A week before my first anniversary as a type 1 I came down with the flu. All year I had heard warnings from doctors, friends, and Internet buddies to be really cautious when you get sick because blood sugars can go crazy with illness. I had a rough cold back in October but nothing that really affected my blood sugars - my good fortune turned out to be short lived though.
Tuesday I was all set to head to the pool at 4pm; around 2:45 I got a slice of pumpkin loaf from Starbucks to shoot my blood sugar up into the 200s. Right before eating I had a bs of 130, 30 minutes after eating I had a bs of 75, wtf! I took a sip of coca-cola, 15 minutes later my blood sugar was 70 and my stomach started to feel less than happy. I sat at my desk wondering what the heck to do. Chelsea my most trusted diabetic alli told me to use a small shot of glucagon if my blood sugar got really low but otherwise just take the subway ride home really slowly.
So with great trepidation I set out of my office for the subway ride home. Once in my apartment I curled up in a ball on my bed until the stomach demons arrived forcing a mad dash to the bathroom. I tried to keep down Ginger Ale and Saltines but nothing was cooperating, worse yet after I emptied my stomach 3 or 4 times my blood sugar started to shoot into the 200s as I felt a fever come on. I tried to drink as much as I could, but I woke up at 1am with a bs of 230, a high fever and a ton of confusion. I knew I needed to drink something, and drink something fast so I mustered all the energy I could to make it to my refrigerator; the trip back to bed wasn't as successful as the trip to the fridge! After about 5 steps I felt my legs give out from under me and heard a loud crash and saw a flash of light. Next thing I knew I woke up in a puddle of sweat staring at my ceiling - guess I didn't get those liquids soon enough. Knocking my head on my hard wood floor kicked some sense into me however. Instead of drinking the ginger ale I remembered I was high, bolused and downed 2 water bottles filled with water and smartly kept one next to my bed that night.
Yesterday my blood sugars were still running a bit high so I found the energy to make it to my pharmacy to pick up my new prescription of insulin (was supposed to pick it up the day I got sick). Thankfully everything seems to be back to normal today but I learned a ton from my 48 hours of hell:
1 - Always, always, always, keep drinking fluids when sick with diabetes, the combination of a fever and high blood sugars can lead to huge problems - like passing out on your living room floor.
2 - Monitor blood sugars every 1/2 hour when battling the flu, recovery is alot easier when the bs is under control.
3 - Be less concerned about eating "perfect" foods than you are with eating things you can keep down when sick, 48 hours of white bread and saltines won't kill your A1c.
Showing posts with label What I learned last week. Show all posts
Showing posts with label What I learned last week. Show all posts
Thursday, March 27, 2008
Monday, March 17, 2008
The 3 Rs - Recovery, Recovery, Recovery (What I Learned Last Week)
Ever since I started this triathlon training thing I've been hearing how important recovery nutrition is. All this information pretty much went in one ear and out the other. I thought I was "tough" enough where I wouldn't need to pound carbs and protein after a long bike ride or run. I said self "dammit, you made it through college athletics not worrying about all this stuff so really you don't need it now." Boy was I wrong!
In the past few months I've noticed that after a couple days of hard training my body would be exhausted. My legs would ache, my muscle felt like they had no energy and I would feel pretty awful in general. Looking at my food logs I was taking in just about the right amount of carbs so I never could figure out why my muscles were fatiguing so quickly.
As I did more research into the endurance sports world it became apparent that recovery food must be ingested within 1/2 hour of finishing a long workout to prevent muscle break down and latic acid build up. Since my carb and protein intake wasn't until much later even though I was taking in the right "amount" of food my body couldn't utilize it in the proper way.
Enter overpriced recovery drinks! Last week I picked up Endurox from the local GNC to give this recovery thing a real try. Endurox is made by Accelerade and is highly recommend by many of the uber-triathletes on Slowtwitch. This past weekend I did a 60 mile bike ride on Saturday and a 7 mile run on Sunday, after each activity I pounded a glass of endurox and can't believe how effective the stuff is. My legs are sore but not dead and my body feels fresh - this stuff really works! Better yet my blood sugars have been stable! The high concentration of carbs in 8oz of this stuff (52 g) is perfect for glucose level recovery and really made an impact in my workouts. Over the next couple weeks I'll be testing Hammer Recoverite and a few other brands to see which works best with my body.
In the past few months I've noticed that after a couple days of hard training my body would be exhausted. My legs would ache, my muscle felt like they had no energy and I would feel pretty awful in general. Looking at my food logs I was taking in just about the right amount of carbs so I never could figure out why my muscles were fatiguing so quickly.
As I did more research into the endurance sports world it became apparent that recovery food must be ingested within 1/2 hour of finishing a long workout to prevent muscle break down and latic acid build up. Since my carb and protein intake wasn't until much later even though I was taking in the right "amount" of food my body couldn't utilize it in the proper way.
Enter overpriced recovery drinks! Last week I picked up Endurox from the local GNC to give this recovery thing a real try. Endurox is made by Accelerade and is highly recommend by many of the uber-triathletes on Slowtwitch. This past weekend I did a 60 mile bike ride on Saturday and a 7 mile run on Sunday, after each activity I pounded a glass of endurox and can't believe how effective the stuff is. My legs are sore but not dead and my body feels fresh - this stuff really works! Better yet my blood sugars have been stable! The high concentration of carbs in 8oz of this stuff (52 g) is perfect for glucose level recovery and really made an impact in my workouts. Over the next couple weeks I'll be testing Hammer Recoverite and a few other brands to see which works best with my body.
Monday, March 3, 2008
What I Learned Last Week - DON'T START OUT HIGH!
The Shamrock Marathon on March 16th in Virginia Beach will be my first marathon. Right now I have about as much confidence in my ability to perform during that race as a live chicken would have for its chance at survival in a tank filled with alligators. For the past month and 1/2 I've been going out for runs greater than 13 miles on Sunday and each Sunday brings about a different issue. Whether it's my surgically repaired knee flaring up due to a bone on bone condition, my blood sugar starting off too low, dehydration or not enough salt, something has made these runs way more painful than they should be. Of course this is all part of the transition from a strength/ power athlete to an endurance athlete but to be honest - the process SUCKS.
Yesterday I learned a really valuable yet frustrating lesson as a diabetic athlete. I was up at my parents all weekend spending some quality time with Moose and had planned to run on the Northern Westchester bike trail yesterday. However, a brief snow storm Friday night covered the trail in snow and ice (I had hoped it would melt away by Sunday but no such luck.) Of course I didn't realize that the trail was not clear enough to run until after I had gone through my morning protocol - eggs, a muffin, a clif bar, basal rate down to 10% - blood sugar up to 200 + and ready to go. At 12 pm I frantically packed my things - hopped into my car and drove to central park.
Since my body still produces some insulin when it feels so inclined I knew I'd need to eat something else prior to my run so I had 1/2 a turkey sandwich 45 minutes pre run. By the time I parked my car on 93rd street my blood sugar was 310!!!! No matter how much water I drank during my run or how much ensure I took it felt like my body was just blowing through whatever liquid I ingested. I could only manage 2 hours out of my 3 hour scheduled run and ended with severe cramping in my left calf - so bad that I could barely walk back to my car.
Diabetes and athletics takes a really delicate balance for success. Each day presents a new challenge; blood sugars spiking after you expect them to forcing you to miss a workout, blood sugars running too high ruining a nutrition plan. My knowledge base grows with every workout but between runs in cold temperatures, sore legs and a heavy heart I really could use a nice easy week :).
Yesterday I learned a really valuable yet frustrating lesson as a diabetic athlete. I was up at my parents all weekend spending some quality time with Moose and had planned to run on the Northern Westchester bike trail yesterday. However, a brief snow storm Friday night covered the trail in snow and ice (I had hoped it would melt away by Sunday but no such luck.) Of course I didn't realize that the trail was not clear enough to run until after I had gone through my morning protocol - eggs, a muffin, a clif bar, basal rate down to 10% - blood sugar up to 200 + and ready to go. At 12 pm I frantically packed my things - hopped into my car and drove to central park.
Since my body still produces some insulin when it feels so inclined I knew I'd need to eat something else prior to my run so I had 1/2 a turkey sandwich 45 minutes pre run. By the time I parked my car on 93rd street my blood sugar was 310!!!! No matter how much water I drank during my run or how much ensure I took it felt like my body was just blowing through whatever liquid I ingested. I could only manage 2 hours out of my 3 hour scheduled run and ended with severe cramping in my left calf - so bad that I could barely walk back to my car.
Diabetes and athletics takes a really delicate balance for success. Each day presents a new challenge; blood sugars spiking after you expect them to forcing you to miss a workout, blood sugars running too high ruining a nutrition plan. My knowledge base grows with every workout but between runs in cold temperatures, sore legs and a heavy heart I really could use a nice easy week :).
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.
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.
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.
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.
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.
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