You Discontinued What?!?

Yesterday I walked into the Duane Reade near my office to pick up the test strips refill I had ordered on-line the day before. When I arrived at NYC's finest pharmacy I was informed that the Freestyle Flash meter was being discontinued and that the test strips would no longer be offered! Thankfully, the pharmacy had 100 test strips left (enough to get me through about 10 days) but charged me the full price of my prescription for them - those bastards!

So my question is - does my pharmacy have a clue as to what's going on? Is the Flash being discontinued in favor of the Lite? And if so what meter should I get, size and accuracy are most important to me. I hope this serves as a heads up to all of you with a Freestyle Flash - Abbot will be hearing from me if in fact they discontinued a meter without informing us a few months before.

Update: Did some investigative research, Abbott is still producing the Freestyle Flash strips but certain pharmacies have decided to discontinue them. I called Duane Reade and DR is one of the pharmacies that is no longer carrying the Freestyle Flash strips.

Might Be Getting the Hang of This

7 workouts up, 7 workouts done - went 7 for 7 last week, no exercise induced lows, no workouts that I had to shorten, hit all my training goals and had a great week exercise wise. This included a week where I had my final in a finance course, took the GMAT, and pretty much had my heart broken. I'm amazed that with all that went on last week I'm sitting here and typing about it.

Last week my training log was the following:

Monday - 1.5 hour primary muscle group lift
Tuesday - 3 mile speed test
Wednesday - 1.5 hour secondary muscle group lift
Thursday - 1/2 hour continuous swim (tried a new basal rate that day that worked great)
Friday - 15 minute recovery run
Saturday - 3.5 mile slow run
Sunday - 3 hour bike ride (conversation pace)

Added to that was the GMAT on Wednesday which I scored a 690 (90th percentile); I'm praying that this score puts me over the top for the MBA programs I'm applying to. If any admissions officers out there suggest I absolutely need to break a 700 I'll hit the books again though. Thursday was my financial management final (hopefully got an A) and Wednesday night I was up till 2am for the personal reasons mentioned above.

On Saturday I needed to make my way to the Upper East Side to retrieve my bike, ride it about 5 miles to football practice in Battery Park. I currently am the head coach for the 11 year old team for the Downtown Giants. After practice I noticed my front tire was totally flat, the C02 cartridge didn't fill up the tube so I had to walk my bike about a mile to the gym in insane NY humidity.

The only lows I encountered all week were after going out for beers with a friend on Thursday night. I think I may have over bolused for the cup cake I had; that coupled with alcohol was a dangerous combination, a full Gatorade and snickers bar later I was only up to 106! I needed to have 5 or 6 glasses of orange juice when I got home to make it to the 120s before I went to sleep.

All in all I pretty much felt like a normal person blood sugar wise last week, I'm getting adjusted to the pump and am starting to be able to work out hard consistently again. The folks at the Berrie Center and me will continue to adjust basal rates and % decreases prior to exercise until we have it down perfectly but last week gave me the confidence that I can still go after my workouts like I used to.

Trusting Your Body

Yesterday I made one of the scariest decisions I've had to since having diabetes in regards to working out. I trusted that my nutrition, pump settings and preparation would allow me to strongly complete my workout even though my meter readings indicated otherwise. My triathlon coach wanted me to do a 3 mile speed test which required me to have optimal blood sugars for performance. About an hour and 45 minutes after lunch my blood sugar was 90, I had turned my pump down to 5% about 45 minutes before that and after the reading had a clif bar. I headed to the gym 10 minutes later and after changing into my running clothes I gobbled up a hammer gel. I stretched and warmed up for 5 minutes, tested again and had a bs of just 99.

I knew I had just ingested over 65 grams of carbs and trusted my nutrition. I figured there was no way I needed more carbs and if I had anything else without a bolus I risked going into DKA (bs over 250). With great trepidation I set the treadmill to a 8:30 pace and finished my 3 mile run in just over 24 minutes (upped the speed each mile). By mile 2.5 my stomach felt like it was in a vice so I knew I was risking going low but I didn't have blurred vision

At Least We Got A Paragraph!

Today the NY Times ran an article on the increased risk for heart attacks in diabetics. Mind you the headline stated Diabetics and not Type 2 diabetics which the 4 page (online version) of the article was almost entirely about. The only mention of Type 1 diabetics was that we are "often thin". Now I don't mean to feel like the bastard step child of the medical community but seriously at least throw us a bone! This comes on the heels of a friend of Courtney's mentioning to her that my blog is boring because it is only about "blood sugars." I'm more amazed each day by the misunderstanding people have with Type 1 diabetes and continue to try and think of outlets to get the word out about this disease.

For example, today ESPN had a segment on Sportscenter about Todd Crandell, a former heroin addict who was able to overcome his addiction through triathlons and ironmen competitions. Todd's story was inspirational and I would love if a similar piece was done on athletes who overcame diabetes. On any given sporting event you'll often hear about an athlete who overcame some adversity in his life to reach the position he is at today. However, groups like Team Type 1, athletes like Adam Morrison, Jay Hewitt, and Michael Sinclair are hardly ever mentioned. I spent my football career without the worry of blood sugars and can't imagine having played at the level I did while having to constantly check my bs.

I think the only way to improve the products we have to help treat the disease (like the work Amy at Diabetes Mine is doing) is to improve the awareness of this disease. My motivation to train for Ironman Lake Placid was in part to inspire all those diabetic kids who are afraid to put on a uniform of some kind but if our message never reaches those kids how are they supposed to be inspired? I'll continue to write like all those people on my blog roll do and hopefully one day our message will be heard.

Back To The Drawing Board

The euphoria I had experienced from Tuesday's run quickly turned into frustration, anger and a general state of pissed offness after my Thursday run. Thursday started off pretty poorly to begin with, I was stressed about a pre-mba finance test, am trying to figure out some personal stuff, and when I finally showed up for my finance test the Professor decided not to be in attendance and gave the test as a take-home! Thanks for announcing that earlier, I really would have liked the hours of sleep I lost because of studying back...

Anyway, at 3:30pm I gave myself a correction since my blood sugar was in the 180s, 2 and 1/2 hours after I had my turkey sandwich for lunch. Prior to the test I had a cliff builder bar and gave myself a bolus of 1.6 for it. When I found out the test was a take home exam I set my pump to 10%, went back to my office, took the test and then ate a cliff bar (no bolus). Pre-cliff bar my bs was 91; I didn't test before my run. 12 minutes into my run I had an orange Hammer Gel (a bit harder to digest than apple cinnamon) and tested at minute 20 - my blood sugar was 82. I slowed the treadmill down and had another hammer gel at minute 23; I soon realized my body wasn't feeling right. I tried to test again but my glucometer must have gotten some sweat in it so I couldn't test. I went to the locker room, tested again after resetting my meter and had a blood sugar of 62 - good thing I got off the treadmill.

I'm not sure if the low was induced by the correction and bolus 2 plus hours before I began my run. I sure hope that's the case. Next week I think I'm going to bring Gatorade with me when I run and just have a gulp every few minutes - it seems to work on my bike rides so hopefully that success translates to my runs.

Breaking 100

Trying to figure out how to keep my blood sugars out of the 60s with the increase in my training has been a real challenge. For the past 3 weeks it seemed that everytime I went to the gym I'd either have to cut a run or swim short or suffer through alot less energy than I normally have. I decided to get over my fear of testing at the gym and now bring my glucometer with me for all my exercises. Yesterday, for the first time since I started training hard I was able to keep my blood sugar above 100 for the entire run! Thank you Hammer Gel!!!!!

Leigh from the Naomi Berrie Center suggested I drop my pump to 10% at least an hour before my workouts rather than the 40% I tried last week. Right before my run my bs was 107, I had a cliff bar and headed out for the gym. 12 minutes into my 1/2 hour run I gobbled up a Apple Cinnamon Hammer Gel - at minute 17 when I normally feel like the Aflac Duck has swapped feet with me I still felt like I had a normal stride. I continued on my run and was able to blast out nearly a half mile in my last 3 minutes (sorry Coach, I know it was supposed to be a slow run but I couldn't help it!). When I got off the treadmill I checked my blood sugar and was ecstatic when I saw 115 on my meter! This marked the first time since I was diagnosed with diabetes that I had a blood sugar above 100 after a run. I just hope there's a way to do this without having a hammer gel every 15 minutes.

Tastes Great & Sugar Free!

During the workday my beverage options are usually a diet soda (which I try to limit to one a day) or water. Now water is fantastic, takes care of my hydration needs but it is severely lacking in the flavor department. At the Supermarket the other day I came across these:

Crystal Light came out with individually packaged drink mixes. I don't really want to take up the whole fridge at work with a pitcher filled of Crystal Light so these things are absolutely perfect. I fill up my Nalgene with some water drop in a packet of this:

Then I have some flavor to add to my day - sugar free and a nice alternative to the water machine.

Novolog Did You Decide to Do Steroids Before Entering My Body?

Last week was my first 6 workout week since probably college - I've been more of a 4 times a week guy up until my crazy idea to train for an Ironman. Since my lunchtime bolus didn't work as effectively as usual in the early part of the week I was hesitant to reduce my basal rate as early for the gym as I normally would. By Thursday my lunchtime bolus seemed to be working again but the insulin in my system must have done some HGH because it became way too sensitive!

From Thursday to Sunday I had 6 recorded blood sugars below 70, including a 48 after a run; Saturday was my scariest low yet, after a pasta and veal dinner my blood sugar was at 61 and I felt like no matter what I ate I couldn't increase my bs. Add one more low to the mix, by the time I got to my office this AM I was down to 58. Now maybe my Novolog is paying tribute to Barry Bonds historic 755th homer but really I'd like it to keep the anabolic roids on the shelf - I have no need for some superstrand of novolog to keep my blood sugar in check - I do a pretty good job of that with the way it normally works.

Perhaps from the extra exercise the insulin has become that much more effective but it's not as if I was inactive prior to this. Is this a sliding scale that I will constantly have to deal with - on weeks where I really have to bust my butt for training am I going to constantly battle lows and on weeks where I'm supposed to rest will I be battling highs? Am I going to have to come up with some equation that says if output for the week equals this then my basal and bolus rates should be that? Or maybe it's just time for a CGM although the $500 a month is a bit steep.

Fatigue & Low Blood Sugar

I've encountered more lows than I'd like to admit from workouts this week. My lunchtime bolus hasn't been as effective for whatever reason so this has made me more hesitant to adjust the basal rate on my pump pre workout. For a lift I like to reduce my pump to 70% an hour before I begin and for a run I drop my pump to 20% to 40% (depending on distance) an hour before I run. However, this week my lunch time bolus has had me at 160 to 170 2 hours after eating rather than the 90 to 100 I'm accustumed to. Rather than giving a correction yesterday when I was at 158 2 hours after eating I waited, 30 minutes later I tested and was down to 97 - going to have to talk to the CDE about this situation.

Back to the workouts, because of the higher blood sugars I've been bolusing for my clif bar and then going to the gym, after my run on Tuesday I was down to 68, my lift on Wednesday I dropped to 62 and yesterday after my run I dropped to a very scary 48. Yesterday was by far the worst of the lows and I still feel like a zombie because of it. My ironman coach wanted me to run 10 minutes at an incline of 1% then increase the incline gradually up to 7% over the next 6 minutes - I was supposed to run at a conversation pace (about 9 min miles for me). Normally this run wouldn't be an issue but yesterday I was laboring like a wilderbeast trying to escape a pack of lions. I assumed it was due to a couple nights of pretty bad sleep and continued to struggle through the rest of my run. About 22 minutes into my run I felt like I switched the lower half of my body with the Aflac Duck and waldeled through the last 8 minutes at a 9:45 min/ mile pace (returning to a 7% grade). I made my way back down to my locker for my post workout test and was scared as hell when I read that my bs had dropped to 48.

For every workout I leave a carb gel of some kind next to my meter in case I'm low at the conclusion of my exercise - thankfully I had one yesterday. A hammer gel and 6 oz of OJ later I was up to 110, I guess no matter what my bs is pre-workout I need to reduce my basal rate to avoid a situation like this one again.