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!
Sunday, March 4, 2012
Monday, January 23, 2012
Thursday, January 19, 2012
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:
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.
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
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.
Friday, January 13, 2012
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...
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...
Tuesday, December 27, 2011
X Factors - Family Holiday Party!
Happy Holidays to all my readers! I hope each of you had as fantastic of a holiday as I did. Since I moved across the country family time has become increasingly more meaningful and special so this Christmas was extra amazing. Especially since I had the opportunity to meet my significant other's entire extended family.
With each holiday season I am however reminded how tough family parties can be with the D. From extra booze to your favorite Aunt's desserts bolusing is never easy. Add to that a sporadic exercise schedule and a routine far from normal and you have a recipe prime for diabetes disaster.
On Christmas Day I went to my SO Uncle's house for her family's Christmas party. Once there I was greeted with sausage rolls, roast beef on baguettes, baked bree and pigs in a blanket. In other words, a carb counter's nightmare! When I woke up Christmas morning I did some hill repeats and made up my own cross-fit routine so had gotten in about 45 minutes of exercise. For breakfast I had some greek yogurt and for brunch an omelet so I was a bit surprised that my blood sugar was 220 when I first bolused for the holiday appetizers.
After peeing no less than 5 times in an hour I wondered if my 5 unit 2 hour extended bolus wasn't enough. Upon testing I saw that my blood sugar was 295 so I gave myself another 3 units of insulin. 5 pee breaks later my blood sugar had crested to 341 and I took in 10 units of insulin. The next time I tested I was at 271 and for the most part hadn't eaten anything in the past 2 hours. I decided to give myself another 5 units of insulin and told my girlfriend to watch out for the warning signs of a low. Before leaving my blood sugar was still in the upper 200s so I took in more insulin yet again.
At that point I wondered if sausage bread really could be that bad for you or if there was any possible way I had eaten more than 700 grams of carbohydrates (or what my bolus rate would have translated to). Once back at my gf's house I took in 12 more units of insulin since I was at 221 and had a bite of cheesecake assuming that I was headed low at some point. Finally my blood sugar dropped to 150 making me worry about a nighttime low but 30 minutes later I was back at 175 so I took in another unit of insulin and had a gel and some other sugar goodies well within reach. When I woke up with a blood sugar of 281 I wondered if I was getting sick...
On the 26th I went out for a 10 mile run and finished with a blood sugar of 180 even though I had only taken in 1 gel and 2 fuel belt bottles of gatorade. I felt my infusion site and realized it was a bit sore so I removed it. Once I removed the canula I was greeted with a lovely 90 degree kink that for whatever reason didn't cause the occlusion alarm to ring!
I should have checked my infusion set far sooner than I did but I figured since the food on the table was so delicious that it must have been bad for you. Live and learn I guess...
With each holiday season I am however reminded how tough family parties can be with the D. From extra booze to your favorite Aunt's desserts bolusing is never easy. Add to that a sporadic exercise schedule and a routine far from normal and you have a recipe prime for diabetes disaster.
On Christmas Day I went to my SO Uncle's house for her family's Christmas party. Once there I was greeted with sausage rolls, roast beef on baguettes, baked bree and pigs in a blanket. In other words, a carb counter's nightmare! When I woke up Christmas morning I did some hill repeats and made up my own cross-fit routine so had gotten in about 45 minutes of exercise. For breakfast I had some greek yogurt and for brunch an omelet so I was a bit surprised that my blood sugar was 220 when I first bolused for the holiday appetizers.
After peeing no less than 5 times in an hour I wondered if my 5 unit 2 hour extended bolus wasn't enough. Upon testing I saw that my blood sugar was 295 so I gave myself another 3 units of insulin. 5 pee breaks later my blood sugar had crested to 341 and I took in 10 units of insulin. The next time I tested I was at 271 and for the most part hadn't eaten anything in the past 2 hours. I decided to give myself another 5 units of insulin and told my girlfriend to watch out for the warning signs of a low. Before leaving my blood sugar was still in the upper 200s so I took in more insulin yet again.
At that point I wondered if sausage bread really could be that bad for you or if there was any possible way I had eaten more than 700 grams of carbohydrates (or what my bolus rate would have translated to). Once back at my gf's house I took in 12 more units of insulin since I was at 221 and had a bite of cheesecake assuming that I was headed low at some point. Finally my blood sugar dropped to 150 making me worry about a nighttime low but 30 minutes later I was back at 175 so I took in another unit of insulin and had a gel and some other sugar goodies well within reach. When I woke up with a blood sugar of 281 I wondered if I was getting sick...
On the 26th I went out for a 10 mile run and finished with a blood sugar of 180 even though I had only taken in 1 gel and 2 fuel belt bottles of gatorade. I felt my infusion site and realized it was a bit sore so I removed it. Once I removed the canula I was greeted with a lovely 90 degree kink that for whatever reason didn't cause the occlusion alarm to ring!
I should have checked my infusion set far sooner than I did but I figured since the food on the table was so delicious that it must have been bad for you. Live and learn I guess...
Tuesday, December 20, 2011
X Factors - Red Eyes
Travel is pretty much unavoidable during the holiday season; especially when you and your significant other's family lives on the opposite coast. Historically, changing time zones has been one of the most difficult variables to manage for my blood sugars. Usually heading east I'll go low and heading west I'll go high. So last night it was with great trepidation that I tried Ambien for the first time.
I'm not a good flyer, even though I flew close to 100k miles during my time at Keas, I freak out just about every time my flight takes off. Bumps make me break out in a cold sweat and god forbid the flight has more than a moderate amount of turbulence. I can tolerate flying but frequently have to close my eyes and imagine I'm on a bumpy road riding my bike. So I was excited to try anything that would take the edge off.
But taking something that makes you stay and fall asleep has its consequences. What if I encountered a low and did not wake up to the normal warning signs? What if the effects of the medicine made me go extremely high or extremely low. I'm nervous anytime I introduce a new variable into my system but was especially nervous to introduce Ambien to my system in an environment that I quite frankly hate.
So I got onto my Virgin America red eye, opened my bottle of water and swallowed the blue pill thinking of Neo. About 20 minutes later I noticed a tingly feeling in my lips, took some food and then was out for the count! For someone who hates flying this is a miracle drugs, bumps were met with the smile of a child on a roller coaster and the 5 hour flight felt like 45 minutes. I did however sleep the entire van ride to my parents house and continued to sleep for another 4 hours once I got home! But best of all my blood sugar was perfect!
When I got onto the flight my blood sugar was a slightly low 78. I ate a kashi protein bar to up that a bit before passing out and landed with a beautiful bs of 98! Upon getting to my parents house I tested again and was greeted with a 91 and haven't crested 125 all day. Traveling and especially red eyes have always been met with blood sugar difficulty, I try and eat as cleanly as possible in the days leading up to them and get a bit of extra exercise but its never easy. Good luck controlling those blood sugars as all of you travel home to your families!
I'm not a good flyer, even though I flew close to 100k miles during my time at Keas, I freak out just about every time my flight takes off. Bumps make me break out in a cold sweat and god forbid the flight has more than a moderate amount of turbulence. I can tolerate flying but frequently have to close my eyes and imagine I'm on a bumpy road riding my bike. So I was excited to try anything that would take the edge off.
But taking something that makes you stay and fall asleep has its consequences. What if I encountered a low and did not wake up to the normal warning signs? What if the effects of the medicine made me go extremely high or extremely low. I'm nervous anytime I introduce a new variable into my system but was especially nervous to introduce Ambien to my system in an environment that I quite frankly hate.
So I got onto my Virgin America red eye, opened my bottle of water and swallowed the blue pill thinking of Neo. About 20 minutes later I noticed a tingly feeling in my lips, took some food and then was out for the count! For someone who hates flying this is a miracle drugs, bumps were met with the smile of a child on a roller coaster and the 5 hour flight felt like 45 minutes. I did however sleep the entire van ride to my parents house and continued to sleep for another 4 hours once I got home! But best of all my blood sugar was perfect!
When I got onto the flight my blood sugar was a slightly low 78. I ate a kashi protein bar to up that a bit before passing out and landed with a beautiful bs of 98! Upon getting to my parents house I tested again and was greeted with a 91 and haven't crested 125 all day. Traveling and especially red eyes have always been met with blood sugar difficulty, I try and eat as cleanly as possible in the days leading up to them and get a bit of extra exercise but its never easy. Good luck controlling those blood sugars as all of you travel home to your families!
Thursday, December 8, 2011
Random Thoughts - Features that Matter
When I first received my Animas pump after years with Minimed/ Medtronic I was incredibly excited to be able to program my pump from my meter. No longer did I have to awkwardly stare down under the table at dinner, contort myself in a movie theater chair or worry about lifting up my shirt just to get access to my pump for my bolus. For the first few weeks I thought programming my pump from my meter was like the greatest Christmas gift of all time. But as time wore on the bulk of the meter out weighed the cirque de solei act I perform to sometimes bolus.
That got me to thinking what features really would make managing diabetes easier. I'm not talking all out revolutions like the artificial pancreas project just simple product feature updates that would have huge value at a low cost.
That got me to thinking what features really would make managing diabetes easier. I'm not talking all out revolutions like the artificial pancreas project just simple product feature updates that would have huge value at a low cost.
- Pump programming from my cell phone - Several phone and health companies have been working on incorporating a glucose meter into a cell phone. That would be a huge help but what would also be useful and perhaps a quicker win would be an insulin pump that could be programmed from an Android or Iphone app. Lets face it the interface of pumps are freaking awful; the amount of buttons I have to hit to perform a simple task makes a bolus seem like a lunar landing. Cell phone apps provide a simple elegant cheap solution to improve the UX and make programming a pump more intuitive. Plus my cell phone already has a happy place in my pocket so its not like adding another device to deal with.
- Size - My favorite glucose meter is the One Touch ultra mini. Its far from the most feature rich meter on the market but what it lacks in bells and whistles it makes up for in ease of carrying. Whether exercising or wearing jeans the ultra-mini meter takes up a fraction of the space of most other meters while doing exactly what I need (and nothing more).
- Readability - Although Animas markets their pump as the easiest to read because of its color screen in bright sun light its really tough to read. Further, the ultra-mini does not have a back light and several other meters are hard to turn the backlight on. One would think since loss of eye sight can be a major complication of diabetes more effort would be put into readability.
- When the lights are off - to my knowledge the only meter which has a "flashlight" type feature is Freestyle. I thought that idea was GENIUS. Having to turn on the bedroom lights just to test is annoying and can disrupt our partners. Alot of the time rather than turning on the bedroom light I shuffle to the bathroom to test at night. Not only is that inconvenient its dangerous. That same thought process exists for movie theaters, or any other dark environment. We should be able to test wherever we are, not be forced to find a light to test under.
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