Diabetics Doing First Conversations about T1D with Mariel Schofield

[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@diabeticsdoingthings.com. Hello and welcome to another episode of Diabetics Doing Things. We are telling the amazing stories of type 1 diabetics from all across the world. My very special guest this morning is Marielle Schofield from California. Marielle, thanks so much for starting the day with us.

[00:01:03] Mariel Schofield: Thanks for having me. I'm so excited to be here.

[00:01:07] Rob Howe: Well, really, really, really excited to have you. And you and I were talking before we started the show. You've had type 1 and T1D for most of your life, and you've only recently started getting plugged into the community. So just wanted to extend a big welcome to you.

[00:01:26] Mariel Schofield: Thank you. Yeah, up until now, I haven't met anyone else with type 1 diabetes. So it's been really cool to connect with you guys and see all the other people that are out there that also go through what we go through.

[00:01:40] Rob Howe: It's kind of interesting, right? I was very similar. I had maybe encountered one or two people that I was friends with. before I got involved with the podcasting world and diabetes and social media. And now I feel like I have just hundreds of type 1 friends that can relate to everything we're going through. So, yeah, welcome to the community.

[00:02:05] Mariel Schofield: Thank you.

[00:02:07] Rob Howe: Cool. So let's kind of take a step back a little bit and talk a little bit about your diagnosis story and kind of growing up with T1D.

[00:02:17] Mariel Schofield: okay and this is actually kind of crazy i never i don't speak about having it very often um it's something that has been kind of sensitive for me so i'm really happy that i had to kind of share my story and actually you know um express it um so i was diagnosed when i was five and at the time I was living in Maryland. I remember very little about it but what I do remember is the common symptoms of being really dehydrated, having visual deficits, being tired all the time. I had two brothers and was a very young and active kid so my parents were kind of like, what is happening right now? I think my mom said I lost a lot of weight. And then eventually they were like, all right, we need to take her to the doctors. Like, let's see what's going on. The year before I had a really bad upper respiratory virus. So they were thinking maybe it was something along those lines of I'm getting sick again and turned out to be right. I was diagnosed immediately and taken to Johns Hopkins in Baltimore. I was there for about two weeks. And I just remember having to give insulin shots of like saline water into dolls. And that's kind of my memory early on of having diabetes.

[00:03:56] Rob Howe: It was around Christmas too, which was... Oh, sorry.

[00:04:00] Mariel Schofield: No, that's okay. It was around the...

[00:04:02] Rob Howe: Isn't it kind of funny how they teach kids how to do things? Like they give you a doll and some saline shots and that's basically your diabetes education.

[00:04:15] Mariel Schofield: Yeah. I was like, okay, why am I stabbing this doll with a needle? And they were like, you are going to do this to yourself. I'm like, what?

[00:04:26] Rob Howe: but um and you yeah you were saying you were diagnosed around christmas christmas yeah um

[00:04:33] Mariel Schofield: so that's kind of my early on memory of of having diabetes other than that i don't remember life before it that well and um i remember my biggest thing was my parents were so concerned because i I was so young. And they kind of over-sheltered me in that sense because they were just always worried about what would happen if my blood sugar drops and they weren't around or am I old enough to take care of myself. And I think I did pretty well. I remember being in, I was in kindergarten at the time and they pulled me out of school and just took a year to make sure that I knew how to do everything right and meeting with a lot of doctors and local physicians in the area.

[00:05:21] Rob Howe: Well, and I think that's important. That's, that's one of the toughest things. Um, and I, I can't relate to it because I don't have children yet, but I, I imagine that especially parents who aren't type 1 themselves, um, there's a lot of like guilt that they feel, I think. And they, you know, there's a lot of unknown and there's not a clear sort of rubric for, you know, what do we do from here? What do we let my child do versus don't do? Or how can we make sure they're better prepared? And I imagine that sort of affects the relationship in some way, but it sounds like you guys, you know, your parents obviously were a big part of your diabetes management at the time how did that progress as you got older like going into high school and

[00:06:09] Mariel Schofield: uh in college and things like that going into high school I feel like I may have been a very just bratty child because they were so overprotective with everything that I did and I would get really frustrated and I'd be like I'm fine I'm a normal kid I can do all these things you know let me live my life and they it was always a battle with them and looking back, you know, they had great intentions. They just wanted me to be safe and healthy. But at the time I viewed it as, um, something holding me back and it, it was just a struggle. Um, I played a lot of sports growing up, which was great. They did let me play sports. Whereas a lot of doctors that I met early on, they were like, you will have all of these impairments for the rest of your life and you shouldn't try to be athletic or pursue athletics and my dad played baseball in college and he was like no like she's gonna do what she wants and physical activity is obviously gonna benefit her in the long run and I'm so glad that he had that mindset because I can't imagine my life without um any physical activity or sports

[00:07:30] Rob Howe: and and i mean that that moment right there like the doc you get a prognosis from a doctor um how important was it to have your dad's support i mean in some ways i imagine you didn't know it was a little bit behind the scenes but to know that you know they were your parents were determined that you live whatever life you wanted to live because i think something that um having talked to over 100 type ones in these interviews now, that rhetoric from the doctor can be either really positive. In my case, it was really positive. They were like, you can do whatever you want, just take care of your diabetes, but also very, very, very negative and short-sighted, in which case I think you experienced some of that. How did that, you know, how did having your parents' support make a big difference for you and especially as you like formed your mindset later on it made a huge difference in that regard

[00:08:27] Mariel Schofield: um and it kind of shapes me into the person i am today um i played volleyball for the university of miami and i continue to play pretty regularly here in la um and just from my experience in physical therapy school uh physical activity and exercise is medicine it is the most powerful tool you have in order to live a healthy life. So having their support in allowing me to be physically active was life-changing. And I think having diabetes is a blessing in disguise because you appreciate your body so much more and you don't take anything for granted because you know that, you know, you, I don't like using the term fragile, but I think, you know, we have a fragile condition that, or the potential to be fragile. Um, and I think having the support from my parents really made me more resilient, um, as a human being. And you bring up a good point. Um, obviously

[00:09:35] Rob Howe: you're, you're a professional, uh, physical therapist and you were talking about, you know, movement and exercise being medicine. I found something like very grateful looking back, um, with that regard as well, because the things that I love to do, I played basketball in college and a little bit in the pros and also recreationally still. And I love it. It's like my favorite thing. It's always been my favorite thing. And being a better, you know, staying in good enough shape to be good and have fun playing basketball affects my diabetes. I mean, it is medicine, just the movement and the physical shape that I need to be in and my blood sugars, are much more stable. Talk a little bit about the science behind that and how important it is for T1Ds to get out and move, whatever that movement is.

[00:10:27] Mariel Schofield: Yeah. In regards to the science behind it, exercise brings so many benefits from just movements in insulin sensitivity and blood sugar regulation is your biggest benefit right there, just because, especially with resistance training, this is something that I am extremely passionate about and it's something that I practice and my physical therapy practice is getting people to lift and building that muscle mass really helps with improving your insulin sensitivity and making you more adaptable to having good blood sugars. and that's the biggest thing when your blood sugar is off that's going to create so much micro damage with within your nervous system and circulatory system and that's where you see diabetics getting amputations and losing their vision and having cardiovascular disease and all of these metabolic problems associated with blood sugar dysregulation so that's why consistently exercising and moving is the best thing that you can do from a metabolic standpoint and just a systemic standpoint in general. Diabetes has the potential to affect every system in your body. And that's what makes it so dangerous. And that's why we have the potential to be fragile, but we can also take the steps necessary in order to prevent that. so it's basically control the controllables is an exercise diet nutrition sleep those are all

[00:12:05] Rob Howe: things that you can control and you bring up a good point about diabetes having the potential to negatively affect every other system in the body i think that's why i get so pumped up about stories about people doing these not just incredible feats for people with diabetes but just feats in general. Um, there'll be an episode that, uh, that comes out soon about a guy who, who's run 50 plus marathons, uh, as a type 1. And I thought like, you know, even a, even a regular person with no hindrances and maybe extreme athletic ability and natural love for, you know, long distance running would have a difficult time doing that. Yeah. And I think, yeah, when you take care of those, those things, it's just inspiring what

[00:12:52] Mariel Schofield: people can do. That's incredible. Yeah, I had personally, and I know you are an athlete too, and I kind of wish I adopted your strategy. I was listening to your podcast and you talked about how when you were playing professionally, you did not tell people on your team or you didn't tell your coaches that you had it. And in a way, I wish I had adopted that strategy because I was definitely looked down upon as I reached an elite level. And, you know, once you reach an elite level of sports, it becomes a business. It becomes, you know, you're contributing or you're not. And if you're not, we let you go. So that was my biggest challenge with playing Division I volleyball.

[00:13:45] Rob Howe: ball um well i don't know i really when he said that well i think yeah like because it's tough because i remember like in college i was very and i think it depends on where you are in your life too like who's responsible for you because um i'm sure you experienced this and i'd love to talk about it as well like during the recruiting process like it was one of the first things that was brought up after like hey we'd like for you to come play for us it's like okay like that's great can we talk to your trainers because I have type 1 diabetes it's not a big deal like I've never had any problems but it's something that they'll need to know and we'll have to have a plan for things if stuff goes wrong and for me like I think that was good I'm glad I did that but there was always a I think after the first couple and I'm not sure if you ever had to do this in college, but like, uh, my college basketball coach was a nut, like very old school, like very hardcore, physical, intense, um, overtraining. And I had to pull myself out of more than a couple practices for a few minutes and just like regulate my blood sugar. Um, and I know like that definitely affected, um, you know, his quote unquote trust in putting me into some situations early on, especially. and I think I just had to like regain that trust you know all the way through my career

[00:15:13] Mariel Schofield: yeah it's that I definitely experienced my coach was the same way at the time I kind of resented her for treating me the way that she did looking back she definitely taught me a lot of valuable life lessons in regards to being proactive and managing my diabetes and, and doing everything that I was supposed to do in order to, um, be the most successful that it could be.

[00:15:44] Rob Howe: You know, it's interesting when you look back on stuff like that, because, um, for most of my college career, my teammates and I, especially at work, just hated our coach. He was like the, he was honestly it seemed like our worst enemy most of the time um because he controlled he or she controls your destiny they have what you want which is like the minutes and the and the playing time and like the responsibility and you know they're in control of it and seemingly like from this like evil warlord tower they just like rule you but you know like you said years later you look back and from just like a personal development or like a management, like I'll never have a boss that demanding or that terrible again. And I still made it through and was able to manage it. So I think those types of things, those hard lessons that in the moment you don't want to learn and you want to get out of, or you want to, it wanted to be easier long-term, they have some way. I I think if you just stick with it, they have some way of working out. At least that's what the inner optimist in me believes. So now, you know, as you're, you know, out of that situation and you can look back and say, okay, take note of some of the things that happened and how they've made you better. It's kind of interesting. I don't know. I'm not able to talk with people about that very often, but it's something that I think is unique to people who really struggle for something that they love and they want at a high level.

[00:17:21] Mariel Schofield: Exactly. Yep. Totally agree.

[00:17:26] Rob Howe: Cool. So let's talk a little bit about the day-to-day. I think I want to dig into a few stories about playing, you playing at Miami, because I know a lot of the questions, and if you listen to that other end-of-the-year podcast, Like I think the, a lot of the questions I get are about exercise and I think everyone wants to know what athletes at the highest levels do to get ready or some of the things that I think it humanizes them whenever there's stories of like challenges that they've overcome. Do you have any stories from your volleyball days that stand out in terms of type 1?

[00:18:06] Mariel Schofield: yeah when so when i got to college and i think this has a lot to do with overtraining and our training habits but i had the most challenges with high blood sugar and volleyball is a very anaerobic sport so it kind of makes sense with all the stress hormones circulating within your body for it to spike. But, um, interest, interestingly enough, um, my coach would, we tried so many different things. Um, at one point my coach made me wear, we were trying to make me wear my insulin pump while I played, which is really uncomfortable because I was a libero. So I'm rolling all over the ground, diving after balls and to have my pump actually attached to me was, uh, I broke my pump a few times doing that, but it was at one point she literally would like tape it to my leg. Um, and that didn't work out, but what we did find to be more or less successful is I would use a long acting insulin prior to training. And then I just had to frequently check and see what my blood sugar was throughout practice. I probably checked my blood sugar 10 times a day, or not a day, during practice.

[00:19:31] Rob Howe: I guess just from a practice perspective, I imagine your practices were in the three to four hour range most of the time, a long or two on a good day.

[00:19:43] Mariel Schofield: yeah so we had practiced usually four and a half to five hours a day we definitely broke some ncaa rules and then we would condition after that so four to five hours plus an hour to 90 minutes of resistance training and conditioning um so it was a full-time job and on top of that if you had any type of physical injuries, you were doing treatment in at like 5 a.m. So it was a grueling battle for me. I have a lot, at the time I felt like I was failing because I would be checking my blood sugar so often, trying to readjust, trying to find that balance. and a lot of it had to do also with you know emotion and stress and we didn't really know what our practice was going to be like would it be more of like a serve and pass practice which would be pretty laid back or was it going to be more rigorous and and six on six um it was something that was unpredictable and and that made it even more challenging for me

[00:21:00] Rob Howe: um yeah and sometimes like it's even frustrating when you succeed i remember um trying to think what what year it wasn't when i was in college but i got you know i had really prepared my blood sugars really well for a strenuous practice um my coach had these ways of sending sort of like subliminal messages about how hard the practice was going to be he would like he was kind of a gossip with some of the other players. So he would like float what was going to happen to one of the players and see if it would spread through the team. And, uh, so like I, it was, it was going to be one of those days where we were really, really, you know, physically demanding a lot of really hard stuff. And, uh, I had managed my blood sugar really well. And I was like, ready. I was like, yes, finally, I'm so ready for this. And then it ended up being the total opposite. He just like pulled the rug out from under us and it was like a 15 minute practice. Wow. So even that was frustrating. I was like, wow, like I've managed this all day to be, you know, ready to go. And now, now just a total waste.

[00:22:07] Mariel Schofield: Yeah, that is frustrating.

[00:22:09] Rob Howe: And I think that's part of the, it's hard to explain the, the stress and the pressure side of things, especially coming from yourself. Like you want to do well. You want to perform well. You want to show well, represent yourself well. There's so much pressure from your coaches. Even before you get to a game where there's like external pressures and like real stakes, you're trying to get playing time. You're trying to meet your coaches' expectations. and when you let them down, even if you're not really, even if they're just pushing you a certain way, your self-talk becomes sort of self-deprecating and you get into that negative mindset. And that affects your blood sugars. I think it's hard to explain that to people who've never been in a situation like that because you don't know it until you know it. But I think that's something that doesn't get talked about enough with college athletics or athletics at any level really is that, you know, people see you wear a university's name on your chest and you're on, you're in the public eye and you're kind of, you know, in this elite group, but you deal with a lot on the other side of it that nobody really sees. And then that times a hundred with your type 1, cause no one sees that either.

[00:23:32] Mariel Schofield: yeah it's you hit that spot on i mean and think of it too stress plays a huge role a huge role physiologically like if i'm stressed out i'm circulating stress hormones and that's going to spike my blood sugar um or it could actually make your blood sugar drop and that's a game that you have to play with too. It's like any emotional, any thought that I have mentally can affect my body and affect how I'm going to perform that day. So having that emotional intelligence, not just in sport, but like in, in work and relationships and any part of your life, it's, it's really important to have that control and that mental toughness to be able to control any physiological response that may occur. I mean, that's hard to do, but it's, it's something that I think is extremely important to have that mental resiliency.

[00:24:32] Rob Howe: And I think that's something where, you know, I look at the last year where I've become more, I guess open is not the right word, but I started meditating with the Headspace app, which I love and I'm finding that taking 10 minutes just like softens my responses to all those sort of variables whether it's work exercise relationships family and I think just finding a way to say hey I know this stuff is going to happen but if I can find ways to not stress as much over it or not hold so tightly to these things where it affects me my physiology, uh, that has been super helpful for me. Um, and you know, everybody has their own ways of dealing with it, but I think that's a resource that I would recommend to somebody who, uh, is type 1 and is having a tough time, uh, with stress in their life, uh, or, you know, stress related blood sugar issues. Right. Yeah. That's a great way of meditation,

[00:25:37] Mariel Schofield: practicing mindfulness, all of those things, yoga even. But yeah, ways to center yourself and have a better feeling of control over situations definitely improves your ability to handle and maintain blood sugar levels. I wish I had that in college and even in PT school, Like that was a struggle. Studying for my board exam, I think my blood sugars were probably the worst that they've been in a very, very long time. And it's something that we need to be conscious of and manage well. Otherwise, it'll have a harmful effect down the road.

[00:26:26] Rob Howe: Yeah, and I echo that sentiment 100%. Like I wish I had, you know, if I only knew then what I know now about stress would have really, really, I think, given a lot of, you know, saved me a lot of really negative self-talk that I had. Before we jumped on the recording, you mentioned that this is, you know, you don't really have anyone close to you that has type 1 and you haven't been involved in the community up until recently. what sparked your your desire to want to get more into the diabetes community

[00:27:07] Mariel Schofield: i think when i you know in physical therapy school you learn a lot about diabetes effects on the human body and and what to do if you have a patient who has diabetes and all those things And I was thinking about it and I was like, you know, these are very generic recommendations. And I'm very interested in the performance aspect of physical therapy and rehab and getting someone from point A to point B and thinking to myself, you know, I really wish I had someone who shared my experience and could have helped me get from point A to point B without going through everything that I went through at university. see Miami. And it came to me, I'm like, I'm that person, like, I can be that person for other people. So I started to do my research. And I found you guys, I found your page. I thought it was awesome seeing all of these people across the world, sharing their stories, and just the cute little posts that you guys do, like, how do you live beyond and, and I thought that was really inspirational and it it made me want to reach out and made me want to um do more for people who are suffering with the same thing that I am um so I guess that's where it came from

[00:28:32] Rob Howe: like my experience at school and that's so cool to hear because I think it's that's such a new a new phenomenon right like um even five years ago you know there weren't places you know you wouldn't be able to do that. Um, you know, those communities didn't necessarily exist. And, um, I agree like beyond, beyond type 1 has changed so much about the post diagnosis world for people who are, who've gotten diagnosed with T1D in the last few years and just the positive messages that are spread now on Instagram, especially like are, uh, they're incredible. I think, you know, just, just to see the, the sheer amount of them, um, is just surprising to me still like that for, you know, for many of us, um, we felt alone for a long time. And now there's just all these amazing people out there that we can connect with who, who deal with the same thing that we're dealing with and can offer assistance. Um, I'm about to do a, uh, very ambitious, uh, over-the-counter 30-day experiment with treating my diabetes with no prescriptions and no insurance just to tell people about you know the options that are available to them and the amount of comments and helpful messages I got from people just by putting that out there was incredible like absolutely affected the way that I'm approaching it so this community is super super powerful and I think it's one of the best kept secrets on the internet. So we're happy to have you. We're glad you're here.

[00:30:14] Mariel Schofield: Thank you. I'm stoked to be here. It's amazing.

[00:30:18] Rob Howe: So I want to talk a couple of things. You know, now you are, you know, you've had diabetes for over 20 years. What are you hopeful for, for the next, you know, when you look to the next 20 or the immediate future what are you hopeful for with your personal T1D for me I mean everyone

[00:30:43] Mariel Schofield: wants a cure right but until that happens I think finding ways to check my blood sugar consistently and the CGMs for me I'm I'm very physical all day long with my job and I just you know I like being outside I like playing sports I like lifting so the biggest challenge that I have is regularly checking my blood sugar because if I'm in the clinic and I'm seeing 20 to 30 patients a day or and then go lift and then you know do everything else that I do throughout the day um I've tried using a CGM and it just does not work well for me it's just uncomfortable and And I sweat a lot, so it comes out whenever I work out. Constantly moving, playing volleyball, diving on it. If it's in your stomach, it's just not ideal. So I think improving that technology would be awesome. And then when I was at the University of Miami, they came out with a study where, and I forget by which mechanism this happened, but they were able to cure someone who had type 1. And I remember applying to be a part of this study, and they were looking for people who had lost the ability to tell when their blood sugar had dropped and who were experiencing really dangerous lows a lot of the time. And that wasn't me. So I didn't fit the criteria for the study, which was kind of unfortunate. But But just hearing about research publications like that really keeps me positive and keeps me hopeful that, you know, one day there might actually be a cure in our near future, in our lifetime. And then, yeah, I guess those would be my biggest, I guess, hopes.

[00:32:49] Rob Howe: yeah and I think you know I always have to look at those research studies with a grain of salt because I used to get really hopeful about them and just not understanding the timeline of any sort of human trials clinical trials approval scenarios so you know I'd read something and then six years would go by not hear anything about it and then all of a sudden it was available so yeah I'm hopeful for a cure as well but I think like you I try to make sure I focus on tomorrow as well like how can I do better today it's an important part of it my last question for you I asked to almost everyone and I'm really excited to hear your answer the context is very important so here it is uh, you imagine you are in an airport, um, and the gate to your flight is about to close. And for whatever reason, whatever's on the other end, you can't miss the flight. It's an important one to be on. So, um, that's the context. And then you run into someone who has either been recently diagnosed or is struggling with their T1D. Um, in that 30 seconds before they close your gate, what's the one thing that you tell them?

[00:34:11] Mariel Schofield: That I tell the person that I meet? Yep. Oh my gosh, that's a tough one. I mean, thinking about how I look on having diabetes and something I wish someone told me a lot earlier is to embrace the challenge. And to be as proactive as you can in managing your condition. Once you have that mindset, I think it becomes a lot easier to manage everything. Once you have that mindset in saying, like, I'm going to own this, I'm going to tackle it head on and embrace it, then everything becomes a lot easier. I don't know if that makes sense.

[00:35:06] Rob Howe: No, yeah, that's great.

[00:35:08] Mariel Schofield: But that is one of my biggest pieces of advice that I live by. So that's what I would say.

[00:35:17] Rob Howe: No, I love it. Yeah, that question is like purposefully high stakes, obviously. So you did great. That was a great answer. So now that you're – first of all, thank you for coming on the show this morning. It was great to finally talk to you and to hear your story. Always love to not only chat with diabetics, but diabetics who've played high-level sports because I think there's just like we know what each other has gone through. I think that's always a fun topic to dig in on, at least for me. Now that you're more involved and getting more involved in the online Type 1 community, if anybody wanted to follow you, where would be the best place to get in touch?

[00:36:08] Mariel Schofield: I'm probably most active on Instagram. I don't have a Twitter, and I'm not very active on Facebook, but my Instagram is Dr. Mariel, and that has links to even my phone number and my email address, so that's probably the best way to find me.

[00:36:28] Rob Howe: Great. Well, we will absolutely include a link in the show notes and obviously in the posts when we launch the episode. But, Mariel, thanks so much for coming on the show. It was great to meet you and looking forward to keeping up with the next things that you start doing in the Type 1 community.

[00:36:47] Mariel Schofield: Likewise. Thank you so much for having me.