Talking about Women's Health and Diabetes

Featured on the Episode:

Jennifer Smith RD, LD, CDCES
Director of Lifestyle and Nutrition
Registered Dietitian, Certified Diabetes Care and Education Specialist
Integrated Diabetes Services

Jennifer Smith, RD, LD, CDCES, Director of Lifestyle and Nutrition, has lived with diabetes since childhood and has first-hand knowledge of diabetes management. She is passionate about achieving healthy nutrition and fitness goals while living with diabetes and in teaching others with diabetes to reach their goals. In 2009 she completed her first 70.3 triathlon, which brought a deeper understanding of athletic training requirements and the importance of nutrition to realize athletic goals. Women's health education is important to her and she works extensively with women to assist them in navigating the ins and outs of managing diabetes before, during and after pregnancy. 

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin-Green Bay. She is a Registered (and Licensed) Dietitian, Certified Diabetes Care and Education Specialist, and is an active member of the American Diabetes Association and the Association of Diabetes Care and Education Specialists. She is a contributing author for DiabetesSisters and Diabetes Daily and a contributor to the Juicebox podcasts.

Resources from this Episode

Co-Author: Pregnancy with Type 1 Diabetes: Your Month to Month guide to Blood Sugar Management

https://www.amazon.com/Pregnancy-Type-Diabetes-Month-Month/dp/1544267347/ref=sr_1_4?s=books&ie=UTF8&qid=1490135930&sr=1-4

Podcast: https://www.juiceboxpodcast.com/diabetesprotip

Thinking Like A Pancreas Blog - integrateddiabetes.com/blog/

Facebook:  Integrated Diabetes Services
Twitter: @Integ_Diabetes
www.integrateddiabetes.com

Transcript

0:24

Hello and welcome to Embracing Diabetes, a podcast that explores the many ways people are thriving with diabetes in the world. I'm your co-host, Dr. Liz Stevens, and today, Amy and I had a chance to talk to Jennifer Smith. Jenny is the Director of Lifestyle and Nutrition at Integrated Diabetes and also works as a registered dietician. Cde E and pump trainer with a focus on women's health. During our conversation, we heard about Jenny's journey with her diabetes diagnosis at age 13, how she found her home and nutrition and health, and learned about her role with integrated diabetes. I hope you enjoy our conversation. Jenny, thank you so much for making time to, talk to us on embracing diabetes. We've been really looking forward to this conversation. Of course I have too. I know we've rescheduled a couple of times. I know. I'm glad it all worked out. it's complicated with all these different time zones. we always start our conversations off with, A little bit of background, your diagnosis story, as much as you feel comfortable sharing. It's just, it's really interesting to see how different everyone's stories are and then how much we all have in common. So if you're comfortable sharing, we'd love to hear about it. Absolutely. So I was diagnosed 35 years ago. It was actually 35 years on May 15th this year. So a long time. I've seen many sort of adjustments in diabetes management over the years. Not as many as some people who just started out on sharpening their own syringes and peeing in a cup. But I've seen lots, right? and when I was diagnosed, I was. 13. So I wasn't a kid, but I was still very much, under the assistive management of my parents. I was diagnosed the weekend of a dance recital. Which was not cool for me. I had rehearsed all day on Friday evening, or all evening on Friday evening, and then all day on Saturday for the Sunday. three shows that we did through the course of the day, and I just. I could not drink enough water. that's, you hear that from from everybody who is at that point of d k A. Absolutely. I was at that point and when I learned more about, once I had the diagnosis, when I learned more about symptoms and all that kind of stuff, it had been a couple of weeks that I had been asking my friends at school for, their milk. Right at li like everybody get an extra milk because Jenny's thirsty. and in between my classes I would stop at the bubbler or the water fountain, we call it the bubbler here in the Midwest. go a water fountain, right? And then I would run to the bathroom in between. like that early teenage year, you don't really think to mention that to your parents. Hey mom, I'm going to the bathroom all the time and I'm really super thirsty. my parents just in a visual way, thought that I was growing taller. Because I was losing weight. But as with kids and everything, you live with them and so you don't really see the considerable change. Because they're in front of you every second of the day. but yeah, I had all the classic symptoms up to that weekend, so practice, drinking tons of water. I couldn't like the big. As a visual of how much, like the big Slurpee cup, like those, whatever ounce they are, I could chug that in 10 minutes and then do dance and then chug another one. Isn't it amazing like how that those specific memories stick with you and Yes, and I remember too standing. Waking up in the middle of the night because I had been dreaming about water, about needing water and going into the hallway bathroom and just like turning on the, handle the sink. The sink, and like putting my head under the sink and drinking and just, and it didn't make a difference. You just, it was. I'll never forget that feeling. And at that time there weren't like, like everybody carries a water bottle today. And being a dancer, I mean we always had some hydration, but specifically in our rehearsals, we had like small cups that we could get at like concession and we would just go back and they would fill them for us. And I remember distinctly telling the guy, I was like, the small cup isn't gonna work. You have to gimme the gallon cup, like the biggest cup, and you need to fill it. I didn't even want ice. I just wanted the water. That's all I wanted. so then Sunday morning comes and I felt so horrible. I. I could barely stand. I was so dizzy and my mom thought, maybe she's just really hungry. I tried to eat breakfast. It all came back out. I, she, at that point she was like, clearly you're not going to your dance recital. She called the pediatrician. He was like, you need to bring your to the emergency department. And from there it's it's interesting because I vaguely remember the drive to the hospital, but I was. So high, so high blood sugar wise, and definitely in d k a, that it was a, like a dreamy kind of memory of that. I remember coming into the emergency department and sitting in the room where my mom would, I, my mom had taken me, my dad stayed home with my brother, my younger brother. and she was doing all the paperwork, like in the admitting area and they hadn't even checked me in yet. Cause all the paperwork had to be done. I remember sitting in the chair thinking when I was so tired. Yeah. so tired. I could barely keep myself up. And I was like, when is somebody gonna check me out? I was just like, really? I, somebody needs to help me because I feel. Horrid, right? Yeah. he had to, pee in a cup and then, in the room with the doctor, he, I remember telling my mom, we have a diagnosis. She has diabetes. It wasn't a defined type one, which at that point would've been called juvenile diabetes. it was just, your daughter has diabetes. And my first question to my mom was, Does this mean I'm going to look like grandma? Wow. Because my grandmother, my mom's mom had type two diabetes Oh. And was on insulin, so at least I had a visual of injections and that kinda stuff. I never, I don't remember whether my grandmother also had oral meds. I'm quite sure she did, but I always remember grandma taking insulin injections at the dinner table. Wow. So I asked my mom and my grandmother was a very large woman, like not only tall, she was like probably 5 9, 5, 10 ish. But she was also a very big boned and a very big woman. And that's I, that was my first. Grandma has diabetes, I'm clearly going to look like grandma. Yeah. And that like in the 13 year old brain, I don't know where I pieced that together in the confusion of my 865 blood sugar. is that's really what it was. That's really what it was. Wow. Yes, it was. extremely high. And that's really high. Yeah. Yes. For someone, yeah. As soon as they got the IV fluids hooked up, she said, I visit visually could watch your skin pull away from the bones on your face. She's I could see you getting hydrated. And she said, she felt so bad. She's I should have seen this, like I should have seen. And she just kept saying, I thought she was just getting taller. Yeah. Growing, my mom has some pictures that she took of the rehearsal and my recital, like costumes were like hanging on me. Yeah. I look like a skeleton. Oh, I wish I had pictures. it's a terrible thing to say, but just for that frame of reference, cuz I, yeah. Yeah, I was diagnosed in, 80 19 85, and so that, okay. Didn't have many pi We didn't have many pictures back then. Yeah. So you had to get'em developed. Yeah. Yeah, exactly. Yes. Yeah. Yes. Yeah. I was 88, so it was three years after you. Yeah. Yeah. And you had that your mom was taking pictures for the recital. Yeah. Correct. Exactly. Otherwise, I'm quite sure she would've never taken a picture of me like in the hospital, like, why would you do that? Yeah. but yeah, I mean I spent, and I don't know how long you spent in the hospital, but I was in the hospital for a week. I was diagnosed on a Sunday, and I didn't get to go home until it was almost a week, Friday evening of the end of that week. Then, and. I remember my hospital stay being fine outside of. I hated the nurses coming in at two o'clock in the morning. Ugh. Yes. Like I was just, let me sleep please. I'm tired. and not only is like the light from the nurses' station shining into my bedroom, even though the door was, I was like, can you just leave me alone? I promise I'm fine. And they're, and pricking your finger too, and, right? Yeah. Yes. and then for the first couple of days, they had to measure my urine output. So I couldn't just go to the bathroom in the toilet. I had to ring the bell and I had to tell them, Hey, I have to go to the bathroom. And they'd bring those little like things that you have to put like in the toilet so you can pee and they can measure it. Oh my God. Like all these things that you remember That are just a piece of that whole experience really. I had a lot of really good friends, which I think to, to whatever degree in this day and age, there's a lot of technology. I. There was not, when we were diagnosed at all, thankfully there were blood glucose monitors, but I had a lot of really good friends who it was the very end of the school year. And so my friend's parents would bring them in after school to visit me. That's great. it was, I was never just there in the afternoon by myself. Either my mom would come, my dad would come, or my friends were there and my friends were very, they weren't scared Yeah. Of what was going on. several of my friends actually asked if there if the nurse could. do their own finger stick. They were like, oh, let's try it. Jenny can do it. Why can't we do it? yeah. which would again, was like, it was like a good assistive, it was like a handholding that, if they're willing to do it, clearly I can keep doing this. And I know I've had a lot of parents who've emailed me and asked, my kid has asked, when is this gonna be done? Like, when am I not gonna have to do this anymore? And as I think maybe it was just an age frame of understanding when I was diagnosed comparative to littler kids, but it wasn't a question that I ever asked. I wasn't at the point of thinking, I just have to do this for this long. Yeah. And then it'll be okay. so yeah, I, I went home and I guess life just, Moved on. my family just adapted. My parents did an awesome job of not making things different just because of me. the, my mom probably, she's a saver. She saved everything. I'm quite sure she probably still has the scale that she measured. All of my food and weighed all of my protein sources. She's probably still got it in the cupboard. Some of these, isn't it crazy? Those old tools, I saved my, I have, I saved like these old journals, handwritten, where I would write down what time it was, what my blood sugar was, how much insulin I gave some. Sometimes I would write what I was eating. Sometimes I would write what I was, what kind of exercise? I mean like these detailed Yes. Detailed journals. Cuz otherwise you'd go to the doctor and you're you. That's and they had nothing give them, right? Yeah, absolutely. And my mom, I mean my mom probably until, I would say probably until I was at the end of high school. Kept as detailed of a journal in the ring bound, like Lined bind, binders. She kept all of that. Yeah. Yeah. She noted all the medication doses and all of that kind of stuff. And I just, that's my personality is just follow the directions. I also learn better, like visually and so I. I just followed suit, I just kept up with it. When I dosed my own insulin, I just told my mom, in the evening or whatever, and I didn't really change very much else. I was On the cheering team, I played volleyball, I still went, I, my, I'm amazed. My parents sent me to Girl Scout Sleepaway Camp for two weeks. About two months after I was diagnosed. Wow. Wow. they were just, I came back with food poisoning, which was very exciting and my mom was not very happy about that. but I didn't die at camp. yeah. So my dad, oh, sorry. Go ahead. I'm interrupting. Have you ever talked to her about that time and what that experience was like for her? cause that been so scary for Yeah. it was scary. But that's not, I guess the way that my mom and dad both were, and maybe this is just a generational part of the way that they lived was you have something, you deal with it and you move on. you, you don't, cry about it and you don't, you just move on and you deal with what you need to do and you keep going from there. And that's just, that's my mom's personality. And so when I've asked her about it, her, I guess her comment is just We just did what we needed to do. Because that's what was gonna keep you alive. and she doesn't really have a fair amount of, she doesn't have a lot of emotion to it. and I think that was a very good thing as I was. Growing and watching and learning is the ability to take emotion out of the navigation and it's something that has to be done. I do it and I just keep moving and then I can do the fun and the enjoyable and what I need to do in my day. Yes, I have to stop for these tasks, but that's it. so the one thing I can remember her being. Somewhat emotional about, and it was a side conversation I heard her having with my dad. My mom was a, a school teacher and one of the teachers she worked with, they were discussing my diagnosis and my, my juvenile diabetes. And her teacher colleague had said, at least she will grow out of it. And the conversation then that I heard my mom having my, with my dad, she was like, I just don't, she's I don't understand. She's an educated person. She's I don't understand how people just don't un they don't get this, that this is not a, it's going to go away, kind of thing. And there was an emotion, but that's again something I can remember. Outside of that, there wasn't a lot of I'm so upset about this, or I. There, there just wasn't, that wasn't part of how I grew up with it. So I think that's probably, I try to reflect back on, just the, just as a parent, the I'm sure there's so much undercurrent that was there, cause I'm sure you cannot even imagine, but what, what a remarkable thing that she didn't. Share that with you and make that burdensome for you too. Cause I do see that sometimes in kids of parents who just didn't have that capacity and it makes for a very complicated relationship with their disease. in terms of victim and, anger and, just stuff that Yeah, you wish that they'd had maybe better support when they were little. But it sounds like, yeah, it sounds like, Ever since the get go, you were fortunate enough even with people who didn't have diabetes, to have this community around you of support, including your parents and your friends. And then, so interesting looking through your bio, Jenny, how you then went on to just do all this diabetes related nutrition. or just nutrition and then wove it all into your careers. Yeah. And then, yeah, and then got connected with integrated diabetes. So tell us a little bit about how you decided on that path. yeah, that's a good question. I, I spoke a bit about my mom. My mom was a cook. We didn't eat a lot of food out of the house. It was a rare occasion that we did something like that. So I grew up with, Parents who cooked, even my dad, if my mom was late with like parent teacher conferences or whatever, my dad would do the cooking. So it wasn't like, this is the day to go to McDonald's because mom isn't home to do the cooking. my dad was also the one who really was. The sports kind of person and kept me very active. really encouraged cycling, or bike riding from a really early age with both myself and my brother. And that's not something that changed when I was diagnosed. If anything, it was encouraged even more to keep it in the picture, and thankfully my pediatrician really encouraged that as well. Knew enough about. Type one diabetes to say this can be a huge benefit. So keep it in the picture. Don't change very much. so originally I wanted to do, I wanted to be a veterinarian, So I did not wanna go the route that I did with people. I totally wanted to be a veterinarian. I had worked, we lived not far from our veterinarian. We had cats when I was growing up. and in the summer I had done a couple summers of volunteer work with the pets that were there. and that was the route. But then by the time I got to about, like junior year-ish in high school, I. I really liked both my diabetes educator, as well as the dietician educator that I worked with on my team. And they were a very good visual to me of just the overall well wellness that you can put into your life. Along with something like diabetes in the picture, if you really pay attention to what you're putting in your body and what you're doing with your body, and so my, I guess my. Focus changed a bit and I got really interested in paying attention to like, how my mom was putting meals together and how she was cooking and what the dietician was teaching me about the macronutrients and why it was important for all of that. and what role it played. Even like I said before, at that time, technology was nothing. sure I could have done finger sticks. I. 50 times a day to get enough data points to put together. But I think at that point I was probably doing six to maybe eight finger sticks a day. Only because my mom asked the doctor to write a script for more than what was initially prescribed. but that's how I moved into the path of going to school for human nutrition. With the full intention then of moving into life as a registered dietician and then moving further as a diabetes educator. I really just, I can't give enough credit to the educators that I had because I think if they had been very different for me, I maybe I wouldn't have had the interest that I had. so yeah, that's how I moved into that route. That's wonderful. And then, and now you work at Integrated Diabetes and you've been there for a long time. I, yes. I was actually just thinking about that the other day. How long I, because I feel like it's still where I wanted to get to and that it's very like, gosh, I haven't been here for very long. And then I look at the amount of time that I have been working with Gary at Integrated, and it's been a long time. I've been there since 2011. and I initially, so my career, if you know how it proceeds, you have to, in order to be a diabetes educator, you have to collect enough hours, you have to sit a really long exam in order to be certified, you have to have a credential such as a nurse or a dietician or something like that, right? so I did all of the nutritions. Stuff. I started out as a clinical dietician. I worked as an I C U dietician. I taught diabetes classes for those with type two diabetes, accumulating all the hours I needed to sit the exam. And then once I passed, then I took on a role at another hospital with an endocrine, group who was. Sort of really fantastic for moving my understanding of diabetes and management up yet another level. And it was that work with that group where the endocrine doctors who worked with the diabetes, clients, they really used the educators on their team, of which there were four of us as right hands, They looked at us as if we had the knowledge that they had, we could. Make recommendations for medication changes or additions or adjustments to insulin and doses and pump changes and everything. And all they did was write off our recommendations because they trusted us. They knew. And eventually I got to the point of being really the educator who got all the people with type one diabetes and then all the people who were using the technology cuz it was really starting to come. Really increased in use and benefit of those products at that point. and then we left that area of the country that was the east coast in the DC area. and then we moved here, to Wisconsin where the use of educators is a little bit different. Yeah. So state, it's so state driven. Yeah. And I think it's not only state driven or area driven, but it's also, It's how they see your credentials in a different way. Totally. Yeah. Culture. Culture for sure. Absolutely. So I took a job. I was, I Downs stepped really as we moved and I knew I was going to do it with the expectation that I. My end goal was really to have my own business. I was stepping down into position when we moved here, as a dietician, and then I reverted back to teaching type two diabetes classes, which was very Ben, that, that was like a highlight of what I was doing when I worked at the clinic that I was at. but again, I couldn't use what I had been doing. In DC because they didn't see my knowledge base that way, and they're, they were not going to, that is, that's not how an RD C D c e S is viewed or used here. so I connected with a mentor that I had out on the East coast and she connected me with Gary She's Hey, I've got this really good. She's I know you've probably heard of him and read his book. think like a pancreas. She's he's looking for another educator. She's majority of his business is remote anyway, so I don't know why it would matter whether you're in the office or not. I had a really great conversation with Gary and we just, we really connected, we really clicked in the way that we work with people. so I started doing consulting for integrated diabetes in 2011 and kept my clinic job. So I was doing kind of two jobs i d s in the evening hours around the weekend. And then I was doing normal clinic stuff in typical work hours. and then it was about, and then I had a child, my first little boy, it was about nine months old when I, when Gary offered me a full-time position then with integrated. And so then I quit the clinic that I was working at and I started working for integrated full-time. yeah. And so just for people who, sorry, Liz, for people who don't know listening, give a overview of what integrated diagnosis That was gonna be my question. Okay. Oh, that's, the great question because yeah, like how do you sign up? How does it, like how does the whole thing work? Yeah. It's always been this kind of, You guys have been out there way ahead of the curve with, virtual and visits Yeah. Gary has absolutely. he, in his schooling and then his diagnosis as an adult with type one, he really found that education was, it was lacking, And it was lacking to a point that he thought and definitely knew that he could build something that would be better. That was more. Truly need education versus just checking off the boxes of, yes, I've taught carb counting. Yes, I've taught how to inject the insulin, or how to take the medication, or, the baseline of education, it doesn't go the distance for somebody who lives this 24 7. And that was his goal of really reaching people and working with people at the level that they need to in order to. Take their diabetes management where it needed to go for improvement and achieving better outcome. so integrated diabetes, Gary, God, it's more than 25 years, if I remember correctly. Gary, has had his business. he's done a phenomenal job of growing. He's very obviously well known across the board in the whole diabetes community and industry and everything. so essentially we're. Kinda the top leader worldwide, in one-on-one, especially remote consulting for. People who want intensive diabetes management. So essentially, although we have a clinic and our clinic is based in the Philadelphia area, only Gary and our, one of our nurse educators, Alicia, actually reside and work out of the clinic. then the rest of us, which our team has grown considerably, when I started with integrated, it was just myself and Gary, and then another. Part-time nurse educator. and now we have many, we've got, A new clinician all the way out in Hawaii. We've got a nurse educator in Iowa. We've got a dietician educator down in Texas. we've got a mental health specialist. We've got another exercise physiology, educator down in Florida. So we're all over and we really work with those people who want intensive management and really want to understand. How to navigate and make adjustments the right way in a safe way. and while the majority of the people we work with have type one, we're absolutely happy and willing and able to work with those who have type two as well. so we work remotely, obviously, worldwide. I've got clients that I work with in Hong Kong, in Australia, in Europe. New Zealand, Canada. And so Jenny, can the person come to you and say, I specifically wanna talk to somebody about my, my diet, or I specifically wanna talk to you about my exercise routine or my mental health stuff. That's a great question. Yes. So we, in order to call the office, obviously it's pretty easy, just integrated diabetes.com. Our contact information is right on there. We've got two great office, administrators that'll kinda walk someone through the process of, there's paperwork, there's an assessment to fill out so that we can really get the most information ahead of a visit. And on that assessment, we absolutely encourage. Someone to put down, what's your goal? What do you want to work on? And then as a clinician, when we review it before the initial visit, essentially gives us an idea of what's their grand plan? What's their best thing, you know that they wanna work on? But where do we see we need to start? That's our job. From a clinician standpoint, we have to say, I see where you wanna get, but right now we're. Right here at this step, and you wanna get six steps up from that. So we have to start, and then we can tear up and move and. Address that along the way as their end goal. so yeah, we work, we've got weight management, I, pump management, those who are new to pump management who wanna get trained on their insulin pump. all the smart tech and devices, we don't encourage any one particular device. In fact, we really try to. Work with somebody enough that if they are choosing tech or choosing to switch between this device and that device, that we can help them find what fits them. right? So I know some clinics are very proprietary, like we're just a this type of pump clinic and we don't know much about the others. We know they're out there, but we don't really work very much with them. We are happy to work with whatever you are working with and also to give some feedback about whether or not it's. It's the best one for that person. To be able to say, Hey, I see this and I see this is your lifestyle. Yeah. We may need to think about switching this up, right? We may need to think about moving into this product, warranty time or whatever. And we help people even navigate through the questions for insurance and how to address and bring questions to their endos or their, their management team. I in particular am the clinician in the office who works with women in the preconception and the pregnancy stage. and so I do a lot of navigating with women's health because I think it's a missing component in education. Totally. we focus on, A baseline of diabetes education and that baseline doesn't meet the need between male and female. It just doesn't. there's a very big difference between hormones here and hormones there. Do you guys have somebody who also can talk to women about. Liz and I have talked about this before. This is something that there is, there are not enough resources out there about, menopause, about women with diabetes and as we are getting older, those issues, yes. Absolutely. In fact, I've got a number of women who are at that point of perimenopause. and many women actually, our age range is somewhere between about, I think our youngest is about 18 months old ish. And I think the oldest client I work with right now is in her seventies. so we span the life cycle. We certainly do, and I've worked especially with enough women through all of those stages to have, some. Some good experience with helping through that, cuz you're a hundred percent right. there's not even research, there's not enough good research, there's nothing. They're just, there's so little. Yeah. We've talked, Amy and I have talked about trying to find someone with some expertise. obviously experience is one thing, but who've studied this and it's just, there's. very little. yeah. Absolutely. Yeah. And there's very little, especially, when you narrow it from diabetes down to just type one diabetes. Oh my gosh. For sure. It even gets harder. there's almost no, there's like nothing. Yeah. Yeah. outside of the expression of, women with diabetes are more likely to start perimenopause or menopause earlier, let's define that Let's give some, what am I. What am I going to expect? Yeah. Yeah. And you look on, but you look on different menopause websites and there's pages of the different symptoms, so to be a woman with diabetes and then looking at these symptoms and it's just, it's fair. It is, it's interesting concept because, we call them symptoms, right? Yeah. And I listened to a podcast not long ago that was very, It was very eyeopening and it, Mel made me feel almost like better about explaining this time of life with women because really symptoms indicates something is wrong. If you think about that word, a symptom means something isn't going right. In fact, We are moving through a time of change. That's almost, that's the way it's supposed to happen, right? So if we look at these as like they're messages, it's information coming from our body that something is shifting and we have to be ready for the shift and we, it should be happening. It's not wrong, right? so many women wanna get through this time period in their life, but we have to take it with a little bit of. Grace and a little bit of ease and say, I'm moving from this and I'm moving into another part of life. And diabetes makes that a little bit more complex. And so as you ask, we need information about I, how to mentally prepare a woman for that change and that shift, and to accept it as this is supposed to be happening. This is, it's a rite of passage into another. Part of life. so I hate the word symptom. That's a great point. No, I love that. I'll never say that word again. That's such a great point because it is, you're a hundred percent right. So much is about the language that we use to talk about these phases of our lives, and it It exactly is supposed to happen. And instead of trying same with diabetes, instead of trying to talk about it as an other, Talking about it as this is something I'm going through, this is something I'm living with, this is a part of me. Yeah, absolutely. Yeah, and I think it's interesting too cuz I just had this thought like, when you live with a condition where you're constant I mean I'm, many people don't do this, but I'm constantly Thinking about what I'm, what's going on in my body, what do I, is that a low, high, just all these different symptoms that might be going on that give me information. Yes. I think menopause does that same, as a person that's post, it, it does give you, a lot of information in terms of physical. Kind of awareness and so there's just a lot of different information you're getting as estrogen is, kind of levels are changing. And I do think the one thing I would say is like estrogen is. A kick ass hormone. Yeah, it's no joke. It is. Yeah. That is, it is. No joke that way. It's no joke. it's really like a powerful, hormone. and you just don't really have to pay attention to that when you're like young and it's just floating around. Awesome. Yeah. When you wouldn't go on, you're like, whoa. Yeah. Yeah. And I think on a woman level in general, and then taking it deeper as a woman with diabetes, In general, I would, I expect that the majority of the population of women, with or without, has no idea of the natural flux and flow of those hormones through your cycle. And many women deci define their cycle as the menstrual. Time, right? Where they're actually having their bleeding, right? Unfortunately, that's not real. Our menstrual cycle is 30 days, and it's every 30 days we have this flow of and shift of hormones that happens. It's supposed to happen, but we are on a constant roller of a different hormone through different phases of each 30 days, and. I would imagine, unless you've gone to school for biology or unless you've done enough research because you're curious and you really wanna know, why am I feeling this way and how does it impact things and whatever. The majority of women just walk around I guess it's that time again. I think or women start to be curious about this during, when they're trying to get pregnant, you start looking Yes. At the different hormone levels and, yeah, I agree. It's just like this great unknown. It's a, it's another part of. Women's health in our Western medication world. That I just think is, just not given nearly enough attention as it Yeah, I, I myself, until my husband and I really, we always wanted to have kids. We just. We were just deciding when. And so I really, while I understood a shift to my insulin needs from a diabetes angle around my cycle, and I understood that for a fair amount of time, I myself didn't really, even though I went to school for human biology and nutrition, I didn't really remember all that cycle stuff and all the hormones and all that kinda stuff until I actually bought a book called Taking Charge of Your Ft. Fertility. It's a phenomenal book and it goes through, All, I mean it's, and it is a thick book. It's phenomenal. It gives you all this fabulous information that I think girls, teens, women, They should read it like you should understand your body. We'll definitely put that in our show notes. Say that name again? Yeah. It's taking charge of your fertility. Okay. I don't remember who the, I don't remember who. We'll find it. The author is, but yeah, we'll find it. Yeah. yeah. It's a great book. That's great. Yeah. gosh, it sounds like we may have to have you on another time to talk about just for sure your experience with the women's health stuff. Sure. Cause my goodness. Yeah. Sounds like we are always really. Curious to, to talk more about that. yeah, of course. But I do think we're kinda probably getting close to time know. Would you? Yeah. Yeah. Cause I know you've got, other things to do today, Jenny. So we always try to leave on a, on a positive note. Sure. and just hear what you're excited about, what you're looking forward to, diabetes or not. things that are going well. Yeah. Gosh, I would have to say as I talk career-wise first, I'm really, this is what I set out like to get to this point. And while it's not my business, originally I said, oh, I'd really like to have my own business. I really. This is what I wanted to be doing. I didn't want to be contained in the brick and mortar education of this is what you can teach. This is how much of it you can teach. And you can't go outside of these parameters. There's no gray area. so I'm like, I really love what I'm doing. I just, I do, I come to work and yes, it's my job, but I really love what I get to do with people. And, so I think the biggest. Thing in today's diabetes is that we have technology that is changing really rapidly, and the good thing to see is that it's changing rapidly in a way that I hope it, it gains more speed for more people with diabetes and with all types of diabetes, Type one and type two diabetes. because I think there are people within the population that sort of get. Missed. and I think the technology today, especially with coverage improving in ways. Will help, meet goals that help to keep people healthy for a much longer period. So that's what I'm really excited about is the shift in the change in technology. the ultimate hope, of course, that I think everybody with diabetes had is some type of just cure. But my true hope isn't really cure. It's just that technology gets to the point of making it less of a daily. Navigation. and as much as I've built that into my own life and I don't really feel like it's. I would really feel weird if it was taken away, right? if I didn't have to think about all the things that are just in the background, what would I do with all of my free time? What would I do? It would be like having an extra 12 hours. I'm excited about where we are and what we have and the information that we have and what we can do with it, and I'm really excited to be. Within the field to be able to help people use it well and understand it, in their, 24 7 of navigating. That's wonderful. Yeah. Cool. We are so lucky to have you out there in the community. Totally. I feel so grateful that there're, I was gonna say people like you, but I think you're unique and your energy and your Yeah. Commitment to this work. Yeah. Thank you. That means a lot. Thank you. Yeah. Jenny, thank you so much for making time to talk with us today and share. Yeah. Your stories and give us a little more up to speed on, what you're doing and all of that stuff. Course, yeah, course. Absolutely. Let me know again, I'm happy to, I'm happy to have a good conversation again, back to talk about, your, all of your athletic endeavors too. Yes. Oh yes. Yeah, absolutely. Which kinda, which they've gone down a little bit since having kids, but I still try to do a couple of different, things through the course of the year, yeah, absolutely. Awesome. Great day. Thank you so much, Jenny. Have a great day. Of course. You as well. Absolutely. It's good to see you guys. Bye. Bye. thank you for listening to this episode of embracing diabetes with your podcast hosts, Dr. Liz Stevens and myself, Amy Stockwell. With music by Noah Mortola. We hope you enjoyed the conversation and maybe felt inspired or informed or less alone or all of the above. Please follow embracing diabetes on all major podcast platforms and leave a comment question or review. Thanks again. We hope you'll come back for more.