#1630 Tilt-A-Whirl

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1630 - "Tilt-A-Whirl"

Host: Scott Benner
Guest: Gabby
Date: September 17, 2025

Episode Overview

This episode features Gabby, a 28-year-old Pilates instructor and dancer living with type 1 diabetes since the age of two, along with ADHD—a central theme of the conversation. Scott leaves the episode largely unedited, intentionally preserving Gabby’s natural pauses and thought processes to shed light on how ADHD impacts diabetes management, daily life, and overall mental health. Together they explore Gabby's history of seizures, struggles in college, the compounding effect of ADHD, challenges with insulin technology, and the emotional toll of managing a complex chronic illness.

---

Key Discussion Points and Insights

1. Gabby’s Background: Life with Type 1 Diabetes and ADHD

• Gabby (28) diagnosed with T1D at age 2.
• Works as a freelance fitness instructor and kids' dance teacher.
• Recently diagnosed with ADHD, takes Concerta but is unsure of its efficacy.
  • “To some extent, yes,” (Gabby on feeling ADHD symptoms all her life, 30:38)
• From a family with a complex structure and history of anxiety and ADHD—mom and sister similarly affected.

2. Fear of Lows and Seizures

• Lifelong pervasive fear of hypoglycemia (“fear of lows”—08:23).
• Gabby has had more than a dozen hypo seizures, mostly as a child during sleep before access to a CGM.
  • “Too many to count.” (Gabby, 08:45)
• Did not get a CGM until about 2018 despite long history of severe lows.
  • “It’s so crazy to me that you’re having all those seizures and nobody’s [suggested CGM].” (Scott, 21:45)
• Seizures continue to occur, though less frequently, largely attributed to rapid drops and complexity of self-management, especially during periods of stress or unstructured schedules.

3. Challenges with Technology and Site Management

• Gabby uses a Tandem Mobi (pump) and Dexcom G6 CGM, previously used Medtronic and manual pumps.
• Difficulty with site absorption and timing—especially on thigh sites, possibly due to muscle mass and activity.
  • “After the second day, it’s just like, nope, we are done.” (Gabby on thigh infusions, 09:19)
• History of disconnecting pump during dance in childhood, per earlier provider’s advice; later, adult providers discouraged this practice.

4. ADHD’s Impact on Diabetes and Daily Life

• Recent ADHD diagnosis has led to new insights on how attention and executive dysfunction affect her diabetes management.
• Medication (Concerta) helps somewhat, but she’s considering a higher dose or alternative (e.g., Vyvanse or Adderall).
  • “Sometimes it feels like [Concerta] pulls at least 10 of [20 things] together… so the one thing… can actually be done.” (Gabby, 28:49)
• Structure (like school schedules) helped in youth, but less so with adult freelancing.

5. Emotional Toll: College Years and Mental Health

• College years marked by poor blood sugar control, high anxiety, panic attacks, and feelings of defeat.
  • “My whole life feels like all the time [I’m] just trying to stay alive. You don’t even have time to think about, like, how could I stop this from happening?” (Gabby, 23:49)
• Lack of medical support/tools resulted in self-blame and feeling unsupported, despite strong personal effort.
  • “I was trying constantly and not set up for success and not… fully supported.” (Gabby, 23:04)

6. Gabby's Service Dog and Family

• Got a diabetes alert dog a year ago due to ongoing fear of lows and seizures.
• Support system includes a much older father (age 82), a mother and siblings with ADHD/anxiety, and a partner of 5 years (age 35) who also has diabetes (possibly LADA).

7. Evolving Relationship with the Podcast & Community

• Initially found listening to the podcast emotionally difficult due to resonant stories about childhood or severe lows.
  • “[Some episodes] would make me just sit down and sometimes just cry.” (Gabby, 39:04)
• Now listens daily while doing chores—has worked through the initial emotional triggers.

8. Navigating Healthcare and Self-Advocacy

• Gabby is preparing to see a new primary physician and has been advised to document symptoms and needs due to organizational challenges with ADHD.
  • “You would benefit from writing down your thoughts, loading them into ChatGPT, and saying, ‘Hey, can you turn this into a document…’” (Scott, 70:35)
• Considering testing for hypothyroidism due to recent fatigue and physical symptoms.

9. Future Strategies Suggested

• Scott strongly advises Gabby to seek better ADHD management as a prerequisite to more effective diabetes care.
  • “You need somebody without ADHD to help you… Seems like most of your issue.” (Scott, 47:02)
• Discussion about GLP-1 medications as a possible avenue (though likely only worth exploring if insulin resistance/weight a major issue).

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Notable Quotes & Memorable Moments

• On ADHD and Diabetes:

  • “It feels like if you put me in [a Tilt-A-Whirl] and started asking me how to bolus for pizza… I feel like you're always in a state of being shook up.” (Scott, 48:51)
  • “It’s just because… it’s like nail on the head.” (Gabby, 49:29, moved to tears by Scott’s summary)

• On Self-Blame & Support:

  • “I was trying constantly and not set up for success and not… fully supported.” (Gabby, 23:04)
  • “My whole life feels like… just trying to stay alive…” (Gabby, 23:49)
  • “Lots of my human work is undoing that… My brain would go, ‘Oh, I’m so stupid.’” (Gabby, 32:06)

• On Family Patterns:

  • “My mom, like, 100% is exactly the same as me and my sister… She just does what I do now.” (Gabby, 33:07)
  • “Sticky notes are my best friend.” (Gabby, 55:04)

• On Navigating the Medical System:

  • “You, of most people… would benefit from writing down your thoughts, loading them into ChatGPT, and saying… ‘turn this into a document’…” (Scott, 70:35)

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Important Timestamps

• 03:17 — Gabby introduces herself, shares age and diagnosis history
• 08:23 — Gabby’s first reaction to life with T1D: “Fear of lows.”
• 08:43–09:01 — Discussion of hypo seizures and early diabetes management, lack of CGM
• 13:09–16:19 — Detailed talk on pump sites, body image, and managing infusion sites as a dancer
• 23:04–24:27 — Gabby describes overwhelming, unsupported attempts at managing diabetes in college
• 30:34–31:33 — Late diagnosis of ADHD and how structure masked symptoms
• 34:55–35:40 — Family history of anxiety and ADHD
• 41:03–43:26 — Recent seizure explained; accidental over-bolus at night due to pump error
• 47:02–48:51 — Scott underscores ADHD’s central role in Gabby’s management barriers, introduces the Tilt-A-Whirl metaphor
• 49:29 — Emotional reaction: Gabby tearfully acknowledges how well Scott understands her struggles
• 53:01–54:54 — Conversation about ADHD medications and switching/side effect management
• 66:16–69:16 — Gabby wonders if she is hypothyroid; discussion of symptoms and testing plan
• 70:35–71:13 — Scott advises strong documentation/self-advocacy for upcoming medical visits

---

Additional Notes & Tone

• Tone: Warm, open, occasionally self-deprecating and humorous—Scott and Gabby balance vulnerability with wit, frequent laughter even while unpacking heavy issues.
• Episode Theme: Deep dive into the lived experience of managing type 1 diabetes with comorbid ADHD, emphasizing how executive function and focus are essential (and often overlooked) tools for chronic illness self-management.
• Memorable Episode Title:
  • “Tilt-A-Whirl” as the metaphor for Gabby’s ever-spinning, hard-to-navigate mental landscape.

---

Actionable Advice/Takeaways

• For Listeners with Similar Struggles:

  • It’s critical to address comorbid ADHD with your healthcare team if it’s affecting diabetes management.
  • Advocate for yourself: write things down, prepare notes, consider using digital tools to summarize symptoms for doctors.
  • Don’t accept feeling unsupported; better tools and strategies exist, but sometimes require persistent self-advocacy.

• For Medical Providers:

  • Listen deeply to the patient’s context (pauses, hesitations), not just the bullet points.
  • Structural interventions—like help with organizational strategies—might be as important as medication.

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Listen to the original episode for the full, unfiltered conversation: JuiceboxPodcast.com

Transcript

[A]

Hello friends and welcome back to another episode of the Juicebox Podcast. All right, Rob, so a couple things happened during this one that are going to make me tell you this. This girl has adhd. She has long pauses and gaps. Normally we would take them out. I want to leave them all in because they help tell her story. They help people to understand how her thought process goes and where it might impact her diabetes and her other care. As a matter of fact, use this as the voice note to open up the show so that the people listening know that normally we would tighten this up, but so that they can really understand Gabby, we're going to leave it all just as it was recorded. Bye Rob. Oh and bye everybody else. I hope you enjoy the podcast. If this is your first time listening to the Juice Box Podcast and you'd like to hear more, download Apple Podcasts or Spotify. Really any audio app at all. Look for the Juice Box Podcast and follow or subscribe. We put out new content every day that you'll enjoy. Want to learn more about your diabetes management? Go to juiceboxpodcast.com up in the menu and look for Bold Beginnings, the Diabetes Pro Tip series and much more than this podcast is full of collections and series of information that will help you to live better with insulin. 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 healthcare plan or becoming bold with insulin.

[B]

Foreign.

[A]

The show you're about to listen to is sponsored by the Eversense 365. The Eversense 365 has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com Juicebox this episode of the Juice Box Podcast is sponsored by the Omnipod 5 and at my link omnipod.com juicebox you can get yourself a free Free what'd I just say? A free Omnipod 5 starter kit. Free. Get out of here. Go click on that link omnipod.com juicebox check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox links in the show notes [e-mail] this episode of the Juice Box Podcast is brought to you by my favorite diabetes organization, Talk Touched by Type 1. Please take a moment to learn more about [e-mail] on Facebook and Instagram. Touchedbytypeone.org check out their many programs Their annual conference awareness campaign, their D box program, Dancing for diabetes. They have a dance program for local kids, a golf night, and so much more. Touched by type1.org you're looking to help or you want to see people helping people with type one. You want touchbytype1.org.

[B]

I am Gabby. I'm. How old am I? I'm 28. I was diagnosed when I was two. Okay, and that's good.

[A]

That's a good start, Gabby. Also, the editor is going to like. When you hear it back, you're going to be like, I'm Gabby. I'm 28, and I was diagnosed when I was 2. And you'll be like, oh, my God. I don't remember being that clear and concise.

[B]

Amazing.

[A]

Yeah. And don't worry, you'll get. You'll get more comfortable.

[B]

I wish life could do that.

[A]

You would like an editor to walk around with you.

[B]

I would love that so much.

[A]

Okay, so now that we've said that, I'm going to tell Rob right here. Don't edit the way Gabby said it. Leave that there, and now edit it again so people can hear what it could sound like if you edit it together. Rob, you know what I'm saying? Do that. Like, let them hear her, and then let them hear what an edit would sound like. Then we'll go into it.

[B]

Here I am, Gabby. I'm 28. I was diagnosed when I was 2.

[A]

So you wish somebody could walk around with you and just take all the pauses out?

[B]

Yes. All the time or. A lot of my work is saying words that are supposed to make sense together in real time.

[A]

Wait, what kind of work do you do?

[B]

I teach Pilates and kids dance.

[A]

Is there a job where your words don't have to make sense together? I guess there are some, right?

[B]

Sometimes not live, at least.

[A]

Oh, I see what you mean. Like, so you have to feel smooth when people are listening to you right away.

[B]

Yeah. Like it's happening.

[A]

I feel like I'm a fairly smooth speaker. And yet sometimes I hear myself back and I'm like, oh, my God, Scott. Like, get to it. Or like, there were six different ways you could have said that. That would have been better. You know, sometimes you just get stuck with what comes out of your mouth.

[B]

As much as you do. How can you expect everything to go right?

[A]

I don't know. There's times when it does. There's. Sometimes I get done. I'm like, that was good. Actually, I think since I know Rob's listening closely to this one now, I actually Think, like, there's not a lot of work in here for Rob. I bet you this one will be easy for him. But then there's others where I get done, and I'm like, oh, poor Rob. That's not going to go well at all. You know? And he's thinking that right now because you said about pausing. He's like, oh, God, I hope Gabby doesn't pause between every word for the next hour.

[B]

I think.

[A]

I know he's laughing right now, listening to this, because he's like, I am absolutely thinking that. Nevertheless, Diagnosed when you were two years old.

[B]

Yeah.

[A]

And you're 28 now.

[B]

Yep.

[A]

Do you have any kids of your own?

[B]

Nope.

[A]

No. Are you anywhere near making a baby?

[B]

No.

[A]

Good for you.

[B]

That's why I giggled, because I was like, that's terrifying. Actually.

[A]

Is having a baby something you've ever thought of?

[B]

Yes. And then I just recently definitely was like, huh. I guess I am 28.

[A]

What's terrifying about it?

[B]

That I'm a freelance, like, fitness and dancer and have no money.

[A]

Listen, that. That should be.

[B]

That's the main thing.

[A]

Yeah. That's definitely your biggest fear. It's very expensive to have kids. It's insane. Yeah, yeah, yeah. Are you with somebody?

[B]

I am. I've had a boyfriend. Partner for, like, as of a couple weeks ago, like, five years.

[A]

Has he ever mentioned, hey, Gabby, are we going to get married or make a baby or anything like that?

[B]

Yes. And baby, like, very much not at all.

[A]

That's not a thing. He's that interested in current, if that makes sense. Oh, does he have a good job?

[B]

Yes, but not that he, like, loves and wants to be at forever, a long time.

[A]

Oh, you can tell him that's how everyone feels.

[B]

Yeah, right.

[A]

I love. What I heard my son say, I don't love this. And I was like, wait, what? You thought somebody loved their job? Stop it.

[B]

I know. Well, I do, but then I burn myself out.

[A]

So you love your job, but you also said it doesn't pay very much, I mean, in the grand scheme to pay for a baby and stuff like that.

[B]

Yeah.

[A]

Is there pressure when you're a lady to think, like, I have to be able to take care of this kid in case that guy flakes on me?

[B]

I mean, that's always a possibility, right?

[A]

Oh, did I just, like, add another concern to your life? I'm sorry.

[B]

No, no. I was gonna say maybe from my childhood, but that's not actually true. Like, my parents divorced, but not for that reason.

[A]

Yeah. I just wonder, like, I mean, I Think if you took a hundred guys and 100 girls who didn't have a kid and said, hey, if one day you have a child and you become divorced, who do you think will get the baby? I bet you most people would say, I think the mom would.

[B]

Yeah.

[A]

And so, you know what I mean, Laws and stuff.

[B]

Or not laws, but most law orienting people would say that too.

[A]

Did you say law orienting people?

[B]

Yes, I did.

[A]

Can we call the episode that, do you think?

[B]

No. There has to be something good.

[A]

I hope you don't say one thing more ridiculous than law orienting people.

[B]

I'm sure there'd be, like, a hundred more ridiculous things.

[A]

All right, we'll get to it then. If I asked you what it was like to grow up with type 1 diabetes, what are the things that pop into your mind first?

[B]

Fear of lows.

[A]

Yeah.

[B]

Yeah.

[A]

Since you were little.

[B]

Yes.

[A]

What are your. Did you get low a lot? And do you still.

[B]

I have had a lot in, like, the whole 26 years of hypo seizures.

[A]

Oh, you've had multiple seizures?

[B]

Yeah. Like, too many to count.

[A]

More than a dozen.

[B]

Yes.

[A]

How do you feel like that happened, like, so, I mean, you were born, what, 96. 96. So do you have a sensor, a CGM right now?

[B]

Yeah. I am currently wearing a G6. And then I am truly changing my new ish tandem Moby.

[A]

You're changing it right now? While we're talking. Yeah, it ran out of insulin.

[B]

It did not run out, which is a thing that I'm, like, working on in life to not have that ever, but it didn't at all. And it still has, like, 15, 14, something left. However, my sight was on my thigh, and I am learning that after the second day, it's just like, nope, we are done.

[A]

So you're starting to see a high blood sugar from your thigh site?

[B]

More than starting.

[A]

Oh. Oh. So why'd you put. You knew we were gonna do this. Why'd you put it off all morning? Let me act like your dad for a second. Why didn't you do it earlier?

[B]

Act like your dad. That's hilarious. Because I was taking my dad to his doctor.

[A]

Oh. Oh, your dad needs help. He's not the one helping.

[B]

No, not anymore.

[A]

Sorry.

[B]

All's been reversed a little bit.

[A]

Your roles have been reversed.

[B]

Yeah.

[A]

Seriously, though, like, you were out this morning doing something.

[B]

Yeah, and the horribly. Purely opposite of any version of any morning person at all. And yet we were at the doctor at 10:30.

[A]

Yeah. I have to tell you, I do notice that People I record with who want earlier times are sometimes more energetic people. Even when I, like, I recorded this morning at nine. And not. Let me be clear, nine is not early. But that's the earliest you can get on my schedule. Right. And I sat down, I was like, I don't even know if I'm awake yet to do this. And I popped on and the person was just full of life. And I was like, oh, my God, you morning people are something. Yeah. Yeah. And I don't. I'm. I get up early. Like, I don't. I'm not a. Like a late riser, generally speaking. Yeah, you're not me, but I don't pop up, like, full of, like, exuberance. Like, I. I'm happy to be awake and see the, you know, see the beginning of the day and everything, but I'm not out there looking to, like, run a marathon or record a podcast or something like that. Yeah.

[B]

Anyway, I was going to say you need your coffee, but not actually, you need your AG1 or something, right?

[A]

Yeah, I don't drink coffee, so that's not helpful.

[B]

Are you still doing AG1?

[A]

Yes. Yeah. But I don't drink coffee. And I do see people, like, supercharge their lives with it, and I'm like, maybe one time I should. I just don't. It doesn't SM good to me. It doesn't. I can't imagine it tastes good. I don't know. Anyway, it freaks me out that, you know, I don't drink coffee. Such a weird thing.

[B]

I mean, a lot of people know a lot of things about you.

[A]

I know. But when you're faced with it one on one, it's strange. It's an abstract when you just sit down and record and say stuff you don't actually like. It's not like I. I walk outside and the thousands of people that just listen to it walk up to me and say, guess what I learned today? Like, it's not until, like, you go online and you see people talking about it and you're like, oh, okay, guess somebody heard that. That makes sense. But even that's. It still remains a little abstract, you know, like, but you and I are now talking, and you're just like, oh, you don't drink coffee. And I'm like, how does she know that?

[B]

Yeah.

[A]

So nevertheless, you didn't change your pump. You knew you should have earlier because you saw the cycle in bed. It happens mostly on your thighs.

[B]

It just has happened, like, the same thing, like a week or a week and a half ago.

[A]

Okay.

[B]

Like literally on the same thigh, a little bit higher or lower. In which I had a really horrible night and I didn't even quite piece it together. Like, it didn't necessarily have an exact. Like. All right, it's two days and we're done.

[A]

Yeah. You didn't see cause and effect right away, but. But you're a dancer, you said. Right. And you're doing Pilates. Do you have like, strong thighs?

[B]

Yeah.

[A]

Yeah, I think. Well, maybe it's like. Yeah. Close to a big muscle. Like, there's reasoning behind that. Like, do you. Using the top of your thighs or the sides.

[B]

Might be weird, but like almost inner.

[A]

Okay. Because there's more.

[B]

Yeah. I don't know. I feel like it's less muscly. Muscly. Which maybe isn't even true, so.

[A]

Well, what other sites have you tried? Have you tried like the, like your hips, top of your butt?

[B]

What have I not tried? It's been 26 years.

[A]

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[B]

Yeah, well, actually, when I was. So I started pumping when I was, like, 10 with, like, you know, manual, of course. And because back then, I was, like, in a ballet class every night wearing nothing, basically, I put that pump with the site that I would only leave on. Yeah. Lesson learned. Much, much, much, much, much later, that site would sit, like, on either hip, and that was my rotation.

[A]

Hip, hip.

[B]

Yeah. So that then it could just have the teeny, tiny sight part without the pump. When I had, like, just ballet tights and leotard.

[A]

I see.

[B]

And it was semi invisible.

[A]

Yeah. You were trying to hide it.

[B]

Yeah, a little bit. But also it just, like, was more comfortable with everything with, like, that, like, leotard. But then how we, you know, put our leg over our head.

[A]

Were you disconnecting to. To dance?

[B]

Yeah, from, like, then. From, like, 10 till, like, pretty much, like, 20.

[A]

Okay. And then what happened at 20?

[B]

I accepted the learning. I was in college dance, so I was still doing all the things, but then it was even more all the time and not, like, uneven in class. And also new doctors as adulting started who were like, you can't do that.

[A]

You have better expectations for yourself.

[B]

I was told I could.

[A]

Yeah. So somebody at some point when you're a kid was like, well, just disconnect for dancing. But then your blood sugar would get high.

[B]

Oh, it wouldn't even. No, I would still go low.

[A]

It would get low still.

[B]

Yes.

[A]

Interesting.

[B]

Absolutely. I would be sitting, not sitting. I would be standing, sweating, shaking, because we're, like, working hard. But then, I mean, not every day or anything, obviously, but, you know, just how lows happen. I would be, like, doing a ballet class combination, and it's like, okay, a combination takes, like, a minute, and then you have the next one in the next minute, and there's like, pause, go, pause, go. So I would stand there Thinking like, I think I'm going low.

[A]

And then you just go, exert, go exert yourself.

[B]

Am I going low?

[A]

Yeah. And then. But you still kept exerting yourself and going, yeah.

[B]

So I'd be like, okay, I don't know. So maybe I'll do this one. And then maybe if I know I'm low, then I'll go, okay.

[A]

Have you ever had a seizure at dance class?

[B]

No.

[A]

No. Where do they. Where did they normally happen?

[B]

In all of childhood, it was always in sleep.

[A]

Okay.

[B]

Night. And my last one was even though I woke up right before it. But others besides last one, like more recent than childhood, have been.

[A]

Just all different, different times. So when you were a child and having them while you were sleeping, did you. You did not have a CGM at that point or you at some points didn't. At some points didn't.

[B]

I didn't get a CGM until like so recently.

[A]

Really?

[B]

Life would have been so incredibly different.

[A]

Wait, how long ago did you get it?

[B]

I think I. Something around like 2018.

[A]

Okay. And that's. Does that kind of line up with you becoming more mature and trying to take better care of yourself or did it line up with you getting insurance or what was the.

[B]

Oh, it was just literally like doctors were like, here, try this. And I was like, cool, you were up for it. It was not presented to me before.

[A]

You look back and think of yourself as having good health care and like forward thinking doctors before or. No.

[B]

Forward thinking. I don't know. Good. Yes. In general, there is one nurse practitioner who, like, I have not seen her in years. And to this day I have, like passionate loathing for her.

[A]

Why? What did she do to you?

[B]

She just really wanted me on the newer Medtronic. And you just didn't want to, quote, tried.

[A]

What do you mean you tried? You didn't really try?

[B]

No, I mean I used the pump for sure. Like, I used that pump for I guess, four years or more.

[A]

Okay.

[B]

But their sensors in like 2018ish were not what they. I guess maybe hopefully are now.

[A]

Yeah. But 20. Did you say 2018?

[B]

Yeah.

[A]

So what I have in front of me is right. And I don't know if it is or not, but I use the Internet. It looks like Dexcom had the 7 Plus in 2009.

[B]

7 Plus?

[A]

Yeah. Then in 2012, the G4 Platinum, then 2015 the G5, then in 2018 the G6 and 2023, the G7. It's so crazy to me that you're having all those seizures and nobody's crazy. Yeah. That somebody didn't say, like, hey, have you tried one of these CGM things?

[B]

Yeah.

[A]

Did they know you were having seizures or did you not tell them?

[B]

No, no, they definitely knew. I mean, I definitely didn't tell them.

[A]

About a couple, but there were so many. You felt like you could hold a couple back for yourself a little bit. What do you. In hindsight, why do you think you had so many seizures?

[B]

They were always incredibly fast, crashing and just the worst combination of all of the million variables.

[A]

But structurally, what do you think? Let's go back into the middle of a day. Did you eat before dance class? Maybe you ate bolus, then went to dance, took off the palm. The exercise, you know, combined with the active insulin, made you low at dance. Then, you know, you addressed it, went home, ate again. Right. Bolused again, and then maybe had, like, a latent low overnight from all the activity. Is that possibly how it went?

[B]

Yes. I mean, that is the likelihood of, like, much earlier in college years, which is like, 2014-18.

[A]

Did you ever try to break that down while it was happening, or were you just like, oh, this is like, my lot in life. How did. How did it feel to you?

[B]

It felt like I was trying constantly and not set up for success and not, like, completely fully supported.

[A]

Not supported.

[B]

Doctor, nurse, team.

[A]

Yeah. Not supported with information and tools.

[B]

Yeah. And technology.

[A]

And technology. Okay. It's so.

[B]

I only know that in hindsight.

[A]

Yeah, no, I understand. But during. During that time. Listen, Gabby, if we all knew everything while it was happening, life would go much easier. But while it was happening, were you trying to make adjustments to what was going on, or were you so busy just staying alive that it felt like. Like, you know what I mean? Did I feel like you were drinking from a fire hose and you couldn't keep up and you were just trying to your head above water? There's a lot of.

[B]

My whole life feels like all the time.

[A]

Oh. Oh, I'm sorry. There's, like, so many metaphors in there. I confused myself. So that's it. Like, it's happening so quickly. You're just trying to stay alive. You don't even have time to think about, like, how could I stop this from happening?

[B]

Yeah. Like, I feel like I always was thinking about and was trying to and was, like, adjusting and checking, like, a million times a day.

[A]

Yeah.

[B]

Like, I had really terrible college time. Blood sugar, like a lot of humans, but none of the, like, oh, I'll just pretend I don't have it.

[A]

You're having Bad outcomes during college. And trying.

[B]

Yes. Like, trying so hard.

[A]

So defeating at least some of the other people's stories are just like, I don't know. I didn't really pay that close attention. You're like, well, all right. Well, that makes sense. Yeah. So it's heart a little heartbreaking then?

[B]

Yes, absolutely.

[A]

Yeah.

[B]

There's have been a lot of, like, not even. Besides just, like, tears, like, anxiety attack.

[A]

Panic attacks, like, mental health stuff.

[B]

Dad? Yeah.

[A]

Did you say Dad?

[B]

I said bad.

[A]

Bad. I was like, oh, God. Are we gonna, like, loop your father into this too? So you have a lot of. Do you. Would you call yourself an anxious person?

[B]

A little bit. Not, like, terribly in general.

[A]

Okay. But this whole process, I would say.

[B]

I had a really terrible season of life with very, very, very bad low anxiety and just anxiety in general about, like, everything in relation. Like, literally seeing an ambulance on the street.

[A]

What time of your life was that? Season?

[B]

That was basically during college.

[A]

College.

[B]

Or like, one of the years that was somehow the worst, especially because of a couple times during those, like. I mean, it was only. I don't know, it was probably three in those four years that. That. Oh, my God. Brain. Brain, brain.

[A]

Three or four times in those years that.

[B]

That I had a seizure, like, three times or something.

[A]

Okay, when's the last time you had one?

[B]

And you're not helping my track.

[A]

I'm sorry.

[B]

Last time. It's fine. I know how you go to. What? I know how you go to. Last time was June 15th.

[A]

Okay. Explain the ADHD to people. What. What's happening right now?

[B]

That my brain has a sentence and then just completely loses it.

[A]

And then while you're looking for it, I'm trying to get you to, like, refocus, and it's. It's less than helpful. It's not helpful when I do that.

[B]

Sometimes it is, but then you ask something different.

[A]

That's because I get. I get bored waiting for your answer. That's what I do, too.

[B]

I'm like, that's how it works, too.

[A]

I'm like, oh, this took so long, I don't even care.

[B]

Ye.

[A]

I'm not doing that.

[B]

How my brain does it too.

[A]

I'm definitely. I'm not doing that. I'm just trying to find ways to help you get to what it is. But I don't want to hinder you and make it worse either. Do you take anything for the adhd?

[B]

So I do, and I'm not confident that it's super helping.

[A]

What are you taking, Vyvanse?

[B]

No, I'M taking concerta.

[A]

Okay.

[B]

At like, a medium dose. And I felt it very strongly at first. Like, an hour after I would take it, I would be like, oh, okay, we have energy. And that means that I am not going to be the inattentive version of ADHD and, like, stare at a wall for 30 minutes. So since I've just been on it for a while, I think my body just feels used to it. Like, too much.

[A]

It's not helping.

[B]

Yeah. So I don't know if I want to pretty much, like, ask for higher or something totally different. For what.

[A]

So explain to people there's. There's times during ADHD that you're inattentive and so you just can't focus on anything. So you stare. Is that the kind of the idea?

[B]

Yes.

[A]

Okay. And there are times where the met. When the medication's helping you. What? You've got, like, crazy energy and you're super focused and kind of have, like, that. What do they call that? Like, you have a lot. You have a lot of cocaine kind of conversations. You know what I mean? A lot of big ideas, can't stop talking, that sort of stuff.

[B]

Not quite.

[A]

Okay.

[B]

It almost feels like the medication when it's, like, energy, but in a good way for the start of the day, too. It almost feels like if I have 20 things floating around my head, it pulls at least 10 of them together so that they either can, like, be what we need them to be, or they can be, like, put on a shelf so that the one thing that we need to be or do or whatever can actually be done.

[A]

Is that a thing that a therapist has explained to you? A thing that you've experienced? But. No, but you're. You're making it up. But you're making it up, like, from your experience, though. Yeah. So this is how it feels to you? I would have trouble putting anything that concrete to any of my actions. I'm guessing that this is a thing that you've lived with for so long that you really have a very intimate understanding of how it works.

[B]

Yes. And though so long without any diagnosis or anything. Until very recently, really. Yeah. So I feel like I understand it in just how I am, and it wasn't necessarily like. I mean, it did feel like there's something wrong with me prior, but not, like, one thing. It was just like, oh, I'm stupid. Oh, I'm, like, failing at this. Oh, I'm forgetful. Oh, I'm whatever. Scattered.

[A]

How long did you live without a diagnosis with it?

[B]

The official one was, like, a Year ago.

[A]

Oh, so you felt like that your entire life?

[B]

To some extent, yes.

[A]

Oh, I'm sorry.

[B]

But I think it also, like, hides in a lot of people, too. And, I mean, a lot of women, obviously, because, you know, the stereotype is, like, the little boy with energy, which obviously, like, literally was my brother. But I think it was truly hidden and masked and everything for me, because a lot of people. Structure. Schoolhood has the structure that essentially I need to function. I functioned so well because of the structure, and now without having pretty much any structure, I was like, oh, this is bad.

[A]

So getting out of college, you're like, well, where's. Where's the schedule? Yeah, yeah. And then. And that got you.

[B]

College was like, you have to make your schedule, but then at least, like.

[A]

It'S made once you have it.

[B]

Yeah.

[A]

My gosh, that sounds exhausting.

[B]

Yeah. And I didn't realize, like, why. I guess, for a while.

[A]

And you just assumed you weren't smart.

[B]

Not that I wasn't smart. Because.

[A]

You'Re probably doing well at school. You knew you were.

[B]

Yeah, exactly. Structure. Like, I wanted to do well. And, like, I was like, oh, try hard. And. Yeah, but. But also. Yes. Like, how I just said, like, oh, I forgot this. I messed this up. Whatever. Yes. My brain would go, oh, I'm so stupid. Blah, blah, blah. So lots of my human work is, like, undoing that sort of.

[A]

Your parents have this too. Like, how come nobody noticed this in you? Were they living with the same thing or were they not that involved?

[B]

Absolutely, they were living with the same thing. And also don't know. Meaning my mom, my dad. I don't know. Maybe. But who knows? My mom, like, 100% is exactly the same as me and my sister. And I don't know, probably still my brother. Because if you're diagnosed as a kid, it doesn't go away.

[A]

Right, Right.

[B]

She just does what I do now. Like, my brother got her a tile when they were, like, brand new so that she could find her phone and then find her keys, and he got her a keychain that says, keys I have not lost yet. Because again, she's like, the smart. Like, mostly has it together, mostly doing well and all the things, like all the degrees and all the kids. But we'll go back in the house three times to get stuff. We'll be late to everything. Like me now. And just all the little things that now she. She'll literally be like, why? And me and my sister are like, mom, there is a reason, actually.

[A]

So it's you, your sister Your brother, your mom, your dad. And you have type 1. Does anybody else have type 1 or other autoimmune stuff?

[B]

No.

[A]

Nobody. Nobody has celiac or thyroid or anything like that?

[B]

Nope.

[A]

Do any of them have anxiety?

[B]

Yes.

[A]

Which ones? Your dad.

[B]

My dad? I don't know. He was just saying how psychologists are nothing.

[A]

Wait, what was he saying?

[B]

That he just doesn't, like, believe in psychologists.

[A]

Oh.

[B]

Even though.

[A]

Do you think he has anxiety?

[B]

I think he worries sometimes more than other times.

[A]

So who else has anxiety?

[B]

My sister and my mom, for sure.

[A]

Okay.

[B]

I just reminded my dad that I have. My dance degree is also a minor in psychology. He was like, oh, yeah, I don't believe in that. Yeah.

[A]

Thanks, dad. Do you believe in the dance at least?

[B]

Yeah. No, he does at least. So that's good.

[A]

Yeah. Yeah, yeah. How do you manage to take care of your diabetes with adhd? Like, does that not make it more difficult?

[B]

Exactly.

[A]

Sorry, I. Like, I feel like I'm just here asking. I feel like I'm. I feel like I'm just here asking you questions that make you feel validated. That's not what.

[B]

No, that's correct. That's accurate.

[A]

Okay.

[B]

Because that is also why I think diabetes has been very challenging. I'm sorry. I'm laughing because I am at my dad's, since I just took him to his doctor and I just overheard him yelling on the phone to a telemarketer to go to hell.

[A]

I don't need solar panels.

[B]

Really? No, I don't think he would know what those are.

[A]

How old's your dad?

[B]

He's very old. For me, at least.

[A]

What does that mean? How old is he?

[B]

He's 82.

[A]

Your dad's 82?

[B]

Yeah.

[A]

And you're 28?

[B]

Yeah.

[A]

Hold on a second. 38. 48. 58. 68. 78, 81. Your dad. Wow. Your dad was 54 when he had you? Yeah, I'm 54 now. If I had a baby right now, I would jump out of a window. I'd be like, I can't take care of this thing.

[B]

Yeah, me too.

[A]

And I got energy. I'm up in the morning. You understand? My hair's still dark, but I would not be okay.

[B]

This is not so dark.

[A]

Are you the oldest?

[B]

No.

[A]

No. You're the youngest.

[B]

Very much the youngest of many that I haven't mentioned yet.

[A]

Wait a minute.

[B]

I mean, not that many.

[A]

Wait, wait, wait, wait, wait, wait. You have a brother and a sister you got on your. Oh. Do your parents have, like, a first family that they have too?

[B]

Basically.

[A]

Do any of those kids have autoimmune type 1 etc?

[B]

No.

[A]

Nothing. These sons of bitches just you. Okay, yeah. So your mom's the second wife?

[B]

Yes, but my dad is also the second husband.

[A]

I was gonna say, was it also your mom's second marriage? Gotcha. Is she younger than him?

[B]

Yes, by like 14 years.

[A]

Have you ever heard the phrase it's a man's world? Terrible. Like, how did you know what I mean? Like, how come your mom couldn't pull a guy that was 14 years younger than her? Not fair. Okay, so you're a late in life baby for them.

[B]

Yeah, my dad had two other kids first too.

[A]

I see. Okay. Because when you were like, I'm taking my dad to the doctor, I'm like, gez, what the hell's wrong with her father? He's his 50s and he can't like get the doctor by himself. But no. Okay, all right, that all makes a little more sense.

[B]

It's mostly his company too, and he can talk to me and admire my service dog.

[A]

And you have. Well, okay, so you have a service. How long have you had a service dog?

[B]

Like a year and a few months.

[A]

Yeah. This is the part in the interview with people with ADHD where Scott gives up on structure and just goes with it. I don't know if you guys realize that happens or not. I try so hard and then eventually I'm just like, all right, I'm just going to follow the stream of consciousness. So when did you get a service dog? I'm sorry?

[B]

Like a year and a few months ago.

[A]

What prompted you to do that?

[B]

This. The beauty's and the seizures and the fear of that.

[A]

How long you been listening to the podcast?

[B]

A while. But I don't remember exactly when I started it, but back then, while ago, I don't know, 18 or something. 20. 18. I don't know. It was hard for me to listen because. Because I would listen and.

[A]

Get mad at people very much.

[B]

No, very much. Depending what it was about. Like some was like, okay, whatever. But if it was about things that just like, I don't know, hit or about low seizures or parents talking about their kids like that lows or I don't know, random too, probably, I would have to like stop what I was doing. As you do things with podcast listening and like just sit down and sometimes just cry.

[A]

So if it hit a trigger of yours, it made you really upset.

[B]

Yeah. But then I would like, you know, move through that.

[A]

What's your trigger around parenting?

[B]

I don't know. That there's, like, one thing that I can name.

[A]

Did you feel like you weren't being helped as a child?

[B]

No, because my parents definitely also were, like, trying very hard.

[A]

Okay.

[B]

And my mom was constantly, like, definitely. There's a source of an anxiety part.

[A]

Right.

[B]

I mean, honestly, still is.

[A]

So give me an example of something you heard on the podcast that stopped you in your tracks, made you cry.

[B]

I don't know, because that would have been so long ago. Because now I listen to it every day, all the time while I'm walking my dog and cleaning the toilet.

[A]

It doesn't make you upset anymore?

[B]

No.

[A]

Okay, so you were hearing, once in.

[B]

A while, I'll get goosebumps, but that's pretty much goosebumps.

[A]

Like you're touched or. Yeah, yeah. People tell the nicest stories. It's so kind of everyone to share their life, actually. Yeah. But. Okay, so when you first started listening, there were pain points that it would bring up for you. You worked through them. That's awesome. Has your management changed since 2018? Like, I mean, what was your A1C then?

[B]

Now, I mean, it is. I'm, like, so far from where I want to be right now, but I'm so much better than then, too.

[A]

And you are. Have you had fewer seizures in the last handful of years?

[B]

Yes and no.

[A]

Why do you think you're still like.

[B]

I actually think. I don't know.

[A]

Yeah. When's the last one? Just, like, months ago, June 15th. June.

[B]

No.

[A]

Okay, two months ago.

[B]

That one. I know. Why? Actually, like, 100%.

[A]

What happened? What happened.

[B]

In my sleep? I mean, obviously I woke up, but I do not remember the sequencing. I must have been somewhat high from late snacks and such. And I gave myself through my T Slim before, where I could bolus through the pump without looking at my phone. 13 units for being what, 200? Max 300. Probably. Probably need max five units or something. I don't know how besides that. That is a fact. That happened because of the pump history, so. But I gave myself 13 units, I guess, by mistake somehow, of that number being my Max bolus at the time.

[A]

While you were sleeping. Woke up, had a high blood sugar bolus, gave yourself way too much insulin. Yeah, got super low. Woke up right before it hit you?

[B]

Yes, I woke up. And I don't know if I saw it on Dexcom or whatever, but I woke up. I turned to my partner and said, can you go get me juice? And the next story is also how he's diabetic, but so he has a cup of juice. From the night before on his side, like on his nightstand. Hand it over to me. I take the cup and place it on my nightstand. And then that was it.

[A]

You didn't even drink the juice?

[B]

No. I knew that I had to put it down somehow.

[A]

But you were pretty low. You were pretty low by then.

[B]

I needed it. And then I knew that I couldn't hold it.

[A]

How many of these seizures are because you gave yourself too much insulin over the years?

[B]

Not many. Definitely not. Never like that.

[A]

Okay, if I asked you to tell me your level of confidence with how much of these seizures are bad tools, not good direction versus just. You didn't know what you were doing. And we're just randomly putting in stuff. Can you put a finger on? I guess. What's your major issue? If. If someone said to you, hey, you've had a lot of seizures in your life, what's happening there? Like, what's the first thing you think of?

[B]

I mean, the first thing I think is that that's a really great question for a doctor that I would love answers to.

[A]

You just don't have any idea.

[B]

Yeah. And we did testing when I was like 17, I wanna say, and there was nothing. But we did all the fun, really great scans and stuff just to have a look.

[A]

Okay. But you're using a MOBI right now, so you're using control iq.

[B]

Yeah.

[A]

Okay. And besides you giving yourself a ton of insulin two months ago and getting low since you've been on control iq, have you had other seizures?

[B]

One, I think.

[A]

One. Do you remember what that one was about?

[B]

Yeah, it was also this past February. It was literally after I gave myself one unit. Like, what?

[A]

And you just got low afterwards, huh?

[B]

One.

[A]

Going back to the last one. Oh, no.

[B]

GOMP site at like a different time. And.

[A]

Yeah, finish that thought. Why would that impact.

[B]

Was that I got up early to go to my early day work to teach children dance. And Pump, I guess, was about to run out of insulin or something. So pumpkin got changed in my actual. Woke up early for that. And the giggle is that I'm bad at waking up early for that or for anything. Pump probably had one unit of insulin left. And I think I delivered it being like, oh, it's the last. Use the gold and maybe I'll actually eat something.

[A]

Yeah.

[B]

And also normally, like, drink a little coffee. We'll go up a little bit. One unit, no big deal. All good. Like, I probably need one unit for a coffee.

[A]

Gabby. Yep. I'm gonna. When I'm done recording with you, I'm gonna Leave a note for Rob at the beginning of this episode so that he knows I don't want him to take out any of your pauses. I want people to, like, be able to listen to what is happening in your mind while you're trying to consider your diabetes. Like, I think that's really important because, I mean, if you ask me after 45 minutes, like, what do you need to be more successful? You need somebody without ADHD to help you like that, to me, seems like most of your issue, you're having trouble considering even why things are happening. Like, when I said, what, you know, what's your main problem? You're like, I need a doctor to tell me that. But you're a bright person. You understand your diabetes. I just think you're having trouble thinking about it, and I think that's valuable for people to hear. So hopefully they'll find this conversation as interesting as I find it. But I find the most interesting parts of your conversation, when you're quiet and you're thinking, it's telling that those pauses are telling. So, I mean, in my opinion, like, if you were my kid, I'd be like, look, we need to go back to the ADHD doctor, whoever that one is, and say, this stuff you've given me, it's not working. I want to try something else because I'm having difficulty with my health, because I'm having trouble concentrating on my type 1. I can't see patterns. I can't take my experiences and apply them later to help myself. I need a better way to control the adhd. That just seems to me like that would be step one. Do you agree with that at all?

[B]

Yeah. I mean, hearing it back is like, more. But I definitely agree with it.

[A]

Yeah. Yeah. I just. It feels like if you're to have a real shot at this, you need to be able to concentrate.

[B]

Yeah.

[A]

When I see parents online talking about their young kids with ADHD and they're like, I'm so worried about what's going to happen to them when they get older and they move out. Like, you feel like the after of that before. Yeah, yeah. You're motivated. You're working hard for yourself. You care about your own health, you're smart or, you know, you're articulate. Like, you have all the pieces. You need to take good care of yourself. It feels to me like, you know that thing at the fair that you sit in and it spins and you get pinned to the wall and your feet, the floor drops down, you're just. You're pinned to the Wall.

[B]

Yeah.

[A]

It feels like if you put me in that and started asking me how to bolus for pizza, I'd be like, can I just tell you when it's over? Please? You know what I mean? Like, I feel like you're always in a state of being shook up. Like, physically shaken to the point where you can't think while you're trying to do something. That takes a lot of thought.

[B]

Mm.

[A]

Do I have it, Gabby?

[B]

Yeah.

[A]

All right. Are you gonna cry? Are you laughing? What are you doing right now?

[B]

No, I'm crying because you, like, have it so much.

[A]

Okay, well, don't cry. It's okay if you want to cry. I'm already tapped out. I interviewed a woman this morning. Like, she used up all my tears already. But I'll sit quietly with you while you. While you process.

[B]

Yeah, it's. It's just because it's like nail on the head.

[A]

Yeah. It just seems to me like that's where you gotta go.

[B]

It's like, unrecognized. Nail on the head.

[A]

No, I mean, it's obvious once you talk to you, if somebody, you know, if anybody would take the minute to talk to you, any doctor would hear this. This is just not how doctor's appointments go. The problem is, if you go to therapy, the therapist is going to want to lean into the therapy parts of it. I don't know that you need therapy. You need somebody to, like, make the tilt a world stop.

[B]

Yeah. Because that's my life.

[A]

Yeah. It sounds like, to me, that's what the inside of your brain feels like. Like there's a bunch of diabetes knowledge in there and stuff you need to do, and then somebody spins it up and it all pins itself to the wall, and you can't. Can focus enough to, like, put it all back together and make sense of it.

[B]

Yeah. Let alone, like, be it, like, correctly.

[A]

Yeah. No. So that's the part I'm spinning because I'm low. Yeah. Yeah. And so that's the part I'm playing in this conversation right now. Right. Is I'm taking that you're sharing, and I'm recontextualizing them and giving them back to you.

[B]

Yeah. That's why it's like, holy shit. That's insanely true.

[A]

This is why I make a podcast that people listen to. It's not about me. It's about you and you needing some. I'm gonna guess, Vyvanse. Like, what's the other one they gave you? Hold on a second.

[B]

They gave me Concerta.

[A]

Concerta. Concerta.

[B]

It's. It's other like science name is wild methyl.

[A]

It's a stimulant. Same family as Ritalin and Adderall. Works by increasing levels of dopamine and neuro something something referene in the brain, which helps improve attention, focus and impulse control. Has it improved attention, focus or impulse control?

[B]

I think it maybe did when it was new.

[A]

Do you have the extended release? Supposed to last?

[B]

I don't think so.

[A]

Yeah, Common side effects, trouble sleeping, decreased appetite, weight loss, headache, stomach ache, increased heart rate or blood pressure. Do you have any of those?

[B]

I probably have increased heart rate when it was new and my body wasn't used to it. But it was for like an hour. Not like nothing crazy.

[A]

Okay.

[B]

Like it felt like I had an extra special espresso shot for like half an hour.

[A]

Got like a little jolt. Okay. Yeah. So what else is there? Vyvanse, Adderall, Aveco a feko, Aveco e V E K E O. Non stimulant options. Strattera.

[B]

Oh, that's. Strattera is the one that I tried first, actually.

[A]

Did that work?

[B]

Because they always try and do non stimulants first and then when those don't work, they try stimulants.

[A]

So that didn't work?

[B]

It did not work. It also had side effects that I was like, nope, this is not happening anymore.

[A]

What kind?

[B]

Constipation. And when I called about it, the phone lady was like, oh, that's okay, you can keep taking it. And I was like, I will not.

[A]

Be taking this phone lady. I haven't in a week. What are you talking about? That's not fun.

[B]

Yeah, I was like, lady, I've been vegetarian for such a long time. Usually I am so good. And this is not okay.

[A]

All right, so you started with Strattera or whatever it is now. You went to concerto. Have you ever tried Vyvanse or at all?

[B]

Not.

[A]

Hmm. Are you gonna.

[B]

I mean, sounds like it.

[A]

Listen, I'm not a person who says run and take Vyvanse or Adderall. But like. Yes, I mean, it seems like you.

[B]

For you here in mine.

[A]

Yeah, yeah, yeah. Keeping your story in mind, I think it's worth a shot. I would hold on a second. Person on Concerta is not being helped, says, try switching to an amphetamine based stimulant like Vyvanse or Adderall. So wait, Concerta's not cool. Wait, is Concerta not stimulant?

[B]

It's definitely a stimulant, but maybe it's not. But I thought it was.

[A]

It contains methylphenidate hydrochloride, which is the same stimulant class as Ritalin. It works by boosting dopamine in the brain, which helps to focus attention and execute function. This. That particular stimulant isn't a good match and. Oh. So if it's not working, it's possible that stimulant isn't a good match and the doctor may switch to an amphetamine based stimulant like Vyvanse or Adderall or stimulants in general may not be the right fit. And a non stimulant medication might be tried. To be clear, Concerta is a stimulant. It's an extended. It's just. I guess it's just a different molecule. Yeah, I mean, God, I would try something different if I could. Is switching like. I want to know if it isn't unusually hard, though it does take some careful steps with a doctor. So there might be some tapering you have to do and then some adjustments to find the right dose.

[B]

Yeah. Tapering back up.

[A]

I would make a thousand sticky notes that say, get your ADHD under control and put them everywhere, along with the doctor's phone number. And to make sure you do this.

[B]

Sticky notes are my best friend.

[A]

Because I'm worried that you're going to leave here and just be like, it'll probably be all right, and then never think about it.

[B]

No, not at all.

[A]

All right, Gabby. I can't believe this went this way. Part of me wanted to call this episode Yo Gabba Gabba, but that's not gonna work out.

[B]

Definitely told that, but Tilt's World is accurate.

[A]

Why did you want to come on the podcast, by the way?

[B]

Funny, because I hate those.

[A]

No one likes them. They're ridiculous.

[B]

But I hate anything like it. Like the teacups.

[A]

Even the teacups. Hey. Oh, it's gonna be okay. I thought that was. Hold on a second. I need a second. I'll explain. I'll be back in 20 seconds. I'll explain when I get back.

[B]

Okay, cool.

[A]

All right. A lot of these words might not make sense. My blue embanja panther chameleon did not eat his super worm this morning. And the superworm was about to make a great escape out of the feeder Run cup.

[B]

Oh, no.

[A]

I don't know if any of that made sense to you or not.

[B]

Did, but how did it escape?

[A]

Well, previously, there was a silkworm in there that he didn't eat, and the silkworms now go into a cocoon. And so it grabbed the silk and climbed up.

[B]

Oh, my gosh.

[A]

I'm leaving it in there to see if he eats the silkworm moth once. It's. What do they call it when it comes out of the. The cocoon? Once it emerges. Emerges, maybe.

[B]

Yeah.

[A]

Yeah. Anyway, he is the weirdest eater of the. Of the chameleons. He stares at his food for hours.

[B]

Oh, wow.

[A]

And then eventually he goes, okay. And then he eats it.

[B]

Huh.

[A]

It's just I have one that, like, make sure. Oh, I have one that would just eat anything. Like, if you put a rock in there and it wiggled, they'd be like, cool, done. I'm eating that. Not him. He's just, like. He is so particular about when he eats. He doesn't like anybody seeing him eat is. He's. He's the closest I've come to, like, wanting to pull my own hair out because that.

[B]

The one that's afraid of certain colors? No, that's the, like, lack of color.

[A]

Now you're making me tell people I have three chameleons. I hope you're happy, Gabby. No, the. The one who's. The one who's afraid of my white socks. He's just staring at me right now because he had, like, a huge broach this morning that he loved, and I think he's. I think he's waiting for another one. I think he's like, hey, let's do that one more time.

[B]

Yeah.

[A]

So. And he just took a great poop the other day, so he's probably super excited to eat.

[B]

He's like, arden, like, so, lunch, right?

[A]

What's that?

[B]

He's like, arden, like lunch, right?

[A]

Like lunch.

[B]

Yeah. Like, it's time for lunch. Like, you're gonna make me lunch.

[A]

No, he's looking at me like one of my kids, and he's just like, somebody has got to bring at least one more of those roaches over here. So. Yeah. The roaches, by the way, people should know who are listening are not the kind that, like, you would. They could infest your house. They're very much.

[B]

They don't see every night in Philly.

[A]

Oh. Oh, oh, you're in Philly.

[B]

Yeah.

[A]

Oh, that's right. How about that? Go Birds.

[B]

Go Birds.

[A]

How about the Phillies are on a run right now, huh?

[B]

Yeah.

[A]

Exciting. Everything's going well. What have we not talked about that we should have?

[B]

Oh, how bent the cannula is that I just took out of my thigh?

[A]

Oh, so it's not your thigh that was the problem. Or maybe it was.

[B]

I don't know.

[A]

You pinch up when you put it in?

[B]

No.

[A]

Well, why not? Gabby, you've had diabetes for 26 years.

[B]

I don't know how to pinch.

[A]

What? There's nothing to pinch? Is that what you said?

[B]

Yeah. I mean, maybe my thighs are too muscly. I don't know.

[A]

Is this a humble brag about your thighs being strong? No.

[B]

Because there's stuff to pinch elsewhere apparent. What? Especially, like, now in life, there's. There's more to pinch.

[A]

You're calling 28. Wait, you're calling 28?

[B]

I don't know if it's pinchy. I'm. They're not small at all. But.

[A]

Gabby, if you think 28 is the now part of life, you're going to be in trouble.

[B]

As you said about Arden and like, oh, if complications in 30 years means that she's 30, 32.

[A]

Yeah, but I'm saying, like, if you think, like, oh, like, you know how. How it gets when your body's run down when you're 28, like, you're gonna look back at 28 one day and be like, oh, my God, I can't believe I said that.

[B]

Oh, I don't mean run down. I just mean that I'm thicker than before.

[A]

You're thicker than before. Okay.

[B]

Yeah.

[A]

I almost asked this a couple of times, but this is such a. What I would call, like, a science based question. But there was part of me that wondered, do you have any reason to try a GLP medication?

[B]

Yes. But also, I don't really have any.

[A]

Resistance because I was wondering. There's like, look, this is apropos of nothing and nobody should listen to me, but there have been a few people on who have talked about, like, starting a glp, seeing a reduction in inflammation, and other things in their life, getting better. And there's part of me that, like, half wonders, like, if you had a chance to try it, if you would notice something different about your attention or ADHD or anything like that. Like, how much is ADHD actually related to, you know, I don't know. Inflammation?

[B]

Yeah, maybe.

[A]

I'm not sure. I mean, I. Listen also, that could all be just crazy, but I just wondered, like, because so many people are seeing these secondary quality effects from GLPs by mistake, right? They start because of their weight, and then they, like, pop up later and say, oh, I had a real, like, turn around in this or this or, like, with me with, like, my digestion. Or, like, you know, there's that lady on recently who Said that a lot of her kids, like, bipolar, like, issues kind of dissipated with it, like, crazy stuff like that. So I don't know, like, do you need to lose weight? Like, could you talk somebody into it for that? Just to try it?

[B]

I kind of want to.

[A]

You have good insurance.

[B]

I could. Could lose some and also, like, one unit of insulin me over, so.

[A]

Well, that's your other concern, is it?

[B]

Like, I also think that's, like, why a doctor would be like, no, I.

[A]

Don'T want you to be more insulin sensitive.

[B]

Yeah. But, I mean, sometimes I feel like I'm resistant, but I'm also like, maybe I just need to push my basil up because I gained a pound.

[A]

Like, what's your total daily insulin use? Do you know?

[B]

It's somewhere around 50.

[A]

Okay. That's not nothing.

[B]

Yeah.

[A]

What's your basil then? Like, around, what, a 0.9 ish? Yeah, yeah. Because you're eating. You said you're a vegetarian?

[B]

Yes.

[A]

Yeah. So you're only using about 20, 25 units a day for food? Yeah, it's mostly. What? Mostly, like, proteins. And you don't probably get a ton of fat either, right? Or do you?

[B]

I don't know. I think I get a good amount because I still eat, like, dairy, so.

[A]

Okay, Are you, like, a vegetarian or are you like, one of those people who's like, potato chips vegetarian?

[B]

I only hesitate because I'm now more like potato chips, but only because, like, as a child and teenager and such, I like, never had potato chips. So after, I don't know, adulting, I was like, potato chips, maybe.

[A]

I just. I laugh because I know a couple of vegetarians who, like, when you say vegetarian to, like, a third party. Well, they think when you say vegetarian to most people, like, oh, you eat, like, beans and lentils and salads and carrots and, you know, roots and. And then you meet a vegetarian, they're like, oh, no, I just, you know, cookies and, you know, like. But there's no meat in it. So, like, I just wanted to know where you fell on the.

[B]

On the cookie. But after you have, like, your lentil vegetable soup.

[A]

Okay. I just want to know where you fell on the spectrum, that's all.

[B]

Yeah, I don't know. I feel somewhere medium ish now.

[A]

Yeah, well, I mean, listen, if you don't think you have a lot of insulin resistance, I don't know if a GLP would decrease your need for insulin, so I don't know. There's a lot there.

[B]

Oh, like you're saying it wouldn't have that effect that much.

[A]

What I feel like I'm seeing when I'm talking to people, obviously I'm not talking to everybody, but I feel like I'm seeing people who could end up with what they call a dual diagnosis at some point. Right. Where they kind of have attributes of type one. They have type one and then they have attributes of type two, usually in the form of, like, insulin resistance, pcos, like, stuff like that.

[B]

Yeah.

[A]

There's been, you know, one specific doctor on here in the last year who said, look, you're gonna start seeing a lot more of these dual diagnosis for people. Now, if you're a person who has Type 1 but doesn't have any attributes of Type 2, but you have weight to lose, then I wonder, like, would it just decrease your appetite? Would it. You know, like, you'd obviously have to change your insulin for those reasons, but it might not be the magic pill that it is for some people, like when you inject it and then your insulin needs suddenly go down by 20%. And so there's a world where if it could help you with weight, it would. I mean, your insulin needs would go down as your body mass decreased, and it would go down if you ate less, obviously, but you could. You could keep up with that adjustment. And if it didn't touch, like, if it didn't have, like, a magical 20% decrease for you, then that wouldn't be an initial concern. And then do you get to see if lowering the inflammation in your body changes anything about your adhd? That's all. But I don't know. There's a lot in there to unpack. I would maybe worry. Good.

[B]

You'd maybe what?

[A]

I think I'd go for the Vyvanse or the other drug first to see where that gets you.

[B]

Well, logically, logistically, I will talk to that doctor before a primary doctor.

[A]

So those two things are worth bringing up. Like, if you've got a reasonably thoughtful doctor, they might, you know, maybe do some research with you and see if there's value in that. And what I'm saying is if you have good insurance, just based on body mass index, if you qualify for, you know, we go via setbound or something like that, the doctor doesn't have to make the case for the rest of it. You can just tell them, like, let's just track that to see if we see improvement in my, you know, in my ability to focus and stuff like that.

[B]

Yeah.

[A]

Who knows? Worth a shot. It's better than what's happening now.

[B]

Yeah, right. Absolutely. I Also have a theory now that I might be hypothyroid.

[A]

And that's not a thing you have to theorize.

[B]

I know, but I do have to get tested, and, like, I can't go get tested, like, in the next hour.

[A]

When did you have this theory?

[B]

You said since when?

[A]

Yeah, when did you have the theory? The first time.

[B]

Oh, well, the theory, like, crystallized. I don't know. Became confident when I had this really weird symptom that I was like, I know I shouldn't Google stuff and, like, get anxious about it or something, but, like, I gotta Google this because it was really weird. I had orange. Dark, rusty orange discoloration on just one. My left hand, on my thumb, where I pick and destroy my cuticles, where the skin right there on that thumb on that day was raw. I knew it was healing, so there it was, like, orangey. And I was like, oh, no. Did I make my finger bleed in my sleep? But it was not blood at all, for sure. And it was just through some other fingers in my left palm. And it wasn't all over a ton. But I was trying to wash my hands so much, and it was dissolving, but over the whole day, not at all from one hand wash at all.

[A]

Okay.

[B]

And when I Googled it.

[A]

Wait, what did Google tell you?

[B]

It was like, you ate 12 million carrots, obviously. And I was like, I am a carrot vegetarian, but I have not eaten 12 million carrots yesterday.

[A]

Okay.

[B]

And then it was like, hypothyroidism. And I was like, okay, do you.

[A]

Have any other hypothyroid, like, symptoms? Have you gained weight recently? Is your hair falling out? Are your nails brittle? Are you tired?

[B]

My nails have been brittle for my whole life. I don't think my hair has, like, fallen out more. It's just been relatively thin for a while. But my fatigue and sort of brain fog, but especially fatigue more recently.

[A]

Well, maybe this doesn't have as much.

[B]

To do with your. Exactly. So I don't know what it is. But then I had that orange and was like, maybe that's it. But my fatigue was. Is still. Is, like, ridiculous.

[A]

Well, Gabby, then if you have ADHD and then you layer the fog of hypothyroidism over top of it, then you need to, like, peel that onion apart and get these things taken care of. Like, so just. I. You got to go to the doctor, lay all this out, and say, I need a blood test. I need you to do a thyroid panel. That's first. Right? I have an autoimmune disease already. It's not crazy to think that I. This could be too.

[B]

Let's check another. Right? Yeah.

[A]

And tell them, like, if. If you see a TSH over, you know, 2.1, then I want to try to medicate these symptoms. We'll do that. That's only going to take a couple of weeks in the thyroid medication to see if you're going to get value out of that. Then you can reassess your ADHD medication. Is that helping, or do I need to switch to something else?

[B]

Right.

[A]

Yeah. I mean, these could be quick fixes for you. You just got to get in there and get somebody moving on it.

[B]

Yeah. I'm set to see a new primary in the beginning of September, so hopefully I don't know the dude, but hopefully he'll be cool and be like, yep. All right, Tess, here we go.

[A]

Write it all out beforehand so that you don't walk in there and seem like a scattered mess.

[B]

Right.

[A]

You know what I mean? Just say to him, like, look, I do, actually.

[B]

I've been working with a naturopath doctor, and she basically has been doing that with me. I mean, lots of other stuff. And she does craniosacral therapy, which is very cool. But one of our main things is organizing, like, literally in document form so that I can walk in to the primary doctor and be like, this is what I want and need, and this is what has been feeling this and that and weird.

[A]

And yeah, you, of most people that I've spoken to, you would benefit from writing down your thoughts, loading them into ChatGPT, and saying, hey, can you turn this into a document that I can hand to a doctor? I'm afraid that I'll be all over the place if I try to speak this out. And then it'll give you something back that you can give right to the doctor. Yeah, yeah. Because you don't want. Because I think you're lovely and I've had a great time with you, but I'm making a podcast with you. Like, if you walked into a doctor's office and I was a doctor, I can see where in the first couple of minutes before I even got to know you. I don't mean this in a bad way, but, like, it can be exhausting dealing with somebody who's got your problems.

[B]

Yeah.

[A]

And so, like, the other person can just be like. Like, I know it's turning into a good podcast, and I know that people will benefit from it. You know, I have a lot of reasons to keep having my conversation with you. If we were like, sitting at a party and I started talking to you, I'd be like, oh, boy. I can't. I can't. I can't do this with Gabby. Like, it's a lot here. But before I let you go, did you say your boyfriend has diabetes? What kind of.

[B]

We don't know.

[A]

What do you mean, you don't know?

[B]

Well, I think, Lada, I'm not an endo, so what can I say? He was diagnosed with type 2, and that was a while ago, and I don't know that he's had antibodies. Run, like, again.

[A]

So how old is he?

[B]

35.

[A]

A Man's World again. Why is this? How come he gets a shot at a 28 year old? Gabby? Not fair.

[B]

I mean, it's only like, what, six years?

[A]

Well, I mean, that's seven years, and that's a lot of time. Imagine when you were one. He was.

[B]

I guess because I'm about to be. My birthday's coming.

[A]

Yeah. Imagine when you were 1 years old. He was 8.

[B]

I know. We talk about that all the time.

[A]

Well, when you were 15, he was 23.

[B]

What can I say?

[A]

Creepy. You know what I mean? I'm just kidding. You're older now. It's fine. But no, like, it's.

[B]

He also did slide into the DMs, quite literally, but, like, also about diabetes, and was like, let's chat about that. So. And then the slide worked.

[A]

He got you that way.

[B]

Yeah.

[A]

You didn't have to go to Hinge or something like that.

[B]

No, especially because it was during COVID.

[A]

Is that how people meet people now? Tinge. Right.

[B]

Well, yeah, actually, he saw me on Tinder, and then I guess my Instagram was, like, on there in that moment. And so I never actually saw him on Tinder, but saw his message on Instagram.

[A]

I don't know how kids date. Like, it's crazy to me.

[B]

It is. Yeah.

[A]

Yeah, yeah. The whole thing sounds insane to me. Like, you just used to go out, like, find a pretty girl and talk to them, and if they didn't act like they were mortified by you, you tried talking to them more. That was pretty much it.

[B]

Yeah.

[A]

Yeah. All right, listen, Gabby. What's that?

[B]

That's how it was after the Instagram text.

[A]

All right, Gabby, I need you to go take care of yourself. Do you have a list? You know what to do?

[B]

Yeah.

[A]

Are you sure? Gabby, do you know, if you want me to, I can ship over your file, have Rob edit it now. He'll send it back to me. I can literally take the Transcript from it, put it through ChatGPT and tell it to put together, like, walking orders for you. Like, things that you should do and things you should say to your doctor, and it'll spit it right back out.

[B]

I mean, that would be interesting to. At the least. For sure.

[A]

How about if I do that? Oh, now I'm giving myself more work. I gotta make a note. Hold on a second. That's interesting, Gabby.

[B]

Even just to see what it has to say.

[A]

Chat doctors ask. All right. Okay. Well, Rob's gonna get away with one here because I'm gonna tell him he doesn't need to edit out any of the gaps, and he's gonna be like, oh, thank you, Scott. And then you have no idea, like, your episode. I'm gonna guess a lot. He would get back to me and say I had to make, like, 600 edits on that.

[B]

Oh, my God.

[A]

Trust me. And you weren't bad. I've. I've talked to some people before that. I was like, oh, Rob's gonna, like, quit. I sign this one over. Nevertheless. Okay. All right. You were terrific. I will do that. I'll package it together with a blog post that'll accompany your episode when it comes up, but I will send it to you ahead of time earlier so that you have it well before September. Okay, cool. All right. Thank you very much for doing this. And, of course, let us all speak. Well, that the Eagles and the Phillies win their respective championships this year as. As should be.

[B]

Of course.

[A]

Right. That's all. I know the Cubs fans are excited. They're having a good season and all, but screw you. It's our turn again. That's pretty much it. That's how I feel about that. I just won a World Series. That's all I want. I mean, how great was it to win the Super Bowl?

[B]

Great.

[A]

It was awesome.

[B]

I mean, it was crazy.

[A]

Yeah. Yeah. It was about the best thing. And how great was it to watch Patrick Mahomes look sad?

[B]

Yeah.

[A]

Yeah. Awesome. Have you ever been to a game at the Link?

[B]

No, just a Phillies game like last year.

[A]

You should try an Eagles game. They're pretty awesome. I should go to an Eagles game.

[B]

You should.

[A]

I haven't been in a while. I'm going to get Eagles tickets. I just decided. Look at you, Gabby. You're fixing my life. Thank you very much. I'll talk to you soon. Hold on for me. I need to tell you some stuff after we're done recording. Okay?

[B]

Okay.

[A]

All right. Touched by type 1. Sponsored this episode of the Juice Box podcast Check them [e-mail] on Instagram and Facebook. Give them a follow. Go check out what they're doing. They are helping people with type 1 diabetes in ways you just can't imagine. This episode of the Juice Box Podcast is sponsored by the Omnipod 5, and at my link omnipod.com juicebox juicebox you can get yourself a free what'd I just say? A free Omnipod 5 starter kit. Free. Get out of here. Go click on that link omnipod.com juicebox check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox links in the show notes [e-mail] I'd like to thank the Eversense 365 for sponsoring this episode of the Juicebox 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 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 Grand Rounds series was designed by listeners to tell doctors what they need, and it also helps you to understand what to ask for. There's a mental wellness series that addresses the emotional side of diabetes and practical ways to stay balanced. And when we talk about GLP medications, well, we'll break down what they are, how they may help you, and if they fit into your diabetes management plan. What do these three things have in common? They're all [e-mail] up in the menu I know it can be hard to find these things in a podcast app, so we've collected them all for you@juicebox podcast.com the episode you just heard was professionally edited by wrongway recording wrongwayrecording.com.