Monday, December 24, 2007
Knowing that my diagnosis is confirmed brings me great peace of mind. No matter how remote the possibility was that my symptoms were caused by something other than Type 1 the hypochondriac in me wouldn't let that idea rest. I visited websites such as wrongidagnosis.com to see if it could be anything else since doctors were only 99% sure. My blood finally declaring the antibodies lets me rest a bit easier.
Happy Holidays, and Merry Christmas!
Thursday, December 20, 2007
Just click the picture above to sign up! So are you up for the challenge?
Tuesday, December 18, 2007
At 340 calories, 67 grams of carbs and 11 grams of protein the Starbucks yogurt parfait gives me the absolute perfect mix for my pre workout food. At $3.45 a pop they aren't cheap but then again that's only a dollar more than the 2 clif bars I normally need cost me. I'm partial to the Strawberry Banana one. I'm not a huge fan of the megalopolis that Starbucks has become but I have to admit they are producing one heck of a tasty product!
Yesterday's workout - an hour recovery ride on my bike trainer; kept the cadence above 90 the entire time! Starting bs was 230 (went a little crazy with the yogurt parfait) ending bs was a steady 120!
Friday, December 14, 2007
I got into work about an hour early so I could hit the gym at 9:50 for my run.
Breakfast: Banana in a soy protein shake with a tablespoon of almond butter - 35 grams of carbs. Basal rate turned down to 5% at 8am.
Pre workout: Clif Bar
Pre workout blood sugar: 245 - guess I went a little crazy with the food but I wasn't too worried.
Exercise: 3.2 miles in 30 minutes at an incline of 1% (easy pace run). No nutrition during run.
Ending bs: 97!!!!!
Alright first workout was down 1 for 1 and off to a great start. I had 1/2 a clif builder bar to recover and ate a turkey sandwich for lunch. At 3pm I picked up a yogurt parfait from Starbucks (the strawberry banana one is freaking awesome) and then had the other 1/2 of my clif bar on the walk to the gym at 4:20 pm.
Pre workout bs: 185
Exercise: 1/2 hour swim, with 6 kick switch drill
Ending bs: 89
Now we're two for two with one workout to go. I've been having a tough time getting used to the steeper seat angle on my bike and Thursday's spin was going to be my most challenging with the new fit. On the way home I pounded a muscle milk and had a clif bar on the subway. I set my bike up on the trainer and:
Pre workout bs: 117 - had some accelerade and 3 glucose tabs
Exercise: 1 hour trainer ride at intervals of increasing difficultly - really tough spin
Nutrition: 2 accel gels, first gel ingested 10 minutes into ride, 2nd gel at 35 minutes into ride
In Exercise BS: 30 minutes into ride - 145; 45 minutes into ride - 89
Ending BS: 104 (170 30 minutes later)
I did it - 3 for 3, the first time I've been able to accomplish that; I have no idea how my bs will react today with all the exercise yesterday and I had to turn down a trip skiing for fear of how my bs would be (want to hit the slopes in a low key way so I can figure all my pump needs out without slowing people down). But I'm thrilled that I was able to go 3 for 3 yesterday - have 2 more workouts today hopefully I'm just as successful.
Wednesday, December 12, 2007
As she was reviewing my logs with me she kept punching numbers into her calculator and giving me firm suggestions of how many grams of carbs or protein I needed at specific intervals throughout the day. Two items of real interest were:
1 - On Saturday I woke up a bit later (ok alot later) than usual and ate a bacon, egg and cheese for breakfast at like 10:50. From 10:50 until 12:30 I went pumpless and thought I would have no problem getting through my trainer ride with some accelerade. Lauren asked the simple question "when do you normally have lunch?" Although I had eaten a substantial meal an hour and 1/2 pre-workout my body's muscles were craving food at 12pm (my normal lunchtime). Since I rode straight through lunch and didn't eat until 2pm my blood sugar was screwed up for the rest of the day. Essentially even if I didn't have diabetes I would have been cranky and miserable but since I have diabetes the symptoms manifested in a low.
2 - On Sunday 45 minutes before my 10k was to start I had a blood sugar of 198 which I thought would hold for the next 55 minutes prior to my first accel-gel. However, 10 minutes before the start of the race or 30 minutes after I was 198 my bs was down to 115. This one really confused me but Lauren's explanation made perfect sense. Due to my body's physiology I burn sugar pretty efficiently (high muscle mass) so while I had a "perfect" pre-race breakfast that breakfast was 2 and 1/2 hours before the start of the race. I need to ingest up to 80 grams of carbs for that period and the clif bar I ravaged before the start of the race actually gave me the perfect # of carbs to start.
All the information she provided was based on some equation that incorporates body weight, % of body fat and activity level. I'll let her master's from Berkeley figure all that stuff out and pretty much just obey her like Pavlov's dog.
In other very exciting news I received my interview invite from the Darden MBA program at the University of Virginia. One of the biggest hurdles in getting into an MBA program is receiving the interview invite - the schools extend invites to about 40% of the applicants. The wait for the invite is probably the most stressful part of the whole process; yesterday it was like 1,000 lbs were lifted from my shoulders when my status on their webpage was updated.
Monday, December 10, 2007
Friday - I set out for a swim workout having had muscle milk (30 g of carbs) a clif bar and 3 glucose tabs with a basal rate of 5%. Arriving at the gym an hour and 1/2 after I started my always fun nutrition protocol my blood sugar was only 114!!! After I changed into my jammers (which make my ass look great) I found out the pool was closed and bolused for the ingested food (stupid idea). An hour later at my apartment by bs was down to 43 - I had a 1/2 hour run scheduled that night so I took my pump off pounded some accelerade, and had a turkey sandwich 2 hours later my bs was 160. I ate 1/2 a clif bar and set out on my run - 15 minutes into it my blood sugar was down to 57; so I found a bench ate some glucose tabs and cabbed it home. Nothing adds to an athletes confidence like having to end a 30 minute run short and cab it home!
Saturday - Woke up around 10 am and took my pump off. Had a bacon, egg and cheese and started my ride around 12 am. 20 minutes into the ride my blood sugar was in the 80s - a 10 minute break and some nutrition got the bs back up to 110 so I was able to finish my ride nice and slow. Ate a BLT with turkey for lunch and headed up to the New York Road Runners Office to grab my race packet, felt kind of weird on the subway and checked, down to 80 an hour and 1/2 after eating so I popped a couple glucose tabs. After my walk from the subway and search for accel-gels at every bike shop on the UES my bs was down to 60 - had some disgusting frozen yogurt and hoped my bs would stabilize for the rest of the day.
Saturday Night - For my pre-race dinner I decided to have whole wheat penne pasta with onions, peas, mushrooms, ground buffalo and red sauce. I bolused for 80 grams of carbs, 2 hours later my bs was a happy 97; an hour and 1/2 after that I was at 235!!!! I tried to correct but nothing happened - changed the infusion site, gave some more bolus and when I woke up at 4am I was 160 - gave another correction woke up at 7am and found my bs to be 90.
Race Day - With a bs of 90, I turned my pump down to 10% 2 and 1/2 hours pre-race. I had 2 eggs, 3 oz of orange juice, 2 pieces of cracked wheat toast and a cup of coffee. On the subway ride to Central Park I downed 32oz of water and checked my bs at 8:50 am - 198, alright I thought to myself right where I want to be. I had a 1/4 clif bar on my walk from the subway to the park, put my bag in the baggage area, changed into my Newtons and walked to the start area. At 9:20 am I checked my bs and was terrified to see a 117!!!!!! No way I could run a 10k with a starting blood sugar of 117 and how the f did it drop so quickly??? I gobbled up the rest of my clif bar, had 3 glucose tabs and said Liebo it's time to HTFU and tell diabetes to F off today.
With my heart racing and seeds of doubt (due to fear of passing out and having a seizure) racing through my head I found the 8 minute pace sign and got into the mass of people at the start. 10 minutes into the race I was still standing, passing people left and right and popped open my first accel-gel. 5 minutes after having my gel I tested - 173, what a relief; at that point I knew I'd be able to do this race and started to hammer.
With that confidence my official statistics were:
Overall place - 1751 (total racers 4840)
Gender place - 1333
Age place - 274 (total racers 1233)
Finish Time - 51:08 (in my goal range!!!!!!!!!)
Pace/ mile - 8:14
Finishing a 10k makes me neither an Ironman nor Triathlete. However, overcoming the mess that was my blood sugar in the 48 hours preceding the race gives me the confidence that I can accomplish my athletic goals. Yesterday, for the first time I felt like an athlete again. I bobbed and weaved through the crowd, raced around people and pushed myself for 6.2 miles. I fell asleep smiling last night looking forward to the hell that will be my training through July. At 9:20 am yesterday I HTFU and completed my first training goal.
Friday, December 7, 2007
Lauren's plan for me is to have 20 - 30 g of protein and 40 g of carbs pre race. I'll probably accomplish this by having eggs on toast. During the race I'm supposed to take in 40 - 45 g of carbs; real food will take too long to digest in a 10k so I'll be using Accel Gels. I'll pop the tab on my first Accel Gel about 10 minutes into the race (hopefully at mile mark 1.4 - 1.7) and then am supposed to follow that up every 15 minutes with another gel. I'll either have 2 or 3 gels during the race.
Coach Eggers has designated this as my pace race for marathon training. My goal time is somewhere between 48 - 54 minutes or between 8 and 9 minute miles. Should be fun!
Wednesday, December 5, 2007
Yesterday I started a 1/2 hour swim with my bs at 154 (the lowest I had ever started a swim workout). However, I was confident I could complete the swim because my bs had only dropped 7 points during the walk from my office to the gym. In the past I have lost as many as 35 points off my blood sugar during that walk. Lauren suggested I have at least 30 grams of protein an hour before my workouts to help maintain my blood sugar and it really seems to be working. The protein is slowing the absorption of the carbs into my body allowing a time delayed release and giving me the energy I need to finish the exercise.
Now it is premature for me to say I have all this worked out but for the first time I feel like I'm on the right track and love the fact I don't need a bs of 210 just to go for a jog.
Tuesday, December 4, 2007
Thursday night I met with Coach Eggers in Rochester and found out I DON'T SUCK AT SWIMMING! Then headed up to Buffalo to visit my best friend from college. The next morning I woke up for a beautiful run in the country (Kev lives in a suburb of Buffalo now near Kissing Ridge Ski Resort). Both him and his fiance were surprised when I told them I couldn't go for a walk with them and their dog because I had to wait for my blood sugar to go high enough for a half hour run. Later Kev told me "we had no idea you had to like not do stuff to be able to do other stuff." Count 2 more people informed about the life of a type 1!
Friday evening was when the fun really started. I had my first Buffalo Wings since being diagnosed (speaking of suicide wings at the Anchor Bar are as tasty as ever but the finger pricks cuase a burining sensation from the sauce somewhere other than my mouth!) and a bowl of chili for dinner, while drinking back at Kevin's house I had a clif bar with a small bolus. By the time we drove into Buffalo my bs was down to 33!!!! I had a cadbury fruit and nut chocolate bar, a coke and 2 slices of pizza. Since I was with my best friend from college I didn't want to call it a night before it even started. By the time we got back to his house I was 189, when I woke up the next morning I was at 195 (ugh).
On my drive home I stopped by my favorite super market chain of all time - WEGMANS! To have the best turkey sandwich ever made. Apparently I miscalculated the carbs a bit - by a bit I mean by about 20 grams and was in the 200s when I checked my bs a couple hours later. I got that under control and my bs remained pretty good until Sunday night. Sunday evening I had whole wheat pasta with turkey meat balls - 2 hours later my bs was at 110 - perfect. As I was doing some work on my computer that evening I felt a slight pull at my infusion site - didn't really think anything of it; an hour or so after I felt that pull my bs was up to 185 (weird) and gave myself a bolus; an hour later I was up to 287 - ugh change the infusion set! I set my alarm for 3 am just to make sure I wasn't super hypo and thankfully as at 150 - I slept the rest of the night.
The roller coaster and learning experience continues; I see the new endo on Thursday!
Tuesday, November 27, 2007
So I sat down face to face with my endo and as she is speaking with me I sense an aggravated tone. I told her I just started working with a new sports nutritionist, which she tersely replied - I suggest you stop seeing her since your A1c went up to a 7.0 from a 5.9. I responded, that Lauren has nothing to do with that since my first meeting with her was last Tuesday! My endo (whom I won't name in this post but can be found elsewhere on my blog) also stated "we really don't like our patients to seek advice outside of the practice." Well that's great you have a patient frustrated with the level of care they are receiving, they are pro-active in trying to solve the problem and you're pissed that this patient is taking a hands on approach to their health (awesome approach!)
She then told me if I had asked her (via e-mail, that she checks 1,000 times a day) for a recommendation of a nutritionist she would have recommended Rich Weil of DESA. I informed her that I sought out Rich myself a few months ago and that he may be the major reason why my A1c went up so much. Rich suggested that I have a bagel before every workout and get my bs above 200 before a run - I was less than impressed with the advice he gave me. For the record, the last time I e-mailed my endo when I lost my meter she told me to call her for clinical matters because she didn't like dealing with clinical matters via e-mail.
I told her I consulted an outside nutritionist because I was frustrated with the advice her practice was giving me and that I felt I was getting nowhere with them. She asked me what I thought of their nutritionist - I said I thought she was great but hasn't been around recently. Their nutritionist just got married, went on a 3 week honeymoon in October and is now on a 2 week vacation. My endo said she knows alot about nutrition, not because of any degrees but because she was the No. 1 tennis player at the Ivy league school she went to and beat David Blake while there! That's great by that logic I should be the head economist for the NFL since I was the No. 1 lineman during my time there and have a BA in economics!!!!!! Ugh.
Their nutritionist is a great person and the 1 person in this practice whom I have any respect for. However, she has never competed in a triathlon or a marathon. Lauren has finished 3 Ironmans, and countless marathons, gives lectures to the top endurance sports groups in Manhattan and has written dozens of articles for endurance sports publications - whose credentials would you trust more?
Anyway, I think it's time for me to actively seek out a new endo who agrees with my approach to this disease and life. I got off to a bad start with them from the beginning - my endo initially thought I was being too positive about my dealing with diabetes. I guess she expected me to be a crying mess who asked "why me." Sorry lady you got the wrong guy - I'm pissed I have this damn thing but it will never affect what I think of myself or my approach to life. She is now furious I went outside the practice and have been actively seeking help to achieve my goals - real professional. So I say take that Harvard Med Degree and shove it up your ass!
Monday, November 26, 2007
Beads of sweat developed on my brow as we got closer to saying grace. Oh boy here we go - time to bolus, I took out my palm pilot and consulted by Calorie King database - 65 grams of carbs seemed like a good estimate so I gave myself a square wave bolus to be delivered over an hour. Less than an hour after I ate my blood sugar was down to 78! How the heck did I go low on Thanksgiving???? My reward - a big slice of Pumpkin Pie with a table spoon of Whip Cream! Now my low wasn't intentional but having an unbolused slice of orange creaminess was almost worth it. Plus treating a low with pie is way better than glucose tabs.
I made it through my first Thanksgiving without going over 200 and without a trip to the hospital from over bolusing - all in all a success.
In other news (from my season ending note to my parents):
I'm thrilled with how the kids competed on Saturday. While we all would have loved a different outcome scoring on our last drive with only 11 healthy players and our 4th string quarterback taking snaps is a huge testament to how far your sons have come. On our first day of practice this year I wasn't sure what I had, I wasn't sure if we could come together as a team or learn the fundamentals of the game. I can now say with confidence we became a team, and a great one at that.
On Saturday we all saw an opponent who played football at the level our organization would like to reach. The Brooklyn Renegades had a high level of discipline, were able to move into multiple formations on offense and kept their responsibilities on defense. As I told the kids on Saturday, this game was a tremendous learning experience and a great end of the season. For two and a half quarters we hung in with a team who had more experience, more players and had competed against a higher level of opponent. For two and a half quarters we showed that the Pee Wee Downtown Giants are becoming an elite team.
End of season record: 7 - 4
Wednesday, November 21, 2007
Lauren has completed 3 Ironmans (Lake Placid, Wisconsin and the now defunct Utah); finished countless marathons and is very active in the triathlon community. She has the education credentials I was looking for including a Graduate Fellowship from Cal Berkeley in Nutritional Biochemistry. This fellowship is really impressive, the Haas program at Berkeley is one of my top choices from an MBA program and getting any sort of grant from them for research and education means you're pretty freakin smart. And most importantly she is a CDE who in my initial conversations displayed a real knowledge of diabetes (yesterday she even told me that she hates that Type 1 and Type 2 are under the same umbrella!)
Anyway, I met with Lauren for close to two hours yesterday. She took detailed notes to comprehend the challenges I'm facing and make better sense out of the nutrition logs I created. She took the time to get it right and understand my needs, for the first time in all of this I felt like I wasn't alone. I've had many people help me along the way but all of us including me were just "guessing" at the right answer - Lauren laid out a plan. Walking out of that office knowing I'm supposed to eat 50 - 60 g of carbs before a run or swim mixed with 15 - 20g of protein lifted a 1,000 pound weight off my shoulders. This plan may be no better than the suggestion of "just eat a bagel" but for me having numbers makes all the difference in the world. Thank you Lauren.
Happy Thanksgiving Everyone!
Monday, November 19, 2007
Thursday, November 15, 2007
I was a fat kid, well let me restate that I was a big kid who always struggled to make weight for Pop Warner football. For the better part of August I would eat nothing but fruit and "turkey roll ups" as my Mom cleverly called them (just turkey cold cuts rolled up with cheese) to drop drown to the weight limit. When I found out some of my kids were a bit over the limit I didn't want them to go through the absolute hell that I had to endure to play youth football.
I initially e-mailed the parents and told them that as a kid I visited nutritionist after nutritionist and now as a triathlete and type 1 diabetic nutrition has always been a staple in my life. That I wanted their sons to lose the weight in a healthy way and that their long term health is way more important than playing in a game (Championship or not). So over the past few weeks my players have been on a diet I outlined for them and this week we started to run together. Last night I took 3 players with me on an hour long run leaving from Grand & Essex St. going all the way past the South Street Seaport - about 4.5 miles.
The fact that these kids are willing to give up their evening to run with me (one isn't over the limit he just wanted to go out with us) means the world to me. Although I've run only 8 or 9 miles this week when I should have finished 12 to 15 - these miles have been the most special of my training. More important than any triathlon, than any game I coach is getting these kids to understand the commitment and dedication necessary for success - our goal as an organization is to make our players "winners in life". The fact that these players are this committed to their team and willing to sacrifice their nights for it proves to me they already are.
Wednesday, November 14, 2007
Monday, November 12, 2007
Diabetic watches the glucose meter
And the number hasn't looked right for so long
The time slows down to a stand still
Suddenly he breaks into song
I'm waiting by the pool
Waiting for you to go back up
And tell me I can be free
Waiting by the treadmill
Waiting for you to go back up
And tell me I can be free
Hello, please go up, it just isn’t fair
These lows are keeping me down In a life where I just want to battle
You act unfair and keep me from running through the town
I'm waiting by the pool
Waiting for you to go back up
And tell me I can be free
Cause I want to break a sweat
I need to break a sweat
I want somebody to make me sweat
You're a nightmare for me
Preventing me from being me
All the difference in the world was made on that day
I'm waiting by the pool
Waiting for you to go back up
And tell me I can be free
Cause I want to break a sweat
I need to break a sweat
I want somebody to make me sweat
Cause I want to run free
I need somebody to show me how to run free
I want somebody to tell me to run free
Cause I want my glucose to be fine
I need somebody to show me
I want somebody to be there with me
Monday, November 5, 2007
Tom Kingery is the founder of Team Running on Insulin; in the future he hopes this organization grows into a national fund raising campaign with athletes from across the country competing in endurance events to raise awareness and funds for diabetes. Tom was a multi-time marathon finisher prior to his diagnosis of diabetes a couple of years ago. When I came across his website I e-mailed him and I was shocked at how similar our stories were. Tom, like me played college football and had a similar outlook to athletic training; we were both somewhat blindsided by our diagnosis. He is one of the main reasons why I initially had the confidence to sign up for an Ironman and I was proud to sponsor him for a mile of his 140.6 mile journey.
Now that you have the background I hope you share in my joy over their triumphs. Coach Eggers had a goal of finishing the Ironman in under 11 hours; she had previously twice completed Ironman Lake Placid and holds several records for short course triathlons but had never obtained her goal Ironman time. On November 3rd, Mary Eggers finished Ironman Florida in 10 hours, 58 minutes and 59 seconds! Congratulations Coach - I can't tell you how psyched I am for you although I will still b*tch when you tell me to run slower during training.
Tom's goal was a bit less ambitious than Mary's - as a side note Curt Eggers (Mary's husband) is an age group national champion and came in 6th at the Duathlon World Championship this year - Tom just wanted to finish. For the first time coming down the finishing shoot he heard the voice of Mike Riley say "Tom Kingery, you are an Ironman!" after 12 hours, 22 minutes and 26 seconds Tom finished the race. I can not tell you what an inspiration he has been for me. Tom as I stated earlier you are one of the main reasons why I have the confidence to chase this crazy goal and the fact that you finished the race in an incredible time and the top half of your age group lets me know that a Type 1 diabetic can pursue those dreams and push themselves to the limit - you rang the bolus on Saturday and displayed what Team Running on Insulin is all about!
Congratulations again Tom and Coach!
Thursday, November 1, 2007
Wednesday, October 24, 2007
Tuesday, October 23, 2007
Wait I'm beeping! I pull my pump out of my pocket and read "No Delivery". I had heard complaints about the minimed alarms before but NEVER thought it would be this weak! Seriously people I'm insulin dependent for a reason one would think if my medical device is not delivering that stuff that keeps me alive it would screech not play a lovely musical medley. I've since changed the reservoir and infusion set but it was an interesting experience.
If you haven't had a chance to watch Kitchen Nightmares yet I highly suggest checking it out. Gordon Ramsey is at his best in it and as a foodie I love seeing awful restaurants turned around. It also lets you see how incredibly dense some people are!
Thursday, October 18, 2007
Stomach Flu: Sucks
Diabetes: Not so much fun
Stomach Flu as a Diabetic: Less fun than getting kicked in the groin by a mule!
On Monday my blood sugars were really screwed up. I had most of my normal meals but was just low and felt very lethargic. It seemed no matter what I ate before I went to the gym just wouldn't get my blood sugars above 150 - a full gatoarde, a clif bar, accel gels; the food just refused to increase my blood sugar. I assumed this was just a by product of the extra workouts in the previous week, but I was wrong. After cutting my run a bit short I met a friend out for some drinks; when I got home my bs was 130. I felt like hell but thought a bacon cheeseburger during the Giants game would cheer me up.
An hour or two after I ate the burger I started to feel really warm, clammy and slightly disoriented. I checked my bs and was at 109 - I thought that was too low for having eaten a pretty big meal so recently so I pounded some gatorade. Before I could check my bs again I was praying to the porcelain goddess. No matter what food I had after that my blood sugar refused to go above 90 - it felt like someone had a vice grip on my stomach and just wasn't going to let the food digest or enter my system.
Thankfully I received a phone call at 1am from my ex. I had texted her letting her know I felt like complete garbage - she demanded I test right away and I was down to 62. As forcibly as she could she made me leave my apartment and go get some sodas/ juice. I was totally out of it so at that point if she told me to chase purple elephants I probably would have thought that was a great idea. Thankfully the Dominican Chicken place was still open and I grabbed 3 pepsis and 1 ginger ale.
Once I climbed my stairs again I felt the butterflies trying to get out and began to empty my stomach into my toilet again. I drank my ginger ale after that and it only brought my bs up to 80 - yikes. I drank a 1/2 a pepsi and got my bs up to 140 so I finally thought it was safe to go to sleep. Just to make sure I turned my pump down to 50% - I woke up a few hours later, had a bs of 180, reset my pump to 70% and slept till 10 am.
Last night I was finally able to eat something besides toast again! But man having the stomach flu and this disease really really sucks! I couldn't figure out how to bolus, and finally decided it would be better to run high for a couple days than run low. Hopefully this will be the only stomach flu I have for a while - my head is still spinning from it.
Monday, October 15, 2007
Biggest challenge of the week - my prescription running out on test strips! My God they are expensive!!!!!!!!! $50 bucks for 50 test strips - I'm now testing like 15 times a day and I seem to ruin 2 or 3 strips a day because the one touch strips love to take less blood than they need. I'm having my endo up my prescription so I can avoid that sticker shock in the future. Making matters worse, I was running with my new wind vest for the first time yesterday - during my run I heard something fall out of my vest, turned around and saw my meter laying on the ground. Earlier during the run my vial of test strips fell out! Thankfully I only had 15 or so strips in the vial but that's like loosing $15 dollars.
After a ton of research last week I think I may have found the organization that will help with my nutritional needs for training. Fit4D.com is a company founded by David Weingard, to help diabetic athletes receive the nutritional guidance they need. David has completed 3 Ironmans, 2 as a diabetic and realized that there aren't enough CDEs who have the expertise for dealing with athletes. Over the next few weeks I'll begin my relationship with them and will be sure to let you all know how it goes. After a phone conversation with David I have all the confidence that Fit4D will go a long way in helping me achieve my goals.
In other news my Downtown Giants won their homecoming game 60 - 0 on Saturday. The kids really came together and in the second half we had players running the ball who hadn't carried it all season, it was alot of fun.
Thursday, October 11, 2007
On Thursday I had my typical turkey sandwich for lunch, about an hour later I was down to the 50s. On Friday the same thing happened - it dawned on me that within an hour after lunch I'd be stuffing my face with unbolused clif bars. Since I was adding so much unbolused food to my system in a desperate attempt to get my bs near 200 I failed to realize that the reason my unbolused clif bar was only getting my bs to 130 or so was because it was treating a low, not getting me high.
I reduced my basal rate and have had great results. On Monday I completed my 40 minute run without a problem, ending with a blood sugar of 100. Tuesday I had a blood sugar above 68 after a lift for the first time in a month. Yesterday was the biggest indicator of all - I tired to cram in a run about two hours before I normally go to the gym when my basal rate is at .25/ hour instead of .15/ hour - blood sugar crashed down to 85 within the first 10 minutes of running. So, I went back to the gym later that night when my basal rate was at .15/ hour for about 3 hours and had turned my pump down to 5% for 2 hours - I was able to complete both a swim and a run! I had to take 10 or 15 minutes off between the two to let the gatorade get into my system but after that I felt like I could have run all day.
This indicates a bigger problem however. For weeks I had been contacting various CDEs in addition to the ones I speak with at the Berrie Center. I asked in each e-mail, what am I doing wrong, why isn't my blood sugar high enough when I work out, why am I having to cut workouts short? I heard suggestions of having an unbolused bagel, turning my pump down to 5% 3 hours before I workout before 1 and 1/2 hours - NOT ONE OF THEM IDENTIFIED THAT MY BASAL RATE COULD HAVE BEEN A PROBLEM. As diabetics shouldn't we be able to trust our team of experts to identify problems before we do? Or is this a fight that we all have to live trusting ourselves and our bodies more than advice we hear based on a few excel spreadsheets?
I simply want to find doctors and CDEs as much as I trust the teams that performed my 4 orthopedic surgeries. The surgeons at the Hospital for Special Surgery have let me live my life as athletically as I wanted - I had reconstructive ankle surgery as a high school junior, I have half my rotator cuff in my right shoulder from surgery my sophomore year in college, post college I've had my left shoulder and right knee scoped. After each surgery I went through aggressive rehab, the doctor's warned of any possible problems but gave me the confidence to pursue my athletic career. Right now, I don't have alot of confidence in any of the diabetic professionals I want to trust that they'll identify the problem long before I do but I'm not close to there yet.
Monday, October 8, 2007
When I applied to grad school last year I felt my essays lacked focus, the motivated, intense individual that I have proven msyelf to be was not apparent in my writing. Its as if the physiological changes my body was going through created an individual who was filled with self doubt. When writing I felt like I had constant writter's block, the words were jumbled on the screen and the ideas that were in my head seemed trapped. This unfortunately caused me to lash out at a person who I cared tremendously about.
Over the course of the year before I was diagnosed I didn't understand why I would pass out after having a beer with a friend, feel as if I was going to throw up after a large meal or start sweating profusely during a movie. I didn't understand why it would take me weeks on end to write an essay about what I wanted out of my lfie. And I certainly didn't understand why I kept pushing the girl whom I loved out of my life.
As I wrote this weekend I realized all that, I realized the challenges I have overcome in the past year. I realized how I have grown as a human, how I have matured and how I am overcoming the biggest hurdle in my life. All those mornings that I couldn't muster the energy to get out of bed, all those shouting matches I got into with people who I loved and all the heart ache that it caused afterwards was mainly due to the monster I had become because of the changes my body was going through.
I have returned to myself. I am an athlete again, I am training again, I am able to confidently and pridefully describe my accomplishments. I am able to coach children the lessons of football and hopefully have an impact on their life. I am more than anything me again. The past 4 days made me realize what a difficult journey I have been through but I am without question a stronger person for going through it.
Diabetes had taken more than my insulin away, it was trying to take a big part of me away. While I still fight my blood sugars and figure out the right basal pattern I know that the biggest struggle is behind me. There may be days when I am high and there may be days when I am low but in the end diabetes will never again be able to take away who I am and what I believe in. For all those who I may have hurt in the year before I was diagnosed I apologize. But I promsie you and I promise msyelf that battle has been won.
Tuesday, October 2, 2007
Yesterday at 5:08 pm my blood sugar was at 170, this was 2 hours and 8 minutes after turning my pump down 95% to 5% of capacity and 1 hour and 30 minutes after an unbolused clif bar I was ready to head to the gym. Before walking out of my office for the 5 block walk to NY Health & Racket I had a chocolate accel-gel hoping to get my bs above 200.
When I arrived at the gym, 12 minutes later my blood sugar was 145 - ugh! I had hoped this was just some weird occurrence so I went upstairs, stretched and hoped on the treadmill, my blood sugar was up 8 points to 153. 15 minutes into my run my blood sugar was 106 - not a good sign, 5 minutes later my blood sugar was at 96 so I took an accel-gel - really not a good sign - 25 minutes into my run I was down to 68 - UGH!!! Bit by low bug again. I stopped the treadmill, picked up my stuff and instead of punching a hole in a wall I went and sat on the side of the boxing rink.
Over the next 15 minutes I tested 3 or 4 times:
6:03 PM (5 minutes after getting off the treadmill) - 71
6:07 PM - some dumb trainer comes up to me and says hello, ummm buddy do you not notice the daggers coming out of my eyes right now, leave me the hell alone
6:10 PM - blood sugar of 89
6:15 PM - blood sugar of 121 - YESSS!!!!!!!!!!! I CAN FINISH MY RUN
I hustle over to the treadmill, set it for 20 minutes and off I went, when I finished my run my blood sugar was a very happy 86.
Over time I'll learn how to avoid going low when I run, but now at least I realize no matter how many annoying trainers come up to me or how pissed I am at diabetes if I have the sugars in my system my blood sugar will eventually rise to the point where I can finish my workout. I just hope by July 20th I have this thing better understood.
Friday, September 28, 2007
Today I reduced my lunch time bolus by a unit of insulin, had a clif bar, 2 acel-gels and 3 glucose tabs before I ran; before I left my office I was at 150, short walk to the gym down to 117, stretched, had that second acel-gel waited a bit - at 120; oh well it will go up I thought. Due to the internet lectures I received I decided to test while I was running today (I hate you guys for making me do this!) 9 minutes into the run my blood sugar was at 88 - crap! Ok lets take a 5 minute break and see what happens; so I stand there on the treadmill staring at the wall and ready to head butt anyone who looks at me weird. After 5 minutes I'm at 79!!!!!!!!!!!!! Call it a day, hop in the shower, at 91 when I finish the shower, back in my office now 45 minutes after I finished my run, over an hour after all that food and I'm only at 112 - WTF!!!!!!!!!!!!!!!!!
I'm ready to forget about the MBA, take the MCAT and see if I can't be Dr. House on this one.
Update: 1 and 1/2 hours I stopped my run and nearly 2 and 1/2 hours after the clif bar my blood sugar is up to 180 - just add some more frustration.
Thursday, September 27, 2007
It all started in the morning, I wanted to get a muffin when I got to my office so I decided to just have a glass of OJ in the morning. As I put on my work clothes I started to feel really weird - man my apartment is hot I thought, but to be safe I tested - 42! WTF how am I down to 42, I didn't over bolus. So I called my boss, let him know I'd be in a bit late and made myself a delicious glucose tab cocktail. I felt somewhat strange for the rest of the day but was still determined to go for my 5 mile run after work.
At 3:15 I turned my pump down 95% and had a blood sugar of 85; at 3:30 I had a clif bar unbolused, at 4:15 my bs was only 100 - really weird - my bs normally shoots up 50 points for an unbolused clif bar. I decided to add an unbolused clif builder bar to my stomach - at 4:45 my bs was 154 so I headed to the gym. 10 minutes later my bs was 106 - ugh! I had an acel-gel, after stretching I was up to 110; oh well I have enough carbs in me I thought lets get this done.
10 minutes into my run I had a second acel-gel but refused to test, 15 mintues after that I had a second acel-gel and refused to test yet again. I completed my 45 minute run with a bs of 87 - yesterday would have been easy for me to walk away from the treadmill. Yesterday I had a perfectly acceptable excuse to tell my coach why I couldn't run, my blood sugars weren't at a safe level to begin exercising. But what I refused to accept that diabetes would stop me from running, from training, from reaching my goals. Perhaps I put too much into getting every workout in but I refuse to let diabetes be an excuse, I was determined to finish that run yesterday and there was nothing this disease could do to stop me. I will continue to fight it and I will continue to win these batttles and ultimatley win the war. Diabetes, when I cross the finish line at IMLP on July 20, 2008 you will have done everything you could to prevent me and I will smile and know that I defeated you and proved that this disease can not stop me.
Tuesday, September 25, 2007
On my workout log account I read 45 minute continuous run at an incline of 1 on the treadmill, no faster than a 9:20 pace. Coach knows I like to go as fast as I can and holds the reigns pretty tightly for the reasons discussed above. However, to date my longest run with diabetes has been 40 minutes - out of the 5 or 10 runs that were supposed to be 40 minutes long I have been able to complete just 3 or 4 of them, the rest were cut short because of low blood sugars. In the 3 or 4 that I was able to complete my blood sugar was in the 70s by the time I took my last stride. So yesterday I went to the gym with some trepidation.
I've been speaking with Rich Weil a certified diabetic educator and exercise phyisiolist, whose also on the board for DESA. Rich and I have talked about why it's difficult for me to maintain my blood sugar during longer runs and his one suggestion so far has been to start my runs with my blood sugar above 185. An unbolused clif bar will get my blood sugar up to about 170. Yesterday I complimented my carrot cake (delicious) clif bar with an Accel-Gel. I had the clif bar about an hour before my run and then had the Accel-Gel when I first walked into my gym's locker room - about 10 or 12 minutes before my run. 14 minutes into the run I had a second Accel-Gel and when I finished the 45 minutes I was greeted by this reading on my meter:
Sorry it's a bit tough to read - but that's a 90 for blood sugar - and the After Exercise setting! Can't wait till Coach makes me run 3 times a week, bike 3 times a week and swim twice a week as she promised in my weekly e-mail to me; as long as I keep getting 90s post workout I'll do all of that with a huge smile.
Monday, September 24, 2007
On Friday night for the first time in at least 20 years a Manhattan based youth football team took the field for a night game. The Downtown Giants are only in their 2nd year of existence and we're playing teams from the boroughs who have fielded teams for years. Friday we played the South Bronx Chargers. From the opening kick off things were not good - our kick return didn't field the ball so we lost our opening possession. Once we finally got on offense we scored on our 3rd play but it turned to provide false hope. We had a second touchdown called back because of a holding penalty and two drives stalled because of multiple offsides penalties. With about a minute left in the 4th quarter we were up 7 - 6, came up with a defensive stop and simply needed to hold onto the ball to win the game. Since my assistant coach and I think the kids need to learn how to play the game we refuse to take a knee. We moved the ball to the 9 yard line, then had an offsides penalty then fumbled the ball on the next play - the Chargers recovered the ball on the 1 yard line and punched it in to win 12 - 7. The frustration of the game spiked my bs to 189 but I was able to bolus for a bacon cheeseburger!
Until I meet with the CDE I'll hold off on naming him - but I had hopes that an exercise physiologist who is also a CDE would have had better advice than "your blood sugars look great." I understand that my A1c is really good but unfortunetley I'm a perfectionist and simply good isn't good enough. Type 1 has an impact on my life, far more of an impact than I find acceptable. I've had to cut too may workouts short to be happy with how I'm handeling the disease. Each day will continue to be a battle and I'll win some of the fights and loose some of the fights; however each of us deals with this disease in our own way. One person may have to fight tooth and nail to get their A1c to single digits while another person may be thrilled to have an A1c of 6.5 or 7. For me I won't be happy until I feel like I truly have this disease under control, that I can adapt to any situation and can face that Ironman without a fear. I've learned how to bolus for cheeseburgers, continue a long bike ride while fighting a low, complete a sprint triathlon but I haven't yet figured out how to consistently go on long runs.
Coaching is also an obstacle, during practice I have to turn my pump down and have a clif bar with a minimal bolus. I like to get in the trenches with my kids, run with the, be hands on, show them how to block, how to tackle. I've told them - there is nothing I will ask them to do that I'm not able to do myself. But when we have a game I'm pretty stoic on the sidelines, sit there in a crouched position, and am intent on what is happening in the game - as much as I'd love to put on a helmet I think having a former college football player play against 11 year olds would be against the rules. So I'm still getting used to adapting my insulin to the different situations of coaching.
For those of you who read my blog this morning I've made some changes to the post - I wrote that at 6:30 am and was way too tired for it to make sense.
Wednesday, September 19, 2007
Finishing the race! :
Getting my kids ready:
Monday, September 17, 2007
On Saturday my Pee Wee football team (the Downtown Giants) took on the Brooklyn Titans. This is only the second year the Downtown Giants have been in existence, the Brooklyn Titans have been around for about 5 years. Most of the kids on my team have never played a down of football in their life and some have only been to three or four practices! But you have to play the cards your dealt and play we did. From the moment my guys got to the field I was impressed, we were able to line up in 2 straight lines and get into our warm up grid flawlessly. My assistant coach and I asked each other who the heck are these kids. They were focused, they were intense and most importantly they were having fun. From the opening kick off my kids played hard and fought each play. Sure we had missed assignments, broke contain a couple times and jumped offsides here and there but by and large they shut down a more experienced, more athletic team. Final score 6 - 0 Downtown Giants!!!!!!!!!!!!!!!!! Only encountered one low during pre game so that was a success as well - but I owe my kids 6 sprints at practice tonight, I made them a deal that for every win we have I'll do one sprint for the # of points we win by, I'm really going to regret that decision once everyone "gets it" and we have some big wins.
Now onto the triathlon er should I say duathlon. Late Friday night I got an e-mail from the race director stating that the swim had been canceled for the Bear Mountain Triathlon. Apparently the fecal matter level was 1,700, the legal limit for a triathlon is 1,000, so it went from a 1/2 mile swim, 12 mile bike and 3.1 mile run to a 1.5 mile run, 12 mile bike and 3.1 mile run; but USAT triathlon points would be awarded so I guess according to the governing body I did a triathlon although I don't know if I can consider myself one just yet until I actually swim in a race.
Waking up at 5:42 am was not easy, I didn't get to my parent's house upstate until midnight and didn't fall asleep until 1. Groggily I got into my car and drove to Bear Mountain; once there I realized how cold it was and really regretted my decision not to bring a jacket for the bike. Pre race I had a muffin, turned my pump down to 10% and had a clif bar - started with a blood sugar of 120 right after the clif bar so was most likely 170 when the race started. I ran the first 1.5 miles in 11 minutes 50 seconds towards the end of the first loop I heard my name being chanted, I looked up and saw my Uncle who runs Marathons and his son who is a cross country runner in high school cheering me on - thanks Freddie and Uncle Fred you two provided a huge boost! I ran over to my bike and T1 was 51 seconds, I hopped onto my bike and headed up an ENORMOUS hill. They say not to do a triathlon without having seen the course before and now I know why. It's not that I had a problem getting up the hill as I passed 5 to 10 people on my initial climb, it's that I had no idea how long it would go for so I didn't know how hard to pedal - my average speed on the bike was 14.1 mph, had I had better race planning I could have increased that by a decent margin.
On the bike I had an accel-gel on my initial climb. My quest to find the perfect workout food for a diabetic continues but accel-gel has taken the lead. Unlike Carb Booms, Hammer Gels or Clif Shots - Accel-Gel has actual sugar not just carbs! The Delicious Key Lim Accel-Gel has 12 g of sugars while chocolate has 17 g of sugars - while Hammer Gel takes about 25 minutes to change by bs Accel-Gel does it within 10 minutes, a huge help during endurance events.
During the first downhill I really really really regretted not having a long sleeve jersey on. While I looked darn sexy in my orange and blue tri suit - the goose bumps on my arms proved how moronic I was! 33 mph on a downhill when it is barely 50 degrees out in a sleeveless tri suit is just a very bad idea, if that makes me soft so be it, I'm not as tough as I once was, I guess an auto-immune disease will do that to a man. I finished up my bike ride drinking gatorade, and had a hammer gel at mile 9 - T2 was 48 seconds, slowed slightly by the amount of gatorade I pounded in the transition area. I ran out of the gate and finished the 3.1 miles in 23 minutes 49 seconds for a 7 minute 39 second pace and a total Triathlon time of 1 hour, 29 minutes and 54 seconds - good for 39th overall (out of 93) and 4th in my age group (out of 9) - couldn't be happier with my results.
Stupidly I didn't test at all during the tri/duathlon for 2 reasons; I felt fantastic and didn't' want to psych myself out, I finished with a bs of 178 so my nutrition was really spot on; had I felt weak at any point I would have tested but I didn't want a seed of doubt entering into my mind. Could I have run into trouble from this mentality - absolutely but I also believe you have to trust your body and listen to it - I had no symptoms of a low and felt like I was at full power so I didn't think it was necessary to test during the race.
Thursday, September 13, 2007
The other big thing coming up this weekend is the start of my triathlon career! I'll be competing in the Bear Mountain Triathlon on Sunday and absolutely can't wait. Although I'm completely fearful of my blood sugars during this race (had a frustrating episode on Monday) I know I've been training incredibly hard and that with enough Gatorade during the event I'll be able to finish it. Going into this one I don't have a ton of expectations, it will be the first time I have to do a transition and the first time I'm doing an open water swim. So on Sunday keep your fingers crossed that my bs will remain high during the 1/2 mile swim, 12.4 mile bike and 3.1 mile run - I'll have some pictures of the event posted next week.
Here's to some great events this weekend and the hope that my blood sugar doesn't let me down!
Monday, September 10, 2007
The feeling was absolutely surreal, I had some things to take care of in the city and didn't get to my parent's house until 8:30 pm but I knew I needed to get my run in. I headed over to the track which was completely empty and had only one set of lights on. Running in the near darkness next to a field that I had amazing memories on allowed me to really reflect on my path of the past year. I recalled running through the gates to my high school field as a 170 lbs. sophomore guard starting my first varsity game and can say those emotions were very similar to the ones I had when I was diagnosed with Type 1. I remembered throwing up on my Dad's shoes after he had me run 15 suicides in the 90 degree August heat as I got prepared for my senior season in college and compare that to the tenacity I have attacked this disease with. But more than anything the time on the track let me realize that I've been working at something as hard as I've been working at controlling diabetes for as long as I can remember.
The darkness also put me at ease for one of the hardest struggles I'm going to have to face in the coming months. I fully believe that the stress I put myself under to get into a top MBA program last year was one of the reasons I developed Type 1 diabetes. After I completed my first master's in Political Economy in 2005 I signed up for a Kaplan course to prepare for the GMAT but was unhappy with the tutoring they provided, from there I enrolled in Manhattan GMAT, took the test and scored a 670 - ok but not quite elite level. That fall I wrote my applications to Darden, Haas, Tuck and Columbia with self-doubt and no confidence. I most likely had blood sugars that were running all over the place as I couldn't figure out why I didn't have the ability to focus as I used to or why I would pass out on my couch after having 2 beers with a friend while watching the Giants. Starting in January I received rejection after rejection and my confidence was shaken blow by blow.
To prove the admissions committees wrong I was pro-active, signed up for an accounting course at Pace, found a GMAT tutor and starting coaching youth football. Somewhere between all that I was also diagnosed with Type 1 diabetes and was struggling to keep a relationship together. I received an A in that accounting course and then took a finance course receiving another A which helped me regain some of my academic confidence, I retook the GMAT and scored in the 90th percentile and found another youth football league to coach in. Now September is here again and I've done all that I can to improve my application but I'm scared to death of the ramifications of going through all this again. Last year the process completely changed my life and this year I have to face all those fears and all those vulnerabilities as I chase my dreams.
Perhaps I've had to fight for everything I've gained so I could be prepared to handle this disease in the way that I have. So I'd have the courage to sign up for an Ironman to inspire children with Type 1 diabetes. So I'd have the intensity and fortitude to only eat turkey sandwiches on whole wheat for lunch or to only have ultra meal protein shakes for breakfast. My entire past has helped me prepare for battling this disease but now I'm at a point where I must battle the situation that may have been the catalyst to my pancreas failing and it is a fight I refuse to loose this time. Tonight Darden's application and me meet again!
Tuesday, September 4, 2007
We first wanted to go to Dinosaur BBQ up in Harlem, so she met me at the Metro North stop at 125th street, we hoped on the bus and headed over to Riverside Dr. Upon arriving at Riverside and battling through the smell of what could only have been 1,000 dying rats we found Dino BBQ to be closed! So we hoped on the 1 train and headed down to 23rd St. to Righteous Urban BBQ (RUB) but they didn't have deviled eggs which I had promised Courtney.
At this point we had been walking around for a while, I was carrying my bag from a weekend up at my parents and decided I should test. I've gotten into the habit of keeping some glucose tabs in my glucose meter case, but one of those tablets had smashed and there were glucose crumbs everywhere. I lightly tapped my case to get some of the "crumbs" out, as I'm doing this my Freestyle Flash decided to show its speed and independence by jumping out of the case and landing squarely onto a drainage grate!
In movie slow motion I the Flash displayed its last act of independence by jumping 2 feet down into the grate. Few things in Manhattan attract as much attention as 2 people trying to lift a locked drainage gate. No less than 5 people asked what we were doing and a homeless guy thought it was buried treasure. If you're at the corner of 23rd and 7th - look in this grate and you'll see a lonely Freestyle Flash meter!
Courtney called 311 (the NYC help line) and 311 in their display of intelligence sent a freaking ambulance! Apparently the words diabetic and glucose meter send up all the panic flares. The EMTs were really helpful but they didn't have the ability to lift the grate. They did however let me know where the closest open pharmacy would be.
So I headed over to one of the few CVS in the city. Thankfully they had an Accu-Check Ultra Mini and 25 test strips on hand, $48 dollars later I was able to test and had some piece of mind. Not to mention some great BBQ at Hill Country, a new place here in Manhattan; even if it was real expensive for some low & slow meat.
I'm going to miss by Flash meter and now really need to get a new one but this whole ordeal made me realize something. As a diabetic my life is now connected to medical devices and although I didn't flip out when the meter fell into the drainage grate my panic inside was at code red. After last night I now consider myself a full fledged member of the Type 1 fraternity.