Juicebox Podcast: Type 1 Diabetes

Episode #1624: “Nappetizer”
Host: Scott Benner
Guest: Melissa (Parent of daughter with Type 1 Diabetes and recent thyroid cancer)
Date: September 10, 2025

Overview

In this episode, Scott welcomes back Melissa, a previous guest and mother of a 12.5-year-old daughter living with Type 1 Diabetes (T1D). Melissa shares her family's journey following her daughter’s recent unexpected thyroid cancer diagnosis and treatment, discussing the emotional, logistical, and medical aspects of handling both chronic illness and cancer in a child. The discussion dives into practical tips for advocacy, medical management, and the resilience required to confront rare complications, all served with the show’s trademark warm and candid tone.

Main Discussion & Key Insights

1. Catching Up Since Last Episode

• Melissa previously appeared in Episode 879 (“Danger Noodle”).
• Life has changed dramatically; Melissa’s daughter, living with T1D, was recently diagnosed with thyroid cancer.
• “Now here I am with this cancer diagnosis that kind of took the wind out of all of our sails. But we’re doing great now.” (Melissa, 03:22)

2. Timeline of Thyroid Cancer Diagnosis and Initial Reactions

• April 2024: Endocrinologist notices thyroiditis and a small goiter during a routine T1D follow-up (04:01).
• December 23, 2024: Ultrasound reveals a suspicious nodule (04:13).
• January 30, 2025: Biopsy confirms papillary malignant thyroid carcinoma (05:10).

Notable moment:
Melissa recounts learning of the diagnosis in her car before her daughter’s 12th birthday party:

“I saw those words and just like cold went through my whole body and I’m like, oh my gosh... just whispered and I said it’s cancer.” (Melissa, 06:07–06:50)

• The parents delayed telling their daughter to protect her birthday experience, holding the secret through the weekend and telling her afterward.

3. Telling the Children & Family Dynamics

• The conversation with her daughter was emotional:

  • Daughter’s first concern—a common one for kids: “Am I going to lose my hair?” (09:04)
  • Melissa reassured her: “Nope, this is… you’re not going to lose your hair. You don’t have to do chemo or radiation…as far as we know at this time.” (09:10)

• Her older son reacted with a mix of empathy and dark humor:

  • “Why does everything always happen to you?” (Melissa, quoting her son, 09:52)

• Melissa and her husband faced the added burden of supporting each of their children differently through the news.

Quote on family resilience:

“She’s our little gypsy that takes… everything with a grain of salt, and there’s a ray of sunshine and positivity for the most part.” (Melissa, 10:25)

4. Processing a Second Major Diagnosis

• Melissa reflects on being somewhat desensitized to medical crises after years managing T1D:
  • “When you’re battling this day in and day out…here’s something else that we have to deal with.” (Melissa, 11:03)
• Early cancer detection may have been a side effect of regular T1D checkups:
  • “If she didn’t have type one, I’m thinking it could have been worse because we would have never been looking for it.” (Melissa, 12:17)
• The extremely rare overlap: “1 in 300 million for a type 1 diabetic to get thyroid cancer.” (12:12)

5. Treatment Journey and Decision-Making

Surgical Decisions

• The family opts for surgery at the Mayo Clinic, where her thyroid is fully removed (19:36).
• Initial post-surgery hormone replacement with levothyroxine, later increased to achieve optimal TSH suppression (19:36, 20:21).

Thyroid Cancer in Children & Prognosis

• Prognosis is generally excellent.
• “It has like a 98% survival rate even when it’s in the lymph node system.” (Scott, 13:52)
• Importance of continuing to monitor: bloodwork and ultrasounds every 6–8 weeks (35:08).

Advocacy Tip:

Melissa urges parents:

“Just have your endo check your thyroid… it’s a simple ultrasound.” (Melissa, 13:55)

6. Radioactive Iodine (RAI) Therapy: To Treat or To Watch?

• Next step after surgery could be RAI, but due to the long-term risks (secondary cancers, fertility issues, impacts to salivary glands), Melissa and her husband decide on “watchful waiting.”

• Importance of patient-specific decision-making, especially with young children:

  • “I get it. If she was a 60 year old woman with thyroid cancer, fine, give her some, you know, nuclear medicine. But she’s a 12 and a half year old.” (Melissa, 38:46)

• The family learns an “uptake scan” can provide more info before needing to commit to RAI (40:32).

• Isolation protocols for RAI treatment would complicate T1D care:

  • “When you take that pill, you’re literally radioactive . . . what if she goes low in the middle of the night?” (Melissa, 43:33)

7. The Hospital Experience & Navigating Systems

• Mayo Clinic praised: “The people at Mayo were almost as nice as like the Disney cast members.” (Melissa, 21:35)
• Detailed recount of the surgery day, parent anxieties, and communication missteps—being led into a private room before hearing the good news (58:19–63:49).

Memorable exchange on stress:

Scott: “Between the two of you, you’re like a dog that just got out of the bath.” (60:26)
Melissa: “Exactly.” (60:30)

8. Support Systems & Community

• Intensive local and community support, including events and T-shirts (“We Play For Reece”) (33:14).
• Emotional exhaustion for the whole family, including “compassion fatigue” from having to relay updates constantly (54:48).
• Community fundraising helped offset massive medical costs—first hospital bill for the overnight stay alone was $54,000, plus $10,000 for the surgeon (56:24).

9. Life After Cancer: Psychological & Practical Impacts

• Melissa is consciously shifting focus to self-care, relaxation, and being present with her family:
  • “I just want to be at home and chilling and catching up on shows... trying to refuel my tank.” (48:45)
• The word “cancer” comes up far less day to day as treatment recedes into the background, though the responsibility of daily medication looms (50:28).

On family perspective:

“We just deal with the hand that is dealt and move forward and figure out the best way to do it and make decisions together and keep on trucking along.” (Melissa, 53:09)

10. Type 1 Diabetes Management Amid Life Changes

• T1D care took a “half-step back” but remained a key concern. Changes in blood sugars attributed mostly to puberty and growth rather than thyroid surgery (65:11–66:23).
• Continual need for adapting insulin ratios and food boluses as daughter discovers new favorite foods (Greek yogurt and granola).

Notable Quotes & Memorable Moments

• On breaking the news: “It’s one of those like negative core memories for me on this ride… I just whispered and I said it’s cancer.” (06:48)
• Sibling support: “Why does everything always happen to you?” (Her son, via Melissa, 09:52)
• Perspective on rare outcomes: “I almost felt like, should I be reacting more to this?” (11:03)
  “If she didn’t have Type 1…I’m thinking it could have been worse.” (12:17)
• On watchful waiting vs. RAI: “It was just the cons far outweighed the pros for me… if we are on what we need to be on consistently and watching.” (44:00)
• Community: “If you have a good support system, you can definitely get through anything.” (Melissa, 54:41)

Important Timestamps

• 03:00: Melissa recounts the prior episode and summarizes changes since
• 04:01: Timeline begins – thyroid issue discovered
• 05:10: Biopsy confirms malignancy
• 06:48: Emotional moment—telling her husband the news
• 09:04: Telling her daughter, first reaction about hair loss
• 12:12: Discussion of rare overlap T1D & thyroid cancer
• 19:36: Surgery decision and journey to Mayo
• 30:13: How the medical team communicated urgency (or lack thereof)
• 35:08: Decision to “watch and wait” on RAI
• 43:33: Concerns about managing diabetes during isolation for RAI
• 54:41: Reflections on community support
• 56:24: Breakdown of medical costs
• 63:36: Relief when hearing her daughter’s vocal cords were undamaged post-surgery

Practical Takeaways

• Advocate for comprehensive endocrine checks in children with T1D. Regular thyroid palpation and ultrasound can identify rare but serious comorbidities early.
• Be aware of medication specifics post-thyroidectomy. Target TSH in cancer survivors is much lower than for the general population.
• Cancer in childhood, especially alongside chronic illness, brings unique challenges. Emotional support and clear communication with medical providers are crucial.
• Radiation-based therapies (RAI) may not be necessary in all pediatric cases and carry long-term risks. Shared decision-making is key.
• Build a strong support network. Community and family aid can make a tangible difference, both emotionally and financially.
• Be gentle with yourself. Parenting a child with complex chronic illness and a cancer diagnosis requires immense adaptability, and it’s normal for self-care and routines to shift.

Episode Tone

Conversational, supportive, often humorous and candid—even when confronting serious challenges. Scott provides empathy and comic relief, while Melissa offers honesty, vulnerability, and practical wisdom from experience.

Suggested Next Steps

• If you or your child are managing T1D, discuss thyroid monitoring with your endocrinologist.
• Advocate for comprehensive, child-specific care and ask about best practices specific to your situation.
• Seek community—whether local, online, or through programs like those highlighted by Scott.

For More Information

• Visit juiceboxpodcast.com for show notes, resources, and the Diabetes Pro Tip series.
• Melissa recommends persistence and clarity when asking for specific medical tests or follow-ups, even if the situation is rare.

“We just deal with the hand that is dealt and move forward.” – Melissa (53:09)