where so that little bit I can see people getting pissed about that. So the whole thing about like your daughter six, five, and you know, like, she has to push the buttons, which means we think if this kills her, it'll be harder for you to sue us if she pushes the buttons.
Christina 39:18
It's a different Yeah, it's different. Not sure exactly. No, there's an informative and asked, but it's okay for us because Annie was already doing that. Like we already but I don't mind also really good with her numbers. Like,
Scott Benner 39:33
yeah, I see what you're saying like, well, first of all, I don't mind that they do that. I just, I don't. I don't like that it gets like let's not pretend like just say it. You know,
Christina 39:42
the reasons behind it. Yes, for sure. And the other
Scott Benner 39:45
thing is, too, you could have a kid who's not good with that. And then we we have a problem now.
Christina 39:51
Right? Exactly. Which is why you know she's always she's always monitored when she's doing it. So she's never like just handed her pump and told to put it in she's always the one that Like there's always someone watching her, making sure it's all good. But she's fast too. And one that's actually been a stressor for some people at the school is that she'll put in her numbers really quickly and click, you know, to Bolus and they're like, Wait, what did you put in? You know?
Scott Benner 40:14
That shows me the system's pretty imperfect on that specific scenario. I want to stop for a second and ask are you generally what is the word I'm looking for nervous about other things? Or is this just this one thing that got you as she was going off to school?
Christina 40:33
As far as being nervous about the social part? Yeah,
Scott Benner 40:35
like when you were when you talked about, I don't want to get too far away from it. Like when you talked about all that, like concern, and we worry about what would like I just, I'm a boy, Christina, like, I don't worry about things that might happen. I worry about things that are happening. And so like, it's just, it's a different way of thinking, I'm probably not specific to boys and girls, I'm just I was just trying to say that I'm a simple minded person, but you don't worry about it. I don't worry about things till they're going wrong. Now there's, you know, okay, there's, I still pre planned, I did a ton of pre planning to send art into school. But I was never worried about it. And like, that's an interesting thing. Like, I've never worried about, like, if people would like her or not like her or give her problems. And I don't know, I just like, was that something that? Like, do you worry about a lot of things? I guess is my question is, is there something specific about this?
Christina 41:30
I would say that, in general, like, I would say that my husband's probably more along your lines a little bit less worried. I come from a family with high anxiety, I do a lot to like, I do a lot to recognize it. When I have anxiety and take steps to mitigate it, like reaching out to families being like, I was understanding, I'm having this like, movie going through my head, that's probably very unrealistic. And I'm gonna go ahead and reach out. And so I can stop that movie playing in my head. And I also didn't really have any reason to be thinking that because I'm a teacher, I'm in the classroom. I see kids interact. And, you know, I don't see that, you know, but it was still a narrative almost that I had running through my head. So yeah, I would say that. It depends. I think that there are certain things that I get a little more anxious over than others.
Scott Benner 42:19
And that's a good point. I couldn't even think of the word anxious. That's what I meant to say. And I couldn't even come up with the word. Were Yeah. How was your experience as a child?
Christina 42:31
My experience as a child was in school. I was. I was I was strong in school. I definitely got. I moved around a little bit. I definitely got some social, like, teasing. I don't even know if I would call it a bullet. Yeah, I think I would actually call it bullying. So I think that that was probably just something that was a little bit more on my mind.
Scott Benner 42:57
Okay, that's I just yeah, thank you. I should have asked you that. But it's fine. Okay, so you have a pretty good system set up with school, you know, you're sending photos back and forth. So you can see what foods been eaten. Does that end up working for you? Yeah,
Christina 43:13
that's that's actually working out pretty well. The other thing too, that's nice. What is it, she receives all of her care in class, I didn't want her leaving to go to the office. Every time an alarm goes off her she ended check her BG or whatever. She does everything in class. And that has helped enable that to just open up that. It's all it's nice, because everybody is on the same page. It feels very cohesive, like we're a team. And it feels like there's this nice net of people who are supporting each other basically.
Scott Benner 43:42
Yeah, I'm a big proponent of it all happening in the classroom as well. I Yeah. A lot could be lost in the walking around the school. And you know, I'm sure I've told this story on here a million times. But leaving second grade, we thought Arden had a serious math deficiency. And it turned out that she was just going for like a scheduled blood sugar check. At the same time every day, and it was cold. It was it was corresponding with the math lesson.
Christina 44:08
Yeah. And the office is a busy place. It's the people in the front office, they do so much. So you know, you might have a child who's you know, unless she's going low or something, it's not an immediate emergency might sit there for 10 minutes. You know what I mean? Well, they're dealing with other things. Yeah,
Scott Benner 44:25
maybe maybe it would be better just to react and handle it. Right there. But do you but can you possibly. I mean, is it possible that one day you could run into a teacher says, Look, I don't want to be responsible for that. Absolutely.
Christina 44:37
Yes. That part of the reason why this is working is that the team is on board. So her teacher has been amazing. And he has been all for it, I think in some ways. Okay, so he sets timers on his phone at key times during the day to just check in with her, you know, ducks Come and check in with us. So it's very structured. And I think in a lot of ways, it's nice for them not to have to make the decision about what to do, because we are telling them what to do. So it takes some of the pressure of, okay, just going low, how much do we give, etc, off. That's, that's been good. I mean, one of the drawbacks, though, is that it is an interruption to him, like his flow of like the classroom, which is why they have ended up bringing in a couple of folks to help with some, some times of the day that were a little bit busier for him to where he wouldn't need to stop the flow. And like a key part of the class there are, as a teacher, there are just certain times a day that a little bit more crazy. And so we were able to mitigate the interruption by just bringing someone else in. And it's fun, because there's more people in the team that can help out so that if there's one person gone, everyone else knows what to do, and how to respond,
Scott Benner 45:55
how did you end up getting them to pay for another person to be in the room.
Christina 45:59
So we are a title one school, and we receive additional funds. So there's these amazing people called calm parents, and they're there as support for kids and academics, primarily. But they're also the people who are our yard supervisors, they fill lots of different roles. And it's like a five, their their day is very scheduled out. So like from this time to this time, they're doing math support, for instance, for k one. And then from this time to this time, they're outside on the playground. And what they did is they just built in a five minute chunk of time, you know, across a couple of their parents days to just do a quick check in with Annie. And it's just very, very quick.
Scott Benner 46:41
So there's no like person sitting in the corner of the room like a broom, waiting to be needed or something.
Christina 46:47
It would be as if the the person who's out on your yard supervision. When they come in, they just check in with me real quick and then go back out. It's it's very quick. It's not like, yeah, it's not like paying for an additional person to be honest people who are already at the school. They just have that one quick check in built into their day.
Scott Benner 47:04
That's excellent. Like when Artem was young. They just that didn't exist. Yeah, there was a you wait, quite literally had to hire a person to be in the room. Right. Right. That school was never going to do that. For Arden.
Christina 47:16
That's for sure. Right. Yeah. I mean, it would I feel, I don't know if that would be possible at every school. But it's it's been, it's been really amazing. And I have any feels very connected to her team. So that's been really good. And it you know, like I said, she didn't she hasn't had to go to the office really at all, like so far this year, which is great. And there have been a lot of challenges. So basically, you know, everything around diabetes is based on patterns. And everything changed when she went to kindergarten. I don't know if you remember this was happening with Arden. But it's like when the times that she eats her snack times her periods of active play completely changed. And the type of outdoor play chain she had she was in preschool before this, but they didn't have you know, a big playground that they're running around playing on it. Typically when we would go to the playground, when she uses lots of muscle groups and is running around. She just like her blood sugar just tanked. So usually we'd have to give her like a good 15 to 20 grams uncovered before we go to the playground, just to keep her even. And so that has been what we've been experiencing pretty much right from the beginning of the year is that she was kind of constantly going low. And that that was challenging, obviously, on the team on the teacher was really stressful, especially with you know, it's a very, one thing to keep in mind is that a lot of it's a very scary diagnosis, right? For people. It's just, it's an intimidating dynamic diagnosis in general and stressful for us. But especially for people who feel you know, are at the school and feel like they're responsible for her not dying, you know, it's there's definitely this urgency to it to where it's pretty stressful. So there's been a lot of adjustment that's had to go on. They at one point asked us to her high alarm goes off at one originally was going off at 140. And that was also stressful. The team was you had had experience with type one before, but not with like a CGM or a pump. So it's a different kind of stress, right? And that it's awesome to know their number. It's also a lot of information and the alarms that were going off can be very, you know, triggering and scary. So they asked us, you know, to basically bring up that bring up that high alarm, and that was really, really tough. I had a hard time with that. I was actually kind of really surprised at the emotional reaction that I had to it and in some ways it kind of felt like I had failed, or that, like me, I felt judged I guess kind of like that feeling you were describing when you came in that first meeting and walked out feeling like they think you're crazy. You know, I kind of felt that way. Like maybe people were thinking that I couldn't take care of her. I felt a lot of shame about her blood sugar numbers and, and I had a lot of like anxiety about the stress and or the perceived stress and burden that I thought it was putting on people.
Scott Benner 50:19
See, this is where you and I will like, like, we have different. We're from different, like generations, because I heard that and I was like, Well, I don't care. Like somebody. That's your job and someone's paying you with the thing stresses you out, see a therapist, but I'm not putting my kids blood sugar higher for you. Yeah, that's a, that's a generational like, disconnect for me.
Christina 50:41
I and that would be like, if
Scott Benner 50:43
my garbage man said to me, it's so hard to lift up this trash. I'd be like, Well, you might not want to be a garbage man, then, you know, like, like, seriously, like, I'd be like, Dude, that's part of the job. You know, it's
Christina 50:53
it's, it's interesting, because when I hear type ones talk about judgment, when they go to the doctor, you know, when they have to when they're showing their CGM, it was kind of like that it was, it was really frustrating. Because before she went to kindergarten home, she was Breyers, very stable, her numbers looked great. And then all of a sudden, it was like, what is happening? It just made her care a lot more public. And it I just felt kind of naked about the whole thing. And
Scott Benner 51:18
now it's interesting, because I really do. Yeah, it's
Christina 51:21
it, it's feel you feel very naked. And you feel like, you almost feel like you want to like defend yourself. Like I promised, we were really good at this. But we're just and one thing that I kept, I think that was really helpful is reminding everyone that we're in the data collecting stage. And that kind of helped them and me in the sense that, you know, I had to remind them, you know, everything's my pattern with type one, everything's changing with their schedule. We're collecting data right now, we're constantly changing little things in our pump. We'll get there. But we need information to see like how her body's reacting to situations, because she also has PE now, you know, a lot more physical exercises she has, you know, she's constantly doing like, up and down movement and lots of thought of dancing and total physical response and kindergarten. And so it just has been really, really interesting. And then on top of that, you know, I think she's just going through a ton of growth, like I can see it. In her she is shooting up. She's lost two teeth there, as I said, the bushes she's growing new ones in, and I can just see her physically changing at an incredible rate. Do you remember this with Arden at all? Of course, do you think like five is nuts?
Scott Benner 52:37
Do you think that you care more about how the teachers feel? Because you know them?
Christina 52:43
Um, no, I don't think so. I actually think it's easier for me to talk to them in about it. I think, you know what, I think I think that there's a lot more trust because I know them, and vice versa. So I think when I'm telling them, you know, this is a data collecting stage, we're getting information, we see the number we just, it just gives us information to chew on how to react to it. I think that that has actually been helpful knowing them, because I think that there is trust there. And, and the other interesting thing, too, is like so yes. Okay, so we brought up her high alarm to 180. But the reason why I was okay with that was because we have such a strong check in system that they're not just like letting her fly all day, right? Like there's there's check in times built into the day, she never gets up to 180 or unless she's got a site failure, which we started. That's another thing that happened. She started having increased site failure, she was on the Medtronic pump. And they changed the we were on the Meo sites, and fusion sites, and they just weren't working for us. So we were that had happened right around the time that she entered kindergarten, and we just started getting high blood sugars at school, it was really weird. And we ended up deciding Medtronic isn't working for us anymore. And we decided to switch her to Omni pod early. We were planning on switching her during the summer. But we just said, you know, this is like a nightmare. I'm having to do site changes at school all the time. Like we're just gonna change her. And that also was another big transition. Because Omni pod how they like their dosing increments for basil are different. And so that was kind of like trying to figure everything out again,
Scott Benner 54:33
starting over a little bit. Yeah, I'm doing my best to get past like, I know, I'm 50 and I don't know how old you are. But I I grew up on the maybe the East Coast. You grew up on the west coast, but I'm literally stuck on the beeping makes me stressed out. I swear to God, if any one of my kids teachers ever says something like that, to me, they're not gonna like where the conversation goes after that, and I'm gonna lose a lot of academic or intellectual cred because I'm gonna lose my shit. someone says something like that. And I'm like, oh, no, the beeping is bothering you. She's got diabetes, you're moron. Like Like, this is the situation. And I don't care how you feel like I, this is probably a good time for me to tell this story. So when Arden was first in school, we had a system set up as well. And I want everyone to remember, Arden didn't have a CGM back then she was on, you know, injections. And we had this system set up to at certain times, certain things had to happen. There was this one time before recess during the day, she had to go to the nurse to get checked and then we would kind of like bumper around with food if we had to before she went out. So I have for all of you are wearing index coms. You know, keep this, keep this idea in mind. It's art and going to the nurse. She's five years old, same ages, Christina's daughter now, and it just doesn't happen one day. So one day, the the nursing staff doesn't call the classroom and ask for Arden to come down, which was the process. The teacher who had at that point, had Arden for three quarters of a year, just, you know, doesn't notice it. The kids go out on the playground. But I know because I know the schedule, and back then Scott paid attention like a, like laser focused. So what would happen was they'd call her down to the office, they check her number, they would call me on the phone, and then I would tell them what to do. And this happened every day before recess. So a couple minutes after recess goes by I don't get the phone call. I tried to be reasonable. 10 minutes later, I call the school I get put through the nurse's office. I'm like, Hey, I did not get my call about Arden pre recess. And the woman that the nurse who I still know is like a friendly like neighbor. I just heard it go, oh, Arden and then she hung up the phone. And I was like what? So I'm sitting there like she hung up on me. And I'm sitting there and five minutes later the call comes. Hey, Arden's blood sugar's like 50. Another student came into the nurse's office was an emergency around his heart, they had to put him on a heart monitor at the exact time they were supposed to call and have already brought down. And so I had been telling them that this process that we set up wasn't good enough for ever, and they would ignore me. This is the day that Arden got somebody to help her with this. And we took it off the nurse because I, after Arden was okay. Put myself in my car, drove over to the high school where the superintendent work, walked into his office demanded to see him sat in his outer office until he saw me sat down, explained the whole thing to him, and then said, Do you think it would be cheaper to hire an aide or for me to sue you when my daughter dies, which do you think would be easier for you? I was like, because if you guys kill my kid, I'm going to spend the rest of what I'm assuming is going to be a long and sad life making you miserable. And I just want to be clear that I'm not that person today. But I think I would be that person later. So many goes here, we'll get her an eight. I was like, great. There we go. Like so Arden had to almost pass out by the way, they found her on the monkey bars with our 50 blood sugar. Like, like up on the monkey bars. So if someone were to say to me, the beeping makes me nervous. I think I would laugh at them. And I'm feeling bad about that as I'm having that thought.
Christina 58:33
Right? Like well and too, I mean so, so there you were advocating for your kiddo. And also, I think for me, it didn't really put me off when they first so first of all, they didn't they weren't necessarily telling me in those words, you know, the beeping is stressful. That's my teacher perspective coming in and knowing what it's like to be teaching class and then to have to have a lot of interruptions whether it's beeping or some other I mean there's 1000 things that interrupt your teaching in a day so I just want to be clear that that was not like the teachers complaining but just that they did they did talk about how the alarm seemed like unnecessarily low like when it was going off because we because we are checking it through so often so that's why like I said I was okay with like, doing that system and at that has worked out bring it up to 180 is totally fine.
Scott Benner 59:30
Lovely that you guys found a like a workaround that worked for everybody. I think that's amazing. And, you know, but I would tell you that I was once told, you know, well, we're not going to correct Orton's budget or that's not what we do with the other type ones and I was like so there are four type ones walking around the school have a one season the eights and you want me to shoot for that
Christina 59:49
like right and that that actually we did talk about as well because I as part of the conversation about raising a per you know her high alarm that was brought up like she is the most managed type one that we have. And you know, and just kind of saying that, you know, most most kids, they're a high alarm goes off at 200 or something. And I said, well, that that's not, I'm not okay with that, basically, like, I had to say, I'm not okay with her sitting at 200. And so I did have to push back against that. And I did say I'm okay with bringing it up to 180. But with the, you know, what, with the understanding that she's going to be checked, and so it was a little bit of that, like, No, I'm not okay with this. I'm only halfway here. As long as this is also happening,
Scott Benner 1:00:39
you are so lovely, because I probably in that same situation would have said, I want you to imagine many years from now my daughter is seven years old, and she drops dead, but she could have lived to 77. But you the beeping was bothering you. And I would have said something completely. By the way, I'd go against everything I've said earlier in the podcast, which is don't be adversarial. Right. And I want to be fair, I was only adversarial. Being serious in the office with the door closed with the superintendent. Like with the nurse, I completely understood the kid with the heart monitor, I understood the situation completely. It wasn't their fault. It was a weird scenario. But that wasn't my point the entire time. Like I can't just leave this up to like, hopefully that the nice lady remembers to call the class.
Christina 1:01:27
Yeah. And you know, we, we had gotten her so stable and stuff before kindergarten, kindergarten happened. And then like I was saying, there's just so much change that has happened this year, that we have the opposite problem, you know, we don't even really worry, we're not have to worry don't have to worry about the highs as much because we're constantly trying to figure out the lows. And I really think a lot of it. In addition to the changes that we've noted in the changes in her schedule and activity, a lot of it just has to do with her growing. We have noticed that with Annie, I think we talk a lot about I hear a lot about high blood sugars with hormones, we get kind of this weird thing where she'll go high, you know, at night. And we'll have to do with Temp Basal, and then she'll go low during the day. So I don't know if you've heard anyone else talk about that. But a lot of times when she's having a growth spurt for like, a week or something, you know, she needs more insulin at night, but then during the daytime, we're fighting lows. It's really interesting. Yeah.
Scott Benner 1:02:27
I mean, you just have to be flexible about it. Like when that happens. You you know you're gonna have to I mean, does the teachers have any comfortable? Like, can you set temp? basals? Yeah, yeah, so
Christina 1:02:44
yeah, exactly. Yeah, it's nice. So I can just come in quickly do it, or a couple times, they've walked her down, and I just said, a Temp Basal. And that helps out a lot. What's frustrating, I think one of the more frustrating things has been, you know, we'll notice a pattern, we'll make changes in our pump. And then, you know, that'll be good for like a week, and then she'll gotta go back to her other her other pattern. So there's just a lot more of that this year. And it's been a lot more of a roller coaster. And I think just a lot of it, like I said, has to do with the amount of change physical change that she's going through
Scott Benner 1:03:16
almost a lot of growth, right. Yeah,
Christina 1:03:19
I mean, I'm almost to a point where I'm noticing a pattern that I'm just setting a Temp Basal for like a week, and then just backing off with them again, because every time I feel like every time I go in and change something or pump, it's like a few days later that all of a sudden, it's back to where it was. And I'm like, Okay, we did, we did have to bring down her carb ratios to like once we switch to the Omni pod, we had been bringing down her BS rates because she was constantly going low. And it was interesting, because when you're looking at her line, it was just flat across the whole day, but Skerton that low line, and and she was getting a lot of uncovered carbs. And so we kept bringing down our basil thinking that that was it, because she wasn't like having a huge crash. It was just like floating below. And then it was they were ridiculously low. At one point I decided this cat like I if I give her any less basil. I just don't even like let's try carb ratios. And that actually ended up helping quite a bit. But it was weird. It was kind of like almost reversed of what you would expect would need to happen.
Scott Benner 1:04:17
Well, there you know, there are people who manage to different ways they like there's a lot of different ways to manage. You could manage good solid basil that holds you nice and steady away from food. Or you could be one of those people who uses less basil and crushes meals with a lot of insulin. And to me that's I don't know if there's a right or wrong way. I mean, I guess it's obvious if you listen to that, I think the way to do it is to start with basil and then get your meals right but you know, that comes from a lot of MDI people I think, like Yeah, you know, like there's not an MDI. A lot of times you'll have a heavier Basal than you end up needing when you're on a pump. You don't realize it and you're maybe you're just eating In the right times, or you're feeding your lows or something like that, but I can see how if you had stability and we're in, it wasn't crashing low, that you might have thought basil for up. But that's really cool that you figure that out, too.
Christina 1:05:12
Yeah, it's doing a lot of work. And it's again, it's like, we'll figure it out. And then the other thing, too, she got her COVID shots. So you think about that, like, she got her flu shot one week, next week, she got her first COVID shot. And then two weeks later, she got a second COVID shot, I mean, between their two, like we had crazy numbers. So basically, pretty much from the time that she has started in August, she had like, a few weeks of really stable numbers. And then beyond that, we've just had so much change. And I think, basically, we're still working on getting her all figured out. And I and I think the big change that I've seen with our team is less fear about the number. So I she has an amazing teacher, he's really actually very interested in learning more about type one, he's actually started listening to a little bit of your podcast even because he just finds finds it fascinating. So we've kind of scored there. And he's just worked really hard to just know how to respond. And he he's actually been able to predict kind of what how will the other good thing about the text message that is that they see the patterns and how we respond. And so they get feel a little bit more confident in what they would do you know what I mean? So it's like, I, you know, I, this is the number and then he'll guests kind of make a guess about what I'm going to say, and see if he's right. So their instincts are growing.
Scott Benner 1:06:36
I like that. That's a great way. That's how I do it with Arden, actually. You know, just like, hey, what would you do here? When she was younger? Like what do you think this is like? What do you think the right numbers? How many carbs? Do you think this is like that stuff all is? It's a great way to learn this?
Christina 1:06:52
Yeah. Yeah, no, that's been good. So I guess like my advice for my, you know, big takeaway advice from this. And like I said, by no means is this a perfect thing. We haven't got her totally stable. We're still figuring it out. Oh, the other thing, too, it's cold now. And the other thing to think about with COVID is that we have to keep windows and doors open. And we've had a super crazy winter here. It's been snowing and stuff, we've got snow on the ground right now, which is not normal for this time of year. And it's freezing. So she's in a classroom, and it's cold. And I think she's just like burning a ton with her body trying to stay warm.
Scott Benner 1:07:28
I'm confused. You have to open the windows because of COVID.
Christina 1:07:31
Yeah, so with COVID, you want to keep airflow. So you have to like I turn up my heater and stuff. But the idea, of course, being that more airflow, the less likely that you're going to have an outbreak in your classroom. Gotcha. Yeah. So my big takeaway for advice is just you know, one thing is, you know, pack snacks. So we have pack two recess Snacks, where they have two recesses, the other kids just have one snack recess, but Annie always has snacks before her recess isn't. And we also pack a snack on Pete for PE days, kind of like you were talking about how you know, just pump are full of little extra carbs, which has been super important. And then I would say, you know, this system that I'm talking about, we're on a thread, the benefits would be, you know, take some of the stress off of decision making for the team for the nurse and the teacher, there's increased communication, we always know how her day was where she was at. So we don't really need to look at her data, there's a much faster response time to her needs. So instead of having to go through the office or something, it's immediate, it feels like a team. And it's easier for the team to kind of notice patterns and how learn how to respond to her numbers based on how we respond to, you know, whatever texts are sending to us. And it's also nice, because the staff can input in from you know, suggestions too. So for instance, if my husband responds, Alright, go ahead, and, you know, cover her snack or whatever, their nurse, sometimes we'll pipe in and respond, you know, remind us, hey, just a reminder, she's got music, and they do a lot of jumping up and down and music. And so I'm like, Oh, that's right, let's, let's keep the two grams uncovered or something. And so it's a nice little safety net, and it feels like it's kind of going back and forth. And that we're all I'm all have eyes on it together. Yeah. And the challenges of that the what we're doing, of course, you got to have a teacher who's on board and a staff that's on board. If there's tech issues, like sometimes her teacher, someone has gone to send a picture of it, and that's not working or something, you know, usually that warrants a phone call, that always warrants a phone call instead, which is not a big deal. And that, you know, the classroom teacher might feel overwhelmed or uncomfortable with an interruption to the day. And I think again, that's where the teacher perspective comes into play, like recognize just recognizing that there is there the classroom is so dynamic, and so it is very triggering to kind of hear feedback about numbers and alarms and also We'll just try to imagine like, trying to imagine, like being in a room trying to herd a bunch of kittens around while like something's on fire, like that's sometimes what teaching feels like. And so, and then also having like this alarm going off, it's just a very, especially with young kids. There's a lot of needs. And so taking those deep breaths when you're having those conversations can be helpful. And
Scott Benner 1:10:29
I can tell you that, you know, first of all, it's good to remember that when I'm talking about when our son was younger at school is a really long time ago. Oh, yeah, well, and
Christina 1:10:38
like you said, No CGM. That's, that's scary enough.
Scott Benner 1:10:41
Yeah. Well, even the idea of like, why couldn't the nurse set an alarm? The nurse couldn't set an alarm because cell phones didn't really exist,
Christina 1:10:47
right? Yeah. Oh, my gosh, I didn't think of that. Yeah, you're right. It didn't come for another year or so after that. We're just like snapping a picture.
Scott Benner 1:10:55
Yeah, yeah. There's no, there's no taking pictures of anything. And nobody had an iCloud account. And a lot of stuff didn't exist. But, you know, what I can tell you that I think has been most valuable through the whole journey was that in the beginning, we had some sort of thing in place. And then if the thing didn't work, we adjusted it. And if the school was helping, that was great, and if they weren't, then I pushed back. But I did not push back just for the sake of pushing back, I pushed back when it was a dire situation, right, plenty of little things that happen, that I could have gotten upset about that I let go. I think I left that school. That elementary school people liked Arden and didn't have a bad feeling about or or me, which I took is a great accomplishment. And why that was very important, is because then when I went to the middle school, to a new place, and tried to explain to them all over again, this thing we've been doing now for years that was working great at that point, they right away, threw their hands up like, Oh, that's not how we do it. But you know, who I brought along to the meeting? I brought the school nurse from the elementary school, who said, you should probably just listen to this guy. Yeah. And so I had a friend and I moved them along. And by the way, when Orton went from the middle school to the high school, the middle school nurse came with me and said the same thing to the high school nurse who immediately heard what we did, and said, No, no, no, we won't be doing that. And I went, Oh, we are. And you know, and she's like, well, I like to know the kids with type one. I want them to be in the room. I'm like, I don't care if you ever meet my daughter. Yeah, yeah. You know, so like you you're there's this transition that always happens in every year, I would strip out any unnecessary stuff from the 504. Because you're gonna find that the 504 plans when they're younger, are overkill as they get
Christina 1:12:40
older. Yeah, absolutely. I'm excited about that, actually. And the reason
Scott Benner 1:12:44
that's important is because it gives the teachers less to be nervous about. So take away the stuff that doesn't matter as you're moving forward. And, you know, having snacks in every room or hidden around the school, you'd be surprised as they get older and older into into high school. What that turns into, like, for the last handful of years, we take, listen, I'm gonna tell you something right now. Arden takes in an omni pod, an omni pod, no insulin, a glucagon? Four or five juice boxes and some test strips. Like, I don't even know why we throw the test strips in there. Yeah, yeah. It's to make the nurse comfortable. Right, right. So what if Yeah, so we'll put this in, because they're like, oh, we have a drawer for her. And I'm like, yeah, she's never gonna come here. But that's not right. And so like, here's some things that make you think I'm taking you seriously. And then that makes them happy. Now this is more 10th 11th 12th grade. And you know, Arden's got a juice in her purse. Yes, that's the extent really, of how we do it. Now. Although I will say this year as a senior, she has a teacher who pulled her aside and said, I bought a whole bunch of snacks. And he opened up a drawer and he goes, these are for you. Oh, she came home. And she was really touched by that. She's like, he bought like all kinds of food in case I get well, and you know, and one time this year, it actually came up where Arden had a low that that we couldn't fix with the juice. And her options were go to the nurse and get the juices that we stashed there. Were I guess she has some in her car, she could have went and got but she's like, I'm just gonna go over to his class and grab, like one of the snacks he has for me. It's really sweet. Yeah, so it just it's going to morph. And yes, I mean, my best advice is, like I said, just set it up so that it works. You know, hope to hell, you don't run into people who aren't going to be helpful because you have a really, you know, a great system. They're set up with great people. I've also interviewed people who that the teachers and the staff, they don't want to be involved at all, you know, right. And that's a different problem, obviously, yes. But at the communication and get get a system in place that works as well for your situation as you possibly can.
Christina 1:14:58
Yeah, absolutely. And you That's like the big thing too is just like expect, expect change. So, obviously, but sometimes dramatic change, like I said, I mean a lot has, for instance, when we went in thinking that we were going to be dosing for fat and protein still, we don't doser fat and protein at all at school, because she just burns it off, you know, she's just running around like a banshee just like playing like crazy. And I when I see her at school, on the playground, she is just red cheeked huffing and puffing like going crazy. So I think that probably it also just depends on the kind of kid you have to you know, not everyone is Annie. But, you know, I think just like, realizing that those first months, possibly even up to for six months to a year, we're just collecting data and trying to figure it out and and just expect some pretty big growth spurts at this time, you know, yeah, there's a lot of hormone fluctuations. And that's been, that's been something that I didn't really expect. And, and again, just like I said, everyone's been very accepting of her. And so if you have any anxiety about your kiddo starting out, it really isn't as scary as you would think it
Scott Benner 1:16:11
is. Everyone goes to school, it'll be okay. Yeah, and hormones were just to get their period.
Christina 1:16:17
I know I am dreading or laughing
Scott Benner 1:16:19
at you right now. What do you think of that?
Christina 1:16:21
I know, I know. Seriously, I think about that, too. And like the cash, this is just kindergarten. One interesting thing. I know we're close to that time. We had we did have a slip up on our end. We had you know, we should we put sticky notes on her lunch with the total on it. My husband had written, you know, 32 grams on her lunchbox, but he had accidentally like looped the end of the three. And so it kind of looks like an eight. So I was in class and I look at the letter CGM. And she is just tanking like dropping and like what is happening. And they had dosed her for 82 instead of 32.
Scott Benner 1:17:02
See, now that's interesting to me. The nurse didn't notice that one day, suddenly, she was getting four times. Well, this was in
Christina 1:17:09
the very beginning. This was literally like, first lunch. So and they don't have any perspective, right
Scott Benner 1:17:15
at that point at that point. Okay. I understand. At that
Christina 1:17:17
point, they don't they notice the pattern over time, like now, if that had happened, again, they would have been like e to that's like, way different. Right? But at that point, they don't. And as a matter of fact, you know, we have kids who, when the nurse was talking to me about this later, she was saying everyone's different, like every type one needs differently. So you had some kids who they might actually eat at to your, you know, grams of carbs in a sitting so it's not really they don't I have no reference. So just be really kind of, you know, clear about
Scott Benner 1:17:49
I understand, hey, did the did the cops have to come when you beat your husband when you got home? Or did you?
Christina 1:17:55
Oh, my gosh, I I actually I felt so I felt so bad for the team. I I've never seen her her teacher looks so just just hangdog. So down. I felt so I actually felt like are you okay? Because he was just so worried I was it was just like, this will never happen again. I was like, well, on our end, either. But really, when they showed me the stick, and I was like, oh no till that toy, it looks like an eight.
Scott Benner 1:18:23
My husband will never make this mistake again. Because his hands are broken, and he can't write. So
Christina 1:18:28
well. And her and her teacher made a joke like, you know, I can send home some handwriting sheets for
Scott Benner 1:18:33
which I thought was pretty funny. You should definitely still do that. That's great. I
Christina 1:18:38
should have put some in his stockings
Scott Benner 1:18:39
to practice your cursive on these dotted lines.
Christina 1:18:44
Oh, yeah, it's been good. It's just been, like I said, you know, a lot of me kind of having to step back and reminding myself not to be judgmental of the journey either. And just recognizing like, man, we've been through a ton of stuff this year. And of course, her blood sugars are going to be need some kind of constant adjustment right now. And just being okay with that. And so,
Scott Benner 1:19:07
I'm just gonna say this to everybody listening, if you think that your insulin isn't gonna be constant adjustment through your life with diabetes, you're fooling yourself.
Christina 1:19:14
Well, I think that's also part of it, though, too, right? Is that I'm like, I'm, I feel this pressure to kind of get her to be like perfectly even throughout the whole day. And then I'm because I feel like, like, it's just crazy. And then there's the other part of me that's like, but she's always going to need adjustment. You know what I mean? Yeah, so I guess that's where I'm at in this journey is me trying to see what normal looks like at school because it is different now. So I'm trying to find the new normal and trying to get her to the most stable spot. And I'm just starting that journey of seeing like, what is a pattern of like, how often I'm actually having to make changes. So that's where I'm very much a newbie. Yeah,
Scott Benner 1:19:59
just because that you don't forget that your new normal might only last for three weeks.
Christina 1:20:04
Okay, yeah. So basically what I'm hearing you say is this is normal. Yeah. And this is this was art in in school. Yeah. Like she was constantly making adjustments
Scott Benner 1:20:13
you, you're because you're newer at it. And you're just seeing this for the first time. You're just you're seeing the same things I saw, you're thinking about them backwards of how I would think of them. So you're, you're seeing she needs more, she needs less activity, like, how do I find normal? Where do I get this? So it's on like, autopilot. Again, I don't think about diabetes like that. Like, I just think it's going to change and you just, you just adjust with it. So there are days when she'll need more and days when she'll need less and you just give her more or less.
Christina 1:20:44
Okay, that's helpful for me. Because yeah, I just feel like, Man, am I just not doing a good job with this? Because like I said, before she wanted to school, it was pretty, like I didn't really think about it that much. And even when she's at home, yeah, I don't really think about it that much. Because she's
Scott Benner 1:21:01
you found the pattern that works,
Christina 1:21:03
right? But school is such a dynamic place. Like I said, yeah, there's more
Scott Benner 1:21:06
going on. And there's and those are all variables for diabetes. And a lot of the very opening it wants to
Christina 1:21:13
write exactly. Okay, here's how helps me just to hear that. Yeah, I
Scott Benner 1:21:17
would judge a here's how I would judge your success or failure. Not to use words that some people don't like, but I have a limited vocabulary. So. So here it is, How frequently does her blood sugar get into an emergency low situation where you're in a panic?
Christina 1:21:34
Well, it depends this year more often than normal. And I guess it depends on the week and a week. I mean, like I said, we've had so many variables, but I would say in a week. She like the week before we left for school. She was getting there probably like once a day. Okay, like a panic, panic being that she has got a low well, so her low alarm goes off at 75. Okay, so you're gonna miss time respond. So that's not panic. But if it but panic, as in maybe she's like, 6620 down, and she's like, on the playground or something.
Scott Benner 1:22:10
Here's the thing, I would adjust your theories about panicking. And then that would be one thing that would help. So I think you're doing good there. What's there anyone say?
Christina 1:22:19
Her last day when she was 6.3?
Scott Benner 1:22:23
And how frequently do you think she's over? 180?
Christina 1:22:28
Well, she's been going high at night. We just started sending Temp Basal. The last week, she has been going high at night, like every night. And then we just were like, just set the Temp Basal. So that was taken care of. Do you mean Hi, what put a number on high for her is 140. Okay,
Scott Benner 1:22:43
you're doing great there. I told you. You're doing fantastic. So your kid has had diabetes for a couple of years, just started school. You had you were living through COVID There was a lot of like, stability, because there. There were far fewer variables. You've introduced a ton of new variables. You have a low six a one C, she doesn't get emergency low more than a couple of times a week, and you don't normally go over 140.
Christina 1:23:11
Well, she'll go over 140 her high alarm has over 140. But I get your point. We're doing all right, you're doing great.
Scott Benner 1:23:18
Listen, I'm gonna say something to you that I end up saying to a lot of people more privately than on the podcast, but I'll say it here. Your desire to do well. Is why you're going to do well. Yeah, yeah, it just it just takes time. You need to have these experiences they have to happen kind of over and over again so that they start to make sense to you. So that you're not chasing them around, but more making meaningful adjustments. Yeah, you know what I mean? Like there's Listen, art and didn't seem to feel well, yesterday. This is Christmas break. She was just very kind of like laying around quiet. She had food that I thought we Bolus pretty well for. And then suddenly, it just, it got away from her. And I got it and she tried to Bolus like before I got to her and it just didn't happen. Like her blood sugar went up to like 200 and it sat there and we crushed it. And it just went up more.
Christina 1:24:18
Yeah, that's happened to us recently, too.
Scott Benner 1:24:21
So it took me a minute to go okay, like I don't know what happened here. But I can't be making incremental adjustments to this. I have to throw a lot of installers to fix this. And and I did and will that happen today? Probably not. You know it but it might and if it does, I'll do it again. But what I was good at was pivoting like I didn't get stuck in dough. This should be working. I got I was like able to look and go this doesn't work. Do something different. Yeah. And
Christina 1:24:54
there's been a lot more of that this year where I have no clue why she is the number that she is. Like I'm just like This is unexplainable right now. But we'll just deal with it. But it's just it's I think it's been a weird year that way. And I guess I'm, I guess it's a little, like a little baby Prelude prelude to puberty. But because I know that it's like crazy pants around puberty time with with blood sugar numbers, yeah. But I can I can understand like, why, you know, it's just, it's frustrating when they're going through a lot of change hormonally to just because you're like, Okay,
Scott Benner 1:25:25
I guarantee that two years from now. Well, that's unfair, because this might take six months to come out, let's say three years. So now, they say three years from now, if you go back and listen to this again, you won't recognize the person on this recording.
Christina 1:25:39
Yeah, very interested. That'll be Yeah. So this, this even helps, though, like hearing it, because like I said, we don't have anyone to really compare to.
Scott Benner 1:25:47
Yeah, no, I understand. Listen, part of my job is just like, like, you know, you know, when the coach like slaps you on the boat, when you run out in the field, and I go get him, you're doing great, you know, and he, and you run away, and he's like, Oh, this guy's falling apart. But like, it's his job to go like, you're doing great. Sometimes it's my job to tell you, you're doing great. Because you are, and you don't know it, because you have nothing to compare it to. And it feels like an utter failure, because you had such crazy stability earlier on. Now, who knows? If it was she was more sedentary because of COVID? Or maybe she was honeymooning a little bit, and you didn't realize it. Yeah. Like there's all kinds of things that could happen. But if you keep assessing her if you assess her Basal, and remember that she's going to keep growing and as she gains weight, she's going to need more insulin. If you keep doing that, you're going to be fine. The biggest favor you could do for yourself is stop to stop expecting that you're going to find like the place where it's all sweet spot. Yeah, yeah, there's there's no sweet spot so far that I can find an artist. Okay. I just had diabetes for 15. I don't know, hold on a second. to seven. Yeah, like 15 years. And the amount of times where I've sat back and gone. I've got it. It's over. It's very infrequently. So
Christina 1:27:02
yeah, yeah. Okay, that actually helps me, I feel like I can remind myself to put that one down a little more than
Scott Benner 1:27:08
Yeah. And if it gets to be too much for you just walk into the woods, and
Christina 1:27:15
perfect, I have a lot of, you know, what's around here, so
Scott Benner 1:27:17
I just wander in a direction and tell your husband like, I'm done goodbye.
Christina 1:27:23
And Backdraft
Scott Benner 1:27:26
it all I can do can't do anymore. Gotta go. Now you're gonna be you're one of those people who's going to be terrific. You just have to stop fighting with reality.
Christina 1:27:37
Yeah, that's helpful to know, I'll carry that one with me.
Scott Benner 1:27:41
Good for you, I listened. It's a hard adjustment to make, because it feels like it feels like it's a problem that you're going to solve. Instead of a life you're going to live. And it is just not listen, you know, are into diabetes for a really long time. And just the other day, I found myself getting in the shower and thinking, this is not what I thought my life was gonna be like. Yeah, and I felt sad about it for a minute. Yeah, it's not what I thought her life was gonna be like, I don't want any of this to be in my life. Like, I don't want this for her. But there's no amount of hoping or that's going to change that. So you might as well figure out how to do it. Well.
Christina 1:28:29
Yeah, and that's a big push for me is like, No, I don't, I don't want to I need to see me responding in a very, like, negative emotional way to her numbers, you know, because I really want a model for her like it's a number and this is what we do next, you know. And, and I think that that's also one really great thing about her team is that they're all really really positive. Even admits that yeah, chaos. So I think that that's probably one of the biggest things that I'm taking from this conversation too is just reminding myself of that goal. Yeah, it's good for you
Scott Benner 1:29:07
listen. Try to keep your variability lower so not as much up and down. Don't be feeding basil. You know, don't be feeding lows. You know, Pre-Bolus your meals try to stop lows before they happen without causing rebound highs. It's pretty much it just timing and amount on the insulin and just the rest of it is not getting sucked into the into that other stuff, Whirlpool where you just constantly worried and anxious and concerned that you're doing a bad job, like like that, that you thought putting up her alarm at school was an indication that you didn't know what you were doing. tells me you have a lot of like, personal stuff to work out around it. Yeah, for sure. Yeah. So little therapy wouldn't hurt. Yeah. That's all. Your thing. Are we good? Did you? Did we talk about everything that you wanted? Yeah, I
Christina 1:30:07
think I think I think I said all the things that I wanted to say, excellent. I hope it's helpful to people who are starting the journey themselves. So
Scott Benner 1:30:15
I appreciate you taking the time to do this. I think it was really helpful. And I'm being texted by my children who are like you said you would cook 20 minutes ago?
Christina 1:30:25
Well, I really appreciate your podcast and your time. So thank you.
Scott Benner 1:30:28
By the way, they can cook for themselves. This is laziness, that they'll sit next to me while I'm cooking. And be like, Oh, look at him cooking their backseat cooking. Yeah, yeah. Oh, they will do that to you don't do this. Right. Like, just take the thing and do it yourself. Tastes good that way. The only mistake you made was having kids. Other than that you're doing great.
Christina 1:30:52
Yeah. All right. different paths, that's for sure. I just
Scott Benner 1:30:56
just 20 years from now, you might be making them eggs. And they while they critique that your eggs are too moist.
Christina 1:31:01
Right? All right. In my cooking class, they said,
Scott Benner 1:31:06
Oh, yeah, because they know anything. Trust me. Right? This isn't gonna end and it would have just been something else if it wasn't diabetes, so don't feel like you were like, seriously, you would just be upset about something different. Right? Right. Anyway, I really do appreciate you doing this. We'll hold on for one second for me, of course. Yes.
Uh huh. Huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juice box. And to get your free benefits check from us med go to us med.com forward slash juice box or call 888-721-1514 Thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Before I go, I'm just going to apologize for the reference I used at the beginning of the of the show. I've done a little checking. The mandrel sisters are in their late 60s and early 70s and Lawrence Welk has been dead for three decades. And so I'm realizing that the reference I used was from my childhood, which was 40 some years ago. Anyway, I hope you enjoyed the program.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!