#1809 Gremlins

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1809 – Gremlins

Host: Scott Benner
Guest: Valerie
Date: March 27, 2026

---

Overview

This episode features Valerie, a woman diagnosed with LADA (Latent Autoimmune Diabetes in Adults, a form of Type 1 diabetes with slower onset) at age 39. Valerie shares her diagnostic journey, her experiences as both a medical professional and patient, and how her unique background—including childhood trauma, foster care, and working on cruise ships—has shaped her approach to living with diabetes. The discussion explores Valerie's transition through various diabetes management tools, her pragmatic approach to care, and broader reflections on resilience and self-advocacy.

---

Key Discussion Points & Insights

Valerie’s Diagnosis and Early Experiences

• Diagnosis at Age 39 (LADA):

  • Valerie was initially misdiagnosed with Type 2 diabetes due to her age [03:16]. She describes only mild symptoms: “I was only tired and thin because when you work on the cruise ship, it’s like 10-hour days.” [05:57]
  • Discovery was incidental, following a urinary tract infection and sugar detected in her urine [10:25]

• Misdiagnosis and Getting the Right Referral:

  • Lived with a Type 2 diagnosis for about 1.5 years [11:16]
  • A dermatologist, seeing unusual skin issues and abnormal labs, referred her to an endocrinologist, leading to her true diagnosis (LADA/Type 1) [11:20 – 12:04]

Navigating the Healthcare System

• Self-Advocacy: Valerie, due to her background in medical administration, knew how to push for specialist referrals when local endocrinologists were unavailable [12:47].
• Practical Challenges:
  • “I’m the one that does everything. Yeah, I just basically go in, like, I need these scripts...I pretty much from the beginning, I've been doing it myself.” [30:22]

Impact of Work and Life Circumstances

• Cruise Ship Life:

  • Long, taxing work hours, transient living arrangements—2 months on, 4 months off [09:07]
  • Saw direct consequences of others’ mismanaged diabetes on cruises [06:35]
  • "It's hard work every day sharing space...you don't really have any alone time." [09:37]

• Current Work as Medical Admin:

  • Now back in a hospital setting in Hawaii, working at an open nursing station (“an island on an island”) [18:09 – 18:16]
  • Describes rapid response demands and constant interruptions in her role [17:06 – 17:43]

Management of Diabetes Over Time

Medications & Devices

• CGM (Continuous Glucose Monitoring):
  • Valerie sought out a Dexcom CGM before insulin was required—"I paid for my own Dexcom before I started insulin... I didn’t mind finger sticking myself, but...it just seemed torturous." [19:59 – 20:54]
• Insulin Use & Caution:
  • Started insulin about a year after LADA diagnosis—less than the initially predicted 5-year grace period [19:53]
  • Focuses on avoiding severe lows and DKA over achieving “perfect” numbers
  • "I'm not bold with insulin... I've always given myself the least amount or enough to keep myself in range, but...I was just always afraid that I'll give myself too much." [21:21]

Pumps (Omnipod, Omnipod 5, iLet)

• Pump Evolution:

  • Started on mealtime insulin, then Omnipod, then switched to iLet [24:24 – 25:47]

• iLet Experience:

  • Loves lower input required with iLet: "I want less involvement. I want less involvement." [26:40 – 26:42]
  • Admits to “fake carbing”—announcing additional meals to trick the algorithm into delivering more insulin [27:29 – 27:42]
  • Prefers iLet over Omnipod, primarily due to infusion set longevity and reduced lows [58:12 – 59:19]
  • Still prefers pre-bolusing to avoid glucose spikes, even when the pump doesn't require it: "The pre-bolusing helped [to avoid peaks]." [60:02]
  • Aesthetically, misses Omnipod for dress-wearing ease [60:10]

• Approach to Metrics & Aggressiveness:

  • Keeps A1c in the 5s–low 6s, but doesn't “chase” numbers [22:33 – 22:53]
  • Focuses on steady management and personal safety
  • “I'm just trying not to end up in the hospital and not have lows.” [62:14]

Attitude Toward Healthcare Professionals

• Relies little on her endo/team for active management—"They don’t really help me. I’m the one that does everything." [30:22]
• Views most HCPs as regular people, given her professional background [31:07]
• Finds therapy helpful as a sounding board—mainly for documentation and the occasional insurance battle, not depression [47:19 – 48:33]

Resilience, Childhood, and Mental Health

• Early Trauma and Foster Care:

  • Removed from abusive parents at age 7, spent years in multiple homes—“about 14 until I was 18” [35:40]
  • Bonded but guarded with her adoptive family, difficulty with attachments [35:53 – 36:07]
  • Found significant support and positive experiences in non-biological families, counterbalancing early adversity

• ACEs and PACEs Testing (Adverse and Positive Childhood Experiences):

  • Takes the test live with Scott, scoring high on positives, which is “why I’m better at thriving” [43:44 – 43:57]
  • Discusses how positive supports in foster/adoptive care may have buffered some damage from early trauma

• Resilience & Humor:

  • Maintains positivity, avoids dwelling on the past: “It’s a waste of energy and I. I don’t have depression, luckily. I do my best to move forward.” [45:42]
  • Makes light of her life story—“God. Very Buddhist of me. I'll say a prayer for you.” [49:24 – 49:27]

Reflections on Relationships and Identity

• Not actively dating but has strong friendships; attributes guardedness to parental dynamics and childhood trauma [32:54 – 33:41]
• Multicultural background (half Thai, half Greek), experienced different traditions in various foster homes, but not religious [49:31 – 49:57]
• Values open-mindedness from diverse living situations: "Just to have an open mind." [50:34]

---

Notable Quotes & Memorable Moments

• On Misdiagnosis:

  • “I don’t believe this diagnosis. Like they did a lab draw...I guess I believe I have diabetes, but I don't understand how I have diabetes.” —Valerie [10:25 – 11:16]

• On Living Alone and Insulin:

  • “I'm not bold with insulin...I do live alone...I'm just afraid of passing out.” —Valerie [21:21 – 22:04]

• On Managing Diabetes:

  • “As long as no one's calling 911 on me and like, they're not doing a wellness check, I think I'm okay.” —Valerie [32:12]

• On Pump Preferences:

  • "I want less involvement...The marketing of the eyelet, it spoke to me on that level." —Valerie [26:41 & 62:00]

• On Resilience:

  • “I'm amazed I'm not a psychopath for what I've been through.” —Valerie [37:08]
  • “I am better at thriving. Maybe that’s the word.” —Valerie [43:40 – 43:44]
  • “People saved you, huh? That’s something.” —Scott [46:12]

• On Therapy and Documentation:

  • “It’s mainly more for documentation purposes. Slash, a sounding board when, like, my insurance ain’t gonna cover something.” —Valerie [47:19]

• On Letting Go and Acceptance:

  • “I don’t dwell. It’s...I think it’s a waste of energy and I...just try not to dwell on [the past].” —Valerie [45:42]

---

Timestamps for Key Segments

• LADA Diagnosis Journey: [03:16 – 13:55]
• Working on Cruise Ships: [03:33 – 09:37]
• Dermatologist’s Role in Diagnosis: [11:20 – 12:04]
• Life in Hawaii, Medical Admin Work: [13:43 – 18:16]
• Transitioning to Pump Therapy: [24:24 – 27:04]
• Pump Preferences & Automation Discussion: [27:04 – 30:07, 58:12 – 62:31]
• Self-advocacy vs Provider Reliance: [30:22 – 32:07]
• Childhood, Foster Care, Resilience: [33:24 – 46:10]
• ACE/PACE Questions: [40:50 – 43:40]
• Personal Philosophy & Humor: [47:19 – 53:12]
• Skin Issues & Aging: [55:00 – 56:46]
• Closing Reflections on Diabetes Philosophy: [61:42 – 64:52]

---

Final Takeaways

• Valerie’s Core Approach:
  Valerie embodies pragmatic, self-reliant diabetes care driven by her medical background, guarded optimism, and past adversities. She seeks the least burdensome tools (CGM, iLet) to avoid hypoglycemia and maintain independence.

• Resilience Shaped by Childhood:
  Her ability to thrive stems from key positive supports after early adversity, openness to diverse experiences, and humor. Valerie’s adaptive philosophy suits the “Bold With Insulin” ethos—though her boldness is in sustaining herself, not chasing perfection.

• Advice for Listeners:
  Valerie’s story is a testament to the power of self-advocacy, adapting technology to fit your lifestyle, and the lasting impact of supportive relationships—no matter when they come into your life.

---

For More Stories & Strategies

Visit juiceboxpodcast.com, or join the Juicebox Podcast Facebook group for ongoing support and community.

Transcript

[A]

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

[B]

Hi, I'm Valerie. I'm here to represent the lotta group of people who get diagnosed with Type one in the later onset of their life.

[A]

How would you like to share a type 1 diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type 1 diabetes. It's not just a vacation, it's a chance to relax, connect and feel understood in a way that is hard to find elsewhere. We're going to sail out of Miami and the cruise includes stops in Cococay, South San Juan, St. Kitts and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility and exceptional amenities. You're going to enjoy a welcoming environment surrounded by others who get life with type 1 diabetes. I'm going to host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining and modern amenities all throughout the Celebrity Beyond. Your kids can be supervised and there's teen programs so everyone gets time to recharge, not just the kids going on vacation, but maybe you get to kick back a little bit too. There's going to be zero judgment, real connections and a whole lot of sun and fun on Juice Cruise 2026. Please come with me. You're going to have a terrific time. You can learn more or set up your [e-mail] juice juice cruise get a hold of Suzanne at Cruise Planners. She will take care of everything. Links in the show Notes links@juicebox podcast.com if you're looking for community around type 1 diabetes, check out the Juice Box Podcast Private Facebook Group juice box podcast type 1 diabetes but everybody is welcome. Type 1 type 2 gestational loved ones it doesn't matter to me if you're impacted by diabetes and you're looking for support, comfort or community, check out Juice box podcast type 1 diabetes on Facebook. Please don't forget that nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. Today's episode of the Juice Box Podcast is sponsored by the Contour Next Gen Blood Glucose Meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you@contour next.com Juicebox Today's episode is also sponsored by Medtronic Diabetes who is making Life with diabetes easier with the mini med 780G system and their new sensor options, which include the Instinct sensor made by Abbott. Would you like to unleash the full potential of the mini med 780G system? You can do that at my link medtronicdiabetes.com Juicebox okay.

[B]

Hi, I'm Valerie. I'm here to represent the LADA group of people who get diagnosed with type one in the later onset of their life. I got this diagnosis, you know, most people get the type 2 first and then I got the correct diagnosis.

[A]

How long ago Was this?

[B]

Exactly? 12 years ago. And it was the same time of month? February. Because I remember I was working on the cruise ship in the medical department and it was like the cruise from hell because that particular cruise had a norovirus outbreak.

[A]

Oh gosh.

[B]

Yeah. And I would only come on and fill in as the secretary. I would relieve the person for their vacation time. So I'd only be on for like eight weeks. But every time I walked on ship I knew that there could be an outbreak. I was just always prepared for if it was going to happen. Just you had to deal with it.

[A]

Are you in the industry still?

[B]

I'm not the cruise. I'm still in medical. I've been in medical for decades. Like admin. Yeah, roles. I'm now back at the hospital where I used to work for. Then I went to work for the cruise line, but I worked in the corporate office and then I ended up just filling in on the ship for the secretary. So I've worked for the cruise line for like 15 years.

[A]

I wonder what they've changed about cruises that those outbreaks don't seem to happen like that as much anymore.

[B]

They're very vigilant on the washy washy of your hands. The people who walk on board, they know that if they present with symptoms they're so hopefully supposed to report them and you know, get the treatment. Don't like go to the buffet and spread your love, I would hope.

[A]

Well, you know though, I think you're onto something because outside I've been on a few cruises recently and outside of the restaurants are hand washing stations. On some cruises there's a person there looking at you going, get those hands, wash your hands. Don't walk past this. And, and I actually noticed that on a, it's funny, on a less expensive ship there's someone there telling you to wash your hands. And on a more expensive ship, what I noticed is nobody doesn't wash their hands. Everybody just sort of does it? And. Yeah, it's interesting. Okay, so 12, you say 12 years ago?

[B]

Yeah, 20. Oh, I was 39.

[A]

You were 39. Okay, so you're 51 now. Okay, 12 years ago. Do you have any people in your life who have type 1 diabetes? People you're related to?

[B]

No, nothing.

[A]

What were your first symptoms? How do you recall the whole thing happening?

[B]

I was only tired and thin because when you work on the cruise ship, it's like 10 hour days. Like I'm medical staff, but I don't, you know, I'm not treating the patients. I'm just doing all the coordination of the paperwork if they're going to stay on board, not stay on board. That's all. Yeah, I mean, I have family history of other diagnoses that I was worried that maybe it would. Yeah. But I didn't think I would. Yeah, I didn't know. And then all the years that I've reviewed medical records, it was rare that I ever saw a type one diagnosis.

[A]

Hey, Valerie, what other family things were you worried about getting?

[B]

Oh, the epilepsy. The one time I worked on the ship, this nurse came down and was like yelling at the doctor and I'm like, why is she yelling at the doc? Like. But she had to go deal with a medical emergency on board because someone had a seizure. And then when the person woke up, got alert, oriented, she's like, oh, I took the amount of insulin that my doctor told me and then the food didn't come out on time and she ended up having a seizure. So I saw that before I even like got, you know, the wrong to write diagnosis. So I was afraid that I would, I don't know, have seizures or. I don't know.

[A]

Did you mean family, like other, other medical issues inside of your family?

[B]

Yeah, so the. My father's already passed away, but he had the epilepsy. And then my mother has a mental. But now she's Alzheimer's. My mother had schizophrenia.

[A]

Oh, your mom was schizophrenic and. But she's, she's still alive now. She's. How old is she?

[B]

Yeah, she's early 80s, but you know, in dementia state. I moved her back to Thailand.

[A]

Oh, oh, is that where you're from originally or they from?

[B]

I was born in America, but I'm half Thai and half like Greek.

[A]

Gotcha. Well, there's probably a story in there about growing up with your mom, huh?

[B]

Yeah, yeah, yeah, I'm one of those. I lived with my parents. I'm fortunate to have, you know, the people See something, say something. I was removed by cps.

[A]

Oh, no kidding?

[B]

Yeah.

[A]

At what age?

[B]

I thought it was eight, but it was seven.

[A]

Seven. Interesting. Okay. In the years leading up to your diagnosis, any medical issues that made you as an adult think like, oh, one day something's gonna happen.

[B]

No, you just have, like a little bit. Yeah, I guess. Normal level of anxiety. Like, I don't want to go see the doctor, even though I work with doctors. You know what I mean? So.

[A]

Okay, that's.

[B]

I think that's about it. Like, I just. And then the cost. You get a medical condition and it's very expensive or what I've had seen working in the roles that I had.

[A]

Yeah, that's the kind of stuff you're worried about.

[B]

Yeah.

[A]

Initially diagnosed with diabetes and you're just. You're just run down and you're thin. Is that happening on the ship or is that happening on land?

[B]

Oh, it happened on ship.

[A]

Okay.

[B]

And it was toward the end of the contract because I would only come on for like eight weeks and then I would go home and I would get. I would have another land job.

[A]

Yeah. And then how. How long did you stay on land before you went back to the ship?

[B]

Four months. So it, like. Yeah, it would be two months on ship, four months off.

[A]

Okay. I was just talking to a guy that works on. I was just on a cruise, and I was talking to one of the guys that works on the cruise, and he. He was in the middle of like a. A six, Like a five month thing and.

[B]

Oh, yeah. So most of the contracts are a lot longer.

[A]

Yeah.

[B]

Okay.

[A]

He was at the end of it, and he's like, we've had a couple of people. I forget what he said, but he was like, I'm thinking of signing on for an extra month. And I was like, so you'll be on.

[B]

I would say no, because you're so run down. And they would do that too. We would see that, but then they would just. Yeah. It's hard work every day sharing space. Like, you don't really have any alone time because you're always on top of something, either working or busy. Yeah.

[A]

Can I ask you, do you ever forget you're on a giant floating thing?

[B]

A little bit, yeah.

[A]

You ever walk through a door and go like, oh, the ocean's there. I forgot about that. No, no, not like that.

[B]

I mean, like, I had an inside cabin. It's not like I had like, you know, a balcony or even a porthole.

[A]

They didn't let me look outside. Scott.

[B]

Yeah.

[A]

Okay. So what again? First symptoms are tired, losing weight, you're on the ship. Do you get so sick you go talk to somebody or does somebody say something to you?

[B]

No. So I had a urinary tract infection and then I did the two courses of the antibiotic and then when they repeated the urine after the second, there was sugar in my urine. And so that's how they got the type 2 diagnosis.

[A]

I see. What do you think made them jump

[B]

to type 2 because of my age? And then they're like, oh, you know, there's, you know, medicines that street. Like, like I was, I'm. I hate pills. So like it took a couple days and the doc is like, okay. Then I'm like, fine, write me the script, I'll go and get the medicine. But I don't, you know, I don't believe this diagnosis. Like they did a lab draw. We could do labs on board. So when I saw the labs that put me into that kind of like pre diabetic diabetes stages, you know, and I was like, okay, now I guess I believe I have diabetes, but I don'. Understand how I have diabetes.

[A]

How long did you live with a type 2 diagnosis?

[B]

A year and a half. I would have always kind of like dermatological kind of stuff. And so how I got the specialist and the right diagnosis was the dermatologist. Because I would be like, okay, I'm not sure what's going on. He did labs, some of the labs were kind of off. And he's like, oh, you should see an endocrinologist. I'm like, okay, great. The people I worked with on the ship at the time, one of the nurses like, oh, you should get an endocrinologist. I knew the doctor that I was particularly working with on board, he would never write me that specialist, you know, because he's like, oh, no, you just take this med and that's fine, you know, so I'm just lucky that I already had an established dermatologist that did labs and I got the right diagnosis.

[A]

What dermatology issues did you have that. That you were seeing a dermatologist? That much?

[B]

It would be acne. I would sometimes have eczema, but I don't think I saw him for eczema. I would go like urgent care if I had a little, like little bit of a flare up.

[A]

Okay.

[B]

And I always had great skin. And then I'm like, oh, this like or something. And then that particular time I had like, it's all over my back. Like it's just these weird spotches. But it wasn't acne. Like, it's just like, you're. There's something off. I. You know, I'm like, okay, this is. Something's not right. Let's. Can. I don't know. What is this? Tell me, do I need to be on a med.

[A]

Was that a thing that happened only after the type 2 diagnosis?

[B]

Yeah. I say so. Yeah.

[A]

Okay.

[B]

Yeah.

[A]

And then he got you to an endo.

[B]

That.

[A]

And that's a year and a half later?

[B]

Yes. Oh, no. So, Well, a year and a half later from the type 2 is when I got the referral to see Endo. And then that was a problem because he's like. Oh, you know, like, he referred me to someone who had already, like, just recently retired. The other two offices, no one. Sorry. No one worked in those offices or they never called me back. So. Because I would walk on the ship and then in my role, I would help with the crew referral. So, like, I already knew how to advocate for myself or call the offices, be like, you know, I have these labs that says I can see an endocrinologist. Are you taking new patients? So I ended up finding an endocrinologist on a different island that I live on because no one in the offices on the island that has more endocrinologists had appointments or people even worked in their office. I don't know.

[A]

Wait, an island you lived on? Where were you living?

[B]

Oh, so I live in Hawaii and I. Yeah, there's a bunch of different islands I lived on. I live on the main island that has the majority of the people.

[A]

And where are you now? You still there?

[B]

Yeah. Oahu.

[A]

Tell people what time it is.

[B]

Oh, it's. Yeah, 4. 16 in the morning.

[A]

I mean, we could have, like, done this later in my day, which would have been later in your day. Why are we doing it at this time of day? Unlike other systems that will wait until your blood sugar is 180 before delivering corrections, the MiniMed 780G system is the only system with meal detection technology that automatically detects rising sugar levels and delivers more insulin as needed to help keep your sugar levels in range, even if you're not a perfect carb counter. Today's episode of the Juice Box podcast is sponsored by Medtronic diabetes and their MiniMed 780G system, which gives you real choices. Because the MiniMed 780G system works with the Instinct sensor made by Abbott, as well as the Simplera Sync and Guardian 4 sensors, giving you options. The Instinct sensor is the longest wear sensor yet lasting 15 days and designed exclusively for the mini Med 780G. And don't forget Medtronic Diabetes makes technology accessible for you with comprehensive insurance support programs to help you with your out of pocket costs. We're switching from other pump and and CGM systems. Learn more and get started today with my link medtronicdiabetes.com juicebox contour next.com juicebox that's the link you'll use to find out more about the Contour Next Gen blood glucose meter when you get there, there's a little bit at the top you can click right on. Blood glucose monitoring. I'll do it with you. Go to meters, click on any of the meters. I'll click on the Next gen and you're going to get more information. It's easy to use and highly accurate. Smart Light provides a simple understanding of your blood glucose levels. And of course with Second Chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the Contour Next Gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next.com juicebox and if you scroll down at that link, you're going to see things like a buy now button. You could register your meter after you purchase it or what is this? Download a coupon? Oh, receive a free Contour Next Gen blood glucose meter. Do tell. Contour next.com juicebox Head over there. Now get the same accurate and reliable meter that we use.

[B]

Oh, because it's before work and it's less noisy because I live somewhere where the. Yeah, I live in town and the noise starts early. The fire station is two blocks away. Like at some point it is so noisy like and I don't have like a quiet room. So that's why we're doing it this early.

[A]

And have you been to sleep?

[B]

I have, yeah, I did. I only probably got like five hours of sleep.

[A]

Oh my gosh. What time do you leave for work?

[B]

I leave for work at 6. I come in at 6:30 when the nurses are about to change over.

[A]

And you're still doing like clerical secretary, that kind of thing.

[B]

Yes.

[A]

How has that changed with computers over the last 10? Like how has your job morphed?

[B]

It's the same. But now the role I'm in, sitting at a nursing station, I'm constantly interrupted. Before I'd have my own office or a cubicle. I'm constantly like. Like it, you know, is it a facility thing I gotta report? Is it an IT thing I gotta report like, the, you know, computer on wheels is not working, so the nurse can't administer meds. Is it a biomed issue? Depending on what device ain't working, I got to put in a biomed, you

[A]

know, so it's actually. You're also making me think about. I was at a. At the hematologist recently getting an iron infusion. And it's an office I've gone to for, like, many years. And all of their staff, the ones who were, like, parked at a computer, a lot of the times they are just in cutouts in the wall, basically. Like, there's no doors, and there's usually two or three of them in a fair tight space.

[B]

Yeah.

[A]

Is that what you're talking about?

[B]

No. I'm at a nursing station where it's wide open.

[A]

Like an island almost.

[B]

Yeah, Yeah. I sit in an island.

[A]

Gotcha.

[B]

Okay. Where people walk behind me, they walk in front of me, they stare at me, and I'm on the phone.

[A]

Well, also, you're on an island. On an island, so.

[B]

Yeah, exactly.

[A]

Get you one more. You might be floating. Okay. When you get the type 1 diagnosis, do you remember feeling any certain way about it? Was it disappointing or was it.

[B]

I remember going, I. For some reason, I knew that my A1C had to be under 7. He told me that you don't need to be on insulin now, but sometime in the next five years, you will need to be on insulin. So I'm like, okay, so what are we waiting for? So. So I do remember that. And then I knew there was also a level of stress because he had to fill out paperwork that said that I can go back to work on the cruise ship. So I was just like, okay. Because that's a role I had before working for them is reviewing the records. Like, if you get ill on the ship as a crew, you have to get, like, a fit for duty, no restrictions, Then you can go back to work on the ship.

[A]

Sure.

[B]

So I knew. I was like, oh, God, can I go back to work? Like, I'm fine. Like, yeah, like

[A]

you just wanted. You wanted to get back to start making money.

[B]

Yeah, exactly. Like, it's. That's like my insurance, you know, it's like, pays my rent. Like, I'm like, oh, yeah, no, no, no. Like, hopefully. And then I'm like, okay, geez.

[A]

And so your biggest concern was getting back to work. But what I'm hearing that it's interesting is that you get a type 1 diagnosis, but it tells you you lotta.

[B]

It's the lotta. It's type one. But, like, it's a slower. The slower.

[A]

Oh, no, no, I understand. What I'm saying is he was saying that he thought that onset would last five years.

[B]

Yeah. I started insulin maybe a year later.

[A]

I was gonna say it didn't make it five years. Right?

[B]

Yeah. No, no, no, no. So I don't know. I did. There's this group that would come here and do conferences. So I did, like, the type 2 track one year, and then when I got the right diagnosis, I did the type 1 track. And then I'm like, okay, well, if we're watching, like, I want to do the Dexcom thing. So I paid for my own Dexcom before I started Insulin because I'm like, what are we watching for? Like, I just. I don't still to this day. My big concerns is I've, you know, I don't want to be a patient in the hospital with dka, so that hasn't happened. And I don't want to have a seizure or have someone have to use glucagon on me. So those were my big kind of, like, concerns. Now, you know, having the right diagnosis.

[A]

How did you know to get a CGM when they were like, hey, we're looking for stuff to happen? How did you figure to do it?

[B]

It's because I went to one of the conferences, and this is like, oh, this type is a little different. That. That's how I knew.

[A]

Okay, because.

[B]

And then I was like, I don't. Like, I didn't mind finger sticking myself, but finger sticking myself, like, before meals, after meals, like, I could do it, but it was, like, it just seemed torturous. And why, like, yeah, okay.

[A]

You know, I mean, CGMs are fantastic. When diabetes shows up in full force and it becomes what it is, you know, Is there a big shift from lada, or does it feel like it's such a slow progression that you kind of understand it slowly?

[B]

And so when it gets there, it's low. I went many years without Lowe's, and then a little bit more. Like, more, but still not too bad. But, you know, you treat it, it goes up. I've been on about the same amount of insulin from the beginning, so it must definitely be your body weight. And it's just the timing of insulin, how much you're going to eat and trying to stay in range. And then I. I'm like, the opposite. Like, I'm not bold with insulin. I had always started giving myself, like. I don't know. I've always given myself, like, the least Amount or enough to keep myself in range, but, like, I was just always afraid that I'll give myself too much.

[A]

Do you live alone?

[B]

I do. I do live alone.

[A]

Is that part of the decision?

[B]

A little bit? Yeah. Because I don't. Yeah, I would say so, yes.

[A]

How much more aggressive do you think you would have been or maybe still would be if you had somebody else around?

[B]

Maybe just because then someone would get me. I'm just afraid of passing out. One of the nurses, like, did you ever go down? I'm like, oh, no. Like, yeah, so, yeah, just. If I. Yeah, I understand.

[A]

What's your A1C right now?

[B]

Oh, I just had labs, but I'm not going to look at them until Wednesday. Like, now. Like, I've never cared for. That was. The Last one was 6.4. Most of them were under 5. I did have a 5.2 and I had zero lows. So I've always gone by, like, the fluctuations in my blood sugar number, not the actual number.

[A]

Valerie, how much. How much more aggressive could you get with a mid six to a five? Yeah, that's pretty.

[B]

Yeah.

[A]

Seriously, what. What do you mean by. Like, I didn't. I'm not more aggressive. Like, how would you be more aggressive?

[B]

Yeah, true. I guess not. I just, you know, after I eat, if it goes up, I, like, watch it. I just look at the arrow. I just. You know what I mean? Like.

[A]

No, I do. I wouldn't understand.

[B]

Okay. If my blood sugar is in the low 200s, as long as I have insulin on board, and then within that three hours, it slowly comes back down and I see. I'm okay with that.

[A]

What number do you go? No, I'm gonna have to do something right now.

[B]

Over 200. If the air, like. Yeah, if it's over 200 and the arrow is going up, I would consider announcing a little bit more because now I'm on the islet. I changed pumps.

[A]

We're getting to that. Don't worry.

[B]

Yeah. Okay.

[A]

So. So don't worry. We got the whole thing covered. So over 200 rising, you would have been a little more aggressive. We're talking about after a meal.

[B]

Yeah, I might. Looking at what my onboard insulin is like, I have a certain number that I'm like, four is usually what I would want after a meal to continue.

[A]

Like, that's how you were thinking about it. Okay.

[B]

Yeah. Or that, you know, it's always been 2 to 4 for meals. Maybe 6 in the morning, I think. Yeah.

[A]

When you're first diagnosed, I imagine you're using Pens. But then do you get to a. Right and then to a pump? What was your first pump?

[B]

The Omnipod. And then I wanted to point out something because I've listened to you for a while. It seemed like most people were starting on that basal insulin. From the beginning, my endocrinologist had charted that we're going to watch her and then we're going to start her on mealtime insulin. So I had saw that because I would review records, and I made sure I got a copy of my record. I started on the mealtime insulin, then I went to the omnipod, and then I tried the basal bolus thing. That's my progression of trying.

[A]

Okay, wait, so you started on just mealtime insulin and then they put you on a pump?

[B]

Oh, I asked to be on the pump because I was against the pump in the beginning because I didn't want two devices on my body. But then I realized, like, the only way you can get insulin in your body is through the injections. And then I have to do this for the rest of my life. So I might as well get an infusion set to rotate. It's either I'm rotating my injections or I have to rotate an infusions.

[A]

Yeah. And you just figured, like, let's get a pump. Okay. All right. And how long do you use Omnipod for?

[B]

Probably, like, about 10 years.

[A]

Okay. All right. Yeah. So you were on a pump pretty quickly. You used it for a long time and now. And so eyelets, a recent switch.

[B]

Yeah, so I've been on it about a year, and for me, it was just. For me, it's always been about mealtime insulin dosing. And so that's. And then I, you know, I. I would count carbs, but I've. I can only eat a certain amount of food in a setting. I've never been able to eat and eat and eat. So I wanted to see what that algorithm did and also see if I can get more days out of the infusion set. Because Omnipod is only that three days, you know, hard three day, eight hours.

[A]

So two of your concerns are you'd like to wear a set longer. It's not about your effort.

[B]

It is. It's like. Like every time you eat, you have to announce, every time I eat, I have to inject, basically. So, like, what can give me less input, you know? Or, like, what I have to.

[A]

You're looking to be less involved at this point?

[B]

Yes, exactly.

[A]

Okay.

[B]

I want less involvement.

[A]

Okay. And so you see eyelet and you're like, well, this thing says. I say small meal. Meal. I forget. You tell me, what are the three choices?

[B]

Oh, yeah. So it is here, I'll look at it. It's usual, more than usual and then less.

[A]

How long have you been using it?

[B]

About a year. Okay, so like, yeah, I'm getting my shipment this week.

[A]

You might say breakfast more than usual if you're going to have a bigger breakfast or breakfast, usual. And same thing, Lunch, dinner. That's it now. And you're wearing your cgm, so you're seeing your outcomes. Okay.

[B]

Yeah.

[A]

So now I don't know if people understand, but with an eyelet pump, like, you cannot make an adjustment. Right. You can't say, I'm 200 and I'm going up and I want more insulin.

[B]

But I've learned how to add more insulin. You just announce again, I figured it out. I was compliant the first three months. Now I do what I want.

[A]

You're fake carving, as they say.

[B]

Yes, but it's not because. Yeah, my endocrinologist said that too. But I look at the. I know how to look what the insulin on board is, and I've always gone on, what is the insulin on board? And what does my CGM tell me?

[A]

Okay, so when you first get this pump and they tell you, like, announce your thing and don't touch it, what were your outcomes like after that?

[B]

I say, it was pretty good. It couldn't figure out certain foods, like sticky rice, but I did. I just let it go high, but then it would slowly bring it down and not like, definitely this one. Less lows. Not like I had too many lows before, but I would have them. So the outcomes, I'd say pretty good. They would be kind of high and I would just kind of like, let it be because it would come down. But now I'm like, I know what to announce to bring it down faster without having a crash.

[A]

I gotcha. What do you mean? How did you have fewer lows when you weren't having that many lows to begin with? Is it because it's going up and staying higher? More, more.

[B]

I don't.

[A]

Time.

[B]

Yeah, I don't know. I wouldn't have, like, when I. I don't know how I wanna go about this.

[A]

Take your time.

[B]

Yeah, so I would have more lows when I was menstruating before. I would have, like, that one week where no matter what I did, it was just like, all over the damn place. But. And I would have to, you know, do something to.

[A]

Is that the week you need more insulin or the week you magically seem like you don't need very much at all.

[B]

More right before would be more, and then after would be kind of. It would stabilize, and I wouldn't. You know, I. I would have less input or less like, I have to fix this. Or less like, why is it higher than usual? And it shouldn't be that high.

[A]

Okay.

[B]

Yeah.

[A]

So you had. When you were having a hormonal impact that was needing more insulin, you were fine.

[B]

More fluctuations where it would be like. And then. Yeah, yeah.

[A]

And you were finding the eyelet more difficult then.

[B]

Oh, no. So I started the eyelet after the. Like, that's when I was on Omnipod.

[A]

Oh, when you were on Omnipod, that's how you were having trouble during that week. I see. And the eyelet's handling that better? Worse. Different. Same.

[B]

It's better. It's definitely better. I'm like, less input. Less like having to treat a low and be stable.

[A]

Valerie, when you were on Omnipod, Was it Omnipod 5, or were you just using dash and making decisions on your own?

[B]

Oh, you know, Omnipod 5 and I would use it in manual mode.

[A]

Okay, so you weren't using the algorithm. You were. You were making decisions.

[B]

I did a little bit. I tried it, but it just. The meals, it. Yeah, it couldn't figure out the meals you couldn't figure. Yeah.

[A]

Who helps you when you need help? Is it an endocrinologist office? Do you have a community around?

[B]

Yes, I know I have an endocrinologist, but they don't really help me. I'm the one that does everything. Yeah, I just basically go in, like, I need these scripts. You can talk about my graph all you want, but I. I don't. I. Yeah, I pretty much from the beginning, I've been doing it myself.

[A]

So even when you're having difficulty, you find their input less valuable than just guessing into the wind?

[B]

Yes.

[A]

Okay.

[B]

I do.

[A]

Now, you work around. You work around medical people. What do you take from that? When you. Do you think you're. I mean, what's the reasoning? Are they. Are they not valuable? Or do you work around medical people and realize they're just people, too, so you don't see them as special or like, what's the.

[B]

Oh, what. Yeah, that's interesting. Maybe because what I see at the hospital where the two nurses have to sign off on the insulin, or maybe because my doctor was on another island and I just. Yeah. I just never wanted the input.

[A]

The endo you have. If You. If you went in, if you went in tomorrow and sat down and said, hey, look, I'm having a problem, I don't have any idea what's wrong. You tell me what to do. Do you think they'd get you to a solution?

[B]

I guess so, yeah. Yeah.

[A]

But do you think it would take more than one visit or more than six months? Or, like, what would your fear be?

[B]

I don't know. Maybe because of how, like, I started the insulin. I don't. Yeah. I don't know. I don't. I don't. Maybe because I had feedback from one of the. They're like, oh, no, you don't have to worry. But I. I don't know. Yeah, I just.

[A]

No, it's interesting. It's just interesting. You don't like, you know, that something's not. Not leaping to mind. Okay.

[B]

No, I just, like, I. I know I have to do this for the rest of my life. As long as no one's calling 911 on me and like, they're not doing a wellness check, I think I'm okay.

[A]

That's how it feels. Okay. Yeah. No, that's what I'm looking for. It's like, how does your day to day. I don't know. Why are you laughing, Valerie? What are you laughing for?

[B]

I don't know.

[A]

Because it's 4:30 in the morning?

[B]

I guess so. Yeah.

[A]

So it's more about getting along, not passing out, not having something horrible happen that's, you know, getting you out of here too soon. You're just trying to stay down the middle as much as you can without putting too much effort into it.

[B]

Yes.

[A]

Okay.

[B]

Yes.

[A]

Are you dating? Do you date?

[B]

Not really. No. But I. I am seeing someone that. We've been friends for a while, so. Yeah.

[A]

Did you date more before the diabetes or.

[B]

No, no, no, I didn't even then. Yeah.

[A]

You don't like people I have.

[B]

No, I like people. I have friends. It's. Yeah, it's just. Yeah. Not. I have a good friend network. I just. It's. Yeah.

[A]

Yeah. You're not looking for it?

[B]

No, not really.

[A]

You think it's because of the dynamic you saw between your parents?

[B]

Probably a little bit. I wish my mother had divorced him, but she stayed with him until he. So, yeah, definitely. It's definitely the dynamics that I saw my. Yeah. Biological parents. Yeah.

[A]

Valerie, you just shocked me a little bit. You're telling me that if, if I put you in a room with your schizophrenic mom and your dad, you'd boot Your dad out first?

[B]

Yes.

[A]

That's a hell of a statement, isn't it?

[B]

Definitely.

[A]

That's a hell of a statement. My goodness. What was his deal? Was he a drinker?

[B]

I don't know. But the adoptive mother made a comment that maybe he was, but I. I don't remember.

[A]

Young. Yeah.

[B]

You know, I was young, and I knew he worked as an accountant in a liquor store. There was never any alcohol at home. I. Yeah, I was so young. So he could have been, but I don't remember.

[A]

Why were you so harsh about him when you thought about him? He hit you.

[B]

It's. Yes. Yes. That's how I got removed from them, was the abuse. Like, people saw it, and that's how I. Yeah.

[A]

Sorry.

[B]

It's all right. I.

[A]

It is a long time ago. I understand. But still.

[B]

Yeah.

[A]

Did he hit your mom?

[B]

Yes. I used to, like, kind of, like, intervene.

[A]

Oh.

[B]

I'd be like, no. Yeah. I don't. Yeah, I'm that young. And I was like, yeah, no, that's not right.

[A]

Other siblings or just you?

[B]

I have a younger sister.

[A]

Did they remove her?

[B]

They did not. She stayed with them until both their medical and things got worse, and then she ended up, like, with a guardian, like high school.

[A]

Isn't that interesting? You had a younger sister when you were 7 or 8 years old, CPS removed you and left her. What, because they didn't hit her?

[B]

I think so. Yeah.

[A]

What a bizarre thing. And then where they put you, did you stay there your whole life or did you bounce?

[B]

I unfortunately bounced. I would have stayed with the first one, but she broke her back. And then that's what started the multiple homes after.

[A]

How many homes do you think you were in until you were 18?

[B]

About 14. But I. I. The last one did legally adopt me.

[A]

Oh.

[B]

So I got, like, you know, before I would be kicked out of the system, I. The family adopted me.

[A]

Did they do that for you?

[B]

For.

[A]

To help you with insurance, or do you think it was a love situation?

[B]

It was a love situation, but for me, like, because of what I went through, I. I can't bond. Yeah. I don't know. I bond, but I bond in my own way, if that makes sense.

[A]

Oh, no, I completely understand. I'm actually reasonably fascinated with this and have been. I'm making a series with Erica right now about the aces and paces testing.

[B]

Oh, yeah. Adverse childhood experiences.

[A]

Yeah, I was going to say, you probably know that acronym.

[B]

Oh, I know. I got a high. A score. Yeah.

[A]

I was gonna say, I bet you would ace the aces.

[B]

Oh, Yeah, I would.

[A]

Yeah.

[B]

Yeah.

[A]

We. We just put together. Well, we're in the middle of putting together a series on it, and I'm building an online tool that people can use to take the quiz so that they can. Yeah. See where they are, probably. Outside of the more mental health stuff that I do on the podcast, I don't talk about it as much in, like, conversations like this, but I am endlessly fascinated by what people do and why they do it.

[B]

Oh, yeah, yeah, yeah, yeah, yeah. I'm amazed I'm not a psychopath for what I've been through.

[A]

Hey, Valerie, it's not too late. Don't worry. You still can.

[B]

Yeah.

[A]

Okay.

[B]

I still get well. What I see at the hospital on a daily basis, I'm like, I'm doing well.

[A]

You're doing. Isn't that something?

[B]

I'm doing real well.

[A]

You look at other people and you're like, huh, I guess I'm not doing that badly.

[B]

Yeah, exactly.

[A]

These poor sons of bitches. Yeah, well, no, no, I hear what you're saying. You know, I'm. I'm working on something now. I. I really. I'm gonna put it on the website pretty soon. I think it's interesting how accurately for some people, that quiz can kind of guess at what your future issues might be.

[B]

Oh, I would like to. Yeah. Because I. Everyone has issues. You know what I mean? So. Yeah, no one's perfect.

[A]

Do you find that beyond, like, you know, having trouble, like, forming bonds? Do you have other issues as well? And how many of them impact your diabetes care, do you think?

[B]

Oh, I don't know. Oh, maybe. I don't think it impacts. I maybe obsess over, like, food and nutrition. It doesn't. It's just. Yeah. I'll spend too much time, or I, like, I'll eat this and maybe not eat that, or.

[A]

Yeah, okay. You said your mom is in Thailand?

[B]

Yes.

[A]

Was your father Thai as well?

[B]

No, he, like a Greek European mix.

[A]

Okay. Where did they meet, you know?

[B]

Yeah. My mother was a nurse in a hospital. They lived in the same apartment building, and I got this from my younger sister.

[A]

Yeah.

[B]

Or not that. Or just the backstory. So he was going to maybe marry someone else, but then he got my mother pregnant, so he ended up having to marry my mother.

[A]

Oh, he's married? He's. Do you think he was angry at you then, man?

[B]

No. Oh. So. No. I. I know he grew up abused. So when I got legally adopted, they gave the family, like, social service records and stuff, and that's how I learned My mother's diagnosis and that my father was, like, one of five kids and the only one that survived out of the five. Then, like, how, like, the abuse that he put on me was something that he had already saw and he thought that was normal child rearing, I guess.

[A]

Really? Yeah. No, I. I'm not surprised. Listen, I'm not surprised by that at all. That's what. That's what all the. That's what all the studies.

[B]

When I read that, I was like, oh, that's probably why she didn't leave him. Or like, she has a mental illness. That's the reason why she stayed. Or. Yeah, I don't. I don't know.

[A]

Yeah, she probably felt like she needed the help too. Right? Even if it wasn't great help, it was probably better than. I'm gonna guess how she felt by herself.

[B]

Yeah, I think so.

[A]

Is it hard for you not to really? I mean, what's it like to have known them and then been taken from them?

[B]

Okay. I would, like, when I felt. When I got older, I would kind of go visit occasionally. When I was younger and I had these forced visits, I would get really, like, sick. Like, after the visit. I would be, like, projectile vomiting or like, why do I have to do this?

[A]

Super upset.

[B]

Yeah, yeah, it was just. It's too traumatizing, like, having to. But I would have to go do these, like, visits.

[A]

Yeah. Hey, can I get your input on my. On the website? I'm making sure.

[B]

Yeah.

[A]

So it. It puts up a question in front of you, you answer yes or no, but there's a small icon at the bottom that if you get overwhelmed, that you can click on it and do a grounding. You think that's a good idea?

[B]

Yeah. Yeah, definitely.

[A]

Would you answer the questions with me for a second?

[B]

Sure. Yeah.

[A]

Are you sure?

[B]

Yeah, positive.

[A]

Did an adult often swear at you, insult you, or humiliate you?

[B]

No.

[A]

No. Did an adult often push, grab, slap, or throw things at you?

[B]

Yes.

[A]

Yes. Did an older person ever touch or fondle you sexually?

[B]

No.

[A]

No. Did you often feel no one in your family loved you or thought you were special?

[B]

I'm gonna say no.

[A]

Interesting. Did you feel often you didn't have enough to eat or no one to protect you?

[B]

Yes.

[A]

Were your parents ever separated or divorced?

[B]

No.

[A]

Was your mother or stepmother offer often hurt or physically threatened?

[B]

Yes. Yes.

[A]

Did you live with anyone who used drugs or was an alcoholic? You're not sure, right?

[B]

I'm not sure we'll say because I lived in different families. They smoked, but they didn't really drink too much, like, even the multiple families I lived with. So. And if they did, they would only have one, you know, after dinner. Wasn't like a. Like a habitual thing. So I'm gonna say no.

[A]

But I'm gonna ask a question. Are some of these answers coming from other families? Not your.

[B]

No. Most of them are coming from the biological family, but I'm kind of like, you know, the drinking one. I'm trying to, like, think through the rest of them. Yeah, think through the rest.

[A]

All right, two more in the set. Was a household member depressed, mentally ill or suicidal? We got a yes there.

[B]

Yes. Yeah. Yes, definitely.

[A]

Did a house member go to prison?

[B]

No.

[A]

No. Okay, so now that's the 10 ACEs questions. And then you can. The way it's set up, then you'll continue on to what they call the paces. These are positive things that can kind of counterbalance stuff like that. So could you talk to your family about your feelings?

[B]

Yes.

[A]

Did your family stand by you during difficult times?

[B]

I'm gonna say yes.

[A]

Did you enjoy participating in community traditions?

[B]

Oh, yes, definitely.

[A]

Did you feel a sense of belonging in high school?

[B]

Yes.

[A]

Did you feel supported by your friends?

[B]

Yes.

[A]

Did you have at least two non parent adults who took a genuine interest in you?

[B]

Yes.

[A]

Did you feel safe and protected by an adult in your home?

[B]

Yes.

[A]

So this is interesting because you have an ace score of four, so four of the first set, but you have a seven on the positive side. So your capacity to, like, you know, is greater, to maybe have success afterwards. It's tough to use the words because words are tough. Like, but find happiness, thrive.

[B]

I am better at thriving. Maybe that's the word.

[A]

You literally answered yes to every positive childhood experience.

[B]

Even though I had, like, not such a great one.

[A]

Exactly.

[B]

You know what I mean? Like, but I still. Yeah, I don't. Yeah.

[A]

Yep. It gives you some things to kind of carry forward, so.

[B]

Oh, definitely.

[A]

Yeah. No kidding. Actually, the website does too. And it indicates to you a couple of things that might happen to you. So if you see like a sharp or kind of ambiguous tone in a text message.

[B]

Mm.

[A]

Do you have, like, do you have any kind of feeling towards that? Does it make you feel, like, extra vigilant?

[B]

You know, right now? It depends on my mood and where I'm at in my blood sugar. That's what I've noticed in this progression of this disease. I'm going to say I am good. But if I'm. Yeah, in. Maybe higher than usual or low, like. Yeah, I do notice that. Yeah.

[A]

It's more.

[B]

Most of the time I'm good and grounded. But I do notice that sometimes I'll get a little bit more, I don't know, anxious or like. Like. Yeah. Well, my demeanor will be a little bit different.

[A]

It's interesting. It really is. When you get constructive feedback at work, do you have like a. Do you have, like a defensive feeling about. You're good about it?

[B]

I'm pretty good. Like, most of the time, I'm not a morning person. Even though I'm up this early talking. Just because that. When that phone start ringing at like 6. I'm there at 6:30. And then the extra noises, I'm. I get kind of irritated really fast.

[A]

Valerie, your story's really kind of uplifting. Yeah. Well, because if from an outsider, from my perspective, hard to say otherwise, you had a pretty start.

[B]

Definitely.

[A]

And that. That bouncing probably took 10 years to, you know.

[B]

Yeah.

[A]

Of that. But talking to you as an adult, you're a mostly positive person.

[B]

I am. I am. I don't dwell. It's. It's. I think it's a waste of energy and I. I don't have depression, luckily. Yeah. I just. I. Yeah, I do my best to move forward. I just. I try not to dwell on.

[A]

Do you think that the experiences you had growing up after you were removed from the home were such that the positivity of them and the support that came from them was able to kind of counterbalance your beginning?

[B]

I think so. Definitely.

[A]

Yeah. People saved you, huh? That's something.

[B]

Yeah, definitely.

[A]

Are you in touch with any of those people, like, along the way?

[B]

No. It was interesting. When I was still living in the Chicago area, I had one of the kids in one of the schools ended up in the school that I was in. So we kind of kept in touch then. But no. And I did try to go back when I still, like, it was decades ago. I've been out here, like, 26 years now that. The first family I like, I would have stayed with them if she didn't break her back. So I did try to reach out back to them because I knew where to find where they lived and, you know.

[A]

Yeah.

[B]

But they had probably already moved to where they had, like, a farm up in Minnesota. So they probably had. That was their retirement plan. So they're probably. Yeah, So I did try.

[A]

So had she not gotten injured, you think that would have been your kind of forever family?

[B]

Yeah, they would have been my forever family.

[A]

Wow. How old were you when you were separated from them?

[B]

I think I was only there for A year. So eight or nine.

[A]

But you still remember it kind of fondly?

[B]

Oh, definitely, yeah.

[A]

Do you go to therapy or have you.

[B]

I do. It's mainly more for documentation purposes. Slash, a sounding board when, like, my insurance ain't gonna cover something or. Yeah, so, yes, I do. I talk to someone once a month as. Yeah.

[A]

What do you mean, when your insurance doesn't cover something?

[B]

Oh. So, yeah, like, during the pandemic, I had to switch insurances to the other company, and then they were covering my Omnipod, and then they stopped covering my Omnipod. They were like, you know, used to. It went from like a reasonable copay to no copay to, like, oh, if you want. This device is now $1,000. And I'm like, what? You know, like, certain times a year, the formulary or whatnot. So I went maybe a year without the Omnipod, which was fine. Like, I can do injections. It's for me, documenting stuff like that.

[A]

But how does a mental health therapist help you with that?

[B]

I'm missing some sounding board. It's there. Maybe if I did get more sick because I didn't have my device or whatnot.

[A]

It's okay.

[B]

Something that will hold up in a court of law. I don't know. Maybe because I used to do depositions. I don't know. It's.

[A]

And do you find it help? Do you find therapy just helpful in general, just to be able to kind of unload on somebody?

[B]

Yeah. It's another viewpoint into whatever it is that I might have problems with or. Yeah. Yeah.

[A]

Wow, that's really great. You are. I mean, for how things started for you. You were an incredibly together person.

[B]

I am. I'm amazed.

[A]

You never killed a bunny rabbit or pulled the wings off of flies or anything like that.

[B]

No, no. I recently did kill a spider.

[A]

Why?

[B]

Because.

[A]

I'm just kidding.

[B]

Because.

[A]

Was it trying to murder you in your home?

[B]

No, it was just like. Yeah, don't do a web here. Yeah. It's not very Buddhist of me, but I did recently kill a. Yeah, listen,

[A]

I'd let you live if you weren't messing up the corner of my room.

[B]

Sometimes I'll just scoop it up and stick it in the toilet and, like, you can have a watery grave.

[A]

But listen, if you can live through this and get to the other side, then God bless you on your way.

[B]

Yeah, definitely.

[A]

God. Very Buddhist of me.

[B]

I'll say a prayer for you. Okay, go.

[A]

Are you Buddhist? Is that your religion?

[B]

No, but that's because my mom from Thailand, like, I Like, their ritual and cultural stuff the most. Because I lived in different families. They did have different traditions. I did live with a Jewish family for a while, so we would have. So every culture has their own kind of traditions to, you know. But I do like, my mother's the most. But I. I don't claim any religion.

[A]

Listen, I was gonna say, speaking to you, if. If you told me you were religious, I would say that would have shocked me, so.

[B]

Yeah. No, I know. Yeah. No, no, no, no, no, no, no.

[A]

I'm assuming you gave up on asking. Into the darkness a while ago.

[B]

Yeah.

[A]

So 10 years old, you're like, you broke her back. Are you kidding me? Yeah. Yeah. No. My goodness.

[B]

Yeah.

[A]

Oh, gosh.

[B]

Yeah.

[A]

What have you taken away from being around so many different people? Like, is there something valuable from having kind of absorbed the way others see the world in so many different settings?

[B]

I guess so. Like, it's just to have an open mind and.

[A]

Valerie, can I tell you, because I'm adopted. Right. But I was adopted as a baby.

[B]

Yeah.

[A]

But the entirety of my life growing up with my family, what I would notice is that if something happened or there was, like, a decision to be made or people got upset or happy, like, my response to a lot of things was never the same as theirs. So I had my response, but I was also able to see their response, which was often different from mine. And I had brothers who. I have brothers who are natural to my. My adopted parents. So, like, the four of them would almost react similarly. And I was over there going, like, I don't think this is the takeaway from this, but. But I found that, like, it's interesting to not feel like you have to adhere to something.

[B]

Oh, yeah, definitely.

[A]

You know what I mean? There's, like, family traditions or religious traditions or something like that. And you. I was always able to kind of stand slightly off to the side of it and go, like, well, I'm just here because you're. You. You rented me.

[B]

Yeah.

[A]

And I never felt stuck to one thing because of that. And I felt like that gave me the opportunity to sample a lot of different people's ideas, and I found that really helpful. But I was wondering if you were too busy being horrifyingly shipped around from person to person to appreciate that or if you took something from.

[B]

I was okay with it because the families were good. They would try to, like, do, like, adoption placements. Like, I had two, and those didn't come out as well. Maybe because they wanted another kid. But then their dynamics. They needed to Work on stuff. And they thought maybe having a child would help their dynamic. But then I was like, yeah. And then the last family, it just worked out. Like, I don't know. I was like, I wasn't planning or wanting to be adopted, but I'm like, okay, like this. Yeah.

[A]

Were you getting older at that point?

[B]

Yeah, I was getting older, and I always did well in school and, you know. Yeah. And I was like, okay, this. This could be the forever home.

[A]

Did some people have more difficulty being loving towards you than others? And did some not try at all?

[B]

Well, some overdid it a little bit. Oh, yeah. Like, I don't know. Like, I was just like, where is this coming from? Yeah. No, and then some were. And then. Yeah, I just remember one. It was. It was. Yeah, yeah, yeah. That one was. Maybe I'm just wasn't accepting to the over of loveness. I don't know.

[A]

Oh, they were trying really hard and you weren't open to it.

[B]

Yes.

[A]

Yeah, I got you.

[B]

I'd say that's. That. That would be it.

[A]

Yeah. Makes sense. I mean, as I'm listening and. And after hearing you, like, answer those questions, like, I'm struck by how lucky you are that, you know, through that whole thing, like, nobody touched you inappropriately.

[B]

Yeah, no. Yeah.

[A]

So lucky. You know what I mean?

[B]

Occasionally I talk. My sister would, like, biological one, we talk, but we're still a little bit estranged. And she has a different autoimmune. She has that pcos. And then she's had multiple surgeries, and. And then I try to get, like, feedback of what she remembers living with them for, like, the medical issues and that sort of stuff. Wait, what? And then I remember her saying that because she goes to therapy, she's like, oh, they think that, you know, that he touched us or whatnot, but I don't ever remember any sort of that going on at all.

[A]

Could have been after you left, even.

[B]

Yeah, yeah, yeah. So I, you know, I'm pretty certain that didn't happen.

[A]

What autoimmune issue does your sister have?

[B]

Oh, that polycystic ovarian syndrome.

[A]

She has pcos.

[B]

Yeah.

[A]

Oh.

[B]

And then, you know, they. They get gross, and then they have to have a surgery. And I think she's had at least two surgeries. And then she would get sick a lot. Like, I'm amazed that I don't really get ill very often. I would just have dermatology stuff.

[A]

Yeah. Did those surgeries help her?

[B]

I think so, yeah. Because they get the growths off. But then, you know, a Few years later, then she has to do it again. Yeah.

[A]

Yeah. That sucks. What would she have, like, real heavy irregular periods, pain?

[B]

Yes, exactly. Yes. Yes.

[A]

You've had some skin. Have you ever had your thyroid tested?

[B]

Yeah, yeah, yeah. I think when I first got that diabetes diagnosis, like, I got the labs. I have an internist. I've seen him for a long time, and I'm like, are we sure that, like, I have diabetes? And then he redid the labs, and then he made a comment like, oh, look, it was, like, a little less than the labs that I brought in.

[A]

Okay.

[B]

And he's like, oh, look, you don't even have diabetes. But then I was like, oh, can we check other stuff? So. And then the endocrinologist, he adds that on the labs. Yeah. But, you know, for most medical things, unless you complain about a symptom, they're not going to check it.

[A]

No, of course.

[B]

Yeah.

[A]

Do you still have skin issues to this day, or are they something that's stopped?

[B]

Oh, if they're kind of resolved. But, yes, I say, yeah, it does happen, but not too often.

[A]

But it does happen on your back, Mostly back.

[B]

Oh, yeah. Now, recently, I have stuff all over my chest. It's like, they're skin tags. And my dermatologist said it's like, oh, it's just like, you're getting older. I'm like, great. This is awesome. Great news. I'm gonna have to see you more regularly. This is what happens when you get old. Like, I have to come see you more often. I don't want to come. See.

[A]

I started to get, like, age spots in some places, and I was like, oh, gosh, maybe I should just give up.

[B]

Yeah. No, I thought they were warts, but they're not warts because of where they're lying on my chest.

[A]

Okay.

[B]

They're warts when they're on, like, your hands. But they're very similar to the stuff that were, you know, around my pinky. So I thought they were warts. They're not warts. They're skin tags that have to be burned off. Yeah.

[A]

Do you get them removed?

[B]

I am, yes. I have another. There's so many of them, it's ridiculous. It used to be just a little spot, and I'm not sure how they all multiplied.

[A]

Maybe they're like gremlins. You're not getting them wet after midnight, are you?

[B]

Exactly. So I'm like, he did. He's like, I already done about 30. I'm like, yeah, I don't have any expectation you're going to get all of these. So just do whatever and I'll see you at the next appointment.

[A]

Do they freeze them until they fall off?

[B]

No, it's. He's burning them. It's. I don't think it's freezing. It's. Yeah, it's a whatever device and. Oh, my gosh.

[A]

And you said, wait, 30 have been they at some point.

[B]

Yeah, I have so much more. Like, I have my appointment next month, so he's not going to get all of them. It's just that hopefully the skin will renew and it will, I don't know, look better.

[A]

When you think about dating, does that concern you or are you old enough you don't give a crap about something?

[B]

Oh, yeah, I'm old. I don't give. Yeah, I don't care. Yeah. Me at the nursing station, like, the docs come and like the nurse have to drop everything. They're juggling like four patients. They gotta drop everything. Go deal with whatever at the bedside. I'm just like, yeah, you can wait.

[A]

My gosh. Listen, we're getting up.

[B]

They don't want to deal with me. I'm like, no, you can wait. Do you see how this person running around? I'm like, you can wait.

[A]

Her blood sugar might be high. She gets a little surly. I hear.

[B]

Yeah.

[A]

So I want to hear a little more. This is, you know, we're getting up on an hour, but, like, tell me, any of your takeaways from using the eyelet pump. What have you enjoyed? What have you not enjoyed? Like, how would you explain it to other people?

[B]

I enjoy it. It is the algorithm I say I like better than the Omnipod. And if you do want to give yourself more insulin that you think you're too high, you can. You just have to announce again. But I say it is pretty good. It can't figure out the carb count because you can't put a carb count in there, but it is pretty good.

[A]

Give me some. Becauses I like it better than Omnipod. Because.

[B]

Oh, number one, it's the infusion set. I can get the three to four days out of it.

[A]

Okay.

[B]

And then it's always been around the flexibility about the mealtime dosing. I still sort of do like the pre bolus where I'll announce and then I'll wait and then I'll eat. But I know I don't have to. But I've just always had that kind of, like, I know the insulin, it takes a half hour or more to peak that I rather, you know, I Have my food. I know what I'm going to eat. I just impatient and wait for the data to change and then eat. But I know I don't need to do it, but it's just already a habit that I do that.

[A]

Why do you say you don't need to do it? Because they tell you not to?

[B]

No, I'd say when I did the three months, I, I wasn't pre bolusing or I was just like. And it did do well, you know,

[A]

if you don't pre bolus with the islet in the first three months, where does your blood sugar go after you've eaten?

[B]

And then it'll go. It would do the low two hundreds but come down and no lows. This one, like, I never had my blood sugar up in the 3002. The islet occasionally would get it up there, but then I would just kind of like, I have no symptoms. I'll just. Let's see what the algorithm does. And it did, you know, bring me down.

[A]

But if you wanted to avoid peaks into the two hundreds at meals, the pre bolusing helped.

[B]

Yes.

[A]

Gotcha. All right, finish this sentence. I miss about Omnipod. What do you miss about Omnipod?

[B]

Oh, that I could wear more dresses. This pump, I find I, I have to clip it on. I. Yeah, the dressing part. Like I, I still wear dresses, but I, it's. I liked that I could. Yeah.

[A]

Omnipod was aesthetically easier for you.

[B]

Yes, aesthetically. And just clothing here. Like, I have to like, make sure I dress this in a certain order of what I put on. Yeah.

[A]

Hey, if. How long does the infusion set on the eyelet work for?

[B]

I can get three to four days because it's the amount of insulin that's left in the device. And then it'll remind you that you should change it out. But I'm like, I still have 30 units and that will last me the two meals for today. Because during work I don't eat breakfast because as soon as I walk into the hospital, it's crazy.

[A]

You're not getting that much more out of it time wise than the Omnipod.

[B]

No, no.

[A]

But you like having extra time with it.

[B]

Yes. Yeah.

[A]

Okay.

[B]

It's just, you know, like. Yeah, it's. I, like I can't wait to get that 15 day Dexcom. That's my appointment on, you know, this Wednesday. And his domestic. Oh, no, it's just going to be a system upgrade. I'm like, no, dummy, you need to write me another script. So.

[A]

Yeah, dummy.

[B]

Yeah. No, because he's like. He's so, like. Yeah, no, it's just going to be like, yeah, yeah, yeah. You're clueless. Like, what.

[A]

Around the diabetes. What I've taken from our conversation is that what's most important to you is ease of use, fewer touches on diabetes, less thinking about it.

[B]

Yes. Yeah, exactly. And that's. That. That was the marketing of the eyelet. So that's. I'm like, okay, let's try this.

[A]

It spoke to you on that.

[B]

On that level, to me, I'm like, I need. I need less. I already got to do so much in my daily life.

[A]

Yeah, yeah, yeah. No, I hear that. Well, it's interesting is because a lot of people come on here and talk about, like, oh, I'm trying to get this number here. I'm trying to be specific about this. You're.

[B]

Yeah, yeah. I. I don't look at my A1C. I look. Okay. And then I remember one appointment. I was just like, what A1C do you want? Because I'm not trying. I'm just trying not to end up in the hospital and not have lows. That. That. Those were always my goals from the beginning.

[A]

Interesting.

[B]

Yeah.

[A]

No, I mean, everybody's got different goals. And, you know, it's interesting to hear your progression, your life, and where I'm

[B]

gonna, like, I. I want to see in 10 years from now, because it's slow progression. Like, I'm not really having many issues besides dermatology issues, so, like. Yeah, I wanna see. I don't know. Yeah.

[A]

Do you have any worries or concerns for the future? Not really.

[B]

What I see in the hospital is kind of disturbing. So. Yeah, we'll see. I don't. Yeah. I want to lose a part of my body. I. Yeah, you do see that? I don't think that will happen, but, you know. Yeah.

[A]

Back your head. You're thinking about it.

[B]

Yeah.

[A]

What would make you change pumps? What would somebody have to present?

[B]

Oh, it's smaller. I saw someone with that, the movie, and it's littler. I'm like, can you run that, like, on manual or. Yeah, I don't know. It was. I liked it because it was smaller. And then you can, like, attach it to yourself. Kind of like the Omnipod.

[A]

Valerie, I'm confused about one thing.

[B]

Yeah.

[A]

You are using a pump right now. Eyelet. That is so hands off. You have no control over it, really, other than to say, it's breakfast, lunch, it's dinner. This is big, medium, small. But you didn't run the Omnipod 5 in automation. And when you think about the MOBA, you wonder if you can run it manually.

[B]

Yes. Yes.

[A]

What's wrong with you? Why?

[B]

Control. It's just the control. Like, yeah, I want control, but then I want less.

[A]

Or none.

[B]

Or none.

[A]

Yeah, I would talk to my therapist about that if I was you.

[B]

Okay. Okay, sounds good.

[A]

Yeah.

[B]

Yeah. Well, I did try the omnipod in the algorithm, but I just didn't. Yeah.

[A]

Didn't What? Yeah, you do that sometimes. Valerie, you don't finish your thought. You didn't. What?

[B]

I. I didn't like it. I don't. I. It just would get too high, and I'm like, why isn't it changing the arrow when I know I can intervene?

[A]

Why didn't you intervene?

[B]

Change that arrow? Because I thought the algorithm would do it. I guess I could have, but then I'm like, yeah.

[A]

And when you got to the islet and it also wasn't stopping high blood sugars, you're like, oh, I'm gonna intervene.

[B]

At some point. I finally did.

[A]

Yeah. So this might have less to do with the system and more to do with your.

[B]

Yeah, I. I agree. I agree.

[A]

Have we missed anything that you wanted to talk about or anything that we, you know, anything I didn't remember to ask you about?

[B]

Yeah, we covered everything. Yeah.

[A]

You happy that you did this?

[B]

I am. I am.

[A]

Good.

[B]

Yeah.

[A]

When you said you've been listening for a long time. Contextually. Is that years?

[B]

Yes, years. So as soon as I got the right diagnosis, I made sure to find the community and then just. Yeah. So I've been listening to you for. Yeah. Years and years.

[A]

Is it possible you've been listening to this for, like, nine, ten years?

[B]

Yeah, I'd say so.

[A]

Oh, wow. Thank you. That's very nice.

[B]

Definitely.

[A]

It's lovely to hear.

[B]

Thank you very much. I listen to each episode. I just kind of come on and I look and I'm like, okay, let's listen to this one. Yeah. No, it's good to hear other people talk about how they're managing it and.

[A]

Yeah, no, it makes me happy that it's there for you when you need it.

[B]

Oh, definitely.

[A]

Really? Awesome. Well, Valerie, I appreciate this. Go ahead to work.

[B]

Okay.

[A]

Live your life as you will.

[B]

I will.

[A]

I really do appreciate you doing this. Your story is going to add to the podcast wonderfully.

[B]

Yes.

[A]

If you hold on for one second, I'll just tell you a couple things before we go.

[B]

Okay, sounds good.

[A]

Thank you. I'd like to thank the blood glucose meter that my daughter carries the Contour Next Gen Blood Glucose Meter. Learn more and get started [e-mail] juicebox and don't forget, you may be paying more through your insurance right now for the meter you have than you would pay for the Contour Next gen in cash. There are links in the show notes of the audio app you're listening in right now, and [e-mail] to contour and all of the sponsors. I'd like to remind you again about the MiniMed 780G automated insulin delivery system, which of course anticipates, adjusts and corrects every five minutes 24 7. It works around the clock so you can focus on what matters. The Juicebox community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, Visit my link medtronicdiabetes.com Juicebox thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple Podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further further an Apple Podcast and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? Have you tried the Small Sip series? They're curated takeaways from the Juice Box Podcast, voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Dive deep, take a sip and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com, click on the Word series in the menu. 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 gaps of time. And when I go and stuff like that and it just, I don't know man. 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. Com.