B (3:35)

My name's Sarah and I'm a junior

A (3:38)

in high school, and somebody else is with us. Who else is here?

C (3:42)

This is her mother. I'm Matilda Fiddler. I'm a Miami native and I'm so grateful to be on the podcast with you today, Scott.

A (3:54)

Mathilde, did you make Sarah come on or did she want to?

B (3:59)

I actually asked to come on.

A (4:01)

Okay, cool. All right, well, let's figure out why all this is happening. Who should we talk to first? Well, who has diabetes?

B (4:09)

I do.

A (4:10)

Sarah does. How old. How old were you when you were diagnosed?

B (4:13)

I was 13 when I was diagnosed. I was going into the summer of. I was in my summer going into eighth grade, and. Yeah, that's when I was diagnosed.

A (4:22)

And now you're a junior.

B (4:23)

Yes.

A (4:24)

Okay. How would you say it's going when you think about your diabetes? Like, what's. Where do you think you're at?

B (4:32)

I think I'm very controlled. I also put a lot of hard work to control my numbers, but I'm really lucky because I haven't had any other health complications come out of it. And overall, I'd say I'm pretty stable and I'm able to, like, live the life that I lived before being diagnosed.

A (4:52)

Yeah. Okay. What do you remember about being diagnosed, Mom? Like, how did it come on? What did you see first?

C (4:58)

What happened was I took the kids. Cause I have another daughter. So both of my daughters. My other daughter is 14 and Sarah's 16 right now. I took them to the annual visit at the pediatrician, and it happened to be that. That day we were seeing a new pediatrician, and my daughter did the annual pee pee in the cup. And she came back and she goes, your daughter? Oh, no. She goes to me, let me do a finger stick. She did the finger stick. And she said immediately, your daughter has diabetes. And I said, what are you talking about? Like, shocked. My daughter had never had one SIM. Her blood sugar at that visit was 240.

A (5:46)

Okay.

C (5:47)

She had had a bagel and, you know, prior to the going to the doctor, the reason I had moved that pediatric visit to that day is because both of my daughters were leaving to sleepaway camp for three weeks in three days.

A (6:08)

Sarah, did you go?

B (6:10)

No, I did not end up going.

A (6:11)

Okay. Do you remember that moment the way your mom remembers it?

B (6:15)

I remember the same thing.

A (6:16)

Yeah. Do you remember being a shot?

B (6:18)

I remember going to the. Going to the hospital after and being really confused and nervous.

A (6:25)

Confused and nervous until you. Are you married?

B (6:28)

I am.

A (6:29)

Okay. Did you call your husband right away?

C (6:31)

I did. He, too, was super confused. He had to pick up my. My other daughter, Sophie, and I took my daughter to the local. They suggested go straight to the E.R. the pediatric E. E.R. unfortunately, we knew a nurse that has been at that institute for many, many years. So she immediately treated us like vip. Immediately they saw my daughter. When they checked her blood sugar, I think she was at that point call it like 160. Right. So they said they took us right away from there to meet the endocrinology team. And I was, let me tell you, a wreck. Like, I think about it, and I can't even believe it was very emotional. But I wanted to come on today to tell you what a fabulous experience we had, because I know so many of your listeners have had such rough diagnosis stories, and they got so little support, and we did not have that experience. My daughter was taken by the endocrinologist immediately. They explained to us that she was in the honeymoon, you know, initially. And so. And within two hours of being at that appointment, they put the Dexcom on her.

A (8:23)

Okay. You know, how's it feel, Sarah, to hear your mom feel so emotional about all this? And have you seen that emotion from her before or since?

B (8:31)

I haven't really seen that emotion from her since I was diagnosed. She always is super strong about it, encourages me to be strong about it, too. And I feel like a big part of me getting through this was because of my mom and all the help she gave me because she's, like. Was kind of my. She still is my partner in managing this.

A (8:52)

Yeah.

B (8:53)

So I'm really grateful to her for that.

A (8:56)

Do you have a similar feeling, like, when you think back on your diagnosis, or are you. Are you listening to her right now and thinking, wow, this is what it feels like to have a kid? Apparently,

B (9:07)

no, when I think back at it, yeah, I got a little, like, upset because, like, in the beginning, I was really Confused on like, on why me? Like, I've never had a health issue in my life. Right up until that point, I was like the healthiest person ever. So I was very confused why like this was showing up and now and I don't know, I was concerned about like, if people were gonna like, look at me differently and like, I remember like being concerned then like, people were gonna think like, I eat, ate too much or like something like that. Cause like, there's a bunch of misconceptions with diabetes and stuff, but obviously there's like a difference between type one and type two.

A (9:49)

Has that been an issue? Do you, did you have friends or acquaintances that misunderstood your situation?

B (9:55)

Yeah. Like still, honestly, to this day, people ask me like, oh, like you can't, I mean, does that mean you can't eat sugar? Blah, blah, like, and it gets, it kind of annoys me. But I mean, honestly, it's not, it's not really their fault because they just haven't been educated on the topic. So whenever something like that occurs, I take a moment to educate people.

A (10:13)

Good. Okay. So you don't get upset, you just realize that there's no way for them to know and you help.

B (10:18)

Yeah.

A (10:18)

Okay. That's awesome. Does it make you feel good mentality to hear that she's having such a, an even response when people talk to her like that?

C (10:27)

I'm extremely grateful. I want you to understand and other parents to understand that, that it's a very steep learning curve. And there was a lot of support. We had therapists involved from the get go. We had nutritionists involved from the get go to really help us with that steep learning curve and to give us that support that we needed so that our living life and enjoying life momentum didn't stop.

A (11:02)

Let's figure out how you figured all this out. So there's some education in the hospital and then what happens is there's outpatient education. After that, do you go back to the hospital afterwards?

C (11:13)

So what happened? Because she was so low, like her, her A1C at that point of diagnosis was 6.0. Her blood sugar, as we all know, 240 isn't that high. That's like on her, you know, to get caught at that, to be diagnosed and found out, you know, when you have zero symptoms. Zero.

A (11:39)

Yeah.

C (11:40)

Is like a blessing and like a, like crazy how that happened.

A (11:46)

That doctor's appointment was just well timed, really.

C (11:49)

Correct.

A (11:49)

Luckily, yeah, correct.

C (11:52)

Uh huh. And then, you know, they sent us home. They sent us home, they gave us the prescriptions for the insulin. They're like, don't use it yet until you need it. And you know, so we got the insulin, the whatever. At that time. I think of Humalog Jr. And you're like staring at it like, when am I supposed to use this? So what happened is she ended up getting, let's call it a month or so later, a tonsillitis. And they put her on prednisone. And that's when the party started. You know, the 300 blood sugar. And so then we had to do the first time the insulin. I wish. And I think Sarah agrees with me because they had us initially on a very carb, strict diet, which in my opinion can cause like, eating dysfunction. Because she was on, let's call it, I think if I can recall, 30 carbs. Nothing a day. Yeah. And we did that for, I don't know, let's call it like a month.

B (13:08)

Ish.

C (13:09)

It's a blur. But maybe max two months. And then finally, thank God, the prednisone thing happened. We had to introduce the insulin injections into start bringing that blood sugar down. And then she was super skinny. Imagine. And she's tall. My daughter right now is 5:9.

A (13:30)

Yeah.

C (13:31)

And she weighs like less than 130 pounds.

A (13:35)

You know, Sarah, I have a couple of questions for you.

B (13:37)

Yes.

A (13:38)

This one might seem out of left field. Do you get tonsillitis a lot?

B (13:42)

No, no, that was the only time I've ever gotten it. And also, mom, you said something about eating dysfunction. I just want to make it clear I've never had an eating disorder to those listening. And I think it was like 30 carbs per meal. I don't know about per day.

A (13:55)

So it's interesting the way you remember it. Mom, is that her? Somebody told you to kind of restrict your carbs to go lower carb.

B (14:02)

Yes.

A (14:02)

Do you remember that time as particularly difficult?

B (14:06)

Yeah, it was super annoying. Like, I had to watch everything I was putting in my mouth.

A (14:10)

Right.

B (14:11)

And honestly, like, looking back on it, like, I should have just been able to eat what I wanted and give an insulin for it.

A (14:16)

Yeah. You didn't quite understand that at that point. And who gave you that?

B (14:20)

Honestly, what was what? I don't. I still don't see the purpose in that.

A (14:23)

Right.

B (14:23)

Like, one. I don't understand.

A (14:26)

Who gave you that information?

B (14:28)

An endocrinologist.

A (14:29)

Endocrinologist. Okay, so let me ask you a question, because you, you said something earlier. A lot of people do this. They come on and they tell me how great their doctors are, and then they tell stories for an hour about how the information they got wasn't great. When you tell me that you were lucky that you got started, well, what does that mean to you? When you think of a CGM and all the good that it brings in your life is the first thing you think about. I love that I have to change it all the time. I love the warm up period every time I have to change it. I love that when I bump into a door frame sometimes it gets ripped off. I love that the adhesive kind of gets mushy sometimes when I sweat and falls off. No, these are not the things that you love about a cgm. Today's episode of the Juicebox podcast is sponsored by the Eversense365, the only CGM that you only have to put on once a year and the only CGM that won't give you any of those problems. The Eversense 365 is the only one year CGM designed to minimize device frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping. You can manage your diabetes instead of your CGM with the Eversense365. Learn more and get started today at eversensecgm.com Juicebox 1 Year 1 CGM let's talk about the Tandem Moby Insulin pump from today's sponsor, Tandem Diabetes Care. Their newest algorithm, Control IQ technology, and the new Tandem Mobi pump offer you unique opportunities to have better control. It's the only system with Autobolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandemoby gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever and they'd like you to check it out@tandomdiabetes.com juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about Tandem's tiny pump that's big on control. Tandemdiabetes.com juicebox the Tandem mobi system is available for people ages 2 and up who want an automated delivery system to help them sleep better, wake up in range and address high blood sugars with auto bolus.

C (16:56)

It means to me that they gave her immediately. The technology, the true diagnosis. Like there was no immediately. I knew my kid had type 1. Like how many times parents are like I don't know what they had. Maybe they have this. So I knew right away her diagnosis. She was introduced to me. The Dexcom is life changing technology immediately on her body. Plus I had the insulin. Now, with what you're saying is true. The diabetic educator put her on that carb restrictive diet, which I agree, no, good. That's where parents. It's incumbent on the parents to educate themselves. And that's where you, Scott, are a blessing in my life. I can't tell you the amount of how you change the course of learning what you did with Arden and learning with the Bold beginning series and listening to other parents and type one people share their stories. That's how I learned.

A (18:12)

Oh, I'm glad. That is lovely. I am so happy that you figured that out. But I want to go back and just put a. Put a kind of a chariot on that other idea. You feel like you were treated well in the beginning because you got a firm, correct answer as far as a diagnosis goes, someone showed you technology and didn't make you wait for it. That really is what you consider to be a great start?

C (18:36)

Yes.

A (18:37)

Yeah. Okay. I think that's valid, by the way. I just wanted to, you know, I think sometimes people hear that and they think that, you know, they got some magical doctor who, you know, knew everything, but you're just saying, look, I just got a good firm, you know, foundation and a good start on all this. Then you went off and found other information. So how long after her diagnosis did you think to yourself, I have to go find other information. I don't have enough to do what I need to do.

C (19:04)

I would say very quickly, initially, you feel very alone, right? Because you're like. And I was so grateful that I was introduced to other mothers in my area, in the Miami area, a group of three ladies. I could message them. And one of the questions that I. That I found so impactful that I. Or realizations that I found so impactful was one day I texted a mom and I said, wait a minute, this is a disease that the goal post is constantly moving? And she goes, bingo. That was a hard pill to swallow.

A (19:52)

Right, right. Not to think you couldn't just figure it out, write it down and keep doing it. It that it was going to keep changing. And did you pass that on to Sarah, like, as you learn things about it? How do you remember your mom bringing you back information? And were you looking for information on your own or were you counting on her?

B (20:09)

Honestly, I counted a lot on my mom. And I remember she started listening to your podcast and she would tell Me things about it, and we use some of your tips and whatever, etcetera, and that really started to help us. And also I met the mothers that my mom was referring to earlier. I met, like, their daughters who are younger than me. But it was nice to see that other people were going through the same thing I was, so that was really helpful.

A (20:37)

Okay, so your mom brought you information, and you found other people in a similar situation and made you feel a little more comfortable while what? Maybe while you were figuring it out, there was a feeling that you could get to some sort of an answer because those girls were doing well. Is that the idea?

B (20:53)

Yeah. Since I saw them doing well, I knew I was gonna be fine. And honestly, I was fine. So it just brought a lot of comfort.

A (21:01)

Okay, awesome. And you use what now? You have a cgm? I heard Dexcom. But do you have a pump?

B (21:07)

I use the Dexcom G7 and Fiasp. Multiple injections and traceeba at night.

A (21:14)

Okay, so you're using pens.

B (21:17)

Correct.

A (21:17)

Awesome. And you've been doing that for how long?

B (21:20)

It was ever since I've been diagnosed. Started using the injections after I had the prednisone.

A (21:26)

Tell me why you don't have a pump.

B (21:28)

I don't like having multiple devices on my body.

A (21:30)

Okay, so just. It's about real estate for you and not hanging more stuff.

B (21:34)

Yes, correct. And I'm doing fine with the injection, so if it ain't broke, don't fix it.

A (21:39)

Yeah. How are you doing? What's your A1C right now? Oof.

B (21:44)

Well, actually, in my last blood work, they forgot to do my A1C.

A (21:49)

How is that possible, sir? What the heck?

B (21:51)

Yeah, I'm not really sure, but on the Dexcom, it says like, about. About 6.2.

A (21:57)

Good for you. That's awesome. Do you have a lot of lows or protracted highs that you can't get down for hours at a time, or is that not your day?

B (22:05)

Usually, like, not really, but I want. Normally when I have a high, I can get it down pretty quickly. It just gets more challenging when it's at night. If I've eaten something carb heav heavy or like, that'll hit later in the night, that's when it gets a little tricky. So I have another. I also have another insulin for that. Mom. What is it called, Scott?

C (22:23)

I can't remember.

A (22:24)

Is it the inhaler?

B (22:25)

I think it's something with an lion jav or something.

A (22:29)

Lumja.

B (22:30)

Yes.

A (22:31)

Okay, so you're using.

B (22:32)

It's an older insulin, correct?

A (22:34)

No, no, it's a newer one. Loomja. Loomjevin and Fiasper. The two faster acting insulins. Why do you have both? Is it not that. Maybe Lispro.

C (22:45)

May I interject? It's the one she uses for nighttime. And I have to think about the name Novolin.

B (22:55)

Novolin.

A (22:56)

Well, who set you up with that?

C (22:58)

Integrated diabetes, which was also introduced to us by you, Scott, through the. You know, the amazing Gary Shiner. I also use their services for when we need additional support and education and normalizing. We use Tavia.

A (23:22)

Oh, sure. Oh, you know, I'm gonna see her in a couple of weeks.

C (23:25)

She told me to tell you hello because we met with. We talked with her yesterday.

A (23:29)

Nice. Yeah, she and I are doing a private event together in like two weeks, maybe three weeks.

C (23:34)

So she suggested, let's say Sarah goes out to party, you know, and then she eats late at night and then goes to sleep. She suggested the Novolin because it's a slower acting insulin that doesn't have a quick onset and it takes along. It stays in the body longer. Am I saying, is it the Novolin are my right about that one.

A (24:01)

I mean, you're asking me what you're doing?

C (24:02)

No, I think we don't do it that much. It's occasional, you know, because she doesn't go out at night all the time and eat late at night all the time.

A (24:11)

So what did they give it to you for? Because it's.

C (24:13)

Because it's slower acting and it stays in the body longer. So if you eat, let's call it like a pizza, late at night, it can help with her control. We don't do it all the time, but the cool thing with it is that you can get it at Walmart with no prescription. It's super strange because it's an old.

A (24:38)

It's R. Insulin, right? Novolin R. That's what you're talking about. Regular.

C (24:42)

I think that's what it is. We don't use it that much, obviously. Look, we don't even remember the name,

A (24:47)

but if you get a sticky high, Sarah, you use that?

B (24:50)

Yes.

A (24:50)

Okay. Sarah, when your mom says going out to party, she means watching Disney Princess films and eating Cheetos, right? What is she talking about exactly? Yeah. Yeah. Are you in Miami?

B (25:01)

Yes.

A (25:01)

Is it hard to live in Miami and be a kid?

B (25:04)

No, it's great.

A (25:05)

It's great. I was just there. Really, last year. And again this year I'm taking a group of listeners on a cruise in June and it goes out of the Miami port. We're Using a different cruise ship this year than we used last year, and the cruise company wanted me to see it. So I went and did a cruise with my wife right before Christmas. So we were in Miami for the night, then went to the port and headed out and then came back that way. So I didn't get to see a whole lot of it. But it's nice place, so. And I know people who have lived there, but the partying is. Is. It's Miami. Right? Like, you're out, there's get togethers. You've got to kind of deal with things. It's.

B (25:42)

Yeah, it's more like casual get togethers that sometimes go late. So if I end up having. I probably end up getting a little hungry at the end.

A (25:52)

A little meal. Yeah, I hear.

B (25:53)

Yeah, exactly.

A (25:54)

And you're doing that. Okay, when you carry your stuff, how do you carry, like a pen is just in your purse or what do you do?

B (26:01)

I have like a huge black. No, it's not huge. It's this black pouch with a bunch of compartments where I keep my juice, my Jibo Kypo pen, and my main insulin and a little sharps box and just all my supplies, my alcohol pads, my needles, everything. So that's my pouch for school. And if I'm going somewhere nicer, I'll just put my stuff in a purse.

A (26:27)

Okay. And you pre bolus your meals or. No. Does the fiasco work fast enough?

B (26:31)

Whenever I can.

A (26:32)

What does that mean, Sarah?

B (26:34)

In the morning before school, it's I can pre bolus at school. I cannot pre bolus. It's very difficult because I don't know what I'm going to be eating.

A (26:45)

Okay. And you don't want to shoot twice like you don't want to give yourself a little bit, then figure out what you're eating and give yourself the rest.

B (26:51)

Honestly, that might not be a bad idea.

A (26:53)

Yeah. So if you don't mind injecting, then I would pick an amount of carbs that you know for sure you're going to eat. Hit that as a pre bolus. And then when you settle on food, just put the rest of it in.

B (27:05)

That's very smart.

A (27:06)

Thank you.

B (27:07)

I'm going to do that.

A (27:08)

All right, try that. See how that works.

B (27:09)

Because I have a lot of trouble keeping my. Well, not a lot of trouble, but I typically spike when I'm in school.

A (27:14)

Yeah, because you're probably bolusing while you're eating, right?

B (27:17)

Yeah.

A (27:18)

Yeah. Oh, that's a good. See if that works for you.

B (27:21)

I'll try it.

A (27:22)

That's a tip that parents use for little kids because they never be. It's a similar idea. They little kids sometimes sit down and don't eat. And so people are like, well, I can't pre Bolst because sometimes the kid doesn't eat anything or they take a couple bites. And I ended up saying like years ago, like, there must be something, you know, they're going to eat. And I remember mom saying, well, like delete at least 5 carbs. I'm like, well, pre bolus 5 carbs then, and then get the insulin on your side, get it moving, helping you, and then put the rest in later. That's all. Well, good for you. Well, look at this. We're fixing problems. No other autoimmune in the family. Thyroid, celiac, anything?

C (27:57)

No. Scott. My father did have diabetes. He was diagnosed in his, let's call it late 30s, early 40s. I always remember seeing needles, syringes, insulin in my home as a child, Young, you know, teenager. But I never understood. I never knew anything about blood sugar. I never knew even the range. I never even knew what insulin did. My father has passed approximately like five years ago. So I was, you know, and he did pass from diabetic related complications that eventually resulted in congestive heart disease. My instinct, because I would go with him to a lot of doctors appointments and I have like little memories that pop in my head. Yeah, I think my father had type one and a half. Can I confirm? No, but it was like my father was an athlete. Always exercised, always jogged. And so who knows? I'll never really know.

A (29:15)

You're never gonna know. Yeah.

C (29:16)

He was uncontrolled due to numerous things. The technology that was available at the time, due to his personality that he loved the wine, the cheese, you know, the meat, whatever, like all the stuff. The good life.

A (29:36)

How, how old was he when he passed?

C (29:40)

70.

A (29:41)

Okay. Yeah. I mean, it's hard to know, right? Like if he, if he was misdiagnosed or. I mean, what was the management like, just insulin for him.

C (29:50)

Yeah, you know, I recall never did he ever, in my life, when we would go out to eat, never did he have insulin on his person. He would check the blood sugar at home in the morning and at night. My father loved juice.

A (30:13)

Imagine, like just fruit juices, orange juice, grapefruit, that kind of thing.

C (30:19)

Juice, all the juices, you know, which is like, hello. The worst thing ever. Yeah.

A (30:26)

Okay. Hey, you talked about in your note about grief and I was wondering, you know, was that for both of you or mom, was it Just for you. What was the. What, what happened? How did you work through it?

C (30:39)

Yes. You know, as it relates to. There definitely was grief for my daughter feeling. Because, you know, I don't want her, I didn't want her to carry that responsibility and burden. So that is very difficult. But with that being said, I'm a person that I can be brokenhearted. Super. But I keep it moving and I keep it cute. I keep it moving and I keep it good. And I can be devastated. But I, I get up, I do my hair, I go get dressed. Nice. And I'm like, that's how I am.

A (31:27)

Yeah. Sarah, is that how you see your mom? Is it, like, surprising to you to know that she experienced grief after your diagnosis or were you not even aware of that?

B (31:36)

No, it's not surprising to hear now, but because it's true, I guess she was going through that kind of thing, but she did keep it moving and she kept it cute.

A (31:45)

So. And how about you, sir? Did you feel grief?

B (31:48)

Yeah, I remember being a little sad,

A (31:49)

stuck to you for a while. What do you think helped it go away? Time or something someone said or did.

B (31:55)

Maybe like time, Honestly, because when you first get diagnosed, it's just a big shock. And like my mom spoke about earlier, it's a big learning curve. So once you learn about those things, and I feel like a big part of this disease is trial and error and you have to go with your gut a lot. And in this disease, yeah, it's kind of like a number game, honestly. And maybe your doctor will tell you to stick to a specific formula. But I'm just going to tell you right now, you can't always listen to your doctor like, this sounds horrible, but you have to do what's best for you as well. Like, if that means giving some extra insulin, you're gonna have to do it.

A (32:36)

Yeah. You think maybe that's a starting point and they're hoping you'll figure the rest of that out. Or do you think that they don't know that there should be, like, what's your experience been when you've gone back to your doctor and said, hey, look, I gave myself more insulin here, or I've changed my settings, that they generally seem supportive of that.

B (32:53)

Yes, they do. But I'm in a different situation than some of their other patients because I think the normal. How many times a year do I have to go visit their mom?

C (33:03)

She, because of her well controlled numbers and, and her responsibility, she normally only goes to the endo now in person once a year.

A (33:14)

Yeah. That's what we do.

C (33:16)

The labs, they come to my house. You know, I pay a little money, and the lady comes to my house and pulls her blood. And we do the diabetic educator appointments virtually for the most part. But Sarah's also a youth ambassador through breakthrough type 1. So we see her endo, like, at events too, you know?

A (33:39)

Yeah.

C (33:39)

I have to tell you something, Scott. This is the most important thing that I want you to impart to the parents. You taught me what to do when you send your kid to school. Right.

A (33:56)

Okay.

C (33:57)

So when my daughter was diagnosed, the first thing she told me was this. Mommy, I cannot be like this one girl that goes to my school that has a nurse walking behind her carrying her book bag and giving her snacks. She was like, I beg you. She was, like, petrified that that was her situation. Correct. So I was, like, scrambling. So I Google, you know, I looked in your podcast, like, school, what to do in school. So I learned from you that when your daughter was a baby, I don't even know, second grade or third grade, you're like, forget it. We're gonna handle this. Between my kid and I, we don't need the nurse. We don't need anybody else. We got it. So I said to myself, okay. Immediately when it was time for her to inject herself, I'm like, you have to do it. You have to do it. I'll text you. We'll text each other. You're going out, text me. Because the biggest thing that I learned from you, Scott, is that you cannot take away the kid from the classroom because they miss instructional time.

A (35:12)

Yeah, no kidding.

C (35:14)

And the public school my kid was at at the time, the rule was if I signed up for nursing services, she would have to go to the nurse three times a day. In the morning, in lunch, and at night. I mean, you know, in the afternoon. Who has time for that?

A (35:33)

Yeah. No, you miss a lot of. A lot of instruction that way, and you can easily just create a gap. Sarah, the thing your mom's talking about is that when my daughter was in second grade, there was a prescribed time that she had to go see the nurse. And it was in preparation for eating. But what? No one realized that she was leaving every day as the math lesson was being taught. And it's just the way the teacher had the day set up. She'd hand out the math lesson, and just a couple of moments later, Art would have to leave. A timer would go off on her phone. She'd stand up and leave. And Arden was missing the direction every day for the math lesson, and she had fallen pretty far behind to the point where we actually, we thought, like, I mean, honestly, Sarah, we thought she was just a little stupid, you know what I mean? And like, like, because it had gotten pretty far out of hand, we were like, oh, Arden's not good at math. And luckily. And she lived the whole year like that, second grade. And then luckily, in third grade, her. Her second grade teacher did that thing where she leveled up with the whole class. So the whole class had the same teacher two years in a row. And then the math lesson moved to a different time in the schedule. And early on in third grade, the teacher called me and she said, oh, my God, Scott. She's like, arden's not bad at math. I figured out what happened, and she told me. And it took Arden a while to catch up, and she did. But it still sticks to her. Like, she's 21 right now. She'll be 22 this summer. And no matter how good she is at school and she's doing very well, and she's fine with math and everything, you can still see in the back of her head, she thinks she's not good at math. Like, it's a thing that stuck to her after all that time. So not only did it slow her down in second and third grade, but it impacted her moving forward. And, you know, you just. You can't miss school like you don't know what it is you're going to miss. Exactly. I'm glad that that worked out for you. So you guys just texted each other and handled it that way?

C (37:28)

Yeah, we texted each other. The school made me. When I selected to be the 529 where she would get extended time for tests and so forth, they said to me, well, if you waive the nursing services. I opted to waive the nursing services because I didn't want my kid to go three times a day to the nurse. And I told them, they're like, well, if there's an emergency. I said, you know what? If there's an emergency, call 911 before you call me. Treat my kid like another kid.

A (38:06)

That's exactly what I told them. It didn't mean I don't want the nurse. If she falls and breaks her arm or she has a seizure or something like that, I want the nurse. I'm just saying I don't think we need her to be there on a schedule constantly. Like, we can take care of bolusing for food and stuff like that. So, yeah, so you basically just did what the What I was talking about in the podcast.

C (38:24)

Correct, Scott. That's why I love you.

A (38:27)

And it worked?

B (38:29)

Yes, it works. Yes.

A (38:32)

Why did you want to come on the podcast, Sarah?

B (38:34)

Because I wanted to show other parents, and even if other kids are listening, that you can still be perfectly normal and have this annoying disease, but still live your day to day life and enjoy life.

A (38:47)

That's awesome.

B (38:48)

And I feel like a common misconception when you have this disease is that you have to stop your life and take a moment to learn everything, which is true, you do. But as you're learning, you can keep going.

A (39:02)

Yeah.

B (39:03)

Like keep it moving. Keep the train moving. The train doesn't stop. And it doesn't. The train is not going to stop for diabetes. So.

A (39:10)

Yeah, that's awesome. I mean, you got a great attitude about it. I'm not going to lie to you. I think that setting you up to be, you know, to have some control over yourself at school goes a long way to getting yourself, you know, your self esteem and, and confidence rolling in the right direction. I mean, you're obviously having good outcomes. You understand how to use your insulin. That's, I think, a big part of the whole thing. You're confident. Were you a confident person before this?

B (39:36)

Yes. Yeah, I think I'm confident by nature.

A (39:39)

Yeah. Being tall doesn't hurt either, huh, Sarah?

B (39:42)

And also, I'd like to add on to the nurse thing. That was like, obviously one of my biggest fears because there was a girl in my school who was constantly being followed around and I was not about to be that girl. And also, as one of my electives at school, I would help in the office and that's where the nurse was. So I would encounter her whenever I went to my little office. Help. And she spoke about some, this other girl and was telling the other office ladies about her health situation. She was diabetic. And that's just a violation of privacy. So that was even more of another. Like, that was. That was just another reason not to use this woman's services.

A (40:23)

So you're there, horrified, listening to her spill the tea on somebody else's life. Yeah. And you're like, whoa, if you knew me, would you be talking about me like this?

B (40:33)

Exactly.

A (40:34)

So you're trying to keep your stuff to yourself.

B (40:36)

Mm.

A (40:37)

Do you have other people you can talk about it with, though? Do you have some close friends who understand, like, if you were with a group of girls and, and you got dizzy and you couldn't help yourself, does somebody know what to do?

B (40:49)

Yes, my close friends know what to do. In that case, they see me feeling bad, I feel like the first instinct would be, oh, do you need to eat something? Or if it's really bad, they know to use the pen, like the jibo Kaibo pen. But I have a good, supportive group of friends who look out for me.

A (41:10)

Awesome. And you sound like a reasonable young person, which I'm happy about. You would never drink or do drugs. No. Is that right, Sarah?

B (41:17)

Yeah.

A (41:17)

Right. And. And if. If your mom wasn't here, you'd say the same thing.

B (41:21)

No, I would definitely say the same. Because, honestly, with diabetes, you just have to. You have to be even more careful with your health.

A (41:28)

You're not looking for extra problems.

B (41:31)

Correct?

A (41:31)

Yeah. Or to make this harder. Right?

C (41:33)

Mm.

A (41:34)

Yeah. Okay. Very nice. Do you plan on going away to college?

B (41:37)

I do.

A (41:38)

Where are you gonna go? That's an interesting thing. Like, when you live in a place where everybody's trying to get to it, where do you think to go when you're leaving? You know what I mean? Like, a lot of people are like, I want to go to Miami to go to college. Like, you're there, so.

B (41:49)

Oh, exactly.

A (41:50)

Yeah. Yeah.

B (41:50)

Honestly, I feel like the, UM is just. Is one of the best universities out there, and if it wasn't two minutes away from my house, catch me there.

A (41:59)

Well, can I share something with you?

B (42:02)

Sure.

A (42:02)

My daughter said to us recently when I was leaving high school, she's like, I thought the worst thing that could happen to me is that I'd be one of those people who went to school five minutes from my house. And so I went to this place, and then she switched and went somewhere else, and she. And then eventually, she's like, I'm just going to come home and finish up at home. And she's like, I don't know if that's the right answer for everybody. She's like, but I do wish I wouldn't have felt so embarrassed by the idea of looking close to home. So I don't know, Maybe. Maybe that won't be your finding, but she's pretty happy with it now.

B (42:34)

Oh, that's so nice to hear.

A (42:35)

But I don't think it's.

C (42:38)

Yeah.

B (42:39)

Yeah. I don't think it's an embarrassment thing. I just think, like, I want to discover something new and.

A (42:44)

Okay.

B (42:45)

Get out of my comfort zone a little bit. And I feel like I'm not gonna be able to do that in my same neighborhood with the same circle of people, with, like, the same support system around me. Like, I feel like I have to step Out a little bit. And I feel like I've worked so hard and like, I don't know, I want something different.

A (43:04)

You're a good student.

B (43:06)

Yeah?

A (43:06)

Yeah. What is it you're interested in?

B (43:08)

I'm interested in possibly studying communications or journalism. I'm the editor in chief of my school newspaper. And maybe, or maybe going into law someday. I'm not really sure, but that's the areas I'm interested in.

A (43:23)

Where do you think you're going to look at school? Like, how far, mom, how far away is okay?

C (43:29)

It needs to be a plane, a non stop flight. Easy. East coast for sure. That's it.

A (43:38)

Yeah. What about the weather, Sarah? Are you gonna go somewhere cold?

B (43:41)

I mean, maybe.

A (43:43)

Oh, my God. I just want to live somewhere warm so badly. I. I would.

B (43:47)

Where do you live?

A (43:48)

In New Jersey.

B (43:50)

We can swap.

A (43:51)

Yeah. You want to come? Oh, you want to be close to the city?

C (43:55)

Maybe.

A (43:56)

I'm a 50 minute train ride from Manhattan. Okay. Listen to her laughing. You can't let her out of the house. She's gonna. Sarah, you're gonna be a problem when you get out of there, aren't you? Listen to her laughing. But you can't let her leave with me.

B (44:13)

Oh, I'm gonna be such a problem.

A (44:16)

Oh, my gosh. Well, that's awesome. And what do you have, two more years?

B (44:19)

I'm finishing well, I'm in the third quarter of my junior year, and then I have my senior year and then I'll be out.

A (44:26)

Okay, very nice. That's awesome. Listen, I've been wondering this the whole time. It's really not apropos of anything and has nothing to do with your story, but your mom speaks more than one language, right?

B (44:36)

Yes.

A (44:36)

Yeah. Do you?

B (44:38)

Yes, I do.

A (44:39)

Okay. Until you. I'm sorry, you first generation or second?

C (44:43)

No, I was born here in the United States. Actually, I was born in Virginia, but I've lived in Coral Gables and my whole life since I was five years old.

A (44:51)

Okay. Okay. Because I was gonna. I have a friend of my daughter's, her mom's first generation from Italy, and she talks a lot about the difficulty she has, like, because her mom struggles with some things, like just, you know, language sometimes or. But you guys don't have that issue?

C (45:09)

No, my. My family. My mother was American from the United States, and my father was Colombian from Medellin, Colombia.

A (45:16)

Oh, he hooked that mom, huh? Is your mom still alive? She okay?

C (45:21)

No, my parents have both deceased. My mother predeceased my father by like seven months.

A (45:27)

Oh, my gosh. Oh, I'm so crazy. Yeah.

C (45:30)

Thank you.

A (45:31)

Yeah. Sarah, can I ask a weird question? Is it weird to hear your mother say, my dad passed away, I think, five years ago. Does it make you feel like, oh, my gosh, is there going to be a time in life when I don't remember exactly when my parents left. Is that too deep or. You're young. I don't know if that hit you or not. When she said that, I don't want you to cry. You'd be like, no, I'm thinking about it now, though. Thanks a lot. But. But like, I. My mom passed away. I told you. That's why I asked. And I'm starting to lose the concept of how long it's been. Difficult.

C (46:03)

Yeah. No, and I'm so sorry for your loss.

B (46:05)

Thank you, Scott.

A (46:07)

But, Sarah, back to my question. Do you have, like, a feeling for, like, time? Is that something? Are you just so young you do not think about that like that?

B (46:16)

No, I. I do have a feeling of time. I feel like, obviously I was diagnosed, it's almost gonna be four years, but I feel like it's. It's crazy to think because I can't believe time has flown by that fast. Not even diabetes related. Like, I can't believe that I'm a junior in high school, starting to look at where I'm gonna go to college. Like, it feels unreal, right?

A (46:39)

No, for sure. Do you date?

B (46:41)

No.

A (46:42)

No. When you think about dating, do you think about the diabetes as well?

B (46:47)

Not really. Because I don't date.

A (46:49)

You're like, I don't need any of that problem. But is that because you can't find. You're just not interested in it right now? You're busy with your other stuff?

B (46:56)

Yeah, I'm like, busy with my. My own life.

A (46:59)

Okay. And you don't want to bring somebody else into it, and. And then you have to give time to something or somebody else. Is that right?

B (47:06)

Yeah, I guess I'm just protecting my peace.

A (47:08)

Yeah. You're telling me there's a lot of crazy people at that school. You can't find one that you think is normal? Listen, I love it when she laughs when she doesn't want to answer. But to you, that's my favorite part of Sarah.

B (47:22)

I think everything is meant to happen for a reason. And when it's the right time, it'll be the right time.

A (47:28)

And you won't have trouble when. When that time comes, you won't have trouble sharing your diabetes with somebody else?

B (47:33)

No.

A (47:34)

Okay. It's not a thing you'll Want to keep private?

B (47:38)

I don't think so.

A (47:39)

Okay, so it's interesting. So you don't. Your problem with an insulin pump isn't that somebody will say it. It's that it's. It literally is that it's on you.

B (47:48)

Yeah.

A (47:49)

Yeah. So you don't mind people, do you inject in public? Do you. Do people see you inject?

B (47:53)

Yeah, I do inject in public.

A (47:54)

Okay. Yeah. Okay, that makes sense. All right. Isn't it great that she's not dating?

C (48:00)

You know, she can. My kids can. They don't have a curfew. They can go out. I always know where they are. They always call me, text me. You know, the culture here is. You know, in Miami, we chose to enjoy life. Go out, be with your friends, have a good time. She's super responsible. If she wanted to date somebody, she's more than allowed, of course, but she's very busy with working out, study with her friends. Yeah, she's very busy.

A (48:32)

You see what your mom's doing? It's genius. She's not holding on tight. So you don't feel restricted, and therefore you don't feel like you have to, like, push back.

B (48:42)

Exactly.

A (48:43)

Did you know she was doing that to you?

B (48:45)

Like, not really, no.

A (48:46)

No. You know, Matilda, how did you figure it out? Were you. Did your parents treat you the same way, or did they try to restrict you and you rebelled?

C (48:53)

No, no, no. I had a boyfriend my whole life. Always.

A (48:56)

Always.

C (48:57)

But that was just how it was. I always had a little boyfriend, and I thought it was. I think it's super healthy and super nice.

A (49:04)

Yeah.

C (49:05)

You know, you get. And then you end up graduating and getting a great husband. Like, what happened to me? But I will tell you something. I want to tell you this, Scott. So the parents know my kid, remember she missed the sleepaway camp when she was diagnosed because she was supposed to leave in three weeks. And the sleepaway camp, they don't have diabetic kids. Right. So the next year came, and I was like, oh, my God, are we going to send her? Because my young kid, my youngest, wanted to go, too. I had to do a lot of mental gymnastics, and we had to do a lot of conference calls. We did, like, conference calls with the camp. I pushed myself and I pushed Sarah. She was a mom. I don't think I want to go. And I was like, you're going. Because a mom that I met, a type 1 mom that has two type 1 kids in this Miami area, she told me, if you were going to do it before diabetes, you Got to do it after. And so I pushed myself, you know, pins and needles, shaking. But you're going. Of course, the camp made the exception to allow her to have the cell phone, which, you know, these camps are cell phone free, but she has to keep it. So that's why, you know, in preparation for if she wanted to leave her house. Scott, I never. I mean, I. When I tell. I've lived in Miami, I went to undergraduate school here and graduate school here. I didn't move out of my house until I was 28, until I bought my own little apartment. Like, I'm a, like a home girl. Like, you know.

A (50:52)

Yeah, yeah, move. You're moving slowly. You're doing things very specifically.

C (50:57)

Yeah, yeah. And so I wanted to. Just for her to have the tools, like, okay, if you want to go, go, but you know, get some practice, you know.

A (51:07)

So you're not in any rush to leave either, Sarah, like, you think it's possible you'll go to college then come back home?

B (51:13)

I think so. Yeah, definitely.

A (51:14)

I mean, listen, you're gonna need to save some money. This stuff ain't cheap.

B (51:18)

Yeah.

A (51:18)

Is that a thing you think about? Like, my, My daughter talks about that sometimes. Like, how do I make sure I can pay for my health insurance as an adult when I'm by myself and everything? Is that something that's entered into your mind yet? You're a little young. You might not have.

B (51:31)

Not really.

A (51:32)

Yeah, I wouldn't have thought about it either. I don't think at your age, I.

B (51:35)

I, like, see the price of things nowadays. It's crazy. So I, I just know I'm going to have to work really hard in general.

A (51:42)

Yeah, it is true. Keep making good decisions and moving forward and stuff comes together.

C (51:47)

Absolutely. And my daughters are. Have faith in God and they put, you know, put God first to make good decisions. Yes, absolutely. She's gonna be fine.

A (52:02)

Yeah.

C (52:03)

One day at a time.

A (52:04)

Sarah, if you're. If you're a person like your mom describes who, you know, has a religious belief in holding, is there a feeling, Give her a think about, like, why did I get this?

B (52:14)

Oh, definitely.

A (52:15)

What have you figured out so far when you mull that over?

B (52:18)

So, yeah, first, when I was diagnosed, I was obviously very confused. And I always thought, why. Why did. Why do I have this? Why. Why didn't. Why me? And honestly, I. Even on the hard days, I still feel that way sometimes. But you go through, like, ups and downs. Some days are harder than others. And it's hard because sometimes when you're having a Hard day. You see others having, like, an easy day, but you. They probably have issues in their life that you don't know about, but this is just the issue I have to carry with me for the rest of my life. But hard to accept at first, but now I know that I. I guess I know it was meant to happen to me, and I think it's made me into a stronger person.

A (53:01)

I bet it does. What constitutes a hard day?

B (53:04)

Probably, like, the sensor being, like, all messed up.

A (53:08)

Okay.

B (53:09)

Or like a hard night where you

A (53:11)

have to put in more extra effort or technology doesn't work the way you expect it to. Boy, you know what? I. I know this is not a thing you have context for, but I've spoken to people who've been living with diabetes for all different lengths of time, and I'm happy that. That what constitutes a hard day for you is that your sensor didn't act right or that you had a blood sugar you had to fight with a little extra longer because that is such a better, better situation for people with diabetes. And it makes me excited for what, you know, what a hard day will sound like 10 years from now. Do you ever think about, like, the algorithms that are available in the automated systems and how they might help you overnight? Do you ever think, like, maybe I should just get a pump?

B (53:52)

No, not really. Because I have. My centers get faulty a lot. I'd say so. It tells me I'm low a lot when I'm actually not low and it'll just mess up my numbers.

A (54:06)

Possibly, yeah. It is part of it, for sure. It doesn't end up being as impactful as you think. But I just wondered if you ever thought about, like, well, maybe this thing, you know, if I'm asleep at 2 in the morning and my blood sugar starts to drift up, this thing will push it back down, take care of it without me having to wake up. See? Or if you try to get low, it can stop you from getting low. So it doesn't happen as often. If it is happening. Are you getting. Do you get low overnight ever?

B (54:32)

Not like, not really.

A (54:34)

Okay. Are you more higher when it's an overnight issue?

B (54:37)

Yes.

A (54:39)

Okay. And how often does that happen?

B (54:41)

How often am I high overnight?

C (54:44)

I would say, you know, let's call it a few nights a month. Also, Scott, there's two reasons she doesn't want to use a pump.

A (54:57)

Okay.

C (54:58)

Number one is because the amount of insulin she uses, small uses, like her basal is very low. Her carb ratio is like, for 10 carbs, one unit. Her insulin Needs maybe are a little low for, let's call it for the regular omnipod. Number two is because she doesn't want it on her body for me. She doesn't want people to see it. And plus she likes to keep, you know, those, those things irritate the body. They irritate the skin. We've done a lot of things. We do a patch under the Dexcom and we do. Then we put the Dexcom on. We know, we treat the skin, we put a patch, then we put the dexcom, then we put another patch. We have like a whole system to protect her skin. So that's like another thing, you know, and then here you're, you know, they're in the bikini in the. And the small clothes.

A (56:02)

So it's like just not looking for extra. Listen, I don't not understand. I'm just. I was just wondering if she thought about like the idea of an algorithm being helpful to her.

C (56:11)

That sounds fabulous. Like, I think if her body needed it and I think she would do it.

A (56:20)

Yeah. I mean, you don't know, like she could also do this, you know, Sarah, you might do injections your whole life and just be like, hey, I'm great at this and it works for me. That'd be awesome too. You know, I'm not saying there's a right or wrong way. I was just wondering, have I skipped anything? Missed anything at all? Is there anything we forgot to talk about or something you wanted to talk about? I want to make sure I don't miss anything because there's two of you and it's a little more confusing for me.

C (56:44)

Ultimately, I think the most important thing is as a parent, you're the one that has to advocate for your kid. You're the one that needs to get educated and learn how to really manage this condition. Because the diabetic educator that you see three to four times a year for max 30 minutes to an hour, they can help, but they can't manage the day to day. You got to figure that stuff out on your own. And that's where your podcast is. So what you've done for the Type one community is like, congratulations, you know, thank you. I really, really appreciate you and, and what you've done for our community.

A (57:41)

Well, that's very kind of you and it's my pleasure. I very much enjoy making the podcast, so you don't really have to thank me for it, but. But I will accept your thanks and, and I carried them throughout my day. I'm just very happy, like to hear you talk about, you know, some of the things you've had success with and how things are working for you guys. Anyway, what is my last question for Sarah? I have one last question. You're so young. I don't know if it's too early, but do you ever think about having kids?

B (58:10)

Yeah, I do.

A (58:11)

You do? And is that a thing that has changed for you since you have diabetes or does it not change for you how you think about it?

B (58:17)

No, I actually wonder about that sometimes. Like, how's that going to work, building, like caring for a human in your body while caring for yourself?

A (58:25)

Yeah, it can be a lot of work. There's a ton of information and a lot of ladies have, have shared their stories in the podcast. If you ever get closer to thinking about it, you can listen to them. They'll talk about how their insulin needs change and shift throughout pregnancy and stuff like that. It's pretty interesting, actually. I have no more questions. I feel like you guys did such a great job of telling your story. I feel like I'm. I feel done.

C (58:49)

Oh, Scott, thanks a million.

A (58:51)

Thank you.

B (58:51)

So real.

A (58:52)

No, really, you guys are terrific. This is lovely of you to do. I appreciate you taking your time. Sarah, why are you not at school?

B (58:58)

What's going on for this podcast?

A (59:02)

Oh, nice. Got a day off.

B (59:04)

Yeah.

A (59:04)

Will you go in late or. No, forget it.

B (59:08)

No, I'm not gonna go and leave. I'm not.

C (59:10)

She's a really. She's super responsible. She can miss today.

A (59:13)

It's not a problem that, that even. That's very nice. I'm glad that, that it seemed important enough for you to do something like that. Thank you. Seriously. Hold on one second for me. I really appreciate this. Touched by Type 1 Sponsored this episode of the Juice Box podcast. Check them out@touchedbytype1.org on Instagram and Facebook. Give them a follow up. Go check out what they're doing. They are helping people with type 1 diabetes in ways you just can't imagine. Head now to tandem diabetes.com juicebox and check out today's sponsor, Tandem Diabetes Care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem Mobi system. Are you tired of getting a rash from your CGM adhesive? Give the Eversense 365 a try. Eversensecgm.com Juicebox beautiful silicone that they use. It changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. Okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show? Or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app. Go to YouTube and follow me. Or Instagram TikTok. 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 you not know about the private group? You have to join the private group. As of this recording, it has 74,4000 members. 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. Tag me. I'll say hi. If you're new to type 1 diabetes, begin with the Bold Beginnings series from the podcast. Don't take my word for it. Listen to what reviewers have said. Bold Beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked. People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen, they recommend it to everyone who's struggling. It's straightforward, practical, and easy to listen to. Bold Beginnings gives you the basics in a way that actually makes sense. The Juice Box podcast is edited by wrong way recording wrongwayrecording.com if you'd like your podcast to sound as good as mine, check out rob@wrestwayrecording.com.