September 18, 2024 • 43 mins
Welcome to another engaging episode of Think Like a Pancreas! This week, Jenny Smith steals the podcast host role to shine the spotlight on the usual host, Gary Scheiner, the Director of Lifestyle and Nutrition at Integrated Diabetes Services. Gary shares his journey from an aspiring medical student to a leading figure in diabetes care, discussing his passion for exercise physiology, sports, and personalized diabetes management.
In This Episode, You'll Learn:
Introduction and Background: Meet Gary Scheiner, our guest for this episode. Gary reflects on his initial aspirations to pursue a career in medicine and how his experiences with his pre-med peers led him to explore other interests, eventually finding his true calling in diabetes management and exercise physiology.
Discovery of Exercise Physiology and Diabetes Management: Gary discusses his journey to discovering exercise physiology's role in diabetes management. After an unfulfilling stint at an advertising agency, a diabetes meeting at a local hospital reignited his passion for sports and managing diabetes actively, leading him to pursue a master's degree in exercise physiology.
Founding Integrated Diabetes Services: Learn how Gary founded Integrated Diabetes Services to fill the gap he observed while working at the Joslin Diabetes Center. He emphasizes the importance of having a team of clinicians who personally understand diabetes and can provide detailed, empathetic care free from institutional constraints.
Passion for Sports and Diabetes Management: Gary shares his love for sports, particularly basketball, and how he manages his diabetes while staying active. He discusses his experiences with various insulin pumps and continuous glucose monitoring (CGM) systems, and the challenges of bolusing for his favorite snack, popcorn.
Family Life and Diabetes Management: Explore how Gary’s family supports him in managing his diabetes. He shares amusing stories about his children helping him find misplaced CGM receivers and his wife's supportive yet concerned role. Gary highlights the balance of accountability and privacy in sharing CGM data with loved ones.
Writing and Future Aspirations: Discover Gary's motivation for writing his book, "Think Like a Pancreas," to extend his reach and impact beyond his practice. He shares his future aspirations if diabetes were cured, including his vision of becoming a "facilitator of physical activity" to combat laziness and promote active living.
Conclusion and Resources: Don't miss this episode, which is filled with expert advice and personal anecdotes! Reach out to Jenny, Gary, or the Integrated Diabetes Services team for personalized guidance on managing diabetes. 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 strategies. 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.
And I am your host today, Jenny Smith.
I am the Director of Lifestyle and Nutrition with
Integrated Diabetes,
and today we will be discussing who is Gary Scheiner. So I
'm very excited to be joined by none other than our
(00:49):
wonderful leader, motivator, Mr.
Gary.
How are you today?
Legends in my own mind.
Yeah, yes, exactly.
That's a great way to say I'm your host, Jenny Smith,
because as many podcasts as you've done over the years,
I don't know,
I've ever heard those words emanate from your mouth.
(01:12):
No, I've never been the host.
It's been, it's very exciting.
Yay.
How are you never thought you'd have?
I guess so.
It's very exciting.
Yeah, it's kind of fun.
It's just fun to, you know, talk to people.
I think that's, that's why I enjoy podcasts.
I enjoy finding certain ones to listen to too.
(01:33):
So, you know,
we're doing all about all of our integrated staff so that
as we put out all of the wonderful things that we like to
talk about, with no outside influence,
all of our good opinion and thoughts about everything.
It's nice to get to know each of us a little bit
differently, right?
(01:53):
Because we all have different families and we live in
different places and we all have different likes and
dislikes about things.
So today we get to highlight who is the real Gary Scheiner.
And you know,
something I've always kind of wondered about myself,
I mean, we've known each other a pretty long time, like 12,
(02:15):
13 -ish years.
And I've always been kind of curious what you were,
what were you passionate about before diabetes?
Because you were diagnosed as an adult, right?
I was 18.
You were 18, so just on the cusp of adulthood, kind of.
I thought I was an adult, but how little I knew.
(02:36):
Right, exactly.
So what were you interested in?
I mean, you were going to college,
so what were you interested in?
What did you think your path was gonna be?
Well, I thought I was gonna go into medicine.
Okay.
That was the original plan,
so when I was looking at colleges,
I looked for these strong pre -med factories so that I
could eventually go to med school.
(02:57):
Okay.
And during my first couple of years of college,
I was doing OK course -wise, grade -wise.
I really,
really disliked the other people in the pre -med curriculum.
I was just so turned off by it.
I saw the amount of work that most had to put in,
(03:20):
it kind of sucked their personalities away.
So a lot of people coming out of that factory, so to speak,
were just a bunch of drones with no creativity,
not much personality.
And I didn't want to turn into that.
So you changed,
did you think that it would really change you or did you
(03:42):
find that you weren't as interested then based on what you
saw people kind of turning into?
And so you changed the path to something else?
The information and the subject still interested me.
I just didn't want to become one of those people.
Sure.
(04:03):
I could see myself just studying and studying and studying
and losing personality, losing creativity,
and just not being the same person.
I'd like to keep my personality and enjoy myself.
It's more like- And you have a great,
you've got a great sense of humor.
(04:24):
You love music, right?
You love basketball and all those pieces they do.
I mean, when we talk about personality, right?
Our personality is something that isn't really a piece of
our body.
It's like, it's part of our spirit.
It's what makes us who we are.
And when you lose a piece of that because you're going one
track or one direction, it's good when you recognize that,
(04:49):
especially as a young person,
because I think there are a lot of young people that they
don't realize it until well after that's happened.
Yeah.
And there's a certain, I guess,
level of respect people get when they have an MD, PhD,
DO after their names.
Of course.
However,
(05:10):
I've come to learn that I probably have been able to have a
better,
bigger influence on people's lives doing what we do.
As CDCES's then as MDs, most of the MDs,
I know they're cycling patients through so fast.
They don't get to know them.
Right.
You don't get to touch on their personal lives and help
(05:33):
them really achieve their goals specifically.
And that's against,
I don't feel like that's a good way to live or something to
build a career around.
Right.
Did your,
I guess your experience being diagnosed at 18 then and
moving through those early college years and moving through
(05:53):
pre -med.
and getting to see where that was leading some people and
you not wanting to go that path.
I guess that probably was an inspiration to maybe move
towards diabetes education.
Was that even something that was on your radar or cause
you're an exercise physiologist?
(06:13):
I had no idea the fields even existed.
Okay.
And that I was a biology major, but I also studied psych,
I studied marketing, little economics.
And I think I learned a lot in those, that coursework.
I think it still benefits me today.
In fact, when I graduated from,
(06:34):
I went to Washington University in St.
Louis.
When I graduated, I ended up working at an ad agency.
Wow.
That was my first job.
I was a copywriter at an ad agency interested in the
Chicago area.
Okay.
So yeah, I got to be creative.
Got to think outside the box and learn about a lot of new
(06:55):
things and interact with people.
It didn't quite provide the level of,
I didn't feel like I was making a positive difference in
many people's lives though.
I could help them sell more widgets, but.
Right, right.
And then I went to a diabetes meeting at a local hospital
(07:17):
and I heard an exercise physiologist who did a talk.
And I was always very passionate about workouts, sports,
had my challenges managing diabetes with the sports
activity.
And I heard this guy speak and my eyes lit up.
I said, wow, I want to do that.
(07:38):
You know, we hear that, you know, Kathryn
says that now about me, she wants to do what I do.
Right.
I want to do what this guy did.
I forgot his first name, his last name was Kowalski.
Which wasn't even diabetes.
It was just something that really was piece of your life.
already being active and really enjoying not only playing,
but also watching sports and sort of like struck something
(08:02):
for you.
And I could probably almost like,
it's kind of like me sometimes when I get interested in
something,
I feel like the wheels turning and you almost see how it
can work within the framework of something that's important
to you, which also included your diabetes management.
So, so you went back to school then went back to school,
(08:23):
got my master's in exercise physiology.
You know,
I was writing advertising copy by day and studying
biochemical pathways by night.
It was an intensive program.
You know, it was a lot of heavy science involved.
Sure.
I got through that and I started looking for jobs.
(08:45):
I wanted to work in the diabetes space as an exercise
physiologist.
The only place I knew that had that was either The Joslin
clinic, the international diabetes center.
In Minnesota.
Yeah.
It weren't many other places.
So, you know,
I just started applying around the country and Joslin
reached that back out to me and I ended up taking a job in
(09:08):
Philadelphia.
So we moved from Chicago to Philly.
This was back in the early nineties.
Okay.
So we loaded up the truck and we moved to Philly and on the
way I'm driving this moving van and put on the radio and
there was an Eagles game on and I remember Randall
Cunningham throwing a touchdown.
I got all excited.
(09:29):
I'm like, yeah, I'm going to, I'm going to enjoy this.
Philly's got a really a strong sports vibe.
So, uh, it was, it was a good fit for me.
That's awesome.
And so you just obviously stayed and how, I guess,
how long did you stay with Joslin then and what sort of
moved you into, I guess,
what maybe from that job inspired you to move into starting
(09:50):
your own practice, being integrated diabetes.
Well,
you probably heard me say the phrase necessity is the mother
of invention.
I developed the practice out of necessity because the Joslin
, it was an affiliate clinic for the Joslin in Boston.
And it was only up and running for about two years before
(10:11):
they started to tear it down,
just breaking the pieces off from it.
Oh, wow.
That of having me full time in the diabetes,
they split my time with like geriatric psychiatry and
ranges things with these patients just to get them active.
Uh,
but I also saw a need and it was one thing I learned from
(10:33):
my mark.
One of my marketing courses in college,
I had this big rotund professor and every day he'd walk in,
he said that marketing is meeting by a needs.
That's how he started every class.
And that's, that's rang very true.
You know, when my time working at Joslin, I saw it.
tremendous need patients had.
(10:55):
Sure.
Well, especially with type one, but you know,
type twos as well,
they get very little guidance and support and assistance
from their physicians, from their healthcare providers.
I saw a need, an unmet need, excuse me, unmet need.
Yes.
My blood sugar is not loud.
That's all good.
(11:15):
It's unmet need that people just needed more detailed help,
more help with the micromanagement of their diabetes than
they could ever get from their healthcare team.
And this is in the early nineties,
when really there is not much technology outside of home
blood glucose monitoring.
And gosh, that's really, I mean,
(11:35):
there were baseline pumps at that time.
Yeah.
It was the first pumper at our Joslin clinic.
They needed a guinea pig because they wanted to start a
pump program.
I was the token type one on the staff.
So naturally Gary goes on a pump.
So I got on a,
it's a mini med 506 with a needle set you couldn't
(12:00):
disconnect from.
So basketball became challenging evident where this big
clunky pump when I played.
Yeah, so we had pumps,
but not a lot of people were using them.
We just had your stick glucose meters and log books that
had blood stains and foods smeared all over them.
And that was the information that we use for helping fine
(12:20):
tune.
Which even then that information wasn't very beneficial
because again, I mean, mine as a teenager,
I remember the number of times I put in like blood glucose
values because I had to remember to get them out of my
monitor and on the way to the doctor my mom's like,
where are all of your blood sugar numbers?
(12:41):
You know, so I mean, it is the best story.
And at that point, then what is the best kind of evaluator?
It is an A1C that's, that's what we had, right?
To give the average,
especially if those numbers in that log book weren't
correct.
And so their education wise was very like tip of the
(13:04):
iceberg that you could probably give.
And the fact that you said it wasn't even great just that
little bit extra that could have been given to find a need
to be able to take something out and do it yourself is
really, it's really awesome.
I learned so much from my coworkers at Joslin.
Yeah, we had both the full multidisciplinary team.
(13:28):
I learned from the doctors and nurses, the psychologists,
the well,
the exercise physiologists we had was up in Boston but also
in the dieticians I learned a lot from.
Sure.
I find dieticians tend to be very well -rounded people.
I don't know if you found that to be the case.
They are, I think they are.
(13:49):
really,
the majority of dietitians who go to school to be truly a
dietitian, a registered dietitian,
they're there kind of with a passion about nutrition and
body systems.
Because quite honestly,
when you go to school for nutrition,
you also go for a biology degree, right?
(14:10):
And you are in pretty much the same pre med classes as
doctors are going for,
it's then you sort of venture off into your different
avenues, you know, of study.
But dietitians know a lot about body systems and
physiology.
I mean,
I had exercise physiology classes in my coursework as well.
(14:32):
So I'm not surprised that you learned probably the most
from the dietitians, especially when you consider diabetes.
I forgot, what's your degree in?
I am a registered dietitian.
Oh, yeah.
(14:53):
That's the love for my I also, you know, I mean,
I went to school knowing essentially where I wanted to go
with lots of little things away along the way,
kind of probably like you, you start out in a place,
you learn what you need to know.
And then you move on because you know, you know,
a different path or a different way to do things,
which it sounds like that's kind of how you came up with
(15:15):
starting your own business.
Yeah, yeah, it was this need.
And I knew also in the back of my mind that you got to
surround yourself with the right people.
You can only can't do it all yourself.
I love that line from the Dirty Harry movies man's got to
know his limitations.
(15:35):
Don't ask my wife, I got so many limitations, my goodness.
So I like to surround myself with the best people in the
field.
And that's why I've only hired people who have that
personal connection to diabetes and also have a tremendous
clinical skills.
They're well rounded, good personalities, you can't,
(15:58):
you can't teach personality, you can teach skills,
you can never teach personality.
No, you really can't.
And that's, I think what you learned early on,
even in school looking at doctors, and by no means,
you know, a negative to doctors, but a lot of them,
like you said, they're sort of a, to a good to a degree,
(16:19):
there, there's not enough personality,
because I think they don't get to do what we do within your
practice, right?
They don't really get to know people truly,
they don't spend enough time,
they don't have allotted enough time.
And so people also don't get to know their doctor's
personality.
And then it kind of goes back and forth,
(16:40):
they ask you the baseline things,
you check them off a list out the office, you go,
you might get some lab reports,
which are also They don't have the personality to that.
So, you know.
It's a big challenge early on and to this date is how to
get people to pay their hard -earned dollars out of pocket
(17:01):
for the kind of service we provide.
Right.
I've taken the approach.
Number one is provide the absolute best level of care and
no holds barred whatever it takes to help that patient help
that client do their absolute best.
Right.
You're not going to get that anywhere else.
So to me,
that's the kind of thing they will be willing to pay for.
(17:24):
And the second thing is flexibility.
You know,
we've never gotten the root of working for any institution.
We've never worked for any company.
So we can be fair and unbiased in what we discuss in our
recommendations.
And yeah, and we're, I think,
more than judgmental when it comes to this stuff,
but there's a reason we have to be.
(17:45):
Right.
But I can also,
and we don't accept insurance so we can be as flexible as
we want to be.
And we are- With our recommendations.
Yeah, I've said before,
we've had patients pay us kind of in barter,
we've received baked goods.
I think I can get copier cartridges from one of my
(18:05):
patients, toner cartridges.
So, you know, whatever works.
With the baked goods though, we do have standards.
They've got to be good baked goods.
I'll always take chocolate.
You got to wear a sign, Jenny.
We'll educate for chocolate.
Dark chocolate.
Good dark chocolate.
(18:26):
You've got a certain cacao percentage that you particularly
like.
80% plus.
80% plus.
That is some dark chocolate.
It is, it's very good, yes.
What's the best chocolate you've ever had?
Oh, gosh.
There are probably a couple.
(18:47):
One I can remember in particular is some friends of ours
went to Iceland last summer.
They took their kids,
they went for two weeks and we took care of some of their
gardening stuff and just watched their house.
When they came back,
they brought us some Icelandic dark chocolate.
(19:08):
And it was some of the best chocolate that I've ever had in
my whole life.
It was just fantastic.
In fact, I went online.
I was like,
can I order Icelandic chocolate to the United States and
how much is shipping?
You never think of Iceland as like the Mecca for chocolate.
Think of like Germany, Switzerland, but Iceland.
(19:33):
I don't know, they may be Italian ice.
I don't know what they'd be famous for,
but you wouldn't think chocolate.
No, I don't, it was just very, very good.
I think my husband and I have been over a year.
up a couple of times.
And we were in Paris,
I can remember having really from a chocolatier,
they're pretty good chocolate.
(19:55):
So yeah, I mean,
the general brand name chocolates are not usually,
we've got a really good chocolatier here in Madison,
Gail Ambrosia, just fantastic.
So anyway, you know, what do you like?
I mean, I like chocolate,
but I'm kind of a salty snacks guy.
(20:18):
Popcorn is one of my favorite things to eat.
And I think one of the reasons I married Debbie is because
when we were dating and it was Valentine's Day,
she got this big giant heart shaped box and just stuffed it
with popcorn.
And I Like, wow, she really knows she,
this woman is sensitive to my needs.
(20:39):
That's the reason when you fly,
which you fly an awful lot is you always try to fly and get
through Chicago, through Chicago to get nuts on Clark.
Popcorn.
And it's only good when it's fresh, right?
You can't send it to Gary because it's gotta be fresh.
Well, it's still pretty good.
If you ordered it, anyone who's listening,
(21:00):
if you order nuts on Clark popcorn and send it to me,
just the plain buttered popcorn,
they seal it up pretty good.
So just in case anyone's listening and wants to send me
something I might like that, that would do it.
That's awesome.
And how does your, uh, how do you navigate popcorn?
Do you have any special tricks?
(21:21):
Not easily.
It seems it's digest so incredibly slow.
No, it's, it's got fat.
It's got fiber.
It takes a while to eat.
So I have to extend my boluses out several hours.
You can't give any of the bolus up front.
Right.
And that usually does the job.
And if I have enough of it,
(21:42):
then the fat will have a delayed effect.
So I got to deal with that later, but it's worth it.
And you know what?
If the popcorn's that good,
even if my blood sugars go up after it's still worth it.
It was still worth it.
Sometimes you just got to say, screw it.
I'm going to enjoy myself and not worry so much about my
blood sugars.
Well, and that, I mean,
(22:02):
that brings up a good piece just in practice, right?
With our practice, having all clinicians who have diabetes,
not only have you moved through a lot of different
technology and pumping systems and tried the continuous
glucose monitors on the market.
I can't even imagine how many glucometers you probably went
(22:25):
through before CGM's came to market, right?
But what have you learned about eating even just popcorn,
right?
The new technology probably.
is so much far superior and more hand -holding than you
experienced years ago, right?
Yeah.
I thought I was going to have a tandem Moby pump to try out
(22:45):
this week, but it hasn't arrived yet.
Oh, no.
I got something else.
I'm going to give the present a real good college effort.
I'm going to go a couple of weeks with this and a basal
insulin.
You're doing an injection.
We all experiment, right?
We all try something,
(23:06):
and we often do a lot of food challenges within our
practice and share lots of it with listeners and different
types of media outlets.
Are you doing completely off -pumping?
What I might do is one week off the pump,
just use maybe a Libre sensor,
(23:29):
because I haven't tried the Libre 3 yet.
OK.
And just take an injection of long acting and Afrezza with
and between meals.
And then the second week I might go back on my open source
loop app just for the basil delivery and use Afrezza at
meal times and see what, if that doesn't kill me,
(23:51):
I'll report back on it.
Yeah.
There's so many different options.
Again,
that's the nice thing about working in a practice with so
many other people who have type one,
because we can bounce ideas and share with each other.
And where does that information go?
It goes to the people that we eventually get to work with,
which means you're getting user friendly ahead of your use,
(24:13):
right?
So you can get it perfected.
And then we can give you the real one, two,
three of kind of how to make it work.
Right.
For the good of science.
We try these things or the good of that.
It was speaking of which, you know, my,
I always share when we do food challenges, right,
I always share that with my husband or my kids.
And I'm like, Hey, mommy's doing a food challenge.
(24:34):
I'm taking pictures of things and I'm really taking photos
of how my graphs are looking and all that kind of stuff.
How,
how does your family navigate your life with diabetes or
are they just kind of, you've got a wife,
you've got kids who are more adult now, right?
Well, back in when,
when CGM first came out and you had to carry a receiver
(24:55):
around with you everywhere,
I would misplace that thing constantly.
I bet Debbie loved that.
My, well, my kids learned a profit from, I would just,
I would pay five bucks that whoever found my CGM first.
And then Debbie kind of cued me in.
She said, Gary, you know, they are fighting it on you.
(25:16):
It's always a mom that knows exactly what the kids are
doing or are up to.
I learned my,
my kids are very entrepreneurial in their own, right.
Uh, so that we try to have fun with it.
You know, I, I will often,
I used to claim my blood sugar was low when there was
something.
to eat.
I wanted all of it.
And then it started asking for proof evidence that I was
(25:37):
actually low.
Imagine not trusting your own father about his glucose
level.
Did you ever have to hide glucose?
Whatever you use to treat your lows?
Did you ever have to hide it?
Like put it away so nobody could find it and eat it up and
then you go to it and there's nothing left?
Yes, I have to do that with Gatorade.
(25:59):
I keep Gatorade in the fridge and I have to put a I have a
sticky note with a skull and crossbones on it that says
Gary's.
I just keep transferring it to the new bottles so that no
one else drinks it.
That's a good idea.
Does Debbie has she ever followed your data or does she not
want to or you don't really care?
(26:21):
No, she hasn't.
And I know it's beneficial to have a loved one follow it,
not just for safety reasons, but they've got evidence.
research that shows people have better control when someone
is following it just because of the accountability that
they give folks.
I just never really felt comfortable having someone else
(26:41):
follow my data.
It's every glucose value.
There's a whole story behind it.
And I don't feel like sharing the whole story when every
time someone says, oh, so why are you high now?
Why are you low now?
I don't wanna go through all of that.
Right?
I do it typically when I travel,
then Nathan will kind of turn on the follow component.
(27:04):
But outside of that,
I don't because while my CGM's work pretty darn well for me
and I don't have many issues,
there are those times where you have a new sensor, right?
And it's reading L -O -W, you're low.
Well, then you're getting these text messages that like,
are you okay?
Did you eat something?
Are you okay?
And nobody, you know, well, that's lovely.
(27:27):
And they mean the best.
And I know Debbie, she would mean her best.
She can get into always good intentions.
Yeah, but it can be an explanation.
Like you said, with every number,
there's an explanation and you don't necessarily,
you do that to yourself, that inner monologue,
you're already navigating that.
And I think that it's hard when as an adult,
(27:48):
especially you have to then tell somebody.
Yeah, it's one of those do as I say,
and that is I do things with having a loved one follow it.
Just like when we're teaching about treatment of
hypoglycemia,
no one wants to know and no one should follow what I do
when I go low.
So I am a chronic overtreater.
(28:10):
Oh.
All the wrong stuff went up.
Stories I never knew and I've known you a long time.
Come on, what is it?
You got to do something.
I mean, I know you manage well, but what's the do as I say,
not as I do thing in Jenny's work.
Oh my goodness.
Well, one that I think we all do is, like,
(28:32):
never changing our landscape.
Oh, that's passé at this point.
That's probably one of the...
I will definitely say that I think with new technology,
I've become more aware because it's more visible the
impact, especially for treatments for lower blood sugar.
(28:53):
I got pretty good at knowing, but as you said,
those symptoms can be pretty aggressive at times and
depending on the time of day, like overnight,
treating a low,
and you just don't want to wake up again and you're, like,
so annoyed and the whole bag of, like,
taffy in the cupboard looks really, really tasty,
so you eat many of them.
(29:16):
But today's technology, it's great because especially,
you know, you're a looper, I also use a do -it -yourself,
and because of that,
it's an easier way to see how much is needed It's an easier
way to see how much is needed.
If your brain is willing to pay attention to that problem
is I listened to my brain when I'm hungry and low and my
(29:39):
brain keeps telling me to eat and eat and eat.
Well,
I guess part of my brain is the pleasure center of my brain,
the intellectual part,
that little tiny scrap that makes up the intellectual part
of my brain.
It's it's same,
but the rest of my brain is eat that now eat more of it.
Eat the whole bag of chips because yes,
(29:59):
they're really quick sugar, right?
More must be better.
More is more is always better.
If you I guess if you had to do anything that was outside
of the realm of being Gary from integrated diabetes,
(30:24):
the super CDCES that you are,
would you choose something else?
Like, let's say people have asked me this.
What if diabetes was cured tomorrow and you had no job left
because nobody needed you?
What would you do?
Well, I thought about that.
And it's hard to come up with a real occupation.
(30:48):
But there's things I could see myself doing.
I have no idea if they would ever pay me enough to even pay
my bills.
But I think I would be a very good laziness cop.
It bothers me when I see people being just not being active
enough and just ridiculously lazy.
And I want to be able to write citations for that and do it
(31:11):
nationwide,
worldwide and make the make the world a healthier place.
Now, for example,
people who who wait to get a parking spot,
they'll sit there with their engine running to get a spot
that's two spots closer to something that's already open.
Right?
Just park.
I hate that.
People who,
(31:31):
who insist on taking the elevator or escalator when there's
a perfectly good staircase right there.
But the worst is the moving walkways.
Oh, yes, works and shopping centers, standing on them.
They get on the moving walkway,
and they think it's a ride in Disney World they just stand
there, and they stand in the middle.
(31:52):
Yeah,
and you can't get past them and the thing is moving like a
foot a minute it hardly moves.
And it's supposed to just help you get there quicker you're
not supposed to stand there and just.
So I would love to just write citations to people for stuff
like that.
I don't know, popular guy,
(32:13):
you'd probably have to have your own business and figure
out how to get yourself paid for doing that because I'm
thinking government grant I'm trying to improve the health
of.
So you're, you would want to be a encourager of movement.
Yes,
you could take out lazy from it to make it actually a facilitator
(32:36):
of physical activity.
There's a new job title.
There you go.
Activity facilitator.
You know,
the one place that that would absolutely be as you talk
about that, I can remember when we lived in Washington,
D.C.
I rode the metro in every single day, right?
(32:57):
And it was very visible people who didn't do that every
single day because they were the ones locking the
escalators up and down and to the to the next train that
was coming.
And you're like, stand on the right, walk on the left,
move quickly or move over, please.
So you would have a prime job right there on the escalators
(33:22):
at any metro or subway station.
I could see training a whole platoon of fellow.
What do we call it?
This is this facilitators of physical activity.
I would train a whole platoon of these and dispatch them
around the world.
You know, that yeah, that would be pretty cool.
(33:43):
I'd love to do that.
As long as the outfit was fancy,
a cute t -shirt or something.
I might come work for you again.
I want something with a lightning bolt on it that would
look really cool.
Like a superhero type thing.
I can understand, you know, I can understand just in again,
knowing you for such a long time,
(34:03):
knowing your personality and having read your think like a
pancreas book as well,
which folds your personality into really good information.
But what I guess what propelled you to write a book and
which you've got a couple,
but really think was your first one.
Am I right?
So what, what really gave you that inkling?
(34:27):
Just getting the word out.
I knew I could.
physically only see so many people.
And even our team,
we've got nine clinicians and we can only see so many
people.
It's just an opportunity to get the word out and help
educate, motivate and inspire that many more people.
I believe it's the top selling book in the type one
(34:49):
diabetes community.
And I don't know how official these numbers are that they
collect,
but I think it is the number one selling book for type
ones.
I'm working on the new edition right now.
And you're helping me with the resource section.
It's even more about apps than anybody I know.
So you're helping me with that part.
(35:10):
I am, I've got some new ones to add.
And also the book section, there are,
I can't remember when your most recent edition came out,
it's a couple of years already, right?
It's almost six years.
Really that long?
I thought it was more recent than that.
But there are a number of new books that I am on are on my
list to type up as well.
(35:31):
So yeah,
if you find an app that helps you find the best chocolate
in any city in the world that I think that'd be popular,
that would be a popular one to add.
That would be I would use the wheels turning Jenny.
That would be a really great.
And you'd make so much money on this app,
(35:53):
you could just spend your time traveling and testing out
all the places and figuring out what in the app while
telling people how to be more active while they eat their
chocolate.
Yeah, yeah.
Well,
dark chocolate's a lot healthier than most other forms.
And it's it's a good thing.
You can walk it off afterwards.
Exactly.
(36:14):
Yeah, absolutely.
Anything else that we need to know about the Gary Scheiner
at all?
My basketball career is continuing nicely.
I'm playing twice a week now.
I've got a very old guys league I play in on Sundays and as
the middle to middle age league I play in on Monday nights.
(36:38):
And the rest of the week is either recovering or just
trying to stay in shape for those games.
So are you still doing lifting as well?
Yeah, yeah.
Three times a week and doing some other cardio stuff the
other days.
I still I love to bike.
That's I mean, bikes basketball is my passion sports wise,
but for fitness purposes,
(36:59):
I love getting out on my bike going for long rides.
You know,
these old railroad lines that have been converted to bike
trails.
Wonderful.
If anyone out there knows some really good ones,
let us let us know about those.
There are some in Northern Virginia as well,
if you've never been.
(37:19):
I know you like with Atlanta.
No, not new Jersey.
Is that the one that you guys often go to sometime?
The shore.
Yeah, go to the Jersey shore, Southern Jersey shore,
like from Kate may up to Atlantic city,
just right through the towns, there's some traffic,
but it's not too bad,
but there's bike trails around the Philadelphia region that
(37:41):
run along the rivers.
And they're beautiful, the nice long all day trips.
That's, that's where I get to reset my brain and really,
really relax.
And some people they do their, you know,
yoga and meditation and whatnot.
I, I get on that bike and I just, so relaxing.
That's kind of funny.
Cause I've always, I told my aunt one time who is,
(38:03):
who has always been very big in yoga and more like natural
health and living and everything.
And I said, you know, I, I can't meditate.
I don't, I can't sit still.
And just think about,
because then I end up thinking about everything and I'm not
meditating,
like I'm not about what I could and should be doing while
(38:24):
I'm meditating.
Right.
So I, she's like, Oh, that's okay.
Jenny, she said, you're a moving meditator.
And that's so like,
it made sense to me because I do when I run weekly.
I think about so many things.
I also do it first thing in the morning.
So I'm well rested,
kind of have a fresh brain and kind of a bigger outlook on
(38:46):
all the things I'm trying to navigate through.
And I come back with some of the best ideas.
Sometimes I actually have a,
an outline for some of my newsletter articles that I write
and kind of put together.
Um, so yeah, it's mo you're a moving meditator, Gary.
Okay.
I'll buy that.
(39:08):
So, well, this has been a pleasure just chatting with you.
Cause we also never really get to just talk.
Yeah.
So, yeah, no, it's always,
we always have tons of business and projects and work going
on that, uh, yeah,
you and I never get a chance to just sit and chat like this
and create a whole podcast to do it.
(39:30):
We did.
Absolutely.
So nothing else you're good.
I'll suppose.
Yeah.
I am using, uh, I'm using a GLP one receptor act.
I do find it's very helpful.
I don't need to lose weight,
but it helps me to manage my food intake very nicely.
(39:50):
So you found the benefit from appetite.
Yeah.
I mean, a lot of us try, you know, we try all the devices,
but we also,
a lot of us tried different medications and that's one that
I've stuck with.
I have found it helpful when I don't use it.
I'm just hungry nonstop and it's really hard to manage your
glucose levels and just be healthy when you're eating and
(40:13):
hungry constantly.
So I find the GLP-1 receptor agonist to be pretty helpful
for that.
We've got a lot of clients on intensive insulin therapy who
do also need to lose weight.
So yeah, I find it can be pretty helpful.
How long,
let's say you didn't take it or you forgot it or whatever,
(40:36):
how long does it take before that appetite suppression that
you find most beneficial?
How long does it take before that kind of wanes off and now
you know your appetite is back up to where it had
generally, it's a weekly injection.
If I go a few days beyond the week when I should have taken
it, so once I get to like nine, 10 days after my last shot,
(41:00):
yeah, the appetite starts coming back with some ferocity.
But what I do is I'm going to go on vacation.
I purposely don't take it because I really want to indulge
and enjoy myself.
especially on your cruises, right?
Yeah, a cruise or any place, you know,
where there's unlimited and really good food.
And I want to take advantage of that.
(41:21):
Kind of like my dad,
I want to get my money's worth from everything.
So if I'm going to be at some kind of all-inclusive,
I want to make sure I eat enough to make it worthwhile.
Totally makes sense.
Well, thank you very much for doing this today.
Thanks for joining in.
Absolutely.
You should be the host of all these podcasts that you're
(41:44):
involved in.
Oh, you're very kind.
That's nice of you.
I'm going to call Scott and tell him that.
Yeah, Jenny should be the host.
You could be a guest once in a while and let her run it.
Just let Jenny talk.
Scott's kind of,
he's pretty darn good about all the people that he gets to
(42:07):
learn a lot about.
So I hopefully, you know,
what we are able to do with our integrated podcast will
really also reach, you know,
everybody I think has a different personality and different
information that they're looking for.
So I'm glad for all of the diabetes podcasts that are
honestly available,
because what you might learn from one person,
(42:30):
maybe you learn a little bit more from another podcast,
you knew something,
but now you can delve a little bit deeper into the
information, which is certainly, you know,
what we do with an Integrated Diabetes,
as we've already said, we try things, we do it ourselves,
we use technology.
We're certainly available at Integrated Diabetes to help
(42:52):
people worldwide.
We don't work just here with those in the United States,
and we assist people of all ages with their glucose
management, self-management, all the education,
help them use all the tools and the technologies,
especially as that technology changes and shifts.
We offer consultations in English and in Spanish,
(43:12):
Tavia is wonderful.
Um,
with specialized services in sports and exercise and weight
loss and type one pregnancy and women's health and all of
the emotional and mental well-being that goes along with
managing a chronic condition.
Um, and on behalf of Think Like a Pancreas, the podcast,
I was your host, Jenny Smith.
(43:35):
And thank you, Gary,
for being my wonderful guest and have a great rest of the
week, everyone.
So for more information,
you can visit us at integrateddiabetes.com or you can email
info@integrateddiabetes.com
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.
And I am your host today, Jenny Smith.
I am the Director of Lifestyle and Nutrition with
Integrated Diabetes,
and today we will be discussing who is Gary Scheiner. So I
'm very excited to be joined by none other than our
(00:49):
wonderful leader, motivator, Mr.
Gary.
How are you today?
Legends in my own mind.
Yeah, yes, exactly.
That's a great way to say I'm your host, Jenny Smith,
because as many podcasts as you've done over the years,
I don't know,
I've ever heard those words emanate from your mouth.
(01:12):
No, I've never been the host.
It's been, it's very exciting.
Yay.
How are you never thought you'd have?
I guess so.
It's very exciting.
Yeah, it's kind of fun.
It's just fun to, you know, talk to people.
I think that's, that's why I enjoy podcasts.
I enjoy finding certain ones to listen to too.
(01:33):
So, you know,
we're doing all about all of our integrated staff so that
as we put out all of the wonderful things that we like to
talk about, with no outside influence,
all of our good opinion and thoughts about everything.
It's nice to get to know each of us a little bit
differently, right?
(01:53):
Because we all have different families and we live in
different places and we all have different likes and
dislikes about things.
So today we get to highlight who is the real Gary Scheiner.
And you know,
something I've always kind of wondered about myself,
I mean, we've known each other a pretty long time, like 12,
(02:15):
13 -ish years.
And I've always been kind of curious what you were,
what were you passionate about before diabetes?
Because you were diagnosed as an adult, right?
I was 18.
You were 18, so just on the cusp of adulthood, kind of.
I thought I was an adult, but how little I knew.
(02:36):
Right, exactly.
So what were you interested in?
I mean, you were going to college,
so what were you interested in?
What did you think your path was gonna be?
Well, I thought I was gonna go into medicine.
Okay.
That was the original plan,
so when I was looking at colleges,
I looked for these strong pre -med factories so that I
could eventually go to med school.
(02:57):
Okay.
And during my first couple of years of college,
I was doing OK course -wise, grade -wise.
I really,
really disliked the other people in the pre -med curriculum.
I was just so turned off by it.
I saw the amount of work that most had to put in,
(03:20):
it kind of sucked their personalities away.
So a lot of people coming out of that factory, so to speak,
were just a bunch of drones with no creativity,
not much personality.
And I didn't want to turn into that.
So you changed,
did you think that it would really change you or did you
(03:42):
find that you weren't as interested then based on what you
saw people kind of turning into?
And so you changed the path to something else?
The information and the subject still interested me.
I just didn't want to become one of those people.
Sure.
(04:03):
I could see myself just studying and studying and studying
and losing personality, losing creativity,
and just not being the same person.
I'd like to keep my personality and enjoy myself.
It's more like- And you have a great,
you've got a great sense of humor.
(04:24):
You love music, right?
You love basketball and all those pieces they do.
I mean, when we talk about personality, right?
Our personality is something that isn't really a piece of
our body.
It's like, it's part of our spirit.
It's what makes us who we are.
And when you lose a piece of that because you're going one
track or one direction, it's good when you recognize that,
(04:49):
especially as a young person,
because I think there are a lot of young people that they
don't realize it until well after that's happened.
Yeah.
And there's a certain, I guess,
level of respect people get when they have an MD, PhD,
DO after their names.
Of course.
However,
(05:10):
I've come to learn that I probably have been able to have a
better,
bigger influence on people's lives doing what we do.
As CDCES's then as MDs, most of the MDs,
I know they're cycling patients through so fast.
They don't get to know them.
Right.
You don't get to touch on their personal lives and help
(05:33):
them really achieve their goals specifically.
And that's against,
I don't feel like that's a good way to live or something to
build a career around.
Right.
Did your,
I guess your experience being diagnosed at 18 then and
moving through those early college years and moving through
(05:53):
pre -med.
and getting to see where that was leading some people and
you not wanting to go that path.
I guess that probably was an inspiration to maybe move
towards diabetes education.
Was that even something that was on your radar or cause
you're an exercise physiologist?
(06:13):
I had no idea the fields even existed.
Okay.
And that I was a biology major, but I also studied psych,
I studied marketing, little economics.
And I think I learned a lot in those, that coursework.
I think it still benefits me today.
In fact, when I graduated from,
(06:34):
I went to Washington University in St.
Louis.
When I graduated, I ended up working at an ad agency.
Wow.
That was my first job.
I was a copywriter at an ad agency interested in the
Chicago area.
Okay.
So yeah, I got to be creative.
Got to think outside the box and learn about a lot of new
(06:55):
things and interact with people.
It didn't quite provide the level of,
I didn't feel like I was making a positive difference in
many people's lives though.
I could help them sell more widgets, but.
Right, right.
And then I went to a diabetes meeting at a local hospital
(07:17):
and I heard an exercise physiologist who did a talk.
And I was always very passionate about workouts, sports,
had my challenges managing diabetes with the sports
activity.
And I heard this guy speak and my eyes lit up.
I said, wow, I want to do that.
(07:38):
You know, we hear that, you know, Kathryn
says that now about me, she wants to do what I do.
Right.
I want to do what this guy did.
I forgot his first name, his last name was Kowalski.
Which wasn't even diabetes.
It was just something that really was piece of your life.
already being active and really enjoying not only playing,
but also watching sports and sort of like struck something
(08:02):
for you.
And I could probably almost like,
it's kind of like me sometimes when I get interested in
something,
I feel like the wheels turning and you almost see how it
can work within the framework of something that's important
to you, which also included your diabetes management.
So, so you went back to school then went back to school,
(08:23):
got my master's in exercise physiology.
You know,
I was writing advertising copy by day and studying
biochemical pathways by night.
It was an intensive program.
You know, it was a lot of heavy science involved.
Sure.
I got through that and I started looking for jobs.
(08:45):
I wanted to work in the diabetes space as an exercise
physiologist.
The only place I knew that had that was either The Joslin
clinic, the international diabetes center.
In Minnesota.
Yeah.
It weren't many other places.
So, you know,
I just started applying around the country and Joslin
reached that back out to me and I ended up taking a job in
(09:08):
Philadelphia.
So we moved from Chicago to Philly.
This was back in the early nineties.
Okay.
So we loaded up the truck and we moved to Philly and on the
way I'm driving this moving van and put on the radio and
there was an Eagles game on and I remember Randall
Cunningham throwing a touchdown.
I got all excited.
(09:29):
I'm like, yeah, I'm going to, I'm going to enjoy this.
Philly's got a really a strong sports vibe.
So, uh, it was, it was a good fit for me.
That's awesome.
And so you just obviously stayed and how, I guess,
how long did you stay with Joslin then and what sort of
moved you into, I guess,
what maybe from that job inspired you to move into starting
(09:50):
your own practice, being integrated diabetes.
Well,
you probably heard me say the phrase necessity is the mother
of invention.
I developed the practice out of necessity because the Joslin
, it was an affiliate clinic for the Joslin in Boston.
And it was only up and running for about two years before
(10:11):
they started to tear it down,
just breaking the pieces off from it.
Oh, wow.
That of having me full time in the diabetes,
they split my time with like geriatric psychiatry and
ranges things with these patients just to get them active.
Uh,
but I also saw a need and it was one thing I learned from
(10:33):
my mark.
One of my marketing courses in college,
I had this big rotund professor and every day he'd walk in,
he said that marketing is meeting by a needs.
That's how he started every class.
And that's, that's rang very true.
You know, when my time working at Joslin, I saw it.
tremendous need patients had.
(10:55):
Sure.
Well, especially with type one, but you know,
type twos as well,
they get very little guidance and support and assistance
from their physicians, from their healthcare providers.
I saw a need, an unmet need, excuse me, unmet need.
Yes.
My blood sugar is not loud.
That's all good.
(11:15):
It's unmet need that people just needed more detailed help,
more help with the micromanagement of their diabetes than
they could ever get from their healthcare team.
And this is in the early nineties,
when really there is not much technology outside of home
blood glucose monitoring.
And gosh, that's really, I mean,
(11:35):
there were baseline pumps at that time.
Yeah.
It was the first pumper at our Joslin clinic.
They needed a guinea pig because they wanted to start a
pump program.
I was the token type one on the staff.
So naturally Gary goes on a pump.
So I got on a,
it's a mini med 506 with a needle set you couldn't
(12:00):
disconnect from.
So basketball became challenging evident where this big
clunky pump when I played.
Yeah, so we had pumps,
but not a lot of people were using them.
We just had your stick glucose meters and log books that
had blood stains and foods smeared all over them.
And that was the information that we use for helping fine
(12:20):
tune.
Which even then that information wasn't very beneficial
because again, I mean, mine as a teenager,
I remember the number of times I put in like blood glucose
values because I had to remember to get them out of my
monitor and on the way to the doctor my mom's like,
where are all of your blood sugar numbers?
(12:41):
You know, so I mean, it is the best story.
And at that point, then what is the best kind of evaluator?
It is an A1C that's, that's what we had, right?
To give the average,
especially if those numbers in that log book weren't
correct.
And so their education wise was very like tip of the
(13:04):
iceberg that you could probably give.
And the fact that you said it wasn't even great just that
little bit extra that could have been given to find a need
to be able to take something out and do it yourself is
really, it's really awesome.
I learned so much from my coworkers at Joslin.
Yeah, we had both the full multidisciplinary team.
(13:28):
I learned from the doctors and nurses, the psychologists,
the well,
the exercise physiologists we had was up in Boston but also
in the dieticians I learned a lot from.
Sure.
I find dieticians tend to be very well -rounded people.
I don't know if you found that to be the case.
They are, I think they are.
(13:49):
really,
the majority of dietitians who go to school to be truly a
dietitian, a registered dietitian,
they're there kind of with a passion about nutrition and
body systems.
Because quite honestly,
when you go to school for nutrition,
you also go for a biology degree, right?
(14:10):
And you are in pretty much the same pre med classes as
doctors are going for,
it's then you sort of venture off into your different
avenues, you know, of study.
But dietitians know a lot about body systems and
physiology.
I mean,
I had exercise physiology classes in my coursework as well.
(14:32):
So I'm not surprised that you learned probably the most
from the dietitians, especially when you consider diabetes.
I forgot, what's your degree in?
I am a registered dietitian.
Oh, yeah.
(14:53):
That's the love for my I also, you know, I mean,
I went to school knowing essentially where I wanted to go
with lots of little things away along the way,
kind of probably like you, you start out in a place,
you learn what you need to know.
And then you move on because you know, you know,
a different path or a different way to do things,
which it sounds like that's kind of how you came up with
(15:15):
starting your own business.
Yeah, yeah, it was this need.
And I knew also in the back of my mind that you got to
surround yourself with the right people.
You can only can't do it all yourself.
I love that line from the Dirty Harry movies man's got to
know his limitations.
(15:35):
Don't ask my wife, I got so many limitations, my goodness.
So I like to surround myself with the best people in the
field.
And that's why I've only hired people who have that
personal connection to diabetes and also have a tremendous
clinical skills.
They're well rounded, good personalities, you can't,
(15:58):
you can't teach personality, you can teach skills,
you can never teach personality.
No, you really can't.
And that's, I think what you learned early on,
even in school looking at doctors, and by no means,
you know, a negative to doctors, but a lot of them,
like you said, they're sort of a, to a good to a degree,
(16:19):
there, there's not enough personality,
because I think they don't get to do what we do within your
practice, right?
They don't really get to know people truly,
they don't spend enough time,
they don't have allotted enough time.
And so people also don't get to know their doctor's
personality.
And then it kind of goes back and forth,
(16:40):
they ask you the baseline things,
you check them off a list out the office, you go,
you might get some lab reports,
which are also They don't have the personality to that.
So, you know.
It's a big challenge early on and to this date is how to
get people to pay their hard -earned dollars out of pocket
(17:01):
for the kind of service we provide.
Right.
I've taken the approach.
Number one is provide the absolute best level of care and
no holds barred whatever it takes to help that patient help
that client do their absolute best.
Right.
You're not going to get that anywhere else.
So to me,
that's the kind of thing they will be willing to pay for.
(17:24):
And the second thing is flexibility.
You know,
we've never gotten the root of working for any institution.
We've never worked for any company.
So we can be fair and unbiased in what we discuss in our
recommendations.
And yeah, and we're, I think,
more than judgmental when it comes to this stuff,
but there's a reason we have to be.
(17:45):
Right.
But I can also,
and we don't accept insurance so we can be as flexible as
we want to be.
And we are- With our recommendations.
Yeah, I've said before,
we've had patients pay us kind of in barter,
we've received baked goods.
I think I can get copier cartridges from one of my
(18:05):
patients, toner cartridges.
So, you know, whatever works.
With the baked goods though, we do have standards.
They've got to be good baked goods.
I'll always take chocolate.
You got to wear a sign, Jenny.
We'll educate for chocolate.
Dark chocolate.
Good dark chocolate.
(18:26):
You've got a certain cacao percentage that you particularly
like.
80% plus.
80% plus.
That is some dark chocolate.
It is, it's very good, yes.
What's the best chocolate you've ever had?
Oh, gosh.
There are probably a couple.
(18:47):
One I can remember in particular is some friends of ours
went to Iceland last summer.
They took their kids,
they went for two weeks and we took care of some of their
gardening stuff and just watched their house.
When they came back,
they brought us some Icelandic dark chocolate.
(19:08):
And it was some of the best chocolate that I've ever had in
my whole life.
It was just fantastic.
In fact, I went online.
I was like,
can I order Icelandic chocolate to the United States and
how much is shipping?
You never think of Iceland as like the Mecca for chocolate.
Think of like Germany, Switzerland, but Iceland.
(19:33):
I don't know, they may be Italian ice.
I don't know what they'd be famous for,
but you wouldn't think chocolate.
No, I don't, it was just very, very good.
I think my husband and I have been over a year.
up a couple of times.
And we were in Paris,
I can remember having really from a chocolatier,
they're pretty good chocolate.
(19:55):
So yeah, I mean,
the general brand name chocolates are not usually,
we've got a really good chocolatier here in Madison,
Gail Ambrosia, just fantastic.
So anyway, you know, what do you like?
I mean, I like chocolate,
but I'm kind of a salty snacks guy.
(20:18):
Popcorn is one of my favorite things to eat.
And I think one of the reasons I married Debbie is because
when we were dating and it was Valentine's Day,
she got this big giant heart shaped box and just stuffed it
with popcorn.
And I Like, wow, she really knows she,
this woman is sensitive to my needs.
(20:39):
That's the reason when you fly,
which you fly an awful lot is you always try to fly and get
through Chicago, through Chicago to get nuts on Clark.
Popcorn.
And it's only good when it's fresh, right?
You can't send it to Gary because it's gotta be fresh.
Well, it's still pretty good.
If you ordered it, anyone who's listening,
(21:00):
if you order nuts on Clark popcorn and send it to me,
just the plain buttered popcorn,
they seal it up pretty good.
So just in case anyone's listening and wants to send me
something I might like that, that would do it.
That's awesome.
And how does your, uh, how do you navigate popcorn?
Do you have any special tricks?
(21:21):
Not easily.
It seems it's digest so incredibly slow.
No, it's, it's got fat.
It's got fiber.
It takes a while to eat.
So I have to extend my boluses out several hours.
You can't give any of the bolus up front.
Right.
And that usually does the job.
And if I have enough of it,
(21:42):
then the fat will have a delayed effect.
So I got to deal with that later, but it's worth it.
And you know what?
If the popcorn's that good,
even if my blood sugars go up after it's still worth it.
It was still worth it.
Sometimes you just got to say, screw it.
I'm going to enjoy myself and not worry so much about my
blood sugars.
Well, and that, I mean,
(22:02):
that brings up a good piece just in practice, right?
With our practice, having all clinicians who have diabetes,
not only have you moved through a lot of different
technology and pumping systems and tried the continuous
glucose monitors on the market.
I can't even imagine how many glucometers you probably went
(22:25):
through before CGM's came to market, right?
But what have you learned about eating even just popcorn,
right?
The new technology probably.
is so much far superior and more hand -holding than you
experienced years ago, right?
Yeah.
I thought I was going to have a tandem Moby pump to try out
(22:45):
this week, but it hasn't arrived yet.
Oh, no.
I got something else.
I'm going to give the present a real good college effort.
I'm going to go a couple of weeks with this and a basal
insulin.
You're doing an injection.
We all experiment, right?
We all try something,
(23:06):
and we often do a lot of food challenges within our
practice and share lots of it with listeners and different
types of media outlets.
Are you doing completely off -pumping?
What I might do is one week off the pump,
just use maybe a Libre sensor,
(23:29):
because I haven't tried the Libre 3 yet.
OK.
And just take an injection of long acting and Afrezza with
and between meals.
And then the second week I might go back on my open source
loop app just for the basil delivery and use Afrezza at
meal times and see what, if that doesn't kill me,
(23:51):
I'll report back on it.
Yeah.
There's so many different options.
Again,
that's the nice thing about working in a practice with so
many other people who have type one,
because we can bounce ideas and share with each other.
And where does that information go?
It goes to the people that we eventually get to work with,
which means you're getting user friendly ahead of your use,
(24:13):
right?
So you can get it perfected.
And then we can give you the real one, two,
three of kind of how to make it work.
Right.
For the good of science.
We try these things or the good of that.
It was speaking of which, you know, my,
I always share when we do food challenges, right,
I always share that with my husband or my kids.
And I'm like, Hey, mommy's doing a food challenge.
(24:34):
I'm taking pictures of things and I'm really taking photos
of how my graphs are looking and all that kind of stuff.
How,
how does your family navigate your life with diabetes or
are they just kind of, you've got a wife,
you've got kids who are more adult now, right?
Well, back in when,
when CGM first came out and you had to carry a receiver
(24:55):
around with you everywhere,
I would misplace that thing constantly.
I bet Debbie loved that.
My, well, my kids learned a profit from, I would just,
I would pay five bucks that whoever found my CGM first.
And then Debbie kind of cued me in.
She said, Gary, you know, they are fighting it on you.
(25:16):
It's always a mom that knows exactly what the kids are
doing or are up to.
I learned my,
my kids are very entrepreneurial in their own, right.
Uh, so that we try to have fun with it.
You know, I, I will often,
I used to claim my blood sugar was low when there was
something.
to eat.
I wanted all of it.
And then it started asking for proof evidence that I was
(25:37):
actually low.
Imagine not trusting your own father about his glucose
level.
Did you ever have to hide glucose?
Whatever you use to treat your lows?
Did you ever have to hide it?
Like put it away so nobody could find it and eat it up and
then you go to it and there's nothing left?
Yes, I have to do that with Gatorade.
(25:59):
I keep Gatorade in the fridge and I have to put a I have a
sticky note with a skull and crossbones on it that says
Gary's.
I just keep transferring it to the new bottles so that no
one else drinks it.
That's a good idea.
Does Debbie has she ever followed your data or does she not
want to or you don't really care?
(26:21):
No, she hasn't.
And I know it's beneficial to have a loved one follow it,
not just for safety reasons, but they've got evidence.
research that shows people have better control when someone
is following it just because of the accountability that
they give folks.
I just never really felt comfortable having someone else
(26:41):
follow my data.
It's every glucose value.
There's a whole story behind it.
And I don't feel like sharing the whole story when every
time someone says, oh, so why are you high now?
Why are you low now?
I don't wanna go through all of that.
Right?
I do it typically when I travel,
then Nathan will kind of turn on the follow component.
(27:04):
But outside of that,
I don't because while my CGM's work pretty darn well for me
and I don't have many issues,
there are those times where you have a new sensor, right?
And it's reading L -O -W, you're low.
Well, then you're getting these text messages that like,
are you okay?
Did you eat something?
Are you okay?
And nobody, you know, well, that's lovely.
(27:27):
And they mean the best.
And I know Debbie, she would mean her best.
She can get into always good intentions.
Yeah, but it can be an explanation.
Like you said, with every number,
there's an explanation and you don't necessarily,
you do that to yourself, that inner monologue,
you're already navigating that.
And I think that it's hard when as an adult,
(27:48):
especially you have to then tell somebody.
Yeah, it's one of those do as I say,
and that is I do things with having a loved one follow it.
Just like when we're teaching about treatment of
hypoglycemia,
no one wants to know and no one should follow what I do
when I go low.
So I am a chronic overtreater.
(28:10):
Oh.
All the wrong stuff went up.
Stories I never knew and I've known you a long time.
Come on, what is it?
You got to do something.
I mean, I know you manage well, but what's the do as I say,
not as I do thing in Jenny's work.
Oh my goodness.
Well, one that I think we all do is, like,
(28:32):
never changing our landscape.
Oh, that's passé at this point.
That's probably one of the...
I will definitely say that I think with new technology,
I've become more aware because it's more visible the
impact, especially for treatments for lower blood sugar.
(28:53):
I got pretty good at knowing, but as you said,
those symptoms can be pretty aggressive at times and
depending on the time of day, like overnight,
treating a low,
and you just don't want to wake up again and you're, like,
so annoyed and the whole bag of, like,
taffy in the cupboard looks really, really tasty,
so you eat many of them.
(29:16):
But today's technology, it's great because especially,
you know, you're a looper, I also use a do -it -yourself,
and because of that,
it's an easier way to see how much is needed It's an easier
way to see how much is needed.
If your brain is willing to pay attention to that problem
is I listened to my brain when I'm hungry and low and my
(29:39):
brain keeps telling me to eat and eat and eat.
Well,
I guess part of my brain is the pleasure center of my brain,
the intellectual part,
that little tiny scrap that makes up the intellectual part
of my brain.
It's it's same,
but the rest of my brain is eat that now eat more of it.
Eat the whole bag of chips because yes,
(29:59):
they're really quick sugar, right?
More must be better.
More is more is always better.
If you I guess if you had to do anything that was outside
of the realm of being Gary from integrated diabetes,
(30:24):
the super CDCES that you are,
would you choose something else?
Like, let's say people have asked me this.
What if diabetes was cured tomorrow and you had no job left
because nobody needed you?
What would you do?
Well, I thought about that.
And it's hard to come up with a real occupation.
(30:48):
But there's things I could see myself doing.
I have no idea if they would ever pay me enough to even pay
my bills.
But I think I would be a very good laziness cop.
It bothers me when I see people being just not being active
enough and just ridiculously lazy.
And I want to be able to write citations for that and do it
(31:11):
nationwide,
worldwide and make the make the world a healthier place.
Now, for example,
people who who wait to get a parking spot,
they'll sit there with their engine running to get a spot
that's two spots closer to something that's already open.
Right?
Just park.
I hate that.
People who,
(31:31):
who insist on taking the elevator or escalator when there's
a perfectly good staircase right there.
But the worst is the moving walkways.
Oh, yes, works and shopping centers, standing on them.
They get on the moving walkway,
and they think it's a ride in Disney World they just stand
there, and they stand in the middle.
(31:52):
Yeah,
and you can't get past them and the thing is moving like a
foot a minute it hardly moves.
And it's supposed to just help you get there quicker you're
not supposed to stand there and just.
So I would love to just write citations to people for stuff
like that.
I don't know, popular guy,
(32:13):
you'd probably have to have your own business and figure
out how to get yourself paid for doing that because I'm
thinking government grant I'm trying to improve the health
of.
So you're, you would want to be a encourager of movement.
Yes,
you could take out lazy from it to make it actually a facilitator
(32:36):
of physical activity.
There's a new job title.
There you go.
Activity facilitator.
You know,
the one place that that would absolutely be as you talk
about that, I can remember when we lived in Washington,
D.C.
I rode the metro in every single day, right?
(32:57):
And it was very visible people who didn't do that every
single day because they were the ones locking the
escalators up and down and to the to the next train that
was coming.
And you're like, stand on the right, walk on the left,
move quickly or move over, please.
So you would have a prime job right there on the escalators
(33:22):
at any metro or subway station.
I could see training a whole platoon of fellow.
What do we call it?
This is this facilitators of physical activity.
I would train a whole platoon of these and dispatch them
around the world.
You know, that yeah, that would be pretty cool.
(33:43):
I'd love to do that.
As long as the outfit was fancy,
a cute t -shirt or something.
I might come work for you again.
I want something with a lightning bolt on it that would
look really cool.
Like a superhero type thing.
I can understand, you know, I can understand just in again,
knowing you for such a long time,
(34:03):
knowing your personality and having read your think like a
pancreas book as well,
which folds your personality into really good information.
But what I guess what propelled you to write a book and
which you've got a couple,
but really think was your first one.
Am I right?
So what, what really gave you that inkling?
(34:27):
Just getting the word out.
I knew I could.
physically only see so many people.
And even our team,
we've got nine clinicians and we can only see so many
people.
It's just an opportunity to get the word out and help
educate, motivate and inspire that many more people.
I believe it's the top selling book in the type one
(34:49):
diabetes community.
And I don't know how official these numbers are that they
collect,
but I think it is the number one selling book for type
ones.
I'm working on the new edition right now.
And you're helping me with the resource section.
It's even more about apps than anybody I know.
So you're helping me with that part.
(35:10):
I am, I've got some new ones to add.
And also the book section, there are,
I can't remember when your most recent edition came out,
it's a couple of years already, right?
It's almost six years.
Really that long?
I thought it was more recent than that.
But there are a number of new books that I am on are on my
list to type up as well.
(35:31):
So yeah,
if you find an app that helps you find the best chocolate
in any city in the world that I think that'd be popular,
that would be a popular one to add.
That would be I would use the wheels turning Jenny.
That would be a really great.
And you'd make so much money on this app,
(35:53):
you could just spend your time traveling and testing out
all the places and figuring out what in the app while
telling people how to be more active while they eat their
chocolate.
Yeah, yeah.
Well,
dark chocolate's a lot healthier than most other forms.
And it's it's a good thing.
You can walk it off afterwards.
Exactly.
(36:14):
Yeah, absolutely.
Anything else that we need to know about the Gary Scheiner
at all?
My basketball career is continuing nicely.
I'm playing twice a week now.
I've got a very old guys league I play in on Sundays and as
the middle to middle age league I play in on Monday nights.
(36:38):
And the rest of the week is either recovering or just
trying to stay in shape for those games.
So are you still doing lifting as well?
Yeah, yeah.
Three times a week and doing some other cardio stuff the
other days.
I still I love to bike.
That's I mean, bikes basketball is my passion sports wise,
but for fitness purposes,
(36:59):
I love getting out on my bike going for long rides.
You know,
these old railroad lines that have been converted to bike
trails.
Wonderful.
If anyone out there knows some really good ones,
let us let us know about those.
There are some in Northern Virginia as well,
if you've never been.
(37:19):
I know you like with Atlanta.
No, not new Jersey.
Is that the one that you guys often go to sometime?
The shore.
Yeah, go to the Jersey shore, Southern Jersey shore,
like from Kate may up to Atlantic city,
just right through the towns, there's some traffic,
but it's not too bad,
but there's bike trails around the Philadelphia region that
(37:41):
run along the rivers.
And they're beautiful, the nice long all day trips.
That's, that's where I get to reset my brain and really,
really relax.
And some people they do their, you know,
yoga and meditation and whatnot.
I, I get on that bike and I just, so relaxing.
That's kind of funny.
Cause I've always, I told my aunt one time who is,
(38:03):
who has always been very big in yoga and more like natural
health and living and everything.
And I said, you know, I, I can't meditate.
I don't, I can't sit still.
And just think about,
because then I end up thinking about everything and I'm not
meditating,
like I'm not about what I could and should be doing while
(38:24):
I'm meditating.
Right.
So I, she's like, Oh, that's okay.
Jenny, she said, you're a moving meditator.
And that's so like,
it made sense to me because I do when I run weekly.
I think about so many things.
I also do it first thing in the morning.
So I'm well rested,
kind of have a fresh brain and kind of a bigger outlook on
(38:46):
all the things I'm trying to navigate through.
And I come back with some of the best ideas.
Sometimes I actually have a,
an outline for some of my newsletter articles that I write
and kind of put together.
Um, so yeah, it's mo you're a moving meditator, Gary.
Okay.
I'll buy that.
(39:08):
So, well, this has been a pleasure just chatting with you.
Cause we also never really get to just talk.
Yeah.
So, yeah, no, it's always,
we always have tons of business and projects and work going
on that, uh, yeah,
you and I never get a chance to just sit and chat like this
and create a whole podcast to do it.
(39:30):
We did.
Absolutely.
So nothing else you're good.
I'll suppose.
Yeah.
I am using, uh, I'm using a GLP one receptor act.
I do find it's very helpful.
I don't need to lose weight,
but it helps me to manage my food intake very nicely.
(39:50):
So you found the benefit from appetite.
Yeah.
I mean, a lot of us try, you know, we try all the devices,
but we also,
a lot of us tried different medications and that's one that
I've stuck with.
I have found it helpful when I don't use it.
I'm just hungry nonstop and it's really hard to manage your
glucose levels and just be healthy when you're eating and
(40:13):
hungry constantly.
So I find the GLP-1 receptor agonist to be pretty helpful
for that.
We've got a lot of clients on intensive insulin therapy who
do also need to lose weight.
So yeah, I find it can be pretty helpful.
How long,
let's say you didn't take it or you forgot it or whatever,
(40:36):
how long does it take before that appetite suppression that
you find most beneficial?
How long does it take before that kind of wanes off and now
you know your appetite is back up to where it had
generally, it's a weekly injection.
If I go a few days beyond the week when I should have taken
it, so once I get to like nine, 10 days after my last shot,
(41:00):
yeah, the appetite starts coming back with some ferocity.
But what I do is I'm going to go on vacation.
I purposely don't take it because I really want to indulge
and enjoy myself.
especially on your cruises, right?
Yeah, a cruise or any place, you know,
where there's unlimited and really good food.
And I want to take advantage of that.
(41:21):
Kind of like my dad,
I want to get my money's worth from everything.
So if I'm going to be at some kind of all-inclusive,
I want to make sure I eat enough to make it worthwhile.
Totally makes sense.
Well, thank you very much for doing this today.
Thanks for joining in.
Absolutely.
You should be the host of all these podcasts that you're
(41:44):
involved in.
Oh, you're very kind.
That's nice of you.
I'm going to call Scott and tell him that.
Yeah, Jenny should be the host.
You could be a guest once in a while and let her run it.
Just let Jenny talk.
Scott's kind of,
he's pretty darn good about all the people that he gets to
(42:07):
learn a lot about.
So I hopefully, you know,
what we are able to do with our integrated podcast will
really also reach, you know,
everybody I think has a different personality and different
information that they're looking for.
So I'm glad for all of the diabetes podcasts that are
honestly available,
because what you might learn from one person,
(42:30):
maybe you learn a little bit more from another podcast,
you knew something,
but now you can delve a little bit deeper into the
information, which is certainly, you know,
what we do with an Integrated Diabetes,
as we've already said, we try things, we do it ourselves,
we use technology.
We're certainly available at Integrated Diabetes to help
(42:52):
people worldwide.
We don't work just here with those in the United States,
and we assist people of all ages with their glucose
management, self-management, all the education,
help them use all the tools and the technologies,
especially as that technology changes and shifts.
We offer consultations in English and in Spanish,
(43:12):
Tavia is wonderful.
Um,
with specialized services in sports and exercise and weight
loss and type one pregnancy and women's health and all of
the emotional and mental well-being that goes along with
managing a chronic condition.
Um, and on behalf of Think Like a Pancreas, the podcast,
I was your host, Jenny Smith.
(43:35):
And thank you, Gary,
for being my wonderful guest and have a great rest of the
week, everyone.
So for more information,
you can visit us at integrateddiabetes.com or you can email
info@integrateddiabetes.com
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