Podcast appearances and mentions of steve adelman

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/popular-culture

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/biography

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/american-studies

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/music

In Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs (Santa Monica Press, 2022), nightclub director Steve Adelman reflects on his years working in some of the world's most popular nightclubs. In his memoir, Adelman reflects on his work in in New York City in the nightclub heyday of the late 1980s and 1990s, at the Roxy, Limelight, Tunnel, and Palladium, followed by Avalon (Boston, Hollywood, and Singapore locations), and the New Daisy Theatre in Memphis. Nocturnal Admissions is a timely, nonconventional look at one of pop culture's most outwardly glamorous, yet misunderstood industries, bringing the reader backstage into the world of nightlife at its highest level. Wearing the multiple hats of ringmaster, entrepreneur, guidance counselor, multimillion-dollar dealmaker, and music soothsayer, Adelman chronicles an improbable journey from small town to big city, filled with a cast of characters he could never have imagined: People named Hedda Lettuce, Jenetalia, Maxi Min, Jiggy, who collide with and around the likes of Jack Nicholson, Bruce Willis, Sir Richard Branson, Leonardo DiCaprio, RuPaul, Rudy Giuliani, and Snoop Dogg, among many, many others. Navigating city crackdowns, crazed partners, and cultural differences, Adelman relates how he watched his Nana out-dance an ex-NFL lineman, was chastised by Bob Dylan, launched the EDM musical movement, helped created the "mash up" with Perry Farrell, butted heads with Jerry Falwell, rang in the New Year with Matt Damon's mother, leveraged porn star Jenna Jameson, relied on advice from felons, almost pancaked Prince, and built the world's most lavish nightclub. Nocturnal Admissions is a hilarious, adrenaline-filled ride through the peak decades of the world's most famous nightclubs and nightlife scenes. Rebekah Buchanan is a Professor of English and Director of English Education at Western Illinois University. Her research focuses on feminism, activism, and literacy practices in youth culture, specifically through zines and music. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/performing-arts

Is taking an “at all costs” approach to our jobs something to be applauded? In this episode of The Event Safety Podcast, Steve Adelman swings by to join Danielle for a conversation about a concerning story making the rounds on social media. They discuss why show stop calls should not be limited to crowd-related incidents, the balance between individual choice and leadership responsibility, and how one's decision to “work through the pain” can affect everyone involved in an event.Notes:Tour Hero (Photo)

We meet with Author and NYC/LA Nightclub legend Steve Adelman about his book Nocturnal Admissions. Fun interview!

This week we have a special treat! We decided to dig deep into the stats and analytics and pick out our favorite moments from our top 10 episodes. We've had a great mix of guests over the years and have learned a lot. Enjoy! 00:00 - 00:16 Top 10 Best Podcast clips mashed up 00:17 - 00:35 Welcome to Peppershock Media's Marketing Expedition Podcast 00:36 - 05:40 No.10 - Playing In and Outside the Sandlot with Marty York 05:41 - 07:56 No.9 - Marketing Yourself through writing with Stacy Ennis 07:57 - 11:36 No.8 - Podcasting for Business 11:37 - 14:29 No.7 - Rebranding your Company and Building Community with Jenn Graham 14:30 - 19:28 No.6 - Navigating the Cryptocurrency Ecosystem with Clay Space 19:29 - 23:16 No.5 - Transforming Company Culture with Ron Price 23:17 - 26:41 No.4 - Branding Success in the Nightlife Industry with Steve Adelman 26:42 - 29:15 No.3 - Personal Branding with Genny Heikka 29:16 - 30:34 No.2 - Improve your Public Speaking with Kirsten Holmberg 30:35 - 33:28 No.1 - Why Graphic Design Matters with Peppershock Design Team 33:29 - 33:55 Thank you so much! Enjoy your Marketing Journey! 33:56 - 34:42 Join The Marketing Expedition Community today! #marketing #business #marketingdigital #digitalmarketing #branding #socialmedia #entrepreneur #socialmediamarketing #success #marketingstrategy #marketingexpeditionpodcast

PCP is taking you inside the VIP room this week! Jordan, Stacy and Nate have spent years stumbling in and out of LA's hottest bars, and they're sharing some of their best (aka messiest) experiences. Legendary nightlife impresario Steve Adelman joins to discuss his new book, ‘Nocturnal Admissions: Behind the Scenes at Tunnel, Limelight, Avalon, and Other Legendary Nightclubs'. Steve takes us DEEP behind the ropes of the wildest, most exclusive clubs from NYC to Hollywood. Cheers! 

This week, Jeff London and DJ JASON SMITH interview one of the iconic club owners in history, Steve Adelman.

In this session from the recent SoundGirls.org Virtual Conference, Signal To Noise podcast co-host Chris Leonard and Steve Adelman, vice president of the Event Safety Alliance and head of the Adelman Law Group, discuss contracts for freelancers, including everything from what defines a contract, cancellation clauses, documentation, and best practices. This is a tough topic to navigate for many; however, this conversation sheds a lot of light on what people really need to know. Our thanks to SoundGirls for allowing us to share this important information.

We're joined by Steve Adelman, Attorney at Adelman Law Group and Vice President of the Event Safety Alliance — talking about event risks (are we treating risks differently now?), legal perspectives on COVID-related "controversies" currently faced by event operators, and why Steve thinks Cardi B is an idiot.

How much is enough? You don't need to be King of Everything, says Steve Adelman, Nightlife Entrepreneur. Instead, be King of Enough and spend time developing long-term relationships. Steve has ruled the nightlife realm for 30 years, but he didn't begin his career as a nightlife entrepreneur. His career transition began as the result of a party at his apartment after he'd left a consulting job he didn't love. Success in making such a drastic career change wasn't easy, but Steve was driven by his interest in the nightlife and entertainment business. Hard work, collaboration, and learning from successes and failures eventually prepared him to direct the four largest nightclubs in New York City. From there, he has gone on to start up nightlife and concert venues in major international cities. Steve still enjoys the creativity involved in being able to conceive of an idea, plan it out, and see what works and what doesn't - night after night. He is currently working on a concept to address how people want to socialize in a post-pandemic world and writing Nocturnal Admissions, a collection of humorous essays about his 30 years as a nightlife entrepreneur, which will be published in early 2022. Steve's career advice is to slow down and pay attention to the relationships you develop during your career by staying in touch. Check out Steve's website for more information about his book and projects. **** Love Shadow (Remix Safety Guide) by rocavaco (c) copyright 2015 Licensed under a Creative Commons Noncommercial Sampling Plus license. http://dig.ccmixter.org/files/rocavaco/52156 Ft: Loveshadow

Widely recognized as the co-founder of the Avalon Nightlife brand, and with a career spanning over thirty years, Steve Adelman has earned a reputation for combining creativity and bottom-line economics into acclaimed projects worldwide. Since 1990, over eighteen million self-expression and entertainment seekers have walked through the doors of Adelman's venues. Adelman received a BA from Kalamazoo College and a MA in Economics from Boston College. His first book, Nocturnal Admissions, is a humorous, behind-the-scenes look at the Nightlife industry in five major cities and will be released later this year by Santa Monica Press. www.steveadelman.com0:00 - 2:26 Steve's Bio2:26 - 5:27 Marketing expedition essential5:27 - 6:38 Misfits Market https://www.peppershock.com/product/misfitsmarket/6:38 - 7:06 Welcome to Peppershock Media's Marketing Expedition podcast7:06 - 7:12 Welcome Steve 7:12 - 12:01 Steve's journey 12:01 - 16:26 Successful tactics 16:26 - 18:26 Customer experience 18:26 - 23:01 “Nocturnal Admissions” 23:01 - 25:11 Steve's advice 25:11 - 27:19 Helpful resources 27:19 - 29:12 Importance of location 29:12 - 30:20 Steve's next steps 30:20 - 30:54 Thank you, Steve30:54 - 31:23 How to connect with Steve https://www.steveadelman.com31:23 - 31:33 Thank you for listening31:33 - 32:09 Join https://themarketingexpedition.com/ today!Here's a $25 credit to save $10 on your first Misfits Market order. Use our link to get your credit.#nightlife #nightclub #promoting #promotion #clubpromoting #branding #marketing #advertising #brandidentity #marketingstrategy #marketingtactics #nocturnaladmissions

Steve Adelman returns to the podcast on episode 112, to give an update on live event safety. They discuss many COVID-19 related topics such as liability, rights of venues/attendees, cancelation policies, insurance, and more. Steve Adelman is head of Adelman Law Group, PLLC and Vice President of the Event Safety Alliance.  His law practice focuses on risk and safety at live events throughout North America, and he serves as an expert witness in crowd-related lawsuits.  Check out the Event Safety Podcast, your source for ideas, discussions, and news from the world of live event safety, brought to you by the Event Safety Alliance.This episode is sponsored by Audix and Allen & Heath.Please check out and support The Roadie Clinic, Their mission is simple. "We exist to empower & heal roadies and their families by providing resources & services tailored to the struggles of the touring lifestyle."Join our Mentorship Program here:https://forms.gle/ZhsJP5D6BFiBLZiX8Be sure to check out the Signal To Noise Facebook Group, & Discord Server It's a space for listeners to create to generate conversations around the people and topics covered in the podcast — we want your questions and comments! Let's build a great sound community with a place to learn, discuss, and reminisce about the “good old days.”The Signal To Noise podcast series on ProSoundWeb is hosted by Live Sound/PSW technical editor Michael Lawrence and pro audio veterans Kyle Chirnside and Chris Leonard, 

"A sad truth is this: Most everywhere, health care is a low-margin industry that lacks resources to invest in leadership development. Although our business's central, sacred function is caring for our fellow human beings, many who move up in the health care hierarchy do so without possessing the so-called 'soft skills' that facilitate one's ability to lead groups and motivate others. 'Soft skills,' a military term that arose in the 1960s, refers to the interpersonal savvy that it takes for organizational stakeholders to succeed. Soft skills are about more than the weaponry and the machinery; they're about the people. Whether it's academic medicine, corporate medicine, or public sector medicine, we are simply not taking enough time to focus our leaders' attention on the interpersonal dimension of their work. Excellent training and supervision enhance essential managerial skills, but most health care organizations choose not to invest in that which is 'soft.'" Steve Adelman is a psychiatrist and can be reached at his self-titled site, AdelMED. He shares his story and discusses his KevinMD article, "The joylessness of harried medical leaders." (https://www.kevinmd.com/blog/2021/07/the-joylessness-of-harried-medical-leaders.html)

Jack Tierney has lived with type 1 for more than 60 years. Not surprising, he was first misdiagnosed with type 2 and lived with that diagnosis for almost two years. He shares the story of finally getting the right diagnosis, living well with T1D before home blood sugar meters or fast acting insulins and why he just last year switched to a pump. Stacey talks to Jack and his son Jamie. You can watch the video that brought them to our attention here. In Tell Me Something Good – boy it was great to get back out to an actual in person conference. Shout out to not just FFL but to my local Charlotte community as well. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with people who've lived with type 1 for more than 50 years: Marty Drilling Jeanne Martin Richard Vaughn Judith Ball Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription below:    Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first pre mixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom. This is Diabetes Connections with Stacey Simms. This week Jack Tierney is 81 years old and was diagnosed with diabetes more than 60 years ago. He had classic symptoms but remembers being shocked to hear the news.   Jack Tierney  0:38 And he told me I was a diabetic and I said to him what's that I had never heard the word or knew nothing about it. And he told me what it was generally speaking, and I'm convinced that the doctor probably did not know the difference between type one and type two because this was January of 1960   Stacey Simms  1:00 Jack was mis diagnosed with Type two for almost two years. He shares the story of finally getting the right diagnosis living well with T1Dbefore home blood sugar meters or fast acting insolence and why he just last year, switch to a pump in Tell me something good boy, it was great to get back out to an actual in person diabetes conference, shout out not just to friends for life, but to my local Charlotte community as well. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. Okay, so glad to have you here we aim to educate and inspire about diabetes with a focus on people who use insulin. My son Benny was diagnosed 14 and a half years ago, just before he turned to my husband lives with type two diabetes. I have diabetes, but I have a background in broadcasting. And that is how you get the podcast. I got an email a couple of weeks ago from Jack Tierney, who you'll hear from today. And he said check out the 12 minute YouTube video that my son and La filmmaker has created for me, it's called an 81 year olds 62 year journey with type 1 diabetes. Well, that caught my attention. I've talked to quite a few people over the years who have lived a very long time with type one, it really is incredible to think about how they made it work without the things that we consider now like the very very basics right home blood sugar meters, and a one c test fast acting insulins, Jack and his son Jamie have a great story. And I will link up that video that started all of this in the show notes you can always go to Diabetes connections.com. If you're listening on a podcast player, you know like apple or Spotify or Pandora, sometimes the show notes are a little wonky. And the links don't work, just head over to the episode homepage. And it also has a transcription. If you follow me on social, you know that I went to the friends for life conference recently the first in person conference for me since March of 2020. I'm going to talk about that after the interview. But I wanted to say a quick Welcome to anybody new who is listening who found me there who I met at that conference, there were so many new people, it was great to be able to say hi and have some hugs and meet your kids. So I'll talk about that a little bit. And I'll get to Jack's story in just a moment. But first Diabetes Connections is brought to you by Dario Health. And, you know, we first noticed Dario a couple of years ago at a conference and very thought being able to turn your smartphone into a meter was pretty amazing. I'm excited to tell you that Dario offers even more now, the Dario diabetes success plan gives you all the supplies and support you need to succeed. You'll get a glucometer that fits in your pocket, unlimited test strips and lancets delivered to your door and a mobile app with a complete view of your data. The plan is tailored for you with coaching when and how you need it and personalized reports based on your activity. Find out more go to my daario.com forward slash diabetes dash connections. Jack and Jamie, thank you so much for joining me. I am so interested to hear this story. Thanks for making time for me today. Oh, you're welcome. We will hear Jack story and I can't wait to hear you in your own words. But Jimmy, let me just start with you. What made you create that video,   Jamie Tierney  4:19 my dad said he was working on some scripts about his thoughts on diabetes and living with it for over 60 years. He wrote a number of different stories about it and wanted to record that on camera. And so we started doing that and we have all seven or eight sorry, eight tapes, I believe, of doing that. But what I was most interested in is his personal story, his life story because once we got started there was there's a lot of things that I didn't know about his story and about about diabetes in general. And so that's what got me interested and then I wanted to follow up with with his doctor and with his with his brother to get multiple sides and also my mom I'm here to get her side of it. It's one of those things that started off as one thing and changed a little bit as we went.   Stacey Simms  5:06 All right. So Jack, you have lived 62 years with type one. Can you talk about your diagnosis? Because not too surprisingly, you weren't diagnosed correctly right away,   Jack Tierney  5:16 right? Yeah. In the first tape that I did with Jamie, I did talk about what happened with me, I actually came down with type one in 1959. At the time, my mother, who was only 43, had a brain tumor, and I was under a lot of stress, and I was attending college. In fact, when I was home with her after she had to have had a tumor removed, I did get the flu, like so many type ones, it just exacerbated or caused type 1 diabetes, because I weighed 100, I'm six foot four at the time, a weighed 150 pounds, I was down to 125 and peeing incessantly, like everyone who gets type one does. And so I returned to college. What happened was, I was just deteriorating so fast. I was in a small town in Indiana attending college. So I went to the local general practitioner, and he did some tests and told me my blood sugar was over 500 and then needed to be 80 to 120. And he told me, I was a diabetic. And I said to him, what's that I had never heard the word or knew nothing about it. He told me what it was generally speaking, and I'm convinced that the doctor probably did not know the difference between type one and type two, because this was January of 1960. And he was a general practitioner in a very small town. But what he did do was consult with the dietician at the college I was attending, and he treated me I now know pretty much like a type two diabetic because he put me on 1000 calorie diet, your I am weighing 125 and surviving on any did give me a pill, I believe it was called diag and Ace, I really survived that way for about 18 months, just living on 1000 calorie diet and and I was in a really rigorous academic program too. But then as my brother indicates on the video, I came home and he was really worried about me. And luckily I had transferred to the University of Dayton and I was, I got in touch with a wonderful Doctor Who put me on insulin shots. And that made all the difference in the world. You know, I did get back to weighing about 150 in about six months, and you know, took the taking shots. In fact, what I say on the video, when I added it all up, I've given myself probably 42,000 shots over the years, by the way, preparing to do the tapes, Jamie because whenever Jamie does film project, he does extensive background for it. And he gave me a book titled breakthrough about the discovery of insulin by Dr. Frederick Banting. And in fact, when I, I'm going to start to cry, because I read that book in two days. Because it just reminded me of how many kids died before Dr. BAMMY who's one of the greatest human beings that ever lived, discovered him. And it just, you know, I just brought back so much to me reading that book. But the man was a absolute saint for all that he did. I'm sorry for crying. But every time I think of that, man, I just think all of us were type ones are eternally grateful to him back, he's got to have one of the highest places and heaven.   Stacey Simms  9:10 It is incredible, you know, as we're marking 100 years of the discovery of insulin to think that someone such as yourself was diagnosed at a time really not that long after, at a time when many doctors and they still mess this up. But you didn't know the differences between the types. I'm curious, you know, I've heard other people talk about being diagnosed in the 40s and 50s. By medical professionals who kind of, you know, gave them really dire diagnosis or dire outcomes or would say, you know, you're really not gonna live that long. Were you I hear the emotion in your voice. Were you told things like that back then? No,   Jack Tierney  9:47 you know, that's, that's very interesting, because I remember Okay, for example, one of the doctors that I know just casually here in San Diego is Dr. Steve Adelman. And he too, is a type one diabetic. And I remember in paper he had written, he mentioned the fact that he was told that that he had he would live no more than 15 years. And he was diagnosed as a young adolescent. So I know that many people who were afflicted with type one word told, for example, one of my doctors is put me in touch with a two or three other type one diabetics here in San Diego who've had it for 60 years. And one of the women that I talked to she's now 70 and she was diagnosed at age 13. And again, the doctors told her that she would live no more than 15 years.   Stacey Simms  10:50 How did you then go forward? I mean, it sounds like you kind of alluded to it, you know, did the shots it wasn't that difficult, you know, again, the weight back but this was at a time before blood sugar meters. This was at a time where I assume if you were checking it wasn't very accurate. What were you doing?   Right back to Jack answering that question. But first Diabetes Connections is brought to you by Gvoke Hypopen . And our endo always told us if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing we're usually able to treat those with fast acting glucose tabs or juice. But a very low blood sugar can be very frightening. Which is why I'm so glad there's a different option for emergency glucagon, it's Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to go with no visible needle, you pull off the red cap and push the yellow end onto bare skin and hold it for five seconds. That's it, find out more, go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma. Visit gvoke glucagon.com slash risk. Now back to Jack answering my question about how he stayed healthy.   Jack Tierney  12:06 Well, I'll tell you one of the tapes that I did with Jamie was on exercise, I quickly realized how important exercise was I just felt intuitively that I would utilize insulin more effectively via exercise. And so as I mentioned on the tape, one day when I was 23 years old, I played 50 holes of golf carrying my own bag. And I used to routinely play basketball because I'm six foot four, three to four hours, sometimes even five or six at a time if I had the opportunity away from my academic studies. So I just found that exercise was so important. And you know, I've been as somewhat of an exercise buff all my life. In fact, one reason why I contacted Yahoo and diabetics the connections because on a news release here in San Diego, I saw where Eric Tozer was running eight different marathons on every continent in the US over a short period of time. Yeah. And he's a type one diabetic. So, in fact, on one of the tapes, I say, whenever I get when two people like Eric, I really follow their story, because it's motivational to me to maintain the exercise level that I like to   Stacey Simms  13:37 let me jump over to Jamie for a minute, as you're hearing your dad talk about, you know, playing 50 holes, and golf and basketball. Growing up. Was he super active? Was this a family thing? Did he make you all get involved? Or was this his thing?   Jamie Tierney  13:50 Oh, no, no, we I've been playing golf and my dad, before I can remember, I was about two years old. And, you know, I was thinking because the US Open was fishing yesterday. And he used to wake up at three in the morning and drive down there and get us a place in line to go play and then then come home and wake me up and take me back there. And then we play golf and maybe come back and do yard work stuff like that. So growing up, I never thought it was any different than anybody else's dad probably more probably quite a bit more active than most other dads I knew around.   Stacey Simms  14:25 Was diabetes kind of in the background, then do you remember as a kid, or you know, as a young adult at all? I'm trying to envision what it would be like because now you know with insulin pumps, we see gems, we see it more. But I'm curious, Jamie, from your perspective, what it was like to grow up with a dad with the type plan?   Jamie Tierney  14:42 Well, I don't always see him do the shots. And you know, I don't remember ever asking him what those were about that I just remember. I was near what it was that he had to take medicine he had to do it every single day and had to do with a needle which isn't fun for anybody. I remember a few times, you know when when we would We are playing golf specifically with hot that he bring like a candy bar with him in case he would start feeling a little woozy he would, you know, he would, he would eat something to kind of revive themselves from there was a couple times I remember when it got a little bit scarier than that where he needed, you know, he needed some assistance needed to get back to the clubhouse quickly to get back to normal. So I was always aware of that. But again, you know, I didn't really know that much about the disease itself and how it works. Other than if you've ever looked a little bit off, it needs to get some, some carbohydrates and and quickly,   Stacey Simms  15:36 Jack, I would imagine and I'm just thinking from my own experience, as a parent and as a daughter are our parents generally don't want us taking care of them. And we don't want our kids taking care of us when we become parents. But type 1 diabetes is kind of always there. Were you consciously trying to think, okay, I don't want Jamie to have this responsibility. I've got this, did that kind of stuff go through your mind?   Jack Tierney  15:58 No, you know, I just felt you know, it's an affliction. Everybody has ailments and afflictions. And, you know, once I realize how valuable and importance for my health, taking shots where it just became second nature to me, and I just felt so much better. But I just told my wife last night, since I've been on the T slim X to in last eight months, I've never felt better in my life, and I'm 81 years old. So I just am seeing the value of the pump, you know, and like Dr. McCallum says on the tape, he was a little surprised that I would take to it but you know, I always respect him so much. He just told me that this T slim is really something and I'm just so thankful I took the leap eight months ago and did it because I feel tremendous. Having done I do feel better now that I'm on the pump than I ever did just taking shots.   Stacey Simms  17:11 Now, what led you to do this? It was was it a conversation with your endocrinologist?   Jack Tierney  17:16 Yes. And and just also, he told me that this pump was exceptional in his point of view. In fact, Stacy, I'll say this to you, I just and so long story but I did talk with Dr. Aaron Kowalski today the president of jdrf in New York, and he told me he's using the T slim the Tandem t slim max to also so that made me feel really good. That maybe this is definitely it just reinforced by decision as being a very good one. Well hearing about this from Dr. Kowalski. Well,   Stacey Simms  17:56 I know Dr. Kowalski, but we chose it to and I gotta tell you, I absolutely love it for my son. It's just the software. It's great. So you were already then using a Dexcom CGM. Because if you're listening and not familiar, the Tandem system works with the Dexcom. Right. Are you using that together? And had you been using a CGM for a while?   Jack Tierney  18:16 Yes, in fact, that's a funny story. You're gonna love this story. What happened was about three years ago, I went to see Dr. McCallum and I wanted to get on a continuous glucose monitor. Because, you know, I'd seen it advertised and it just sounded like the cat's meow. So I'm waiting to see him. And there's a young man waiting to see another endocrinologist. And he says, Dr. Tierney, and I said what and what it was, it was a gentleman, a young man that whose first name is Brandon. And I saw Brandon when he was nine years old to help him get ready for a test to get into a highly academic private school here in San Diego. And he at the time, he told me he was a type one diabetic. And so what happened was he was using the Libre and went over all of the advantages to the Libre before I saw Dr. McCallum, so I walked into Dr. McCallum's office, and I said, Well, Dr. McCallum I think I've made a decision on the continuous glucose monitor that I should be using because I one of my former students told me the benefits up Wow, so I went on the Libre. But then, in fact, at the time that I went on the Libre, the Dexcom, six wasn't available, right. And so it just sounded like the best one for me at the time. But then, of course, eight months ago, when I made the decision to go on the T slim. They told me it was worked in concert with the Dexcom six and that's why of course I switch to that saying it's great to   Stacey Simms  19:58 Yeah, it's it's Wonderful to have these choices. You know, I was gonna ask you, right, I was gonna kind of ask you to take us through the process of going from, you know, no home blood sugar meter to kind of you know what it was like in the 80s. And then, you know, the different insolence, but you like rocketed ahead, and now you're on a hybrid closed loop system. So you've right, it's   Jack Tierney  20:20 so sad, you know, there was nothing available. Thinking back, I did a lot of research before I did the eight tapes that Jamie debts. And one of the things that I learned and I had read a little bit about that, because I read a lot about that diabetic compilations and controls study that was done in 1980s and early 1990s, with type ones. And you know, in fact, they abbreviated the study early because it showed that tight control of type one of your blood sugar is imperative. In fact, I think I in my research for those tapes, that study I think, yeah, it was called the DCC, diabetic comm closed stations control trials dcct. And that thing, that thing, I was concluded early, because it showed how important it was. And I think as a result of that the a one C was developed, and also kilmallock. Because before that I was using NPH, insulin from 1961 until the latter part of the 1990s when human log became available, and also, I got my first day one see back in the 1990s. Well, because that wasn't available. Until you know after that monumental study, the dcct. That's when the a one c came about, I believe. And also more synthetic insulins like human lock, right. And that helped me a lot getting on unilock it really good. But I didn't get on that till about I think 1998 1999 thanks to Dr. McCallum   Stacey Simms  22:13 What does he say to you? It's must be really interesting for him to talk to someone. I mean, my guess is that you educate him about many, many things as well. I'm curious. It just sounds like he's really open minded and really a team player with you to to encourage someone who has you know, not but on an insulin pump has lived with type one for more than 60 years. And then to make that change. Do you feel like maybe you're educating him as well? Oh, yeah, I   Jack Tierney  22:41 think it's mutual. Definitely. In fact, what happened was, Jamie said to me in mid March, he said, Dad, I'd like to interview Dr. McCallum. We've done the eight tapes. But like Jamie just said previously, I'd like to interview Dr. McCallum. So I called me and Jamie had to come down here on another job to San Diego from LA. And he wanted to do it on a Friday afternoon. Well, I called Dr. McCallum and he said, You know, I can't do as it's just chaotic once you guys come in Saturday morning, I couldn't believe he invited us in Saturday morning. We were the only one over there. And so I said to him, Well, can I sit in and listen, because Jamie interviewed him for an hour and a half. And I resist taking in his responses to all the questions, because you know, a lot of what he presented I had not heard before. And so it was just a very good education on my part to hear his responses to Jamie's questions. And also all along. He's been very respectful of my what I've learned. I'll give you one good example. And this is good to know, for every type one diabetic, sure, you got to pay attention to your endocrinologist, but also, you've got to pay attention to your experience. I remember when I first got on insulin back in the early 1960s that I was obsessive compulsive about making sure it was refrigerated. I mean, I was Oh, CD on it. I really was well, I'm reading a Life magazine. And this had to be in like 1963 about a gentleman by the name of Franklin, Billy Talbert. And Billy Calvert was one of the greatest tennis players ever. He was diagnosed in 1929. He lived to be 80 years old. In fact, that's one reason why I made the tapes. I said, Well, Billy made it to 80. Maybe my time is coming up. So I better do something that I've been contemplating doing for a while. But in that article back in the 60s, this is what Billy said, I'm playing tennis all over the world. I can't keep my insulin refrigerated all the time. And so I wasn't as I can, you know, you kind of learn by experience what you can do in the like, I mean, sure you take the advice of all of your doctors. But after that I wasn't obsessive compulsive about keeping my insulin refrigerated when I learned what Billy tailrace experience was. And that's what I found with Dr. McCallum he really paid attention to my experiences with this chronic illness. That's great.   Stacey Simms  25:28 Jamie, let me ask you, you know, you are a filmmaker, what do you hope happens with this video, I could ask you why you made it. I kind of have, you know, there's so many reasons why you would do something like this. But I'm curious to know, why did you do it?   Jamie Tierney  25:41 Well, I mean, my dad asked me to maybe not make exactly a film like this. But I just think it's an interesting story. I mean, when I when I got into it, I mean, the thing that kind of hit me the first thing that he survived for almost two years without insulin, yeah, I don't know how that happened, to be honest. And, and I tried to do some research. And I did ask the doctor, how many people have ever made it for that long, I don't think there's too many have forgot about it. He's my dad, but just from a human interest perspective, that someone could survive like that on a small amount of calories and no insulin with basically the pancreas not producing any more insulin at all. So that I feel like it's, it's pretty interesting, just the triumph of the human spirit, I think, and then having lived for, you know, 16 more years after that episode. And but then also, what's interesting to me is just how he's gone through every single phase of treatment. I know the first two treatments were began in the 20s. But it sounds to me like in the 60s, when he first started, it was basically a similar treatment to the 20. So it's pretty much gone through every single medical advance. And I just wonder, again, how many people are out there who are 81, who are getting started on something technologically advanced, like this pump and take into it? I feel like there's an interesting story there, too. I don't know how many people are are in his in his boat with that, too. Yeah. Can I piggyback a little bit? I'm going to tell you something. I haven't told too many people. As we said earlier, Jamie did fill eight scripts. Well, everything led to script number eight. And in script number eight, what happened was from 1992 to 1995, I was asked to be superintendent of the schools in a school district, that was the worst in the state out of 1000. And when that three year period finished, I believe, and maybe I don't think I'm off on this. It became the best school district in the state. And Jamie was getting his master's degree at USC, and screenwriting. And he said to me, dad, someday you have to tell this story. And I thought that was commendable on his part. In fact, he bought me a recorder. And so for a whole year, whenever I was driving, in my new assignment anywhere, which involved a lot of teacher training, I would record my thoughts. And when I finished, I recorded 55 hours of material. And I vowed to write three books. And I have written those three books on my experience there. And that is my ultimate reason for doing these tapes with Jamie helping me because I want to get a little bit of personal notoriety out there in hopes that a reputable publisher will publish my three books, because I think I've got a story. In fact, I told my wife and I just finished watching Downton Abbey because many of our friends thought it was so good. Well, I said to myself, after I watched Downton Abbey, my three books are an American Downton happy because it's a story that in fact, when I was contemplating doing when I started writing the three books of fellow Superintendent friend of mine said, Jack Tierney, he said, You beat me to it. When I retired, I was going to write a Michener light novel titled School District, because what really goes on behind the scenes in a school district has never been taught and what goes on in a border town. The story of what really goes on a border town has not really been told yet. And that is my ultimate person, poor person. I want these books, hopefully a reputable publisher rather than my working on self publishing, and maybe even three movies be made because I think it has the potential for that. And every month cent made will go to be find a cure for type 1 diabetes.   Stacey Simms  29:57 That's great. Well as we start to wrap this up, I'm curious to ask we on this podcast hear from a lot of adults who have been diagnosed with type one, I mean, sure, there's a lot of children as well, this audience is really half and half. And I'm curious, what would you say? What would you say to somebody you know, who was 60? Or 50? You know, who's not six years old? What would you talk about or tell somebody who's diagnosed as an adult?   Jack Tierney  30:21 Well, I probably would say the same thing. That I would say to someone who's diagnosed that like those four young men that I saw, for SAT prep, one of them was diagnosed at age three, the other two were re diagnosed at age seven. And then Brandon, who I mentioned earlier, nine, they have the ability and the courage to take this head on, you know, it is a chronic ailment, but with taking the advice of your endocrinologist and working at it, it is indeed manageable. I'll tell you what one one of the four young men told me when I met him for the first time, we finished the session on SAT prep. And I knew in advance that he was a type one diabetic, he actually had been diagnosed when he was seven. And he was now 16. And I said to him, I said, Well, probably in your lifetime, there will be a cure. And you know what he said to me? You're not going to believe what he said, Stacey, what did he say? He said, I wouldn't take it, huh? Because he had learned how to do it. And he had met this challenge. In fact, when he said that to me, I said, Jamie knows I've said this a lot. I think a lot of young people today, we don't have fixed rites of passage and societies too much anymore, where you did something notable. And the whole community recognized you as a aspiring adult. So young people are picking their own ways to prove to themselves the world and their families that they can stand on their own two feet. So I think that's why that young man made because he had his rite of passage thrust upon him. And he felt that he had successively done it. And so he didn't want to take him away necessarily. Yeah. Anyhow, that's my degree in philosophy. Coming to the fore here on why he responded the way he did, I've heard my dad tell versions of the story, my whole life, but it's, it's nice to have something that you can condense into 11 minutes and hopefully that people can get a sense of him, but also just how you can thrive and have a great life amidst the challenge of this disease. And as he says that, you know, hopefully, this this treatment is, is great, but hopefully there is a there is a cure someday and stories like harrowing stories of what my dad went through it in something. The future,   Stacey Simms  33:04 Jackie, so playing golf.   Jack Tierney  33:05 Oh, yeah. All right. Oh, yeah. I don't play that well, but I love to play. And what's best of all, I love playing with Jamie and his sister. In fact, every time we play, they're a lot better than I am. And they always give me a good tip. And that helps me to play a tad bit better. One of my neatest experiences as a father. In fact, the three of us, three of us always played on Father's Day. We don't now because Emily's in Cape Cod as being a doctor and Jamie's MLA. But whenever we did, when they were in elementary school in high school, it was one of my fondest memories on Father's Day.   Stacey Simms  33:51 Well, thank you so much for sharing your story. Jamie and Jack, I really I can't thank you both.   Jack Tierney  33:57 Give your best to your son, your 16 year old now. Just neat. He's doing so well. And what a champion he is.   Stacey Simms  34:06 Thank you very much. That means so much. And I appreciate you both coming on to share your story. And you know, we can learn so much from it. So thanks, guys. I really appreciate it.   You're listening to Diabetes Connections with Stacey Simms. More information about Jack and Jamie at Diabetes connections.com including the video with lots and lots of photos, Family Photos, if you'd like to take a look at that. I really appreciate them coming on. So much fun to hear that story and really reflect back and I love that you started using an insulin pump. Just last year, I have a friend who was diagnosed with type one in her late 60s and immediately went out and got the technology she wanted. A CGM right away hasn't started using an insulin pump yet she may never and that's okay but just knowing that the option is there. I think it doesn't matter what age, right? It's all about finding what works for you. And if you're interested in learning more about people who have lived a long time with type one, like I said, at the very beginning of the show, I've talked to several people who've lived, you know, 60, or even 75 years with type one, Richard Vaughn comes to mind. But there are a couple of other people who've been on the show before. And I'll try to link that up in the show notes as well and kind of make a little list if you'd like to go back if you're new to the show, and want to hear more from these incredible pioneers in our community, a little bit more about in person connections and things like that. But first Diabetes Connections is brought to you by Dexcom. And you know, a couple of weeks ago, we were watching TV, and I got a Dexcom alert, Benny was upstairs in his room, we were downstairs. And for some reason, it kind of took my brain back to the days when we basically had blood sugar checks on a timer, we would check during the finger stick the same times every day at home and at school, you know, whatever extra we needed to as well. But it's amazing to think about how much our diabetes management has changed with share and follow. I didn't have to stop the show to get up and check on him. I knew what was going on, I could decide whether I wanted to text him or you know, go upstairs and help him out. Using share and follow apps have really helped us talk less about diabetes, which I never thought would happen with a teenager. Trust me, he loves that part too. And that's what's so great about the Dexcom system, I think for the caregiver, or the spouse or the friend, you can help the person with diabetes manage in the way that works for you know, their individual situation. Internet connectivity is required to access Dexcom follow separate follow app required, learn more, go to Diabetes connections.com and click on the Dexcom logo. So tell me something good is usually where I share your good news. And hey, send me your stuff, Stacey at Diabetes, Connections calm or I'll post in the Facebook group Diabetes Connections va group, I'd love to hear the good things that are going on for you, you know, this summer, and as we head into August, let me know what's going on. But for me, the Tell me something good this month was friends for life. I didn't even realize how much I needed that until I was there. If you're not familiar, and I know many of you are joining me because you met me at that conference. But if you're not familiar, it is the largest diabetes conference in the country. This year, they made a joke. It's the largest one on the planet because it's like one of the only ones happening on earth this year. Usually it's almost 3000 people meeting up in Walt Disney World at the convention center there. It's gosh, it's so hot in Orlando in July, but it's always so worth it this year. I think it was about a third I want to say maybe 1000 people were there was a smaller event. But it was still fantastic speakers education a chance to meet the industry people touch insulin pumps, talk to vendors, things like that. There's a lot of stuff happening. And for the kids, you know, it's a chance to see and and adults too, it's a chance to see lots of other people wearing the technology that many feel self conscious about. And usually by the end of the week, and I met a family like this a shy seven year old who didn't want to meet anybody and was almost hiding in her hotel room was jumping in the pool by the end of the conference showing off her Dexcom and her insulin pump. So it's about empowering people with diabetes. It's about educating families. It's about support. As I mentioned, last time, we had an episode I was gonna say last week, but it was two weeks ago. I mentioned a new presentation that I was doing reframe your diabetes parent brain. I thought that went really well. I was really thrilled with the crowd. really terrific people. And they did the presentation. I was always afraid of people gonna play along and give me their examples that everybody was great. So if you are interested, I'll do this on zoom. I'll come to your group. Welcome to your parent meetup. It doesn't have to be anything formal. It's really just about taking the terrible things we say to ourselves. I'm failing my child. I'm the worst Mom, I'm not doing as well as everybody else. How could I possibly have forgotten the blah blah blah. And reframing those thoughts to help us not only feel better, this isn't like a woowoo thing although there's nothing wrong with with changing the way you feel. But this is really actionable stuff about seeing how you are actually living so well with diabetes and you're doing a great job and your child is thriving right under your nose when sometimes you think everything is going wrong. So that was really fun. Sometimes it friends for life or new at the at a conference a couple weeks ago. Sometimes there's big announcements about new technology or you know, people will do presentations and show the new stuff. There really isn't anything like that this year. There's a lot of delays because of COVID. As you know, if you listen you know we are waiting for Omnipod five with Horizon, we are waiting for tandems boltless by phone, we are waiting for Dexcom to be submitted to submit g seven to the FDA. So there's a lot of things we're waiting on. But the community is always there. And I really really needed to see those other moms to hang out with everybody and just to breathe that air again. So thank you so much for everybody who came who said Hi, and who's listening. Now. We also had a really, really great meetup in the Charlotte area and I only share this because you can do this where you live, even if you don't know anybody with diabetes, reach out to your local jdrf or post in some of these Facebook groups post in the Diabetes Connections group you never know maybe there's somebody who's local to you and start talking about let's get together. We had a fantastic meetup. It was parents and kids, and it was adults with type one. Our chapter has really gotten on the ball with adults, they have a whole volunteer outreach now for them. And you know, it's so cool to see people of all ages living well with diabetes, and we all help each other right? So I share that not just to say, isn't my chapter great, which it is shout out to my fabulous friend and Sutton, who makes that chapter home. But also just to spur you on to think about meetups in your own area. They're hard to organize, I do them too. And it's sometimes 20 people come sometimes two people come, but it is really worth it to keep putting it out there and keep trying to find parents, kids, adults in your area, we need our diabetes community, you only see your doctor for teeny weeny amounts of time, every couple of months. Diabetes is 24 seven. So reach out, find people post in the Diabetes Connections Facebook group, if you have questions, we can help you I do a whole presentation on making connections. So I can definitely give you tips and tricks, especially as we get closer to school starting about how to find other families in your area. All right before I let you go, if you have listened for this long as you are listening to this episode, if you listen as it goes live, Benny knock on wood should be coming home from Israel today. As I am taping, it's still a couple of days away. But it will have been a month and I should be picking him up at the airport as this episode is airing. I am hoping that after he sleeps and showers, or sleeps for a couple of days, that he will do a debriefing on the show and talk to me about what it was like not just going to Israel with camp for a month. But what it was like doing all the diabetes stuff completely on his own. At this point. I don't really know a lot. I've seen his numbers. And I think I know what's going on. But I really want to hear it from him. So couple of days left, I can do it. Keep breathing. Oh my gosh, this has been so stressful. And I will share more with you all warts and all. I'll share the honest story, but not until he's back and home safe. All right. Thank you so much to my editor John Bukenas from audio editing solutions. Thank you so much for listening in the news every Wednesday live on Facebook at 430. And then we turn that around into a Friday podcast episode. Do not miss out in the news is like six or seven minutes. It's real quick. I'm trying to get it to five minutes, but I can't get it to five minutes. It's only six or seven minutes long. There's just so much good stuff happening and news to bring you from the diabetes community. So join me every Wednesday live for that or listen for the episode here. I will see you back here in just a couple of days. Until then be kind to yourself.   Benny  42:51 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

This episode comes at a very interesting time as parts of the world start to open up. A feature of many of our “normal” lives is live events – sport, theatre, live entertainment. We put this episode live one week before the Tokyo Olympics and a week after the European and South American football championships. Live events are reflections of our societies. With that, meet our guest, Steve Adelman. Steve is a lawyer and a world-renowned expert on event safety and security. He literally wrote the book on crowd safety in the USA, was the lead author on The Event Safety Alliance Reopening Guide, and has worked with numerous large organisations on live events. He even deposed Eminem. Steve has a rare gift for making complex topics come to life. This makes for a super interesting and fun conversation. We cover crowd behaviour, risk assessment in large events, the pandemic, reopening, and much more. Show notes: Steve's law firm, Adelman Law Group Event Safety Alliance Adelman on Venues The Crucible by Henry Miller The Hillsborough Disaster Love Parade Disaster The Black Swan by Nassim Taleb Thinking, Fast and Slow by Daniel Kahneman Route 91 shooting Manchester Arena bombing The Unthinkable by Amanda Ripley Event Safety Summit _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Like what you heard? Subscribe and/or leave a rating and review on Apple Podcasts: http://apple.co/1PjLmK Subscribe on Stitcher: http://www.stitcher.com/podcast/all-things-risk/the-all-things-risk-podcast Subscribe on Soundcloud: https://soundcloud.com/ben-cattaneo Follow the podcast on Twitter: https://twitter.com/RiskThings Drop us a note: allthingsrisk@gmail.com  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Our free course module “How to Set Up Any Decision for Success” from our upcoming course How to Make Decisions With Calm and Confidence

Can you require your employees to be vaccinated? Can you ask your guests to show proof of vaccination before entry? Can you legally eject patrons for disregarding your event's mask mandate? And what the heck does HIPAA stand for, anyway?! In this episode of the Event Safety Podcast, Steve Adelman puts on his attorney cap and provides a legal perspective on these and other timely COVID-related “controversies” currently facing event operators.

Dr. Stephen Ponder coined the term "Sugar Surfing" in 2013 to describe a real-time, dynamic system of managing diabetes. In this "Classic" episode we take a deep dive into what Sugar Surfing is all about and get Dr. Ponder's perspective on everything from parenting teens with diabetes to how he feels after 50+ years of living with T1D himself. Dr. Ponder is the medical director at Texas Lions Diabetes camp where he’s volunteered for almost 40 years and in 2018 he was named Diabetes Educator of the Year It’s hard to believe now with CGMs and closed loop systems, but the thinking you’ll hear Dr. Ponder talk about was pretty revolutionary in the early 2000s. This interview is less than a year after he published his book. Sugar Surfing info (including how to get a free book if newly diagnosed) Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below    Stacey Simms  0:00 Diabetes Connections is brought to you by Inside the breakthrough a new history of science podcast full of did you know stuff.   Announcer  0:11 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:17 Welcome to a classic episode of the show. I will be so happy to have you along we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms, and this time around, I'm revisiting my first interview with Sugar Surfing Dr. Steven Ponder. Dr. Ponder has lived with type one for more than 50 years. He is a pediatric endocrinologist and a certified diabetes educator. Sugar Surfing is about real time management of diabetes. Dr. Ponder coined the term in 2013. But it was a long time coming, a lot of research, a lot of work. It's hard to believe now with continuous glucose monitors and closed loop systems. But the thinking that you're going to hear Dr. Ponder talk about was pretty revolutionary in the early and mid 2000s. This interview comes less than a year after he published his book sugar surfing and by the way that is still free for newly diagnosed people, newly diagnosed families. And I will link up more information about how you can get that in the show notes over at Diabetes connections.com. So what is Dr. Ponder up to these days? Well, he has become a frequent and welcome guest on this show. I last spoke to him for our New Year's Day episode when health care providers were getting the COVID vaccine that was such a joyful show. I loved being able to talk to them some of the first people in the country to get the COVID vaccines and he was one of them. Dr. Ponder is the medical director at Texas lions diabetes camp, where he has volunteered for almost 40 years. And in 2018 he was named the National Diabetes Educator of the Year he also founded a free medical clinic for children all children, not just those with diabetes, our original sugar surfing interview in just a moment. But first, this episode of Diabetes Connections is supported by inside the breakthrough surprising stories from the history of science. Dan Riskin, digs deep and entertains as he connects those old stories to what modern day medical researchers are facing. As you know, 2021 is the 100 year anniversary of the discovery of insulin that is arguably the biggest scientific discovery in Canadian history. This series examines that moment and many others through the lens of Canadian researchers trying to find what's next for the fight against diabetes. I love this podcast I have listened to every episode I highly recommended search for insight the breakthrough anywhere you find podcasts, and a good time to remind you this podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Dr. Ponder, thank you so much for joining me.   Dr. Stephen Ponder  2:50 Thanks for having me today. Appreciate it.   Stacey Simms  2:52 Yeah, it's I'm excited to talk to you. But before we talk about sugar surfing and some of the listener questions 50 years with type 1 diabetes this month, how are you doing? And do you remember your diagnosis?   Dr. Stephen Ponder   3:03 Oh, very much. So I was nine years old when I went into the hospital. And I was having fairly mild symptoms, increased urination, you know, weight loss and so on. Parents were puzzled by that took me to my pediatrician. And I don't remember all the details. I do remember getting poked a few times. And lo and behold, later that day, my mom was getting was called by my pediatrician. And I was admitted to a local hospital in an old fashioned ward of all things with four beds. They were they were not separate rooms at that point in time. And I was managed for about nine to 10 days in the hospital. Interestingly, by today's standards, I never saw a pediatric endocrinologist. Of course, there were not many of them in existence in the in the 1960s outside of large, you know, academic institutions. But I was managed by a pediatrician my entire childhood.   Stacey Simms  3:55 You were managed by a pediatrician. That's fascinating. What was the treatment? What was the management like?   Dr. Stephen Ponder   4:01 Well, not unlike a lot of people today you know where you'll hear stories where the doctor or the nurse handed down a lemon or an orange to practice injections on I really fell into that classic model where that I was given a piece of fruit to inject my insulin into practice. We did have plastic needles back then but the reality was I was sent home with glass syringes and reusable needles which were about 2625 to 26 gauge which by today's standards were huge. In terms of both length and and and width. And I took one shot today of a what what doesn't exist anymore and insulin call lanti le n te the closest thing that comes to it is his mph insulin, the cloudy mph and even many of your listeners won't even know what that is anymore in this day and age but I was treated with lenta insulin for gosh about 15 years until I started medicals School in 1980. And my first endocrinologist who put me on the path to multi dose insulin therapy, and very quickly after that insulin pumps,   Stacey Simms  5:09 Wow, that's amazing how much the practice must have changed what led you to become a pediatric endocrinologist?   Dr. Stephen Ponder   5:15 Well, I think that diabetes camp when I went to camp in 1981, it was kind of interesting. The person who ultimately would become my mentor was doing a research study for one of the insulin companies that were just rolling out biosynthetic human insulin, up until then we were using animal insulins. And during that study, his research nurse asked me this innocent question about diabetes camp. And she said, Oh, by the way, Steve, we have this camp for kids with diabetes. And I had actually gone to camp, not the same one. But I'd gone to a camp a couple of years after I was diagnosed. So I said, Sure, why not. And I said, it was about that much commitment. And after I went to the camp, in 1981, I just found my calling, I went back every year, and I have been going back every year since and, and about 25 years ago, actually became the medical director of the children's diabetes camp in Texas at the Texas lions camp. And that pretty much sealed my fate in regards to becoming a PDA, pediatric endocrinologist. The friendships I made, and the people I was able to, in some ways, I suppose influence. And it's been something I'll continue to do until I can't do it anymore. And I go back every year, I've spent several years of my life in the town where this camp is located. In fact, we recently, about 10 years ago, they just recently purchased a home not too far from there, which I may well retire to at some point in the future. You know,   Stacey Simms  6:52 this is the time of year when a lot of families have already signed up for summer camp for diabetes camp, but there may still be people on the bubble trying to figure out is this the year we do it? What would you say to them? Why is it good for kids? And what about the reluctance of cash? You know, I think it'd be home sick, are they gonna be taking Well, you know, care for as well as I can do at home?   Dr. Stephen Ponder   7:12 Well, I think it depends on the camp, the camp that I work at, serves children with special needs during the rest of the summer. And so they're very accustomed to taking children whose parents are, have been generally reluctant to let them out of the home. And these are children and they have visual problems, hearing problems, physical disabilities, cerebral palsy Down syndrome. And so they're extremely capable and competent. And getting the young boys and girls involved very quickly. In fact, as soon as the children are dropped off, they're whisked away to be, you know, to a playground to be active, to get settled into their, their banks and so on. They have really taken it to a fine art to the ability to keep kids from being homesick. Now we take kids that are aged eight to 15. At this camp, and, and yes, there's always a little bit of that at the beginning. For some of the eight year olds, not always, but some of them may struggle a little bit. But they are generally within a day or so just right in the swing of things if not just in a matter of hours into the swing of things. So I think we've we've not had to worry so much about that. Now my medical staff, we take about 75 people on the medical staff and we have 220 campers in two separate sessions. So 440 total, and we have a very high level of competency in that group too. Many of them are former campers, their medical professionals, nurses, doctors, you know, endocrinologist and volunteers. So we I think we've done a pretty good job over the last 35 years refining the methods to keep kids engaged, happy and active to the point that when they go home a week later, there are many of them or would like to say a little bit a few days longer.   Stacey Simms  8:52 I think diabetes camp is fantastic. My son is going to have his fourth year fifth year he'll be he'll be a fifth year camper this year. And it's been amazing the friendships he makes the the kids he stays in contact with and the empowerment this camp is where he did his first inset it's where he moved his Dexcom to a different location it's it's just so great for those kids to kind of figure out who they are I think two away from their parents. I'm a huge supporter of summer camp I think that's great.   Dr. Stephen Ponder   9:20 It's a wonderful experience all the way around and and and it forges some great friendships as you've already mentioned, that can continue well after camp especially I suppose in this day of social media era of social media. The the campers can stay in touch but you know,   Stacey Simms  9:34 don't get me started on the group texting that goes on my kids go to a different a longer summer camp later in the summer to them the group texts that are going it's crazy. But let's let's talk about sugar surfing. You have really hit a nerve I think in a great way with so much of the diabetes community. Sugar surfing and I'll ask you to better explain it but it seems to me is about learning how your body reacts and really Staying on top of your diabetes, more so so that you're I guess less reacting less to what's going on trying to predict more. And instead of making big changes all day long, trying to kind of nudge your blood sugar here and there, am I am I even close?   Dr. Stephen Ponder   10:15 Oh, you're absolutely right. That's exactly what it's about. It's management in the moment, as I say, in the book, once you look at blood sugars in a dynamic fashion is something that's constantly shifting and changing, you come to the same conclusion that you have to make anticipatory judgments as well as reactive judgments. And in a perfect world, half of your control is what you plan. The other half is what you have to react to what you have to do based on unexpected occurrences. And that's just life in general. So I think you can take a lot of the things you know about life in general and apply them to diabetes, you just have to be comfortable, or develop a sense of comfort with the various forces that you have at your disposal, that can move your blood sugars around whether it's insulin activity, the food you eat, the types of foods, the amount you eat, when you eat them. And when you boil it down. Diabetes Care is nothing more than a series of informed choices. At the beginning, those choices are in some ways made for you, or at least you're instructed to make these choices a certain way. But many people find that very limiting, and they want to break free of that. And many of them have and have done that well before I wrote this book. And whether they call it sugar surfing or have some other term for it. They're making more management decisions in the moment, which really improves their control and helps him better steer their their glycaemic trend lines in a more normal fashion.   Stacey Simms  11:43 Well, let's see if we could get kind of specific if you don't mind. I'm curious, like, how would you tell someone, here's how we're going to use sugar surfing to make your morning and your breakfast, a little bit more smooth, would you mind maybe taking us through that, like you wake up at a certain blood sugar and you're going to eat something for breakfast and how you might handle that?   Dr. Stephen Ponder   12:03 Well, a lot of the principles behind sugar surfing are things have been taught for many years, they include, you know, waiting a sufficient time after you take your insulin, to better time it or get it in synchrony with the food you're about to eat. Also understanding the glycaemic or the the fingerprint, if you will, of the meal of the food you're about to eat as well. So you have to match those two things up, you know, I use metaphors a lot. And I will say this to the young children, that, you know, a football quarterback that's throwing a football to the wide receiver is actually throwing the ball to a spot that there's no person at at that particular point, it's released. And you're trying to do the same thing with between timing food and insulin. If If food is the ball, and the wide receiver is the insulin, you know, the the quarterback, that is the patient needs to lead, you know, lead the inflammation of the lead a little bit before you throw the food at it. And in a practical way, what's your surfing, when you're looking at the trend line on your continuous glucose monitoring device, you will often want to wait for a band or an inflection point downward. That generally occurs anywhere from 10 to 15 to 20 minutes, maybe longer, maybe shorter. After that insulin dose is given such that the downward force that insulin is being seen on the glucose trend line, then the when the food is consumed, then it's more likely to be matched up or synchronized with the rising force, if you will, of the sugar that comes from that particular meal, assuming there is a lot of carbohydrates and you have to then adjust that insulin dose according to what you understand about those that particular food. And to be more specific for breakfast, I promote the concept of the top 10 list. And this is not David Letterman perspective. There, everyone has a top 10 favorites, everything you have a top 10 favorite breakfast, the top 10 favorite lunch and dinner. And that can easily be determined over the span of several weeks, you could actually count well how much how many times they this person he decided the other thing anyway, focus on your top 10 list. So if you if you enjoy a certain type of cereal, or oatmeal or toast or pancake or whatever you have for breakfast, then determined over time. And this is through observation, determine what effect those nosepieces meals have in general on your blood sugar, how soon they respond, how how aggressive they tend to be. And then you design an insulin regimen that best matches those and you use your trend line on your sensor to give you the best idea of how well you're matching those two things up to the point that you minimize the rise in the blood sugar. You want to prevent the spike that occurs after the after you eat what most people make the mistake of doing and they've been taught this and it's not always their their fault is they've been told it is to take their insulin at or after they eat. Now while that works fine for a child or toddler who you don't know will finish their meal if it's an older child or an adult who can easily you know, complete the whatever they've been had food put in front of them, then they should be timing their insulin with their food better with the goal to be to minimize the rise that occurs afterwards. Now, that's what the a one c elevations come from. And most people that are down in the six, seven and 8% range is what happens to their blood sugar after the not so much what they are before the. And I'll use this example a lot with people, if I was teaching somebody how to hit the golf ball, and I gave them the proper stance and positioning and so on the right clubs and all that, and I left and strike the ball and 100 times, yet, I never let them see where the ball landed, I'm not sure I'd make them a very good golfer. And that's in a sense what you're doing, you need to see where all that effort really leaves you. And if you're not checking a blood sugar in the next two to three hours after a meal, which a lot of people don't, or they've never been told to do, then you're setting people up in some ways to fail, because the assumption is that the doctor has given you some sort of ratio or some sort of formula. And they've told you to measure certain amount of food. And if you only do those two things correctly, you'll basically hit a hole in one every time and I think anybody who's done this for any period of time knows that that's just not true. And you need to have a different way of looking at this and that you may have to steer it even as it's moving. And that's a more advanced sugar surfing method is is trying to steer the direction of your your trend line after you've already taken your insulin and after you've already taken your food. But I'll tell you I do it all the time. You know,   Stacey Simms  16:31 I use it a little bit because that is you say that, and I'll put this back in here. It's a little bit more advanced, you want to be careful with this stuff. But how do you do that?   Dr. Stephen Ponder   16:39 Oh, well, you know, it's observation, it constant observation, I glanced at my sensor track anywhere between 40 and 50 times a day. It's not unlike you glancing at the dashboard of your car, when you're driving home, or looking in the rearview mirror, you're constantly scanning your surroundings as you're moving forward. And you have to take that same principle with you. When you sugar syrup. I mean, if you're surfing, you have to be well aware of your of your surroundings. So you just can't act three or four times a day. When you take an insulin dose and or eat food and expect to have the tightest control possible. You have to decide how willing Are you are her how able are you to be more aware of what's going on in the moment. As you see something trending up or trending down, keep us keep more of an eye on it and decide do I need to step in and alter the direction of my my trend line. I mean, as we're talking right now I'm looking at my sensor and I'm straight line at 96. On my particular sensor I've been I've been in my zone between 70 and 140. For the last several hours, I'm pretty much a straight trend line. But when I start to slowly drift down or slowly drift up, I pay a little bit more attention to that. And I want to see if it is is it approaching a threshold that I've decided in advance that I'm going to act upon. And I change those thresholds all the time based on the circumstances if I'm outside doing lots of intense work, I may want to run a little bit higher, and I'll tolerate a blood sugar of 161 7182. So I'll have a bit of a buffer underneath me if I'm if I'm you know doing a lot of yard work or doing a lot of exercise. Yet when I'm in the office like I am now I like being around 100 between 80 and 120. And I did steer the line in that fashion. And I do it through frequent glances and audit. A lot of times it's just looking at the sensor plot. And that's it, I do nothing else. I just stopped looking at it a couple a few seconds ago. And but if I saw something trending down, I'm going to preempt or act in advance of developing a low, I'll do the same thing in advance of what I think will become a high. Now do I sometimes over treat or prevent do too much? Yes, I've done that in the past. That's when I was just beginning this. But I've learned to use much smaller quantities of both insulin and carbohydrates to steer this line, I don't have to take 15 grams treated low, I can prevent a low with four grams. And I use things that are easily available. sips of juice, glucose tablets that have four grams of carbohydrates. So I've used these units of currency if you will. And I've learned how to use these to make small steering moves in the direction of the line of blood sugar. And that's really what sugar syrup is all about is steering that line, which everyone has. And nobody has a straight line blood sugar everybody, everybody's blood sugar line moves with or without diabetes. And I say this in the book, I say it in my workshops. The only person with a straight line blood sugar is a dead person, always on the move. And you just have to learn how to steer it. And the continuous glucose monitoring technology is a paradigm shift in diabetes management.   Stacey Simms  19:43 Let's talk about the CGM. I have to tell you in the last we've used it for a little bit more than two years and it really has changed our management and just like what you're going to talk about here in that when you see it going up. You can take a little bit of action or when you see it going down. Do you need a CGM of some kind of sugar, surf and You know, is that something that really has changed your way of even looking at management.   Dr. Stephen Ponder   20:06 When I first came into sugar surfing through the concept of what I call frequent pattern management, we did a research project a few years ago, we published in 2012, and diabetes care. This is a randomized control trial, where we developed the technology which would share information every night, with families, electronically, they their blood glucose meter was a wireless ahead of wireless modem, it would upload to the cloud, and every night, it would send all the information back in a very colorful format for families to look at. But we did a year long study where we wanted to see what the impact of that that frequent feedback would have on on on behaviors. And we found that we saw improved control. with patients who got that regular feedback rather than taking the time and effort themselves to go download or print something out or write things down in a logbook. And such, we use a control group where they everyone else just did that, they just they would do that whenever they felt like it. But that frequent follow up that frequent exposure to the data, improved control by a full percentage point, if there anyone sees or over 8%, at the beginning of the study, after a year, it had dropped and stayed stayed down about 1%. If it was seven and a half, or below, I'm sorry, it is below eight. That is they improved by about a half a percent. And this was with zero physician interaction with just getting information back in their hands. So this is a very, very preliminary version of what you could call CGM, which is, and that's really hyper frequent pattern management, because you're glancing down at that sensor. Now, that depends on the human being that using that data, you know, yes, it's recording every several minutes, it's giving you a data point, but somebody still has to look at it. And somebody still has to make decisions about what to do with that information. And then they need just like Kenny Rogers, you know, you know, walk away, run, hold and fold, and that sort of thing. That's what you're doing with with this information, you're making decisions in the moment. The fact of the matter is, they see that people are making decisions all day long with your diabetes. This is in the book, there's a study a few years ago that showed the average person without diabetes makes 221 choices a day about food. And so that's just about food, much less whether you have diabetes, and you're worried about food. So choices are the currency of control. And as you're making these choices, you're not always going to make the best choice, you're always gonna make the right choice. But you hopefully you're somebody that's wise enough to learn from those choices, and make better choices the next time. So it's a constant series of self improvement steps that you're doing with sugar surfing, it's not that the doctor gives you or issues you a set of directives that are somehow magically going to keep you in control. Those are starting points Don't get me wrong, I think dosing algorithms and so on, are all right, but they're not an end all be all. In fact, I have a hard time giving them out to patients now because I don't believe them or use them myself, other than just as a starting point. And I can't and I say that as a caveat, the family that said, Listen, I'm going to have to do this because you have to have your school orders for your child that a nurse will have to administer, I can't expect the nurse to be able to nuance things like you can as a mom or a dad or as a teenager. But I have to do this, it's part of what I have to do now. But it kind of pains me a little bit that I have to do this because I don't believe in it anymore, like I did a number of years ago, because of the dynamic nature of how diabetes can be controlled. Now you can get reasonable controls, don't get me wrong with with your with your algorithms, your carb ratios and your correction factors and so on. But, but you really can, you can take it to a whole nother level. And I get my keep it once he's down to 5% range. Now, by doing this in a dynamic fashion, you can get a good respectable 6% to 10% a one c by doing it old school, you want to call it that way. But you want to take it to a higher level and get down to the five or even to the normal. Below that it takes a lot more, you know, attention to detail. And and and sugar surfing.   Stacey Simms  24:00 Well let's let's grab a couple of questions that I took from social media for you about that exact point. This one is these are mostly about kids. But I think they're they're relevant overall. So this person says, if you want to employ just a couple of techniques with a child to increase in range time, what would they be? I don't this is her. These are her words. I don't want to go insane and spend every moment thinking about and evaluating my child's diabetes we want to live but I'm willing to make some changes.   Dr. Stephen Ponder   24:29 Absolutely. That's a great question. The first thing that I find with any patient I see when they come to see me new and they've been taken care of somewhere else is that they do the they don't do as good a job in timing the insulin and we touched on touched on that a little bit earlier. Many folks will come in and they may have been very well trained. They're very well motivated, but there's still dosing insulin after the fact. And if you see the impact of impact of that, on the rise of blood sugar that occurs after the meal, you will quickly say well, we need to do something being different, we need to take that infant ahead of schedule and we can. Now depending on the child, if there's somebody you, you know, who will reliably consume the meal they have in front of them, then then go for it. If it's somebody, you're not sure that they'll eat the whole meal, if they're on an insulin pump, there's some tricks you can play, like, extend the bolus over 30 minutes or 45 minutes. That said, once you know that, they're not going to complete the meal, you can still aboard the rest of that dose, and they can get about half of it that way. So there are all sorts of tricks you can play if you're using pumps. Now, if you're doing shots, you have to just be certain that that child is going to be able to consume the carbohydrates that are put in front of them. And, and I think that's an important that's an important tip and sugar surfing, is timing, timing is everything. The other is checking blood sugar Two hours later, whether it's with a sensor with a meter, and correct anything that's out of range, and you want to use a golf metaphor for that. That's what that's like having part three part four Whole Again, my feeling is nobody has a hole in one with every every insulin meal combination, that two hour reading gives you an opportunity to do a corrective dose to steer that blood sugar back toward your your, your target number, which in turn will lower that a one c because you'll spend less time up in the higher range which again, will contribute to a higher a one c value.   Stacey Simms  26:20 I like all the golf metaphor is you got to come to Charlotte and I'll take you out we'll play some golf, do you? Alright, so the next question is, can I ask? She says, Can you ask Dr. ponder about basil rates and we didn't talk about this yet at all. But she goes on to say I know he doesn't advise we use too many. But I find that my child a teen does better with about five basil rates, especially at least two overnight to account for the morning rise. Can you address that?   Dr. Stephen Ponder   26:49 Well, basal rates are our habits have a purpose behind them that sometimes they have. Some people use them in a different way. Let me just try to explain this. In the way a basal rate should work is just to keep you steady at whatever level your blood sugar is after your mealtime insolence, or your corrective insolence have gone away have dissipated. In other words, he just keeps you steady. However, some people use basil rates to offset indiscriminate eating and snacking that people don't vote for. And so as a result in in the Western world, we tend to run basil heavy, as opposed to maybe in some other parts of the world. In Japan, for example, they run rather basil light, there's less between meal snacking that goes on in some cultures. And there was a study done a few years ago that looked at basil insulin needs in and Japanese children, it found that they were about 30 to 35% of their total daily insulin dose, which flies in the face of you know, the general rule of thumb, which is you take about half of your daily insulin dose is a basil, insulin. So I think that I think there's a general tendency for people to look at blood sugar patterns, and just try to adjust basal rates rather than just to steer them around in a moment. There are there are increases that occur in blood sugar's overnight. And I agree, growth hormone and cortisol, which is another hormone that you produce early in the morning upon awakening can steer your blood sugar's up. And if you're trying to anticipate those in advance and, and and give additional infant espressos that has been something that's been done for many, many years, but generally speaking, most people can do well with either one, two or three basil rates. And a good friend of mine who you may have interviewed Steve Adelman is notorious for saying that anyone with more than three basil rates needs a new endocrinologist. And he can say that he's an he's a, he's an adult endocrinologist with type 1 diabetes almost as long as I've had it, and very well known and respected in the community. And I certainly adhere to his recommendation. Now if I if I see a new patient, it's on five or six basil rates, if I can tell them if you don't eat breakfast, which is what you should be able to do and your your blood sugar's in range. If your base rate set correctly, you'll stay in range more times than not over the next several hours until the next meal. But if all of a sudden you're you start dropping or start going up, well, your basal rate may not be set, right? You may be thinking that it is but it really isn't. But just think about the original intent of a baby, right is to keep you steady. It's not supposed to bring you down, it's not supposed to let you go up. It's just supposed to keep you at where you're at. As soon as the other insolence that would move you up and down, have gone away. And so if I wake up if I'm if I'm traveling through the night at 200, you know, between, say, I go to bed and I go up to 200 at midnight, and I'm at 200 in the morning, my basil rates, okay, that's perfectly fine. It's just that I didn't correct that that height and bring it down. It wasn't that it was going from 200 to 300 to 400. That would have said it was not enough or it was going from 200 to 100 to 50. Over six hours, that would be too much, but that it would just stay steady. That's the purpose of the base rate. It's different versus a bowl with insulin. So the the individual injections of fat that the insulin I know blog, blogger Piedra that used to maneuver up and down another metaphor, a pilot told me that they perfectly understood this concept of sugar serving. He said, you know, he's cruising at 30,000 seats. And you know, he that's what he's that's his cruising altitude. And if he wants to go down to 28,000 feet, he has to take action to make that happen or go up from 28,000 to 32,000 feet in his in his jet airplane, he said, I totally understand the concept of maneuvering, various levels in the base rate is just maintaining altitude, that's all it is. So these rates are sometimes misunderstood. And they're, they're overdone and some people, but I've gotten to the point of just letting people play on the rates they are. And if they can, if they live up to the original intent, and CPU steady in the absence of food, or exercise, then then that's fine. But I find a lot of people don't find that's the case, they find it when they don't add the foods and all the facts in there that the base rate really isn't what they need, they need to be on something more simple. And I try to simplify that whenever I can.   Stacey Simms  31:06 That's really interesting. And while we were talking there, I grabbed my phone, because I take pictures. Anytime I change a pump setting, I take a picture of it, because then I always have it with me, even if my kids pump is not with me, I have I have six programmed into my son's insulin pump. But the funny thing is that three of them, well, four of them really are about the same as the one you know before. So I really, if I really wanted to, I could get it down to three. Tomorrow. That's funny, I never even thought for some reason I never even thought about that. But they're but they're separated by point 0251 of   Dr. Stephen Ponder   31:39 them very subtle, it remember, it takes about an hour and a half to two hours before any, any rate change has a significant effect on blood sugar. So what happens is, if these are very close together, they may essentially just be blending into each other. And there's there's wobble in a pump rate the pump is not, you know, it's accurate up to a point. But even it has some variability built in. And if you factor in air bubbles, and you know, the sides may be leaking, there's there all sorts of things that, that make our diabetes prone to having variants in it, and plus the meters themselves, the sensors aren't 100%, but they at least give you a trend. foods are digested differently every day. There's so many variables. And it's in chapter five of the book, you know, false idols, there's so many variables in our control that you have, you can do nothing but just steer within a range. And I think that's the bottom line whether my blood sugar is exactly right now as I speak 93, or whether it's 95, or whether it's 90, Israel irrelevant to me, it says I'm trending straight, I'm in a zone, which allows me to function normally do my job, have this conversation with you, and not have a worry that I'm going to be dropping in the next 15 minutes or start spiking up in which time I'd have to excuse myself and take a small dose of insulin to prevent that.   Stacey Simms  32:58 Let me ask you another question. And this will be more of a personal one. For me. I did get a question about teenage boys. This one wants to know, what should a teenage boys a one c be? And I'll let you answer that. I think there's a lot of variability there, too. That's so personal. But my question is about teenagers. My son is 11. And he was diagnosed before we turn to so of course, we went through many years, and we did everything. He has a lot of independence. He takes care of himself beautifully when he's on his own. But the last year, really less six months, we've seen some of this teenage goofiness that I've heard from other people sneaking in, in terms of well, I forgot to check. I didn't bring my stuff. And you know, with the hormone levels, we're seeing blood sugars that we haven't seen in quite some time. I'm curious what you tell parents in your practice, you know, what do you do when you're super enthusiastic kid who is very responsible? And does everything suddenly? Is this stinky teenager who's in a different mindset? Frankly, it really it does seem to happen to so many people.   Dr. Stephen Ponder   33:55 Oh, it's actually very normal. That's that's the normal process of adolescence, you know, they, they're no longer you're smiling little kid, they're they're trying to establish their own identity. And one of the first things they do is to start to you know, they're spending more time out of the house or spending time with peer groups, they get into that phase where they want to be like everybody else, and then you don't know what you're talking about. It goes you go through that phase. Now, some people go through that more than others. Some don't seem to go through much at all. But you know, the listeners here are going to, if not in their own families, no other families for you know, the teenagers were just doing great as children, and then they just totally lost interest in any of their diabetes care or their diabetes management No matter how much they knew. And intelligence is not really the issue so much. It's, it's it is a lot of things that that are very unique and very individually as you said, even within a family you can have two or three responsible adolescence and then one that's just totally, you know, irresponsible, even though they they grew up very well adjusted, and they We're very well supported. That's just the normal process of of growing up as a team. I'll say one other thing, though, and I want to make this point clear. You know, a lot of people can can get comfortable with the two year old that grows up to be 11, doing all these things and and the parents can then start to be backing off of it, perhaps more than they should. And I always use this this example. And it's kind of silly example, but I tell parents, would you let your 11 or 12 year old kid with diabetes, pay your bills for you? or drive a car? I mean, some of these 13 year olds are physically capable of reaching all the pedals and driving a car, they have better reflexes in the rest of us. Would you trust them to do that? Well, most parents who say, Well, of course not. And my comeback is, well, you'll trust them with a life threatening disease, but you won't let them pay your bills, you won't let them drive your car. And so it's kind of an interesting conundrum there. It's because you've been lulled into a sense of security, that they've been doing this so long that because they can do the act of doing this, the actions of doing this, the sound of how they had the maturity to do it. It's like me saying, you know, because I hammer a nail a sock aboard, and I'm a carpenter, the carpenter is a set of skills and experience. It's not individual actions, all strung together in diabetes, because it's involving actions like taking a shot, checking a blood sugar, logging something, and even recognizing something higher low, that's a little bit different than organizing things and working through a problem and solving a problem. Most kids are concrete thinkers, up till about age 16. Now, a lot of them can be shown how to do things. And through practice, and coaching, they can learn how to solve most problems. But if you feel a raw concept that a teenager, without any background, just the concept, most will struggle very, very hard to kind of put an answer together to that all but just a small few. That's because kids are concrete thinkers, and about 25% of adults are concrete thinkers as well, that's been proven in the medical literature for years. Diabetes Care, especially surfing does require a lot of abstract thought, you know, those lines that you see on your sensor plot represents something that you can't see feel or touch, you know, if you're measuring the amount of sugar that's, that's present in the four liters, five liters of your blood, and how it's coming and going. And there, there are entry points and exit points. And that's a very abstract thought when you think about it. And you're trying to say, what are the forces that I can use to influence the rate of entry or exit of glucose into that closed space called the bloodstream, even though knowing the body for sugar and other places you're not measuring the sugar in the liver, you're not measuring the sugar in the in the muscles, and that's where some of your sugar pops up in your blood. It's when you stress, you're shoving sugar out of your liver and muscles in your blood. Likewise, it doesn't measure the count the amount of carbohydrates in your gut because they're still in your gut being absorbed and digested, you're just measuring within that bloodstream. In a sense, that's what matters, obviously, because your brain needs drawn sugar, but you're just not you're a flux manager in Sugar Surfingall about managing flux, and drift. And I say that in the workshops, it's in the book. That's what you're doing flux is a rapid upward or downward swing, a blood sugar's drift if something more gradual or slow, and how you learn to do that over time. And as you develop more skills and confidence is what determines your abilities as a sugar surfer. In the end, Dr. Ponder,   Stacey Simms  38:19 let me devil's advocate for just a moment about the the advice to parents. And I guess I'm going to ask you to play a little psychiatrist here. It hardly seems fair to parents, that at the time, when you say they're not ready to drive a car, right at 11, or 12, or 15, or or operate heavy machinery, why would you let them handle their diabetes? It's not fair that that's the age at which they seem the most resistant to input from parents. So as a parent, we know how do you balance that kid who wants to, you know, who's saying to their parents leave me alone, I've got this. And I get dumber as my kids get older, apparently, I know, a lot less than I used to know, according to them, how do you do that? As a parent? How do you say I'm going to help you I'm going to oversee this just when they're pushing back?   Dr. Stephen Ponder   39:03 I think the hardest part is when somebody's managing a child from age two onward. The person who really owns that diabetes is at that point is the parent. And when you're trying to make that transition and letting them manage that, oftentimes, the parent may may take an emotional response, like, well, gosh, you're messing up my diabetes that I've worked so hard to take care of all these years, and they're going to make mistakes, they're going to fall off the bicycle, you got to put them back on. The thing to do is, and I'm not saying you, the parent does everything until they're 16. In fact, on the contrary, that parent needs to become a sharer, they need to be sharing those responsibilities with the kid. And in fact, they should be there with them not to not to lecture them, not to tell them what they're doing wrong, just to be there to support them. And that's that's a very difficult balancing act for some parents who become accustomed to handling all the decision making, judging everything that goes down and in telling the child what to do and child's obviously pushing back. That's the whole point of adolescence is to break away from the family. And diabetes is caught in the middle of that. So the research and this is this is work that's been done by Barbara Anderson and others, good friends of mine is that shared responsibility up until around age 16 is the key doesn't mean doing things for them. But being there with them, you're still providing them the supplies, you may still be reminding of the things, but you need being there and letting them do it with your you know, with your guidance, or maybe your just your presence is all as necessary, especially, for example, in your case, your 11 year old sounds very capable and very potentially independent. But he would still benefit from having you there in the room, when you're when you're, you know, checking blood sugars and our dosing or making dosing decisions inside you have any questions and he doesn't well, then fine, but at least you know, it's been done. And it's and it's a shared responsibility. He also knows you care, at that point is as well, as opposed to saying, Hey, this is your responsibility, you gonna live with this rest of your life, I've heard that a million times from people that, you know, parents would want to drop that off and a 10 or 11 year olds lab, expect them to man up or woman up to do this. And all they're doing is, is setting a kid up to fail long term. Yeah, they may do it for a few months, or maybe a year or two. But at some point, that adolescent phase kicks in, and they start taking they started risk taking doing some, some experiments and so on. And that's what adolescence is about it is about risk taking. And that risk taking could include skipping insulin doses, eating more food, not checking blood, sugar's all those things, you know, and it can, if the parents aren't there, at least to support them, that's more likely to occur. That's, that's what I've seen over the 30 years, I've been doing this.   Stacey Simms  41:43 Thanks for talking about that. I think that is a really, really important piece of information to keep in mind. And you know, you are a pediatric endocrinologist. I know so many adults do so well with sugar surfing, but I want to pick your brain for one more question if I could, for the parents. And that is, it seems to me, you know, I am I am not a medical professional. But it just seems to me that there is more fear out there for parents than evolute when my son was diagnosed nine years ago. And I think some of that has to do with social media and how things kind of get spread and and rumors get started and different things get out there. But what do you tell your patients, parents about fear? And I guess I'm talking about, you know, overnight, checking every hour or letting kids go on sleepovers or things like that, or even just the the kind of fear that isn't specific in that way? Do you talk to your parents, your patients parents about that?   Dr. Stephen Ponder   42:34 Oh, yeah, I completely agree with you. The rise of social media allows one isolated story at any point in the globe, to go viral, and then frighten everyone else on the planet. You know, in regards to the you know, the one that everybody worries about is the severe hypoglycemia, the so called dead in bed syndrome thing. And then I see this all the time on social media. In fact, I've gotten out of several groups for that out there, because it just does nothing more than whips people up into, into a frenzy that this is going to happen to their child. I've been taking care of kids for 35 years, and I have had people that have passed away from diabetes that are friends that were adults, and some of them that are from two or three of them are eight to say this, we're from suicide. Another was from another was was from severe hypoglycemic event, this individual also had some other hormone deficiencies that made them more prone to have a problem, they were an adult as well. But in general is exquisitely rare. In some cases, and this is never discussed, you never see the details and the stories. Sometimes, some of these kids, these kids can have struggle with their control may not have the proper education or training. Some have some haven't. But you never know. And you really can't question that when when when you get a story like that online. So you have to just take it at face value that such and such loss your life and in there's no way of escaping the fact that that's tragic, completely, totally agree nobody should lose their life to this disease under any circumstances in childhood or even young adulthood In my opinion, but it does happen. People, you know, people have bad outcomes, but it's not something that hangs over my head every night. I try not to hang it over anybody else's head in my practice, and but it really does define people's concerns. I do know that that same fear is oftentimes leveraged as in a way to raise funds for diabetes as well. That's something I've been long critical of. And I've said that to many parents in the privacy of the clinic room that that you know, being told it we're gonna save you from disease we're gonna kill your kid really upsets me quite a bit because my goal for anybody with diabetes is to live a normal life you know, it has nothing to do with a one sees it's really being able to be the person you want to be the God meant you to be. And that's what What I aim for and anything I can do to help you achieve that through coaching knowledge, that's sugar serving whatever, people have to make their own choices, but I've not found fear to be a good motivator. In the long term for for achieving that goal. It's really trying to empower people to teach people they can take charge of this if they want to. But it's their choice. And I'm totally a believer in choice. It's all riddle to the book. It's all choice choice choice. I managed people who have chosen to do only so much with their diabetes, as much as many people listening to this and think that was the otter crazy, it happens all the time. And there are other people who, who spend their whole day managing this. And, to your question earlier about, you know, maintaining sanity, yes, you have to maintain a balance in your life, you know, watching your diabetes constantly throughout the day is not normal. You've got to have some balancing point out there, whether you're a parent or an adult with diabetes, but but fear is my one of my greatest   enemies. And, you know, the, quote, the famous, you know, Roosevelt, you know, you know, all we have to fear is fear itself. And that's very true. My parents were not fearful of hypoglycemia when I was a kid, but we didn't maintain the kind of control we're trying to maintain now, either. And so there was never a thought given about passing away. The fear back then was complications. And privately, my parents, and I even thought that I wouldn't live to see, you know, young adulthood. That was what they knew back in the 60s, because it's all based on information from the 20s 30s and 40s, which was not terribly good at that point. But over the years, I've learned what that was all, you know, that was all just myth and misconception on my part, because now, you know, now I've had it for 50 years, and I hope to have it you know, for many more years to come, I have beat this disease, anybody who's lived any length of time has beat this disease. In fact, I use this I say this to parents all the time, in the in the natural world order, I should have died 50 years ago, I should have you know, without insulin, but thank God that we I live in the era that I live in, I live in the country la live ended, I have access to the supplies I need. And I have the intelligence and the access to the resources, not that not everybody has I realized in this world to take charge of this but but missing element is that desire to do so. And I've been fortunate to have that desire. And I try to, I try to promote that, that attitude with anybody I come into contact with, whether it's a patient or a friend, or an acquaintance that has diabetes, but ultimately, we all have to make our own choices. And we all have to live with the consequences of those choices.   Stacey Simms  47:37 That's fantastic. I mean, what a statement as you're celebrating or marking, I'm not quite sure what the word is. But I'll say celebrating 50 years with type one, what when, when you look to the future here, what excites you? I know, are you testing a new kind of insulin? Do you look at different kinds of equipment, what what excites you about diabetes care, and in the next 50 years,   Dr. Stephen Ponder   47:59 my feeling is that the more we can educate, teach and provide support to people with diabetes, the better off the world will be, I'm seeing a troubling trend of late have more of an emphasis on technology and devices and new drugs, as opposed to investing more time and quality education, self management education, because it said before, you know, it all comes down to the choices we make, hey, I'm using a new insulin now that just happened to come out recently. It's an insulin degludec it has a much smoother action curve for me as a type one adult, I don't have any glows at night are even close to lows at night, which is one of the known consequences of that medication. downside is it's a new drug, which means it's more expensive. I'm excited about all the work that's going on with you know, encapsulation projects for islets were for artificial pancreas is and so on. My only concern is cost of these things and costs in terms of investment in time to the patient as well as money, and who will pay for these things. And I foresee there being almost this this multi tiered level of patience in the future of people, the haves and the have nots, as as our cure, quote, unquote, you know, becomes more and more costly. But you know, I say this to parents all the time about the word cure. The word cure is Latin, it comes from the word Curie, which actually means to care, that to be concerned for or to attend to. And in that literal sense of the word cure. I've been curing diabetes for 50 years and anybody who's still alive listening to this, and has diabetes has cured diabetes since they were diagnosed. The Romans never really understood disease in the sense that we understand it today. So they just felt that if they just took care of you just you know attended to your needs, that you would your body would would heal itself. And in a way, you know, the daily care I've been taking since March 1 1966. In terms of insulin dosages, checking my blood sugar or urine sugar back in those days in some fashion and making some decisions primitive as they were back in the 60s 70s and 80s, more advanced as they are now in the in the in the in the new millennium, is why I'm still here. And that plus the grace of God that I've not had an accident or had some other illness befall me. Those are the things that and I'm very thankful that I'm just happy I wake up every morning, I really am grateful when I get up every day, knowing that I beat this disease for half a century, and there are people that never had diabetes that haven't lived that long. And I live longer than so I have nothing but grateful I am nothing but grateful. I don't waste my time, being resentful being mad at this disease. I'm totally at peace with it. I know people still struggle with it, who are listening to this. I can't tell them they should be at peace. That's something yet that's a very personal thing to say. But I am I'm very much at peace with this. And if I pass Tomorrow, I will say I thought that my life was well lived with or without diabetes.   Stacey Simms  51:05 Dr. Ponder, I can't thank you enough for joining me, I was looking forward to an interesting discussion about blood sugar maintenance techniques. And instead, I just feel like talking to you has been a light today. Thank you so much for sharing so much time with me and with my listeners. I really appreciate it.   Dr. Stephen Ponder   51:23 Thank you. Thank you much for your time as well.   You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  51:36 I told you at the top of the show that Dr. Ponder has a free copy of sugar surfing for newly diagnosed families for newly diagnosed people. And that information is at Diabetes, Connections calm or hopefully linked up in the show notes as you listen on different podcast apps. One of the funniest things for me going back and listening to these older episodes. This is five years ago now is the terror in my questions about the teen years and Benny Benny is 11 years old when this interview happened. He is now 16. And I gotta tell you, middle school was the hardest. You heard me talking about there but is a Wednesday inching up and it's insolently it's going way up and his brain fog. And that was all in middle school. I can't say it's been completely smooth sailing since then. Because when is diabetes ever smooth sailing, but it certainly wasn't the, quote teen years as much as the tween years for us that were an issue. Of course, we're not at the teen years yet. So I probably shouldn't say anything, I'll knock some wood and will knock on my head and all that good stuff. All right, coming up next week, I'm going to be talking to a family with a child diagnosed during the pandemic. Can you even imagine? It's hard enough to have your toddler she was three years old, this little girl diagnosed at all. But when you can't meet up with other families in person, you can't go to conferences, you're isolated at home. There's so many families that this happened to in the last year. And I'm grateful that they decided to share their story. So we will be talking about that next week. thank you as always to my editor, john Buchanan. It's from audio editing solutions. Thank you so much for listening.   Unknown Speaker  53:02 I'm Stacey Simms.   Stacey Simms  53:03 I'll see you back here in just a couple of days until then, be kind to yourself.   Benny  53:12 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Our hosts speak with Steve Adelman, VP of the Event Safety Alliance, and head of Adelman Law Group, about the role each of us in the industry will play in the roadmap for restarting live events safely, including a discussion about liability and professional responsibility. https://www.eventsafetyalliance.org/ESA Reopening Guide: https://www.eventsafetyalliance.org/esa-reopening-guideSteve Adelman VP, Event Safety Alliance YouTube Channel: https://www.youtube.com/user/fen2005WayThis episode is sponsored by: Audix You can watch the video of this podcast episode here: https://youtu.be/ESVTSsiWaNsPlease check out and support The Roadie Clinic, Their mission is simple. "We exist to empower & heal roadies and their families by providing resources & services tailored to the struggles of the touring lifestyle." Be sure to check out the Signal To Noise Facebook Group. It's a space for listeners to create to generate conversations around the people and topics covered in the podcast — we want your questions and comments! Let's build a great sound community with a place to learn, discuss and reminisce about the “good old days.”The Signal To Noise podcast series on ProSoundWeb is hosted by Live Sound/PSW technical editor Michael Lawrence and pro audio veterans Kyle Chirnside/Chris Leonard