I can't wait!!!!

I can't even write coherently. The next two weeks are going to be so cool!!!! I’m headed out to a Best Practices Conference for Children with Diabetes in Marco Island. These conferences are geared towards families where one (or more) of the children are diagnosed with diabetes. Parents attend session on diabetes management while the kids are off on supervised activities. Tricia and I will be flying out with my niece, Ella who’s six (we thought that would give us a good taste of what it'll be like to have a little one:).

Tricia and I will be presenting one of the sessions together, which is a first for us. Since she has a nutrition background and I have exercise physiology we thought we would do it on how to integrate nutrition and activity into diabetes management. I’ll also be presenting with Joe Eldridge from Team Type 1 on taking sports to the next level.

I’ll be flying home for work (of course) but then flying back the following weekend for Team CWD, a new initiative for CWD. We’ll be running in the Walt Disney Marathon weekend; family members are participating in the 5k, ½ marathon, or marathon. So very cool!!!!

Some new year resolutions…

I realize that New Year's Eve is still a few days away, but my MD appointment last week really got me thinking about what I need to work on. At diabetes conferences people always say how remarkable it is that I participate in triathlons, but I'm not perfect - far from it. Regardless of how people perceive us, there are always things we can improve on.Well, here's my list.

Caffeine Boy, I don’t know if it was the new job, or the move to a new state, but I’m drinking coffee – a lot of coffee. I make a pot of coffee and usually have to make another one before my wife even wakes up. Then I have it throughout the day, I even catch myself having it when I check into hotels in the evening.My Resolution Cut the caffeine. I went out and bought some decaf for the house, and am going to make a conscious effort to buy decaf when I’m out.

Water This kind of went hand in hand with the caffeine. The water went out, the caffeine went in. I feel like I’m borderline dehydrated most of the time.My Resolution Instead of a coffee cup, I I’ll start carrying a water bottle in the car. I’m also going to buy some of those Crystal Light on the go packets to make the water flavored.

Time Management This is something I’ve really struggled with, but now with the job and the new demands for CWD, and Triabetes, I really need to get this stuff sorted out. I think I let things like MD appointments and personal issues take a back seat, which is not good for me, or my family.My Resolution I’m going to try learning a little more about what my PDA has to offer (I use outlook) in the hopes of scheduling some time for everything

And for all of you?If I was going to make some recommendations about New Year’s resolutions, I would certainly recommend setting some goals for the year. Now is the perfect time to do so (everyone else is doing it!!!!)

1)Remember that people get in the habit of trying to do too much, too soon and end up failing at everything. Don’t get caught in this trap. Pick one or two small changes that you can make, then when you successfully accomplish them move on to bigger and better things.

2)Pick goals that you are able to measure, ‘feeling better’ is noteworthy, but it is subjective and hard to quantify. Weight loss or a daily fitness regimen is easier to measure, and is related to feeling better.

3) Find support. Tell your friend and family members about your goals, get them to follow suit. Find a way to support them while they support you, whether you have the same goals or not.

God bless Us...Every One (especially whoever invented the extended bolus)

And that's OK, you can't be too hard on Tiny Tim. After all, insulin hadn't been discovered when Charles Dickens had written the Christmas Story, let alone invented an insulin pump. But man, good things really can come in small packages... and my pump didn't even need to have a bow on it to be a Christmas miracle.

Now I don't know about you, but a part of me has always dreaded the holiday season. Because for as much excitement, anticipation, and all round good feelings that family and friends can create, it ALWAYS, ALWAYS, ALWAYS, created wildly swinging BGs for me, which then led to several days of trying to get a handle on the rollercoaster. It's been a pattern for me as old as gift giving, and it's become so problematic that the holidays have been something I'd almost rather not have.


But this holiday went great! And why you might ask? (no, you have to ask in order for me to tell you - that's how this question and answer thing works).Well, it's all thanks to the extended bolus. An extended bolus takes a delivery of insulin and spreads the delivery out over a certain time period. So instead of taking 3 units all at once, I can spread it out over 3 hours. It can have several uses, but for me it's vital for meals that are higher in fat or protein that don't get a big dose of glucose initally but also take longer to digest.

The trick for me is to take an extended big enough to compensate. Fat and protein can really do a number on me, so I have to have the confidence to take a bolus big enough to do the job. So for this holiday season I tacked on a combo bolus so huge that it would make me go low just thinking about it, but thanks to my ravenous appetite and all of the yummy foods that family members had made, my BGs were pretty good. 168, 183, 161, 61, 93, 73, 108, 119, and 72. Not perfect, but who is?

So the lesson for today's holiday season? Learn that extended bolus -it's huge.

Proud of my mate

I'm just so damn proud of my wife. I know I said in a previous post that I was running the Walt Disney Marathon next month as part of Team CWD (children with diabetes). But I don't know if i mentioned my wife was doing it too. Well she is, and she's gonna do great.

To give a little background....I am the runner, she is the supporter. And those aren't my classifications, those are hers. Running does not come as easy for her as it does for me, and she has been satisfied to go to Boston or New York and cheer from the sidelines. She ran the Vermont Marathon several years ago as part of Team Diabetes, but she retired after that and has been happy to expend her calories in the gym in areobics or step classes.

But with the announcement of Team CWD last year, she saw a chance to come out of retirement and give it another go, and so it has gone. With the inclement weather outside (in Buffalo at Xmas time, the weather outside is oh so more then just 'frightful' - it's ghastly, hideous, horrible, vile, wicked, and just plain ol wrong (I got an early Xmas gift of a thesaurus)) she has been running at the gym, logging runs of 2+ hours.

Yesterday we went to the gym and she ran 3 hours!!! Personally, I got flagged a little more then an hour and a half into it with a low bg, and I limped the rest on an elliptical trainer (usually easier for me if I have a bad low bg).

As I fumed on the elliptical, I watched her run. And I realized that since my running has not been going well, I should take the opportunity to switch roles, to be supportive of her efforts. I'm gonna keep running, but i'm going to let her inspire me instead of the other way around.

Walt Disney World....here WE come.

Manic over my MD visit (part 2)

Of course there's a sequel to the last story - every great story teller leaves an option to tell more. All great movies have sequels to them - 'the Godfather', 'the Lord of the Rings', and of course 'Rambo II'. (and the last one should obviously go without saying. Stallone can make any sequel he wants = personally I'm waiting with baited breath for the sequel to 'Demolition Man', and after that hopefully, 'Stop or my Mom will Shoot.')

So back to reality, I did go to my Doctor appointment this week. As I said in my last blog entry, I think in the past I've had issues with seeing an MD, and have possibly even sabotaged my own visits by being aloof or afraid to talk. So before i went in I made the commitment to myself that I was going to start on the right foot by being more involved in my own diabetes care.

My bloodwork was in good shape except for my A1c - 7%. I almost broke down and cried in front of her. It was obvious it was not what I wanted to hear because my tone completely changed in the conversation when she told me. It's the highest I've been probably since college, and regardless of whther it is lower then the average, I'm not average, I'm me. And when it's significantly higher then what you're used to it freaks you out.

But I used it as an opportunity, and from that point forward the visit was great. We had a good discussion about some of the current problems I'm having (lows during a particular point during the day, consistently exercising after the last ironman, and a little bit of fatigue). It was closer to a conversation, kind of what I'd been hoping to have with my endo for years.

She looked at my BGs and made a few suggestions on my basals, which i did change (another first). Usually I try to argue my point that what I'm doing it right and there's a logical explanation why I'm low here or high here, but you know what? I'm not an endo. Any maybe, just maybe, looking at patterns all day gives them a leg up on me.

She asked me to fax some BGs to her this week to let her now how the changes are, and that
was important to me, it lets me know she's involved. Hopefully the changes will help.

Manic over my MD visit

So I've got see my endocrinologist (or endo for short) this week - it's my first appointment with her, and I'm completely freaking out over it. I've been in the area almost six months now, but it took this long just to find an endo that was accepting new patients and could actually schedule within 6 monhts. That's not a reflection of them - that's the industry. There just aren't alot of endos out there. You know only 8% of people with diabetes actually see an endo??? Crazy.

So back to the freaking out part. I guess it's because I'm not sure what to expect.

Some MD's I've had in the past are all knowing (or at least they think they are). And act like the downloads you provide from your meter or pump wll provide all the information about your life in order to 'fix' everything. (Yes, I had one advise me he needed to 'fix' me). They threaten, huff, sigh, and act like your inconvenincing them.

But then I think about the majority of the patients they see. Non-compliant, unmotivated, and unwilling to even take the effort to bring in the information that an MD would need to even take a wild guess at how to help them with their diabetes. That's an important point - their diabetes. It's not the doctor's disease, it's the patients. and I think far too often patients sit back and expect the MD to fix it. Well, it doesn't work that way.

Hey, don't ignore me, you know you're out there.

So the problem isn't just one side or the other, it's the combination of the two. I don't have an answer how to solve it, but I am going to do my part. I'm going to talk to her, I'm going to tell her what I want I want out of life (and my goals for my disease), and I'm going to bring in the information she asks in order to have her help me take care of my diabetes.

It won't be a PR, that's for sure

So I'm scheduled to run the Walt Disney Marathon in a little more then a month......It's not going to be pretty.

It's not that I didn't want to do well. I really did. I'm going as part of Children with Diabetes. We thought as a focus on fitness and the family that being at an event like this would be fun. Walt Disney puts on a weekend of events, a 5k, a 1/2 marathon, and a full marathon - a distance for everyone. So a bunch of people got together and formed Team CWD.

But, I haven't been training. I felt fine after the Ironman, but I after the Atlantic City Marathon in October i was really drained. Then the weather that we should have been getting in Buffalo finally hit, and those things, plus the 40+++++ hour weeks I've been working finally took its toll. So, I'm about three pounds heavier, and much, much, much, less fit.

But, this isn't about me. It's about something bigger. I'm going out there to make a statement about diabetes - me and everyone else with Team CWD. We're going out there to show that those with diabetes can do anything they want to - and regardless of my shape, I'm going to be there.

Givin it the ol college try again!

So here we are, in front of the computer trying to be a consistent blogger….again. I’ve tried to be a good blogger before, but have failed miserably. I got all excited about it, spruced up the website, played with the fonts to see how it looks, and even looked up definitions to words that I use often so that I sound smarte.

 

I did well for a while, but then I missed an entry, then another, then another. And before you know it it’s May and I hadn’t written since. I got embarrassed and frustrated at the same time, and before you know it I started denying I ever had a blog. It would be shameful only if it was the first time, but it wasn’t…..I’m a yo-yo blogger.

 

Wow, am I talking about my blog or am I talking about my diabetes management?    

 

Not much difference I guess. It can happen with managing my diabetes that sometimes I get in a rut and can’t seem to get out. Things can go well for a while but life gets in the way (that darn ol life) and my diabetes takes a backseat. Then it becomes hard to get going again, I think about all I have not done, and I get depressed about even trying again.

 

But the really great thing about both (diabetes and writing) is that you can always start over. Forget about the past, today is a new day. I can saddle up the computer to write an entry, and I can get out my BG meter, check and start keeping tabs on what I’m eating.

 

So that’s what I’m going to do. Start writing and start checking. So what about you? In a rut with your diabetes? Don’t beat yourself up about it, pick yourself up, dust yourself off, and go check your BG.

Last night was bad

The title probably says it all, but you probably want to know more. It was absolutely awful.

 

I’m ashamed to tell you how I did it, but if I don’t speak up someone might make the same mistake. And that’s the last thing I could ever want. So I was on the phone talking to mom (yes I still call my mom) and I was fidgeting. I had no pen to click, or piece of paper to fold, so I was fooling around with my infusion set (yea, you know where this is going). I was disconnecting and re-connecting my set over and over, except for the last re-connect. I then proceeded to bolus for 50 grams of carbs, ate a bowl (a big bowl) of edy’s lowfat ice cream and went to bed.

 

Two hours later, I woke up and had to go to the bathroom. I didn’t realize something was wrong until I tried getting up, and that’s when it hit me. It felt like my skin was on fire. I walked slowly to the bathroom (although it felt like the last 5 meters of the 100 yard dash) and peed, and after I was finished (which felt like forever, but must have only been twenty minutes or so) I came out and decided ‘oh, I must be high’

 

I should have looked at my set; that would have been the smart thing to do. But when you can hardly stand the last thing you’re thinking of is let me check myself. I slumped into my chair and took a bolus. (damn the bg calculator – I don’t have time for that!)

I gave the bolus and slumped into my chair to watch some re-runs that I’ve seem more times then I can count.

 

My hands felt like they were cold (even though they were burning) so I stuck them under my shirt (which is when I felt the moisture). I screamed some more obscenities and I clicked the site then checked my IOB. It said I had about 5 units on board, but I knew that wasn’t right. I took another huge bolus, hoping that it would get better. It did – but not right away. Three alarms later to wake up and make sure I didn’t crash and I still had a 222 BG when I woke up this morning, feeling like I had gotten hit with a sledge hammer (multiple times).

 

So why share? Well I like to think I know a lot about diabetes but I make some dumb mistakes sometimes – we all do. It’s part of having diabetes, it’s a part of life. But I hope if anyone reads this tonite and checks their site before they go to bed then it was worth it.

 

And the workout for today – yea you guessed it, no workout in the AM, but I did swim for 50 minutes tonight.

 

I have no idea what to do today

I have no idea what to do today…Really, I don’t. Not a frigg’n clue. I’ve got all the intensity of an Ironman Triathlete, and the vision of a near sighted librarian. I’m up bright and early, I’m dressed for either running or biking (thank goodness the clothes don’t differ much) but I don’t know what to do. It wasn’t always like this, and it certainly wasn’t planned to be like this. It all hit me last night while I was filling out my information to attend the Diabetes Training Camp this June in Chicago.

Several months back I had a plan (emphasis on the had part). I’m a smart guy, I’ve got a masters in exercise phys, a marathon coach, and I’m a certified athletic freak; I know lots and lots (too much if you ask my wife) about training. And after taking a month layoff from the New York marathon, I had sat myself down for weeks with the intensity you see in a 4 year old trying to stay in the lines of her coloring book. At the end, I had a training plan that would make the pros weak in the knees.

But that was months ago. Since then I’ve gotten a new job, relocated, attempted to sell and buy a house (both still in the works) and made the 7 hour drive home and back to try and maintain a marriage (yea, yea, yea - If you read my blog you know that already). The result of all this is a training plan, (to put it with a ‘PG’ spin) that has gone to pieces. I’m training, but not methodically. I just get up and run, or get up and bike, (or not at all).

I’ve never been in this situation before. My training has always been specific, always with a goal. Even if it is just to recover from a hard race, there’s always another in the back of my mind. Now I have a goal and my training is so haphazard I don’t know what to do.

I get like this with my diabetes sometimes too, all the knowledge and don’t know where to go with it. Anyone else? It makes it just as frustrating to have knowledge and not know where to go with it. Sometimes the best thing is to take a deep breath to take it all in, refocus, and re-evaluate where to go from here. I can’t make up for lost time, I can only move forward.

So what am I going to do today? You’re guess is as good as mine. I’ll write tomorrow and let you know.

It's all about attitude!

Sorry for the long delay in writing, I’ve been super busy. A friend sent me the following link about what it is like to be the parent of a Type 1 patient. It’s absolutely great.

 

http://www.mykpp.com/Movie_Type1MomSong.html

 

 

 

Not exactly exercise...

This was a rough weekend to say the least. I was scheduled to ride the bike for three hours yesterday (but didn’t). Instead I had an endurance event of a different sort, almost like a duathlon only there was no running or cycling. The wife and I drove the car for about 6 hours and then saw a total of 18 houses over a two day period. (yes,a big woo-hoo indeed) To say that I’m going to start the week a wee bit tired is an understatement. I actually got to the hotel tonight and started examining the room as if I was going to purchase it. I’d write more, but I’m absolutely exhausted – so good night.

Oh yes, most of the Triabetes team are out in Santa Barbara right now at the Diabetes Triathlon Training camp – I wanted to go but I couldn’t spend my first week in my new job in California on a bike. But there are a few others this year – I’m hoping to go to one of them.

So-Long

Don't beleive the picture, I didn’t think today was going to be this hard...

Today was my last day at my old office job; I’m moving out of the corporate office into a sales position in New York – something I’ve wanted for I don’t know how long. It’s been a long time coming. I’ve wanted to be in the field for a long time, but with not wanting to leave the company where I worked (A COMPANY I LOVE) and also needing a job that would fit for my wife’s choice of employment really made things difficult – it had to be the right situation. Which meant it was a long wait.

But it finally came. A sales job in New York that will give me a chance to work with both patients with diabetes and their clinicians face to face, and I can’t tell you who thrilled I am about that. It’s bringing me one step closer to be a diabetes advocate who can go out and exemplify what it means to have diabetes and be successful in the open. I was doing all of these things already of course (but this gives me the chance to interact with people face to ace, and I believe I can have a greater impact then I previously did.)

But it also meant I was going to have to leave some people who have grown dear to me. I’ve been at my current position for over five years, and only a few of us are still there that have been there since the beginning. Many of us have diabetes (We had a section of cubicles we used to call ‘blood sugar row’) and many of us have been through highs and lows together, both in life and in diabetes. After five years, they’re not co-workers, they’re family.

We had a party with a lot of yummy food of course (I’m still training for an ironman) and a lot of well wishes, but it was really very hard. I can only liken it to my college graduation – excited to be moving on but very sad to see it go. Over the years I’ve seen others leave our tight-knit group, and many would leave good bye e-mails. When the time came I couldn’t do it – it was just too emotional.

My grandmother hated it whenever the grandkids said good-bye. She said that good-bye is too final – she preferred so-long because it implies that you’ll see them again. I don’t think anyone noticed at work that day, but I told everyone s- long before I left. You never really say good bye to family.

Navigator Approved!!!

Well, the day has finally arrived.

Abbott's Navigator, a continous glucose monitor (or CGM for short) has finally been approved by the US Food and Drug Association. The Navigator had been approved around the same time last year (give or take a month) and we all thought it would only be a few weeks before it was approved, but again, that was around the same time last year (give or take a month). BUT THE DAY HAS FINALLY ARRIVED!!!!

One of these days I'll have to do a comparison on these for you. I wear the Dexcom right now and trialed the Navigator. There's another one on the market from Mini Med Gaurdian Real Tiem System, but I have not worn it.

You can check out the Navigator new here.

Team Type 1 news...

I just got word from one of the diabetic forums that Team Type 1, a professional racing team that includes individuals with diabetes on both their professional and developmental teams just scored their first win. Check it out here and scroll down to 'Team Type 1 scores in Taiwan.'

oweee

Yea, a little bit sore….

Yesterday’s medicine ball workout really threw me out. I had woken up this morning with the idea of running about 13 miles for an hour and a half, but struggled through 10 in an hour and fifteen minutes and called it quits – I was oh, so sore. It had started raining about halfway through and I didn’t want to get a repeat of the flu. Had an Almond Crunch PureFit bar along with breakfast; I figured if I was going to be in agony I may as well have something that tastes good. Let’s hope that the soreness works itself out.

 

 

Just keep trying

I went to the doctors today – man I was coughing so hard and so often I couldn’t even take the sprometer test (that’s where you breathe into a tube and they measure your breathing. They had me get a chest x-ray to confirm it was pneumonia – which it was. But in addition to pneumonia I may have also had the flu, which is always fun to hear. I've got symptoms of both sicknesses so I was probably fighting off both at the same time. The MD had given me a five day supply of an antibiotic and a cough expectorant today which hopefully will help.

Eye checkup

I had to get an eye exam today. Actually I had to get one a year ago today - but i didn't, and that's the problem, and this blog entry. I hadn't had one in over a year and a half. I know, I know, we (those of us who are insulin challenged) are supposed to get then yearly. But at the last exam the MD had told me something I had never heard before at a check up and it really freaked me out; he told me I was showing some signs of disease.

Now I've had diabetes for 28 years and I've had good control for almost all of them. Exercise (specifically running) has been a blessing to me because without it i never would have gotten the level of control I've had. What began as a competitive kick has became a lifelong passion. Without it I wouldn't have worked out so much, wouldn't have cared what I ate, and wouldn't have checked as many times as I have without it. It's lead to 28 years of complication free living with diabetes...

Until now. Last year at my annual checkup the MD advised that i had early stages of eye disease, and because of it I needed to start scheduling my appointments every 6 months instead of every year. Yea, that's pretty much how he said it. He didn't even look at me when he said it (pretty callous if you asked me). He didn't explain what it was, or how we could prevent it.

So yes, you would think i would have the appointment right away, but hearing what he said (and the way he said it) freaked me out. I mean really freaked me out. I had been so proud of myself to go that long without showing any signs of disease; it was something I had been very proud of. After losing some of my competitiveness in running I guess the competitiveness had transferred to the diabetes - and i had decided i was going to win. I would not get complications.

So i did what most of us have done. I ignored it. I was a no show for my 6 month appointment, and then my yearly. I was so afraid of what the MD would say I thought if i just didn't hear the news that would make it ok. It's funny that I've spoken to probably thousands of people with diabetes who have done this with one MD appointment or another. Counseled them through the understanding that ignoring the problem would not make it go away. Then I go and do it. Great example, huh?

This last trip to the CWD conference though was inspiring. I had to go to the MD, if not for me, then for them. The role model that I want to be wouldn't sit down and take this, so i made the appointment an went.

And as far as the outcome? Well for now I'm not showing any signs of glaucoma, which was wonderful news. But I am still showing signs of eye disease. At this visit though, i was more prepared I asked how much had it progressed and what else could i do to try and prevent it. The signs had not progressed at all (yes, wondeful news!) and the MD said he would forward the info to talk to my endo more in depth. For more info on eye disease you can click here.

Lessons learned? Well if i can be greatful for any of this it is that it gives me a new perspective. I do undestand the fear that those of us with diabetes have when we're faced with results we don't want to know. And i hope that that helps me reach others with diabetes that i have not in the past. Only time will tell, but I like to think that i can see forward and know this will happen.

I still had the cough, but oh was it ever better. After two days of the prescription I was taking, (that I fondly named ‘god’s little helper’ I finally felt half way alive. My breathing had cleared up a great deal, and when I coughed I actually brought stuff up (I know, kind of yuck, but at least I was getting it out.) Sill no exercise, unless you count getting the mail and taking out the trash (hey I gott start getting back in to it somewhere).

And I guess I can make it official now…..i have a new job! I’m the new territory manager for upstate New York I knew I was in the running for a week or so, but I really didn’t want to mention it in the blog and start getting excited about it if it wasn’t going to happen. I start in just a few short weeks, so the wife and I are going to have to get the hose ready to hopefully sell it, buy another and up and move. That along with learning a new job is going to make training for this triathlon difficult, but not impossible. That’s what this documentary was supposed to show. People with diabetes living their lives while training for this race. Yes, the training schedule will have to change (again) but that’s training for you.

And the hits just keep on coming...

Thank god, at least some level of success on my BGs, but I couldn’t believe how much insulin it was taking: a 130% basal increase and cutting my I:CHO and my ISF in half finally brought my BGs in the 100s. It was more then double what I usually took for insulin, it was scary to think I was taking naps with that much insulin in my system but I never went low. I was really beginning to worry about the coughing. I would cough in such spasms that I’d almost choke when I was done – the congestions was cutting off my air supply. I was scared to go to bed. I slept Sunday night sitting up thinking it would make it easier to breath (it didn’t). I had already spoke to my boss and had been told not to expect to come to work for a tl least a week.

Death Warmed Over

Sorry for the lack of blogging, I've been hit with a bad cold. And not just hit, but knocked down, tied up, flogged, and finally left for dead. I haven't been this sick in a while. The throat feels like i swallowed glass, my head feels like it's got a vice around it, and I'm coughing as if I was trying to start my first car during the middle of winter. (No, not good.)

My sugars are just all over the place. Take your pick at what it's from; hormones flying around fighting off the infection, sugar in the medicine that I'm taking (why don't they have carbs listed in my halls cough drops?) And not to mention the lack of activity that I'm getting (I haven't biked since Thursday).

I hate being sick, and if there's anything else I hate more then being sick is having a high blood sugar when I'm feeling sick. I'm sitting here at home on a Saturday when I could be out training. The whole thing just makes me sick (wait a minute, I'm already sick).

I'm going to sign off now, feeling like I'm gonna be sick. Later.

My Java Bottle

So last week I was dragging through my morning bike rides. And it wasn’t just last week. I can always seem to get up and run without a problem, but the bike is completely different, the inside workouts are an absolute chore. You would think just the opposite; nice and warm inside, light instead of complete darkness, the boob tube – what more could ya want? But I always seem to struggle….

That was up until this morning. Last night before bed I decided I’d set the coffee maker to be ready when I woke up, figuring I’d have just a little before I got on my bike. Then I had the absolute, fantastic, stupendous, idea of having my coffee while riding. Awesome! I set up a little table next to my bike and sat my big fat mug (that’s the thing that holds the coffee) on it and helped myself to that caffeine charged elixir whenever I needed a fix. It worked out great.

Don’t get me wrong. Water and Gatorade still have their place at my training table – but not at 5 in the morning. From now on when the alarm clock goes off for an early morning ride - it’s not go time – it’s Joe time!

sugar sniffer

I remember a year or so ago I saw a girl and her dog on Dlife; the dog had been trained to sense when the girl’s BG was going low and was able to warn her of it or others if needed. I’ll admit that the, ‘Timmy’s in trouble Lassie, show me where!’ jokes began to run through my head, but I also got a twinge of jealousy too. Even though I’ve got a pump that delivers precise amounts and a CGM device that’s designed to warn me of impending– these things are not idiot proof. (Ok, wait - let me retract that last part.) They aren’t without their problems. I still wake up with occasional highs or lows in the middle of the night, and these are perhaps worse then the ones in the day if for no other reason that it comes to you as a complete shock – wake up - boom - you’re low.

Then from today’s RSS feed I got a wire from ADA that spoke about the same type of idea, training dogs to tell when someone with diabetes is going low. (You can read it here.) So I fished around on the web and googled up http://www.heavenscentpaws.com/ .This is yet another great example of someone in the diabetes community with a personal involvement, trying to make it better for others dealing with the same disease. Click on their site and read their story for how just how they got involved.

I hope this becomes more mainstream. I would love to have my dogs warn me of highs and lows.

Race Summary

So the quick version is that it was a great start and a horrible finish, possibly one of my worst (finishes). I’m a bit more retrospective today (also a bit sore) so let’s see if we can’t break down what really happened.

I woke up at 5:30 am with a BG of 86mg/dl. My insulin on board lasts about 3 hours. The plan was to turn my basal rate incrementally 3 hours before that start and to supplement that with a bolus (again, that would be gone by the start). The rationale behind the drop 3 hours before is because I need to have a very small amount of insulin in my system when racing, and although dropping it an hour before does the trick for an hour long workout – it won’t for a three hour race. The idea behind an incremental drop is because as the race goes on, carbs get depleted from your body and you begin to use more and more protein and fat.

The basal rates then were as follows:

· 5:00am 1.00 (normal rate)

· 7:30am 0.700 (starting the drop)

· 8:30am 0.200

· 9:30am 0.100

· 10:30am 0.075 (race starts)

· 11:30am 0.050

I took two boluses, one at 6:30 for my meal (5.0u), and the second at 7:45 for the basal drop (1.6u)

The BGs pre-race were almost perfect. Here they are:

· 5:30am 86 mg/dl

· 7:00am 67 mg/dl

· 7:30am 95 mg/dl

· 8:20am 145 mg/dl

· 9:20am 95 mg/dl

· 10:12am 79 mg/dl

I had .88u on board before I started, which was a bit more then I wanted. I chugged about 65 grams of Gatorade and dashed off to the start.

The first 13 miles were absolutely splendid. The course was very hilly. And after some juggling at the first 3 miles I settled in and began picking people off. I’d guess that by the 6^th or 7^th mile I as in the top 5 with three other runners. I listed to the others and they were breathing pretty heavy while I felt good. I thought I was in a great position. It was too cold to get any blood from a finger (even with gloves and the blood rushing) so after ½ hour I began to have about 8 grams of carb every 10-15 minutes.

We went through 10 miles in 1 hr 8 min and 13 miles in 1 hr 28 min and 30 seconds. It was here that I started to struggle. Not breathing wise, but I knew something was going on. I tried to keep taking in sugar but it wasn’t working. I struggled through the next six with the guy I was running with, but soon after mile 19 he pulled away.

Then it got bad, really bad. I got nauseous, and dizzy; I had to start walking and I couldn’t believe it. After another mile I stopped at a water stop and had someone rub my hand until I was able to get blood for a test – 57 mg/dl. And it probably had been hovering there for the last hour. I drank enough Gatorade to jiggle when I jogged and began the long road to the finish. It was hard to take other people were flying by me while I continued to limp along. I watched the time go by what I wanted to run, then my last run, then a bad run, and still I was out there. when I say the long road – that is not an exaggeration. To put in perspective, it took me and hour and a half to run the first 13 and an hour and 40 minutes to limp the last 6. I did make it to the end though.

You would think I’d be demoralized, but I wasn’t – it was one of the proudest runs I‘ve had in a long time. Regardless of the time, I finished. And I will finish others. If I was to sum up the race, I would say it was a great confidence booster and a dose of humility all in one. Although my rates were low, each rate was actually .025 higher then New York, I had bumped them up thinking I would need it (guess not). And I think the hills could have made me use more energy then I had expected, so I should have turned my basal down even more. And lastly, starting the race with .88 was too much; I should have bolused less and bolused earlier.

Will there be another – damn skippy (that’s a yes). But for now, I just need to get my training hours in for the week (remember that comment about being sore? Yea that’s right; it’s going to make getting 10 hours in the week pretty tough).

Ha-Ha

I, the Guru, who be me, have come up with a short list of descriptions for Brian’s last marathon. Brian got:

• His ars kicked
• His clock cleaned
• Beat like a drum
• Waxed like on of Mr. Miagi's karate students
• Squashed like a bug
• Whipped like the cool frosty frozen topping on my fruit
• His charmin sqozed by the grip of death
• Licked like the tootsie roll center of a tootsie pop

And my personal favorite….

• Beat like he stole sumthin’

If you have any others you'd like to add feel free to comment. His feelings mean nothing to me.

And the result?

This will be short, not sweet. I got demolished in the race. I'd be more retrosective about it but I'm demoralized and dejected. I'll talk more about it tomorrow.

Marathon #2 for 2008

So tomorrow I've got another marathon. The 47th annual George Washington marathon is in Greebelt Maryland. It's supposed to be a pretty hilly course (see below) but that's the kind of work I need right now, there will be plenty of time to taper and run fast.


I kept up my training this week and right now my oly hope is to come out without being too sore to keep up the training the following week?

The plan? Well the plan is to mimic the same thing I planned in New York. My insulin (IOB) lasts about 3 hours. I take a bolus for my meal 3.4 hours before race start, I turn my basal rates down in increments starting at 3 hours before the race, and add a bolus (1.5u) 3 hours before the start. the idea is that the bolus takes the place of the basal, and by the time the bolus is finished I'm left with only a trace of basal insulin.

I'm hoping this works out, I think the idea is solid, I just need to work out the finer points.

Another triabetic

100 and counting...

Is that 100 yrs old or 100 mg/dl? Honestly, I’d like both.

In article I found in an RSS feed from ADA it has been suggested that getting to the century mark of life is not as impossible as it sounds – whether you have a chronic disease or not.

A group of individuals (700 in fact) who had reached the century mark were contacted via phone for interviews and health assessments. They found that although 2/3 of them had avoided chronic diseases (yay for them) the other 1/3 were surviving despite a chronic related disease like high blood pressure or diabetes. YAY FOR US!

That’s absolutely fantastic news! I can’t tell you how many times as a kid I wondered if I’d make it to my grandparent’s age because of my diabetes. These and other stories about individuals living to the ripe old age of (what age is it when you become ripe?) gives us all hope that there doesn’t have to be such a thing as down and out.

too much...

Boy have I got some adjustments to make…

I found my self at work today with my shirt half ironed, my face unshaved, and my hair uncombed, looking pretty much like the elf from travelocity.com. I know I jumped into my training head first but I’ve got to be a little more realistic. I’m just doing a lot right now, too much to try to bump up my training. What’s got me so busy? (Ok, you asked.)

The wife is traveling, so I’m left at home all alone. Now don’t laugh, being alone usually isn’t enough to throw me – I can pay bills and cook a can of ravioli as good as anybody. But I’ve also got to take care of the boys (and yes, they’re only dogs. But they don’t get along with each other which means no one else can walk them or feed them and they always have to be separated and it’s a big huge hassle and waaayyyy too large of a topic to get into right now.) And this isn’t an overnighter - it’s for two weeks.

I’m trying to study for my certification as an RCEP (Registered Clinical Exercise Physiologist) which I have to take at some point in this lifetime. If I don’t do it soon, I’ll lose my candidacy and there’s no way I’m putting more intern hours in.

I’m also trying to get every little ‘to do’ project done in the next two weeks before we put our house back on the market – and oh yes, I’m supposed to be looking at future houses, just in case we actually sell our house.

So that’s a lot – it is for me anyway. All of this stuff is piling up and I’m finding there’s no way I can slip in an extra hour on the bike, or time to head to the pool. So I think I’m going to shift a few things around training wise. I’m ok with training the number of hours that I am now, but I’m just not ready to start tacking on more. So we’re going to just kind of stay in a holding position for now. At least until I have something else added on to my plateJ

Rollin, Rollin..Ru-Ro

Yes, in the immortal words of Scooby, 'Ru-Ro'. Yesterday I was scheduled to ride for three hours. This time of year it's too darn cold to ride outside. I've got a trainer set up downstairs, and although it's probably easier in the basement I don't always feel like I get a good ride in. So I headed off to the local Y to get my bikin' in.

I was all set. A bag full of glucose tabs, jelly belly sport beans (cause I hardly ever use the glucose tabs) gatorade, and a few power bars. Of course I had my meter, strips, lancing device, Dexcom, extra infusion set (am I forgetting anything?) ah yes, the easy bake oven and kitchen sink.

I was surprised at how well the ride went the first two hours. I began at a pace a little over 20 mph and was able to maintain that pretty comfortably. I had about 8 grams of carb every 15 minutes or so and washed it down with a little water.

I must have gotten a little greedy with the carbs, because when i checked at 1hr 30 min I was up to 198 mg/dl. A good number when exercising, but i started out around 110 mg/dl so that means i was climbing. i questioned whether i should bolus or not, and decided the gym was the best place to do this - if i crashed at least it wouldn't be on the road. So i bolused 0.75u with my pump.
I really began to hammer the last hour, but with about 25 minutes to go I began to get sick of what i was doing. and for me - that's a sign I'm going low. I checked and low an behold, the crash wasn't coming - it already happened. I was 50 mg/dl.

After you bike for 2 1/2 hours and you need another, 1/2 hour, the last thing you want to do is get off, because the whole goal of riding long is to ride long. So I slowed the resistance down and began to force feed myslef the sport beans. I had two packs (25 grams in each pack) of them plus gatorade (22 grams) and after about 15 minutes i felt ok to pick it back up the last 10 minutes.

Not what i had hoped for, but you have to take this kind of stuff in stride; I'd much rather have this happen now then when I'm in a race. I still got the time in, and got to eat jelly belly sport beans - a pretty good training day after all.

Is that your BG calling?

I’ve got an honest question that deserves an honest answer. Have you used your BG logbook today? That’s ok, a bad day happens to all of us. How about this week? No? This year?

I’m not judging. If you asked me the same question my answer wouldn’t be any different then yours. We all struggle with this.

Diabetes management came a long way when we were able to toss out the 3 ring notebook in favor of a computer program, but it’s still no where near where it needs to be. What do you want to download today? Pumps, meters, and PDA’s, Oh my! And each one with different cables and attachments for all (oh goodie). Animas had a great idea trying to get meters from different companies to work with their software but that involved A LOT of work on their end.

The problem is that diabetes can not be looked at weekly, or when you happen to be able to get your 5 year old computer to stop freezing up on you long enough to load your meter. It had to be analyzed minute to minute, because that’s how often were living with this disease. Software needs to go the same route as the insulin pumps, working 24/7. But until then perhaps there’s a close second.

Now the only other thing that gets carried with me as often as my pump and meter is my phone. And here lies a possible solution. A new product was just launched through Mobile Diabetic called the logbook FX; it’s a diabetes health diary that combines all the cool ‘techy’ things you can do through phones (like multimedia pictures and melodies) along with the very important part of graphing and reporting blood glucose numbers.

Now I will admit. I have yet to download it to my phone so I don’t want to give it a premature thumbs up, but it sounds pretty cool. And to be honest, other then my colored screen pump, there aren’t a lot of ‘cool’ things about diabetes. Go ahead and view their site here.

If you’ve tried and have a comment, please feel free to leave it.

RPE

Silly Brian, worried because he doesn’t have the cash to fix his heart rate monitor. Oh Boo-Hoo! Need a tissue!?

The Guru doesn’t fool with any of that technical gadgetry. No, not because I don’t know how to work it. Oh believe me, I know how to work it. I work it all the time. For example, the garage door would not open this weekend. But did I cry, No! Did I whine, No! I used my expansive knowledge on the subject, (and after that I asked my wife who told me to change the batteries. No wait a minute - you didn't hear that last part) and whal-lah! It opened (and closed). So stop teasing me and let me get on with what I was saying. What was I saying?

Oh yes, I don’t use a heart rate monitor because I don’t need to – I’m that good. (And I am, no really I am). I use something called the RPE, or the Rating of Preconceived Expedition. It’s a rating scale of how long I think I might work out later while driving in my Ford Expedition.

Huh? That’s not right? Ugh….. Well of course it’s not right! I was testing you! RPE actually stands for…..(frantically turning pages in a book)ugh….Hey is that a flying saucer in the window? Go look, go, go. I’ll wait for you (still franticly turning pages).

Oh well, must have been a kite, so let’s see what did you want to know? Oh yes. The RPE stands for the RATING OF PERCIEVED EXERTION. This is a way of gauging the intensity of your workout by a set of numbers, 1 to 10 for example. 1 would be easy, 10 would be the absolute hardest you can do.

The idea is to mix up your workouts so you’re not doing the same plane jane thing every day. One day you might exercise at a high level, like 8. The next day you might work out twice as long but only do a 4. This way you’re workouts stay fresh (and so do you).

The RPE is very similar to a heart rate monitor except it’s just more ‘geeky’. So be a geek like Brian if you want to. Or, you could be like the Guru and use the RPE.

Heart Rate Monitor Misfortune

Yesterday was kind of a bummer…

I got my polar heart rate monitor back yesterday. It’s one of those super techie gadgets; a combined heart rate monitor and a foot pod. It could tell your heart rate, as well as measure the distance you've run. it was a great tool that I used in my training. For me,the biggest benefit was to see the effects my BG had on my heart rate. There were times when i was running way slower then I usually do because of a high or low BG, but my heart rate would be at the same mark as if i were running the faster time. To be able to use heart rate as the training goal as opposed to a time was ausome. It was a combined birthday – Christmas gift from the better half. I really did love it. (With an emphasis on the ‘really did’ part.)

Anyway it wasn’t working so I sent it back to get looked at for repair. They sent it back along with a list the size of my groceries (and that’s a big list) of things that were wrong with it. Bottom Line? It was going to cost about $220 big ones to get it fixed. Yea that’s right, about the same price it would cost to buy a new one.

They did say I could ‘upgrade’ and pay about $250 for a new improved model. (Yea, sure i can.) When you don’t have $220 to fix the one you have, you sure as heck don’t have $250 to upgrade it (even if it does measure your speed on the bike).

So how am I going to train? Well, it won’t be as scientific as I’d like it to be, but I can still put the miles in. I might have a little trouble knowing when I’ve pushed too hard, but it could be worse. I could be signed up for the Ironman without a decent bike. (Wait a minute – I don’t have a decent bike…..)

P.S.

Note to self: DOMS does not feel better when you have a 233 mg/dl (Damn the cream of wheat and raisins!!!)

Sore?

I was able to ride for an hour and a half this morning, despite being a little sore in the-you-know-what (that would be the butt, if you-don’t-know-what).

I'll admit, I'm not much into weight lifiting. I can run for an hour, but i can hardly lift a bar with five pounds on each side (see the image). I know i need to, but it's not something that comes easy for me. So in the beginning of my traning season i start of with core exercises and medicine ball drills. These are exercises that use your body weight (like a push up) and for some a medicine ball - which is essentially a heavy basketball.

So, I did these core exercises / medicine ball drills for the first time in a long time yesterday, and the muscles are pretty sore today. Maybe I over did it? (don't answer for, that would be a big Y-E-S.)For me, the muscles that seem to get sore in the beginning of any weight training program are the quads and the hammies (muscles in the upper legs) and the glutes (muscles in the butt).

Whenever you get sore the day or two after you work out its called Delayed Onset Muscle Soreness (or DOMS) – it’s actually a physiological response and is pretty common whenever you start a new activity. It goes away in a few days, and that means you’re body is beginning to adapt.

Butt it doesn’t feel too good now, tomorrow can’t get here soon enough. Later.

Ugh!

Man I feel awful.

For our anniversary, my wife and I went out to dinner to celebrate. (no that's not what i feel awful about). I should probably give some background information.....When it comes to carbohydrate counting, I am the King of my own castle. I've got the size of my bowls, cups, and plates to a science. You can put any amount of food in them and if i know that carbohydrate content of the food (from the label of course) then i can tell you the carbs. It's not something that came right away, but after measuring and measuring you just get the feel for it.

Now the important part here is that last part ...of my own castle. When we go out to dinner it's a whole different story; differnt plate sizes, more preservatives then i would use at home, more fat then i would want to guess - all of these will screw up my bolusing. It's almost a garuntee.

So back to dinner.... Ithought that I had the bolus down. I didn’t eat anything out of control, I was pretty good actually – large salad and black bean soup. When I was ready for bed my BG was dropping a little and was at 87 mg/dl – so I decided to cancel the rest of my combo bolus. But I woke up around 4:30 am feeling like I hadn’t had a drink of water in months (and had a 266 mg/dl). I corrected and was back down to normal by the time I got to work this morning but had to skip the morning bike because I didn't get enough sleep.

Damn.

Test

This is a test page by the guru

I'm so excited!

Just two days away – Hooray! No, not the Super Bowl pre-game hype; that started the second the Giants beat the Packers two weeks ago. I’m talking about The Diabetes Day in Iowa on Saturday! (I talked about it in a previous post.) Yours truly is gonna get the chance to rub elbows with 2,000 other people (most of em’ diabetics). There’s gonna be a host of speakers to talk on diabetes issues like carb counting, using an insulin pump, and family dynamics; I’m lucky enough to be talking about diabetes and exercise.

So this is my last plea for people to come visit me if you’re in Iowa! Here’s some easy links.
Info and Registration (3.2MB)

Brochure (3.7MB)

Register online

Plans with the Best of Intentions.

So I have yet to meet with the doctor who’s going to help set up my training. (Gulp! And we’re at the 9 month mark – I’ve got to get motoring!) It’s not his fault, he’s busy, I’m busy, we’re all busy. (That’s why I don’t keep a BG log). It’s not like I’m not training, (I’m always in training) but I’d say my training right now is mixed without purpose.

But hey! I know a lot about this training stuff. Who’s run five Boston Marathon’s in a row? Who’s qualified for New York. Who went to Triathlon Nationals (and the Powerman Duathlon Nationals) Me - that’s who! So yesterday I decided that I knew enough about all this physiology stuff to set up my own plan (oh so bold am I). So picked up my (big) head off of the pillow on the couch and headed off to find my training materials

I couldn’t find my Triathlete training bible, which isn’t a huge shock, I haven’t been able to find it for weeks. So I went into the garage and dug up an old notebook I had when I got certified as a Triathlon Coach from USAT. I pulled out a couple of plans and looked up some info on a could of sites and wa-la! I had a plan. It’s still far from finished but you can see it here . I hope to have it finished this weekend and will post it in one of the sidebars so you can see it all of the time.

I was thinking to myself during the last half of my bike ride this morning that I wish some health club would step up to the plate and try to encourage those with diabetes to take action and join a gym. Then low and behold! When I opened my e-mail this morning I got an e-mail from good ol’ ADA, announcing a partnership with Gold’s Gym. ‘What a great idea’ I thought, ‘why didn’t I think of that?’ Here it is. Sign on up!

Get Fit. Fight Diabetes. Make a Difference.

As a supporter of the American Diabetes Association's Tour de Cure or Step Out to Fight Diabetes event, you know that regular physical activity and eating healthy can help prevent or delay the onset of type 2 diabetes as well as help in the management of complications of the disease. That's why Gold's Gym (a National Strategic Partner of the Association and the number one fund-raising team in the country for Tour de Cure), wants to give you an opportunity to continue your efforts in living a healthy lifestyle.

Gold's Gym recently launched a special online membership offer for supporters of the American Diabetes Association (ADA) as well as for their family and friends. With a goal of making fitness more accessible and supporting the fight against diabetes, the company has substantially reduced its enrollment fee and will donate a portion of every enrollment to support the mission of the ADA.

Consumers who take advantage of this special online enrollment will also receive

• A complimentary personal fitness assessment


• The "Get Started to Fitness" guide that was developed by Gold's Gym & ADA

This special offer is only available online, so visit http://main.diabetes.org/site/R?i=1tJOLSkK_-McsWfnf-y3Wg.. for more details. Don't forget, feel free to forward this email to your friends and family members that could benefit from starting an exercise program.

The American Diabetes Association thanks you for your support and we look forward to seeing you at the next Tour de Cure and/or Step Out to Fight Diabetes event.

Went biking this morning for an hour on my trainer. It took almost half of the time to get in the mood to do actually do it. I was really dragging to get it done (and I mean dragging, I’m considering putting only ½ hour ride in my log instead of 1 hour). Funny how I’m always been able to just jump out of bed and run, while biking actually takes some time for me to rev up. It may be that I just need time to wake up, but I’m not going to get up a half hour earlier when I’m already getting up at 5am to wake myself up. I have a nice bruise from the site that was so horrible yesterday but it doesn’t hurt. A small price to pay for insulin pump therapy – it is absolutely 200% worth it. Talk soon….