Wednesday, November 24, 2010

Seasons? Or Something In The Water?

Over the past week or so my blood sugars have been angry, even with the new pump.  I have been struggling to get my blood sugars out of the 300s even with big boluses, lots of water, a good amount of exercise and an increasing basal rate.  My first thought to get my blood sugars back in line was to have a day of nothing but Ezikuel bread (which is really sprouted grains), salad and quinoa. When a dinner of just quinoa still had me high I figured something bigger wast at play.

Yesterday on Facebook a post by Anne popped up that said, "RAGE BOLUS!"  I e-mailed her and asked if her blood sugars had been crazy for the past week as well.  She told me she couldn't figure out what was going on and that she too was struggling to keep her blood sugars under the 250 mark.  Moreover, another type 1 friend of hers was experiencing the same issues.  WTF!!!!!!!

So either there is a mass conspiracy in San Francisco to drive all diabetic's A1c above 10 or the change in seasons this year is just really weird.  The temperatures in San Fran have dropped pretty starkly over the past week after some unusually warm weather.  My best guest is the drastic change in temperatures has messed with people's metabolisms.  "Normal," people as Lauren Antennucci, my sports nutritionist, used to say will be more tired than usual in the face of a changing metabolism but for someone special, like Anne, her friend and me the repercussions are blood sugars that are totally SNAFU.  Hopefully all the SF blood sugars get under control soon; if not an investment in the companies that produce insulin might not be the worst idea!

Wednesday, November 17, 2010

36 hours of shots....

10 am this morning could not have come fast enough.  For the past 36 hours I've been managing my blood sugars with a combination of lantus and novolog injections.  The last time I was on lantus I was still in the "honeymoon," phase of type 1 so I gave myself something like 13 or 14 units of lantus a day.  Because my exercise rate varies daily due to training I manage my blood sugars with a combination of my basal rate and planned boluses throughout the day.  Therefore, I had no clue how much lantus to give msyelf for the the first 24 hours without my tail.

After Anne gave me the lantus I knew I didn't want to go overboard with my long lasting insulin so I gave myself 11 units and planned to manage any highs with novolog injections.  I woke up with a blood sugar of 255 and had an egg on a small multigrain english muffin for breakfast.  By the time I got into work about an hour later my glucose had popped to 352.  The day was not off to a good start and I was feeling awful, I was thirsty, had to pee, had unclear vision and my head felt like someone was lightly tapping it from the inside.  For the next 6 hours my blood sugar oscillated between 275 and 325 as I gave myself injection after injection.  Finally around 3pm my blood sugar dipped below 100 and then quickly dropped into the 70s.  I had a clif bar to bring my bs back up and then took another injection when I saw my blood sugar rise to 180.

When I got home at 7:30 pm I took in 14 units of lantus and 4 units of novolog to cover the salad I was having for dinner.  Thankfully my blood sugar finally stabilized as I laid on my bed and watched some Netflix too exhausted to move.  I woke up with a blood sugar of 190, took in 2 units of insulin, had a cup of coffee and rode my bike to work.  Once at work my blood sugar remained at 120 and finally at 10am my new pump arrived.

Today I feel 1,000 times better than I did yesterday; I have no idea how I lived like that everyday for a year as I went undiagnosed.  The headache, the thirst, the muscle cramps, the problems seeing; all those little symptoms that had me so confused from 2006 - 2007 were on full display yesterday as my blood sugar was consistently the highest it had been in many, many years.  With a stomach sore from the # of injections I gave myself yesterday I sit here tremendously happy knowing that my tail is firmly in place and that I'm back in control.

Tuesday, November 16, 2010

Another pump bites the dust

The new purple pancreas was with us for a very short period of time so it will not be receiving the 21 gun salute that the original purple pancreas received.  In fact, if not returning the pump didn't cost $3,000+ for not returning (can you follow all those negatives?) it would currently be somewhere between my apartment and the Pacific Ocean for how far I would have thrown it!  The freaking thing lasted from late August until mid-November; not my idea of a quality built product.  Alas, here I am waiting for my new pump to arrive - it won't arrive until Wednesday, so I'm on lantus for the first time since June, 2008 for 24 hours.

The beauty of Triabetes and the diabetic community was on full display last night.  After my pump would not prime and a ton of moisture was underneath the screen I called Medtronic.  Since my pump died at like 9:15 pm PDT, UPS could no longer ship it out for next day delivery.  Apparently Big Brown says you have to place an order by 11pm central time for it to arrive the next day.  That doesn't sound like just in time logistics to me; but whatever I guess commercials lie. 

I hopped on gmail to see if any of the local Triabetes crew was online, God smiled down on me as Anne of Annetics happily had the green available to chat button next to her name.  The crazy thing is Anne was one of the first diabetics I had ever spoken with, how I became involved in Triabetes and was a guiding light during my early days of both triathlon training and more importantly managing the D. 

Our conversation went something like - "Hey Anne, my pump broke, do you have any lantus or syringes?" Anne replied, "let me check; yep I do, come on over!"  Simple as that I wouldn't have to totally freak out for 24 hours without any tail.  I do feel kind of paralyzed though.  I was supposed to ride in GG Park this morning with a friend of mine from SF Tri Club but I had to bail because I'm not sure at all how my body will respond to lantus.  So for 24 hours I'll be eating pretty light (not that, that's a huge change) but won't have the ability to really work out.  I remember when I was on multiple-injections I was low pretty much all the time so I'll just have to be extra vigilant about that today.

Pretty frustrating that technology failed me again so quickly.  Maybe it's because I went for a run in the rain with my pump; maybe it's because it was a refurbished pump.  I love the purple pancreas but lets just say if any pump manufacturers want to sponsor me right now I wouldn't be opposed to switching.

Friday, November 12, 2010

Finding a Pool - the life of a triathlete on the move

A triathlete faces many obstacles when moving.  Beyond figuring out how to get one's most prized possession (a tri bike) from point A to point B safely, securely and in one glorious piece the triathlete has to figure out where the heck to work out in their new city.  Finding running and cycling routes is one thing; finding a new pool is a completely different story.

I became somewhat spoiled having UVA's pool as my body of water to train in for the past two years.  Having top notch division 1 facilities, a clean locker room; a wall of windows and enough lanes to satisfy all the bike commuters in San Francisco.  The luxury of having that pool for 2 years has left it hard for me to be satisfied of another pool to train in.  Thus far I'm up to trying out three pools in SF and researching about 5 others.

Each pool has had a really interesting draw back:

  • the first was USFs' pool - nice enough, a good amount of lanes, kind of weird because there is no shallow end so during rest periods you have to hold onto the wall for dear life.  The big kicker at this place is to join I have to "try out" for the masters team.  I'm not worried about the try out but am just kind of annoyed by the fact that I have to be "approved" to swim in the pool so I don't have to spend $15 every time I show up.
  • the second was UCSF's Mission Bay Pool.  Really nice facilities although kind of confusing to navigate.  I can join this as a "neighbor" because my apartment is near their other campus.  However the big challenge here is that the pool is on the roof - outside.  An outside pool is awesome somewhere like oh I don't know Miami, but San Francisco gets freaking cold and is wet, ALOT.  Swimming outside in the rain in 50 degree temperatures isn't my idea of a good time.  If this pool had a tent over it or something it would be a great option.
  • Now last night's fiasco.  I was real excited to find a Y 2 miles away from my apartment with awesome hours.  Their website said the pool had 8 lanes (4 split in 2s) and while Ys aren't glamorous they normally get the job done.  I got to the pool last night to swim, each lane was marked for speed, Fast, Medium Fast, Medium and Slow.  Looking over the swimmers in each lane I opted for the fast lane - with 3 other swimmers.  I'm not a huge fan of circle swimming to begin with; if everyone is doing the same workout it's great; it's pretty awful if there are individual agendas going on.  
 To continue.... two of the people in the lane were wearing paddles, one of the swimmers with paddles had a weird tube around his feet that was kind of like a pull buoy but seemed way more bouant and then there was the woman....  I should have known this woman would be a disaster when I arrived at the pool and the lifeguard tried to explain something to her.  So I hop in the pool as the woman continues to just stand in the middle of the lane.  Finally I push off the wall and go to swim; when I returned to the starting wall the woman was still standing in the middle of the lane.  After my next 100 she had finally crossed the length of the pool and stopped in the adjacent half lane (i.e., the one you would kick off from during circle swim) when I asked her, "do you have any idea how to circle swim?"  I know, I know but I was frustrated.

She continued to do bizzare things including just swimming a very slow breast stroke which continued to clog the other 3 of us.  Finally she left to go to the medium slow lane.  Since she continued to clog up the lane the other 3 of us came dangerously close to hitting into each other during the push offs from the wall; at least I thought that was her causing all of it.  But no..... as I continued to try and circle swim one of the swimmers with the paddles would stop every 50 yards and instead of getting to the corner that would give the rest of us more room he would stop short of the wall and kind of take up both 1/2 lanes.  This caused me to almost hit into the dude with the inner tube thing 3 times.  And at one point as the paddle guy was walking between lanes I pushed off the wall directly into him, fun. 

Then inner tube guy had his son also wearing an inner tube on his feet join him in the fast lane.  They decided that chatting along the wall taking up an entire 5 yards of a half lane was ok as they allowed their inner tube feet to float to the surface.  Concurrently paddle guy was standing in the other half lane doing absolutley nothing so as I returned to the wall I literally had no where to push off of or touch.  At that point I had, had enough jumped out of the pool, packed up and went home.  The Stonestown Y will not be my pool of choice.

As it stands now it looks like I'll have to get over my annoyance and try out for the Masters team.  Either that or get over my fear of sharks and swim at Chrissy Field for free year round (although the rain and cold thing would put a damper on that).  Oh the joys of a moving triathlete.

Thursday, November 11, 2010

Returning To Form

Hello again, it's been a while since I've had the time to sit down and collect my thoughts.  Life at a start-up keeps you busy for sure, the frantic pace and constant need to move things forward keeps it interesting and fun but a 36 hour day would help things out quite a bit!  However, now that I'm finally settled into life on the West Coast things are returning to normal.

Late last week I decided to start training again.  My body needed some time to recover from training for CDA and well I overall needed to adjust to the move and new job.  I technically never stopped working out but I hadn't worn my heart rate monitor for a couple of months and really had no structure to anything that I was doing. All that was a nice change of pace but I was craving a direction and some hard core heart pounding work outs.  With that I finally turned the corner on Sunday and found my mojo to push it again.

Sunday was a rainy day here in San Francisco, but I woke up feeling a desire to run that I hadn't felt in some time.  My previous 5ish runs had been cut short because of blood sugar issues but for this run I made sure to prepare my nutrition and to load on carbs pre-run just like I do during normal training periods.  I left my house with a blood sugar of 238 ready to take on the hills of SF.  The goal for the day was to run more than 7 miles.

I headed through Golden Gate Park with fresh legs and a focus in my mind I hadn't felt in a while.  My blood sugar felt stable as I cruised with a really comfortable stride.  The miles began ticking off, my heart rate was staying in zone 3 and I was feeling fantastic.  I ran along the Great Highway cruising at an 8:30 pace, looked at the Pacific and smiled; this was my first real California moment, running the rain with waves crashing to my right - one of the exact images I had hoped to find when I so wanted to move to the West Coast.

I slowed my pace just a bit from mile 6 to 7 as I wanted to push the pace a bit for mile 8.  Mile 8 ticked by with my watch showing an hour and 9 minutes; which left me with a great mile cool down as I jogged back to my apartment.  My first "real run" since CDA, and better yet my blood sugar was a happy 140 when I got out of the rain.

The day after the powers that be at my firm gave the company the day off for a super successful product launch.  So I locked El Bastardo to the roof of my car and drove down to Santa Cruz for what was sure to be some great riding.  Made a blood sugar mistake on the way down as I started the ride with a bs of 392 - scones sure have alot of carbs!  The ride in Santa Cruz was in a word, perfect.

I started my 40 mile loop with a 10 mile beast of a climb.  The climb reached grades of 11% for short stretches and averaged about 6% for the entire climb.  The climb was longer than anything I had done in Virginia and was unbelievably challenging as I couldn't get into my biggest gears on my rear cog (need to make some rear derailleur adjustments).  But I kept a steady cadence (dropping to 45 at one point!) and kept the wheels rolling.  Close to an hour later I had conquered the first 10 miles and faced a crazy steep descent.

The amazing thing about riding in California is the drastic temperature swings.  I was pretty warm on the climb up in my merino wool jersey, warmers and bib shorts.  But I was cold to the point of shivering on the way down!  At one point I had to stop in a patch of sun light to stop my teeth from chattering and warm up a bit.  Once I finished the descent I was greeted by an unbelievable view of the Pacific Ocean and 15 miles of pure bliss as I time trialed it down US 1.  Sadly, my damn Droid didn't save the pictures I took of the ocean so the images are only burned in my mind not on film.

For 15 miles I jammed along at a 24 mph pace and my legs turned the pedals seemingly like they never forgot how.  Riding along the Pacific, enjoying the view was the happiest I had been since I moved to California.  I couldn't have asked for a better loop.

The ramp up in exercise has of course begun dropping my basal rates like a lead balloon.  One of the many reasons I hopped back on the saddle was an escalating basal rate and some blood sugar numbers I wasn't happy seeing.  The combination of commuting by bike and my daily workouts has me exercising close to 2 hours a day which has brought my basal rate from a high of 17.5 back down to 15 in a 10 day period.  That has translated to blood sugars that were hovering around the 160 mark to blood sugars between 100 and 120.  My basal rate still isn't as refined as it should be, the move and recovery took its tool.  However, slowly everything is returning to form.