Race Report: Chicago Triathlon; Ouch!

I was excited to head to Chicago for the race; neither Katie nor I had ever spent time in Chicago and I was competing having raised more than $1,000 for Insulindependence adding some special flare to the event.  Heading into the race I had felt in pretty decent shape, my training was a bit off in the weeks heading into the race as we had switched apartments and work became absolutely crazy but I was feeling good nonetheless.  Ironically, however, in the race I had raised money to support a non-profit that promotes active lifestyles for people with juvenile diabetes I was deeply affected by high blood sugars for the first time on a race day.

We left for Chicago Saturday morning and my blood sugar was a happy and stable 110.  Once in Chicago we walked to the Hilton to pick up my bike from Tri Bike Transport and on the way home my blood sugar dropped down to the 40s, the only period my blood sugar would be below 250 for the next 14 hours.

Once I finally got my blood sugar to rebound it continued to climb no matter how much insulin I took in.  From 3pm until I went to bed at about 11pm my blood sugar stayed above 300; I took in about 10 units of insulin with little or no impact.  The high blood sugars were making me feel sick, very sick.

I woke the next day at 5am to a blood sugar of 275, decided to change my infusion set and headed off to transition to rack my bike.  After riding to transition (about 3/4 a mile away) and walking back my blood sugar dipped to 230 but would then start to rise again post my breakfast of an extremely low glycemic cereal.

Once at the race site for my 8:30 am start time my blood sugar was still above 200 but started to trend just slightly downward.  The declining trend had me really worried about going low during the race so I took in a gel, got to the swim start and was off.  About a 1/4 of the way through the swim I started to feel pretty nauseous but got through it in 35 minutes (sans wet suit) and then was off for the 1/4 mile jog back to transition.

In transition I tested and had a blood sugar of 185; the downward trend was continuing so I took in another gel and headed off on the bike.  Once on the bike I knew I didn't have the pop in my legs I normally do as my mouth was getting more watery by the pedal stroke.  I finished the 25ish mile course in an hour and 10 minutes, a bit slow compared to where my cycling is and I just didn't feel right.  On the second half of the bike I was going in and out of focus; my vision was blury from time to time and I felt like I was holding back vomit as the miles ticked by.

Back in transition I tested again and had a blood sugar of 105; uhoh still trending down and time for a run.  I took in another gel and 2 minutes 30 seconds into the run I was spent.  I could barely focus, my stomach felt like it was in a vise and all I wanted to do was sleep.  I started to walk less than a 1/2 mile into the run and had to refrain myself from punching someone who shouted words of encouragement "that's it just keep going at your pace."  I thought, "dude I'm about to throw up everywhere all my pace is doing is keeping me from projectile vomiting on your face."  Realizing that I was in no condition to keep moving I found a grove of trees to "hide in." 

I sat for about 10 minutes trying to get the energy to run again.  Once I felt like my legs were coming back and that my blood sugar was rebounding I got back to my feet and started to jog again.  About another half mile in my stomach started to kill me and I started throwing up a little bit at a time.  I then began walking for the next 2 miles.  The first 2.8 miles of the run took me 45 minutes; just under the time it should have taken me to finish the entire run.

At mile 3 I was able to start jogging again fighting off stomach cramps and overall just feeling incredibly crappy.  Once down the finisher shoot I could barely focus, was starring at my shoes and just wanted to cross the finish line to throw up again.  I crossed the line, found a spot on the railing and waited for Katie to meet me with my Uncle and cousin (they live in Chicago and were awesome to come out to support me).  Once Katie met me at the railing I handed her my stuff and said "sorry I'll be back I need to go throw up."

I found a private spot and began to yak (note to self warm clif shots coming back up are disgusting).  After emptying my stomach my cramps started to go away and I began to take in a ton of fluids.  Finally back at transition I tested again and had a blood sugar of 150.  It seemed that whatever was going on my blood sugar was finally getting back to normal.

But, I finished; when I set out on this journey my goal was to prove that a chronic illness does not have to prevent what someone can accomplish and to inspire children with type 1 to chase their dreams.  The Chicago triathlon was by far the worse race I have had, the stomach cramps, weird blood sugar and just overall sickness I felt made this race emotionally and mentally more challenging than any Ironman I had done.  While laying in the trees I thought to myself, "I'm sick of this disease, I'm tired of fighting, I'm tired of being affected by a condition which is invisible to so many."  But by the time my mental focus was coming back I felt a renewed desire to fight this disease.

Managing type 1 diabetes isn't easy and sometimes I lose sight of that.  I've accomplished so much in my 5 - 6 years with this disease that I forget it is a constant, daily struggle to live as healthy as I can.  Each day a diabetic faces a new challenge; each day a new lesson is learned.  At the Chicago tri the money I raised for IN reminded me of that.  I was reminded that yet again diabetes cannot define who I am, but it does in part make me who I am.

The Kinks

I've been making great progress getting my blood sugars back under solid management.  Since my A1c wake up call I've gotten myself back to having blood sugars consistently in the 90 - 140 range and can totally feel the difference.  The constant headaches, stomach cramps and other issues related to bouncing blood sugars have left.  I'm able to focus more consistently, enjoy all my workouts and eat like myself again.  All this has left me feeling great and hopefully made me a lot more pleasant to be around.

But... from time to time I'm still getting some really annoying/ weird blood sugar situations.  I'm not sure if the infusion sets that Animas uses are less sturdy than the sets Medtronic uses but I have vastly more issues now than I did with OPP.  I've noticed a few things with the Animas infusion sets:

• Kinks at the end of the animas set are alot more likely
• The cannula has a much greater tendency to dislodge itself
• Leaving the infusion set in for more than 3 days leads to a bit of a calcium/ scar tissue build up

I felt like the Medtronic sets were alot more consistent and that if I had solid skin contact on initial insertion I could be confident the cannula would be in there when my reservoir ran out.  With the Animas sets that simply isn't the case.  I'm running into case after case of the kinks; where the end of the cannula gets pinched or crimped leading to improper insulin flow.

For the past few weeks the only times I've gone above 225 have been from a case of the kinks.  I have no real desire to ever get off an insulin pump but at least with shots you know the insulin was delivered.  With a pump getting a case of the kinks is just something you have to deal with; but with tighter regulation I can be pretty sure that if my blood sugar is above 250 something is going on.

Race Report: NJ State Triathlon - Maybe I should have done a brick...

Well it's official, I'm back to being a triathlete!  On Sunday for the first time since July of 2010 I crossed the finish line in a triathlon; granted this time it wasn't an Ironman but the joy I felt when crossing the finish line almost rivaled that in Idaho a couple years ago.  The short report - I loved every freaking second of the race, I was excited to get started from the moment I woke up and even though my legs felt like I had spent the past year in a prison torture camp when I got across the finish line I finished with a smile on my face.  The long report - well keep reading...

It struck me the day before the race that I had never been more comfortable or more relaxed heading into a triathlon.  I woke up at 8am to go for a morning jog, picked up some last minute necessities from Jack Rabbit Sports and then hopped in the car with Katie to head down to Princeton.  Once there I picked up my packet and was so laisez-faire about the whole thing I didn't even have my race number memorized.  After check in Katie and I headed to the hotel which was having major room change issues which forced us to wait 2 hours to get into the room.  Historically that would have sent me off the deep end but this time around I simply said, whatever lets just grab lunch outside.


So either one of two things, or a combination of both happened.  I've realized that old man sports should just be fun and a day out racing is better than about 95% of other stuff I could be doing.  Or my girlfriend has finally rubbed off on me and I've started not to take every challenge so seriously - either way it's working.  We finally got into the hotel and I was off to bed at 10pm with a 1/4 ambien to help me sleep.


I slept fairly well for the night before the race and woke up with a blood sugar of 62; on the low side but I had an infusion set issue the evening before so I wasn't all that surprised.  I took in about 35 g of carbs with Ezekuiel cereal, strawberries and almond milk and left the hotel by 5:30 am.  The race site was fairly empty at 5:50 am so I set up my transition area in a breeze and was off for a quick warm up jog.  Post warm-up my blood sugar was a high 281, so I took in some extra insulin, finished listening to my warm up mix and was down to the water to swim - without a wet suit!


Although the race was just wet suit legal with the water topping out at 78 degrees I figured I'd over heat in my fat baby seal costume so I opted to do it in the tri kit.  (By the way Pete, when you design the tri kit next year lets try and avoid see through white on the legs) I warmed up and felt pretty smooth in the water so was excited for my wave to go off.  A complete 180 from the Napa disaster I was smiling with Katie before the race, posed for her camera shots and overall just felt really excited and happy to be racing again.  I ate my clif bar, peed on myself as soon as my body was in the water and when the gun went off I was off, no freak outs, no nerves just a nice easy pace.


As I had mentioned last week, I was pretty nervous about completing the swim; while I knew I had crossed more than 2x that distance before I still feared my lack of training would catch up to me.  Much to my surprise I excited the water in about 32 minutes, just about the median for the field and without a wet suit.  I without question have a ton of work left to do but getting through this swim painlessly was a huge bonus as I work my way back into triathlon.

However, once I exited the water it was my time to really have fun.  I've been working so hard on the bike the past couple years and wanted to finally perform in a race the way I do while I train.  I had always felt like my training rides were vastly superior to my results in a race and just wanted to hold it together for one day on the bike.  In transition I was happy to see a blood sugar right around 180 so I went out without hesitation (although my t1 took 2 minutes and 34 seconds!).

Once on the bike I knew I was in for a good day, I flew down the first stretch of the course blowing by a ton of people who had come out of the water before me.  The course was perfectly suited for my riding style, mostly flat, some technical turns and 2 very small inclines - "hills" I could just power over.  3/4 of the way through the first lap I realized I was on pace to ride the fastest 10 miles I ever had and finished the first 12.75 mile loop in 34 minutes - by far the best I had ever ridden in a race.

The second lap was a bit more crowded as people who went off in an earlier swim wave were now on their first lap of the bike course.  Thankfully the crits I've been racing prepared me to move in a pack as I nimbly weaved around people avoiding any drafting and maintaining my speed. Throughout the entire bike I believe I was only passed 3 times (all by discs) and ended up negative splitting the bike leg!  My second lap I did in just about 33 minutes for a 25.5 mile time of 1 hour 7 minutes and 35 seconds for an average pace of 22.6 mph or 102nd best in the race!  I could not be happier with how I performed on the bike; I've been working incredibly hard to have a solid race day performance and it finally happened now if only the transition after the bike didn't take me 3 minutes and 44 seconds (only about 30 people were slower than me!)


I'm thinking part of the reason transitions took me so long was the transition volunteer.  A 40ish year old guy was the most energetic volunteer I had ever encountered.  For each person who came into transition he had a personal message and hardly 10 seconds went by before he would shout some other words of encouragement.  At times he did come across as a bit over zealous but really his energy and enthusiasm was awesome; I thanked him as I left transition but honestly I should have given him a hug, the guy is pretty much volunteer of the year!

Then it was time for the run... the last time I had run after a bike ride was February or March of 2011 so it had been quite some time and the last time I had run more than 2 miles after a bike ride was July of 2010.  So lets just say I was anticipating some pain but thought I was in good enough shape to just power through it.  I'm pretty sure thinking was my problem because nothing could have preparred me for how my legs would feel - but first the good part.

For the first 3.2 miles with tired legs I was rocking my run, the first 3 miles ticked off in just under 26 minutes about 90 seconds slower than I had hoped for but well within range of having an incredibly solid run.  My plan was to run for the first 4 miles of the race and then walk as I drank water at the mile 4 aid station.  At the mile 3.3 aid station that plan fell apart as I could no longer hold out for water and my walk started .7 miles early.  Once I slowed the legs down they had no desire to speed back up and I was stuck for the next 2.7 miles of the race stuck somewhere between a fat man shuffle and a walk.  While the first 3.2 miles took me 26 minutes the next 2.9 miles took me  45 minutes!  My legs had never been so tired or mad at me before, but I finished.


With legs screaming and barely able to keep my head up anymore I finished the race with a smile on my face.  I was so incredibly happy to simply just race and have fun, not worry about a time and enjoy everything the day had to offer.  I gave Katie a quick thumbs up as I shuffled down the shoot knowing that all the work I've done in the past 4 - 5 months to get my blood sugars back under control, my weight back below 190 and a renewed focus on everything is paying off.  It was a hell of a race and a tremendously fun day but the moral of the story is do some bricks before you hop back into tris or your legs will still be killing you 3 days later!

The Last Push

This Sunday I'll hop into the water to start a triathlon for the first time in nearly a year and 1/2.  My last tri, well that didn't go so well.  After the worst swim I've had in a half iron and a far too painful bike I decided to call it quits and go drink wine.  For that race I was under trained, not motivated and really had no desire to actually push myself; at that point I was burnt out.  But ever since moving back to NY I've been excited to race again, my schedule has more stability, I'm loving my new job and couldn't be happier back home.

I've been training incredibly consistently logging about 15 hours a week of work outs.  My weight is down to 189 and my basal rates while being wonky of late have slowly crept down from the 16+ units a day they were back in May to about 14.5 units per day now.  Although I still become incredibly frustrated with my pump from time to time (seriously I don't remember a love-hate relationship like this with OPP) my blood sugars have become much more stable.  So everything seems to be moving in the right direction.

But... I'm nearly as nervous for this triathlon as I was for my first way back in 2008!  After today I'll have swam a total of 6 times since March of 2011; so although I know I can cover a .9 mile swim I'm not sure my arms are going to agree with me.  My bike has been incredible of late, I'm not sure if I've crossed the 10,000 hour threshold Malcolm Gladwell has written about or if the weight loss has made me faster on the bike but in training I'm sustaining faster speeds for longer than I ever have before.  And my run is super solid my zone 3 pace has dropped from an 8:45 min mile to an 8:25 min mile and I've been able to ramp that pace up at the end of runs without bonking.  Most importantly, I have not hit one low that has cut a workout short in some 2 months.

But with that I haven't done a brick yet, I'm off for my last swim today and I don't know if I can string together a race.  Katie keeps telling me to treat this race as a practice race, to just let it come to me and have fun; that it's been so long since I've raced to take it one step at a time.  I'd love to say I can do that, I'd love to say that all this is just a step to getting back into great shape and having fun with the sport again.  I guess Sunday will really tell me how far I've come physically and mentally, stay tuned....

Those Whoops Moments

Over the past 10 days or so I've had a few "whoops" moments.  A whoop is a time when you think you know better than your cgm or glucose monitor, could swear you have a low coming on, or just totally miscalculate the amount of insulin you need.  My two most recent whoops moments were rice pudding and a cupcake.

Katie and I had made a pact to skip dessert for the foreseeable future but passing up rice pudding at one of our favorite shore restaurants proved to be too much of a temptation.  Before ordering I looked at my CGM and saw that I was still in the mid 140s after dinner; and that was after a 2 hour period where I was fighting off lows.  Thinking I "deserved" dessert after 4 hours of workouts that weekend we opted to go for it.  Mid-way through the drive home my CGM went off and I confirmed with a test my bs was rising and fast.  Apparently the rice pudding needed more than the 2 units I added to my dinner bolus as I was up to a bs of 300, whoops.

The other day at work I was 100% convinced I had a low coming on.  My legs felt wobbley, my mouth felt dry and I was speaking coherently but I'm not sure how the words were forming coherent sentences.  So when an email came through from the marketing team that simply stated "treats... come get em" I couldn't resist.  The sight of a moist, delicious looking cupcake was enough to make me certain I had a pending low so I devoured the treat and took on just a unit of insulin to prepare for the spike.  So I may have been heading slightly low but 20 minutes after the cupcake I began to develop a ragging head ache and had to take on a good bit of insulin to bring my blood sugar down from the sugar spike.  Next time I'll stick with a bit of OJ when I think I'm going low, whoops.

A few years ago I would have been majorly frustrated at those mistakes but now I know that every so often I will make a mistake with this disease.  It's alot easier to say whoops than to kick myself for a 30 minute mis-management of my blood sugars.

Back IN the Game

I've run into alot of memories over the past few weeks.  A couple weekends ago it was my first bike ride on 9W in more than 3 years reminding me of how much I used to struggle on that road as I learned to ride.  Then it was seeing all the jerseys of the various tri teams out training for whatever summer races they have coming up.  After that it was returning to my old pool at Stuyvesant High School only to learn the pool was closed for a year.  That of course brought up the panic of a NY triathlete wondering where the heck a pool with a free lane could exist (the Cobble Hill Y...).  But this past weekend the biggest flood of memories came to me.

I decided to jump back into the world of triathlons this summer.  I'm a bit late to the party as I had to wait until I was employed to determine if I'd have any funds to race and also needed to have a schedule and a place to train from before I knew if I'd be in shape.  When both those things happened in May I decided to sign up for both the NJ State Triathlon and the Chicago Triathlon.  Rather than jump head first back into tris after my painful experience at the Napa Valley Half Iron more than a year ago I'm easing back in with Olympics this time around.  And I'm giving back to the organization that has met so much to me.

Saturday reconfirmed how much Triabetes has meant to my evolution as a diabetic.  I received my 2012 tri kit and when I put on the jersey I felt a rush of pride.  It's not the same feeling as when I would put on my football jersey back in college, it's more a feeling that I'm part of an organization that is promoting something that is so near and dear to my heart and my ability to live.  What Peter has accomplished is nothing short of amazing and I'm humbled to be able to help give back to him.

Wearing the new kit reminded me of all the growing pains I had learning to manage my disease and learning how to be a triathlete.  If it wasn't for the people in Triabetes like Anne or Pete or so many countless others I never would have been able to accomplish what I have.  So please help me support triabetes with a small donation as this organization truly touches and helps all those trying to tackle their goals while dealing with diabetes.  You can donate here.

5x 40 Club

The 5x 40 club is not a club you want to be a card carrying member for.  Yesterday my blood sugar crashed into the 40s 5 times, probably the most frustrating  day of blood sugar management I had ever had. 

The day started off perfectly, I woke up with a blood sugar of 93, had some cereal and a clif bar then went for my Sunday run.  Back in full training mode my run was awesome, 8 perfect miles in a high zone 2, low zone 3 heart rate, non-stop running between 8:20 and 8:45 minute miles.  Total time for the run was 1:08 and it marked my longest contiguous run since 2011.  To top it off when I finished the run my blood sugar was a gorgeous 108.

Post run I took in some chocolate milk and then had to conduct an hour long phone interview for work.  Post the call I tested and was frustrated to see 301 on my meter.  That could have been the excess carbs I had on board from my sports nutrition but it aggravated me just a bit.  I then made an egg sandwich on a pumpernickel wrap and bolused up for the 25 - 30 grams of carbs.  About 2 hours later I hit my first 40 of the day, I took in some OJ and went back to the power point I was working on.

Around 3 pm (2 hours after my first low) I tested again and 40 came up yet again, more OJ.  I then took a short walk to the store to buy some stuff for lunch for the week and coffee for the morning, when I returned 30 minutes later I was in the 40s again (now 3 times for the day).  I took in more OJ and at 6pm Katie and I headed out for dinner.

The wait for the restaurant (2+ hours) we wanted to go to caused us to dinner in reverse last night.  I was craving frozen yogurt in a big way so we hit up 16 handles pre-dinner and I bolused for the 30g of low fat deliciousness I was about to eat.  Yet my blood sugar decided to pop into the mid 200s post fro yo but finally started to come back down once we got to Lucali (rated as NY's top pizza place).

I combo bolused for what I assumed to be the 100g of carbohydrates I was about to inhale.  By 11:30 pm my blood sugar had tumbled back into the 40s for the fourth time that day.  Instead of OJ I opted for 24g of carbohydrates from yogurt and decided to go to sleep.  At 2 am my CGM started beeping with my fifth blood sugar in the 40s for the day which brought me to the fridge to pound some OJ.

This is the frustrating part of blood sugar management.  I have been testing my basal rates non-stop all week, and I thought I had them dialed in.  Then a day like yesterday will pop up and it throws everything out of whack.  I have a greater ability to deal with extremely low blood sugars than most diabetics I have met.   Whether it was the 38 I encountered at IMLP, the countless times I have gone low during a business meeting, or combating 40 after 40 on a day like yesterday I have not really run into a low that has fully shut down my thought process or coordination.  I'm terrified however that I tempt fate 1 too many times and eventually this will catch up with me.  The 5x 40 club just isn't a fun place to be.

A lecture on the rain from Animas customer service

About a year into my switch from Medtronic to Animas and I'm really starting to regret the decision.  Today's incident may have finally pushed me over the top.  Previously it took me 4 days to reach someone to find out how to connect with my new endo to fill my pump supply order, no one ever replied to my questions about patient assistance when I was unemployed and overall the entire experience with them hasn't been all that stellar.

I've been having some blood sugar issues lately; since I've refocused my management efforts most of the time my blood sugar is really spot on but there are times where my blood sugar simply doesn't make sense.  Those occurrences seem to be happening more frequently so I've seriously begun to doubt the quality of my pump.  Most recently I went out to see the Avengers on Monday night.  Prior to dinner my blood sugar was an awesome and stable 105.  I had organic coos coos for dinner with vegetables and then had a small popcorn during the movie.  All in I took in 5 units of insulin for dinner and another 4 units of insluin for the small popcorn (which I split with Katie).  By the end of the movie my blood sugar was a shocking 451!

Today I woke up with a blood sugar of 303, I took in 2 units of insulin to correct, had a very light breakfast and went for a 4 mile run.  Post run I was down to 150 and then took the 5 mile ride into work.  After being at work for an hour and having no additional food my bs had climbed to 195.  2 units of insulin later my blood sugar was sticking around 175.  For lunch I had a romanie hearts salad with a small amount of cheese, a ton of veggies, balsamic vinaigrette dressing and a small piece of whole wheat bread took in 4.55 units of insulin for the meal and had climbed to 353 an hour and 1/2 after lunch!  I did 2 corrections for that 2 hours apart and finally my blood sugar has come below 250.

So with that final bit I decided to give Animas a call to see if we could go through a diagnostic test on my pump.  But first the tech rep asked me some pretty standard questions, but kept interjecting how many fabulous self corrections and tests the pump does (which began to annoy me).  Then she asked "how frequently do you change your infusion set?"  My response, "um I don't keep total track of it but usually every 3 - 4 days."  Well good God you could have thought I just told her I'm drowning myself in a cocktail of drugs and booze every night while playing Russian Roulette and clubbing baby seals.  The tech rep then went on a 10 minute lecture about how insulin is like rain and when it rains too much and the ground can't absorb anymore the ground floods.  After she went on her rant for 10 minutes I politely said, "thanks for that but I don't really need a lecture right now can we just do the pump diagnositc?"  To which she replied something else about the GD rain so then I said "ya know what why don't you just pass me along to a supervisor."  Sadly a supervisor was not available so I have to wait for Animas to call me back but when she offered to go through the diagnostic with me I told her I'd rather just wait for the supervisor.  Sorry lady I'd rather deal with high blood sugars and feeling like sh*t than get a lecture from you again.

So yeah right now I'm kind of thinking Animas sucks and I really miss Medtronic.

I won the Flywheel battle but they won the war...

The other night Katie convinced me to hit up Fly Wheel a new style spinning class that has become all the rage.  There are actually dedicated arguments on the interwebs about which version of the new spinning class is better - Fly Wheel or Soul Cycle (so its honestly become kind of cult like). Katie wanted to check out Fly Wheel first and after her first class she was hooked; so we decided on a Fly Wheel date earlier this week.

The format of the class is pretty interesting, Fly Wheel supplies water, spin shoes and a spin bike that can be fully adjusted.  The spin bikes are arranged in a "stadium style" arena with the instructor at the lowest point on the floor facing the rest of the class.  At the front of the room there is what Fly Wheel calls the "torque board" which is a leaderboard that is calculated by some formula which compares the tension on your spin bike and cadence - the board is split by gender. 

The class uses top 40/ high energy rock type music to keep the class motivated and the cadence ranges from 50 - 115 and three positions (seated, standing on the hoods, standing leaning forward).  The class also incorporates some weird minor muscle group upper body lifts using body bars at some point during the class.

So for my thoughts, the class was pretty interesting for spinning but not really my thing.  I "won" the class sitting atop the leaderboard with 50 or 60 more points than the next closest person and I felt like I got a great aerobic workout in but not really training in, if that makes sense.  I'm also pretty sure I won the competition for most sweat all time in a spin class; damn that room was hot!  But winning the sweating battle also led to a major problem for me.

After the class Katie and I went to a local sports bar to check out the Devils Stanley Cup Game (we won't go into the details of game 6...) and I was pretty surprised to see my blood sugar had climbed to the 200s by the time we got there.  I took in insulin and checked my blood sugar about 45 minutes into our visit and my blood sugar had climbed to about 280ish even though I had taken in a good bit of insulin.  By the time we decided to leave mid way through the 3rd period my blood sugar was up in the 300s so I went to the bathroom and in the low light it seemed like my infusion set had come out but I couldn't tell.

Once home under the bright lights of our bathroom I was able to confirm that the infusion set had popped out due to the sweat but the damage was done.  By this point my blood sugar was 500 or higher and I felt like I was going to throw up all over the place.  For the next couple of hours I took on bolus after bolus trying to bring my blood sugar down.  I started with 4 units to be on the safe side and then took another 4 units of insulin 2 hours later when I was still at 450 at 1 am.  By the time I woke up after the 8+ units of insulin my blood sugar was down to 80; but I felt pretty crappy the entire day.

The past week has not been fun for me and my pump.  I now see why so many people choose to use injections vs relying on technology and non-certain delivery.  I still love the freedom my pump provides but really trusting this is becoming hard.

Trust Your Pump?

Monday morning I changed my reservoir and infusion site, Wednesday mid-day I changed my infusion site again and by Thursday I made a last ditch effort and sucked the insulin out of the current reservoir into a new one - let me explain.

After the cheesecake debacle on Sunday evening my blood sugars only climbed higher.  I was able to correct for the huge portion of fat I had that evening but I couldn't figure out why my blood sugar was continuously + 250 from mid-day Monday to late yesterday.  I was exercising, I was eating incredibly healthy and I was getting a pretty good amount of sleep.  It simply didn't add up; either my insulin needs had increased 10x in a 24 hour period or something was up with my pump.

The magnitude of the blood sugar snafu struck me on Tuesday morning.  I woke up at 6:20 am to go for a run before work, my blood sugar was a shockingly high 248.  Thinking it was because I had adjusted my basal rate a bit too low pre-run I had my pre-run breakfast (ezekuiel cereal and strawberries) and took in 2 units of insulin.  Post run my blood sugar was 202 - normally my blood sugar drops 100 - 150 points during a 5 mile run, especially after eating something as low glycemic as that cereal.

I took in 2 units of insulin post run, showered and hopped on Mr. Foldie to get to work.  By the time I finished the 5ish mile ride into work my blood sugar was a hellacious 350!  Rage bolusing did little to bring my insulin in line as my blood sugar was above the pixie stick line for most of the day.  About 15 units of insulin later my blood sugar finally started to fall and post bike ride home my bs was around 185.  However, after a light dinner of chicken sausage and arugula salad my blood sugar was back in the 250 range!

Wednesday morning I woke again with a blood sugar near 300 and the pattern from Tuesday was mirrored.  At that point I decided to change my infusion set to see if there was some blockage going on that my pump wasn't reporting but to no avail.  I continued to rage bolus for most of the day but by 10 pm I was fighting off a ton of lows although no where near how low I should have been based on the amount of insulin I was taking on.  Thursday morning the pattern became much worse and I was in the mid 300s the entire day. 

With an awful headache, an upset stomach and blurry vision I ran to Google and searched "how do I know if my animas pump is broken."  I came across this fantastic blog post from back in July 2011.  The symptoms the post speaks about seemed to be pretty close to what I was dealing with.  So by the time I got to the end of the post and read about a strong smell of insulin inside the pump from a leaky reservoir I just had to investigate.  Sure enough when I checked the reservoir cavity I was overwhelmed with the smell of burning rubber (what I think insulin smells like) and the bottom of the reservoir totally smelt like it too. 

That's when I took the extra reservoir I had in my back pack to suck the insulin from the current reservoir into a new one.  I wanted to make sure that my insulin didn't go bad so was trying to keep things consistent.  An hour after I changed reservoirs my blood sugar began coming back into line.  This morning with no changes and a very similar routine I woke with a blood sugar of 125, having my customary breakfast I rode to work and got in with a blood sugar of 89.  It's nice being back to normal, now if I could just shake the cob webs of the past couple days of highs.

The bigger question is, how do I start to trust my pump again?

Avoid The Cheesecake!

Workouts and my blood sugar had been going so well that I decided to splurge on a piece of Cheesecake this past Sunday night.  Katie and I left the shoe box of a sublet we were originally staying in out near Prospect Park for new luxurious digs on the Columbia Waterfront.  At the original apartment we were terrified to cook so had to eat out every meal, thus were overly excited to finally be able to cook again on Sunday.  For the past week my blood sugars had been rock solid, I got in over 20 miles of running last week, some seriously solid lifts and a few bike commutes so was feeling I could binge a bit on dessert.

For dinner Katie and I cooked whole wheat pappardelle, turkey meatballs and an awesome arugula salad.  Having run 7 miles earlier that day and 6 miles the day prior I thought that entitled me to a bit of extra carbohydrates.  Union Market had a single serving cheesecake honestly the circumference of a small juice glass; so Katie and I figured it couldn't be that bad for you.  Once we got home we flipped it over and realized this miniscule portion of desert had 17g of fat and 22g of carbohydrates!  Throwing caution to the wind I decided to have 3 spoon fulls of the desert (about 1/4 of the serving) and call it a night.

Shortly after that I lost any thoughts of romance as I began to recall the feeling of my pre-diagnosed days.  Looking at my CGM I saw my blood sugar had climbed from 145 at the end of dinner to 197 about an hour later and took in another unit and 1/2 of insulin.  A half hour later Katie came to the bedroom and I was all but dead to the world sprawled out on the bed somewhere between sleep and a diabetic haze.  I woke up at about 5:30 am to go to the bathroom and still felt incredibly warm and pretty out of it, when I tested my blood sugar was a shocking 338! 

Still with the shock fresh in my mind I quickly looked at my CGM and saw that I had been in the 350 - 400+ range all night!  I had turned off the high alarm on my unit as I continue to get my blood sugars back under control but really could have used them the other night.  But I also realize what an advantage it is to live with a type 3 (those who love those who have diabetes) as I told Katie the next time I suddenly seem totally out of it to check my CGM.  But most importantly I learned to avoid Junior's Cheesecake at all costs!

Blast From the Past

The other day when I logged into facebook I was greeted by this photo from 2008:

That was me before the Mooseman Half Iron, my first, up in New Hampshire.  At the time I was like a sponge absorbing everything I could about blood sugar management during exercise.  That race taught me so many things about nutrition.  I remember coming out of the water with a blood sugar too low (I thought) to go out and bike.  I remember my front derailleur breaking yet again on my bike during the first lap of the course and my seat post constantly slipping down.  I remember the most painful cramps I had ever experienced during the run.  But I also remember completing my first half ironman and thinking how awesome that was to cross the finish line.

This morning I went out for my pre-work run.  A quick 4 miles at 7am; back then the idea of a quick 4 miles was not even a glimer in my eye.  This morning I left the apartment with a blood sugar of 152, back then I would not have dreamed of starting a run with a blood sugar below 200.  This morning I ran with no nutrition, back then I ran with a convenience store in my fuel belt.  This morning after I finished my run I had a gulp of water and some eggs, back then I would have monitored my blood sugar every 15 minutes with a coke in one hand, a gel in the other and a cornucopia of carbohydrates in front of me "just in case."  It's pretty obvious things have changed.

But like I said in my post back to basics, the big picture has become alot easier to manage and I have alot more confidence that I'm not going to spontaneously drop to a blood sugar of 25 or spike to a blood sugar of 500 during exercise.  That confidence does not have me ignoring blood sugar management however, I simply need to test a little bit less and have a much greater base of experience to know how my body will respond to exercise.  For example this morning my legs felt like lead when I started my run, in 2008 I would have tested every other stride wondering why I felt so tired.  Today I knew it was because I was up a bit late last night watching the Stanley Cup and did a hard core leg workout yesterday at the gym.  With each passing experience my knowledge base has grown allowing me to push a bit harder in workouts and know when my body really needs a break.  Yes things have changed and seeing that picture made me realize how far my collective experience has come.

Grinding Away

I received the below email from Dr. B today after he reviewed my stats from my first 5 days back on a Dexcom. 

"Sensor tracings look GOOD! Strong work! I noticed a bit of a peak in am (likely post breakfast) so watch that area as you may need more insulin with that meal, otherwise if you keep this up your HbA1c will be much better by next check!"

Even though I've only recently gotten back on the blood sugar war path, the daily grind has been tough.  Waking up at 6:30 to make sure I get in a 4 mile run before work, eating the same breakfast each day, counting ever carb and fighting to find the right thing when eating out has been exhausting.  Last night I had a really long conversation with Katie letting her know what I'm going through.  It has been a long time since I've focused this strongly on getting my blood sugars under control so alot of the mental fatigue that goes along with that had been forgotten.

Currently we're living in a craptastic studio in Park Slope.  When I received my job offer from EDH I knew I wouldn't be able to stomach the 2+ hour commute each way from my parents to my office.  So I hopped on Craig's List to find an inexpensive stay for the month of May.  When I first went to see the apartment I think my blood sugar was slightly low because I thought the apartment was small but totally liveable.  When I returned with keys in hand, I nearly had a nervous break down as the girl I'm subletting from neglected to remove any of her stuff from the closet, didn't leave me a drawer to put anything and essentially has each and every crevice of this 10 x 10 studio packed to the gills.  To top things off we're both terrified to cook in the apartment and are forced to sleep seperately as there is only a full size lofted mattress and a futon in the apartment (two on the mattress is too close for comfort.)

So with the size of the apartment I'm unable to bring my bikes (besides Mr. Foldie) and am forced to eat out each night.  We fear Mothra will crawl out from the wall or one of the 1,000 empty shoe boxes to eat both us and our food if we attempt to cook.   Combine that with the news about my A1c and I'm living in a high stress diabetic zone.  That has led to a pretty melancholy Ed.  

Katie, as any reasonable person would think, assumed that I was either unhappy with my job, the move to NY or our relationship.  None of those could be further from the truth, I am incredibly happy to be back home, have found what I honestly think is my dream job and am thrilled to be starting a life here with her.  So for the first time she is really learning what it means to date a diabetic with all the ups and downs this disease can throw us.

What I explained to Katie last night is that the apartment has essentially taken away the tools I know how to use to manage my disease.  What has always worked best for me is cooking my meals, and riding my bike - neither of which is an option right now.  So that means each weekend we go away, or each day I'm forced to examine a new restaurant menu adds to the fear that my A1c will continue to rise.  Maybe it's an addiction, maybe it's a phobia but I'm terrified of letting this disease impact my life so each little thing that contributes to taking away my tools has really frustrated me.  

But, the daily grind is getting easier and starting next month we move to a different place where I can both cook and store my bike; then the daily grind will become routine and my #s will continue to stabilize.   For now I can just focus on turning my numbers around in a pretty difficult blood sugar management environment and know I'm doing the best I can.  And right now the best I can seems to be working.

No one said this would be easy...

Tired legs, a sore back and pesky lows; how I forgot about all those things in my training hiatus.  I had remained in reasonably good shape; my lab results indicate I ate healthy enough and while my weight went up a bit it's not as if I jumped 5 points on the BMI scale.  But man at times I feel like a washed up old journey man fighter in my path back to fitness and blood sugar glory (if an A1c under 6.5 counts as blood sugar glory).

Last week I had an outstanding week of training.  I got in 3 runs, 3 lifts, 2 bike rides to work and a solid training ride on Sunday.  The sublet I currently have is too small for the lady friend, el toro and me so the bull has to sit this one out up in Mahopac.  That means my rides during the week are limited to Mr. Foldie and me scrambling across the Brooklyn Bridge.  Nonetheless all the rides into work, morning runs and training sessions add up to have a profound impact on my basal rate.

For the past 48 hours I've been fighting off low after low.  30 miles into my ride yesterday I had to call it a day as my blood sugar kept dropping below 70.  That pattern continued throughout the night as I hit 50 three times from 6pm to 10:30 pm even though I treated with a cranberry juice and had a delicious sushi and rice dinner. 

Right now my basal rate is about 16 units per day, I suspect that it will drop by at least .75 units over the next 24 hours and continue to fall to about 13 units a day over the next 45 days.  Once my basal rate stabilizes I know my recovery time will decrease and my ability to push through endurance fatigue will increase.  Until then though this is going to be a long, slow, up hill climb.

Routine really matters

It's been about two weeks now since my life returned to the normal pace, flow and stresses that I had become accustomed to.  During my unemployment my biggest frustration was that I had no control over what great opportunity would let me take the next step in my career.  That forced me to search the internet and network for hours on end trying everything I could to take the next great leap.  The same intensity I put towards that effort also got me totally out of my eating and exercise routine.  Combining those factors is what I believe lead to my worst A1c yet.

However, I've seen a HUGE change in my blood sugar stability, energy levels and overall health since I've returned to work, settled into a sublet and gotten back to my hour + of exercise a day.  Yesterday for example my blood sugar was never higher than 165 and I only hit one low (68) after my bike ride home post lifting.  Numbers like 91, 98, 107 and 117 are visiting my meter much more frequently than numbers like 57, 237, 312 and 192.  Variability is bad for business as a diabetic so the more consistent I stick to my routine the better off I am. 

Thus far since I've refocused my blood sugar management efforts I've really only had one bad day of finger pricks.  On a business trip to Pittsburgh earlier this week my blood sugar went haywire.  I ran about 4 miles in the morning starting with a blood sugar of 210 but I finished with a blood sugar of 208; after taking in a decent amount of insulin my blood sugar had climbed to 268 and was still in the mid 200s at lunch time.  I struggled for most of the day getting my bs in check and may have over corrected as I dropped to 50 right before my plane ride home.  A frustrating day, but I'll take it, if I can hit my #s 9 out of 10 days I'm in a much better place than I was.

Also, I apparently decided to make my return to d-blogging on world diabetes week; pretty happy to be back.

It's different the second time around

Last evening I was writing an email to my local Animas rep to get hooked up with pump supplies when it struck me how much I've learned over the past few years.  The first time I chose a pump I scoured the internet, blogs and articles for hours on end to learn anything I could about the differences between pumps.  I picked other t1d's brains about the type of infusion set they were using, the ease of using the pump and even talked a couple companies into letting me try out a pump with saline.  My way of coping with my diagnosis was to bury myself as deeply as I could into understanding how to manage the disease.

Fast forward six years and in my email to my Animas rep I knew exactly what to say and exactly what I needed.  In a brief 2 sentence and 2 bullet point email I emailed my rep with the infusion set and reservoir that I needed.  No fan fare, no worries, just a calm knowledge that I have this thing (at least the ordering of supplies under control).  Now had you asked me a month ago when I was still without health insurance I would have been more frantic, but the details have become common place, it's the management that remains hard.

Back to Basics

It's time to come clean, I was burnt out. 

For the first four years after my diagnosis I did everything right, I obseviely calculated the carbohydrates in a meal, tracked every second of exercise and was so regimented about logging I had automated excel models that would predict my future blood sugar.  Due to all that I was obsessive, I wanted my blood sugar to be perfect every single time I tested and when it wasn't I would either work out like a fiend or spend an hour working out a new predictive formula.  That in the end had me burn out from the daily tracking and hard core exercising that had made me so successful in the management of my disease; that is also what lead me to stop blogging except for the occasional outburst here and there.  I simply couldn't focus on the disease with the same intensity I had in the past and needed a break.

Fast forward to the end of 2011/ start of 2012.  I had lost my job and began to seriously doubt the value of my MBA.  I was determined to pursue my mission of helping people live healthier lives and to pursue a career that personally meant something but my dream had seemed to vanish.  I was unemployed for 6 months, and was facing a huge decision about where to move to.  While in San Francisco I met the most wonderful woman I could imagine and no longer was thinking just for myself so couldn't just jump at the next risky and interesting opportunity, I had to analyze the consequences and make a real adult decision.  That landed me back in NY, back where I belong (as I've come to truly believe over the past month).

Given all the stress and the travel that Katie and I did my blood sugars were thrown into dissary.  If my parents offered help for a high or a low I couldn't handle it, I simply didn't want people to be concerned about my disease because it was one more responsibility I couldn't focus on.  Thankfully I stock piled insulin and pump supplies but not a day went by where I didn't feel like I had to ration my insulin intake or test strip usage.  Add to that the constant job search had me cutting back on workouts for fear I would miss a phone call that would get me off a pay check from Uncle Sam.  I was still exercising and doing the occasional bike race but overall I wasn't the same active, happy guy that people have come to know.

When we hit mid-March I began to really worry.  I had some kindles in the fire but I really didn't know when the job thing would flush out.  I had to contact an old endo to write me a script for Novolog which my parent's so generously paid for.  I was finding cheap test strips online so that my Dad could still be compliant with his type 2 diabetes.  My sleep cycle was off and I was fearful that I would never recover from the mountain of student debt I accrued during my time at Darden.  I was perhaps, for the first time, lost.

I did the best I could to muster enough energy for one last big push to find a job I still believed in.  I had been networking with a few companies but the process was slow and agonizing.  But I pushed hard knowing that I wanted to be back in NY and knowing that I still wanted to be in healthcare.  Finally in late April I was offered what I truly consider to be my dream job or launching pad to something great, and I finally got to return to the city I love.

Being back in NY has me re-energized, it has me in a place where I am comfortable and happy and in a place where I am so excited to start the next chapter in my life.  That wonderful woman is still with me, and things are about as serious as they get and I know I couldn't have gotten through those dark months without her, and that family of mine has always supported me with everything they have and of course this time was no different.  They were there for me like they never have been before (maybe because they never really had to be there for me like this before). 

On Tuesday I got in to see my old endo, Dr. Baker.  I have an amazing relationship with Dr. B and believe he is one of the greatest doctors out there.  The numbers in his office didn't lie, it showed how much focus I had lost over the past 6 months.  My weight was 200 lbs, the first time I have reached that number in 5 years (normally I'm around 190), my A1c was 7, the highest it has been since I gained control of blood sugars after diagnosis.  That visit served as a wake up call and this city is serving as a platform for me to Ring The Bolus again.

I spoke with Dr. Baker and have 3 simple goals for my August re-visit.  I will be 190 lbs or lighter, I will have an A1c below 6.5 and I will reduce my daily basal rate by at least 10%.  I am signing up for 3 triathlons this summer, 2 olympics and 1 half iron and I am starting to bike into work again.  I have already seen a change in my blood sugar consistency after running 3 mornings this week and I am getting back into the weight room later today.  It's time to get back to basics, gain control of my disease and return to sharing my story about how I fight to control it. 

Hello again.

The ADA just doesn't get it

Today the ADA will launch new guidelines for blood sugar management goals.  As usual the article focuses on type 2 diabetics but I'm going to assume that the new guidelines will not discriminate between the two diseases.  Historically, I firmly believe, the ADA has focused on type 2 diabetes with both their research and guideline efforts.  As a disclaimer this organization frustrates me to no end and I think the JDRF is way more valuable, ethical and with it but that's beside the point.

In this NPR article the ADA is now stating that for older/ existing cases of diabetes the target A1c can be 8 and that for newly diagnosed type 2 diabetics an A1c of 7 is ok.  As a type 1 diabetic or someone who produces no insulin, who even if they ran on a hamster wheel continuously without insulin would still have blood sugar spikes well above 300 an A1c of 8 would be an incredible failure, incredibly dangerous and overall poor for my lifestyle!

To explain, A1c is kind of the 3 month moving average of daily blood sugar values.  A person with neither type 1 nor type 2 diabetes has an A1c of around 5 which equates to an average blood sugar of 90 - 100.  An A1c of 8 equates to an average blood sugar of 183!  How that is deemed medically safe is beyond me.  If my average blood sugar is above 160 I become dehydrated, urinate more frequently, will have low level headaches and overall be flat out miserable.  I strive to achieve an A1c below 6 but at my last test my A1c was 6.3. 

I would love to know how the ADA came to this conclusion rather than suggesting more stringent guidelines to suggest better eating, exercise and lifestyle habits.  They really frustrate me to no end.

A Special Egg

My foray into endurance sports all started standing in line to register for Ironman Lake Placid.  The day prior I was working an aid station on the run course when the girl I was dating at the time gave some woman with a big smile and a running skirt a huge hug.  I had no idea who this mysterious woman was at the time but her enthusiasm was infectious so I gave her a hug just the same.

The next day that same woman happened to be standing behind us in line to register; her joy at the race was a big motivation for me to sign up for IMLP '08.  Later on that woman became my first triathlon coach and someone who provided an amazing amount of emotional support during my first year with type 1 diabetes.  Her name, Mary Eggers, or to me the Egg.

Egg has always had crazy ambitions; she never doubted that I would finish my first IM with a smile on my face (having never done an endurance event when I first signed up for IMLP), she never doubted that I could push myself beyond perceivable limits and she never doubted my ability to tackle diabetes.  She has brought that same support and enthusiasm to Teens Living with Cancer; a non-profit devoted to helping kids fighting cancer.

So it came as no surprise to me when she called out none other than Lance Armstrong to a kick off in buffalo on April 28th.  Lance will be in Buffalo for a public speaking opportunity so the Egg thought nothing of it when she challenged him on Twitter and wrote this amazing blog post challenging LA.  When Egg gets an idea in her head it's pretty tough to convince her otherwise.  So it also came as no surprise to me that Lance RESPONDED TO MARY EGGERS ON TWITTER!

Armstrong v Eggers will go down in late April in Buffalo.  This excites me for a ton of reasons, it shows the good that social media can bring, it shows how an ambitious woman's idea can bring help and joy to others and it shows that when someone is committed to doing great things for others all the tools we need are right there in front of us.  Good luck Egg, I'll be cheering you on and I don't see how its possible not to get excited about what you just accomplished.  Readers, check out the charity, check out the challenge and if you knew this woman as well as I do you'd expect nothing else from her.

Back On the Bull

Sorry for being MIA the past few months; between the job search, moving back to NY and a trip to Thailand the opportunity to collect my thoughts have been few and far between.  I've had some great blood sugar management learnings over the past few weeks but today's post is about getting back on El Toro.

Living a bi-coastal life has made consistent work outs a challenge.  But now that I'm camping out at my parents house as I continue my job search I've had the opportunity to get back into the gym and back onto my bike.  My fitness is feeling surprisingly good and the weather has finally ticked up a few degrees in the North East.  With that and El Toro (my Cervelo) arriving from California I was itching to stretch the legs and race.  Much to my delight I found a crit about 30 minutes away from my parent's hosue, the Bethel Spring Series.

To Katie's worry I signed up for the race without having full health insurance coverage.  I've been out of work a bit longer than anticipated (thankfully I stock piled diabetic supplies) but that doesn't limit the chance of a crash during a crit.  I spoke with some people who had done the series in year's past and they said it was more like a circuit than a crit.  The difference?  Crit's are lap races in which riders race in tight quarters on a course that's less than a mile.  Normally there are at least 4 75 - 90 degree turns on the course making for some sketchy situations.  A circuit is normally on a slightly longer course and the turns are much more gradual so the field can spread out a bit more.  The Bethel Spring Series is on a .9 mile course with only one "real" turn so I was less worried about crashing out in a corner than I had been at the Early Birds out in CA.

I signed up for Sunday's race on 3/1 but sadly found out that I was on the waiting list.  After e-mailing with the great race organizers a few times they  finally informed me at 7:30 pm on Saturday night that I was in fact in the race!  My excitement was tempered by the fact that I was at a wine bar with my sister and brother-in-law greatly enjoying a fantastic d'Abruzzo.  With some hesitation I cut off the drinking picked up some dinner on the way home and got to bed by 10:30.  6:20 am came far too early and I was out the door by 6:55 am to make my way to Bethel.

My biggest worry was my fitness level.  Since Thanksgiving I have ridden my bike outside a grand total of 3 times!  Logging about 150 miles over those 3 rides hardly makes a fit rider.  But I've been hitting the trainer pretty hard, running 20 - 30 miles a week and recently found out about freaking awesome trainer videos, Sufferfest.  But I knew I wasn't logging good base miles on the road like I needed so I really wasn't sure if I could hold a zone 4 heart rate for 30 + minutes; I'd soon find out...

The Cat 5 race started with a basic skills clinic to make sure riders were aware of the proper way to ride a crit.  Most crashes are caused by a rider coming off of his line or making an aggressive move; since you ride in such close quarters each mistake is magnified.  It seemed like the field was realxed enough for a good race so we were all set to go. 

With a stable blood sugar of 150 the gun went off and I was out to race for the first time in nearly 6 months!  I finished the first lap feeling great, I probably pushed the pace a bit too much but wanted to stretch the legs and see how hard I could punch it up the finishing hill.  By the 3rd of 15 laps I had settled into my rhythm and was drafting off the pack to save energy.  The backside of the course had a pretty strong headwind which tempted me to hammer to try and gain some space on the field but I held back.  No reason to kill myself in a spring series and only my 4th cycling race.  Going into the final laps I was right where I wanted to be.  I had kept my heart rate at a low zone 4 for what I thought were laps 13 and 14; sadly they were laps 12 and 13.

Right before the climb to what I thought would be the bell lap (final lap), I punched it hard and opened up a decent split on the field.  I came across the line but to my horror did not hear a bell!  I kept the pace and maintained my lead through about 3/4 of the 14th lap.  Knowing that were some much lighter riders in the field I felt I needed a slight lead heading into the climb for any chance to pull out a win.  Had the 14th lap been the 15th I would have executed my plan perfectly; apparently they didn't teach counting or being Pavlov at Darden.

Up the climb when I realized there was another lap left I was gassed and knew I wouldn't be able to hang with the leaders on the final lap.  I made my move a lap too early and then just stayed with the pack for the finish.  I've gotten progressively better with each of the now 4 crits I've done and I'm really excited about racing on the east coast.   Since I know the Northeast so well it's way easier for me to know which races are within driving distance and to find friends to stay with before a race.  I'm already signed up for 2 more races in the Bethel Spring Series, for a circuit up in Binghamton and potentially a stage race in the Catskills.  Hopefully I keep improving, I simply find cycling races to be a flat out blast!

Sh*t Cyclist Say

Couldn't resist posting, one of the funniest videos I've seen in a while...

Disgusted by Paula Deen

As most of you have read by now Paula Deen will be a spokesman for Novo Nordisk to promote their type 2 diabetic drug.  In my view this alliance and Paula Deen's development of the disease represents everything that is wrong with both the American health system and the obesity issue in America.  Paula Deen should in no way be viewed as a role model for people with type 2 diabetes, she should rather be viewed as the poster person for EXACTLY HOW NOT TO EAT.

I took a quick look at her top recipes on foodtv.com, I've listed the high fat, high carb ingredients in the top 3 recipes:

• Chicken & Rice Casserole - 1 can condensed cream of celery soup (220 calories, 13.6 g fat, 21.4 g carbohydrates), 1 cup mayonnaise (916 calories, 78.5 g fat, 56.2 g carbohydrates),  for a total of 1,136 calories, 92.1 g fat and 77.6 g carbohydrates.
• Lady & Sons Chicken Pot Pie - 1 quart heavy cream (3,284 calories, 352 g fat, 24 g carbohydrates), 1/3 cup butter (542 calories, 61.3 g fat, < 1 g carbohydrates), 2/3 cup all purpose flour (309 calories, < 1 g fat, 64.6 g carbohydrates), 4 sheets frozen puff pastry (1.036 calories, 71.6 g fat, 84.8 g carbohydrates) for a total of 5,171 calories, 484.9 g fat and 173.4 g carbohydrates
• Chicken & Dumplings - 1 can condensed cream of celery soup (220 calories, 13.6 g fat, 21.4 g carbohydrates), 2 cups all purpose flour (910 calories, 2.4 g fat, 191 g carbohydrates) for a total of 1,130 calories, 16 g fat and 212.4 g carbohdyrates

Even in moderation the foods above should be avoided at all costs; the human body simply should not process foods that dense in calories, fat or carbohydrates.  And to keep it simple I didn't break down the difference between good and bad fats above or include the level of sodium in each dish.  Fat tastes good, no question about it, but after years of eating clean the mere sight of the nutritional content above makes me nausesus.

Rather than promoting someone whose cooking habits and lifestyle no doubt led to the development of a lifestyle disease shouldn't we celebrate people like Jamie Oliver or studying the glycemic index of foods like Michael Montignac suggested?  Paula Deen is addressing the problem after something has happened rather than making a chance prior to the problem happening.  Think about what would happen if you didn't change the oil in your car's engine until after your engine seized.  That would be a tad more expensive than the $40 oil change and your local shop, right?  That's exactly what Novo Nordisk is suggesting by using Paula Deen as a spokesmen.  We need to get ahead of the problem and change eating habits, not address the consequences once we are too far downstream.
 

Ooozing Insulin

So this may be my grossest blog post of all time...

Upon my return trip from Thailand (full bolus food report forthcoming) my blood sugars were unsurprisingly wacky.  A 12 hour time change and 30 hours of travel to make it home can send a person's metabolism totally out of whack, even if they have no issues to speak of.  So for a type 1 diabetic extensive travel often comes with some blood sugar management issues.

However, when I got back from Thailand my blood sugars were all over the map.  My bs didn't want to be consistent, cropping up at weird times and staying stagnant for a short period of time after a meal until a big spike occurred.  I assumed it was just my body getting used to a different eating schedule and planned to suffer through for a couple days.

On one of my last boluses before changing my infusion set I began to think something other than the time change was affecting me. The long trip had my stomach in knots and a wacky sleep pattern had me not very hungry.  So for my first 2 days back in the States I was living on toast and chicken soup.  For dinner on Wednesday night I had 2 pieces of whole wheat toast and a can of Campbell's Chicken & Stars soup - we're talking a total of no more than 80 grams of carbohdyrates.  Even though I took in 7.5 untis of insulin for that meal my blood sugar spiked to 308 about an hour and 1/2 after my meal.  I had around 7 units of insulin left in my pump so it was time for a change anyway.

When I removed my infusion set and was rewinding my pump I suddenly felt a ton of wetness on the side of my stomach.  When I looked down there was something that looked like water around the injection area.  I then ran my hand over it and it smelt like insulin - hmm odd I thought.  I ran my finger over my infusion old infusion site and some more insulin seemed to pop out.  So then like any curious person would do I squeezed the old infusion site and the hole gushed insulin - I'd say at least 10 units!

Disgusting! As I changed my infusion site insulin was freaking leaking out of my body, doesn't it know it's supposed to stay in there!  I checked out the old cannula and it was crimped at the end - something that seems to be happening way more often with my Animas sets than my old Medtronic sets.  At least I finally have an answer for where all the unused insulin goes when your site is crimped, it comes out the other end...