It's Official - I'm a Tri Dork

Coach Orton obviously has a plan to not only make me fast but to improve my overall fashion style - Major Tom here I come!

Eric had wanted me to pick up an aero helmet, realcyclist.com had the Giro Advantage 2 for a great price so..... ummm yeah.

Why Aren't Diabetic Supplies Designed Cradle To Cradle?

Today in our sustainability and entrepreneurship course we are speaking with the CEO of Method, a company that produces house hold cleaning products that are healthy for the environment and designed to either be recycled or 100% biodegradable. As I changed my infusion site this morning, with the Method case fresh in my mind I once again became frustrated over how much waste is created through the simple act of refilling my insulin.

When I change my insulin reservoir I am throwing out:

1. 2' long plastic tube
2. 1.8 ml plastic canister
3. 2" long metal needle
4. 3" wide adhesive tape
5. Whatever insulin is left over in the reservoir
6. Plastic packaging from the new infusion site
7. Plastic wrap from new reservoir
8. Plastic cap from reservoir
9. Aluminum wrapper for IV Prep
10. IV Prep Cloth

In addition each box of infusion sets has a ton of documentation and instructions; the same documentation in each box!

That process above is repeated 3 times a week, 52 weeks a year, for the rest of my life. Not to mention the hard plastic containers One Touch uses to house their test strips, or the waste that each test strip creates. That's a ton of non-recyclable waste; there has to be a better way!

One of the things we're learning about is how to design a product for cradle to cradle. Cradle to cradle means that the life cycle of the product is continuous, it is either 100% bio-degradable or the non bio-degradable portions can be recycled and incorporated into a future product - essentially carbon neutral. This design process ensures no additional harm to the environment and actually can create significant cost savings to the manufacturer. Cost savings can be found throughout the supply chain or in something like shipping costs from lighter or less packaging.

I haven't yet fully identified all the potential ways to improve how to redesign all insulin pump supplies or testing supplies. However, packaging test strips in bulk with a plastic canister that can be reused would be a great start and create a huge cost savings for the supplier. A trade in program for Medtronic could be a second innovation; the plastics Medtronic uses can be recycled which would reduce their supply costs and decrease the amount of waste through our necessary activities. There are some simple changes that can be made, that would decrease the price to consumers, increase the profitability of corporations and most importantly be better for the environment.

2:26 AM - Awesome

I would love to be writing a blog post at 2:26 AM about how incredible a drunken night with my friends was. Unfortunately, that's not the case of this post - it's 2:26 AM, I've been trying to fall asleep for about 2 hours, and every 20 minutes or so I wake up shaking and confused. Since 9pm tonight, my blood sugar has struggled to get above 70 and for most of the night it has been in the 50s.

Sunday had me complete my 40 mile ride mostly in zone 3, in 2 hours and 3 minutes; then it was out for a nice hour long zone 2 transition run, about 6 miles. For the 3 hours of exercise I need 460 to 480 grams of carbohydrates. During the bike I took in about 120 grams of carbs, then took in 80 more grams of carbs before my run. Post run I had Endurox for 50 grams of carbs, and ate an entire flat bread pizza for another 135 grams. After that I added a Whole Foods "super foods" salad, and had a fruit smoothie - about 80 grams. I should have taken in enough carbohydrates to avoid a huge deficit (unless this is cumulative from during the week).

After the salad and smoothie when I noticed the lows I've added 2 glasses of orange juice, a 1/4 clif bar and now a clif nectar bar. Hopefully the clif nectar bar at 2:20 AM does the trick. I feel my mind and body slowing down as I write this so I can only hope that means my blood sugars are bouncing back up. I had hoped that avoiding late nights out with my friends this weekend and only having a couple social beers at our Darden Trivia event on Friday and tailgate on Saturday would help me avoid this. My recovery week isn't off to the start I had hoped it would be!

Final Push

Next Sunday I will be competing in the Patriots Triathlon held in Williamsburg Virginia. I'm excited for the race for a few reasons. A couple of my Darden friends are going to do the sprint version of the race while I do the oympic! This will be the first race that Coach E and I have done a full training cycle for and my blood sugars have been super solid for all but one day of the past month.

As I had posted earlier in the week, my emotions were running out of control which caused my blood sugars to fly all over the place. I'm still not 100% sure what happened; whether it was a combination of lack of sleep, insulin going bad and a racing mind or if it was all the food I had with lower boluses from the super intense workout weekend, but my blood sugars were sky high Monday. I think my efforts to let go of having to control every situation will go far in helping to limit situations like that in the future. Since Monday my blood sugars have returned to normal levels and have been steady as a rock during workouts - 6 hours thus far this week, with 2 hours on tap for today (a lift with core strength and a 40 minute run); then THE BIG WEEKEND.

This weekend Coach Orton has me doing a 35 minute continuous swim with a 15 minute warm up and 5 minute cool down on Saturday. I may try and find a lake somewhere around C'Ville to do it in open water, as a continuous swim in the UVA pool sounds about as enticing as cleaning my disaster of an apartment. There are two outdoor lap pools in Charlottesville so I may test my luck at one of them tomorrow morning to get the swim in. Sunday is the big day however, a 40 mile bike at my race cadence followed by a 1 hour run - essentially 75% of a half ironman.

Coach has had me cycling at a cadence of 80 to 85 for most of the past month. The idea behind this was cycling at a higher cadence was destabilizing my back muscles causing alot of spasms I was experiencing on longer rides. The lower cadence combined with the new fit has done wonders for my back and hip, I'm feeling great and stronger than ever on the bike.

I have also been running in the Nike Frees (more on these next week). My stride has become more efficient and some of the normal running stresses I've encountered have been just about eliminated. I feel like I'm running much more naturally than I have been and am enjoying running again!

All this leads me to great excitement for what can occur in Williamsburg next weekend. My nutrition has been dialed in, my training has been outstanding and my Coach is totally kicking my butt. I'll write more about my goals for the race next week, but I am putting the most effort into giving up control and just going with the flow of the moment. I was at my best in college football when I let the play come to me, when I didn't force things and when I adapted to the situations, letting the theory of play dictate my actions. On Sunday's big training day my goal will be to ride within myself, not force a higher heart rate, not feel like I need to hammer through the ground, enjoy the beautiful scenery and ride every second with a smile. Then on the run I want to run with the joy Emil Zatopek did in the 1952 Olympics - embrace the challenge, love the pain, but enjoy every second.

4 Things....

In our Sustainability, Innovation & Entrepreneurship class Professor Larson asked us to write down four things that were core to our future happiness. These four things were to center around our professional life and were supposed to identify the four qualities a future job would need to make us professionally and personally happy. For years I have been thinking about things like this - probably part of my weird make up that has me wanting to control situations. But as I reflected on what is really important to me, it gave me great hope that if I can give up some of that control I'm going to have a much happier and more fulfilling life, those 4 things to me are:

1. Have time to be the best Father and Husband I can be. Family has been and will always be a huge priority in my life, although I am neither a father nor husband yet; I know that my future career better allow me to make both my children and wife a priority. In large part this is why I did not go into coaching football out of undergrad, because I knew the commitment required for a high level of success in that career almost eliminates the time for anything else.

2. Have a position that lets me impact others and aids them in living a healthier lifestyle. I want to help people, I need to learn how to do this in a less controlling fashion, and need to learn just to listen sometimes. But I have a core belief that living actively, and eating healthy will lead to a greater level of happiness for everyone.

3. Work in something that is related to athletics, in a non-corporate culture and wants to be sustainable. Athletics has been the one thing that has always made sense to me, and the one thing that has always made my worst day better. Staying involved with athletics, whether through nutrition, apparel or something I haven't even considered yet will be a huge driver to having fun and enjoying my profession.

4. Solve a problem and leave an impact. This one is pretty self explanatory; I'm a problem solver by nature, for better or worse. I think strategically, I act analytically and I crave a puzzle. Professionally, this is an awesome quality, personally this one needs to be shut off sometimes and I'm working on that. But to be professionally fulfilled I need to be working towards solving a strategic issue that will allow me to leave a positive impact.

Hope For A Better CGM

I have no idea how Abbot will use my user feedback in the further development of the Navigator. Although the idea of having the potential even the smallest voice in the development process makes me feel like this blog is potentially accomplishing something. I even included some of my thoughts on sustainability in future generations of the Navigator. And who knows who else might come along the below view points; because I think we're all striving for the same thing - a better, easier way to manage our blood sugars that is more integrated into our daily activities. Here are my hopes for the next generation Navigator:

1. Adhesion, although I have used several different types of external medical tape I have continued to have a problem keeping the sensor attached to my body. This has been in part due to the size of the transmitter and the lack of adhesive tape attached to the sensor. Often after a simple shower or a 1/2 hour in the pool the sensor will fall off, sometimes without my knowledge. Would love to see future versions of the sensor have extra adhesion.

2. The 90 degree cannula neither stays in my body as well nor is as comfortable as a 45 degree or variable angle cannula, like the Minimed Silhoute. When speaking with diabetic educators about which insertion set to go with for my insulin pump they unanimously suggested the variable angle type. A longer cannula would also give me piece of mind that the sensor is staying in place, and actually provides more comfort because its further below the tactile nerves in my skin.

3. A universal insertion device would achieve two goals. From a sustainability perspective, a "gun" similar to the one Medtronic uses for their insertion devices reduces the amount of plastic required for each sensor. This reduces the environmental impact of each sensor as there would be less waste material; additionally this may provide more consistency for insertion as a "gun" is much easier to handle than the bulky automatic inserter. Secondly, this could provide a huge cost savings to Abbott; less plastic means lower manufacturing and shipping costs. The production line for the mold of each automatic inserter could be removed, by removing the plastic automatic inserter each shipping box will be smaller, a smaller and lower weight shipping box means lower shipping costs for Abbott - a win, win for consumer and producer.

4. A smaller transmitter and smaller receiver. In a perfect world the receiver would be the size of a Garmin Forerunner watch. For training purposes wearing a watch that displayed my blood glucose and trend at all times would be a gift from heaven. The watch would allow me to view my blood glucose more easily and require less effort than the current receiver does. Additionally, the lower bulk of a watch makes it a more practical solution - for my needs communication distance is much less important than size. Both the Polar HRM and Garmin Forerunners are great models for product innovation.

5. Although you are serving two consumer bases, the menu options on the receiver are a bit limited. Because it is produced for such a generic audience I understand that you need to keep it as simple as possible. However, I think the simplicity at times makes it more complicated than it needs to be. Additionally, I would like to see my glucose number always displayed; and the backlight automatically come on when I hit a button; rather than having to hit a button to display glucose and a second button for the back light.

6. Battery life and battery recycling is another main concern. A shift to a rechargeable battery or a longer life battery would help a ton. Too often the battery in the transmitter goes dead without my knowledge; having a rechargeable unit in place would allow more frequent use of the device and ensure that the device does not go dead mid-cycle.

Of Stress, Emotions & Blood Sugars

It's easy to forget the impact ones blood sugars can have on their blood sugar management. Yesterday due to a perfect storm of events my blood sugars were out of control requiring a little extra effort to slow my mind down to help me process everything that was going on.

Sunday night I barely slept as I was thinking through some stuff in my personal life, this made my looming operations strategy class seem way more important than it actually was. I went to bed with a blood sugar of 340 on Sunday, as I tested throughout the night my glucose level never dropped below 200 although I had given myself more than enough insulin. Its amazing how much of an affect blood sugar plays on your thought process - when I'm that high I feel like my brain simply can't slow down.

Monday I had egg whites, coffee and a glass of OJ for breakfast, but my blood sugar spiked above 200 just an hour after eating. I sat through class, dizzy and ultra focused as I was trying to understand a concept. Mind you, under normal bs levels competitive cost analysis wouldn't be that hard for me to figure out. Oh the joys of diabetes.

Throughout the rest of the day my blood sugar fluctuated between 180 and 300; and the pending club fair at Darden did little to ease my worries. I'm the founder of a new type of club at Darden which is a cross-academic endeavor that is combining the new Batten School of Leadership & Public Policy and Darden to form the Business & Public Policy Club. In order to be an official club at Darden we need at least 20 members. I was nervous about having to pitch my club to the first years, and terrified we wouldn't get the #s needed to become sanctioned. I was blown away by the response, we had 40 first years sign up for the club which exceeded our wildest expectations.

I came home, did some valuation homework, then went to my second year coaches course, where I skipped the free pizza and just had a diet coke. Finally back home at 8:30 pm, I had a salad with chicken sausage and was glad to see my blood sugar pre meal and post meal come in at the same level of 205 (consistency is a move in the right direction). I gave myself 2 extra units of insulin before bed, went to sleep at 11:15 and am super happy to wake up with a blood sugar of 75. Now its off to the pool before my 10am class, hopefully the exercise, extra sleep and understanding some stuff better will get my blood sugars back to where they should be.