#1778 Doctor Mom

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1778 “Doctor Mom”
Host: Scott Benner
Guest: Jen (Pediatrician, Mom of 3, parent of a teen with T1D)
Release Date: February 20, 2026

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Episode Overview

In this engaging and heartfelt episode, Scott Benner hosts Jen, a practicing pediatrician and mother of three whose oldest child was diagnosed with type 1 diabetes (T1D) about 18 months ago. Their candid conversation weaves together Jen’s professional expertise and motherhood journey, tackling the unique perspective and challenges that come when a doctor becomes the parent of a child with a chronic condition. The conversation offers real-world strategies, hard-earned insights, and honest reflections for parents, caregivers, and healthcare providers—especially those navigating the early years of a T1D diagnosis.

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Main Discussion Points & Insights

1. Jen’s Background: Pediatrician and Mom

• Jen, a pediatrician for 14-15 years, works part-time to balance her medical career with motherhood.
• From childhood, she knew she wanted to work with kids and gravitated toward pediatrics due to her experiences working with children.
• She remarks on how pediatricians often play the role of psychologist as much as physician, providing reassurance, counseling, and support (04:10–07:45).
  • “A lot of people come in saying, ‘I’m worried about this or that.’ We do a lot of counseling, reassurance… There’s a lot of counseling involved with kids at all ages and family members.” – Jen, [07:17]
• Jen’s own entry into motherhood during residency gave her new empathy for the concerns of parents.

2. Diagnosis Journey: Catching T1D as a Doctor/Mom

• Despite her medical training, Jen still experienced doubt and denial when her son showed signs of T1D.
  • Symptoms: Excessive thirst, frequent urination, water bottles accumulating in his room ([10:43]).
  • She acted quickly once the signs became clear; her son's A1C was “around 8,” lower than typical at diagnosis, suggesting early detection ([11:00]).
• She shares the difficulty of hoping it’s “not diabetes”—the universal parental wish to be wrong about bad news ([09:25]).
  • “I wanted to be wrong. You want to be in denial. You don’t want something to be right.” —Jen, [09:25]

3. Navigating the Medical System as a Physician-Parent

• Jen opted to keep her doctor status “on the down-low” during her son’s hospitalization to ensure she received full, layperson-level T1D education ([17:44]).

  • She appreciated the advances in diabetes technology—her previous experience was limited to finger sticks and traditional insulin protocols.

• Jen notes pediatricians often defer deep T1D management to endocrinologists, especially in regions without local pediatric endos.

• Her new experience as a T1D parent has changed her approach with patients; she now emphasizes school accommodations (504 plans) and broader support for families.

  • “So many things I’ve learned about…504 plans and school accommodations—not just for diabetes, but for other chronic medical conditions.” —Jen, [19:15]

4. The Challenge of 504 Plans & School Advocacy

• Jen found advocacy essential in securing necessary school accommodations, especially as her child transitioned to high school ([20:47–26:33]).

  • She highlights the underappreciated role of cell phones as crucial diabetes management tools in modern schooling, contrasting schools’ desire to restrict phones with their necessity as CGM receivers and insulin pump controllers ([21:44]).

  • The process involves persistent communication, sometimes shifting to “mom mode” to make her case heard.

  • "Being proactive and advocating for your kids is just so important on so many levels." —Jen, [25:09]

  • The host and Jen discuss how school systems often try to oversimplify 504 plans, underestimating students' needs.

5. Hospital and Community Support Post-Diagnosis

• Jen describes her family’s rapid adjustment (“in and out in less than 24 hours…back to school the next day” [31:15–31:41]), aided by real-life peer and online support.
  • She cautions against “drinking from the fire hose”—trying to consume and process too much diabetes information at once ([29:46]).
  • "Don't drink from the fire hose." —Jen quoting an early bit of advice, [29:47]
• Her son, a teenager, manages much of his own care, but Jen oversees clinical and logistical aspects, calling it a “team effort.” She acknowledges the importance of letting children gradually take over their care ([34:14–36:06]).

6. Quality of Life and Realistic Diabetes Goals

• They discuss realistic targets and the variability inherent in T1D management.
  • Jen’s key lesson: The goal is not 100% time in range, but safety and functioning.
  • “Knowing that the goal is not perfection and that the goal is being safe and having quality of life and functioning and feeling good, I think, is the point.” —Jen, [37:37]
• The host underscores the need for gradual progress, not overnight perfection.
  • “There is a standard that you’re reaching for. You don’t need to get to it today…It’s a process.” —Scott, [41:15]

7. Online Communities, Comparisons & Parental Pressure

• Jen notes that social media and online communities are a double-edged sword—helpful but also sources of unhealthy comparison ([39:06–41:03]).
  • She warns against feeling pressured by “perfect” T1D diets or management shared online.
  • "I think that it's important to step back and realize, again, what works for your family is what works for you." —Jen, [40:22]
• Her new experiences have made her more empathetic and holistic in her clinical work.

8. Should Parents Have Access to Algorithms and Calculators?

• Scott explores whether tools like insulin dosing calculators (using standard medical formulas) should be shared more directly with families ([41:50–48:02]).
  • Jen’s perspective: Useful to compare/understand contexts, but prefers initial dosing be managed by specialists due to added complexities and individual variability.
  • This leads to an animated discussion about patient empowerment vs. professional caution.

9. How Parenthood and T1D Changed Jen’s Practice

• Jen now pays more attention to the “whole picture”—the needs of siblings, families, and the emotional toll of chronic diseases.
  • “I try to make sure that the siblings are okay and the families are okay and how can I help...” —Jen, [52:17]
• She’s shifted to prioritize navigating systems and providing practical support, even outside of diabetes.

10. The Realities of Pediatric Practice

• Not all families are supportive or equipped; some kids have real disadvantages (e.g., lack of transportation or advocacy, inconsistent follow-up) ([58:24–61:02]).
  • “I see a lot of kids who don’t have supportive families…and I think that that is even more difficult and sad.” —Jen, [58:24]
• Sometimes families “fall off the grid,” making longitudinal care difficult.

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Memorable Quotes

• On balancing medical expertise and motherhood:
  “I try to kind of keep that on the down-low that I’m a doctor because I want people to talk to me like I don’t know anything, because truthfully, I don’t.” —Jen, [17:44]

• On school advocacy:
  “Being proactive and advocating for your kids is just so important on so many levels.” —Jen, [25:09]

• On 504 frustration:
  "It's frustrating, and it's a lot of extra work that, in the end, everybody goes, 'Oh, okay,' and you're like, 'Yeah, why are you fighting with me?'" —Scott, [26:24]

• On comparing yourself online:
  "In reality, I think you have to do what works best for you and your family and your situation." —Jen, [40:22]

• On time in range, perfectionism:
  "The goal is not perfection. The goal is being safe and having quality of life." —Jen, [37:37]

• On how T1D changed her practice:
  “I try to be a whole picture kind of person…wanting to help those kids and those families navigate the healthcare system, because it can be really challenging if you don’t know what you’re talking about.” —Jen, [52:17]

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Notable Segments with Timestamps

• [03:17] — Jen introduces herself; her T1D parenting journey begins
• [08:54–11:14] — The rollercoaster of diagnosing her own child
• [17:44–19:47] — Hospital experience; value in being treated as a “regular” parent, not a doctor
• [20:47–26:33] — The 504 Plan battles: advocating for school accommodations
• [29:46] — “Don’t drink from the fire hose”—coping with the initial deluge of information
• [31:41–36:08] — Teamwork in T1D management, letting a teen take the reins
• [37:37–41:47] — Letting go of “perfect”; aiming for safety and functionality
• [41:50–48:02] — Debate on sharing medical algorithms/calculators with families
• [52:17–57:24] — Impact of T1D on Jen’s approach to patient care and systemic challenges in pediatric practice

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Tone & Takeaways

The episode is candid, insightful, and compassionate. Jen’s dual perspective—both seasoned pediatrician and newly-minted “doctor mom”—offers listeners empathy, encouragement, and practical wisdom. Scott weaves humor and self-reflection throughout, ensuring the conversation remains accessible and human.

Takeaways:

• Early detection matters, but even experienced eyes can second-guess themselves during diagnosis.
• The experience of T1D radically transforms how a parent and physician sees and supports families with chronic illness.
• Advocacy in schools is crucial, especially as rules shift around vital diabetes management tech.
• Striving for “good enough” over perfection is key to sustaining quality of life—progress, not perfection.
• Personal experiences as a parent can profoundly, positively impact a health provider’s practice.

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Final Words

Jen’s story is a reminder: clinical knowledge is powerful, but lived experience—both the struggle and adaptation—can open the door to deeper empathy, better advocacy, and a stronger sense of community in the world of type 1 diabetes.

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[For further connection and resources, the host recommends the Juicebox Podcast’s private Facebook group and the Bold Beginnings series for newly diagnosed families.]

Transcript

[A]

Here we are back together again, friends, for another episode of the Juice Box Podcast.

[B]

My name is Jen. I'm a pediatrician and a mom to three kids. My oldest was diagnosed with type 1 diabetes about a year and a half ago.

[A]

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[B]

My name is Jen. I'm a pediatrician and a mom to three kids. My oldest was diagnosed with type 1 diabetes about a year and a half ago.

[A]

Okay, Jen, I like how long you took to pull yourself together before you said that, because I don't think most people don't hear the part that happens before because Rob edits it out where I say, like, you know, the next sound you hear will be you introducing yourself, trying to give it to the idea of the person. Like, go ahead and gather yourself and go ahead and you did exactly that. Some people launch into it very quickly. Others wait for me to prompt them again. And we'll sit there for, like, an uncomfortably long time. And I'll go, you can go whenever you want.

[B]

They go, oh, right.

[A]

So I liked yours. Yours was like, let me think of how I'm going to say this, and I'm going to say it nicely. And we're on our way. So, Jen, you have three children. Do we want to say their ages or.

[B]

No, no, that's fine.

[A]

Okay. Three kids, married.

[B]

I am.

[A]

And you're a pediatrician.

[B]

I am.

[A]

What do you take of this? My friend of mine is a pediatrician. It's been for a very, very long time. Went to a great school. I one day talked to him about being a doctor, and he said, I'm not a doctor. I'm a pediatrician.

[B]

Sometimes I feel more like more of a psychologist than a medical doctor. Yeah, it's fun. I've been practicing for about 14 years out of 14, 15 years out of training.

[A]

It's a good long time.

[B]

Yeah. And I work part time, so I can kind of do the mom thing most of the time.

[A]

Very nice. He described it once to me as like, having to have a. Like a wide understanding of what's going on in the community as far as people's illnesses go. Because in the end he said, you know, most of the time you just see people coming in with what's going on. Does that fit the criteria to you?

[B]

A little bit, yeah. I mean, it's also kind of like your first patient weighs five pounds because they're a baby, and your next patient weighs 300 pounds because they're an 18 year old.

[A]

Yeah. There's a wide scope of people that

[B]

you meet with wide range.

[A]

Yeah, yeah, yeah. Very, very interesting. Okay. What made you want to be a pediatrician?

[B]

Oh, gosh, I don't know. I was one of those kids when I was 8 years old and they said, what do you want to be when you grow up? And I said I wanted to be a pediatrician. I don't really know. I did a lot of volunteer work and a lot of work in high school and college, you know, with kids. I always liked working with kids, and I originally thought about doing pediatric physical therapy was one of my thoughts, but really went with my gut and decided to go into medicine instead. Wow.

[A]

How long do you train for that? Like, from, like, give me. You know, I left for college as a freshman, did a four year. And like, how long does that whole thing take?

[B]

So college, four years, medical school, four years, and then pediatric residency is three years.

[A]

Oh, wow. And you've been practicing for 14 on top of that?

[B]

Correct.

[A]

Oh, so you have 10 years, 25 years of effort since you left high school, right?

[B]

Yeah.

[A]

Have you been paid back?

[B]

Ish.

[A]

Ish. Tell people how many student loans you still have left.

[B]

Oh, I still have them, yes. I'm definitely still paying off my loans.

[A]

No kidding. And the insurance is insane, right? The liability insurance and everything?

[B]

I guess so. My practice pays for that, thankfully.

[A]

Oh, lovely. Do you work in a kind of like, family type practice or has yours been swallowed up by a giant conglomerate

[B]

currently in private practice?

[A]

Do you have a preference? Have you done both?

[B]

I have not. I prefer to be in an outpatient setting. I was always one of those doctors who said, I never wanted to work in a hospital. So I like being, you know, just in a. In a clinic and doing outpatient medicine.

[A]

Yeah. Tell me why you say a lot of your job is maybe being a therapist for people.

[B]

Well, you know, a lot of people come in saying, no, I'm worried about this or I'm worried about that. You know, we do a lot of, well, child checks, especially in the first couple years. You see the kids quite often. So a lot of it is, you know, reassurance about your toddler doing this or your toddler doing that and will I ever get sleep again, or the teenagers, you know, in teenage behavior. And, you know, there's a lot of counseling involved with kids at all ages and family members at all ages as well.

[A]

Is that an on the job training situation or is that something you feel like medical school and residency prepared you for?

[B]

No. I don't think any of the training really prepared you, prepared you for that. I think it's just with a matter of time, I always joke because, you know, my oldest child had him at the end of my residency, towards the end of my residency. And it just completely changes your perspective of things where I'm like, oh, I can't believe these parents are doing X, Y, and Z. And then you're a parent and you're going, oh, okay.

[A]

They think they're killing that kid 24 hours a day. They're looking for. They're looking for someone to tell him it's okay. He said this. He made a noise, he burped. Is he okay?

[B]

Right.

[A]

I can't go through this again.

[B]

Spot on their skin. Yeah, it's. It's a lot of that.

[A]

Well, so you think a little bit of the timing of when you had your first helped you maybe as you launched into your career?

[B]

Absolutely.

[A]

Yeah. That's interesting. Okay, so let's fast forward a little bit. I'm gonna. I'm. Listen, I'm just gonna go out on a limb and say, I hope that you were able to diagnose your kid with diabetes, but tell me what happened and, you know, how you figured it out.

[B]

Yeah, so I did. You know, I get a lot of people saying, oh, at least you caught it early. At least you know what to look for. At least his parents are doctors. And I think. I don't want to say guilt is the right word. It's just maybe a little. I don't know, I'm having trouble finding the right word for it.

[A]

Are you. Are you trying to tell me that you still feel like you didn't figure it out fast enough?

[B]

No, I think I did.

[A]

You did. What's the adverse feeling from.

[B]

I guess just I wanted to be wrong.

[A]

Oh, oh, you feel like you gave it to him because you recognized it kind of thing.

[B]

Not that I gave it to him, but just. I wanted to be wrong. You know, I was like, well, maybe it's just that his, you know, just extra thirsty and growing and. And all of that, you know, you. You want to be in denial. You don't want something to be right.

[A]

Jennifer, I'm going to try one more time to pick through the, like, the psychology of this. I might be way off. Do you not want to be part of the story? You were just hoping that there was nothing wrong that was. That was big picture, gonna take the. Take up the rest of his life kind of feeling, or do you just. Do you hate that? Like, Part of that story is you going, oh, I think he has diabetes.

[B]

Maybe a little bit of both.

[A]

Yeah, I. Go ahead.

[B]

A lot of me just wanting to be wrong. I think, okay, you know where I kind of had it in the back of my mind, like, could this be. And then part of me getting him checked was thinking, okay, I'm gonna be wrong.

[A]

Yeah, this is great. We'll go over, we'll do a thing, we'll have lunch and, you know, we'll figure out what this. What else did you think it could be if it wasn't diabetes?

[B]

Yeah, maybe just. Just growing, being active. You know, there's a lot of things that happen in the teenage years, so physiologically so sometimes you just don't know if you know what you're experiencing is right or wrong.

[A]

What symptoms was he having that got you thinking?

[B]

Mainly just the normal stuff. Waking up at night to go to the bathroom and drinking a lot of water and wanting me to refill his water and finding water bottles in his room at night and. And that was about it. He felt fine.

[A]

It was the excessive thirst that clicked into it right away.

[B]

Yeah. And I mean, his A1C was around 8 when he was diagnosed, so even the doctors said, you know, they never see it that low at diagnosis.

[A]

Yeah. How long do you think it had been going on before you got him to the doctor?

[B]

Maybe a couple weeks.

[A]

Okay, that's pretty quick. Anybody else in your family have type one extended family?

[B]

Not blood related, but my sister's husband, my brother in law has type 1 diabetes.

[A]

But nobody related to you or your husband?

[B]

No. We do have other autoimmune things in the family.

[A]

Like what?

[B]

Hashimoto's ulcerative colitis. So with those two things, you know, you're at higher risk for having other autoimmune things.

[A]

Can I ask a crazy question? Because I've been thinking about this lately. Anyone in your extended family a great athlete, very flexible, can throw a ball hard, anything like that?

[B]

I wish. No, No.

[A]

I was getting a massage the other day. Somebody gave me a massage as a gift. My wife, by the way. Two Christmases ago, I sat on this thing stuck to my refrigerator for a year, made the appointment a day after the gift certificate expired, begged them into letting me use it anyway and went to just go get a massage. And the person who was doing the massage for me, she was lovely. And during the process, she was kind of going off the side of my hips. My hip pointers hurt a lot. I was like, oh, that really hurt. And she goes right Here. And she touched him. I said, yeah, the left one's worse than the right one. They've been hurting for a while. And she goes, okay, I'll fix that. There's part of you that's like, sure. But she grabbed my leg, did a thing, was leaning into my hip, going, going, going. I'm sitting there going, this hurts. And she's doing it. I'm like, this is not helping. And then as I'm thinking, this is not helping, she goes, it's not releasing. And then she kept going and kept going. And I'm not kidding you. As the pain disappeared, she said, oh, I got it. And I was like. I said, that was really impressive. And I hadn't talked through the whole thing, by the way. I know myself. So at the beginning of the massage, she said, is there any instructions? And I said, yes, I am an entertainer at heart. If you start talking to me, I'm gonna want you to have a good time. And I'm not gonna relax, and I'm just gonna talk through the whole thing. I was like, so please just don't talk to me. And I was like, I'm not being rude, but trust me, I'll ruin it for you and for me. So she laughed, and she. And I really didn't speak for a really long time, but I said, that was so impressive. You announced that you got it just as the pain went away. How did you know? And she said, well, from working on myself, I've been able to figure stuff like that. I have Ehlers Danlos.

[B]

Okay.

[A]

She starts going, it's an autoimmune. I went, ah, yeah, I know. I was like, yeah, yeah, I got it. And anyway, so she had that. She and I chatted afterwards, and I said, maybe I should send my daughter in here. I said, you know, no diagnosis or anything, but, like, Arden's really flexible. She has joint pain. Like, you know, her shoulders feel like they're not in place sometimes. I was like. She goes, yeah, send her in. I'll help her. And I was like, awesome. And she said, how did you figure it out? And I told her I kind of painted a bigger picture. I said, but, you know, there's this one thing I've always wondered. Both of my kids have exceptional arms. They both played baseball or softball, and they could throw a ball like a rocket. And when you watch them on video, what you see is they have this exceptional extension when they reach back, like, so much more so than most people do. And I always wondered if that's part of. Part of that or not, anyway, I'm not sure. Yeah, you. You would have. No idea. But I would just like, you know, sometimes I say to people, like, are there bipolar people in your extended family? And a lot of people go. A lot of people go, yes. So I thought maybe I could, like, find a new question, like, does anyone in your family throw really well, anyway, there's a long way to go for no, for nothing at all. But anyway, I, I think I might have her on the podcast how to Help that because she was so effective with it and was telling me her own story that I think people would find interesting. But I digress.

[B]

Cool.

[A]

Okay. So in the extended family, you know, little bit of that, but not a lot. Did it ever occur to you, as a doctor, did you ever say, I might have a baby one day that has one of these issues? Or is that not a thing ever popped in your head?

[B]

Not really. I mean, you always want your kids to be healthy, you know, but never really thought about it.

[A]

Okay. All right. So we got him in the hospital. He's got his A1C around 8. They think you got it pretty quickly. Now, does the thing happen to you immediately where they think, well, you're a doctor, we don't need to tell her anything. She already knows. You can manage diabetes confidently with the Powerfully Simple Dexcom G7 dexcom.com Juicebox the Dexcom G7 is the CGM that my daughter is wearing. The G7 is a simple CGM system that delivers real time glucose numbers to your smartphone or smart watch. The G7 is made for all types of diabetes, type 1 and type 2, but also people experiencing gestational diabetes. The Dexcom G7 can help you spend more time in range, which is proven to lower a 1C. The more time you spend in range, the better and healthier you feel. And with the Dexcom Clarity app, you can track your glucose trends. And the app will also provide you with a projected A1C in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for Dexcom. Dexcom.com Juicebox when you use my link, you're supporting the podcast Dexcom.com Juicebox Head over there now. Today's episode is brought to you by Omnipod. Did you know that the majority of Omnipod 5 users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod 5 users pay $0 per month? You heard that right. Zero. That's less than your daily coffee. For all of the benefits of tubeless, waterproof, automated insulin delivery, my daughter has been wearing an Omnipod every day since she was 4 years old, and she's about to be 21. My family relies on Omnipod, and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link omnipod.com Juicebox Omnipod has been an advertiser for a decade, but even if they weren't, I would tell you proudly, my daughter wears an Omnipod omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit? Full terms and conditions can be found@ omnipod.com juicebox

[B]

I try to kind of keep that on the DL that I'm a doctor because I want people to talk to me like I don't know anything, you know, because truthfully, I don't. You know, as the general pediatrician, you know, you see the kids who are sick and they come in, okay, how's your blood sugars, this and that. Like, I really knew nothing about pumps and CGMs and this and that. I was a diabetes camp counselor back in the day down in Florida, but that was when kids were still doing, you know, finger sticks before meals and lining up for their insulin. Yeah. So things have changed so much since I've been trained, so I wanted people to talk to me like I was just everybody else.

[A]

Yeah. Do you have kids in your practice who have type one?

[B]

I do, yeah.

[A]

Do you get very involved prior to your child's diagnosis? Did you get very involved in it, or was it one of those things where you're like, well, that's the endo, and this is me?

[B]

Yeah, pretty much, yeah. We don't have anybody locally for pediatric endocrinology, so people have to travel. I pretty much make sure, you know, they're seeing their specialists, their A1Cs are good, they're doing what they need to do. You know, prior to this, kind of just let the endocrinologists deal with it

[A]

all in that situation. Are there now hindsight, are there overlaps that should impact your care? That previously you weren't thinking about that, now you are.

[B]

Absolutely.

[A]

So another learning experience for you, like, this is. You think this will help a lot of your patients, too?

[B]

Absolutely. You know, so many things that I've learned about, especially with the pumps and the CGMs and the symptoms of things I'VE learned a lot about 504 plans and school accommodations. So not just for diabetes, but for other chronic medical conditions. You know, I really encourage families to be proactive and get 504 plans and make sure they're advocating for their kids school system, which I don't think I did as much of before all this.

[A]

Are you telling me that there were other kids under your care that you maybe in hindsight should have said, hey, maybe you guys should have a 504 plan or.

[B]

Yeah, I mean, I know the endocrinologists and the specialists tend to take care of that, but in reality, it's the pediatrician's job to say, do you have everything set up for what you need?

[A]

I've tried my hardest to forget about 504 plans because it harkens back to a terrible time in my life. But when you, you kind of, you kind of laughed about it. So tell me a little bit about the process. So you realized he's going to need this. You started looking into it. You know, it's not cut and dry as far as, like, it's not what should go in the plan. You don't recognize at first that the school very well may not be thrilled that you're trying to apply a 504 plan, that they might fight with you or try to simplify it to limit their exposure. There's a lot of things that happened once this whole thing starts moving in that direction. But would you tell me a little bit about what happened to you guys?

[B]

It was interesting because he was finishing up middle school and then going into high school, so we didn't really do anything in the middle school timeframe because there wasn't a lot of school left. I'm a reader. I try to do as much reading as I can, and I get perspectives from other people, talk to some people online, get questions answered. And I Learned that really 100% of type 1 diabetes kids should have a 504 plan. Research the ADA website. The school comes back with what they think. They're kind of their cookie cutter, okay? They get this and that and the other. Because cell phones have become such a bigger issue with schools over the past year or two, I was surprised at how much you need to advocate for your kids for a 504 plan and what they need to thrive in school.

[A]

Specific to cell phones or in general,

[B]

generally, I think everything is okay. But I think with the cell phones, you know, you have people say, well, you know, kids dealt with diabetes, you know, before cell phones existed. I think that the general public and even in education don't realize how important the cell phones are to keeping you alive and keeping you managed on a 24. 7 basis.

[A]

Yeah. Your regular and MPH was not attached to a digital device that was controlling it.

[B]

Right? Right.

[A]

It's almost more helpful just to talk about it as the insulin pump controller or the CGM receiver and then spring on them at the end. It's also a cell phone.

[B]

Right.

[A]

You know, it's so funny because I'm old enough. How old are you? Do you mind? Sorry.

[B]

That's okay. I just had a birthday. I'm 45.

[A]

Oh, happy birthday. I'm about 10 years older than you.

[B]

Okay.

[A]

When they started letting kids take cell phones to school, I was like, hey, this is a bad idea.

[B]

Right?

[A]

And then it was a bad idea, but it became commonplace. And people, especially parents, are so pushy. Then they just. My kids got to have this. What if there's a problem? How are they going to get a hold of me? The same way I got a hold of my mom in 1978. If there was a problem when I got home, I spoke to her. But, okay, we. We got it into our heads that, like, you know, the danger that's around if you can't contact somebody immediately, like, you know, and it became the norm. Right. And by the way.

[B]

Right.

[A]

There's a ton of good reasons that people should have communication. I'm not even saying that. What I'm saying is it clearly messed with how school works. Right? Like, kids are like, can't put their phones down. They're. You know, it creates all kinds of other problems. It took us. I mean, when did I get my. My first iPhone? 2007. Is that right? Is that right? I think that's right. Okay. So if that's right, then nearly 20 years later, we all went, huh, that was a bad idea. Letting kids take phones to school. It took 18 years for people to go, you know, we probably shouldn't give them a screen to porn and games while they're trying to learn.

[B]

Right.

[A]

Or whatever else they're looking at. But mostly games important just in case you're wondering what they're doing.

[B]

Oh, boy.

[A]

I mean, just put your head down. It's. You don't want to know. Point being is that in that time, some really good things came out of it. Like, hey, you can see your CGM on your phone or give your insulin for your phone, or I'm sure there's a number of things outside of diabetes that has a lot of value for. And now we're going to tell everybody, nope, you can't have them. And then there's the part of me that goes, yeah, that's a great idea. And then there's the part of me that says, what are you supposed to do? Because then I say, well, Jennifer's kid gets to keep his phone, but not your kid. And where's that going to lead? You know, show and a half in five minutes. But anyway, you're trying to get the 504 plan in place. They're not understanding the necessity of the phone, especially in this time where the pushback is now going the other way. Is that what you're saying to me? Right? Yeah.

[B]

Yeah. And I think, you know, they got the point that the, you know, seeing the numbers and keeping the phone close and everything. But one of the things I fought for was his ability to communicate with me during the day if needed.

[A]

Well, you know, I made that impassioned plea about, you don't need to talk to your parents all day, but I'll tell you, you can text with somebody who's helping you manage your diabetes. Especially when you're younger, you don't know. It's such a big deal and it makes everything so much better. So.

[B]

Right.

[A]

Look at me arguing with myself. It's fun.

[B]

Well, and I think that if you have something in writing and you have, you know, legal protection, then nobody's going to get in trouble and there's not going to be any problems. So I think that, you know, being proactive and advocating for your kids is just so important on so many levels.

[A]

You know, some kids are going to be like, just say, hey, look, I need this. It's no, I don't care. But when the rules start falling, flying back the other direction where people can't have, they're going to be. Some people are going to be embarrassed that now your cell phone's going to be a way for people to know that you have an illness or something.

[B]

Right?

[A]

Yeah. You know, so then they're going to be kids who struggle with that, not want to take their phones out. I already talk to people whose kids are like, I don't, you know, I can't get them to give them self insulin in class. Why not? Doesn't want. He doesn't want to pull his phone out when no one else is allowed to. That nobody wants a, you know, a spotlight shined on them. It's interesting how the problems will, like, continue to morph and shift off of the issue. But did you finally get it set into place? Did they argue for a long time. Did you need an attorney?

[B]

No, we didn't need to make it go that far. Everything got into place just fine. I just kind of sometimes just had to make myself clear, I guess, go into mom mode.

[A]

So when you made the sound about 504, it's more about the. The speed bumps that you look back on and go, this didn't need to be this way.

[B]

Right, Right.

[A]

Yeah. It's just. It's frustrating, and it's a lot of extra work that in the end, everybody goes, oh, okay. And you're like, yeah, why are you fighting with me?

[B]

Right. Well, and it's interesting because I think, you know, I talk to families with, you know, multiple different chronic medical conditions. Right. And a lot of people say, okay, do you have a 504 plan? And people will say, what's that? So it's interesting to know that it's not even common knowledge that someone may need one.

[A]

Or they go, oh, is that an iep? And you go, no, not really. No. It's not really the same thing.

[B]

Right.

[A]

Yeah. Yeah. I guess I remember your frustration because at one point I recall telling somebody, you can argue about this as long as you want, but when it's over, this is what's going to happen.

[B]

Right.

[A]

And I know that's way more direct than most people, probably. Actually, people have been telling me. Yeah. People online have been telling me I'm very direct, and I keep fighting with them, which I guess is part of me being direct. I don't see myself as that. I know that's maybe insane, but I don't see myself as being direct. I just see the world as, like, more common sense. Y. Like, why would you not say that?

[B]

That's exactly.

[A]

That's right. You know, and. And if I'm wrong, then I'll be shown to be wrong, and then I'll stop saying it, but.

[B]

Right.

[A]

Yeah.

[B]

Well. And I hear a lot of, you know, people want to complain about things. Right. In general, people would rather complain about things than not be active and do something about it. Right, Right.

[A]

Yeah. No, it's easier.

[B]

So. So I think it's easier to just be upfront and say, this is the way it's going to be.

[A]

Like you said, this is what's going to happen. I said, you can fight if you want, but when this is over, this is what's going to happen. And then when it happened, the problem is then if one side keeps ego about it, now you're at odds forever.

[B]

Right.

[A]

Because now that person feels like I Beat them because people are insane. But I guess the way the mind works is it's bizarre.

[B]

Right?

[A]

So, okay, so now it's set in place. You probably never even look at it.

[B]

Right.

[A]

Are you happy you have it still?

[B]

Absolutely.

[A]

Why?

[B]

Well, like I said, I think it's just legal protection. I think if somebody in the hallway or somebody who doesn't know him or a substitute or somebody wants to get him in trouble, then and say, nope, that's not going to happen.

[A]

Yeah, it is that easy sometimes. Like, you know, put your phone away. I'm giving myself insulin. Put your phone away. I don't care. Well, you. Right, you're going to care because. Yeah, the administrator is about to tell you to shut up. So.

[B]

Right, yeah. Right.

[A]

It really is that. It's just. It's more like a document that keeps people from. Who don't understand your situation from being a jerk to you.

[B]

That pretty much is exactly.

[A]

Yeah. Well, and then if something goes wrong, you can get it fixed because it's been laid out somewhere and agreed upon.

[B]

Exactly.

[A]

Yeah. Which is why they try to pass off a super simple 504 to you, because it's less for them to comply with.

[B]

Right.

[A]

More importantly, fewer things for them that they could potentially get in trouble for.

[B]

Right.

[A]

Always look at it like that. You'll know where people are coming from. All right, anyway, okay, so management stuff, you don't know what you're doing. You get people to talk to you plainly. But did that help? Or were you. Did you find yourself like, my people are great, or were you like, oh, I'm not getting much helpful advice here?

[B]

No, I mean, I think, you know, a lot of people talk about horrible hospital experiences. I think that we had a pretty good experience. You know, everybody was really good. I kind of got online right away, found some. I'm in some Dr. Mom Facebook groups and got connected to some people who, you know, kind of gave me some basic advice. One of my favorite expressions that I learned early on from someone, I wish I knew who it was, but they said, don't drink from the fire hose. And that has stuck with me because I think you get so much thrown at you at one time, you know, And I can't imagine what it's like to not have a medical background and have all this stuff thrown at you.

[A]

So even with things being thrown at you quickly and you understanding a lot of contextually what it was, it was still too much.

[B]

Yeah, yeah, yeah, exactly.

[A]

I made that Defining Diabetes series because of that idea. Like, I thought everyone's Yelling buzzwords at people, and they don't know what they mean, and they say them. They say like. Like you don't realize if you're a person who says bolus all the time, that there are a lot of people who go, I don't know what you're saying, you know, like, so. And then you just keep rolling on with it, and the person you're talking to is back there going, I don't. I guess I'll figure out what bolus means later, and then I'll. Maybe this will all make sense. Nope, it won't. So what did you find? Like, I know how I think of it. I mean, if you. It's not a secret. I think of it the way it's in the bowl. Beginning series. Like, that's. That's how I think about the beginning. But what did you find that was helpful?

[B]

You know, just talking to people, really. You know, and I think that the people in the hospital did a great job with him and with me. And, you know, we were. It was less than 24 hours that we were in and out and, you know, put a dexcom on him right away, which was great. And, you know. You know, it turned into a pretty good experience. Went back to school the. The following day.

[A]

Did you. He's right back again.

[B]

Oh, yeah.

[A]

Well, did you have that, like, we can do this, nothing's gonna stop us vibe going, I tried. You tried? Is your husband in medicine too?

[B]

He is, yeah.

[A]

Is he, like, just a different kind of doctor?

[B]

He's an anesthesiologist.

[A]

That's the best job, isn't it?

[B]

Yeah, he just doesn't. He talks to them, puts them asleep,

[A]

then he pops on a podcast, right?

[B]

Yeah.

[A]

Like, I don't know what he does. Don't ask him. Hey, listen, an anesthesiologist saved me recently. I've been put out a number of times, actually. My son said to me the other day, he goes, you know, you've had a lot of surgeries. And I was like, yeah, I was thinking that the other day too. You know, when I get the Jackson juice, it burns like crazy for me. Doesn't. Doesn't for everybody, by the way. So last time, I had to have it. You're laughing at what part? The Jackson juice. Yeah. Okay. So, like, I. So I said that to the anesthesiologist, I'm like, hey, yo, easy. That's gonna burn. I was like, is there anything you can do about that? And he goes, oh, yeah, no problem. And he tourniquet my arm and kind of like put it in a little slower and then held it for a minute before he let it through. And it didn't burn. And I was like. I remember thinking, thank you, but I couldn't actually say it because I was gone. I was gone, right? But now if I have something done, it's the last thing I tell people. Like, are you aware of how to do this? Because otherwise, when they inject it into my. I. My arm feels like it's on fire. And then that goes across my chest, and that's like, my last remembrance as I pass out. Oh, I mean, in the. In. You know, meanwhile, I guess it really doesn't matter because you're asleep in, like, a split second. Tell your husband if he ever wants to come on to a podcast, to explain the complexities of the idea that we understand that anesthesia makes people go to sleep and wake back up again, but we don't know understand how. I'm fascinated by that conversation. So, yeah.

[B]

Oh, yeah. He was seriously.

[A]

I. There. Maybe I was just saying it to Arden the other day. She was talking about something medical. She's like, why can't they just. I was like, arden, you know what I said, do you know that we don't know why anesthesia works? And she goes, what? I'm like, the stuff they put in you, you fall asleep, you don't die, and you wake back up and they take it away. And she goes, yeah. I said, we know that happens. We have no idea why. She's like, what? I'm like, yeah, now imagine what else we don't know.

[B]

Yeah, yeah, right.

[A]

But, okay, so he's. He's been through med school. You've been through med school. But does somebody take the reins on the diabetes thing or do you have that, like. We're trying to stay very vague about your children. Is your child of the age where you're like, oh, no, it's theirs to take over, or did you feel like, no, I should be helping?

[B]

Yeah, it's. I mean, it's pretty much all me. Like I said, I work part time, so. And because I'm more on the general practice kind of side of things, I tend to manage most of it. You know, as far as I'm the one who's calling the insurance and, you know, making the appointments and sending the messages. I mean, the nice thing about having a teenager who is smart and functional is that he does a lot of it himself. You know, every once in a while, I'm like, oh, is it a Dexcom day or So a lot of it

[A]

is on him, but by choice, like, does he want you not to be involved, or is it. No, he's looking for.

[B]

No, no, no. I mean, we. I'd say it's a team effort, but, you know, he's very intuitive.

[A]

Okay.

[B]

Which I think is good. It's funny because we've even had his endocrinologists, the nurse practitioner say, you know, don't make changes on your pump without talking to us. And I'm gone. Okay.

[A]

Yeah, I'll call you up before I change the basal from 0.65 to 0.7.

[B]

Exactly. Exactly. Now, there has been times. I mean, we definitely communicate with them. I try not to play doctor with my kids, so I do want to communicate with them and make sure that everybody's on the same page. But I think for little things like that, there's definitely something he and I can do together.

[A]

You feel like you'll grow together? Do you have an expectation that at some point he's going to look at you and go, okay, that's enough now. I'm good. I don't want you involved anymore. Do you think he'll keep accepting your help?

[B]

I don't know. I guess we'll see with time.

[A]

You're not an anxious person, huh?

[B]

That depends who you ask.

[A]

I know your husband thinks you are, but I'm asking you.

[B]

He probably does. Yeah. Yeah. I mean, I'm definitely a worrier, but I think it just depends on what's going on.

[A]

More so since she had kids.

[B]

Definitely.

[A]

Definitely. Yeah. That's the thing. I know I've probably joked about it one too many times, and I was like, I think there's a switch in there. The kids grab it on the way out and they, like, flip it. And then. Because my wife was a lot more chill before I made her pregnant. But it's good, though, right? Keeping the kid alive? Not good for you. It's good for them. You're very vigilant for them. That's awesome.

[B]

Right?

[A]

So I will tell you, as a person who's been at this for a very long time, being the parent of someone with diabetes, there is more than likely going to be a moment where your child is just like, hey, I'm good. And they're probably not really going to be. But it turns into more of, like, a psychological necessity at that point. You're going to have to, at some point, create boundaries, and he'll probably make them, and then you're going to have to, like, find a way to, like, live with them. Not ruin your relationship, but still, at the same time, make sure that the health part is okay. It's a really unfun part of this whole thing. In case any of you are wondering what comes next, this is.

[B]

Right.

[A]

It's not a big party, but you get through it. Like, you know, and it's, it's just, It's a process like the, like the rest of it, right? What kind of outcomes are you having right now? How does this, like, what do you think of as a spike at a meal? What are numbers you're shooting for? What kind of A1C's you trying for? Or how do you like your variability? Stuff like that.

[B]

You know, I mean, the crazy thing that, I mean, you know, about diabetes is like, you know, doing the exact same thing every day and your numbers are going to be different because that's just the way it is. One thing that I think helped early on was that one of the doctors said, you know, the goal is to not be a hundred percent in range. Right. All the time. And I think that, you know, knowing that the goal is not perfection and that the goal is, you know, being safe and having quality of life and, you know, functioning and feeling good, I think is the point on the. I don't know if it's on the Dexcom app or the Mobi app, but they're. They do give a percentage on the bottom, the app about your time and range, which I think is good and bad if you're a numbers person.

[A]

Because if you think that any number under 100 seems like failure to some

[B]

people, I mean, I could see where some people might feel like that, right? And because every day is so different, you might have a day where you're 50 to 60% in range, right? And then you might have a day where you're 90% in range. So I think that seeing that and can sometimes be a little bit frustrating, I'm sure. But yeah, I mean, the goal is to make sure he's feeling good and keep numbers in range as much as possible. But I think that aiming for that 100%, I think, is tough.

[A]

You don't feel that way. It's failure if you don't do a certain thing. If not, how did you get to that?

[B]

No, I don't. And I think that all things in parenting, you see things online, right? And you see, you know, at first I was following all these people online and, oh, my kid only eats veggies and meat and blah, blah, blah, and you know, and you're like, oh, well, I wish that it was like this. And I wish it was like that. But in reality, I think you have to do what works best for you and your family and your situation. Right?

[A]

Yeah, for sure. I agree. Like, so how does that happen? You look online. For what? For community, for people who understand, for answers, that kind of thing. At some point you find someone who was like, I'll tell you what I did. I eat one carb a year and it's fixed everything. And you're like, okay, well, we'll just. That's what we'll do. Right. Because they show you a beautiful graph and you're like this. I'm looking for that.

[B]

Oh, yeah, yeah.

[A]

And then what does it hit you? Five seconds later you go, I do. I would like a piece of bread once in a while. Like, hold on a second. Like, I.

[B]

Exactly, Yeah.

[A]

I didn't want things to change that much. Does that leave you feeling like it's an all or nothing situation? Like, well, I either have to be completely no carb or I have horrible blood sugars.

[B]

Not necessarily, but I think that that probably takes time to get that message through.

[A]

Yeah.

[B]

And I think there's a lot of that in parenting, you know, the comparing to other people. And, well, my kid's reading at 3 years old and, you know, my kid's in advanced classes and my kid's not. And, you know, there's a lot of that, I think, in all aspects of parenting. So I think that it's important to step back and realize, you know, again, what works for your family is what works for you. And I counsel that a lot in my job with different aspects of life. So a lot of this has kind of turned over into the way that I counsel families and do reassurance and have empathy for their situations and talk to them about their life.

[A]

Yeah. I find that the messaging I wish, I hope I'm. I'm giving out is that there is a standard that you're reaching for. You don't need to get to it today.

[B]

Exactly.

[A]

You also don't want to get halfway to it and go, ah, that's good enough. It's a process. And that process may take longer or shorter for different people, and you're certainly not going to get through it quickly or at all if you don't have at least some of the tools and the basic understandings. So go find those understandings. Live through your experiences over and over again and keep making adjustments till you find. Find the thing that works. The tough part is that the diabetes is adjusting while you're Adjusting, correct? Yeah, yeah. It's not a lot of fun, right? Really. It really isn't.

[B]

Right.

[A]

Can I ask you a question?

[B]

Okay, yeah.

[A]

Yeah. So this is. Have I not been asking you questions? Do you just think, like, have you not been asking me questions for the last 40 minutes? You dumb. But like. So I've been. I just talked about this with another person. So it's going to come up in the podcast in succession for you. Listening, guys, listening. I'm sorry, but. So you're a mom. Your kid has type 1 diabetes. Not for a long time, but for, you know, a rather newer diagnosis. You're also obviously who you are professionally. If I told you that I have on my website, I've just not made it public yet. I have a calculator that if you put your weight into it, would give you an average start for insulin to carb ratio, basal and sensitivity, would you say? I think that's a good thing for people to see, possibly. How much does your child weigh?

[B]

Mine? I have no idea.

[A]

Can you ballpark guess?

[B]

Maybe 130.

[A]

Okay, so if I type 130 in as the weight, it will tell you that an estimated total daily dose is around 32 and a half units. Do you think he uses about 32 and a half units a day or is that wildly off for him?

[B]

No, that's possibly about right.

[A]

About right. Okay, is his basil about 0.68 an hour? 0.7. Does he use about. Does he use about 16 units a day in basal?

[B]

That sounds about right, I think.

[A]

Okay, do you think a unit moves him how far? Like when you're doing a Correction? If he's 200, what gets him to 100?

[B]

Maybe three or four units. I'm not sure.

[A]

It could be more. Yeah, it's interesting. This tells you like you know it. It says, look, here's an estimated start for your insulin sensitivity. You know, one unit drops you by 55 at a standard eight. So it's using. For insulin sensitivity, it's using the. The 1800 rule to find the number. You can switch it to use different, like a more resistant or a more sensitive rule. Same thing for the insulin to carb calculation. It's being done by the 500 rule, which is where the math comes from, to figure out people's starting rates for their. Their carbs. And for Basil, there's different factors. It's using the standard, which is 0.55, but it also gives you opportunities to switch to high sensitivity, resistant or highly resistant. My question is, if you had that because you have access to people. You talk to a lot of people. So if it's true that people are being asked to do something with specious settings, they're not quite sure if their settings are right, would it not be helpful to give them something that says, look, these are about maybe where you should start looking at your settings for. Does that seem like a value to you?

[B]

Possibly. I know we relied on his doctors to kind of create those settings and at the beginning and periodically when we check in. And those are all on his phone, which is why I said I wasn't sure.

[A]

Yeah, of course.

[B]

So all of those settings are there. And I know that the medical professionals created those settings and we adjust up and down as needed.

[A]

I'm wondering, because you're a doctor, if you could somehow look at this calculator and go, okay, well, these are the, these are the mathematical formulas that an endocrinologist is using to get a starting point for these numbers.

[B]

Right.

[A]

Right. Would you consider sharing it with somebody or would that scare you? And if so, what scares you about it?

[B]

I would probably let the specialists do that just because they have. So a pediatric endocrinologist has three extra years of training compared to me.

[A]

Yeah.

[B]

So like my residency is in general pediatrics and I did some rotations in endocrinology. But, but if you're an endocrinologist, pediatric endocrinologist, you've done three more years on top of that. So I feel like probably leaving it to them to create the mathematical goals and do that, at least to start. Everything is a good thing. Like I said, we kind of adjust up and down in increments if needed. But I think getting their perspective from the beginning is important.

[A]

How long has your child had type 1 now?

[B]

A year and a half.

[A]

Year and a half. The reason I asked you a question about the calculator is because you're very new at type one, but you've been a doctor for a very long time. So you're going to be more risk adverse about like just telling people like, hey, click on this link. But at the same time, have you not gotten a lot of your information that way?

[B]

Right. That's true.

[A]

Yeah. Yeah. So I, it's just, it's, it's interesting. The reason I ask is because I'm going to spend a fair amount of time this year talking to people in clinical settings. I want to be able to say to them, listen, I've been doing this for 12 years. This is what they need to know, and these things will help them get to it. Faster. But you've got to believe that it's a big leap if you're a person who went to medical school or you're a nurse or, you know, a professional person and a guy comes along and goes, hey, I make a podcast. You know, everything that I know about diabetes is in these, these series right here. I think if you listen to them and understand these T shirt slogan sayings about type one, you'll be well on your way. But you do need good settings. So here's the thing that'll help you get to that. Godspeed. Like, take all that, synthesize it together, apply it to your own life. And I think you're going to be better off if you do. How do you make a person like. Because that's my pitch. And by the way, I believe it, okay? And I believe it because I've seen it work for, I mean, honestly, countless people. So, like, but how do I say it? But, but what I just realized is when I said it to you, you were kind of like, I don't know, I don't think so. I want, I want. And you listen to, you've listened to this podcast, right?

[B]

Yeah, yeah.

[A]

So you, you listen to this podcast, you've had some success. I would bet on things that I've said and I mean, what's your kids A1C right now?

[B]

Probably around six point something.

[A]

Yeah, you're doing good. And when I said, hey, do you think I should tell people that you were like, What made you go, well,

[B]

just kind of like, I don't know, it's hard to explain. You know, I mean, it's good to get online and get people's perspective of things. I think like when we were looking at pumps or you know, various inform to get information. Right?

[A]

Yeah, yeah, go ahead.

[B]

But

[A]

may I? Yeah, you trust yourself.

[B]

Yeah.

[A]

So if we step out of this conversation and we, and we, you as a doctor, look at you as a parent situation, you say, well, yeah, that person was able to go online, get things and synthesize it and put it together because they were a doctor and they had more critical thinking. But what about the people who don't have the critical thinking? So you think it's possible that you had success because you had knowledge that other people don't have? I'm telling you that this works. Eight to 80, blind, crippled or crazy, it doesn't matter.

[B]

It's just like a lot of things, I mean, half my day is people coming into my office saying, well, I looked at this online or I found this on Google or I asked ChatGPT.

[A]

Right, right. And so you're freaked out because what if they're getting bad information, but you got good information when you did it?

[B]

Right.

[A]

So that's gonna be my problem when I'm talking to doctors. So you've just identified for me what I have to change about my pitch.

[B]

Hmm.

[A]

Thank you. Because. Because here, I'll pitch it to you a different way. You may or may not know this, but if you go to one of these AI like models at this point and ask it diabetes questions, it's gonna give you some pretty rock solid advice.

[B]

Oh, yeah?

[A]

Yeah. I just had a medical problem cleared up for me because of ChatGPT.

[B]

Oh, definitely.

[A]

Something I, I struggled with forever. I talked about on the podcast recently. If you haven't heard it, it's worth listening to. I was hilarious when I explained it. But I'd still be struggling today if it wasn't for that. And you could say, well, you could have Googled it. I did Google it. It didn't work out that way for me. Like, I couldn't get an answer that way. I've seen people drop their graphs into a model and ask it where they think they're making their mistakes with their insulin. And without any context, it's being valuable to them.

[B]

Right.

[A]

So. But I get also that I don't want just people running around yelling out into the ether and whatever they hear echoed back at them. They just start doing. But I'm not saying that. I'm saying that when a person is lost in the woods, if you don't have a flashlight and a map to give them, it still might be nice to stand off in the distance and yell over here and see if they can't make their way to you.

[B]

Right, Right.

[A]

That's kind of how I think about it. I know that the medical system, and for a lot of good reasons, does not think about it that way, but I'm going to guess a couple hundred thousand people have listened to this podcast and they're doing okay. So, like, so I'm trying to figure out how to, like, how do I leave that message? Because I have until April. I have until the middle of April because I have. Hey, Scott. I am the diabetes coordinator for the office, and I am thrilled to announce that you have been chosen as the keynote speaker at our symposium. So I have about, I got about three months to figure out how to say that. So anyway, I, I, I, I like that you were. I could bounce it off of you for a second. Thank you.

[B]

Sure.

[A]

Yeah. Yeah, but I. But your reaction told me a lot. It was very helpful because you're. You're a. You're a lovely, reasonable, smart person. I've been talking to you for an hour, and you listen to the podcast and got value out of it. And still when I said, should we tell other people about it? You're like, oh, I don't know, man. That was pretty good information for me. I appreciate that. Anything in your story that we haven't touched on, stuff that you want to talk about that we've missed? I don't want to miss any of your topics.

[B]

I guess just talking about the way that it's changed the way that I practice medicine a little bit. And it's not just diabetes, but just really any chronic medical condition, too. One of the things that I try to address, I try to be a whole picture kind of person. So if I know I'm seeing a sibling of someone who, you know, I know the sibling has been undergoing cancer treatments or the sibling has had some health problems, you know, I try to make sure that the siblings are okay and the families are okay and how can I help? Kind of thing.

[A]

Yeah.

[B]

Or what do you need? Kind of thing. You know, I'd like to admit that I was like this before.

[A]

You don't think you are?

[B]

I don't know. I think that it has changed a little bit. Like I said, I definitely know more about the school stuff and the 504 and the, you know, just in general. You know, I recently was on the school, on the phone with a school for, like, almost an hour, talking about a kid with. Not diabetes. Something else. But I think it's just wanting to help those kids and those families navigate the healthcare system, because it can be really challenging if you don't know what you're talking about.

[A]

What I feel like I'm hearing is that as your family's story gets deeper and richer and you have more perspective and experiences, that's impacting how you're talking to people in the practice.

[B]

It is.

[A]

That's what people mean when they, you know, when they say, like, oh, my doctor's great. They've been doing this forever. It's the. It's the that stuff. It's the nuanced stuff, the stuff that nobody teaches you or writes in a book that you get out of. Out of that. Like, it's life. Like, you have more. You have more life now than you had before, and now you have a really great place to apply it. And answer for me, why is it that that stuff Wasn't common sense before you had the life experience. And this isn't me coming down on you. This is me trying to understand the human mind. Because honestly, now that you've said it out loud, it's not like it's some great stroke of genius, right. To say. Yeah. To say to somebody, hey, your brother's sick, I'm going to be a little more compassionate to you. Like, so what, what do you think that is? Is the job just so clinical that it doesn't allow for that, or what. What is that?

[B]

It is. And a lot of it is time. I'll be honest. You know, if you're doing a well child check and you have 15 to 20 minutes in with the, with someone, you know, you're. You're going over a lot of things and those that 15, 20 minutes. But I think I've also learned to kind of pick and choose what needs to be gone over.

[A]

Okay, so your experiences are making you reallocate the time differently.

[B]

Correct.

[A]

Gotcha. It's like when they ask you, what's that one pediatrician thing that I. They clearly you're supposed to assess their mental health. Right. If they're depressed and you do it with like one sentence. What's the sentence? Say it.

[B]

Well, there's different screenings that we're supposed to be doing with the kids. Like there's One called a PHQ9. I tend to just talk to the kids about how they're doing or if there was any concerns.

[A]

I have an interesting experience because my kid's pediatrician who's no longer their doctor, they're older now, but was a friend and so he'd like look and go, arden, are you sad or anything?

[B]

Don't say that.

[A]

Yeah. She'd be like, no. He'd look at me and I go, she seems okay. They're like, all right. And that was sort of how it would go.

[B]

Right? Right.

[A]

But, yeah, but so you have like these little like lead in questions that you're supposed to ask, things you're looking

[B]

for that kind of stuff, right? Yeah. And I think like, I don't, I tend to not argue with parents as much if they're wanting something that's relatively easy. You know, a lot of people come in and they say, well, I want labs or I want a referral or I want this. And a lot of the times if it seems reasonable, I'm like, okay.

[A]

And prior you'd be like, this situation doesn't call for that. Or I don't.

[B]

Right.

[A]

And you're. Instead, you're like, this will make them happy or comfortable or satiated.

[B]

Exact. If you feel more comfortable checking some lab work. And we have a reason, like something we can code for. And you're concerned I'm fine doing it, yeah.

[A]

Why? I am. You have a tough enough life. Why am I making a fight here?

[B]

Exactly. Exactly.

[A]

And that comes from. Now you know what it's like to have a tougher life.

[B]

Right.

[A]

Prior to Arden's diagnosis, I would tell you that I had a 2 year old and a, like, I don't know, 4 year old. And I just bought a little house and we were fixing it up and we had property and everything. Like, we were doing okay and everything felt like it was going. And I was like, oh, my life is. This is what I was trying for. Like, you know what I mean? Like, all this stuff is happening. And prior to that, like, any of the hardships I had before that were gone, like, I kind of, like, moved into another part of my life, you know, and then this happened and I was like, oh, God, like, this is. I didn't expect this level of resistance from the world, you know, and it was. It was really a shift. And I'm wondering, like, did you have a similar experience where things were going okay and then suddenly this happened, or did you have a lot of struggles that prepared you for this?

[B]

No, I think probably very similar experience, you know, when you're just cruising along and then, you know, my grandfather used to have an expression where he would say, man plans and God laughs. So, you know, but I wouldn't say it changed too much. I mean, we still travel. You know, I think when you originally maybe get the news of the diagnosis, like, okay, what's going to change? Right. Well, we still travel. We still do the things that we want to do, you know, but you have to adjust. But I think that is the original fear, of course. Yeah.

[A]

So it's not perfect, but you still. You make your way through it. Okay.

[B]

Yeah, we try.

[A]

I feel badly when, like, you're talking about how, like, you know, how it impact. How things can impact people. Like, I mean, it was hard. I'm not going to say. And like, I've said this before, I didn't have a podcast to listen to, you know, a lot of the things that I just say off the top of my head now that people are like, oh, Scott's so lucky. Like, I figure all that out by, like, you know, living through horrible situations still. I'm okay, you know, you know, like, it. But it wasn't great. Like, there Was. There was a. There were years of like, oh, my God, this is going wrong, you know, and. And this isn't going to be okay. And she's gonna have real problems, and. But I just. I don't know why I didn't give up to be. Perfectly honestly, I'm just happy. That sort of. Not how I'm, like, built or whatever, but. But now I look up and I see people who are. Have access to help or information or even ideas, you know, and then they can't get to them. And then that. That kind of breaks my heart too.

[B]

Oh, right.

[A]

Because you know what people are going through, and.

[B]

Absolutely.

[A]

Some of it's just not necessary.

[B]

Yeah. Well. And I mean, I see a lot of kids who don't have supportive families and it's, you know, don't have transportation to their specialists and don't have people who are taking care of them, and I think that that is even more difficult and Sad.

[A]

Out of 10 random people, how many kids do you think are living a life with a parent that's not supportive in one of those ways?

[B]

You mean on a regular day?

[A]

Yeah. How many times a day do you walk out and just run your head into the concrete wall across from the door when you walk out?

[B]

Boy. Multiple. No, probably a handful.

[A]

Yeah.

[B]

Yeah.

[A]

It's tough.

[B]

Yeah.

[A]

I mean, have you sat quietly and thought about that? Like, what's the help there? Or is there just nothing to do?

[B]

Definitely.

[A]

Have you come up with any answers, like, how do you. How do you circumvent a parent? That's not valuable in the situation.

[B]

I mean, it's definitely tricky. You can't call CPS on everybody. You know, I try to just make sure that they have what they need and, you know, any referrals or. Like I said, I try to say, how can I help? You know, sometimes it's just a tricky situation.

[A]

Yeah. Does it end up. I mean, you've been at it long enough now. Think back 10 years ago to a family that you were like, oh, this is a show and this kid's in trouble. Did it end up that way or did it. Do things have a way of working out when you don't expect them to?

[B]

It's hard to know from 10 years ago because a lot of times people fall off the grid. So, you know, if there was somebody at that point, they may not even be in our town anymore or in our practice or. You don't, you know, Hard to. Hard to know. Right.

[A]

Yeah, you don't. You don't always get to, like, See somebody all the way through. Is that tough?

[B]

Exactly.

[A]

Is it hard to, like, put so much effort into somebody and then not see the result? Or is that part of the job?

[B]

I mean, it's kind of part of the job, I think, especially when you're in a practice with there's. There's six of us in our practice. So, you know, I'm not always seeing the kids for everything. So sometimes people will bounce back and forth between different doctors. So you may see them for a little bit and then not see them for a little bit.

[A]

Yeah, people don't even consistently come when they're supposed to. No. Oh, you said that like, no, dummy. I can't believe you asked that like a question. I would never not do that. That's why, like, it doesn't. It doesn't occur to me.

[B]

Yeah, well, I'll see someone who said, oh, I haven't been here in three or four years, so. Well, A, you're lucky that you haven't needed a doctor in three or four years. And B, I say, well, you're here now, and that's all that matters.

[A]

You just made the same noise my son made to me the other day when I said, I go, this is going to sound. I don't know if it's going to sound Pollyanna or childish, I'm not sure. But I said, man, so many people drink too much in the world. It's not part of my lifestyle. So I don't really. I'm not aware of it, I guess. But he laughed and he went, yeah. I was like. He's like, dude, everybody. And I was like, gotcha. It's also, by the way, you do whatever you want. I honestly don't. I honestly don't care. We, me and my kids had this conversation again recently about, like, judgment. And I stood there and I was like, listen, I am not judgmental. I was like, you can live your life any way you want to. That's not going to stop me from assessing it the way I see it. But my assessment's not a judgment. And I was like, and that's only a thing you can measure in my heart. So you have to believe me, if you ask me to talk about a life's ill in stark terms, I guess you'd be like, wow, that's really judgmental. But the part you wouldn't hear is that if that's their life and that's what they want, whatever. I don't really have an opinion about what other people do. I have an opinion about the idea, but not about your decision. And I keep like, oh, my God, are they gonna understand what I'm saying at some point or not? Because I think people listen to this, would say, generally speaking, like, I don't think Scott's judgmental at all. Like, I think he's. I'm pretty live and let live. Like, I'm a. You know, that. That's my vibe. But if you ask me, like, do I think you should be drinking a case of beer every couple of days, I have some pretty strong thoughts about that.

[B]

Right?

[A]

Yeah. Yeah.

[B]

Yeah, me too.

[A]

Yeah, you're right. But if that's what you're doing, like, go get it. You know what I mean? Like, it's all right with me. Like, just, you know, pretty much it anyway. And so when I said that about the drinking, my son was like, yeah, dur. Like, which is, anyway, what you just made me think of when I was like, do people not come to their appointment? You're like, yeah, they don't.

[B]

Okay, sorry, I didn't know that.

[A]

I just. Like, if you tell me I made this baby and I got to take care of it, I'm taking care of it. Like, I don't know. Like, I just. That's. Again, I'm not even taking credit for it. I think I'm just wired that way or my past experiences that put me in that situation or whatever. Anyway, so. Okay, well, this is interesting. Like, I. I. Do you think you'll keep practicing?

[B]

I do. You know, I'm still young in the field of medicine. I guess I always think that maybe I'll do some other things, but this is kind of what I know how to do, so I don't really want to start over and do something else.

[A]

Well, if you keep that promise to yourself and I can keep this podcast going, would you, like, come back in a few years?

[B]

Absolutely.

[A]

I really want to hear how you've morphed.

[B]

Okay.

[A]

Yeah. Because you're very new at this. You don't even realize it. You're like, no, I've been at this a year and three. And the year and three months, Scott. I don't know if you heard the three months. Okay, you're gonna, like, three years from now, you're gonna have such a different perspective, and I am super interested to figure out how it impacts your profession. Yeah. Keep me in mind, is what I'm saying. I mean, did you have a good time?

[B]

Yeah, definitely.

[A]

Good, good. You're a little reserved, so sometimes I didn't know if I was insulting you or. You're Just being proper. Do you know that about yourself? Are you being professional or you're reserved?

[B]

I don't know. I talk on the phone to a lot of people, parents and stuff. So maybe it's just me being you.

[A]

Like, you have a. You were. You were measured a couple of times. You're like, oh, I'm not going to say that out loud. He joked about this. I will not respond to that. But. But. But I made you laugh a couple of times, which made me feel good. Yeah, yeah, yeah. I'm like, oh, I got to her. Which, by the way, is why I told the masseuse, let's not start. Okay. Because if you start chatting me up, I am going to feel like a compulsion to make you laugh, and I'm trying to relax. Okay.

[B]

Yeah.

[A]

You really. You were lovely, Jennifer. Thank you.

[B]

Well, thank you.

[A]

Seriously, do you think you'll keep listening to the podcast for support, community, or do you think you were there for information and you have it?

[B]

I think I will. I tend to be a little bit choosy. Can I say, you know, a lot of things that I see online and things that I look at are younger kids and, you know, while it's still helpful for me, maybe in practice, not

[A]

really personally might not feel the same.

[B]

Yeah. So it just. It feels a little bit different. But. So I. I kind of go through the podcast and look for things about teenagers and various things, and.

[A]

Yeah.

[B]

So it hits home a little bit more for me.

[A]

Gotcha. Yeah. Well, don't miss knowing all of your tools, part one and part two, because in part two, I talk about the medical thing that happened to me, and if nothing else, I believe I was hilarious when I explained it. So you don't want to miss that. I also think that. Not that. Not that I'm telling. Look. And I crank out a lot of content. I'm not telling you you have to listen to 20 episodes a month, although I. Please do. But what I am saying is that I think there's something in those stories sometimes that you don't know the value of until the day you need it, and then suddenly you have it. Maybe not unlike what you're learning about your own personal experiences and how they're helping you at work.

[B]

Right.

[A]

I just like to tell people that. One of the reasons, like when people are like, why don't the. The descriptions of the podcast tell you exactly what the episode's about? There's a couple of reasons. One, if you even just stop and think about the last hour, what the hell was this about? You know what I mean? Like, how you breaking that down? You can't break that down into a sentence. But two, let's say it was about like, I don't know, celiac. And, you know, like, say that when we got done, you were like, well, what we basically talked about here was celiac. And this, I know it's not what we talked about, but like, let's say that was it. And I put that in a script today. Jen comes on, she's a pediatrician who's blah, blah, blah, blah, blah, blah. And you see two words, you go, I don't need that part. And then you miss the rest of it.

[B]

That's true.

[A]

That's the thing about it. Maybe I'm giving myself credit and I don't mean to be, but I think that these conversations are really valuable in ways you can't even know all the time, even while you're listening to them. And sometimes it takes time before you go, oh, I'm glad I heard that.

[B]

Right, right.

[A]

Anyway, keep listening if you like. If you don't, there's other people listening. I'll be okay, John.

[B]

I will.

[A]

All right, hold on one second for me. Okay. You really were terrific. Thank you. Happy New Year.

[B]

Thank you.

[A]

This episode of the Juice Box Podcast is sponsored by the Omnipod 5. And at my link omnipod.com juicebox jump you can get yourself a free. What 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] Dexcom sponsored this episode of the Juice Box Podcast. Learn more about the Dexcom G7 at my link dexcom.com juicebox thank you so much for listening. I'll be back very soon with another episode of the Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple Podcasts, please do that now. Now, seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? If this is your first time listening to the Juice Box Podcast and you'd like to hear more than 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. This podcast is full of collections and series of information that will help you to live better with insulin. If you're new to type 1 diabetes, begin with the Bold Beginnings series from the podcast. Don't take my word for it. Listen to what reviewers have said. Bold Beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked. People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen to, they recommend it to everyone who's struggling. It's straightforward, practical and easy to listen to. Bold Beginnings gives you the basics in a way that actually makes sense. The Juice Box Podcast is edited by wrongway recording wrongwayrecording.com if you'd like your podcast to sound as good as mine, check out [e-mail].