#1897 Face Your Face

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1897 – “Face Your Face”

Host: Scott Benner
Guest: Cassie
Date: July 8, 2026

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Episode Overview

In this deeply moving and informative episode, Scott Benner speaks with Cassie, a woman living with type 1 diabetes whose identical twin sister and older brother also had/have the condition. Cassie shares honest strategies for living well with diabetes amidst profound challenges, including sibling loss, family dynamics, and adapting to diabetes technology. The episode highlights the emotional realities of diabetes in families, grief, resilience, and how technology and community help shape better outcomes and acceptance.

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Key Discussion Points & Timeline

1. Cassie’s Family and Diabetes Origins

[01:30–04:47]

• Cassie introduces herself: She, her identical twin, and her older brother all have (or had) type 1 diabetes. No prior family history of diabetes, but some autoimmune history in parents.
• Discusses her sister’s passing five years prior (“it still feels like yesterday” [03:41]) and how annual anniversaries trigger deep emotions.
• The challenges of looking like her late sister: “I guess…even just looking in the mirror…and having other people, you know, telling you, ‘You look just like her.’” [04:47]

2. Diagnosis Stories and Family Dynamics

[06:39–13:41]

• Cassie and her sister diagnosed at age 3 and 3.5, brother at age 12.
• Family’s chaotic diagnosis moments, especially her brother’s, which involved emergency care while camping in remote mountains ([12:31–13:41]).
• The strain on their mother managing three children with type 1 diabetes, pre-modern insulins: “I have no idea how she managed it…she pretty much did it on her own.” [08:00]

3. Growing Up with Sibling Dynamics & Diabetes

[15:27–19:08]

• The madness and “manic” adaptation of a family with three kids with type 1: “I remember…dig insulin out of couch cushions…we were all trading insulin vials based on who needed what.” [15:46]
• Discussion on feeling like “the favorite” between siblings, noting that family dynamics are complex whether or not diabetes is present.
• Scott on parental guilt and outcome anxiety: “The letdown you must feel in yourself as a parent…if one of the kids has a blood sugar, you’re like, okay, that’s what I was shooting for. Then the other one doesn’t. And…oh, I let that one down.” [20:16]

4. Relationship Challenges & Support Systems

[21:11–23:34]

• Cassie describes shielding her partner from her diabetes management to avoid burdening him, realizing later that partner education is vital for safety and relationship health.
• “The first scary low blood sugar…he didn’t know, do I give her carbs? Do I give her insulin? That…I was like, okay, this is dangerous to our relationship, and it’s time to do some educating.” [22:57]

5. Variability, Twin-to-Twin Transfusion, and Health Outcomes

[25:26–33:10]

• Not all diabetes is the same, even for identical twins: Cassie and her sister’s outcomes diverged due to birth complications (twin anemia-polycythemic sequence – TAPS).
• Her twin’s reduced blood vessel development led to lifelong circulation and immune challenges, severe enough to result in multiple strokes and sepsis.
• “[My sister] had very poor circulation…she had sepsis three times. She had three strokes. She just really went through the ringer.” [32:06]

6. Diabetes Technology Evolution

[34:05–49:06]

• Discussion about shifting from old insulins to Lantus, Humalog, and later pumps.
• Cassie details using different pump technologies: Animus, Medtronic, T Slim, Beta Bionics iLet, and settling on Omnipod 5.
• “Man, have I tried all the pumps. I’m on the Omnipod now. Love it. It’s been my favorite. My last A1C was a 6.5.” [45:17]
• Technology and increased diabetes knowledge (including via the podcast) drove much of her improved control and confidence: “Not only did I keep hearing people talk about Omnipod 5, I found people who learned how to use [it] through your podcast.” [51:42]

7. Grief, Trauma, and Facing the Loss of a Twin

[63:21–82:54]

• The death of her sister as a point of transformation: “Her passing really kind of scared me straight.” [63:21]
• Changes made: improved diet, regimented planning, increased exercise, staying engaged with medical care, and particularly the importance of regular therapy.
• Cassie on survivor’s guilt and processing through therapy:

  “I couldn’t face that for a lot of years. I couldn’t face it.” [73:52]
  “There is this whole trying to figure out how to be a me when I’ve been a we my entire life. That’s been very, very difficult.” [67:10]

• Creating awareness for twin loss and TAPS: “Not a lot of resources for it, which is why I felt that it was kind of important for me to find a platform…to bring a little awareness to twin loss. Because it is complicated.” [74:13]

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Notable Quotes & Memorable Moments

• On Grief and Identity:
  “It’s a little bit of both, because I feel the responsibility…of living for both of us. There is this whole trying to figure out how to be a me when I’ve been a we…” — Cassie [67:10]

• On Diabetes in the Family:
  “My mom raised two three year olds with type one. I have no idea how she managed it…She pretty much did it on her own.” — Cassie [08:00]

• On the Pressure to ‘Get Better’:
  “I don’t want to feel like this forever. And it just made me get a little more serious about it.” — Cassie [44:36]

• On Community and Technology:
  “[Diabetes] is not…the same situation for every type 1 diabetic. It’s completely different in each person, and not one case is ever going to be the same.” — Cassie [25:26]

• On Living Well with Diabetes:
  “It’s amazing how quick things are changing. Just I feel like every day I’m reading something and I’m like, oh, that’s amazing.” — Cassie [60:08]

• On Facing Trauma:
  “At some point, you do have to look back and realize the damage you caused and not run from it, but face it and face everything you’re going through.” — Cassie [80:31]

• On the Gift and Burden of Memory:
  “When you’re an identical twin, there’s this strange tether where it’s like, half of me is wherever she is, and the other half is here.” — Cassie [67:37]

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Discussion of Diabetes Technology (Pumps & CGMs)

[45:17–57:02]

• Omnipod 5 praised for improving A1C and ease of use, especially after overcoming earlier technical challenges.
• Candid pros/cons about other pumps (T Slim, Medtronic, Beta Bionics iLet).
• The power of community knowledge: “I started listening to your podcast…Not only did I hear people talk about [Omnipod 5], I found people who learned how to use it through your podcast.” — Cassie [51:42]
• The value of pre-bolusing featured as a small but impactful change [53:12–53:41].

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Mental Health, Resilience, and Moving Forward

[63:21–82:54]

• Cassie emphasizes therapy as crucial for processing twin loss and trauma: “Therapy helps a lot…ignoring anything positive that could have come from that…I think would be ignoring an entire part of her.”
• Learning to balance guilt, gratitude, and new identity after profound loss.
• The support of close family, friends, and the diabetes community, both in person and online.

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Uplifting Takeaways and Empowering Moments

• Cassie has taken conscious steps to live deliberately and healthfully after years of dissociation and self-neglect: advanced planning, regular exercise, and full engagement with her care team.
• Scott reminds listeners that living boldly and facing tough truths—whether about diabetes, family, or grief—are acts of courage that others can learn from.
• The episode ends with mutual gratitude and acknowledgment of healing found in sharing one’s story: “Congratulations on facing your stuff. I think it is commendable…You’re saving your life, you know.” — Scott [82:54]

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Final Thoughts

This episode is a testament to the value of openness, self-compassion, and communal wisdom in living well with diabetes and loss. Cassie’s unflinching honesty about trauma, resilience, and ongoing learning resonates for anyone touched by diabetes or grief. The conversation is rich with both practical strategies and emotional truths—encouragement to “face your face” and move forward with boldness.

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Selected Timestamps

• [03:41] — Grief anniversary and body memory
• [05:16] — “Seeing you reminds us of her…”
• [15:46] — Insulin chaos: “dig insulin out of couch cushions”
• [21:33] — The necessity of educating partners
• [25:26] — Diabetes is not “one size fits all,” even for twins
• [32:05] — Sister’s severe health outcomes (sepsis, strokes)
• [45:17] — “Man, have I tried all the pumps…my last A1C was 6.5”
• [63:21] — Sister’s death as a turning point
• [73:52] — “I couldn’t face that for a lot of years”
• [80:31] — Facing your past: “At some point, you do have to look back and realize the damage you caused…”

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“You’re saving your life, you know.” — Scott [82:54]

Transcript

[Podcast Host (Sponsor Announcer)]

Friends, we're all back together for the next episode of the Juice Box Podcast.

[Scott (Podcast Host)]

Welcome.

[Cassie (Guest)]

I have type 1 diabetes, my identical twin sister had type 1 diabetes, and my older brother has type 1 diabetes.

[Podcast Host (Sponsor Announcer)]

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. This episode of the Juice Box Podcast is sponsored by Omnipod5. Omnipod5 is a tube free automated insulin delivery system that's been shown to significantly improve A1C and time and range for people with type 1 diabetes when they've switched from daily injections. Learn more and get started today@ omnipod.com juicebox at my link. You can get a free starter kit right now. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox this episode of the Juice Box Podcast is sponsored by usmed usmed.com juicebox or call 888-721-1514. Get your supplies the same way we do from us Med.

[Cassie (Guest)]

Hi, my name is Cassie. I am here to talk about type 1 diabetes in siblings, address twin loss, and talk about a little bit of how twin to twin transfusion or taps can affect the vascular system and type 1 diabetics in the long run.

[Scott (Podcast Host)]

Cassie. Geez. Becoming prepared.

[Cassie (Guest)]

I am prepared.

[Scott (Podcast Host)]

Like, I'm gonna have to listen harder. Do people call you Cass?

[Cassie (Guest)]

Yeah, some people do.

[Scott (Podcast Host)]

Is those people people you like or you prefer when people call you Cassie?

[Cassie (Guest)]

No, Cass is fine. People close to me call me that.

[Scott (Podcast Host)]

Oh, well, I'm not close to you. I can't do that.

[Cassie (Guest)]

You know what, Scott? I feel close to you. I've been listening to your podcast for a minute.

[Scott (Podcast Host)]

Oh, all right, well, then if I slip into that, you won't be offended. I appreciate that.

[Cassie (Guest)]

No, not at all.

[Scott (Podcast Host)]

Let's start at the beginning. You have diabetes?

[Cassie (Guest)]

Yes, I have type 1 diabetes. My identical twin sister had type 1 diabetes, and my older brother has type 1 diabetes.

[Scott (Podcast Host)]

Wait, you are one of three children, all of whom have it?

[Podcast Host (Sponsor Announcer)]

Yes.

[Scott (Podcast Host)]

And do your parents have any autoimmune issues?

[Cassie (Guest)]

Um, my mom has, like, hypothyroidism. My dad has arthritis, like rheumatoid arthritis. Um, but we don't have any family history of diabetes.

[Scott (Podcast Host)]

Okay, no type one that you guys could find in the extended family?

[Cassie (Guest)]

No.

[Scott (Podcast Host)]

How about the brothers and sisters? Did you guys have anything other than type one?

[Cassie (Guest)]

So my sister, she had a slew of things. She had all kinds of mysterious illnesses along the way that took us A very long time to find answers to my brother. He's pretty healthy. He's type one. Other than that, he's had a few complications with the Type 1, but overall, pretty healthy.

[Scott (Podcast Host)]

Okay. How old are you?

[Cassie (Guest)]

I'm 32.

[Scott (Podcast Host)]

32. Is your brother older or younger?

[Cassie (Guest)]

He's older. He's 35.

[Scott (Podcast Host)]

And then I guess I have to ask you, how long ago did your sister pass away?

[Cassie (Guest)]

So it's actually going to be five years on Friday.

[Scott (Podcast Host)]

Oh, my gosh. I'm sorry.

[Cassie (Guest)]

I know it still feels like yesterday.

[Scott (Podcast Host)]

I was going to say is the difficulty got lessened at all, or what's it like knowing that it's coming up on Friday?

[Cassie (Guest)]

I would say the difficulty, and it has lessened a little bit, but it still kind of feels like I'm right there. Still kind of in that same headspace that same day five years ago. And every year, this time of year comes around, I start feeling a little off, and I'm like, what's wrong with me?

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

And then I'm like, oh, well, this makes sense, because your body remembers.

[Scott (Podcast Host)]

Yeah. Hey, are you. Were you guys identical twins or fraternal?

[Cassie (Guest)]

We are identical.

[Scott (Podcast Host)]

Can I ask a really difficult. Let me ask the difficult question in the first three minutes. Okay. And then we'll. We'll get through this is. What's it like to look into a casket and see somebody that looks just like you there?

[Cassie (Guest)]

So she was cremated.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

So I didn't particularly have that experience.

[Scott (Podcast Host)]

I feel like I'm glad for you.

[Cassie (Guest)]

I was with her when she passed, and it was a strange moment because I knew, like, I knew the exact moment she wasn't there anymore. I guess, maybe, like, the equivalent to seeing her in a casket is maybe even just looking in the mirror and having other people, you know, telling you, oh, you look. You look just like her. Seeing you, it reminds us of her. It's. It's a little bit of a tricky one.

[Scott (Podcast Host)]

Yeah, I was gonna say. Right. Because there are people that miss her that see you. Right.

[Cassie (Guest)]

Yes. And I'm still close with a lot of people who were close to her. Her husband, who took very, very good care of her along the way. We've been friends since high school, so he's still a pretty active member in my family. And then some of her friends, I'll catch here and there. And then I come from a very large female dominant family. We're all very close, and they're a huge support system.

[Scott (Podcast Host)]

I'm glad. Yeah. Did she have children?

[Cassie (Guest)]

No.

[Scott (Podcast Host)]

Okay. Do you find that when you're like, when people who miss her are in your presence, does it bring them comfort or sadness, do you think?

[Cassie (Guest)]

I'm not sure. I would imagine it would probably make them a little uneasy, because I feel like it would make me a little uneasy.

[Scott (Podcast Host)]

I mean. Yeah, I feel there's an entire conversation just in this part of your story right here. Is it a thing you think about much, or are you right now going, why is this guy who makes a diabetes podcast digging into my psyche?

[Cassie (Guest)]

No, I. I think about it waking up in the morning. I think about it when I go to bed at night.

[Scott (Podcast Host)]

Yeah, I would imagine. Oh, my gosh. Okay. All right. We're going to get past this part, but I cannot guarantee we're not coming back to it. So are you diagnosed at what age you.

[Cassie (Guest)]

I was diagnosed at three and a half. My sister was diagnosed at three.

[Scott (Podcast Host)]

You were six months after.

[Cassie (Guest)]

Six months apart.

[Scott (Podcast Host)]

Yeah.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Scott (Podcast Host)]

And. And your brother before or after you guys?

[Cassie (Guest)]

Quite a bit after. He was 12 years old. We would have been about nine.

[Scott (Podcast Host)]

Okay, you were not. So maybe three years after you were diagnosed.

[Cassie (Guest)]

Six years.

[Scott (Podcast Host)]

No. Say, I'm sorry, you were you. I'm sorry, you said you were three when you were diagnosed.

[Cassie (Guest)]

Yes, I was three and a half. My brother was 12. Would have made my sister and I about nine or 10 when he was diagnosed.

[Scott (Podcast Host)]

Gotcha. I'm sorry, I. I lost one of the steps in the math equation there for a.

[Cassie (Guest)]

No, that's okay.

[Scott (Podcast Host)]

I really did. I was like, what happened? Why did I get so confused? My gosh. So your mom raised two three year olds with type one. How long ago?

[Cassie (Guest)]

Oh, so we were diagnosed in 97. So this is before Lantus and right in the era that Humalog was approved. So we're talking about, like, the humulant N Humulin R era. Yeah, of insulin.

[Scott (Podcast Host)]

Thirty years ago, maybe?

[Cassie (Guest)]

Yeah, just about 30 years.

[Scott (Podcast Host)]

Yeah. Okay. Did she look crazy by the time you were in high school? Did you look at her and, like, think like, that lady needs to go for a walk and sit on a beach? Or. How did she manage it?

[Cassie (Guest)]

100%. I have no idea how she managed it. You know, in one of your podcasts a little while back, I think it was behind the cheese, you were saying how you think you could sneak in and change a pot out on your daughter without her noticing. And there was a lot of that. There was a lot of sneaking into the room at night and poking fingers, checking blood sugar levels, trying not to wake one of us. Because if one of us woke the other would wake. Um, so I can't even imagine. She pretty much did it on her own.

[Scott (Podcast Host)]

Oh, what a great title for an episode. Behind the Cheese. Is that where they kept the insulin?

[Cassie (Guest)]

Yeah, yeah, I think that was an older episode. I just listened to it, though, and really enjoyed it, honestly.

[Scott (Podcast Host)]

It's one of my skills, picking the titles, but I have so few marketable skills. That's a good one, Cassie. I just the other day thought to myself, I have to keep this podcast going. I don't know what else I'm qualified to do. I'm too. I'm too young to retire, and I'm too abjectly unqualified to do anything else.

[Cassie (Guest)]

Well, the community needs you, so you're gonna have to keep the podcast going for the rest of us.

[Scott (Podcast Host)]

You're very nice. Thank you. It is really my.

[Cassie (Guest)]

Sorry to not give you a choice.

[Scott (Podcast Host)]

Oh, I don't. I don't mind, actually. I. I would like to. It's just the fear of how it's. I don't want to. I'm not going to go down this road, but, like, you know, my thing is, is. Is held up by a social media structure that is just, I don't know, nebulous. It's hard. It. It's hard to understand how it works. It's hard to understand when it's going to shift. And it just. It feels like. I don't know. I. I really don't know how to put it. It just feels like I'm cruising along on a nice, calm ocean and somebody said to me, we can just keep doing this forever, or maybe a, you know, a tidal wave will come and just knock you over and you'll be gone and you won't see it coming, and that'll be the end of it. And then that. That beautiful boat you had. We're not getting that again. Like, that's the. That's the anxiety I live with around. Around this work. But that's not the point. The point is, is that I'm unqualified to do anything else. So you're.

[Cassie (Guest)]

I'm sure the. I'm sorry to interrupt.

[Scott (Podcast Host)]

No, no, don't. You're not interrupting me. You're a good conversationalist, and I'm not used to that this early in the episode, so go ahead.

[Cassie (Guest)]

I'm sure the uncertainty of that is pretty scary, was all I was going to say.

[Scott (Podcast Host)]

Thank you. It really is. I don't want to complain because, you know, people dig holes for a living and things like that, and it. It's unseemly, but I do worry about it. So your mom is raising two little girls with type one. Your brother is probably just off on the side going, man, I dodged one here, didn't I? And then it hits him. So when it gets to him, what's your remembrance of him being diagnosed?

[Podcast Host (Sponsor Announcer)]

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[Cassie (Guest)]

So actually I remember a lot because we were in a pretty precarious situation because we were camping out in the Blue Ridge Mountains when he started showing symptoms. You know, being thirsty and using the bathroom a lot. Because of my sister, my mom was able to identify the signs pretty early. So I didn't go into DKA yet. Diagnosis my brother did, but mainly from lack of resources from where like we were at. So we were so far away from a hospital. I think it took us maybe three or four hours to get them into a hospital.

[Scott (Podcast Host)]

And then hospital came on.

[Cassie (Guest)]

In the hospital. Yeah.

[Scott (Podcast Host)]

Yeah. Okay.

[Cassie (Guest)]

And then we were in a hospital that had maybe a hundred rooms In. It was very tiny in the middle of nowhere.

[Scott (Podcast Host)]

Oh, gosh. Blue Ridge Mountains. That Tennessee.

[Cassie (Guest)]

I think that's Virginia.

[Scott (Podcast Host)]

Virginia. Okay. Once I move south, Cassie, once I move south, I'll know all this. Don't you worry. I'll blend right in. At the moment, I live in the north. I have no idea what I'm talking about. So you're up in the mountains. You get to there. He's already in dka.

[Cassie (Guest)]

I'm not completely sure. I think so. He was showing the symptoms and the signs. Sorry, excuse me.

[Scott (Podcast Host)]

You're fine.

[Cassie (Guest)]

He looked. I remember him looking very pale and almost a little gray, and he was very agitated, and who could blame him? He felt so awful. Um, and then there was, like, a lot of drama around the campsite with my cousins, and they were bickering and he was bickering with people. He didn't feel good. And then it just kind of, like, dawned on my mom, like, oh, shit. This is what's happening. I've seen this before.

[Scott (Podcast Host)]

Have you spoken to her since, as an adult? Was she waiting for the other shoe to drop once the first two got it?

[Cassie (Guest)]

I think. I think she probably was. Um, I know there's some kind of testing you can do to see if there's. What is it, like, the gene or.

[Scott (Podcast Host)]

Yeah, there's. It's like, something like that. There's a number of places that do it at this point. I think JDRF does it trialnet. There's a bunch of places you can get tested to see if it's likely that you could possibly get it.

[Cassie (Guest)]

Yeah. And they've been doing that with his. With his children. I think, like, with the two of us having it, it was almost inevitable, like being identical twins. Our DNA's identical, so that makes sense. Having a third child in the family, that's a little unique.

[Scott (Podcast Host)]

Oh, it is.

[Cassie (Guest)]

It just means that Jean must have been extremely strong.

[Scott (Podcast Host)]

How old's your mom?

[Cassie (Guest)]

Somewhere along the line, she is 63.

[Scott (Podcast Host)]

How would she be on a podcast?

[Cassie (Guest)]

I think she'd probably be pretty good.

[Scott (Podcast Host)]

Yeah. I. I think I might be interested in talking to your mom one day. That's. That's a pretty. Pretty unique situation, right? Like.

[Cassie (Guest)]

Yeah, I'll let her know.

[Scott (Podcast Host)]

Yeah, please. And if. Then there's no pressure, obviously, but. Okay. Okay. So would you consider growing up, the three of you, with type one? Was it manic? Was it insane? Or was it so part of the. Of life that it didn't feel different or odd?

[Cassie (Guest)]

Um, it was manic. Definitely a little insane, but I Think that was almost normal for us because we were also adapted to it. And I remember, like, running around and trying to dig insulin out of, like, couch cushions and stuff, because we were all trading insulin vials based on who needed what at the time, and stuff would go missing. And then somebody needed their Lantus or someone needed their Humalog and didn't have it, and they're going to the fridge and taking somebody else's prescription, and it just got really wild for a while there.

[Scott (Podcast Host)]

Weird question. A lot of times I'll talk to people where the siblings who don't have type one feel left out. Left out's the wrong word. They feel probably like they're like their. Their sibling with type one is getting more attention. But when you all have it, does that feeling still exist? Like, if you. If I said to you right now your mom's favorite was, do you have an answer?

[Cassie (Guest)]

I would say my sister.

[Podcast Host (Sponsor Announcer)]

Okay.

[Cassie (Guest)]

Um, they were just very close and seemed to function a lot on, like, the same wavelength. I think that probably that feeling still existed for him, just outside of the fact that he had twin sisters. Um, so there probably was a part of that that was a little isolating that may not have anything to do with the diabetes itself.

[Scott (Podcast Host)]

Do you think your sister thought you or your brother was the favorite?

[Cassie (Guest)]

Maybe I was, like, a little bit more introverted than my siblings.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

Like, hung out in my room a lot by myself, and so she was just always a little more social than me. And my brother, he's pretty. He's pretty introverted as well, but he's also pretty close with my. With my mom. They have their issues, of course, but she might say, my brother.

[Scott (Podcast Host)]

Yeah, Isn't that funny? I wonder what your brother would say.

[Cassie (Guest)]

I know. I'm curious. I should ask him sometime.

[Scott (Podcast Host)]

I just think it's. It's incredibly interesting because we. We. When the conversation happens, the idea is, well, because that one has type one, this one feels like you are paying more attention to them because of their type one. I'm going to tell you, I just think this is how kids feel. And you need a. You need a thing to call. The reason when you. When you say, well, mom's nicer to that one, or this one or whatever, like, where dad does this instead of that one. Dad's. I. I guarantee you, if you pull both my kids in here right now, put one of them in a soundproof booth, ask the first one, you know, do mom and dad have a favorite? They're going to say yes. It's not True. Yeah. They're going to say, do you get treated differently than the other one? They're going to say, yes, it's not true. And yeah, vice versa. They're both gonna think it was the other one. Fascinating. So I don't know. I didn't feel like that growing up,

[Cassie (Guest)]

but I had all, I don't know, had the conversation. Actually not that long ago, my mom and I did around like favorite kids and she was telling me like, you know, the favorite kid thing doesn't really exist, but there is a certain level of like compatibility and interest with some of your kids that maybe you don't have with other kids.

[Scott (Podcast Host)]

Feel like your personalities match more. Yeah.

[Cassie (Guest)]

So it's a little more that than actually having a favorite. They're still appreciating the differences, but the compatibility kind of makes a difference.

[Scott (Podcast Host)]

Yeah. Yeah. Both of my kids are a pain in the ass and really fantastic. So I don't even, I wouldn't even know how to judge them that way. I'm sure they think the same on me. Probably like, he's a fan of the ass. Okay, so pumps, trading insulin, general craziness. How about health and outcomes? Is there goals back then? I mean, in the first. Let's cut it into the first 10 years. In the first 10 years, is it just about staying alive or are you trying to hit numbers?

[Cassie (Guest)]

I think it's more just trying to stay alive. My sister and I did not go on to a pump until we were a bit older, when technology was a little more advanced. I think maybe we were. My brother, to this day is not on an insulin pump. He still does multiple daily injections. He has the CGM. But the first 10 years I think were a lot of survival because I think trying to have the standard of keeping three type 1 diabetic children on your own in perfect control is just impossible. It's impossible with one child, let alone three.

[Scott (Podcast Host)]

No, I can't even, I can't even imagine the, the, the, the letdown you must feel in yourself as a parent. When you look over and one of the kids has a blood sugar, you're like, okay, that's what I was shooting for. Then the other one doesn't. And you probably feel like, oh, I let that one down. And then you start doing the, the thing in your head about the health and long term outcomes. And I don't. Your mom must have been out of her mind. I would have. I might have been too. You know what I mean?

[Cassie (Guest)]

Yeah, I think I definitely would be because I have enough trouble like managing my own. I can't imagine having that kind of responsibility for somebody else's life, let alone your own child and then having multiple children. I just can't imagine how difficult it was. And it just. It makes me realize how much of like a wonder woman she is.

[Scott (Podcast Host)]

Yeah, no kidding, right? Well, do you have kids now?

[Cassie (Guest)]

I don't.

[Scott (Podcast Host)]

Married.

[Cassie (Guest)]

I do have a partner, yes. He. I kept him very uninvolved for quite a while because I didn't want it to be a burden for him or anything he had to worry about. Let me tell you, I don't think that's the way to go.

[Scott (Podcast Host)]

You should have let him in sooner.

[Cassie (Guest)]

Yeah. I think your partner definitely needs to have a certain amount of education around your diabetes. Because we've been in a few situations in the past where it was a little like, what do I do? Because I never taught him because I was so committed to not making it his problem. We've been together for nine years, so he's definitely learned a lot. That was probably like the first five years. He's definitely starting to learn. And he does help me when I'm really, really burnout or overwhelmed. Changing your pot at three in the morning or a sensor fail when you're out swimming, or he does help me in those really stressful situations.

[Scott (Podcast Host)]

Well, I mean, imagine being in a, In. In a, an emergent situation, you and your partner, and you're trying to help them. You don't have any idea of how to do that, and they're not able to tell you. But that must be a feeling of lost and out of control. That. That's unmatched, honestly. Right. Like. Like if somebody yells, does anybody know cpr? And you're the only one there and you're like, nope, I don't.

[Podcast Host (Sponsor Announcer)]

Sorry.

[Scott (Podcast Host)]

You know, and then somebody's standing there choking in front of you. Oh, my gosh. So tell me a little more about why you kept it from him for a while. You. You. I mean, was it about, I want this guy to like me or I don't want him to feel like I'm a burden. Like, can you put words to any of that?

[Cassie (Guest)]

Yeah, it was really just. I didn't want him to have to take on the mental load. It's, you know, the every hour, every minute disease. That's a lot to put on somebody else. And I was very committed to making sure that that wasn't going to be his problem or his worry or his issue. And it really wasn't until the first scary low blood sugar, where he didn't know, do I give her carbs? Do I give her insulin? That I was like, okay, so actually, this is dangerous to our relationship, and it's time to do some educating.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

So then we've really taken a different approach in the last five years, and he's learned a lot. Luckily, I'm pretty stable. Both my brother and sister are awfully brittle. I've never been in dka. I've never had a low blood sugar seizure. I've been very fortunate. So I kind of just thought I could keep pushing on that way and there wouldn't be any problems. Do you have Fooling myself?

[Scott (Podcast Host)]

Yeah. You're not dodging this one forever. Like, you have to. I don't know. I'm a proponent of just. The people around you should know how to help you, and not just a little bit, but really understand to their best of their ability. And I also don't have type one. I don't know what I'm talking about, really. Like, I'm just, you know, talking from an academic space. But, yeah, I mean, you do not want to be in a situation one day where you really need help and the people around you who really want to help you don't know how. I mean, imagine if you. If something dire happened and those people are now left with the idea that, oh, I was there and I couldn't. I couldn't help. You know, it's. I don't know. There's a lot to it, honestly. You should think everybody's got to think of her on their own and decide what they think. But also, sometimes people have others around them that are not excited to help or maybe even good candidates to help, which can happen as well. But what I want to understand is three different people. Three, same household. Growing up, you got to make it through. No Lantus at first, eventually get into pumps, insulin, getting better, all that stuff. But the three of your cares probably don't end up blossoming the same way. Right. That's where it becomes pretty, I would guess, specific to your personality, your drive, and your desire. So how would you characterize your personal care versus your sisters versus your brothers?

[Cassie (Guest)]

So that actually kind of takes me into a few things I kind of wanted to address, which, as, you know, type 1 diabetes is not a, like, same situation for every type 1 diabetic. It's completely different in each person, and not one case is ever going to be the same. And that even applies to, like, my sister and I, as identical twins. You would think we would have similar scenarios, situations that Our whole process would be similar, but it just wasn't. It was very different for both of us. And I think that kind of goes back to our birth, actually, because at the time it wasn't a diagnosis, but we had something called capsule, which is twin anemia. Polycythemic sequence. Big words.

[Scott (Podcast Host)]

Wow. I don't know what that means at all. Go ahead, please.

[Cassie (Guest)]

Yeah, so pretty much what it means is that while we're being developed in the womb, our shared blood vessels became unequal, where hers were much smaller than mine and I was getting too much blood beam polycythemic, and she wasn't getting enough being anemic.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

Um, so your blood vessels in those situations as you're developing, they develop that way. So her blood vessels were developed small, narrow, and stiff. And as you know, type 1 diabetes is really hard on your vascular system. So she really just had double the challenges that maybe I did with more open. And I almost had a safeguard in my. In my vessels from scar tissue, because.

[Scott (Podcast Host)]

Wait, so you had more than you needed and she had less than she needed?

[Cassie (Guest)]

Basically, yeah. So it just like developed on equal, where I was just getting too much blood and it was thick like syrup, and she was just very anemic.

[Scott (Podcast Host)]

What's the impact?

[Cassie (Guest)]

It happens in twins.

[Scott (Podcast Host)]

It happens in twins. Don't let me stop you. It happens in twins.

[Cassie (Guest)]

So in 93, when we were born, taps, they didn't know about taps until 2007, but they knew about twin to twin transfusion syndrome, which is kind of similar, but it's more acute. Big vessels transfer fluid and blood from one twin to the other, but it happens pretty rapidly where tabs is more chronic. It happens early on, and it goes on throughout the pregnancy, and you develop that way. So they thought at the time that we might have had the twin to twin transfusion. We didn't meet all the criteria, so we were never formally diagnosed. And then later, when they discovered taps, we met each criteria for the taps.

[Podcast Host (Sponsor Announcer)]

Geez.

[Scott (Podcast Host)]

And is there anything that they were able to do for either of you?

[Cassie (Guest)]

So I was very sick. My blood was too thick. It's really hard on your heart and your lungs. So immediately I was. My heart stopped pretty quick. They did a little cpr, came back very quickly, and they put me on a ventilator. They tried traditional medications to help with my lung product, like getting my lungs to function, and that didn't work. And they pretty much were like, you know, it's in God's hands at this point. But they tried an experimental treatment for the Lungs and that did work. So I was on the ventilator, I think for about six days. They didn't move or touch me for the first two weeks because when they would touch me, my blood pressure would skyrocket, which is dangerous when you have thick blood. They were still doing the blood transfusions.

[Scott (Podcast Host)]

Oh, wow. You just laid there.

[Cassie (Guest)]

Yeah. Yep. For about two weeks. And then they fed me for the first time, I think at. At that two week period.

[Scott (Podcast Host)]

Gosh.

[Podcast Host (Sponsor Announcer)]

What.

[Cassie (Guest)]

So for the.

[Scott (Podcast Host)]

Can I. I'm gonna stop you for a half a second. You and your mom ever talk about this as adults?

[Cassie (Guest)]

We actually just recently did. Some of this is rather new information that just wasn't out there in 93.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

They're still kind of figuring out long term effects on Paps babies and the like lifelong effects that that has on. On someone.

[Scott (Podcast Host)]

Brain injury, stuff like that can come, right?

[Cassie (Guest)]

Yes. So slow processing time. They're finding there's a link with Paps to ADHD and organ. You can have issues with your organs, especially in the anemic twin.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

Who had the lack of oxygen in their blood.

[Scott (Podcast Host)]

Right.

[Cassie (Guest)]

Can cause long term deafness. There's. There's a few long term issues. We didn't present with all of those, but it definitely structurally rebuilt our vascular systems. Very different.

[Scott (Podcast Host)]

And then describe to me, if you can, growing up through life, the issues that your sister had. Any. That you might have had.

[Cassie (Guest)]

So we were both diagnosed with hypothyroidism when we were like nine. We were pretty young. And then just anytime my sister got sick, she got very sick. And we'd both get sick at the same time. I would bounce back much quicker. I just overall had a stronger immune system. And then into our teenage years, there were just these body aches and flare ups and she'd get a virus and it would be almost deadly to her, as viruses are with type 1s. They're scary. But everything affected her much heavier than it affected my brother and I. And that going into our early twenties stuff started to get really kind of scary for her with her. Her blood vessels. She just had very poor circulation, which that combined with type one diabetes is a scary combo.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

She had sepsis three times. She had three strokes. She just really went through the ringer.

[Scott (Podcast Host)]

Three strokes from just the. The limited blood flow. And do they know why?

[Cassie (Guest)]

One of them was from a clot like a scab. So she had a fall and she hit her head and damaged some of the vessels. I guess they scab over. That scab can release and then Cause a clot in the brain.

[Scott (Podcast Host)]

Geez.

[Cassie (Guest)]

Um, so I think that was her third stroke was from that. And I'm not completely sure what the first two, what the first two were from.

[Scott (Podcast Host)]

In that time into your early 20s, what would you say your diabetes outcomes were? Like? Do you know what your A1Cs were or what, you know, how you treated your blood sugars? Can you talk about that a little bit?

[Cassie (Guest)]

Yeah. So by the time. Well, our teenage years were a disaster. You know, you go into high school and you are getting out of high school, you want to do what your friends are doing, you want to eat what your friends are eating. You don't want to pull out syringes at the dinner table or when you're hanging out. And, you know. So our A1Cs were garbage as teenagers into our early 20s was when we both were on insulin pumps and things got drastically better. I think my A1C was a 7.5 and hers was about a 7. So they were. They were pretty decently controlled at the time.

[Scott (Podcast Host)]

On the pumps.

[Cassie (Guest)]

On the pumps.

[Scott (Podcast Host)]

Do you have any idea what a number would have been prior to that during garbage time?

[Cassie (Guest)]

Oh, 11.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

Yeah, they were garbage.

[Scott (Podcast Host)]

What you were shooting, were you regular and mph at that point? Did you go regular on mph to pumping?

[Cassie (Guest)]

No, we went from regular mph. We did Lantus and Humalog and then went on the pump about 18.

[Scott (Podcast Host)]

Okay, so even during Atlantis and Humalog, what were you doing shooting Atlantis but not shooting for meals all the time?

[Cassie (Guest)]

It was actually kind of the opposite where the thing we would forget the most was the Lantus. And then we were in those kind of situations where somebody was out of Lantus and needed it and we couldn't get it and somebody had to like go to an ER or trying to get a hold of an endo in the middle of the night to see where we can find a 24 hour pharmacy to get a prescription.

[Scott (Podcast Host)]

Cassie's that. Is that a financial issue or a just not somebody not handling ordering supplies correctly?

[Cassie (Guest)]

I think it's a bit of both. So my parents owned their own business. We didn't fall into the same kind of like medical insurance where you're on it until you're 26. So then at 18, I don't think any of us had medical coverage at 18. So there's a lot of programs out there where you could get a month's worth of insulin for 60 bucks or. But with three of us and my mom trying to find all these programs that can make it affordable until we could figure out our next best step, which I don't know the nuances of it all.

[Scott (Podcast Host)]

Would you describe for me? What? The financial situation in the house. Would you have called yourself? Poor, working class? Middle class? Upper middle class? What were you?

[Cassie (Guest)]

Middle class? I. I would say, you know, I don't. Not so sure the classes really exist anymore, but.

[Scott (Podcast Host)]

No, there's just two now. Yeah, but go ahead.

[Cassie (Guest)]

There was a lot of times where it was like, money was doing really well, and then there were times where money was doing really bad.

[Scott (Podcast Host)]

Little feast kind of thing going on. Like, the business would do great, we'd do a little better. We're going on vacation, everybody's eating that kind of stuff, and then it goes the other way.

[Cassie (Guest)]

Yeah, exactly.

[Scott (Podcast Host)]

What kind of business? Like, not the name of it, but, like, what kind of work they do.

[Cassie (Guest)]

Like, audits and pre OSHA inspections for, like, construction sites and schools, that kind of thing.

[Scott (Podcast Host)]

Okay. And do your parents. Your dad's alive still, or your mom. I know your mom is.

[Cassie (Guest)]

Yeah, they're both alive. I'm pretty estranged, like, from my. From my dad. We don't have much of a relationship just from stuff growing up. But they still own the business together and run the business together. My brother's also working there.

[Scott (Podcast Host)]

They're married still.

[Cassie (Guest)]

I don't want to work with family. No, they're not.

[Scott (Podcast Host)]

They're not married. They run the business together.

[Cassie (Guest)]

Yeah.

[Scott (Podcast Host)]

Wow, that must be fun.

[Cassie (Guest)]

Oh, yeah, a lot of fun.

[Scott (Podcast Host)]

And now listen, I can't imagine that if you're estranged from your father, I can't imagine your mom is okay with your dad. Is that right?

[Cassie (Guest)]

I think she sticks around for my brother.

[Scott (Podcast Host)]

For your brother. And there's a part about your brother that we haven't talked about yet. Right. Is he. Has he struggled in other ways?

[Cassie (Guest)]

Yeah, he struggled with addiction for quite a few years. He'd have these time periods where he'd be clean for six years, like, in between, and you kind of get that feeling like, okay, everything's gonna be okay. Like, everything's okay now. And then his last stint of addiction, he did end up going into a correctional facility. He was charged for drug trafficking and possession of drugs. And his care in there was just. It was just awful.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Scott (Podcast Host)]

I've only interviewed a couple of people who have been in prison. Prison with type one, but it doesn't seem like it's set up for success, that's for sure.

[Cassie (Guest)]

No, they checked his blood sugar twice a day. 7:00am, 4:30 in the afternoon. They'd give him insulin before they knew what he was going to be eating. So there was no carb ratio put into place. They were still doing Humulin and Humulin R, which everybody knows is very old school. Might keep you alive. It's not gonna prevent complications. And he developed retinopathy, neuropathy. He had five or six different low blood sugar seizures. He had to provide his own low blood sugar treatment from his commissary.

[Scott (Podcast Host)]

They didn't see that as medication.

[Cassie (Guest)]

Apparently not. Because they wouldn't give him glucose gel because of the high sugar content. They were afraid people were going to use it to make alcohol.

[Scott (Podcast Host)]

Oh. I guess there is a different set of concerns in prison. Am I. So your parents are running this business to give your brother a place to work and to help themselves financially, Is that right?

[Cassie (Guest)]

I think they started it together and they both just love it like it's their baby.

[Scott (Podcast Host)]

I see.

[Cassie (Guest)]

They both grew it from the ground up. It's been what they raised us doing and what they bought their house doing. And I think it just meant so much to both of them.

[Scott (Podcast Host)]

They want to lose it that neither

[Cassie (Guest)]

one of them could walk away. But now that my brother is so heavily invested in the business, I think my mom's a little hesitant to walk away. As long as he's still there, it's

[Scott (Podcast Host)]

providing stability for him.

[Cassie (Guest)]

Yeah. A support system. I suppose.

[Scott (Podcast Host)]

Hard question.

[Cassie (Guest)]

It's tricky. Yeah.

[Scott (Podcast Host)]

Yeah. Hard question for you. Okay. Your sister's really sick most of her life. She's a lot. I mean, a lot of issues and passes away. You all three have type one. Your brother had addiction issues. Do you have any idea. What was it the stress of all that that broke your parents up, or do you think it was something else or a mixture?

[Cassie (Guest)]

I think it could be a combination, but I think a lot of the issues were going on before the. The diabetes.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Scott (Podcast Host)]

I didn't mean that they were the Brady Bunch and then you guys got diabetes. That's not what I was saying. But. But I. But you think. Is it a. I don't know how to ask this. Like, do you think that the. The thing. There's no way for you to answer this question? I don't know why I'm asking you, but I'm going to finish it now because I started their collection of issues. Without three kids with health issues, do you think they would have been okay?

[Cassie (Guest)]

No, I don't.

[Scott (Podcast Host)]

No. They were. They were on their way.

[Cassie (Guest)]

No matter what. I think their outcome probably would have been about the same with us in the picture was not in the Picture. There were just other things going on that I think made their separation a little bit unavoidable.

[Scott (Podcast Host)]

Gotcha. I heard. I heard what you said. I think. I know. I'm not going to guess out loud, but I think I got it. Sorry.

[Cassie (Guest)]

No, that's okay.

[Scott (Podcast Host)]

No, I mean, I. I grew up in a shaky household, too, so I'm sorry for you.

[Cassie (Guest)]

My God, I'm trying to, like, tiptoe because I don't want to hurt anybody's feelings.

[Podcast Host (Sponsor Announcer)]

Of course.

[Scott (Podcast Host)]

No, you're doing a good job.

[Cassie (Guest)]

At the end of the day, you know what? This isn't really about them. This is about me sharing my story.

[Scott (Podcast Host)]

So, yeah, it's your life. You know, they were. They made themselves characters in it. The kinds of characters that they were. They could have. They could have made themselves different characters. You know, we all could. We could all do that.

[Podcast Host (Sponsor Announcer)]

Wow.

[Scott (Podcast Host)]

Okay. So when you go to a pump and your A1C comes down to the sevens, do you. And you're in your early 20s, are you in college? Are you working? Where are you at in your life?

[Cassie (Guest)]

Oh, I started the pump at 18, and actually they would not put me on the pump until my A1C was A7. They said if I couldn't get my shit together or under control, that a pump wasn't gonna make the difference. They wanted to see I could do the work first, which now makes absolutely no sense to me.

[Scott (Podcast Host)]

I come down on the side of that's wrong, but go ahead.

[Cassie (Guest)]

Yeah, but this was the older generation of Endos, very scare tactic oriented, would come in with a picture of somebody with a missing foot or of I and be like, you know, do you want this to happen to you? The old generation of Endos were a little harsh. Glad that there's been a big shift in that and a big change. But I did. I did the work. I really went to work with the multiple daily injections at 18 and got onto the pump, and it just made a world of difference. My sister very shortly went onto the pump right after me. So then we both were in pretty good condition with our diabetes at the time. I was in training to be an emt. I was doing trades at the time. Never felt like college was gonna be a good fit for me because I struggled a bit in high school. So then I was like, you know what? Let's give trades a try. So that's what I was doing at the time. My sister was very sick at the time. She was working part time at a greenhouse. She loved plants. She loved plants. She loved Gardening. That was like her whole life being in the sun. So that's kind of where we were about that point.

[Scott (Podcast Host)]

What made you serious about it? Like, why? Like, how could you. If someone, you say, I'm gonna get a pump, and they go, no, you're not getting a pump until you lower your A1C by 4 points. What makes you. What makes you do it? Like, how did you accomplish that? You know what I mean? Like, something had to change in you that make you want to do that, right?

[Cassie (Guest)]

I think I was moving out of. I was kind of moving a little bit more into adulthood and everything gets more serious and you're like, oh, this isn't like a game anymore. Like, it's hard to be afraid of long term complications because you're not seeing them in the moment. But I just got so tired of feeling bad.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

And feeling bad became so normal. And then I was struggling to go to my classes and I was struggling to do the physical part of my trades with lifting people and things like that. And I was like, I'm just kind of. I don't want to feel like this forever. And it just made me get a little more serious about it.

[Scott (Podcast Host)]

Yeah, I guess I don't want to be Troy. But you were sick and tired of being sick and tired.

[Cassie (Guest)]

Yeah, exactly.

[Scott (Podcast Host)]

That's where that saying comes from. Okay. And so you buckled down, did what they made you do, got the pump, life got better, et cetera, so on.

[Cassie (Guest)]

Yeah, my diabetes has been pretty well controlled, like, since moving to a pump. And man, have I tried all the pumps. I'm on the Omni pod now. Love it. It's been my favorite, my A1. My last A1C was a 6.5.

[Scott (Podcast Host)]

Good for you.

[Cassie (Guest)]

It's never been under a 7 with any other pumps.

[Scott (Podcast Host)]

You're Omnipod 5.

[Cassie (Guest)]

Yeah.

[Scott (Podcast Host)]

Have you gotten the update yet for the 100 target?

[Cassie (Guest)]

I did, and I just did the update yesterday and then I wasn't quite sure what to do from there.

[Scott (Podcast Host)]

Set your target to 100.

[Cassie (Guest)]

Okay. I was just like, does it just do it automatically? And then.

[Scott (Podcast Host)]

Hello, thing. Are you doing it? Are you doing it, Thing? No. Go into your settings and make your target 100. Why doesn't the thing know, Cassie? I mean, come on.

[Cassie (Guest)]

I told you, I'm challenged with technology.

[Scott (Podcast Host)]

I mean, you, you. Cassie had something happen and when we were setting up. Let me tell them real quick. So when I'm trying to figure out, like, sometimes people, you know, it's very nice to people to come on here and do that. Do this. But like, I don't exactly attract a crowd of people who are always making podcasts and stuff. So they cobble together, you know, microphones or headphones or whatever. And when I'm trying to see if they've properly turned their mic on that they're wearing or is like, you know, their laptop mic being used, I'll often say, cover the microphone with your hand. Because Cassie's voice was really dim and low and she covers the microphone with her hand and her. And her voice gets louder and I'm like, wait, what's happening? And she's like, I'm challenged.

[Podcast Host (Sponsor Announcer)]

But.

[Scott (Podcast Host)]

But no, seriously, like, yeah, move your. Do you know where your target is now?

[Cassie (Guest)]

Yeah, I think My target is 1, 2. The 1. Yeah.

[Scott (Podcast Host)]

Okay. Make it a hundred. I'm. I hear from people who are using it that it's a. It's a. It's not just the target that they change. Some other stuff got changed too. And people are seeing a real difference. So give it a whirl.

[Cassie (Guest)]

I'm definitely going to. I was like trying to gather notes for. For today, so I didn't come in here and talk about, you know, my own stuff and sound like an idiot talking about my own stuff. And I was like, eh, that seems like tomorrow's issue, isn't it?

[Scott (Podcast Host)]

Isn't it hilarious?

[Cassie (Guest)]

Do that tomorrow.

[Scott (Podcast Host)]

You say to somebody like, what's your basal rate? And they go, that. I don't know. I'm like, well, if you don't know, who knows, right? Yeah, no, but seriously, I would also, let me say not medical advice. I'm just saying I would move it if I was you. And while we're dropping in disclaimers and links, omnipod.com juicebox to learn more about the Omnipod V, please support the sponsors links in the show notes links@juicebox podcast.com okay, now I guess you will move forward. Yeah, part of the thing we talked about earlier, I have to. I will say this. I don't. I'm going to use the word hate for a second. I don't hate that there are great companies that support the podcast. That's fantastic. I wish that it wasn't part of my life to have to remind you all that if you don't use those links, if you don't download the show, if you blah, blah, blah, then I can't keep it going. And it. Because it sounds like crap. I know it does. Like, I. Because I've heard people who make YouTube videos, podcasts, et cetera, they say the same thing. And when they're saying it, my knee jerk reaction is, oh, shut up. Like, leave me alone. Like, that's not gonna make your podcast fault. But it will. Like, it absolutely will. But it's a hard thing to hear from a listener position, I think, because I don't have a good reaction to it and yet I find myself saying it, which is. I don't know if that's an oxymoron or not, but I feel like a moron when I'm doing it, I can tell you that much. Okay, so we'll get your. We'll get your goal down, your target down to 100 yomi pod 5. You said on other pumps you were never able to get under a seven.

[Cassie (Guest)]

Yeah, I would say the closest I got was exactly a seven. And that was with the T Slim. And I really thought for a while that technology couldn't get better than the T Slim, IQ control and closed loop system because it was so life changing to me. I went on the T Slim after I was on the Medtronic, you know, with the Guardian sensor. Yeah, I hated the Medtronic.

[Scott (Podcast Host)]

Hi. You did it all?

[Cassie (Guest)]

I did. I started on Animus and then went to Medtronic, then went to the T Slim. And then I tried that new pump, the. The bionic pancreas.

[Scott (Podcast Host)]

Did you really?

[Cassie (Guest)]

The beta, the eyelid, the eyelet, and that tanked my timing range. I went from 80% down to 55% on that one.

[Scott (Podcast Host)]

How long did you try that for? 6 months.

[Cassie (Guest)]

I gave it a year.

[Podcast Host (Sponsor Announcer)]

A year.

[Cassie (Guest)]

But after a year, I just, like, finally told my endo, like, I can't. I can't do this. Like, it's not working. And he was able to write to my insurance to be like, yeah, the warranty thing. Like, yeah, we'd like to switch back, please.

[Scott (Podcast Host)]

That's crazy. Well, they're not sponsored, so I'm okay with that. No, I mean, I'm just joking. I think. No, don't be sorry. I think that, first of all, I think that all of the. Of the pumps that are represented here on the podcast by. By ads, they weren't. They weren't just taken because they were interested in making ads. I think they're all very good pumps and. And I believe they do a good job for people. I do wonder.

[Cassie (Guest)]

Yeah, it's just finding the one that works for you.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Scott (Podcast Host)]

What works for you? I would also guess too, that your knowledge of diabetes has gotten better over time.

[Podcast Host (Sponsor Announcer)]

Like, I would.

[Cassie (Guest)]

Yeah, I hope so.

[Scott (Podcast Host)]

Yeah, right. Like, so have you Been listening to the podcast for long.

[Cassie (Guest)]

I started listening to your podcast, God, probably about a year ago. It hasn't been. Been crazy long. I know. You've been doing this for a while. I listened to one not that long ago. That was from 2008. 18.

[Scott (Podcast Host)]

Oh. I've been doing this for 12 years. This podcast started in 2015. Did it start in 2015? Yeah, in January. But my point being, is it possible that over, like, watch how long you've been using Omnipod 5?

[Cassie (Guest)]

I've been on the Omnipod 5 for only about eight months, I think.

[Scott (Podcast Host)]

Is there an argument to be made that the podcast is the reason you're doing better? I don't want to take anything from Omnipod, but is there?

[Cassie (Guest)]

No, I. I do think that. Because not only did I keep hearing people talk about the Omnipod 5, I found people who learned how to use the Omnipod 5 through your podcast.

[Scott (Podcast Host)]

Okay.

[Cassie (Guest)]

Um, and then I. One of my best friends is also a type 1 diabetic. She lives in Florida, and she's been on the Omnipod for years. And for so many years, she kept telling me to do it, but I was so attached to my T Slim. It was like, nothing's gonna get better than the T Slim. And then finally I gave it a go and was like, this is the best pump I've been on. I've been on them all.

[Scott (Podcast Host)]

Awesome. I'm gonna go out on a limb here and say something. I don't have any idea if I'm right about or not, but I bet you if today Cassie wore the T Slim pump, she'd have a six and a half, a 1C. And I bet you if today Cassidy went and wore the 780G from Medtronic. Or is it Mini Med or Medtronic? I mean, you guys, you got. If you go wear the mini med 780G, I bet you'd have a six and a half, a 1C. I bet you are just better at it now. I would also argue that people who listen with some consistency stay. Stay engaged with their diabetes without feeling focused on it. That's the. That's how I hear back from a lot of adults when I listen. I just do better. I couldn't possibly tell you why, but I also don't find myself thinking about it more. I find myself thinking about it less, but doing more. I don't know if any of that, like, resonates with you, but.

[Cassie (Guest)]

No, it. It does. I think in the last year, something that I was always A little bit like, you know, it's not that important. Was pre bolusing, like, I used to always kind of bolus, be like, oh, yeah, I'm gonna eat in like, three minutes. And I would bolus then. And now I really make sure to take the time to do it 20 minutes or 15 minutes ahead of time. And it really just made a world of difference.

[Scott (Podcast Host)]

And that's from the podcast?

[Cassie (Guest)]

Yeah.

[Scott (Podcast Host)]

All right. I don't want to break on the pod's heart, but obviously I'm the one that fixed this.

[Cassie (Guest)]

Clearly, Scott gets the credit here.

[Scott (Podcast Host)]

I mean, really, it was me. I get you also. Now, I realize when people say that I'm direct and that they find my confidence unsettling, I now know what they're talking about, but I don't see it. I don't see it that way. What I see is that, like, very simply put, I've in the past tried to lose weight by myself, and I've tried to lose weight with support, and with support, it goes better. And I've also tried to lose weight with support and assistance from technology. And what do you know? That even works better. So my point is that the podcast is a support system for you, and it's absolutely. And you get dribs and drabs of information or ideas or concepts. You start applying them without even maybe believing that, even knowing that you are. So much so that when a year later comes and you say, hey, what's going on? Why is your A1C A6 and a half? You go, let's say Omnipod 5. And I'm telling you that I think those algorithms are all great. Medtronicdiabetes.com juicebox tandem. Wait, Medtronic diabetes? Yeah. And tandem diabetes.com juiceboxomnipod.com they're all, go find the one. Go find the one you like the best, but know how to use it. That's where the real success is going to come from.

[Cassie (Guest)]

You gotta be honest about the Guardian, though. The Guardian sense.

[Scott (Podcast Host)]

Oh, that old center. Well, there's a reason they got rid of it. They don't make that anymore, do they?

[Cassie (Guest)]

It was pretty awful. I don't know. I like. I don't think that so quick and never looked back.

[Scott (Podcast Host)]

So. Yeah, I mean, listen, I think I believe that the CEO of the company was on here and said that we called it the. And when I said people call it the harpoon, she was like, yeah, yeah. But I don't think anybody's saying otherwise. I will tell you, you've never Heard the harpoon?

[Cassie (Guest)]

No.

[Scott (Podcast Host)]

Okay. Cassie, I would also tell you this, and I mean this and I've been saying this for years. Anybody can look back and hear me say this because I'd make fun of Medtronic because the thing was a harpoon but they went first and you gotta respect that. They made a cgm, you know what I mean? And the insertion process was not great. And even the usability, you know where you like having to what you had to always put in a blood sugar and stuff like it's not great but it got everything going. And now here we are, what 3 libre G7 15 day. The Simpleris sync is the one that Medtronic has now. And the other, they have another one too. Right? Medtronic actually has two options now. The Instinct sensor, it's a 15 day sensor is simpler. Async that works with the mini med 780G. And now ever since has their implantable CGM like you know, respected Medtronic for going first. You don't first through the door is the one that gets shot. You ever heard that one?

[Cassie (Guest)]

So. So I think like the closed loop system is really what changed the game. The closed loop system really I think is what came in like made life so much, so much easier. Um, I don't know much about the implant or if the implant works with the closed loop system yet. I like the idea of the implant. It does scare me a little bit. Um.

[Scott (Podcast Host)]

But you're intrigued of it.

[Cassie (Guest)]

But I'm intrigued by it. Yeah. I definitely want to learn more about that and I have a little bit. I've also learned a little more into. I've heard a lot about the twist.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Cassie (Guest)]

Which was six months ago. I didn't know anything about.

[Scott (Podcast Host)]

And you love jumping around bumps so it won't be long for you. I know.

[Cassie (Guest)]

I don't know. I'm pretty committed now. I love not having a tube.

[Scott (Podcast Host)]

I, I listen, I, I think that tubeless is a great option. A lot of people really like it. It's not a. You know, but there's other companies making other stuff. You're going to see a lot of things happen. Also I don't want to seem like a show but twist.com/juicebox has two eyes.

[Cassie (Guest)]

I walked you right into it.

[Scott (Podcast Host)]

Thank you.

[Cassie (Guest)]

But I think you want to say

[Scott (Podcast Host)]

anything nice about Dexcom US Med or the Consort next gen. You know I've

[Cassie (Guest)]

always wanted to try the 15 day desks.

[Scott (Podcast Host)]

I haven't tried that texcom.com juicebox. You're so funny. Ever since. Oh, my God. But listen, what else can I throw? I'm trying to joke around here, but I hope those of you who listened to me earlier look into this. Like, this is what it takes to keep this going. Like, so if you're like, hey, the podcast is great. It's a. Like, listen. You know what I mean? Like, it's a. It's a ton of work and it's a ton of, like, you have just. You just have no idea. Like, I know it's easy to like, flip on YouTube and be like, oh, look at that guy. He's probably making money or whatever doing this thing. It's a slog, man. I mean, it's not. It's not. I used to work in a sheet metal shop. I'll do this any day of the week. Okay? It's fine. But the pressure to keep it going and the orbit around it that supports it and makes it possible for me to, you know, I mean, you. You have no idea about my day yesterday, but I will just tell you that I had to. I had to start editing the podcast yesterday, this week on my own again. And I've been head down at my desk 18 hours a day for the last five days.

[Cassie (Guest)]

How's your neck feeling?

[Scott (Podcast Host)]

It's not. I actually walked downstairs to my wife and I was like, my back is so sore. Why is my back so sore? My back hasn't been sore forever. I started complaining. I was like, since I've lost weight, my back hasn't hurt. My back hurts now. She's like, you've been sitting in that room for four days. And I was like, oh, oh, okay. So it's just, you know, I don't get outside. I actually had a moment. I did a thing for myself yesterday. I. I spent a couple of hours in the morning doing something I had to be in my car for. And this was beautiful. The sun was out, wasn't humid, and I was like, out in the world at like 8am and I thought, I haven't been outside at 8am in forever. Like, this is. This is nice. You know, I was like, anyway, I'm. We're not here to complain about my life. My life's fine. Point being, support the sponsors and that pumps nowadays are all pretty great. And I think the next step is your understanding of how to use insulin, how the food is impacting your system, how did you make changes to your settings? We need changes to your settings. That's pretty much it.

[Cassie (Guest)]

Yeah. Well, it's a lot. It's just so much to learn and. But, you know, it's. It's amazing how quick things are changing.

[Scott (Podcast Host)]

Oh, yeah.

[Cassie (Guest)]

Just I feel like every day I'm reading something and I'm like, oh, that's amazing. Like, I was just reading about. What's his name? Alexander. The tennis player?

[Scott (Podcast Host)]

Yeah, yeah, yeah. He won the USA title.

[Cassie (Guest)]

Yeah. He just became the first Grand Slam single title holder as a Type one. Like, breaking out there, breaking records.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

A lot of people on your podcast are out there doing really incredible things. A few I was reading about or listening to, like, in the mountains, snowboarding, and just really out there doing incredible things that I'm not sure would be possible without a lot of the new technology.

[Scott (Podcast Host)]

Do you know a type 1 pilot's the space station? The International Space Station.

[Cassie (Guest)]

I did not know that.

[Scott (Podcast Host)]

Yep, she's been on here. She's very cool, too. Her name's April. And, yeah.

[Cassie (Guest)]

Breaking records all over for type ones. And the technology really kind of makes that possible.

[Scott (Podcast Host)]

You watch baseball for us?

[Cassie (Guest)]

I don't. Recently I used to be really into baseball.

[Scott (Podcast Host)]

The. The closer for the Padres, Mason Miller, I think he throws like, 102 miles an hour or something like that. He's type one.

[Cassie (Guest)]

Yeah. Look at that. Like, just doing what other people can do. And I know there's some nuances to it with others who also have other autoimmune disorders.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

Makes it, you know, a little more challenging for some.

[Scott (Podcast Host)]

Hey, listen, my daughter's going to college with it, you know.

[Cassie (Guest)]

Yeah.

[Scott (Podcast Host)]

Her friend is in college. She has Type one. Arden has two friends in college with Type one. And college isn't easy, and diabetes isn't easy, and each makes the other thing more of a challenge. And people are out there doing. Doesn't always have to be like, I throw a baseball, you know, 100 miles an hour. I, you know, I fly a space station. I think it's, you know, a wide range of people who are out there just living life and doing a great job and, you know, trying to do better for themselves. And while these technology companies are getting better. But your point about things getting better faster, I think that's incredibly exciting about around what kind of technology is going to pop up. And. And even so, the technology doesn't have to be the way we used to think about it, which is like, you know, you have to make a new thing. That's technology. Now. The technology lives inside of the thing, and that's much easier to update and improve and get out into people's hands. So I. I'm expecting. I'm expecting, I'm expecting all the companies to keep going, right? Mini Med, I think they're going to make improvements to their thing. Twist, I would hope would bring out another version of the twist loop, which I would imagine they're trying to do. Omnipod 6. I've already heard people talking about control IQ. They just got FDA approval for pregnancy. You know, on and on and on. That's senseonics. They ever sense cgm, the implantable cgm? You know, when it came out, it could be in for, I don't know, three months, then it was six months. Now it's a year, like woo hoo. You know what I mean? Like, let's go. And that, that stuff happened in much quicker, much more quickly than I've ever seen in the past around diabetes technology.

[Cassie (Guest)]

It's crazy to think where we're gonna be at in a year. I do kind of wish I could have seen how much this new technology would have impacted some of my sister's health issues. I know, like her passing really kind of scared me straight as well. It was really like, okay, major life changes need to happen.

[Scott (Podcast Host)]

How, what adjustments did you make?

[Cassie (Guest)]

Um, I just started eating a very solid regular like diet. I stopped going through my weeks like, oh, what am I gonna eat for breakfast? And just figuring it out. Then I started planning ahead of time my entire week of what I'm gonna eat for breakfast, lunch, dinner. I know exactly how many carbs I'm gonna get at those times throughout the week. It keeps it consistent. It's helped me greatly. Um, I've just started getting more physical exercise, getting out into the sun, more concentrating on the basics that people forget about like diet, sleep, water, sunshine, that all make a major impact on our lives that we kind of push to the side like, oh, it's not that big a deal, but they're our baseline for functioning. And I quit, I quit drinking soda, which I did only drink diet, but, but it's like, you know, I'll let myself here and there, but not every day like I used to. And it just really got me into doctor's appointments more frequently and keeping an eye on things because there's always this baseline of like, we're identical. What happened to her can happen to me. And things pop up where I'm like, she went through this, so it's happening. Yeah, like it's starting to happen. I just had a real scary event with my, with my kidneys where every time I get my kidney function checked, it's my worst fear to open it and it be, you know, below that 60. And just recently, I kind of went through that, and I opened it. It was 30, because I was on an antibiotic called Bactrim, which in some people can cause their kidneys not to filter protein or not protein. Potassium. So then my potassium levels were really high. And they told me, like, go to the emergency room right now. And I was like, this is it. This it's happening. Like, this is how it started for her, and now it's happening to me. And this was just three weeks ago. Within three days of coming off the medication, of coming off the Bactrim, my kidney function is completely normal again. All my levels were completely normal. It's just crazy how one.

[Scott (Podcast Host)]

Cause you didn't forget the fear of it, though.

[Cassie (Guest)]

I didn't forget the fear. And the entire experience was a little triggering and I would even say maybe a little traumatic. I think medical trauma goes a little unseen.

[Scott (Podcast Host)]

Oh, yeah. You start feeling like you're gonna die.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Cassie (Guest)]

And there's just this constant reminder that I share an identical DNA with somebody that had a bad outcome. Hmm. That's what makes the everyday life a little bit different.

[Scott (Podcast Host)]

Can I tell you something that I found really encouraging about that little bit of your story? Is that I so often hear people say that they're doing things for other people. But I heard you say, I'm doing this for me. And I thought that was awesome. Like, I really did. Like, I. When you started talking, I was gonna ask you a question. I was gonna say, do you think that you're doing it because you wanna be healthier? Or you think you're doing it because your sister can't do it for herself anymore? But as you kept talking, I thought, no, Cassie's doing this for herself. Like, she's trying to pull her. Her stuff together. Good for you.

[Cassie (Guest)]

It's a little bit of both, because I feel the responsibility, a little bit of living for. For both of us. There is this whole trying to figure out how to be a me when I've been a we our entire life. That's been very, very difficult. It's a very lonely process. It's a very unique situation to be in that there's not a lot of support for.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

And nobody really understands unless you are an identical twin. So now I have this strange tether where it's like, half of me is wherever she is and the other half is here. And that tether almost kept me stuck in one place for a little while. Still does a little bit. And now I'm kind of Like, I have to do what she didn't get to do. I have to, like, live long enough and be healthy enough. Not just for me, but for both of us. Because moving forward as her other half, whatever I'm doing, she's doing.

[Scott (Podcast Host)]

Yeah. Death is an abstract. Until you experience it, it's just a thing that you. No one really. I mean, we know we're going to die, but we don't think we're going to die. Do you know what I mean? Like, you do not walk around thinking, like, oh, life's gonna end and then someone's life ends. It's impactful. But when that person is your sister and looks just like you and shares, like you said, your DNA, boy, if this didn't do it to you, you called it scared straight. But if it didn't do it to you, then nothing was going to. Because, I mean, I can't exactly. Oh, I can't imagine anything more impactful than this, honestly.

[Cassie (Guest)]

It has this strange, bittersweet, like, thing to it where it's like the worst possible thing that could have happened to me already happened. So it definitely pushes me forward with a little less fear and a little less anxiety on that aspect of it. There's also this aspect of getting to know myself in a way that I never had the opportunity to.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

I never got to know myself as an individual, which if I, you know, could go back and choose, I absolutely wouldn't. Um, but that's been an interesting. An interesting journey.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

Of really trying to get to know who I am as just me when it's always been us. And I miss it more than anything. I miss her more than anything. She was my best friend in the entire world. We shared so much. When you grow up with someone the same age as you, literally from day one, you share the same kind of. You learn empathy very young. You start to understand feelings very young because you're bouncing it kind of back and forth with somebody who's the closest person in the world to you. I don't know if the twin thing really exists, but I know her, and I definitely had a shared empathy where I could understand her and understand what she needed. We didn't always have to talk about it.

[Scott (Podcast Host)]

Yeah. I'm interested, too, in how you're able to accept the gifts that come from her passing without. I don't know. I really don't know. Like, it's tough. The gifts are coming from such a tragedy. But it would be easy to just, I don't know, not pick them up because it felt Wrong to take them. But you're. You're taking them, which to me says they're not being wasted because there are things you're getting out of. Of her not being here any longer. And instead of ignoring them because it's uncomfortable, you're. You really are paying attention to them.

[Cassie (Guest)]

Therapy, Scott.

[Scott (Podcast Host)]

Therapy.

[Podcast Host (Sponsor Announcer)]

Gotcha.

[Cassie (Guest)]

Therapy helps a lot. But, yeah, it does seem like a waste because it's like ignoring anything positive that could have come from that. I think would be ignoring an entire part of her almost that was lost in all of this. It.

[Scott (Podcast Host)]

Listen, you're in your 30s. You're in your 30s. Kathy. Let me put this in the terms that people your age can understand. Black Widow gave her life so Hawkeye could go back to his family. He's got. Right. Okay. He's got to go do that now, or what she did is wasted.

[Cassie (Guest)]

Exactly.

[Podcast Host (Sponsor Announcer)]

Yeah.

[Scott (Podcast Host)]

That's all. Everything. See a Marvel movie. I fixed it for you with. What was that? End game? I don't remember exactly.

[Cassie (Guest)]

It was end game.

[Scott (Podcast Host)]

It wasn't. Oh, my God. Apparently I do remember. And I knew you would know because of your age, by the way. Those movies were so good. Not good like, you know, War and Peace good, but they were good.

[Cassie (Guest)]

They were good.

[Scott (Podcast Host)]

Yeah, yeah, yeah. Any. And anyway, how much therapy did it take for you to accept that?

[Cassie (Guest)]

So I spent quite a few years kind of in denial, a little bit kind of in this state of disassociating where I was rather manic. I was drinking a lot. I was partying a lot. I was going out and just kind of being crazy, and I was completely disassociating from the experience. And I was kind of not even thinking about therapy. And then I had a moment in. I want to say it was 2022. It was the summer of 2022, where I kind of looked back at this trail of destruction I was causing from dissociating from what was really going on. Just people around me that I was hurting with my actions or my words without even realizing it because I wasn't fully here. And it scared. Being that way scared me so much that I immediately got a therapist. I immediately got a psychiatrist. And at first they thought I might have been bipolar or. And it was really just trauma. It was really just disassociating from this experience that I couldn't even imagine beginning to deal with. And I honestly haven't started to until. Until maybe six months ago is when I've really been able to start talking about it and focusing on it in my therapy. And really starting to kind of accept where I'm at and the fact that she's not necessarily here with me. She is, but she, you know, she isn't.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

And I couldn't face that for a lot of years. I couldn't face it.

[Scott (Podcast Host)]

I can't imagine, honestly. It's the. You're having an incredibly unique experience, you know.

[Cassie (Guest)]

Well, it's unique and there's not a lot of. There's not a lot of resources for it, which is why I felt that it was kind of important for me to find a platform.

[Scott (Podcast Host)]

Yeah. I was gonna say that's what led you here to do this. Right.

[Cassie (Guest)]

Yeah. To not only talk about the diabetes and the health issues, but to bring a little of awareness to twin loss. Because it is complicated.

[Scott (Podcast Host)]

Well, I mean, I looked into taps a little bit while you were talking, and it. I mean, it's not a thing that affects a lot of people. You know what I mean? Like, so when. When you're having something that unique happening to you, the support system around it is going to be, I mean, shaky, you would imagine, you know, and then moving forward, living as a twin, it's not a thing that, you know, a lot of people, you know, have experience with. Losing a twin is even less so. Having medical issues prior to that, sharing the medical issue, some of the medical issues. Like, you are in an incredibly unique situation. You did a really good job for yourself getting out of this.

[Cassie (Guest)]

I've done the best I could. There's been. The tap stuff has been rather. Rather recent. That explained a lot of unanswered questions.

[Scott (Podcast Host)]

Is it important to get those explanations?

[Cassie (Guest)]

You know, I. I do think I'm gonna have some closure with it because for the last five years, we were kind of like, why did this happen? Like, why did her kidneys fail? Because they biopsied the kidneys and said it was not diabetes related. And they diagnosed her with lupus along the way. They never really thought that was what was causing the vascular issues, and they just never really felt. Figured out what was going on. Ultimately, she got an infection, got sepsis from that infection, which sepsis has a 40% mortality rate. So that's kind of what happened there. And it was during COVID so they weren't letting anyone into the hospital. There was two weeks, which is the longest we've ever gone without talking or seeing each other, where they weren't letting me in to the hospital to be with her. And then by the time I did, she was in a coma. And I never got a chance to talk to her, but they pretty much told us there's. There's nothing we can do. And you guys need to decide if you're going to take her off life support or keep her, you know, in this state where she'll probably die anyways because nobody's going to operate on her and the state she's in. It was a very unanimous decision between her husband, myself, and my mother. And I laid with her and I held her when they took her off. And it. Oh, sorry. This is the first.

[Scott (Podcast Host)]

You're gonna make me cry. Just keep going. You're fine.

[Cassie (Guest)]

And I felt it. I felt the energy leave. And I knew. I knew when she wasn't there anymore. And then there was this sense of guilt that I had for not only still being the one here, but why this happened to her and not me. And then looking at the taps and being the receiver, being the one that, like, took all of the blood and took all of the. There was a certain amount of guilt that has come with that that I haven't quite worked through yet.

[Scott (Podcast Host)]

I have to tell you, when I was reading about the taps, I thought whoever named these arms of this really wasn't thinking about the human side of it. Like, why would you. Why would you couch that this way? You know what I mean? Like, the receiver is. Yeah, yeah, yeah, yeah. No, I hear you.

[Cassie (Guest)]

I hate that word because multiple reasons. Growing up, my grandma was always like, you know, Cassie, since birth, you've always been the fatter twin and things like that. And it's true, all the way through our relationship, I've always liked. Weighed more than her and whatnot. But it just stemmed from that.

[Scott (Podcast Host)]

Like.

[Cassie (Guest)]

Yeah, it stemmed from the difference in her size at birth and her health conditions along the way. That there was nothing they could have done then anyways to have changed the outcome.

[Scott (Podcast Host)]

What's also even saying you, like, right? Like, you took. You were fatter, you were. It's not like a conscience. It's not like. It's not like they came and found the zygote and they're like, hey, would one of you like to take? And one of you, like, get taken from. And you were like, yeah, me, I'll do it. Like, you know what I mean?

[Podcast Host (Sponsor Announcer)]

It's not really you.

[Scott (Podcast Host)]

It's just the. It's. I don't know. It's got nothing to do with you.

[Cassie (Guest)]

It doesn't. Rationally and logically, I know that. I know I made no decisions in any of this and that none of it was my fault. I think that one's just going to take a little more. A little more time, especially because I am just kind of recently starting to work through some of this and it being just, you know, a couple days away, you kind of. Your body knows, even if you don't.

[Scott (Podcast Host)]

Yeah.

[Cassie (Guest)]

Like, kind of like, what's wrong with me right now? Why am I acting weird? Why am I so tired and depressed and whatnot? And then you're like. But it doesn't have anything to do with that. So it's like, there's still a part of me that can be in real denial about it all.

[Scott (Podcast Host)]

Yeah. You're not drinking anymore, are you?

[Cassie (Guest)]

No.

[Scott (Podcast Host)]

Good for you.

[Cassie (Guest)]

Occasionally on the weekends, but never more than one or two. And I'm looking into taking ldn, the low dose naltrexone for base level inflammation. So there's no drinking with that, which is.

[Scott (Podcast Host)]

You sound like a perfect person to go to Hopkins and ask about that MDMA therapy.

[Cassie (Guest)]

Well, I don't think I would be really about that.

[Scott (Podcast Host)]

Yeah, you would think they'd be like, wait, what's that?

[Cassie (Guest)]

Really enjoy that.

[Scott (Podcast Host)]

What's that story? Yeah, you're in. Let's go. You have.

[Cassie (Guest)]

You want to make me feel happy. Okay.

[Scott (Podcast Host)]

They say it just makes your trauma melt away. I don't know. So I don't know if that's true or not, but it's what. It's what everybody's saying. I can't thank you enough for sharing this with me. I. I struggled with what they call the episode for a minute. I thought I wanted to call it tired of sick and tired, but I might call it trail of destruction. I don't. If I. I'm not sure why it

[Cassie (Guest)]

does feel that way.

[Scott (Podcast Host)]

Well, you. It's a phrase you used. And. And I thought that might be right. But you're not on that trail anymore, right? You wouldn't think of yourself that way.

[Cassie (Guest)]

No, not at all. I'm very hyper aware of myself and my actions and my words. It's just, you know, at some point, you do have to look back and realize the damage you caused and not run from it, but face it and face everything you're going through. And you know, your body does it to protect you, which it's like, thank you, but no thank you.

[Scott (Podcast Host)]

You know how I know when the conver. You know how I know a conversation's going well? When you're speaking or the person I'm talking to speaking? I have my thought. I'm like, oh, I want to say this next. And then you say it instead and that just happened. You. I. I thought, you gotta face your shit. And I'll hold that thought, let her finish her thought, and then I'll. I'll chime in with that. And then you just said it instead. And so, yeah, maybe you just have to. Maybe that's the. Maybe that's the title of this one. And I can't put shit in the title, though. Face yourself. What do you think?

[Cassie (Guest)]

Well, you know, you did say that that's what you do best. So I leave that to you.

[Scott (Podcast Host)]

See, why would. That's horrible to do to me at the very. I was giving you the chance to name this episode and just left me.

[Cassie (Guest)]

I'll never come up with one better than behind the Cheese.

[Scott (Podcast Host)]

I am a genius.

[Cassie (Guest)]

That was a genius title. It pulled me right in.

[Scott (Podcast Host)]

I hear what you're saying. I am thrilled that you only found the podcast a year ago and it feels so valuable and present to you that it doesn't feel like an old thing you found in the closet that still is fun, but smells weird. And that means a lot to me that the podcast is, is, is producing at a high level. Still this far into it. I'm going to take that from this and a lot else, by the way, so thank you very much. I guess we'll find out what it's called when it comes out, but if you'll hold on for just one second. I just need to tell you a couple things after we're done recording, but thank you.

[Cassie (Guest)]

Thank you for giving me this opportunity to bring awareness. And this was also pretty healing for me because I haven't talked about a lot of this yet.

[Scott (Podcast Host)]

So I'm glad.

[Cassie (Guest)]

This was a very healing experience for me. So I appreciate you having me on and giving me the platform to do so.

[Scott (Podcast Host)]

Well, congratulations on facing your stuff. I think it is commendable and not a thing that everybody can make happen all the time. So you, you, you took a huge step.

[Cassie (Guest)]

Thank you.

[Scott (Podcast Host)]

Yeah, you're welcome. You're saving your life, you know. Hold on one second.

[Podcast Host (Sponsor Announcer)]

This episode of the Juice Box podcast was sponsored by US MED usmed.com juicebox or call 888-721-1514. Get started today with US MED. Links in the show notes [e-mail]

[Scott (Podcast Host)]

A

[Podcast Host (Sponsor Announcer)]

huge thanks to my longest sponsor, Omnipod. Check out the Omnipod 5 now with my link omnipod.com juicebox you may be eligible for a free starter kit. A free Omnipod 5 starter kit at my link. Go check it out. Omnipod.com Juicebox terms and conditions apply. Full terms and conditions can be found@ omnipod.com juice juice box. 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 in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card?