#763 Bold Beginnings: Community

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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

Scott Benner 0:00
Hello friends and welcome to episode 763 of the Juicebox Podcast. This episode is another in the bold beginnings series

hopefully, you've been listening to the bold beginning series, and you're all caught up and ready to take on the latest episode, community. If you haven't heard the others, you should check them out. You can find them in your podcast player by typing in Juicebox Podcast bold beginnings. Or you can find them at juicebox podcast.com. They're in your podcast player you understand. But if you're looking for a list, I'm saying juicebox podcast.com. And you'll also be able to find a list in the private Facebook group for the podcast Juicebox Podcast type one diabetes. If you'd like to hire Jenny Smith, you can do that she works at integrated diabetes.com Head over there and you'll be able to figure it out. While you're listening today, 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 healthcare plan. Or becoming bold with insulin. No ads in this one, just gonna have a little announcement here after the music and then straight through me and Jenny chiton in chat

I'm just here to ask you for your support. And there's not much you need to do to give it follow the podcast or subscribe to the podcast in an audio app, like Amazon music, Apple podcasts, Spotify, something like that. That's one thing you can do. You could tell someone else about the podcast, that's a big deal, actually. Like you're talking to a friend like I got diabetes like you, you should try Juicebox Podcast. Or maybe you tell your doctor about it. Your doctors like to be your doctor in this scenario. Oh my god, how did you get your agency this good? You say I'll be you know, I listen to the Juicebox Podcast, you should check it out Juicebox Podcast and you start telling them that like in your you plot your app, show them on your phone, or tell him about juicebox podcast.com. You know, I'm saying sure the show is pretty much it actually. So I want to say to you, there's no ads today. So enjoy the podcast. The only ad is for for the show, support it, download it, subscribe to it, tell a friend about it followed on Instagram, check out the private Facebook group. That's pretty much it. I appreciate your time. Enjoy the episode. So Jenny, we are doing well with our bull beginning series, a few more episodes left to record. I am beginning as I told you earlier, but more and more getting nice feedback from people newly diagnosed people who have found it and are joining it finding it to be helpful. Yay. It's it's really been a fulfilling thing. Which you know, if you all know me, like I don't say things like I feel. But I really do. And so interestingly enough, I got a note yesterday from a guy, a young man's probably 20 to 23 years old just graduated from college. And it it's going to fit in nicely with the the topic we're doing today. So today's topic is community. And I'm not the type of person who prior to diabetes would have said to you, you know how you handle problems in your life, you surround yourself with people who understand, like I did not grow up in it that would have seemed granola and crunchy to me prior to all this, if that makes sense. Now I am a firm believer in it. I am a firm believer in the idea that people who understand your situation are in a unique situation themselves, and they're able to offer you support. Even if it's not directly that you can't get anywhere else. I've never right, the experience of seeing a person feel supported with just the knowledge that someone else understands. And they don't even know each other is fascinating. I never thought I would see that. But there are the vast majority of people who listen to this podcast or go on my Facebook group or in another community never say a word. They don't type a message. They don't send me a note to tell me they enjoy the podcast. They're just there. Right? Yeah. And there's something really magical about it.

Jennifer Smith, CDE 5:00
There is it's a feeling of, as you said, I mean, a lot of people I think, are for one example Facebook, they're lurkers, right? They sort of just are there. And what they get out of it is either information or against a sense of like belonging to a group that gets it as well in whatever realm of, you know, chronic condition or lifestyle or whatever you might have. I mean, there are lots and lots of Facebook groups for things. Sure. But diabetes, being such a it's, it's something always that there. And I think you can find posts all the time, something new, this is happening, I had this occur, and there's always somebody who's going to chime in and say, I've had that happen, too. I kind of feel it, I get it.

Scott Benner 5:53
Well, the people who listen to the podcast teach me what the podcast is, which is a weird thing, because I'm the one that makes it, but they're the one who tells me, they're the ones who tell me what it is to them, which is okay. It's an interesting, it's an odd dichotomy, right? Because I think I'm doing one thing, like, if you would have asked me five years ago, and even maybe three years ago, I would have told you the podcast is about managing insulin. That's it. That's how I saw it. And then I, I one day had this, this young girl on in her mid 20s. And she's like, you know, I started listening to the podcast, and my A onesies came down. And I thought, probably a little like, smugly. I was like, oh, yeah, cuz you heard how I talked about insulin fixture wholesaling, right? She does now, I always knew that stuff. She said, I just never did it. Yeah. And I was like, Well, what made you do it? And she goes, I don't know. She's like, Just hearing that other people were doing it. And that, I just thought, well, I probably could, too, you know, and then she just, she just did it. So I knew I didn't know that, like her conversation. And other conversations and notes taught me that it's, it's almost strange, because I don't have it in my life the same way that other people do, because I'm the one making it. So like, I can't, I can't be involved in it the same way. I don't know how that it's a strange position to be in, like my facebook group has at this point. By the time this comes out, there'll be 28,000 people in there. And I see the background metrics between 70 and 110 new posts a day. 24 of the 28,000 people are active in it, which is crazy, because Facebook groups are always like, well, we have 100,000 followers, when you look there's two posts every week, you know, like, right, they that

Jennifer Smith, CDE 7:46
by the same people all the time. Yes.

Scott Benner 7:49
each other, we think they're talking 200,000 people. But what's really amazing about that is, is that people will ask a question, and then you get a wide variety of answers by rack but not screwball answers. There's something about people who listen to the podcast, and then go online and participate they have they have enough information, where they're not saying things that you're like, wow, that's doesn't make any sense it all

Jennifer Smith, CDE 8:18
right. It's not like crackerjack information. And if Yeah, if they're

Scott Benner 8:23
a little off, there's such a great vibe in there, that other people will come in and be like, Hey, I see what you said. But have you considered this and it's all taken well, and I'm, I'm stunned every time I see it, because Facebook is, you know, colloquially it's a place where people argue, but yes, does not happen in this space. Really, really?

Jennifer Smith, CDE 8:43
Yeah, I have not I mean, with you know, all the lurking that I myself do. I don't I don't off in fact, I don't think I've ever seen in your group negativity in a way that's, you know, cutting to other people who've made comments or have offered up this is what's happening, you know, whatever. And I've seen that in other groups. Yeah, of course is unfortunate.

Scott Benner 9:09
So the way I do it is probably it's probably opposite of how people think about it, but I don't over moderate the thing. Right there adults get any mean like if they can't figure it out? How am I going to figure it out? Little things you know, there's obviously there's the rules in the Facebook group are kind of funny, if you go read them. I think it's, you know, like the basically it's the it's the equivalent of like, don't be a dick bait, you know, basically, you know, don't don't talk about politics, you know, that kind of stuff, like just just talk about diabetes with people and and it works and it doesn't just, I at one point thought it was going to be like, in addition to the podcast, and then I started realizing that the Facebook group had such a good it had such good word of mouth online, that people were ending up in the Facebook group, have no idea what the podcast is, like, forget that they haven't heard it. They don't know what it is. They just they were told, like, click on this link, and these people will help you with your diabetes. And you see them come in and ask, they'll ask a question. And other person will say, oh, you should try episode, this podcast. And they'll say what podcast, right? And that's amazing, because now there's these, there's these two entities, and they somehow support each other, but can operate

Jennifer Smith, CDE 10:33
separately independently. Really, really interesting.

Scott Benner 10:37
So some feedback from people, if you know, other type ones, reach out to them, if you don't know them, find a community and build a support system. As an adult diagnosed with type one diabetes, I didn't know anything about diabetes, and I had a lot of misconceptions, I felt very alone, finding support groups like Facebook helped READING A reading helped a lot getting Dexcom helped. I found out about them through Facebook groups, I would have loved to have been assigned and experienced type one to talk things through. So this person is a great idea. Yes, right. Yeah,

Jennifer Smith, CDE 11:13
that's I mean, it's there. I know that there are diabetes, like mentors, especially like I think JDRF used to have, they don't still have it, they used to have like a mentoring kind of program. I know that the college diabetes network has some nice mentors, especially within the college chapters, you know, but that is from a boil down, like, Hey, here's your diagnosis, you know, et cetera. But here's somebody to connect with. This is somebody in your area, this is somebody that, you know, would be really good in terms of age level or lifestyle or whatnot. Because, you know, I, I can imagine the, and I have to imagine, because I don't really remember feeling alone when I was diagnosed, but it was a very different time than we have today with technology. So I think in today's world, there's so much connection on so many levels, whether it's texting, or you know, a Facebook or a some type of online group or whatnot. I think it would be a nice idea, actually be like, Hey, here's somebody connect with them, and they can help you like, feel okay,

Scott Benner 12:31
have conversations. Yeah, I think that's one of the places where the podcast fills a void, because I hear from people a lot. I don't know, another person with diabetes. And I come on here, and the few times a week you put these conversations up with people, and I get to meet an airplane pilot who has type one and a firefighter as type one, or just some person, you know, and where someone comes on and says, Oh, you know, I have Hashimotos, too. And I'm, and they think I have Hashimotos. And then you know, it's just it's, it's an opportunity that just doesn't exist in the real world, unless you're gonna go to a diabetes camp. Right? You know, which they have for adults, and they have for for kids. But that's another thing you have to it's a week or two weeks, and they're not all over the country. And, and camps are an interesting, I like watching people talk about camps, because they're an interesting conversation. People fall on one of two sides of camps. They're either like, Camp is the greatest thing. You know, adults will be like, I still my best friends I met in camp when I was 16. And then there are people like, Arden, who I we wants to do you want to go to diabetes camp, and she was like, oh, no, do not make me do that place. And you know, and she didn't want to go to camp forget that it was about diabetes. Right? Right. You know, I have to skip through these. A lot of these people statements, they're lovely. And I want to thank everybody for them. But a number of them are just like, hey, that's the podcast, I found the podcasts and I don't want to just read all those. This person said, I wish they would have given us more access to a community, but like not not deliver it to us. Just tell us that existed. Like tell me there are groups online that there are podcasts. I had so much fear and anxiety, self doubt and blame no matter how much they say otherwise. But this community of moms and dads and adults with type ones was amazing for me. I think. I think that it's a message for doctors really, you know, it is

Jennifer Smith, CDE 14:27
and I think it shows it shows a degree of sort of a lack of information on the clinicians side. Not because they don't want it but because there's not one that's just a an approved Hey, these are the really quality places that you can go for more information. Here's your rip off card along with your rip off card about how to carb count. Here is your like resources from a community based law Have all and they're they're good places they're not, you know, Johnny's corner shop of information.

Scott Benner 15:07
Here's my I mean, I think my focus is pretty clear. But to put it in this episode, I think good, easy to understand information early is important. Yes, there is an entire segment of people who believe the absolute opposite, keep you not understanding give you small bits of information very slowly. They say don't overwhelm people, we had a real I'm not a very dramatic person. And online, I'm very proud of kind of the pragmatic way that I've run a Facebook group. But there was another Facebook group, that if you mentioned the podcast in the group, your posts would just be deleted. And people would come back to me and say, Do you have any idea what happened here? As if I would know I'm like, I don't know. I don't know these people. But I said, you know, they asked what helps you with diabetes? And I said, Oh, I began to listen to the defining diabetes series of the Juicebox Podcast, and I moved on to the Pro Tip series. Now my son has this a one C. And that's what helped me. And then they deleted it. And I said, Well, it's two things. First of all, people fervently love the podcast. And when they talk about it, they mostly speak very well about it. Except for a person who left a review the other day, Jenny about our bold beginnings thing that said they would be better if I didn't talk as much. And

Jennifer Smith, CDE 16:34
maybe they just like my voice better than yours and hurt

Scott Benner 16:37
my feelings, sir. Sorry. But But, but so I said, so I think there's a little bit of that when people share the podcast over and over and over again, it could probably seem like I put you up to it. And also, it's a weird thing, Jenny, but these Facebook groups become territorial. If sure if you have Face Book Group, a Jenny Facebook group, and you say what helped you, and they say, Scott's Facebook group, well, then you go to Scotts Facebook group and never come back to Jenny's Facebook group. And, and that bothers people, they lose their numbers. And,

Jennifer Smith, CDE 17:14
and I think the unfortunate thing there is that as a, let's call it, whatever you are a moderator of your group or whatnot, you're then limiting, you're limiting the quality that you're seeing that you're trying to put out there. Right, you know, you're limiting access to what might work for one person. Great. I'm happy to have somebody go elsewhere. If I'm not the right provider, or the right caregiver or whatever, for you. Go ahead, I would rather that you get good information and good care. And if you're getting it in a different way from a different place. Awesome. glad about

Scott Benner 17:54
that. I agree. But that's exactly how I run it. Like if when that happens in my space, and somebody's like, what happened, you know, what helped you and they're like, this XYZ Facebook group, I think, okay, good. Like, I think it's a strange thing. From a content. On some level, Jenny, I'm a content creator, right. And I need people to continue to listen to my content and share it or the, it'll just stop, like, it'll just end. It's hard not to be overwhelmed by that feeling. It's difficult to keep up the whatever's best for people's best for people. But I believe that, and that's what I do. Like, I also think that the time you spend online in the community, once you find it and realize that it's very valuable, you will spend a fair amount of time there. But it's usually six months, on the outset, maybe a year, and then people fade away. And that's beautiful. They learn what they need to know. And they go back to their lives, right. It's, it's what you would if you care about people, this is what you would want for them, you know, it's what

Jennifer Smith, CDE 19:00
and or when there's new information, people who feel like they've learned enough, may end up coming back now that there's something new available, something new that there might be information that's again, discussed in a different way, or a completely different technology or something. You know, they'll eventually come back. Yeah, honestly.

Scott Benner 19:21
So I hear from people too, that that happens to them, they cycle, but then they'll watch their a one C start to drift up. And they say, I just went back to listen to the podcast, and it wasn't management stuff anymore, because I knew the management stuff. It was It keeps them engaged, I think, yeah.

Jennifer Smith, CDE 19:38
It's motivating. And I think because there's enough, there's enough posting. I see which is really nice. of both. Like, let's call it the wonderful day, right? The no hitters where you're like, Oh, I'm clearly cured today. All right. All right. And then Next day or whatever, there are also posts of, I don't know what's going on, or, you know, this is what's happening. And people chime in, and they're like, ah, you know, we've had that before too, and whatever. So it's a sense of, when you're trying to get back to your management, sometimes it's a sense of seeing those motivators from other people, like other people have really bad days to or really bad times, or have had something occur in their life that got them off track. This is a way to get back on track to get those, those motivators even if you're just reading and you're not posting anything. It just helps us to stay connected and remind yourself I know, I know all the tools, I just, I just have to put them back in the right places in my life. And it's

Scott Benner 20:44
on you a little bit to be in the right mindset, too. Because if you see someone's success, and you're in the right mindset, their success looks hopeful. Yeah. And if you're in the wrong mindset, their success is like, it makes you think I can bleep this out. It makes you think, Oh. Why don't you Bolus for your blood sugar to over 120 You mother. But you have to be able to you mean you have to be able to let that go. And to step back and say, this is possible. Like I think this podcast as it grows, in my mind, it's mostly about what's possible. At this point, right? It's possible to do this, if that person can do it, then I can do it. They might know something that I don't know right now. But, and I, I'm stopping myself from reading over and over again. By far, this has been the best community Juicebox Podcast on Facebook, starting your podcast, especially defining diabetes in the QuickStart Series. I wish they would have given me your Pro Tip series on day one. Like there are countless comments here about this. And I want to tell you this story. Well, let me finish the other side of this. So we say when people are doing well, you can kind of respond to it a couple of ways. And when people are doing poorly. It also is helpful. I know that sounds crazy. But it's the same idea. You look and you think well, they're having a bad day. I've had bad days. Right? So this is normal to you know, it's not going well. And it takes away a lot of the angst from the whole Right. Right. It really does. Yeah. So so this thing at the beginning that I mentioned, I had a message yesterday from this is a long message. I'm not going to read it to you. But I'll give you the I'll give you the breakdown. diagnosed in high school, I think a senior on his way to college, finds the podcast listens to a couple of episodes, doesn't keep listening, goes away to college, drinking weed smoking, spiraling not paying attention to diabetes whatsoever. Blood sugar because it's college, three hundreds blood sugar's higher, a one C going up crazy. doesn't just doesn't even worry about it. I think COVID hits kind of refocuses the person a little bit person goes to a doctor to their Endo, and says, Hey, I found this podcast and I'm gonna try some stuff. And you can already see my agency starting to come down, I'm seeing some stuff, it's positive, and he starts telling them he's going to try it, doctor, whatever, do whatever you want, because doctors not helping. And then the person has a big success moves the agency really far life is changing, goes back to the doctor tells them I want to tell you about the podcast tells them all about the podcast, the doctor gives them the one of two responses that people tell me about either the doctors are like, This is amazing. It's great. Whenever it's more, whatever you're doing. Yeah, going, or you're just going to spend your whole life staring at your diabetes. And I guarantee you that that guy on that podcast doesn't do anything except watch blood sugars and blood and really amazing. Think about that. Right? The person takes their a one C from double digits into the sevens and the advice the doctor gave them was stop doing that. Just essentially Fascinating, right? So the the kid essentially telling this person,

Jennifer Smith, CDE 24:15
that they're putting too much time and effort into their own health management. Yeah, that's really the cut and dry of what this physician was saying what's

Scott Benner 24:24
in rest of that sentence that doesn't get spoken. So go ahead and have major problems later in your life or sooner maybe, you know, right? Yeah, but hey, at least you'll be drunk as a sophomore. Like what the hell are you saying to the kid right? Because the kid has making a change and is excited about it and then the doctor steps on it fast as fast that happens a lot. You have no idea how many notes I get from people. I went to the doctor, I was super excited. I knew my A once he was going to be lower. I knew my lows were going to be less. And all the doctor told me was to put my one C higher. Right Right. And and this three months of hard work, and you're looking for the pat on the butt at the end. And instead you get, don't do that. And it's hard for people to push through sometimes.

Jennifer Smith, CDE 25:12
Absolutely. I mean, you're not surprising to me, you get people all the time who are frustrated with the fact that not only are they usually being told that the highest can be expected, like high higher than you would want highs, right? And that if your insulin is working, you know, you're, you're to expect this and that's and or just the comment of, well, that's just diabetes i in today's day and age, that is still a common that's being you know, or a message that's being given to people. And that's really, really sad,

Scott Benner 25:49
really sad, especially in a world where I can pick my phone up right now and see that Arden's blood sugar has been somewhere between 80 and 110 for the last 15 hours, right? How can you tell somebody that's just diabetes? Why don't you tell them? Hey, here's this stuff that exists or try that or good job? How about how about good job? How about how about good job? person moved there a one see multiple points and found stability? How about good job, that'd be great. By the way, there's another part of that story I can't tell on here. But I'll tell you afterwards. It's about the doctor. And it's fascinating. I apologize that I can't say it here. When I was diagnosed in 2020, you and Jenny, we're all I had this. This group has been my support and my family. I was kicked out of the ER in DKA with insulin to Use as directed, but had to wait five and a half months for my first endo appointment. Every episode I listened to save my life and my Saturday. Oh, and I'm wonderful.

Jennifer Smith, CDE 26:48
That's wonderful. And it's also an I've said it before, but that's, that's why I love I just love being able to contribute, you know, to what you've put together because well, it makes it makes me just smile. That's super awesome.

Scott Benner 27:01
I am happy when you're happy for certain Yeah, this isn't a

Jennifer Smith, CDE 27:04
show you my I know people can't see this. But this was my day yesterday.

Scott Benner 27:07
Wow. Jenny's Jenny's showing me a graph. That's 24 hours. Oh, yeah, it's 24 hours. Yeah, some of you might look at and be like

Jennifer Smith, CDE 27:22
some of my data to kind of, I have an endo appointment coming up. And I like to take photos and whatnot of like, really busy days, like it included a run and included swimming in the afternoon with my boys and included, like all these things. And you know, not every day is 100% like that. But they're they're pretty days where you're like,

Scott Benner 27:41
I know, I did it. That's exactly right. And you should, by the way, celebrate that stuff. You really should. And it, it just it's very important. So anyway, I put all that I put this in this series, because A, I didn't realize how important it was when I started. And I've learned and B I think it's hard for people to accept, especially in the beginning, like you didn't want to have diabetes. And now what now you're gonna surround yourself with more people with diabetes, right? You're probably like, I wasn't looking to be in this club. Thanks. But it's, it's just like, give into it. I don't care. I don't care if you're one of those people who learns and stays on the Facebook page for years helping other people. Or if you get what you need, and you leave, or if you never say a word and you just read it, it doesn't matter. There's something really valuable about it. And it's it's not completely possible to quantify. But I am 100% Short works. And there's this long, there's this long lesson here that I won't read the entire thing. But this person said they found the podcast, and it felt overwhelming. And I understand that. And that's why something like bold beginnings exists, and why defining diabetes exists and all these other series that are inside of the podcast. So I did something Jenny, the other day that I want to put right in here. Yeah, I used so there's juicebox podcast.com, which is just it's a website where you can go and see most recent episodes, and a few of the series like pro tips and stuff are broken out on the front page. Because there are now 741 episodes of the podcast as of this recording. And podcast apps while they're amazing. They're not. It's not the Dewey Decimal System. It's it's not super easy to find stuff, you have to know what you're searching for if you're going to search. So I've had for a long time, another URL diabetes pro tip.com. And it just used to be an online player of the Pro Tip series and the defining diabetes series. But the other night, let me get it up here so I can make sure I'm saying this correctly. diabetes pro tip.com I revamp our tips Tip Because to Hakan No, really leave off, leave off the list. As for savings Jenny, I at first I thought, oh, diabetes pro tips.com. And then it was taken. So I use diabetes pro tip.com. When you get there, you scroll a little bit, and there is a player, the player has the first one, you'll see defining diabetes 44 episodes of that. And you can scroll right through really do that many doors, there'll be more so like, you just scroll through, and there's a player right there, you can play them in order, you can play them one at a time, or you can see the episode names and numbers and go back into your podcast player and find them there if that's, you know, easier for you. But you scroll a little farther, the bowl beginning series is there, which as of this recording has 11 episodes, we'll have more by the time you get there. 22 episodes of the diabetes variable series 25 episodes of The Pro Tip series after dark is now up to 27 episodes. And the cool thing about this is that as I add new episodes, they automatically populate in these players. So it's great, I don't have to go back in and add them like I put up a protip or excuse me, I put up an after dark episode today. And it's already available there. And then there are the wellness series, which was mostly with Erica Forsythe, and Eric and I are planning on doing a lot more in the coming months and years are asking, you know, when we do ask Scott and Jenny episodes, yeah, that's how many you know how many there are? No,

Jennifer Smith, CDE 31:36
I don't know.

Scott Benner 31:38
18 As of this recording, so really, we'll send in questions and we record episodes answering their questions, there's 18 of them. Algorithm pumping series is up to 17 episodes, defining thyroid series we did is there. I'm about to add some pregnancy episodes. So basically any collection of management type stuff. If you can't find it in your podcast player will always be at diabetes protip.com. And you can get to it through juicebox podcast.com as well. Good organization.

Jennifer Smith, CDE 32:11
That's I like that. Yes, I know. That's the kind of person I like organization.

Scott Benner 32:17
I think we all know that. That's not my wheelhouse. And it's pretty crazy that I even did that. But it just seems it seems important. I mean, listen, from a podcaster standpoint, I just want you listening in a podcasting app. It's the best thing for the show. But at some point, I realized, like this podcast has become it's a compendium of information. And it should be accessible, you know, in multitudes of ways. So that's one of them. I hope it helps everybody. Oh, good job.

Jennifer Smith, CDE 32:45
Awesome. Very nice. Thank

Scott Benner 32:46
you. Once again, if you need help with your diabetes, Jenny works at integrated diabetes.com. And in my opinion, there's no one better go check her out. I'd like to thank you for listening remind you that there is an entire bold beginning series that I hope you check out. The podcast has experienced insane growth in 2022. And that is directly because of all of you. So we're just going to take this opportunity right here before the music stops to say thank you, when you support the show, you're supporting me and the work we're doing. And you're helping other people with type one diabetes to be able to find this material. So thank you very much. Hope you enjoyed this episode of The Juicebox Podcast. I'll be back very soon, with much much more

Test your knowledge of episode 763

1. How should blood sugar levels be monitored in relation to exercise?

• Only before exercise
• Only during exercise
• Before, during, and after exercise
• Not at all

2. How should low blood sugar episodes during exercise be handled?

• By ignoring them
• By consuming fast-acting carbs
• By stopping exercise permanently
• By drinking water

3. What is the impact of stress on blood sugar levels?

• It lowers blood sugar levels
• It has no impact
• It raises blood sugar levels
• It depends on the individual

4. How should insulin doses be adjusted based on physical activity?

• By ignoring blood sugar levels
• By increasing the insulin dose
• According to the intensity and duration of physical activity
• By avoiding physical activity altogether

5. Which types of exercises are beneficial for diabetes management?

• Only high-intensity exercises
• Only low-intensity exercises
• Both aerobic and anaerobic exercises
• No exercises are beneficial

6. What is the role of consistent physical activity in long-term diabetes management?

• It has no role
• It helps in maintaining stable blood sugar levels
• It should be avoided
• It complicates diabetes management

7. How should one prepare for exercise to avoid blood sugar fluctuations?

• By eating a large meal before exercise
• By monitoring blood sugar levels and adjusting insulin accordingly
• By avoiding any food intake
• By drinking sugary drinks

8. What are the benefits of incorporating different types of physical activities, such as aerobic and anaerobic exercises?

• It has no benefits
• It helps in better blood sugar management and overall health
• It should be avoided
• It only benefits type 2 diabetes

Submit

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#762 Artic Driver

Saxon is a UK based truck driver with type 1 diabetes.

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

Scott Benner 0:00
Hello friends, and welcome to Episode 762, an episode that was almost called BJ in the bear, who remembers Greg Gaffigan. And that charming chimpanzee

Saxon is an adult living with type one diabetes, and he's a truck driver, which I find compelling. It's a crazy job with a lot of demand. And I thought it'd be interesting to hear about a type one who does such a thing. Hopefully you'll think the same thing. While you're listening to Saxon and I speak. If we should say something about you know, like medical stuff. Try remembering 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. We're becoming bold with insulin is everybody holding their arm up next to them right now and pretending to pull down on the air horn. Remember that when we were kids, the people do that anymore. And I don't have an air horn sound effect. While you're listening today, please consider going to T one D exchange.org. Forward slash juicebox only do this if you're a US resident who has type one diabetes, where is the caregiver of someone with type one. But if you are those things, and you go to that link, all you have to do is fill out the survey and complete it. And you've supported me, yourself and other people living with type one diabetes, T one D exchange.org. Forward slash Juicebox.

Podcast this show is sponsored today by the glucagon that my daughter carries G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox. today's podcast is also sponsored by Ian pen from Medtronic diabetes, not interested in insulin pump, but you'd like some of the functionality that they offer. You are looking for the in pen, check it out at in pen today.com Do not forget to check out touched by type one.org great organization helping people with type one diabetes, they're doing more than I can tell you to be perfectly honest, it's just they have a lot of what they call irons in the fire. They're doing a lot of great things for people with type one, all they want is for you to know about it. So head over to touched by type one.org and see what they're doing. You can also find them on Instagram and Facebook. These are other places that you could follow touch by type on it. Go ahead and do it. What are you busy, you don't have time, the phones in your hand right now don't act like it isn't touched by type one.org Get going?

Saxon 2:42
When I'm Saxon. And I suppose I applied to get on here when I saw a post on your Facebook group asking if anybody has any crazy jobs or hobbies. And I thought well, I don't know if it's crazy or not. But people seem to think that truck drivings a bit much for them. So

Scott Benner 3:06
you threw yourself?

Saxon 3:08
I suppose so. Yeah.

Scott Benner 3:10
I appreciate it very much. Thank you least I didn't know, you know, imagine if you're taxidermy and field mice or something like that. And you have an army of them. You know, I have a hobby. I have an army of taxidermied field mice and one day and Okay, thank you. I probably would have said yes to that too. But I found truck driving really interesting. As I don't I don't know how anyone does it. I mean, you know, I'm saying like it feels to me, like, Okay, I could, I could go for a ride for an hour, two hours, maybe three and then I'm gonna need to stop walk around, I'm gonna get tired. There's that road noise that kind of lulls you into a coma. And trucks are just everywhere. I mean, I I imagine people know that. Trains, trucks, ships, that's really how we move things around the world. You know, I guess it could feel like you just order something from Amazon and it shows up at your house and a van. But

Saxon 4:11
it's I mean, that stuff doesn't just appear on the shelf. It doesn't

Scott Benner 4:15
just appear there, right? You've like this, this job that basically keeps everything going and seems difficult to me, but I'm gonna find out about it when they ask you some questions. So before we do that, how old were you when you were diagnosed with type one?

Saxon 4:31
So I was just a few months before turning 31

Scott Benner 4:35
Oh, no kidding. How am I now?

Saxon 4:39
Or next week? I'll be 34 Oh, this

Scott Benner 4:41
is pretty recent for you, though. fairly recent. Yeah. Hey, you've been driving your adult life.

Saxon 4:49
11 years now as a truck driver.

Scott Benner 4:51
Okay. Okay. So you were entrenched in your job when when this happened?

Saxon 4:56
Well, yeah, sure. And a few years back I Well, when I first started looking on some forums about training, I was saying even then, so 11 years ago, I would have just lost my right to drive trucks altogether for being on insulin.

Scott Benner 5:14
So 11 years ago, when you were thinking about getting this job, that was a, when did it stop being?

Saxon 5:21
I'm not quite sure when it actually stopped. But it was certainly a concern when I when I got diagnosed. And it was a couple of weeks time and two or three more weeks after diagnosis, when finally I saw one of the specialist doctors we have here and it says no, you can still drive until we tell you that you can't it, you know, it's okay. Now you can live a normal life, so long as you look after yourself. Oh, that's

Scott Benner 5:46
so that's interesting. So after you're diagnosed, you're only remembrance of this rule is from when you first got the job, probably six years prior? And were you concerned that you were going to lose your job as well as get diabetes?

Saxon 6:00
Well, yeah, of course. And I thought, well, this is the only way I really know how to earn an amount that I'm self sufficient on. I'd have to completely retrain, what the hell do I do? I've got a mortgage to cover and all that, you know, it's, it's a little stressful. And in the meantime, I've also been told that same time, they said, I can still do it, that I also then couldn't do it for at least a month until I could show stable sugar readings.

Scott Benner 6:28
Well, that's a motivator, I guess.

Saxon 6:31
Yeah. Well, it gave me time to learn. But it's a bit ridiculous in that you can still drive a car, you can drive a van or whatever, up to three and a half tons. But anything bigger than that you're not allowed to drive until the doctor says that you're stable enough.

Scott Benner 6:49
Do you drive a tandem truck?

Saxon 6:52
Oh, you mean with a

Scott Benner 6:54
trailer? The trailer? Yeah.

Saxon 6:55
Yes, yes. We call them Artix. Here, I think you call them a semi don't you over there.

Scott Benner 7:00
Semi tandem yet? What did you What do you call it? Arctic? A RT?

Saxon 7:06
C? Yeah, because it's articulated, or whatever.

Scott Benner 7:11
Gotcha. I was trying to find the connection to the cold. And I was like, I don't see it. But that makes sense. So over the road, local, how far of distance do you drive in the course of a day?

Saxon 7:29
Ah, I mean, the job that I have now is largely going into central London and back certainly, with a tower crane company. So yeah, it was a lot into London. It's about two and a half hours away from where we're based. Okay. But then the other day. Well, I had a whole weekend driving up to, like, halfway up Scotland and back. So that was probably a 500 mile round trip. Okay. I across the course of three days.

Scott Benner 8:03
And you sleep in the truck?

Saxon 8:05
Yeah, yeah. Lucky me.

Scott Benner 8:08
We, when my son was very young, there was a gentleman that coached his like local sports team. And he was in a what we would call an over the road drivers. He was gone for days at a time. And he would drive up and back from New York to Florida, over and over again.

Saxon 8:27
And yeah, that sounds like a long way.

Scott Benner 8:29
Yeah, it's terrible. I can tell it took a toll on him. Is there? I'm gonna ask you such a crazy Well, is there a lot of drug use in in truck driving? Like, how do people stay awake that long?

Saxon 8:42
Ah, I honestly, I don't know. I mean, where I work. Now we have drugs testing anyway. So it's not too much prom. For us. There probably was a lot before. But we have a lot of regulations. And we've got devices that record all our movements, to try and restrict us getting overworked and therefore not getting so tired. Okay? Although you talk to some of the older drivers and those because it used to be like a wax disk in attacker graph that would just like scratch a graph on to show your movements. And they would always cheat them by putting a magnet on it, stop the needle actually moving or something like that. So they're often cheating because they got to make more money that way. And of course, then work like almost an entire day and say that it was better back in that day. So you

Scott Benner 9:35
could say that you weren't driving when you were and then yes, accomplish your task and skip the safety regulations. Oh,

Saxon 9:43
yeah. And then make more money because you've got another job and which is going against competition law and all that stuff.

Scott Benner 9:51
It's interesting because I mean, time is time, right? You know, like, you can't How fast can you possibly drive But the actual task of keeping the truck on the road? It's is it? How technologically advanced? Are the trucks to this point? Do they have Lane Keeping? Do they did they do anything that helps you or are you constantly keeping that truck in between the lines,

Saxon 10:20
while mostly it is still down to the driver to be in control of the vehicle, keeping it but obviously between the lines itself, but the the vehicle I have does, it looks to make a noise, if anytime you get near the white line, it will just cut out the stereo and your lovely voice that comes through the speaker just disappears. And it's replaced with a rumble, which is very irritating as a lot of the time. It's actually it's wrong. You know, the sun could be reflecting off of a puddle. And it will think that that's the white line you're getting there. So this thing's there to try and help with the attention. They call it Driver Assist. But I think it's more driver annoy. There's other bits about though, which are i I've gotten to like because it's built in the Mercedes truck that I have will adjust speed for corners as well. So there's a lot of a lot of corners going through the country back towards the airfield where we're based. And I can just use the cruise control. And it will speed up slow down for all the corners as we go through. And I just need to just I suppose just pay attention and turn the wheel. But it will do all the speeding up and slowing down the braking. coasting up to the corners and the junctions it's it saves saves a lot on my right foot. And because it's automatic, hopefully will reduce me having one extremely athletic calf. And the other one not looking quite so to find

Scott Benner 12:04
that big, big strong right leg of yours. Yeah. So when you when this going back to when it happened, your diagnosis was there. And they give you this month, what are you learning to do with that time? Are you injecting insulin? Is it a meter? Like what do you do? It's only a few years ago. So what did they give you?

Saxon 12:27
They started off. So I received the meter. And I was given Novem mix 50. So as a 5050 mixture. And I was just told to take so many units at breakfast, so many units at dinner. And just try and follow some guidance as to what to eat, which I later learned was probably more advice for type twos managing on diet without insulin. Because it was very hard to apply to say cereal, and then say a beef stew with dumplings that just did. There's just no flexibility with it. But within a couple of weeks when I was back at the clinic, and I said that, well look, I don't really have a schedule with my job. What am I supposed to do with this mixture? You know, I'm taking it in the morning. But if I start at three and I don't get a chance to actually have any breakfast for some hours, you know, when am I supposed to take it? And should would you be interested in the Basal Bolus system as well? What's that? And that's when I was then given some Lantus and Nova rapid and, and to sit, you know, take so many into Lantis. And here's your rapid we recommend a unit for 10. But just start off with four units for each meal and see how you go. You know, if if you said patients like this, because if you want to have some pudding as well, you can just take a bit more, which you can't really do with the mixture. So yeah, I've been on that. But I found Lantus to be very frustrating in that. It was sort of peak about five or six hours in and then just tail off and I wasn't really quite sure. The best way to adjust for that. And I have recently been given a pump, thankfully about seven months ago now. So kind of learning all over again.

Scott Benner 14:33
Yeah. So you went you went about did you go about three years with Atlantis? Yes, yeah. Yeah. Was it? Was it your finding that it just didn't last 24 hours and it also had times where it worked more aggressively than others?

Saxon 14:49
Ah, yes, pretty much. But it was also I don't know if I'm just very sensitive to it or what it is, but they're just comes a time where suddenly, I just do not need as much as I've been taking. And it but it's in you for the whole day. And all you can do is then eat your way out of multiple lows. So I'm one day diving into a garage to buy, I just bought a four pack of chocolate bars. By the end of the day, I got through the entire packet, I hadn't dosed for a single one, and I'm still struggling to keep my numbers up. You know, and it's just like waiting until the evening work. And then finally, put in a smaller amount of Lantis. And hopefully try to get it right,

Scott Benner 15:38
ya know,

Saxon 15:39
and it's so nice to be on the pump. Now that I'm going oh, it's a bit much at the moment. Let's turn it down. And you see change in a few hours.

Scott Benner 15:46
You said two things that are really interesting. So the one was that, in the beginning, the doctor said to you look, it's one for 10 Unless it's not to start with four units and then adjust. They give you a lot of freedom to make that decision on your own. Right. You felt like that was your job to make that adjustment? Yes, yeah. Not like come back, like not stay low for three months or high for three months and come back and see me again.

Saxon 16:12
Yeah, yeah. In a way. So I think was the specialist nurse who told me about that stuff. Yeah, it was like, yeah, here's some rough guideline Dryden, see what works. But then when you do go in, and they look at your numbers and go, Oh, maybe try a bit less? Plan your meals a bit better? I'm trying I really am. Yeah, I know. You don't like to see the lows? No, they do. I?

Scott Benner 16:41
Did you spend a lot of that time eating those lows away? Or did you figure out to change the Lantis?

Saxon 16:49
Ah, both. I'd say. It took me a while to realize that when I would normally say beyond maybe 21 units of basil for the day, that it would eventually settle in at 14. So it was like a third of what I was taking. So eventually, it took me what I figured out that roughly, that was the ratio, I was on like 14 or 21 units, but it did take me a while to get there.

Scott Benner 17:19
Okay, 14, are you

Saxon 17:22
so you got two basil profiles in the pump? And at the moment, so we've got one on 14.4 and the other one on 19.3? Yeah. And it's the for the day that is so that's how many units for the day.

Scott Benner 17:39
What's the how does that shake out? Like is the 14th while you're driving, and you're sitting still on the 19th? When you're moving around more? Or excuse me, vice versa?

Saxon 17:49
No, it seems to be more perhaps if I'm fighting off a bug or if I've been given you know, a vaccination, sometimes, I can't really quite work out why, okay? It just is one or it's the other

Scott Benner 18:05
day, but you don't notice a significant difference when you're just sitting and driving all day versus when you're up and around.

Saxon 18:12
For that, yeah, I can do. Typically, if I've obviously had a meal, I need to try and remember to maybe not eat quite so much. But that's that's a tricky thing I find particularly with work. If if I'm going to have something to eat on them on the road for say, an hour and a half or two hours, I don't want to take a reduced amount of insulin because I will then get really high. But then when I get to the site, I've then got to be active, taking all the straps off the load running around getting freeing stuff up. And at that point, I'm then being really active. So I don't want too much insulin. And that's quite a hard thing to balance. And I'm trying to work out the right amount to say do a temporary basil, which obviously previously I couldn't do with Lantus, right so that was just scuffle load of biscuits before I get out the cab.

Unknown Speaker 19:08
How many stones sometimes it works?

Saxon 19:12
Stone up. Didn't think Americans did stone we put on my 1112 That's

Scott Benner 19:17
funny. I don't I just was trying to be ready because I thought if I asked you how much you weighed, you'd have no idea and pounds but I noticed about 100 kilos. Oh I see oh, let's see everybody we're you're on 150 pounds 155 What do you

Saxon 19:35
sell? I don't really work in pounds and there's some buying beef mints. Then it's one

Scott Benner 19:43
I'm gonna figure it out. We're gonna figure out together how much you weigh

Saxon 19:48
into metrics quite frustrating. You know, I was working through a recipe earlier and it's it's clearly American recipe because there's cups for this and cups for that and it's our please just deal on weight, not volume.

Scott Benner 19:59
How many kilos Did you say you were

Saxon 20:01
about 7575? So

Scott Benner 20:03
you're about you're about 168 pounds somewhere in there. Okay, just so everybody can have context because your basil is it's a little light for your weight, which is great. You know what I mean? Like, it's it's good. Actually doesn't matter much. It just surprised me a little. It was a little it was a little light for your weight. I don't know why it's hit greatest. What do I care how much basil you use. But I was just trying to get that straight in my mind. So because at 19 a day, you're not quite one an hour at fortnight, and you know what, 14, you're more like, what, like point six an hour or something like that?

Saxon 20:44
It's currently on? Yeah, point six, two at the moment. Okay. I do prefer it when I need more, though, because it doesn't seem to my numbers don't jump around as much when I'm less sensitive.

Scott Benner 20:58
Okay, so when you're when your Basal is a little higher, you see more stability? I think so. Yeah. When your Basal is lowered? Do you adjust your meal ratio and make it a little heavier or no? Ah, I

Saxon 21:11
mean, that's another tricky one. So I've heard you say before, you've heard from other people that it's that they either need so much, or they need another amount, until they don't. And in between, it's just chaos. And that sometimes is how it feels like sometimes I feel like I need to lower the Basal because I can see on the graph that I'm just drifting on, like, trending down. So then you try and have maybe a little less of a Bolus. And you just go screaming up straight up. So is that what what do I need? Do I need more or less than clearly, I need less Basal but more Bolus, right. And there's always a few days of it settling in. And then when you finally figure it out? Yeah. And maybe sometimes I'll see I'll get a day, maybe two days where I'm 100% in range, and it's about to change.

Scott Benner 22:03
Like, this can't last forever.

Saxon 22:05
It doesn't know. Yeah, like I'm, I'm really looking forward to getting the pump integrated with Dexcom. They can't bring that quick enough, I don't think.

Scott Benner 22:19
Yeah. And you guys are usually Ha, you guys are usually a couple of years behind when it comes here. Right? Is that how it?

Saxon 22:29
I guess so? I guess so. I went when I went through the pump process, and they showed like several pumps. I think they had a an Accu check. And Donna and those are under Medtronic. And and then they said they're having an IP. So med one come along, which I don't think you have over there. No. So what about the what about the T slim as our we don't currently have access to that within within the trust here? Okay, that's a shame because that's the one I'd really like. And I found out at my six month review that they now offer it I really. So I'm on the IPS omega, which they bought the bought access to the tandem algorithm, but they haven't got it approved yet.

Scott Benner 23:24
Okay. And if so mad is it's not quite I'm trying to remember it. It's not quite tubeless. Right. It's like a short tube on it. Ah, what am I?

Saxon 23:39
I'm not sure. I mean, the tube I've got I think is 60 centimeters.

Scott Benner 23:44
Okay. Yeah, I'm lucky.

Saxon 23:46
So a couple of feet.

Scott Benner 23:48
So yeah, so you do you do have like a pump with a with with tubing on it and then into an infusion set? That's the estimate.

Saxon 23:56
Yes, I got it. Yeah. It's a very, very small pump. It's like half the size of an iPhone.

Scott Benner 24:02
You guys have Omnipod there, right?

Saxon 24:05
Yeah, but my trust seem to think that that's only for children.

Scott Benner 24:09
Really? That's interesting. I mean, do you use more than 200 units of insulin and three days?

Saxon 24:15
She said, No, I don't. Right.

Scott Benner 24:17
Right. Yeah, well, then it's for you, too. And they're gonna have their algorithm too. I mean, it just got it cleared by the FDA here in America a few weeks ago. They're doing a limited release at the moment, and then it's gonna go wider soon. So I don't know when that puts it in Europe, to be perfectly honest. But I mean, I think you're right. I think that algorithms that talk to your CGM and your pomp are a big deal, you know, because all this stuff you've been talking about for the last half an hour. A lot of it isn't going to exist in your life day to day when this algorithms making that decision. It's it's gonna, it's gonna lift a real burden for a lot of people. But

Saxon 25:01
yeah, I'm really looking forward to it just to just free up some headspace not just focus on other stuff. Not that I have to think about too much while I'm fumbling along the road.

Scott Benner 25:13
Well, what is it like, though? I mean, does it add an extra level of, I don't know, like, concern that you're constantly driving. I mean, when people have type one diabetes, they usually put a lot of effort into making sure that their drives are well protected. You know, they know what their blood sugar is, before they start, they check while they're driving. They have stuff with them all the time. But when you're driving all day long, how do you manage that? Do you ever have to pull over to to help yourself? Or is it something you can keep going? Pretty well.

Saxon 25:46
Um, so we can only drive here within two hours of performing a blood glucose check. I think they recently did approve CGM for driving but not a large vehicle. So even though I do have a Dexcom, I still have to pull over and prick my finger for say, every two hours of driving.

Scott Benner 26:11
And that's a vehicle to.

Saxon 26:15
So I could drive my car on just the Dexcom as long as I wear it in an approved place, okay. But then I get better results with it on my pec than I actually do on my stomach or the back of the arm. So yeah, I might as well just prick my finger anyway. But yeah, I have the rules that are given to me by the driving agency that we have here. And so if your glucose is less than five, which I think is 90 over there, isn't it, you know, have a snack, and it's less than four, then you have to retest or correct with some sugar and test again. And once you've been back in range for more than 45 minutes, then you can get going again. 40, which is incredibly frustrating when you get to 3.9.

Scott Benner 27:09
And then you have to wait 45 minutes?

Saxon 27:12
Well, it's an hour really, because you've got a correct test again, and then 45 minutes after, after that you can go again. And that's yeah, it's very frustrating. How on time how strict

Scott Benner 27:22
are the rules? Like if you got caught? Not following them? Would you get a ticket? Would you lose your license? How would that work? Do you know?

Saxon 27:33
Um, potentially I could lose my license, you know, being control of a 44 ton vehicle with? Well, it would be classed as being not fully in control of the vehicle, I suppose. It's they were set out as a dangerous weapon in the wrong hands. And yeah, they're worried about if you're low, it's affecting your concentration. And let's say that it takes at least 45 minutes for your brain to recover from a low which I imagine if you're prior to being able to keep yourself in range with CGM that anytime you got below five, he probably did feel absolutely rubbish. And therefore we enter a proper hypo. Yes, you did need to probably stop because I do try to keep myself as in range as possible. I actually feel okay when I'm around the for just a little bit less, you know, just just a tiny bit less. But obviously the clinics will tell you that they're worried about you losing hyper awareness. But I thought I can function just fine. I've only had one occasion where I did think yeah, I really do definitely need to stop. I'd just helped another driver who's loaded. All his straps came loose, loose when his loads shifted. So I just helped him strap it up, got back in the truck and start to drive down the road again. And I felt like the entire cab was shrinking around me. And I just looked at my watch to see the see the number like oh, okay, yeah, that's dropping fast. Now this is what it means when they say you might act drunk or feel drunk with it. And so I just scuffed a load of jelly babies and orange juice and I'm pulled over tested and was like Oh 2.2 Yeah, that that felt low. Wow, it didn't enjoy that.

Scott Benner 29:40
Gee vo Capo pen has no visible needle, and is a premixed auto injector of glucagon for treatment of very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to Jeeva glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or phaeochromocytoma, visit G Ro glucagon.com/risk. Here you are using insulin, and you'd like to do it more deftly. But you don't want an insulin pump. That's fair. You don't have to get an insulin pump if you don't want to. But right now what you have right is an insulin pen that just, it just acts as the thing that measures and puts the insulin in, you need something more, you need the in pen from Medtronic diabetes. Now the end. Now the pen is an insulin pen, but it connects to an application on your phone through Bluetooth. This app does many things. For instance, it has a dosing calculator shows your current glucose, your meal history, active insulin remaining glucose history, dosing history, activity log and reports. You might be wondering how it does that. The pen does all that with the help of your CGM. Go check it out in pen today.com. When you get there, you're gonna see the pen, you're gonna see the app, there are forms to fill out if you're ready to try. And there's going to be information that you need. For instance, you may not have known this, but in Penn offers you 24 hour technical support, hands on product training, online educational resources, and who Holy heck. Now this offer is available to people with commercial insurance, of course Terms and Conditions apply. But you may pay as little as I don't even know what's the impact. Imagine the number think of a number in your head. The number is $35. pay as little as $35. That is a possibility. Go check it out in Penn today.com. There's even a Frequently Asked Questions portion of the website all the way at the bottom, it's going to fill in anything that I haven't told you in pen today.com Take the right insulin dose at the right time with the in pen from Medtronic diabetes. Don't forget, it's super simple to support the podcast use my links if you're interested in in pen. Or if you're interested in Chivo caipital pen or any of the sponsors. There's links in the show notes of the podcast player you're listening in right now please tell me you're listening to the podcast player. If you're not, please find an audio app that you like and subscribe it. Anyway, I digress, or there are links at juicebox podcast.com. You can also just type them in with your browser. Your fingers, I meant, you know type of the browser you type with your fingers into the browser. I think we're getting away from the point. Let's get back to Saxon and his lovely accent and story. Yeah, crap, I forgot to tell you something I have to say hold on writing. In pen 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 blood glucose levels. For more safety information visit in Penn today.com. All right. I don't want to get yelled at now let's get back to the show. No kidding. So you say that you feel pretty good around a four which is the 72 here but 2.2 is in the 40s it is 40 Yeah, that's low.

Saxon 33:04
Yeah, yeah. No, I didn't enjoy that.

Scott Benner 33:07
So that just activity of jumping around that truck and pulling those straps and re sensing that load made you low.

Saxon 33:15
Yes, it did. And then I was struggling with lows for the entire day. So it's just one of those moments where my body's decided that it doesn't need as much insulin but it never tells you that it's going to have that kind of day you just have to work it out for yourself. Well

Scott Benner 33:28
yeah, you don't know the kind of day you're going to have but Saxon I would bet that it's the activity and the you probably kind of activated the insulin that was already in you so I'm I'd be surprised if it if it isn't true that when you're sedentary and not moving that you need more insulin to keep your blood sugar stable at a certain number than you do when you're active.

Saxon 33:49
Oh, I wouldn't disagree with that. Yeah, yeah. So

Scott Benner 33:51
I think you just jumped out started moving around that other truck and you got you caught alo your prompt did you have active Do you remember that moment? Did you have active insulin had you eaten in the hours prior to that?

Saxon 34:03
About Yeah, probably about an hour and a half before so yes, admittedly the rapid would have been peaking at that point. Right you know, initially I was just thinking of trying to keep the other guys safe because he had to his straps are dragging on the road so I had to just try and keep them safe whilst whilst that was happening. But as I say later on in the day, you know, just driving around and like oh creeping down again and again and again.

Scott Benner 34:30
It just stopped then after that.

Saxon 34:33
Yeah, I'm for a few days that I was on a lower amount of lattice again.

Scott Benner 34:40
But but now the moves around Yeah, but now the pump has made all that easier for you. Yeah, easier. Yeah. Not that easy, just easier. Well, I'll tell you,

Saxon 34:51
I knew wouldn't be a fixed and the doctor did say to me when when I was approved for it that he that I would not get better. results than what I was already achieving with pens. Just that I was less likely to burn out from the effort, which they seem to think I'm putting into it. The very wide I get stressed with the effort and it's like, no, it's there is a number, correct it move on.

Scott Benner 35:17
Yeah. Well, so you said something much earlier in the conversation that I related to a lot. The idea when you're injecting a slow acting insulin like Lantus, you know, lever meritocracy, but whatever you're using, that it's in there, and now it's in there, and you can't do anything about it. I used to have that feel at least you're an adult, right? Like, we used to inject that into my daughter when she was two and three and four years old. And it was the I thought that was almost the worst part of it is that you had to put it in, but you weren't sure if you were going to need it. And then you had to work backwards from it. And you know, at least you can, you know, tell yourself, I have to eat this and you can do it like you should try tell him like a three year old that's not hungry that they need to eat something because they they look right through you. But But it's the that you just brought back a memory when you said that that really sticks with me that I felt that way at the time. Like every day, you're like, I'm gonna put this in. And I hope we need Yeah, you know?

Saxon 36:18
Yeah, well, I mean, watching my mom trying to feed my brother and sister all those years ago was that look like hard enough work without the extra complication of managing diabetes for your daughter as well?

Scott Benner 36:30
No kidding. So are there other autoimmune issues in your family line? Or does anybody else have diabetes?

Saxon 36:39
There is no diabetes that we are aware of at all in neither my mom's or my dad sides. I've heard you mentioned possibly that bipolar might be a thing that linked with it. We suspect that my grandma might have had it. But I mean, she died in 91. So I think back then they just call it hysteria. But that's about all that I'm aware of in terms of anything autoimmune in the family.

Scott Benner 37:10
You know, I have to admit, when I start having bad days, I'm going to start saying I have hysteria because that sounds like a nice way to describe a day that's gone wrong. What's wrong with you? I'm a little hysterical.

Saxon 37:25
Sounds like good plan. Not today.

Scott Benner 37:27
Any thyroid stuff?

Saxon 37:29
Not that I've heard of.

Scott Benner 37:30
Okay. So it's fair to say that you were completely shocked to have diabetes?

Saxon 37:37
Yes, absolutely. I think we've, well, the only thing that makes sense to it was earlier on that year I had flu. That's, that's the only thing I can really see as being a trigger for it. Because for about three months, I just had absolutely no strength. And then come the summer, I start seeing a few other symptoms, which I can now relate to it. Dealing with a little bit of thrush, and then later on, started losing weight. And then I was like, Oh, I'm in the thick of that. I went out for a run. I thought start running. And that night, I had to wake up five times to go pee in the light. Well, obviously, it's not actually related. I don't think but, you know, that kind of put me off running a little bit. And then it's like, okay, every hour, I'm driving on the road, I have to pull over what's going on? And yeah, it was it was quite a shock. For me. Even in the hospital. The doctor was asking me like, Do you have any pain in your stomach? If you've been throwing up at all? No. Are you? Are you tired? A lot? Yeah. Sometimes I'm up at 1am to start my job. Okay, you pick it up? Yeah. I like coffee. You can write so many of these things off. Sure. But when you when you really have all the symptoms, they're like, oh, yeah, they're all there, aren't they? Yeah, this makes sense.

Scott Benner 38:57
The thrush is like a yeast infection in your mouth. Right?

Saxon 39:01
I actually I had it more in other sensitive areas. Yeah. And so there was a few a couple of like conversations I suppose with well, my now ex wife but so that I don't know what's going on here. You know? Yeah, maybe not tonight if you don't want to catch us, I don't know where it's coming from. You know, and I was seeing the doctor. I went to the local doctor a couple of times and I was getting some creams and then one day I went and so it's still not going away but I now feel like I'm also pulling away my weight and I'm ah, that sounds like diabetes. Let me go get the meter like scuze me

Scott Benner 39:37
Wow. So the thrush alone didn't get him but you mentioned the urination. He went right to diabetes. Yeah, because he saw the high blood sugar because the yeast infection Yeah.

Saxon 39:49
Why well as the weight loss as well in the

Scott Benner 39:51
weight loss, how long did it take you to think to diagnose it a couple of months.

Saxon 39:57
Ah, I suppose from actually seeing Dr for that yeah, probably was a month or two. But I think I can trace symptoms back about five or six months.

Scott Benner 40:09
Wow. That's a long time. It's not just not something you expect as an adult, especially if you don't have in your family. And it sounds like you're onset might have been a little slow. Do you remember what your blood sugar was? When? When he got that meter?

Saxon 40:25
Well, they when they tested me in the hospital, it was 29. Okay, no, I've quite got the conversion for you. There.

Scott Benner 40:34
I got it. It's about 522. For hear okay. Yeah. Which is high, but not the highest number I've ever heard.

Saxon 40:42
How did you feel? I've heard some high numbers on your show. Yeah, some

Scott Benner 40:45
sometimes you're like, wow. But how did you feel at that point? The tiredness was it? Was it getting worse? Or was it just that you were Yeah, yeah. Yeah, I

Saxon 40:57
suppose say. I mean, I was quite happy to get myself into bed at eight o'clock some nights. And then once I started taking the incident was like, oh, yeah, yeah, I've got the energy back. But it's you do get used to feeling rubbish. And you, you just get on with it. You adapt.

Scott Benner 41:13
I'm gonna ask you a question. It's none of my business acts. And so you can tell me to go ahead, screw off. But did the diabetes have anything to do with the end of your marriage?

Saxon 41:23
Um, some people would think it like that. But no, I think I can honestly see patterns in her behavior long before that, which led up to us getting divorced. Okay, was it but maybe it was a little bit the end? Well, when we split, she told me not to change. Nope, don't change who I am.

Scott Benner 41:47
Okay. Well, that's good. Yeah. Don't just not for me, but I gotta go. How long? Yeah. How long had you been married?

Saxon 42:01
About five years at that point. We've been married. We've been together about 10.

Scott Benner 42:06
Okay. All right. Well, I'm sorry, that happened. I was just I felt like I felt like I should ask.

Saxon 42:12
No, no, no, that's, that's absolutely fair enough. But you know, I'm here to be honest. But it's, I'd say it really worked out for the best in the end. Obviously, we weren't for each other. And I then met somebody. I'd say as far fire lovelier pretty quickly afterwards.

Scott Benner 42:29
How do you meet a girl when you drive a truck all day?

Saxon 42:31
Well, that's a tricky thing, I suppose. Luckily, I do four days on four days off. So I'm only working half the time so I can actually meet people. But you know, in this day and age, it is. Tinder, I suppose, isn't it?

Scott Benner 42:46
Yeah. Oh, yeah. Swiping around. I gotcha. Well, that makes sense. Yeah. Well,

Saxon 42:49
yeah. I just said I'm not in the I'm not in the right place for relationship having just come out of the long term one. So you know, I'm just looking to meet people. And, and Natalie said to me, that she was about to go to America. So perfect. And two and a half years later, she's still here with me.

Scott Benner 43:08
Oh, you changed her plans? Yeah, look at you. That's, I see. You're, you're flexing a little bit there. Saxon. I see what's going on.

Saxon 43:22
Being honest, and nice, actually was something she wasn't used to. So there was a reason to stay.

Scott Benner 43:28
That's excellent. Oh, good. I'm glad for you. Is she is she very involved in your diabetes? How much of it? Do you let her see?

Saxon 43:36
Oh, let's see the whole lot. But she's not. She's not supposed like involved in terms of having to take any care. But she's a she's a nurse and she has found it very interesting. And has given a lot of confidence, seeing what I do. In terms of actually then treating the patients that she has. Okay, so she's, she's not scared of the of the insulin

Scott Benner 44:06
anymore. Wow. She works in a hospital.

Saxon 44:09
Yes, yeah. So when I met her, she was a critical care nurse. So she should manage people with DKA newly diagnosed or having other problems, various other types of insulin needs. So I think somebody would say, due to a brain injury, the body was or the brain wasn't telling them to release the insulin. So yeah, so it's things like that.

Scott Benner 44:39
Okay. You know, I will tell you that I had a fair amount of stress just now when I said she works in a hospital because I couldn't decide if I should put the in front of the in front of hospital or if I because you guys guys just say hospital, and I didn't know what to do and I panicked.

Saxon 45:02
Yeah, I'm not too sure what the right answer actually is here. Do we say go to a hospital or go to the hospital? You know, sometimes the the north of England, don't use the word there. You know, do you want a cup of tea?

Scott Benner 45:16
I'm just telling you, it's shot me into a panic, I could. So if you're me, I have this weird, like, skill or life thing that happens to me, where I'm a little aware, when I'm recording this podcast, I'm a little aware of my next like, eight words before they come out of my mouth. And so you're talking and I'm asked, I know, I want to ask if she works in a hospital. And I can just I can hear voices in my head fighting going. Don't say the US say it. Don't say.

Saxon 45:47
That sounds a little tiring at times.

Scott Benner 45:49
I was just like, I don't want to like I don't know, I, you know, it's stupid. Doesn't matter. But I've just interviewed enough people from, you know, from England, where I'm just very aware of it. And, and I still can't get it right. So I knew I whatever. Cannot we know what you mean? Thank you. Can I ask you a question that there's no way prior to two weeks ago, I would never would have asked you. How close do you feel to Ukraine right now?

Saxon 46:18
Oh, ah. Well, I don't know. I mean, I'm in a country where half more than half of them decided to get away from anything to do with Europe. So I'm not really too sure. But I doesn't sound nice. What's happening over there.

Scott Benner 46:34
But but your own personal safety? Do you feel close to it?

Saxon 46:40
Are there I mean, I suppose, like the far east of Europe to us, but who knows how far Putin might decide to reach? But we don't seem to be doing much to, to aid them for some reason. So maybe we'll be okay. I'm wondering if our politicians are a bit too scared to really provide proper assistance. Now, I think we're arming the Ukraine, but we're not sending troops. So I don't

Scott Benner 47:12
know, that seems to be how they're all handling it. I just wondered if because you're attached. And you're there. You know, like if it felt like a regional conflict that you have no real concern about reaching you? Or if it feels different? Because it's closer. That's all I you know, I mean, from here. It you know, it's horrifying. And concerning, obviously. But I don't feel like it's going to be here anytime soon. I just didn't know if like the distance made it different for you. But it sounds like you are having a fairly similar experience to the one I'm having.

Saxon 47:49
Yeah, I don't really know what to feel about it. I'll be honest. You know, I have a friend from Estonia. And at some point, I'll find out what what she thinks about it, because they're only they are another country or to a long from from Ukraine.

Unknown Speaker 48:04
Yeah, that shows more

Saxon 48:05
concerning for her and the family that she has back over there, having previously been a part of the Soviet Union.

Scott Benner 48:12
Wow, it just all seems you got that little tiny bit of water, but then I gotta help you.

Saxon 48:19
I mean, it's helped us but before if, you know, for those people who can't let go, the Second World War,

Scott Benner 48:23
slows them down a little bit having to get on a boat and something like that. Oh, my gosh, do you see the world? Like, very does the internet? What am I? What's my question? Like? Does the internet make everything seemed local at this point? Like, do you have more understanding of the United States, for instance, in places that are far away? In your 30s that you didn't your teens and your 20s?

Saxon 48:52
Um, possibly, I try. I try and stay off social media, because it's just, it's just saturated with rubbish. And I don't like going on there. And the news is just too damn depressing. Right. So I have to admit a lot of what I pick up about the world these days, I actually get from here and your guests, for wherever they are. Because at least getting somebody's own personal story with it. But you turn on the news, and it's like, oh, like for a couple of years. It was Brexit, more Brexit, you know? And it's like, Oh, can we have something else? Oh, we're talking about COVID. Okay, now that's getting boring now. Can we talk about Brexit again? No, that's still bad. Yeah, there's just been very little to make me feel like I want to tune into the news. I wonder I thought I'll just find out what's actually going on in the world. Again, after like months of not listening to the radio. And, oh, Stephen Hawking died. Oh, that was tuned in now.

Scott Benner 49:55
I'm sad. I was just depressing. Yeah, I know. We were on a car trip. The other day, and my wife said, Put the news on, I want to hear about Ukraine. And we listened for, you know, 10 or 15 minutes. And I don't know, a couple hours went by, and she's like, put it back on again. And we put it back on again. And I realized they were just saying the same thing. And then I start paying attention at the top of every hour, they were just making the same statement, and then having the same conversations off of it over and over again, I said to her, I was like, There's no new news here. Like they're just, they're just re saying the same thing over and over, you know, so we,

Saxon 50:30
yes, 24 hours of news, but it's no longer new.

Scott Benner 50:34
No, and he said it. My favorite part is that every time they say something, they go, this is breaking news. I'm like, Everything can't be breaking. It's like something I don't know, I just I agree with you, I I do my best to stay away from just medic mass market media news. And even like you said, like Brexit is a good example. You start getting involved in these like political discussions, you realize that you have almost no say in how this goes. And it's going to do what it's going to do anyway. And, and being twisted up in the, in the moment to moment of it really has no value to you. It doesn't make you better informed. It just sort of makes you you know, I think it makes you just kind of more nervous and anxious, honestly, about something. Yeah, no effect on.

Saxon 51:23
Yeah, I think I spent spent a day listening to like COVID updates and getting a whole bunch of stuff. And by the end of the day, I felt awful. And I'm gonna go back to audio books, podcasts, whatever, you know, let's get some music going on. Let's just stay away from the radio.

Scott Benner 51:38
How was that driving a truck during COVID? Like because you you travel a distance, then you have contact with people, I imagined that that change what happens when you get to a destination or do a pickup?

Saxon 51:51
Yeah, for a while that was that was definitely a different experience. You know, arriving at the site not being allowed inside though. In not allowed in a warehouse, they'd come out and meet you. As long as you've already masked up even though you're outside. Take your keys off you still but they go in a bag. You know, that hiring portaloos to be in the yard so that you don't go inside to use their toilets? That's yeah, that was That's strange. You know, not everyone is completely relaxed yet either. I yeah, in some ways, it was kind of nice, because you know, other places where they normally would take your keys and then sit you in a different room. You weren't allowed to stay in your vehicle. They stopped all that. So it was like finally I can take where I'm already comfortable with my own stuff and my food. Yeah. I don't really have to deal with that too much now. Because when I first got got in touch with you, I was part of the general haulage company and we were moving a lot of just various goods. And now I'm part of a crane company. It's we've just gotten a building sites. You know, just take take the crane, drop that off, leave. You know, it's not too bad. Now.

Scott Benner 53:11
Can you explain to people step by step how to pee in a bottle while you're driving?

Saxon 53:16
Um, I would imagine, you'd imagine, well, there's got a big enough spout. I personally haven't tried it because I don't want to get it wrong. And I have all over my seat. But I know, I remember one man saying he, he met up with a couple of where he met a couple of Irish drivers in Liverpool had a had a couple of pints with beginners of Guinness with them. And then they set off towards Dover to get on the other channel tunnel. And he said after 10 hours, he just had to stop and pee. And they just kept going. So obviously they've masked Yeah, yeah, I'll just pull over. I mean, now I have to anyway. Yeah, I won't do that.

Scott Benner 54:11
I imagine the wide mouth bottle is pretty much the it's the key to the whole thing. Honestly, right.

Saxon 54:17
I mean, there's times we okay, like you park up in a service station for the night and takes like three or four minutes to walk inside to the facilities. And it's chucking down with rain. You're like now I'm just gonna pee in a bowl tonight.

Scott Benner 54:33
Are there places that when you stop, like have shower facilities and things like that for you?

Saxon 54:39
Yeah, yeah. There are a few of those arounds. Not necessarily good, but they are available.

Scott Benner 54:46
Okay. Not something you would want to use on purpose, just more of a necessity.

Saxon 54:50
Yes, some of them aren't too bad, some of them but there's a couple of places where they're really nice. A lot of them are just about adequate One of the one of the private truck stops that we have, I don't think it's particularly good for the we have a payment system. So that you can just give you registration, the company is billed, the driver doesn't have to pay over money and wait for any expenses to come back. But because this company then takes a percentage, the truckstop has decided that to get that money back, they'll then not include a shower token with the parking. So we then three pounds to have a shower. But then you also have a ticket to put into the machine to give you so many minutes of water. And then when you press the button that I know, it's like at the swimming pools, you press a button, you've got so many seconds of water, and then you've got press it again. Well, the buttons and these showers pop out again within two seconds. And half of that water is coming out of the back of the showerhead and running down the wall. And it's it's no wonder a lot of people kind of get disenfranchised with I suppose this lifestyle is is a bit more of a lifestyle than a job. When that's the kind of treatment or care that you get for almost dedicating your life to

Scott Benner 56:20
Yeah, it's hard. It's hard work to I mean, it takes a lot out of you. I imagine there's you say you work for the f4 off but the first day must be recovery. Right?

Saxon 56:30
Hey can be yes. ticked off to say that a 15 hour day. Yeah, I tried to have the first day is just take it slow, man get some chores in the, you know, the day after. But yeah, it can be like that, you know, I've had times where I've had to be at work for three o'clock in the morning, on the first day, and then I've not got home till 11 o'clock on the fourth day. And yeah, that's kind of takes away a little bit of your weekend as well. But you know, both at both sides of

Scott Benner 57:00
that in a in a 15 hour workday. How many of those hours do you think you're actually driving?

Saxon 57:07
Ah, well, we're limited to nine hours of driving in a day. Twice a week that can be increased to 10. But usually it might be say seven, eight hours of driving.

Scott Benner 57:21
And I recognize that you're happy in your relationship. But I have a question you might have information about is the idea of Lot lizards. Is that something that translates to you a

Saxon 57:32
lot lizard?

Scott Benner 57:33
Do you do not know the phrase?

Saxon 57:36
I'm gonna assume from lat You mean like a parking area? Is this going to be do with like ladies of the night? Yes,

Scott Benner 57:42
it is. Is that a real thing in this world? From my movies,

Saxon 57:47
I've heard of it. I haven't experienced it. Okay.

Scott Benner 57:51
It's not it's not like, it's not like I made to believe in a movie where you pull into your parking spot and just you're swarmed by prostitution.

Saxon 58:01
No one one man did tell me that happened at a particular service station. It was just like, every 10 minutes, there's somebody knocking on the door, anything just go away. I'm desperate for sleep.

Scott Benner 58:11
Yeah, I can't imagine how exhausted you must be at the end of a of nine hours of driving. We. So we just drove to take art and to visit a school college she's considering going to, which I guess is a university in your mind. And it was crossed the country. So we kind of took it a little slow and easy. But by the time we got there, we had been in the car about 14 or 15 hours. And you know, with a couple of stops here and there for you know, restrooms and food and things. And we stopped at a hotel. And we were waiting at the front desk to check in. And my wife goes, Are you okay? And I said, is the room moving? Or is it me? Like you have that weird feeling like you're swaying but you're not moving? And if that makes any sense to you, maybe it does. But yeah, yeah, I found it very disconcerting. I don't normally drive that far in, you know, in a shot, so I don't know what that is. It just felt like exhaustion, but um, I'm not certain. A probably

Saxon 59:13
is if you're not used to concentrating for that long.

Scott Benner 59:17
Yeah, that's the hardest part. Isn't it? Just the paying attention?

Saxon 59:22
Yeah, fun. It can be like most days, it's, it's not too bad. You know, usually lasts like, Don't you get bored, but I just consider it more that I'm absorbing my choice of entertainment whilst I'm driving. The days when it's heavy rain, if it's really, if there's heavy fog, then I find it very tiring. Because then I'm really having to focus and try and peer through the weather conditions. That's a struggle,

Scott Benner 59:51
and you're moving heavy equipment. That's not that isn't that not like cases or boxes that can get stacked up and the distribution of weight is probably a little different for the stuff you're pulling to, right? Because the I'm kind of guessing about moving cranes around. But it sounds like it's not as stable as far as the the load goes.

Saxon 1:00:14
So it's not too bad. To be honest. If it is a heavy load, it's usually because of the ballast weights, which then just go on the deck. So that's kind of at least giving you a reasonable center of gravity. Stack a few bits on top, but you just, if you're not sure, if it's quite secure enough, put another strap over it, just get it down really tight. Yeah, sometimes they don't quite put stuff in the right place for you. And that more is has an effect on your, on the traction of your your drive axle.

Scott Benner 1:00:49
Do you learn a little bit Do you load and unload? No, I don't know. There's people there that handle the basically the packaging of the crane onto your truck. And then you drive it away?

Saxon 1:01:00
Yeah, yeah, in our yards. Yeah, we have the yard men operate the cranes, and they'll lift, lift the stuff on. And then we secure we take it to the site, where we then have the directors there who then do sort all the lifting off when they're erecting the crane or when the dismantling they're the ones who are putting it all on. And again, then we just secure it. But we're not actually allowed to participate in the loading or unloading of the vehicle. Just securing it and getting it there.

Scott Benner 1:01:33
Gotcha. Is it weird to stand there and watch other people work? Ever feel like you can like help a little bit like, oh, here, I'll get that like, just so they don't look at you like

Saxon 1:01:47
I mean, there's times like that, but there'll be loading stuff on. And whilst they're doing that I'm just throwing the straps over. So I'm still usually doing something. But yeah, there are other times if they're really struggling with taking the crane apart. You know, I can't get involved in that. And so I just sit there and I think I had one day in central London. I was there for 10 hours, and they still hadn't put anything on me. And it turned out Yeah, they were struggling to bash the pins out of the crane because they bent and flight USA after about 10 hours, they finally put a couple of bits on me. And then I just had to get out of London before my before my hours ran out for the day. But yeah, for a day like that. So I guess I'll watch another movie. I'll I'll go asleep. And I'll take some some Warhammer miniatures with me. I can just paint up in the cab while I'm waiting for them. Yeah, my job now involves quite often a lot of sitting around.

Scott Benner 1:02:42
No kidding. Wow. So you, you bring your hobbies with you even because you know you have downtime.

Saxon 1:02:48
Yeah, yeah. That's cool. Yeah, it's not bad. Some of the other guys say like, they knew that when they're on their third movie of the day that they really weren't gonna go anywhere.

Scott Benner 1:02:58
You start binge watching shows, and you're halfway through three seasons you like what is what is happening, right? Well, listen, does it pay? Well? Is it a good job?

Saxon 1:03:09
Where I am now? Actually, I would say yes, it is. It's maybe not paying quite so well, during the winter months because of the wind. You can't really lift much when you know when the storms are coming in. But yeah, I think I think where I am now is fairly good pay. And a lot of other haulage companies are coming up to meet that pay because they're they've been desperate to hold on to drivers lately,

Scott Benner 1:03:34
right? Yeah, there's the craziest thing I've seen here during COVID. Is that jobs that you used to think of as like, jobs that like teenagers would keep or you know, like high school students, stuff that was for after school is suddenly paying like, you know, $20 an hour. And I just feel like they can't they can't keep anybody so they just keep jacking up the pay trying to hold on to, you know, two workers. Yeah, you know,

Saxon 1:04:01
it's Yeah, yeah, no, I've seen a lot of that. But the last company I was in, they lost a load of people with a dangerous goods license. So they up to the bonus for that. And then the local drivers a whole load of them left. So they upped their pay. And then the national trampers they said, they're the ones who sleep in the cab for the week. Like five of them left in two weeks. So again, their pay went up. And the four of us that we're doing four days on four days off there we went, what about us? And I said, oh, there's a queue of people waiting to get in your trucks. We don't need to have your money. So I then heard about this other job with a crane company. I'll see you

Scott Benner 1:04:46
that's not true. Goodbye. Yeah. How long does it take to to train like if I if I showed up there in my mind, and I was like, I'm gonna drive these trucks. I'm gonna go do what's x and does I have noticed I'd like no training at all, how long would it take me to, to get the license.

Saxon 1:05:06
Um, I think it took me three or four months before in turn. So applying for the provisional category on your license, getting in the medicals doing the theory, having the first test was for just driving a rigid truck. So you know, like just one without, without a trailer. So then you can just go and drive one of those once you get your license to get the test back from that. And that was, I did a three day course followed by a test. Because you already know how to drive, they're just adjusting your driving style to a bigger vehicle for the size. Yeah, so that was just wait for the license to come back. And then get booked in to do the next category, which is to have the trailer on the back as well. So that was about three or four months, at the moment, because of COVID. Getting licenses back from the DVLA is as taking so long, I think like, because I have to have my license is on a one year restriction, because I'm on insulin. So every year, I have to submit renewal for medical grounds, see a couple of doctors in the meantime, I can continue to drive until I'm told otherwise. But I am having to say keep renewing the license. And last year that took nine months to get the license back. My my brother who is I think it's gonna be 19 this year. He he's applied for his provisional license to confer to start driving. And he he sent that off, I'm sure in September, he is still waiting to get his provisional license back. So at the moment, he is just stuck in the town that we've come from. You can't go anywhere yet. Yeah, I don't know if he wants to. But he doesn't have the option.

Scott Benner 1:06:58
He just can't. Wow.

Saxon 1:07:00
They're just taking so long to do anything. Right. And you can't get on the phone to them. It just says there's no one available. Thanks. I just sat through a five minute message to get to this point.

Scott Benner 1:07:10
So it's a nine minute wait to reset a one year. A nine month, nine month wait to reset a one year cycle. Yeah, that's, that's not working.

Saxon 1:07:21
Yeah, no, it seems like that. And there's I have another colleague as well. There was also type one, and you were submitted maybe a couple of weeks apart for our licenses. And they said right, okay, well, I'll do a bet with you. Whoever gets a license back first has to give the other one a packet of jelly babies.

Scott Benner 1:07:38
diabetes bedding, less fun than the other? Yeah, yeah.

Saxon 1:07:43
Do you usually get some a lot less trouble?

Scott Benner 1:07:46
No kidding, right. Do you when you submit that for reinstatement basically does that? Is that something you have to get from your doctor? Do you have to write down logs? Do you have to send them numbers? Like how does that work?

Saxon 1:07:59
Ah, so yeah, so I just let the DVLA know that I wish to continue driving, I wish to keep a category on my license. And then they say they send out a questionnaire and then there's stuff in there. Like, you know, ion insulin, have you had any severe episodes? And you're allowed one a year with help? You know, that's okay, any more than that? And then they really going to question your ability, you know, how many hypose Would you say you have, on average, you know, like so many a week or so many a month or hardly any? Have you lost any limbs, you know, all that kind of stuff. And then they say, oh, we'd like to get some more information. So we've arranged an appointment for you with a doctor. And so then the doctor looks through your, your meter to just see the last three months of sugars, just to show that you're not having too many hypose. And if you are that you're correcting them. And you think, well, you're here, aren't you, you're still alive. And after another like month or so of that form being sent off, they say we want some more information. So we've now arranged an appointment for you with an independent doctor. So I then have to drive another hour up the road friend of mine who got perfectly good hospital within 10 minutes. So I have to go to another hospital and see somebody there. Who does exactly the same thing. Yeah, looks through the last three months of readings, says yeah, okay. I asked you, I asked you a couple of questions about you know, do keep carbs within easy reach. If you do have a low, you know, what do you do then when do you feel a low coming on? Just write all that down and sends that off, and then you get your license back for another year. And then you've got to repeat the process. Yeah,

Scott Benner 1:09:56
that sounds

Saxon 1:09:57
thankfully. Yeah. Oh, We have already done it a couple of times so far, but I'm sure it will get tiring.

Scott Benner 1:10:04
Sucks. And I appreciate you doing this. I have one last question that has absolutely nothing to do with any of this. And if you think it's silly, tell me but in your mind, how do you think of the Beatles? Like when you think of Paul McCartney, do you think he's a genius? Who just like, do I think differently of him? Because he doesn't come from here. Does that make sense?

Saxon 1:10:24
Oh, ah, I would say I prefer the Rolling Stones.

Scott Benner 1:10:28
Okay. All right. You're younger too. So like, it's interesting that it's interesting that like, it's not music, that like you didn't grow up with it the first time. Obviously, I didn't either. But I'm just interested, though. Like, like when something comes from the place you are? Is it like, is there lore around it here that doesn't exist? They're like, I don't not love the Rolling Stones. I'm just interested. Like, do you think Paul McCartney is a genius?

Saxon 1:11:00
I know, I don't know. Like, I think the song Hey, dude, certainly ruins any oppression, I have any appreciation that I have for him. Because it just goes on for far too long. I won't deny that the Beatles have clearly had an influence on music. You know, I respect them for what they've done. And for the, I suppose the ability they had to play like when they went over to America to be able to play through the screaming crowds in the stadium with the tiny little speakers behind them, and they couldn't hear each other and be able to do that when they got there. But no, they're not really for me. A bit soft. I have to say for me, though. That's the thing. You know, I like the Rolling Stones because they they rock a lot more. I like it heavy, heavy.

Scott Benner 1:11:51
It's amazing. Those guys still play. It's crazy. Like Mick Jagger still puts on shows. Paul McCartney pulls himself out once in a while and sings it's like, it's ridiculous. Yeah,

Saxon 1:12:01
you know? Yeah. I mean, I'll see the Rolling Stones drummer died last year didn't make recently. Yeah. Yeah. And then Keith Richards just needs an eye and when he goes on stage, but otherwise, that's yeah, I don't know. But I mean, what I'm looking forward to seeing later this year is Ramstein. So that's more my, you know, my tastes.

Scott Benner 1:12:26
So when you go out to is that going to be a festival? Or will you just see

Saxon 1:12:30
this? This is a concert in in a stadium? Okay. I'll have to go to Wales for that one. But I've been waiting two years to get there.

Scott Benner 1:12:38
Yeah, and nobody's I haven't seen a live show and quite some time considering going and seeing some comedy soon. Which seems like that seems like it's okay to do. So. Yeah. But there's been a long pause.

Saxon 1:12:50
Well, you vaccinated now.

Scott Benner 1:12:51
I am I have a, what do I do, we did j&j That I did j&j the first time. And then I did Maderna. The second time to give myself a little, a little flavor from a and a little flavor from be just the case that

Saxon 1:13:07
well, you've done what you can now You're about as protected as you gonna be. You might as well get on with it.

Scott Benner 1:13:13
Yeah, no, I agree. Well, oh, I didn't know you were listening to metal music that might have changed our whole conversation about that.

Saxon 1:13:20
Oh, yeah, I think I have heard you mentioned Metallica a couple of times. Well, when

Scott Benner 1:13:23
when I was younger, we listened to a lot of Pantera. And, and stuff, stuff along those lines. I have to admit, now that I'm older, I don't know that I have the like, I don't know that my taste for it is the same anymore. But I still enjoy it periodically. But oh

Saxon 1:13:42
no, I understand that. I think I'm listening to a lot more podcasts and audiobooks than I am music these days. But every now and then I just do need a reset and just put on something good and heavy. Yeah. Yeah.

Scott Benner 1:13:56
I often think that needs to be done. As an adult. I've achieved a level of stereo in my car that my 19 year old self would have appreciated a lot more than I do.

Saxon 1:14:08
Yeah, fair enough. I mean, I think I've heard you as well having to try and listen to rap music so you can still relate to your son. That's, I don't know if I'm particularly looking forward to that when I finally have some children. Like

Scott Benner 1:14:22
I can't even begin to wonder if you made a baby right now. 15 years from now what I don't even know what music would be and what you would have to try to, to learn to enjoy.

Saxon 1:14:33
Oh, yeah, I don't know. But I'm sure Natalie will be able to cope with that. Because I've talked to other people about music is that well, I like heavy metal. She likes everything else.

Scott Benner 1:14:43
Do you think she'll be at cope? Do you think I don't want to put you on the spot. Do you think you're gonna get married?

Saxon 1:14:50
Oh, that's booked for May next year.

Scott Benner 1:14:53
Oh, okay. Congratulations. That's lovely. Yeah,

Saxon 1:14:57
yeah, I suppose some might say was a bit maybe A bit quick, but it really did feel right. And I actually proposed probably about a month or two before I got divorced.

Scott Benner 1:15:07
There you go, stack up, stack them up, stack them in line.

Saxon 1:15:11
I know, I know, it sounds a bit crazy. But then, at the time I've had other aside, this is actually how will things I think should have felt. And in the marriage I had before. Okay, well, that's excellent. Yeah. You move on to you learn.

Scott Benner 1:15:26
That's excellent. All right. Hey, man, I really appreciate you doing this. I, I, I found your job to be fascinating. And I hope more people reach out to do things that, you know, maybe the rest of us don't know about. I was really, at one point stunned when you said that you learn about things around the world from this podcast. So hopefully, you will have taught somebody else something today.

Saxon 1:15:48
Well, maybe I mean, I think I mean, going back through your older episodes, and hearing the woman who had her daughter went to went up Everest, and then there was an avalanche and stuff like that. It's there just conversations that you would never otherwise get to listen into. Yeah, you know, it's brilliant. I will say, when I first found your podcast, I looked back to see if there was anything to apply to say the job I'm doing. And I was very disappointed when I listened through the episode just keep on trucking, and that it had absolutely nothing to do with trucking. And then, obviously, over the over the time, I've learned that your titles don't seem to have anything to do with what's happening. Apart from obviously, that the after dark episodes, I have to say, are fantastic that they give me an insight into a lot of things that I would otherwise have no contact with, or insight. So I think they're brilliant. And you should definitely keep doing those for people.

Scott Benner 1:16:43
I very, I enjoyed doing them very much actually. And I've had actually, just last night on social media, the girl who came on and talked about being diagnosed during a heroin Bender, like was like, she was just right in front of me on social media. And I thought she looks so good. And I just made me happy. You know, she looked like she was doing so well. And I agree. Like there are stories where you're just like, I don't know anything about this world. And it's it's fascinating to hear more about it. I actually think this I mean, yours is not an after dark, but it's a very similar situation like we don't think about, you know, truck drivers. It's a tough job. It's, it's incredibly important. And I don't think you know, I don't think anybody even like they look right through it, they don't even see it. So, I mean, between that and the girl that was a stripper from a few episodes ago. I find that all really fascinating. And I'm sorry about the titles of the show. I don't know what to do like today's today's Today's episode is called Chile, Chacho. And I believe that I don't even believe those two words actually go together. I didn't even care. Okay. It's just at some point in the conversation. The woman I was talking to was like, I think her cat's name is Chacho. And she, and she was from Chile. And she's just like, you know, explain to me what the word means and everything. And I was just gonna call the episode, Chacho. And I was putting it up and I thought, huh, what if I put Chile with it? So that's fine. I'm doing that. So it's a, you know, woman's got a cat. What do you want for me? And by the way, the cat has nothing to do with the story section. Not at all.

Saxon 1:18:27
Like, I've listened to enough of your episodes to believe you.

Scott Benner 1:18:30
Thank you. I think she mentioned the cat for eight seconds and an hour and 15 minute conversation. But I don't know what yeah, what am I gonna call it? You know what I mean? Like, I really do believe that if you give the titles, too much specificity, that it's unfair to the episode The episodes not about this one thing and then I get fearful that someone will come along and say, Oh, I don't need this and they'll gonna miss out on the other 15 You know, discussions that happened inside of the hour just because they thought oh, this is about

Saxon 1:19:04
I don't know. Oh, you know, Yeah, cuz otherwise would be every episode would be cool. diabetes wouldn't.

Scott Benner 1:19:08
Yeah, what Yeah, I What would I do? You don't I mean, that's. Anyway, I appreciate that. You appreciate it. Thank you very much.

Saxon 1:19:16
That's all good. Yeah, thank you, of course.

Scott Benner 1:19:29
A 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 I'd also like to thank Ian pen from Medtronic diabetes and remind you to go to in pen today.com I'm to get started right now with the ink pen I hope you enjoyed my conversation with Saxon I'll be back very soon with another episode of The Juicebox Podcast

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#761 Andy's Room

Andy's daughter uses Omnipod 5.

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.

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

Scott Benner 0:00
Maybe I should just start the episodes by saying of the number then jump right into the content. What do you think? We'll try, we'll just try it this one time. 761 I'll put the music right here

don't know I already don't like that. Hello friends, and welcome to episode 761 of the Juicebox Podcast. On today's show, we're going to speak with Andy. He is the father of a girl who has type one diabetes. And she is an omni pod five user Previously she used on the pod Dash. And before that she was MDI, and he's got a bit of an engineers brain. And so he keeps track of his daughter's time and range in a one sees in a very easy to understand graph, which he and I were looking at while we were recording today, you'll see why that's important later. For now, just remember this, 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. We're becoming bold with insulin. If you have type one diabetes, or are the caregiver of someone with type one, and our US citizen, please go to T one D exchange.org. Forward slash juicebox. Join the registry, complete the survey. That's all I'm asking you to do T one D exchange.org forward slash juicebox. You must be out of Harry Potter quizzes to take by now. Take a survey that I hope people would type one. If you enjoy the Juicebox Podcast if you love that it is free and it is plentiful. Please help me thank the sponsors Dexcom Omnipod, je voc hypo pen, the Contour Next One blood glucose meter us med touched by type one and in pen from Medtronic diabetes, you can do that by clicking on their links, today's links of choice us med get your diabetes supplies from us met. All you have to do to get started is go to us med.com Ford slash juice box or call this number 888-721-1514. Get your diabetes supplies the way we do with us. Today's offering of the podcast is also sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitoring system. Find out the speed and direction as well as the number of your blood sugar or a loved ones budgeter with Dexcom. Find out if you're eligible for a free 10 day trial, the Dexcom g six@dexcom.com. Forward slash juicebox. If you're good, I'm going to start the recording. And then when you're ready, just introduce yourself and we'll start talking sounds great.

Andy 2:57
So I'm Andy. I'm a husband. I have an amazing wife and we have two kids. So I have a four year old son and a seven year old daughter. In fact today while we're recording, it's her birthday. So excited about that. So yeah, the seven year old daughter Anna, she has type one diabetes and celiac disease.

Scott Benner 3:19
She's got type one and celiac. When was she diagnosed with type one?

Andy 3:23
February of 2019.

Scott Benner 3:27
Over three years now, yeah. Okay, we

Andy 3:30
actually recently hit the milestone of more days with diabetes in our lives in her life rather than without

Scott Benner 3:38
was that an impactful thing for you?

Andy 3:41
It definitely struck me so I knew she was about three and a half when she was diagnosed. And so now we're approaching her seventh birthday here and I'm going Okay, three and a half. We got to be getting close to where we hit that tipping point. So it definitely struck us as like, wow, we were more experienced doing life this way than then before. Yeah.

Scott Benner 4:03
And what did you really know before honestly, those first three years your first kid? Yeah, not much.

Andy 4:08
No, they're just crawling around having fun.

Scott Benner 4:12
Do you have any autoimmune stuff? Is your wife anybody on either sides, your family?

Andy 4:18
Mostly? No, we have some in our extended you know, histories of some thyroid, though I'm not sure that any of its audio autoimmune. Have some diabetes, and there's a possibility that like, a great great. Somebody of Anna's, you know, had diabetes not really clear on if it was type one or type two, they definitely did injections. But not long,

Scott Benner 4:42
long time ago. Yes. Yeah.

Andy 4:44
So this would be I don't know 100 years ago or something? Yeah. Not not 100 several, several decades plus,

Scott Benner 4:53
well, let's see could they just came up with insulin in 1922. Right. So Oh, yeah, a long time ago. Nonetheless, anything over 10 years ago seems like a long time ago. So well, I want to ask you, How involved are you with the diabetes versus your wife?

Andy 5:15
Yeah, we make a really great team, we're both significantly involved. So my wife, very fortunately, is a pediatric nurse. So, in fact, we had this very odd situation of she was our daughter was admitted on the one floor below where she had worked for about nine years or so at that time. And so she's great, you know, obviously has a lot of the medical know how really good with blood and injections and stuff early on. But then, you know, I'm really involved too. I'm, we're both really type A, you know, I'm, maybe someone say pretty controlling and things like that certainly involved, like, one set,

Scott Benner 5:56
some would say, and

Andy 5:57
some might, I don't know if I believe him, but yeah, some might say that.

Scott Benner 6:00
Who are these people who might say that hypothetical people?

Andy 6:03
No, I don't, maybe my wife. But you know, so Anna's in first grade now at the school, we have an amazing nursing team, and we just have a text thread among the nurse, my wife and I, so whoever's ready for it at a given moment, we're just communicating and both really involved. Okay.

Scott Benner 6:22
So what's the management style? You MDI pumping? What are you doing?

Andy 6:27
Yeah, so, actually, for the last three months, we've been on Omnipod, five, with Dexcom, G six, of course. So that's been going great. And so we started, you know, diagnosed in 2019. Several months in there, we got on to Dexcom. Pretty quickly. About a year after that, we started just Omni pod Dash. And then, yeah, the last few months had been Omnipod. Five,

Scott Benner 6:55
how were things going, I guess, incrementally. Was there a honeymoon for your daughter?

Andy 7:00
Essentially? No. Okay, nothing weekend mark. She was

Scott Benner 7:04
just needing her insulin right from the get go.

Andy 7:07
That's right. And just pretty consistently cranking down carb ratios.

Scott Benner 7:11
Okay. So you did MDI for a little while? Yeah, over a year. Okay, shots for a year CGM for most of that time. That's right. What were her outcomes like in that first bit?

Andy 7:25
They were good. I mean, you know, we've we've been fortunate, I think, as I hear, you know, listen to podcasts, I think we were really blessed with the education and the endo team that we got from day one. So we've always been on kind of a progression of just getting better improving, really seeing things as a learning. So like, you know, when she was diagnosed, when she was almost 11, so high 10s. Even on the, you know, MDI, we were, you know, got things down into the about low eights, got onto the pod and progressed into the seven. So we've been kind of a continual progression of just improving and getting better.

Scott Benner 8:13
Do you see many lows with the MDI?

Andy 8:18
Yeah, I would say so. I mean, I don't know not, not not, but terrible now, right? Like, not like, we felt like we were fighting lows all the time.

Scott Benner 8:28
Okay, so you had some? So who sets up that insulin for you for MDI? And do you ride with what they gave you? Or did you start making adjustments to it?

Andy 8:38
Yeah. It's a good question. And, you know, part of what what I was reaching out is how I've kind of evolved, particularly myself in my thinking about controlling diabetes. So early on, you know, you get these equations and these ratios, and you go, Oh, this is great. This, these medical people, they have the answer, I'll just follow these numbers. This is fantastic. Like, I can do that. But, you know, they did give us really good training, and they kind of teed us up for, this isn't how everything is going to continue to look into the future. You need to look at, you know, patterns and see where can you adjust. And we latched on to that pretty quickly. I mean, within a couple few months, you know, maybe at first we would call the endocrinology teams, a hey, we saw this, we're thinking we're going to change your carb ratio for lunch, and they say, Yeah, give that a try. But then pretty quickly realized, like, we're the ones here with with the insulin pen, you know, why are we calling oh, what? Yeah, we know what she's eating. We're going to deal with the rim and fake ramifications either way, and really started taking that on within a few months

Scott Benner 9:49
and they were supportive of that the whole way it sounds like Yeah, absolutely.

Andy 9:53
Okay. Yeah, they they planted a lot of good seeds. I mean, I do, we had, you know, like the section She for endocrinology was our attending and she planted seeds along the way of, you don't have to start doing this right now. But this is what you need to start thinking about around Pre-Bolus saying, around looping, I mean, even that specific, like, DIY loop, hey, you may want to start looking into this people are using this and really doing great, you know, we ultimately never did that. But I give them a lot of credit for kind of giving us things to start looking into ourselves.

Scott Benner 10:26
Okay. All right. So you do really want to come on in for a specific reason. So tell me what you do for a living. You don't tell me where you work. But what are you doing? What's your training in your background?

Andy 10:37
Yeah, yeah. So I am an engineer, you know, my education is in mechanical engineering. And I work in research and development, right. So I get to put my engineering to use day in and day out some of those, you know, scientific concepts and things like that. And I've even specifically worked in like areas of manufacturing process development. And so much of what goes into a continuous manufacturing process is closed loop control in various forms. And so as I look back on the last three and a half years with with type one for Anna, and it's been an interesting journey to how I took kind of that engineering thinking, some of that control thinking from from my technical background, and it's, it's evolved and how I use that and think about it relative to diabetes.

Scott Benner 11:33
Okay, now, so there are times when I talk to people who have an engineering background, and diabetes flummoxed them, because it doesn't follow the numbers the way they're told. But you notice that, and you adjust it somehow. Is that right?

Andy 11:49
Yes, though, not right away. So you know, kind of the funny stories relating to that, right? So you get presented with this diagnosis, you get training, like I say, the equations, right, so there's, there's a carb ratio, there's a correction factor, right. So it's a number minus something, apply your correction factor. So I think early on, I was in that camp of, oh, this was great, I, I will do this math, I am fine with this math. And I will follow this, I will waste things to the 10th of a gram. And we are going to nail this and I you know, I did that for a time and and you get what you get, you don't get consistency. I actually, after the first day of of education in the hospital, I came back and the team was doing their rounds in the morning. And so they all came in attending physician and a few others. And, you know, I had come up with these odd combinations of like, what her blood blood sugar could be, and what correction factor was resolved and some carbs and like rounding, like, you know, point one of of a unit, and I'm gonna know, that's not the right rounding for this. And they're like, well, that's our that's the rule you use. And I Okay, well, that seems odd to me. But then, you know, really, particularly through the podcast, so I've been listening to the podcast for not quite a year and a half, I started realizing like, Okay, if this thing really, is this dynamic, and it doesn't follow that simple equation? Well, you should adapt, you should find out what the control really is what it really should be. And was able to get on with that.

Scott Benner 13:32
So you were able to, were you able to take the unknown parts, the parts that come from the body, and find some rhythm to it? Or did you just learn to be flexible with it, just go with it. And when it asks for something, you give it to it?

Andy 13:47
Yeah, more. So just being able to be flexible?

Scott Benner 13:51
Yeah, it really is the whole key to the thing. It's insulin works the way it works. And if you can get the same, if you can get the same response every time from the body from the need, then yeah, it all works terrific. But that's, it's not going to happen. And then there's variables like you know, infusion sets, how old they are, where you put them your hydration, and on and on and on. And you also can't sit down and there's no spreadsheet you're going to make that's going to keep all that straight for you. Because you don't know, you'll never know the input from those things. Ever. Yep, you know, so

Andy 14:25
and I do I do try to find little thing. So you mentioned spreadsheets, I definitely have lots of spreadsheets relating to Anna's diabetes. So, you know, I can tell you statistically, over time, how much leg pods have been different compared to arm pods and things and I do that just a little bit of my own, you know, fun, because when you get right down to it, even that impact is really small. And if you compare that to, hey, what's the difference between a pasta dinner and you know, bacon and eggs for dinner? That difference really washes out the other things Even though they might be fun little,

Scott Benner 15:02
like, so you may be you're on a leg. But it's pasta. So you're being pretty hard with the insulin anyway, the leg part doesn't really matter. Maybe if it was on a stomach and the stomach work better for you, then use a little bit less insulin, but not not a ton different. I'm looking at the charts, you said I'm trying to decide, like, how far are you getting into this? Are these? Are these generated in Excel? Are you in like, are instead of making these

Andy 15:28
lots in Excel? I do have a couple of other statistical packages I use, like when I when I say that comparison, you know, between different parts of the body have a couple other statistical packages I've used. Yeah,

Scott Benner 15:39
I watched my son do this for is his degree. And I'm starting to learn about it a little bit. I don't know how to use it. But I know what he's doing at least. Why aren't you telling me what I'm looking at here a little bit. So I have your time and range chart in front of me that goes all the way back to looks like May of 2019. Till. Geez. Martin last

Andy 15:59
weekend. Yeah, right here. That's right. So and this was, you know, when I think you had put out a request for people who want to be on the podcast, you know, I was certainly interested, if really love your podcast, I'm glad. And I had the data to back up, which is this chart, you're talking about the fact that the simple matter of you know, us listening to the podcast, and starting to pick up little nuances and try them out has made a shift in the data. Right. So the graph you see time and range, it starts when we started Dexcom. And we were on MDI, cc times and ranges maybe they averaged.

Scott Benner 16:45
Let's begin today with Dexcom. And talk to you about getting the Dexcom G six continuous glucose monitor. There are a ton of management reasons why you would want the Dexcom. But let's start instead, with peace of mind, alerts and alarms set at your discretion. Would you like to know when you're going lower at 9080 70 105? It's up to you. Same thing about high alarms, we have our high alarm set at 120 and 130. But maybe you want yours at 150 or 110. Again, completely up to you. Then when you reach those thresholds Dexcom will let you know when you're using insulin. Peace of mind comes from knowing that you're not going to get too high or too low Dexcom can help you with that dexcom.com forward slash juice box. You want to try it out for yourself you can you may be eligible for a free 10 day trial, the Dexcom G six, that is something you can find out@dexcom.com forward slash juicebox. You'll also be able to learn way more about what Dexcom does know what I just told you. As a matter of fact, I need to pick up my phone. I'm doing it while I'm talking I swiped up. The phone has recognized my gorgeous face with face ID and I can see that Arden's blood sugar is 109 and it's stable. That was pretty quick. I'm looking at the number, the direction and the speed of my daughter's blood sugar right here on my iPhone. You could do that as well on your iPhone, or your Android device. There are links in the show notes of the podcast player that you're listening in now. And links at juicebox podcast.com to Dexcom and to the place where we get our diabetes supplies us med us med is the number one distributor for FreeStyle Libre systems nationwide. They're the number one specialty distributor for Omni pod dash. They're the number one fastest growing tandem distributor. They're where we got the Omni pod five, and they're also the number one rated distributor index. com customer satisfaction surveys. What more do you want the what US med is offering us med.com Ford slash juice box or call 888-721-1514. They've got an A plus rating with the Better Business Bureau and they accept Medicare nationwide as well as over 800 private insurers. They carry everything from insulin pumps to diabetes testing supplies to your latest CGM, just like I mentioned a moment ago. US med always provides 90 days worth of supplies, and your shipping will always always always be fast and free, better service than what you're getting now. And better care than you expect. That's what you're going to get at US med after this episode. If you're interested in getting the Omni pod five, or the Omni pod dash, and gosh by golly you might just be when you hear what Andy says next. Please use my link on the pod.com Ford slash juice box.

Andy 19:56
The graph you see time and range it starts when we started Dexcom and we were on him The I see see times and ranges, maybe they averaged 50 something percent, then the next section on the graph is when we started Omnipod dash and just being able to get up in the middle of the night, see a number, literally from my bedside table, you know, do a bump through the wall love that about the, you know, kind of remote Bluetooth aspect of the Omni pod, we shifted up, there's a clear shift in time and range up to the high 60%, probably close to 70%, sometimes close to 80. And then there's the you know, juice box section of the graph. And there's another really clear shift up there really averaged close to 80%. Time and range.

Scott Benner 20:45
This, I'd like to explain what I'm looking to looking at for people. So you have points on a graph that that are amazing. I mean, pre pod, you have it set up, like you said, probably the average, right? There's about 50%. Time in range, what is the time in range? What's the range you're looking for?

Andy 21:04
Yeah, those are all against a 70 to 180. You know, we certainly target better than that. But it just keeps the data. Okay.

Scott Benner 21:10
So you're about in the 50%. Like, that's where your grouping is with a cluster of your most of your data points are. And then like you said, you go to using on the pod dash and it comes up. I call it like high 60s. Right. Right. Now you start listening to the podcast, and it jumps up to what would you say? 80?

Andy 21:30
Yeah, yeah, average? About 80%. There.

Scott Benner 21:33
Wow. And there are you have data points listening to the podcast, that are almost at 90, as well. That's right. Now here's here's the part that's both impressive, and exciting. And I think it speaks well for on the pod five. And for me, to be perfectly honest, which is you left, you left up a little with on the pod five. But it isn't that much better than just doing what the podcast says

Andy 21:57
that that is fair on these weekly data points. So far, though, that we are still trending up, I think in Omni pod fine.

Scott Benner 22:05
I'm seeing that too. There's no other place on your graph that's bending towards the heavens as much as the Omni pod five. So you jumped into Omni pod five, how long ago now? Tell me again, right? About three months. Okay. And so you're those first couple data points. It's pretty equal with the podcast a little higher, but then all of a sudden, it's on its way. So would you say you're seeing the algorithm beginning to work better for you?

Andy 22:30
Yeah, absolutely. Okay, so now we're, you know, the last several weeks, and each one of these data points is just the weekly charity report time and range. And we're now always seemingly low 90s. You know, percent time in range and the average glucose now we're hitting is right about one 141 30s.

Scott Benner 22:51
So give me a little perspective, pre pod a one sees in the eights you said? That's right. On the pod dash. Where do you think she was?

Andy 23:01
Yeah, they were mid sevens. And mid sevens?

Scott Benner 23:06
Did you get into the fives with me?

Andy 23:09
No. So it actually have a different graph on the thing I'm looking at. And it leads up to a one sees next that so in the in our juicebox period,

Scott Benner 23:19
I have that one, two, I'm sorry. Let me scroll guy. Yeah, yeah.

Andy 23:22
Yeah. So you know, anywhere from like six and a half to seven. One was kind of our juicebox time period. And then we actually just had our appointment here recently, after a couple months on Omni pod five and, and had our first 6.0. Wow. So really excited about that.

Scott Benner 23:39
And I would imagine and let me say, I fully expect less work with on the pod five than following the podcast.

Andy 23:48
Absolutely. Yeah. Okay. Particularly the fact that we sleep through the night you know, I I get the thing teed up where I want to go into bed and I'm I have pretty good confidence. It's gonna stay there.

Scott Benner 24:00
Yeah, I don't think I think the longer you do the podcast way. I don't know if that's a thing. The way I talked about diabetes, if you do that your real life, I think, did you notice it getting easier as time was going on?

Andy 24:17
Yes, I would say so. Right? Because you just pick up little, little nuances. You have that flexibility in your thinking. I think that's really the key thing is just be flexible. Yeah, there are cases where you need more insulin, you don't have to solve why necessarily you gotta meet the need.

Scott Benner 24:32
Right? Right. It's so cool to hear people say something that occurred to me because i i Well, okay, so let me ask you this. So as you're doing it the podcast way I can't wait. I'm saying that. I don't even believe that but, but you're being flexible. You're understanding how insulin works. You know, you're not looking at high blood sugars not doing stuff about it. You're not overcorrecting and lows, that kind of stuff when you're doing that, and it's getting a little easier as it goes along. But but is it? Was it sustainable?

Andy 25:07
Yeah, that's the it's a great question. And actually, our our endo the appointment before last. She was super kind and really drilled on that question like, you guys, this is great. But are you good? And overall, I actually think yes. So we were able to kind of have, you know, a learning mindset and know that yet we're being flexible. Yes, we're going to meet the needs, and we're not always going to be perfect. So like, we're not going to beat ourselves up if we do something or we try a Bolus and it doesn't exactly hit right. It wasn't, you know, it wasn't easy. I don't think managing diabetes in any form is, but it was sustainable. I do think so now that I get less sleep, you know, even four months ago, yes. But it was sustainable.

Scott Benner 26:06
Yeah, I agree. By the way, I just I think that this is so interesting. Looking at this on your, the way you have it graphed out because basically MDI is, is how things used to be and you were MDI with a CGM, by the way. So what are you really missing MDI that you didn't have with the pod? Where is it that you didn't want to be? You weren't looking to give her a quarter of a unit or a half a unit through an injection to move a number, you were happier to look at a higher number than to have to shoot or more, is that right?

Andy 26:39
That's right. Yeah, just the ability to you on the on the pod. And even that, that remote aspect, I don't even have to walk up within 510 feet of Anna and give a little dose I realized, man, it needs that extra even for her at the time just needs that extra point to and it's going to make the difference. I didn't even have a pen that could give a point to

Scott Benner 27:00
Right. Right. I remember thinking when Arden went from shots to on the pod long time ago, I remember believing that one of the best points of this not only what we just said about being able to give small corrections. But it was for her not to have to be interacted with as much just turned out to feel like God, this is happening again, this is happening again, because you see it on their face. And then that makes you less likely to want to do it. And then suddenly, you find yourself in that scenario where you're going oh, or budget is only 160. I guess I'll just leave it alone. I don't want to bother. I don't want to shoot it with this needle again. And that's a that's a big piece of it. Also, I would think how much did you get into looking at Basal rates once you went from MDI? That must have been a picnic for you. You must have been happy. Your little math brain must have been

Andy 27:51
Yeah, no, no, absolutely. So we did know. Definitely, like Temp Basal goals and being able to identify where we needed. Different Basal rates didn't didn't try to overdo that too much. But I mean, your point on on. And it doesn't even notice. So like the school nurse, she sneaks into the classroom all the time, and will be on the computer with her headphones on. And she's like, Yep, I said to those guys, she she didn't even see me. So there is something to that.

Scott Benner 28:19
I know, when you're on an algorithm. Sometimes, Arden and I were in the car recently, and we were driving along and we stopped at a light, the music stopped for a second it got really quiet. And we just heard click, click, click and I was like, Oh, you're getting insulin? And she's like, Oh, yeah. And you don't even really think about it just sort of happens. Okay, so what did you because you started on the pod five, three months ago, then my on the pod five episodes that I did in conjunction with insolate. They weren't out yet. So how was it starting on the pipeline without any kind of real information?

Andy 28:59
Yeah. Overall, it went pretty well, we felt great with the dash, I think it was a pretty good experience to transition from dash to five and do the online training. You know, I'm the type of person that like, I'll read the whole manual front to back. And so I did that for the Omnipod five, and I actually do think there's value so for things that helped us in going to Omnipod five, for example, and I see questions that come up a lot. It's a it's a great question. It's a logical one is, oh, this this max Basal rate that that must mean something that's a setting in Omnipod. Five, you probably know, but it doesn't have anything to do with the algorithm. That's a that's a make sure you don't fat finger typing in a Basal rate thing. So just understanding even through the manual, and through the video training, how is this thing working? What is it looking at? And knowing that it's looking at total daily insulin and that's really how it's making calculations. So then I knew, Okay, if if the knob to turn, so to speak, to get this thing to react is total daily insulin, I need to impact the total daily insulin. And if I'm an automated, the way to do that is bolusing. So we were able to, you know, I think I see, you know, people, other groups, I'm a part of their, their struggles transitioning to and as that the, the pod five is learning. There are definitely struggles, but I just sit like, we don't oblige high blood sugars. And so I gotta give a half a unit that

Scott Benner 30:35
I'm doing. And then the algorithm learns that, you know, the algorithm, I guess, is saying to itself in very rudimentary ways, I use this much insulin, but the user keeps coming in and putting in more, so I'll get more aggressive with it as well. Yep. Yeah.

Andy 30:49
Yeah. All it knows is the last three days, you know, we use 22 units of insulin. Yeah, that's like the new kind of baseline. And I do think, you know, my background, and as I understand control systems and sensing, in my world, and my technical world, I was able to say, really just dig into one of those details that matter. And let's put thrown in on that with the pot.

Scott Benner 31:15
How much of that do you think helped you? Well, I am I have a tooth. I guess I have a two ton question here, but did anything about what you learned from me help you use the algorithm?

Andy 31:30
It's a good question. Yeah. Yes, yes. Undoubtedly, particularly meet the need, like, I knew that whatever FDA approval went through, and all that, to sit there and like stay in automated mode, as it would learn and be sitting at like, 200. I wasn't going to just sit there and watch that whether or not it would mess up the learning. I was going to meet the need and give insulin. So even even if that was going to throw off the learning, which I didn't think it would write the algorithm learning. I was gonna do that. Because

Scott Benner 32:07
how do you how do you sit and look at it? Yeah, no, I know, I have I had very similar feelings. When we when we were setting up on the pathfinders. Like I got a Bolus, like what are we doing here? I have to Bolus I think we started it with not enough basil. And that I followed that idea for a while then I really, I realized that Arden was having other impacts that I was also seeing. It was flow mixing loop as well. So these impacts were flow mixing loop, they flummoxed on the pod five. And then we were able to actually change her her health in an interesting way, which I'm going to bring up a couple of times in the podcast. So we learned that Arden wasn't digesting her food, she had gastritis basically. And so food wasn't going through her quickly enough. And we were seeing these, like almost every meal looked like a high fat meal all of a sudden, because the impact was lasting too long. The blood sugar was too high. You felt like you couldn't give her enough insulin all of a sudden. And and we went through all the all the I don't I don't know how to put it like normal doctors you could to try to figure out what was going on. And I've told this, I've told this on another episode. It's not out yet. But when she got a endoscopy that, you know, looked in her stomach said, Hey, there's a lot of inflammation here. There's even some like lettuce leftover from last night in here, which shouldn't be. They did a couple of biopsies. Nothing was crazy wrong. And they said, you know, we're gonna put her on a gastro precice diet, which freaks you out because of diabetes. But gastroparesis is a generalized medical term. That means slow digestion, right? When you when you think of it, and in terms of diabetes, you think, Oh, God, there's been some nerve damage, and I'm not dying, you know? So anyway, after we all got past that moment, where the doctor is like, Oh, this is just some gastroparesis. We were like, wait, what? And? And he's like, No, it's just, it's slow digestion. And I was like, Okay, could we just, why don't we just fucking call it slow digestion. Okay, man. Let's do that. Let's stick with that. If you don't mind, you know? And he's like, okay, and I was like, Alright, good. I said, um, and then he wanted to give her you know, being a kind of a, a general doctor. I don't know what the word is. I want not an outside of the box thinker, doing what the system says, right? Here's medicine for pain. So her stomach doesn't hurt anymore. And here's this and here's that. Let's put her on a super restrictive diet, where she won't eat anything that isn't easy to digest. Well, my God, it's like no skin, no raw vegetables, no meat. No like anything that takes takes any kind of time to digest. And God bless her. She did it for like, a week. Before she was like, listen, I think I'd prefer for my stomach just to her. And I was like, all right. But we didn't want that, obviously. And she was a month or so away from going to college. And I just, I did not want to send Arden to school with stomach pain that she had had for. I mean, if I'm being honest with you, for years, maybe, you know, off and on for years getting worse and worse. And so we went to

I just, I just said, Look, this doesn't make any sense. It's like, what do we really need here? Like, what is this really need? We need food to clear her stomach quicker. We need her to eliminate the waist so that they can her stomach can continue to clear, right? This is what we're looking for. I went to a health food store. And I was like, I need digestive enzymes. Is that a thing? I was like, What do I put in the belly to make the food digest faster, and she's like, there's something called digestive enzymes. I didn't know about that before that was like, that's great. Perfect. Give me those. And she's like, let's give her a probiotic to help heal her stomach. And, and then we went back to her a week later, I was like, Listen, this is all great. All this stuff. I'm talking about these high blood sugars that meals like Gone, not even that but she's eating like high fat meals that aren't showing high blood sugars anymore. It's like this is the digestion part of this is great. I said we're not seeing the action on the other side as much though. And she's like, ah, magnesium oxide gives us one of those ardent gets on a better bah, bah, bah, next thing, you know, her system is running really well. Yeah. And in the week before, you know, we were getting ready to leave for college. I'm starting to see like low blood sugars. I was like what's going on? You know, so, at first you just do it the way you always do it, you just managing managing and four or five days into it. We're now driving down to Georgia on a long car ride where I really expected Arden's blood sugar to go up for all the sedentary, you know, just not moving all day long. And she was still in the look like she was good, not low, but like super, like good blood sugars. Like this doesn't make sense, you know. And then we get there. And that night in the hotel, her blood sugar is just low and we can't get. And then the next day, it's choppy during the day, we're correcting lows, trying to figure out what's going on her first night in her dorm, she is low all night. Like I'm up the road at a hotel. And we're we're texting and fixing her blood sugar's over and over again. And I'm like, What is going on? Now? I should tell you that right before we left a couple, I don't know, a month or so before Arden stopped using Omni pod five. And she went back to loop because she was more comfortable with it. And she didn't want to carry the PDM as she was going off to college. She's like, Yeah, she's like, I really know how loop works. On the pod five is not difficult, but I have to carry an extra thing. Can I just go back to loop? And we're like, Yeah, that's fine. So she went back to loop. But even on loop, like, we're like saving loads all night long. So I wake up the next day, I'm like, I have to rethink this whole thing. You know, like something's wrong, I looked at digestion piece, her body's working differently. So her needs different now. And if I told you that her insulin sensitivity went from like 42 to 70. Her Basal rate during the day went from 1.1 to six point 2.65. And her carb ratio went from like four, four and a half. You have four and a half carbs, a unit for four and a half carbs, two, maybe it's like six now. Wow. And then everything leveled right out. So now we're in the process of fine tuning as she's actually going through her first week of school, but it's all I could think of earlier when you were talking about like, be flexible. Its you know, its timing and its amount but then it's timing and amount and flexibility. Fighting against these other forces that you have no idea what they're going to be. And that just showed it so with with poor digestion and poor elimination Arden's insulin needs probably were 35 40% greater than they needed to be. Wow, fast. It's fascinating, you know, yeah. Yeah. So anyway, now she's good again. And we're just, you know, we're now we're just learning how to, you know, how to live through different schedules, and it's much hotter there than it is here. But she's doing really well with it. So anyway, that's great. Yeah, that's great. So how much of this? How much of the stability that you have right now? Do you ever look at and think well, sure, but there's no hormones yet? Because your daughter's young? She's seven.

Andy 39:57
Yeah, she's seven. So that I do think about that. Largely, though we leave that worry for a future year, it's good. You know, and I kind of look at it and go, alright, if I hear that's challenging, that's going to be really dynamic. But even then, you know, think about, okay, how can we track cycles and be able to kind of tackle them that way? So I largely stay like blissfully away from that.

Scott Benner 40:30
It's a good idea. You have many years, I mean, you might have six years. So you have to worry about that. If you're, that'd be nice. Trust me, it's not a lot of fun. But it's also not. It's also not unknowable, right? It's just and I can't wait to see how algorithms handle stuff like that, you know, so sure. And I do wonder to how they're going to improve as time goes on, because as well as Omnipod, five is working for you right now. This is the first iteration of this algorithm for them. Right. You know, so what happens in the future? I don't know. But I'm excited to find out that's for sure.

Andy 41:03
Yeah, I'll tell you, I, you know, I don't see myself going into the line of work around developing diabetes technologies, I guess, never say never. But some ideas that I have in that way. You know, if you think about, like, people are smartwatches, right? What kind of data does smartwatches have on people around heart rates? Temperatures, I assume? What is other sensing? We could do? You know, what if the the Dexcom sensor had one section of the wire that was doing what it does today? And another part measured a different or motor? It measured adrenaline, right? I think there's some, obviously you look at things like bionic pancreas is that's an area of development. But I think there's just like, we're getting into machine learning in a lot of different places. And if you can bring in more inputs, right, we all know, it's not just the carbs, and it's not just a blood sugar. Those are the two things we pretty well know and can measure today. But what else is out there that's maybe being measured just passively right by like a smartwatch? Or that you could measure alongside it and put together a really smart system. So it would pick up that adrenaline rise, because it would detect the adrenaline now, i i can i can imagine the FDA choking on this concept as I speak. But yeah, there's some really interesting things out there that will be done there, the

Scott Benner 42:26
machine learning aspect of it is, it's really, I think that's the best path to more because, you know, I mean, think you look up at the night sky, and you think you see a certain amount of stars, and there's billions more than you can see. And right now, like you said, we're looking at, you know, carbs, basically, and insulin, they don't, most doctors won't even tell you about the impact of fat or protein. So you know, and these are quantifiable ideas. And we don't talk about them. We're talking about two, two of the things. And how many of how many more can there be like, Alright, you're always the insulin on the one side, it's always gonna be the insulin, but how many more things could the insulin be thinking about? I think it's a great idea. And I don't know how well people understand the concept of machine learning. But the, the best way I can describe it from things I know, just from pop culture, is that Tesla, for example, had to build their own computers to do the computations that they're getting back from self driving, like the computer didn't exist, that was strong enough to even think about all the data that they had. And once they saw, at some point, they were like, we have all this data, we can't even compile it and make sense out of it. So we'll build a better computer that does that. And now this, you know, I don't know how well self driving is ever going to work. But however, well, it's going to work, we're gonna get to it much faster, because there are computers, looking at these data points and saying, Okay, this, we can count on this we can count on, you know, and the I don't know how long that takes those computers probably in a week do what it would take a human being a year to accomplish, I would imagine.

Andy 44:01
So we're for 1000s of years. But yeah, yeah, right. Right. Thanks, like

Scott Benner 44:05
a long ass time, because we're not so smart. And and, and look how that applies to diabetes, right? There are all these other things happening, that we just can't keep in our heads. Which is why, which is why, you know, it's funny, you said something earlier, that really fits into how I think, which is why I don't want to say dumbed down. But why I talked about diabetes the way I do, because there are some ideas that if you just give yourself over to them will cover most situations. But if you get caught up trying to think of exactly what's happening in every situation, and scenario, it'll just be analysis, paralysis, right? You'll sit there you won't be able to do anything. So some things like you said earlier data. Yes, I can see the difference between sites, but it's not appreciable enough to make some big adjustment over, right? So that's right. So your blood sugar's high, use more insulin, your blood sugar is low, use less insulin. Have you not? I mean, you spike too fast before a meal, try changing your Pre-Bolus. Like that kind of stuff is it handles most things. So I don't know, my my inability to see the bigger I can see the bigger picture, I can understand it, which made me run back to like, let's, let's let let's simplify this with T shirts locates, basically. And I can't believe it worked for you, because your mind in my mind are probably radically different. Yeah, that's pretty cool. How does your daughter do with diabetes in general? How is it on the personal side?

Andy 45:34
Yeah, super well, she's incredibly smart. And you know, so actually early, I asked my wife I science and we have when did we start? Dexcom? And so she pulled up. What was the video of Anna doing a tutorial on like, Dexcom number two that she put on, she's got this cute little four year old boys, late three year old boys. And she's going, this is my Dexcom G six, and just just talking everybody through it sharing with with anybody and everybody. So it is really nice to see, obviously. I wish she wasn't as smart about diabetes related things. Like if she wouldn't have it, but but she does. And she rolls with it. So well. You know, I think in school, navigating, well, why does Anna get a starburst? Every once in a while? Or, you know, what, how are we going to manage where the devices go? And like, is a phone a fun thing to play with? Or is that a medical device? Right? That's a little challenge.

Scott Benner 46:39
Yeah, it goes away as they get older. There was one kid in high school that tried to make a big deal out of it. Arden was the only kid that could keep her cell phone on her going into this one room. And the kids like why does she get to keep her cell phone and it became like a thing. And the teacher called me and said we're gonna have to take our cell phone from her. Because people were complaining. I was like, Well, hey, you're thinking about that backwards? And and I was like, but um, no. I said, Why don't you go back to the student and tell them if they want to get an incurable disease, they can keep their cell phone till that's what seems fair. And and that seemed to put an end to it. But it was interesting how it was interesting how the teacher went with was willing to ignore the whole health ramifications of it just to make the argument go away. Like, let's just make her happy and put on the cell phone. And I'm like, no, sorry for not doing that. But yeah, I take your point. There's things that they they get, and there's things that they understand that you would be much happier if they didn't have to understand but yeah, it isn't.

Andy 47:48
So she she doesn't know, you know, we'll say Well, Anna, you you can address that whoever you like, you know, you could if when they ask you, what's that bandage on your arm? You could say, oh, it's just something I have to wear. Or you can say that's the next common question my blood sugar, but then she is intelligent enough to say, Well, yeah, but then they'll say, Well, what's blood sugar? And, you know, now I'm funneling, I'm having a dynamic.

Scott Benner 48:12
Well, that's excellent. So she's not having any trouble that you can see so far. What and you guys are getting through? Okay. Has it caused any issues for you, anything that you would tell people to look out for?

Andy 48:26
Yeah, I mean, definitely, more stressful. So you got to just give yourself grace, give, give whoever your team is. For us. Like I said, I have an amazing wife. We are so fortunate with the school team, we have both the teachers, counselors, Principal, nursing staff. So I could definitely see if you didn't have some of those support systems and people that were on your team and going along, saying, Hey, we're taking your lead mom and dad because you know, this the best. I can see that just being incredibly frustrating and stressful. So, you know, as much as possible, getting those those support teams on your side, you know, family, we were fortunate to have family locally, and they get involved and learn. So yeah, overall goes pretty well. I think. You know, I'm able to compartmentalize the things, it. I think it weighs on my wife a little bit more mentally just around feelings of guilt. Like if something isn't like if a budgetary is right, and I and she's like, I gave this Bolus and you know, and I'm like, You made exactly the right decision. So I think being able to coach yourself just around I need to kind of separate what was this outcome, you know, from this given Bolus? Or Or did I give the right amount of juice to start bringing something up? It's not a reflection on you as a person, right? It's just you tried something And here was the result, it either worked great and you brought the high down, or maybe it stayed up for another two hours.

Scott Benner 50:07
Now, I think it's incredibly important not to ignore what you learned, but not to take it on as some sort of a personal failing, either. It's just, it really is all. It's just you're having these experiences over and over again, and you should be incrementally learning from them, you know, and not spending your time beating yourself up. Because I do think you lose the, I think you lose the the teaching of the moment, if you spend that time saying, Oh, I did it wrong. It's not what happened. I mean, you know, it's, it's an extension of when you hear people say, diabetes, I do everything the same one day as I do the next day, and I get totally different results. And I understand the feeling, but it's not true, something's different. Right? You might not know what it is, but something's different. You can't, you can't take that on as a personal failure. Because I don't know you had a hormonal shift overnight that you're unaware of at the moment, that's not you messing up. It's a it's a variable you can't see. So don't worry about that's why I tell people like don't worry about why. Just fix it. You know what I mean? Like, you can't, I mean, I know you want to understand, and you're hoping to stop it next time. That all makes sense. But in the moment, why is not important. And the amount of feedback I get from people that say that that that one idea was like a saving grace for them. It's fascinating, really, you people get stuck on the wrong things. And then they just can't let go of it. They get their teeth into it, and they just can't let go of it. Tell me about starting on the pod five. So how did you decide what settings to put in? And now first of all, I want to say there's somebody has to be listening to this from insolate, who is so thrilled you read that manual there probably any I wrote, I wrote chapter for how much work must have went into that manual. And people probably pick it up and flip through the book and set it back down again. And you're like, I read it cover to cover. And I'm sure when that happened, somebody giggled and was like, thank you. But But tell me, you know, what did you do? I guess where were her settings on Dash? And how did you put them into Omnipod? Five? Yeah.

Andy 52:20
So we had, you know, we were pretty consistent with making sure that her Basal profile was where we wanted it. It wasn't too crazy, segmented. But we knew some areas like in the nighttime that needed to be a little different than a morning than a daytime. So overall, we took things directly over. So right just based on profile, as it was carb ratios as they were because again, we do we do carb count and just Bolus, you know, put the carbs in and use that. So put them straight over, I will say, looking back with what I know now, and I think you said a similar thing, I would, I would have punched up just all the numbers across the board a little bit. So I had to punch up the basil in our basil. Average is probably about 0.4 units an hour. And you know, even if it just bumping them up to that point four or five, just give everything a little bit more or maybe touch because ultimately some of what we did, for example was we edged carb ratios down a little bit, right. So more insulin a little bit more insulin for the same amount of carbs. So just knowing how that algorithm learned and the total daily insulin, I would have just set things up so they got a little more insulin starting out. Okay, give it a better starting point, a better learning starting point.

Scott Benner 53:45
Okay, I actually just thought of something I want to tell Arden just jotted it down in front of me based off of what we were just talking about. So, a little more aggressive on all the numbers, because let me guess why? Because you still bump and nudge a little bit with my system. So you're adding extra insulin in along the day? Because you can't figure out where it goes yourself. You're not sure does it belong in the Basal does it belong in the meal correction, like that kind of stuff. So if your settings are what your settings are, but you're adding in a few more units across the board, you're like, let me just split that 5050 I'll put some of it in the carb ratio and I'll put some of it in the Basal so that the algorithm understands how much total daily insulin I'm using. Right Yeah, and now

Andy 54:30
and I think based on what I see feedback from from people I think the way they set up the learning for the starting out with only five five was was conservative, right? I mean, if you think of the FDA and what these companies have to do, they need to ensure that that safety, so I would just try to take out a little bit of the conservatism.

Scott Benner 54:55
Okay, I take your point. I think you're probably right. I've never obviously been in One of those meetings, but I would imagine what the meeting is, is, look, you're gonna give this to X amount of people. And our goal is for zero of them to experience low blood sugars. So, you know, how do you do that? You probably lean in that direction. Yeah. Now that that makes total sense. Is there anything that we haven't talked about that you want to talk about?

Andy 55:21
Maybe I'd share a couple just kind of like hospital, you know, admitted stories, and then maybe have one funny question slash bone to pick with you. Cool. We'll see if we get that

Scott Benner 55:32
every day, every day. I'm not lying to you. I plunk this thing down, I put this I put this microphone in front of me. And I think this is going to be a someone just says, You're an asshole. I don't agree with you. Let's go, we're gonna have some great conversation about it. Maybe today will be that day.

Andy 55:47
There you go. So I mean, a couple of the stories were reflecting on you. I mentioned my wife, she was a pediatric nurse at the Children's Hospital went to on her specialty had been oncology for years, right? So get the get the surprising news that hey, you got to go down to the ER, and then hey, you're getting admitted. So it was this really bizarre situation, particularly for my wife that, you know, she's seeing physicians walking around, and they're all doing double takes with each other? Like, haven't you floated to this floor before? And so that was that was definitely just a bizarre situation. But then it also resulted in you know, it really good intention people but saying, oh, oh, yeah, you're a nurse here, you you know, all of this probably. And then they, they were literally going to cut short our education, because they're called we she's a nurse, like, you guys know this. But really, fortunately, Laura is like, my specialty is oncology, not diabetes and Endocrinology. So I don't know this, you should assume I don't know this. And in fact, I don't. So I give her a lot of credit for that. And and then we did we actually got a really good education, you know, the full whatever it was three day deal. Which I do I give our, our team in the hospital there. A lot of credit. I hear, obviously, unfortunately,

Scott Benner 57:17
bad stories, everybody gets, well, you know, what, to? Everybody's different? Is that a nice way of saying it? You know, like, even the things that I say on the podcast, what I said, you were like, Oh, that makes sense. And then you went and did it in the manner that I would hope that you would, but there are plenty of people who probably hear me and then go off and don't do it the right way. You know, like, and so then you get caught in that scenario where you're like, Well, what are we not gonna say it out loud, because some people aren't gonna understand it. Like, that doesn't make sense, right? Like, everybody's not going to be on the same, you know, starting level, and that doesn't mean that they don't get to hear the information. It's, it's it's the one thing you can't fix about this. You can't, you can't put everybody in the same place, and then tell them something and have them go off and have the same I mean, you have had an astonishing outcome with your daughter over and over again, like switching from MDI, to pumping from pumping, listen to podcasts and party, you just keep doing it. This thing, whatever this is, fits well with how you think. And that doesn't make you smarter or doesn't make somebody else stupid, or you know what I mean? It's it's a, it's just the situation you get into, and then they do the same thing in the hospital. Right? They're just like, here, here it is, like, I don't know, like, I'm sad. I'm upset. This isn't my vibe. I'm super artistic. I'm not good with math. Meanwhile, you don't have to be good with math. I'm my my major. Like I want to remember to say about you I'm super impressed at how you how you gave away the parts of your thinking that didn't that didn't jive with what you needed to do because I've I have talked to other people who beat their head through five concrete blocks not wanting to give up the idea that this is the carb ratio. Yeah, I mean, so I don't know why you hang on

Andy 59:16
to bits and pieces you know, I we got to scale in the kitchen I use it more than anybody else that but it's all good.

Scott Benner 59:23
And then I hear

Andy 59:26
you know, a couple of our other a couple things blew my mind while we were admitted there you know to start this journey. The first one being that I don't think we were ever sat down and presented a test result that said Your daughter has type one diabetes right so it all it all played out. Pediatrician couldn't you know was like I don't know what's going on. Let me do as an as they're putting on their coats to leave the pediatrician. And we had taken her in saying something's off. He goes You're not let me do it. Let me do a finger stick real quick. And so you progress from that. And obviously there's high blood sugars like they're all like, well, she you know, she has diabetes, so you need to go and but it blew my mind I there in the chart probably but we were never presented like, either these are the the the antibodies or whatever it is so one that just blew my mind have we just started acting that way, right? You just started giving her insulin. I thought that was a funny thing. And then the other one is the first time maybe it was on day one or day two, the nurse said, Okay, Dad, you know, it's your turn for this injection for lunch, maybe. And I was like, what? You were in the hospital? You're the you're the nurse. That's, that's what you do we come to the hospital for the medical people to do the medical things. Why would I do this and just being so naive at what, the next days, weeks, months years was gonna look like, but I look back on I mean, it was it was just so startling to hear that like what I mean, like, you know, a patio layer comes to your house and Gaza, here's how he puts the bricks down. Okay, you put the breaker turn. Oh, I'm not. So that was just so fun. We reflect

Scott Benner 1:01:20
we stopped in the commissary at the hospital when we were discharged. Because I think we didn't want to do the first shot not in the hospital. But then went downstairs bought food. And then we're sitting on those like horrible plastic chairs and I'm holding this needle like down on my knee to put it in her leg, you know, and, and I'm just like, I don't know what I'm doing. You know, like this is this is not going to work out well. And it does. You know, they may like it eventually works out well. But I take your point, like just Why are you involving me in this and that's when it hits you right? Oh my god, we're gonna leave here. Yeah, that lady is not coming with us enough to do. Yeah, it's gonna be us. Two o'clock in the morning. Um, I called that poor doctor in the middle of the night, the first night and I said, Arden's blood sugar is high. And I think I want to give her a half unit of insulin. And she's like, okay, and I'm like, Can I do that? And she goes, yeah. I was like, okay, she goes, What's the blood sugar? And I told her and she goes, yeah, go do it test again. And a little while and I was like, Alright, thank you. I'm sorry, I woke you up at three, four o'clock in the morning, you know, this lovely endocrinologist. But I didn't know what to do. I had no idea. So anyway. Alright, you want to pick a bone? Is that right? Yeah. Good. So

Andy 1:02:37
one thing I'm curious about? And again, I'm not I'm just curious about this. It's a question. You often will ask people particularly around basil. It's like, away from food and insulin. What's a number your your blood sugar will sit at? And I think you're often asking around, you know, is the Basal rate right? And I think I hear you describing it as you know, if their answer was well, yeah, I sit steady overnight. At 160 you might propose while your Basal isn't, isn't heavy enough there, but my my bone to pick with that is I'm thinking if that line is flat at whatever number it may be away from food or away from insulin. That's actually telling you your Basal is right at that time. You just need this shifted starting point. So I don't know

Scott Benner 1:03:32
this is my one of my favorite online arguments about diabetes. I have a couple of them. This is one of them. It's so oh my god, how did you pick on one of them that I love it unless you were gonna bring up the about diabetes at Disney and not being an it not being a disability. That is an argument. I also enjoy watching people. So here's what I think. I am in this odd scenario in people's minds, the Great and Powerful Oz. Okay. And they're coming to the Emerald City to ask a question. And I can't possibly know what the answer is. Like, I don't live with them. I don't see it happen over and over again. They're throwing a graph at me. And they're like, Hey, tell me everything that's wrong with my kids basil right now. So I asked the question away from active insulin away from a correction or an insulin you've used for food? Where does your blood sugar most often sit stable? And if it's a higher number, okay, what would happen next? If you corrected that number? Would it drop down and stay down? Or would it drop down and come back up? I'm trying to get them to think it through because I can't be sure of anything I'm saying. So the idea is, let's get away from active insulin first because then we're seeing stability right so the Basal is working on some level, are you at 150 Or are you at 75? If you're at 75, your basil is either great depending on what you want, or a little heavy, maybe Maybe you want your blood sugar to be a little higher, if it's at 150, and you want your blood sugar to be 150 than right on, but if you don't want it to be 150, here's the next question. If we just turned the basil up magically, would it bring you down to 130? And hold you there? Maybe? Also, maybe the basil is perfect. And you made a mistake earlier with a meal or there was fat in the meal that you didn't? Didn't think of. So then let's correct it and see, does it go down? And come back up? Or does it go down and stay down? If it goes down and comes back up? I think it's likely your Basal is not strong enough. If it goes down and stays down, then you did something in the past that maybe your basil is okay. I'm just trying to get people to think about it that way. Because in my mind, that's the simplest way to do it without basil testing. Because when you tell somebody to basil test, what they think is, oh, I'm not doing that. So

Andy 1:05:54
we haven't done that.

Scott Benner 1:05:55
Right, right. So I'm trying to get them to where they need to be. Because I think that the establishment tells them I can't answer that question Basal test. And they know damn, well, when you tell people to Basal test, they're not going to do it. So it's a cop out. So I didn't want to cop out on people when they asked the question. Another way of saying all this is are you more frequently stopping lows with carbs or highs with insulin? If you're more frequently stopping lows with carbs, maybe your Basal is too heavy, you know, it's not for sure, maybe you're screwing up your meal, insulin, and you're constantly having to stop it later. I don't know I'm not there. If I was there, I could figure it out in about an hour and a half. But I'm not I'm not there. And I can't be there. And what I've learned is people are not going to stop asking me this question. So does that make sense? And do you still think I'm wrong? Because you felt

Andy 1:06:50
it does make sense? And earlier you said our brains probably work differently? And I think that is the case on this point, I'll say, like diplomatically, say I think about it differently. To me, it's that point on particularly, where it tends to be away from insulin and food are those overnight hours, right? So let's say you know, midnight to five or whatever. To me that key question around Basil is, is it stable? So forget the number if it's able at 70? If it's stable at 100, or 150? If it's stable, right, that rate of change of the blood sugar. That to me is answering the question on the basil, because let's say it's stable at 150 Most of the time, you know, overnight hours. And you you increase that basil, I think what you could end up with is you've actually just been slightly missing your, say, a dinner Bolus, but then you sit stable because the basil keeps you right there. And if you increase that, basil, you're actually going to get a declining line, right? Like a slow down hill, right overnight. Now, is that good? Is that bringing your blood sugar down? Yes. But I'd really rather just sit stable at like, 98.

Scott Benner 1:08:02
No, me too. Yeah, I think that's a great number. Also, there's more to consider when you're talking to masses of people. So if this conversation is between you and I, I think yeah, that makes sense. Because you see this input of data, and then you make more decisions, right? You don't just stop, whereas most people are just they don't want. I hate to say this, but most people don't want the level of granularity that you're interested in. They just want it to work. They don't have the time, the interest or the ability to think it through to the nth degree. And they're looking for what works. So you go back to old days, and MDI, when they knew people weren't bolusing for their food, their food, they would just keep jacking up their Basal, because they're like, they'd be like, Look, this guy is never going to give himself insulin for food. So what are we going to do to try to keep them alive as long as we can? Is that the right way to do it? It's not, it ended up being the best thing they could do for that person. And so my expectation is, anybody who thinks that the podcast is some set of rules set in stone, and if you just do it, everything works out, right? I don't intend it that way. I'm telling you, this is how we do it. And then once you do it that way, you probably are going to then take it and adapt it to the way your body works, your exercise schedule, the way your brain thinks about things. There's a lot more coming that I'll never have any input on. And, and what I think I've done, if I'm gonna give myself credit for something, is I think I found a medium is medium, the right word, where nobody is screwed, and everybody has a chance to do better. That's what I think the information I shared does, I think it doesn't, it isn't going to screw you up. And depending on how far you want to dig into it, you can do better and better and better. Yeah, yeah, that's all I because I as I look back on it, in the very beginning, I was like, Well, I know if I do this, this works, but it's not going to work that way for everybody. So then what most people did in the space? Or what most people do in any space is they go, Okay, there's no answer, we're not going to do anything. We're not going to help people. And I just thought, like, that can't be okay. Like, there's got to be a way to adapt this enough that it helps somebody. So if I get to the person who's got an 11, a one C, who listens to the podcast now has an eight a one C, that's terrific. If they never do better than that. I still took three points out of their a one C, you know, if I take somebody from a seven to a five and a half, that's great. You know, but it's also why I love the the idea of the algorithms because you put an algorithm on somebody, and just give it that Omnipod five is a great example. Because it is a really hands off device, you really do not need to know anything about how it works, right? You put it on somebody. And some people say, Oh, it's better. My Awan sees this now, but I still have high blood sugars. But I want the thing to take care of it. So they won't Bolus it. Whereas you looked at it. You're like, I don't give a shit how this thing works. I'm not letting my kids blood sugar be 180. I'm giving her more insulin again. Right? Everybody's different. And I can't be with everybody. So I just tried to find a middle that helps as many people as possible, if that makes sense.

Andy 1:11:15
It does. And undoubtedly, you do help a ton of people. We obviously hear that a bunch. I have the data that backs it up. I may have to put these graphs out there when this airs. I do have a prediction. I'll be right about 880 ish. Absolute number. That's That's my guess.

Scott Benner 1:11:34
So well, no, you're way off on this. Andy, I'm putting this out really quick. Well, because why? Couple things. Here's why. I think our conversation should make people interested in looking into on the pod five, and I want people to be healthy. So I want to get that out quickly. I also think that your charts really highlight that my podcast works really well. I'd like that to get out into the world as quickly as possible. Not I don't, it's not for me, I enjoy that. It's true. Like I have to admit, when I looked at this graph, I was like, wow, it just made me feel. I don't know, it gave me some like justification. You don't I mean, I was like, wow, this is this isn't just how I like this isn't just me thinking like somebody went and plotted points and it shows like, if you want if you want to do as well as you can, with your time and range, you should either listen to this podcast or get an on the pot five, like that's what I'm looking at here. And that's to say that the words inside of this podcast are slightly mimicking an algorithm for people's. I'm just, I'm proud of that. Yeah. And if it really is true, then it should be out there. So people knows they can do better. Because the difference between your daughter's outcomes, MDI and Dexcom versus Omnipod, and Dexcom versus Omnipod, Dexcom. The podcast are, I mean, it's substantial. It's a big difference for her in her health and her happiness. So that's what I want people to know. You know, me too. Yeah. Cool. All right. That was it. That was your bone. I don't talk too much. You don't hate my accent? You think I'm an idiot? Nothing like that. All right, maybe one day, I, I, by the way, just try to imagine, I will actually have the conversation. If it ever happens. I'm not going to back away from it. It's going to turn into like a giant screaming match. I think it's going to be incredibly entertaining.

Andy 1:13:34
We need to get those people that come on,

Scott Benner 1:13:37
I need somebody to call me call me names and like to have a real conversation about that. And so

Andy 1:13:42
I just think I just think you asked the basil question wrong. That's all.

Scott Benner 1:13:46
So so how would you ask the Basal question? Yeah.

Andy 1:13:49
So I would ask the basic question. You know, similarly when away from food when away from impacts of food, or you know, Bolus insulin of any kind? Does your blood sugar stable consistently? At any number? And it's really about that rate, right? So it does the does the Dexcom graph look flat and horizontal? Or is it slowly climbing up a hill or slowly going down? And

Scott Benner 1:14:15
let me ask you a question. If the person's blood sugar overnight, in your example, keeping in mind by the way that your kid does not have the hormonal impact that a lot of other people have because of her age. If your kids blood sugar was super stable at 225, overnight, which you think or basil was okay. Yes. What if you corrected it? It went down that went back up to 25. Again, yeah, then something would be off. Okay. Sure. So you just don't like the way I phrase it? That's right. You don't even disagree with what I'm saying very much. You just don't like my entree into the conversation.

Andy 1:14:47
That's right. Yeah. You just asked that question differently.

Scott Benner 1:14:50
I've had there's a part I wish I knew her name. She argues with me on every time I say it online. She comes in and she's like, You're wrong. And I was like, Oh, here we go. And and I love the conversation. I wish I could explain to her how much I enjoy the conversation. Because the truth is, is that in this specific scenario, while we're talking online, either I'm right or she's right. It's one or the other. Either it's the Basal or it's something from before bed insulin to carb ratio, carb counting, etc, etc. It's always one or the other it when this question is being asked, but it's almost like politics, because the person who comes in to argue with me always acts like it couldn't possibly be the basil. And I think that comes from their personal experience. And I don't I I've had enough experience talking to people that I don't really I try to come in very down the middle. Like, I don't assume it's one or the other. And I think and I think, I don't know, it's just it's one of the great diabetes arguments. I love them. We should make a list of them one day. Yeah, yeah. All right. Well, Andy, hold on one second. I appreciate you doing this very much. And let me tell you about when this is gonna go up so you can prepare yourself. Sounds good. Thank you. Thank you.

Huge thanks to Andy and if you're hearing this in the first week of its release, you should probably go check out the private Facebook group because Andy's gonna put his charts in there. I want to thank Dexcom, makers of the Dexcom G six continuous glucose monitor and remind you that you may be eligible for a free 10 day trial the Dexcom G six dexcom.com forward slash juice box. Get your diabetes supplies from us med either call 888-721-1514 or go to us med.com forward slash juice box get your free benefits check and get started today with us med.

Thank you so much for listening and for supporting the podcast. Please subscribe or follow in an audio app like Spotify, Apple podcasts, Amazon music, something like that, whatever you use. And don't forget to tell a friend about the Juicebox Podcast. Thank you so much for listening. I'll be back very soon with another episode.

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