B (3:18)

I'm 36 years old. Professionally, I'm a pharmacist, educator and researcher at a university. And personally, I'm a husband, a dad, an endurance runner, and a foster parent. And as of about nine months ago, I joined the Type 1 club after being diagnosed with LADA.

C (3:33)

I'm going to pat myself on the back to start off, Zach. Longtime listeners are not a surprise to people who just started listening are wondering what's wrong with me. But that's okay. I looked at my calendar last night before I went to bed because I had to set my alarm, and I said to myself, I'm recording at 9am tomorrow. 9am Nobody picks 9am right? And then I thought, swear to God, my next thought was, what's this? Going to be some super healthy person or something?

B (4:01)

Oh my gosh. Oh, man.

C (4:03)

And then you pop up like, I'm an endurance runner. And by the way, you're a go getter. Like, how many kids do you have?

B (4:11)

I have two biological kids and we have a foster child.

C (4:14)

That's my point. And if that wasn't enough, you were like, hey, I'll take another one, send it over, no problem. I was like, of course you're up at 9am working. You're a go get. You are. You are right, Zach.

B (4:26)

I am an early riser. I try to get up before everyone because that's the only way I can get some stuff done by myself. And I get into the office early. It's true.

C (4:34)

Yeah. I'll tell you right now, I knew all that by the fact that we were recording at 9:00am hey, had you

B (4:40)

had 7:00am I probably would have taken it.

C (4:43)

Well, that's why it's not there. Even as I get older, surprised at how my family's vibe for not going to bed early has not changed. Like, I'm 12:30. One o' clock is about when I go to bed.

B (5:00)

No, it's not.

C (5:01)

Yeah, yeah, that's pretty much it. And if I have, I have to get up early. I just get up early. Yeah.

B (5:06)

Wow.

C (5:06)

Like, I did take my son to the airport yesterday, five o'. Clock. He's like. He's like, what do you say? We gotta leave by 5:30? I was like, we, like, all right. And he's like, do you want me to have to pay for parking at the airport? I was like, well, no, not really. So I'm like. I'm like, okay. So I set my alarm at 5. But then, I don't know. I live my life. I do my stuff. Like, I make the podcast during the day, but I also cook in the house, and I'm also the. What did somebody call me recently? They'll laugh. I'm the grocery bitch. So, you know, if, like, if somebody runs out of something, I'm the one at the store. And then I come home, I work a little more. The website and, you know, the Facebook stuff and everything. And then I don't have any time for myself. So my time for myself comes, like, really late at night.

B (5:55)

Yeah, but I like to do that late at night. Do you read? Do you. Do you veg out on Netflix? What do you do?

C (6:02)

Read, Zach. Listen, you're lovely, okay? I read one book about Randall Cunningham about 40 years ago and a couple of other books. My reading list is very strange. Like, I've read Meditations. I've read. I love a little book. It's not really a book called this is Water. I read that a fair amount. I'm not a reader, okay?

A (6:26)

I just.

C (6:26)

It doesn't. It takes so damn long. And I do walk any part of the day where I'm not speaking to a family member or making this podcast. I am listening to somebody explain something to me in my ears.

B (6:41)

Okay? Do you listen to it on normal speed or what's your preferred speed rate?

C (6:45)

Normal speed. Because I also enjoy it as entertainment.

B (6:48)

I love that. Yeah, that's. That's good advice.

C (6:50)

I also, oddly enough, don't like books on tape.

B (6:54)

Okay? Audiobooks.

C (6:56)

I don't want somebody reading to me, okay. Damn it. I can't read. I don't deserve it, you understand?

B (7:04)

But.

C (7:05)

But nevertheless, later at night, it depends on what time of the year it is, okay? Because if it's a certain time of year, then I will put a baseball game on somewhere.

B (7:15)

Yeah.

C (7:16)

But then I'll sit with my laptop and make something for the podcast or the website or something like that, too. My life is definitely going by too quickly. Something's wrong, but you're. But I still feel like I'm cramming a lot into it. Like, I feel good about it like, how about you at the end of the day, do you feel like. I'm exhausted, but in a good way. But I'm. I'm sad to go to sleep. Do you have that feeling ever?

B (7:40)

I have had that feeling at moments in my life. In the current season, most of the time when I hit the pillow at night, I am ready to hit the pillow at night.

C (7:48)

Scott, how old are those kids?

B (7:50)

So eight, seven. And then our foster child is nine months old.

C (7:53)

Oh my goodness. Is that like a helping a friend thing or were you in the system and somebody called you?

B (7:59)

You know, it has been a kind of long time just desire for my wife and I and about a year and a half ago embarked on the, the journey to become foster parents. And we had a couple of families that we helped out for like a weekend and things like that. But our current foster child is our first long term placement, so it's been a relatively recent endeavor.

C (8:21)

I'm going to enjoy this conversation, I think for a number of reasons. But one, because you started interviewing me right away, I'm going to figure out why that's your inclination. But first, how old were you now when you were diagnosed?

B (8:34)

Sure. So I was diagnosed actually just nine months ago. I was 30 when I first noticed something was off. But nine months ago was my diagnosis.

C (8:43)

Wow. Maybe that was your payback for fostering a baby.

B (8:48)

Yeah, you know, it's funny, I got diagnosed and then two weeks later we got our foster child. So it was a, it was a very full 20, 25 for us.

C (8:56)

No kidding. And you hadn't had a baby in five years at least. Right?

B (8:58)

So that's seven years. Yeah, yeah, yeah.

C (9:01)

Oh my gosh. Okay. Well, what did you notice first? How did you figure out you had type one?

B (9:06)

Yeah, so the first thing I noticed was actually just my lab work. I was 30, I was 135 pounds running marathons, and my A1C went from 5 to 5.7. So I think most would look at and think, oh, you know, no big deal. But technically it's pre diabetic and I'm in the health field and new enough to be concerned. And so that was my first kind of cue. Ever since then, my wife and I have joked that I was on the fast track to diabetes, not knowing that it would actually come to, to fruition. But what really kind of clued me in from a symptom standpoint was about a few months prior to my diagnosis, I noticed myself getting up three, four times a night to use the bathroom, usually before midnight. Constantly fatigued, which I attributed just to children, but in hindsight, it certainly wasn't. And so kind of the classic symptoms, to be honest with you, I got kind of fed up with it. After I did a race locally, and I felt terrible. During the event, my heart rate shot up to over 200, and I just. Something wasn't right. The following weekend, I told my wife, I said, I'm going to order a glucometer and test strips and see what my glucose is. And I enjoyed my favorite Thai meal that evening, which is chicken pat. See you. And two hours later, check my glucose. And it was 459. So at that moment, I knew I had diabetes.

C (10:24)

Okay.

A (10:25)

Hey.

C (10:25)

The week between the race and the buying the meter was that you're like. Like, were you getting your head right? What was that week for?

B (10:34)

Yeah, it was. It was me connecting all the dots and being like, no, like, I need. Something's not right. I can remember journaling just around that time that I was going to stop eating snacks late at night. I thought, oh, well, maybe that's what's causing my symptoms. And in hindsight, I'm like, that was so foolish. So, in some ways, Scott, you're right. It was me kind of getting my head right and just coming to the conclusion that something's not right. It's not just me, you know, eating too many sweets at night.

C (11:02)

You pull that meter out the first time, and. And the blood drop comes out as you're reaching for your. For the drop with the meter, you know it's going to be high.

B (11:10)

Yeah, I thought it would be around 150, 180, because I just had, you know, this huge time EO. And when I saw 459, I gasped. My kids were watching a movie. They thought I'd hurt myself. They didn't know what was going on.

A (11:22)

Really?

C (11:22)

Audible, audibly. Like it shocked you. Yeah.

B (11:25)

Yeah.

C (11:26)

Did you go right to the hospital or did you wait to call the doctor the next day?

B (11:30)

No, I didn't. So actually, I had a couple colleagues who are also pharmacists and specialize in the diabetes space, and I talked with them about it. After I got off the phone with them, I decided I would check my ketones. So I got some keto strips from Walmart and checked my ketones. They were negative. And so I felt comfortable just waiting it out so I could get to my primary care the next day.

C (11:51)

Yeah, your vision was still okay.

B (11:53)

Everything like that, you know, Scott, that was one of the things that after my diagnosis, I looked back on was like, oh, my goodness. That's why every afternoon after lunch, I could hardly see the screen. My vision was blurry. I'm like, I don't know what's going on. I'm getting old here, Scott. And lo and behold, like, it was just, I could trace it all back to the hyperglycemia.

C (12:13)

Okay. Yeah, well, no, it's not, not, not unexpected out on a limb here. You eat pretty well, I imagine.

B (12:22)

I mean, I, I think it's relative. I will say that my wife makes sure I eat well. She has a, a plant based diet, and so I'm the kind of indirect beneficiary of her diet. She does most of the cooking in our house. And so whatever she makes, I eat. And it's usually pretty, pretty healthy.

C (12:38)

Very amenable. That's nice. Yeah, you don't need. I will say, did you fight back at all when it started?

B (12:46)

Oh, I did, I did absolutely fight back, yes.

C (12:51)

Like, that's just a carrot. I, I, I, Right.

B (12:55)

Yeah, I, I was definitely opposed at first, but over time, she's kind of help inform me of some of the evidence. But also I can, I can see the, the benefits myself on this side of my diagnosis.

C (13:08)

Listen, I'm aware of some people who are like real, like legit vegans who are super healthy and, you know, save themselves from a, a number of different ailments along the way.

B (13:19)

Yeah.

C (13:19)

Yeah. Well, okay, so you go to the primary, they set you all up. Now, I guess the, the way your mind works and, you know, I'm assuming you're a dedicated, structured, scheduled person. I mean, you're writing, you're journaling, and so, and you're, you're a runner. So are you a runner because you love running or like, you know, Zach, it's time to be honest? Are you out of your mind and you're trying to keep the voices down or what's the running about?

A (13:46)

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 smartwatch. 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. We talk a lot about ways to lower your A1C on this podcast. Did you know that the Omnipod 5 was shown to lower A1C? That's right. Omnipod 5 is a tube free automated insulin delivery system and it was shown to significantly improve A1C and time and range for people with type 1 diabetes when they switched from daily injections. My daughter is about to turn 21 years old and she has been wearing an Omnipod every day since she was four. It has been a friend to our family, and I think it could be a friend to yours. If you're ready to try Omnipod 5 for yourself or your family, use my link now to get started. Omnipod.com juicebox get that free Omnipod 5 starter kit today. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox are you out of your

C (15:43)

mind and you're trying to keep the voices down or what's the running about?

B (15:46)

You know, I started running in high school and if I'm being honest, when I started running I realized I was kind of good at it in high school and ended up running in college at a D1 university. And ever since then I've just kind of continued it as a way to kind of stay sane, have some time to myself and stay healthy. I view it a little bit differently on this side of the diagnosis, but for the longest time it was just, I think it's good to do hard things. And for me, running was one of those hard things that helped me grow kind of mentally and gave me a space to do something therapeutic for myself.

C (16:20)

That's awesome.

B (16:21)

Yeah.

C (16:21)

You, you ran in college?

B (16:23)

I did, yeah.

C (16:24)

A friend of my son's was like a prototype. He looked like, I don't know how to put this. They look like they built him in a Russian lab for an 80s movie. Do you know what I mean?

B (16:36)

Yeah.

C (16:37)

Long but strong, gliding, you know, just so fast. He went off to college, you know, got picked up by a big school. He couldn't even make the team. And it was like tenths of seconds. It was, it was, it was insane. Like, you know, I still see him now. It's got to be seven years since they left for college and they're back, and he still, as he runs through the town, I think he's just there to make people feel bad about themselves, you know? Seriously, I'm like, is he gonna go

A (17:06)

fight Rocky after this?

C (17:07)

It's. It's really something. But you. What kind of running did you do? Were you sprinter? Distance? Yeah.

B (17:13)

Long distance runner. I don't know how familiar you are with the steeplechase, but it's a long distance hurdling event. People know it by, you know, you kind of YouTube steeplechase falls, and you'll see some pretty epic falls that most people remember. The race by.

C (17:28)

Zach, why did I think of a fake rabbit being chased by dogs when you said that?

B (17:33)

You know, I'm really not sure, Scott.

C (17:34)

Okay. My brain put the wrong words together with pictures. I was like, that's not right. Okay, so we understand how you eat, we understand how you, like, kind of how you run your life and everything. Was diabetes like one of those things? Like, are you going to be the story where you're like, I met the challenge, Scott. I figured it all out and everything's fine? Or did you struggle with it? Or how's the last nine months gone?

B (18:01)

I would say the. The last nine months have. They've certainly been formative, Scott. I have embraced it. I, you know, some people, I think, have a really hard time embracing the life change that comes with it. I think because I'm in the healthcare and because I had some prior knowledge about diabetes and diabetes management, I kind of knew a lot of what to do. I just lacked the confidence of doing it. I have to give a little bit of credit to you and the Juicebox podcast because some of that confidence building came from hearing experiences from you and some of the people you have on the show. So a lot of it over the last nine months has just been confidence building. And so much of diabetes is trial and error, figuring out what works, how much insulin to do for what meals and when, those sorts of things. And then relearning exercise. That's probably been the single biggest change for me, is relearning how I exercise and how I can do it safely. But honestly, when I look back on it, I feel like I'm in a pretty good spot now. My A1C is 5.4% most recently, and I feel like I'm kind of getting into the groove of things.

C (19:07)

Okay, well, I want to hear about the confidence and the exercise but first, I'm going to share this with you. I just went to click on your intake form so that I could just see what you wrote, you know, when you were signing up to be on. But I clicked on yesterday by mistake, and I didn't realize I clicked on yesterday by mistake. When I started reading, I want to talk about the stress of coming out as a gay woman. And I thought, how is this going to be Zach's story?

A (19:30)

This is insane.

C (19:32)

And for a half a second, I was super excited. I was like, oh, my God, this thing's going to take such a turn.

A (19:36)

It's soon.

C (19:37)

That I was like, sorry. Don't be sorry, Zach. And then I was like, oh, no, wait, that was yesterday.

B (19:42)

You know, Scott, the number of listeners are going to be way less with my story.

C (19:46)

I mean, listen, imagine if you could tell a story about how you came out as a gay woman, that would really have, like, lit this on fire. But instead, let's talk about how you built your confidence up and then how you use that to, I mean, relearn. Relearning. Exercise is a big thing. And if you think you figured it out in nine months, I want to hear that story, like, front to back.

B (20:07)

Okay. All right. Well, I'd say biggest confidence builders for me were so bump and nudge. Listen to some of your old comments around kind of small movements getting things moving in the right direction as opposed to larger, just focusing on single boluses. So the bump and nudge concept really stuck with me pre bolusing. So as a healthcare provider, I know how to counsel my patients to pre bolus. But as someone with diabetes taking insulin, it scared me. And so hearing just stories about pre bolting and the impact that that has had and how to do it successfully was really, really important for building my, my confidence. And then just hearing stories about people that were able to just attain really good glucose control and doing it safely. You know, we hear about the A1C goals of six and a half percent or seven percent and that. But it was also really good to hear stories of people achieving an A1C of less than 6% and being able to do so responsibly and safely.

C (21:12)

Okay, so confidence comes from hearing other people accomplishing a thing that at the time is frightening to you because it seems very unknown.

B (21:24)

Yeah, absolutely. That's a really good way of putting it.

C (21:26)

It's funny, I'm listening to you and thinking about having made that, that thing, like, I don't know, the first time. Listen, if people listen for any length of time. This is not surprising to them. But, like, I didn't sit down and think, like, I have to come up with a phrase that allows people to understand that, like, small amounts of insulin make small movements. I just said, I don't know, I just bump it around sometimes I nudge it, like, you know what I mean? Like, and it just. I really wish there was more to it than that. And. But I have seen it help people exactly the way you've described. And I realized as you were talking about, like, oh, it's like the rule of small numbers is what I'm talking about. But I had no idea that that's what I was talking about when it occurred to me originally, if that makes sense.

B (22:09)

Yeah.

C (22:10)

But I really do sometimes think that the benefit of me not having a classic education or a classic or. Or an educated ability to reach for other words, I think that just proved that out just now in the last sentence, because I was looking for vocabulary, and it came 17 other words. Yeah, I think that because I didn't. I don't have that. But I was having the experiences, like, I had to force myself to explain them to myself, and then when I said them out loud to people, I had to explain them that way. And I think that's what dumbs them down.

B (22:43)

Like, and I.

C (22:43)

And that's not the right phrasing, but I think that's what makes it accessible for people.

B (22:48)

Scott is so true. One of the things that we as healthcare providers are kind of fall victim of is this notion of an expert blind spot, meaning that as you learn something and as you kind of live that experience and you gain a knowledge in it, it becomes a kind of automated thought process for you, and you forget those intermediate steps that are needed to arrive at a similar conclusion. And what you're describing, Scott, is you don't have that background knowledge, so you're describing it step by step and in simple terms and in so many ways, that is actually more effective in terms of educating others. So thanks for what you do and what you said. Spot on.

C (23:26)

No, I appreciate it. I'm basically. I'm Captain Exposition for diabetes. Like, I don't know if people know that I said that to. I said that in my front of my family the other day. I was like, no one knows that phrase. And I'm like, it's the person on your television show who has no value in the story except to come on the screen and tell you all who are watching what's about to happen or why things are happening. They lay out the exposition, because they don't have time to act it out. So, yeah, so I'm explaining that. And I could watch Arden go, oh, my God. I'm like, yeah, that's where that, like, not too handsome, but not ugly character who's pleasant enough, comes on screen, looks in the camera and goes, do you mean that happened because the car was red and they stole the money from the bank? And you go, that is why it happened. And like, they're not actors.

B (24:13)

They're.

C (24:14)

They're the guy off stage, you know, given the screen direction and so that you can hear it is the thing. I think that might be what I'm doing.

B (24:23)

That's a great analogy.

C (24:25)

It just occurred to me just now, I was like, oh, my God, is that what I'm doing? I'll tell you what makes me pleased is that a person like yourself, I mean, did you say you're a pharmacist?

B (24:34)

I am, yeah.

C (24:35)

A fair amount of education there and a lot of science and that. And that your brain and my brain probably, you know, don't work exactly alike. That you heard the thing I said and that it was valuable for you. That makes me happy because it's been my intention all along to not leave anyone behind across the spectrum with what I'm saying. I feel like I may. I feel pretty comfortable that I've accomplished that. It's a nice feeling. Awesome. You understand how to time your insulin. You understand about using the right amount, not just like blindly put in this much because the thing says so or whatever, you know, not to let things drift away. You can bounce them back, get them back again. But then you go out to run. I'm imagining. What are you low Immediately? Yeah.

B (25:23)

I remember shortly after my diagnosis, I had just started basal insulin with meals, and I had a really small bowl of spaghetti, like maybe 60 grams of carbs. And normally I would have way more. I mean, you can imagine as a runner, I consume quite a matter of. Of carbs and calories. Was trying to figure things out. But I went with a small bowl of spaghetti. I bolus for it, and I ended up over 400, which I could not believe. And I was furious about it, Scott. And in my kind of anger, in the moment, I told my wife, I'm like, I gotta go run off some glucose. And I went for a run, expecting my glucose to drop from maybe 400 to 300. And, Scott, within 20 minutes of starting my run, I went from 400 to under 200. And by the time I finished my 40 minute run, I was sitting at 140 and that was kind of an aha moment for me. I realized that not. It's not an additive effect of insulin and exercise. It's really a synergistic effect, almost like a multiplicative effect when you combine the two. So I realized it was a powerful tool. But I also in that moment realized like, holy cow, this could get dangerous really quick if you're not careful.

C (26:30)

Yeah. And you can manipulate it like, you know, like. I'm assuming now you run with no active insulin.

B (26:36)

That's exactly right. Yeah, I run only fasted in the morning.

C (26:39)

Yeah. Right. So you saw what was happening and you thought like, okay, I see how this touches this and that touches that. What do I take out of this equation so that the other thing doesn't move? It was that simple, right?

B (26:50)

Exactly.

C (26:50)

Yeah.

B (26:51)

Yep. Yeah.

C (26:52)

I mean, tough to wrap your head around sometimes, but it is.

B (26:56)

And there's so many moving kind of variables within the equation. You know, I do endurance running or aerobic, longer durations of running, but others might walk and do shorter durations or do high intensity training. And each of those influences it so much differently. And so while I feel like I have gotten it down for what I do, if you were to take me and put it in a different scenario where I was doing, let's say, a high intensity interval workout, well, that would change the dynamic of things pretty quickly.

C (27:25)

Yeah. Plenty of people bolus to lift. Yeah, yeah. You start building muscle and people are needing insulin during that time. And. Yeah. And if that. Listen, and when you leave the hospital and the entirety of your direction is like, count these carbs that put in this insulin and eat and you're going to get high anyway because nobody told you pre bolus, everything's already off kilter. You don't understand what. It's very difficult to cause and affect things if you take out the. All the inputs that the doctor gave you as things that are possible to be changed. Like, because I think that is what goes wrong is that like people get direction and they're like, okay, well, those are the constants. That's the concrete right there. And they never quite think about, like, what if I change something about what was said to me? And then you're on. You're only fighting, you're only on the reactive side at that point, then. Yep, the insulin, the food, whatever, is doing what it's doing to you. And instead of trying to control that, stop that from happening, or manipulate how it happens so that it happens in the way that you'd like it to. You're just busy playing defense, trying to keep everything from catching fire.

B (28:32)

Yeah, that's a great way of putting it.

C (28:34)

Yeah. I'm just saying, like, instead of running around the house with a garden hose, like, what if we just didn't light the house on fire?

B (28:40)

Yeah, absolutely. Absolutely.

C (28:43)

Like, once it occurred to me, it just made so much sense all at once.

B (28:49)

Yeah.

C (28:49)

You know, but until it did, I was lost. Like, really lost.

B (28:52)

Yeah. Well, Scott, let me ask you this. What? You know, thinking about your experiences with Ardith, One of the things that I struggle with is, like, spontaneous exercise. Like, Thanksgiving, flag football game, we're gonna go out. I know I have a bunch of insulin on board for my Thanksgiving meal, and I know with almost 100% certainty that I'm gonna drop low at some point, and I just kind of have to live with that and stop when I need to stop or if I want to go out and shoot basketball with my son. And I've eaten, I know I'm gonna have to, you know, probably stop after 10 to 15 minutes.

C (29:22)

Yeah.

B (29:24)

How did you handle that? How did artists handle that? And the kind of spontaneous exercise piece, that's probably the biggest thing I'm still figuring out.

C (29:31)

No problem. First of all, let me tell you so it doesn't make you feel uncomfortable later. But Arden with an N. Oh, I'm sorry. No, don't apologize. And it's a weird name. We yanked it out of a book. Well, listen, I think part of that answer is not. Is. Is not going to feel good. But I do think that's, to some degree, that's a little bit of the game. Like, you know, like, you know what I mean? Like, it's. I don't know. It's like saying, like, I. I don't like that girls are throwing themselves at me, but I'm a professional baseball player. Like, this is what happens. Like, I. You know, I. I just. You can't avoid that part. And so you're sitting around Thanksgiving dinner, you got a bunch of insulin going, and everyone yells, we're running outside. Yeah, you. Maybe you're gonna get lower and, you know, can you. Can you get ahead of it? What a weird thing to say because, like, there's no way you want to add food at that moment.

B (30:22)

Right, Right.

C (30:23)

So you're just like, well, hope for the best. And then I think it's more about vigilance, honestly. And I don't know that people want to hear that, but, like, I think that you stop problems again by just Never letting them occur as best as possible. So, you know, you don't run outside to play flag football going, I'm going to throw this up to God and hopefully it's going to be fine. But you know, later when I get low, I'm going to pissed because I have diabetes. Like, just pay attention, you know, like, look, once in a while, am I dropping quickly? Well, you know, all right, great. It's 87. I'm looking at the graph, the graphs, you know, looks like it's running downhill. Let me drink or eat something now to stop the low. Don't just sit there and wait to be low so that you. I don't know why. Like, I don't understand people's minds well enough because I watch it happen with my kid. I watch it happen with other people. I. They know they're going to get low and they just sit there like, it's not going to happen. It's not going to happen. It's not. I can't believe it happened. You know, like, it's. I don't know, it's like driving at a wall, not putting your foot on the brake and then being pissed at the wall when you run into it. So it's a really weird thing. Now, having said that, a lot of these algorithms are going to go a long way to trying to stop that. So I, as soon as you asked that question, made me think, are you on an automated system? I don't think you are.

B (31:40)

I am, actually. I started about three weeks after my diagnosis. I started on one, actually. I do pump trainings now.

C (31:48)

Oh.

B (31:49)

And so I am on one. And it does help. But if I have, I. If I have active insulin from Ebolis, that's where I always run into trouble.

C (31:58)

Yeah. Well, no, for sure you're going to. I don't see a ton of way around it, to be perfectly honest.

B (32:03)

I love your word, though, vigilance. And I think that is. That's a great, A great way to think about.

C (32:08)

And listen, we could, you know, start talking about the psychological side of.

A (32:13)

It's unfair.

C (32:14)

It sucks. I could see where you would burn out from it. Like, there's a lot about that answer that's not. That doesn't take the entire picture into account, you know, but in that moment, running around outside, I don't. I mean, that's it, man. You have diabetes. You've got active man made insulin in you, and you've just randomly decided to go outside and start running around. You're gonna have to pay attention if you want this not to be a problem later. And I think that's where you probably see the parents. It's probably where you see the parents and the adults when they're together in a community. Like, that's a. That's an interesting spot because an adult is going to, very rightfully so say, I don't want to have to pay attention to that. I've had this thing for 20 years. I just want to go outside and throw that football. This isn't fair. It's not right. People around me don't understand. It can be embarrassing. I don't want people seeing me looking at my phone. Listen, I'm almost up to 2,000 episodes. I know what you guys are thinking. Like, as best as I can, I agree with it all. And then sometimes they see a parent, they're like, oh, look, he's just. They're helicoptering. Which is thankfully a term that doesn't get used much more because it was irritating. But, you know, like, they're paying too close of attention. Like, those kids are never going to have a life. They're never going to have fun. You're ruining it like that. And that parents thinking, I'm just trying to stop the kid from getting dizzy while they're throwing the football around.

B (33:31)

Yeah.

C (33:32)

It's interesting to see that sometimes the two sides understand each other, but often, until they have some conversation and spend some time together, they don't right away. I'm trying to tell everybody, there's a ton that you can both learn from each other. As an adult, you do have to be vigilant about not just your diabetes and that blood sugar and that number, but about your mental health and the longevity of the time you're going to spend doing this. A parent could learn from that, and they should that. You know, I think the problem is it gets said wrong. Like, people go, oh, like, you know what doctors tell you? Like, you're gonna make yourself crazy, chase imperfection. That's not really what's happening. I'm trying to stop my kid from having a low blood sugar. I'm trying to stop my kid's blood sugar from bouncing around so that they can have a reasonable experience as a human being. I'm not trying to be perfect. I'm in the game. I'm in. And I'm doing my best to play. And by the way, you guys didn't even tell me where the pieces and the cards go. I'm trying to figure out Monopoly without instructions right now, and you're telling me, oh, gosh, you're putting so much effort into it. You're making, you're trying to be perfect. And then on the flip side, an adult who's been through a lifetime of this horse and who knows that, you know, you know What? Honestly, my A1C went from 55 to 62 and I'm still okay. Or you know what? One year it was 6:2 and the next year it was 6:7. Then I got it back down to 6:3 and like, you know what? I'm all right. They have that context, and I would like it if parents knew that part. But the problem can be, for some people, like, for some, knowing that's going to be a relief, right? And it's going to be a lessening and, but some people are going to take it as, I don't know, they're going to take it as a pass to stop thinking about it. And then they're going to. Their kids situation is going to tumble away. And that happens to sometimes to adults too, where they say, look, I can't be in my face constantly, Scott. I just want to go run around and throw that football. But once you give it away a little, for some people, it runs off a cliff. And then the next thing they know, they wake up and their A1C is nine and a half and it's 10 and they go, ah, it's fine. And then, you know, 10 years later they go, ah, why do my feet tingle? If you're me in the middle, what's the right way to talk about it? So that you don't. So that as few people as possible have terrible medical outcomes or terrible psychological outcomes. And I think that should be the goal of doctors, too. So I don't, I don't know how I got to that, but you made me think of that. So thank you.

B (36:18)

It's great. It's great.

C (36:20)

So I don't know what you're supposed to do because you're nine months in and right now you're like, I can be vigilant.

A (36:24)

It's going to be fine.

C (36:24)

I get you back on here, nine years later, you might be like, scott, I, I, I, I, I, I, I, I'm gonna jump out a window like, like, I, you know, like, you know, I don't know how it's gonna go for you. You know what I mean?

B (36:35)

Well, I, I think, you know, at the heart of some, what you're talking about is acceptance, like accepting that, okay, this is part of life, and I feel like I'm there. I've accepted that. And I know others you know, that can be more of a journey in some ways, but I've accepted it and am okay with it. But I'm still kind of figuring tips, tricks, techniques to kind of manage the moments where I get low or can't exercise in the way I want to. But as you said, that's just. That's part of living with it.

C (37:06)

Yeah. I'm sorry to come back to it, but, like, this is it.

B (37:11)

Yeah. Yeah.

C (37:12)

The rest of it's going to be your wiring, how you respond and what level of this you're willing to deal with. Yeah, yeah. And it took me a long time to hear enough stories to realize that some people don't want to hear that. You know, they want to know, like, just tell me where to put this number. So my kid's okay. And that's not always the situation. Your kid might be Zach, and your kid might be somebody else, and you're not going to know. All those little babies are not going to be what we used to say, president of the United States. That's not really a great way to go anymore. But, like. But, like, you know, all those. And so I've pivoted to saying, like, some of those little beautiful babies you're holding, they. They grow up to be addicted to meth. And you don't know who's who or what path people are going to get put into. And, you know, it's not going to be just as easy as, like, I put that number in a spot, and it's definitely going to be okay. There's still a lot more to. To think about and be aware of. And, you know, some people have the bandwidth for it, and some people don't. Some people just don't have the motivation for it. Like, it. And I don't judge anybody. Like, it's just. It's who you are. You know, you got this unfair thing. So. I don't know, man. It's a bummer. Why'd you. Why did you. Why did you get a foster kid? Is this a religious thing? What's going on?

B (38:31)

It's a religious thing. So certainly my. My wife and I, you know, we do have faith and are spiritual, but honestly, a lot of it has to do with just. When I was growing up, particularly in high school, I had some really influential people in my life that took me in during some hard times, and those were coaches, mentors, people in our church and in our community. And I saw the impact of really taking someone in under your wing or in your house and helping them. And so for Whatever reason, you know, my wife and I have been married for 15 years and ever since we got married, we, we've said that we wanted to adopt our foster. And so, yeah, it's just been a long standing desire.

C (39:20)

I think it's lovely.

A (39:21)

Also, I'm going to tell you, I

C (39:22)

think most people have that conversation. Very few people follow through. So what gets you past, like, it gets easy to talk about, you know, what we're going to do, you know,

A (39:31)

it would be great.

C (39:32)

What gets you to actually, how do you. I don't know. I'm trying to figure out how you get from the part that everybody talks about to the part that very few people do. Like, what's the process to follow through?

B (39:44)

Yeah, that's a really insightful question, Scott. I think, you know, for us, we had, we were leaning towards adoption, but we felt just financially that it was a bit prohibitive. And then when we looked at the foster system and just saw how broken it was and how much need there was for foster parents, we just, we felt like that was a place we can make a good, meaningful impact. I think the deciding factor for us was our biological kids had reached an age where they were more self sufficient. Right. So I mean, they still need a lot of care, but it's not like they're newborns. And so we reached a place where we knew we weren't going to have any more biological children and we felt like we were ready to take the next step in foster care. And honestly, it's something that really aligns with our values, Scott. And so when we make these kind of big life decisions, so much of it I think should hinge on how much does it align with our values. Sure, we could do a lot of other things with our time and with our energy, but in this phase of life, we're more than okay with giving that to a foster child because it's something that we really value.

C (40:55)

And so, yeah, my parents fostered a boy before they adopted me, really, by the way, I don't think I've ever said that before. What's up, Russell, if you're out there. But. And I didn't really know him obviously, because he was a little older and he wasn't around for, you know, forever. But yeah, my, my mom couldn't get pregnant. That's what they told her. And so I think they were, you know, trying to adopt. That wasn't going well. They fostered Russell for a while and then I think I came along. And then suddenly, whatever happened to, you know, my mom suddenly could have kids. And now, you know, I spent the last, I spent last night 90 minutes talking to my brother on the phone. It was awesome. But, but I, I've always even looked back on that as, like, this is a real kindness. Like, that's a formed, like you have a baby, you know, your foster is a baby, but you bring an older person that's somebody who's already been, you know, they've been forged by somebody already, and you bring them into your life and, and do your best to, to. It's a, it's just a, it's a really kind thing to do. Like, I don't know why you didn't just get a chameleon, but like, I mean, this.

B (42:06)

Well, Scott, I mean, you know, I appreciate you saying that, but, you know, my wife and I were pretty clear up front with what our kind of boundaries are and what we were and weren't comfortable with. And, you know, you gave a really good example. Like, there's such a need for people to take in foster children that are older. But that was not something that my wife and I were willing to do, mostly because we have, you know, a seven and eight year old. And so we have to be mindful of how that kind of shapes and molds them too. Yeah, but it's so important just to be really, really deliberate about what those boundaries are when you go into foster care, because it can and it will burn you out if you're not careful, thoughtful and intentional about it.

C (42:43)

What's the expectation is that the baby will be there until it's placed with an adoption or that it could be with you long term?

B (42:52)

You know, Scott, foster care is all about trying to reunite with, you know, biological mom and dad, if it's safe to do so. And so usually in the first year, when you take in a foster child, that is the ultimate goal that they're shooting for. And obviously that's contingent on biological mom and dad doing what's needed. And so once we reach a point to where we kind of reach a fork in the road, like, yes, we're on the right trajectory. We're not. That's where they start to make decisions about alternative placement plans, whether it's adoption or guardianship, et cetera. And so we're kind of in the phase of we're just, we're going to love on our foster child for as long as we can. And if we're presented with an opportunity to, to, to keep them long term, then we'll cross that bridge when it gets here. But we're just taking it one day at a time.

C (43:42)

It's a process then. And you're just kind of along for the ride.

B (43:46)

Yes. Yeah, you definitely have to relinquish control

C (43:50)

in many ways if, if you know, and let's hope, right, a few months from now you get the note, hey, the parents have got a place to live. They got it all together. Baby's going back. That's going to be heartbreaking, I imagine. But after a period of time, do you think you'd say, okay, send another one over, or do you think, is that going to hinge on how painful it was for the baby to leave, do you think?

B (44:13)

I think there is no question that if our foster child left, it would be very, very hard. Not just for, you know, my wife and I, but also for our two older kids. However, you know, humans are resilient and we know if there are other opportunities that we would probably, that we would probably pursue those. After a time of kind of healing and working through the grieving process. I know many foster parents who have had placements for, you know, one, two or more years. And then the child leaves and then they, they say, you know what, I'm going to take a six month or a year break. I'm not going to take any foster children during that time. And then we could come back to it with kind of a fresh mind.

C (44:52)

Two questions. First of all, what do you do with that sweet, sweet cash the steak gives you? I'm just joking. It's probably not enough to pay for a diaper, but like, what's the, what do you think the cost to you is a month for fostering the baby? This episode was too good to cut

A (45:14)

anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's going to be the next episode in your feed. This episode of the Juice Box podcast is sponsored by Omnipod5. Omnipod5 is a tube free automated insulin delivery system that's been shown to significantly improve A1C and time and range for people with type 1 diabetes when they've switched from daily injections. Learn more and get started today@ omnipod.com juicebox at my link. You can get a free starter kit right now. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox Dexcom sponsored this episode of the Juicebox Podcast. Learn more about the Dexcom G7 at my link dexcom.com juicebox okay, well, here

C (46:08)

we are at the end of the

A (46:09)

episode, you're still with me. Thank you. I really do appreciate that. What else could you do for me?

C (46:15)

Why don't you tell a friend about

A (46:16)

the show or leave a five star review.

C (46:18)

Maybe you could could make sure you're

A (46:20)

following or subscribed in your podcast app.

C (46:23)

Go to YouTube and follow me. Or Instagram TikTok.

A (46:27)

Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't want to miss, please do

C (46:37)

you not know about the private group? You have to join the private group.

A (46:40)

As of this recording, it has 74,000 members.

C (46:43)

They're active, talking about diabetes. Whatever you need to know, there's a conversation happening in there right now and I'm there all the time.

A (46:51)

Tag me, I'll say hi. If you've ever heard a diabetes term and thought okay, but what does that actually mean? You need the Defining Diabetes series from the Juice Box podcast. Defining Diabetes takes all those phrases and terms that you don't understand and makes them clear quick and easy episodes. Find out what bolus means, basal insulin sensitivity and all of the rest. There has to be over 60 episodes of defining diabetes.

C (47:16)

Check it out out now in your

A (47:18)

audio player or go to juicebox podcast.com and go up into the menu. Hey, do you need support?

C (47:23)

I have some stuff for you. It's all free.

A (47:25)

Juicebox podcast.com click on support in the menu.

C (47:29)

Let's see what you get there.

A (47:30)

A1C and blood glucose calculator.

C (47:32)

People love that.

A (47:33)

That's actually, I think the most popular

C (47:34)

page on the website some months. A list of great endocrinologists from listeners that's from all over the country.

A (47:41)

There's a link to the private Facebook group, to the Circle community and we have a fantastic thing there, American Sign Language. There's a great sign language interpreter who did the entire Bold Beginning series in asl.

C (47:54)

So if you know anybody who would

A (47:55)

benefit from that, please send them that way. Just go to juicebox podcast.com and click on support. While you're there, check out the guides like the Pre Bolusing Guide, Fat and Protein Insulin Calculator. Oh gosh.

C (48:08)

Thyroid glp Caregiver Burnout. You should go to the website, click around a little bit on those menus. It really. There's a lot more there than you think.

A (48:16)

If you have a podcast and you need a fantastic editor, you want Rob from Wrong way recording. Listen, truth be told, I'm like 20% smarter. When Rob edits me. He takes out all the, like, gaps of time.

C (48:29)

And when I go and stuff like that. And it just. I don't know, man.

A (48:33)

Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.

C (48:42)

Com.