#1780 Best Of Juicebox: Type 3c Diabetes

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1780: Best Of Juicebox – Type 3c Diabetes

Aired: February 22, 2026
Guests:

• Host: Scott Benner
• Guest: Lara (Type 3c Diabetes, pancreatic cancer survivor, British Columbia, Canada)

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Main Theme / Purpose

This episode explores a rare diabetes journey: Type 3c diabetes as experienced by Lara, a 46-year-old Canadian who developed the condition after losing her pancreas (plus spleen, gallbladder, and part of her stomach) during cancer surgery. Lara and Scott dig deep into Lara’s diagnosis, her experience navigating both cancer and diabetes—especially the emotional toll, the inadequacies of the Canadian healthcare system, and practical and emotional strategies for managing a life-changing diagnosis. The episode offers hope, candor, and boldness for those dealing with complex diabetes, especially pancreatic and secondary diabetes.

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Key Discussion Points & Insights

1. Lara’s Diagnosis and Early Symptoms

• Initial Presentation:
  • March 2021, severe back pain, radiating through shoulders, oily stool, abdominal pain, nausea, general malaise.
  • Initially attributed to a keto diet; symptoms were intermittent ("In hindsight, really, the warning signs were there from long ago." – Lara, 05:05)
• Diagnosis:
  • Hospitalized for pancreatitis; abnormal bile duct found later (July 2021); initial scans clear.
  • Follow-up CT in February 2022 found a 1.44cm pancreatic mass, described as "very small" and caught early. No symptoms at time of detection.

2. The Cancer Journey & Emotional Responses

• Cancer Confirmation:
  • PET scan & biopsy: invasive pancreatic ductal adenocarcinoma, very aggressive (13:12).
  • Past family trauma: Lara’s uncle died of pancreatic cancer, adding emotional weight.
• Honest Reflections:
  • Both host and guest share vulnerability, with Scott connecting via his mother’s cancer ("At some point I'm going to cry today. Just so you know." – Scott, 15:01).
  • Lara describes the shock of hearing about her cancer: "When I first got the first report that I had pancreatic cancer...the Google tells you no one comes out of it." (26:02)

3. Surgery & New Reality: Sudden Type 3c Diabetes

• Surgery Surprises:

  • Six weeks before surgery tumor grew rapidly (from 1.4cm to 4.5cm; "It grew by like 40 times its size in six weeks." – Scott, 19:24).
  • Surgery outcome: Total removal of pancreas (plus spleen, gallbladder, part of stomach).
  • Post-Op Shock: Nurses panicked over uncontrollable blood sugar (25+ mmol/L [~450 mg/dL]); Lara knew nothing about DKA or diabetes at that point (23:16).
  • "I awoke to nurses in sheer panic because they were unable to control my blood sugar." (20:44)

• Hospital Management (or Lack Thereof):

  • For nine days, little education provided; insulin given with meals, but no context.
  • First severe hypoglycemic event happened alone at night, with Lara not understanding what was happening (34:27).
  • Basic discharge orders: Fixed insulin doses with minimal instruction; no carb counting or education about lows (42:13).
  • Digestive enzymes prescribed for life due to missing pancreas, but dosage was guesswork: "Too little or too much have the same effect—serious diarrhea." (47:03)

4. Gaps in Diabetes Care and Self-Education

• Systemic Failures:
  • Little support or information about diabetes upon discharge or during recovery:
    • "No one told me anything about diabetes." (33:25)
    • "I didn't know that I could give myself more insulin if I had a snack. I didn't know any of that until I found your podcast." (42:18)
  • Lara fired her initial endocrinologist for being out of touch: "I like the facts. I don't need the fluffy stuff." (28:08)
• Self-Advocacy:
  • Discovered The Juicebox Podcast via searching for people "like me" (i.e., with no pancreas); Episode #279 with Jen was the entry point, after which Lara became a regular listener.
  • Became "Bold With Insulin" through self-education and community, not clinical guidance.

5. Canadian Healthcare System: Shortcomings and Workarounds

• Systemic Delays:

  • "In Canada, it's a province coin flip whether you get good health care or not." (07:42)
  • Delays in crucial scans (three months overdue), stat PET scans skipped due to waitlists; Lara paid privately to expedite her care, likely saving her life (56:04).
  • Bureaucracy: Delays in reading scans, need to physically deliver imaging discs to cancer center (59:27).
  • Insufficient access to emerging diabetes tech; had to fight for pumps and CGM.

• Host’s Comparison:

  • Scott highlights tradeoffs of Canadian vs. U.S. health care—cost vs. speed and access.
  • Both emphasize that self-advocacy is essential regardless of system: "If you take what someone tells you, you are very frequently not going to end up well." (67:43)

6. Cancer Recurrence and Ongoing Treatment

• Unexpected Recurrence:
  • Six-month "clean margins" post-chemo, but tumor marker spiked from <27 (normal) to over 1,800 (55:56).
  • Private PET scan showed new liver/kidney/lymph node metastases—while CT scan still pending.
  • Continued chemotherapy (Gemcitabine/Abraxane), plus naturopathic adjuncts (high-dose IV vitamin C, targeted hyperthermia treatments).
  • Positive response: Metastatic tumors shrinking/disappeared ("I am in the third of that third that are responding exceptionally well." – 63:06).

7. The Real Impact: Family, Legacy & Emotional Growth

• Motherhood and Mortality:
  • Lara is preparing for her daughter's graduation and for possible absence at future life milestones.
  • Preparing memory notes and experiences to leave behind—an honest dialogue about life, death, and legacy.
  • "We're trying to learn to be patient and graceful...giving each other grace and space and time." (75:18)
• Value of Hope & Attitude:
  • Lara cultivates a positive mindset deliberately, with the help of her support system and mental discipline.
  • "Some days I fake it and some days I don't" about optimism (80:32).
  • Focus on “helping others”—her motivation to share the story (51:14).

8. Advocacy and Advice

• Universal Takeaway:
  • Systemic gaps in care demand self-advocacy, persistence, and family/community support.
  • Knowledge is power: Lara cites the crucial role of podcasts and lived experience stories in filling educational, emotional, and practical voids left by healthcare systems.

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Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote / Moment | |-----------|---------|----------------| | 05:05 | Lara | "In hindsight, really, the warning signs were there from long ago." | | 15:01 | Scott | "At some point I'm going to cry today. Just so you know." | | 19:24 | Scott | "It grew by like 40 times its size in six weeks." | | 23:16 | Lara | "I awoke to nurses in sheer panic because they were unable to control my blood sugar." | | 34:27 | Lara | "I didn't feel well...I pressed the call button and...I had a low blood sugar. I didn't know this was going to happen to me. They didn't tell me." | | 42:18 | Lara | "I didn't know that I could give myself more insulin if I had a snack. I didn't know any of that until I found your podcast." | | 47:03 | Lara | "Too little or too much [enzymes] have the same effect—serious diarrhea." | | 56:04 | Lara | "I ended up having to pay for a private PET scan because I couldn't get one done in a timely manner here." | | 63:06 | Lara | "I am in the third of that third that are responding exceptionally well." | | 75:18 | Lara | "We're trying to learn to be patient and graceful...giving each other grace and space and time." | | 80:32 | Lara | "Some days I fake it and some days I don't [stay positive]." |

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Important Timestamps

• 02:03 – Lara introduces herself; medical history begins.
• 03:09-11:21 – Details and symptoms leading to diagnosis.
• 11:21-20:01 – Cancer diagnosis, PET scan outcomes, family cancer history.
• 20:01-26:13 – Surgery outcomes; instant Type 3c diabetes and emotional impact.
• 33:10-42:13 – Poor inpatient diabetes education and dangerous gaps in care.
• 42:13-47:14 – Discharge and life at home with new diagnoses.
• 51:14-52:12 – Lara’s motivation to help others by sharing her experience.
• 52:12-56:44 – Cancer recurrence, dealing with the Canadian health system’s delays.
• 61:29-63:06 – Positive chemo response; holistic adjuncts.
• 73:30-80:10 – Legacy, family conversations, preparing for daughter’s future.
• 80:32-81:49 – Mindset, positivity, emotional strategies.

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Tone and Style

• Open, candid, humorous in adversity: Both Lara and Scott use honest, sometimes dark humor to cope.
• Supportive and educational: Focus on lived experience, not medical advice.
• Raw, heartfelt reflections: Vulnerability around loss, illness, preparing for the future.

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Conclusion / Takeaways

• Be bold and proactive: In health, no one will advocate for you more powerfully than yourself.
• Stay informed & seek community: Education and support networks (like podcasts, Facebook groups) can make a life-saving difference.
• Cherish the present, plan with hope: Lara’s story is a testament to resilience—balancing hope, humor, candor, and purposeful living, even in uncertainty.

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For more, listen to [Episode 279: Jen Had a Pancreatectomy] (referenced by Lara) and connect via the Juicebox Podcast Facebook Community.

Transcript

[A]

Hello friends and welcome to episode 1109 of the Juice Box Podcast. 46 year old Lara has type 3C diabetes. She lost her pancreas, spleen, gallbladder and part of her stomach during a pancreatic tumor surgery. Lara found the podcast while she was looking for help with her new diabetes. She found episode 279 and has been a listener ever since. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan. When you place your first order for AG1 with my link, you'll get 5 free travel packs and a free year supply of vitamin D drink ag1.com/juicebox don't forget to save 40% off of your entire order at cozyearth.com all you have to do is use the offer code Juicebox at checkout. That's Juicebox at Checkout to save [e-mail] if you're looking for community around type 1 diabetes, check out the Juice Box Podcast. Private Facebook Group juice box podcast type 1 diabetes if you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show. This episode of the Juice Box Podcast is sponsored by the continuous glucose monitor that my daughter wears, the Dexcom G7 dexcom.com Juicebox get started today using this link and you'll not only be doing something great for yourself, you'll be supporting the Juice Box Podcast. This show is sponsored today by the glucagon that my daughter carries, Gvoke Hypopen. Find out [e-mail] Juicebox My name is

[B]

Lara, I am Canadian. I live in Canada, in British Columbia, about an hour outside of Vancouver. I am 46 years old. I'm married and have one daughter who is 17, graduating high school this year and we couldn't be more excited about that.

[A]

Nice.

[B]

And I'm currently in a battle with pancreatic cancer.

[A]

Not as nice. Okay, okay. So my first question is, before we started recording, because of the spelling of your name, I said, is it Lara? And you said yes. But then because of your Canadian accent, I thought you said Laura. So now I don't know what to do.

[B]

You know what? It's a okay by me. It's pronounced Lara. I get Lara Laura. It doesn't bother me whatsoever, but I

[A]

want to get it right.

[B]

It's Lara.

[A]

I'm leaning on the R too much. Right?

[B]

Lara.

[A]

Yeah. So Lara. Did I get it?

[B]

Yep, you got it.

[A]

Well, I was going to curse right off the bat and say, that sucks, but. When did you learn about the cancer?

[B]

Well, it was March. I'm going to back up a little bit because it all started in March of 2021. I was two weeks out of moving. We had a major underway to move to acreage and a much larger house. And two weeks before our giant move, I ended up in the hospital with pancreatitis, which was unusual for someone of my age. And I spent seven days in the hospital being treated for pancreatitis. I'd had all of the CTs, the MRIs. Everything came out perfectly clear. Clear pancreas. They did find in July when I had the secondary scan, an abnormality in a bile duct. And at that point, they told me that they were going to monitor it and I might need to have my gallbladder out.

[A]

Okay, so can I ask first? Let me, let me, let me step you through it. What are the symptoms that landed you in the hospital?

[B]

Initially, I had a terrible, terrible back pain. So it was radiating in the middle of the night from my mid back through my shoulder blades. Severe nausea, oily stool, abdominal pain, and just a general feeling of unwell. But actually, by the time I ended up in the hospital, my symptoms had recovered, but my blood work was still showing high lipase numbers and inflammation markers were up. So. So the only way to fix that is to put you on IV drip only and no food for seven days.

[A]

Okay. Lipase is. That's just an indicator for the pancreas, is that right?

[B]

That's right, yes. And by the way, when those numbers

[A]

are high, oily stools, never something you want. I don't care. For what reason.

[B]

No, but I was on a keto diet at the time, too, so I kind of thought at the same time maybe that was all related, like it wasn't something. And initially I didn't have any pain that started later, so I didn't really think much of it, to be honest with you. It kind of came and went. And in hindsight, really, the warning signs were there from long ago. And that's kind of what I want to bring attention to people to be really in tune with their body.

[A]

If you take insulin or sulfonylureas, you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with Gvoke Hypopen. My daughter carries Gvoke Hypopen everywhere she goes because it's a ready to use rescue pen for treating Very low blood sugar in people with diabetes ages 2 and above that I trust. Low blood sugar Emergencies can happen unexpectedly and they demand quick action. Luckily, Jeevo Kypopen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store Jeevo Kypopen and how to use it. They need to know how to use Jevo Kypopen before an emergency situation happens. Learn more about why Jevo Kypopen is in Arden's diabetes [e-mail] juicebox Gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromacytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit gvoke glucagon.com risk for safety information. Yeah, now I'm my, my, I'm doing a little reading right here. So lipase does not correlate the pain, in case you're wondering.

[B]

It doesn't.

[A]

It doesn't. And it, there is a concern here is, is lipase attached? Does it mean diabetes? You know, for example, and it does say that light based elevation shortly precedes the onset of type one. But that's probably a thing. Nobody knows when it's happening, I would imagine.

[B]

That's right.

[A]

Yeah.

[B]

And it's not something that they normally test for unless you're having issues. So until you're already at the point where you're having some symptoms and some issues, that's when it look, when they look for it. And it was actually by chance my doctor thought, oh, I shouldn't even check for this, this level because he had also had a patient recently just before me with the same issues. So. And that was her issue.

[A]

Yeah. I was wondering how they got to it so quickly, honestly. Plus, and I don't mean to be pejorative, but you're in Canada so you, it's a province coin flip whether you get good health care or not. Right.

[B]

Is that ever the truth? And I can tell you some nightmare stories that I've been through recently, actually about that. But in this case, in the very beginning stages, I was treated very well. They were on top of it right away. I had the proper scans and, and everything. It seemed to be going along pretty well.

[A]

But yeah. So, so what was the treat? What was the initial treatment?

[B]

The initial treatment for me was hospitalization, clear fluids. After a few days I was on only IV fluids because they're, they put you on digestive Rest is really the only way to get past that. And then by the time I left the hospital, I thought I was all good to go. Weird. We'll check and see if maybe the gallbladder needs out later. But I felt totally fine.

[A]

Okay. Was the gallbladder showing any indication or was that just a thing they said we have to watch out for?

[B]

Gallbladder and pancreatitis go together very often, and because they found that abnormality in the bile duct, they were watching that, and that might have been the trigger where they would have pulled the gallbladder out if that hadn't resolved itself.

[A]

And my last question is, when they, when you said they scanned your pancreas, was that ultrasound?

[B]

It was CT scan, CT.

[A]

Okay, thank you. Sorry, go ahead. Keep you. You left, you thought you were good to go. I'm sorry. Keep going.

[B]

And then so they said, come back in six months. And so that put it around February, my birthday of 2022, and I was feeling fine. Well, they had scheduled me for the follow up CT scan and I was expecting at the very worst that I would have to have gallbladder surgery. No big deal. But I got a phone call after that initial scan in February of 2022, two days later to come back in. And I knew at that point that I was in trouble. So at the second scan, they found a 1.44 millimeter mass on my pancreas. It was very, very small, very, very early. It had zero spread. There was no indication of any real seriousness at that point. They thought, no big deal, we can get in there really quick, get it out without having any spread. And I didn't have any symptoms. They thought this, this would be a curable thing for me.

[A]

For clarity. You said it once, but I want to make sure I repeat it. The pain was gone, right?

[B]

Pain was gone. I was totally fine. I was actually very annoyed that I had to go in for this scan because I had to take time out to do it. And it was a contrast dye one, which I didn't really like doing. And I thought to myself, well, I was fine, so why am I doing this? But I did my due diligence and thank God I did because it was, it was a bad thing.

[A]

Before we move forward and you tell me about, you know, what they, what they decided to do, you mentioned this, but I want to dig into it for a second. You said hindsight, like, I don't know if you use those words, but I thought, like, were there hindsight symptoms? Where even for years before, did you have Issues that you ignored or stuff that you, like, look back and go, oh, I think this was a thing.

[B]

The only thing I would say that I should have paid more attention to was the symptoms from the pancreatitis, which was the oily stool, and I should have been on top of that. But I. With the keto diet, I was. I thought maybe I'm just not digesting well, which clearly I wasn't because there was issues there, and it was completely unrelated to the keto diet. But it. That also could have been something that triggered it as well.

[A]

How long before and for how long did that occur before you got the lower back pain shooting to your shoulders?

[B]

I would say several months. Okay. But not continually off and on, not every day. So I. I didn't really think anything of it, and that was silly on my part. So.

[A]

You know, honestly, Lar, probably not. You know what I mean? Like, because for every person who can say I ignored this and it turned into cancer, there's a. There's a million people, you know what I mean, who are like, oh, I ignored it. Guess what? Everything was fine. So, I mean, don't beat yourself up.

[B]

I guess that is the case, yes.

[A]

Yeah, don't beat yourself up. But. But at the same time, it's. It's great to know what to look for. Also, I think it helps highlight that your pancreas has something to do with your digestion, and a lot of people don't know that. So.

[B]

Huge portion. Yeah.

[A]

Okay. So they see this. This little mass, and they're going to try to take it out. So what are next steps?

[B]

So the next steps are PET scan and biopsy. I had the referral to a hepatobiliary oncologist surgeon who was confident that this was going to be a curable thing for me, given that it was so small. So PET scan showed just this very same. Actually, it showed the same tumor, very small. It also let out my thyroid, which I had a thyroid nodule. They said that was going to be okay. They would do a fine needle biopsy on that, but it would be unrelated to what I was dealing with with pancreatic cancer. The biopsy was done, and it confirmed that we were dealing with invasive ductal adenocarcinoma, which is the worst kind of pancreatic cancer to have. It spreads quickly and it's quite aggressive. But we were still confident that with the surgery and then six months of chemo after the surgery was done, that I would have the cure that we were looking for. So I went in very Very positive and confident that I was in good hands and that things would be a. Okay. And I do want to say that this was all extra scary for me because 10 years ago we lost my uncle to pancreatic cancer. Seven.

[A]

Really?

[B]

Yes.

[A]

Yeah. I have to tell you, Lara, I don't. I don't know if people know this. I haven't said this in a while, but when I sit down to record, generally speaking, I don't really know what I'm doing. I don't like, I don't pre plan my conversations and I don't really look at my calendar. So you know how some people really want to know what the weather is before they go outside? I'm more of a wander outside and see what the weather's like person. And I do that with this too. And I just want to tell you up front, I don't want to slow you down, but if I pause, I lost my mom to cancer in the last year and I'm having a more difficult time with this than I thought I would. So don't. I don't want to stop you. We're definitely having this conversation, but at some point I'm going to cry today. Just so you know. Like, let's just put that out. You know what?

[B]

And I likely will too. And that's a. Okay.

[A]

Okay. Okay. Good. Good. As long as we're both expecting it.

[B]

Yes.

[A]

Yeah. You just. It just, it took me by surprise a second ago and I was like, I don't feel right. Why do I not feel right?

[B]

It gets.

[A]

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[B]

No, I really did. Because by all stretches of the imagination, this was found by accident. It was found so early, it was very small, almost at the point where it wouldn't even be something that would be detected. It has to be a certain size before it can be detected on scans. The cells can be caught in PET scan just floating around because they light up like they feed them sugar and the cancer cells light up like Christmas tree. But the actual tumors need to be big enough to be able to be found. So this was just at the point it was so small surgery, there was going to be a distal pancreatectomy, which means they would have taken half of the pancreas and my spleen because those things are connected. And by all stretches of the imagination, they told me that the pancreas that was left over was going to take over the insulin production and I wouldn't be a diabetic. I would be fully cured and just had to get through this hard road for, well, six months surgery, well recovery, and then six months of chemo. So they started the chemo six months after the full surgery.

[A]

Right. So you thought, I'm getting a surgery, not much is going to change other than I'm not going to have cancer anymore and that's it? Yeah. Okay, so when did they tell you that's not what happened? Is it like right when you woke up or how does that go?

[B]

So my surgery was scheduled for March 28th of 2022, and on the 25th of March, I had my last CT scan before going into surgery. And I never saw the results of that. And while I was being wheeled into surgery from the little holding room, after I'd been laying there crying my eyes out, scared as scared could be, I met the surgeon for the first time face to face, because this was still times where they were doing phone appointments and I hadn't seen his face even so, there he stood with me and told me that the tumor had grown in that six week time frame from one CT scan to the next, from 1.4 millimeters to four and a half centimeters, and it had taken over the entire pancreas.

[A]

I'm not good with the metric system, but that sounds like a significant increase.

[B]

Significant is right so it went from one tiny little dot in there to taking over the whole pancreas. And at that point he said there still haven't been any spread, but the likelihood that I was going to lose the entire pancreas was, was pretty probable.

[A]

Yeah. For people like me who don't know the, the metric system, that's about a 40 times gross or growth of, of the mass.

[B]

Yes.

[A]

It grew by like 40 times its size in six weeks.

[B]

That's right.

[A]

Yeah. That's.

[B]

So when they're saying invasive and aggressive, that it, that it is. So the importance of the early detection was astronomically important. I can't even say because at this point the surgery, the whole pancreas could still come out. The cancer hadn't still spread at that point. So there was a silver lining to that, although I was completely unprepared for what, what I was going to find when I woke up.

[A]

So yeah, yeah, it's like, it's like the opposite of Christmas. You got two gifts instead of one. And usually they were like, hey, guess what? You have cancer and diabetes. You're like, I didn't have either of these things five minutes ago. What the hell? And so you're coming out of a surgery as a type 1. Basically it's type 3, right. Is what they call type 3C.

[B]

Type 3C.

[A]

Type 3C. You come out of surgery as a type 3C and somebody telling you, hey, there's way more cancer in there than we thought. And that's all out of nowhere from. And so for all the crying you did before, how does it you do a little more after? I imagine.

[B]

So the surgery was nine hours when it was supposed to be like three and a half. So that alone was a huge undertaking. And I, when I got to the recovery room, it was very late and that's when they told me that I had lost my whole pancreas. And I also awoke to nurses in sheer panic because they were unable to control my blood sugar. So they kept me in the recovery room because they got me on this point, Insulin drip, which has to be done with one to one care. And they're worried about DKA at this point. And I don't even know what DKA is.

[A]

Sure you're not even awake, but you definitely don't know what it is. Right. Also, I take your point about the time I remember we dropped my mom at about 8 or 9 in the morning at the hospital during COVID We couldn't even go with my, my like 70 at that point. 78 year old mother. I think. I think 78 or 79. We basically wheeled her through the front door, gave her a good running push and was like, good luck. And then had to leave, you know, like, because they wouldn't even let you come in with her. And that was frightening in and of itself. But the doctor said, I'll call. Like, my number was the one he was going to call after the surgery was over. And I'm not lying to you, it was like 7:30 at night when he finally called me. And he. And he called to say, my assistant basically is still closing your mom up, but I'm done now. And I was like, wait, this, this. Like, I just figured the schedule got messed up or they lost her. Like, seriously? Because you could. Yeah, because I. We really did just kind of run through the door with the wheelchair and we're like, all right, Mom. Like, we'll good.

[B]

Good luck.

[A]

Yeah. And like I said, maybe she's just sitting in a hallway somewhere, you know, but. But instead, it took the better part of the day to do what they ended up having to do for the same reason, because they got there and they were like, wow, there's more here than we expected.

[B]

So, yeah.

[A]

Yeah.

[B]

My family was completely unprepared because they were waiting at the hospital, and at some point they had to go home. And I remember them, My husband saying, yeah, we got the phone call. We were almost home, and it was way late at night, and the surgeon called and told him, but I still hadn't spoken or seen any of my family.

[A]

That sucks.

[B]

And listening to these nurses in panic about these things that I don't know about.

[A]

They're like, hey, we can't get our blood sugar under control. And you're like, well, that wasn't part of why I was here.

[B]

Right? Yeah. And then there's. And I don't even know what numbers mean at this point. Right. So my Sugars were at 25 and I don't know what.

[A]

Oh, I could tell you, but I. Only after I go to a conversion chart on my website.

[B]

I have a conversion chart saved on my phone from the juice box podcast.

[A]

Thank you. 20. Oh, my God, 25. Wait, are you serious?

[B]

Yeah. Yep.

[A]

Oh, that's a four. Like a 450 blood sugar. Yeah, yeah, yeah. Okay.

[B]

For hours. For hours and hours and hours. And once they got them finally back down, I think it was about 1:30 in the morning is finally when I left recovery and then went up to the ward. But I had had to ask to call my mom because I just wanted My mom, I just. As you do. Yeah, I just needed her. And so I had the phone call with her completely out of it, totally confused and very angry.

[A]

Yeah. And angry for a Canadian. What does that even mean? Were you saying, darn it,

[B]

Oh, I can get super angry.

[A]

I always tell people, you know, you don't know about Canadians. So people always say there's, there's not as much gun violence in Canada. I was like, but they love to stab each other, so don't go giving them too much credit.

[B]

And I also hear we're very sweary, so.

[A]

Well, I know for sure in bars you're very stabby, so.

[B]

Because we can't get guns here, Right?

[A]

Well, I assume that's why it's happening.

[B]

Yes. Yep.

[A]

So while you reached for your mom, like, you skipped right over. I, I, I don't mean this in a bad way. I, I honestly don't. But when you thought, I need help, you didn't go to your husband, you went to your mother.

[B]

I went to my mom and I, and I always do, especially with the medical stuff, because she, she understands more. My husband's a little bit more of a stress case when it comes to all of these things, and I knew that he had my daughter with him, and I kind of didn't want to get her involved at this point point before I'd even figured things out. And I think you always just, I, I do just reach for my mom.

[A]

I just think that this highlights a mother's instinct on your part. Because if I was in trouble, I would drag everybody into my horror immediately. Be like, I don't. Can't believe you people left. Like, I need everyone back here. I want a visual. There should be candles. Crying, actually cry in shifts. So every time I look up, I see somebody said,

[B]

I went total opposite. I went into, like, recluse mode. I didn't want to see anybody at all.

[A]

Yeah. Did you think you were going to die? Is that when does that occur to you? The first time.

[B]

The first time it occurred to me that I might die was when I first got the first report with the, that I had pancreatic cancer. Because, I mean, the Google tells you no one comes out of it.

[A]

Yeah.

[B]

And so I tried really hard, and I did. Probably to my dismay, actually, in the end, I stayed off the Google and I stayed off all of the Facebook groups for pancreatic cancer because it was all nothing but doom and gloom. And I wanted to stay positive because I knew mindset had something to do with it. And I felt that I was in good hands and that I should trust the people that were dealing with me in my situation and not the random strangers that have had a myriad of different experiences, some good, some terrible. And I didn't know where I was going to fit into all of that. I hear you. So I didn't do a whole lot.

[A]

You don't want to jump into somebody else's story and put it on yourself when maybe you're not in the same position they're in.

[B]

Yes. And especially since so many of those stories are not good. It was not a safe place when I was learning a whole new life at the same time.

[A]

Yeah, yeah. You make yourself crazy, I would imagine.

[B]

Totally.

[A]

Yeah. So, okay, so you're. You're kind of locked down. You're. You got your mom. What's your. Does your mom say anything valuable or is it all just a lot of love?

[B]

It's just a lot of love because at this point, she didn't know what was going to be valuable to say other than she was, it was going to be okay, and that she would be there every step of the way, which she has been holding my hand every step of the way along this whole journey. She's not left my side and has been an amazing support for all of us, my family included. So we couldn't have done any of this without her.

[A]

Did she get off the phone with you and latch up the dogs, take a big cut a whale blubber and head right to you on her sled? Or how did she stay where she was? That's how you guys get around, right?

[B]

That's right. Yeah, yeah, yeah. So she was there early the next morning. So at 1 in the morning, I ended up back in my room. A room which was nice. I had a private room, which doesn't happen very often here in Canada. They're usually a four bed ward room. And given the nature of what I was going through, I appreciated that time where I was just alone and not having other patients in the room. But she was there and you almost had to kick her out to leave at the end of the day. So I spent nine full days in the hospital recovering from the surgery. The next day after the surgery, they'd sent in the first endocrinologist that I was taking to me and I sent her out the door as fast as she came in because I knew immediately she wasn't going to be a fit for me. How come she came in so bubbly and squealing with her hair in a high ponytail and she's talking to Me like, life is good. We have insulin. And she was so trying to be this bubbly, positive person. And I was just. I'm like, I like the facts. I don't need no, like, fluffy stuff. Tell me where it is at. Like, tell me what I need to know, what I need to do.

[A]

You and Arden might get along really well because you. I like that. The. The most despicable part of her was her high ponytail.

[B]

I. I just couldn't. I couldn't deal with her. And. And she just. She came in, she gave me a meter, she gave me. And left the nurses a basic larpen. That's what. That's how that went down.

[A]

You know what I was really surprised by earlier in your story? You can't be the first person to go into surgery and come out without a pancreas. Why were the nurses so thrown off by it in post op? Because obviously you're not a person using basal insulin when you went in, so you have no insulin at all. Like, your body's, like, devoid of insulin. And so I'm not a doctor. I just want to be clear. And if you took a person and handed them to me and said, hey, I just took this person's pancreas out, my brain would go, well, we have to get basal insulin going right now. I don't know why that's difficult. Like, you know what?

[B]

I don't either. But I do know that they don't do these surgeries very often, and I am one of the few that it does happen, because normally these things are found too late for this to make a difference.

[A]

So they don't do the removal because it's over by the. Before it starts.

[B]

That's right. Yeah. So that part I get. But when you're. When you are in that one to one care recovery room, I mean, surely you've had diabetics through there before. You know how to deal with the one to one and the IV drip of insulin, but they were shocked and didn't know what to do.

[A]

So this endo that comes and sees you after the surgery, she wasn't meeting your energy? Let's just say that.

[B]

No.

[A]

Yeah, because your energy was. Hey, I just found out I have way more. I had way more cancer than I thought I did, and now I have diabetes on top of that. And she came in like Mr. Rogers, and you were like, no, we're not doing this.

[B]

Yeah, that's right.

[A]

Okay. Yeah, I understand, by the way. So what ends up happening then? Like, you got your basal gar pen, but what else did you get out of that?

[B]

So they never actually. This, this is, this is. I know you're going to find this shocking and I've heard because I listened to the diet that the diagnosis stories on the Juice Box podcast, they would come in at night and give me a shot of basic lar. They didn't explain to me what that was. And then with my meals as I could eat because there was a long period of time where I had just really any difficulty because they removed part of my stomach as well. So this surgery comes with gallbladder spleen removal. Part of your stomach and your pancreas. So they've reconnected it all.

[A]

Why the stomach? Was there cancer there?

[B]

There wasn't. But just how the digestive tract works. They have to. When they remove. Yeah. They make the stomach smaller.

[A]

Okay. The basal gars basalt. So that's your. So they were giving you slow acting at night but not telling you what it was. They didn't say this is basal insulin or nothing. Well, and in fairness, you did scare the lady away. Who might have told you that.

[B]

Well, she didn't. She came in and she wasn't even really prepared to give me any education or anything at that point. I think they thought maybe too early, but obviously they didn't know me because I need to be armed with the facts and I need to know what it is that I'm doing and how, how, like, how is this gonna work? Like, you can't just come and shoot me up with something and then expect me to know what it is when this hasn't been a part of my life and it' and I actually, truth be told, only know One other type 1 diabetic in my life, so I didn't know. Right.

[A]

No. Yeah, you don't. You have no idea. You say nine days in the hospital after that? Yep, nine days. Okay. Do you have any idea what you're doing? Diabetes related. By the time you leave even one night?

[B]

I'm going to tell you this because no one told me anything about diabetes. They would come in, they would give me. When I would eat, they would give me a shot of insulin with my meal, they would give me the basaglar at night, but they didn't explain to me like how much or what would happen or whatever. And I remember one night not knowing. Not knowing anything. And I. I didn't feel well. And if you know me, you have to. I have to be near death to press that nurse call button because I just can't stand it. And it was in the middle of the night. And I thought, I'm going to annoy all these people at this point. I was in a four bedroom and I was sweating and shaking and I felt like I was running out of time. I pressed the call button and of course I had a low blood sugar. I didn't know this was going to happen to me. They didn't tell me. They said, oh, you have low blood sugar, drink this juice. Okay? But they didn't tell me this would keep happening either.

[A]

You just thought like, oh, they probably just got it wrong this one time. This will never happen again.

[B]

Yeah, they didn't tell me this was going to be a regular, almost daily occurrence for me.

[A]

It's so difficult to be prepared for the first time anything happens. And this is going to sound disconnected for a second. But I have a fairly healthy life overall. Like, I'm a pretty robust person. We were cleaning the other day. My wife and I did the very adult thing of cleaning our house one Saturday and just, you know, spent the entire day cleaning stuff. And I'm a boy, so she's downstairs doing what she's doing. I just take bleach and cut it with water, put it in a spray bottle and just like douse everything, wipe it down and like, hey, look, it's clean. And by the way, works great. But I was cleaning in a corner and this is going to sound ridiculous, but there's a toilet in the corner and a corner in the corner. And so I sprayed down the toilet and I sprayed down the floor. And then I walked away and came back and I was in a room, obviously with a fan that was drawing the air up from the ground and. And I turned back around to kind of go down onto my knees into the space to, you know, wipe everything up and do everything I was going to do. And I think between the, the ceiling fan running and how much I had sprayed, I just bent down and took in a bunch of bleach in through like a breath and I felt it hit the back of my throat and then started going down. My assault, like, I don't, I don't know how air works, but it was going down through my chest. And as it was going down, like, I, I wasn't, I couldn't breathe. And I've never been in that situation before. And so I'm wearing rubber gloves, I'm holding stuff, I have earphones in my ears, like, you know what I mean? Like, and I, I'm like, oh. And I'm like, okay, I need to get like, I Feel like I should drink something. It's the only thought I have. I stand up immediately. Snot running out of my nose. My eyes are watering. Crazy. I'm coughing to try. And I'm thinking, oh, God, I'm coughing. At least I'm breath. And I'm coughing and coughing. And I'm trying to pull the gloves off because I don't have a cup. And I'm going to. I know I'm about to, like, just take water like Tom Hanks in one of those movies and, like, throw it at my face and try to get some in my mouth. What was that one when he was on the island Castaway that I'm like. And I'm going to, like, do that, right? And. But I have the wherewithal to think I have bleach on my gloves. I have to take the gloves off. But as I'm reaching for the gloves, I'm like, oh, I'm going to die. Like, I am going to die cleaning the goddamn toilet. That is literally what went through my head. I was like, son of a. I'm quasi famous. This is gonna get around. And, like. So I'm like. I'm pulling on these gloves, trying to get them off. I'm trying to get the water running. And as I reach for the water, I think, water or milk? I forget, is water bad? Is what are gonna make it worse. And then I just had the thought. I was like, whatever, I gotta clear it. Like, so I just started, like, shoveling water at my face. I got one good breath and I was like, help. Need help. So I start heading through the house to get to Kelly, and I'm like, going down the stairs. I'm like, like hacking up. Like, it felt like a lung was coming out. But we've been married forever, so she ignores me all the time. So. So, like, I'm coming down the stairs and I'm like, kel, Kel, Kel, help, help, help. She goes, what's going on? And I'm like, all I want to say is, you son of a bitch. Like, what's going on? I'm dying. Look at me. Like, I agree. And I'm like. I'm like, blah, blah, blah. So now I'm, like, running through the kitchen getting. Trying to get a glass so I can force down as much liquid as I can in between breaths. And having that real panic feeling like my brain's going to shut off because I don't have enough oxygen. And I finally get it in, and I'm standing there just dripping out of Every hole on my face and, like, just dying. And she's like, what's going on? And I was like, you were no help whatsoever. And I'm like,

[B]

oh, God.

[A]

I was like, I was counting on you, and you just stared at me. But. But my point in telling the story, besides, Laura, let's be honest, it's funny, but besides telling it. Yeah, besides telling it. For that story, I was thrust into a situation I'd never been in before, around my health, and I barely held myself together, and I. And I think I was in trouble. Like, I was in real trouble. And then she got put into a situation she had never been in before, and she kind of, like, just froze. And so I'm picturing you a couple of days shy of learning that, you know, all this just happened. With my pancreas and all this other stuff, you get a low blood sugar. You must have been me standing at the sink. You must have been like, I. Right. I don't know what is happening or what I'm supposed to do. Yeah.

[B]

It never happened to me before in my life, and I wasn't expecting it. Didn't know it was a thing for me, and I didn't know how to deal with it. But drink this juice. Yeah, Everything will be fine.

[A]

Let me just say this. If more of you would click on the links for the advertisers, I could probably afford to hire a cleaner to come through once a month and do a deep clean on the bathroom.

[B]

I will share it all.

[A]

Yeah, I mean, you guys could probably save my life by supporting the advertisers better. I'm not a person who pays to have things done around my house. Like, I. Like, even my neighbors. Like, somebody's cutting their lawn. I'm like, can you just go cut your own lawn? And she's like, I'm 60. And I'm like, just get out there and do it. You'll be fine. I'm kidding. But, I mean, if the podcast got big enough, I would get somebody to clean the bathroom. Just so you all know, you could save my life by supporting the sponsors.

[B]

And that's.

[A]

It's an important thing for me, Larry, because I obviously don't know enough to, like, dilute the bleach better before I use.

[B]

Oh, boy.

[A]

I basically atoms.

[B]

We learn.

[A]

Yeah, I basically atomized bleach and then, like, sucked it up. So anyway, I'm an idiot, but anyway, okay. And by the way, what am I complaining to you? You have in cancer. So. Yeah. Yeah, we haven't gotten to the. The truly Horrific part of your story yet. Okay, so you're low blood sugar. They get you back up. Does that make you think not even, like, this could happen again? You're not even at that yet.

[B]

Yeah, because I didn't know. Like, I. I honestly hadn't a clue. Because really, at this point, nothing had been explained. They just kept coming in, giving me insulin, feeding me, which was a difficult thing for me to do. They're giving me insulin for meals that I don't know that I can eat.

[A]

Yeah, yeah, so.

[B]

And then even checking blood sugars. They would come in, poke my finger, but not really explaining. They would say, this is good, or whatever. I mean, I honestly didn't know. I had a meter they gave me, but they didn't come with enough lancets or strips to do anything with. Just one of the sample ones.

[A]

Yeah, yeah, Sample meter. Ten. Ten strips at it. Right?

[B]

Yeah, done. So I was just really relying upon the care that they were giving me, and I figured by the time I was going to go home, I would have been to a class of some sort. I don't know what. How does this even work?

[A]

Apparently not. Well, Good job.

[B]

And I fired my. My oncologist or my endocrinologist, so I. They had to find a new one for me, which they did. Thank God. It wasn't until I. They were getting ready to send me home after this. Nine days in there, and I said, but I don't know, like, what am I? What do I do? They still hadn't explained that to me. So the endocrinologist came in and said, give yourself 35 units of Basagla at night, four units of AD log for breakfast and lunch, and six units of ADEN log at dinner.

[A]

Did they tell you to count? Like, would they put you on a sliding scale or tell you to have a certain amount of carbs or anything like that?

[B]

Just eat, like, a diabetic plate. Oh, so my dad's a type 2 diabetic, so my mom's like, okay, well, you need to have, like, a little bit of carbs, lots of vegetables and some protein. So outside of that, I didn't know how to eat anything else. I didn't know that I could give myself more insulin if I had a snack. I didn't know any of that until I found your podcast. No one taught me that.

[A]

That's something. I wonder if people in the medical profession hear that and are just ashamed.

[B]

Well, they should be, because it is such a huge thing, and it is something that can, as you know, kill you in A second. Or send you into DKA if you're not careful with taking enough insulin at the right time. Brutal.

[A]

I'm assuming you're struggling along with this because these meals were probably not properly covered by insulin at all. I mean, who even knows if that was the right amount of basil for you? Right.

[B]

So who knows?

[A]

Because 35. I mean, may I ask how much you weigh?

[B]

I was much heavier at the time.

[A]

Okay.

[B]

But as you well know, cancer and all of this surgery and all, I. The massive weight loss very quickly then put me into a point where I was experiencing multiple lows through the night.

[A]

Yeah.

[B]

Because I was having too much at that point. So I was. I think at the end I was down to 21 units of basic LAR.

[A]

I was going to say. Yeah. Did you have any situation where somebody who you kind of knew saw you one day and was like, oh, my God, Laura Ozempic? And you were like, no, cancer?

[B]

Pretty much, yeah. I kept it all very quiet, actually. I didn't tell anybody what was going on until. Until I started chemo, actually. I didn't let anyone in. I was so in such a terrible state of mind. I didn't let any. Other than my very close circle. No one knew what I was going through.

[A]

Can you give me a little bit of color on why that was? Like, why did it seem important to you to keep it to yourself?

[B]

At first, it seems silly now, but I felt like I was going to be judged for maybe having a bad lifestyle or. I don't know. I think it was just also shocking for me to, like, even just saying the words out loud put me into a place where I didn't want to be. And it made it all more realistic. And I wasn't prepared to answer people's questions because, well, I really didn't know what was going on at that point for myself and trying to explain it all, I just wasn't ready for it all. And in the end, when I did tell everyone, the support and the outreach was astronomical and I probably should have done it sooner.

[A]

Yeah. Your worry was. You just imagined, really?

[B]

Yeah. Yeah, 100%.

[A]

Okay.

[B]

So when I left the hospital, I left the hospital with my one basic LAR pen and had to stop at the Diabetes Educator on the way home from the hospital where she gave me a sample of the Freestyle Libre. A little schooling on how to inject, where to inject, and then I stopped at the pharmacy for my ad MOG pens, which I didn't have. Needles, digestive enzymes, which is another something I have to Take every day with everything I put in my mouth.

[A]

Yeah. Which ones do you use?

[B]

I use bio case.

[A]

Okay. I use pure encapsulations, but I don't need it every time. But. And I obviously don't have the same issue you do. I might not even have an issue. I don't even know. I just know it helps.

[B]

That solid support.

[A]

Yeah. Yeah. Honestly, like, I had a slice of pizza yesterday, and I put the pizza on the plate, and then I thought, where are those little pills? And I pop two of my mouth. I went with two. Because cheese and grease and boom. I swear to you, I don't know that I eat pizza. Like, any bloating or. No bloating, no gas, no unpleasant trip to the bathroom, you know, hours or days later, nothing like that. And it's all just from this little tiny freaking, like, thing. It's amazing. So. But you need it because they took your pancreas, which is a huge part in digestion.

[B]

Yes. And with pancreatic enzymes, there is either. It's a fine balance. Too little or too much have the same effect. And trying to find that happy medium sometimes is just impossible.

[A]

What's the effect?

[B]

You get serous diarrhea.

[A]

Yeah, that's what I thought you were going to say. Too much or too little. Same situation.

[B]

Yep.

[A]

Gotcha. Okay.

[B]

Which is fun. Really fun.

[A]

Yeah. Make you long for those oily stools, right?

[B]

I'll take that.

[A]

Isn't it weird where you draw your lines?

[B]

My life is full of grossness, let me tell you.

[A]

That's what happens when you bring the inside outside.

[B]

Yeah, yeah, yeah.

[A]

Okay. So you've alluded to this a couple of times, but you really, like, we. I haven't let you dig into it because I'm in. I'm trying to be modest, but the podcast helped you with your diabetes care. Like, in totality. Like, this is it. This is where you learned about it. Okay.

[B]

100%. I taught. I took what they told me at the Diabetes Educator. I threw it out the window. I've only actually had one appointment with my endocrinologist. Then this all went down. And managed myself and learned to be bold and brave with the insulin so that I wasn't getting the huge spikes that I had. But it was the episode where Jen. Her name is Jen. She had a total pancreatectomy as well. She was actually my gateway in the Google search for finding, like, people like me.

[A]

Wow.

[B]

And that's how I found it and haven't stopped listening since.

[A]

Let me tell you, I mentioned earlier that there's something I have to tell you right yesterday. I mean, I have a fairly robust Facebook group. And I forget I posted something yesterday and someone. A lot of times people use my threads just to find me, which is smart because tagging me at this point is. It's difficult. I have trouble seeing all my tags. She just asks out of nowhere, have you ever had somebody on with T3C? And I thought, I definitely have. Like, I thought of Jen right away. But what I. But then what I thought was, and I'm about to sit down with somebody who I think has it, because this was like literally like two hours ago that I saw this post and I thought. And I had looked at my. I did. I did brush my eyes over my. My calendar this morning, like as I was getting ready to sit down to do this. And so I'm like sitting here answering messages and at the same time setting up the file for you. And I'm basically, I open up my calendar to like put your name in the file. And I saw it. And then what struck me was it said, what's your connection to diabetes? And it said, other. And I was like, other, what does that mean? And I scrolled and then I saw I am a pancreatic cancer survivor. And then I saw all your notes and I was like, huh? And so then I finished responding to the person online, I said, and ironically, I'm interviewing someone today, like, who has it. Like, you know, who has this situation. And that's incredibly odd because people do not ask me about it with any frequency.

[B]

Timing is everything.

[A]

Really insane. I thought so. Yeah. So, okay, so you found Jen's. Which is. Hers is just called type 3C, right? Let me see if I can find.

[B]

I think it says Jen has no pancreas.

[A]

Oh yeah, I do name things. Like a four year old. Hold on a second. It's not my fault. I was not well educated. I was not well educated. I don't have a lot of big words at my disposal. Let's see. Yeah, let me see if I can find it. I'll tell people what episode it is. Okay, what do we got here? Pre owned pancreas. Owner of a useless pancreas. Two artificial pancreas studies. You too can build an artificial pancreas. Kelly's Bionic Pancreas. I. Wait, was that not. It was pancreas. Not in the word in the title.

[B]

I thought it was.

[A]

Hold on. Jen had a pancreatectomy.

[B]

That's it.

[A]

Episode 279. There it is. If you want to Hear that? Well, that was years ago. Oh, my God. I've been doing this forever. How about that? 2019. Okay. Well, then it was about time we had somebody else on to share their story. So that's really. It's great of you to do. You mentioned before we started recording today that this is out of your wheelhouse, like being on the podcast. But you just wanted to help other people.

[B]

I do. I have an innate desire to help people. It's just who I am. And I think that with this platform and the things that I've gone through, there is a lot of help or support or hope or whatever can be offered. And for people that are going through this, that is everything.

[A]

Yeah. So once the surgery's done and you kind of, you know, you find the podcast and you figure out how to take care of your blood sugars and everything. How. What's the length of time it's been from. Well, I guess first from the surgery. How long? It's March 2021. Was the surgery, is that right?

[B]

It was March 2022.

[A]

2022. Excuse me. Okay, so that's a year and more than a half ago for the surgery. And you did the six months of chemo?

[B]

I did.

[A]

At the end of chemo, you rang the bell. They told you you were clean.

[B]

The whole thing, the whole nine yards? Yep. Totally clean. Scans were clean. There was no sign of cancer. And because I didn't do my research and I stayed off the Google, I didn't realize that this is something that recurs. Even like they told me my margins were clear, everything was good. They took 32 lymph nodes as well. They were all clear. So after the six months of really strong chemo, which also. That chemo, I will tell you, is infused in sugar water over 46 hours, which is good for diabetic.

[A]

You had to bolus for chemo.

[B]

Bolus, chemo. And they said, keep your. Try and keep your sugars at 10. Okay, well, 16 to 22 was the average over those three days of chemo.

[A]

Hey, did you get the bone pain after chemo? Yeah. Did anything help it?

[B]

I take like a Tylenol 3. Mostly. It bothers me at night time. It gives me restless legs, and the bone pain in my legs is. Is pretty bad. So. Codeine, Tylenol. Codeine helps with that.

[A]

Did they give you anything for the restless leg besides the codeine?

[B]

No. And I've had restless legs for years off and on, but it just gets exacerbated like crazy on chemo nights. It makes chemo Nights are impossible to sleep just from the jiggly legs and the pain.

[A]

There's a medicine that helped my mom with the legs. I'll ask my brothers and see if I can get you an answer.

[B]

Cool.

[A]

Oh, shit. Lara. I'm sorry. Yeah, so, I'm sorry. So you did the chemo and it was really aggressive and you're clean margins, but you didn't know that it has a likelihood of coming back. They didn't tell you.

[B]

They didn't tell me this. There was zero discussion of reoccurrence.

[A]

Yeah, they told my mom, like, this is an aggressive cancer you have, but you know, it's, you know, it's here in your ovaries. And we're gonna take all that out. Like my mom got a whole hysterectomy, right? So to take all that out and you're clean and blah, blah, and. But then nobody really said anything about like, but it could come back. And it was crazy because ovarian cancer eventually takes my mom, but shouldn't have ovaries anymore. So if you're a layperson, you think that doesn't make sense? Like, you know what I mean? Like, how, how could I have finger cancer if my fingers are gone? But turns out you can, right? So are they tracking you? Did you get markers or symptoms? How did you know that there was a recurrence?

[B]

So in July, I had my first scheduled follow up. So they were. The plan for me was to do scans and blood work every six months for three years and then yearly after that for two years. So July was my first six month follow up. And because of our beautiful free medical system here in Canada, my CT scan that should have occurred in July actually wasn't scheduled until the end of September. But I went for the blood work and they were tracking my CA99 tumor marker. And when I got that result, because we can check those lab results on yourself. I was sitting at home that day. I had had this test done and my tumor marker came back at 18, 23 and normal is under 27.

[A]

Then they gave you a scan. They couldn't find any masses, but they tell you we're going to track the marker and we're going to go back to chemo. Is that about the plan?

[B]

So they put, they put in a request to get the scan done in a stat manner. And I ended up having to pay for a private PET scan because I couldn't get one done in a timely manner here. And I was going to have to drive four hours to get it. And I Don't know if you know this, that with a PET scan, you have to be off all insulin for six hours before a PET scan.

[A]

Oh.

[B]

And when you are insulin dependent, that's a feat in itself. It has to be below 10. Your sugars have to be below 10.

[A]

But without insulin.

[B]

Without insulin.

[A]

So what, do you just starve yourself?

[B]

Yes, pretty much. So I did it, but I thought driving four hours do that. I wasn't going to do it. So we paid to have a private PET scan done which showed spread. So I have no pancreas, but the pancreatic cancer cells were showing on my liver, kidneys and lymph nodes. But there was three masses that they could see on my liver.

[A]

So they could see masses already. How long ago was this?

[B]

This was in July, four months ago.

[A]

Yeah. Well, first of all, you're not nearly the only Canadian I know who can't get in for simple testing. And, you know, so there's an argument to be made like, yeah, healthcare is really expensive in America, but at the very least, if you're waving cash around, somebody will see you.

[B]

Yes.

[A]

You know, like so, you know, I have insurance, there's someone to bill. Oh, we can get you in. But in Canada, I think I know this to be true from people's personal experiences. They basically, it's. Whoever's going to die first is at the top of the list. So that's right. Right. So you could have a problem that isn't, you know, imminent and you could. You could end up waiting a year or more to get treatment for it. And that's not.

[B]

That's right.

[A]

Not uncommon. From what I understand.

[B]

It's not uncommon at all.

[A]

Yeah. Some provinces are apparently better than others where. I guess again, I should say province. But you don't know. You sound like that. Right. It's just that. Yeah. You have no idea.

[B]

And so it's okay.

[A]

Oh, yeah, yeah. So you get put in that. So they would have killed you if you didn't pay for the PET scan.

[B]

That's right.

[A]

And you ran the risk of your sled dogs being picked up on the scan by mistake, so. Because you had to go. Yeah, right, right. I understand what's going on up there. Don't you worry. And the Abominal Snowman and all the stuff you guys have.

[B]

Yep.

[A]

So. Oh, my God. So, yeah. Like, let's really think about that for a second. If you would have waited on their schedule, all these masses are growing the entire time.

[B]

That's right.

[A]

There's no way you would have lived yeah.

[B]

When I finally got in for my provincially paid for CT scan, it took 17 days for it to be read by a radiologist.

[A]

Oh, that's not bad. Just 17?

[B]

Just 17.

[A]

What the.

[B]

Shows cancer, but 17 days before it was read by a radiologist.

[A]

No kidding.

[B]

I already knew that I had cancer because the PET scan told me this and. But. And the blood work showed me this. But then the oncologists wouldn't go by my private PET scan and they were waiting for the CT scan result.

[A]

It really. They wouldn't look at the scan you had done?

[B]

No, we had to hand deliver the images and the reports to them for them to put in the file, but they were waiting for the CT scan. We had to drive an hour to this facility, get a CD ROM disc or whatever.

[A]

I remember the agency, old school.

[B]

Deliver it, hand deliver it to the BC Cancer Center.

[A]

Someone just had me fax something for an insurance thing. And I said, am I sending it to 87? Like, what are we doing? I can't just send you a PDF. And they're like, no, no, no. It's like, why does anyone ever stop and wonder why? Like. Like there's.

[B]

I ask these questions all the time.

[A]

And by the way, at least, you know, a handful of years ago, Trudeau was at least handsome. Now he's a little chubby. So you're not even getting anything out of that anymore, you know?

[B]

Nope. Canada.

[A]

I'm shaking my hand in Canada. And you got all that snow.

[B]

I am, yeah. I'm shaking my head every day too. Like, what?

[A]

So, Lars. So I'm sorry, so this doesn't sound positive. So, I mean, obviously chemo, and. And I guess you're getting infusions to shrink. Swell. Yeah, Right.

[B]

I am. So I. I've opted for a few things and I do have some positive. I do have some positivity to talk about because I am doing very, very well. So I have started on gem, cytabine, abraxane, combination chemo, which is different from the first chemo. They told me that the first. First time the cancer cells have already seen this drug or these drugs. It was a four dose combination and they're still here. So I opted to try something different, which is not the first line treatment, it's the second line. So it is working well for me. My recent scans show that there is delineation, there is shrinkage, there is no evidence in the kidneys any longer.

[A]

Oh, wow.

[B]

The liver masses, the three of them, they are shrinking and delineated. So I'm Also, along with what I'm doing the chemo, I'm doing high dose vitamin C infusions and hyperthermia treatments along with a million supplements through a naturopath, which they.

[A]

Are you doing cold plunge or you just walking outside?

[B]

I'm actually. The hyperthermia is cold plunging. Although I have considered it. I haven't done it yet. I'm a little bit of a chicken Larry of cancer.

[A]

I don't think there's anything left to be afraid of.

[B]

True.

[A]

Yeah.

[B]

The hyperthermia is where they heat the tumor. So tumors, cancer, can't live anything over 40 degrees.

[A]

Oh, you said hyper, not hypo. I'm sorry, Hyper. Okay.

[B]

Yeah, that's okay. So, yep, hyperthermia. So I. It's targeted treatment. So. So I lay in this waterbed type thing and then they have a panel that goes over top of you and it sends heat up and down, so it heats the tumors, which then help the die off. So you do that the day after you do chemo and then the day after that. So two days in a row, along with high dose vitamin C infusions by iv.

[A]

And this is being provided by Canada or you're. No, no, I was gonna say. You're paying for this yourself, right?

[B]

Yeah. It's $655 for one treatment.

[A]

Jesus. So I did cry, in case you're wondering. When you said the tumors were shrinking, it made me cry. You got me.

[B]

Thank you.

[A]

Yeah, yeah.

[B]

So I've been told that one third of pancreatic cancer patients risk don't respond to treatment. One third respond moderately. One third respond well. And I am in the third of that third that are responding exceptionally well.

[A]

Oh, good for you. That's. Well, that's lovely. And I have a.

[B]

So I'm determined.

[A]

Well. And maybe I have an answer for you. My brother sent me the answer, so. Rope in a roll. But it's commonly known as requip. And it's a Parkinson's and restless leg drug. So. R, E, Q, U, I, P. Okay,

[B]

I'm gonna look into that. I'll ask about that because it's brutal.

[A]

We tried a number of different things to help my mom. My mom was like. My mom was doing some, like, drugs at the, you know, for the. For the restless leg and the bone pain at one point. And we just kept pushing and pushing and requip was one of the things that actually helped her.

[B]

Cool, that's good to know. Yeah, I like to hear that.

[A]

Meanwhile, you're gonna have to call a doctor and they'll they'll return your call in 17 days, and then you'll mention that you heard it on a podcast. They'll say, I'm sorry, we have to do our own testing. And then they'll give you an appointment for nine years from now. And your leg should stop shaking about the time that you die of natural causes in your 90s. So that'll be perfect. Yeah.

[B]

Oh, you got this Canadian medical system

[A]

down patch, but it's free.

[B]

I know, right?

[A]

You know why it's free?

[B]

Does that suck?

[A]

It's not worth any money.

[B]

Yeah, yeah.

[A]

You should live here because people still bring up Canada. They're like, oh, it's free in Canada. I'm like, have you ever spoken to a Canadian?

[B]

Oh, the Americans, especially with pancreatic cancer, are so far ahead of the game and standards of care. It's unbelievable the things that can happen down there in these big medical centers. If I was rich, rich man, I would be down there and I'd be getting a nano knife surgery, and you name it, I would get it all.

[A]

I mean, there's no, listen, there's no doubt in varying degrees of, you know, everything, that the luck of the jaw of where you're born and how much money is in somebody's pocket is a lot to do with the kind of care you get. And it. You can, you know, you can whine and complain all you want that it's unfair, but that's how the world works, and it's what it is. So that really is advocate, advocate, advocate.

[B]

That's all you can do.

[A]

Got to keep arguing, that's for sure. I have found recently, Jenny and I are doing a series that is aimed at doctors. I keep being upset by the word advocate because I know what the intention of it doesn't exactly match the reality of it. Like, people are like, you have to advocate for yourself. Which means, like, you know. Which should mean what? Like, you know, don't. You're asking for things you should just have anyway and that they should give you. So you're telling me, like, I have to talk you into doing your job more completely. Like, that's like, I need to understand what I need medically or else it won't happen.

[B]

Yep.

[A]

And then, by the way, when I bring it up, you're going to yell at me and tell me not to look at the Internet. How the hell do you want me to understand this? You're telling me you either know and won't do it or don't know. Either way, I'm not comforted by that answer. And so I have come to you and push you to do more, but I. I need information about what that means. So I go to the Internet. So I turn to you and I go, hey, look, I read online. You go read online. Like, wait, what? So you know. You know what I mean? So I don't know. It's upsetting. Seriously, the word just keeps pissing me off because I don't think it should have. It shouldn't exist. You know what I mean?

[B]

It's. You shouldn't have to. I actually have two oncologists. One that. My. One that I started with and the one that I was referred back to. And apparently he's very brilliant, but trying to have a conversation with him, like, I'm very real. I like to ask questions. Unless he's read it in a textbook or it comes out of a textbook, he can't have an off the cuff conversation about anything. So I have found a second oncologist who's teaming up with him. That's my real talk guy, and he. I can ask him stuff. I. He's the one who gives me the positivity and the good notes and the. And the high fives, whereas the other one basically looks at me and says, well, we can't cure you. We're just prolonging your life and this is how it's going to be. And this other guy is like, we're going to get you into some clinical trials. And I've talked to this other specialist, so the help is there. Unfortunately, you really do have to look for it yourself.

[A]

Yeah, no, that's exactly right. And that advice and experience clearly translates back to managing diabetes. And, you know, like, if people are like, oh, God, he's talking about cancer. It's a diabetes podcast. What are we doing? It's all very specific to just helping yourself. If you take what someone tells you, you are very frequently not going to end up well. Like, you know, I don't know if you've heard me talk about this on the podcast, and I am going to try to get through this real quickly. My mom only got the surgery to remove her cancer because my neighbor's son grew up to be a surgeon, and he went to medical school with a girl who eventually ended up in OB oncology. And so I could ask my neighbor if it was cool if I texted his son. When I texted his son, I said, is there any chance, you know, somebody that could be helpful with this? Because the oncologist my mom has seen will not help her. Like he was talking about, like, just hospice and, you know, blah, blah. My mom got two more years, and instead, he was just going to manage her into the ground over the idea that he. He said, I'm not going to kill your mom in surgery. Which my neighbor's son told me translates to, hey, his hospital keeps score, and if someone dies in his surgery, his score goes down. And I was like, are you serious?

[B]

Because that's the important stuff, right?

[A]

Right. And so I'm like, okay. So he's like, don't worry. I know a girl from med school. So he calls his girl. That girl's like, oh, yeah, I work for this guy. He's amazing. And two days later, my mom and I are sitting in an appointment, and the guy is scheduling her surgery.

[B]

Amazing.

[A]

If my neighbor's kid grows up and does something different, my mom dies two years earlier. That is not an over exaggeration, and that's not acceptable. Yeah. Is that how this is all supposed to work? Like, right, I'm lucky because my. I don't know. That's ridiculous. By the way, the guy on the other side's kid is an engineer. So I guess, good thing I bought on this side of the street. Like, you know what I mean? Like, yeah. How is it that random?

[B]

It's ridiculous.

[A]

You guys are right now, like, Scott, one of your neighbor's kids is an engineer, and the other one's a surgeon. Your son's got a quantitative econ degree. Where the hell do you live? I'm in a castle, okay?

[B]

A castle. Yes.

[A]

The freaking point is. What the hell?

[B]

Yeah. I have fought my way through everything. I fought. I have fought. I fought. I fought for myself. And. And even when it comes down to diabetic technology, like, I. They made me wait a year before I could get the Omnipod I asked to switch to the Dexcom. Like, those are all things that I took control over myself and. And forced the issue because they would have just let me keep going. That is quo. And I know there's better.

[A]

Yeah. Listen. People die, okay? And some people don't have great care. And that's a fact of life. But what you need to understand is that the people you're talking to, they try very hard to see you as a person. But honestly, you're a drop in a stream. And when you look at a stream, you don't see droplets of water. You see water rushing by. And so if you want to be treated like a special drop, you need to take care of yourself, because everyone else is just at work. Doing their best. You know what I mean? Like, I listen you. If you have a really nice car and you take it in for new tires and it gets scratched later, they didn't see your really nice car and think, like, oh, my God, it's a Mercedes. I should try harder. They got 50 cars they got to change tires on today. That's that. And this. This. Whether you want to hear it or not, medicine's exactly the same way. It's just life.

[B]

Totally.

[A]

And it's not that they're bad people. They're not bad people. They're fantastic, fantastic people. They went to college for 10 goddamn years so they could figure out how to get inside you and take out your pancreas without killing you. I mean, that's amazing. You know what I mean? Like, God bless them and thank you. But the system.

[B]

Yep.

[A]

The process is where if you're not. If you're not on top of it, then somebody else is. Like, so.

[B]

That's right.

[A]

You know, I grew up around here, so I'm. I'm more accustomed to kill or be killed lifestyle, because that's just. I mean, if you. For you guys that live in the south and everybody's like, oh, I'm gonna go to lunch, and two hours later, I'll do like you would. You know, that doesn't happen here. Like, you're out there trying to get ahead constantly. You know what I mean? Like, you're not just climbing a ladder. You're also kicking with your foot as you're going up, making sure nobody's following you. And. And that is not a good way to live. This wasn't my point, but when you have that. That inside of you, it helps with this other stuff. Like, if you've ever listened to the podcast and been like, how did Scott get that for his daughter? How did. Like, I would never accept anything less. That. That's how.

[B]

And that's the thing. You don't have to. You don't have to accept anything.

[A]

You just need to know what to do. And often people don't have the knowledge of, like, where to go next or who to speak to or, like, you know, even if you have all this piss and vinegar, like, where do I point it? Exactly.

[B]

Yeah.

[A]

You know, absolutely. Just. I can't say that. It's. It's just so true. It just. It just really is. You know, I just happen to be a person who won't. I won't accept that, and I will reset the hill I'll die on every day. So, like, you don't want to, like, get into a thing with me. I won't give up, you know, and. But I have people in my family. My mom was like, well, they said they can't do anything. And I was like, no, no, Mom. I'm like, that's for other people. We're going to work this out, you know? And so that's me, too. Yeah. Good for you. It's why you're here.

[B]

Yep. I'm already defying the odds with this time frame, so I'm just gonna keep going.

[A]

Yeah, good for you. And when does your daughter graduate? Did you say?

[B]

She graduates this year, so her grad will be in June of this year.

[A]

Can I ask a hard question?

[B]

Yes.

[A]

She's young, so obviously you and your husband have had private conversations, but when do you. When do you bring your. Your child into it and say, look, Mommy's fighting. We're doing all these things. This is what's going. Right. But we should have a conversation about the things I haven't said to you yet that you might need to know, Especially a person like you who knows the value of talking to their mother, even in their mid-40s. So have you done that or are you thinking about it?

[B]

Yeah, that's. That's the hard one for me because. And this is where I cry,

[A]

though

[B]

those conversations do happen, and we're pretty real about things around here. And there's a few things that I'm working on for her so that she has some things for. From me after I'm not here should something terrible happen to me in an untimely manner while I'm not ready. But we do have the real talk about. About those things, and unfortunately, that brings forward a lot of emotion and. And for a 17. Well, she'll be 17 this month. It's really hard to regulate those emotions around those things. So we're trying to learn to be patient and graceful with each other and giving each other grace and space and time. But there's definitely some. Some work still to be done in that regard with her and the family. But I, at this point, I'm focusing on doing well. It consumes me, of course.

[A]

Right. I mean, because what do you. What do you start thinking about something you want to say to her on her wedding day or if she has a baby, like that kind of stuff, right?

[B]

Yeah, exactly that. And I saw. I saw in one of the feeds on Facebook, it was a going away to college like photo album with notes and gift cards and that kind of thing for specific days along the way. And I was kind of working on that. One page would have like a photograph and then a little note for me and, and go get a manicure or buy someone a coffee or something like that. So I'm focusing on, on those kinds of things and then preparing for the eventuality should I not be there. At first I wasn't sure I was going to be here for her graduation, but I'm pretty sure that that's going to be a. Okay. Given how things are going.

[A]

That's amazing.

[B]

But beyond that, I don't know.

[A]

Yeah, I saw these two girls on TikTok maybe and they're not, not that old. They felt to me like between 19 and like 22, like that, that age. They're sisters, right. And I guess they lost their mom to cancer and they get together once in a while and tell their mom into a tick tock video all the things that, that, that you're thinking it's going to be something sweet. They tell them all that. They tell their mom all the things they've screwed up or didn't tell her when she was alive or something. It's pretty hilarious. And I love that they like unburden themselves to their mother through TikTok. They're their, their mother has passed. And at one point the girl, one of the girls just starts cackling, laughing and she goes, I drove my car for a year without insurance. I didn't know you needed it. Like. And she's just like laughing and you know, and she's like here. I think they get on, they're like, mom, here's all the things we've done since you've gone that I know you'd be disappointed by. And they just start rattling all the stuff. It's very funny.

[B]

I kind of love that.

[A]

Yeah, it's very funny actually. And it made me feel good for them because they were really like together. Just they were laughing heartily like they, they, they were remembering their mom in a, in a really lovely way. And at the same time I think there was some like, child like, hey, I screwed a couple things up and I need to tell somebody. Like it was, it was really interesting. So. But again, we're not going to think about that for you. No, but it would be. I mean, I don't know how I call myself good at this and don't ask you that question. So I appreciate you answering it. No, seriously.

[B]

Yeah. No, it's, it's the real, it's the real talk about this stuff. I mean there's so many different layers and, and so many things to think about and, and plans to make, both good and bad. But I, I think in actuality, everybody needs to be prepared for that because life changes in a second.

[A]

Yeah. And you know what else, too? Like, I could get all granola here and say something and it'll sound like, but it's actually true. Having the idea, like we all live with the idea generally that we're going to live forever, Right? You know, like, we all feel like, oh, we'll live into our 80s and, you know, by the time I go, I'll be peeing on myself and I won't care anymore. Or I say stupid stuff like, I'm going to, like, I can't wait to, like, pinch nurses in a nursing home because nobody will say anything like, like, like I want to get to that age, you know?

[B]

Yeah.

[A]

But the truth is, is that there, there would be value in knowing your expiration date because, you know, it's hard to think about. But you know, even for me, like, my son's not married. If I was going to get hit by a car tomorrow, I'd spend the rest of the day writing things down to my children and my wife and letting them know what I, what I want them to know. But I don't know that. So instead, if I get whacked tomorrow by a car or if. Hey, let's be more realistic, Larry. What if I try to clean the toilet and almost kill myself? Okay? And so, like, what if I have a terrible toilet cleaning accident and I'm dead and I never. By the way, do you think my kids would care about my advice if that's how I die? Probably not, right? They'd be like, what are we listening to this guy for? Killed himself with a spray bottle. Anyway, I would, I would have the wherewithal to do some of the things that you're thinking about. And, you know, it's not a thing you want to think about happening. But if it's going to happen, then isn't it a blessing of sorts to know and be able to prepare and not a blessing for, well, you know what I was going to say, not a blessing for you, but maybe because you get to live through those emotions as hard as they are. But then five, ten years from now, your daughter gets to have your thoughts with her. So I don't know, there's an argument

[B]

to be made that's a part of it all.

[A]

Yeah, there's an argument to be made. What you're trying to do is you're trying to complete your contract as A parent, even if you're not going to be able to stay for the entire employment, basically.

[B]

That's right. Yeah. That's a good way to look at it.

[A]

Yeah, of course it is. It's easy to say of course for me, as I do not currently have cancer, but for you, I just think as the person talking to you and listening to you, that makes sense to me. So. Yeah, well, you have such a good attitude. Can I ask that? My last question is, how are you maintaining this good attitude? Well, are you on the Canadian weed? Is that what's going on?

[B]

No, I. I think if you asked me before, I was quite a very pessimistic person. But I quickly learned that this is not a time for pessimism because I. I'm just simply not ready. And I know that I subscribe now to the thoughts that what you put out there, you be specific about you. You keep your attitude positive even when it's not. Some days I fake it and some days I. I don't. But I have an immense support system. I have so much support from family and friends that has helped a great deal. And I think, honestly, it's just. It's just had. I've had to take a mind switch and change. I had to. Otherwise I wasn't going to be getting out of bed every day and I wasn't going to be putting in the effort to get dressed. And I. It was very. In those early stages, I realized that I was going to go downhill very, very quickly if I. If I didn't turn that around. So I just. I work. It's something I work at every day, and I try to keep myself out of the news and surround myself with positive stories.

[A]

Yeah. I bet you cancer really makes you stop caring about global warming pretty quick, huh?

[B]

Pretty quick, yeah.

[A]

You're like, who are they going to vote in? And you're like, don't care.

[B]

Don't care what's going on in the world. I really don't know. Just.

[A]

Yeah.

[B]

Focus on myself.

[A]

Yeah. My situation just changed. I don't care what you do. That's fine. Oh, you discovered a new plant, did you? Don't care. Yeah.

[B]

Yeah.

[A]

Well, that's me. I know you came on to help other people, but I'm going to end by thanking you for doing something kind for me, which you don't know that you did. To know that I did something that helped you was. It felt very good for me and really did well. And you're. You're nice to say that, and I'm not unaware of the reach and the impact of the podcast. But for some reason, this coupled. Not for some reason, for pretty obvious reasons, that knowledge coupled with you also struggling with cancer and what has recently transpired with my mom. Because there's part of me that thinks I didn't help my mom enough. And I know that's not. Trust me, intellectually I understand that's not true. But emotionally, it feels like I could have made a couple better decisions along the way or zigged when we zagged or something like that, or I was listening to this thing the other day. I learned about this supplement that helps with your blood pressure. And my mom couldn't take her infusions after chemo because her blood pressure was too high. And I thought, oh, I wonder if this supplement would have brought her blood pressure down and then she could have kept taking the. The infusions that were going to keep away the ovarian cancer and would she have lived longer? And like, that's a really unreasonable thing to think so. I don't consciously think it. I want to be clear. Like, I'm not sitting around beating myself up about that. Yeah, but emotionally it hurts. And when you said what you said, you emotionally made me feel better. I thought like, oh, this lady has this struggle and I made this thing and it made it better for her. It didn't fix it, but it made it better. And anyway, so you've made me feel good. I appreciate it.

[B]

I'm so glad. I really enjoy the podcast. I shared it with others. I don't know. I think there's value in it for a lot of people.

[A]

Yep. I also defy other people to make a 90 minute podcast about pancreatic cancer where you laugh and curse as much as we did. I thought we had a good time.

[B]

We did.

[A]

I really did. I did enjoy it. Well, thank you so much for doing this. If you hold on for just one second, I'd like to talk to you after we're done recording.

[B]

Yeah, you bet.

[A]

Thanks so much to Lara for coming on the show and sharing her story with us. A huge thanks to Dexcom for supporting the podcast and for sponsoring this episode. Dexcom.com Juicebox Go get yourself a Dexcom G7 right now using my link. A huge thank you to one of today's sponsors, Gvoke Glucagon. Find out more about Gvoke Hypopen at gvokeglucagon Juicebox. You spell that G V O K E G L U C A G O N.com forward/juicebox. If you're looking for community around type 1 diabetes, check out the Juice Box Podcast. Private Facebook Group juice box podcast type 1 diabetes but everybody is welcome. Type 1 type 2 gestational loved ones it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community, check out Juice Box podcast type 1 diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording wrongwayrecording.com if you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show. And get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast.