Diabetics Doing Extra Long Bike Rides with Hilary Andersen

[00:00:07] Rob Howe: Welcome to the Diabetics Doing Things podcast. We've been telling the amazing stories of type 1 diabetics all across the world since 2015, and we have over a thousand years of living with T1D on the podcast. The interviews range from incredible feats to everyday victories, and we celebrate them all just the same. Thanks for listening, and if you want to get involved even further, just send me an email at rob at diabeticsdoingthings.com. This episode is sponsored by Health IQ. What's Health IQ? Health IQ is a life insurance agency. But with a very modern and cool twist, Health IQ is making life insurance fair by unlocking the value of health consciousness for the 50 million Americans who take responsibility for their health. This is especially relevant for me because as a type 1 diabetic, I've been denied life insurance coverage by other providers. Even though my A1Cs are in range, I eat Whole30 and can still kill guys 10 years younger than me on the basketball court, which is super frustrating. Health IQ can give people exclusive rates through their Health IQ quiz, and they even take into account data points from things like Fitbits and other trackers. You can learn more about Health IQ and get a free quote at healthiq.com slash DDT. That's D-D-T, short for Diabetics Doing Things. And if you're like, Rob, I am not really in a place where I'm thinking about life insurance, I'll tell you this. When it comes to retirement and planning for when you're not around, there's no time like the present to at least learn what you qualify for. So give it a shot. Go to healthiq.com slash DDT and get a free quote today. Welcome back to another episode of Diabetics Doing Things. We are telling the amazing stories of type 1 diabetics from all across the world. And my very special guest today is Hilary Andersen. Hilary, thanks for joining the podcast. Thanks for having me, Rob. It's exciting to the different ways that people get to reach out now. And so I'm really glad that you were the one that reached out to me because so often it's the other way around. And, uh, I really get excited when people want to get interviewed. And, uh, I think so many times just like opening up those conversations where, uh, you know, I didn't really even know, uh, some of these stories were out there. It just is super fun for me. So appreciate it.

[00:02:38] Hilary Andersen: Yeah. Thanks for doing this podcast. It's really amazing. Um, I heard about it from another type 1 diabetic, who I was describing my sort of adventures to. And she was like, you have to listen to this podcast. It's really applicable. So that's kind of how it all came about.

[00:02:53] Rob Howe: Oh, that's so cool. And it totally is applicable. So shout out to your friend for listening. That's awesome. So Hilary, why don't you just kind of give us a little bit of frame of reference for you and your type 1, so your diagnosis story. And then we'll kind of go and talk into a little bit about what makes you so applicable to this podcast. Pretty exciting.

[00:03:13] Hilary Andersen: Cool. That sounds good. So I always say that there's two dates in my diabetic life. One when I was diagnosed, which was in 1994. I was nine years old at the time, and I had a really pretty straightforward diagnosis. I had complained to my mother that I was incessantly thirsty and couldn't drink enough juice. And my mom was the one that usually took me to the doctor. But I think there was some sort of scheduling conflict with some event that my younger sister was going to. And so she had my dad take me in. And we went in and they were like, oh, your blood sugar is really high. You need to be hospitalized tonight, which I think, in hindsight, my mom felt terrible that she wasn't there with me, but it was fine. I was in the hospital for three days and I was still in that honeymoon period for several months thereafter. So I remember going to diabetic camp shortly thereafter, and they were always amazed at how good my blood sugars were because I was still in that honeymoon phase. The second day to my diabetic life I like to say is when I was put on an insulin pump which was in 1998 Riley Children's Hospital in Indianapolis and it was sort of a as it was described to me a pioneering thing because at that time they weren't putting young adults or children on insulin pumps because they were afraid that because children had very different sort of erratic schedules that weren't predictable, that pumps would not be a good option for either small children who, you know, their peers could mess around with their buttons or for even kids my age. At that time, I would have been in the eighth grade. And I was very active and in sports. So they were concerned about my blood sugar plummeting while I was on a pump. But it was a really positive experience for me personally. Um, and so I've been on a pump for nearly 20 years. Wow. Yeah. And yeah,

[00:05:31] Rob Howe: I mean, that's so, you know, there's so much, you know, positive messaging out there around pumps obviously, but like for a long time it was, uh, you know, there were a lot of worries and a lot of, I think overblown narratives and not, not that, you know, any sort of like tragic diabetes pump accident or whatever is is overblown but I think for parents there's a lot of like

[00:05:52] Hilary Andersen: irrational fear around that for a while yeah totally and it was very real in the late 90s because especially for I remember they were also putting another like two-year-old on a pump at that time which was really pioneering as the endocrinologist described to me because of that fear, like that parental fear, the doctorate fear, you know, the doctoral fear or whatnot. And I think the medical system too. Yeah, absolutely. I think, you know, it's

[00:06:24] Rob Howe: when you're blazing that trail, obviously like innovation is sometimes hard and definitely not without, you know, bumps in the road. So, you know, what a cool thing to be a part of.

[00:06:34] Hilary Andersen: Yeah, it was really amazing. So for you, you know, you know,

[00:06:38] Rob Howe: looking back like 20 years, like your first pump to today, and we're going to talk a little bit more about your new pump, but, um, you know, what are the big things that you remember as you were like, uh, transitioning to either new technology or when you first got on the pump or things like

[00:06:52] Hilary Andersen: that? Yeah, I, um, the pump was really pretty stable. And I, and I mean that in the sense, like it didn't change for a long time, the basic design. Um, I would get upgrades, you know, every five years or whatnot when they went out of warranty. But it wasn't really until I was put on a 630G, Medtronic 630G earlier this spring that seemed like the technology had really advanced in different and exciting ways. I remember being very frustrated by CGM systems. I was first, I first tried to use one when I ran a half marathon maybe a decade ago. And I just remember the thing blowing up in the middle of the night and just like alarming waking me up my blood sugar was actually 98 or something and it it was reading me as below 60 and so like the inaccuracy really

[00:07:50] Rob Howe: drove me nuts and I stopped using them um yeah I had a very similar I guess not very similar mine didn't even like make it that long I it was probably seven years ago maybe and I had like the medtronic educator come to my college and like spend the half a day with me in the library like going over it and like connecting everything and like putting it on and then i went to the gym immediately after and like didn't even have like i was testing it like i didn't even do like a an average workout in terms of intensity just very casual and it fell off like 20 minutes in oh god and so it's just i was just like man like this isn't gonna work i just said this can't you You know, my lifestyle is much too crazy for this thing.

[00:08:36] Hilary Andersen: Totally. Yeah. I think that it's gotten better. I tried out a Dexcom probably four years ago again and still wasn't really satisfied with its accuracy levels. And so, again, put it on the shelf. And then the latest Medtronic systems, the 630 and the 670, both work in concert, of course, with the CGM. and I'm getting much better at it and managing the CGM device actually, which is ironic. It's like this pesky infant that I'm always just having dialogue with.

[00:09:12] Rob Howe: And in what way? Is that just because it's telling you, hey, you're out of range, or hey, do this?

[00:09:18] Hilary Andersen: Yeah, I've had so many funny things. Like, I was camping and my CGM started blowing up because it couldn't, you know, it was not transmitting accurately to the pump that was less than a foot away on the other side of my body. But because it was in a cocooned sleeping bag, it wasn't functioning. I mean, so stuff like that where I'm like, why are you waking me up at 4 o'clock in the morning? Right.

[00:09:47] Rob Howe: Right. Yeah. There was like a really cool, uh, I think JDRF did it or somebody did it earlier this year, uh, where you like put in how long you've had diabetes and it gave you like some rough stats based on like how many pricks of your finger you've done, how many injections, how many pump changes, how many hours of sleep lost. And I was like, yeah, like I definitely relate to this because you know, there's those either 4am wake ups or just like, you know, in the middle of the night, cold sweat, low blood sugar wake ups, or, you know, can't sleep because, you know, your blood sugar has just been weird all day, all those types of things. Totally. That really speaks to me, too. That's funny. So for you, like, one of the reasons why your friend recommends you to find this podcast is because you have a pretty interesting, unique cycling background and cycling experience, if I'm not mistaken, right? Yeah, that's right. So tell us a little bit more about that, because I have questions. And I think it's really interesting.

[00:10:53] Hilary Andersen: Yeah, so it's funny, because I've done a lot of long distance tours at this point, but I haven't actually done any of the JDRF rides, which has been on my boilerplate, like to do list for some time. So I recognize my desire and clear fit with that work. but I you know I was talking to a good girlfriend of mine in 2011 and we were talking about how much we would love to do a bike tour and I said that sounds great I love bike commuting now I love living an active life it would be really interesting to do so I live in Austin Texas and I said to my friend Zoe I said well my sister's graduating from her undergraduate degree at the end of May in Terre Haute, Indiana. Why don't we ride to that? So we did. And I mean, so we ended up riding to Chicago effectively. And then I took the train back from Chicago. But I did that initial tour in the spring of 2012 with two of my dear girlfriends. And it was a blast. It was super fun. It was definitely the most, like, roller coaster of my blood sugar tours so far because I was novice at it and trying to figure out how much food I needed to eat and how to stabilize my blood sugar. And, again, at that time, I wasn't on a CGM and so didn't have that sort of real-time information. So that was the first tour.

[00:12:31] Rob Howe: and then so i want to pause you for one second because you said something like long distance right so you know if you're a long distance runner you run 20 miles right or you know maybe even less than that uh and but a long distance bike ride like you from austin to chicago yeah like that's like what 1600 miles 1800 miles yeah that sounds about right so um i'm by the way i'm patting myself on the back for my u.s geography knowledge even if that's even remotely in the ballpark i'll be happy but um so that's a long way um how long how many days is that we did it in two weeks okay just a casual two week almost 2 000 mile bike ride um what how do you train for something like that you talked about being a relative novice uh that's that's not something that you just wake up

[00:13:25] Hilary Andersen: and do? No, it's not. I, you know, I think that is a question that a lot of people have, like, how do you train for that? And we had done some experimental rides here around Central Texas, um, and overnights, you know, that were about 50 miles out and 50 miles back. Um, cause we were estimate, so I should, I should frame this. We carried all our own gear. There was no sag wagon or support ride behind us. So I carried all my medical equipment with me and all of our sleeping bags and tents and cooking supplies and food and clothing and whatnot, you know, just basics. But it is interesting that we were training without the amount of weight that we you were carrying because that really slows you down in a lot of ways when you're carrying, you know, a 30-pound bike, steel frame bike, plus, you know, another 30 to 35 pounds worth of gear in some cases. 65 pounds worth of gear might be a little on the high end of it, but it really makes a difference, right, in terms of hauling up hills or even downhills and whatnot. In terms of training, I don't think that we did enough of it. You know, I think we kind of suffered for the first week. And then the second week, we just we called our peanut butter our health insurance plan, you know, because it was through. But, yeah, I mean, like I said, we had done a little bit of long distance cycling around here and done a few rides. But was there an overt training plan? No. And that was that was interesting.

[00:15:14] Rob Howe: Well I think it's just First of all not having I think you called it a sag wagon Or just a support vehicle Or somebody driving along with you That just adds Another layer of difficulty Obviously And carrying all your gear is another one Me personally I can't make it A weekend trip without Almost two Suitcases full of stuff I'm just a bad packer I think but I just think like two weeks on the road on a bike um and having to carry it all including food that's just a another wrinkle that I just you know I'm just I want to make sure that we get this accurate picture of this because I think it's super impressive and I don't want to downplay anything I don't want to miss anything that's like a big juicy detail yeah I mean I think that there

[00:16:06] Hilary Andersen: was points when we were just really tired of the weight we were carrying and we all shipped stuff back home and I shipped some of my medical supplies, not intentionally, but they were part of a bag, they call them panniers on bicycles, that I just thought, you know, I should really lessen this load. And so I think I had sent back some test strips, which were easily replaceable at a CVS, but we didn't really recognize what had happened until I think we were in the middle of nowhere, somewhere in either Arkansas or maybe southern Tennessee. I'm not sure where it was. But we were really pretty remote, and I thought, oh, gee, I'm out of test strips. This is bad. I know what I've done. I shipped them, you know, back in Jackson, Mississippi, back home or whatnot. And so we went. You know, I was really grateful for a cell phone at that time, and we used it to find a local CVS up the road and replaced it. But it was all doable. I mean, the thing with pump supplies is that that's not so replaceable when you're on the road, right? You can't roll up to a pharmacy and replace that stuff. But luckily that has never been the case that I've ever shipped or forgotten those kinds of supplies. But you do have to overpack because if you're, like I sweat off, some sites and that has to be replaced. And so it might not be three days between a site change. And so I always pack 20% more than what I know I will need at a minimum.

[00:17:47] Rob Howe: Right. I kind of put it in my Instagram story, like going on a trip very recently, asking people if they bring just an extra week of supplies maybe than they need. you know just to have like for me i think it's less about worry and more about flexibility like you know hey what if i want to just do something spontaneous and i want to be able to you know and i think that's that's part of the the overpacking thing as well maybe even extends into like my clothes and stuff too because i just want to be able to have that option because so much of living and preparing for life with diabetes is just knowing and thinking one step ahead and just adding that extra step to whatever process you're doing. It's like, hey, don't forget to order your insulin because you might only have enough doses left in your vial to fill up one pump reservoir. So just keeping everything in perspective.

[00:18:47] Hilary Andersen: Totally. There have been some odd things on some of the tours that I hadn't prepared for that I didn't think of before I left. And then we just kind of worked around them. We were creative and intrepid, if you will, about it.

[00:19:08] Rob Howe: Give me an example.

[00:19:10] Hilary Andersen: So my now husband and I just got back from bike touring in Japan in August. And when we were there, for reference, I had been in China for close to a month prior to meeting my husband in Tokyo. And so I had really packed a lot of insulin supplies and pump supplies for the extended duration, which I was out of the country. and long story short there was a mix-up in an order that Medtronic sent to my home address and my husband flew with some CGM supplies with me that were not compatible with my system at the time or he flew with those pump supplies to meet me in Tokyo and we just worked around it you know I had enough that lasted me the entire time but again I was trying to meet that extra 20% mark The other one that was really odd on that trip was my Lancet device. The spring in it actually broke, which is not something I didn't pack an extra Lancet device because I've never had that happen on any of my tours or in my vacations. It's kind of comical because it happened when we were in Tokyo and we walked to a pharmacy and, you know, thinking like in the States, I could buy a Lancet device there. And no, they don't sell them there. you've got to go to a doctor. So we went, we walked into a doctor's office. He spoke English very well, but he said, you know, there's a doctor just up the street. He speaks English fluently. He went to UCLA to get his, his medical degree. You should go talk to him. So we went over there and, and, um, because space is at such a premium and in Tokyo and Japan, um, they had to order the lancet device, ship it into the doctor's office, and then I had to come back and pick it up later. Well, the funny thing about Japanese lancet devices is that you can't reuse a lancet, and they'd only sent 30 lancets with the device, right? And not that I'm advocating reusing a lancet but occasionally I'll reset a lancet device because it either hasn't pricked my finger or you know I haven't bled enough or whatnot right and 30 lancets is not going to last me more than like three days because I compulsively check my blood sugar a lot and so we were like well we're just going to have to work around this and use my American lancet device right um so we jerry-rigged um a pencil that could reach inside of the Microlet is what the brand was that was broken that i had to to like jam it down to be able to reset the spring and i did that for nearly three weeks wow that's wild yeah so it's kind of funny but it works yeah it's kind

[00:22:20] Rob Howe: it's like you just you make do with what you've got right totally um i love japan i'm a huge fan of japan uh what where did you guys ride to and what was your favorite part hokkaido it was just

[00:22:35] Hilary Andersen: amazing we so the extra level of insanity to this is that my husband flew with both of our touring bikes to Tokyo with him. And then we took an additional flight with the bikes from Tokyo to Sapporo and then rode in Hokkaido, the northernmost island of Japan, because it's cool there right now and we wanted to escape the Texas heat. And it was our first international tour. We've done several in the States. And I'm really very blessed because I've always had someone else that toured with me. So I've never been alone and I never would do it alone. But this was really amazing because it did add a new layer of challenge for me and my diabetes, but was really, really beautiful and an incredible experience for a lot of different reasons. Because I, too, really love Japan, as it turns out. And the cycling infrastructure in remote rural Japan was, bar none, some of the best I've seen anywhere. so um it was such a treat i mean to be cycling with the mountains on my right side and the ocean on my left side it was just astounding yeah i i would encourage i've never been to

[00:23:53] Rob Howe: but i uh i guess it was literally almost two years ago to the day uh i had maybe the most magical day that i've ever had just by myself in uh in kyoto i took i took the shinkasa from tokyo to kyoto for the day and just like in this remote part of of the world like the train i'd never had to get off the train to get to where i wanted to go and then i walked like 15 miles in this beautiful october day uh right by the ocean right right in the hills it was it was just

[00:24:26] Hilary Andersen: incredible yeah it sounds really amazing it's just yeah beautiful yeah just a magical place

[00:24:34] Rob Howe: so yeah so obviously like in these in these tours anything can happen how do you uh and like you said you're a compulsive tester uh where does that come from is that just a you know you want you feel a certain way and you want to know the number or have you always sort of been that way or is that just a part of you know riding your bike a long distance i think i do it even when i'm not doing

[00:25:00] Hilary Andersen: long distance riding. I check my blood sugar a lot. I think it's just sort of been ingrained in me. And again, if you, if we back up to the first tour I did, I wasn't wearing a CGM at the time. And so the only way I had real in time, you know, in time knowledge about what my blood sugar was doing was to test it. And so I was testing a lot on that first tour because I wanted to know where my blood sugar was sitting. I now know that, um, and this is what a non-diabetic needs to ingest as well when bike train, but I need 100 calories an hour to not crash or what some cyclists call bonking. And it's what anybody would need, right? Not just a diabetic, but because I'm really in tune with what my blood sugar is doing. I know if I have this crazy calculation on my pump, I set a temp basal for the seven hours I'm riding. Well, let me back up. I have a second basal rate for when I'm cycling that I do 24 hours a day. It is 50% of what my normal basal rate is when I'm not doing these tours. But because I have so much caloric intake that I need because of the amount of output that my body is putting out there, I have to have 50% of my normal basal rate. And then when I'm actually on the bike for the seven to eight hours, I actually take 10% of that half. So I'm really not getting much insulin on a daily basis when I'm on my bike. I think I average between three and four units a day, which is very little compared to my normal, normal non-biking life. But even at that rate, so I'm, I bolus at a normal rate, but my ingested basil is much, much lower. But I have to eat 100 calories an hour of, you know, like a shot or in Japan, there was substitute foods, there's something called calorie bar that was the translation into English that I used there. And then I always had juice boxes too that we found at convenience stores. And we ate out of convenience stores nearly 100% of the time when we were out in Hokkaido in the rural areas when we were biking because it was what was around. But for context, I mean, you can dine like a king when you're at a convenience store in Japan. They're not like convenience stores here. So we ate very well and healthy food and fruits and vegetables and rice basically and protein. when we were eating out of the convenience stores, but it worked out really nicely.

[00:27:52] Rob Howe: All right, we're going to try something different here about the midway point of this interview. We talked about it at the beginning of the podcast, but I just wanted to give another plug to Health IQ. Really, Health IQ is just like car insurance, but for life insurance. And let me explain. It's like if you're a safe driver, you get more competitive rates. That makes sense. Health IQ just takes into account an overall healthy lifestyle and passes those savings along. It's that simple. Plus, it's good for you. The American Heart Association reports that an overall healthy lifestyle is associated with nearly 60% lower risk of mortality by cardiovascular disease. That's always good news. So get the rewards for living that healthy lifestyle. Check out healthiq.com slash DDT today. And now we'll get back to the episode. that's interesting like i um you know just thinking about long-term preparation and knowing like your trends and knowing yourself what do you what do you notice about um the way that your body responds to different types of exercise or different types of terrain or weather

[00:28:59] Hilary Andersen: when you're on your trips? Yeah. When I am doing really intense extended cycling or activity of any kind, I really have to be getting less insulin overnight. Otherwise, it will crash in the middle of the night. And I unfortunately found this out really for the first time in high school. I swam competitively on my high school swim team and so would swim for three hours in the morning before school and then swam for four to five hours after school. I mean, I was in the best shape of my life, but also just exercising a ton. And I didn't know at that time how my body worked. And the only time I've ever passed out as a result of a low blood sugar was actually in the middle of the night. I woke up, felt my low blood sugar. I've always felt my lows. Woke up, went upstairs, tested my blood sugar, it was like a 51. And my dad woke up because he heard me and he came out and I had passed out at that time, which is terrifying. You know, nobody wants to go through that. But it was that experience that taught me to learn my body that because of the amount of exercise that I was doing, the very intense extended day in, day out exercise, I can't have that much insulin overnight through a pump or, you know, if you weren't on a pump, like, like long acting insulin or something like that.

[00:30:25] Rob Howe: Well, and I think that's interesting because, you know, you've got to think even more ahead of like a competition day or an extended day of exercise. Like, you know, going back 12, 18 hours and really setting yourself up for success. That can be a challenge.

[00:30:44] Hilary Andersen: Yeah. And I think, you know, I've always, because I've been on the pump, I've taken short acting insulin, right? Humalog or Novolog. And when you think about short-acting insulin, you don't think necessarily about how your body is ingesting or metabolizing food on a 24-hour basis, right? Because you think, I go to bed, my blood sugar is at a safe 120, 130, right? But then if I'm crashing because of the amount of exercise I've done in the previous 12 hours, that's something that I didn't understand

[00:31:20] Rob Howe: and how to anticipate. No, totally. Yeah. And I think, you know, I think a lot of the questions that I get on the podcast are about exercise and about how you, you know, how you treat yourself, you know, whether you're having a low or a high in a high intensity type scenario, or how, you know, you train for something like that, or, you know, how different food reacts, or how different situations react. So, you know, I think it's always really interesting to you know, to dig into the approaches that, that each of us have. Um, because, you know, it's, you know, the, the more information that you can get, the better off you are and the more decisions you can make. And you, I think everybody, everybody's very different. There's diabetes, especially type type 1 diabetes is not the same for every, for two people, you know, every, every two people are different. But I think when you hear something, it's like, Oh, well I do that or, oh yeah, that's happened to me before, is really helpful when you're out there because you don't feel necessarily so different or frustrated by the result.

[00:32:26] Hilary Andersen: Yeah. I think too, it's just not about, I can't beat myself up for whatever happens with my blood sugar when I was out there. I was very frustrated when I was in China and Japan because they don't read Chinese or Japanese and I don't understand character languages. And so nutritional labels were a real challenge for me, even though there's Google translate that doesn't, you know, a hodgepodge job of translating kanji into English. It's not very accurate. And so I was having, especially in China, a lot of trouble reading nutritional labels and trying to figure out how to dose for things because the food's very foreign than anything I had eaten here in the states Chinese food is obviously very different here in a lot of cases than it is there right it's not it's not orange chicken and lo mein no it's not so I was really frustrated because I was having higher blood sugars but I was like Hilary you know you don't speak these languages it's okay it's okay that you're not on the numbers perfectly right because this is a real challenge and it's something that you've never done before and it's hard to navigate

[00:33:46] Rob Howe: well it is and like i'm thinking now um i had this this is a little similar similar situation not quite as uh as meaningful i suppose but i was buying uh i was in japan and it was like a saturday night and i was getting ready to go out uh and i was trying to buy a beer from the gas station like from like a 7-eleven which is which are everywhere in japan and like it's so different than 7-elevens here but uh i was just looking at these different like beers and i ended up getting a non-alcoholic version so i was like i was like drinking this beer i was like this beer tastes weird i don't what's go what is this and it was just basically beer flavored water um which is disgusting anyway it was just it was like i laughed i had to laugh because like it was a just a weird tourist thing but yeah in that was my own microcosm of uh of a mislabeling type

[00:34:43] Hilary Andersen: type scenario i love it there's so many good stories like that that are really excellent as you know adventures abroad while living with diabetes right yeah and i think that's

[00:34:55] Rob Howe: that's something i want to talk to you about as well because uh i think there is in some ways a fear of long distance travel and foreign country travel for all the reasons that we've talked about uh you know you don't have there's not a cvs around the corner necessarily or uh you know you don't want to you're afraid to pack all your supplies for a long trip talk about maybe your first trip and what you would tell people you know who who are looking

[00:35:23] Hilary Andersen: to make a trip like that yeah you know when I was an undergraduate and call you know I went I studied abroad in France and so that was my first adventure in packing long term with pump supplies and packed for the entire four months that I was there France was probably the most I'll say medically accessible country that I've done this in. I also thereafter lived in Guatemala for some time and could only get three months worth of supplies shipped to my parents address in the States. And then I paid them to ship it down to me in Guatemala. And that was an interesting challenge. And then this recent trip to China and Japan was really the first time where a I didn't speak the language and be the character based language be you know presented a challenge I think that for me in all of these cases it was about being a meticulous life planner and you know anticipating supplies and then in the case of like living in Guatemala just ordering them so far in advance because yeah the shipping time from the states to Guatemala is very, very, very long. And so it wasn't just like me calling up Medtronic and then my supplies being here in my home, you know, three days later, right? It's like me calling up Medtronic and then the supplies being to me in a month. So those were really interesting challenges, but they were also very exciting to me. I, for a long time, really didn't, I didn't want my identity to be first built on my disease, right? So I wanted to live my life, and I always felt like I was given this extension on life because of my treatment. And so I have been a very intrepid individual and an adventurous diabetic. So I think that I pushed my parents to their limit in a lot of ways, because they were always like, how is she going to do this? How I think at this point in my early 30s, my folks are like, oh, this is just what Hillary does now, you know. But I think that it was, it's always been, I just, I really love life puzzles and life challenges. And so I was really curious about how my body would do in those kinds of scenarios. And, you know, quite frankly, different kinds of cuisines and different foods, learning how to bowl is for different things and um and then also plan for all these things given my sort of compulsive self if you know what i mean yeah and i think i you really nailed it when you said

[00:38:17] Rob Howe: like it's life puzzles and being curious um because you can read and you can read yourself to death you know you can worry yourself to death or fear yourself to death and i think for me, I didn't realize because I'm very similar, I'm very intrepid, I just like to do stuff I think I get excited by you know, adventure so I wanted to do those things and I think only recently did I realize my parents were asking the same things that yours were because they weren't asking them to me, they were asking them to each other and I think just, what's the worst that could happen and if you think about that, you're like okay, well, if I plan, you know, if I can handle that, then, you know, I'm fine, you know, whatever it is, like, I get to I land in a foreign country, and they steal all my insulin and throw me in a jail full of sugar, and I have to eat my way out. Like, you know, that's if that's the worst that could happen, I don't think that's gonna and I'd still be okay. Yeah, you know, then I think we're gonna be all right. So yeah, I think it's just, I have to be gentle with with other people, because I think people are different. Not everybody's like me and everybody's like you. And so some of us are a little bit more defined by the disease and allow it a little bit more power than others. And so, yeah, I think I want to I want to use these stories. And I'm so glad that there's so many interesting, intrepid, adventurous people that I get to talk to because it's just like I never could use this as an example on my own. But I know because there's somebody out there who's willing to go to China for a month right on their bike and then go to Japan and do the same thing all over the world with their diabetes and, you know, overcoming obstacles like, you know, broken lancets, which is such a weird thing. And I think, you know, I have before I got my newest meter, I had like a mixed hodgepodge of like of different like meter materials from exactly that type of thing. Right.

[00:40:21] Hilary Andersen: body and so those are some real gifts that have come about as well which is you know been a um a really interesting way to think about living with the disease right it's not always

[00:40:34] Rob Howe: like a really negative thing well and i think too um oh no i just lost my train of thought uh which which i hate when that happens but um you know how many people there it is i found it But it's interesting to me, like you talked about developing, you know, healthy eating habits. It's amazing to me how many people, because they have diabetes, are heightened awareness of their own health and fitness or wellness, well-being, mindfulness, whatever that is, because they have to take care of themselves. So, you know, it's such a trap, you can kind of drone on through life without a focus, and then you're forced to pay attention to something, and then you, you know, find something good.

[00:41:16] Hilary Andersen: totally yeah it's really I don't think that most like the general population has an intimate view of their own bodies as diabetics do which is really awesome right because diabetics are living longer now they're like living better now than ever before and um as seen in this podcast they're doing really amazing things that non-diabetics might not even be doing. So that's so cool. Like, that's just really cool to hear about folks that are, you know, trying to change legislation to fly planes or, you know, doing long distance running or, you know, whatever it is, right? Yoga

[00:42:00] Rob Howe: and living life to the fullest. It is. And I think, you know, in that same, in that same vein i love the everyday victories too just the people who get their kids to school um or who go to their job um you know those those are important to celebrate as well um i always i always ask sort of um two questions um on the podcast and one i think is uh is really important for for our conversation because you are on the medtronic 670 currently if i'm not if if I'm not mistaken. That's correct. Um, so the latest and greatest pump technology, we talked a little bit earlier about how the pump didn't change very drastically until sort of these new models. Um, talk to us a little bit about what life is like with that. Um, and, and what are you hopeful for, um, you know, in that world of type 1 diabetes, you know, treatment and living with

[00:42:58] Hilary Andersen: type 1, you know, because in light of that? Yeah, I, so I've, I'm not an individual that hasn't been able to feel my lows or my highs, really, I, I, I feel my blood sugar, if it's changing, before usually even a system can. Now that one exception to that is when I'm running, I can't feel those coming on because of the amount of adrenaline coursing through my body. or in some cases when I'm cycling. And so that's why I was a priority upgrade to a 670 because I'm doing this long distance stuff and it's only in those scenarios when I sometimes can't feel my low blood sugar coming on. Now that being said, it's funny because I, like I said earlier, I sometimes talk to my CGM and I'm like, you're not keeping up. I've already done my blood sugar. I already know where, you know, it might be dropping right now, you know? So it's a weird like banter thing that I have going on with it. But I think that the coolest thing about the 670 and I was previously on the 630 was anticipation of where your blood sugar is going, right? And how fast it's either dropping or rising and being able to respond to that with human input as well, right? So I joke with a lot of people that I'm, this is my joking self, but I'm a bionic woman, right? I can be downloaded onto the motherboard if I'm plugged in, right? But there's this cool way in which all these systems are working across my body and communicating with one another. But there's still me as an independent, non-robotic human that has input into those systems too. So I think that that's all been calculated by the FDA and part of why there's not autonomous pump devices is because of the potential of failure. Just like, I guess you could think about autonomous cars too in the same way. But I think the technology is moving there and that's really cool. So, yeah, it's been really, really nice to be on a system that has what I think is a really responsive CGM. And actually, after I got back from my bike tour, I did my three-month checkup with my endocrinologist, and my HbA1c was actually the lowest it's been ever. And I really attribute that to being on the system. I have never been on any other kind of pump though. So I don't want to sound like I'm just advertising Medtronic here, but it's, it's been tried and true throughout, you know, two decades from in my case. And I think it's, I've done really well with it. So the other thing that I really like is that it's water resistant as I understand it. And I am no longer fearful of being thrown in a pool and you know some sort of celebratory um just yeah i uh that that's good to

[00:46:13] Rob Howe: know i don't have the 670 yet but uh i'm i'm going to get it soon so uh that i i didn't ever really think about that everybody talks about the closed loop and that's really great but also yeah you can slip or fall into a pool and that would be just fine yeah that's really funny um fail before because of that oh man that's crazy yeah i had i have only had one pump fail uh in my i guess almost over 10 year nine years of wearing a pump and uh it was just like a weird like some sweat got in it like i had it like in my compression shorts while i was working out and then like it just failed it just it was just like nope this is it and it was just one of those weird it was like friday night it failed and then so i couldn't get anything shipped out until sunday so i was like three days without the pump and then it was again one of those things that seemed like a big deal and then like i worked my way through it and pretty much no problem so yeah oh man it was just like

[00:47:11] Hilary Andersen: nope deuces you're this is it i can't do that yeah just like made that it's like beep beep and

[00:47:17] Rob Howe: it's done just like useless that's funny um all right my last question that i that i always ask and you may have heard it so you might be prepared but you're in the airport, the context is important you're in the airport, your gate's going to close you've got to be on the plane and you run into somebody who's either recently been diagnosed or is struggling with their type 1 what's the one thing that you tell them before you've got to get on the plane?

[00:47:47] Hilary Andersen: This might be a sort of tired trope at this point Rob, but I think that it would just be like what we've been talking about be gentle with yourself, be patient with yourself and don't beat yourself up over it. Right. Like as a type 1, you're not going to have picture perfect blood sugars day in and day out. There are going to be things outside of your control that you can't, you know, you can't change, right. You might be stressed one day or, um, not enough sleep or, um, you know, you could just have something that doesn't work well in your system and your blood sugar gets high and then you get cranky or whatever it's okay like it's a it's a it's not a short-term thing it's a long long narrative arc in your life and the little things on the day you know days in and days out really don't matter it's about being in it for the long ride and that that's okay it's not a death

[00:48:43] Rob Howe: sentence yeah and you know what that might be that might be try or you know tired and overused potentially, but that's okay. I think like those types of things, you can't, you can't tell when it's the right time for you to hear it. So I think saying it over and over is really important. Plus, you know, for you, you understand the long ride better than most of us. Um, and that's my, that's my pun for the day. But, um, yeah, I think it's really important to hear those things. And that repetition is important. It may not be today. That's the right day for somebody to hear it. They might think, Oh, I've heard that so many times, but you know, the next time they hear it, maybe the right time. Yeah, totally. I think, oh, sorry. No, no, go ahead. I really did have this

[00:49:27] Hilary Andersen: happen randomly recently when I ran into a kid who noticed my CGM device. And instead of giving him advice, he was actually, and we were, I was on a trail and we were out on a hike and he noticed it and he said, oh, I'm a type 1 diabetic too. And it was his chance to just like unload all this stuff, right? He was in high school, he had dealt with so much stuff with his school, with his school nurses. And it was just my turn to listen, right? To not even give him advice. And just to be like, affirming in that, in that moment, in that, yes, I've been there too, right? And so for some folks too, it's just like, if I'm, if I'm in that situation, and somebody just needs to say to me, like, I've been this frustrating thing has happened in my diabetic life. It's also really, it's a cool time to be able to listen to that too, especially for young people, I think.

[00:50:21] Rob Howe: I agree. I think I'm having a similar conversation that one of my JDR reps sent me a name of a kid and we're going to have coffee tomorrow. This kid is having a tough time. And so I think I all get to be that person who's there to listen. And I think sometimes you just need somebody that knows what you're going through. and you don't really need advice as much as just like yeah, you're valid those things are valid that's real super real Hilary, thanks so much for coming on the show

[00:50:55] Hilary Andersen: yeah, thank you so much for having me Rob

[00:50:58] Rob Howe: yeah, it was super great to meet you and hear about all your adventures and yeah, definitely keep us posted on those because I think those are super important to keep telling everyone if anybody wants to get connected with you online where can they find you?

[00:51:15] Hilary Andersen: My Instagram handle is thecheeselouise. I actually don't even eat cheese, but I just thought it was funny. That's my Instagram handle. And my Twitter account is cheeselouise5 because I'm just that creative.

[00:51:33] Rob Howe: Great. I love it. And I imagine there are four other Cheeseluises out there somewhere. Who knows?

[00:51:39] Hilary Andersen: Yeah, probably.

[00:51:41] Rob Howe: Well, great. Well, thank you so much again for coming on the show. It was just great to hear your perspective and look forward to seeing what you do in the future.

[00:51:49] Hilary Andersen: Yeah. Thank you again, Rob. This has been great.