#1620 Thick Thighs Save Lives - Part 1

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1620: Thick Thighs Save Lives – Part 1
Host: Scott Benner
Guest: Laura
Date: September 5, 2025

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Episode Overview

In this gripping and candid episode, Scott Benner welcomes Laura, who shares her remarkable story of being diagnosed with type 1 diabetes at age 54. The conversation delves into late-onset type 1, acute medical emergencies, persistent self-advocacy, the intersection of career stress and health, and practical strategies for bold, empowered diabetes management. The episode weaves together harrowing medical episodes with humor and actionable insights, making the experience both deeply personal and widely relatable for anyone touched by diabetes.

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Key Discussion Points & Insights

Laura’s Diagnosis Story: Acute Adult Onset T1D

• Surprising Diagnosis (02:31)

  • Laura details her disbelief in being diagnosed with type 1 diabetes as an adult at 54, especially after previously having only gestational diabetes.
  • Quote:

    "I was diagnosed with type 1 diabetes at the age of 54 in March of 24, which I didn’t even know was a thing. Adult onset type 1 until I was diagnosed with it. Who knew?" – Laura [02:32]

• Medical Crisis: DKA and Necrotizing Fasciitis (04:33–19:56)

  • Laura describes ignoring symptoms—rapid weight loss, severe fatigue, and a mysterious growth on her thigh—while pushing through a corporate deadline.
  • Memorable detail: Laura initially believed the growth was just a result of new undergarments causing friction [08:57], but it quickly escalated.
  • She explains how her inability to recognize symptom severity (blurred vision, exhaustion, digestive distress) was exacerbated by mental confusion from high blood sugars.

• Critical Week Timeline (08:57–19:56)

  • Tuesday: Saw nurse practitioner for cough and mentioned 30lb weight loss; prescribed strong prednisone.
  • Thursday–Saturday: Thigh discomfort escalates to a “small potato”-like lesion; extreme exhaustion ensues.
  • Tuesday night (next week): Laura is so impaired she lets her husband drive her car—an act very out of character.
  • Wednesday: Too sick to stand, misses doctor’s appointment due to late arrival. Husband finally insists on ER visit.
  • Notable quote:

    "I go until I can’t. And that’s what I do. Not just in corporate life..." – Laura [13:20]

• Hospitalization: Near-Death Experience

  • Laura goes into DKA, develops septicaemia and necrotizing fasciitis, and requires emergency surgery. She experiences hallucinations and codes during surgery [24:13].
  • Quote:

    "I even coded on the table." – Laura [25:01]

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Managing Recovery & Diabetes Education

• Discharge Instructions & Early Management (26:42–28:54)

  • Initial management advice was sparse—basics on insulin injection/prep, glucose monitoring, and nutrition.
  • Laura relied on prior gestational diabetes experience and previous dietary education.

• Corporate Mindset and Research (27:30–30:08)

  • Laura’s strong professional drive propels her to research and self-educate quickly, even while still recuperating.
  • She finds community and resources through a recommended Facebook support group and Adam Brown’s book Bright Spots and Landmines.
  • Discovery of the Juicebox Podcast becomes transformational.

    "Your podcast is what gave me the complete confidence that, okay, this is the best resource. This is real world, and it’s consumable in a way that feels personal." – Laura [30:09]

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The Power of Technology & Modern Treatments

• CGM as a Game Changer (41:11–42:21)

  • Laura shares how transitioning from finger sticks to a Continuous Glucose Monitor (CGM) revolutionized her understanding of post-meal glucose spikes and food choices.
  • Example: Realizing that a frozen breakfast sandwich spiked her blood sugar above 200, despite being “under 180” at the two-hour mark via finger stick.

• GLP-1 Agonist Therapy and Honeymooning (32:13–34:04)

  • Laura transitions from basal-bolus insulin to GLP-1 agonist (Mounjaro), drastically reducing and eventually eliminating her insulin requirement during a prolonged “honeymoon” phase.
  • She has also reduced her thyroid medication as her weight and inflammation decreased.

    "We've also reduced my thyroid meds twice...I'm down about 45 pounds." – Laura [34:08 & 34:19]

• GLP-1 Side Effects and Self-Management (35:46–37:14)

  • Practical advice: GLP-1 can intensify pre-existing digestive issues. Laura warns others to anticipate magnified sensitivity, especially with trigger foods like barbecue sauce or high sodium.

    "If you notice you have anything digestive before the medication, it’s probably going to be magnified when you’re using the medication." – Laura [36:09]

  • Discussion of bathroom habits, sodium sensitivity, and weight-travel strategies.

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Bold Strategies and Takeaways

• Adapting Diet and Lifestyle (42:21–43:47)

  • CGM data empowers Laura to switch up foods and make targeted adjustments—e.g., swapping out high-carb breakfast sandwiches for Greek yogurt or chia-protein puddings.

• Dealing with Side Effects (44:47–45:29)

  • Both Scott and Laura discuss acclimating to the GI effects of GLP-1s, differentiating between tolerable and serious side effects, and trusting that some issues will resolve with time.

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Notable Quotes & Memorable Moments

• On Adult Onset Diagnosis

  “I didn’t even know there was a thing. Adult onset type 1 until I was diagnosed with it.” – Laura [02:32]

• On Medical Emergency & Denial

  “I go until I can’t. And that’s what I do.” – Laura [13:20]

• On Surviving Thanks to Her Body

  “The only time in my life, Scott, that I have been happy that I had a thicker thigh because it only got into the fatty tissue and not into any muscle or any connective tissue.” – Laura [22:56]

• On Starting Over After Hospitalization

  “I was in corporate mode before I left the hospital.” – Laura [27:33]

• On Importance of CGM

  “Oh, it is a complete game changer...Once I got a cgm, I had that same breakfast sandwich. Didn’t realize I was going up over 200.” – Laura [41:11]

• On GLP-1 and Insulin Reduction

  “Every time we titrated up for the Manjaro, my insulin needs reduced. And then once I was on 12.5, that's when I was controlled without insulin.” – Laura [32:39]

• On Peer Support and Community

  “Your podcast...gave me the complete confidence that...this is the best resource. This is real world, and it’s consumable in a way that feels personal.” – Laura [30:09]

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Timestamps for Important Segments

• Diagnosis and Early Symptoms: 02:31–08:57
• Critical Medical Week & Hospitalization: 08:57–25:01
• ICU Experience and Surgeries: 25:01–26:42
• Navigating Early Diabetes Management: 26:42–30:09
• Finding Community and Resources: 30:09–32:13
• Transition to GLP-1, Weight Loss, Medication Shifts: 32:13–35:46
• GLP-1 Side Effects (GI, sodium sensitivity, lifestyle adjustments): 35:46–41:11
• Role of CGM & Diet Choices: 41:11–43:47
• Adapting to GLP Side Effects & Real Life Management: 44:47–End

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Tone and Atmosphere

The conversation is open, relatable, and often laced with humor—even regarding grave medical topics. Laura’s candor and Scott’s affable, inquisitive style create a safe space for unpacking difficult experiences, breaking through shame and self-blame, and celebrating the resilience of people living with type 1 diabetes.

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Conclusion

Laura’s story is a vivid testament to the unpredictability of type 1 diabetes, the necessity of self-advocacy, and the value of tech-enabled management. This episode offers both practical tips (CGM insights, GLP-1 impact, dietary experimentation) and important emotional support, urging listeners to trust their bodies, seek help when needed, and leverage the collective wisdom of the diabetes community.

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For deep dives on specific tactics, broader management series, and personal stories, check out further episodes and the "Pro Tip" series as recommended by Scott.

Transcript

[A]

Friends, we're all back together for the next episode of the Juice Box Podcast. Welcome.

[B]

Hi Scott, My name is Laura and I was diagnosed with type 1 diabetes at the age of 54 in March of 24, which I didn't even know was a thing. Adult onset type 1 until I was diagnosed with it. Who knew?

[A]

If you're living with type 1 diabetes, the after Dark collection from the Juice Box Podcast is the only place to hear the stories that no one else talks about, from drugs to depression, self harm, trauma, addiction and so much more. Go to juiceboxpodcast.com up in the menu and click on After Dark. There you'll see a full list of all of the After Dark episodes. Please don't forget that nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin. Summertime is right around the corner and Omnipod 5 is the only tube free automated insulin delivery system in the United States because it's tube free. It's also waterproof and it goes wherever you go. Learn more at my link omnipod.com juicebox that's right, Omnipod is sponsoring this episode of the podcast and at my link you can get a free starter kit. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox the episode you're about to listen to was sponsored by touched by type 1. Go check them out right now on Facebook, Instagram and of [e-mail] check out that programs tab when you get to the website to see all the great things that they're doing for people living with type 1 diabetes. Touched by type1.org I'm having an on body Vibe alert. This episode of the Juice Box Podcast is sponsored by Eversense365. The only one year wear CGM. That's one insertion and one CGM a year. One CGM one year, not every 10 or 14 days. Eversensecgm.com Juicebox hi Scott, my name is.

[B]

Laura and I was diagnosed with type 1 diabetes at the age of 54 in March of 24, which I didn't even know was a thing. Adult onset type 1 until I was diagnosed with it.

[A]

Wow.

[B]

Who knew?

[A]

Yeah, this was just a year ago and prior to that not even a year.

[B]

Little over a year.

[A]

Little over a year. And never once in your entire life did somebody say diabetes.

[B]

I did have gestational diabetes with both of my pregnancies But I didn't know there was such thing as an adult onset type 1.

[A]

I see, I see. And you didn't know anybody else with type one in your family?

[B]

None.

[A]

None. How about other autoimmune issues?

[B]

No. My grandmother had myasthenia gravis.

[A]

What is that?

[B]

It's an autoimmune that attacks the smooth muscles of the body.

[A]

Okay. How did that affect her through her life?

[B]

I don't know because we didn't talk about it, and I didn't realize that was autoimmune. I just knew she was a very loving old lady that I looked like a lot like. And she took a lot of medicine, but she lived into her early 80s and. And ultimately it was strokes that took her out.

[A]

Okay, early 80s. I could deal with that, I think. You know, unless they change something, like, awesome in the next 10 or 15 years, where, like, being older isn't like, being older than it is now. You know what I mean?

[B]

Right?

[A]

Yeah. That's not a bad run at all. Well, I guess. Are you married? Do you have kids? What's your family structure look like?

[B]

So I'm married. Just had my seventh anniversary two days ago, and I have two grown children. They're both in their 30s, and one grandson.

[A]

Okay. This is your second marriage?

[B]

It is, it is.

[A]

Okay. Well, congratulations on your anniversary. Very nice.

[B]

Thank you.

[A]

And your lovely family. Tell me a little bit about being diagnosed as an adult. Out of nowhere, how it showed up, and how did you figure your way through it?

[B]

Well, the story, Scott, is I worked myself to the edge of death, and when my husband took me to the er, I was in dka. I had necrotizing fasciitis, and I was in septic shock.

[A]

So how long do you feel like looking back? How long were you ill before you did something?

[B]

I was very symptomatic for probably about three weeks. And in the ER, my blood sugar was somewhere around 500, and my A1C was 12 or 13. I had gone to the doctor a week prior to the ER visit because I had a cough, a long cough that I just couldn't shake. So I went to the doctor, and I told him during that visit that I had lost 30 pounds without trying. And I was concerned about that, but he wasn't concerned.

[A]

£30 that you were happy to lose or that were concerning?

[B]

I was happy to lose. However, it was very concerning. For years, I had tried losing weight and couldn't lose more than three to five pounds at a time. And suddenly 30 pounds just melted off over the course of about two months.

[A]

When it was happening, how did you think about it?

[B]

I did have diabetes in mind, but I didn't have any concept of. Of how dangerous out of control blood sugar could be.

[A]

So were you doing. Because other people have said this to me and it's okay if that's not what you were thinking, but were you doing the like, oh, I might be getting diabetes, but I have needed to lose this weight, so I'll just ride this a little while before I look into it, or was it not occurring to you like that?

[B]

Honestly, it crossed my mind a couple of times, but I did seek medical help. I just wasn't. I was blown off.

[A]

Oh. So when you went to that doctor and you said, I've lost 30 pounds, did you say, I've lost 30 pounds, I'm wondering if I have diabetes.

[B]

I didn't say diabetes.

[A]

Okay. But they didn't think it through to that degree.

[B]

Correct. And that's part of my. With self reflection. What could I have done differently or what could I have done better? Because I actually did have a glucose meter because I worked with a dietitian about a year and a half prior and she prescribed me one, but my thought processes, they just weren't clear. During that time, it didn't occur to me that I had a tool that I could check on myself.

[A]

I see.

[B]

I was relying on a medical professional to say. To take my hand and say, oh, that is concerning. Let's do something about it.

[A]

So when he or she's not concerned, does that shut off your concern or does it just make you think, like, maybe the thing I was thinking isn't backburnered the concern. Okay. Okay.

[B]

Because my mother was diabetic and one of my sisters too.

[A]

I see. You know, just tell the doctor I tried. I've tried to lose weight throughout my life. It's never worked.

[B]

That wasn't part of the conversation.

[A]

It wasn't part of the conversation. Okay. So you think the doctor just got fixed on the idea that losing 30 pounds was probably good for you, so we're not going to think about it any deeper than that.

[B]

Right. And my chief complaint going in was a cough, and he prescribed a very strong dose of prednisone, which apparently will make even a healthy person's blood sugar spike.

[A]

Yes, actually, it very well could. How about that? That's all he did. That's interesting. Didn't look to see if you had like an illness that caused the cough or anything like that?

[B]

No.

[A]

Is it just a gp?

[B]

Nurse practitioner.

[A]

Nurse practitioner. Gotcha. Okay, so that happens. How long before you end up in the hospital? Like how. Like when's that doctor's appointment? Timeline wise, that was on a Tuesday.

[B]

And the next week on Wednesday was when I was in the er.

[A]

Wow, that quickly. And I'm sorry, I feel like I heard you mention that. Flesh eating disease.

[B]

Yes.

[A]

When did that. Okay, hold on. Because this came on so quickly, now that I understand the lay of the land. And it came on so quickly in less than a week from like, hey, doc, something's wrong. I've lost 30 pounds to I'm in the hospital. What does that week look like? Like, walk me through that week. At first I noticed this. On top of this. On top of this, I kept ignoring, like, show me the timeline there.

[B]

So the doctor's visit was on a Tuesday. On Thursday, I noticed some discomfort on the back of my leg. And frankly, I had new undergarments and I thought it was causing just a little friction rub. So Thursday, I started noticing the discomfort. Friday, I noticed that there was a bit of a growth and protrusion at that spot.

[A]

Skin tag, you were thinking something like that?

[B]

Maybe something like that, Yeah. I knew I had a dermatologist appointment the next Wednesday, so I wasn't concerned about it. Oh, just another thing for that doctor to look at.

[A]

Yeah.

[B]

Saturday it looked like a small potato oozing just a little bit. And again, well, I already have an appointment to see the dermatologist, so they can look at it on Wednesday.

[A]

Russet or yellow potato? I'm just kidding. So that thing's growing exponentially.

[B]

It's growing quickly.

[A]

Yeah. Yeah. Okay.

[B]

And during this time, I am so exhausted that I can't go for more than an hour without laying down or taking a couple of naps during the day. But I had work to do, Scott. So as. As a career, I am a corporate trainer, and I was the head of a sales enablement team in Sales kickoff, which is the largest internal event of the year for any company that does it for most companies.

[A]

Okay.

[B]

And I had a team that my predecessor hired. Really amazing people. Most of them, however, had never done sales enablement or sales training before they were hired. So there was a lot of burden on me to deliver this event. So I was working as hard as I could, nonstop hours on end. And that's the part where I said I worked myself to the edge of death, including doing executive readouts that I didn't have anybody on my team that could do them. So I was pushing myself to get the job done as I'VE said for years, pain may slow me down, but it never stops me. So I am working and napping and working and napping and working and napping. I had to do an executive readout on Tuesday. Tuesday night. My husband is so concerned. We were out of town for his work. We were driving back, and it's about a two and a half hour drive between where we were for his work. Excuse me. And our home. I was so tired on the way home that I actually asked my husband to park his truck at one of his work locations and drive my vehicle home. Scott, I don't let him drive my vehicles.

[A]

Why not? What bothers you about how he drives your cars? What is it? Is it just that it's yours?

[B]

It's not that. It's because it's mine. We have very, very different driving styles, and it makes. And I get uncomfortable when you don't.

[A]

Like it when he's driving.

[B]

Right.

[A]

Is it that he stops late, accelerates too quickly, stuff like that doesn't necessarily.

[B]

Stop late, but the way he uses distance and lane usage and speed.

[A]

Yeah.

[B]

He's an excellent driver, by the way. He has a cdl.

[A]

Makes you janky. Makes you feel weird. Yeah.

[B]

Just be. Just be a little more respectful with my baby, please.

[A]

I understand you love that car. I gotcha. So, point being is, you guys are trying to make this ride. You can't do it. You can't stay awake. You're exhausted. I mean, listen, you're. In fairness, you're giving birth to a potato, and that can't be easy.

[B]

Right?

[A]

Listen, if everybody feels like I'm now talking to my wife but not to you, I'm sorry, but, like, what is it about you people that you can't just, like, admit, like, you're tired or that, you know, I heard you say something so corporate. It just made me upset. Like you owned it. Like, I know. You mean you own the process or you own the thing, like it's your responsibility. I see my wife, you know, saying stuff like that all the time. Like, why does everybody think that they can just live forever through anything? And nobody ever stops to say, like, I'm exhausted or, I can't do this. What do you think stops you, like, from that business side? What is it that stops you from saying, hey, I'm in trouble.

[B]

I go until I can't. And that's. That's what I do. Not just in corporate life, but a good example is I live in the mountains, in the woods, and our primary heat source is firewood. And so Chopping, stacking firewood is a huge task, especially at my age. And I work myself to the point of exhaustion. I go until I can't go anymore. And where did that come from? I really don't know, but it's part of my mo.

[A]

One of your parents real demanding or never give praise? Are you Catholic? Anything like that?

[B]

Neither of them were demanding. They were mostly absent.

[A]

Oh, okay. You felt like everything was on you?

[B]

Yes.

[A]

Ah, we found it. Okay. All right. Okay. So you're going to kill yourself by ignoring flesh eating disease, type 1 diabetes and a few other things. So he pulls over. I mean uacus, let him drive the car. Where does it go from there? Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings. The Eversense 365. I'm talking, of course, about the world's first and only CGM that lasts for one year. One year, one CGM. Are you tired of those other CGMs, the ones that give you all those problems that you didn't expect? Knocking them off, false alerts, not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link eversensecgm.com juicebox to learn more about the Eversense 365. Some of you may be able to experience the Eversense 365 for as low as $199 for a full year. At my link you'll find those details and can learn about eligibility. Eversensecgm.com juicebox check it out. Today's episode is brought to you by Omnipod. It might sound crazy to say, but summertime is right around the corner. That means more swimming, sports activities, vacations. And you know what's a great feeling? Being able to stay connected to automated insulin delivery while doing it all. Omnipod 5 is the only tube free automated insulin delivery system in the US and because it's tube free and waterproof, it goes everywhere you do in the pool, in the ocean or on the soccer field. Unlike traditional insulin pumps, you never have to disconnect from Omnipod 5 for daily activities, which means you never have to take a break from automated insulin delivery. Ready to go, tube free Request your free Omnipod 5 starter kit today@ omnipod.com JuiceBox terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox type that link into your browser or go to juiceboxpodcast.com and click on the image of Omnipod right at the bottom. There's also a link right in the show notes of your podcast player.

[B]

So we get home, and I'm having trouble with my motor functions. So my husband. Actually, I've had two back surgeries, Scott. I have four rods and 12 screws in my back. And from my back surgeries, I still have a walker from my recovery time. So my husband pulled the walker out of the closet and made me use the walker in the house because he was so afraid I was going to fall.

[A]

Wow.

[B]

Yeah.

[A]

Yeah.

[B]

But I had a doctor's appointment the next day, Scott.

[A]

So we don't need to go to the hospital. This will be fine. Even though I'm now a fully mobile person using a walker and can't stay awake.

[B]

Yes.

[A]

You hear it when you were talking about it, right?

[B]

Yes.

[A]

Yeah. Okay.

[B]

At the. At the time, not only were my motor functions failing, I couldn't think straight. I didn't know that I was not being smart.

[A]

I see. You thought you were just managing the situation. Yes, I got that.

[B]

There was a plan. That's all I knew.

[A]

Got it. Okay. And your husband, is he pushing you or even retrospectively telling you, like, you know, I thought we should have gone, or where was he in that moment?

[B]

He was respectfully expressing his concerns but.

[A]

Not pushing second marriage. In his first marriage, he would have drugged your straight to the hospital.

[B]

Probably. Yeah.

[A]

Yeah. The first marriage teaches you to be more respectful of people. Yeah. Yeah, I got you. Okay. So he's worried, but he's. He's leaving it to you. But he doesn't know that you're not exactly making great decisions. And you don't either.

[B]

Exactly.

[A]

Scary, right?

[B]

Exactly.

[A]

That's scary. Thinking back on that, it is.

[B]

I am really fortunate to. To be alive.

[A]

Yeah, no kidding.

[B]

But that's. That's kind of a. It's kind of a weird super power. And the women in my family, they don't die. It takes a lot.

[A]

Yeah. Hey, did you end up baking the potato or did you mash it? Okay, so you go to bed and then what happens? Sorry.

[B]

Yeah. So in the morning, I'm getting ready to go to the doctor's appointment, but I'm so exhausted, I can't do five minutes of standing just to do my skin care.

[A]

Yeah.

[B]

Brush my hair, get myself dressed. So I had to rest so many times because I was out of breath. And I'm very concerned at this point. But again, I had a doctor's appointment it took me so long to get ready that we were late and the doctor couldn't see me. So my husband just said, that's it. We're going to the er.

[A]

Your doctor blew you off because you were late because you were so sick you couldn't get there in time.

[B]

They didn't know that.

[A]

Oh, okay. You live in the mountains. Are you telling me.

[B]

Yes.

[A]

Also, we're gonna have to get back to that at the end, because that sounds attractive to me, but I want to make sure that I'm understanding all the downsides, so. Okay. So you right off to the E.R. sorry, go ahead.

[B]

A couple of other things that. Again, not thinking straight. My vision was really blurred, and parts of my vision were dropping out. I don't know if you've ever had a migraine, but when I get migraines, my vision drops out, but it's replaced by more like white, but this time it was related with black. I had frequent urination, which I just thought because I'd had a hysterectomy a few months before. I thought, oh, I'm having bladder dysfunction because of my hysterectomy. That's what happens when you're an old lady. I was having a lot of digestive distress. I was having a lot of heartburn. Well, Scott, turns out that wasn't heartburn. I was vomiting while I was sleeping.

[A]

Oh, my God.

[B]

Yeah.

[A]

Jeez. Digestive distress, Constipation or diarrhea?

[B]

Mostly upper. Digestive. Upper.

[A]

Okay, so you thought, oh, I have heartburn, but you're vomiting into your mouth.

[B]

I didn't know that.

[A]

Oh, my gosh.

[B]

I just thought it was really bad. Acid reflux.

[A]

Yeah. So technically speaking, you were dying.

[B]

Yes.

[A]

Yes. Got it.

[B]

I even coded on the table.

[A]

Wait, okay, hold on. So you get into the er and how did they. I mean, do you remember how you presented yourself and what they started doing?

[B]

I told my husband as we're getting just out of the. Out of the vehicle that I couldn't walk in. I needed him to get me a wheelchair. I took a few steps, and it just wasn't working. So he gets me in. I'm in and out of consciousness. I remember answering some of the questions, and they seemed a little accusatory and saying, her blood sugar must have been like this for a very long time. No, it hasn't.

[A]

Well, not that, you know, but, you know, they have you pegged as the aka Is that right?

[B]

Yeah.

[A]

Okay.

[B]

So. And then my. My husband tells them about the. The growth. The infection on my leg immediately get into surgery. And I remember thinking, they're moving too fast. They're going to kill me. Every line, everything that they hooked up to me, I ripped off.

[A]

You were worried they were doing it wrong?

[B]

Yeah, that was one of my last thoughts before I went under.

[A]

You were backseat driving the.

[B]

I was.

[A]

Do you do that while your husband's driving your car, too?

[B]

I stayed politely respectful.

[A]

Look at you. Okay. All right. So you're freaking out in that hospital, feeling like something's wrong. They feel like they're moving too quickly. They're doing wrong things. So you. You look combative then.

[B]

Yeah, yeah.

[A]

Got it.

[B]

But that's, you know, the fight or flight. That's what I felt in the moment.

[A]

Right, right.

[B]

Yeah.

[A]

Wow.

[B]

And so I had two surgeries.

[A]

What was the surgery for?

[B]

It was to cut the infection out of me.

[A]

Okay. Back of your leg, thigh. Back of your knee, back of your calf.

[B]

Upper thigh.

[A]

Upper thigh. Okay. Yeah. You said you thought your underwear was rubbing up. By the way, when you said that, it made me super excited that I ordered new underwear. And it's arriving today.

[B]

Oh, yay.

[A]

I don't know why. Like, I. I think it's because I.

[B]

Grew up so broke.

[A]

Like, when I replace my underwear, I feel like I'm really winning. I know that's probably ridiculous, but I love that I have two packs coming today. Nevertheless. So they cut out. How much of your thigh did they have to take away?

[B]

Oh, goodness. I don't have a number for you, but I can tell you that it was kind of spider shaped because the infection tunneled and it took an entire roll of gauze. So what is that, four yards? That's three inches wide to pack the wound.

[A]

Oh, gosh. Yeah. Okay.

[B]

The only time in my life, Scott, that I have been happy that I had a thicker thigh because it only got into the infection, only got into the fatty tissue and not into any. Any muscle or any connective tissue.

[A]

Wow, that's. So you were lucky enough it didn't make it to a place where it could run more deeply. It was in. It was in the fatty tissue at that point.

[B]

Exactly, exactly.

[A]

All right. How do you end up with that? Did they tell you later? Like, how do you get the flesh eating disease?

[B]

That's something that we haven't been able to figure out.

[A]

Okay, well, you do live in the woods.

[B]

I do, yeah.

[A]

And then you said you had a second surgery. What was the second surgery for?

[B]

The second surgery was to go back in and make sure that they got all of the infection.

[A]

I see. Was that days later.

[B]

That was the next day.

[A]

The next day. Okay. So they did what they thought was like saving life. Saving. And then get somebody else to come back and be more meticulous about it.

[B]

Yes.

[A]

Okay.

[B]

Yes.

[A]

And they're getting you out of DK at the same time. How do they put you into surgery when you're coming out of dk? Is that not dangerous?

[B]

I have no idea.

[A]

Yeah. So you're pretty out of it during this time.

[B]

Yes.

[A]

Okay. When's the first time in the hospital stay that you start, like, coming out of it, realizing what's going on? Ooh.

[B]

They had me so heavily medicated. So heavily medicated, Scott. I was hallucinating in anime.

[A]

Oh, well, that's kind of fun.

[B]

Yeah.

[A]

Do you watch anime?

[B]

I don't.

[A]

Oh, that's awesome.

[B]

Yeah. And then at one point, somebody had come into the room to empty the trash and whatnot, and I had a conversation and said, you know, I can tell things are getting better now because my hallucinations are more realistic.

[A]

Jeez. Did anybody ever tell them back to you?

[B]

No.

[A]

No. That's a shame.

[B]

And my husband doubts that I actually had that conversation. Oh, it was probably a hallucination, too.

[A]

That might have been a hallucination also. You were really. You really were close to death, huh?

[B]

Yes.

[A]

Wow.

[B]

I coded.

[A]

Oh, yeah. Oh. So I'm sorry, during which one of the surgeries? The first or the second?

[B]

The first one.

[A]

Wow. They have to, like, do the thing like in the TV show where they yell clear and then they shock your heart.

[B]

Perhaps.

[A]

Oh, you're not sure? Oh, I would have definitely asked about that one. Wow. No kidding. When did they tell you that?

[B]

They didn't tell me. I heard it when they were doing the rounds.

[A]

Oh.

[B]

Oh, yeah.

[A]

So somebody said she coded during the surgery, and you heard them, but you don't. But is that possible that that didn't happen too? Like, how hallucination heavy were you?

[B]

No, I heard that every day that I was in icu. Six days.

[A]

It's a part of the thing that they were passing from nurse to nurse to make sure that they knew because they wondered if it was going to happen to you again, probably. And they wanted to keep.

[B]

It was a teaching hospital.

[A]

Oh, I see. I see. Wow. So how long you're in the hospital for? How long after all this?

[B]

Nine days total.

[A]

Well, nine days. And then does one of the problems supersede the other? Like, does somebody ignore talking to you about your diabetes because they're so worried about the other thing or vice versa?

[B]

In icu they were heavily focused on the wound and the infection. Then once I got to out of that onto the trauma floor, that's when they very closely, they were ready to release me after the surgery, but not until my diabetes was under control. So that's where I had two extra days on the trauma floor.

[A]

Gotcha. Wow. So what's your expectations for how to manage diabetes leaving on day one? What do they tell you? What do you, I mean, because you said it was out of nowhere, it's later in life, it's not a thing you were expecting. So, you know, when you left, what did you think management looked like compared to what you feel like it is.

[B]

Now when I left. So I had prescriptions for a long acting and a fast acting and I had instructions of once a day to take the long acting, but not when they gave me instructions on how to prepare for the injection, how to store the insulin using the glucose monitor, which I had done previously.

[A]

Right.

[B]

They sent a nutritionist to talk to me about what my plate should look like. And that was, that was pretty much it.

[A]

Yeah. Okay, so start looking into it on your own. Like I imagine you're exhausted after this experience. So like you're not like, or did you go right back to corporate Lara mode as soon as you got home? Like, or did you, I mean, it had to have taken you time to recuperate, right?

[B]

I was in corporate mode before I left the hospital.

[A]

Okay, Laura, I see. So you're already looking into like how to take care of your diabetes on your own, Right. What'd you figure out?

[B]

Early on, because I had gestational diabetes 30 plus years ago, I had a bit of a baseline. And then because I had worked with a dietitian a year and a half prior and already confirmed that I understood nutrition and understood carbs and proteins and all of that, I felt like I was in a pretty good place there. It was more about understanding is the insulin the right insulin and the right amount of insulin and when to take it. So I was just told take it before you eat. So I'd sit down to eat, jab and then eat, not waiting the 15 minutes beforehand.

[A]

You have a CGM on at that point?

[B]

Not at that point.

[A]

Not at that point. So what do you, how far after the meal did they tell you to test again? They usually say three hours, but two hours. Two hours. Okay. So what were you seeing at the two hour test?

[B]

Usually 150 or less.

[A]

Okay. Do you think you were honeymooning at all?

[B]

Oh, I'm completely honeymooning.

[A]

You are okay.

[B]

Yeah.

[A]

All right. So that doesn't. See. I would imagine that doesn't seem bad. Right. Like, I gave myself insulin. My blood sugar is 150. A couple hours after. I probably felt like you were doing well.

[B]

Yeah. I wasn't concerned.

[A]

What happens that makes you feel like I need to understand more and more. Like, how do you start digging into it to get to where.

[B]

I mean, you are now going back to sales kickoff. And by the way, I was in the hospital for 11 days. I only missed. Or excuse me, nine days. I only missed 11 days of work.

[A]

Oh, Jesus.

[B]

I had sales kickoff to deliver.

[A]

Yeah.

[B]

And so in January, flew to headquarters to do sales kickoff. And one of the executives, she was one of my keynotes. And when she walked into the room where I was producing the event, I saw that she had a CGM on. And I asked her about it and told her that I was recently diagnosed. And she just. She looked horrified. And she said, you know What? I was 35 when I was diagnosed. It was scary. It came out of nowhere. And she recommended a Facebook group for me to join and a book to read.

[A]

Okay.

[B]

When I was. I do audio books. And so after I finished that first one, which was Bright Spots and Landmines, something like that.

[A]

Adam's book. Yeah, yeah, yeah.

[B]

I was searching through Audible for other resources so I could really educate myself, and that's when I found your podcast.

[A]

Oh.

[B]

Because I'm an author, your podcast is. Is what gave me the complete confidence that, okay, this is the best resource. This is real world, and it's consumable in a way that feels personal.

[A]

Oh, I'm glad. That's awesome. Also, how crazy is it that somebody wrote a book that's inaudible and that's how you found the podcast? I feel so random. I've been surrounded by random things this week, so I'm paying a little closer attention to them. Oh, that's awesome. Can you help me for a second? Cause you're a very clear person. You find the podcast. There's a lot of episodes. I realize that, but how do you figure out what to go listen to? Or do you just start and then eventually hear about, like, the Pro Tip series and go find it? I'm interested in the process of picking through and getting settled with the show.

[B]

I started with most recent episodes and just started working backwards.

[A]

Okay. And then did you get to, like, management series somehow?

[B]

Yes.

[A]

Did you find out through the Facebook group or just by listening through the Facebook group? Okay. Because we have them up in the feature tab. And there's like all those lists up there. Is that how you found out or because people share them in the group? You don't recall?

[B]

I'm not recalling at the moment.

[A]

That's fine. Also, I'd like to tell everybody. Juiceboxpodcast.com lists with an S. I've taken all those lists that exist in the Facebook group and I put them online for you so you can find them on a webpage too. So if you want to go look at them there, that's where they are, are. And they're shareable and usable from there.

[B]

Right on.

[A]

Yeah.

[B]

By the way, I think that your snippets, your smaller ones.

[A]

Oh, the small sips.

[B]

They're brilliant.

[A]

Awesome. I'm glad. I'm glad. Yeah, we're gonna work on how to make more of those. But they were. They were more difficult to make than you might imagine. Like, you know, like take like a big idea and jam it down into 10 minutes somehow. But it seemed important to do. So. I'm glad you like those. Basically, you found the podcast, you figured out what to do, and you're doing well. Where are you at now? What's your A1C? How's your variability?

[B]

My A1C is 5.8 and I don't know what my variability is other than when I received steroid injections for my back in December. I haven't needed insulin since October.

[A]

Oh, so you're on like a honeymoon that where you don't need insulin.

[B]

I'm also on Manjaro.

[A]

Okay, hold on, let's pick through that. You're using insulin, then you go to a glp and then you don't need insulin again.

[B]

Correct. So when I started, I was on 32 units of long acting and 5 units of fast acting. And then every time we titrated up for the Manjaro, my insulin needs reduced. And then once I was on 12.5, that's when I was controlled without insulin.

[A]

Okay, so for all the people who are going to say you don't have type 1 diabetes now, did you do C peptide? Do you have markers for type one?

[B]

I do.

[A]

Okay, so you're honeymooning pretty hard. And you know that if you listen to the podcast, there's other people have come on and talked about this, you know, in the middle of probably some sort of a latent, like a lot of diagnosis, that they jump on a GLP for weight usually. And then I've only heard the story a few times, but it's a few people who've come on and told it, and you start to. Your insulin needs go down and down, and some of them end up on almost. Almost none or none. But your expectation is, I imagine, that one day that's the GLP is not going to be enough, and it's going to be. It's going to come back. The need for the insulin, is that how you're thinking about it?

[B]

Precisely.

[A]

Yeah. Okay. Wow. I wonder how long that. Well, how long has it been going for already?

[B]

We started the Mounjaro last year in March.

[A]

April. Oh, April, May, June, July, August. Oh, like 16 months now.

[B]

Yes.

[A]

That's incredible. Wow.

[B]

We've also reduced my thyroid meds twice.

[A]

Really? After the glp?

[B]

Correct.

[A]

So inflammation, you think? What do you think? I mean, is there anybody guessing why that is? Weight. Has your weight gone down?

[B]

My weight's gone down, so I'm down about 45 pounds.

[A]

I mean, that's why. Less body mass. You need less medication for the thyroid. I would have. Plus. Wait, 45. Plus the 30 or 45 total.

[B]

Plus.

[A]

Oh, so you've lost £75 since the day you started growing a potato or the couple days before you started growing the potato?

[B]

A couple months, yeah.

[A]

Wow. Do you have more to go? Are you interested in losing more? You like where you're at? Where does that sit?

[B]

Probably about 15.

[A]

Oh, okay. Can you talk about if there have been any other benefits from the GLP that you see?

[B]

Massive reduction in inflammation. So the benefits. So number one benefit, Glucose control. So my blood sugars have been improving from the very first shot. I didn't start losing weight, substantial weight, until I got on to 10, the 10 dose, but I lost so many inches because of all of that inflammation.

[A]

Wow, that's crazy. So you weren't exactly dropping a lot of weight, but your body was, like, tightening. You feel like, like visually tightening up?

[B]

Yes.

[A]

Okay.

[B]

That's a good way to say.

[A]

Yeah, yeah. You were shrinking but not losing weight.

[B]

Correct.

[A]

Okay, that's interesting. Did you ever in the past have any, like, GERD or any other digestive issues, or is that just during the diagnosis part?

[B]

Years of acid reflux and a history of peptic ulcers.

[A]

And how about the reflux? Is it gone?

[B]

It flares up. And here's one of the things that I want to share as a tip for anybody on a glp. One, if you notice you have anything digestive before the medication, it's probably going to be magnified when you're using the medication.

[A]

Interesting.

[B]

So I love barbecue sauce and especially a tangy one, not a sweet one. But I get heartburn when I have it that's gone on for years now. If I have anything that I know that previously would have caused a little bloat, a little discomfort, a little acid reflux, it's guaranteed to do it.

[A]

I had acid reflux and it's gone now.

[B]

Oh, good.

[A]

Yeah, but it.

[B]

Food trigger. Very specific food triggers.

[A]

You had specific food triggers. You do. I don't know what mine was, if it was weight or if it was just my poor digestion. Like, my digestion was terrible. It's so much better with the glp. I'm not sure exactly what it was. I can still get it minorly. If I eat too late at night, then I might overnight notice it, but very mildly. But I used to, like, I used to be. It was constant for a while. Like, I was taking something to try to, like, you know, quell it for quite some time. So that's interesting. Okay. Anything else? Sorry.

[B]

I'm also much more sensitive to sodium now.

[A]

How so?

[B]

Extra water retention. I've heard you talk about this when you're doing your segments on how's it going with your GLP1 and extra sodium scale goes up for a couple of days.

[A]

Okay. Yeah. You had chicken wings. I tried chicken. Every time I tried to eat chicken wings, I gained water weight. It's crazy. That was pretty common for me to begin with. So that's just one of the things that hasn't gone away. Gone away. I'll tell you the glp, where it's helped me recently is that I've been traveling more. So I did a cruise with a bunch of listeners and I was on, you know, I was on the ship for six days. Five, six days. I was very busy. Like, super, super busy. I just didn't have a ton of time. It's going to sound crazy if you're not in my situation, but, like, you know, when you're just on the cruise, you live your life. You eat, you go to the bathroom and you go to the bathroom, et cetera. When you have no free time during the day, you actually do eat so that you won't be in a situation where a bathroom visit is a surprise. Does that make sense? Like, so a hundred percent? Yeah, yeah, yeah. So you, like, you probably know, you go on work trips and stuff like that. Like, you get up in the morning, it's more like, oh, I'll have some fruit. I'll have an egg. I'll have this. Like, you kind of like, I was eating, like, hard Boiled eggs for my protein, chicken for my protein. More lettuce, like, than I normally have, a little more fruit than I usually have. Like, I was simplifying my diet so that I could decide when to use the restroom. Like, simple, right? But what made it easy was that I was never hungry the entire time I was on that ship. Now, what made it difficult was, is that part of me being on the ship was that I had two dinners a night because it was my goal to have dinner with everybody that was there. So I would have, like, a 5pm dinner with 10 people and a 7:15 dinner with 10 people. And I was already exhausted. Like, so there was so much talking and I was already beat and everything. But the menu would come, and I eventually got, like, a rhythm. Like, this young server, she basically turned into my mom. Like, she'd be like, just get this right now, and we'll get you this the second meal. And I was like, that's a good idea. So we were, like, spreading the food out and everything. But that glp, like, I would have been voraciously hungry without it that entire time, and I still would have had to have done what I did. It's interesting how it shuts off. I don't know. It's not probably the same for everybody, but I don't get head or stomach hungry usually ever. It's very interesting. Although on day six and seven, I can eat a lot more than I can on days one through five with the injection. I don't know if that happens to you.

[B]

It does, yeah. Exactly the same.

[A]

I think it's novo. It might be Novo and Lilly, but, like, they're both trying to come up with a daily pill that replaces the injection, but still has the impact that the injection's been having for people. So I'm wondering if that will spread out the impact a little, a little better for people in the future. I don't know how long it'll, you know, if they actually work it out and get it to work and get it to market. I don't know how long something like that would take, but I'm interested in that, too. I don't mind the injection, but I want the coverage to be more even is my goal.

[B]

I'd also see the benefit for a pill would be shelf stable without refrigeration.

[A]

Yeah. Oh, do you have too much GLP in your refrigerator?

[B]

I wouldn't say too much.

[A]

Oh, no, no. You, My wife. I mean, my wife and I are using it for weight. We have it here for Arden, for, you know, you know, for, you know, what you're talking about, inflammation and blood glucose control and stuff like that. So, like, there's like a. It feels like there's a GLP section in the refrigerator. It's a little weird, actually, but okay, so the GLP has been really valuable for you. I'm looking at your notes here. Can you tell people a little bit the difference between managing with and without a cgm? How does it change?

[B]

Oh, it is a complete game changer. A good example is for a quick breakfast. Just had a frozen breakfast sandwich and I thought I was doing well with that sandwich because two hours after eating I'd be under 180. So that. Okay, I'm golden. Well, once I got a cgm, I had that same breakfast sandwich. Didn't realize I was going up over 200. So then I started taking off one piece of bread to make sure I wasn't going over 180. And I said, you know what? I can't do this. This is not healthy enough for me. Yeah. So just having that awareness of how I respond to different foods, but also knowing I better get up and take a walk or I better start pedaling on my little elliptical peddler.

[A]

Yeah, yeah.

[B]

To bring the numbers bound.

[A]

The CGM is more about you understanding how the food's hitting you and how the insulin's and. But also how the insulin's working. But what you saw first was this is not a thing I should be eating. Is that right?

[B]

Correct.

[A]

Yeah.

[B]

Yep.

[A]

How did you change. What did you do to. You didn't just keep modifying the sandwich. You changed what you eat for breakfast.

[B]

I changed. So a Greek yogurt with some low carb granola or what I did especially early on, the manjaro with the constipation chia seeds in a protein drink and make a pudding out of it.

[A]

Yeah. That's a lot of fiber, right? And womb.

[B]

Yes.

[A]

Yeah. I just went to the magnesium oxide. I also have gone through, like, seasons on the glp. My wife and I were talking about this the other day that, like, I think there's a difference between tolerating it but having side effects that are expected and having something serious happen. Like, I, I want to say there's. I think there's a difference there. But, you know, I. I've gone through GLP constipation. I've gone through glp. Like, I wouldn't call it diarrhea, but I would call it like, like, very, like, loose stool. And it's not a day or two. Like, it's a season. Like, your body is clearly adjusting to something as it goes along. At least was for me. And now I'm two years into it all. That's, like, straight now. Like, I don't have what you would call, like, distress, like, in the bathroom unless I go eat something that, like, I know I shouldn't eat to begin with. And for me, that's a lot of, like, any. Anything fried, like, crappy restaurant food, stuff like that is going to send. It's going to make my stomach go, oh, I don't know what this is, but I want it gone. And other than that, like, if I go through my normal day on that, even on the ship, like, people. I know this is crazy, but, like, I lost five pounds on that ship. And I know people like, oh, you go on a cruise, you'll gain so much weight. Like, I had to be more careful about it, and it was a little more difficult, but there was good food there. You just had to, like, you had to pick through it. Like, you know, everything's not chicken fingers and french fries if you're. If you're careful enough. And then this week at Children With Diabetes, I was in a hotel all week long, and I came back. I think I lost a couple pounds that week, too. So you can do it. You can find that food in the world. But like I say, if I just, like, I mean, I think it was a few weeks ago. My wife and I were out one day and we were both hungry and it was Saturday, so we were both at the end of our injections and everything, and we were like, oh, there's this diner we used to like to go to. We went to that diner. I'm going to tell you, like, we left that diner, went home, and an hour later I was like, excuse me, I got to go. That food did not jive with me at all. If I eat purposefully, I don't have that problem at all anymore. But there were months at a time where I was struggling with some of the side effects. But I don't know, I. The way I explain it to people is I don't know if I'm right about this, but I figured it took me a lot of years to get in this situation. It wasn't just going to change on a dime. And there was going to be some adjustments, like, literally, like, on a cellular level that have been happening. But in the end, I just. I count myself as somebody who probably just does not have enough GLP in my system without it being added as a replacement with this injection, that that's in the end what I think is.

[B]

Happening to me sounds like a fair assessment.

[A]

Good awareness, best I can do. I've been trying to pay attention. All right, so listen here. I have two things left on your list here. I feel like we've covered. We covered judgy providers, CGMs, GLPs, your DKA experience. You just say here integrative medicine experience, which I want to hear about. But then it feels like you want to interview me at the end, so we'll save that for the end. Tell me about your integrative medicine experience, though. This episode was too good to cut anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's going to be the next episode in your feed. This episode was sponsored by Touched by Type one. I want you to go find them on Facebook, Instagram and give them a follow and then head to touchedbytype1.org where you're going to learn all about their programs and resources for people with type 1 diabetes. I'd like to thank the Eversense365 for sponsoring this episode of the Juice Box Podcast and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want the Eversense CGM. Eversensecgm.com Juicebox 1 year 1 CGM Summertime is right around the corner and Omnipod 5 is the only tube free automated insulin delivery system in the United States. Because it's tube free, it's also waterproof and it goes wherever you go. Learn more at my link omnipod.com juicebox that's right, Omnipod is sponsoring this episode of the podcast and at my link you can get a free starter kit. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. My Diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference. This series is all about mastering the fundamentals, whether it's the basics of insulin dosing, adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience, and we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between episode 1000 and 1025 in your podcast player, or you can listen to [e-mail] by going up into the menu. Hey, kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the Juice Box podcast. I know you're thinking, oh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community. Juice box podcast, type 1 diabetes on Facebook. Of course, if you have type 2, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in. We'll make sure you're not a bottle or an evildoer. Then you're on your way. You'll be part of the family. Hey, what's up, everybody? If you've noticed that the podcast sounds better and you're thinking, like, how does that happen? What you're hearing is Rob at Wrongway Recording doing his magic to these files. So if you want him to do his magic to you. Wrongwayrecording.com you got a podcast, you want somebody to edit it. You want Rob.