Tuesday, November 27, 2007

How To Piss Off Your Endo

Unfortunately when you deal with an endocrinologist who runs a practice famous for dealing with children, that endocrinologist may forget you're an adult. Yesterday I had my first appointment with my endo in about 4 months. Over the course of those 4 months the best advice I had gotten from her CDEs was to lower my basal rate 3 and 1/2 hours before I work out to combat any exercise induced lows. Sure that's a great idea if I got out of work everyday at the same time, but since I work in a city so famous for it's work-life balance planning like that isn't really an option (an hour and 1/2, or 2 hours I can manage but 3 and 1/2 - no chance). So I went in frustrated with the whole office, at best.

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

My First Turkey Day

Well first as a type 1. I went into my Thanksgiving meal absolutely terrified. How the heck could I bolus for mashed potatoes, corn, gravy, stuffing and green bean casserole! All home made and not by me - what did my Aunt put in this dish, did my Mom use 2 cans of cream of mushroom soup or 1, was that gravy from a jar or did they make it old school style? What about pie - could I possibly have a slice of pumpkin pie after all these carbs????

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

Nutrition Energy

On the day before Thanksgiving I have something to be very thankful for. I've searched high and low for a sports nutritionist that could meet my complex needs as a diabetic and as an athlete. Some programs I found like fit4d.com sounded fantastic but the fact that the nutritionist wasn't local made me a bit hesitant. Other nutritionist I spoke with were famous in their industry but didn't have the expertise required to deal with a diabetic athlete. But yesterday I had a close to 2 hour conversation with Lauren Antonucci, of NutritionEnergy.com.

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


Yesterday the Downtown Giants went 3 for 3 in our Champiship games. The hardwork, commitment and dedication my Pee Wee team showed during the season paid off in a 56 - 0 win in our Championship Game! I'm too excited, hung over and thrilled to give a full recap. Diabetes, blood sugar and triathlon are about the furthest thing from my mind right now. I can't put into words how amazing this feels and how proud I am of each and every one of my players - and yes the kids who ran with me made weight!
What a day!

Thursday, November 15, 2007

A Change to My Training

This week instead of running at a 8 to 9 minute mile pace I've slowed way down, gone outside and run for something much more important. On Sunday November 18th the Downtown Giants have 3 teams in the Metro Division Championships - one of the three teams just happens to be mine! American Youth Football has a 134 pound weight limit for their Pee Wee teams. 4 of my players are right on the verge of not making weight, and won't be allowed to play if they are over at the weigh in.

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

A Low On World Diabetes Day

One would think that my pancreas would have gotten the message that this is WDD. I mean if they can light the Empire State Building blue for an evening can't my body process sugar in the right way? Apparently WDD isn't like my little sister's birthday - whatever she wants she gets; rather it unfortunately is just another day for all of us. The extra awareness, the blue umbrellas and the landmarks around the world doesn't change the way we count carbs, program our pumps or inject a bolus. The extra awareness is a great thing and hopefully it will propel some genius in Med School who is deciding between career paths into endocrinology so we can start to get some bright minds working on a cure or a better way to manage and treat this disease. I long for the day when I prick my finger and see 90 on my meter each and every time.

Monday, November 12, 2007

Watching The Meter

Inspired By Soul Asylum – Somebody to Shove

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


This past weekend was Ironman Florida and two people who are integral to my training and diabetes management both competed. I'm Coached by Mary Eggers who owns Train-This, a Rochester, NY based triathlon team and training program. I was introduced to Mary through Courtney at Ironman Lake Placid; after interviewing potential Coaches I realized the Egg was the right one for me when she said "I take more joy in seeing my athletes cross the finish line than when I cross it myself." Coach has been unbelievably supportive throughout my training and has taken the time out of her schedule (which included taking care of her son with a broken leg!) to try and find ways to keep my bs more consistent during workouts. I've played for alot of Coaches throughout my athletic career and Eggers is without question one of the most dedicated and caring I have ever had the pleasure to train under.

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

One down....

What a relief - my Darden application was submitted around 3pm yesterday a full 33 hours before the deadline! The past 8 or 9 months has basically been devoted to improving my application and gaining admissions to that MBA program - so essentially I gave birth to 20 pages of paper yesterday. This time around the words weren't blurry, I was able to edit my essays without feeling like my brain was traveling at 1,000 miles per hour and I didn't need 15 gallons of water just to sit in front of my computer for a couple of hours. I was calm, relaxed and confident - now when I was about to submit I was anything but calm and relaxed; in fact I was surprised I didn't need a new computer as I was hosting butterflies the size of a taradacktyl in my stomach before I hit submit. Best part of all - the blood sugars stayed pretty stable, actually had some lows over the past week even with all the stress, excitement and anxiety of getting together what I've worked so hard on.