Friday, February 29, 2008

Blood Sugar - Why Do You Taunt Me?

During a week when I wish everything else in my life could have remained nice and easy, my blood sugar of course decided to act up again. After 16 consecutive days of workouts my blood sugar, understandably was low all day on Tuesday. Rather than fight through what would have been a feeble swim I decided to fight another day and treated myself to a nice bowl of whole wheat pasta for dinner. Last night however, one of my most frustrating experiences with blood sugars occurred.

Excited to return to some sense of normalcy and get my my mind off of Moose I headed to 63rd and Lex for my second swim practice with the Terriers. My bag was packed, swim trunks, swim cap and goggles all ready to go, and then I tested. 128, 10 minutes before I was supposed to get into the water. WTF!?!?! For dinner I had one of my favorite Middle Eastern dishes, donner kebab (essentially lamb gyro) over rice pilaf with coban salad and pita bread. My basal rate was decreased to 10% 2 hours before I tested and I had eaten an hour and 15 minutes prior to the finger stick. I didn't bolus for my dinner so I knew the carbs were somewhere in my system but they just decided not to enter my blood stream yet - perhaps there is some beach in my stomach that carbs like to hang out on, grab a nice frozen cocktail, catch some rays and then hop into my blood stream.

Anyway, I knew I had ingested 55 to 65 grams of carbs and that any additional energy gels or sports drinks would have been a disaster. At some point I knew that my blood sugar was going to spike and I didn't want to be in the 4 or 5 hundreds when that spike happened. So I went to check on my sister who happens to live on the same street as the Equinox; she's been having a tough time with Moose's diagnosis. So as I sat on her really uncomfortable couch I tested 20 minutes later - 131, hmm weird. Finally at 9:30 some 3 hours after I ate my blood sugar spiked to 230; where was that 2 hours ago when I was supposed to work out! I know the lamb has alot of protein in it and the vegetables may have delayed the absorption of the carbs somewhat - but seriously 3 hours to get into my system is just insane - looks like my stomach is going to have to put a time limit on that carb beach so those things get into my blood stream faster.

Wednesday, February 27, 2008

My Life Has Turned Into A Bad Country Song

When I was accepted into the University of Virginia's Darden School of Business I thought every problem I've had over the past year would fall to the side, that my life would become easy and that all the struggles I had faced would have been defeated. While my personal triumphs of training, controlling diabetes and getting into the MBA program of my dreams have given me great satisfaction, external forces have taken alot of the joy away from them.

Last night I received a phone call from my parents that our family dog, Moose has been diagnosed with lymphoma. Without chemotherapy the first dog our family has ever had, the one I purchased just after 9/11 when I couldn't find my first job out of college, after the first classmate I knew passed away, will die within 3 months. With a wag of his tail, a sloppy lick to the face or a leap on your chest, Moose can bring unbelievable joy to anyone on their darkest day.

The Moose and I had a short lived marriage here in Manhattan. I had wanted a dog so badly back then, moving into the big city with only a couple friends - he and I lived in a studio apartment on 87th street. At the time I was about 260 lbs., and going out almost every night. I'd walk Moose every night when I'd get home at 1 or 2 am, then wake up again at 6:30 to take him to play in the park for a couple hours before work. I'd then rush home by 5:30 or 6pm to take him back to the park for a few more hours of play after dinner - and start the whole routine over. While both of us were exhausted, him from being cooped up in a 300 sq foot apartment all day and me from well 4 hours of sleep a night each moment we shared together was awesome. After a couple months of this crazy schedule, my parents and I decided that it would be best if he had room to run at our house upstate.

Whenever I'm home my sister says to me, "man you're right, Moose just won't let you sit there." With other members of our family Moose is happy to sleep next to them, watch tv or simply go for a walk - but I really think Moose believes I'm part dog. When him and I are together all we do is play - or I pet him and get his hair all over my Mother's rugs to her delight. Whether it's pretending he's a defensive end as I pass block him from grabbing a bucket in the back yard (a bucket is his favorite toy), butt heads as we wrestle over a stuffed animal in the living room, or simply let him jump around and bark at me to his hearts delight we play for hours on end until we're both exhausted (normally he passes out before I do). Amazingly, he's just as moody as I am, and has bad days, when my parents call and let me know that Moose is depressed I know a trip home that weekend is all he needs to cheer up.

When I came home from the emergency room the day it was theorized that I had type 1 diabetes - the greeting I got from Moose made all my fears go away. This dog has had such an impact on my life, and has brought so much joy to my entire family that this is a really hard situation to deal with.

I've always known that Moose would pass away before me and that at some point in his life he would grow old. However, I never expected this to happen so soon. He's only 6 years old and the knowledge he might not make it to 7 terrifies me. I'll be speaking with various vets today to find out exactly what stage the lymphoma is and weigh the options of chemotherapy. Dogs are receptive to chemo and the side effects are less severe than they are in humans but it's still a really heavy decision to weight.

I had really hoped to bring Moose to Virginia with me, while Manhattan wasn't a great place for a dog whose a bundle of energy to live, the rolling hills of Charlottesville without question are. Also, last night the girl who I've been struggling to maintain a relationship with, my best friend who I've dated for over 3 years finally told me she couldn't deal with my move to Virginia. Our relationship has been on thin ice for the past year and 1/2. My health issues, her financial struggles, health problems in her family and some other circumstances all put a huge strain on our relationship. I finally came around to getting over alot of the past hurt but in the end she can't handle a long distance relationship with me, preventing her from giving me her heart. So as the old joke says in a bad country song you need 3 parts, a dog, a girl and a truck - hopefully my parents don't call me today to say that a tree fell on my Pathfinder.

Thanks for listening - I'm a pretty private person so this wasn't the easiest thing to write.

Updated: Moose met with Dr. Brodsky at the Veterinary Oncology & Hematology Center in Norwalk, Ct today. The center was founded by Dr. Gerald Post reconigzed as one of the best Vets in the tri-state area and founder of the American Canine Cancer Association. They confirmed that Moose has t-cell lymphoma and without treatment he would have died by the end of March. My sister, parents and I decided we wanted to give Moose the best chance of survival possible and started him on chemotherapy today. The prognosis for a year is a pretty good after treatment but after that it is considerably more merky but I'm praying for the best.

Tuesday, February 26, 2008

What I learned Last Week - Training & Blood Sugars

Last week a series of random occurrences helped me gain confidence in my training and taught me some foods that will shoot blood sugars through the roof without a bolus.

1 - Baklava and Sweet Potatoes unbolused give a body all the sugar it needs: Prior to my swim workout last Thursday I had lamb gyro over rice without a bolus and added a delicious piece of baklava for good measure. Just an hour after eating my blood sugar spiked to 310, after an hour of a pretty tough swim I was down to 115 only to return to 185 on my subway ride home. 310 can start to compromise performance but I wasn't too upset about being that high - didn't want to have to sit out my first workout with my new triathlon team. Last night, I had a sweet potato unbolused before my hour long trainer ride, 40 minutes after eating my blood sugar was at 280 - however the high was short lived and didn't provide the long term negative effects the baklava did. I finished my ride with a blood sugar of 97 - it stayed there through the night; apparently a dessert covered in honey isn't as healthy as an orange potato - who knew!

2 - I can still lay down the hammer: During my 2 and 1/2 hour run on Sunday one of those female runner types - decides to pass me like a bat out of hell then slow down about a foot in front of me, I go to pass her and she speeds up again. I don't know if this was runner speak for I'm a 16 year old girl who just got her drivers license and I'm going to full around with the cute guy in the car next to me or if she was just a freaking idiot. 2 hours into my run I was in no mood to flirt or be held up by a 90 lbs. person, so I decided to see if my quads still could do what god meant them to do. I dug deep and sprinted for about a 1/4 mile, leaving the sultan of skinny in my wake. I was SHOCKED that I could still lay it down after 2 hours and even more amazed that I didn't throw up all over myself after finishing my display of machismo.

3 - Triathlon related; My jumbles aren't as tough as I'd like: I'm currently riding the Selle Italia NTI saddle, this saddle has a ton of padding, especially on the nose - so much padding that the nose kind of curves up a bit and provides a bit too much pressure on some very sensitive areas. I'm headed to the shop this weekend to try out some new saddles so I can get comfortable on the new bike - while the NT1 is comfortable while I'm sitting a bit further back, the second I get up on the nose all sorts of things start hurting.

4 - My old football coaches were right, drinking makes it harder to practice! A week ago I had just returned from a bachelor party in Miami and a few days in Key West - the workouts immediately after my return were PAINFUL. However, last week more than 120 hours removed from any alcohol my workouts were tremendous! Last week was without question my best week of workouts, my nutrition was spot on which I think has as much to do with it as any physical fitness.

Monday, February 25, 2008

100% For Placid!!!!

Last week for the first time since I started training for Ironman USA in Lake Placid I completed 100% of my training goals! Prior to last week blood sugar issues, an injury or life circumstances got in the way of completed all my assigned workouts. The new bike prevented my quad from flaring up, life finally cooperated and I was able to work through some nasty stomach cramps while sweating through 10 hours and 55 minutes of workouts!

I'm still a bit behind on my Annual Training Plan (ATP) goals but know that by July 20th I'll exceed them. It has been really difficult to stay positive in the face of alot of life's challenges recently. I had thought I could maintain my blood sugars by using Accel Gel during long workouts but found that destroyed my stomach and have since had to switch to Ensure. A week ago my long run was cut short because my right knee which I have had all cartilage removed from flared up. So completing everything last week was a HUGE relief!

Friday, February 22, 2008

My First Terrier Practice

I joined Terrier Tri, a Manhattan based Triathlon club back in December but for various reasons I hadn't yet made it to a practice. My original excuse was that I didn't know anyone in the club and wanted to wait for the annual "kick off" meeting. I attended that event with a wicked cold and then due to work travel and vacation couldn't make a practice until last evening.

I showed up at the 63rd street Equinox with swim gear in hand at about 7:40 pm. The last time I attended an organized swim practice I was 12 years old at Camp Kiwi (where I never lost a free style race!) so I was a bit nervous. To make sure my blood sugars were in tact I had lamb gyro over rice and a piece of baklava unbolused for dinner - at 7:40 my blood sugar was 301!!!!! Yikes, at least I didn't have to worry about going low.

At the pool I spoke with the two coaches Robert and Megan to find out which lane I should start in. Originally Robert placed me in the medium paced lane but after a couple warm up laps he put me as the last person in the fast lane. I was pretty excited about this move but didn't know the enjoyable hell I was in for :)!

Megan had promised me that I would really enjoy a group swim workout and that while my mentality is great, going solo for every workout doesn't prove as efficient as working out with a team. I had a blast swimming last night and while I don't remember all the names of the people who were in my lane I'm sure I'll see them again soon. Derek, one of the people in my lane was insanely fast and it was a huge change from the people I see at my gym pool. At the NYHRC I go to I'm usually one of, if not the fastest person in the pool and lap people on a regular basis - last night Derek was smoking me, damn dude swam like a fish - so it was kind of fun to get my a** kicked by someone :).

When I got out of the pool my blood sugar was 115, about an hour later I spiked a bit to 185 but I'll take that for my first organized practice in quite some time.

Wednesday, February 20, 2008

The New Blood Sugar Mobile

After months of careful consideration I finally took the plunge and made a major upgrade in my trusty steed. Prior to Saturday I was riding this 4 year old Specalized Allez with a super flexy bottom bracket, pedals that made my legs cramp and a creaky chain. The frame flexed so much that my Coach affectionatley called it Gumby: Gumby was my first bike since my parents bought me a Dyno Detour during the first BMX craze of the late 80s/ early 90s. I flew over the handle bars of my Dyno when I was 13 years old and didn't get on a bike again until I bought Gumby 4 years ago. So pretty much I learned to ride again on that bike and while I had a love-hate relationship with it, I'll forever have great memories of suffering through many a ride on a bike that seemed to want to give up anytime I got out of the saddle.

Now I've gone from driving a 1980 Pinto to a Porsche 911. My new Orbea Ordu is everything I wanted it to be and so much more! It's way to sexy a bike for my humble needs and I probably never will tap into the potential this frame has but man do I love riding it:

Once Anne finally posts about how to test and ride I'll be all set! On my virgin voyage of Central Park with the new bike I averaged 5 mph faster than the same ride with Gumby (a huge difference!) I can't wait to tackle Lake Placid aboard this rocket ship.

Sunday, February 17, 2008

How Would You Bolus For.....

Finally got around to uploading my pictures from vacation. Could you all have done a better job than me calculating the carbs for each of the below!?!

Coconut Fried Grouper at Alonzo's Oyster Bar in Key West:

I guessed 40 grams of carbs and used the dual wave - pretty sure I was WAY off, a couple hours later, after a few drinks and a Pina Colada I was at 285!

For 2 years I have been craving what is allegedly the best fried grouper sandwich on earth (notice a trend?) Allegedly, B.O. Fish Wagon has them - although a tasty sandwich it didn't quite live up to the hype. I'll still take a Flo's Hot Dog, Cheesesteak from Pats, Lobster Roll from Abbots, or wings from the Anchor Bar any day over this:

Did pretty well with the bolus on this one though; dual wave, guessed 60 grams of carbs and 2 hours later was 160 (needed a slight correction - but was also totally hung over).

A view like this can make all your worries about diabetes, triathlon training and anything else going on in your life go away:

Thursday, February 14, 2008

What I Learned Last Week - Vacation Edition

The second edition of "What I learned Last Week," is a bit delayed due to just returning from a bachelor party in Miami followed up by a few days in Key West. For all of the type 1s out there still trying to figure out how to manage blood sugars with alcohol this post should provide some great tips.

1 - Carb loading is my key to drinking safely as a type 1 diabetic: As a single 28 year old guy, drinking socially is a bit part of my life. I don't go out like I'm 23 anymore (thank god) but when the opportunity presents itself I do like to have a good time. Back in May I threw a bachelor party for my friend in Montreal, terrified of how alcohol would affect me I drank but was very very cautious. After a few months I've learned to control my blood sugars much better and this past Saturday put my knowledge to the test. Most of the guys at the bachelor party had been drinking all day, but I wanted to save up until I could eat a pretty big meal. We went to Taverna Opa on South Beach where I stuffed myself with pita bread, hummus, and proteins and of course beer. I bolused for only 60 grams of carbs although I knew I'd be having vastly more carbs than that - 4 hours after dinner started and a few sheets to the wind my blood sugar was 110 so I followed that up with a clif bar and continued to drink Jack & Cokes/ Diet Cokes (alternated) until 3am at Mansion. When I woke up the next morning my blood sugar was a nice and happy 125.

2 - Pina Coladas have a ton of sugar! After a 15 mile run on Monday in Key West, I had some lows throughout the day due to over active insulin. I intentionally under bolused for my delicious coconut fried Grouper at Alonzo's Oyster House and enjoyed some great dark & stormys. Walking on Duval St. it just felt right to have a frozen drink and felt a Pina Colada was the way to go (notice a coconut theme to this night!) Prior to the Pina Colada my blood sugar was about 160 - perfect start for a night of fun. An hour and a half after the frozen goodness I was up to 281!!!! Lesson learned.

3 - Ensure is a great way to get carbs in while training without having stomach issues. Because of my insulin sensitivity I need a ton of carbs to complete an hour of exercise even if I turn my pump off 2 hours prior to activity. Lauren has figured out I need 45 to 65 grams of carbs depending on stress level per hour of training. However, 2 gels an hour for two hours forces me to curl up on my bed in the fetal position in between trips running to my bathroom. She suggested I try Ensure. During that 15 mile run in Key West I put Ensure to the test and it passed with flying colors. My run of 2 hours and 15 minutes required about 100 to 120 grams of carbs, 2 and 1/2 to 3 bottles of Ensure. With the Accel Gels after about an hour and 1/2 I would start to feel stomach cramps but I had no symptoms of GI issues with the Ensure. Yeah the bottles are kind of a pain to carry around and the liquid looks gross on my fuel belt but it gets the job done and doesn't make me think an alien is coming out of my stomach.

Monday, February 4, 2008

What I Learned Last Week

Each week I'm going to try and have a segment discussing what I learned as a diabetic in the prior week. Hopefully this will serve as a great resource for people to learn from my experiences and hopefully help them tackle some of the same obstacles I've dealt with. Some of the things I'll have learned will be training related and others will deal with daily diabetes management - let me know if you have any suggestions on how to make this more worthwhile.

Things I learned last week:

1 - The dual wave bolus is a gift from God! For my first 9 months as a diabetic I really didn't understand how to use the dual wave bolus. If I had pizza, a burrito or some other high fat food I would under bolus for the amount of carbs and then give a correction bolus 2 hours later. For high fat, high carb foods, I knew the proper bolus ratio would make me go low and that an adjustment would be required later. After the 72 hours of CGMS hell, Dr. Baker taught me about the dual wave bolus - for the past week I've been having a blast with it (well as much fun as you can have with percentages and time ratios) and my blood sugars have been much more stable. For training I need to incorporate fats into my diet every now and again, this is a great way for me to keep my bs under control while taking in alot of carbs with protein and fats mixed in.

2 - The square wave bolus works awesome on Super Bowl Sunday. First, yesterday's game was one of the top 5 football games I have ever seen. I was 8 years old when I first started playing football and have been around the game ever since. Having watched just about every Giants game of the past 20 years (including Super Bowl 25, in person) I can't believe their performance yesterday. David Tyree's catch in the 4th quarter will go down as one of the 3 greatest plays in NFL post season history and the Giants' front four reminded me of the Big Blue Wrecking Crew from the late 80s/ early 90s - what a game! But this was also my first Super as someone who needed artificial insulin. Yesterday I set my pump for 4 and 1/2 hours of a square wave bolus with 75 grams of carbs - by the end of the game my blood sugar was a terrific 105! Although that impressive number pales in comparison to how well Justin Tuck played.

3 - Stick to a plan during workouts. During both my half marathon and my long run yesterday my blood sugars dropped lower than I ideally like them during workouts. I started the half marathon with a blood sugar of about 125, and yesterday during my run after 1/2 hour my blood sugar was down to 96. In each case I stuck with the plan Lauren laid out for me and trusted my nutritionist to know more about my body than I did. Although I haven't yet gotten used to how the Accel Gels affect my stomach I am starting to believe that the sugars in those gels will get me through the runs. While I have to take a gel or two more than the guy next to me, I at least know that I can keep running as long as I have a supply of carbs.

Friday, February 1, 2008

Darden - HERE I COME!

Yesterday I received the best news I have gotten in 2 years; at 10:46 AM, Whitney from the Darden School of Business at the University of Virginia left a message on my cell phone telling me she had "good news" and to call her back. Waiting to call Whitney back was excruciating, for 2 years I have worked my ass off to get into this program, for 2 years I have dealt with set backs, fights with loved ones and sleepless nights as I chased my dreams - finding out if I achieved a dream was delayed because I was stuck in a conference room up in Boston!

After my first meeting ended I called Whitney, got her voice mail and left a message. During my second meeting of the day I said I'm sorry I have to take this call, walked into the hall way and with a fist pump and a smile (about as much emotion as I'll ever show) I heard the words "congratulations, you have been admitted to Darden!"

On February 9, 2007 at 12:01 am, I read on Darden's website the words "admissions not offered" with a single tear I was determined to change my fate and gain acceptance into the program. That night I listed out the 5 things I needed to do to get into the program and stuck that to my refrigerator to be reminded of what I needed to do to advance my career. Step by step those things began to fall and as I worked harder my achievements became greater. The journey gave me experiences that exceeded my expectations - coaching kids, believing in my methods and finding my confidence were all things the past year provided. "They" say everything happens for a reason - and I truly believe I was denied by the 4 programs I applied to last year so I could become the person I needed to be to achieve all my dreams.

There is no way I could have had the strength to fight everyday of the past year to gain acceptance to Darden without the unbelievable support of some very special friends and members of my family. My Mom and Dad fought with me every step of the way and were there to support me - we overcame the denials together and we're overcoming diabetes together - hearing the tears in their voices just let me know that they will always share in my triumphs and tribulations. My 3 sisters, Heidi, Bari and Lynn have all been so supportive over the last year. My youngest sister, Lynn has taken the brunt of my frustrations but started to cry in her office when I told her the news - she "took" me out to dinner (meaning I paid) when I got my interview invite and I know she was more happy for me than even I was yesterday; her unquestioned and unwavering support gave me the strength to do all I had to do over the past year. Courtney, Steve, Eric, Marc, Smith, Sean, Conor, Linda and Mike have supported me through the process and have been there every step of the way - my friends have given me the strength to fight. A special thanks to Courtney for all that she has put up in the past year, for the stress it put on our relationship and for her willingness to let me express my frustrations to her. And to Scott and Paul the Darden alums who guided me through the process - thank you, your insight helped get me through. To Tom W., Professor Fleischer, Alan (Darth Data) and Mike - my recommenders thank you for the kind words and making me look great!

There are two people in particular who guided me in a more direct way, who made me a better candidate and who showed me how to get accepted to business school. Seth, my GMAT tutor helped me learn what was necessary to score in the top 10th percentile on the test and for that I'll be ever grateful. But my most heartfelt thanks goes out to Julian - a great friend whom I met while coaching for the Downtown Giants. Julian was the head coach of the Jr. Pee Wee team, a Harvard Business School and Michigan Law School alum. After a couple e-mails and before I ever met him, Julian offered to help me through the application process. He helped make my essays the best prose I have ever written. Most importantly, this guy who I have known for less than a year believed in me so strongly that I couldn't help but have faith that what I was doing would get me into grad school. I wish I could play the message he left me on my cell phone yesterday, I have never heard someone be so unconditionally and unquestionably happy for someone else, thank you Julian!

I'm sure I rambled through the above post - I'm still not back on earth yet but man this feels great! I have never worked for something so hard in my life, and I have never had to fight through so much to reach an achievement. Just about everything that could have went wrong in the first half of 2007, went wrong for me from a job I hated to my health deteriorating to being rejected by each MBA program I applied to. But I kept my head down, I kept my eye on the goal and I fought tooth and nail to get to this point. To all those who supported me, I promise you I'll continue to fight and work as hard as I possibly can to live up to the faith and belief you have in me - thank you again. Diabetes be damned, now I can just focus on the Ironman and smile knowing that come September I'll be enrolled at Darden!