Friday, November 11, 2011

Friday X Factors - Cross Fit

Each Friday I'll post a new story about something that has made me rethink how I have to manage my blood sugars.  The impact everything from eating out to exercise has on bs management can make this disease really variable.  This will be what I've learned from those scenarios.

Back in August I was itching for a new athletic challenge.  Due to life I didn't really have time to train as hard as I wanted for triathlon anymore and trying to fit in a century every weekend on the bike really just wasn't possible.  I still wanted to bike and run as frequently as my schedule would allow but I was dying to find something new.

One of the things I really missed over the past few years was a new challenge in the weight room.  From the time I was 8 years old until November of my 21st year I was a football player.  I lived in the weight room and got excited to push myself to lift heavier, faster and better.  To me nothing releases more stress than a good hard lift that leaves your muscles shaking.  But due to two shoulder surgeries, and some other joint issues I had to greatly reduce the amount of time I spent in the gym.  After 3 or 4 years away from heavy lifting I was ready to see what my body had left.  This would also mark the first time since my T1 diagnosis that I'd focus on high intesnisity exercise.

I had been hearing about Cross Fit for a while; CX sessions focus on a workout of the day which includes high repetitions of an Olympic lift, a body control movement like pull ups and some anaerobic activity like air squats.  The "box," as CF gyms are referred to, that I go to is LaLanne Fitness; founded by the nephew of legendary Jack LaLanne, the father of modern fitness.  The big issue for me was I had no idea how my blood sugar would react to a high intensity fast twitch focused session.

My first session was quite a learning experience; I did something like 75 push presses and 50 burpees; I couldn't lift my arms for a week, literally!  The blood sugars trended somewhat high during that workout but I just attributed that to nerves.  The second time I went to CX the workout of the day incorporated some more short sprints and a few other cortisol producing exercises.  Prior to the workout I had some muscle milk and had set my pump down to 60% of normal basal.  About 1/2 way into the WOD my blood sugar had spiked to 375!!!!!  I then realized this type of exercise would require a totally different protocol than long bike rides and runs.

I'm now three months into my CX experiment and while I still haven't mastered the kipping pull up my blood sugars are alot more consistent during classes.  As opposed to endurance training I try and start a CX class with my blood sugar around 120 (just in case).  About 25 minutes before class I'll have some muscle milk with non-fat milk and about a unit of insulin.  When class starts I'll reduce my basal rate to 80% of normal as the start of class trends towards aerobic versus anaerobic.  Then immediately after the workout of the day I take in 1.5 units of insulin (after checking my blood sugar) to make sure the extra cortisol in my system doesn't have any negative effects.  CX takes a totally different approach to managing blood sugars than what I was used to but its a blast!

Wednesday, November 9, 2011

Wednesday Wackiness - The New Pump

Each Wednesday I plan to share a story about those moments where I think I have T1 totally under control until I encounter a new experience that makes me realize there's still more to learn.

For a T1 a new pump is a super exciting experience.  For more than 4 years every 3 days I had stuck my body with a large needle supplied by Medtronic, primed my purple pump and clipped the tubing into my infusion site.  For 4+ years I relied on Medtronic to essentially keep me alive.  I was able to put those infusion sites in drunk, hung over, in a rush, in the dark or when I wasn't feeling well.  But I had grown a bit frustrated with my Medtronic pump, I lost trust in the machinery working properly and since I do depend so much on the pump to keep me healthy I simply had to move on.

I flirted with Animas when I first got my Medtronic pump but my first Endo whom I had an awful relationship with strong armed me away from the company.  I had kept up on Animas' development, I liked the partnership with J&J, I liked that Animas integrated with Dexcom and I loved that the pump offered more flexibility in basal rates than Medtronic.  But.... what I did not realize was the small things can add up, when comfort with a system turns into habit its really hard to change.

Inserting my Minimed Silhouette infusion set had become second nature to me.  Much like knowing how to tie your shoes I had become so accustumed to the Silhoutte I could insert it in just about any situation.  Over the 4+ years with Minimed I had inserted this set at least 400 times.  I figured the Animas infusion set would be like driving a car; different make, different model but the gas is still on the right and brake on the left.  I was ummm.... WRONG.

The first time I inserted my Animas set it took me 30 minutes to figure out where all the pieces went.  I then went through 3 infusion sets before I figured out how to insert it properly.  The second time I inserted the infusion set I couldn't figure out how to prime the pump and the god awful Animas alarm went off at least 25 times letting me know there was no insulin delivery.  And the third time.... that's when the s*it hit the fan.

I was in San Diego for a wedding, after a one or two drinks too many and hours of dancing the gf and I were a bit hungry when we returned to the hotel.  I had enough insulin to last me through the night but not enough to cover a meal of Wendys.  I had brought 3 infusion sets with me, "just in case," knowing I hadn't had alot of success inserting the sites properly.  Thank God I brought 3!

On my first attempt the infusion set fell off when I removed the needle making the set useless to me.  On my second attempt the canula popped out of my skin after I inserted the infsuion set and bled kind of alot.  And the third attempt that's when it really got to me.

On my third attempt I was extra careful, In inserted the infusion set and began to pull the needle out of the canula but my hand slipped and the set did not stay in place.  At that moment I got pretty nervous knowing I would need insulin for the next 24 hours and knowing that I wouldn't return to my apartment until 9pm the following night.  with a half used infusion set in my hand I had to thread the needle back through the canula and attempt to insert it again. With sweaty palms, a racing heartbeat and a girlfriend nervous as heck in the corner I was finally able to get the infusion set into my body.

I'm now used to inserting the Animas set; but it took a while.  A seemingly easy and brainless task caused huge frustrations.  Each time I had to insert a site I was nervous for the first month or two of using my new pump.  The big change - I had to take the front level of tape off of the infusion site at a different step of the process than with the Minimed.  A 5 second task caused all my frustrations but that's what habit causes.  Sometimes you think you have this disease totally under control and then a 5 second task puts it all back in perspective.

Monday, November 7, 2011

Monday Metrics - Back in the groove

Daily Basal Total - 13.92 u
Weight - 195 lbs (total guess, I need to buy a scale)

Over the past month I've successfully reduced my basal rate by about 2.5 units per day.  September was a bit of a crazy month for me where I spent maybe a total of 5 days in San Francisco.  3 time zones, 3 weddings and a trip to Vegas took its toll.  Once the travel was over I had a 3 day string where my blood sugar barely came below 300; you can imagine how great I felt over those 3 days.  But that string of awful blood sugars was exactly what I needed to get back on track.

Upon the final return to San Francisco (post Vegas) I knew my weight was creeping ever closer to 205, that my basal rate was disgustingly high and that my aerobic fitness was a far cry from what my status quo is.  I frankly had, had enough and although my A1c was an ok 6.7 I wanted to be better.  With my general health as motivation I got back on the bike, upped going to Crossfit to twice a week and started running again.

My diet returned to focusing on vegetables and organic foods, I decreased my alcohol intake and upped the amount of water I was drinking. My blood sugars slowly returned to the 90 - 130 band that I like to see pre-meal and my absorption rate for boluses went way up.  Having a significant other makes it a bit more difficult to go hard core diabetic diet than it was when I was a simple Ironman Bachelor.  That difficulty also expands my food choices, who knew I was the only person alive willing to eat ground bison and quinoa everyday!

The goal is to get my daily basal rate back in the 12 - 13 units per day range.  Historically that is when I've felt my healthiest, I'd also like to get my weight consistently below 185.  Each Monday we'll see how I do with that!

Wednesday, November 2, 2011

Back in Silver & Black!

Hello friends, miss me? My past few months away from blogging have seen me go through some tremendous life changes both diabetic and non-diabetic. I've switched pumps, left Keas, moved in with quite possibly the world's most perfect woman, got back into training and attended my sister's story book wedding. Not a bad 4 month stint!

The big diabetic news: I'm now an Animas pumper! I began to grow frustrated with the quality issues I had with my Minimed pump and simply lost trust in the machinery. When you depend on a battery and screw to stay healthy trust is a pretty important thing. Once my third pump of the year started acting funky I had had enough and made the switch. I'll have more on the transition in a future post but lets just say after 4+ years with one device the transition was anything but smooth. But I'm up the learning curve and my fancy shiny, silver & black, pump and I are getting along just fine.

The future of Ring the Bolus: My time away gave me some great perspective on what I want this blog to become. The first 2ish years of blogging was great, I felt like I shared some really relevant information with all of you and you all gave me some great feedback. The business school came, the job at Keas started and the quality of my blogging fell way off. I care deeply about the diabetic community and want to share my successes and failures with you all. So some simple ways I'm going to do that:
  • Mondays - I will list my weight and current daily basal amount and highlight any big trends
  • Wednesdays - Stories of frustration, not a week goes by without a D Event that drives me bonkers; I have more than enough to keep Wednesdays entertaining.
  • Fridays - Training reports; I've started doing a bunch of different training stuff and the ways my blood sugars have reacted has been crazy.  Time to share the learning on all this!
Look forward to getting this conversation going again!

Wednesday, June 22, 2011

We only part to meet again

After a few months of struggling with this decision I've decided to walk away from Ring the Bolus. I bid you adieu but will not say farewell; my desire to share my fight toward healthy blood sugar management remains strong but for the next six or seven months that focus is firmly on trying to help Keas grow.

I hope you have enjoyed reading my stories of triumph, failure and learning as much as I have enjoyed sharing them. Over the past four + years you have all given me the extra will-power needed to become a 2x Ironman finisher. And have all helped me with the most difficult obstacle of my life; my diagnosis of type 1 diabetes.

If anyone out there was even fractionally inspired to test their physical limits while fighting a chronic illness then one of my dreams has been accomplished. Thank you for letting me share my stories with you and for all the comments and inspiration you provided me. We will meet again but for now thank you and good bye.

Monday, May 9, 2011

Having a little confidence goes a long way

Sunday I raced in the Berkeley Hills Road Race, my first cycling road race. The crits I did in January were fantastic and alot of fun but I'm not the most graceful individual so 4 tight turns on a course with 50 other riders isn't the most comfortable position for me to be in. I was really excited to test my legs in a road race and was enthusiastic about it all week. The big difference between the road race and my tri two weekends ago, I wasn't nervous, I wasn't anxious; I was just psyched to have the opportunity to have some fun.

The contrast could not have been more apparent between the two events than in their respective days before. For the Half Iron I made sure to have pancakes by 10am, and dinner by 6:30 pm. Dinner was quinoa and buffalo for the half iron; for the road race; a big a** Taqueria Cancun Burrito. Yes that had my blood sugars sky rocket to 345 the night before the race (never said it was a smart decision) but it showed that I knew life didn't have to be "perfect," to have fun in a cycling race. I left Katie and her visiting friends around 9:45 pm after our huge burritos and a day of drinking some wine (yes I also had some wine the day before a race!) to get into bed for my 6am wake up.

Unlike a triathlon I didn't have to pack for 3 sports; fill up 100 water bottles with my nutrition or get to the transition area at the crack of dawn to have time to prepare. I simply got to the race site about 20 minutes before the Cat 5s were to start, signed in and hung out - pretty sweet!

Cycling feels like a huge grass roots movement; there wasn't a huge speaker blasting music, race numbers are pinned on with safety pins and while everyone has a sweet bike they aren't displayed as art pieces they are a piece of athletic equipment. Although unlike triathlon where I'm pretty close to the same height as most of the athletes I was a midget once again compared to the other cyclists - these dudes are tall! After taking 10 minutes to figure out which way my race # was supposed to be pinned on I was off to find a bathroom and get to the race start.

Race instructions were given, then the race started; just like that. No diving into frigid water, no getting punched in the face, just a clip and a pedal. I was a bit nervous right at the start and it took me a bit longer to clip in, I"m pretty sure it looked like this was the first time I had ever been on a bike.

The start of the race was pretty cool we followed a car out of the state park so I felt very much like a legit cyclist. Once we made it to the main road the car turned left, we turned right and were off!

For the first 5 miles or so I hopped to the front and tried to push the pace. I'm not yet well versed in the strategy of road cycling and some people had given me advice to just jump to the front and see what happened. I figured I could find another rider willing to push the pace with me and thin out the herd. In all about 50 riders started as Cat 5s, I think we had that down to about 30 riders by the time the "real" race started.

After the first fast 5 miles we were into Berkeley's 3 bears, bringing back memories from Lake Placid. I didn't really know the course so got caught totally out of position heading up the first Bear. As people were shifting into easier gears I had a water bottle in my mouth and was taking a breather. Within the first few hundred feet of the climb I had been gaped by the lead group; any chance for a top 3 finish was out the window.

Never one to give up I punched it trying to catch as many riders as I could. This course, NOT EASY! I think there was something like 1700 feet of climbing, most of it bunched together. After 1/2 of a lap where I pretty much rode solo to catch other riders I finally caught a few guys cranking away. This is where I learned the true beauty of cycling.

As I passed this group of riders, one of them hopped on my wheel. The idea in cycling is to do as little work as possible while still going fast. Drafting requires 1/3 the effort of actually riding as the rider in front cuts the air for you. The rider from Team Moustache and I took turns pulling for 30 seconds each, we were quickly catching other riders and having a blast doing it. Awesome learning experience and one that will have me much better poised for my next race.

In all I didn't finish first and I didn't finish last; I finished my first road race and couldn't be happier. Was an incredibly fun experience; can't wait to test my legs again on June 18th down in Santa Cruz.

Tuesday, May 3, 2011

Race Report: Napa Valley Half Iron - The Decision

I was dreading the Napa Vally Half Iron for the three weeks preceding the race. I knew that my fitness level was not as high as I'd like it to be heading into a race. I knew that my life had become busier than ever; that trying to build a business, develop a relationship and explore a new city had all taken priority over hours SBRing, and rightfully so. I knew that my passion for the sport was starting to wane and that my heart was not fully into triathlon anymore.

I proceeded like I would for any other race, I began waking up 15 minutes earlier each day starting on Tuesday. In the three days leading up to the race my sleep wouldn't cooperate and while I was waking up at 4:30 - 4:45 am I wasn't falling asleep until 11pm or later. The night before the race I had maybe 2 hours of sleep.

With blurry eyes, a splitting head ache and a pit in my stomach I drove to the race site early Saturday morning. I was silent for the entire drive, not because my intensity to do the race was peaking but because I was dreading toeing the starting line. It was becoming increasingly apparent that my heart and soul just weren't into the sport anymore.

Ever since my diagnosis of type 1 in 2007 I have fought tirelessly to prove to myself that I could accomplish whatever I wanted with a life changing disease. The way I mentally dealt with my diagnosis was signing up for an Ironman, and ultimately proving I could actually compete in an Ironman like I did at CDA. In my anniversary post I wrote that I was at peace with having diabetes, with having to test my blood sugars constantly and avoiding certain foods. I had mentally over come my diagnosis and had become 100% comfortable with everything it meant. While I still love sport and still love athletics I was realizing that triathlon was not what I loved anymore.

Once at the race venue the adrenaline kicked in a bit and for a few minutes I was excited to race. I went for my warm up run, got in my wet suit and did my warm up swim. But something weird was going on, I had one desire - to ride my bike. I did not want to swim and did not want to run I simply wanted to ride my bike, see beautiful sites, descend fast and climb hard. I stood at the starting line thinking how different it felt than starting CDA or even the start of a small race in South Carolina. Instead of feeling excitement and energy I felt dread and downtrodden.

We started in a time trial fashion, the fastest swimmer did the alleged 1.2 miles in 33 minutes (the water was brutal). My time was 42 minutes. I left the water my legs were killing me, I had cramps in my shin muscles, my feet arches and my calves. I tested and was at 118, I thought of stopping, I thought of not doing the one thing in the sport I still undoubtedly loved. My blood sugar spiked 6 minutes later to 154, I put on my cycling shoes and out I went.

From my first pedal stroke I knew this would be my last triathlon for a while. As I passed cyclist after cyclist I wondered why I didn't just focus on the one discipline that brings me almost as much joy as football did.

As I continued to ride the lack of sleep was catching up to me, my stomach was upset, I threw up a little in my mouth. I continued to ride, averaging close to 20 mph for the first 20 miles of the course, my back acted up a little bit but I pushed on. At one out and back I thought of heading back to the finish and skip miles of the race, just pull out without finishing the bike. I turned it into a training ride and kept fighting knowing I had my first road race the following weekend.

My speeds topped out at 28 on the flats, they slowed to 7 to 11 on the climbs. The course was brutal, my time 3:04, slow for me but respectful for a tough course. Not bad for a guy whose longest ride in the past 2 months was 50 miles. I can still ride, I can't still tri.

I got into transition, dismounted my bike and instead of jogging with my bike to my rack took a slow, long deliberate walk. The entire time I knew what was to come, the entire time I knew I was going to remove my timing chip the second I got to my rack.

I got to my rack, looked at Katie, smiled and asked "are you ready to drink some wine?" Her, knowing me so well smiled back and said "absolutely." She, unbeknownst to me knew for weeks that this would be my last triathlon for a while. She later told me she could see the joy in my face when I talked about cycling or went out for a ride but heard the dread in my voice when I would go for a swim or out for a run. She knew what I didn't yet realize, that I was ready to walk away.

I racked my bike, removed my helmet and tri top. I reached down, pulled apart the velcro and held my timing chip in my hand. It was as if a huge weight was lifted from my shoulders, I smiled as I knew it was time to take a break. I walked to the aid tent, and said "athlete 160 is turning in his chip." The two EMTs looked at me curiously, I responded "after doing something like 10 of these sometimes you just know it's time to walk away."

I smiled walking back to my bike. Triathlon has brought me so far, has helped me with so much has let me meet so many incredible people, has turned me into an endurance athlete. But for now, for this year I'm taking a break. I can't sacrifice what I need to, to train for tris and compete as I want anymore. Training doesn't bring the same smile to my face it once did, in a word I'm exhausted. For the next year I'll focus on what I enjoy so much. Its time to take a bit of a break; 3 days after the race I'm as happy as I was the second I turned in my chip, walking away was unquestionably the right decision.