Monday, December 24, 2007

I Finally Declared!

Like a proud sophomore going in to see his college advisor my blood finally declared that I have Type 1 diabetes. Sure all the symptoms have been there for at least a year, the high blood sugars leading to DKA before my diagnosis, the constant thirst and the blurry vision then once I was on insulin those symptoms swiftly disappeared. But until Friday no doctor was 100% sure that I did in fact have Type 1 - 99% sure but there was that 1% doubt that it could have been something else, a tumor, a thyroid or pituitary issue or a host of rare disorders that can present themselves with the same symptoms as diabetes. But when Dr. Baker walked into the exam room on Friday he triumphantly declared - "you have antibodies." I now have the islet cell antibody confirming the diagnosis and leaving no question that my diabetes was caused by an autoimmune disease. In my earlier blood work the antibodies were absent.

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 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

2008 Diabetic Runner Challenge

Inspired by the UN's World Diabetes Day, Jamie over at The Diabetic Runner has come up with the 2008 diabetic runner challenge. This is a personal pledge to run 500 or 1,000 miles in 2008 to raise awareness for diabetes. Currently there are 6 participants for the 1,000 mile challenge and 2 participants for the 500 mile challenge. In the future the challenge may grow to become a fund raising campaign or hopefully if enough people sign up a national awareness campaign. In order to really generate interest in this Jamie needs as many people as possible to take the plunge!

Just click the picture above to sign up! So are you up for the challenge?

Tuesday, December 18, 2007

Yogurt Parfait - The Perfect Workout Food?

Lauren had suggested that I find something other than muscle milk and clif bars to fuel with pre-workout. Apparently triathletes have a nasty habit of getting sick of "energy food" and just want something real. To prevent that burn out she wants me to eat fruits with protein as often as I can to substitute for all the protein based health products. My main reason for eating Clif bars and protein shakes is convenience and my laziness. Then I found it - the holy grail of healthy food:

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

My First 3some!!!! (no not that kind)

On Wednesday I caught the office cold that was going around and had to skip the run and swim Coach had scheduled me to do. In order to get all my workouts in for the week I had to triple up yesterday. As you can imagine the thought of 3 separate workouts in one day had me terrified; anytime I've tried this in the past I have failed miserably and ended the day frustrated at diabetes and what the disease has done to my ability to perform as an athlete. Thursday, I was determined to try it again.

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

Physiology, Sports Nutrition & Diabetes

I met with Lauren (my sports nutritionist) for about an hour yesterday to go over my bs logs from the past couple weeks. I took more care to document everything I ate and tested more often over the past 2 weeks than I ever had before. Lauren was able to utilize all this information and came up with some pretty awesome answers to my questions yesterday.

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

Training Goal # 1 - Complete!

Yesterday with a stomach full of butterflies I ran in my first competitive road race as a diabetic. The two days before the race were filled with lows only adding to the doubt I had that I would ever again be the type of athlete I was before my diagnosis. Before I get into my race results here's a brief overview of how crappy my Friday and Saturday was:

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

Big 10K on Sunday

Sunday I'm running the Joe Kliernman 10k in Central Park. To date this is my most important test as a triathlete and more importantly as a diabetic athlete. The 10k will be my longest competitive run to date so my nutrition needs to be spot on.

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

The Power of Protein

Over the past week something fantastic has happened. I've been able to complete all my workouts, dual workouts haven't been as big of a problem, I've been able to feel my legs on all runs, am not afraid of drowning in the pool and relish the opportunity to get on my bike trainer. Lauren made one simple suggestion - have more protein before I work out. Prior nutritionist had tried to suggest this but each of their suggestions relied around my blood sugar spiking into the 200s for a workout.

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

A Weekend of His and Lows

Space Mountain had nothing on my blood sugars from the past couple days! My weekend started early with a visit to Ithaca, NY for a class visit with the Johnson School of Business at Cornell. I left Manhattan at 6:30am with a banana in almond butter for breakfast. The bs held steady until I arrived but... I forgot my meter in my car when I went to the admissions office! No time to go back and get it so I went 6 hours feeling naked and insecure (a really weird feeling). I had a meeting with a director of their leaders fellowship program and felt hypo (still no time to get my meter) so I gobbled up some glucose tabs - 20 minutes later when I got to my car I was at 78 (must have really been hypo).

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!