Here We Go Again!

Last week I signed up for the Charlottesville Marathon which will be held the same weekend as my 30th birthday in April. With Darden's first quarter under my belt I couldn't help but scratch that athletic itch again. Having gained about 9 lbs since Ironman Lake Placid it was time to lace up the sneakers, place an order with PBN and get my butt back into shape. To make it even better my amazing girlfriend and some of my Darden classmates will be running the race with me.

One of my biggest disappointments from the 2008 season was having to pull out of the Shamrock Marathon. I have yet to run a stand alone Marathon and really want to push myself to run my best in it. With my Abbott Freestyle Navigator in hand (if I ever get it), solid nutrition plan and dedication to training I think a sub 4 hour marathon is very possible. Plus with all my training buddies here at Darden - the training should be fun!

I unfortunately had to tell Triabetes I will not be able to compete at IMAZ with them in 2009. The Darden schedule is just too demanding to train for 20 hours a week and I did not want to race an IM unprepared. I hope that my schedule will allow for about 10 hours a week of marathon training - I'm energized and ready to go!

Abbot Is Incredible

The good news is, I'm still getting my constant glucose monitor; the bad news is, I have no idea when. At first Abbot had given my supplier the wrong insurance information which delayed the process a week. Today I received a call from my supplier letting me know that all orders to Abbot for the Freestyle Navigator are on back order!!! For a company that is trying to introduce a new and I'm assuming highly profitable technology they may have the worst sales and marketing force in history. If there is one thing that my marketing course at Darden has taught me it is - to know your customer! At each step of the way Abbot has failed on general customer service, I would receive calls from multiple people asking the same information, they would not meet self mandated deadlines to keep me in the loop, they had asked my doctor for the wrong information and they seemingly never wrote down anything I told them. It would be nice if the companies that make the products that allow us to better manage our disease actually knew how to manage their workforce.

HUGE NEWS!!!!!

Today I received a phone call that I've been awaiting for nearly a year. I checked my voice mail after class today and had a message from Angela of Abbott Pharmaceutical, normally the conversation with her would have me complaining about Abbott's lack of communication regarding the freestyle navigator with me - but today was different. Today when I called Abbot back I found out I've been APPROVED FOR A CONSTANT GLUCOSE MONITOR!!!!!!

I haven't had alot of diabetes related information to blog about recently, unless you would like to hear about bolusing during 9 case studies a day, there just isn't much to share. But now I have a new blood sugar management tool! Now, I don't have to worry about pouring rain during a workout! Now, I don't have to worry about it being too cold for my meter to work! Now I can feel like a normal person during exercise - I'll hopefully never fly blind again!!!!! Today was the best diabetic news I've ever received and I'm so freaking excited to figure out how to use a CGM and let you all know how it goes. Now I'll have real data to analyze, now I can compare my blood sugar movements with my heart rate, now I have the ability to see exactly how food affects my system!

Tomorrow I also meet my new endocrinologist, thanks to a classmate who was a doctor at UVA prior to coming to Darden - he pulled some string to get me in. In the coming weeks Ring The Bolus should be back and I invite you all along for the ride again. Q1 is over, I made it through the hardest part of my academic career at Darden and now it's time to return to my commitment of sharing my battle with diabetes with all of you.

Finals, Travel & Weddings

Wow - talk about getting triple teamed by bloods sugar demons! Last Friday began our finals for Q1 at Darden, right after I finished our hellish marketing exam I hoped on a plane to fly to Geneva, NY for one of my best friend's wedding. The lack of sleep, amount of travel and excess of wine has shot my blood sugars through the roof. Although the combination of those things had me looking like this:

So with that combination my blood sugar has hit 300 a couple times over the past few days, and all day Monday I was above 200. I'm playing with my basals and bolus rates to try and figure out what is going on. Each morning during my first class my blood sugar has spiked 100 to 150 points even though I'm only having 2 slices of whole wheat toast for breakfast - so I'm thinking it's more a basal issue than a bolus issue. Hopefully after a few workouts it will go back down - or after I'm done with finals hell.

Just Because I'm Learning About Distributions.....

Doesn't mean my blood sugars need to give me a lesson in standard deviations and variability. Yesterday I felt awful, but as so many of us have realized just because our blood sugars are all over the place doesn't stop our life from continuing. High blood sugars that were resistant to insulin started Sunday evening. My basal rates continue to edge down from getting back into a workout routine so Sunday morning I encountered a series of lows. I took this as a green light to have a "fat day" and ate a big Harris Teeter Cheeseburger for lunch, with a tomato stuffed with orzo, pine nuts and feta cheese then an enormous bowl of ice cream (I went on a 40 mile bike ride Saturday, figured I deserved it!) By Sunday night I was in a war with my blood sugars at learning team as I was above 200 for 3 to 4 hours.

I woke Monday morning to a blood sugar of 140 but was greeted by 230, 2 hours after a breakfast of egg whites on a piece of whole wheat toast. Throughout all my morning classes my blood sugar was above 200 and did not get under 120 until after 2 pm.

Although I really didn't have that many carbohydrates on Sunday the high fat meal at lunch made it that much more difficult to correct my blood sguars. I'm continually surprised by how big of an impact the nutritional mix of food has on insulin needs. A low glycemic, low fat food requires less insulin to account for the same amount of carbohydrates in a high glycemic, high fat food. While Type 1 diabetes acts much differently than Type 2 diabetes most of the time, the nutritional mix of what we eat is the most direct comparison between the two diseases. I'm not going to give up the occasional burger but I know I'm not chasing that burger with pumpkin ice cream anymore, the 24 hour long headache, shaky eye sight and irritability just isn't worth it.

Slowly But Surely

My basal rates continue to creep down each week. The day before the Ironman my basal rate was 6.25 units of insulin/ 24 hour period. Two to three weeks after that my basal rate over a 24 hour period climbed to 13.5 units of insulin. While I know other Type 1s who have a much higher basal rate requirement the doubling of my basal rates led to blood sugars that were less stable and less reliable. Today, after slowly easing myself back into a regular workout routine my basal rates have dipped to 10.3 units/ 24 hour period.

The best news out of all this is that maintaining more stable blood sugars hasn't required training 18 to 23 hours a week. Each day I'm afforded about a half hour to get into the gym, or get out for a run. The Darden case load is simply too demanding to do any more than that. Over the past two weeks I've been on two half hour runs, lifted for 45 minutes 3 times, gone on a 42 mile bike ride and playing a rousing hour match of racquetball (with a former pro triathlete!). Not only has this helped stabilize some shaky blood sugars but it has also done wonders for my mental state.

Since March I've been dealing with an Internet stalker. Normally I don't get too personal on this blog as I try and keep it as professional as possible as I look to be an outlet to help people with a chronic illness. However, after yesterday's encounter, enough is enough. In the days leading up to IMLP this person had left me dozens of comments asking what my "excuse" would be for Placid, after I became an Ironman they consistently harassed me over a time I'm very proud of. This individual has consistently e-mailed me and began to sexually harass a person who is very special to me via the web. They have obviously compromised my e-mail account because they have made some comments that no one but me and one other person know about.

I confronted whom I had hoped this person to be last night, but was not shocked when that person convinced me it was not them. The person who has been leaving these comments and harassing people I know is someone from my past and totally inconceivable that after all this time they still spend this much time on me. I find it disgusting that someone who has set up a non-profit to help children try to derail the efforts of someone who has put himself in a public forum to help so many.

The anonymity of the Internet provides an outlet for cowards everywhere to have a voice. No matter what public service you are trying to provide immature individuals will try to detract from those efforts with insane comments that can best be described to acting like a 7 year old. I've stayed silent for too long about this and simply want to say I'm disgusted by this person's actions and believe it speaks volumes about their character and is truly pathetic.

Good Luck Triabetes!

This weekend Team Triabetes will take on IM MOO, aka Ironman Wisconsin. The group has done so much for diabetic research that their year long effort has already been a wild success. Tomorrow these 12 athletes will finish their year long quest to become Ironmen and complete what hopes to be a ground-breaking documentary on how blood sugars are affected by extreme exercise.

Good luck Team Triabetes! Can't wait to race with you all next year.