The Healthy Diabetic

#140: Diabetes Patients vs. Their Medical Team

Coach Ken / Mark Picardo

Hey Diabuddy thank you for listening to show, send me some positive vibes with your favorite part of this episode.

In today's episode, I welcome back Mark Picardo, T1D, elementary school administrator and father. Mark recently met with someone on his medical team about the trouble he's been having with this insulin pump. He was surprised to find out what had taken place. I urge all medical professionals and people in the diabetes community to listen to this one in its entirety. Mark's story reiterates the importance of building a strong rapport with your medical team and treating the relationship with professionalism, compassion, and mutual trust.

Show Notes:
Mark's Instagram
Previous Episode - #134

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Speaker 1:

So she got, so she get. At one point she asked so what do you do? I said well, i'm a school principal and well, i try to put this in thoughts. If all of your kids didn't follow the rules, what would happen in your school? it would be in disarray. Well, you're in disarray right now. When I switched over from the pumps seven or eight months ago, i was taking 23 units a day. At receiver I said so, that's what I'm going to do. I said so, could you tell him that I did? I did tell him that. I look in your chart, but he says he's comfortable with the 15 units based on the data, but the data is inaccurate.

Speaker 2:

But the data is inaccurate because you've been trending so much at 250, so right there. That's a red flag to me. The data doesn't matter, the data gets thrown out. Welcome back. This is episode number 140 of the healthy diabetic podcast. Before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise. Please always consult your medical team before making any changes to diabetes management. Okay, we're going to jump right into this.

Speaker 2:

I had the pleasure of bringing back Mark Picardo on the show. Mark was on, i think it was like April 28th, like a couple months ago, and he is a type one diabetic, an assistant administrator at a local high school or actually it's a local elementary school and roger's, new york, and he's actually getting ready to move to north carolina, which adds a whole another complexity to you know your management style. When you have a big move like that, you have so many things going on. You know he's going to have to find a new endocrinologist, a new medical team, so we talked a little bit about that in his process and strategy of trying to think about how to move, but really the big bulk of this conversation was about his most recent and last conversation and interaction with his medical team, and the reason I wanted to bring this to the forefront we wanted we both wanted to sit down and chat about this is because it's just another example of a lack of compassion, empathy and kindness coming from our medical team. And, regardless if you're part of someone's medical team and listening to this, or you're the patient or the caregiver or someone in the community with diabetes, i implore you to listen to this episode and in its entirety. We need to have more conversations about this on both sides. Our perspective shape our reality, regardless of what that perspective is, and our world views also shape our reality and your reality. Your perspective might be different than someone else's perspective because you're not asking questions, and that is what this episode is all about on both sides.

Speaker 2:

You're going to hear us talk a lot about the medical team or Mark's medical team and our frustration with what happened, but it also comes down to the to the patient, because the patient needs to be able to advocate for themselves. Not saying that Mark did not do that in this situation, because he did, but I know there are situations where you don't advocate for yourself and then you leave your doctor's office or your doctor's visits um in tears or very frustrated because you didn't. You didn't feel like you got you were heard. That's partly because one you didn't advocate for yourself and you didn't ask questions. And then it's the same on the on the other side of the medical team.

Speaker 2:

We have to ask questions so we understand what the story is, instead of asking one question or just coming to a conclusion based off of what's in front of us. If you're just looking at some random data and not looking at trends and not asking specific questions, then you don't have the full picture of the story. You don't have multiple data points to actually come to a conclusion without further ado, let's get with Mark Picarta. Yeah, so I'm. I'm really excited now to like not that I wasn't excited before to talk to you again, but I'm like intrigued about this story.

Speaker 2:

Now, man, i'm kind of I'm kind of heated, i'm going to be honest with you okay, cool and we can talk about this because, if it's going the way I think it's going to go, like this is going to be a perfect topic to talk about, because, I think, i think, i talk.

Speaker 2:

I talk about this a lot. I think of what you were, i think I know where you're going to go with this and I talk about it a lot, so it's going to be really cool to have another conversation about this, because it's it just brings it to the forefront and brings light to something that really needs to be talked about yeah, and I'm gonna try the best that I can to separate emotion from reflection, because I I don't want to come off as an asshole.

Speaker 2:

So yeah but hey, yeah, so if you're gonna come off as an asshole, you're gonna come off as an asshole who gives a. Who cares? yeah, and I look that you're drinking right now. It's like I should have a beer in my hand.

Speaker 1:

I have a glass just pour of a glass of red wine. So okay, so I I'm trying to, i'm trying to go back to our first conversation too, when we talk first. But did I tell you that we're moving?

Speaker 1:

yes, you mentioned that you're a move, so so between between now and then, we I mean everything has has just fallen into place and waiting for something bad to happen, because that's just the pessimists in me. But between now and then, we've our house has gone through, we've sold our current home, my wife and I both have jobs lined up, my parents move nine days from now, you know well. So everything is just perfect. So one of the last things that I've been trying to do is get in touch with my doctors in the area to make sure my prescriptions are good and, and you know, xyz, because, because I'm OCD like that, i need to make sure that everything is in line.

Speaker 1:

Not that that's not important, but so, simultaneously, as I'm going through all these things, i have just been having a little bit of a difficult time with my, with the Omnipod, and one of the biggest things that the biggest challenge that has been for me has been when I'm finding that a, a pod that I have been certain is just is not, is not absorbing the insulin, and the way that I'm interpreting that. So, just to make sure I'm being clear, the way that, the way, the way that I'm interpreting then, the reason I'm saying that is when I have a site and my blood sugar is is being stubborn to the fact that I need to inject to bring my number down. Yeah, i find like my interpretation of that scenario or that situation is that it's a bed, it would be a bed site or a bad spot, and obviously this is after multiple boluses thinking about what I ate, looking at activity.

Speaker 1:

You know, you know all those things, so so I'm not. I just want to be clear and saying that I'm not. I'm not a doctor, but I would. I would be able to reflect on that situation and think that's a pretty accurate interpretation of what's happening yeah, but you have you.

Speaker 2:

So not to cut you off, because I think this is I want to just want to add this as we tell the story, because it almost sounds like you're going through the same thing I went through about two or three months ago, where you're giving so much insulin, so much insulin nothing's happening. Yeah, if something does happen, it's big. It's almost like you have to give double or triple what you'd normally give, right, and then a file comes down, yeah, when it finally starts coming back down, and there's a, there's a. I want to let you finish your story, but there's a. There's a bunch of different things that go on in that scenario that could be happening, that could be leading to this. You know, this high blood sugar or this roller coaster. That's that's happening, and I just want the listeners to understand that and and I've talked in length about this before so this is amazing that we're having this calm.

Speaker 1:

This is great that we're having this conversation, absolutely I mean there's and I said this our first time together you could do the same thing, you know. You could do ABC on Monday and ABC on Tuesday and do it exact same time, way, shape form, and you could have completely different control on Monday and Tuesday, and and that's yeah, that's the reality of.

Speaker 2:

Yeah, it is the reality. So when you, when you're going through this process, right when this has happening to you, do you have like a system, like a system in place or a scenario of like checklists or whatever, that you say, like, hey, if this roller coaster or this blood, if I've got a like a sticky blood sugar in this instance is there, like, hey, the first thing I'm gonna do is x, that's the next thing is I'm gonna do this. Next thing, i'm gonna do this. And if all of those things don't work, then I need to go to another, the next, the next step down do you have that in place.

Speaker 1:

So for me, and a lot of again, a lot of this has been trial and error and figuring out what works, what doesn't. So for me, the process that I kind of go through, you know, i say I have a blood sugar that's come up, it's in 220, whatever, and it's just, you know, i bowl, i'll correct, give it. I usually get. I usually give it about an hour, 45 minutes to an hour, sometimes a little bit less patient. But if, if, by the time that the hour has come around and my blood sugar isn't at least starting to trend down, then I'll probably try another bowlless. Think about, think about, okay, maybe I miss calculated, for an eight, xyz could be, yeah, thousand things. If that that like hour and a half mark comes where I've, i've bowled twice now and I'm still not seeing any trend down, that I'm starting to think, okay, what? so I'm trying, i'm trying to ask myself why, um, if my blood sugar isn't yet going up, like it's just kind of level at that 200 point which has happened for whatever, i guess you could call that sticky um, i'll try, i'll give myself a shot, and so I'll give myself, you know, a third, another, another bowlless? maybe it's, and I'll be a little bit conservative because I know I kind of hit that we have insulin on board but I give myself a couple units that will bring me down, sometimes just that little extra from the shot. Those the trick and I'll stay, you know, level. It's working okay, whatever reason. If then I come up again and you know, after that shot I'm coming up again I'm just not, i'm not able to stay down, i'm not stable, then I'll change my site and I'm, i'm much more aggressive with that. You know, i talked to a lot of people, um, and a lot of diabetics who say you know, who had that like two hour, three hour rule and try to see if the insulin I'm I am much more aggressive and I acknowledge that. Um, yeah, me too, but that's the way I'm aggressive too, yeah, but that's just, that's just my preference, um, so, anyway, so. So, as I said, so simultaneously, we, along with this move, i have been noticing exactly what I said is I'm getting those sticky blood sugars. I'm getting sites that are really less than me, maybe like a day and a half that. That day and a half point, i'm noticing exactly what I just explained, that I'm not. My absorption is not as effective. My insulin sensitivity is super low, or at least that's what it's what it's coming off to seem like.

Speaker 1:

Yeah, and when I switched to the pump, the, it was in like October. My first one was the 10. I were first with a piece, one that I went to the omnipod and really the only reason for me of making that choice was because I had been off a pump for six years, seven years to that point, and all this new technology is flooding in and I'm like you know, let me just try it, let me see what works, let me see if this and you know, with that being, with that being said, my A1C, when I was on shots, i think, was like around five, five, five, six. So my control was fantastic, but I was trying to make sure I'm being humble and recognizing that I don't know everything and maybe using one of these would be great. Well, it hasn't been the. It hasn't been the experience that I had hoped for. It wasn't, it wasn't as great as it was.

Speaker 1:

That's an alarming curve Yeah it's an alarming curve, for sure. And I and have I? have I really gone with fidelity? No, i will. I, you know I'm egotistical in the stance for giving the technology and I'll figure it out like I I get it.

Speaker 1:

Yeah, yeah. But I decided that I want to go back to shots and I actually did. I've. This is day three of going back. I started on Saturday and I honestly I felt better. I had a. I had a shit night last night, but besides that, my I've really been level. I've been great, yeah.

Speaker 1:

So I messaged my endocrinologist office last week. I said I'm getting ready to move, i'm also considering going back to shots. Can we set up an appointment so I can just go over my prescriptions and talk about whatever she sent back? well, why don't you meet with the pump, with the pump specialist or the pump trainer, and go through it? and I said, okay, if and if I need prescription changes, she can make it. Yep, she can make her recommendations. It's great. No problem, all right, cool, we'll do a virtual, it's or no, we did it in person. I went in person. I want to do a virtual, but they said no. I went in person. So I met with her and And I talked about it so much that I feel myself saying these things to myself, but she doesn't want to listen. Those want to hear what you have to say.

Speaker 2:

This is the pump educator that didn't want to listen.

Speaker 1:

Yeah, or the doctor The pump. I didn't see the doctor The pump educator. And so I explained everything that I said. So she was well, you're not using the algorithm in the pump And I said okay. I said okay because I'm oftentimes more often than not I'll do a manual bowl. Yeah For using, using the omnipot.

Speaker 2:

Yeah, that's what I do.

Speaker 1:

Well, apparently, if you're not in, if you're not in certain in putting the number of carbs that you're eating, it's not learning as much as it could And it's not as okay. And I said, okay, i get that. Like that's like. I understand you're probably right. I said, but, with that being said, that's not really the problem that I'm having. Like, when I, when I get a brand new site for that next 12 to 16 hours, i'm fantastic, like I do great. I said, but you know, for me I just found the same thing, my, you know, for whatever reason, the shots work much better for me. Well, i've had 75 year old patients who have much more scar tissue than you do, who work where the omnipot and have no problem. And this is why I wanted you to come in so that I could look at your scar tissue today. And you know, i I hate to tell you, but it's just, you know you're, it's not as bad as you think it is.

Speaker 2:

And but it could. It might not be scar tissue though.

Speaker 1:

And that's the thing, and it couldn't it?

Speaker 2:

just because you don't have scar tissue doesn't mean that you have like the, the insulin resistance is high. There could be other other things that are happening that are accounting for this roller coaster and these sticky blood sugars.

Speaker 1:

Yes, Yep, and so so she got, so she get. At one point she had. So what do you do? I said, well, i'm a, I'm a school principal. And well, i try to put this in in thoughts if, if all of your kids didn't follow the rules, what would happen in your school? It would be in disarray. Well, you're in disarray right now. It's like all right.

Speaker 1:

So at this point I kind of shut off. I said okay, well, this is what I'm going to do. I'm going to go back to shop, i said I. I moved on in three weeks, once I get down and I transfer to my new team, then I can come back and and relook at the pumps. And because the Omnipot is covered by insurance, so I still have my pump insurance readily, so I could go on anything at any point. Yeah, And do you still have more pods left over? Yeah, oh, i'm good with the. Yeah, i'm good, i'm great with it.

Speaker 1:

So she was okay. Well, you haven't seen a doctor since September. I said I know she was both. So it might be tricky for us to fill your, your prescriptions because you haven't seen a doctor in person. So, like I said, okay, i said, but you know, i reached out, asked what I should. This was, this was the suggestion that was given to me. So this was the route that I had gone there.

Speaker 1:

And I said if I had known from the beginning I would have done. I would have done anything. I said, can I? I said can I just go see a doctor now? Well, no, you can't see a doctor now, you? you think about how backed up we are And I'm like, okay, so she sent me home. I said I'll talk to the doctor Q I yeah, whatever, see what he says. So she calls me back. And well, he will. He's going to fill one box of trachea before you, which is what I need now, it's my long term and one box of the quick acting puns. I said okay, well, i said I'll try to. I'll call tomorrow and try to get in. I said, but more likely than not, they're not going to be able to get me in in three weeks before I leave.

Speaker 2:

Yep.

Speaker 1:

Yep, well, i think. I think he's actually being generous. So okay, what I want to like? screw you lady. So okay, well, i will. I said I'll figure it out, then I'll take care of it?

Speaker 2:

Does this, does this? does this educator even have diabetes? That's a great question, like because if she does, I'm not crazy.

Speaker 2:

She's crazy if she has diabetes, first off. Second of all, if she doesn't have diabetes, who the heck is she to tell you what you should or shouldn't be doing? This is what I. I love this because I'm going to start getting really irritated for you because I have been. I've talked to so many individuals first diagnosed.

Speaker 2:

Just going on the pump for the first time Like this is ridiculous, how, how we are put in these situations and we're not heard, like it's unbelievable to me. It's like, regardless if, if she thinks that you are non-compliant or aren't following the rules and I'm in, i'm doing quotation marks, everybody that shouldn't matter. What should matter is she has a patient in front of her that is having trouble with the system and instead of coming at you with compassion and understanding and empathy and trying to to kind of peel back the the what you're actually doing with the system, she comes up with anger, like, oh well, you're not using the system right or you're not doing this right. I'm like who cares? Who cares if I'm not using it right? It's not working the way it should be working. It's not working the way I want it to work.

Speaker 2:

So therefore, because I had so much success on pins. I'm just going to go back to that. And if I was her listening to that and I was coming at you with compassion and empathy, i would have said to you okay, what was your A1C when you were on pins? What was the control like? Tell me about that, let's let's dive into that. Because if you would have come back and said, actually, my A1C was at like seven, 7.5, then maybe I would have pushed back a little bit more on the pump.

Speaker 2:

But if you came back and said if you come back and you say like actually my A1C was like 5.5, 5.7, i would have been like why the hell are you trying to use a pin? Or why the hell are you trying to use a pump? What was the point of?

Speaker 1:

this. So in this, in our first conversation, we had talked a lot about how, how a lot of times these doctors just want to look at the numbers and the data. And so this is. So she sits there and she calculates my well, your daily, your daily average intake of insulin is 40 or whatever, and by a looks of your pump it shows that you're getting 15 units a day for your basal. But she talks to a doctor. Well, the doctor feels comfortable giving you this, that will. She wants you to take 15 units a day of basal. So okay, i said I get that. But just so you know, when I switched over from the pumps seven or eight months ago, i was taking 23 units a day of placebo. I said so, that's what I'm going to do. I said so could you tell him that I did? I did tell him that I look in your chart, but he says he's comfortable with the 15 units based on the data.

Speaker 2:

But the data is inaccurate. Okay, okay.

Speaker 2:

But the data is inaccurate because you've been trending so much at 250. So, right there, that's a red flag to me. The data doesn't matter, the data gets thrown out. I don't even look at the data at this point, because you're trending at 250 all the time. It's just it's so crazy, mark. It is so crazy that it's like let's push these pumps, let's get people on these pumps, like, yes, okay, cool, they're amazing devices. I wear an Omnipod and DEXCOM and I'm on the closed loop system. I love the Omnipod 5, but it's not for everybody. It's not for everybody.

Speaker 1:

I'd love to love it. I'd love to love everything. I would love to love the Metronik that I started on 20 years ago.

Speaker 2:

Here's my question to you. I have a very specific question for you, right? I am so curious that you went down this route at having a steady blood sugar of 5.5 on even just under 6 on MDI is incredible. So many people would love that. Just have to wear one freaking device. I only have to wear one device and I have to take my long acting insulin once, maybe twice a day, if you're splitting up through your tricepia, depending on how much you're on right. I would love to do that. I was not good at MDI. That's why I went on a pump, Because the pump I can wash my hands of it, I can take it out of my pocket, get myself a bowl. it's a correction. whatever I need to do, I don't even follow the algorithm very well. I just got my A1C checked. It was like at 6.1.

Speaker 2:

Yeah that's great. I mean this is the problem. This is the problem because we're as the patient, as the consumer, we're not being heard. It is all about oh well, you're having trouble, so you must be doing it. It's you, It's on you, It's your fault. It's your fault, It's your freaking technology's fault.

Speaker 1:

That's why, Well the reality, too, is, if I didn't need to go into the doctor every so often for my prescriptions to be able to get refilled, i wouldn't. Really, i don't think I would want to. What the hell would you need them for? So then you go in and they say well, why are you here? pretty much. Well, i'm here because I need you to sign the paperwork so that I can get my insulin. And well, we'll took you this and took it this and took it this, and you're not doing this and you're not doing this, and this is what you're supposed to do. I'm doing. Fine, just write my fucking prescription.

Speaker 2:

But the interesting piece too is, if I'm your doctor in this scenario and I understand you as my patient right, i actually am coming at you with compassion, empathy and understanding and know what your trends are and know that previously, regardless if you were on the Pumper MDI, your A1C was 5.5. So you were doing something right for a long freaking time right. And now we put in this other variable into your management style and that management style is like thrown to shit. It could be a. There could be different reasons for that, it could be human error, absolutely It could absolutely be.

Speaker 1:

It's not gonna be isolated and it doesn't have to be an isolated.

Speaker 2:

Yeah, it's not. It's not like everyone uses the technology differently, and I say that because even when I was on tandem pump and I love that pump too Even when I was on the tandem pump, i literally have interviewed over the last two years 10 different people that were on the tandem pump, and almost all of them Use the algorithms, use the pump, in a different way than I do.

Speaker 1:

Yeah right.

Speaker 2:

Yeah, i haven't used the omnipod long enough to make that determination for the omnipod, but it I'm sure it's the same idea. Yeah, so what I just? I just get so frustrated when I hear these types of stories.

Speaker 1:

The reason the, the reason that the shots work for me and I had so much time really thinking the reason the shots work for me is Because I Am able to hold myself accountable. That's just something that I'm really good at. I'm very good Yeah.

Speaker 1:

I'm very good at routine, i'm very good at You know, i wake up at 4, 30 in the morning and it'll work out before school, like that's just, that's who it's kind of the fines, how I am.

Speaker 1:

I'm very good at holding myself, but if I, the reason that I look at a pump was because, you know, one day, when he was 5, 5, then maybe it was 5, 9 and 5, 7, because I, oh, i tightened up again a little bit and So with, i think, with shots, if you're not good at Making sure your pre-volicing, if you're not good at Being a, being aggressive, if you're not comfortable with running a little bit low, because that's what I did And I was aggressive and I ran, and you know, the reason that my time in range went between shops and Omni pod went from 80% to 90% Was because I wasn't running it as low except my, except my daily average, or my average blood sugar was now 135 instead of 120. So I don't know from give it a give or take, whichever, but I, i, but so the pump does so much of that background work for you.

Speaker 2:

I, i feel yeah, and that's the beauty of that technology is like for someone that really struggles with MDI for it was someone that struggles with, like their routine, someone that is kind of insulin resistant, like you can you can pack on the basil and And rock and roll throughout the whole entire day. Yeah, right, and and the and the algorithm, especially for the Omni pod 5, because it it's brand new technology and it's a brand new algorithm. It can really save you. And when I first started the Omni pod 5, i saw it, i saw it work, i saw it like in motion, like oh shit, this thing is really learning me, because I was doing like I was allowing the it to learn what, what I needed throughout the day at specific time frames, like all that type of stuff. And and I think that's that is the power of the closed loop system, because it just it allows you to take your hands off. But again, it's not for everyone, it's right, not for you.

Speaker 1:

It allows you to Be hands off until you have to be hands on it's like. It's like the run. It's like the Ron Poole peel rotisserie. You put that, you put the turkey in the rotisserie. You let it go until all the sudden in the oil and the grease in the bottom touches fire. And yeah, you can't sit and watch it.

Speaker 2:

Yeah, but I also think, going back to like MDI and the success that you've had on MDI, it's also a testament to your Regiment, your schedule, who you are as a person, your mindset. There's so much that goes into it. The fact that you are so insulin sensitive is a is a huge help with MDI, like people that are people that are insulin resistant. I mean it's it's hard on MDI. You're just pounding on that freaking insulin. Yeah, you know, but you can stay very in control if you are super insulin sensitive because Your body is going to help with the background, your body is going to help burn off those extra calories or burn off that extra sugar, because you're so active like you being in the profession That you are in constantly up and down the hallways, up and down the hallways doing stuff all the time like yeah.

Speaker 1:

And I do think that, so that in your point right there, we spend we spend so much time trying to make sure that people understand the differences between type one and type two. I think that, right, there is one of the biggest commonalities between, and just one of the overall Symptoms of diabetes is that that insulin sensitivity the reason that people develop type two diabetes is because their health and lifestyle Get so poor to a point that they become so is insulin resistant. Well, if you're a type one diabetic and you're not taking care of yourself, you're not eating the right things, you're not doing the right things, just like someone who can develop type two, your insulin resistance goes up, your insulin sensitivity decreases, and that's something that's so, so common between the two, but it's so important, no matter, you know, just because you're a type one Well, i didn't get this, because a lifestyle doesn't mean that your lifestyle is not- gonna impact your control.

Speaker 2:

Yeah, for sure, for sure, Yeah, and it's, and I think that it's. It's one of those things that, when we look at a individual specific lifestyle, what are the things that always Throw a wrench into the system? and that's the relationship with food and how they think about food and what type of food there And the what, the type of food they're actually eating, a quality of the food.

Speaker 1:

Yeah, yeah and it's. It's one of the many reasons a lot of Diabetics I've seen lately say they've become healthier since the diagnosis. Because If you could, you know there's two. There's two ways to go. You could either Use it as an excuse or use it or use it as an opportunity. And yeah, people, people cross that line back and forth all the time. But When you use it as an opportunity, you're using it as a reason to be motivated and make the right choices.

Speaker 2:

Yeah, yeah, yeah, it's hard, it's great.

Speaker 1:

It is hard.

Speaker 2:

It is very hard, just like it's hard to go from one thing that works and change it up to something you don't aren't really sure It's gonna happen. And then what happens? you know, shit falls apart.

Speaker 1:

So but it does awesome in. But you willing, you know you have to be willing to try. I tried, I Mean I would say? I would say, eight months is a decent effort, we try.

Speaker 2:

You did it for eight months.

Speaker 1:

November When did I switch to my Omni-Path?

Speaker 2:

November November Yeah, you gave it. I mean shit you gave it. That they mark in the book. It's correct. The wife said it. Wife said it.

Speaker 1:

Yeah, she says, six months is a fair trial.

Speaker 2:

I mean.

Speaker 1:

So you gave her next two months going to her so And you know, and so I and I told, i told the doctor today too. I said, listen, i have so much going on right now I need to feel good and If it means going back to shops and then one time Subtle and my new house and my new place, then I can talk to my new team and Re-in, revisit it. Or maybe I don't, but either way. So I think you think about those. You know I always go to the sports analogies. You know you try trying something new, trying new offense, not work and not work and go back to what works. You know you're about the ball run the ball.

Speaker 2:

Yeah, yeah, i mean I still can't believe. You went down the route, man, like an A1 C of under six. So the question is, were you having too many lows then?

Speaker 1:

That was. Was that part of the?

Speaker 2:

part of the thing that like kind of made you One of the things that you know popped up and made you switch.

Speaker 1:

I would say Yes, yes, but it wasn't. It wasn't that I was having too many lows, that was really. It was. I was running low Most, you know. There was times where I but I was okay with running out of 75, sometimes during an 80, you know, and that's just a me thing, i will pay with that. It was more so Again. It's that, waking up at 430 in the morning and if I'm at 70, it's hard, it's hard to get myself to a point where I can go Run six miles or seven miles. So maybe the Omnipod helps me with that. If I, you know, seeing those a lot of those dips, because Maybe my tricep is a little bit too high, maybe the Omnipod, having just one influence, helps with that. But yeah, That was why I put it.

Speaker 1:

That was why I tried. I wasn't afraid to try.

Speaker 2:

Yeah and I would say to that too, with the. The one thing I do like about the Algorithm on both sides of tandem and the Omnipod is that it's designed for those of us who, it's designed for people that go low constantly because it's trying to prevent Hypoglycemia and hospitalization right and death right. That's what it's really trying to do.

Speaker 2:

Right, it's really that's what, and sometimes that frustrates me, because I want to be running at 100, not 110, and the algorithm Stops everything if you're gonna go past 110. So it does stop lows, but it also for us to like that, like to be super tight with our management. It also Doesn't allow for a lot of like Hey, i have to do, i have to do a bunch of extra corrections when I'm at 120 because it's turning off. Insane, it's turning off.

Speaker 1:

It's not giving me more insulin the difference, the difference between 120 and 100 for a pump company might, might be the death. So they're trying to be, so there's, but the difference between 120 and 100 for someone like you and I might be five years. I'm added to add into our life. There you go, because I was just going to say that's the death thing.

Speaker 2:

Yeah, i knew, because I was. Yeah, i was just gonna to bring up the a1c, and I'm glad you brought that up, because that's the better analogy than what I was gonna say. What I was gonna say is I was gonna take it back to the a1c. Right, the difference in a1c at a 120 and a 110 or 100 is What? probably five or six point. Five or six points, maybe two or three points right which Yeah.

Speaker 2:

You have some more wine there, brother? um, yeah, because I a1c chart. I Use the same a1c chart all the time. We're gonna use this one. Okay, load, there we go, here we go. So 120 Is a five, an average of 120 is a five. Point six Corner this chart. Yeah, that makes an average of 130 is a five point eight. So we're talking point two. Average of 100 is about a five point oh Which. That's really hard for diabetics.

Speaker 2:

So Really you know, and The interesting piece is when I, when I thought about this, when I look at this a1c chart because I look at my trends over time, right. So I was at six point two, probably this time a year ago, and then I ran into all this crap with my tandem pump And I couldn't figure it out. It's like almost the same situation that you've been having, where it's just sticky blood sugars Like wouldn't go down, like it takes extra, extra, extra insulin. I think I'm I'm between my total. My total daily amount of basil and bolus every single day is between 35 and 40, and I think I was close to 50 at that point and It was just not working. Nothing was working.

Speaker 2:

And I have a whole entire system that I run through, right, the site is first, then it's the, then it's the pumps, the pump, then it's the pump settings, then I look at my exercise, my activity, what that's, what has that been? Is it been non-existent? has it been like lower than usual? then I'll go right into My stress levels and my super stress with things that are going on. Am I not getting enough sleep? my hydrated?

Speaker 2:

I'm going through all my checklists and I going through that whole situation of basically two months of trying to figure stuff out. Now, i never thought to put The your insulin is expiring or their insulin's losing its potency higher up on the list. So now it's way super higher up on the list, and Because I've never ran into that issue, i ran into all the other issues. So, and this is why I love diabetes and I love this thought process Understanding what works for you and and then also understanding that it evolves all, all time, because you're going to learn different things. These front things are always going to work differently for you and I. I was a testament to that which was I was really happy with. I wasn't happy with the, with what?

Speaker 2:

was going on, but I was happy with the result and as soon as I changed the insulin got a new vial in there. It was like it worked like a charm and that was like the very first thing I thought you were going to go into, like when you were going down, your list is like okay, well, once I finally change the insulin, then everything changed, you know. So, yeah, it's the a1c chart. Going back to the a1c chart, it's My a1c was six point two. All that happened. It jumped all the way up to six point seven. I'd changed nothing.

Speaker 2:

I'm talking no different strategies, nothing. As soon as I got a good insulin in and it was working properly, i got back down to six point one within 30 days. It so it's. It is. It's a whole system of Understanding what works for you and I think that's just it. That is this the most powerful thing that I can tell people, the biggest thing that I have learned, the biggest thing that I continue to talk to people about, and when I hear conversations like yours, it's like man, stick with what works, brother.

Speaker 1:

Yeah, if it ain't broke, don't fix it.

Speaker 2:

Don't fix it. It was a good experiment. It was a good experiment.

Speaker 2:

The situation wasn't good at the end. Think about this, mark. I challenge you to think about this right, because obviously, from your body language, from your tone, when we started this conversation, you were really irritated about that conversation, that they were putting it on you and they weren't hearing you. How would you have felt if they actually heard you, if they came at you with compassion, empathy and just understood how you really should interact with us as a medical professional and even your doctor, when that educator went to your doctor and even your doctor, coming back and saying you know what? it hasn't been working. He tried it out. He's been awesome on MDI. Let's get him back on MDI.

Speaker 1:

Okay, so hold on to that question for a second. I'm going to get there, but I'm going to go around for a minute. But this is why it's so important. We'll get political for a second. This is why it's so important that, as educators, we are teaching our kids and, as parents, we are teaching our kids stuff beyond just math and history and reading and writing, because your kid can be the smartest kid in the world, but if he leaves school like a dick and can't be empathetic and compassionate and caring and eloquent in the way that they speak and relatable and make connections, then all they're going to do is provide experiences like what we talked about today. That's why it's so important that we're teaching kids how to be more beyond what you see in a book. I don't know when it became this big, i don't know how to get into it, but I know you're coming from the education field.

Speaker 1:

It's a big anti-education, but anyways Coming back to your question.

Speaker 1:

Yeah, come back to my question, because then I want to go back to something that you just said Coming back to your question, if the approach would have been different and maybe she would have tried to Nothing that she said was Well. Some of what she said was incorrect, but a lot of what she said was true That, according to the way that these products are being built, i should be following it this way. However, i feel as though we have all learned enough about diabetes to know that using a pump in one way will field a billion different kinds of results, because you have a. However many people use the tandem T-Slim, i would say you'll have that many different sets of data. That's why you have data, because all data does is give you averages. Maybe the average on the T-Slim is slightly higher than the average on this. It doesn't mean that every single person that uses it has that exact same experience.

Speaker 2:

Yeah, Even when they are doing things the way the system is designed to work. That's the other thing. Because I think one thing that medical field, the community in general, forget, is that we are all unique individuals. How one thing works for someone else doesn't mean that it's going to work the same for everyone. All of the research that they do with these products, everything they do to get these products to market, i'm sure for how we can throw out numbers and say 50% to 60% of the population will work, use the system, that uses the system correctly, have the same type of results. But there's also going to be those people that don't necessarily use the system the way it was designed to do, that still have really good results. That works for them.

Speaker 1:

Right.

Speaker 2:

Yep, that's the thing that frustrates me the most is when you get individuals like this that are in front of you and they don't understand those pieces that we're all unique individuals. Instead of coming at the patient with you're wrong, i'm right. They should be coming at you with compassion, empathy and kindness and trying to help you peel back the layers of why this is not working, instead of coming at you with anger and irritation and Yeah, So I guess, again to answer the question, i think the purpose of a doctor, when you get down to the layman terms, is to make sure you don't die.

Speaker 1:

If you had a list, what was my job? I'm a doctor. Well, just make sure you don't die, i guess that's what it's become.

Speaker 2:

I know The very way that.

Speaker 1:

But so anyways, what she didn't accomplish was me not worrying about, because I don't know how long six pens of tricepola gets me, but I don't know. I projected maybe a month and a half, two months. So I guess I have to hope that I can find it on the chronologist that will be willing to make sure that they can write me a prescription for tricepola and I'll get my prescription and it'll all work out down in North Carolina before I run out. So But here's the thing. So she did not accomplish that. So now I, yeah.

Speaker 2:

So, but here's the thing And I don't know if this is true, this worked for me when I switched into chronologists If you call up your doctor in three months and you're out of tricepola, or two months or however long that's going to last, if you call up your doctor, proactively, obviously, and say hey, i haven't found an endo down here yet. I just saw you two months ago or whatever, can you write me another prescription for tricepola? I would hope that he would Well that was like the.

Speaker 1:

Yeah, that was like the. That was the conversation, though that I had now pretty much, pretty much they're telling me because I wasn't able to see, i hadn't seen my endo or an MP since September 6th. She said, and I, when I said, well, i said I'll see him now, i'll get in, i'll come in, i'll do it, i'll come in. It's not a big, i'm here, i'll do it. I don't know where I was, i'm sorry. And she scoffs at the idea of me getting the She did or he did.

Speaker 1:

She did, she did, and so I said this was just to suggest the route that I take. If I knew that I had to come and see an MP, i'd come and see an MP. So, anyways, i feel like that was the conversation that I was having today was the fact that a box of Tresiba and a box of Fias was written for me was a favor, and so if I call again, i feel certain that I won't get the same generosity that I was given today.

Speaker 2:

Yeah, Here's a question for you, because I know this is a thing now that we're past COVID, because a lot of endos will take patients to telehealth.

Speaker 1:

So that's what I've done a mix of that. I would have preferred to do everything to telehealth, and I'm being. It's the same pump educator that the first two times I saw her was via Zoom. She keeps saying I can't do everything, that I do this and I can't keep doing it.

Speaker 2:

And. I think, that's correct, mark. I just think that And it might be once a year you might have to go to your endo. But let's say you're in North Carolina and you find an endo in South Carolina. Maybe it's five hours from you. Okay, so once a year you make a five-hour trip, or whatever it is.

Speaker 1:

It's not ideal, but I always tell people I have to go. Yeah, if I have to go into the doctor every six months to get my prescription, that's fine. But if I have to go and do that once every six months, but then also I want to potentially change over to the Omnipod, well, let me come and do my six-month visit. But if you want to do my training, let me do that over Zoom, or let me be flexible. I work every day from 7.30. The very latest that I could really get out is four, and there's only so many times that I could say, hey, i'm leaving at three today so I could get to that 3.45, four-hour appointment. The last appointments that a doctor will do is four, maybe 4.30 if you go to sleep.

Speaker 2:

There's some crazy witchcraft endo that is willing to stay open until five now, so I Yeah, but the funny thing Here's the other funny thing that I literally just thought of this I don't know what I'm saying. Yeah, then I open Saturdays. I totally forgot about this until we started talking about this. My endo trusts me so much. When I changed to the Omnipod I didn't have to do a live visit. They literally gave me the code, they sent me the first kit and I did all the training from my computer.

Speaker 1:

Yeah, yeah, and I'm not asking a doctor to do something that's unethical, but What is unethical Which we?

Speaker 2:

believe I'm not asking a doctor to do something that's unethical, but What is?

Speaker 1:

unethical, which we believe. I'm not asking a doctor to trust you. My insurance requires new notes, new doctor's notes, every six months to make sure that they can.

Speaker 2:

Everyone's does. That's insurance policy.

Speaker 1:

So now, all of a sudden, if I'm not going in person, my This place doesn't feel comfortable submitting new notes or whatever. So they want to. Essentially, what they want to do is micromanage, which is fine, my previous endo.

Speaker 2:

This is crazy, my previous endo from Ohio State University. I was sitting here for four years and I had to leave her because my insurance changed and my insurance no longer carried would cover OSU So I had to find a new endo. That took three, four months. For three or four months I still was able to send her a micart and ask her for prescriptions and she was like, yeah, sure, it's right there done.

Speaker 1:

Because that would make sense. You would have thought, and I guarantee you, if you were going to move to North Carolina or whatever, that person would have said listen, we can help you out for up to maybe six months beyond that. It would be really tough for us, but in the meantime, whatever you need, Yeah.

Speaker 2:

I guess in this scenario, i can understand them saying well, you haven't seen your doctor in over a year or over six months, so we really need to see you because it's part of our policy. But instead what you got was no, you can't do this, this isn't correct. No, you can't do that. You can't do that.

Speaker 1:

The funniest part about it, too, is the NT that I messaged apparently doesn't work there anymore. She left. She left Because I messaged her through I don't know if my chart is a national. I messaged her through the app we use as my chart. Yeah, Instead of having to call you, just send a message. Well, I guess she doesn't work there anymore.

Speaker 2:

But does her shit get forwarded? She answered me.

Speaker 1:

Oh, she answered me on my chart. She answered me in the thing and said because she was the one that said okay, i'll set you up with a call between so-and-so and so-and-so, our pump educators. Yeah, and my response was great. I said okay, and if I need prescription updates, can so-and-so do that? That's a great question, mark. If any recommendations they send, they'll send it over to the NP or to the doctor and they can write the script based on so-and-so's recommendations. Okay, great, great idea, i'll do it Whatever. Yeah.

Speaker 1:

So really, in theory, the way I started my appointment today was this is what's happening, this is what I want to do, this is what I think I should do. But what do you think Should I? And so they bullittled me on the way that I was using the Omnipod, shamed me in saying that I'm not using it right, i'm in disarray, and I said okay. I said honestly, i don't. I'm not disagreeing with anything that you're saying, i said, but I said it's honestly giving me even more confidence in deciding that I'm going to take a step back, use something that I'm comfortable with and that has worked for me, and then, once I am settled, i can really give it another try, another solid try, if that's what I think is going to be best for me.

Speaker 2:

Well, you have said that to them. I'm going to give it a solid try later. Drew, you said those words to them. if they wouldn't be a little due At that point, appeasing them by saying I'll come back to it.

Speaker 1:

Yeah, i mean, the entire purpose of doing it was to. I'll be honest, when I messaged the NP, my goal was I needed my new prescription for tricea And I needed a new prescription for the needles that you put on the pen. I wasn't going. I didn't feel as though I had the ability to just send the message and say I'm going to go back again now because I knew what the policy is. I know that I need to be seen or whatever, and I had already made that change after my last appointment. So I was trying to be understood. I was trying to accommodate everything that is necessary.

Speaker 2:

Yeah, you still shouldn't have been met with that type of conversation, though, at the end of the day, for me, regardless if you weren't using the system in the right way or not, you shouldn't have been the conversation, and that's the problem. That is the underlining problem with everything that's going on at diagnosis, with people that haven't gotten it, people that they are saying are non-compliant, when they're not non-compliant. You just haven't educated them. You haven't educated them. You haven't been able to hold their hand for the time they needed their hand held, because diabetes is a complex fucking disease. It is.

Speaker 1:

It's a fucking complex disease. So I might have just gotten inspiration for the next time that we talk. Yeah, i think it's because I, because I, just I want to ask this question now. You, just, you, just you really just made me start thinking differently. Our dollar, the way that medicine is done in the United States is that it's so specialized which Which I understand that if I have to go and get Brain surgery, i want the very best person who knows you have someone that does it every freaking day.

Speaker 1:

I want. I want them to know as much as they kind about brain surgery. So I get that. But it comes back to asking this question Do you think that maybe all of our medical professionals, or all of our professionals, at some degree, should be getting this, that same kind of education that involves a counseling slash, mental health type of work? because, because you are, when you're dealing with people, you're dealing with people and you need to be able to. You need to be able to have an education and expertise in listening as much as you do in speaking. How do?

Speaker 2:

you teach that to some? how do you? and this does not go. I want. I want to say this that not every doctor is bad, not, and and not even bad, like bad is a bad is a bad word, like I don't want to use bad. Not every doctor comes at you with, with, like this type of emotions, but but mark what I, what I, what I think, the, the and I said this with.

Speaker 2:

What the underlining issue is is Is we're not, we're not coming at each other as human beings. We're coming at each other from a place of authority and We're coming from a place of not mutual respect. Regardless, if you have more education than me, you still need to respect me as a human being. You, regardless if you think that I'm non-compliant So I hate that freaking term regardless, if you think I'm non-compliant or I'm not following your specific policy rules, you still should respect me as a human being and not be little me when I'm having a difficult time. That's the problem, and that doesn't just go for the medical system. That goes for every industry across our freaking planet earth. That we, and across all of humanity, we don't come at each other with mutual respect. We come at each other with authority and if I have more authority of you, if I think I'm better than you, you're under my bootstrap. That's it.

Speaker 1:

I'm gonna say to That this is why it's also so important that you're doing what you do, because So my it's my mom. My mother will always say that if I'll make a post on my Instagram and she'll say you know, you didn't tell me about that, you didn't tell me about that. And yeah, funny, because I know that she'll listen she listened to the first episode and, and You know, very similar Reaction was.

Speaker 1:

You know, i'm so happy that I listened to it because I learned you know a thousand things Well yeah she asked me how I put one today and I told her fine, because I don't want to talk about it again and, to be honest with you too, it's hard In my and I said this on the first episode every person in my family has been nothing but unbelievably supportive.

Speaker 2:

But I didn't.

Speaker 1:

I even say this, my wife is that you don't really get it unless you're experiencing it, and that's why I think it's so important that two people can have a conversation to try The very best that they can to shed some light on what it's really like And what the experiences are for people who deal with it 24 hours, seven days a week. You know, 365 days a year, a doctor, unless you're dealing with it for all that, time doesn't really, and I Agree with what you said a thousand percent. I know I do not want to cough of saying I'm anti And I hope I didn't give that impression today, but But if you're not, if you're being closed off and you're not listening, then You're missing the most important data, the most influential data in the equation, which is the human being yeah.

Speaker 2:

Not, not the data that's in front of you. The data in front of you is painting a picture. It's a very small picture. It doesn't tell the story. Only the human being can tell the story, not that, not the data. The data doesn't tell me the story, and it's the same concept when we look at a CGM data. Right, i look at a CGM data. I can see my data throughout 24, seven of the whole entire day. I can look at trends and have all these data points. That is only a picture. It does not tell my story, and This is my problem with with the world Not just with the medical community, but the world because we want to.

Speaker 2:

We want to put Blanket statements based off of our own personal bias on a situation or scenario, and I I Don't believe in that, because we're all unique individuals with different things that are happening every single day. Right, someone walked down the street today and Could have got run over by a car. Someone walked down the street and their husband died. A Poor mom is taking care of three kids and their husband gets shot. What, whatever it is?

Speaker 2:

So many bad things could happen at any point in any time, and to sit there and say like oh, this person's being a dick. Well, you know what? there might be a reason why they're being a dick and you need to respect that Right. And even in this situation, in this scenario, that person was being a dick. It shouldn't have happened. But was that person having a bad day? Or was that person just thinking of you as all kinds of other people that walk into her office And aren't using the algorithm the right way and are also having trouble with it because they don't understand? They haven't figured out what works for them right?

Speaker 1:

So many things could be happening in that situation and I think I think There's, so I there's so many things, different things, that what I feel, like that I really want to have a actual and I'm saying this on your show, but, but I'm saying this also to you that, like I, there's so many different things that I really actually want to have a conversation with you about, because I want to have a conversation about the Human, that the human factor in diabetes management. I want to have a conversation with you about. You know what is? what is the role of government? Like, the whole purpose of government is to help the people who live in your country survive and thrive and Survive and thrive, i get. The role of government is to is to make Everybody be the best version of themselves, you know, and to just give those basic human needs. Okay, so then, the negative thing I want to talk to you about, too, is Specialized health care. You know I'm in the education field, and so my job is to do everything that I can, whether it's sometimes through individualized education plans, in other words, special education. They give the kids what they need to be successful, because I feel education is a basic human right.

Speaker 1:

Well, i think medicine is a basic human right, so should should Patience be considered in the same way that students are. That just the should, that you can't. You know, i don't If, if a curriculum is a if curriculum would be, would would be compared to the same thing. Yeah, my wife is saying one size fits all. So curriculum Isn't just you don't just give it to kids, you have to instruct and deliver it. I, i just don't take insulin and just here's insulin. Everybody. You have to instruct and deliver insulin.

Speaker 2:

But I think they are but I think they are instructing and delivering insulin. They're just going about it and different and the way that I believe me in a personal level is Is is the wrong way. Right, because you think about when you go it, go into to see your endo. You're there for five minutes.

Speaker 2:

Yeah you don't. You don't form a big route, you don't form a relationship with that person until maybe after the 10th or 12th or 13th appointment with them. That's the first thing. And then then, on top of that, that they're all they're doing is trying to change your medication. They're not trying to peel back the onions. Are you getting enough sleep? Are you exercising? Are you hydrating? What are you doing for exercise? It? all of these, these trends are telling me that you're going low here, here and here. What's going on there? Let's talk about it. Yeah, they're not diving into that last time Making them.

Speaker 1:

Yeah, that's last time I saw you. I remember that you said this and You know, maybe it's more than just Well, what, what, what you're saying? you know because I, because I know that about you, yeah, and are you telling me everything? because what I know about you is that sometimes you hold back. So are you telling me, oh, maybe you did miss something. Oh, okay, maybe that is the something that could be the difference.

Speaker 1:

Yeah, and I can get and I can get that out of you because you trust me. Yeah, why do you trust me? because I respect you and have a rapport, because it's a have a relationship.

Speaker 2:

Yeah, you have a relationship and you have a mutual respect, even though you have authority over me. I have a mutual respect for you because when I ask you a question, you're not giving me bs and when I ask you a question, you're giving me your honest thought processes. I'll tell you what, like I I am. I am like on point with my endo. Like I grill him like crazy. I make him stay in there with me for 10 to 15 minutes because I'm asking so many freaking questions About things that I've seen on social media. I saw this the other day. I was like wondering what you thought about this. Like I asked him. The last time I saw him I was like researching or like looking at because it's popped up my feed so many times a fresa, which I just did an episode with Ginger Yeah, what two weeks ago and she took he strictly takes a fresa, you do know her.

Speaker 1:

Yeah.

Speaker 2:

Yeah, she's great, she's.

Speaker 1:

I'm only saying that, because I'm saying she's great, yeah, she's amazing, yeah.

Speaker 2:

But I was asking him about about it and he was like, honestly, i can't really give you my opinion because I don't know much about it. That's the type of doctor I want. I don't want to type a doctor that's only going to push his agenda. I don't want to type a doctor that's only going to push his thought process. I want to talk to doctor That's going to be saying, like, in my experience, this is what I think, but but that's what I think And I trust that you're going to make the decision and we're going to make the decision together. What's going to be best for you. That's the type of conversation that I have with my endo, and I would not be with him If I wasn't having those types of conversations, if he wasn't open to those conversations. And I'll and I will tell you.

Speaker 1:

This, too, is the fact, or the fact that I've had to find, i fact, the fact that I still feel as though I'm trying to find, that I'm, though that You'll find them.

Speaker 2:

No, him or her, you'll find them eventually.

Speaker 1:

No, but what it makes me feel is that it's me. It's like dating. I'm thinking I'm dating Dude, it's not, you Don't, it's not you.

Speaker 2:

It's not that anymore. It's me, it's not you, though It's both of you.

Speaker 2:

Yeah yeah, it's not you, it's both of you, because you both haven't figured out how to communicate together, whether that's you bringing it to his attention and then him responding in a in a positive and respectful way, or whether it's him trying to ask you a question and you're not responding to him, because it goes both ways. It takes two to tango here. That's how you find the endo that that works for you and you're not gonna find, you're not gonna understand that when you first start with someone. I think I've seen my endo now five times and I'm finally And and I only see him every over- how over?

Speaker 1:

how long is that? How long is the time span? five times over the course of.

Speaker 2:

It's probably been close to almost a year now.

Speaker 1:

See, that's a lot, that's good.

Speaker 2:

It is a lot and it is man. It is it's a lot and that's great. You can speak. You could speed up the process by asking more questions.

Speaker 1:

And you've seen your. you've seen your endo, your specific endocrinologist, four or five times, five times What's? where do you live?

Speaker 2:

again In Columbus, ohio. You're in Ohio, okay, right, so, but I'm gonna preface this.

Speaker 1:

Maybe it was only four, if I only four, so I'm supposed to go, i'm supposed to go into my office twice a year. It's an, it's an understanding That if I'm lucky it, within those two Appointments, i might, i might see my endo once. Yeah, i'm definitely not gonna see him both of those times. I've like, definitely not. Yeah, maybe if I'm lucky, if I'm, if he's generous, yeah, so, but here's.

Speaker 2:

Here's what I think is happening, because this has happened to me at OSU Depending on where you're going, if you're going to an actual hospital, especially a public hospital or private hospital, they don't have time to see you like that, like they're not gonna, like they can't get in to you, can't get in to see them. So you're gonna see the MP or you're gonna see the nurse practitioner, yeah, and I will also preface sometimes that's a better choice, because there's their.

Speaker 2:

Their schedule is so strict. But, right, if I don't need to talk to them, if I don't have a specific question for That person from when I this is from when I was at OSU if I don't have a specific question for them, i don't want to see them because they're not going to help me in the way I need to help, because they're trying to get out the door and they're trying to hurry me up. Yeah, i want to see the person that's gonna sit there for 10, 15, 20 minutes and answer my questions, right, and that's why I love the guy that I'm with, because he's with Ohio Health. He's like he's also brand new, like he's three years into his practice, which is perfect for me because I can educate him, which he's very grateful for, because I'm educating him on different things that I'm reading about and then bringing It's his attention and then he's going back and reading it if he doesn't know what's going on, right, so it's a give-and-take thing and that's what it. That's what the relationship should be.

Speaker 2:

Is a give-and-take? Not? hey, i'm showing up. Oh, my blood sugars have been high. I've had some sticky blood sugars, maybe a little bit of low blood sugars. I don't know what's going on? Okay, let me just change your insulin insulin dosages. I guess sometimes that might be the that the answer, but a lot of times it's not.

Speaker 1:

Just not and I've never really looked at, i've never looked at. Yeah, that parallel again between you know, education or education in medicine, or It's a fascinating thing we can. What I was going to say was hold on what I was going to say Sorry item was that as a teacher, i learned from my students every single day. Yeah, i've never made that parallel with doctors or meta or medical professionals of how much you might learn from your patients I've never thought about.

Speaker 2:

I've never thought about it that way, because most of them Thank you for highly don't live with that. I appreciate that Most of them don't live with the disease. So the more they can learn about the day-to-day is only more power for them, because they can start learning how to Educate and talk to their patients from that perspective. And that's what I talked to my endo about. I'm saying, hey, like doc, you're telling me this, but it's not really like that. It's like this over here, from when you actually live with it, this is how it really is. And he's like, okay, tell me about that. Like what is it? what happens, what goes on? and like then we're having a real conversation. That's cool. And and that's that's what I wanted from my previous endo.

Speaker 2:

I loved my previous endo from OSU. I loved her so much. She was amazing. But she was super book smart, right, she does a lot of research, like she's one of the top endos in the country. Like it was cool. It was cool to have like Conversations with her, but but I was never able to have like deep, deep conversations with her because she was in and out, because she had to get to the next person.

Speaker 1:

Right and I was all.

Speaker 2:

It's not your fault like I respect that of her, i respect that of the policy, of what's going on, like I didn't really need to see her but you know it's a bigger.

Speaker 1:

It's a bigger issue.

Speaker 2:

Yeah, it's. It's what I was in that situation.

Speaker 1:

It was a bigger. It was a bigger thing, it was a bigger it was.

Speaker 2:

It was a. It was more of an issue on the other front of like. She only saw patients Like three days out of the week because she was doing surgeries and and and, i believe, doing a lot of research on the other two days Like. So she, her time was valuable and like she, she doesn't have time. Now this new endo and the reason I say I've seen him four times in the past I think it's been a year, maybe it's even been earlier than that, it's only been eight, seven or eight months, but it's because when we first started he needs to understand me and what I'm doing, so he wanted to see me more often. So we did like three or four times of like four month increments. Sometimes there's three months because I needed to come in for a prescription or something like that right.

Speaker 2:

Now we're at six months. Right now, i'm only seeing him twice a week, twice a year, which is fine, because I only I don't need to see him that often. You were dying, but it was you were diagnosed?

Speaker 1:

How long ago again It?

Speaker 2:

was at 20 at 2007 I was 25, right, yeah, so it's.

Speaker 1:

So, even so, even though you've been, i just think it's, i think it's great that you have been able to find, find a Situation which you can have, somebody so readily accessible, and I think it's great and it gets awesome And I found him from a referral from another colleague. Yeah, that's how I found him.

Speaker 2:

It would have taken me five months to get to see him, but she pushed it along and because I know her, he saw me. In what two months? I do hope.

Speaker 1:

I do hope to hold myself Accountable. through on my page, i want to try to highlight The differences that I see when I'm going from state to state, not even, not even to necessarily bash one state or to promote another, but I think that we ask each other this stuff all the time because of the healthcare and across state lines It's so different when you, when you move. Yeah, i do want to hope, like I hope I can And I'll share enough, share some with you too, but yeah, man, this was great.

Speaker 2:

I appreciate your time, as always no, i, i would.

Speaker 1:

I think that I Think that it's really great to have an opportunity to be able to talk to somebody who gets it, and I again, that's why I, why I'd say thank you, because you know I don't have the work, i don't have the expertise in what you're doing to be able to share that with other people, and It's a different medium to be able to have a voice and to be able to, yeah, have something that people can listen to, and so it's great that the show that you do is fantastic And that's why I'm just yeah, i think the opportunity to be able to come on and just speak, thank you, develop that relationship with somebody.

Speaker 2:

Yeah, i feel the same way, man, and I'm gonna say this to you You, because you need a pat on your back, because I watch what you are constantly posting. You talk about a voice. You have a voice. You'll hundred percent have a voice. People are watching you, people follow you, people interacting with you. So you do have a voice. I just a different voice, right, and and it's a very powerful voice. So Man pops to you. I appreciate that. Thank you, yeah, yeah, absolutely All right, man, until next time, you know.

Speaker 2:

I think Everyone. I think mark is gonna be a regular guest, maybe once a month, once every couple months, like, and we're just gonna dive into stuff. Man, he just threw like five different topics at me earlier, so now, yeah, now I got to get on them all like five more times to talk about specific stuff. Man All right.

Speaker 1:

so I'm gonna plan something great So wait.

Speaker 2:

All right, mark. Thank you so much. This is, but this was great. Everyone is listening. Thank you for joining us. This is gonna be a long episode. Probably you're listening to him. Sure, it's an hour in. I haven't edited it yet, so it looks like at the end. But thanks everybody for listening. Mark, thank you. Keep pushing your your message to on social, so yeah, It's a pal for me Yeah yeah, my pleasure, man, thank you.

Speaker 2:

Thank you everyone for listening. I hope you took away some really good points out of this conversation. You have to advocate for yourself because no one else will, and if you're part of our medical team, i just implore you to ask more questions and come at us with more empathy, kindness and and compassion, because we're coming from a place of fear. We're coming from a place of loneliness. Some of us are coming from a place of depression and denial, and just because we're maybe not engaged with what you're saying or it takes us a long time to Understand Diabetes on a deep level, doesn't mean we're non-compliant, doesn't mean that we don't care. It just means we need more education and support. That's it. We need more education and support To be able to identify what is going to work for us.

Speaker 2:

If this episode resonated with you, i encourage you to share it with someone living with diabetes. Or maybe it's a caregiver or a parent of Someone living with diabetes. I encourage you to share this episode in this podcast with them. I know that diabetes is a very lonely disease, especially if you don't have a strong support system, so please Share this episode and share this podcast with someone that you know, living with diabetes. And then, last thing, please remember to like, subscribe and leave a five star review on whatever podcast platform that you are listening to the show on. Thank you so much for listening. I'll see everybody next time.

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