Well, I made it! My first full marathon is in the books. (Do they still have books for that? At least it’s in the online results…how about that?) Although running 26.2 miles is never going to be easy, I’m pretty happy with how the day went.
Managing diabetes (on race days in particular) is a lot like balancing a bank account. You have to balance the credits of things that raise your blood sugar (like food, nerves, adrenaline) with the debits of things that lower it (like insulin and running -lots and lots of running). I can craft a pretty mean Excel formula, but in this case all I could do was develop a plan and stick to it as closely as possible.
My wife’s brother and his family live just outside of DC, so we stayed with them the nights before and after the race. This was great…not only because we like them and it was free, but it also allowed me to control things more going into Saturday morning. I cooked a trusted shrimp pasta dish for dinner Friday night, and since I’d eaten that many times before, I had a pretty good idea how my blood sugars would react. (As noted previously, I don’t like starting out a long run with crappy high blood sugar.) I also had my traditional (boring) pre-run breakfast of plain toast, so as far as food goes; I was able to avoid the unknown variables that would normally accompany an out-of-town race.
The other unknown variable was how the race-day nerves & anxiety would affect my blood sugar. I’ve dealt with this before, but never on the scale of “holy crap I’m in a strange city with 30,000 other runners trying to run 6.2 miles longer than I’ve ever run in my life”. Thankfully the anxiety wasn’t a huge problem…my blood sugar hovered around 200 most of the morning before the start – higher than I’d prefer, but not so high that I felt bad. I waited until about 30 minutes before the start to lower my basal rate (while waiting in the ridiculously long porta-potty line), which as I realized later was probably a little too late.
About 3 miles in, my Dexcom showed that unfriendly straight down arrow indicator, which just reinforced the feeling that I was dropping like a rock. I normally plan to have a GU gel every 3-4 miles, so I had to bump that plan up a little and had I think about 3 gels by mile 5. Around mile 6 or 7, things finally leveled off at around 85 mg/dl. The weird thing is, I stayed within 3 points of that the entire rest of the race. Normally there’s a gentle wave in the Dexcom graph between energy gels, but this time it was completely flat…almost to the point that I was worried something was wrong with my sensor. I really wanted to be over 100, so I had Gatorade at every water stop and ate GU packets as often as I could tolerate them, but nothing seemed to budge. I finally consoled myself that 85 would work, as long as it didn’t go lower than that. Aside from that minor struggle and the fact that I felt like Batman with so much crap strapped to my belt, diabetes was a relatively minor factor in the race.
Running-wise, I felt really good. I was hoping to finish in around 4 ½ hours, but I was a little nervous about being able to keep my pace consistent enough to reach that goal. The race had arranged pace groups for 4:25 and 4:40 goals, which I was afraid were a little too fast or slow, respectively, for my fitness. After the first few miles I decided I felt pretty comfortable tucked in behind the 4:25 group, and I surprised myself by hanging with them for the first 20 miles…I even managed a half marathon PR along the way!
To the casual observer, the 20 mile mark would seem like a seemingly insignificant part of the race. I had read and heard a lot about how the race changes at that point, but it was a completely different thing to actually experience it. I had heard conflicting perspectives about the remainder of the race from marathon running friends…one told me that “it’s only a 10k from that point”, and the other said “the last 6 miles feel like Vietnam”. Turns out they were both right – it’s only a 10k. It’s also THE HARDEST 10K OF YOUR LIFE. If 10Ks were all like that, no one would ever do them. It’s amazing how you can see the difference in people before and after that point in the race. For the first 20 miles, most people are enjoying themselves and having friendly chats back and forth. After 20 miles, there’s a significant shift…people are still talking to each other, but conversation is mostly focused on 1) how much this sucks 2) where the next freaking mile marker is, and 3) reasons that you can’t give up. I remember being happy whenever I reached a new mile marker, but aside from that, I don’t remember much about miles 20-25. I think the organizers expected this, as they ran that part of the course through the least interesting sections of our nation’s capitol.
After mile marker 25, the finish was in sight, so I knew I could make it. I had been taking occasional walk breaks since mile 20, but I really wanted to finish the last 1.2 miles without having to walk…I made it about ¾ of a mile to that goal, and just couldn’t do it. I walked for probably 30 seconds, and then inspired by the growing crowd noise, slugged my way to the finish. I was lucky enough to see my wife, daughter, and brother-in-law on the final turn, so that gave me enough steam to make it to the finish line (they were also about to catch me at 2 other points along the route, which was awesome). I crossed the finish line in 4:32:29…not quite at my (admittedly arbitrary and untested) goal, but a performance I’m very happy with.
I’m very happy to have finally accomplished this goal that’s been on my list for several years, and of course I’ve already had several people ask if I’ll do another one. To save you all the effort…Yes…however, I’d like to spend some quality time with my family and do other things in addition to running before tackling marathon 2.0.
Have I told you guys I’m training for a marathon? That is, of course, a rhetorical question. Clearly I haven’t, since it’s been a bazillion days since I’ve updated this blog. There were many times I’ve thought of telling you. Like when I was first considering the marathon. Or around the time I actually started training. Or after my 18 mile run several weeks ago, when it went amazingly well and I was super happy. But facts are facts, and I’ve done a terrible job blogging, and that’s all I’m going to say about that.
So yesterday I ran 20 (.27) miles. It was, without question, one of the hardest things I’ve ever done. Sure, the distance was hard. But I’ve been working up to that – 12, 13, 14, 15, 16, 18…I was ready for the mileage. And I’ve gotten pretty good at adjusting basal insulin rates and carb intake for my long runs. Yesterday was different though. It all started Saturday night. I had a nice shrimp pasta dinner, and a few hours later, my blood sugar was a little lowish, so I had some ice cream. Before bed, I tested and was trending toward being high, so I took a little insulin to stabilize myself overnight. I set my alarm for 6:30 Sunday morning so I could get up, lower my basal rate, and get some breakfast.
BEEP BEEP BEEP!!!
You can read that as either the alarm clock going off, or the Dexcom “HIGH” alert…unfortunately either one works. I was at 275 mg/dl, and had been there most of the night. Not exactly where you want to be before you run 20 miles. I took a partial correction bolus and had some breakfast. Again, not really where you want to be bg-wise before eating, but I wasn’t about to go for that long of a run on an empty stomach. So a little while later, I was actually in a decent place blood sugar-wise, and I headed out for my run.
The run started off okay…my legs were a little stiff, but that’s normal. Usually though, I loosen up and start to feel better. That just didn’t happen yesterday. For some reason, no matter how long I ran, my blood sugar never really went below the low 200′s. In fact, when I stopped to refill water and GU packets at the halfway point, my body decided that would be a great time to spike even higher. I took some micro-doses to try to bring things back down, but that always scares me because it’s amazing how powerful a unit of insulin is when you’re running. Stopping eating isn’t really an option, as it’s certain to lead to “bonking”. I had to stop and rest/walk WAY more often than I had planned, because my entire body felt as dry as the Sahara, no matter how much I drank. I felt like my body would be like the Body Worlds exhibit if you were to cut me open…everything would be there, but not a drop of moisture to be found. I felt REALLY HIGH, but not in the way that any college stoner could ever hope for.
I finished, but it was miserable. Normally during the course of a bad run, there’s at least one good mile. I didn’t have a single one yesterday. Some were less unpleasant than others, but they all sucked. I could deal with this at any other time, but this was it. This was the peak of my training. The longest run in my life (so far), and the longest before the actual 26.2 in the race.
Part of me knows that diabetes is the reason that this run went so badly. Unfortunately, the part of me that thinks “Harry, you suck and your body isn’t ready” is screaming much louder right now. I’d be much more confident going into the race if the 20 miler had gone better, but I guess on the positive side, I got the 20 miles in despite feeling like crap, so it should be a piece of cake on race day when I don’t have bg issues to deal with. And that’s my mission for the next 3 weeks…find a way to ensure that I don’t repeat this scenario on March 16th.
I’m pretty sure that plan shouldn’t involve treating bedtime lows with ice cream, so I’m going to start there.
Diabetes sucks. I don’t need to tell anyone that. There’s all of the usual stuff – the blood-letting, the doctor visits, the expenses. Despite all of that, we’re always told that we can live like “regular” people. We can play sports, eat sweets (as long as we bolus correctly), and have babies. I’ve done all of those things (I’m pretty good at the last 2, the first one…meh).
Thanks to diabetes though, there’s one “regular” thing I can’t do – grow an effing beard. It seems simple enough, right? You just don’t shave for a few days, and it should be there. It’s the epitome of laziness. It’s winter time. It’s what people do. They wear sweaters and grow beards and swap out their iPod playlists for gloomy acoustic indie rock (no? just me?). But unfortunately, my beard has some rather noticeable bald spots. I should clarify that it’s not diabetes directly that causes this, but rather another autoimmune disease that goes by the heartwarming name of Alopecia Areata.
In this case, the immune system attacks the hair follicles, much in the same way it sought out my pancreatic cells 20 years ago. Why it can’t put that effort into fighting off a common cold, I’ll never know. Of course when you research this condition, you come across that all-too-familar “occurs more often among people with autoimmune disorders such as diabetes”. I get so sick of seeing this. I can handle the diabetes, I just wish it was JUST diabetes.
Is not growing a beard the end of the world? No, of course not. I realize it could be worse. Better bald spots on my face where I shave normally anyway than in the area where I expect to have hair. But how am I ever going to fit in if we move to Seattle? I guess the bright side is that I’ve read that the hair often does eventually regrow, so maybe I can try again in a few years. Perhaps that will inspire my pancreas to do the same!
You know how you ask your friend about their weekend and they tell you about a restaurant they went to, and you’re like “Holy shit that place is still open?!?…I went there years ago and it was okay, but it’s really far out of the way.”? Well that probably happened to you today. Except the friend was Kerri Sparling, and the restaurant was, well, this blog. You see, she was kind enough to mention that we finally met several weeks ago, and linked to my blog so people would know that I’m a real person and not just a sarcastic twitter bot. And then I felt really bad, because Kerri is an awesome blogger (and person, but more on that later), and my blog is in a severe state of disrepair. It’s really hard to believe how long it has been since I posted here. To put it another way, it’s hard to believe everything that has happened since I last posted. I got a new job. We sold our house. We bought a new house. Our daughter turned one. You get the idea. It’s not an excuse, but it’s an explanation. Truthfully, I haven’t been the greatest diabetic in that time either. I haven’t exercised as much as I’d like or should have, and my last A1c was 6.8. Granted that’s not horrible, but it’s the worst I’ve been in several years. I’m really trying to get back on the horse though. Or is it off the wagon? I’m horrible with non-motorized metaphors.
Anyway, back to the “when Harry met Kerri” thing. It’s hard to explain the awesomeness of this community to people that aren’t in it. It’s easy to describe members of the DOC as my ‘internet friends’, but that’s a little too “mom’s basement” for my liking. The internet and social media are what help us get together, but it’s not really what brings us together. As Kerri said, it’s hard to explain, but it makes sense. I’d like to think Kerri and I would be friends if it weren’t for diabetes since as she told me today, I’m a “taller, blonder, more sarcastic her”…but I’m not sure how it would happen. It’s funny that even though diabetes is what initially connected us, we didn’t really talk about it. We talked about things that regular friends talk about, and it was amazing. Kerri is right, we didn’t get a picture…but I’m okay with that. The experience was more fun than I’ve ever had looking at a picture. However, to fill the space in the scrapbooks and time capsules, I’ve put together an artist’s* rendering. As you can see, we’re very classy.
*term used loosely
So I was pretty excited when I went to order new pump supplies a while back, and Medtronic had these new mio infusion sets. 32″ tubing? Awesome. Self-contained inserting device? Neato. Pretty colors? Meh.
What seemed like a good idea in concept does not seem to be working for me in reality. I ordered 1 box of the mio sets just to try them out, and I’ve gotten so annoyed with them that I can’t even seem to get through those 10 set. First there’s the fact that the inserting device just doesn’t work as smoothly as I’d like. I’ve found that I have to apply the IV Prep wipes and let my skin dry to the point that it’s really sticky to prevent the needle from pulling the whole site out when I try to remove it. Nothing worse than inserting the same set twice. And then there’s the issue of what to do with that inserting device when you’re done. There’s really no way to remove the needle part, and I haven’t seen a sharps container* yet that will hold that whole plastic mess.
Another issue I’m not terribly happy with is how the tubing connects to the implanted site. Notwithstanding the fact that it looks sort of like some clear unambitious stingray, it just plain hurts to connect this thing. It seems to require an extraordinary amount of force to get the connection to firmly snap in place, and I’m not crazy about wiggling around things that are stuck inside my body (that’s what she said?). And they only included 2 “plugs” (unlike the Quick-sets, where you get one with each infusion set), which took me about 3 trips to the pool to lose forever to the chlorine-y depths.
So is this blog post just a way for me to bitch about my medical equipment? Sort of. But the bigger picture is this…I’ve been considering a switch to the Animas pump, and looking at their website, their “Inset” family of infusion sets bears a very striking resemblance to the mio. I’m concerned that with Animas the infusion set options are more limited than with Medtronic, and I’m really not sure if I like this design as my primary option. Animas users, any input? Are the Inset sets really the same as the mio? Are there other options that I’m not aware of?
* By “sharps container”, I of course mean “old Clorox bottle”
Yes, I know. It’s been a while. We’ll get into that later. But today, it’s D-Blog Day, and if there’s any time to update, this has to be it. Thanks to Gina‘s organization, this year’s topic is “6 things you want people to know about diabetes”. So here goes:
- I don’t have “bad” diabetes. I don’t have good diabetes either. I just have diabetes. There are lots of things I can do to keep myself healthy, but nothing I do will make it go away. The fact that I use an insulin pump doesn’t mean I have it any worse than I did when I was taking 6-8 shots a day. It’s just a different method of treatment, one which I feel works best for my lifestyle. I think I’m in pretty good control, but that doesn’t mean I don’t still have the risk of long-term complications.
- Yes, I can eat that. In fact, I can eat pretty much anything I want. Diabetes has come a long way in a short time, but public opinion has not. Long gone are the days where diabetics had to adhere to a strict diet of 1 meat, 2 vegetables, and 2 starches each meal. As long as I know how many carbohydrates are in a food, I can take an adequate dose of insulin to counteract it.
- Diabetes kills spontaneity. I can’t just hop off the couch and go for a run, or stop for an ice cream cone on a summer day. That’s not to say I can’t do either of the aforementioned things, but there is always planning involved. What is my blood sugar now? Do I have insulin in my body that’s going to cause me to crash 2 miles into the run? Do I have enough insulin in my pump to cover this ice cream? Hold on, I need to look up how many carbs are in that.
- Diabetes isn’t necessarily hereditary, but it still scares the hell out of me. I love my daughter more than anything. Even though she’s only 2 months old, I know she can handle anything the world throws at her. However, I don’t want her to have to handle this. She has my blonde hair, blue eyes, and affinity for dairy products, but I really hope that she’s able to dodge this curveball.
- Diabetes brings people together, but they’re still people. The DOC (Diabetes Online Community) is an amazing thing. I’ve met so many amazing friends that share this disease, but we share so much more than that. We’re music fans, runners, triathletes, parents. It’s nice to have a common bond and a group of people that understand the issues you face on a daily basis, but it’s also really nice to know that they’re regular people with regular lives.
- There is no cure. There are treatments, medicines, and devices, but these are just ways to manage the problem, not ways to make it go away. Please consider donating to fund diabetes research.
I know you probably think this is some Inception-like dream sequence. “Surely Harry can’t be writing a blog post, right?” Sorry to disappoint you guys, but this is not a dream, and this post has absolutely nothing to do with Leonardo DiCaprio.
Anyway, on to the good stuff…yesterday I raced my first ever triathlon. Very few things about the day could be described as “successful”, but I did finish and didn’t have to be picked up by the sag wagon, so I suppose there’s something to be said for that. I’ve been signed up for this race since January (since registration fills up very quickly), but I’ve been seriously training for the past 3 months or so. I think it is important to note that when I signed up for the race, I didn’t really know how to swim. I could tread water and keep myself from drowning, but getting from point A to point B in a hurry was completely out of the question. I’ve been biking and running for years so that wasn’t a problem, but I knew the swimming part was going to take some work. I’ve worked really hard this summer on swimming though, I even enrolled in an endurance swimming class at the YMCA. I’m still the weakest at swimming, but I’m at least at the point where I can do the 750 meters required by the triathlon course (I’ve done much more in practice, but it’s a lot different when there’s no wall to hang on to…
But enough background info…on to the race report. After getting up at 4:45am to get everything ready and get to the race site, 7:00 quickly rolled around and it was time to start lining up for the swim start. My blood sugar had been uncooperative at best all morning, but after a couple of energy gel packs in the transition area, I felt like I was at a comfortable place to start the swim. The start of the swim…that’s about where “comfortable” ended. I’ve done this course at least 4 times over the previous weeks, but somehow right after the second turn bouy, a mysterious current appeared around me in this completely landlocked lake. I swear I swam for 5 minutes and never got anywhere. I turned over on my back at one point to float and catch my breath, and somehow ended up pointed in the complete opposite direction when I flipped back over a few seconds later. I honestly don’t understand it. Anyway, I finally finished the swim, and ran to the transition area to get ready to hop on the bike. Feeling a little week after gracefully flailing in the water for 25 minutes, I thought it would be a good idea to check my blood sugar. I had practiced my transitions earlier in the week, but I failed to practice one thing: removing a single test strip from the vial with wet hands. Of course in my haste to get out on the bike course quickly, I rushed my way into an “ERROR 3 – Meter Not Ready” on the first try, so I had to start over. Believe it or not, wet test strips like to stick together, so in the end my 126 mg/dl cost me about $4. Also during this time, I grabbed my pump out of my bike shoe and started to connect back to my infusion site, at which point I noticed said site was completely dyed red with blood. I’ve been pumping for over 2 years, and this has NEVER happened. Oh well, I thought…I’ll just connect and hope that it works, since I really have no other option right now.
Heading out onto the bike course with this comforting and expensive knowledge, I actually felt pretty good. The bike course travels over many of my favorite training roads, so I was cruising along pretty quickly, knowing just where I needed to conserve my energy for the hills. Right before the first of those aforementioned hills, I was going downhill at about 30 mph when I heard one of the worst sounds in cycling…the “psssssssssssstt” of a flat rear tire (this sound is eclipsed only by the crashing of carbon and aluminum against asphalt, but luckily I dodged that bullet this time). Since I was at the worst possible spot for this to happen, I pedaled my pathetic flat tire up to the next subdivision entrance so I could pull over and change the tube. If I did set any speed records during this race, tire-changing would have to be my gold-medal category. In fact, that might be my proudest moment of the race. I still managed to finish the 17 mile bike leg in 58:42 including the tube change, so I’m pretty proud of that. The rest of the bike leg went by without incident, and before I knew it I was back in the transition area getting ready for the 5k run. The blood sugar check went a little smoother this time around, but the result was quite disappointing: 68 mg/dl. I could tell I was feeling pretty low, but for some reason it really hit me when I saw the number.
I ran up the hill to the run course, but had to stop and walk at the top to chug down another gel pack to hopefully bring up that low…I had also removed my pump at the transition, as the blood from the infusion site had worked its way back through the tubing. But judging by the 68 mg/dl, I didn’t really need it anway, so why carry the extra weight, right? Luckily the start of the run was mostly downhill, so I had a little time to recover. Don’t get me wrong, the run still absolutely sucked, but at that point I knew I was close enough to finish. And finish I did. I didn’t do as well as I had hoped, but a lot of things seemed to be working against me. As Lance Armstrong said after a rough stage at the Tour de France this year, “Some days you’re the hammer, some days you’re the nail.” Yesterday I was the nail.
Strange as it may seem, I still really enjoyed my first triathlon experience. It certainly didn’t go according to plan, but hopefully I got all the bad luck out my way for a few races. There WILL be a next time. Before then though, a few things need to happen:
- Someone needs to develop a test strip device that dispenses one strip at a time. This system should preferably be able to be mounted on a bike to save time in the transition area.
- I need to get a CGM that doesn’t suck ass. I thought the Medtronic system seemed like a good idea at the time, as I could have one device for my insulin pump and CGM receiver. That was before I found out the Medtronic sensor wouldn’t even last 50 meters in the pool before coming off. Really, people? That was the best design you could come up with?
- My bike needs to stop hating me.
Oh, but the one good thing about the day? We managed to convince LT that she was not allowed to exit her mother’s womb until after the race. She held up her end of the bargain and let Daddy finish his race that he had been training for. Now that we’ve got that out of the way, bring on the babies!!!
Hello, friends. Thank goodness today’s post is primarily about pictures, because I’m almost out of words for the week! Since no one really want to see pictures of itchy sensor site rashes, or needle-hole ridden ab shots, I thought I’d share a few noteworthy accessory-related photos.
First of all, I always find it astounding how many supplies I go through in a typical month. Since I try not to do math on the weekends (and also because it’s depressing), I’m not going to add up how much all of this stuff costs, but it really is a lot when you look at a whole 30 days’ supply:
Secondly, I thought I’d share a photo of my most often-used accessory – the pump clip. I don’t use it during the day as the pump normally resides in my left front pants pocket, but I couldn’t sleep or work out without this thing. It’s such a simple little piece of plastic, but without it, my insulin pump would just be a $6,000 pendulum hanging from my body.
Speaking of working out, I always wear my trusty RoadID when I’m away from the house on a run or bike ride. I wore the medic alert necklace for years (in fact, I still have the first one my mom bought for me when I was 12), but I’ve found the RoadID bracelet to be much more comfortable, not to mention more informative, as it has emergency contact numbers for my wife and parents if I were to have an accident. You’d be hard-pressed to fit all of that on the back of a Medic Alert necklace. I also added a little pun at the bottom, which I borrowed from the name of Alexis’s blog (hope you don’t mind!). It makes me smile when I look down at it during a workout, and who knows…maybe it will give the EMTs something to talk about on the ambulance ride someday (hopefully they never have the opportunity, though).
Hope you guys have an awesome weekend!
Exercise…love it or hate it? Interesting question, especially for today. To explain why, let me give you a rundown of my afternoon:
Around 2pm, my boss tells me if I’m caught up on everything, I should leave and get an early start on the weekend. Awesome, I think. I’ve got enough time to fit in a bike ride before my sister-in-law (who’s spending the night with us) arrives. So I get home, plot out a nice 24 mile loop, and head out on my way. About 8 miles in, I hear the noise that no cyclist ever wants to hear: psssssssssssshhhhh. FANTASTIC. I LOVE flat tires. I pull over to the side of the road, get out my spare tube, CO2 inflator, and get to work. (Did I mention it was 90˚ outside?) Since this isn’t my first roadside tire change, it actually went pretty smoothly, so I get ready to start riding again, and I look at the pump to see how my blood sugar is doing:
This is not what you want to see when you still have 16 miles to go, and have already used 1 of the 2 PowerBal gels that you brought with you. I ripped open the other gel pack, gulped it down, and started pedaling. A few miles later, I check the pump again, this time it’s at 84, still with a down arrow. Knowing that when it comes to lows, the CGM is usually higher than the actual number, I know I’m in trouble. At this point, I decided to call my wife for a ride home, as I can feel myself running out of juice. No answer. I tried a couple of friends in the area…no answer there either. Well crap. Using the old internal GPS, I routed the shortest, most downhill route home and started back. I finally made it home (and since I had suspended the pump, my blood sugar at least leveled off rather than continuing to drop), but still frustrated that once again, diabetes had foiled a perfectly good workout plan.
I like cycling, running, and other forms of exercise, but I often find it really frustrating how difficult it is to do while managing the whole insulin/food/blood sugar issue. I’ve got the normal after-work routine figured out, but any time I change one variable (time of day, duration of exercise, etc.), I never know what’s going to happen. That’s the part I hate. I don’t want to jump ahead to the “after-cure” post topic, but I often fantasize about being able to just go for a run or bike ride, whenever the mood strikes me. Maybe one of these days…
To me, it’s not really a question. I love carbs. They are delicious. I understand the thinking behind the low-carb diet thing, but it’s not the method I would choose for weight control. I would much rather go for a long run or bike ride to work off a big meal rather than completely deprive myself of a food that I want. Of course I think about carbs, but it’s primarily because it affects my insulin dosage, not because I’m keeping a running tally of the intake. If you ask me, we diabetics have enough numbers to keep track of, I just don’t have the capacity to get down to the complete caloric breakdown of everything that enters my body. That’s not to say I feel everyone should just go nuts and eat whatever they want, after all, you don’t want to end up on Maury Povich. But at long as you’re reasonable with what you eat, you take the insulin to cover it, and you exercise to keep your body healthy, I think that’s enough.
I’m not sure if that addresses today’s blogging prompt, but it’s the best I can do. I considering just playing off of Kerri and writing about the crab’s evil sea-cohort, the carp. But I powered through. Sort of.