The Incurable Runner

Bad-Assedness

2011-10-15T22:42:00.001-07:00

I wrote this a few days ago in the "Diabetics Who Run Marathons" group on TuDiabetes. It occurs to me that it might be OK for a blog post, and I'm not writing much else. So here it is.

So... I've been thinking about the headline "Stunts to Impress" in Higdon's advice on multiple marathons, and the much appreciated comments on me being "BADASS" and "amazing."
Of course I'm often looking for opportunities in the conversation here to brag about things I've done. I like to be called bad-ass. And I don't see anything wrong with that. Some of the greatest achievements of mankind have been done so someone could say the equivalent of "Look, Ma! No hands!"
A good part of people doing this is that it expands the realm of possibilities for others.
In that spirit I feel like I should point out that I know a type 1 diabetic who's run about twice as many marathons as I have, and run them faster.
I've met two diabetics who have gotten the silver buckle at the Western States 100 mile endurance run, and I'm aware of at least one other whom I haven't met. You get the silver buckle for finishing in less than 24 hours. There are probably others I'm not aware of.
There is a type 1 diabetic world class marathon and ultra marathon runner.
I could go on. I guess the point is that while I like being called "BADASS" and that's at least part of why I do some of the things I do, I'm aware that there are others more bad-ass than I am.
And 14 years ago I was a diabetic runner afraid to try a marathon. I was inspired and comforted by reading about or meeting other diabetic athletes, and not just the fantastic athletic ones, but the ordinary folks like me.
Wherever you're at with diabetes and exercise, there are people ahead of you and behind you on the bad-ass scale. Well, since everyone is different, and every life situation is different, there really isn't a scale we can all be measured against.
We are all inspiring each other.
Reading back over this, I kind of rambled. I hope I had something to say.
"Stunts to Impress" aren't necessarily a bad thing.

In other news, along with a contingent of runners from Glucomotive, I ran the Denver Rock 'N' Roll Marathon last Sunday.

Team Type 1 Has No Stout Members

2011-10-08T09:00:00.000-07:00

It's true. James Stout, who was a member of the Team Type 1 Pro Cycling squad was terminated last November.
Team Type 1 says he was terminated for two infractions:

1) Wearing this shirt to a party at a friend's house:

2) Sending this tweet from his twitter account:

RT @AJELive: Afghan president Hamid Karzai says that the killed of Osama bin Laden is very important news. #AlJazeera #noshitsherlock

I don't have a big problem with Team Type 1 deciding when to terminate the contract of a professional rider. They have to be able to make those decisions, even if I feel they're being puritanical, prudish prigs about it, they have to draw the line somewhere, and it's a very subjective thing.
I don't hold it against them that they were never able to help James Stout with his visa, since I don't personally know how difficult it is to arrange a work visa for a professional cyclist. It may simply take a long time, or there may have been some bureaucratic snafu. It could be due to incompetence, whether at Team Type 1 or a government office.
I don't even hold it against Team Type 1 that they stopped providing insulin to James Stout as they had agreed. There may have been very good reasons why they couldn't afford to be responsible for riders' medications. It may even have been the Willem Van den Eynde case that made them make that decision.

Oh, maybe I should explain that Willem Van den Eynde is another of the type 1 diabetic bike racers who rode for Team Type 1 and felt abused. I only mention it here because Willem said that Team Type 1 failed to provide the health care he was promised. It's possible that his case caused enough problems that Team Type 1 decided not to be involved to the same extent in the medical requirements of riders.
In 2009, 18 year old Willem was never sure of medical supplies, mainly insulin and test strips, from the time Team Type 1 brought him over from Belgium until he got money from his parents to go back home. His A1c went from being consistently in the 7s to being 9.9 after several months with Team Type 1.

But I was about to say what really disturbs me about the actions of Team Type 1 in James Stout's case.
They did not communicate to him that they were about to terminate his employment, that they were in the process of terminating, or that he was terminated, until he left the USA. Then they told him his employment had been terminated months earlier.
They stopped paying him and helping him with diabetic supplies, stopped dealing with him at all. It's almost as if they were waiting for him to quit instead of telling him he was fired. Knowing that they've treated others similarly makes this seem like a plausible explanation.
They let him think he still worked for them. He continued to represent Team Type 1 at events. He continued to communicate with them about what he was doing. He would ask about his pay and his work visa, and there was always some delay.

You might wonder how he could go on that way, working at a job he wasn't getting paid for. I can't explain his actions. I can only guess. My guess is that like many of us he was inspired by what Team Type 1 has accomplished and what it represents. I guess he was glad that he was a part of it, and he didn't want to give it up.

Although I have many friends on Team Type 1 teams, cyclists, runners, triathletes... and I love to read about and hear about the inspiring things they're doing, I worry about what is happening to kids like James and Willem, and the others who are afraid to speak out.
I worry about the riders breaking their backs to support the team's mission.
I worry that the mission and the message will be corrupted if the organization doesn't wise up and treat these athletes fairly.

Meanwhile, I've come up with a couple of ideas for shirts:

Please enter any shirt ideas you have in the comments below.

Stout podcast about Team Type 1 on Crank Cycling, when Stout believed he worked for Team Type 1.
http://www.crankcycling.com/podcast-interview-with-team-type-1s-james-stout/

A two part Bikezilla interview with James Stout and the author's analysis:
http://cyclismas.com/2011/07/bikezilla-interview-with-james-stout-part-1/
http://cyclismas.com/2011/07/bikezilla-interview-with-james-stout-part-2/
http://cyclismas.com/2011/08/team-type-1-and-electric-kool-aid-litmus-test/

A letter from a lawyer friend sent in a futile attempt at reasoning with Team Type 1 management for decent treatment:
http://www.newcyclingpathway.com/news/blog/the-global-mission-of-team-type-1-and-the-ethics-of-managing-a-team

A post by James Stout about his feelings toward Team Type 1, which are not all bad:
http://www.newcyclingpathway.com/news/blog/team-type-1-and-ethics-a-post-from-james-stout

Willem Van den Eynde's Team Type 1 story, never disputed by the team.
http://forum.cyclingnews.com/showthread.php?t=645

Team Type 1 response, or lack thereof re: the treatment Willem Van den Eynde got from Team Type 1:
http://www.podiumcafe.com/2009/5/7/867897/team-type-1-a-sad-truth

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the Politics of Diabetes

2011-10-07T08:30:00.000-07:00

I know I haven't been blogging for a while. I don't know exactly why. I really can't say that I've been too busy. I've been letting a lot of things in my life slide.
I have friends who can keep writing new stuff day after day. And it's interesting stuff.
It's honest. It comes from the heart. They are putting their lives out there for the world to see.
It's easier for some of them, because they're nice people. They wouldn't be so open with their thoughts and feelings if they were selfish, egotistical, greedy, lazy, apathetic, lecherous, chauvinistic, cantankerous curmudgeons like me.

But I'll try to blog more often anyway, because as I've observed before, if you don't write anything, no one follows your blog.

If you follow my twitter account, then you know one of the areas which I'm obsessed with, but I don't blog about, is politics. I have felt that this blog was not about politics, and it would be easy for me to drive away people who were interested in diabetes and endurance events if I posted too much about politics.
But on twitter, you're probably seeing more than you'd like of my political opinions. Too bad.

I've decided I may occasionally say something about things happening in the news, including political events or non-events that are in the headlines.
That's because these things do involve diabetes and how people with diabetes live.
Of the two main political parties in the US, one has supported a rational approach to stem cell research, while the other has opposed it. As a diabetic, I would like scientists to be able to explore all ethical avenues which might lead to a cure.
One party supported taking some action toward affordable health care for all, and one party wants to repeal the little that has been done. As a diabetic, I would like to be confident that I will not find myself unable to afford the best possible treatment.
One party has become decidedly anti-science. As a diabetic, I depend on science every day to survive.

That's probably enough for today.

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St. George Experience

2011-05-17T16:11:00.002-07:00

You may find a couple of things about this blog post remarkable. First, it may seem like I've written a longer post for just the swim portion of an Ironman than anyone would expect if I had done the whole thing. Second, it may seem like a long, whiny list of excuses.
Well, that all may be true. But I see it as an explanation. Basically, I was again at the start of an Ironman race without having once done an Ironman distance swim in the required time. This time, I know I was a good enough swimmer that I could have made it if all conditions were perfect. No one should ever expect all conditions to be perfect, should they?

Conditions were actually excellent in several ways for this swim. The weather outside of the water was great. There was no wind to speak of at the reservoir, so the water was nice and smooth.
It was cold, but it was never so cold that it bothered me much. I had earplugs and a neoprene hood, so I may have been better off than others. I never got the shivers after getting out, as I did in 2009. The water temperature wasn't a factor except for the fact that it was cold enough for me to wear a wetsuit, which is a huge benefit. I can't complain about that.

But I did have some problems. None of these would have been enough to keep me from making it in time if I was better than a marginal swimmer. And I am to blame for not being a better swimmer. Like the last time, I worked very hard on it, but I started too late.
Next time, and there will be a next time, I swear I will have the swim in the bag.

I got up at 3 AM and my blood sugar was in good shape. I drank and bolused for a Banana Cream Ensure Muscle Health. Then I walked over to my Triabetes teammate, Brian's room and gave him back his Dexcom charger, which he had generously allowed me to borrow because I'd forgotten to bring mine. We were both staying at the Motel 6 next door to Denny's. I went over to Denny's and got toast and a huge cup of coffee to go. I thought I bolused right for that as well.
By a quarter to 5, on the bus out to Sand Hollow Lake, my Dexcom was saying my blood sugar was over 300, and I test at 281, so I took a big bolus to bring it down, thinking that it was probably rising because of nerves, and I wasn't likely to get any more relaxed as the start approached.
When we got to the lake, I went straight through the transition area to the porta-johns. After that, I went to get water to fill the bottles on my bike, and then I figured I would take a look at my blood sugar again.
That's when I notice my Dexcom receiver was gone. It had fallen out of my pocket.
I frantically retraced my steps. I asked volunteers at one of the changing tents if there was a place for lost and found items, and they sent me to the other changing tent. The volunteers there didn't know anything about a lost and found, but said I should go to the other end of the transition area and talk to the guy with the microphone. Over there, no one knew anything about a lost and found, but one volunteer said that I was the third person to ask about it.
So I went back to tracing my steps, and I could just barely see my Dexcom leaning against the base of one of the porta-johns, just sitting there waiting for me to come back.
Of course it had been out of range for a while, so it didn't provide any information, and I had started thinking about how much time I had left to get my wet suit on and get ready for the swim start.

I went over to the start, got my wetsuit on, and did one last blood sugar test. It was 127. I had set aside three energy gels for the swim, but I had to eat one right away, knowing that my blood sugar was on a downward trend. I had been hoping to start the swim with my blood sugar a little high, so the exercise could bring it down safely, but clearly I had over-estimated the effect that starting line stress was going to have on me.

There was supposed to be a table to drop off things like prescription lenses. I wanted to drop off my glucose meter. The problem was that there was not a drop off at water entry and a pick up at water exit. There was only one table, at water exit.
This simply meant that I had check my blood sugar, run over to water exit, then get back into the massive lineup at water entry. I don't know how someone who actually required prescription lenses to get around was supposed to drop off those prescription lenses and navigate back to water entry.

The one good thing about that was that I was lucky enough to run into my Mom, who came with me to St. George for support. She came in on the spectator shuttle, and the timing was perfect as she was headed toward the shoreline while I was going back to the start. It was nice to get a hug from her.

There was a very narrow gap, a single lane dirt road, down to the water entrance, with about 1500 people backed up behind it. With the pro start at 6:45 AM, there was only 15 minutes for all of these people, mostly barefoot, of course, to squeeze through the narrow space, get out into the water, and swim to the start.
It didn't help to have someone on the PA system telling us over and over that we had to get into the water. There simply was not enough time to get all of the swimmers through a narrow opening down to the water and out to the start.
I was up to my shins when the gun went off, and there were still many people behind me.

When I got deep enough to start swimming, my goggles started to fill with water. I hadn't pressed them down tightly onto my face to create a water-tight seal yet. I had to stop swimming, pull my goggles loose enough to shake out the water, and press them back on. Fortunately, it worked perfectly first try, and I didn't have any more problems with them.

Within a few yards of swimming, I hit the upper branches of a submerged tree. I looked around to see if it was another swimmer before I figured out what it was. Many of us swam over this tree. It would have been nice if the branches near the surface could have been trimmed off.

From where I was at start time, it wasn't at all clear where the start was, so I went off in the wrong direction.

I don't think the diagram of the swim course was accurate. This might have been helpful. The diagram made it look like the start was right at the shoreline. It wasn't. It made it look like the first long straightaway of the swim went parallel to the shore. I don't think it did. I think it actually angled away from the shore.
If you look at the aerial photo below, you see some rocks pointed to at B at the bottom. The first long line of buoys actually ran straight from about the island toward those rocks, not the direction indicated by the diagram.
The start was not at the shoreline, but many yards out from A. I don't know how far, because I never knew exactly where the start was. We should have swam toward the island, then turned right, to the south. I didn't know where to go, so I started going parallel to shore long before I got out far enough. When I realized I was alone, I looked up and saw some people swimming diagonally away from shore, and others swimming perpendicular to shore.
I yelled and yelled at boats and kayaks I saw. I mostly loudly yelled, "Which way?!"
I was definitely down at this point, with the thought filling my mind that it was already over. I had to fight it off and tell myself to just keep trying. I wasn't going to give up.

I kept trying to guess which way I should be going, and swim in that general direction. After a while, someone finally did answer me and put me on the right track, but it didn't seem like anyone was trying to do that in the critical first 200 to 300 yards.

After I got on the course, I could see I wasn't alone. There were others who were going to be close to the cutoff time. There was one guy in particular who was doing a lot of breast stroke. I would pass him while he was doing that, then he would pass me when he switched to freestyle again.
At the first left turn, I saw someone getting out of the water onto a boat. I could sympathize, but I thought I was going to be fine. I was doing much better than I have in any long open water swim in the past.
I had already noticed that I was having a hard time swimming a straight line. I needed to sight out ahead frequently.
When I got to the second left, turning northward, I grabbed the buoy and took a look at my watch. I knew I was more than a mile into the swim, and it was 56 minutes since the start, so I was doing all right. But I had to keep pushing to make it.

Sometime after the first quarter of that long northward straight, a woman on a surfboard came alongside me while I was resting for a second, to ask if I needed help. I pulled one of the power gels out of my wet suit, sucked it down and handed her the wrapper.
She stuck near me for a while, and I decided I may as well sight on her if she was going my way. I asked her if she would stick with me and if I could sight on her, and she said it was fine. I'm sure it helped some, and I'm sure that at times she was too close to me, and I got an unfair drafting advantage, but it didn't go as well as I would have hoped.
Very soon she was crowding me on the left side, and I assumed that I must have been going too far to the left, so I steered right. After a while she told me, "You're going too far to the right."
If I had gone to the left more, I would have hit her surfboard.
I should have known then that she and I had different ideas about how this should work. I should have told her, "Just go in a straight line parallel to the buoys, and I will try to stay parallel to you."
Instead, I was never sure if she was getting closer or farther away simply because she wasn't going in a straight line.
After I had kept my head down and sighted only on her for several hundred yards, then looked up, I saw I was way out to the right of the line of buoys, and I said, "I'm way off course!"
She said, "You're fine. Do you want to swim closer to the buoys?"
"Yes!"
But I still didn't explain to her what I wanted. I didn't want to complain, and I thought that it was obvious. But the obvious thing was that she didn't know what I expected.
We approached the last turn, which, rather than being way out in the lake as indicated in the diagram, was very close to the point marked as C in the photograph. I was unsure if I was just tired, or low, so I ate my last power gel.
I was afraid to swim past the turn buoy, so I made several unnecessary stops as I got closer. When I finally made the turn, I had a hard time seeing the finish. When I finally saw the line of buoys ahead of me, I lined myself up, put my head down, and started swimming. The volunteer on the surfboard started yelling at me after only a few strokes, "You're going too far to the right!"
So I stopped and looked up. I was still in a perfect line with the buoys. So she didn't correct me when I was going a long way off line, but was yelling at me when I was still in line.
They told me I had twenty minutes. So I put my head down and tried to swim as consistently as I could. The surfboard kept me from going too far to the right, which is always my problem. When I finally took another sighting, they told me I had ten minutes left.
I wasted a few seconds toward the end. I almost hit the boat dock. Someone warned me at the last moment, and instead of crashing head first, I put my hand on the end of the dock. I took the biggest gulp of lake water I'd had all day and coughed it out.
I started back to the boat ramp, and the water was so clear, I could see the concrete underneath me. It looked shallow enough to walk, so I stopped swimming and put my feet down, but I couldn't reach the ramp. I swam on, and when I was sure I was in shallow water, I did the same thing, with the same result. So I swam some more, and put my feet down, and just barely touched ground.
Then I walked up the ramp to some disappointed looking race officials.
I reached the end of the swim about 2 minutes too late to continue. I know that if I had been a better swimmer, little things wouldn't matter, and I would have finished in time. There's no reason why I should have expected everything to go perfectly.
It was a good thing I had the gels during the swim, since I tested at 109 shortly after the finish.
Here's the Dexcom graph from the swim, starting at 7 AM and ending at 9:22 AM. The gap is where I lost my Dexcom receiver in the transition area for a while.

I ate one gel at about 6:30. As I said, my meter said 127, but the Dexcom said 174. When I tested at 109 at the end, my Dexcom said 177.
So my Dexcom was consistently higher than my actual blood sugar. My Dexcom graph shows a low of 143 during the swim, so my blood sugar was probably close to going low.

Anyway, that was it. I was a spectator again for most of the day.
I went to the motel pool toward the end of the day, for a symbolic swim. I just wanted to make a statement to myself that I wasn't beaten, I would keep working until I made it.
It was of course a very small pool, so it took about three strokes to cross it diagonally, from one corner to the other.
Someone at the pool asked me if I had done the Ironman that day. I knew I still had the number "52" painted on my leg, buy I didn't want to explain. I just said, "No."

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Wearing the D Gear

2011-02-22T23:55:00.000-07:00

What seems like many years ago I read about Bill King running marathons with a glucose meter strapped on his wrist. I tried a few ways to do that myself, but it seemed like more hassle than it was worth. It's really not easy to insert a strip, get a drop of blood, and touch it to the strip, all pretty much using one hand. It's more convenient to carry the meter elsewhere, like a SPIbelt, and take it out when you need it.
But at Ironman Arizona in 2009, I saw Bill Carlson with a Dexcom receiver in a plastic bag duct-taped to his forearm. That looked convenient, but painful to remove. Bill had his current blood sugar trend at the touch of a button, right there like a wrist watch.
So I've given some thought, and done some experiments, in that direction.
My first thoughts went toward sleeve-like things, cheap garments from a thrift store, cut-off tube socks or sleeves with some modification to hold the Dexcom.
I had this idea that all I really needed to do was to wrap the Dexcom in plastic wrap. Then I thought, well, just wrap it all the way around my arm. It's actually difficult to wrap my arm and the Dexcom together that way, though, and it would become a sweaty mess very quickly.
I had used stretch bandage that comes in rolls, one brand is called Co-Band, to attach some things to my bike before. It's the stuff they wrap your elbow in when you give blood. It seemed like this might work for this purpose also.
So here's something that seemed to work, the Dexcom receiver wrapped in plastic wrap with lots of plastic hanging off the ends, then the ends wrapped onto my arm using stretch bandage material.

This seems to hang on well enough while biking. I haven't tried it on a run yet. I'll probably go back to the sleeve idea, since it would save a lot of time in the swim to bike transition to have something I could just pull on, instead of wrapping my arm. I can't see fitting my wetsuit over this, even if I wanted to.

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Things I should have posted about

2011-02-18T16:22:00.001-07:00

As a race, the Carlsbad Marathon on January 23rd went as well as I could expect. That means awful. But it was still a great experience. It was a huge Glucomotive event, and my brother Jon was also there to enjoy the festivities and support the race.
I had close to zero training, so I figured I had to be conservative. I thought 4:30 would be a remotely possible time goal, so I aimed for 10 minute miles.
I saw Gary Schmidt and Emily Iannello at the start and ran with them for a bit. I also met Ed Ettinghausen, who is going for the world record for marathons in one year.
He isn't keeping his stats up to date, but you can get an idea of what Ed's doing by looking at his stats on the Marathon Maniacs site.
Anyway, I ran OK to about 17 miles. It was clear well before that that I wasn't going to last, but at a big steep hill along the beach, at the last turnaround, I really came apart.
I slowed way down for about a mile. Realizing I was just trudging along, I started walking. Several times I tried to start running again, and it just seemed too hard. Then at about 20 miles, right before the marathon course hooked back up with the half course, I started running again and felt fine. At least fine enough to just jog through it.
I ran for a couple of miles, then came across some Glucomotive folks doing the half, Jim Collins and Ashley Ernst, who was one of the "Heroes of the Marathon", and Ashley's friend. I have to apologize for not remembering her name.
Jim was having cramp problems, so they were all helping each other along, walking and jogging as possible.
With a little over 3 miles to go, we got to the Glucomotive group of volunteers, where my brother Jon was with his girlfriend, Gina.
I asked them if they wanted to walk to the finish with me, and they did.
So I walked it off.
I had about a 20 mile run, and a lot of walking on the day. It was not a good race, but as I said, it was a great day.

In general, my new Animas Ping insulin pump is working great. I swim with it frequently. I just stick it in the side of my suit with the clip sticking out and the pump against my skin.
There are some little annoyances, but the same could be said for Medtronic pump I was using before. I wish I could take the good points from each and put them together. It all seems like common sense to me, the things I don't like, but I'm sure there are some patents that are keeping it from being as good as it could be.
For example, the Animas pump will calculate the bolus for me, then just display it. It's then up to me to enter how much I want to bolus. There's no way to just say, "Give me what you just calculated that I need, you stupid machine."
Then entering an amount to bolus is ridiculous. You can click up or down 0.05 units per button press, or you can hold down the button and it will start to roll by increasing amounts. You know how this goes. It's a similar to the Medtronic pumps. It's actually a pretty common interface, for setting digital clocks, thermostats, etc.
With Medtronic, it's easier to get used to. Animas is fricking crazy. It seems to go 0.05, 0.10, 0.15, 0.50, 1,5, 3.5, 5, 8, ... not moving at all, then moving way way too fast. And the kicker is it doesn't stop when you take your finger off the button, so if you take your finger off at 5, it will probably stop at 6.5. Entering carbs is about the same.
So you either click up one step at a time or go way over then back down too far, then over, then under, getting closer and closer to what you want to enter. It's terrible. And I can't believe they could have failed to see this in usability testing.
Maybe I'll get used to it, but if I do, it will take a while, and I will be getting used to something that's more difficult than it has to be.
Changing the reservoir is harder on the Animas, but inserting an infusion site is easier. The Animas pump times out frequently, rapidly, while changing the reservoir. And when it times out, it goes back to the Home screen, so you have to click back into the Prime/Rewind screen. Crazy and annoying.
The woman who trained me on the Animas said that I'll eventually be able to change the reservoir and an infusion site without it timing out. After changing everything out several times, I doubt it. It would take the kind of skill required of Marines who can disassemble and reassemble an M16 blindfolded in 60 seconds.
The only way I've been able to get close, and still not avoid a time out, is to put in the new site and fill up a new reservoir, having everything ready before rewinding. It's not user friendly. It's unfriendly.
Still, I'm getting comfortable with the new pump, and as I said, it's great for swimming.

The Dexcom CGM is just incredible. I know my A1c is going to be down at my next checkup. I can't help it. Being able to see what is going on with my blood sugar all the time means I am fixing problems I wasn't even aware of before.

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New Year, New Pump

2011-01-01T19:17:00.000-07:00

Hurt

2010-12-21T12:38:00.005-07:00

"I hurt myself today
to see if I still feel"
- Trent Reznor, "Hurt"

Ouch.
Yesterday my legs felt baseball-bat-beaten. They're a little better today.
I ran the Arizona Road Racers Desert Classic 30K on Sunday, which should have been a fun, unique distance. It should be too short to "hit the Wall." But the sad fact is I was in no shape to do this race, and it's been a long time since I've been in shape to do any race.

I have some amazing friends, and some of them also ran this 30K.

The indomitable Melissa Williams was first in her age group, with Lara Pockros just behind her in second and type 1 diabetic Ironman Kevin Burgess following her.

Mel and Lara

I had kept right with them through the first half of the race, on an out and back course along the Arizona Canal. But I was hurting. Both legs were sore, but at the twelve mile marker, I thought to myself, "It's only a little over a 10K to go. Pick it up!"
As soon as I accelerated a little, my left calf started to cramp. It never knotted up, but it threatened me.
And after about 14 miles, I had no more energy to even think about accelerating.
People started passing me from behind. They weren't speeding up, most of them. It was just that I was slowing down.
I had dropped into that death march that should only happen in a marathon you're under-trained for, and this was just a 30K.

OK. Lesson learned. Again.
I have the Carlsbad Marathon on January 23rd, and plenty of time to train for it. I got one good, long run in on Sunday. I put in a lot of miles at marathon pace. I can be ready to race without hurting myself too bad by January 23rd, right?

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That's impressive

2010-12-13T23:25:00.001-07:00

Back on November 20th, I rode El Tour de Tucson, 109 miles around Tucson, Arizona. I had imagined that I might be able to do it in under 8 hours, but it was just my imagination once again.
There were a few hills, and some headwinds that may as well have been hills, but mostly it was just a long, more or less flat ride. I have got to get in way better shape by the time May 7, 2011, and Ironman St. George rolls around.

Another thing that makes El Tour de Tucson slower than it would otherwise be are a couple of stretches of trail, where you have to dismount your bike and walk it for at least a quarter mile on narrow, dusty (muddy in some other years) trails as you cross a river and a creek bed.
But of course, the most significant thing slowing me down is the fact that I haven't been riding that much. Other than the JDRF ride across Death Valley, I hadn't ridden over 25 miles in months.
So El Tour de Tucson ended up being an all day thing, another nine hour ride. I was a lot more comfortable than in Death Valley. The weather was perfect, overcast most of the day.

The following day Ironman Arizona was going on in Tempe, and several Triabetes athletes, like Julie Sekella, Steve Parker, and Jason Uhl, were out doing it. I didn't get down to the course to cheer them on until about five in the afternoon. (I was laying tile getting the house ready for Thanksgiving company.)
I hadn't eaten yet when I got there, and neither had Jenny Crandell and Christian Chiappe who had been cheerleading all day. So I suggested we make a quick trip to FatBurger, as Peter Nerothin had earlier that day.
Shortly after we ordered, Chrissie Wellington herself walked into the restaurant. She got a standing ovation. She would have been appreciated any time, of course, but this was just a couple hours after she had set a new women's Ironman world record.

Christian and Jenny were wearing their Triabetes jackets, and they asked to get their picture taken with her. She was very cheery and accommodating. I took a picture with Jenny's phone. She assures me it's not my fault it's so blurry.

We thanked Chrissie for her patience, and sat down to continue our meal. I started to send a text to my brother Jon about being in FatBurger with Chrissie Wellington. Chrissie walked over and asked Jenny for a recommendation on the fries, steak fries or skinny fries. Jenny said she had chosen the skinny fries.
It took me a moment to realize I should stop texting and actually pay attention to what was happening in real life.
Chrissie then commented on the burgers we had, and I told her I had bacon, egg, and cheese on mine. (Yes, I had the half pound burger with bacon, egg, and cheese on it. Why go to FatBurger if you're not getting a big, fat, burger?)
She said, "Yes, but you haven't finished yours." Well, I hadn't finished mine as quickly as Jenny and Christian because they had ordered more ordinary burgers, not gut-busters, but before I could explain that, Chrissie said, "But you didn't do an Ironman today, did you?"
I just said, "No, I didn't, but I'll finish this."
Then Jenny said, "He did ride his bike 109 miles yesterday, though."
And Chrissie Wellington, a couple of hours after setting a world Ironman record, looked me in the eye and said, with no hint of sarcasm I could detect, "That's impressive."

I should have said something. I should have said, "Thanks." But all I could do was tip my head to the side, furrow my brow and go,"Ohhhhhh." It was like a groan. I was dumbstruck.

.

An Inconvenient Truth

2010-11-17T17:48:00.001-07:00

I went to see my endocrinologist last week, and we looked at some unfortunate patterns in my blood sugars. I explained that my basal rates were almost certainly too low since my activity has decreased so much from where it has been in the past. She agreed, and made some suggestions about adjusting the basals upward incrementally. There might be no need to go through basal testing while fasting if I already know I need to increase the basal rates. Later I could fine tune it if necessary.
So I was listening to this and nodding my head, but meanwhile, inside, I'm thinking, "NO! It's not my basal rate that's wrong! It's my body! I need to get more exercise, not compensate for not exercising!"
So it's been a week, and my basal rates are still too low, as I knew they were before I even went to see the endo, but I'm reluctant to make the change. It's like conceding that I'm lazy.
Maybe a century ride down in Tucson on Saturday will kickstart me out of this funk. Maybe.

Medtronic and "upgrading"

2010-11-10T23:20:00.001-07:00

My insulin pump, a Medtronic Paradigm 522, is out of warranty, so my insurance will cover a new one. Medtronic would like me to upgrade to a Revel, but I don't think I will.
Everyone has their own wants and needs, and Medtronic may be the best brand for a lot of people. I just don't think it's right for me at this time. I've heard their sales pitches and looked at the features online. Even as Medtronic explains it, I don't feel great about choosing Medtronic.

Here are the features Medtronic mentions in a comparison with other pump brands, with my thoughts on them highlighted.

          o Insulin Pump With Built-In CGM
I don't care. I've used the CGM, and I'm unimpressed. I wrote about it here before, saying how I both loved and hated it. From what I've heard, the other CGM option available is much more user-friendly, even though it is not integrated with a pump. The bottom line is that a CGM that is seldom used is not much better than no CGM at all.

          o Always Tracks Active Insulin
This feature matters, but Medtronic is only marginally better than Animas, which loses track of active insulin during a battery change, once every few weeks. Omnipod is stupid in its handling of active insulin, so it's not much to beat them.

          o Simple Bolus Calculation
I don't know why Medtronic considers this a feature of their pump. Medtronic is just like everyone else, except for not having a food database. They are critical of the difficulties in using the food databases in the other pumps, but that ignores the fact that with Medtronic you still need to get the carb count, maybe reading a label or something, and punch it in.

          o Pediatric Friendly Features
Not being a child, I don't care, obviously. And it's annoying to have to say that I don't care, but I do every time I talk to a Medtronic rep.

          o Specialized Type II Features
As a type 1 diabetic, I don't care, obviously. And it's annoying to have to say that I don't care, but I do every time I talk to a Medtronic rep.

          o Easy Task Completion
The interface is not that good that Medtronic should think it's worth bragging about. Where do they find designers and user interface experts?

          o Active Lifestyle
Swimming, sweating, bike riding in the rain. All of these things are facilitated by waterproofing. Medtronic actually calls out "The pump can be detached" as a way you can adapt your pump therapy to your active lifestyle. That's so stupid it's insulting.

          o Convenient Software with Clinical Evidence
CareLink sucks. Really, where do they get human interface experts? It's convenient in the same sense that the forms for filing your income tax return with the IRS are convenient. Thanks tons, Medtronic.

          o Diabetes Support Team
Medtronic does seem to lead on this, but I only use their support a couple of times a year. So I don't rate this as a high priority for me.

          o Partner for Life
All pump companies would like to be my partner for life. It is profitable.
Some companies have dropped out of the pump business. So right now, Medtronic is the oldest company in the insulin pump business. Is PanAm the best airline, or do you prefer to fly TWA?
This is not a selling point for me.

Here are some of the technical features of Medtronic's next generation pump, with my comments highlighted:

New Basal Features in the Paradigm Revel™:
· The smallest basal increment (0.025 U/hr)
· Basal Delivery Pulse based on basal rate volume:
   - Delivers in pulses of 0.025 for basal rates from 0.025 to 1 unit per hour
   - Delivers in pulses of 0.05 for basal rates from 1 unit per hour to 9.95 units per hour
   - Delivers in pulses of 0.10 for basal rates of 10 units per hour or more

I don't care about any of these.

New Bolus Features in the Paradigm Revel™:
· Missed Bolus Reminders
   - Set up to 4 per day by time period (i.e.: 11:00 AM – 12:45 PM for lunch missed bolus reminder)

I don't care. Forget to bolus? Happens about once every five years for me. This feature would just be reminding me to bolus when I didn't bolus because I didn't need to.

· The smallest bolus increment (0.025 units) of any pump
· Widest Carbohydrate Ratios available from 1:1gram to 1:200grams
· Adjustable Bolus Scroll Rate feature allows for the most precise bolus dosing:   - Default setting is 0.1 units
   - When the scroll rate is set to 0.025 units, boluses smaller than 1 unit are calculated to the nearest 0.025 unit
   - When the scroll rate is set to 0.025 or 0.05 units, boluses between 1 to 10 units are calculated to the nearest 0.05 unit
   - All boluses greater than 10 units are calculated to the nearest 0.1 units
· Variable Bolus Delivery Speed (regardless of scroll rate selected)
   - Boluses in the range of 0.025 to 0.975 units are delivered in 0.025 pulses delivered at a very gentle rate of 1 unit in 1 minute 16 seconds.
   - Boluses from 0.975 to 9.975 are delivered in 0.05 unit pulses and delivered at a rate of 1.5 units per minute.
   - Boluses of 10 units and larger are delivered in pulses of 0.10 and are delivered in 5 minutes. Even a 25 unit bolus is delivered in 5 minutes.

I don't care about any of these.

· Active Insulin is displayed on the "Estimate Detail," "Status" and the "Bolus + Delivery" screens
   - Active insulin will be displayed even if the Bolus Wizard is not used

Neat. However, it's not a big deal to have it finally work the way it always should have. And like a lot of these improvements, this seems like a software/firmware upgrade which must have been fairly easy to do.

· High and Low glucose alerts will sound on the Revel™ from a RF meter reading

I don't care. If I check my blood sugar with the meter, I know if I'm high or low from the meter.

· Capture Option
   - Allows users to electronically save certain types of information, including BG measurements, amount of insulin used, carbohydrates eaten, exercise and other information that is useful in diabetes management with the CareLink

Nice. However, this saves only a little bit of information. You can fill in more later in CareLink. This is getting better, but still feels like 20th century, rather 21st century technology.

New CGM Features in the Paradigm Revel™:

So far, I have found the CGM almost unusable. All of my comments should be seen in this light. A feature might sound good on its own, but the drawbacks of the whole system probably render it irrelevant to me.

· Predictive Alerts
   - Can alert user of a hypo or hyper event 5-30 minutes prior to threshold being hit
   - An internal study published this year showed that when Predictive Alerts are used, the hypo detection rate increased by 36% compared to using a low glucose alert alone

Nice.

· Rate of Change Alerts
   - Alerts patients to rapid changes in glucose regardless of where the Sensor Glucose is. Rate of change alerts can be set for fall or rise rates from 1.1 mg/dl/min to 5.0 mg/dl/min

Imagine, my blood sugar is 40 but rising quickly, so I get a rate of change alarm. My blood sugar is 350 but falling rapidly, so I get a rate of change alarm. I should not get these alarms.
The only reason I can imagine to provide these alerts in addition to predictive alerts is if the sensor may be totally inaccurate.

· Customizable alert thresholds
   - Up to 8 different time buckets can be programmed with individualized high and low thresholds

Nice.

· Historical Sensor Glucose Graphs are displayed for the previous 3, 6, 12 and 24 hours
· Glucose Sensor graph timeouts can be set to 2, 4, 6 minutes or none. If NONE is selected the graph will not time out unless and alert/alarm occurs· Area-Under-the-Curve ( AUC ) metric   - New measure of glucose exposure under and over preset glucose threshold

These features are nice, but not a big deal.

· CGM demo option for training purposes

This is totally irrelevant to anyone but a Medtronic sales rep.

· All alerts can be silenced for a set period of time up to 24 hours

I hope they didn't spend any time working on this feature that they could have used doing something useful.

Other important information:

· USB included with all pump purchases not just CGM orders

Neat. However, it's not a big deal to have it finally work the way it always should have.

· Alert Directed Navigation
   - When an alert goes off the Revel™ goes directly to the screen to resolve alert, dramatically minimizing button pushing

Neat. However, it's not a big deal to have it finally work the way it always should have.

· Simplified menus and language used (Manual Prime changed to Fill Tubing)

Wow! I mean, wow they really think this is worth mentioning? It only calls attention to the fact that they didn't do it right the first time.

· Auto Calibration has been improved
   - Sensor patients can use RF feature to beam readings directly to the Revel™, but they will be asked if they want to use BG reading for calibration

Neat. However, it's not a big deal to have it finally work the way it always should have. Seems like a software/firmware upgrade that should have been done a long time ago.

· CareLink Professional and Personal have been updated and will be available later in March
   - Guardian REAL-Time will be on the new version of CL Pro

First, it's been my experience that CareLink sucks. Second, I am personally insulted that there's a version of CareLink that provides additional features for health care professionals, but it's not for lowly diabetic patients.

Once again, I remind everyone that these are just my opinions. I haven't used a Revel or the latest Medtronic CGM sensors.
You may need features I don't care about. You may like things I dislike.
I'm just sharing my thoughts on the decision I'm making.

My current pump.

What an insulin pump looked like a dozen years ago.

A 21st century pump.

D-blog Day: 6 things

2010-11-09T21:42:00.003-07:00

As noted before, November is National Diabetes Month, and November 14 is World Diabetes Day. Today is D-blog Day, started on November 9th 2005 during Diabetes Awareness Month to help unite diabetes bloggers and create awareness about diabetes.

This year’s topic is: 6 things you want people to know about diabetes.
Here are the first six things that came to mind for me:

1. Diabetes is not one disease. Some times people like to say there are two types, "type 1" and "type 2," but those names are inadequate and don't fit a lot of people with diabetes. Doctors fell back to numbered types because they kept picking bad names for the diseases, as in "juvenile onset diabetes" for a disease that could strike at any age, "insulin-dependent diabetes" when dependence on insulin could come about in many totally different ways.
Type 1 and type 2 are still lousy names and there aren't enough of them. There are many different causes and symptoms of different people with both "type 1" and "type 2" diabetes.
The generic nature of these names, type 1 and type 2, expresses a continuing lack of understanding of the diseases.
It's hard to blame the public for not knowing the difference between type 1 and type 2. They sound the same.
Names like insulin-resistant diabetes or autoimmune diabetes, monogenic diabetes, MODY, LADA, would all be good for the public to learn.

2. I would like people to know that the idea that unnecessary medical tests are a huge financial burden on our health care system is a myth. Medical tests are how doctors figure out what you've got.
Did you see the short list of kinds of diabetes above? Do you know that there are more? Do you know that not only does most of the public treat them all the same, but so do many in the medical community?
Do you know that many people who think they have autoimmune diabetes may in fact have monogenic diabetes? Those with autoimmune diabetes require injected insulin, but some with monogenic diabetes could be treated with oral medications, if their doctors knew.
Diagnosis makes a difference.
There is a part of our health care system that takes 30% off the top and provides no health benefit. It is not medical testing. It's the insurance industry.

3. I would like people to know that diabetics suffer disproportionately in the broken health care system of the U.S.
I'm grateful that we have finally done something about affordable health care after all these decades of people struggling, suffering, and dying because of the system we have had in place. I wish more had been possible, but not much can be done politically when billions of dollars are at stake.

4. I would like people to know that my insulin pump does not take care of my diabetes for me. Being diabetic requires a lot of attention, 24/7.

5. I would like people to know that insulin is not a cure, and we really want a cure.

6. I would like people to know that while it's no fun to be diabetic, it's something we can deal with because we have to. It has to be dealt with, but it doesn't have to limit us.

.

The Cure

2010-11-08T21:00:00.002-07:00

The Cure

For years they prayed for the day,
the day they could stop
bleeding him for blood sugars.
staring at his food,
counting the carbohydrates,
insulin on board...

They wished they could forget it all,
all of the knowledge and lore,
the glycemic index,
site sensitivity,
medical adhesives,
long-term complications...

... as if it weren't all complicated.

They wanted to stop worrying
about the impact of joyful play
on blood sugar balance.

So they wished for the day,
the day they could get rid of it all...
boxes of test strips,
the sharp things, needles, lancets, syringes,
the technological marvels...
meters, pumps, sensors,
the tools of replacing beta cells
and mimicking
the way the body is supposed to work,
the insulin
would all finally be stacked up in a big pile,
packed up to be sent away.

They wished and prayed the day would come,
But diabetes left in the night,
And with it took their son.

When I first posted this on Tu Diabetes in the Poetry Club, I apologized and wrote, "Why did I write this? I don't know. Maybe I shouldn't have. But here it is."
I'm sorry to be so negative sometimes. I hope that this blog is positive often enough to make up for it. It's sad that when I try to be profound, I'm often profoundly depressing instead of profoundly uplifting or inspiring.
The whole picture is bound to have some dark as well as light, though, when you're trying to show what it's like to live with type 1 diabetes.
So what made me write this?
I've certainly heard of a lot of diabetic children dying, and it's hard not to try to imagine how that must be for parents. And I heard a little bit of what it's like. And right after that, I read about someone else imagining what it would be like to finally have a cure.
The two ideas swam around in my head for a while, then collided. And the above poem is the wreck.

Here's another poem, a Haiku.

The Diagnosis

Your food is poison
But there is an antidote
It is poison too

For more positive feelings, watch this video, and help provide insulin to kids in need:
The BiG Blue Test.
November is National Diabetes Month, and November 14 is World Diabetes Day.

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Yea, though I ride through the valley of death...

2010-11-05T12:05:00.003-07:00

Once again I'm blogging well after the event I'm blogging about. If you've been reading this blog, you've probably come to expect that.
If this is your first time here, you probably haven't been waiting for this, so it's all right with you, too.

On October 16th I rode my bicycle across Death Valley with about 350 others, all of us having made the commitment to work toward a cure for type 1 diabetes. In addition to the riders there were dozens of volunteers working at the aid stations, in the SAG (Support And Gear) vehicles, and at the start/finish. Behind every rider there were the many people who made donations that are the real, rather than simply symbolic, investment in a cure.

I want to thank everyone who contributed to my efforts to raise $3000 to cure type 1 diabetes.

However, I'm writing about the symbolic journey across the Valley of Death.
My blood sugar was 152 before breakfast at 5:30, and I didn't bolus as much as I would have if I wasn't about to go for a long ride. Knowing my blood sugar was a little high I didn't check again before the start.
I started riding with friends I had made in the Western Wisconsin Chapter of the JDRF. I was the only rider from the Desert Southwest Chapter. (something we should fix)

Riders lined up behind me

Riders lined up ahead of me

Since I had, in my registration for the ride, said that I was riding to honor the memory of Jesse Alswager, and I wanted to share a room, I bunked with Jeff Steuer, a Western Wisconsin rider who who has a 17 year old daughter with type 1 diabetes.

Jeff and me

Jeanne, one of the fantastic coaches

So when I started out, I was riding with Jeff, his sister, Nancy and brother-in-law Keith, and other cheeseheads. I was glad to be welcomed to their group, but I couldn't stay with them.
I almost never do group rides, so I'm not used to sticking to a pace line. When I was in a line, I would either be working harder than I wanted to keep up, or feeling like I was blocked by the rider in front of me and had to coast or even brake. They would go up the hills faster than I was comfortable with, then coast down the other side. Except for Jubilee Pass at the turnaround point, the road was all rolling hills, or at least seemed that way to me.
We had been told that the best plan for success was to get as far as we could while the valley was in shade, before the sun came up over the eastern mountains. We had to do that without, of course, going so hard we ended up worn out before we got to the big climb at Jubilee Pass.
I couldn't see the benefit in coasting downhill, especially in the early going. So I would go to the back of our little pack on the uphills, then keep pedaling and pass everyone on the downhills. Finally, the ups outweighed the downs, and I fell behind and couldn't catch up. But I was going my own, inconsistent pace, riding alone the way I am used to.
I caught up again at Badwater, the first rest stop and the turnaround point for those doing the 32 mile option, but they were well on their way by the time I checked my blood sugar, (126) ate some food, took a couple of pictures, waited in line, and used the restroom.

Badwater. I'll be back.

This stop verified that so far, my hydration and food plan was working well. I hit the road.
That first 16 miles had taken about an hour.

A couple of Western Wisconsin riders in Godspeed Jesse jerseys.

At the pre-ride dinner the night before, it had been announced that we would have a special feature added during this ride, which may become part of all JDRF rides from now on. One mile of the ride would be declared a "mile of silence" to honor those we have lost to diabetes. It could have been any mile, but it was declared mile 23. February 3rd, 2/3, was the day that Jesse Alswager died.
I rode in silence most of the day, but out there between Badwater and the second rest stop, Mormon Point, I rode a mile in silence to honor Jesse, and all others who have died fighting type 1 diabetes.
This stretch was more of the same rolling hills, or actually gaining and losing elevation as the road followed the curves of the mountains on the eastern edge of Death Valley.
We were mostly in the shade of the valley until about 8:30, when the sun came out and the temperature began to climb.
At Mormon Point, 31 miles, my blood sugar was 135, so I was pretty happy with how I was doing. I ate some more from the well-stocked tables, another half banana, another quarter pbj, refilled my three water bottles, and was off again.

The rolling continued for a while, then there was a long, rather steep hill before I reached the next stop, Ashford Mills, at 46 miles. Although the distance between Mormon Point and Ashford Mills was shorter than the distances between the previous two rest stops, with the climb in the heat, it was much harder, and of course, the next segment of the ride, from there to Jubilee Pass was supposed to be 6 miles that would take at least an hour.
My blood sugar at Ashford Mills was 104. There was not a lot of room there. I would have liked it to be higher. I didn't want to panic, though. It wasn't as if I had a real low blood sugar, and it wasn't as if I was really dropping rapidly. It was about 10:15, so I had dropped about 30 points in an hour.
I tried to eat more than I had at the previous stop before setting out on the six mile climb up to Jubilee Pass, about 1300 feet of elevation increase.
It had gotten seriously hot, and I say that as someone who has lived for almost a decade in the Phoenix area. People with thermometers on their bikes were seeing temperatures like 113. Someone said 118.
So I cranked away as best I could, climbing and climbing, trying to keep drinking the warm water I had in my bottles, water that had been ice cold minutes before, feeling more and more exhausted, but knowing I was getting closer to the top.
When I got to the Jubilee Pass aid station, I discovered it is actually a few yards away from the actual summit. For about two seconds I considered riding up to the summit before coming back to stop at the aid station... then I wised up and stopped. I got into the scant shade as quickly as I could, and checked my blood sugar again.
86. Hmm, a little sugar would have made that climb easier.
Bob Panisch, one of the coaches and a CDE came over and asked me how I was doing and what my blood sugar was. I told him and let him know what was going on. He made some good suggestions, but I told him I was going to do this my way.
I could see that he had good reason to be concerned about me. My bike shorts and my jersey were crusty with salt. Many riders were dropping out. I had a borderline low blood sugar.
But I assured him that I had done a lot of hard things before, and I wouldn't be stupid.

More Godspeed Jesse jerseys, with 2/3 on the sleeve.

I pigged out, refilled everything, and rode to the summit for a picture.

The kind of picture you take when you won't stand in line.

Then I started back. On the way down, one of the coaches asked how I was doing, and I said that I was glad the hard part was over.
He said, "That was tough, but the hard part is getting all the way back."
And he was right. After one large, wonderful cloud blocked the sun for maybe half an hour, the heat did not let up. I felt at times like I could feel waves of heat coming off the pavement. It was like being roasted.
Back at Ashford Mills, my blood sugar was back at 140.
When I reached Mormon Point, it was 144. All was well in that regard.
Then at Badwater it was 198. I was probably getting dehydrated. Looking back, my pace had greatly decreased in that section of the ride. But my reaction was to just not fuel up so much. I probably could have cooled off in the shade a little longer and drank more before going on.
Anyway, an additional rest stop had been set up for us, because of the conditions, about 10 miles from the finish. When I got there, about an hour after I had stopped in Badwater, my blood sugar was still 188.
Figuring that I "only" had ten miles to go, and I would be done soon, I thought it would be a good idea to give myself a small correction bolus, less than I would give if I wasn't riding.
And I didn't eat anything.
Well, those miles dragged on. It was hot. The hills were steep. My body was sore all over. Sure my muscles were sore from working, but my back was sore from being hunched over, my neck was sore from looking up from my hunched over position, my butt and my crotch were sore from hours in the saddle, my feet were sore from pushing down on them all day.
And I was feeling like my blood sugar was low.
So with less than a mile to go, with one last, short, 100 yard climb left before a long downhill into Furnace Creek Ranch, I just stopped. I considered testing my blood sugar, but instead just pulled out a Clif bar and started trying to eat it. That was a poor choice. I only ate the bar because I had been carrying it all day. Before that, I ate gels while I was riding, and replaced them with new ones from the rest stops. I felt silly about everything that I carried the whole way without using it, like my cell phone.
It turns out a Clif bar is really hard to chew and swallow when you're dehydrated.
So I was probably standing by the side of the road for a long time before I started up again. About eight other riders passed me, and of course all asked if I was OK.
I cranked up that last hill, turned the corner, and rolled the remaining half mile in.
At the medical tent (Everyone checks in at the medical tent after finishing. It's a rule at this ride.) my blood sugar was 98. It certainly must have been lower before I stopped to eat the Clif bar.
So it wasn't perfect blood sugar management for the day, two minor lows, enough to affect my energy level, but it was a magnificent experience.

105 miles ridden. 9 and a half hours. 1 mile of silence. $3000. A shot at ending type 1 diabetes.

Keith, Nancy, Jeanne, and Jeff post-ride.

Some pictures of Death Valley from Dante's View.

Furnace Creek is toward the upper right.

Badwater is down the mountain from here.

Penny smelling my sweat-salt crusted jersey after I got home.

We're Not Stuck

2010-10-02T23:14:00.000-07:00

I attended a JDRF Research and Technology Update today. I'm not sure what I expected, but I was curious. I didn't expect to get fired up about the prospect of a cure.
I know, I'm asking all my friends and family to donate to the JDRF, which was founded and is dedicated to the search for a cure for type 1 diabetes. But I wasn't going to get my hopes up that it would happen soon. And I still don't believe a cure is right around the corner.
But one of the local JDRF Outreach Managers, Elizabeth Romero, speaking at the seminar, said something very simple that really hit home for me.
She noted that many of us who have had type 1 diabetes for a long time have become somewhat jaded. We heard when we were diagnosed that a cure was only a few years away, and we've heard that over and over ever since. It's been 36 years for me. That's how long I've been hearing and reading about cures around the corner.
Elizabeth said she understands that. And she said, "But we're not stuck."
She went on to point out many of the things that have come about partly because of the presence of the JDRF, since it was founded 40 years ago.
The essential thing is that there has been a lot of progress. We know more about diabetes now than we have ever known before, and next year we will know more. And the rate of progress is accelerating.
We're not stuck.
We don't have a cure yet, but we're not stuck.
So that's the good part.

The other part of this story is where it seems like we aren't making progress.
There was a pediatric endocrinologist on the panel of speakers, the only doctor in the group. He referred to multiple daily injections as "conventional" treatment, even though he said that it is better to have a pump. How long will it be before a pump is "conventional?" Why isn't it now, when studies show that people manage their blood sugars better on pumps?
Some parents of diabetic children expressed some frustration that they were having to wait for insurance coverage, and the doctor seemed to feel the delaying tactics were a good thing, that for some reason people should learn to deal with injected insulin before they were allowed to use a pump. He said that it was a "red flag" to him when someone newly diagnosed wanted an insulin pump.
To me, requiring people to get used to injections before teaching them to use a pump is like making them learn to drive a stick shift before they can use an automatic transmission, or maybe more like making them prove they can steer with their knees for a few months before you let them put their hands on the wheel.
I just don't get that.

All in all, I'm glad I went. I got another back-up meter, that may become my main meter, I like it so much, I met some great people, and I got a little bit fired up about the search for a cure.

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Glucomotive 2010 Ragnar Great River Relay

2010-10-01T18:04:00.001-07:00

Yes, this relay was run in August, the 20th and 21st. Yes, it is October. That's how slow I am.

Andrew, the driver for van 1, the van I was in, had just injured his ankle on a bike ride. It was so swollen and ugly that we wondered if he could reliably work the accelerator and brakes as he drove us up the Mississippi.

Andrew's ankle later that day, as we waited for van 2 to come into the second van exchange. In the small version of this picture, it looks OK because the swelling has gone down, but if you zoom in, you can see the tiger-striping from the bruise being wrapped with an Ace bandage. But Andrew did fine driving. He kept us guessing about whether he was about to run into things, but he must have known what he was doing.
You get a good look at some of our Costco supplies in this picture, too.

Dave and Daniel relaxing at the first van exchange, I think, before Saci (below) hands off to Pratt from van 2.

Saci in Triabetes gear smiling through his first leg, which was rated "Very Hard."

Daniel, Saci, Jennifer, and Igor after a dip in the Mississippi at the second van exchange.

Daniel by our van in the early morning of the second day, at the fourth van exchange.

The runners from both vans get a rare chance to spend some time together at the fifth van exchange, waiting for Saci to come in. This is counter-clockwise from Daniel, shirtless, Gary in the "Diabetes. Run with it." shirt, Emily in her "Running on Insulin" shirt, Dave, Jennifer, Andrew, and Corinne.

Pratt hauling up a monstrous hill on his last leg.

Dave, Daniel, Igor, Anne, Saci, and Jennifer at the finish, ready for our anchor runner, Corinne, to come in.

Corinne tearing down the pavement toward the finish.

Post-race joy.

Gary, Emily, Mike, Corinne, Pratt, Anne, Igor, Jennifer, Saci, Dave, me, and Daniel.
Not pictured, the awesome drivers, Andrew and John.
Here's a great video Peter put together from stuff we shot during the race.

(Teammates, I left out last names because I wasn't sure if anyone would mind. Am I being silly?)

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House on Fire

2010-09-23T23:10:00.001-07:00

A certain diabetic marathon runner said some controversial things recently. I would like to be a fan of this guy, but he makes it difficult.
Mike Huckabee, former Governor of Arkansas and candidate for President, compared the provisions in the Affordable Health Care Act which prohibit insurance companies from denying coverage for pre-existing medical conditions to enabling people to purchase home owners' insurance for a house that has already burned down.
As someone with a house on fire, you might have expected Mr. Huckabee to be more sympathetic to people with pre-existing conditions.
I think it's likely Mike Huckabee's viewpoint is influenced by his type 2 diabetes. He was over 300 pounds and a self-confessed foodaholic. He turned his own health around, corrected his diet and started exercising, lost over 100 pounds, and became a marathon runner.
He may have a tendency to feel that sick people are responsible for their own illnesses.
My position is probably influenced by my experience. I was diagnosed with type 1 diabetes at the age of 15. No one is completely certain about the cause, but it certainly wasn't anything I knowingly did.
And I can't just eat right and exercise and have the symptoms go away.
But Huckabee has a point. Insuring that sick people will not continue to be sick is not a profitable proposition.
That seems simple enough.
It was called the Affordable Health Care Act, not the Profitable Health Insurance Act, because we need affordable health care. There is no great public outcry for a more profitable health insurance industry. Health insurance is, after all, extremely profitable.
Huckabee was right about this law being tough on insurance companies. It's another reason we need to get insurance companies out of our health care.
I don't think it's fair to make insurance companies insure houses that have already burned down, but when my house is on fire (As a type 1 diabetic, my house is definitely on fire.) I want to be able to dial 911 and get a fire truck.

Huckabee was speaking at the Values Voter Summit. It's clear that human health and life are not among those values.

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Support the JDRF

2010-09-21T07:12:00.000-07:00

If we know each other, you probably already got this in email, but I'm posting it here just in case.

Hello,
Please bear with me for a minute. After writing this, I thought for a moment I might be getting over-dramatic.
But how can you be over-dramatic when kids are dying?

This October I'll be taking part in the Juvenile Diabetes Research Foundation's Ride to Cure Diabetes in Death Valley along with riders from across the country as we try to help the JDRF reach it's goal of curing type 1 diabetes.

I was diagnosed with type 1 diabetes at the age of 15, 37 years ago. Although I personally would like to see a cure for myself, that's not really why I'm riding for the JDRF.
I've been living with diabetes for a long time. I know I can survive, even be healthy, in spite of it. I'm used to it. But this disease is hard on kids.

In February of this year, a personal hero of mine, Jesse Alswager passed away at the age of thirteen, after 10 years of fighting type 1 diabetes.
When I say fighting, I don't just mean like all of us type 1 diabetics fight, with finger stick blood tests, injections or infusion sets, machines and medicines, counting grams of carbohydrate, thinking through the metabolic effects of every meal, every bit of physical activity, everything....
What I mean is that Jesse was fighting as if he was in a war.
When Jesse was diagnosed at the age of three, his mother, Michelle Alswager, declared war on the disease, and she took her son into battle.
Jesse raised thousands of dollars for the cure, a cure he will never enjoy. Michelle, as a member of the board of directors for several diabetes foundations and an executive at the Juvenile Diabetes Research Foundation, was involved in raising millions.
Jesse met governors, Congress members, First Lady Laura Bush. Politicians loved to be photographed with him and talk about him.
I never met Jesse. I wish I had the chance to thank him. He did a lot for me, and all people with type 1 diabetes.

One of the things that Michelle Alswager did to fight diabetes was to come up with the idea of a type 1 diabetic triathlon team, and a documentary about how they could train for and complete an Ironman.
That was how Triabetes began.
Triabetes has had a profound effect on my life, and I know that it has touched many more diabetics out there.
When I first heard that Jesse had died, it knocked the wind out of me. It was more than a little discouraging personally, to learn that the inspiration for Triabetes had died.
The inspiration had died.
Yeah, that's how I felt.
And it was heart-breaking to think that Michelle Alswager, who had worked to spread hope to people like her son, people like me, suffering from type 1 diabetes, had lost her son.
For several hours this was a hope-crushing thought for me.
But now I've decided that it's part of a war. I've been around for the war, but mostly on the sidelines. I have not yet begun to fight.
I have to take to the battlefield now.

I'm riding across Death Valley in honor of Jesse Alswager, and to help the children who now have this disease or will have it in the future.

Also riding will be Michelle Alswager, in memory of her son, and Bob and Jen Nicholson, who lost their 14 year old son Trent to type 1 diabetes in March of this year.

Please go to this page to donate to the Juvenile Diabetes Research Foundation:
http://ride.jdrf.org/index.cfm?fuseaction=rideCentral.personalpage&riderID=9801

Thank you,
Jerry

PS:
See this video to learn more about Jesse:
http://www.youtube.com/watch?v=L8yNxqWoasg
Or here:
http://www.youtube.com/watch?v=QPDS2V1AF9w
Learn more about Michelle Alswager here:
http://www.dlife.com/dlifeTv/v587287464001-michelle-alswager.html
And more about Triabetes here:
http://www.dlife.com/dlifeTv/v14985633001-Triabetes.html

Memorials to Jesse:
http://www.caringbridge.org/visit/jessealswager

Memorials to Trent:
http://www.tributes.com/show/Trent-Nicholson-88196543

PPS:
Many employers do charity matching gifts. If you decide to give to the JDRF, please find out if your company will match your gift, and make your contribution count twice as much.

If you want to make a contribution in honor of or in memory of someone, whether they have diabetes or for any other reason, please state that in the "Message for Rider" box in the online contribution form. I will put that person's name on my bib number to wear while I ride across Death Valley. Thank you for the opportunity.

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Diabetes Meme

2010-09-13T20:45:00.000-07:00

This is a link in a chain of blogs started by Kerri Sparling of Six Until Me.

What type of diabetes do you have:
I have the bad kind. No, seriously I've got type 1 diabetes.
This question can rightly be seen as either vitally important or totally irrelevant.
Type 1 and type 2 diabetes are both terrible diseases that have some things in common but are also extremely different from each other.
When we lump them together it's a little like lumping together muscular dystrophy and multiple sclerosis.

When were you diagnosed:
I don't know the exact date, but it was in the fall of 1974.

What's your current blood sugar:
119.

What kind of meter do you use:
OneTouch UltraMini.

How many times a day do you test your blood sugar:
Usually 8 to 10 times, but depending on things that might be going on, like some kind of problem with an infusion site or some athletic activity, it could be over 15 times.

What's a "high" number for you:
It depends on context, insulin on board, if I'm about to do something like go for a run...
I will do a correction bolus for 130 if I haven't had a bolus recently, but shortly after a meal and a bolus, I will only think about whether or not to correct if I'm over 190.
Sometimes I go by both the number on the meter and by "feel."

What's do you consider "low":
This also depends on context, but I don't like to be under 90 ever. I wouldn't call it a "low blood sugar" or "hypoglycemia" unless I was under 75, but I would eat something.

What's your favorite low blood sugar reaction treater:
I love having an excuse to slurp down a juice box, but I always carry glucose tablets because they're so convenient, 40 grams of carbohydrate in a tube of ten tablets.

Describe your dream endo:
She would look like Halle Berry and be able to cure type 1 diabetes. Maybe it is Halle Berry.
I want my endo to listen to me and respect my opinions, and to stay up on the treatments even more than I do. Someone who understands my life would be good. A type 1 diabetic marathon running endocrinologist would be good.

What's your biggest diabetes achievement:
I'm not even sure what a "diabetes achievement" is. If there is an achievement, is it a diabetic achievement just because I have diabetes?
I got on the cover of Diabetes Forecast once.
I once ran 10 marathon or longer races in one year. I know faster type 1 diabetics. I know at least one type 1 diabetic who has run more marathons than I have. But I'm not sure whether there is another type 1 diabetic who has run 10 marathons and ultra marathons in a year. (8 marathons, 2 50Ks.)

What's your biggest diabetes-related fear:
Not waking up tomorrow morning.

Who's on your support team:
InsulInDependence, Triabetes, Glucomotive, DESA, Team Diabetes and Coach Dave, the DOC, Sue, my kids, my brothers, my parents, Penny, Rusty, East Valley Runners, Sole Sports Running, any friends not already mentioned...
Oh yeah, and my endo.

Do you think there will be a cure in your lifetime:
No, I don't think so. As many others have said, I've been told that a cure is only a few years away ever since I was diagnosed, in my case, 36 years ago.
I'm planning to get a Medic Alert tattoo, something I won't need if I'm ever cured.
But that's just what I think, and it's not an excuse for not working for the cure.

What is a "cure" to you:
A cure means not requiring any medicine or devices to keep my blood sugar in a normal range. It means being like I was before I had diabetes.
Oh, and this.

The most annoying thing people say to you about your diabetes is:
I'm not easily annoyed. It doesn't happen often, but the most annoying thing is when someone who doesn't know what it's like starts to talk about how easy the disease is to manage with all of the technology, like pumps and meters.
Oh, yeah. The most annoying thing is when insurance companies want to tell you that some technology that's been available for over a dozen years is "experimental," or that you want too many test strips, or insulin, or that you can't have this because your blood sugar management isn't good enough, or that because your blood sugar management isn't bad enough.
Basically, anything an insurance company says about your health care, any excuse for a short-sighted, unhealthy decision, is the most annoying thing people say.
And anything that Dr. Oz says.

What is the most common misconception about diabetes:
It's hard to pick one, but it's probably still the idea that there is only one kind of diabetes, that it's all pretty much the same thing.

If you could say one thing to your pancreas, what would it be:
I don't blame my pancreas. I blame my immune system. The pancreas is the victim in all this. I would ask my pancreas to keep fighting, but I would tell my immune system to wise up.

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Coach Milam

2010-09-10T17:02:00.001-07:00

I was just informed that Coach Rick Milam, who was my high school cross country coach, recently passed away due to a series of events. He had been fighting cancer for 8 months, and it had greatly weakened him. While driving, he apparently had a heart attack and subsequently an accident. He had another heart attack in the hospital and passed away.
I hadn't seen Coach Milam since a race in the '80s where he was race director. Although he was very busy that day, I was able to get over to see him before the race. He shook my hand and seemed to be glad to see me and curious about what I had been up to.
After coaching successfully at the high school level, Rick Milam went on to work in the field of Sports Psychology. He worked with many college and professional teams.
He was a fixture in Bay Area Track and Field, organizing meets and races, and working as an official at everything he could fit into his schedule.
He was a great coach. He worked us hard, but no one disliked him. We had fun running for him.
Coach Milam will always be connected in my mind to the onset of my type 1 diabetes. It was during my second year on the cross country team that I started to show serious symptoms. I'm sure the coach was wondering what was going on with me as I slowed down and seemed to get in worse shape rather than better as training continued.
I will always be thankful to Coach Milam that he never hesitated to encourage me to get back on the team and continue to run when I got out of a week in the hospital. Who knows how I could have turned out if he had a different, more cautious attitude.

A memorial service for Coach Rick Milam will be held in the Los Gatos gym on Sunday, Sept. 19 from 2-4 p.m.

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How Tough is Ironman St. George?

2010-09-02T23:00:00.001-07:00

Holy crap!
That's the phrase that leapt to mind when I saw this analysis from RunTri.com of the easiest/hardest Ironman courses, based on average completion times:
Easiest/Hardest Ironman Course

Overall, St. George has the longest average finish time:
Finish Times

St. George is ahead by a wide margin, half an hour longer than the next longest time, over two hours longer than the fastest ones.
I can take some small degree of solace in the fact that St. George has only one year of results, so this may be an anomaly.

Swim, St. George is tied for 3rd slowest:
Swim Times

There is about 20 minutes between the slowest and fastest.
You would think that water is water and there couldn't be that much difference. The guy doing this analysis says that things like the crowding/tightness of the course, chop/roughness of the water, and currents matter. Temperature matters to me.
The St. George course is tight at the start, and the water is cold. The water didn't look choppy to me the first and only time the race was held, but according to some reports it gets windy sometimes and it could be worse in 2011.

Bike, St. George is tied for slowest:
Bike Times

There is about an hour and twenty minutes differential here between the slowest and fastest courses. The three slowest are almost the same, and about 20 minutes slower than the next course on the list.

Run, St. George is 6th slowest out of the 25 races analyzed:
Marathon Times

Having seen the run course, this is surprising. That's a tough marathon. I would have guessed it was in the toughest 20%.

St. George isn't just a tough course, it is the toughest.
So what does that mean for me?
I can't just train to be an Ironman. I have to train to be one tough Ironman. I can't train with the thought that I just need to be good enough to make it through this. I have to train to be a serious triathlete. To do all right at St. George, I have to be ready to excel on any other course.
Good enough isn't good enough.
I'm pretty scared.
Holy crap.

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Happy Birthday, Peter

2010-09-01T13:24:00.002-07:00

Years ago, I didn't know anyone else who was trying to stay athletic in spite of having type 1 diabetes. I met a few other type 1 diabetics, and I heard about athletes with type 1 diabetes, but I had no real connection with anyone like me.
Eventually, I became acquainted with other diabetic athletes via the internet. First I sought out the email addresses of people like Bill King. Then I joined DESA and other groups. That's how I made a connection with InsulInDependence and became a charter member.
For about a year I exchanged email with Peter before we finally met for lunch the day before the Rock 'N' Roll Arizona Marathon in 2008.
That's when I entered the third stage of my life as a diabetic athlete. That's when I became a part of a real community of diabetic athletes.
I was 48 years old, sitting across the table from this kid, from the same generation as my children, and thinking about the life he had already led, from hitch-hiking across Europe, to visiting Base Camp on Everest, to multiple Ironman finishes. I was amazed.
And I didn't know Peter well enough to be appropriately impressed.
I have met a lot of amazing and special people through Peter and InsulInDependence, but Peter is the most amazing for this reason.
He shows others, each of us, how special we all are. It seems to be his mission.
We are all better for having met him.

Happy birthday, Peter!

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You Like Me, You Really Like Me

2010-08-17T22:37:00.000-07:00

Wow. I made somebody's list of Top 50 Blogs About Diabetes over at The Health Crazies.

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Symptoms of Hypoglycemia

2010-08-13T23:30:00.008-07:00

What are the symptoms of hypoglycemia?
This is what the American Diabetes Association says:

Symptoms of hypoglycemia include the following:

    * Shakiness
    * Dizziness
    * Sweating
    * Hunger
    * Headache
    * Pale skin color
    * Sudden moodiness or behavior changes, such as crying for no apparent reason
    * Clumsy or jerky movements
    * Seizure
    * Difficulty paying attention, or confusion
    * Tingling sensations around the mouth

These are good guidelines, but I've been thinking about what hypoglycemia means to me. Here are some more personal experiences of the "symptoms of hypoglycemia."

Being quite certain, as you watch "Angels in the Outfield" on television with your wife and kids, that the angels in the movie are speaking directly to you, and the whole movie was created to send you personally a message that you must change your ways, touching you so deeply that you begin crying uncontrollably so that at first you seem funny but gradually more and more worrisome to your wife and perplexing to your children.

Noticing on the way to work that you can't remember driving the last few miles and realizing it's more than just an ordinary commute driver's trance because you're starting to feel those waves of the universe going in and out of focus, and knowing you need to get off the freeway and stop but taking an exit that turns out to be a truck weigh station that you cruise through way too fast on your way to a real exit where you pull onto the shoulder and fumble some glucose tablets out of your pocket and into your mouth.

Knowing, without a doubt, as you watch a Twilight Zone marathon, that you are being abducted to a duplicate dimension while someone else takes your place in the real world, while simultaneously knowing that you are just experiencing a hypoglycemic event, but also knowing that your low is part of the alternate universe you are being trapped in.

Feeling exhilarated and light-footed running down the beach with two of your brothers, suddenly noticing twinges beginning in your hamstrings, and knowing what it is, but thinking maybe you can just make it back to the car, until the hamstrings just fold up under you, your legs unable to bear any weight, and your abs beginning to convulse, folding you, clenching and unclenching your entire body, your neck, your jaws, seemingly the whole world, tight, loose, tight, loose, whim, wham, and you're laughing, terrified, but laughing uncontrollably as you jerk uncontrollably, because it's so damn funny, to be carried, in seizures, off the beach, by your brothers, who are simply terrified, unable to see how funny it is.

Coming to groggy consciousness staring straight up into a bright, white light in a white panelled ceiling in a hospital hallway with your back flat on a gurney, arms and legs strapped firmly to the rails, head aching, muscles sore, remembering only reeling, swirling glimpses of how you got here, somehow, from sleeping in your own bed, learning only later that you fought for several minutes with three EMTs you can't even remember seeing while they were trying to save your life.

Then there is that other symptom of hypoglycemia, going to bed and not getting up, ever again, like a nurse in Tucson a few years ago, or a teenager recently in Southern California, or others I've heard about over the years. It happens. Insulin is a killer.
That's one major reason that, even though I am surviving pretty well with diabetes, I'm still hoping for a cure.

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The Magic Hat

2010-08-05T13:00:00.031-07:00

I have a running hat I got a few years ago from the Inaugural Rock'N'Roll Arizona Marathon. One day when I went to see Jeff Galloway at a local running store, it occurred to me that it would be cool to get him to sign my hat.
That got it started. The next signature was Frank Shorter, followed by John "The Penguin" Bingham.
I continued to get celebrity autographs for a while, then when I went to Diabetes Training Camp in 2009, and I was surrounded by amazing athletes, diabetics, and scientists, some of them famous, some of them not-so-famous, but all of them inspiring, I decided I had to get everyone there to sign.
I've gotten a few more celebrities since then, but I've had to slow down on collecting signatures on the magic hat. There just isn't any more room.

This is who has signed:

John Bingham (the Penguin) - running writer, guru, inspiration to millions
Art Bloom - studly diabetic triathlete, marketing professional *
Casey Boren - 2009 Triabetes Captain, on the verge of qualifying for Kona *
David Bourdon - 2009 Triabetes Captain *
Katie Bringe - iron-willed diabetic triathlete, WILD *
Bill Carlson - 2009 Triabetes Captain, first type 1 diabetic Ironman (1983) elite cyclist, runner, etc. *
Edy Chambers - indomitable diabetic triathlete, fantastic CDE for diabetic athletes, WILD *
Carrie Cheadle - sport and exercise mental skills coach to elite professionals and pluggers like me
Matt Corcoran - MD, CDE, diabetes and exercise specialist, heart of Diabetes Training Camp
Josh Cox - Elite marathon runner, American record 50K
Rick Crawford (RC) - Elite cycling and triathlon coach, coached a kid named Lance
Grant Curry - expert bike mechanic and fitter, musician, cyclist, dreamer *
Chuck Dumke - Phd exercise physiologist studying type 1 diabetes
Nancy Eastman - tenacious diabetic triathlete, WILD *
Brian Foster, the Glucose Guru - 2009 Triabetes Captain *
Missy Foy - elite marathon runner, ultra runner, diabetic *
Nicole Freedman - Olympic cyclist, Bike Czar of Boston
Jeff Galloway - Olympic marathon runner, running guru, coach
Adam Greene - Expert in data analysis working to improve the lives of people with diabetes
Nate Heintzman - type 3 diabetic, co-founder of InsulInDependence
Ray Ibsen - Emmy-winning film-maker, visionary
Dean Karnazes (Team Dean) - running guru, inspiration to millions, running and marketing legend
Susan Loken - elite masters marathon runner, running evangelist and altruist angel
Sean McKendry - 2009 Triabetes Captain *
Mark McCullough - 2009 Triabetes Captain *
Jim Murphy - 2009 Triabetes Captain *
Peter Nerothin (Agent Nero) - diabetic adventurer, Ironman, founder of InsulInDependence *
Aaron Perry (Iron) - 2009 Triabetes Captain, first type 1 diabetic African American Ironman *
Pam Reed - uniquely skilled elite ultra runner
Denise Ricci - 2009 Triabetes Captain *
Lyndsay Riffe - nutritionist, spunky diabetic triathlete, WILD *
Sebastien Sasseville (SL SII) - 2009 Triabetes Cpt., 1st t1 diabetic Canadian atop Everest, international playboy *
Steve Scott - legendary miler, most sub-4 miles by anyone (136), American record mile for 25 yrs. '82-'07
Frank Shorter - legendary marathon runner, Olympic Gold in '72, '76 (sort of)
Celeste St. Pierre - superlative swim and triathlon coach, TI expert
Reid Stewart - 2009 Triabetes Captain *
Jen Toomey - elite Arizona 800m and 1500m runner
Micah True (Caballo Blanco) - aka Gypsy Cowboy, guide to the Copper Canyons of Mexico
Heather Warren - 2009 Triabetes Captain, fitness club owner *
Bart Yasso - running writer, adventurer, evangelist, inventor of Yasso 800s

* has diabetes

There are a couple of signatures I'm not sure on. If you signed my hat, maybe you can help me out. One of these two signatures belongs to a type 1 diabetic high school athlete who was at DTC for a couple of days. The other, I'm not sure. Sorry, whoever you are.
One of the unknown signatures is:
SAM
That could be initials or someone named Sam.
The other is hard to read:
Mar[k?y?] R-something-y

Somehow at Diabetes Training Camp I failed to get the signature of fellow Triabetes Captains Anne Findlay and Kevin Burgess. I will remedy that situation and probably retire the hat. There are a lot more people who could sign. I will meet many at the Ragnar Great River Relay with Glucomotive later this month. But as I said, and you can see, there just isn't room on this hat.

I've discovered that over hundreds of miles, sweat has a curious effect on even "permanent" ink. Jeff Galloway's signature is almost gone. If I didn't know it was there, I couldn't find a trace of it. Frank Shorter's signature is fading. I was hoping for some kind of Voodoo to take place, the signatures on the hat would dissolve into my scalp, conveying the abilities of elite athletes into my body. I've had no such luck.
Still, I love my hat. It doesn't matter if all of the names are illegible. I know who I've met, and thinking about it on a long run helps move me down the road or trail.

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Glucomotive News

2010-08-02T10:59:00.001-07:00

In a couple of weeks, August 20th and 21st, I'll be running the Ragnar Great River Relay as part of the Glucomotive team of 12 runners with diabetes. One of our teammates, Anne Hospod, has a journalist friend who wrote an article about us for the Washington Times.

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Money and Relationships

2010-07-26T12:52:00.005-07:00

Just a quick thought to get something in the blog today.
There's a dichotomy between saving money by buying things online or at a mega store or maintaining the local sports community by buying things at your local running store or bike shop. Discussions of this often come up.
No one is right or wrong, it's all just opinions and values. I have a hard time spending money to maintain relationships with local store owners.
I'm cheap.
I buy my Perpetuem and incidental items at Landis Cyclery, two miles from my house. They sponsor a local tri-club, a bike club, and local races. They contribute a lot to the local cycling and triathlon community.
But a bike is a big ticket item.
I got a good deal on a bike at TriSports, 90 miles away. I'm not going to spend hundreds more on an equivalent bike, or get a lesser bike, to maintain my relationship with Landis.
What do you think?

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Big Local Diabetes Events Weekend

2010-07-22T13:22:00.001-07:00

There a couple of important events in the local diabetes community this weekend.
First, dine at any Phoenix area Souper Salad location Friday, July 23rd from 5 to 9 PM. Souper Salad will donate 10% of the night’s sales, plus tips and donations, to the American Diabetes Association. My wife, Sue, and I will be eating at the Souper Salad at 1649 S. Stapley in Mesa, just off 60. The 2011 Team Diabetes committee will be hosting there.
Then on Saturday, Jenny Crandell, 2010-11 Triabetes Captain will be hosting a Dawn Phenom at Life Time Fitness in Gilbert. A Dawn Phenom is an occasional gathering of people with diabetes sponsored by, among others, InsulInDependence. As they describe it:

The Dawn Phenom is perhaps the easiest way for people to stay inspired, and fit, with the help of the local diabetes community. Whether you are Type 1, Type 2, or a supporter of someone with diabetes, meet us monthly for exercising, socializing, and fun.

Here are the details as Jenny explains them:

Hey everyone!

Part of my "duties" as a triabetes team captain is to put on monthly get togethers where people can come and get some exercise and socialize. Whether you are diabetic or not, you are welcome to join us for our first Arizona Dawn Phenom event! Usually we'll meet and go for a walk/jog/run, but because AZ is so hot I got a REALLY cool deal for us! Seriously, a free day pass to come swim, work out, hang out, and have refreshments?? What could be better? PLEASE COME!! Your whole family is welcome, and we'd love it if you'd invite a friend. If you know someone who is diabetic PLEASE invite them to come along. This will be a blast!

Just visit the link to register online. Remember, it is FREE! (If you need to you can register on the day of the event, but it would really help us out to know how many people are coming, so please try to register online first).

The link is https://www.z2systems.com/np/clients/insulindependence/event.jsp?event=219

Phoenix Dawn Phenom
07/24/2010 09:00 AM - 12:00 PM PT
Lifetime Fitness
381 E Warner Rd.
Gilbert, AZ 85296
Admission: Free
The Dawn Phenom is perhaps the easiest way for people to stay inspired, and fit, with the help of the local diabetes community. Whether you are Type 1, Type 2, or a supporter of someone with diabetes, meet us monthly in the Phoenix area for exercising, socializing, and fun.

Click here to register online

On Saturday, July 23, 2010 Insulindependence will be hosting Phoenix's FIRST monthly Dawn Phenom event at Lifetime Fitness in Gilbert, AZ! This is open to all people with diabetes and their family/friends. Join us for socializing, swimming, a cycle class, or a run on the treadmill - there are many options to choose from, and all ability levels are welcome!

You can get your exercise and avoid the heat. Join us after your workout for coffee, fruit, and socializing with friends.

Directions:
Please click HERE for directions.

Please be sure to let us know you are coming by registering for the event HERE.

More Poetry

2010-07-21T13:00:00.026-07:00

The publication of the new No Sugar Added Poetry book from the Diabetes Hands Foundation has sent me back to the poetry and writing groups on TuDiabetes, and reading more diabetic poetry has, of course, inspired me to write some more. So here are a couple of things I've written in the past week:

The Big D

Once a certain death
Diabetes is now
something a person can live with.

Once a certain death
of a boy I read about
reminded me
Diabetes isn't something a person can ignore
and live with.

Once a certain death
standing in the darkness by the bed
as I came sweating and trembling to awareness
reminded me my death
is something I live with.

Haiku-betes
Haiku-betes is one of the groups in the TuDiabetes social network. It is dedicated to diabetes-related Haiku.

Woke up wondering
What is my blood sugar now?
And so go the days

I'm not sure if what follows, a set of three paragraphs, qualifies as Haiku or not.Whatever it is, I submit it for your amusement.

Car radio plays
Song by Bernie and Elton
might be about me

And all this science
Just my job five days a week
I don't understand

I'm a rocket man
Not the man they think I am
Burnin' out his fuse

No Sugar Added Poetry

2010-07-19T13:00:00.001-07:00

A new poetry book is out, published by Tu Diabetes and the Diabetes Hands Foundation. It is a collection of poems about diabetes by members of Tu Diabetes who are living with diabetes.
Whether you're a person with diabetes or someone with no interest in diabetes at all, you will find beautiful, painful, transcending perspectives on humanity and chronic illness in these poems.
I wrote two of the poems, but I would want to give copies of this book to my loved ones even if I didn't have any of my own writing in the book. The book is only $15, and it goes to continue the efforts of the Diabetes Hands Foundation, supporting communication and creative projects in the diabetes community.

http://www.tudiabetes.org/profile/NoSugarAddedPoetry

Here's what other people are saying:

"In reading No-Sugar Added Poetry, we bring different perspectives, but we can all gain the same enlightenment – an appreciation of the challenge of diabetes and the enormity of the triumph in living well with it."

- Jeff Hitchcock
President/Editor
Children With Diabetes

"I cried, I ached, I loved, I cherished, and most importantly: I learned. Thank you TuDiabetes."

- Tom Karlya
Diabetes Dad

"This book is proof that something truly beautiful can be born from adversity."

- Kerri Sparling
Six Until Me

Be a Diabetic

2010-07-16T12:19:00.003-07:00

A few days ago in a comment about another person with type 1 diabetes I wrote that he should "buck up, be a diabetic, and test his blood sugar."
The second I typed that, it started to make me wonder what I meant, and I've been thinking about it for a while. It definitely had some connotations similar to old, chauvinistic terms like "Be a man."
That's kind of what I meant. Like "being a man," being a diabetic implies that you have certain responsibilities, to yourself and to the people around you.
If you have it, you have it. However, really owning your diabetes implies a certain level of self-reliance, self-control, and self-respect.
I didn't decide to be diabetic, but now that it's here, I can take pride in how I handle it. (Sometimes.) I've met a lot of people who make me proud to be a diabetic.
So wear the scarlet letter, own the big D, make it yours, take care of it. Test when you need to test. Shoot up or change your infusion set when you need to.
There's no reason to be ashamed or embarrassed about diabetes, type 1 or type 2. It's a disease.
If you do feel ashamed or embarrassed, fine, feel that way, but feel that way while you're taking care of yourself, not while you're avoiding doing a blood test. You don't need to be obnoxious about it, but you need to do what you need to do for your health.
We're in this for the long run.

Fathers' Day Ride

2010-06-25T12:51:00.001-07:00

Last Sunday, Fathers' Day, I went for a ride with my son, Francis. His favorite participatory sports is skateboarding, but he's getting used to biking, going to school and to work. It was great to ride with him around Ahwatukee on Sunday.

When I ride with Francis, I assume that I need to slow down and make sure I don't leave him behind, but we did a few good hills on this ride. Up the first big hill, I left him behind about halfway up. I wasn't being competitive, but I needed to keep my momentum up.
Then we hauled down the backside of the hill and started the second big climb together. After a few minutes I suddenly realized Francis was twenty feet ahead of me and pulling away.
Well, yeah, at that point I did get competitive. :-) I had to shift up and stand out of the seat a little while to catch up and pass him. I'm old, but I'm not dead yet.
He caught up again in a short while, but I think I was ahead of him when we crested the hill. However, it's pretty clear that if I had any edge on my son on the bike, it is fading fast.
Oh, well, it's more motivation to train harder.
And a great way to spend Fathers' Day.

A Visit from a Legend

2010-06-15T13:05:00.001-07:00

I know, I've been a non-blogger and a non-runner with a running blog for a while. Well, not quite a non-runner. I've been putting in 10-12 miles per week.
But here we go. I have three straight days of working out.
Saturday I had a great 40 plus mile ride with Jenny and Lynanne, two friends from Triabetes. We weren't fast, but we did the Usery Pass hill, 4 miles of climbing, which is a good workout however you do it.
Then Sunday I was feeling lazy, but I got a call in the afternoon from the legendary Bill Carlson. Bill is almost my age, a year younger, has had diabetes almost as long as I have, a little less. He is an elite level bicycle racer, a marathoner and ultramarathoner with a sub-24 hour finish in the Western States 100, and the first type 1 diabetic Ironman, having done Kona in 1983.
Bill told me last week that he was coming out to Arizona, and he'd like to go for a run with me while he and his family were in Phoenix. For me, this is a bit like having Michael Jordan say he'd like to shoot some hoops with you while he's in the neighborhood.
So Sunday night, Bill and I ran from his hotel to the Ironman Arizona venue and went around Tempe Town Lake. It was a little over 7 miles at a comfortable pace for me, which I'm sure was tedious for Bill. But it was great to talk to him again, to share some stories and hear some of the wild stuff he's been doing and is planning to do.
It was very inspiring. So I'm getting back on track.

Diabetes Blog Week

2010-05-17T22:29:00.000-07:00

I missed the 6th and 7th days of Diabetes Blog Week, Diabetes Snapshots and Life After A Cure.
I'm afraid I'm going to be lazy again and finish this off with links to previous posts:
Diabetes Snapshots: Sharp Stuff
Life After A Cure: Diabetic Poetry

Let's Get Moving

2010-05-14T12:10:00.001-07:00

It's day 5 of Diabetes Blog Week, and the topic is Let's Get Moving.
Depending on how I treat it, this is either the hardest topic or the easiest, because it is essentially the reason for my blog.
Here's how Karen, who started this, describes today's assignment:

Exercise . . . love it or hate it? Do you have a regular exercise routine? Or do you have trouble finding your exercise motivation? How do you manage your insulin and food to avoid bottoming out during your workout? Today is the day to tell us all about your exercise habits, or lack thereof.

Well, I love it. It's part of my life, like breathing, eating, drinking... The idea of a sedentary life sounds like punishment to me.
However, I can't claim that I have a regular routine, and I do sometimes struggle with motivation and finding the time.
Hmm, I think I'm going to make this the easiest topic for me to post about, by referring you to this blog.

Back so soon?

To Carb, or not to Carb

2010-05-13T13:32:00.000-07:00

The fourth in the series of Diabetes Blogger Week posts is To Carb, or Not To Carb.

I am a type 1 diabetic, and this is one of those topics that I think is completely different from the different perspectives of type 1 and type 2.
For me, this is the way I look at it. High blood sugar is not my basic problem. It is a symptom of the real problem, which is that my immune system is destroying cells in my pancreas that are required for metabolic equilibrium.
The idea that people like me should avoid carbs because we have this problem reminds me of the old Vaudeville joke, where the patient tells the doctor, "Doc, it hurts when I do this." And the doctor replies, "Then don't do that!"
Carbs are not my problem. I take Novolog insulin analog to replace the insulin my body isn't producing. And as a type 1 diabetic friend once said, "I'm not on an insulin budget."
I think that basically covers my philosophy. Carbs are not the enemy. Insulin is not the enemy.
Of course it's a good idea to have a healthy, balanced diet. That diet would have to include a fair amount of carbs for someone who was going to put in a lot of miles.

My Biggest Supporter

2010-05-12T12:47:00.001-07:00

The third in the series of Diabetes Blogger Week posts is about My Biggest Supporter.

It's hard to pick just one person, because so many people have been very supportive of me, but after giving it a lot of thought, I decided I have to say it's Mom.
She was there at the start of my diabetic life.
Sometimes people ask diabetics when they "got" the disease, but what diabetics answer with is when they were diagnosed. We all had symptoms coming on gradually before we knew what was going on, so the diagnosis is the only definitive starting point we have.
Mom was the person who saw that I was sick and took me to a doctor. She was there while I explained my symptoms, answered questions, had blood drawn, and found out I had diabetes.
She probably saved my life that day, and probably several times after that. (She is not alone in having saved my life.)
She had the patience to make sure I was taking care of myself as a typical teenager, balancing that with giving me enough space to feel like I was doing it myself.
Through all of the things I've done since, she has always had a positive, supportive attitude.

Thanks, Mom!

Make The Low Go

2010-05-11T11:51:00.000-07:00

It's day 2 of Diabetes Blog Week, and the topic is "Making the low go."

My favorite hypo treatment for years has been the juice box.

They go down easy. They last a long time. They're delicious. I feel like I'm getting some real, healthy food when I have a juice.
I keep them in my car, in my fridge, in my office, but they're just not convenient to carry everywhere.
So I always have a tube of glucose tablets in my pocket.

However, I don't like to eat the glucose tablets. I would just rather eat real food. If I'm going low, and there is any other source of food available, the glucose stays in my pocket. If I have the option to walk out during a movie and buy something for $2 from the snack bar, that's probably what I'm going to do instead of just pulling out the glucose tablets.
Sometimes the same ten glucose tablets will be in the tube for months as I walk, ride, and run around, the tablets jostling against each other the whole time. When I finally pop the tube open, a puff of pulverized glucose dust bursts into the air.

A Day in the Life

2010-05-10T13:30:00.001-07:00

Hmm, if dozens of diabetic bloggers are blogging about a day in the life the day after Mother's Day, aren't they going to come up with a lot of stories about Mother's Day?
OK. I'll talk about the day before Mother's Day, because it shows what a genius I am.
I went out for a ride around South Mountain with Kim P., a type 1 diabetic woman training for Ironman Arizona in November. I had to get up at 4 AM, eat a light breakfast for which I under-bolused, anticipating that I would burn off carbs while riding.
We rode for over 3 and a half hours, with lots of stops for blood sugar tests and refueling. I started with my blood sugar a little high, and gradually worked it into a good range, and Kim started with her blood sugar at the low end, but was able to take in enough carbs to get it where she wanted. And we covered about 50 miles.
We had great weather. It was warming up by the time we finished, but it stayed nice and cool for most of the ride.
Later that day, I went to Saguaro Lake with my brother Jon, to do some open water swimming. Neither of us have been swimming much lately, so we were just going to see how it went.
A blood sugar check before going into the water showed my blood sugar was 95, which would have been a little low to start swimming, but I knew that I had checked at home before heading to the lake, and my blood sugar there was 115. So I was on a downward trend.
So I ate a few glucose tablets before going into the water.
Jon is a much better swimmer than I am, which I expected, but still found a little depressing. Oh, well. I have more room for improvement.
After I had swum about 300 meters, I could feel the infusion site for my pump flapping on my side. I checked it and saw that the adhesive was just barely hanging on, and the cannula was all the way out of my skin.
Jon was a couple of hundred yards away from the beach, so I walked ashore and waited for him to come back in. Then I showed him my infusion set and told him we had to go.
We went to my house, I put in a new infusion site, and I tested at 169. Not too much of a problem. It was getting late, and neither Jon nor I, nor my wife Sue, had eaten anything for dinner, so we went out to dinner at Arriba's Mexican restaurant in Ahwatukee. I had a 20 oz cerveza, some chips and salsa while waiting for our orders, and some kind of chicken dinner with rice, beans and tortillas. It was all delicious.
This is where I demonstrate my genius.
I bolused on instinct, guesstimating carbs and how long they would take to digest. It was an artful dual-wave bolus.
After this, Sue and I went out to the movies and saw Ironman 2. I had a small bag of popcorn, and did another dual wave to cover that. The dual wave with the popcorn is as much because of how slowly it is eaten as it is because of how long it takes to digest.
After the movie and before bed, my blood sugar was 121. When I woke up the next morning, it was 122.
Genius.
Seriously though, I know I just got lucky. It's just that so often I look at the number I get on my blood glucose meter and think, "What the heck?" It is so often not what I want or expect, I like to give myself some credit, deserved or not, when it comes out right.

365 Days

2010-05-07T23:03:00.004-07:00

Today is May 7, 2010. The next Ironman St. George is May 7, 2011.

My Triabetes Teammate, and a Triabetes Team Captain for the next season, Tiffany Heindel, reminded me of that today. It's just 365 days until I become an Ironman. Sure, I set out to do this before, but I had doubts then. I've seen what it takes, and now I'm going to do it. It's taking me a little longer than it takes some, but I'm OK with that.
Barring any unavoidable catastrophes (Anything is possible.) it's only 365 more days.

Let's have a little fun with this. Here is a brief history of Ironman.

1963 Marvel comic book Iron Man.

1968 A U.K. children's book, The Iron Man. (Renamed The Iron Giant when published in the U.S.)

1970 Black Sabbath song Iron Man.

1978 First Ironman competition, February 18. Combined three existing long-distance competitions, the Waikiki Roughwater Swim, the Around-Oahu Bike Race, and the Honolulu Marathon. "Whoever finishes first, we'll call him the Iron Man." Navy Commander John Collins.

1979 Sports Illustrated 10 page Ironman story by Barry McDermott, who was on Oahu to cover a golf tournament.

1980 ABC Wide World of Sports first Ironman coverage. Collins is transferred to Washington, DC, and turns the event over to Valerie Silk, owner of a local health club.

1981 Race moved from Oahu to the Kona District on Hawaii, the Big Island.

1982 Bud Light sponsors. Julie Moss crawls in to finish second.

Cal Ripken, Jr. begins the longest streak of consecutive games played in MLB, eventually becoming known as "The Iron Man." (Lou Gehrig, who previously held the record, had been known as "The Iron Horse.")

1982 Race moves from February to October. Second Ironman in one year.

1983 17 hour time limit established. Kona becomes a championship race as LA has an Ironman competition. Sylviane Puntous of Canada becomes first international champion. Bill Carlson is the first insulin-dependent diabetic Ironman.

1985 Scott Tinley wins with the first use of aerobars in an Ironman, setting a Kona course record. Ironman races are held internationally.

1986 Patricia Puntous finishes first woman at Kona, but is later disqualified for having drafted while on the bike.

1989 Dave Scott and Mark Allen duel it out for 8 hours, 9 minutes, 15 seconds. Allen prevails.

1989 Pete Townsend produces rock opera, The Iron Man: A Musical, an adaptation of the children's book.

1990 Ironman Triathlon sold to Dr. Jim Gills, who starts World Triathlon Corporation. Kona race course is altered to avoid airport traffic.

1991 Gatorade sponsors. NBC Sports televises.

1996 Rapper Ghostface Killah, a type 1 diabetic, produces an album, Ironman.

1998 Cal Ripken, Jr. voluntarily removes his name from the lineup for the Orioles final game of the season, ending his streak after 17 full seasons, 2,632 games.

2008 12 type 1 diabetics forming the Triabetes team participate in Ironman Wisconsin.

2009 Another group of Triabetes Captains and more Triabetes team members participate in Ironman Arizona.

2011 10 Triabetes Captains and more team members continue the tradition at Ironman St. George.

My Motto

2010-04-29T18:30:00.005-07:00

I've been giving my motto some thought, specifically, my family motto. Please bear with me. I'll try to tie this into the basic topic of this blog, being a type 1 diabetic endurance athlete.
I don't know what my family motto is, historically. There have been several different Nairn mottos used by various Nairns and Nairnes over the years. I have no idea which one would be appropriate for my branch of the family.
Nairn is a sept, a sub-clan, of the clan Mackintosh. Clan Mackintosh became part of Clan Chattan in 1291, when the chieftain of the Mackintosh clan assumed leadership of Clan Chattan through marriage.

The most common motto used for both Clan Chattan and Clan Mackintosh is the old English, "Touch not the cat bot a glove," or in Gaelic, ""Na bean don chat gun lamhainn."
There are two similar interpretations of this motto. It is either taken to mean "Don't touch the cat without (unless you are wearing) gloves," or "Don't touch the cat unless his claws are sheathed (gloved)."
At any rate, the cat is the symbol of the clan, and it means "Don't mess with us."
One family member suggested that this motto was a historical variation of the modern warning to practice safe sex, "No glove, no love."
I'm not sure about that interpretation.
I could see this as a pretty cool motto. Someone might say, "Oh, it's just a kitty cat. You gonna scratch me?"
But this is actually the Scottish wildcat, about 50% larger than the average domestic cat and supposedly impossible to tame, even when raised in captivity.

Of course, if a motto needs to be explained, that's a strike against it.
It is also a threatening, war-like motto which may have been appropriate for the feudal clans of the Scottish Highlands, but doesn't really match up with the life I lead.

Moving on, there are mottos more specific to the Nairn Clan.
Maybe part of the reason it's hard to find a definitive Nairn motto is the fact that Nairn is an armigerous clan, meaning it does not have a recognized chief and has no legal standing under Scots law.

One motto used by Nairns has been "Sero, sed serio," Latin for "Late, but in earnest," or "Late, but serious."
My first reaction to this was, "Huh?" But it refers to the Battle of Ancrum Moor.
The battle was a 1545 victory of Scottish forces over a larger English army. The victory was achieved by attacking with a small group which retreated and led the English into a difficult position, at which point the main Scottish force attacked, "late, but in earnest." The English, and their German and Spanish mercenaries, found themselves on uneven ground, fighting uphill into the setting sun.
About a third of them were slaughtered and the survivors scattered into the surrounding countryside. Several clans in the battle adopted this motto.
So this could be kind of a war-like, kick-a$$ motto.
It applies to my life a little bit in that I am slow but steady. I may finish back in the pack, but I am serious about finishing.
But that explanation is way too long.

Another motto was "Spes ultra," Latin for "Hope beyond," which is combined with the French, "L'esperance me confort," "Hope comforts me."
The hope I have for a cure for type 1 diabetes could be symbolized in this motto, but that hope is guarded. I don't see it as a key part of my philosophy.
I like to remain optimistic, hopeful, but I don't find this an inspiring motto.

So what's left? The Latin, "Plus ultra." "More beyond," or "Farther beyond."
That already sounds more like me.
(You thought I wouldn't get back into the topic of this blog?)
The tie-in with ultra-endurance events, ultramarathons, etc. is pretty obvious.
This phrase, "Plus ultra," has been used fairly often as a motto, because it refers back to an inscription which was supposed to be on the Pillars of Hercules. According to Roman mythology the pillars were built by Hercules near the Straits of Gibraltar and marked the edge of the world. On these pillars was the warning "Nec plus ultra" or "Non plus ultra," "nothing further beyond," a warning to go no further.
I might have glimpsed the Pillars of Hercules as I was diagnosed with an incurable disease back in 1974. I might have seen it as the end of a lot of things in my life.
I was fortunate that no one around me tried to tell me that diabetes was going to stop me. Unlike some other people I know with diabetes, I had no one saying, "Non plus ultra." "No more after this."
I thank my family for that.
Instead I was left to make my own choices on what was possible, and while it's often been a struggle, it's clear I chose "Plus ultra." "More beyond."

OK, that is an explanation, but it really isn't required.
"Plus Ultra" is my motto.

Desert RATS Trail Running Festival

2010-04-28T18:00:00.002-07:00

About a week and a half ago, April 17th, I was in Fruita, CO to run the 25 mile trail race of the Desert RATS (Race Across The Sands) Trail Running Festival with Peter Nerothin of InsulInDependence.

If you pay any attention to the chart of my running log on the left hand side of this blog, then you know I didn't prepare for this at all. A while back Peter had been talking about this race, specifically the 50 mile race at this event, and I said, "I'll do it if you will."

Famous last words.

Anyway, with next to zero miles in the bank, after driving most of the previous day and arriving after midnight, I managed to convince Peter we should switch to the 25 mile race, which is an option allowed by the race director.

The 25 miler was so tough, and I am so out of shape, that I wasn't able to finish 25 miles before the cut-off time for continuing on the 50 mile course anyway.

I'm not sure what to say about the run. I definitely felt the altitude. My blood sugar was a little high in the first few miles, then when I got it down, it was bouncing, over 200 to under 70. It was 70 at the finish. I was cramping on and off for much of the run. I walked all of the uphills. The sad story you would expect to hear about someone doing something like this with no training.

Other than that, it was great weather and beautiful geography. Without further ado, here are some pictures:

Oh, yeah. I forgot to mention I fell down in the first 5 miles. I had superficial scrapes on my legs, right forearm, and hands, with bruises under each scrape. I took a pretty good Superman dive. I hurt my pride as much as anything, as there were still lots of other runners around.

Peter striking a pose I have seen in other pictures of him. Apparently he thinks this is his best look. He calls it "Blue Steel."
Note the guy in the background rethinking his breakfast.

Peter hung with me all day in spite of the fact that I was going tediously slow. I much appreciate it.

I'm sure it sounds terrible from my description, but I hope the pictures tell a better story. As I said to another runner on the trail, "The worst day running is better than the best day at work."
I wouldn't have wanted to be anywhere else.

A pro cycling team named Team Type 1

2010-04-14T18:15:00.004-07:00

The news this week from the Team Type 1 Weekly Update is that "Team Type 1" was successful in the Tour Maroc and "Team Type 1" is going to race in the Tour of California.
Why do I not care?
I have been a Team Type 1 fan for years. I am eager to hear good news about what Team Type 1 is doing.
However, the professional cycling team that is called "Team Type 1" is mostly non-diabetics. Whenever I see an article about "Team Type 1" I do a quick scan to see if it involves the mens professional cycling team. If it does, then I will probably skip it.
The exception is if it deals with one of the type 1 diabetic riders, Joe Eldridge, Javier Megias Leal, Martijn Verschoor, or Fabio Calabria. If there are no diabetic riders mentioned, I have no interest in it.
Maybe you have trouble determining whether you're reading about a diabetic when you see a story from Team Type 1. Here's what I find usually works:
If it doesn't say the rider has diabetes in the story, he doesn't.
A lot of diabetics are, as you would expect, unaware that "Team Type 1" does not mean a team of type 1 diabetics. After all, for years, Team Type 1 was all type 1 diabetic riders. There are still teams bearing the name Team Type 1 which are all diabetic. You have to read the small print to know what is going on with the professional cycling team.
Not that there's anything wrong with that.
If the people that have worked very hard to create the Team Type 1 brand want to use it for a professional cycling team, that's their choice.
I don't think they are intentionally trying to deceive. The professional cycling team does serve the diabetic community in a way. They have diabetic riders on the team, and more diabetic riders in development.
I don't know what it means to be on a development team, but that's because I don't know much about professional cycling.
I've tried to figure out what the professional team is about.
I didn't find a mission statement on the Team Type 1 web site, but this statement is prominently displayed:

We strive to instill hope and inspiration for people around the world affected by diabetes.

That is clearly what the all-diabetic teams, like those competing in RAAM, are about.
I think the diabetics who are most inspired by the professional cycling team are the ones who don't know that most of the riders aren't diabetic.
From my current perspective, the pro team seems to be more about selling to diabetics than inspiring diabetics.
The pro team is not inspiring to me as a diabetic.
I have some understanding of what this team does for diabetic riders. I like to associate with other diabetics involved in the kinds of athletic activities I like. We share experiences and feelings, we inspire and help each other.
I've never been close, in any sport, to the level at which the diabetic riders on the "Team Type 1" professional or development cycling teams compete. If I was a competitive cyclist, I'd want to be on the "Team Type 1" professional team.
However, I think that success in cycling, like success in other sports, depends on individual abilities. No one can be put at the pinnacle by someone else.
There are diabetic athletes at or near the highest levels of almost every sport. Almost all of them have gotten where they are without being given special consideration for being diabetic.
Having this mostly non-diabetic professional cycling team gathered specifically to elevate diabetic cyclists seems to imply that diabetics can't make it in the sport without special consideration.
I don't buy that. I see it as a marketing gimmick for the team sponsors.

I wish all of the athletes on all of the Team Type 1 teams continued success, whether or not they are diabetic. I am naturally more excited about the successes of the diabetics.

What's Wrong with Team Type 1?

2010-03-30T19:00:00.023-07:00

This post has been rumbling around in my head for a long time. I've been reluctant to write it.
I know that it's easier to criticize than to actually do amazing things, and I give Team Type 1 credit for doing amazing things. I know I am just sitting on the sidelines pointing out little problems. You might even call it nit-picking.
But the fact is, Team Type 1 isn't perfect. It could be better. It could be more encouraging to more people. This post will deal with one of the two main problems I have with Team Type 1.
Here's a quote from the recent Weekly Update from Team Type 1:

In terms of diabetes, 74% of Team Type 1 has either type 1 or type 2 diabetes. 56% of us have type 1 diabetes, 18% have type 2 diabetes and 26% of us do not have diabetes. This fact makes Team Type 1 unique in that it is an organization comprised primarily of individuals with diabetes inspiring others to better manage their diabetes.

My problem with this quote is the fact that Team Type 1 is not at all unique in being an "organization comprised primarily of individuals with diabetes inspiring others to better manage their diabetes." It is not even unique amongst athletic organizations of diabetics inspiring other diabetics.
Although Team Type 1 has rightfully gotten a lot of press, although they act as if they are the only people doing what they do, they are actually a small organization in terms of membership, diabetic or otherwise.
That's all right. There is room for inclusive clubs like Triabetes and Glucomotive, open to every diabetic who wants to become a member, and exclusive, elite clubs, like the Team Type 1 RAAM team that has repeat wins cycling across the United States.
But Team Type 1 should not be promoting the idea that they are the only "organization comprised primarily of individuals with diabetes inspiring others to better manage their diabetes." That tends to reinforce the idea that there are only a few athletic diabetics.
Team Type 1 should acknowledge that there are many, many diabetics out there living active, healthy, athletic lives. They should promote awareness of the existence of Team WILD, Triabetes, Glucomotive, MAD (Mountains for Active Diabetics), HypoActive, Type 1 Rider, and other organizations "comprised primarily of individuals with diabetes inspiring others to better manage their diabetes."
I apologize to the organizations not mentioned. I know there are more, but these were the ones that leapt to mind for me.
I know that members of Team Type 1 are aware of the existence of these other organizations because there is a lot of cross-over. Many athletes are members of Team Type 1 and other diabetic athletic organizations. Matt Vogel of the Team Type 1 Triathlon team is the founder of Insulin Factor, another organization of this type.
Personally, I would like to see Team Type 1 do more to use their prominence and public attention to promote membership in DESA and other organizations like those I've mentioned.
I know that they do make occasional appearances that help to promote other diabetic causes, and that's a good thing. Tom Kingery of the Team Type 1 Triathlon Team has visited the Phoenix area twice in the past few months, once for the Team Diabetes marathon training program, and once for the Tour de Cure.
I know his help was greatly appreciated by the ADA, and local diabetic athletes were very happy to meet him and talk to him.
The current Team Type 1 web site is a work in progress. There are a lot of links there that say, "Coming soon..." I hope that as the web site comes together, it becomes a place where people with diabetes who want to become athletes, and not just fans of elite athletes, can find links to resources that can help them.
If Team Type 1 is reluctant acknowledge that these resources exist, that doesn't seem likely to happen.

I Blame Oprah and Oz

2010-03-27T12:54:00.000-07:00

I thought that I developed type 1 diabetes as a teenager, I was diagnosed at the age of 15. Imagine my surprise to find out I was born with it. Or maybe not. Was I born 35 years ago?
Let me start over. A while back, I was asked, in order to help promote the Phoenix Tour de Cure, to submit a brief bio to Sweat Magazine, which serves the local amateur athletics and fitness community. In a couple of paragraphs, I would explain who I was and why I was riding in the TdC.
So I gave my bio to the TdC coordinator, who made slight changes to a couple of lines to clarify and promote the Tour, then sent it into the magazine.
When it came out in the March issue online, this was in there:

In spite of being born with type-1, Nairn strives to live an active and healthy lifestyle. Combating the life-threatening nuisance for over 35-years, he decided to join the Red Riders for the Phoenix Tour de Cure come March 13.

So you can understand my confusion. I kind of like the description of diabetes as a "life-threatening nuisance," but this other stuff that was not in the original bio isn't right. I am not 35 years old. I have not been a type 1 diabetic since birth.
Where did that come from?
I blame Dr. Oz and Oprah.
Dr. Oz has said at least once on television and twice in print that type 1 diabetics are born with it. This simply is not true. Although it happens sometimes, it is rare for someone to be born a type 1 diabetic.
Another blogger has said that Dr. Oz will never answer a question by saying, "I don't know." Instead, he will just make stuff up.
This is true.
Sadly, he doesn't even have to be asked a question before he will start just making stuff up. If he is pontificating in front of an audience, and he gets into an area where he doesn't know very much, he will just make stuff up.
Sadder still, the things he makes up enter the public consciousness as facts. He's a doctor. He went to Harvard. He's on TV. He's wearing hospital scrubs. It must be true.
I don't care if you're a plumber or a mechanic or a gardener or a software engineer like me, you know people in your field who won't say they don't know. They just make stuff up. Dr. Oz is that kind of physician.
He discredits his profession and the schools he attended and Oprah Winfrey. He spreads ignorance and misinformation. I could speculate on why he does that. I was about to speculate, but I will refrain. I will just reiterate that it is a fact, he just makes stuff up.
So someone writing for Sweat saw in my bio that I was a type 1 diabetic and, knowing that type 1 diabetics are born with it, added that I was born with it.
I wrote to the editor, and she says this story will probably be fixed in the print edition, but it's still wrong on the web site.
Oh, well. I blame Dr. Oz and Oprah.

PS: There is a twisted way of looking at this issue which might permit one to say that "Type 1 diabetics are born with it."
There appears to be a genetic predisposition to type 1 diabetes in many of those who eventually develop it.
However, the same is true for type 2 diabetics, so following that logic, type 2 diabetics are born with it.

Diabetic, or Person with Diabetes?

2010-03-26T11:37:00.000-07:00

This question comes up all the time. Is it wrong for people who happen to have diabetes to be called diabetics? Does that imply that diabetes is the most important thing about them?
Should I tell people that I am not a diabetic, I am a person with diabetes?
This post on I Run On Insulin prompted me to reply with a succinct description of my feelings on this topic.

Words like "diabetic" are not really that rare. I have heard celiac, hemophiliac, asthmatic, arthritic, etc.
Think of alcoholic, and all of the derived "holic" terms, workaholic, shopaholic, chocoholic, ...
Really, whenever we say someone is an addict, instead of saying they are a "person with an addiction" or "addicted person" aren't we doing the same thing we do with "diabetic" and diabetes?
Even "maniac" is a word derived in this way to describe someone with mania.
Think nymphomaniac, satyromaniac, egomaniac, etc.
Hardly rare.
I don't find "diabetic" offensive when used in the correct context, when it's appropriate. In a situation where it would be inappropriate to call me a diabetic, it would also be inappropriate to describe me as a PWD.

I hope that explains my position. Feel free to comment.

Glucose Meter Accuracy and the FDA

2010-03-20T14:36:00.029-07:00

A topic that many diabetic bloggers have weighed in on recently is the fact that the FDA is planning a public discussion of "the clinical accuracy requirements of blood glucose meters...." The hope among many diabetics is that the FDA will decide to require greater accuracy from these devices. Currently, they are allowed to be within plus or minus 20 percent of a clinical blood test.

If you have an opinion, you have until April 10 to tell the FDA here.

Here are some of my thoughts on the issue.
The FDA, in its notice of this public meeting, explains:

Blood glucose meters are being used in clinical settings and at home in ways that are not within the intended use of the devices as evaluated by FDA. For example, glucose meters are increasingly being used to achieve tight glycemic control despite the fact that these devices have not been cleared for this use.

Excuse me, but that just doesn't cut it. The American Association of Clinical Endocrinologists (AACE) recommends that diabetics have a target A1c of 6.5, with a target blood glucose level of less than 110.
If the FDA rationalization above is relevant, then we can ignore the target blood glucose, because we don't have anything to test blood glucose with, not if we're trying to adhere to these guidelines. According to the FDA, it is not the intended use of our blood glucose meters to keep our blood sugars that tightly controlled.
Of course, if these meters aren't intended for this purpose, then we are missing a key piece in the diabetes management system.
Reading any reference on diabetes management, consulting with any manual on how to use an insulin pump, an insulin pen, or a CGM will show repeatedly that we require accurate meters to do what doctors, CDEs, and medical device manufacturers are telling us to do.
Whether or not the FDA and the meter industry want to concede the point, these meters are for "tight glycemic control."

To determine how accurate the meters should be, I suggest they look at how accurate the dosing of insulin is.
Look at the lines on the side of a 1/3 cc insulin syringe, or the increments on an insulin pen. Consider the insulin pumps with increments of 0.025 units of insulin.
Blood glucose meters should approach this level of accuracy, or something is out of whack.
If it's OK for my blood sugar reading to be 30 points off, why should my pump be able to deliver increments of less than half a unit?

Indeed, why am I not still just peeing on a color-changing strip and taking one shot of long-acting insulin a day?

To see some other blogs on this topic:

Scott's Blog - Tell the FDA +/- 20% Is Not "Good Enough" Today

Diabetesaliciousness(tm) - Meters = Diabetes GPS System!

Six Until Me - Accuracy in Glucose Meters

Your Diabetes May Vary - What is Accuracy?

Phoenix Tour de Cure 2010

2010-03-19T18:00:00.007-07:00

Here I am at the Phoenix Tour de Cure last Saturday. I know how badly the outfit clashes, but I wanted to represent both the Red Riders (with the jersey) and Triabetes (with the shorts).
It was a beautiful, sunny day on a course on the outskirts of Phoenix running up past Anthem and New River. I took it easy and stopped at all five aid stations and one Burger King on the 64 mile course. No I didn't go in for a burger, I just figured it would be quicker to make a pit stop there than to wait in line for a port-a-john at an aid station, and I was right.
My new 2009 Kestrel Evoke performed great. I had never ridden it before, never used the integrated brakes/shifters before, but it all worked fine. I figured out the shifters within the first thirty miles, none the worse for the wear.
I had worried that my Kestrel Evoke would seem tediously slow compared to the Kestrel Airfoil I had been riding last year. (This was my first ride since November 2009.) The Airfoil costs about four times as much as the Evoke. But it seemed great to me. I was surprised how easy it was to crank it up over 20 mph on a flat stretch.
I look forward to riding it again tomorrow.

My New Ride

2010-03-09T12:14:00.000-07:00

As you probably know, I'll be riding in the Phoenix Tour de Cure on March 13. (That's my birthday. It's not too late to donate if you're wondering what to get me.) The big question leading up to this ride has been what bike I would be on. The Kestrel Airfoil I rode last year went back to Triabetes, where you can buy it now if you want a bargain on a fantastic bike. Since I gave that one up, I have not been on another bike.
But on Saturday, I went to TriFest with my brother, Jon, and met up with Peter Nerothin and Kevin Burgess, Triabetes Teammates who had set up the Triabetes tent there. I wanted to help out Triabetes a little, but mostly, I wanted to see what was shaking at TriFest, and possibly get a deal on a bike.
Well, I got a great deal on a 2009 Kestrel Evoke. It felt good during the fitting, but I haven't had a chance to ride it outside yet. The metric century Tour de Cure may be my first ride on that bike. I know that's not the wisest thing to do, but it's about par for me. That just seems to be the way I do things.

It should be a blast, riding with hundreds of Red Riders and people concerned about diabetes. This is actually a great time and place for a shakedown cruise. There will be all kinds of support for me and my bike out there, and the forecast is for beautiful weather.

2000 Miles to Chicago

2010-03-02T12:48:00.000-07:00

So it's about 2000 miles from Chandler, AZ to Harpo Studios in Chicago, IL, where Oprah and Dr. Oz film their TV shows. If I were to bike the distance, I suppose I could do around 50 miles per day for 40 days. It would be possible to do it faster.
Running, I wouldn't want to schedule myself for more than 20 miles per day, which would mean it would take at least 100 days.
I'm trying to think about how I could fit it into my life to do an epic ride or run out there to tell O&O they are full of crap.
At this point, this is just a crazy idea that I haven't really thought through. Don't count on it happening. It's just what I would like to do, if I didn't have any responsibilities. It's a dream.

In my dream, I would set out for Chicago and get more and more publicity on the way until Dr. Oz started to think, "Gee, maybe I should set the record straight on some of the absolute hooey I have been repeating over and over in print and on television."
And of course, Oprah might ask herself if Dr. Oz is really as smart as she thought he was.
Then by the time I got there, we would have nothing left we disagreed about, and I would just go home.

Carlsbad Marathon etc.

2010-02-11T22:35:00.001-07:00

I haven't done much of anything for almost two weeks. This seems like a good time to catch up on blogging about things that happened recently.

Starting Friday I will be on a road trip vacation to Northern California to visit my favorite daughter and the world's cutest grandson. I may be even more detached from this blog than usual.

I realize that there can be no "regular readers" of a blog that doesn't have writing regularly updating it, so I really do want to keep up my blogging.

On January 24th, I did the Carlsbad Marathon as part of the huge Glucomotive presence at that event. It was another fantastic experience for me, as every Glucomotive event I've done has been.

I drove out to the coast with my brother Jon, and the first thing we got to do Friday night when we called and asked how we could help, was to go pick up Kerry Kuck from where he was staying and bring him to the first gathering of the weekend.

Kerry is a courageous and amazing blind marathoner with type 1 diabetes.

That was just the first of many things from that weekend I will remember forever. Saturday, we had breakfast on the beach with many of the PWDs and diabetic supporters in town for the race.

Sunday I ran the Carlsbad marathon, my 50th lifetime marathon, and crossed the finish line with Peter Nerothin, type 1 diabetic, Ironman, ultramarathoner, founder of InsulInDependence, Triabetes, and Glucomotive, and John Moore, type 1 diabetic, Ironman, marathoner, ultramarathoner, and Amy Flores, a type 1 diabetic doing her first half marathon.

It was a special moment to share with Peter and John, friends of mine for a while, but being there with Amy made it just magical, she was so excited about the new directions her life is going.
Then following the race we went to a barbecue hosted by type 1 diabetic surf hero Matt Besley and his family, to celebrate our accomplishments and watch a little playoffs football.

The weekend was just packed with fun. It was hard to finally decide that it was over and Jon and I had to start back.

I'm looking forward to the next adventure.

Oh, yeah. I already had the next adventure at the Desert Classic Marathon on January 30th.

But that's another blog post...

Pay No Attention To That Man On Oprah

2010-02-05T18:13:00.003-07:00

Let me put these two disclaimers right up front.

First: I am not a doctor. I have no other medical background than being a diabetic for close to 36 years, and keeping my eyes open for information that might help me survive. I read the occasional article on the subject of diabetes.
If I was going to do a show about diabetes, I would have to bring in experts, like maybe an endocrinologist.
I am not an egotistical, know-it-all cardiologist who can glibly and confidently talk down to a studio audience and millions of home viewers.

Second: I didn't watch the Oprah Diabetes Show, America's Silent Killer. I only learned a little about it from friends and went to her web site to try to get a transcript. She is selling transcripts for $20. I didn't think it was right that I should pay $20 to her just because my friends were so incensed by her show that I wanted to see what they were so upset about.
So I did the next best thing and read the article on her web site. I figure this is fair, since it would be much easier to make this article accurate than a verbatim transcript of the show. My statements about the show are based on the articles about the show and the videos on the web.

So, somehow Dr. Oz did this whole show focusing on type 2 diabetes without mentioning insulin resistance. Bob Greene talks about it, and seems to understand it, but not Dr. Oz.
Dr. Oz also did not mention carbohydrates except to say that sugars are also referred to as simple carbohydrates. Neither did he mention the glycemic index.
There was no endocrinologist on this show about diabetes.
I know that if you, like me, have been discussing diabetes with other diabetics you find this hard to believe. How did they do a whole show? What did they talk about? How did they avoid subjects like these?

The American Diabetes Association lists the 10 most prevalent diabetes myths. The Oprah show actively reinforced four out of ten.
I will edit and summarize:

Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.
Fact: Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Myth: Eating too much sugar causes diabetes.
Fact: Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors.

Myth: People with diabetes can't eat sweets or chocolate.
Fact: They are no more “off limits” to people with diabetes than they are to people without diabetes.

Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly.
Fact: Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.

Concerning the other six myths, except for the first one, Dr. Oz did not address them. The first Myth on the ADA web site is:

Myth: Diabetes is not that serious of a disease.

The Oprah show seemed to be concentrated on sensationalizing the complications of diabetes to the extent that it seems it spent more time on that than on prevention, diagnosis, and treatment. They called it America's Silent Killer, after all.

I went through the article counting up things I knew to be wrong. I marked off 25. For example:

"Most diabetes is preventable," he says. "It is treatable, even reversible."

No, diabetes is treatable but not "reversible."
TYPE 2* diabetics can often control their blood sugar through diet and exercise. But if they discontinue the regimen of diet and exercise to control the diabetes, the high blood sugars, and the complications, will return.
The diabetes is not "reversed." They are not cured. They have simply found a way to control their diabetes.
They have found an effective treatment. They have reversed the symptoms of diabetes.
If they discontinue the treatment, the symptoms of diabetes return. This is the difference between diabetics and non-diabetics.
Note that the difference is not obesity. The difference between a diabetic and a non-diabetic is that behaviors that don't cause high blood sugar in a non-diabetic do cause high blood sugar in a diabetic.

*Why doesn't he say TYPE 2 when referring to type 2 diabetes and diabetes when referring to all diabetes?

"There are two types of diabetes: type 1 and type 2."

This very article contains reference to gestational diabetes, which is not type 1 or type 2.
In addition, there are many people with diabetes who are not easily put into either category of type 1 or type 2 diabetes.

Type 1 diabetes, formerly known as juvenile diabetes, affects 10 percent of Americans diagnosed with diabetes. "[You're] not making enough insulin."

Not making enough? Most type 1 diabetics make absolutely no insulin. Before the full onset of the disease, there may be a "honeymoon" period during which a type 1 diabetic produces a trace of insulin.
Some people make very little insulin, and that is one way someone might not fit into either category of type 1 or type 2.

"That's generally from genetic reasons because your pancreas just doesn't work correctly,"

Generally from genetic reasons?
The pancreas just doesn't work correctly?
Is this wrong, or just dumb?
Let's just say it. I don't think Oprah's viewers are too dumb to understand. Does Dr. Oz?
Type 1 diabetes is usually caused by a person's immune system malfunctioning and killing off the insulin-producing cells in the pancreas.

Type 2 develops from lifestyle issues.

There is always a genetic component in type 2 diabetes, just as in type 1. It is not just caused by lifestyle choices.
Remember the ADA says, "Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight."

"[Patients] have a lot of belly fat and the like, and they have enough insulin," he says. "But it's not listening anymore...."

No, insulin resistance, however it is caused, is not the only cause of type 2 diabetes. Many type 2 diabetics are not producing enough insulin. In fact, many type 2 medications promote the production of insulin for this very reason.

Diabetes, particularly type 2, is the fastest-growing disease in history because of one thing—sugar.

Obesity is a problem, and the rise in type 2 diabetes is related to the rise in obesity. But sugar is not nearly the sole cause of all of these problems. That's ridiculous.

At this point I have to break off quoting Dr. Oz. He is wrong on generalities. He is wrong on specifics.
He is so full of crap on things I actually know something about, that I don't believe him on anything I don't know about.

The whole Oprah diabetes show was a giant, steaming pile of misinformation and mythology, stereotypes and sensationalism.

Oddly enough, Dr. Ian Smith and Bob Greene were apparently able to discuss diabetes sensibly, without any falsehoods, stereotypes, or myths, to make it clear when they were talking about obesity, type 2 diabetes, or diabetes in general.
So it can be done, even on Oprah.

UPDATE: It's been suggested, and it seems like a good idea, that all of the blogs on this topic include a link to comment to Oprah. http://www.oprah.com/ownshow/plug_form.html?plug_id=220

Let's Roll

2010-02-04T13:13:00.002-07:00

One of the problems with being slow to blog about what happens in your life is the fact that other things come along.
I have been intending to write about the Carlsbad Marathon weekend for two weeks now. I did start a blog post, but didn't get very far. But something else happened Wednesday that demands my attention today.

Jesse Alswager passed away at the age of thirteen, after 10 years of fighting type 1 diabetes. When I say fighting, I don't just mean like all of us type 1 diabetics fight, with finger stick blood tests, injections or infusion sets, CGMs, counting carbs, thinking through the metabolic effects of every meal, every bit of physical activity, everything....
What I mean is that he was fighting like he was in a war.
When Jesse was diagnosed at the age of three, his mother, Michelle Alswager, declared war on the disease, and she took her son into battle.
Jesse raised thousands of dollars for the cure, a cure he will never enjoy. Michelle, as a member of the board of directors for several diabetes foundations and eventually an executive at the Juvenile Diabetes Research Foundation was involved in raising millions.
Jesse met governors, Congress members, First Lady Bush. Politicians loved to be photographed with him and talk about him.
I never met Jesse. I wish I had the chance to thank him. He did a lot for me.

One of the things that Michelle Alswager did to raise funds for the cure was the JDRF Ride for the Cure. She met type 1 diabetic athletes, and learned how they were overcoming the challenges of the disease.
Michelle became a cyclist, then a triathlete, then an Ironman. Some time in 2006 she came up with the idea of a type 1 diabetic triathlon team, and a documentary about how they could train for and complete an Ironman.
That was how Triabetes began.
Triabetes has had a profound effect on my life, and I know that it has touched many more diabetics out there.
When I first heard, it knocked the wind out of me. It was more than a little discouraging personally, to learn that the inspiration for Triabetes had died. The inspiration had died. Yeah, that's how I felt.
And it was heart-breaking to think that Michelle Alswager, who had worked to spread hope to people like her son, people like me, suffering from type 1 diabetes, had lost her son.
For several hours this was a hope-crushing thought for me.
But now I've decided that it's part of this war. I've been around for the war, but mostly on the sidelines. I have not yet begun to fight.
I have to take to the battlefield now.

This has been true for the past couple of years, but I would like you to take notice of it now. There is almost always a link on the left hand side of my blog to some diabetes-related charity. Right now it is the Tour de Cure for the American Diabetes Association, but that will change. There will always be something.
If you read my blog, please consider, every few weeks, clicking one of the links and making a donation. This request is my first tentative step.
Tonight I'll be swimming, thinking of Jesse. Tomorrow I'll run. In March, I'll ride for the ADA. Later this year I'll ride for the JDRF.
Next year I'll complete an Ironman.

Anne is in contact with the Alswager family and will post information about memorial services and how to express condolences on her blog.

UPDATE: There is a memorial site for Jesse at: http://www.caringbridge.org/visit/jessealswager

What It's All About

2010-01-28T17:10:00.001-07:00

I had a fantastic time at the Carlsbad Marathon this past weekend, and I want to write it up soon, but that's not happening today. Today my Mom called me and read me something out of the latest edition of Diabetes Forecast Magazine.
What's better than getting written up in Diabetes Forecast Magazine as I was a little over a year ago? When someone writes a letter like this to the editors:

Last year I sent in a letter inquiring about diabetic marathoners and how they trained for their success [Mail Call, March '09, p. 13]. Tracey Neithercott's article "Success!" [Dec. '08, p. 61] about runner Jerry Nairn and his training program was very inspiring, and the advice was worthwhile.

I wanted to follow up to let you know that I just completed my first sprint triathlon. What a thrill! It was hard swimming in a lake with 800 other competitors, then biking 10 miles, and running 3 miles, but I overcame the obstacles and accomplished my goal. I am hooked! I love my fitness level now and my blood sugar control. I am more aware of my body and I am taking care of it.

I truly appreciate the "Success!" article, as it led me to believe that I could dream.

Dena Linda, Houston

Yeah, that makes me pretty happy.

Rock 'N' Roll Arizona Marathon

2010-01-18T13:20:00.000-07:00

I got a text message from one of my brothers yesterday asking if I had won the Rock 'N' Roll Arizona Marathon that morning. He knew that I was untrained and unmotivated, even though I had agreed to do it months ago, and I had gone to the expo.
My reply said that I had won my own private little race, a 16 mile run followed by a 7.5 mile walk back to my car. I had warned everyone, Sandra, who organized the pace group leaders, and Jennifer, who was sharing duties with me to lead the 4:15 marathon group, that I probably was not going to be able to complete the distance in time. I was told it would be all right if I did the best I could, so that's what I did.
For myself I didn't really want to run this marathon. I knew I wasn't ready. But Jennifer wanted me to help her, or at least spend some time running with her again. We used to run together quite a bit.
And once I started, I really wanted to finish for the people we were there to support, the runners trying to hit their PRs or make their BQ times.
My legs were aching and sore from about 8 miles on, mostly calves and quads, but also my hips a little bit. I had an ultra-marathon-like soreness building up as we passed 12 miles, and I knew I couldn't make it in 4:15. I could always gut it out to the finish, but I didn't want anyone to be following me while I crashed and burned. So I handed my sign to Frank, a friend who seemed to be steady and strong on the pace, and I stepped off the course at mile 16.
I put my long sleeve shirt, which I had worn for the colder, starting miles, back on over my official pacer tank top, and started walking the course. I took a shortcut back to the finish area where I was parked, and cut off a little under three miles, or I would have had the marathon distance. As it was, I covered 16 miles in 2:36, and 23.5 miles in 5 hours.
I hope, but I'm not sure, that I helped some of the other runners out there by being there as long as I could. If Jennifer wasn't there to carry through to the finish, I wouldn't have even tried.
Blood sugars were fine all day. I was at 107 about 30 minutes before the start, and had a half a bagel right before the start. I had gels as scheduled during the run, and when I stopped at 16 miles, I was at 106. My blood sugar could have safely been a little higher, but it was never an issue.
I'm not calling this a DNF because I wasn't registered, and it wouldn't have counted as an official marathon if I had finished. For some reason this year, not all of the pacers were given free registration. This is the fourth year I've been a pacer at this marathon, and the first time they've done it this way. Anyway, for me it made it easier to do what I had to do, drop out.
If there's a silver lining, this experience this weekend may have been good preparation for next weekend, the Carlsbad Marathon. That will really be my 50th official marathon. I would love to be in better shape, but I can take my time and finish feeling good.

Here we go again...

2010-01-12T12:51:00.000-07:00

I started last year with three marathons in three weeks, and I'm starting this year with the same three marathons, one after the other. The difference is that last year I was at least a little bit prepared before I started the set. My total running mileage for all of December was 13.
Oh, well, I'm not going to be setting any new personal records this month. I hadn't planned to do this, but this is the way it played out.
I had agreed to be a pace group leader, for runners trying to make it in 4:15, at the Rock 'N' Roll Arizona Marathon, as I have for the past three years. I was sick much of the time for the past six weeks, but this marathon is coming up this weekend, on the 17th.
I am running the Carlsbad Marathon on the 24th as part of the massive Glucomotive presence there, probably about 50 runners, many of them diabetic.
Then diabetic mountaineering legend and Ironman Sebastien Sasseville and diabetic Ironman Brian Foster will be in town for a conference and will run the Desert Classic Marathon while they're here on the 30th. I could hardly not show up for that event, and as long as I'm there, I might as well run the marathon.
It really seems as if I have no choice. I wonder how so many people avoid running marathons.

Havasu Falls

2010-01-07T17:30:00.001-07:00

Well, I can't leave this blog just sitting here like this. I've been thinking about blogging, and things I should comment on. I even uploaded a bunch of pictures from a hike my son and I took down to Havasu Falls back on November 29th of last year, but I never got around to writing anything about it.

Anyway, please enjoy these pictures.

Snow! Something we hadn't seen for a while. It had us thinking it would be very cold in the canyon, but it wasn't.

At the rim of the Grand Canyon before heading in.

Passing the Havasupai village on the way down.

Francis shooting some video from the edge of one of the smaller waterfalls along the way.

Havasu Falls from above.

I Am Not An Ironman

2009-12-04T08:33:00.001-07:00

Well, the day of reckoning was almost two weeks ago, so I apologize for keeping you waiting for a report.
The race result was what I had been worried about since before I signed up. I did not make the time cutoff for the swim. I needed to swim 2.4 miles in under 2 hours, 20 minutes, and I only made it about 2.2 miles when time ran out.
I thought about writing something about biting off more than I could chew, but the truth is, I came close enough to finishing the swim to know that if I had started seriously working on my swim earlier, and worked harder on it once I started, I could have done it. And I didn't.
When we challenge ourselves, when we set out to do difficult things, we learn about ourselves. Sometimes not everything we learn is good. I told everyone that I would do whatever it took to finish the swim, and I didn't.
I was too cocky early on. I had some fun and impressed a few people with my craziness by running 5 marathon distance or longer races between January 18th and February 15th. But looking back, it was just silly. I had one specific goal I had to achieve, and I wasn't even getting started on it.
Then I went to Diabetes Training Camp with my teammates, but I had the Old Pueblo 50 Mile in the back of my mind the whole time. I should have had more respect for the really important task at hand. I should have been concentrating on what I needed to do to get to the point I could swim 2.4 miles.
I was too stubborn. If I had been working on my swim sooner, I would have realized earlier that I needed someone to teach me how to swim. I was not going to get from splashing across the pool to gliding smoothly through lakes just by reading and watching videos. But I wanted to try to do it myself. This was also cockiness.
I was too lazy and disorganized. Sure I got up at 4 AM lots of mornings to go to the pool, but that's what everyone training for Ironman does. I missed a lot of days, too, sometimes because I didn't prepare well, and sometimes because I was too lazy. When I say I was lazy, I am comparing myself to others who trained for and completed the race, not the general public.
I know no one is going to say it, but I let a lot of people down. I don't think anyone is more disappointed than I am, but all of the people who backed me and supported me expected more from me. I was given so much support from so many sources, I don't think I can list everyone here.
Thank you all so much.
I'm disappointed with my result from race day, but race day was an awesome experience from the sidelines, watching the rest of the team shine.
I'm glad I signed up. I'm glad I challenged myself and set out on this tremendous, life-changing journey. It was well outside my comfort zone.
It's not over.
I'm continuing with my swimming, and I'm buying a bike. I don't know where or when it will happen, but I will meet this Ironman challenge.
Congratulations to all of the Triabetes teammates out there who had a successful race. You guys are awesome!
Please remember that it's people like me that help make people like you look good. :-)

I Believe...

2009-10-23T21:21:00.001-07:00

I haven't been blogging much even though a lot has been going on. The thing is, I've been apprehensive about swimming 2.4 miles. And the events that I've been doing generally haven't been very reassuring.
However, on Thursday night I did a Splash & Dash race at Tempe Town Lake, a 1000 meter swim and a 4K run. The swim was not great, but I know I can do better. And I managed the pace I will need to do to complete the Ironman swim within the cutoff time.
The following morning I got up and went to the pool and put in a good workout.
I'm swimming better every time, and feeling more comfortable every time I get in open water and swim in a crowd.
It's not going to be easy, but there's no reason to believe that I can't make the swim. It will take focus and hard work, but I should be able to make it.
I'm still scared, but I'm starting to believe...

DIY

2009-10-12T17:00:00.003-07:00

You got to cross that River Jordan,
You got to cross it for yourself;
O there can't nobody cross it for you,
You got to cross it for yourself;

Those words from an old spiritual, sung by slaves on plantations before the Civil War, have profound meaning that can be broadly applied. There is the spiritual, religious meaning, but these spirituals were sometimes used as veiled ways for those held in slavery to sing about seeking freedom. There are many meanings to this song.
Since March of this year, I've consulted six different swim coaches. I have had as many as three different swim coaches writing workout schedules for me at one time. I've read swimming instructions from dozens of books, articles, and websites, and watched several demonstrations on web sites and DVDs. I've almost lost count of how many friends and acquaintances have given me advice.
All of this help has gotten me closer to actually doing a 2.4 mile open water swim in under two hours, which is what I have to do on the morning of November 22, Ironman morning. I'm grateful to everyone who has contributed to getting me this far.
But I haven't done it yet. It all comes down to me swimming. And swimming and swimming and swimming.
No one else can do it for me. I've got to do it for myself. It's a pretty simple idea, but an important one.

David, my Triabuddy

2009-10-07T17:00:00.002-07:00

A part of the Triabetes experience which I haven't mentioned much on this blog is the Triabuddies. Triabuddies are kids who inspire those of us training for Ironman, while we try to return the favor.
When we cross the finish line at Ironman, we will each take our Triabuddy with us. This is a way to connect the older generations, like mine, with the younger ones coming up. Facing physical challenges, living adventurously instead of sitting at home in front of a TV, is a concept that applies to everyone who wants to live a healthier life.
My Triabuddy is David Auth, a great kid I unfortunately have not been able to spend enough time with. He lives in Carlsbad, California, and I'm here in Chandler, Arizona. We have exchanged a couple of emails and talked on the phone, but we finally met face to face for a short time last week.
Sue and I were in California helping Sue's father get some of his affairs in order after he moved into an assisted living facility. We made a detour through Carlsbad on our way home.
David and his family, Mom, Dad, two brothers and little sister, had just gotten home from camping. David had the bad luck of finishing his trip by falling on the camp fire and burning his hand, so he kept his hand in a glass of ice water the whole time we talked. He was clearly in pain, but he's tough.
He had already told me in email to "remember to never give up!"
David has never given up in his battle with type 1 diabetes. He's been fighting it since he was 4 years old. There's not much that could be more challenging than that, but to David, it's just part of life.
He enjoys lots of activities besides camping. We talked about how his hand injury might cost him some flag football practice the next day. He also likes soccer, basketball, skateboarding... He says street hockey "is the coolest sport."
David does it all with the enthusiasm of any other kid, but it takes a little more for him than for most other kids. It takes counting carbohydrates in his food, being aware of how much insulin is in his system, testing his blood sugar with frequent finger sticks.
But David says, "It's just what I do."
David does these health-maintenance chores because he knows that managing his blood sugar helps him feel better and keeps him healthy for all of the things he enjoys.

David is looking forward to the three-day sailing and kayaking journey to the Channel Islands he will take with the other Triabuddies. They will enjoy hiking and camping and diving with certified wilderness guides, experienced diabetes mentors, and kids just like themselves. This trip, and participation in the Ironman, aims at teaching these diabetic children not just that they can live normal lives, but that they can do anything.
No stranger to swimming in the ocean and exploring nature, David has been a YMCA Adventure Guide and an Oceanside Junior Lifeguard. He loves the outdoors and hopes to someday have a career which involves being a wildlife expert. A couple of his favorite TV shows are "Survivorman" and "Man vs. Wild."
Please consider helping David reach his fund-raising goal, and Triabetes continue this inspiring program.

David's page:
http://www.firstgiving.com/davidauth

Triabuddies:
http://triabetes.org/triabuddies.php

Triabetes:
http://triabetes.org/

Don't Worry...

2009-10-05T17:00:00.003-07:00

With apologies to Bobby McFerrin

Here's a little song I heard
Hope no one minds I changed the words

Don't worry
Be happy

Swimming is easy in your wet suit
A heat wave can make that point moot

Don't worry
Be happy

Tempe Town Lake's not really a sewer
But on a bad day smells like manure

Don't worry
Be happy

Swim coach said keep your head down
Try to remember that while you drown

Don't worry
Be happy

Gotta find a way to swim downhill
Mill bridge to Rural then Rural to Mill

Don't worry
Be happy

You've got two hours to get ashore
Or they won't let you race no more

Don't worry
Be happy

Transition 1 takes extra time
Reconnecting your Paradigm

Don't worry
Be happy

Check your sugar and adjust your plan
And then continue the Ironman

Don't worry
Be happy

The Beeline Highway on windy days
Feels like riding uphill both ways

Don't worry
Be happy

Spend some hours in the aero pose
Weight on your crotch and clipped in toes

Don't worry
Be happy

After three trips out to Fountain Hills
You get to test your running skills

Don't worry
Be happy

30 Things About My Invisible Illness You May Not Know

2009-09-18T17:25:00.007-07:00

On his blog, Marcus Grimm responded to this list, and I thought it would be a good way for me to start blogging again, too.

30 Things About My Invisible Illness You May Not Know

1. The illness I live with is: Type 1 Diabetes

2. I was diagnosed with it in the year: 1974

3. But I had symptoms since: Not sure.

4. The biggest adjustment I’ve had to make is: Thinking about my blood sugar all of the time.

5. Most people assume: that "managing the disease" is like having a cure. Insulin is a killer, too. It's bad medicine.

6. The hardest part about mornings are: waking up with a blood sugar that's way off, too high or too low. There's the frustration of trying to figure out what went wrong, but it also can throw your whole schedule off. A high blood sugar will mean that I shouldn't eat breakfast for a while. A low blood sugar will mean that I'll want to eat something right away, even if I was planning a workout.

7. My favorite medical TV show is: an odd thing to ask. I'm not really into medical TV shows. Scrubs was funny. Is it still on?

8. A gadget I couldn’t live without is: There are different meanings to that phrase "couldn't live without." In the context of chronic diseases, you could take it literally. There's no "gadget" that I couldn't literally live without. Type 1 diabetics were able to survive with regular insulin and glass syringes.
But there are several pieces of technology which will help me live a longer, healthier life, my pump, my CGM, my meter and test strips.

9. The hardest part about nights is: trying to feel safe going to sleep, trying to be sure that your basal and bolusing has been well matched to your activity and food and your blood sugar won't go high or low while you're not awake.

10. Each day I take lots of vitamins, and insulin.

11. Regarding alternative treatments I: don't have any.

12. If I had to choose between an invisible illness or visible I would choose: depending on how the illness was visible. If it wasn't obnoxious, I'd like people to see the illness.

13. Regarding working and career: most of the time diabetes doesn't matter, but it sucks when it does interfere.

14. People would be surprised to know: how often I'm thinking about my blood sugar.

15. The hardest thing to accept about my new reality has been: (not a new reality) I have to keep explaining it to people.

16. Something I never thought I could do with my illness that I did was: run marathons.

17. The commercials about my illness: are not aimed at my demographic.

18. Something I really miss doing since I was diagnosed is: not thinking about diabetes, not trying to think like a pancreas.

19. It was really hard to have to give up: orange juice, except as a treatment for lows.

20. A new hobby I have taken up since my diagnosis is: crossword puzzles. Seriously, I only started doing crossword puzzles to kill time for the couple of weeks in the hospital after my diagnosis. I'm still at it, 35 years later.

21. If I could have one day of feeling normal again I would: just relax and eat like there was no tomorrow, burgers and fries, steak, Boston cream pie, cheese cake, ...

22. My illness has taught me: I can deal with hardships.

23. Want to know a secret? One thing people say that gets under my skin is: "I couldn't do that." There was also one guy that said, "Yeah, but you just check your blood and take your shots and you're fine, right?" Most people aren't that ignorant.

24. But I love it when people: contribute to my cause.

25. My favorite motto, scripture, quote that gets me through tough times is:
"Nothing you can know that isn't known.
Nothing you can see that isn't shown.
Nowhere you can be that isn't where you're meant to be.
It's easy.
All you need is love."

26. When someone is diagnosed I’d like to tell them: Don't believe a cure is just around the corner. They've been saying that for decades. Do whatever you can now to keep yourself healthy in spite of the disease.

27. Something that has surprised me about living with an illness is: I have an extended family of diabetics out there, going through a lot of the same things I'm going through. They're my brothers and sisters of the needle.

28. The nicest thing someone did for me when I wasn’t feeling well was: take me to a doctor.

29. I’m involved with Invisible Illness Week because: I had a dry spell in my blogging.

30. The fact that you read this list makes me feel: Did you read all the way through this? Wow! Thanks! I'm grateful.

Hearts Go Out

2009-09-09T12:01:00.002-07:00

More running poetry.

hearts go out
Written 9/26/01
by Jerry "Geronimo" Nairn

I'm like everyone else, but
I'm told my
heart
beats
slow
because I run.
I go out to run before dawn
just to feel my blood flowing
my legs flowing
my body
the sweat
and the beneficial side effects like a
slow
strong
heart
beat
and seeing the sun rise through the mist of a grey September morning
before I wash the sweat from my body in the shower
before I step out and my wife tells me
in very plain, simple words
that something that could
not
happen
has happened.
"...and now both towers have crumbled to the ground."
I run
for the beneficial side effects
like seeing the sun rise through the mist of a grey September morning
before I know thousands of beating hearts were suddenly
crushed into stillness
before, like millions of others
my heart stops
my heart breaks
my heart goes out

Uncle Bernard and Aunt Gertrude

2009-09-08T19:19:00.003-07:00

I'm thinking again about how lucky I am to be living now. One thing that makes this very clear is hearing about my relatives who had diabetes. Apparently type 1 diabetes skipped a generation on my mother's side of the family. Mom had two brothers and three sisters, none with type 1 diabetes, but her mother, my grandmother had two type 1 siblings.
Dude, as they called my Grand Aunt Gertrude, married young, and at the age of 19, was pregnant and diabetic. A specialist put her on insulin, but her own doctor didn't think insulin was safe. So she and her baby died.
Grand Uncle Bernard, six years older than Gertrude, was also diagnosed with diabetes, and stayed on insulin. He was a farmer and worked hard his whole life. When I was diagnosed, I was told of his vigorous health in spite of diabetes. It was only recently I heard that he didn't live to reach 40.
I never met either of my type 1 relatives, but I find their stories interesting, and I think there are lessons I can learn from them. Maybe the most important thing to be learned is that I should be grateful for the medical treatment available to me, and make the best possible use of it.

Sloth

2009-08-22T09:16:00.002-07:00

I'm not sure why, but I have been absolutely slothful for a week.
Well, I know how it started. My sister-in-law passed away. I was not so close to her that I could claim a need for mourning, but of course, Sue, my wife, was broken up. So my priorities shifted to family matters. I got in one last swim before we left for the funeral. I jogged with Sue in the neighborhood near our motel.
When it came time to go to the funeral, Sue's father couldn't get out of bed. To make a long story short, he had a stroke. It was one of those things where most of the symptoms pass, but he simply can't live alone any more. He needs help to make sure he doesn't fall down when he tries to get anywhere, and someone to make sure he takes all of his meds correctly.
So when I returned home, Sue stayed to help her dad get his affairs in order and get into a new living situation.
I've been here with my son, Francis, who is grown and attending Mesa Community College. It should be easier for me to get up and go do my workouts. I can turn the alarm up. There's no reason to keep the lights out in the room and try to be quiet so I don't wake Sue at 4:30.
Yet somehow I've been a sloth for the past week. It came to a peak yesterday, when I actually got up, started the coffee maker, laid down on the couch, and woke up late for work.
I lost a week of training I really couldn't spare. Well, I didn't totally lose it. I did some kind of exercise after work for the past five days, but I haven't been training enough. It's hard to get back at it.

S.I.P.E. at Mountain Man?

2009-07-29T11:57:00.002-07:00

Anne Findlay, one of my Triabetes teammates, suggested that what happened to me at the Mountain Man Sprint Triathlon may have been SIPE, swimming-induced pulmonary edema. After reading about it on Anne's blog and SlowTwitch.com, I think that's a strong possibility.
The idea that the lack of oxygen would affect me like that just didn't make sense to me. I have run several races in the Flagstaff area, including the Flagstaff Marathon, which tops out at over 8600 feet in elevation, and I never felt anything like I did trying to run that 5K at Lake Mary, about 7000 ft.
However, SIPE would explain what happened in the swim, and my weakness for the rest of the day, especially when trying to run. I didn't have the worst symptoms of SIPE, but mild congestion in my lungs combined with the natural effects of altitude provides a good explanation of what happened.
And if I know what happened, I know some things I can do about it:
I can start taking an ACE inhibitor, which can strengthen my capillaries. These are often prescribed for diabetics as a precautionary measure, to protect the kidneys.
I can get more time practicing swimming in my wet suit which I just purchased.
I can make sure I'm warmed up before I start swimming hard.
I can avoid taking electrolyte tablets and drinking a lot of water until after I finish the swim. This may not be the standard advice, but it can help with this problem of pulmonary edema.

Just one more thing to think about and be prepared for.

Mountain Man Sprint Triathlon 2009

2009-07-28T12:00:00.013-07:00

This is a long story, so I'll just put the short version here at the top for those who don't need all of the details.
The 700 meter swim was one of the hardest things I've ever done in my life.
Except for wiping out 3 times, the bike ride was uneventful.
I could not run during the "run" portion. I don't know if it was exhaustion, dehydration, lack of food, lack of oxygen, or all of the above.
I finished last, but I'm glad I stuck it out and finished.

Now the long story:

Before the Mountain Man Sprint Triathlon Sunday, July 19th, at Lake Mary outside of Flagstaff, I thought I knew that doing Ironman Arizona was going to be very hard. I've done some pretty hard things.
I didn't have a clue.

The night before the race I laid out everything I was going to need for the race on the extra bed in my room in the Budget Host Motel. I made lists of what I needed in each transition:
Transition 0, at the start, Triabetes tri-shorts and top, sunscreen BodyGlide, wet suit, goggles, swim cap, ankle strap chip, gel...
Transition 1, swim to bike, gels, water bottles, bike shoes, helmet, gloves, sunglasses, more BodyGlide, ...
Transition 2, bike to run, gels, running shoes, hat, more BodyGlide, ...
I get kind of nervous before races that I'm... well, nervous about. And I was pretty stressed out about the 700 meter open water swim I was going to have to do. Swimming is a very weak area for me, and I had dropped out of the Tempe International Triathlon Sprint just a few meters into the 400 meter swim in that event.
I had so little concern about the bike ride and the run portion of this triathlon that when my son asked me how long those portions were, I had to admit that I didn't know. I hadn't given any attention to them until he asked. It turns it's a 700 meter swim, an 18K bike ride, and a 5K run.
I set the alarm for 4 AM, but I wasn't able to sleep very well. I finally got up at 3 and didn't go back to sleep. My blood sugar was 145 mg/dl when I checked, and I took a 0.8 unit correction bolus with my insulin pump.
I had a PureFit bar and some coffee at 4 AM and took the bolus wizard recommended 1.8 units to cover it. I took care of some biological necessities and at about 4:45 I loaded my stuff back into my car, dropped my key off at the motel office, and hit the road out to Lake Mary just as the sky was starting to get light.
There had been a few drops of rain the day before, but it didn't look like there would be any of that on race morning.
I got lucky with parking and took a spot across the road and just a few yards north of the entrance to the parking lot where the transition and finish areas were. With no concern for speedy transitions, I set up in a fairly clear area at the back of one row. It hardly mattered how much space I had when I got there, though, because it all filled up quickly.
The bustling pre-race atmosphere had a special Mountain Man touch added by the presence of actual Mountain Men on horseback. They were riding and walking around, getting their pictures taken, talking to athletes and supporters, and lightening the mood. The horses contributed by leaving a couple of large, steaming piles in the walkway through the transition area.
Adding even more rustic, frontier charm, outside of the fencing and on the uphill side of the transition area, just a few feet away from where I had carefully laid all of my gear out on a towel, one of the horses stopped to urinate. He went buckets. The Mountain Man atmosphere almost took my breath away.
Fortunately for me, the slope of the parking lot had the flood flowing away from my bike, but toward others. From what I could see, most people were able to move their belongings in time, but the flow continued on out of my sight. I don't know if everyone was spared. And of course, the already crowded conditions got worse over that way.
At about 6:15 my blood sugar was 143. I set my basal rate to a lower level, not so much in anticipation of the swim as to be where I wanted it to be for the bike and run. I was going to have to disconnect from my pump, getting no basal insulin, before leaving transition for the swim.
At about 6:30, I had a juice box and took half a unit bolus, disconnected, pulled on my rented wet suit up to my waist, and walked barefoot over to the swim start, about a quarter mile. The pavement had been shoveled clean, but I tried to watch out for where those horse piles had been.
The last wave of swimmers scheduled to go out was mine, all of the males in the sprint competition, about 140 of us, at 7:17 AM. I listened to the swim instructions to the women in the sprint race, then hung around nervously on the boat launch ramp for about twenty minutes to hear them again for my group.
I suppose I should have gotten into the water and tried to get used to the temperature and the feel of it before the start. This was my first time swimming in a wet suit. A couple of minutes splashing around with no pressure might have helped.
The thing is, I didn't feel like I had any pressure to do well. I just wanted to finish. Speed was not an issue. So I didn't want to waste any energy.
When it was our turn to start, I walked into the water up to my knees and stopped, in the last row. Some men were out up to their chests. The starter warned some of them, up to their necks, to back up a little, telling them the steps they were trying to save wouldn't matter, unless they got disqualified for it.
I was content to be way in the back, maybe the last person, in any wave, to start swimming.

When the start went off, I put my head down and started swimming, the way I've been training, as smoothly and efficiently as I could. I kept telling myself not to get too excited, keep cool. It fascinated me the way it seemed like the crowd of swimmers around were pulling me along, like I was in a strong current flowing away from shore. Perhaps it's the way a school of fish help each other swim together faster than one can alone.
After about seven strokes I realized I wasn't breathing. I took one breath, two strokes, another breath, and raised my head to look around. I was still doing all right, and I put my head down and swam for another few strokes and breaths.
Then I had that feeling like I had to see where I was again. I was still in the rush of the crowd then, but as I breast-stroked a little, they got away from me. There were others around me, also not sticking to a freestyle stroke.
I tried to get back at it, but it was somehow terribly uncomfortable, head down, nothing but green water and bubbles, and the breast stroke was easy and comfortable, and I could always see where I was going, and that I was making progress.
So I gave up on freestyle.
There was already one guy hanging onto a kayak a few yards away from me. In another minute, as I was calmly, more or less, stroking toward the first buoy, a kayaker out ahead of me raised his paddle in the air signaling that he had a swimmer who wanted out of the water.
Another kayaker looked directly at me and raised his head as if to say, "How you doin'?" I gave him a thumbs up and kept going. The breast stroke felt easy, and I could see I was approaching the first buoy.
The swim course for the sprint was very simple, about 150 meters straight out to the first buoy, a big, red, inflated tetrahedron, about six feet on each edge, then turn left, parallel to shore for about 400 meters to the second big, red, tetrahedron, then left back to shore.
The first buoy was collecting swimmers, first one, then another... I think at one time there were five guys hanging on there. I imagined for a few seconds that all of those guys might actually be pulling the buoy away from me, making me swim farther, but the feeling passed when I saw I was getting close.
I felt no need to rest at this point, and I set it as a goal not to get any help or hang onto anything. I wasn't moving fast, but i was making steady progress.
On the long swim between the buoys, it became pretty clear that I was in last place. Others would stop and float on their backs, or hang onto kayaks, and I would almost catch up, but there was no one behind me. I was bringing up the rear.
After a while, one guy in a yellow kayak, the one who had looked at me for a high sign early on, cruised along within a few feet of me.
Somewhere about two thirds of the distance between the buoys I started to think I had made a mistake. I was trying and trying to do it without any help, but I saw others hanging onto the kayaks and the buoys, then swimming on. My energy was fading fast, and I started to think maybe if I just rested a moment...
My friend in the yellow kayak asked me how I was doing. I call him "my friend" even though he didn't know me because it would be weird, even though appropriate, to call him "my guardian angel." I finally told my angel that I could use a rest, and he let me grab onto the nose of his kayak.
Once I wasn't trying to swim, I noticed something strange going on with my breath. It had a reedy sound to it I had never heard before. The word "asthmatic" came to mind, but I don't have asthma. I didn't want to think about it.
After a minute or so, I swam on toward the buoy. There were other swimmers there, hanging on, but they were gone by the time I was almost there, and I was begging for another chance to hang onto the kayak.
I took another break just before reaching the buoy and, thinking maybe I was so beat because my blood sugar was low, I pulled out the gel I had shoved into the sleeve of my wet suit, tore off the top, and slurped it down. The guy in the kayak took the litter off my hands.
After that, I swam around the buoy, and a little farther on. Another swimmer near me, the last swimmer near me, got pulled out of the water onto a motor boat. There were about four or five drop outs in wet suits on the boat.
I could see other swimmers in the water, the last of them, approaching the boat ramp where they could exit the water, finishing the swim. I knew I was only a few pool-lengths away, but I just couldn't swim it. The breathing noise was getting louder. Hanging onto the kayak again, I asked the angel, who had a goatee and was wearing a ball cap, if he could hear my breath. He said yes, and I told him it wasn't right.
We talked a little, and he was convinced I had just let too much water down my gullet. I knew that I had been swimming with my head out of the water, but I didn't want to use that word I was thinking of, asthma.
I coughed and spat, and tried to clear my throat, but it didn't help.
I kept swimming and stopping, the swims getting shorter, the stops getting longer. I kept trying to clear my throat. I started breathing more forcefully, inhaling and exhaling harder because it seemed to work for a little while. All the while I was getting closer to shore, but it always seemed like it was still too far for me to make it, because I was more and more exhausted.
Finally it was just so close that I could not give up. And for what seemed like hours I kept stroking for those last few yards, seeming to advance only inches at a time... and suddenly... my feet were on concrete and I stood up.
The few volunteers who were there waiting for me applauded, and one guy in a cowboy hat came toward me, held up his hands and said, "Now take a full breath. Take a few deep breaths."
Apparently some people faint when they reach the shore and try to walk out. Fortunately that didn't happen.
I walked slowly out of the water and tried to grab the strap on the back of my wet suit. The volunteer said, "I'll get that," and unzipped me. I pulled down the front of my suit, then could not pull my arms out. I just kind of stood there looking at my arms as I tried to move them. It wasn't that there was too much friction. I had lubed up with BodyGlide before putting the suit on. My arms were just too weak to move.
Finally the volunteer realized what was going on and yanked my right arm most of the way free. I just didn't have the energy. My left arm stayed stuck as I walked away.
I was halfway up the ramp when the guy who helped me with my right arm finally ran up and helped me with the left.
My friends Erica and Lara, there to cheer others and to race on a relay team, had been watching and waiting for me. They congratulated me for finishing what was obviously a difficult swim.

I crossed the timing mat into the transition area with a touch of doubt about the rest of the race.
But my breathing had already returned to normal. By the time I got to my bike, I felt like I could at least go out and coast for a while.
So I checked my blood sugar. 310! So I wasn't low in the water. Dang. Talking with Erika, David Bourdon's wife, who was there at the edge of the transition enclosure, she told me that David has the same attitude I do sometimes. Sometimes you look at that glucose meter hoping it will give you an excuse.
Not today... at least, low blood sugar was not going to be an excuse.
The guy who had helped me with my wet suit came by and said, "There you go! There you go!" He could see that I wasn't going to drop out, and he seemed pretty happy about it.
I took a 3.5 unit bolus and headed out on the bike. If I wasn't in the middle of a triathlon, I would have given myself at least twice as much insulin.
The ride was going pretty well. The lake and the shore, tall green grass with a few wildflowers, piny woods, it was all beautiful, and a welcome change from the desert around Chandler, where I live.
I felt no need for speed. My race was all about finishing after that swim, but once I was out on the road, in the race, it seemed silly to just coast through it.
My shoulders and arms were very sore, and I didn't feel like staying in the aero position, but I tried to keep spinning as much as I could. It felt fine. I was about halfway back after the turnaround when, for no reason I can explain, I went off the road.
I was looking down at the edge of the blacktop thinking I was getting too close, and I guess I was just so out of it, and my arms were so weak, I just drifted over the edge. I rolled along into the ditch, full of high grass, for a surprisingly long time before I flew off the bike, rolled onto my back, and had the bike land on top of me.
I wasn't hurt at all. It was very comfortable lying on my back looking up past my bike frame at the sky. Without the road and countryside whizzing by, I became aware of my breathing. I hadn't realized how hard and loud I was breathing until I was lying there otherwise still.
After a decent rest, I got myself out of the ditch, thanked a couple in a station wagon who had stopped to see if I needed help, and set off down the road again. In a little while, I became worried about a little wiggle I felt in my rear wheel. I was thinking maybe I had a puncture and the tire was going flat, but I wasn't sure.
I tried to stop to check this, and for the first time in months, I fell while trying to get my cleats off the pedals. I scraped my calf on the front gears right over the spot where I still have a scar from the last time this happened.
My tire was fine, though, so I just reassured the motorcyclist who asked if I was OK, got back on the bike and headed toward my next transition, for the "run."
To make it into transition, I had to make a left turn across the road in the last few yards. Volunteers had momentarily stopped traffic on the road for a couple of us to cross, so there were lots of spectators and people in their cars watching at this point.
As soon as I started to turn, my back wheel popped loose and got wedged into place in my frame. It had been loosened up when I went off-roading, and that's what caused the unsteadiness I had felt. As soon as I tried to turn, there was enough torque to pop the wheel out.
My tire scraped across the ground unable to turn and my tube blew out.
I was able to dismount without incident this time, and after a moment of hesitation in the middle of the road, I picked up the bike and carried it into transition.

In transition, my blood sugar was 284, still way too high. In hindsight, I probably should have bolused more and eaten something, but at the time, I was just thinking it was coming down and it would be all right.
I tried to run out of transition, but the first few yards were uphill, from the parking lot onto the road, and I was feeling faint. So I walked until I was up on the road, then I jogged across the road and tried to keep jogging.
But I could only do this slow, plodding pace for about 50 feet before I felt like I was going to pass out. I could have been starved for oxygen, dehydrated, or just weak from lack of nutrition. I hadn't eaten anything since the gel I had out on the lake. I had done a lot of swimming after that.
There was no way to hydrate during the swim, and I hadn't thought very much about drinking while on the bike.
And even though I didn't have that noise in my breath any more, I still felt like I was constantly in oxygen debt.
So I just walked the 5K. Walking felt OK. I could actually do it fairly easily, with no worries. But when I tried to run a few times, I felt light-headed, dizzy, and like I might pass out.
I was amazed that it took me over an hour to walk this 5K. It didn't feel that slow. But it doesn't matter. I was just trying to finish.
Finishing was the best I could do, and I did it.

My blood sugar was 267 after the finish, and I finally bolused enough so that it would come down and I could eat something in a little while.

Afterwards, heading out of town, I turned on my radio and hit the seek button to find a station. It stopped at "The Magic 106.1" and I left it there because they were playing the kind of "classic rock" I usually listen to. Then the DJ said he was about to play a Mily Cyrus song, from the "Hannah Montana" movie soundtrack. I've heard of Mily Cyrus, but I don't remember ever listening to her sing, and I wasn't sure I wanted to. I was thinking about changing the station, but I gave it a chance, and they played "The Climb," by Jessi Alexander and Jon Mabe.

The struggles I'm facing
The chances I'm taking
Sometimes might knock me down
But no, I'm not breaking

I may not know it
But these are the moments
I'm gonna remember most
Just gotta keep going
And I gotta be strong
Just keep pushing on

'Cause there's always gonna be another mountain
I'm always gonna wanna make it move
Always gonna be an uphill battle
Sometimes I'm gonna have to lose

Ain't about how fast I get there
Ain't about what's waiting on the other side
It's the climb

It broke me up pretty much. I was cruising south down Highway 17 with tears streaming down my face. It caught me in a weakened state.
Anyway, as I said earlier, I thought I had some idea how hard Ironman Arizona was going to be. I don't think I really had a clue. I may still have no idea.
But this is going to be hard.

Last Sunday's Ride

2009-07-10T16:41:00.005-07:00

On paper, there was nothing difficult about this ride. It would be flat and not very long, just over to my Mom's house and back home. Going the "long" way, it would be 17 miles.
But it turned out to be good experience. The ride out was uneventful. It was hot out, since I was starting in the middle of the day, over 100, I'm sure, but I had plenty of water, and I wasn't working too hard.
I stopped at Mom's and had a nice, cool drink in the air conditioned house, talked about stuff, and started back.
About a mile and a half later, as I was starting out from a standstill at a traffic light, my right foot came off the pedal. I thought my cleat had come off the pedal, that I had improperly popped it on, but when I tried to put it back, I saw that my cleat was still stuck on the pedal. It had come off my shoe.
There were only two of the four screws still in the cleat. Who knows when or where I lost the other two. There was a rock stuck in the cleat where one of the screws should have been. I wondered how this happened for a second. I had one shoe, the left one, with no problems, and the other shoe was all messed up.
Then I realized that I always unclip on the right side when I stop, and I usually leave my left shoe on the pedal. The right shoe gets the extra stress of getting popped on and off the pedal, and also keeps getting put to the ground, sometimes kind of forcefully as I stop or push off for a start.
Fortunately, I was only about a hundred yards from Curbside Cyclery when this happened. I went in and asked to borrow a screwdriver, but they took my shoe, got the rock out of the cleat, replaced the missing screws, and put it all together for me.
Meanwhile, while I was waiting, they had Tour de France coverage on a big screen TV, with free drinks and cookies set out for anyone who wanted to stop by. I felt pretty lucky.
I got my shoe back on and hit the road, and did all right for two more miles, when my ride suddenly got noisy and rough. My rear tire had gone flat.
I've changed the tube in the front tire several times, but I was a little scared to mess around in the back, where the derailleur and gears are. But now I had to do it.
I got the wheel off the bike, and was looking for a way to lay the bike down or prop it up without scratching it. I leaned it on a low bush in the landscaping off the road. It was only later, as I was about to leave, that I realized this bush was covered with thorns. It was just luck I didn't flatten another tire.
I got the tube off the tire and put a new one in without much trouble. It's much easier to change inner tubes when its over 100 out and you've softened everything up by heating it up on the blacktop.
I took out my CO2 inflater and put a cartridge in it. When I tried to tighten the top down I couldn't get it to go on straight, and I partially punctured the cartridge, so I was struggling to get the top on while I was losing the pressure I had hoped to fill the tire with. There was a maddening and frustrating minute or two before I had to give up.
Then I was sitting there with one last cartridge to try the same thing again. Somehow, miraculously, this second time I did it perfectly. Glad I brought two cartridges.
It took me a minute to figure out how to get the wheel back on with the chain around the gears, and I was back on the road.
So all in all, it was a great ride. I had some hardships, but I got through them. I'm sure that the next time I have a flat, and it will happen, I'll be able to deal with it. That was something I couldn't be sure of before.

Results are in

2009-06-23T15:52:00.001-07:00

The results from the little triathlon I did this past weekend are in. Considering I was DFL* in the swim, I did all right. I was 17th out of 39 competitors, 7th out of 12 amongst masters men.

A fellow Triabetes Team member, Julie, was first place woman! She swam more than twice as far as I did, biked a mile farther, and was right behind me on the run. In short, she kicked my butt, but I can't feel bad about that. She kicked almost everyone's butt.

*DFL means Dead Last.

I was 10th on the bike, and third overall on the run. I can't be too thrilled with my run finish because obviously I didn't wear myself out as much as others did in the swim.

Still, at the risk of repeating myself, it was a lot of fun.

Lifetime Fitness Indoor Triathlon

2009-06-20T19:29:00.004-07:00

I am now a triathlete. I have actually completed a triathlon.
Of course, it was kind of a different, and easier triathlon. It was all based on time, so there was no way, once I entered, that I could not finish.
It was a 10 minute swim in the lap pool, a 10 minute transition, a 30 minute ride on a stationary bike, a five minute transition, and a twenty minute run.
I had turned down my basal rate an hour before the start time, but when I checked my blood sugar in the parking lot, with about 35 minutes to go to the start, it was 68. I ate a Pure Fit bar and washed it down with some water.
I did only nine lengths in the pool, with lots of long breaks at the end of each length, and a few mid-length stops. That's just 225 meters. I don't know if anyone did less.
It was probably very good practice for me. I was right up against one wall, sharing a lane with another guy. I hit the wall with my arm several times, and a couple of those stops in the middle of a length were because I was disturbed by how close I was to the other swimmer. He did nothing wrong. I just need to get used to swimming with other people around me.
I got to the bikes and threw my stuff down by one of them. I checked my blood sugar, and it was 173. That was cool.
Then I went to get on the bike and see if I needed to adjust anything, and I saw that it had no toe clips! Some of the bikes had toe clips, and some just had cleats. I was in my running shoes, and needed the clips. So with only a few minutes to go, I was frantically looking for an unoccupied bike with toe clips. I found it with only a minute to spare, and had no time to adjust it. In fact, I only had one foot really into the clip, and had to stop to force my other foot in after the start.
And the seat I was on was way too low for me. I wasn't getting anything close to full extension. Oh well, there was nothing to do about it but ride.
I tried to stay consistent, but I was aware of times when I realized I had slowed down and I needed to pick it up.
My odometer hit 14.0 when we finished. I don't know if that means I could really go 28 mph for half an hour.
Checking my blood sugar before the run, it was 145. I thought that was fine, but if it continued to slide, I would go low, so I ate a couple of clif shot blocks. That was a bad idea. I know things about what happens when I run in different ways, but sometimes I ignore the things I know. For example, I know that when I run a 5K, the race environment and the intensity of the effort can drive my blood sugar up. At least I know I never need to turn down my basal for a 5K. I leave it alone, then check to see if I need to bolus after the race.
So anyway the run went well. I had some of that brick feeling, but I just gradually upped the speed on the treadmill as I got comfortable at each pace, and pretty soon I was running a 7 minute mile pace. This worked for a while, to about 1 mile, but I realized I wasn't going to be able to keep it up for 12 more minutes.
I cranked it back to 7:30 for a while. Twice, I turned back up to 7, then back down to 7:30 when I felt like I couldn't hold it. Going into the last three minutes, I tried to speed up again, but I gave up on it after a few seconds. I was just too beat.
Amongst the people around me whose distances I heard, my 2.71 miles seemed to be the best. I'm sure some people did better, but I did all right.
I will have to wait to see the results. It was a great learning experience, and fun!
Oh yeah, after showering and walking out to my car, I finally checked my blood sugar again and it was 270! It's totally understandable, and I should have known better, but it kind of delayed my recovery meal.

When to Educate

2009-06-19T16:43:00.002-07:00

I picked up some test strips from the pharmacy today, and had a brief conversation with the pharmacist that I don't think I handled well.
She expressed some surprise at how many strips I was getting, and actually asked me, "Do you really test 10 or 12 times per day?"
At the time, I wasn't insulted. She didn't ask in an accusatory way. But looking back, when someone asks that in that context, it implies you're scamming the insurance for more than you need.
I just answered, "Yes, I really do." So she asked, "Does your blood sugar really fluctuate that often?"
I smiled, thinking, "You have no idea what this is like..." but all I said was "Yes, it does."
She made a couple other statements about how "strange" it was that my blood sugar should "fluctuate that much," but I just smiled and left.
As I was leaving, though, I thought I really should have set her straight on a few things. It is not "strange" for someone on insulin to be checking that often. If you think about testing only before and after three meals and one snack, that gets you up to 8 tests per day. If you test before and after exercise, and you exercise once per day, that's ten.
And don't get me started on the fluctuating blood sugars.
Yet here is a pharmacist, a person in a position to offer me consultations on my prescriptions, who has absolutely no idea what life is like for type 1 diabetics, saying things like that. Sure, it doesn't affect someone who's been diabetic for 35 years, but someone else might actually believe her. She's in a position of authority. Some newly diagnosed diabetic might think, "Oh, maybe I don't need to check my blood sugar so often." or "Maybe there's something wrong with me because I don't always predict the perfect dosage for every meal I eat."
I should have tried to educate her, I suppose.
Then there was a woman a couple of weeks ago who, upon finding out I was diabetic, told me of a diabetic child she knew who had a "very severe case." She knew this because he was always testing his blood sugar and taking insulin. To me it just sounded like living with diabetes, but I didn't correct her either.
One of the reasons I'm training for Ironman is supposed to be to change people's ideas about diabetes. I need to do that more in my personal life.
I think I had given up on educating people. So many think they already know it all, and whatever you say to them, they misinterpret to confirm what they already believed, or it goes in one ear and out the other.
But I really should continue to try. It matters.

Sorry, My Bad

2009-06-16T15:24:00.003-07:00

Apparently the health care crisis is caused by "exercise freaks" like me. Sorry about that.

In the words of Rush Limbaugh:

Folks, I gotta tell you, I, uh, I think that those of you who regularly exercise, playing softball, baseball, basketball, soccer, mountain biking, running, rock climbing, skiing, skating, running, you're the people getting injured. You're the people showing up at the hospital with busted knees, and tendons and skin cancer, ankle sprains, knee and hip replacements, broken bones, concussions, muscle ligament tendon cartilage strains and tears, tendinitis, rotator cuff tears. All you exercise freaks. You're the ones putting stress on the health care system.

What happens when people don't regularly exercise, keep their weight relatively under control? Nothing. They probably don't even know their doctors names.

So you're urged, what, to do all this stuff and you end up in the hospital all the time with these injuries, and some people think these injuries are badges of honor, knee surgery scars are badge of honor, shows toughness.

Yeah, toughness somebody else has to pay for.

Overweight drug addicts are bearing the burden of the medical expenses of people who go outside and exercise. Hm. I've had that all turned around.
I know Rush Limbaugh is strictly for entertainment and should never be taken seriously, but I find it hard to believe this rant strikes a chord with even his most steadfast admirers.
Don't play softball or baseball? Isn't that un-American?
It's odd Mr. Limbaugh seems to have omitted more violent sports like football, boxing, wrestling, and martial arts.
I guess tennis is OK, too. Golf is fine, I'm sure, as long as you drive a cart.
Running is so bad he mentions it twice.
Anyway, I'm sure he was talking about me, because even some people who exercise think I do a lot. I'm sure I seem like an "exercise freak" to someone like Mr. Limbaugh.
However, Rush Limbaugh definitely knows his doctor's name. He probably has more than one doctor on speed dial, if only to fill his prescriptions.

Ow

2009-06-12T18:07:00.004-07:00

Tim Bolen is a generous and gifted coach and triathlete. He holds a track workout at a local high school every Wednesday morning, and anyone who wants to show up at 5:30 AM for a little training is welcome.
I feel very lucky to have the option to add a workout like this to my training, and I've been going there for the past few weeks.
Sometimes I feel great about it, and sometimes I would compare it to being forced to join a graduate class on quantum physics some time in the middle of the semester. I'm just not physically ready for it.

This past Wednesday, Tim started out by saying, "If you're racing this weekend, don't do this workout."
At this point several of the several dozen certifiable nutcases gathered there before most sane people are out of bed turned to each other and ominously whispered, "That's not a good sign!"
Then Tim went on to say, "If you're injured, or you think you might have an injury coming on, don't try to do this workout."
Another wave of fearful muttering went through the crowd of lunatics.

Then we started in on drills, hop on one foot, forward, back, side, other side, forward, back, etc. for a minute.
Then frog jumps, feet wide, squat down low, leap up high, reaching up, then right back down, again, for a minute.
Then walking lunges, reaching ahead with forward leg, keeping back leg straight, not touching the knee to the ground.
Then side to side, on one foot, jump to right side landing on right foot, lower knee of left leg almost to the ground, then jump to other side landing on other foot, lowering the other knee.
I am beginning to wonder if Mr. Bolen is just making up new ways to punish us on the spur of the moment.
Then 200 meters fast. 20 secs rest.
400 meters at 5K pace, 20 sec. rest.
200 meters fast.
Then the series of drills again. hops, jumps, lunges, hops.
Then the 200, 400, 200 series again, twice.
Then 2 X bleacher steps, 3 at a time.
Then timed 1600 meters.
Then cool down.
I still suspect that this whole series of activities was made up right there on the track for the express purpose of causing pain.
Drills were hard for me. I did not do great.
I did the 200s well, but the 400s slow.
The bleacher steps 3 at a time I could not do. I could either do 3 at a time walking fast, or do 2 at a time running.
I did the final mile in about 7:30, which I can't be too unhappy about.
That workout was a tough five miles.

I have been sore from this workout for two and a half days.
So I just want to tell Tim thanks.
And ow.

Trigger Finger

2009-06-10T16:59:00.002-07:00

There is so much good stuff going on, I don't know why it so often ends up being the bad stuff that finally motivates me to write on my blog.
Good stuff is that I'm feeling like I'm making progress with my swimming. I'm getting more mileage in, both biking and running. Training is going pretty well.
The bad thing is trigger finger. I have a self-diagnosed case of trigger finger in the pinkie of my left hand. I haven't seen a doctor about it yet, but it's a pretty obvious thing to diagnose.
Trigger finger occurs when a tendon that flexes one of your fingers gets a nodule of cartilage stuck on it, so that it can no longer easily slide through the sheath of tendons that hold it in place as you flex and extend the finger.
The finger can get stuck in a curled position, like it was wrapped around a trigger, and make a slight pop or snap as you extend the finger and the nodule moves past the tendons obstructing it.
So now I am waking up in the morning with my pinkie curled over and locked, and it's getting harder and harder, and more and more painful, to extend it out normally.
This condition is way more common in diabetics, and especially in those who have had diabetes for a long time. Treatments include rest, cortisone injections, and surgery.
I'm going to start by resting it. I'll start by splinting the finger in an extended position. The hope is that once the tendons aren't rubbing against each other all the time, the nodule will break up and go away.
I suspect that leaning on my hands while riding may have started the problem, so I'll get a new pair of biking gloves with more padding. And I'll try to spare the pinkie while I use the handlebars.
However, often this condition eventually strikes more fingers once it has hit one.

National Running Day

2009-06-03T12:01:00.000-07:00

Hey,
It's National Running Day! I don't know what that means except that it's a good day to get out and run.
Of course, every day is a good day to run.
I ran a track workout this morning, and I'm considering a group run tonight. My mileage is too low, running mileage, biking mileage, and swimming mileage.
My swimming is actually improving. I'm actually looking forward to my next swim, maybe tonight after the run. I would bag the run and just swim, but hey, it's National Running Day!

Memorial Day

2009-05-27T12:04:00.002-07:00

I know this is late, but I've been thinking about, and I did think about what Memorial Day is about while I had a burger and a hot dog and a beer on Monday.

We say, and it's true, that this training for Ironman takes commitment and dedication, but it doesn't bear up to any comparison to the commitment and dedication of those we honor on Memorial Day. Their solemn dedication is on another level.
It takes some courage to sign up to toe the line at Ironman, but it's nothing like putting your life on the line for your country in the chaos of war.
So, as long as I've got this public soapbox here, I should take at least a moment to say thanks.

On another note, I've been reading Joe Friel's Triathlon Training Bible, and I found his description of the evolution of a wish... to a dream... to a goal... to a mission, to be very accurate and worth thinking about. I believe I need to move on from the dream/goal stage to the goal/mission stage.
I need to get on a mission.

Tempe International Triathlon

2009-05-18T11:38:00.004-07:00

On Friday, I had no intention of signing up for a triathlon. But there was the Tempe International Triathlon, just a few miles from my home. All of my local Triabetes phrends were doing it, Kevin, David, and Julie. They all encouraged me to "give it a shot."
So on Saturday I went down to Tempe Beach Park, registered, and checked my bike in. I fretted about it Saturday night, getting my stuff together. I got up at 4 AM Sunday morning and ate a quick breakfast.
I went back over everything I had prepared for the race:
- chilled water bottles to go onto my bike, partially frozen because it was going to be a hot day.
- insulin and a syringe in my Frio, in case my infusion set came out during the swim.
- bike shoes.
- running shoes.
- new Giro helmet and sunglasses.
- bike gloves.
- socks strategically rolled up to be easily unrolled onto my feet after the swim.
I drove back to the park for the race. The start was to be at 6:30 AM for the first wave, and I was in the third wave. I got there about 5:40 AM.
I got my chip on my ankle, got my number and age written on my arms and legs, and went in and carefully laid out my stuff for transition. I had turned my basal rate down thinking I didn't want too much insulin on board during the swim. When I checked, I was at 200.
I didn't want to be too high. I remembered everything I heard from my diabetic friends who have done this was that the adrenalin at the start of the swim will always send your blood sugar up. So I bolused half a unit.
I met with Kevin, David, Julie, and other friends. I talked for a while with Aaron.
Then it was time to actually walk over to the water. I pulled on my swim cap, put my goggles on my head, and got in line.
I watched and waited while the other waves were starting. I kept a look out for other people who looked like they might be as bad at swimming as I am. I saw a few people who stopped and did a side stroke for a few feet before swimming again. I was a little encouraged.
But I was getting a little doubtful looking at the actual course. It is a long way. I knew it was farther than I had ever swum before.
Then it was time to get in the water. I was far back in my group as I could get. I got in and started treading water. I can't say that it wore me out. I felt comfortable enough at that point.
And soon enough the horn went off and we were swimming ahead.
I only swam for a few strokes, then I looked up to see where I was. I was right where I should have expected myself to be, at the back of the pack. I took a few more strokes, and felt compelled to look up again.
I could only bring myself to swim a few strokes at a time, and I kept feeling more and more uneasy. So of course, I was falling farther and farther behind my wave.
Maybe I was hyperventilating. I can't say for sure. It just seemed like I couldn't bear to just put my head down and swim and keep swimming.
I had some thoughts running through my mind, things like maybe I should have checked my blood sugar again, maybe I'll go low because it's so far, the next wave is going to swim right over me, etc.
But it really wasn't a decision I made because I thought about it. I didn't reason it out, weigh the pros and cons, and decide I should quit. I was swimming a little, then stopping, swimming and stopping. I was looking at the girl in one of the kayaks thinking, "Will she help me?" Then out of the corner of my eye I saw one of the little piers they have paddle boats parked at. I had been drifting closer and closer to the shore.
I saw an easy way out, and I took it. As I said, I didn't think about. It was more like how you'd expect me to react if I'd fallen in. I found the quickest way out.
All of the preparation, everything planned and set up for the race, none of it mattered. I didn't even consider it. I just wanted out of the water.
Once I had grabbed onto the pier, I thought about all of the people watching. Most of them hardly noticed me climbing out. They were watching other people in the race. Still, I was surprised that I wasn't mortified. I ought to have been more embarrassed, but there didn't seem to be any point. It was done.
I just got out and sat down. I thought about it for a while, then went to the finish line and turned in my chip.
I'm seriously shaken up by this wake up call.
I was embarrassed at the race, but when I think about it, I'm ashamed that I had the audacity to get in the water without doing the necessary work first. My friends who rocked at the race yesterday were able to do it because they had done the work to prepare themselves.
I don't blame anyone for "talking me into it." No one knew where I was better than I did. Both registering for the race and quitting were my decisions, right or wrong.
So now, after hundreds of races, including dozens of marathons, I've got my first DNF in my first triathlon.
I'm trying to take the best lesson I can from this experience and re-commit myself to training harder, especially in swimming.
After bailing out, I actually had a nice morning walking around talking to people and watching the race. I had breakfast with Sue at a creperie in downtown Tempe.
Then I got back down to the finish just in time to see David, Kevin, and Julie finish their successful races.
Congratulations, Triabetes Teammates!

Avenue of the Giants

2009-05-08T14:54:00.004-07:00

If it looks like I'm really suffering in this picture from the Avenue of the Giants Marathon, then it's a good likeness.
I was not in shape for a marathon last weekend. I did a 65 mile bike ride that I wasn't in shape for the week before.
So I almost got the marathon I deserved. The thing that was better than I deserved was the fact that this is a beautiful course, and the weather was perfect for running. The temperature stayed in the 50's for the whole race, probably cooler in lots of places due to the shade of the forest.
Anyway, I got my 49th lifetime marathon out of the way, and I won't do any more of those until after Ironman Arizona.
The marathon was just part of the trip to Northern California. The more important part was the visit with my daughter, her fiance, and my grandson, River.
Now I'm sick. I've got a head full of mucous. It's hard to get motivated feeling like this. The main motivation right now is the dread of having an awful time trying to finish in November.

Learning to Swim

2009-04-25T05:15:00.004-07:00

As a runner, being around other runners for decades, I've heard and read lots of stories that start like, "I couldn't make it around the block..." or even "I couldn't run to the corner..." Then this person runs around the block, then a mile, gradually becomes a runner, perhaps even runs marathons or longer.
Well, that's me with swimming.
Last night I reached a milestone by swimming without stopping farther than I have in more than three decades. Now I only need to work up to swimming 160 times as far by November 22.
Later on at home, I reached down to pick up a can of juice, and water ran out of my nose. That hasn't happened since I was a teenager, and I used to body surf for hours.
A while back I bought a nose clip for swimming, but I haven't been wearing it. I don't see anyone else wearing one, and I feel dorky enough without it.
But maybe I need it. I do have freakishly large nostrils.

Anyone can run a marathon

2009-04-23T17:00:00.001-07:00

That's right. I said anyone can run a marathon.
Well, I'm exaggerating just a little bit. At Pat's Run this past Sunday, I competed with several people with various fractions of the usual complement of limbs. I saw the same thing at the Bataan Memorial Death March Marathon.
Sarah Reinertsen made the cover of Runners World with only one leg.
So almost anyone can run a marathon, or at least complete a marathon somehow.
The same is not true for Ironman. And I may not be saying this for the reasons you would think.
You see, there are thousands of marathons. There are big ones and little ones all over the world. No matter where you live, there is probably at least one within easy travel distance.
And there are reasonable entrance fees. Some marathons are more expensive than they seem to have any right to be, but some are down-right cheap, even free.
And the required equipment is negligible. Not even shoes are a necessity. Abebe Bikila won the Olympic Gold Medal barefoot in the 1960 Olympic Marathon.
Although training, and knowing how to train, will help a marathoner, all you need to know is how to run.
In contrast, there are few Ironman competitions, and they are expensive to enter. (I'm not saying you don't get your money's worth, just that it's a lot of money.)
They require a bicycle. The better the bike, the better a triathlete's chances of finishing. Mechanical considerations can make or break the race. An ability and willingness to spend money matters on the bike.
It goes without saying that knowing how to ride and swim, and hours of training in those disciplines, are required.
The Ironman, in addition to being very difficult physically, is financially exclusive.
Don't get me wrong. I'm not saying that it's not worth the money. I'm not saying that it isn't a tremendous physical challenge.

One of the things I love about running is the simplicity and commonality of it. Running is universal.
Triathlon, and especially Ironman, while it has a lot of other things going for it, does not have that.

On doing it Oprah-style

2009-04-13T14:00:00.001-07:00

A while back I said I had some mixed feelings about the fantastic treatment I got at Diabetes Training Camp.
You see, back in 1994 Oprah Winfrey ran a marathon. I hate to pick on her, because many other celebrities have completed things like marathons and Ironman triathlons much the same way, that is with personal trainers, personal nutritionists, basically everything that can be done to make it easier, given nearly unlimited financial resources.
To me, this always put a qualifier on Oprah's marathon. She ran it, *BUT* she had help, even to the point of having her personal trainer with her every step of the way on the course.
I never had that much help. Like most marathon runners, I did it myself.
And yet, here I am training for Ironman and taking all of the help I can get. Well, I have to be honest about this. If I could have had the help Oprah had, I might have taken it. And in the end, it was Oprah who ran her marathon. No one else can do it for you.
(Unless you're that Big Loser, Dane.)
I appreciate the help I'm getting. I don't think there's much chance of anyone who knows me thinking I wouldn't do this without the help. There have been many times that I drove for hours alone to the start on the morning of a marathon or ultra, ran the race, got in my car, and drove home.
As silly, and maybe arrogant, as it is, I still have some mixed feelings about not doing this on my own.
I suppose an important thing to realize is that almost no one is really going solo. I always have the support of my friends and my family.

The Zone

2009-04-09T14:00:00.001-07:00

Some running poetry. Something I wrote a couple of years ago.

The Zone
by Jerry "Geronimo" Nairn

It could be anywhere.
Any piece of pavement
running in the midst of normal people passing
oblivious in cars
Any remote trail
dirt collecting in the sweaty creases of my skin
Any night in a park
dodging through tree trunks, ducking branches, dimly remembering
things ancient ancestors did
I've never done.

I can only ever get there after several stubborn miles
miles going nowhere
until something brings me out
Maybe someone passes
or I glance at my watch
or I'm struck by a desire
to just finish this run

A step quicker
suddenly I'm there

The legs move without effort
My friend momentum follows
flows
one footstep to the next
until footsteps blur
striding so easy there are no strides
only moving
only flowing
I am running but it's not running
which now moves me
my feet play on the ground
as the earth passes under me
effortless
breath flows in and out
on its own
it isn't running now that moves me
like swimming downstream
in a deep, fast river
and becoming water
it isn't running now that moves me
It's the world I set in motion
running miles ago
days ago
years ago
and all the rushing air, all the rolling earth,
all the flowing body
asks in return
to run like this forever
is to never stop

Photos by Steve Craft

No Tour for You!

2009-04-06T11:43:00.004-07:00

Since I did the Tour de Cure Phoenix a few weeks back, and the 62 mile ride didn't seem too tough, and I've done some riding since, I thought I could do all right at El Tour de Phoenix on Saturday. It's a 72 or 74 mile ride (depending on which part of the web site you read), and it has some good climbs in it. I knew it would be a challenge, but I thought it would be good for me.
Man, i feel stoopid.
I went down to the expo to register, payed my money, got my chip, went to the orientation seminar. Five minutes into it, the race official says, "No aerobars," and keeps right on talking.
Duh. I raise my hand, "What's that mean, no aerobars? Is it all right if they're on the bike, but I don't use them?"
Apparently everybody but me already knew this. I got a very bad vibe from everyone there.
No aerobars in the tour!
I have only one bike I'd be willing to ride 70+ miles, and it has aerobars on it. So I got my money back and left. They weren't happy to return my registration fee. I mean the woman handling it didn't argue, but she didn't smile either. And she didn't waste any words on me. "Where's your receipt?" "Where's your chip?" "Here's your money."
I had no idea there were such rules.
Later, talking with more bike-savvy friends, I was told there is some conflict and even hostility between triathletes and bike riders. Triathlons usually don't allow drafting. "Tour" type rides usually don't allow aerobars.
Who knew?
In my defense, the Perimeter Bicycling web site that has the El Tour information on it is a labyrinth.
Anyway, I ended up not doing much of anything over the weekend, a 10 mile run and a swim class.

Diabetic Poetry

2009-04-03T12:00:00.001-07:00

Over on Tu Diabetes they had a poetry contest/collaboration, the No Sugar Added Poetry Contest. Members of the Tu Diabetes community contributed poems. For four weeks, each week, two winners were chosen from the poems contributed that week. The winning poems are to be published in a book to support the Diabetes Hands Foundation.
I contributed a poem on the last week that was chosen as a runner-up.

I Couldn't Do That

I couldn't do that.

It's the silliest thing people say
to a diabetic.

We're not doing this for fun.

When you see the diabetic girl in the park,
poking and squeezing her finger for a drop of blood,
see also the threatening figure leaning on her,
holding a needle to her eye.
"Do it or I'll blind you!"

When you see the diabetic man in the restaurant,
jabbing the syringe through his pants into his leg,
see also the demon behind him
with an ice-pick against his kidney.
"Do it or I'll gut you!"

You could do it
with a gun to your head.

Then a few of us couldn't stop once they got us started, and we continued to add poetry to the page after the contest was over. Maybe my definition of poetry is loose. Anyway, I wrote two more of what I call poems:

Perfect

I'm a fish out of water
inside my own skin,
wrestling with my rebellious metabolism.

I know some of you who are always
effortlessly perfect
in the blood sugar realm
want to think you understand,
but you can't
any more than I can understand you.

After the cure sometimes
will I wonder about my blood sugar,
and wish I had a meter?

Or will I feel perfect always?

Insulin Is Not a Cure

It's like Evel Knievel's helmet.
It might have saved his life, but it never kept him safe.

Insulin is not a cure.
It only creates an illusion of health.

I'd like to go without for a while.
No pricking my fingers, no infusion sets.
No "managing the disease."

Then everyone could see that I'm still sick.
But there'd be a penalty to pay.

False health is better than real death.

So I'll rise and fall, soar and crash.
And keep getting up.

But insulin is not a cure.

Back Fill Blogging

2009-04-02T11:34:00.004-07:00

If you take a look at the bottom left side of my blog, you'll see that there are suddenly a lot more posts in the Blog Archive, dating all the way back to 2002. I've just added a bunch of race reports which were originally written for and posted in a Yahoo! group, The Roads Scholars Running Group.
If you have a lot of time on your hands, you can browse back through some of my running history.
If you decide to check out the Roads Scholars, you'll find a very friendly group founded by runner and writer, Michael Selman.
I have also added the saga of my Boston Marathon experience, in three posts.
Deciding to Run Boston and Qualifying
Training for Boston
Boston and the Boston Marathon
This story was originally on my blog at YourRunning.com.

As a postscript to the Boston story, I did finally break 3:30 at the St. George Marathon in October of 2007 with a finishing time of 3:29:47.
I'm now 50 years old, so I only need a 3:35 to qualify again. That's not easy for me, but I've done it in four previous marathons.

What's in a name?

2009-03-30T20:31:00.002-07:00

I am considering moving this blog to WordPress and getting a domain name for it. There's a poll on the left side of the blog to see if anyone reading this has any preferences. Suggestions can be made as comments on this blog post. I appreciate your input.

Diabetes Training Camp

2009-03-28T18:15:00.003-07:00

Diabetes Training Camp was awesome... incredible.

I want to name a few of the personnel, to give an idea of the level of training at the camp, but it's not really fair. There are many others involved, and they were all fantastic at their jobs.

Missy Foy, type 1 diabetic and world class marathoner and ultra marathoner, and for a long time a personal hero of mine, was our running coach at the camp.

Rick Crawford, a former pro bike rider and triathlete, now a coach, who has coached many pro triathletes and cyclists, including a kid named Lance Armstrong, lectured us on training the central nervous system and was available for private consultations. We had a beer together and talked for about an hour about my Ironman training program.
He wrote this article the day after our camp ended:

http://www.velonews.com/article/89008/

Carrie Cheadle was there to help us with the mental part of the event.

Nicole Freedman, former pro rider and Olympic competitor, and Bike Czar of Boston, was our bike coach.

I rode to the top of Gates Pass from the "easy" side.
I had an opportunity to do a supported ride up Mt. Lemmon, but it seemed like a bad idea for the day before Old Pueblo.
If I hadn't been running Old Pueblo, I could have done a run with Dave Scott that morning, as part of TriFest, instead.

It was just an incredible week.
So why do I have mixed feelings about it? I'll have to cover that in another post.

Relay Haiku

2009-03-27T15:10:00.003-07:00

I may not be much of a poet, but I enjoy writing, so this blog will occasionally contain verse, as well as prose.
Here are a couple of Haiku inspired by the Relay Del Sol.

desert run at night
point headlamp upward to see
a sky full of stars

running beside you
I hear your feet, your breathing
and your damn ipod

Hope you enjoyed it.

Old Pueblo 50

2009-03-26T14:15:00.001-07:00

I'm finally posting my account, such as it is, of the Old Pueblo 50.
I got sore, especially in the quads, but I had no injuries and nothing much to complain about. I finished in 13 hours and 23 minutes, so my goal of 10 hours was out of the question.
I didn't have much of a break after the Ragnar Relay. I had one night at home, then was off to Diabetes Training Camp for four and a half full days of workouts and lectures. Seriously, they had us at the first workout at 6:30 AM every day, and then workouts and lectures, consultations, medical testing, fittings for bikes and gear, etc. all day, every day, usually until past 10 at night.
So the day after DTC, all I had to do was sit around at the Triabetes booth at Tri-Fest for half a day, then rest up for the Old Pueblo 50 mile trail run on Saturday.
I knew just driving out to the start that I was too tired to really race it. I didn't have enough time to recover from all of the previous marathons and 50Ks going into the Ragnar relay, and after the relay, I had no real chance to recover from that experience.
So I was walking the uphills from the start, and always trying to conserve energy while maintaining some momentum. Later in the day, it helped to use some of the techniques Carrie Cheadle had taught us at Diabetes Training Camp to keep my shoulders relaxed and not expend any extra energy on useless tension.
The course was a lot tougher than I expected. Even on fresh legs I don't think I would have been ready to do it in 10 hours. But now that I know what it's like, I think I could train for it and make it.
I did best against the competition in a couple of sections that were steep, rocky downhills for miles. Others were walking them, but I let gravity carry me and tried to stay light on my feet. I didn't trip anywhere, but the few places that I came close were where it was mostly level and there were only a few rocks sticking up.
This was 50 miles of mountainous trails and dirt roads. 51 miles by my Garmin. Don't get me started. Well, I am started.
The other place I did well was nearing the finish late in the day. I thought I was going to finish before the sun set if I just kept running, so I was running even uphill, for a while, after the 40 mile aid station. Since I had been taking it easy all day, most of the people around me were really spent, and weren't running at all.
I passed about six people between the 40 mile aid station and where my Garmin said it was 45 miles. Then, when the Garmin said I was 46.75 into the race, I came upon a sign that said I was 1/4 mile from the 46 mile aid station.
That totally knocked the wind out of me. I thought I was a little over 3 miles from the finish, and I suddenly found I was still more than 4 miles out. I'm sure it doesn't sound like much, but for some reason, at the time it mentally crushed me.
But I kept running to the aid station, ate a little more, (I ate like a pig through the whole race.) and ran on.
At this point, I was running with a small group leaving the aid station more or less together. I think we were all looking forward to finishing.
Then with three miles to go we came to the base of a set of wicked steep switchbacks, maybe the steepest hill on the course, rising hundreds of feet in a few hundred yards. I probably wouldn't run this hill if it was in a 10K, let alone at the end of a 50 miler. It was just a sick joke.
I made it to the top, though, and kept on chugging toward the finish.
However, the sun had set, and it was rapidly getting darker and colder. My little headlight that clips onto my cap, which was fine for running on the road in the relay, was totally inadequate on the narrow, twisty, rocky trail of the last mile. My shirt was also inadequate, as the temperature was dropping rapidly.
It took me half an hour to go the last mile, and by the time I crossed the finish line, I think I had borderline hypothermia. It felt good to get some hot coffee, hot chili, and a warm burger.
My blood sugars were manageable. I checked at every aid station, and once between aid stations. The first few miles I was a little high, and bolused conservatively to correct and cover what I was eating. As the day wore on, I didn't need to bolus at all in spite of eating almost everything available, gels, V8, bananas, pretzels, potato chips, salt potatoes, chicken noodle soup, etc.
My basal was at a reduced rate all day until I finished. I stayed up late (with a couple of naps thrown in) and ate heavily, checking my blood sugar frequently, and had no post-race problems.

There's actually a whole other story about post-race activities, but it will have to wait for another day, like if we ever meet and you ask me about it.

strips everywhere

2009-03-23T13:45:00.002-07:00

Like some of you out there, I spend a fair amount of time checking my blood sugar in my car. I get in and decide to test before driving somewhere, or I drive somewhere and decide I'd like to test before I go in.
So I was sitting in my car preparing to test my blood sugar when I dropped a test strip. I looked, and I could see the strip between the base of the seat and the side of the saddle over the transmission. Each strip is worth about $1, and we're in some kind of a global economic downturn, so I decided I had to recover it.
But as I reached to grab it, the strip slid away. I couldn't get my thumb down there, so I tried to squeeze it between my first and second finger. It slid further down. I reached again, I strained, I got it, I pulled it up, and saw the test strip I recovered was from a meter I hadn't used in years.
OK, I couldn't give up now, so I opened my door, got out and got down near the floor of the car and reached from the other side. And I pulled back two strips. I thought this was weird, because while I use a lot of strips, I generally keep all of the used ones in the change tray in front of the gear shift lever. I don't throw them all over.
When all cars had ash trays, mine used to always fill up with test strips. I'm sure some of you reading this know how that is.
Anyway, unsure that I had recovered the strip I had just dropped, I kept reaching under that part of the seat. Understand that I wasn't reaching all over, combing the carpeting for strips. I was just finding the one strip I had just dropped. And soon I had eight strips.
I never considered it a design flaw before, but these Freestyle test strips don't look any different after they've been used. You can't see if they have old dried blood in them. You have to put them in the meter to see if they're going to work.
It turned out that none of the strips I found under the seat was functional, and in the end I had to pull out a new strip to get my blood sugar.
Five or ten minutes in the life of a diabetic.

Scattered Pictures

2009-03-21T22:10:00.009-07:00

I took a few pictures, very few, over the past few weeks, but I think they're at least a little interesting.
First is this picture of Greg Florian's SpiBelt with a OneTouch Mini and lancet device mounted on it. It reminded me of the TV Batman's utility belt, and I mean that in a good way. I love it. I may work out something like this for my long runs.

This illustrates a couple of things. One of them is how when you get a group of diabetics together, they can learn a lot from each other. Greg was one of the teammates in the Glucomotive all diabetic team in the Relay Del Sol.
The other thing it shows is the functionality of a SpiBelt, which is a product of a great sponsor of Triabetes and Insulindependence.

Speaking of sponsors, below is a picture of a pile of swag I recieved from sponsors at Diabetes Training Camp. Featured prominently is a huge stack of PureFit bars, which I am getting plenty of use out of.

The picture below is very simple. They say a picture is worth a thousand words, but I don't think this picture is better than a thousand word description of the Old Pueblo Run.
However, it does kind of tell a story succinctly.

2009 So Far

2009-03-20T11:00:00.000-07:00

I haven't posted here since February 26, when I had done only four marathons and one ultra-marathon this year.
What's happened since?

The Ragnar Relay Del Sol, 204 miles with 12 diabetic runners, 2/27-28.

Diabetes Training Camp in Tucson, 3/1-5.

TriFest 2009, 3/6-8.

The Old Pueblo 50 Mile Endurance Run, 3/7.

Half century birthday, 3/13.

Tour de Cure Phoenix 100K Ride, 3/14.

Those are just the highlights, and each one of them is worth at least a page here, but if I take the time to do that, I'll never get caught up to today. Once again, my life is outrunning my blogging.

As time permits, I'll try to post something about each of these events over the next few weeks. My plans don't call for anything big, just Ironman training, until a marathon in May. After that, I will be totally focused on Ironman Arizona in November.

Sharp Stuff

2009-02-26T16:33:00.002-07:00

Thinking about what to blog about, I've decided a few of these things should be about being diabetic, and not just an active, athletic diabetic. I mean I write about running and sometimes you wouldn't even know you were reading the blog of a diabetic.
Well, sometimes I'm going to write something that will make it obvious this blog belongs to a diabetic, but there may not be any running/biking/swimming/triathlon content.

I hate needles.

I've been a diabetic for 35 years, and I'm lousy at giving myself shots.
When I was first diagnosed, in the hospital I practiced that quick jab insertion of the syringe into an orange, over and over. I've done injections into my own skin that way maybe five times. The rest of the time I've pressed the point of the needles against the skin and pushed it in. Maybe it's more painful, but it seems somehow less violent.
And I look away when a needle is put into one of my veins to draw blood.
I hate it all.

I love/hate the sensors for my CGMS. While they are in and reporting what's going on inside of me, taking some of that burden off me, saving my life, I love them. I hate looking at them. I hate putting them in.
I mean seriously. LOOK at those things! Are you kidding me? Just stick that thing into my own skin? It's like a nail!

I love/hate Silhouette infusion sets. They stay in much better than any others I've tried. I've seen a QuickSet fall out two miles into a 5 mile run. I've run dozens of marathons using Silhouettes with no problem.
But don't you think they could put it in with just a little shorter needle? Does it really have to be that long? LOOK at that thing!
It goes in at an angle, but if I were to stab it straight in, I could hit any vital organ.

Glad I could get that off my chest... if not out from under my skin.

If you like this post, or even if you don't, you may want to visit the Diabetic Running Mama, who blogged on almost the same topic today, and inspired me to post this.

Biking At Last

2009-02-25T12:06:00.006-07:00

You may notice that my training chart finally includes biking as well as running and swimming. I have some kind of unreasonable phobia about biking that has delayed the start of any serious bicycle training.
But I finally put that behind me on Saturday. Biking around the neighborhood, I felt great and had no problems.
Of course, after going nearly 11 miles without incident, I rolled up in front of my house, got one foot out of the SpeedPlay clips, failed to get the other foot free, and fell down, gouging the back of my right calf on the cranks.
This has put a hole in my swimming training for a few days, but I am fine for running and biking.

Click here for a gruesome picture. I left it out of the post because I thought it might gross some people out.

Lost Weekend

2009-02-18T17:27:00.008-07:00

OK, So I did that. The Pemberton Trail 50K on Saturday and the Lost Dutchman Marathon on Sunday.
And I wasn't alone. At least four of my fellow Marathon Maniacs did both events, and my friend, Melissa, who was not even registered for Lost Dutchman until the afternoon after running Pemberton, ran the whole race with me Sunday.
Melissa has now proudly joined the ranks of the Marathon Maniacs, and she does it at the exalted Iridium level, a level it took me two and a half years to achieve. Awesome.

Pemberton Trail 50K

Believe it or not, the hardest of the two days for me was Saturday. I started out thinking that two weeks off from marathons was enough recovery time for me to run well for the 50K. After all, it isn't a tough course for a trail run, and the trail should have been easier on these old joints.
As it turns out, I'm not as tough as I thought I was. I wasn't fully recovered from three marathons in the previous four weeks. I felt pretty tired after the first few miles.
I hit the wall hard after 17 or 18 miles.
Pemberton is a two lap course, and there's a rough, rocky section about two miles out from the start. The first time through was a breeze, actually kind of fun. The second time through I was just trying to keep my feet under me and not fall down.
There were less than 150 of us running this race, so I spent a lot of time running alone through the desert. This Haiku came to me as I covered the desolate miles on my aching legs:

when the race day comes
it doesn't help to regret
the workouts you missed

Something to remember every day during training. Sitting here now typing this up, I'm thinking along these lines:

easy to register
for unknown levels of pain
far in the future

With about 10 miles to go, I started walking every significant uphill. I was thinking ahead to Lost Dutchman, and I was unsure about being able to run it at all if I didn't try to conserve energy.

Lost Dutchman Marathon

Lost Dutchman is a fun race with lots of little things to make it interesting. That's why Runners World named it one of the Best Little Marathons, or something like that.
We got bussed out into the desert, under the weird rock formations at the base of the Superstition Mountains, where we warmed ourselves sitting around presto logs, waiting for the start.
The main difference between this start and Pemberton was that I had dreams of running well on Saturday. Sunday morning, those illusions were gone. I knew I just had to keep making forward progress, so that was my only goal.
And that turned out to be remarkably easy, if painful.
I wore my Marathon Maniacs shirt, which I hardly ever do, simply because I have so many other commitments and affiliations. But it's always good to get cheers from fellow Maniacs and comments from other marathoners when I do wear the yellow singlet. It was a good choice for a race that was going to take a long time and require a lot of encouragement.
Of course, as is usually the case, we saw a lot of the same people over and over again all day, and we made some new friends. Melissa was happy to tell anyone who would listen that we had run 50K the day before, and many people became fans.

There were no blood sugar issues either day. I checked three times during the 50K, and I was always above 120 and below 170. I went totally by feel through the marathon (by feel and experience) and was at 91 after the finish.