← Diabetes Connections | Type 1 Diabetes
Diabetes Connections | Type 1 Diabetes
A T1D Dad’s Worst Fear: His Son’s Diagnosis. The Surprising Outcome? “It Made Me Calmer.”
00:41:49
A very common fear among adults with type 1 is having a child diagnosed with T1D. My guest this week was diagnosed at age 7 and he says he held his breath each time one of his three children passed the milestone. But then, his youngest was diagnosed...
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- [00:05]
A
This week on Diabetes Connections. A very common fear among adults with type 1 is having a child diagnosed with T1D. My guest this week has lived with type 1 since age 7 and he says he held his breath each time one of his three children passed that milestone. But then his youngest was diagnosed at age 8. I'm talking to Brian Foster about that experience, what surprised him, how everybody's doing.
- [00:30]
B
Now, and a lot more.
- [00:32]
A
He's a triathlete and a diabetes educator and we also talk about his advice for the endurance sports he loves. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your healthcare provider. Welcome to another week of Diabetes Connections. I'm your host, Stacey Sims. You know, we aim to educate and inspire fire about diabetes with a focus on people who use insulin. And I apologize. Little rough voice. Woke up with a bit of a cold this morning, but I feel fine. So we will barrel through. It's a rainy, not really chilly day. We're not quite there yet. Here in Charlotte, North Carolina. Our fall tends to feel a little bit like summer. Sometimes it gets really humid around here this time of year. Very weird. But I'm taping a couple of days before the episode is released. But, but the day this episode is released is my birthday. And I'm only mentioning that because, and I, I mean this, I know it sounds really corny, but what a gift to keep doing this show, to keep expanding the business, to have these in person events, to be able to meet so many more of you. I mean, it's just incredible. And I am going to spend this day, my birthday, doing things that I really love. I'm going to the gym first thing. I mean, I love that when I'm done with it, I, I'm having breakfast with a really dear friend. I'm gonna play golf and then I'm gonna go to Trivia. I gotta tell you, my favorite thing today is trivia. I love it so much. I'm such a nerd. But you know, look, at this point, let's just be free to be the weird that we are and to do the things that bring us joy. And more joy and excitement is on the way for me because Phoenix is coming up. Mom's night out. Phoenix. October 24th and 25th. It's our last Mom's night out of this year. What a ride this has been. Phoenix is number 11 and we've got.
- [02:17]
B
Four on the books for next year.
- [02:19]
A
I'm already in the middle of planning for Nashville and Washington D.C. i believe the dates will be announced possibly by the time this episode goes live. Definitely by the time we're in Phoenix. But check the website, diabetes-connections. Com, click on the events tab. And next fall we are in Detroit and Seattle. There are already signups on the website for city specific alerts and announcements. So jump in on that something that's not sparking quite the same amount of joy. We are going through the process of getting Benny a new insulin pump. We're only getting a new pump because his is coming out of warranty. He's not switching. He's staying with the T Slim X2, which he's had for many years, really since he's had, I think since he was about 12, when he switched away from animus when that went out of business, but who's had basically the same kind of tubed pump hardware kind of situation. Anyway, I'm trying to make him handle this himself because he is now 20. He's doing a really good job.
- [03:12]
B
But, you know, there was a little.
- [03:13]
A
Bit of insurance questions. There was a little bit of mix up in terms of where we would order it from. So we got on the phone with Tandem and big shout out to Alison.
- [03:23]
B
Who took our call.
- [03:25]
A
And it turns out she knew who we were. She recognized my voice. I had also met her at the Breakthrough T1D Summit in New Jersey not too long ago.
- [03:36]
C
So.
- [03:36]
A
So that was really funny. We had a fun conversation and she helped me out. We had to go through some verification of benefits because I have. I buy my healthcare on the marketplace. Long story short. So next call is to the medical supply company to actually place the order. Now that I knew the coverage that we had and that that was the correct place to order from. Quick side note, it's interesting now with more pumps being available at the pharmacy, our insurance agent was super confused because he was only checking the pharmacy line as to our coverage. I mean, it's just there's so much to keep track of. So we had to call Edge park and left them a message. And at this point, we were really used to the drill of Benny being a legal adult and having to give permission for me to talk on his behalf. So we left kind of a tag team message with me saying, you know, here, Benny, here's the phone. Tell him they can talk to me. And Benny giving his permission and of course, being who we are. I don't even remember what we said, but we were definitely being a little goofy and we went on for a little bit giving Edge park that permission. So when Lisa called us back, we spent the first 30 seconds of that phone call laughing about it. And, you know, it's just nice to have a little bit of humor when you're dealing with all this nonsense, because as nice as these people are, this process is ridiculous. And I'm still not exactly sure of our exact dollar coverage and spending on this thing. And, you know, this is not our first rodeo. This is more than 18 years of using an insulin pump and getting insurance coverage and ordering and all that nonsense. I know everyone listening understands exactly what I'm talking about, and I'm so glad you're here to understand. I'm sorry it's such a pain, but thank you for getting it. All right, my guest this week is a certified diabetes care and education specialist. In addition to being a diabetes educator, he is a clinical exercise physiologist, and he's lived with type one for 45 years. Brian Foster is also a runner, he's a triathlete, he loves endurance sports, and his youngest child was diagnosed with Type one about two years ago. He's got a blog called My Sweet Hat Trick. I will link that up in the show notes. And we're gonna talk about why the name? He's got three perspectives on diabetes, he says, you know, from just one guy. And my conversation with Brian Foster is coming up right after this.
- [05:58]
B
Benny has been using the Dexcom GM for more than 10 years now. The first insertion was in 2013, just before he turned nine. It was great then. I mean, if you have done finger sticks for a while, you know how amazing it is to go from that to continuous glucose monitoring. But it's even better now. The Dexcom CGM systems just keep improving. They continue to get more and more accurate with no finger sticks or scanning required. The easy push button insertion has made it easy for Benny to do it himself. He has done every one since we switched to the G6 in 2018, which was great for his independence back then as a younger teen. And of course, we still love the alerts and alarms and that we can set them how we want. Find out more. Go to diabetes-connections.com and click on the Dexcom logo. If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. Brian, welcome to Diabetes Connections. It's great to talk to you. How are you doing today?
- [06:57]
C
I'm doing really well, thank you. I'm really happy to be here.
- [07:00]
B
Yeah, I'm glad to talk to you. We have a lot to talk about. You know what let's start with the hat trick. Explain this to me, because I think I know what a hat trick is in sports. Explain the concept to me.
- [07:10]
C
Sure. A hat trick is when a player scores three goals in one game. Typically, you would hear about it during hockey. My daughter plays soccer. This is going back when she was little. He had scored three goals in a game. So then we learned what hat trick was. And when I thought about what I'd like to talk about in a blog, I thought I'd like to talk about it from a couple different perspectives. You know, I'm someone who lives with diabetes, but I'm also now raising a child with diabetes and having a background as a diabetes educator. I think I can talk about diabetes from a couple different vantage points. So I came up with the idea. It's called My Sweet Hat Trick.
- [07:46]
B
Tell me about your diagnosis. You were diagnosed as a kid. Do you remember? You were seven?
- [07:51]
C
Yes, I remember parts of it. I remember leading up to it. In fact, my mom laughs when I ask her to. I've asked her to retell me the story once or twice because I want to be able to make sure I put it in bright light. Apparently, the week before I was diagnosed, my family and I drove down to Florida to Walt Disney World. So this was my family, and then my mother's sister. So her family. And they have two children. I have a brother. So it was four kids, four adults in a van driving down. I don't know how they did it, but apparently I was peeing so much, I wanted to get out and go. They actually bought. It was a. One of those vans, like, larger vans extended. So they actually bought a porta Potty. On the way down, they stopped and got it because it was every 30 seconds I wanted to get out.
- [08:40]
B
Unbelievable.
- [08:41]
C
So they bought it so I could pee in front of everybody, which was great. And apparently we spent almost the majority of the majority of the trip me in the bathroom, drinking from a fountain and peeing in the bathroom, either my mother taking me or my father taking me. And, you know, those lines are so long. So within the span of going on a ride, I'd be like, I have to go. My parents would jump out of line, take me. Sometimes we'd make it back for the ride, sometimes not. And I do remember that, certain aspects of that trip, I remember it vividly, those kinds of things. So.
- [09:11]
B
And how soon after you got home, you weren't diagnosed while you were in Florida?
- [09:14]
C
No, I was diagnosed like a week after. So I went into dka. I was At a birthday party, roller skating party, which was all the rage back then.
- [09:24]
B
Oh, I remember that, man.
- [09:26]
C
So I must have loaded up on ice cream and cake and went out and I went down. No one roller skates anymore. You might know, because we look about the same age. You know that move where you go.
- [09:35]
B
Down on the floor with one leg in front. You can't see. But he is trying to show me this over. Zoom. You just disappeared. Bridie went off.
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C
Yeah, I was going to say, you got to look down or.
- [09:45]
B
All right, you put your leg out, one leg under you.
- [09:48]
C
Apparently. Apparently I went down and went down and, like, crashed into a wall. Just like, almost passed out and hit it. And from there on, I kind of woke up in the emergency room. So that was it.
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B
Anybody in your family with type one? Anyone with experience with type one?
- [10:03]
C
No. Now my mother has type two, my aunt has type two, but no one with type one. You know, and it's funny, my mother had asked my grandmother about it, and she was like, I don't know, we may have. But people died young at that age, and no one really knew why. And that was the truth. My grandmother was one of, like, eight children, but they had had others. Did one of them have type one as a juvenile? Maybe. Who knows? I'm the only recent one. Yeah. Well, now the second two recent ones.
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B
And that. That brings us to your son, one of your three kids diagnosed with Type one.
- [10:37]
C
Diagnosed.
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B
I have so many questions for you because I get a lot of listeners who say, like, as I'm a type 1 adult, and I have a lot of friends with type one who say, like, one of their worst fears, right.
- [10:47]
C
Is that their childhood, and it was growing up.
- [10:49]
B
And, you know, I always say, I have a kid with type one, and, like, it's very, very hard, but, you know, he's a great kid and it's okay. But I think that there's a. There's a very different feel because I don't have type one.
- [11:00]
C
I had this irrational thought. I have my doctorate. I'm very sciency. But this was totally no reason for it. After each one reached their eighth birthday, I would take a breath of relief, like, oh, they made it till they're eight. Like, that was the stopping point. I have no idea why, but that was it. And Owen was d. Owen turned 8, and I breathed that sigh of relief. And what do you know? Probably two weeks later was that week where I started to put one and two together. He went through one night where he had peed the bed three Times in one night. And that should have been that. That should have been it. But I think in the exhaustion of having to change the bed three times and then getting up and trying to get three kids to school, that it just didn't click until I was at work. I went to the bathroom. Then there was the finger snap, like, oh, oh, okay. It was actually the end of work, thank goodness. And he was at home, so I went home, tested his blood sugar twice, read high on the meter two times, and just high.
- [12:01]
B
Just the word high.
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C
Just the high. Yeah. So, yes, we avoided DKA for him, thankfully. Oh, good.
- [12:06]
B
Well, that's. I mean, I said, oh, good.
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A
But it is something. It is important.
- [12:10]
C
It is, it is. You know what, though? But both his, his mother and I are diabetes educators and we miss the signs for all the, all the other ones, you know, and I can say, like, oh, he was a skinny kid, you know, but I'm sure there was weight loss, you know, I'm sure there was a change in demeanor and. And we just didn't pick up on those.
- [12:27]
B
When you were in the hospital with your son, I assume there were those few days of education, even though you're an educator. Right. The family still goes through that. Did anything stand out to you as being very different from your experience?
- [12:39]
C
Yes. So I was diagnosed and I went to Children's Hospital Philadelphia. And even back then, they were kid oriented. You know what I mean? If you go into a children's hospital, you see the drawings on the wall and you think, oh, that must be new. I remember getting wheeled in, wheel wagon. McDonald's was there, which I don't know if that was healthy, but that was what they had. And I don't know what they're. Are they atriums like that? It was a big kind of. So I vividly remember being brought in and kind of looking up, because you don't really see that in any other kinds of buildings. And looking up and seeing that and just kind of being like, wow, now we. He was diagnosed at Nemours, which is probably about a 45 drive from where I am, but they have the same thing. So it was very interesting that that night I spent the first night with him. I went down to get coffee, and as I was coming up, I kind of like looked up and saw the atrium and I was like, wow, this looks very similar. It was very much a big flashback. Brought back a lot of things.
- [13:36]
B
I thought you were going to talk about the care. That's interesting that it's the building, but. But those are the things that stick in our brains.
- [13:42]
C
Well, yes. I mean, honestly, when I was. I was actually diagnosed at Atlantic City Hospital. Not Children's. Children's is where they sent me after they couldn't take care of me at Atlantic City. Yeah. And Atlantic City was that ugly yellow wall that's like, cafeteria. Like, I shared a room with, like, a guy that was probably 80 years old that was yelling the whole time because we only had a curtain between us. And I wanted to watch cartoons and he wanted to watch westerns. That whole trip, that whole thing was crazy. Oh. And I was like, oh, man, I wish I got diagnosed here. His room was in beautiful colors. His bed was comfortable. He got the room to himself. He got to eat. You could order from a menu at any time during the day. He had a. I don't even know what they are. Game boxes, DreamWorks, whatever. He had a game console in there that he could play games. I was just like, wow, he's not gonna wanna leave.
- [14:30]
B
This is okay. Brian, I'm trying to ask you about the diabetes game.
- [14:35]
C
Sorry.
- [14:36]
B
It's fine. We. All right. I mean, those are legit. When Benny was diagnosed, what stands out to me the most was that the Mickey Mouse Clubhouse had just come to Disney or whatever, Nickelodeon or whatever we were watching at the time, but you couldn't get it. And this is before streaming. It wasn't yet out on physical media, so remember the days that they would release it in the theater or on tv, Then six months later, you could get the dvd. He was obsessed with Mickey Mouse Clubhouse. No dvd. We're in the hospital. All he wants to watch is Mickey Mouse Clubhouse. I would have paid $300 for one.
- [15:08]
A
DVD of that damn show.
- [15:10]
B
So that's what I remember. So I hear you.
- [15:13]
C
I will say I'll add one other thing, and this is diabetes related. You know, when I went and got coffee that night, obviously I really didn't sleep that first night. I did go for a walk around the floor at three in the morning. It's. The hallway's dark, you know, and the only thing you can hear are, like, beeps coming from machines in other rooms. And I've worked in a hospital, so I recognize what those beeps are and what they mean and how serious they can be. And, you know, I walked around and kind of realized that Owen's going to be okay again. I have diabetes. Both his mother and I are diabetes educators. I mean, you know, you never wish for something to happen on your kids. But if. If there, there, there was a lot of other Things he could have had that we would have been unprepared for. And, I mean, the diabetes space itself has changed so much. I mean, in the last couple years. I was gonna say the last 20 years, but I mean, just the last few years seems to make a huge change every few years. So, I mean, he's in a. He's in a good place and. And we're. We're doing okay. And I kind of realized that that evening.
- [16:09]
B
I definitely hear that. I remember Benny running around the hallway. He was scooting around. They had like some roller horse. He's like, rid. And I was like, where are all the other kids? And the nurse, like, oof. And she looked at me. She wasn't scolding me, but she said, most of the kids here don't feel well enough to play.
- [16:26]
C
Right.
- [16:26]
A
And I was like, oh, all right, we're gonna buckle up now. We're gonna put our big girl pants on and deal with this. Cause we're okay.
- [16:33]
B
So talk to me about the differences of 7 year old Brian and 8 year old Owen in terms of diabetes care that first year. Did he leave with the CGM and get a pump soon? Were you at home doing it wasn't even MDI back then.
- [16:48]
C
Right. It was just. It was one. One shot. Wow. And so. And. And I remember my nurse telling me how lucky I was because we no longer had to boil our needles. And I was thinking like, yeah, yes.
- [17:00]
B
So the golden age.
- [17:02]
C
Yes, exactly. We didn't check blood. We were still peeing on a stick for ketones. The blood testing did start soon after. I'm not sure. I couldn't tell you how soon after, but it was medieval compared to what it is now. You know, the meters were about the size of a. Oh, trying to think. I mean, the meters were probably. You know, my first meter was probably about that large. And you would have to put blood on a strip.
- [17:26]
B
Like an old VHS recording box.
- [17:28]
C
Yeah, actually that's.
- [17:29]
B
That's a very VHS tape.
- [17:31]
C
Yep, yep. You would put blood on a strip, then you would have to blot it off a certain number of seconds after. And then you would have to put it in the device and it would read it. But you would put it in with the part you tested your blood on first because it read that. It read that part. It didn't kind of. I mean, the meters now, you kind of like put a strip in and you put it at the end and then it reads all the way through. This one, you had to physically stick in so it could read it and they took about two minutes, I think I could be wrong. You'd have to check.
- [17:57]
B
Long time. And so what, did Owen go home from the hospital with a CGM or. He did not go home with.
- [18:02]
A
Not quite yet.
- [18:03]
C
Yeah. At first they were like, oh, we don't know if we're going to get it on him. And his mother and I kind of looked at each other. I was like, well, he's either going to go on mine, right. I'm going to bring one of them home, or we could go through, you know, insurance. So, yeah, he went. He went home on one, and we got home on a pump probably a week later. His godmother worked for Tandem, so we had an in. So we were lucky enough to get him up and running pretty quick.
- [18:29]
B
You know, you've mentioned that you and your wife are divorced, different households. This is not something that gets talked about a lot in the diabetes community. It's just difficult. And you're obviously two well educated, concerned parents. And I don't want to get too personal, but I guess what I'll ask is, what works? What do you do that you think works in terms of tracking, helping Owen and kind of running diabetes from two different households? Because it's tough. Right back to our conversation. But first, Diabetes Connections is brought to you by Omnipod.
- [19:05]
C
Did you hear the pod drop?
- [19:15]
B
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- [20:03]
C
You know, and Owen's not the only one with his own medical challenges. For our kids, that's one thing that we have done well, is aside from the other stuff, you know, we both want the best for them medically, and that seems to center us around other things that happen with divorced individuals. Yeah, I guess having the diabetes experience, we both know what bad care looks like. You know, we know what the repercussions are. And I do think that's one thing we do very well together, is we. We do work together to make sure he's taken care of.
- [20:35]
B
Do you use any apps or anything that makes it easier to keep track? Is it notebooks? Is it communication? Is it texting?
- [20:41]
C
No, it's really just texting. That. That seems to be the easiest way. I mean, and we. We might make small changes to his, you know, to his settings, but for the most part, we're. We're letting Nemours drive the train. Pediatric diabetes is certainly different from other things. And you. You kind of know where you're. Where you specialize and where you don't. And while we might see something and. And make an adjustment, the nice thing is with Nemours and. And I would hope other parents could have the same kind of thing. When you send a message to Nemours, it sends it to both parents.
- [21:12]
B
Right.
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C
So you're not necessarily feeling like, oh, I didn't include them. You are, because they have the ability to see what you texted. So if she wants to make a change to his basal regimen or I want to change a bolus setting, you can kind of tell them that you're doing that, explain the rationale, and then both of us are able to see that.
- [21:30]
B
It's funny, I'm almost thinking about the.
- [21:31]
A
Days, and it's not that long ago.
- [21:33]
B
Before CGM and sharing and everybody carrying their phone 24 7. Because even when it's not that long ago, but when you would track blood glucose.
- [21:43]
A
Right.
- [21:44]
B
Trying to tell another parent, listen, this is how it was yesterday, this is how it was last week. Again, I'm not trying to say it's easy, but at least you can see it more easily.
- [21:52]
C
Yeah. I couldn't even imagine. I think so much more of my parents now for having to do that than they're the original gangsters of advocacy parents. That's awesome to have to do what they did at that time. It is. It's really amazing.
- [22:06]
B
So let's talk about sports, exercise physiology. This is, you know, part of the hat trick.
- [22:11]
C
Yep.
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B
Part of what you do. What kind of.
- [22:14]
A
You can tell how sporty I am.
- [22:16]
B
What activities, Brian, what's your thing?
- [22:19]
C
So my thing is endurance activities. So. And they would be running, but they could be swimming, biking, triathloning. I've had the chance to do a lot of different endurance activities over the years. I've been lucky to do that.
- [22:33]
B
Lucky. I'm like, oh, that sounds like torture. Well, I'm kidding. I know. I know. Everybody. It's a wonderful thing. I don't mean to cut you off. Continue.
- [22:40]
C
To those. No, that's okay. To those that do it. It is. It's a blessing. It's. It's, you know, it's. It's full of challenges. It's full of moments where you wonder why you're doing it, but, you know, at the end of the day, you're very happy for. For having done it. I ran in high school and college, just kind of continued that on afterwards.
- [22:55]
B
So you're running in high school at a time when there's no CGMs, there's barely, frankly, decent insulins.
- [23:01]
C
Right. We were using something called nph.
- [23:04]
B
Right.
- [23:05]
C
Um, we used to call it Not Particularly Helpful. I don't know what it actually stands for, but that's. That's how we worded it. Yeah. By that time, we were doing multiple daily injections.
- [23:14]
B
What were the biggest challenges? I'm thinking about running as such a difficult sport to begin with for type one, and then to not have the.
- [23:22]
A
Technology and the tools.
- [23:23]
C
Yeah. I mean, at that time, we would. They did have meters you could use, but was al. What also was very popular was using a test strip and using like a. I don't know what else to call it, but like a color wheel.
- [23:36]
B
Okay.
- [23:37]
C
Where you had, like, two colors, and you had to match those colors against a line of colors. And each line represented a different blood sugar number.
- [23:44]
B
So people are familiar, I think maybe with older ketone sticks.
- [23:47]
C
Yes. Same idea. Exact same idea. You know, but. But the ranges would be like 80 to 120, 120 to 160, 160 to 200. You know, they were pretty wide range. And, you know, the whole idea was you had to blot it in a certain number of seconds, which is really hard if you don't have a watch on you. You know, I mean, it is. There's a lot of error, I think, involved in that. That method, but that's. That's what we had. I had learned by that point about trending. It wasn't talked about at all, but I kind of knew that, you know, having a blood sugar that said 120 was fantastic, but I didn't know where I was going. So typically before a race, I would test twice, maybe about 20 to 30 minutes apart, and then use that as a guide on what to do.
- [24:32]
B
So knowing what you know now, and you know a lot now, what works for a sport like running, for endurance athletes, and everybody's different. Right. I'm not trying to Ask you to give medical advice.
- [24:42]
C
Right.
- [24:43]
B
To listeners you don't know. But I can't have you here and not ask like high level what, what should people be thinking about?
- [24:49]
C
I think that the software we have now to look at our blood sugars is fantastic. And I so wish I'd had something like that when I was a kid. If I ever wonder what's going on with my blood sugars, to be able to look at it and to look at the day before and the day before that and the day before that is really, really helpful. If you can log an item and every pump's a little bit different, but if you can log events in and that might be using Dexcom or Libre instead of your pump software, you know, to be able to track something and see what happens, that's hugely important. I mean that's what we were doing with paper and pen. Not very well. But you could do such a better job with the software today. So I mean, that's one thing I'd recommend. Every day is different and certainly I haven't done it right lots of times, but it is true. The more you do it, the, the larger your book of experiences gets. So when you run into a situation, you can kind of think to yourself what you've done in the past and what you might want to do now. Situations always change. But again, I think having that book of experiences in your back pocket helps you to figure out what's going on.
- [25:56]
B
Now what do you do day of with something like a long triathlon?
- [26:00]
C
Typically most of the endurance events begin in the morning, unless there are some ultra runs that start in the middle of the night. But you know, for the most part they're, they're morning events. I do pretty much what I did when I was on shots or pumps that didn't were not CGM enabled. I had breakfast at least 3 hours before the event. Cause I wanted to make sure that the insulin that I took for the breakfast was out of my system. You know, I think the insulin onboard feature is huge for people now in athletics and that that is probably an underutilized tool. So what I would do is I would take it to be sure that the insulin was out of my system. Just like all the recommendations say. I would, I would lower it a half hour before the activity. And every activity is a little bit different. I think in my early years I was someone that struggled with turning on the basal low early on because my excitement would raise my blood sugar. So everybody's a little different in that. So you do have to fine tune that. I know for a marathon, and this is probably true for everybody to do. I follow the same exact advice that you would follow for someone without diabetes, which is about 30, 60 to grams of carbohydrate for every hour of activity. And now they're, they're upping that to closer to 60 to 90 if your activity is going to be longer than an hour and a half. So for those that are going to do a, for example, a marathon, the idea is that now they're recommending somewhere between 60 to 90 hours, 60 to 90 carbs of carbohydrate, and you can either take insulin or if you can have the pump, figure it out. I think that that depends a lot on, on your fueling strategy. I wear the Omnipod and I'm sure others on other pumps have had this experience. But I'd say lately, within the last two or three years, I found that in my endurance runs, the races that last longer than six hours, I'm able to eat and not take any insulin.
- [27:47]
B
Yeah, that's what I was going to ask is why, you know, do you really need to take insulin for those carbs? How are you eating while you're running? This is always, I mean, that sounds like a stupid question to those of you who do marathons, but I'm always like, what are you doing?
- [27:57]
C
Well, I mean, typically you try to bring foods that you can eat that are easy to eat while you run with kind of the endurance running community, they typically have stations that you would take and kind of refuel. I always try to emphasize a lot of athletes will eat a whole lot at that station and then take off, which is fine, blood sugar wise. That's not always the best policy. So what I try and do is make sure that I'm bringing things that I can kind of carry with me and eat as I go. Something like cookies. Oreo cookies are great. I'll always have like a plastic bag with me and I'll throw a couple in there so I don't eat eight of them at one time. I'll spread it out over the next hour, you know, because that's. It's easiest for the pumps to handle glycemic load if you're putting it in gradually for all the pumps. If you eat a huge amount, it will begin to give auto corrections, but they might not be significant enough to deal with what you're trying to, you know, for the athletics for that day. So, I mean, I think more of balanced. The first woman that qualified for the Olympic Trials Missy Foy. So she was the first woman with diabetes to qualify for the Olympic marathon trials. And what she would do is she would take the small packs of goo and she would tuck them in her racing bib. And about every seven or eight minutes she would take a little out, take a little squeeze and then put it back. Because she knew at that time it's kind of the balanced glucose over the course of two and a half hours. That was much better than taking a goo all at once and then going.
- [29:26]
B
I have done an interview with a gentleman who was in the process of running a marathon in every state. And when he was either in north or South Carolina, and I'm in North Carolina. So we were laughing about this. He was low and there weren't any stations. And he went off the route and ran into a Bojangles, which is a fried chicken chain down here, and got some bow rounds. They're like, you know, french fries, potatoes, got some food from Bojangles. Had somebody, he took, had somebody take a picture of him. Cause they thought it was so funny. And then went back out on the route. So, you know, people with diabetes, you don't fool around, you make it work.
- [29:59]
C
Yeah, that's good advice. I always carry a credit card with me now when I run. Yeah, it wasn't something that I often did, but I mean, there have been times where I've hammered through all the glucose that I brought with me, and those are rare where that happens, but it does happen. But at least in my area, there are enough wawas convenience stores that I can stop and get something to eat if I need it.
- [30:18]
B
What's your favorite type of endurance activity? Do you like the variety of the triathlon? Do you just want to swim? You know, what's your thing?
- [30:27]
C
I've kind of gone through phases. I think I very much enjoyed the marathon training when I had the time to train. There's a period in my life where I used to qualify for Boston every single year. I had done nine in a row at one point. And I very much enjoyed the training that's required to qualify for those types of events. Now that I have three kids, that is not. It's just not feasible. I've only qualified twice since having kids, so over the last 15 years, so it's tough. But what I've found is that the ultra running community I'm very much becoming a fan of, it's not necessarily speed oriented. It's more about time on your feet. You know, I do a lot of walking now in addition to Running. And I think that helps, at least for these events. You know, the races I'm doing Now are like 6 hours or 12 hours long. And it's really just about. It's not going out with a hundred percent effort. It's going out with a 60 to 65% effort and then trying to maintain that the whole kind of 12 hours. What I love now about the adventure racing or the ultra endurance racing is that the race is different every time. I think when I was younger, I wanted regimen every year. I would tend to do the same marathons because I knew the course. Oh, that's funny. You know, but. But it's. It's the same idea of. I know that I have. If I. If I break my race down, if I run this pace and I have my carb at this time, and then I, you know, I slow down or I speed up. That was something I could repeat over and over again and get the same type of outcome. The races now, some might have 2,000ft of elevation, another one might have 5,000. You know, it could be 80 degrees out, it could be a hundred degrees out. I always tend to bring my food with me, but I also tend to take what they offer, and that can change race to race. So what I'm finding now is I'm very much enjoying the idea of, well, I haven't done this before. What should I do? Yeah, and I'm enjoying that. I'm enjoying that.
- [32:14]
B
Yeah. Figuring it out. That's great.
- [32:16]
C
Yeah.
- [32:16]
B
So to be clear, Brian, you do specialize in exercise physiology. You're a diabetes. You're a certified diabetes care and education specialist. Do you counsel people with diabetes about exercise specifically?
- [32:26]
C
I haven't in some time, but I'm thinking about that. I used to do a lot of public speaking because I'm also a clinical exercise physiologist. And that is very similar to a registered dietitian in terms of what you can do. And yeah, there was a time in my life where I talked very much about what to do specifically. It's something that I've thought about more and more recently. A couple people have asked if I'd be interested in doing that, and I am. I just haven't figured out how.
- [32:50]
B
And pardon my ignorance, because I, you know, I don't. We've had a wonderful diabetes educator when Benny was smaller, but I'm not, you.
- [32:56]
A
Know, I don't know all the nuances of the.
- [32:58]
B
Of the specialty.
- [32:59]
C
Right.
- [33:00]
B
Um, it's really interesting.
- [33:01]
C
There's so many individuals out there that are balancing Exercise and diabetes. You know, you can go to Facebook and find at least 30 different groups. There's the Diabetes Sports Project is out there, Team Novo Nordisk. You know, there are a lot of different groups for people that are. Want to be very, very competitive or people that just want to go out and do their 30 minutes of activity a day. There are resources out there, much more than when I had. I think if people are interested, they need to look because it is. It's out there.
- [33:32]
B
I want to circle back to your son because as I mentioned, I think this is the worst fear of a lot of adults with diabetes, and it's come true for you.
- [33:42]
A
I'm going to be really blunt, Brian.
- [33:44]
B
Listen, there's nothing good about having type 1 diabetes, right? So I say this because I don't know how else to ask it. Is it as bad as you thought it would be?
- [33:54]
C
Do you mean it's raising him with.
- [33:57]
B
Diabetes, the blow of your child being.
- [34:00]
A
Diagnosed with type 1 diabetes?
- [34:01]
B
Because I feel like it is built up as a fear where there's so much guilt. You know, there has to be this.
- [34:07]
A
Feeling of blaming yourself.
- [34:09]
C
There's a lot.
- [34:10]
A
Right.
- [34:11]
B
So I, you know, I didn't send you that question in advance. I know it's tough to just talk about off the top of your head. I can also rephrase it as, like, what do you want other parents dealing with this to know? I mean, your kid's probably great. It's been two years, right? You got three kids, you're all running around, you're doing life with just some thoughts.
- [34:27]
C
It's funny, there's so much talk out there about, like, your kids aren't supposed to be your heroes. That's not a good connection to have with them. That puts them on pedestal. But I do, I look to him for a lot of this, and he's remarkable. He's the third kid. And I'm sure parents with multiple kids can probably attest to this. I don't know that it's a scientific fact, but it is from other parents I talk to, you know, the kids become more resilient as you go through them. You know, the first one, not so much second. So he's very resilient. He's well prepared to deal with this, personality wise. I take a lot from him. I mean, he just. He lets things roll off his shoulder and he's like, okay, if I say, you know, we gotta take insulin, okay? He's not very. He doesn't get too upset. I mean, he has his moments, of course, oh, yeah, any. Any child would. But I find very often that I'm having to calm down because he's calm, if that makes sense. We balance out each other. Well, I'd say, you know, when he's having those moments, I can say, okay, I'm the adult. I have to be calm about this. You know, and when there's moments internally where my. My stomach squeezed and turning, I see that he's very calm about it. And I'm just like, okay, he's good. He can't see what you're feeling, so let's just go with it. Exactly.
- [35:38]
B
Have you. Have you both talked. Have you talked to each other about Both having type 1? I know it can be a little dicey because you do have two other children, and I only have one other kid, and she's always like, diabetes is all this. People talk about in this house. And I, you know, the attention that he got when he was a kid was unbelievable. And we've. We have a great relationship, but, man, have we hashed it out. So I know I'm kind of asking something, but what I mean is, have you and Owen talked about how both.
- [35:59]
A
Of you have this?
- [35:59]
C
We very much have. I told him early on, and of course, this was the worst thing I could have ever done. Although I'm sure every parent has that. Oh, oh, I've got those. We were talking about diabetes, and I said, you know, bud, really, out of the three, you are the best prepared for this. You know, you've. You've got a resilience that the others just don't. And what does he do? He turns right around and tells the others.
- [36:20]
B
Tells them, oh, of course.
- [36:22]
C
Are you kidding me?
- [36:23]
B
No.
- [36:23]
C
He's like, I'm the best. That was supposed to be like a pinky diabetes, blood packed. Nope, nope, nope, nope. I'm going to turn right around and tell Peyton and Kendall, so.
- [36:33]
B
Oh, parenting is so humbling.
- [36:35]
C
That's funny. But we do. We do talk about it. He struggles at times with the sight change. I struggle with the sight change, you know, and I'm 50 something, so I'm careful to give him his space and let him know that it's okay to be upset. But I also let him know that there are things that are just. We just have to do.
- [36:51]
B
Has it helped you with your diabetes at all? I mean, it doesn't sound like you were. You had a problem, quote, unquote, you know?
- [36:57]
C
No, I think. I think I'm very much a type 1, type A when it comes to diabetes, you know, I'M very fearful of the pumps being taking complete control.
- [37:08]
A
Really?
- [37:09]
C
Oh, yeah. I want to have. And there's probably a lot out there like that that want to have the control, like, no, I know my diabetes best. And there are a lot of instances, I think, where that's not true. The pumps know better than us. But there are also times where, especially in terms of exercise, you know, I think about him. I actually have a basal rate set called trampoline that is just low basals, you know, high correction factor. You know, the idea is that everything's changed to try and deal with his activity. That comes on Saturday afternoon when he just runs around with his friends and plays all day. That's one of those instances where I can't use his regular rates because the pump might give him two and a half units for lunch, and he might go out and run and go out to play, and within 15 minutes, he'd crash. Yeah. In that instance, the pumps are great. But then I kind of have to think a little off the cuff about what he's doing, what his needs are, and how I might deal with what I have.
- [38:03]
B
Like any parent, you brought the question back to your son. But truly, has it changed the way you manage at all?
- [38:09]
C
Yeah. Yeah, I think so. It's. It's actually, I think it's made me calmer about some situations. I used to be very. My blood sugar's over 200. I gotta fix it. And if it's. Now, I have to bolus 12 times to get it down. And now I'm a little more careful, just like him. I wouldn't overcorrect twice an hour. I try to remember those same rules that, for me, that apply.
- [38:30]
A
Amazing.
- [38:31]
B
Brian, before I let you go, gotta mention, you were with the company that had my heart with Animus back in the day. Our first insulin pump.
- [38:40]
C
Yeah.
- [38:41]
B
Oh, loved the pump, loved the company. I blogged for them back in the day. They're the people that brought me into the diabetes community as a blogger and gave me some of my early, early first taste of meeting people across the country. But you're obviously not with Animus now. And I know you've had a long path, but if it's okay to say you are. You are looking for. You're looking for your next thing in the diabetes community or elsewhere. Right.
- [39:03]
C
Yeah. My last role was with the American Diabetes association, which I loved. We were working on healthcare grants that were just, you know, to sum it up just to improve people's lives, you know, make. Make their outcomes better. It's as simple as that. I really did love it. Having the research back, a little bit of research background, I enjoyed. I really enjoyed that aspect. But, yeah, there's not as many health grants as there were out a year ago. And I find myself in that situation that a lot of people are now in the sense that they're. They're looking for what's next.
- [39:31]
B
Yeah, well, look him up. There's a lot going on with Brian Foster. Snap him up before somebody else does. Brian, thank you so much for joining me. I can't imagine what it is like. It's a very, very different experience having a child with Type one when you have Type one yourself. And I appreciate you just being open to some of the questions and sharing some of those thoughts because there's a lot of people who are scared of it or dealing with it. So thanks for coming on and sharing so much of what you did.
- [39:58]
C
I mean, I think overall, people with diabetes want to share their story. They want to be able to talk to someone else who gets it. And you're giving people a platform to do just that. As someone with diabetes, I really appreciate what you do. It's making a difference.
- [40:11]
B
Well, thank you so much. All right, all the best to you and Owen and your whole family. And hopefully we'll talk again soon. Brian, thanks so much.
- [40:18]
C
That would be great.
- [40:23]
A
More information about Brian and I will link up his blog in the show notes. You can head over to diabetes-connections.com and click on the episode homepage. I'll also try to link up some more endurance athlete information. And we've certainly done many episodes on this in the last 10 years. Marathon, New York City Marathon, Boston Marathon stuff. Lots of endurance athletes. Really incredible. I was just talking to somebody else about this recently about how when Someone has type 1 diabetes and is a professional athlete or is on a reality TV show, five, 10 years ago that would have seemed like such a huge deal. And now I think it's really becoming more and more commonplace, which is just fantastic. And as this next generation of kids and next generation of kids, they're in their early 20s now, really has never been told no, has always been told you have type 1 diabetes, but you can do this. And I really do think that that's just incredible. All right, let's hope this cold goes away in time for my birthday a couple of days from now. Thank you to my editor, John Buquetis from Audio Editing Solutions. Thank you so much for listening. I'm Stacey Sims. I'll see you back here soon. Until then, then. Be kind to yourself.
- [41:35]
B
Diabetes Connections is a production of Stacey Sims Media.
- [41:38]
C
All rights reserved. All wrongs avenged.