September 4, 2024 • 35 mins
Welcome to another inspiring episode of Think Like a Pancreas! Join host Gary Scheiner as he delves into a captivating conversation with Tavia Vital, the Director of Intensive Diabetes Management at Integrated Diabetes Services. Together, they explore Tavia’s multifaceted approach to diabetes care, highlighting her unique background and extensive experience.
In This Episode, You'll Learn:
- Introduction and Background: Meet Tavia Vital and learn about her upbringing in a small town in Iowa. Tavia shares the benefits of small-town living and a humorous take on counting the town's few traffic lights.
- Tavia's Journey into Diabetes Care: Discover Tavia's long-standing relationship with type 1 diabetes and how it inspired her to pursue a career in diabetes education. She emphasizes the importance of understanding the nuances of diabetes management and relating to patients' experiences.
- Multilingual Skills and Working with Spanish-Speaking Families: Explore Tavia's multilingual background, including Spanish, Portuguese, German, and Chinese. Learn about her work as a certified medical interpreter in Spanish and her dedication to supporting Spanish-speaking families in managing diabetes.
- Supporting Families and Children with Type 1 Diabetes: Gain insights into Tavia’s experience working with families and children with Type 1 diabetes, including her own son's diagnosis. She highlights the importance of early screening and the emotional support provided through the 'Time Out for Caregivers' group.
- Pregnancy Management and Collaboration: Understand Tavia's expertise in helping women plan for and navigate pregnancy while living with type 1 diabetes. Learn about her collaboration with Jenny Smith to provide comprehensive support throughout the pregnancy journey.
- Personal Life and Hobbies: Get a glimpse into Tavia’s personal life, including living in a two-family home with her extended family to care for her parents. Discover her love for outdoor activities like kayaking and her past involvement in playing percussion instruments like steel drums and marimba.
Meet the Hosts and Guest: Join host Gary Scheiner and guest Tavia Vital as they share their expertise and personal experiences in diabetes management and education. Tavia’s journey and insights provide valuable lessons for anyone living with diabetes.
Conclusion and Resources: Don't miss this episode filled with expert advice and practical strategies! Reach out to Tavia or the Integrated Diabetes Services team for personalized guidance on diabetes management. Explore additional resources and support networks to enhance your diabetes management journey.
Join Us: Subscribe now to Think Like a Pancreas for more episodes packed with expert advice and practical tips. Share this episode with fellow diabetes warriors, and leave a review to let us know your thoughts!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
Welcome to Think Like a Pancreas, the podcast.
Our goal is to keep you informed, inspired,
and a little entertained on all things diabetes.
The information contained in the program is based on the
experience and opinions of the Integrated Diabetes Services
Clinical Team.
Since this is a very individualized condition,
(00:25):
please check with your healthcare provider before
implementing any of the weird stuff we may happen to share
with you today.
I'm your host, Gary Scheiner,
owner and clinical director of Integrated Diabetes
Services.
Today I have the unique pleasure of being joined by Tavia
Vital, who is, what's your title with the practice?
(00:46):
I forget.
Director of Intensive Diabetes Management.
There you go.
You know, we always come up with really great titles.
Yeah.
You know, you want it to be like Grand Poobock,
Queen of the World, but that was taken.
So we had to come up with something else.
Yeah.
So you are from Dewitt, Iowa.
(01:07):
Yes.
Which,
and I looked on the map and it's nestled between Davenport
and Dubuque, Iowa.
Yep.
They name all the towns with D's along the eastern border
of Iowa.
Many of them are named after explorers that came through
once upon a time.
So if you look across the US,
there are about 10 different Dewitts or at least three that
(01:28):
I know of that pop up quite right away when you look.
So there was a Dubuque and a Davenport also that.
There are some around.
Okay.
What's it like living in, it's a small town.
I looked up the Dairy Queen there.
That was about it.
What's it like living in a really small town?
You know,
one thing that is good about living in a relatively small
(01:51):
town is there is not a lot of,
there aren't as many things to worry about as far as safety
concerns as compared to a larger city.
One other thing is,
as long as the planes are not spraying pesticides currently
on the fields nearby, the air is amazing.
(02:11):
You go outside, you breathe in,
you do not smell exhaust typically.
And traffic, there's not really traffic.
When there is traffic that we're annoyed with,
it's because a football game got out or some other,
you know,
a play just finished and all the cars are emptying out of
the school parking lot.
So it's a couple of minutes.
That's traffic.
(02:32):
How many traffic lights do you have into it?
Four, if we count the ones that are on the edge of top.
We have an extra one right now, though,
because there's some construction on a bridge,
so they put a temporary light in.
The fact that you can count them tells me everything I need
to know.
I might be shorting a couple of them,
but four pops that I can think of right now.
Yeah.
Yeah.
(02:53):
I always fancy that if I didn't work in diabetes,
I might be a good traffic engineer.
and there's a lot of traffic lights I'd like to do away
with because they're just superfluous and unnecessary.
Like why do you need them in every block?
That doesn't make any sense to me.
You don't, you don't.
So you've worked in the diabetes field for a while.
(03:15):
What was your impetus to work in diabetes?
My long -standing love -hate relationship with my diabetes
basically, that's where it came from.
So since I've lived with type 1 for over,
I'm at the 43 -year mark now.
Great, yeah, I guess.
(03:36):
Yeah,
and I had already gone to college and was working in the
business industry and long since had decided I really enjoy
helping people.
I like helping people solve problems.
I like helping people figure out they have this,
they need this, how do they get from here to there?
But I didn't really care.
(03:56):
If I helped people with their business problems,
I felt like, okay, we solved it.
But I went to a diabetes education class because my new
endow, when I moved to Colorado, they required it to come.
CNN know you had to take their diabetes education classes.
At that time,
I had had type 1 diabetes for more than 25 years.
So I was a little annoyed thinking,
(04:17):
what do I have to go to a classroom?
What am I going to learn?
I learned things.
It was eye -opening.
I learned how to treat a low glucose.
Sounds wild,
but I never really thought about how much does my glucose
go up?
When you treat a low, what am I trying to accomplish?
Other than not dying, right?
It was just mind -boggling, little details.
(04:39):
So my approach of just keep forcing food in your face till
you feel better, it's not optimal.
That's not the ideal way.
It is an option, but optimal.
No, it feels good though.
For the moment, for the moment,
and there's the next few hours.
Yeah.
And there was a diabetes educator teaching the class.
she had type 1 diabetes, and I little light bulb went on.
(05:01):
I could do that.
This would be great.
I could talk to people about diabetes,
they would understand what I'm saying.
How exciting could be in an office full of people who care
about people with type 1 diabetes.
Yeah, yeah,
we have it in common because I was sort of floundering
after undergraduate college.
I was working in advertising and marketing and it wasn't
(05:25):
really satisfying personally.
And then I went to a hospital program where there was an
exercise physiologist doing a talk and I learned so much
from him and I looked at him and I said,
that's what I want to do.
I developed my passion for it just from hearing someone
else and their passion for it.
Yep, it was that.
So we're going to have to change the title on your cards to
(05:48):
the diabetes fixer because you're really good at solving.
problems.
Maybe the diabetes detective.
I don't like to fix things.
I like to help people explore so that they can fix it.
Me fixing it does no good.
That's a true male -female difference, really.
Because guys, we love to fix things.
(06:09):
Yes.
Fix it, forget about it, we're done, put it away.
But women like to investigate, think about it.
I can tell people what to do, but a lot of times,
I don't like it if you tell me what to do.
Even if it's a great idea,
I might just shoot it down for the sake of,
because you told me, you're not the boss of me.
You share a challenge you're having with your husband.
(06:32):
You want him to just hear you and listen to you.
And what does he want to do?
He wants to figure it out.
Well, here's all you have to do, just do that, right?
Right.
Yeah, that's true.
That's a natural thing.
So we talk to our girlfriends when we want somebody to go
through it with us.
If we really are sick to death of this thing,
(06:52):
then we tell our spouse and then they can just give us the
answer and we move on.
It seems like just- So we're basically the last resort.
No, that's where if we're really ready to take action.
Oh, I see.
It's different stages, like contemplation and all.
Right.
Got it.
My pants are getting a little tight and I feel like I
should start exercising more and maybe eating more healthy
(07:14):
and maybe cutting down on the amount of creamer I put in my
coffee because I like creamer.
I like a little coffee with my creamer, right?
But I may not be ready to execute on any of those.
So if I asked my husband, he'd be like, well,
you stopped doing your morning walk a while ago.
Why don't you just do that?
Okay.
Yes, I could.
So yeah.
(07:35):
Or I would say just buy bigger pants and don't worry about
it.
Solutions is different solutions.
So besides your diabetes,
you have more diabetes in your family, right?
I sure do.
So we have two kids.
And they were involved in research studies since they were
newborns we actually took cord blood.
(07:57):
I didn't understand and put it into a test tube.
And,
and they've been enrolled in diabetes related research throughout
their infant infant hood and childhood.
So my oldest is now 16,
and he was diagnosed in May of 2020 very common is a common
diabetes anniversary with many people.
(08:20):
May of 2020 at age 12.
Yep.
Okay.
Yeah, 12 is a pretty common age for diagnosis,
all those during COVID chicken and create insulin
resistance it just makes the pancreas work that much
harder.
Yeah.
Yeah.
So has your other son been screened for for diabetes.
Yep, he's been screened.
(08:41):
At some point in time he put his foot down and said stop
poking me with needles so he has not recently been screened
we're working on talking about it too.
maybe we'll do the finger poke screen this time instead.
We'll see.
Yeah, you know,
Barbara Davis Center actually developed some best practice
guidelines for how often people need to be re -checked and
(09:04):
you may not have to do it every year.
If somebody doesn't have any antibodies, they usually say,
yeah, you could probably wait.
If it's a child,
you can wait at least a couple years before checking again.
Adults,
it can be every five years or just one time only might do
it.
So just for the benefit of our listening audience here,
all two people that might be listening,
(09:26):
what's the benefit of screening somebody who's at high risk
for type 1 diabetes?
There are a few benefits.
In our case,
I wanted to be aware of the subtle changes that were taking
place because there were a few other research studies that
my son may have been able to qualify for that were testing
(09:47):
out the efficacy of other medications at shutting down that
autoimmune process.
So they,
it could either halt the type 1 diabetes where it was and
not let it progress rapidly or reverse it so that he could
keep making his own insulin or at least make some insulin,
which is always very helpful when you're trying to live a
(10:08):
long healthy life without as much amazing ability to
fluctuate blood sugars astoundingly.
And it also helps protect against long -term complications
if you have some insulin production.
So knowing this,
that was one key reason that I wanted to keep in these
screening programs.
And then the other is for people who may not have the
(10:32):
experience of a surprise diabetes diagnosis that typically
is diagnosed when someone goes into diabetic ketoacidosis,
DKA, which typically is very scary as a parent,
seeing your child,
or even as an adult was healthy all of a sudden.
sick in the ER can be life threatening.
(10:53):
It's a terrible thing to have to go through.
So the studies have shown that if you're screening,
then kids that are screened are far less likely to
experience life threatening or serious DKA.
You catch the diabetes diagnosis much sooner.
You can start insulin sooner,
which is what the body means to thrive and be healthy.
So it's a better option for health and for mental sanity
(11:17):
and the experience of the family.
Yeah,
they keep finding new and more effective ways to delay the
development of Type 1 or the progression.
It doesn't just pop up all of a sudden.
You have the antibodies and then there has to be a phase of
beta cell destruction and then the glucose levels become
(11:38):
abnormal and then the Type 1 develops or it's diagnosed.
And catching it, like you said,
catching it early helps preserve beta cell function.
They're finding more and more ways we can slow down the
progression and detect it very early.
Teasial Taplizumab can be infused intravenously for a
(11:59):
couple of weeks and that delays an average of about two and
a half years, the progression, but there's a lot of stuff.
Anything that eases the workload on the pancreas seems to
be beneficial.
So we can learn from our brothers and sisters with type two
about how to do that.
And anything that eases metabolic distress is what I like
(12:21):
to call it.
So anything that helps your body be more healthy,
less insulin resistant, less cancer causing,
less inflammatory causing those types of lifestyle pieces
and supplements, getting sleep, getting exercise,
not smoking, stress reduction,
(12:43):
all the things that we know help make us healthy,
slow that progress and are important.
You got that nursing background that helps you integrate a
lot of the physiology into your patient care.
Now you didn't go to nursing school in Iowa though.
You were what happened in that was it Colorado?
Yep.
(13:03):
Mm hmm.
Yeah.
I was in Colorado when I went to nursing school.
What was that experience like going out to Denver?
The big city?
Oh, it was great.
Yeah.
So at the time I plotted on the map,
here are the places I want to go live.
And then we selected one, moved, and that was that.
And I was working, I got a job as a medical secretary.
(13:25):
It was my first hospital related job.
I worked in a business environment first.
And then shortly after arriving in Denver,
then I got the medical secretary job.
And I interacted with an endocrinologist who was the
director of the adult medical research unit that I was
(13:47):
working on.
and then I got into nursing school.
It was accelerated, so I worked full -time.
Our classes were on Fridays.
It was a very small group of people.
We went through four years of nursing school in three years
with classes only on Fridays, clinicals,
12 hours on the weekends once we got to the clinical part.
(14:07):
I am not surprised to hear that you got through a four
-year program in three.
So honestly,
you are maybe the most organized person I've ever met.
Besides being a problem solver,
you are extremely organized about things.
It definitely helps when you're living with diabetes,
but it also helps when you're coaching and teaching
(14:28):
patients about their diabetes management as well.
You also have a background in Spanish.
Is that from your upbringing or is that purely through your
own study?
That's through my own study.
I just, I love languages.
So when I went to college the first time, in Iowa,
(14:48):
I studied business and languages.
I studied Spanish, Portuguese, German, and Chinese,
and I only minimally remember how to say a few things in
most of those languages, but Spanish,
I had the most experience with,
I could practice it the most, use it the most, so yeah.
Wow, with all those languages, I was just thinking, man,
(15:09):
that could really open up some major markets for us.
It would not be good.
I can count up to a certain number and ask how you are and
say what my name is,
but if you try to tell me about your life.
Okay, so I'm gonna test you.
Can you say, hi, my name is Tavia in Chinese?
Oh, I probably, okay,
but if anybody speaks Chinese natively,
(15:30):
don't turn off the podcast because my accent is- Here's
Tavia's phone number, call her to complain.
No, I don't even,
my accent would be awful because it's really complicated.
All right, let's hear.
If you get right, let's see.
Ni hao, wo shuo, Tavia.
All right, well, the Tavia part, I think you got, right?
Who knows?
That part I got, yeah, the rest of it, ooh.
(15:53):
That's impressive.
So the Spanish part, you really took to a high level.
You're a certified medical interpreter in the Spanish
language.
That can't be easy to do.
You gotta know all the nomenclatures and whatnot.
So what kind of,
how are you applying your Spanish skills in your career
(16:14):
now?
Now I get to,
I get this great opportunity to work with Spanish speaking
families and people who have,
live with type one diabetes and we have a consult so it can
do them entirely in Spanish.
And it's great because anything that you might be nervous
or stressed about, or that's really important to you,
(16:36):
it's better if you can communicate in your primary
language,
even if you're completely fluent in another language,
you just, it sinks in better.
It makes more sense.
You can calm down anxiety better in your own language,
even like I said,
even if you're fluent in another language.
So yeah, it's a great opportunity for me.
(16:58):
I'm really pleased to be able to work with a number of
Spanish -speaking families that I am working with
currently.
It's my favorite thing, really.
Yeah.
Yeah,
it makes a difference because it's not readily available,
at least for people with Type 1 needing specialized help.
It's not specific Spanish service in most places.
And you work with a lot of people in Panama,
(17:20):
you want to do a shout out to any of your special friends
and colleagues in Panama?
Oh, I better not because what if I forget somebody's name?
But I could say a shout out to the Baker family because I
work with the mom, Pilar Gomez.
Yes,
she runs a foundation for Spanish -speaking individuals
(17:43):
from Latino America,
especially Central and South America focus and provides a
lot of great educational opportunities and social bonding
for kids and adults with type one and we work together on
many projects along the way and I'm super grateful for her
insight and And information and she has children with type
(18:05):
one diabetes and she lets me help them manage it and so
it's a it's a great.
She said I'm part of their family, for better or for worse,
they've adopted me so that's good.
Good for me.
It's a nice family to be part of.
Yeah, it is.
They're great.
Just a great family.
Yeah, I mean,
we are practice we work with clients all over the world and
it's interesting to learn about the health systems in
(18:29):
different countries.
In some ways,
I'm jealous of the situation that some people are in,
but I'm also.
I feel, you know,
I feel a little bad about some of the limitations we see in
other countries and you deal a lot with people in South
America Central America.
(18:50):
Where do you see they have either advantages or
disadvantages from a healthcare standpoint.
You know, each country is different with how it operates,
which is an interesting thing because if you look at it on
a map, you sort of think,
South America must be like the United States.
No,
it's a bunch of countries individually operating in their
(19:11):
own government underneath their own government system so
every country has its own carve out with what public aid
covers.
If there's a privatized insurance versus the public health
insurance and there are different doctors and hospitals and
different supplies are covered or not covered.
(19:31):
So it's just it varies wildly what people have access to
financially, depending on where they live,
and then physically so let's say you live in country x,
and you want pump a,
you may not be able to physically purchase it in your
country you might have to.
travel to other countries or go to the United States and
have it prescribed and then get it shipped to you and then
(19:52):
fly back home.
And then if you think about every three months you need
more supplies,
that's an ongoing challenge to many people living around
the world.
And even the insulins.
I mean,
there is a type of rapid acting insulin in every country
that I'm aware of in Central and South America,
but there may only be one type.
Yeah,
(20:13):
and the ultra -rapids haven't made it to every country
either.
Definitely not, yeah.
Well, I just got a package in the mail today.
It's my Afrezza starter kit.
I mean, I've tried inhaled insulin before.
I'm gonna give it at least a couple of weeks and use it
exclusively as my mealtime insulin and see how it goes.
(20:37):
And then hopefully my Moby pump will show up soon and I'll
be able to give that a try and I'll use a...
a libre sensor with it.
So we tried all kinds of things.
What are you using today for your day?
(20:57):
I am using an old Omnipod pod, the Eros version,
with a RileyLink radio transmitter.
And I'm using Trio,
which is every more people have heard of do it yourself
loop, open source coding loop,
and beta testing loop with several people on our team,
actually.
(21:17):
And one of our team members is actively involved in the
development and ongoing instructional documentation and
usability of Trio.
Yeah,
it's nothing like personal experience with these devices
and systems.
I feel like it gives us a better feel for how to make them
(21:38):
work well.
And this stuff that's just not in the user guide in the
manual that you'll learn just from actually wearing it and
using it day in and day out.
Right,
so when people have questions or they have trouble with it,
if you've worn it enough,
then you probably experience that.
Or you could at least understand what their specific issue
(21:59):
might be and guide them to the right section of the menu or
explain how the device works, how's the algorithm work,
what is the button pushing involved that creates that error
every 10 seconds, if you do the buttons this way,
you won't have that problem, whatever it is.
Even with CGM's,
we've got patients who have trouble wearing the CGM and the
quote unquote approved body parts.
(22:21):
And we're able to give them some insight about where it
might stick better,
where it won't get knocked around as much where it'll still
perform really well, just from personal experience.
Yeah, for sure.
And then if somebody says,
it's not working the way that they market it to work,
you have personal experience so you could,
whether it's through ourselves or through our clients that
(22:42):
tell us, you know,
their experience and we see it on graphs on the screen and
And at least I think a big part of what we do is validate
people's experiences where sometimes they try,
I'll call customer service for the company that their
device is through and maybe not be met with ideal responses
or their doctor's office,
maybe their provider office doesn't have somebody who's
(23:03):
tried all these devices out.
And so they really can't,
they can't empathize and they can't really understand what
the person is experiencing.
And so I think that's one thing we get a lot of feedback
for from our clients is thank you.
I feel validated.
I just got one of those messages from a mom in Panama this
week.
In fact, yeah, no,
you got a lot of diverse skills and you've got some
(23:25):
tremendous expertise in Spanish and issues facing Spanish
speaking users.
You've got experience with every pump and CGM and now with
the the open source, you know, the DIY type systems.
And I guess having a son with Type 1 gives you a unique
(23:45):
perspective about working with families that have kids with
Type 1.
Yeah, it does.
So what are some of the specific or other areas that you
can provide service for clients?
One area that I love is working with moms that are planning
pregnancy or who are pregnant to help them navigate the
(24:08):
expectations and all the ongoing changes that are needed to
insulin dosing,
but also where to wear your pump or other issues that come
up because of skin integrity throughout pregnancy.
And just the I've been there.
I've had two healthy children while living with Type 1
(24:29):
diabetes.
So when they come on and have their anxieties or the things
they're most concerned about,
I understand what they're saying.
And I love being able to give them information that helps
them understand their concerns and strategize so that the
concerns aren't what drives every day of their life.
They don't have to go through pregnancy super anxious the
(24:49):
whole time.
Instead, we can focus on healthy pregnancy.
You and Jenny Smith are our dynamic duo in terms of working
with women who are hoping to have a healthy,
successful pregnancy.
And our success rate is off the charts.
I think we do better to help more women have successful
(25:09):
pregnancies percentage -wise in any place else I've ever
seen.
I got pictures this week.
It was, yes, what day is today?
Today is, I don't even know what day it is.
It's Sunday.
Every day runs into the next.
I got pictures last week from a new baby that I helped them
on with through her pregnancy.
(25:30):
It's so exciting.
Super healthy baby.
Just the right size.
No, they didn't need the ICU.
They didn't need any of those things.
Healthy, healthy mom and baby is so exciting.
Yeah.
That's nice.
And you've sort of co -managed a,
not really a support network, but a, well, yeah,
kind of a support network for parents of kids with type 1.
(25:52):
Tell us a little about that.
Yeah, sure.
So one thing that many of us have noticed along the way,
working with parents of kids with type 1 diabetes is just
the overall intensity of managing a child's diabetes.
When it's your own diabetes,
that's one level of intensity that can exist,
but it's your child.
Parents,
we want the best for our children and we want them to be
(26:14):
healthy.
Sometimes we go about that,
looking at all possible healthy options and choosing and
navigating through, making mistakes, learning.
Sometimes though we get so concerned that we stopped using
strategies and we start basing everything off of anxiety
-based decisions and it's all -encompassing.
(26:35):
Parents will often,
it's really common for parents to feel like,
I don't do anything other than...
what I have to get done in the day and my child's type 1
diabetes.
I'm not sleeping.
I'm not talking to friends.
I'm not going out.
I'm not, you know, it's just very, very intense for them.
And so helping parents find a place where other parents are
going through the same thing so they can interact with each
(26:56):
other socially,
but also providing information about coping skills and how
to let go a little bit,
not let go of helping your child be healthy,
but switching from anxiety or intense guilt or worry
focused decision making to here's the issue.
Here's the thing we're planning for.
(27:17):
What are the steps I need to do to ensure we're successful
as possible?
If it doesn't go well,
I know what to do to help my child be healthy in the event
of a higher or low blood sugar and just taking that
emotional burden down a few matches.
So we created,
I didn't think it was as they think like a pancreas,
but that's what you created.
Time Out for Caregivers is the name of the sessions that we
(27:39):
created so people can come together about once a month or
once every other month and join in on our conversation.
We have it co -led right now with Anna Savino,
one of our licensed social workers who specializes in
working with kids and parents and people living with type 1
diabetes and the emotional burden that it can entail.
(28:00):
So she and I run it and it's a great opportunity for people
to feel that stress decompression.
Yeah.
How do you feel when you're running those programs?
Do you feel it's a good catharsis for you as well?
It really is.
It surprised me when we started it.
I thought, well, this will be great for the parents.
Then as they were telling their stories and I realized
(28:22):
like, oh yeah,
I didn't sleep for the last two nights well because my
son's alarms were going off and I need to change his pump
settings.
Like, oh yeah, okay.
We're speaking the same language.
It's great.
Yeah.
Yeah.
I've always felt that parenting a child with diabetes is 10
times harder than living it with yourself.
(28:42):
And if you were, if we have a higher or low glucose,
we're like, yeah, screw it, move on.
When your child has those issues,
we internalize it and we feel guilty and we dwell on it.
And it's a big issue.
So yeah, I guess helping parents relax,
put things in perspective a little bit can make a big
(29:03):
difference in the quality of life.
And just having,
most parents are doing this on their own because they don't
live in a place where all of their friends' children have
type 1 diabetes.
So they don't have someone that they can just readily talk
to about a frustration or just all of the things that make
up dealing with a child's type 1 diabetes,
(29:25):
just being able to bounce those things around and hearing
other people going through their experiences.
It's just super, just emotionally,
but also there's like a physical release.
A lot of people cry.
Like, I'm not even a crier.
I don't even know why I'm crying.
It's because you feel validated.
You feel like you're not the only one because you're not.
(29:47):
It's good to get that.
And you know, yeah.
Yeah.
So thinking again about the life of Tabia and being in the
middle of the White Iowa,
I know you've got cornfields in sight and I expected you to
have like a hen house and cows and you've got other pets.
Tell us about your dogs.
(30:07):
We have my husband and sons and I have a Husky.
His name's Cisco and he's amazing.
He's usually in here.
He's not in here today, but he will be later, I'm sure.
So he's a lot of fun.
He has lots of energy.
Thankfully,
he also sleeps a lot so that kind of balances out.
So yeah.
And then we built a two -family home to help with
(30:32):
caregiving for my parents.
And my mom has two chihuahuas.
So I think one of them was barking earlier.
He probably heard her, it's Chica.
And so there are lots of dog hair in my house that we were
perpetually cleaning up.
We used to have birds as pets,
but they are very noisy and you have to do a lot of
cleaning and they require a lot of focus and energy.
(30:55):
And we started helping caregiving for my stepdad and we
gave them to a nice woman who is retired and gets to play
with them all the time.
So there's less zoo -like noises in our home now than ever
before.
Well,
it's nice that you thought about your family and your parents
and your in -laws and all.
(31:18):
And your kids can grow up being really close to the
extended family that way.
Yeah.
Does it create any challenges for you having them in the
same house or the same structure?
Of course.
I mean,
imagine living with any of parents or in -laws all the
time.
I try not to think about that.
So it doesn't matter.
(31:39):
how great of people you are.
If you live with someone else,
there are moments where it doesn't go as well as you like.
But overall, I mean,
we built the house so that it's really two homes in one.
So we go into our living area.
My mom is in her living area now.
And it's pretty, I'm pretty chill anyway,
it takes a lot to get me all riled up about something.
(31:59):
So add patience to your growing list of skill sets.
If my mom decided to talk to me in her, I'm your mom,
you're a teenager voice,
we would have to talk about that and change that but she
doesn't.
So so if she does skill set, we got to add so patience,
but also steel drums.
So you played steel drums back in school,
(32:21):
marimba percussion.
So in high school, I played percussion.
I really like mallet instruments like marimba xylophone
bells.
And I played steel drums in college.
Yeah, I wish I had them in our house right now.
But I guess it's one less thing to distract me from what I
need to be concentrating.
So yeah.
(32:41):
It's a magical sound because everyone just thinks about a
tropical island and stress level goes down.
You hear a steel drum.
Yeah, that's where I so I physically in Iowa,
but I'm mentally by an ocean somewhere.
That's you see the turquoise kind of colored things I have
going on my wall is a light kind of horizon sort of blue.
(33:05):
Yeah,
I looked at the map and I think the width Iowa is as far
from any ocean as a human being.
Pretty much.
Yeah.
As far as it could be.
It's very close to many lakes and ponds and the backyard.
We do.
Yeah, that was an amazing thing.
So can swim and pretend it's the ocean.
(33:28):
Yeah.
And you're you're into kayaking, right?
Yeah, we went last week we went kayaking.
And so we either part of the family goes or if we all go
then two of us walk and hike around while two of us kayak
and then we trade places and it's a lot of fun.
It's great because I had hand surgery not long ago and it's
(33:49):
healed enough so I could kayak and no pain.
It was very exciting.
Nice.
Nice.
Can't even see any mark on your hand now.
Well, zoom does a lot to cover up and imperfect.
There's a low mark but no biggie.
I mean, that's pretty good.
Wasn't open it.
Yeah, okay.
We went the kids and I went yesterday for Oh,
we were gone for almost two hours.
(34:11):
We went out on a bike ride when exploring and was great
weather instead of being 100 and some degrees hasn't been
100 degrees here,
but it's been hot and humid like everywhere.
Yesterday was perfect.
So we went out road and road and road.
It was great day.
Nice.
All right.
Anything any last words anything else you'd like to share
(34:31):
about the Tabia Vital experience?
I don't I told you beginning that if you if you ask me
questions, I'm glad to answer,
but don't make me just talk about myself.
I'd rather talk about anything else.
So yeah, not like doing that.
There's some exceptions.
That's true.
(34:52):
Well, I am so happy you're part of our team.
And I know of our patients, all of our clients,
they're extremely thrilled that you're part of our team as
well and can help them.
Besides our Spanish speaking clients, pregnancy,
women going through pregnancy,
parents and kids and patients in general,
(35:15):
you got technology skills and really help with a lot of
different things.
So keep up the great work, Tavia.
I try most days.
So if anybody's interested in setting up a meeting with
Tavia and our consultation, please reach out.
So thank you.
(35:35):
I want to thank everyone for joining us today.
On behalf of Think Like a Pancreas, the podcast,
I'm Gary Scheiner.
Have a great rest of your week.
Welcome to Think Like a Pancreas, the podcast.
Our goal is to keep you informed, inspired,
and a little entertained on all things diabetes.
The information contained in the program is based on the
experience and opinions of the Integrated Diabetes Services
Clinical Team.
Since this is a very individualized condition,
(00:25):
please check with your healthcare provider before
implementing any of the weird stuff we may happen to share
with you today.
I'm your host, Gary Scheiner,
owner and clinical director of Integrated Diabetes
Services.
Today I have the unique pleasure of being joined by Tavia
Vital, who is, what's your title with the practice?
(00:46):
I forget.
Director of Intensive Diabetes Management.
There you go.
You know, we always come up with really great titles.
Yeah.
You know, you want it to be like Grand Poobock,
Queen of the World, but that was taken.
So we had to come up with something else.
Yeah.
So you are from Dewitt, Iowa.
(01:07):
Yes.
Which,
and I looked on the map and it's nestled between Davenport
and Dubuque, Iowa.
Yep.
They name all the towns with D's along the eastern border
of Iowa.
Many of them are named after explorers that came through
once upon a time.
So if you look across the US,
there are about 10 different Dewitts or at least three that
(01:28):
I know of that pop up quite right away when you look.
So there was a Dubuque and a Davenport also that.
There are some around.
Okay.
What's it like living in, it's a small town.
I looked up the Dairy Queen there.
That was about it.
What's it like living in a really small town?
You know,
one thing that is good about living in a relatively small
(01:51):
town is there is not a lot of,
there aren't as many things to worry about as far as safety
concerns as compared to a larger city.
One other thing is,
as long as the planes are not spraying pesticides currently
on the fields nearby, the air is amazing.
(02:11):
You go outside, you breathe in,
you do not smell exhaust typically.
And traffic, there's not really traffic.
When there is traffic that we're annoyed with,
it's because a football game got out or some other,
you know,
a play just finished and all the cars are emptying out of
the school parking lot.
So it's a couple of minutes.
That's traffic.
(02:32):
How many traffic lights do you have into it?
Four, if we count the ones that are on the edge of top.
We have an extra one right now, though,
because there's some construction on a bridge,
so they put a temporary light in.
The fact that you can count them tells me everything I need
to know.
I might be shorting a couple of them,
but four pops that I can think of right now.
Yeah.
Yeah.
(02:53):
I always fancy that if I didn't work in diabetes,
I might be a good traffic engineer.
and there's a lot of traffic lights I'd like to do away
with because they're just superfluous and unnecessary.
Like why do you need them in every block?
That doesn't make any sense to me.
You don't, you don't.
So you've worked in the diabetes field for a while.
(03:15):
What was your impetus to work in diabetes?
My long -standing love -hate relationship with my diabetes
basically, that's where it came from.
So since I've lived with type 1 for over,
I'm at the 43 -year mark now.
Great, yeah, I guess.
(03:36):
Yeah,
and I had already gone to college and was working in the
business industry and long since had decided I really enjoy
helping people.
I like helping people solve problems.
I like helping people figure out they have this,
they need this, how do they get from here to there?
But I didn't really care.
(03:56):
If I helped people with their business problems,
I felt like, okay, we solved it.
But I went to a diabetes education class because my new
endow, when I moved to Colorado, they required it to come.
CNN know you had to take their diabetes education classes.
At that time,
I had had type 1 diabetes for more than 25 years.
So I was a little annoyed thinking,
(04:17):
what do I have to go to a classroom?
What am I going to learn?
I learned things.
It was eye -opening.
I learned how to treat a low glucose.
Sounds wild,
but I never really thought about how much does my glucose
go up?
When you treat a low, what am I trying to accomplish?
Other than not dying, right?
It was just mind -boggling, little details.
(04:39):
So my approach of just keep forcing food in your face till
you feel better, it's not optimal.
That's not the ideal way.
It is an option, but optimal.
No, it feels good though.
For the moment, for the moment,
and there's the next few hours.
Yeah.
And there was a diabetes educator teaching the class.
she had type 1 diabetes, and I little light bulb went on.
(05:01):
I could do that.
This would be great.
I could talk to people about diabetes,
they would understand what I'm saying.
How exciting could be in an office full of people who care
about people with type 1 diabetes.
Yeah, yeah,
we have it in common because I was sort of floundering
after undergraduate college.
I was working in advertising and marketing and it wasn't
(05:25):
really satisfying personally.
And then I went to a hospital program where there was an
exercise physiologist doing a talk and I learned so much
from him and I looked at him and I said,
that's what I want to do.
I developed my passion for it just from hearing someone
else and their passion for it.
Yep, it was that.
So we're going to have to change the title on your cards to
(05:48):
the diabetes fixer because you're really good at solving.
problems.
Maybe the diabetes detective.
I don't like to fix things.
I like to help people explore so that they can fix it.
Me fixing it does no good.
That's a true male -female difference, really.
Because guys, we love to fix things.
(06:09):
Yes.
Fix it, forget about it, we're done, put it away.
But women like to investigate, think about it.
I can tell people what to do, but a lot of times,
I don't like it if you tell me what to do.
Even if it's a great idea,
I might just shoot it down for the sake of,
because you told me, you're not the boss of me.
You share a challenge you're having with your husband.
(06:32):
You want him to just hear you and listen to you.
And what does he want to do?
He wants to figure it out.
Well, here's all you have to do, just do that, right?
Right.
Yeah, that's true.
That's a natural thing.
So we talk to our girlfriends when we want somebody to go
through it with us.
If we really are sick to death of this thing,
(06:52):
then we tell our spouse and then they can just give us the
answer and we move on.
It seems like just- So we're basically the last resort.
No, that's where if we're really ready to take action.
Oh, I see.
It's different stages, like contemplation and all.
Right.
Got it.
My pants are getting a little tight and I feel like I
should start exercising more and maybe eating more healthy
(07:14):
and maybe cutting down on the amount of creamer I put in my
coffee because I like creamer.
I like a little coffee with my creamer, right?
But I may not be ready to execute on any of those.
So if I asked my husband, he'd be like, well,
you stopped doing your morning walk a while ago.
Why don't you just do that?
Okay.
Yes, I could.
So yeah.
(07:35):
Or I would say just buy bigger pants and don't worry about
it.
Solutions is different solutions.
So besides your diabetes,
you have more diabetes in your family, right?
I sure do.
So we have two kids.
And they were involved in research studies since they were
newborns we actually took cord blood.
(07:57):
I didn't understand and put it into a test tube.
And,
and they've been enrolled in diabetes related research throughout
their infant infant hood and childhood.
So my oldest is now 16,
and he was diagnosed in May of 2020 very common is a common
diabetes anniversary with many people.
(08:20):
May of 2020 at age 12.
Yep.
Okay.
Yeah, 12 is a pretty common age for diagnosis,
all those during COVID chicken and create insulin
resistance it just makes the pancreas work that much
harder.
Yeah.
Yeah.
So has your other son been screened for for diabetes.
Yep, he's been screened.
(08:41):
At some point in time he put his foot down and said stop
poking me with needles so he has not recently been screened
we're working on talking about it too.
maybe we'll do the finger poke screen this time instead.
We'll see.
Yeah, you know,
Barbara Davis Center actually developed some best practice
guidelines for how often people need to be re -checked and
(09:04):
you may not have to do it every year.
If somebody doesn't have any antibodies, they usually say,
yeah, you could probably wait.
If it's a child,
you can wait at least a couple years before checking again.
Adults,
it can be every five years or just one time only might do
it.
So just for the benefit of our listening audience here,
all two people that might be listening,
(09:26):
what's the benefit of screening somebody who's at high risk
for type 1 diabetes?
There are a few benefits.
In our case,
I wanted to be aware of the subtle changes that were taking
place because there were a few other research studies that
my son may have been able to qualify for that were testing
(09:47):
out the efficacy of other medications at shutting down that
autoimmune process.
So they,
it could either halt the type 1 diabetes where it was and
not let it progress rapidly or reverse it so that he could
keep making his own insulin or at least make some insulin,
which is always very helpful when you're trying to live a
(10:08):
long healthy life without as much amazing ability to
fluctuate blood sugars astoundingly.
And it also helps protect against long -term complications
if you have some insulin production.
So knowing this,
that was one key reason that I wanted to keep in these
screening programs.
And then the other is for people who may not have the
(10:32):
experience of a surprise diabetes diagnosis that typically
is diagnosed when someone goes into diabetic ketoacidosis,
DKA, which typically is very scary as a parent,
seeing your child,
or even as an adult was healthy all of a sudden.
sick in the ER can be life threatening.
(10:53):
It's a terrible thing to have to go through.
So the studies have shown that if you're screening,
then kids that are screened are far less likely to
experience life threatening or serious DKA.
You catch the diabetes diagnosis much sooner.
You can start insulin sooner,
which is what the body means to thrive and be healthy.
So it's a better option for health and for mental sanity
(11:17):
and the experience of the family.
Yeah,
they keep finding new and more effective ways to delay the
development of Type 1 or the progression.
It doesn't just pop up all of a sudden.
You have the antibodies and then there has to be a phase of
beta cell destruction and then the glucose levels become
(11:38):
abnormal and then the Type 1 develops or it's diagnosed.
And catching it, like you said,
catching it early helps preserve beta cell function.
They're finding more and more ways we can slow down the
progression and detect it very early.
Teasial Taplizumab can be infused intravenously for a
(11:59):
couple of weeks and that delays an average of about two and
a half years, the progression, but there's a lot of stuff.
Anything that eases the workload on the pancreas seems to
be beneficial.
So we can learn from our brothers and sisters with type two
about how to do that.
And anything that eases metabolic distress is what I like
(12:21):
to call it.
So anything that helps your body be more healthy,
less insulin resistant, less cancer causing,
less inflammatory causing those types of lifestyle pieces
and supplements, getting sleep, getting exercise,
not smoking, stress reduction,
(12:43):
all the things that we know help make us healthy,
slow that progress and are important.
You got that nursing background that helps you integrate a
lot of the physiology into your patient care.
Now you didn't go to nursing school in Iowa though.
You were what happened in that was it Colorado?
Yep.
(13:03):
Mm hmm.
Yeah.
I was in Colorado when I went to nursing school.
What was that experience like going out to Denver?
The big city?
Oh, it was great.
Yeah.
So at the time I plotted on the map,
here are the places I want to go live.
And then we selected one, moved, and that was that.
And I was working, I got a job as a medical secretary.
(13:25):
It was my first hospital related job.
I worked in a business environment first.
And then shortly after arriving in Denver,
then I got the medical secretary job.
And I interacted with an endocrinologist who was the
director of the adult medical research unit that I was
(13:47):
working on.
and then I got into nursing school.
It was accelerated, so I worked full -time.
Our classes were on Fridays.
It was a very small group of people.
We went through four years of nursing school in three years
with classes only on Fridays, clinicals,
12 hours on the weekends once we got to the clinical part.
(14:07):
I am not surprised to hear that you got through a four
-year program in three.
So honestly,
you are maybe the most organized person I've ever met.
Besides being a problem solver,
you are extremely organized about things.
It definitely helps when you're living with diabetes,
but it also helps when you're coaching and teaching
(14:28):
patients about their diabetes management as well.
You also have a background in Spanish.
Is that from your upbringing or is that purely through your
own study?
That's through my own study.
I just, I love languages.
So when I went to college the first time, in Iowa,
(14:48):
I studied business and languages.
I studied Spanish, Portuguese, German, and Chinese,
and I only minimally remember how to say a few things in
most of those languages, but Spanish,
I had the most experience with,
I could practice it the most, use it the most, so yeah.
Wow, with all those languages, I was just thinking, man,
(15:09):
that could really open up some major markets for us.
It would not be good.
I can count up to a certain number and ask how you are and
say what my name is,
but if you try to tell me about your life.
Okay, so I'm gonna test you.
Can you say, hi, my name is Tavia in Chinese?
Oh, I probably, okay,
but if anybody speaks Chinese natively,
(15:30):
don't turn off the podcast because my accent is- Here's
Tavia's phone number, call her to complain.
No, I don't even,
my accent would be awful because it's really complicated.
All right, let's hear.
If you get right, let's see.
Ni hao, wo shuo, Tavia.
All right, well, the Tavia part, I think you got, right?
Who knows?
That part I got, yeah, the rest of it, ooh.
(15:53):
That's impressive.
So the Spanish part, you really took to a high level.
You're a certified medical interpreter in the Spanish
language.
That can't be easy to do.
You gotta know all the nomenclatures and whatnot.
So what kind of,
how are you applying your Spanish skills in your career
(16:14):
now?
Now I get to,
I get this great opportunity to work with Spanish speaking
families and people who have,
live with type one diabetes and we have a consult so it can
do them entirely in Spanish.
And it's great because anything that you might be nervous
or stressed about, or that's really important to you,
(16:36):
it's better if you can communicate in your primary
language,
even if you're completely fluent in another language,
you just, it sinks in better.
It makes more sense.
You can calm down anxiety better in your own language,
even like I said,
even if you're fluent in another language.
So yeah, it's a great opportunity for me.
(16:58):
I'm really pleased to be able to work with a number of
Spanish -speaking families that I am working with
currently.
It's my favorite thing, really.
Yeah.
Yeah,
it makes a difference because it's not readily available,
at least for people with Type 1 needing specialized help.
It's not specific Spanish service in most places.
And you work with a lot of people in Panama,
(17:20):
you want to do a shout out to any of your special friends
and colleagues in Panama?
Oh, I better not because what if I forget somebody's name?
But I could say a shout out to the Baker family because I
work with the mom, Pilar Gomez.
Yes,
she runs a foundation for Spanish -speaking individuals
(17:43):
from Latino America,
especially Central and South America focus and provides a
lot of great educational opportunities and social bonding
for kids and adults with type one and we work together on
many projects along the way and I'm super grateful for her
insight and And information and she has children with type
(18:05):
one diabetes and she lets me help them manage it and so
it's a it's a great.
She said I'm part of their family, for better or for worse,
they've adopted me so that's good.
Good for me.
It's a nice family to be part of.
Yeah, it is.
They're great.
Just a great family.
Yeah, I mean,
we are practice we work with clients all over the world and
it's interesting to learn about the health systems in
(18:29):
different countries.
In some ways,
I'm jealous of the situation that some people are in,
but I'm also.
I feel, you know,
I feel a little bad about some of the limitations we see in
other countries and you deal a lot with people in South
America Central America.
(18:50):
Where do you see they have either advantages or
disadvantages from a healthcare standpoint.
You know, each country is different with how it operates,
which is an interesting thing because if you look at it on
a map, you sort of think,
South America must be like the United States.
No,
it's a bunch of countries individually operating in their
(19:11):
own government underneath their own government system so
every country has its own carve out with what public aid
covers.
If there's a privatized insurance versus the public health
insurance and there are different doctors and hospitals and
different supplies are covered or not covered.
(19:31):
So it's just it varies wildly what people have access to
financially, depending on where they live,
and then physically so let's say you live in country x,
and you want pump a,
you may not be able to physically purchase it in your
country you might have to.
travel to other countries or go to the United States and
have it prescribed and then get it shipped to you and then
(19:52):
fly back home.
And then if you think about every three months you need
more supplies,
that's an ongoing challenge to many people living around
the world.
And even the insulins.
I mean,
there is a type of rapid acting insulin in every country
that I'm aware of in Central and South America,
but there may only be one type.
Yeah,
(20:13):
and the ultra -rapids haven't made it to every country
either.
Definitely not, yeah.
Well, I just got a package in the mail today.
It's my Afrezza starter kit.
I mean, I've tried inhaled insulin before.
I'm gonna give it at least a couple of weeks and use it
exclusively as my mealtime insulin and see how it goes.
(20:37):
And then hopefully my Moby pump will show up soon and I'll
be able to give that a try and I'll use a...
a libre sensor with it.
So we tried all kinds of things.
What are you using today for your day?
(20:57):
I am using an old Omnipod pod, the Eros version,
with a RileyLink radio transmitter.
And I'm using Trio,
which is every more people have heard of do it yourself
loop, open source coding loop,
and beta testing loop with several people on our team,
actually.
(21:17):
And one of our team members is actively involved in the
development and ongoing instructional documentation and
usability of Trio.
Yeah,
it's nothing like personal experience with these devices
and systems.
I feel like it gives us a better feel for how to make them
(21:38):
work well.
And this stuff that's just not in the user guide in the
manual that you'll learn just from actually wearing it and
using it day in and day out.
Right,
so when people have questions or they have trouble with it,
if you've worn it enough,
then you probably experience that.
Or you could at least understand what their specific issue
(21:59):
might be and guide them to the right section of the menu or
explain how the device works, how's the algorithm work,
what is the button pushing involved that creates that error
every 10 seconds, if you do the buttons this way,
you won't have that problem, whatever it is.
Even with CGM's,
we've got patients who have trouble wearing the CGM and the
quote unquote approved body parts.
(22:21):
And we're able to give them some insight about where it
might stick better,
where it won't get knocked around as much where it'll still
perform really well, just from personal experience.
Yeah, for sure.
And then if somebody says,
it's not working the way that they market it to work,
you have personal experience so you could,
whether it's through ourselves or through our clients that
(22:42):
tell us, you know,
their experience and we see it on graphs on the screen and
And at least I think a big part of what we do is validate
people's experiences where sometimes they try,
I'll call customer service for the company that their
device is through and maybe not be met with ideal responses
or their doctor's office,
maybe their provider office doesn't have somebody who's
(23:03):
tried all these devices out.
And so they really can't,
they can't empathize and they can't really understand what
the person is experiencing.
And so I think that's one thing we get a lot of feedback
for from our clients is thank you.
I feel validated.
I just got one of those messages from a mom in Panama this
week.
In fact, yeah, no,
you got a lot of diverse skills and you've got some
(23:25):
tremendous expertise in Spanish and issues facing Spanish
speaking users.
You've got experience with every pump and CGM and now with
the the open source, you know, the DIY type systems.
And I guess having a son with Type 1 gives you a unique
(23:45):
perspective about working with families that have kids with
Type 1.
Yeah, it does.
So what are some of the specific or other areas that you
can provide service for clients?
One area that I love is working with moms that are planning
pregnancy or who are pregnant to help them navigate the
(24:08):
expectations and all the ongoing changes that are needed to
insulin dosing,
but also where to wear your pump or other issues that come
up because of skin integrity throughout pregnancy.
And just the I've been there.
I've had two healthy children while living with Type 1
(24:29):
diabetes.
So when they come on and have their anxieties or the things
they're most concerned about,
I understand what they're saying.
And I love being able to give them information that helps
them understand their concerns and strategize so that the
concerns aren't what drives every day of their life.
They don't have to go through pregnancy super anxious the
(24:49):
whole time.
Instead, we can focus on healthy pregnancy.
You and Jenny Smith are our dynamic duo in terms of working
with women who are hoping to have a healthy,
successful pregnancy.
And our success rate is off the charts.
I think we do better to help more women have successful
(25:09):
pregnancies percentage -wise in any place else I've ever
seen.
I got pictures this week.
It was, yes, what day is today?
Today is, I don't even know what day it is.
It's Sunday.
Every day runs into the next.
I got pictures last week from a new baby that I helped them
on with through her pregnancy.
(25:30):
It's so exciting.
Super healthy baby.
Just the right size.
No, they didn't need the ICU.
They didn't need any of those things.
Healthy, healthy mom and baby is so exciting.
Yeah.
That's nice.
And you've sort of co -managed a,
not really a support network, but a, well, yeah,
kind of a support network for parents of kids with type 1.
(25:52):
Tell us a little about that.
Yeah, sure.
So one thing that many of us have noticed along the way,
working with parents of kids with type 1 diabetes is just
the overall intensity of managing a child's diabetes.
When it's your own diabetes,
that's one level of intensity that can exist,
but it's your child.
Parents,
we want the best for our children and we want them to be
(26:14):
healthy.
Sometimes we go about that,
looking at all possible healthy options and choosing and
navigating through, making mistakes, learning.
Sometimes though we get so concerned that we stopped using
strategies and we start basing everything off of anxiety
-based decisions and it's all -encompassing.
(26:35):
Parents will often,
it's really common for parents to feel like,
I don't do anything other than...
what I have to get done in the day and my child's type 1
diabetes.
I'm not sleeping.
I'm not talking to friends.
I'm not going out.
I'm not, you know, it's just very, very intense for them.
And so helping parents find a place where other parents are
going through the same thing so they can interact with each
(26:56):
other socially,
but also providing information about coping skills and how
to let go a little bit,
not let go of helping your child be healthy,
but switching from anxiety or intense guilt or worry
focused decision making to here's the issue.
Here's the thing we're planning for.
(27:17):
What are the steps I need to do to ensure we're successful
as possible?
If it doesn't go well,
I know what to do to help my child be healthy in the event
of a higher or low blood sugar and just taking that
emotional burden down a few matches.
So we created,
I didn't think it was as they think like a pancreas,
but that's what you created.
Time Out for Caregivers is the name of the sessions that we
(27:39):
created so people can come together about once a month or
once every other month and join in on our conversation.
We have it co -led right now with Anna Savino,
one of our licensed social workers who specializes in
working with kids and parents and people living with type 1
diabetes and the emotional burden that it can entail.
(28:00):
So she and I run it and it's a great opportunity for people
to feel that stress decompression.
Yeah.
How do you feel when you're running those programs?
Do you feel it's a good catharsis for you as well?
It really is.
It surprised me when we started it.
I thought, well, this will be great for the parents.
Then as they were telling their stories and I realized
(28:22):
like, oh yeah,
I didn't sleep for the last two nights well because my
son's alarms were going off and I need to change his pump
settings.
Like, oh yeah, okay.
We're speaking the same language.
It's great.
Yeah.
Yeah.
I've always felt that parenting a child with diabetes is 10
times harder than living it with yourself.
(28:42):
And if you were, if we have a higher or low glucose,
we're like, yeah, screw it, move on.
When your child has those issues,
we internalize it and we feel guilty and we dwell on it.
And it's a big issue.
So yeah, I guess helping parents relax,
put things in perspective a little bit can make a big
(29:03):
difference in the quality of life.
And just having,
most parents are doing this on their own because they don't
live in a place where all of their friends' children have
type 1 diabetes.
So they don't have someone that they can just readily talk
to about a frustration or just all of the things that make
up dealing with a child's type 1 diabetes,
(29:25):
just being able to bounce those things around and hearing
other people going through their experiences.
It's just super, just emotionally,
but also there's like a physical release.
A lot of people cry.
Like, I'm not even a crier.
I don't even know why I'm crying.
It's because you feel validated.
You feel like you're not the only one because you're not.
(29:47):
It's good to get that.
And you know, yeah.
Yeah.
So thinking again about the life of Tabia and being in the
middle of the White Iowa,
I know you've got cornfields in sight and I expected you to
have like a hen house and cows and you've got other pets.
Tell us about your dogs.
(30:07):
We have my husband and sons and I have a Husky.
His name's Cisco and he's amazing.
He's usually in here.
He's not in here today, but he will be later, I'm sure.
So he's a lot of fun.
He has lots of energy.
Thankfully,
he also sleeps a lot so that kind of balances out.
So yeah.
And then we built a two -family home to help with
(30:32):
caregiving for my parents.
And my mom has two chihuahuas.
So I think one of them was barking earlier.
He probably heard her, it's Chica.
And so there are lots of dog hair in my house that we were
perpetually cleaning up.
We used to have birds as pets,
but they are very noisy and you have to do a lot of
cleaning and they require a lot of focus and energy.
(30:55):
And we started helping caregiving for my stepdad and we
gave them to a nice woman who is retired and gets to play
with them all the time.
So there's less zoo -like noises in our home now than ever
before.
Well,
it's nice that you thought about your family and your parents
and your in -laws and all.
(31:18):
And your kids can grow up being really close to the
extended family that way.
Yeah.
Does it create any challenges for you having them in the
same house or the same structure?
Of course.
I mean,
imagine living with any of parents or in -laws all the
time.
I try not to think about that.
So it doesn't matter.
(31:39):
how great of people you are.
If you live with someone else,
there are moments where it doesn't go as well as you like.
But overall, I mean,
we built the house so that it's really two homes in one.
So we go into our living area.
My mom is in her living area now.
And it's pretty, I'm pretty chill anyway,
it takes a lot to get me all riled up about something.
(31:59):
So add patience to your growing list of skill sets.
If my mom decided to talk to me in her, I'm your mom,
you're a teenager voice,
we would have to talk about that and change that but she
doesn't.
So so if she does skill set, we got to add so patience,
but also steel drums.
So you played steel drums back in school,
(32:21):
marimba percussion.
So in high school, I played percussion.
I really like mallet instruments like marimba xylophone
bells.
And I played steel drums in college.
Yeah, I wish I had them in our house right now.
But I guess it's one less thing to distract me from what I
need to be concentrating.
So yeah.
(32:41):
It's a magical sound because everyone just thinks about a
tropical island and stress level goes down.
You hear a steel drum.
Yeah, that's where I so I physically in Iowa,
but I'm mentally by an ocean somewhere.
That's you see the turquoise kind of colored things I have
going on my wall is a light kind of horizon sort of blue.
(33:05):
Yeah,
I looked at the map and I think the width Iowa is as far
from any ocean as a human being.
Pretty much.
Yeah.
As far as it could be.
It's very close to many lakes and ponds and the backyard.
We do.
Yeah, that was an amazing thing.
So can swim and pretend it's the ocean.
(33:28):
Yeah.
And you're you're into kayaking, right?
Yeah, we went last week we went kayaking.
And so we either part of the family goes or if we all go
then two of us walk and hike around while two of us kayak
and then we trade places and it's a lot of fun.
It's great because I had hand surgery not long ago and it's
(33:49):
healed enough so I could kayak and no pain.
It was very exciting.
Nice.
Nice.
Can't even see any mark on your hand now.
Well, zoom does a lot to cover up and imperfect.
There's a low mark but no biggie.
I mean, that's pretty good.
Wasn't open it.
Yeah, okay.
We went the kids and I went yesterday for Oh,
we were gone for almost two hours.
(34:11):
We went out on a bike ride when exploring and was great
weather instead of being 100 and some degrees hasn't been
100 degrees here,
but it's been hot and humid like everywhere.
Yesterday was perfect.
So we went out road and road and road.
It was great day.
Nice.
All right.
Anything any last words anything else you'd like to share
(34:31):
about the Tabia Vital experience?
I don't I told you beginning that if you if you ask me
questions, I'm glad to answer,
but don't make me just talk about myself.
I'd rather talk about anything else.
So yeah, not like doing that.
There's some exceptions.
That's true.
(34:52):
Well, I am so happy you're part of our team.
And I know of our patients, all of our clients,
they're extremely thrilled that you're part of our team as
well and can help them.
Besides our Spanish speaking clients, pregnancy,
women going through pregnancy,
parents and kids and patients in general,
(35:15):
you got technology skills and really help with a lot of
different things.
So keep up the great work, Tavia.
I try most days.
So if anybody's interested in setting up a meeting with
Tavia and our consultation, please reach out.
So thank you.
(35:35):
I want to thank everyone for joining us today.
On behalf of Think Like a Pancreas, the podcast,
I'm Gary Scheiner.
Have a great rest of your week.
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