Altitude – Lets Add Another Variable To The BSM System!

After a little help from some amazing friends I was able to ski during each day of my Aspen adventure and live to talk about it the next day. I'm still in awe of how my friends came to my aid when I was in need of a new blood sugar monitor last week and proved to me once again how incredible my support network is. As much as I'd like to be tough as nails and say I can face this disease alone, the truth is each day is a new battle and it takes a whole network of individuals who come together as family to let someone achieve everything they want to achieve. But, what Aspen let me realize is that there are variables I had never considered in my blood sugar management system analysis; by the time I flush out my thoughts for this thing I'm going to have a laundry list of things to quantify.

From the moment I landed in Aspen my stomach had angry gremlins running around in it. One of my friends politely referred to the gremlins as "alti-tooties," in less suave terms I was smelling up the joint quite frequently – no matter what I ate or drank. The altitude was wreaking havoc on my digestive process so for the first 3 days of fun in the snow I had to constantly eat to maintain a healthy blood sugar. Over the first 3 days in Aspen I think I had 9 to 12 lows. As my metabolic system slowly got adjusted to the altitude the leftover carbohydrates ingested to combat the lows were released into my blood stream causing some nasty highs. On Wednesday, our fourth full day in Aspen and the day I lost my meter my blood sugar was as high as 520 even though I had done nothing different from the prior day.

For the next two days I fought off highs as my body continued to digest the food from the previous 72 hours and become more acclimated to the altitude. I'm also sure that the copious amounts of alcohol had some impact on my blood sugars as well. So if nothing else the crazy blood sugars due to the travel put an additional log on the fire for my choice to pursue a non-traditional MBA path that will not have me travel as much as a job in something like consulting would have. I'm continually amazed by how variable this disease can be and how in-depth the system of blood sugar management is.

I also had the privilege of running hill repeats in the Colorado altitude – it was freaking awesome!!!!! Apparently two of my friends were talking about how I went out to do hill repeats and one said "but yeah well Ed's insane, so it's just a normal day for him," ahh the life of a triathlete. I could not believe how hard the hill repeats in altitude were. Coach Orton had assigned me 6, 1 minute hill repeats at a "train not strain," effort – or just below max effort without throwing up all over myself. I took off on the hill for my first repeat and thought my heart was going to explode. For the next 5 hill repeats I could only go for 30 second at a time. The intensity combined with the altitude was having me get light headed 30 seconds into each repeat so that's all I could last – unreal! On the "cool down" run home I was heading up the access road at a 13 minute pace with my heart rate hitting zone 5 – steep and light air = more craziness. Altitude training definitely has some huge advantages, I had a blast challenging myself in the thin air.

So in closing, altitude is awesome for training, kind of not so awesome for blood sugars, all in all it was one heck of a week!

Adventures of a diabetic in Aspen

After four straight days of incredible skiing I took the morning off to do some hill repeats (yes I do hill repeats on vacation, masochist, maybe, bat sh*t crazy – absolutely!) so I had some extra time to collect some of my thoughts and blog about them. So far Aspen has been incredible, I still haven't found that elusive cougar to pay off my student loans but that hasn't stopped this experience with my great Darden friends from being incredible. We were blessed with some amazing powder on the slopes and essentially have the mountain to ourselves. The altitude had made blood sugar management a bit difficult over the first few days but thankfully that's under control now.

Monday, I had one of the most amazing, heart –warming experiences of my life; an experience where I had to totally trust and depend on my friends and an experience that turned some of my Darden classmates into family. As I mentioned above the altitude had made blood sugar management pretty difficult. As my body adjusted to the thin air I wasn't digesting food at the same rate as I normally do, this caused my blood sugars to be pretty low for the first two days in Aspen. By day 3 all that food I had to eat to maintain a safe blood sugar level started to enter my blood system so my bs was above 300 from 7:30 am until 4pm, reaching as high as 520! My friends could see in my face that I wasn't doing well and all of them offered to ski home with me during lunch. Never wanting to admit that I need help I told them I would be ok and skied back to the condo to rest up and hopefully get my blood sugar under control.

Somewhere along the trail on my way back to the condo my blood sugar meter fell out of my pocket, when I realized this I didn't think it was that big of a deal as there is a pharmacy down the road at Snowmass. I tossed on a pair of sweats and took the condo shuttle to the pharmacy – here's where things get interesting – they didn't carry blood sugar meters. Ok, no big deal I'll just head into Aspen to hit up Carl's Pharmacy and pick up a blood sugar meter there; Carl's doesn't keep bs meters in stock and would have had to order me one!!! Seriously, a legitimate pharmacy that fills prescriptions doesn't have blood sugar meters in stock, ok now I'm starting to get a little worried.

I loaded Google maps on my blackberry and searched for pharmacy, it seemed there was a clinic just down the road in Aspen so I hoofed it over there – the clinic was out of business (the plot thickens). One more shot in Aspen, the city market, and you guessed it, no blood sugar meters there either. Apparently the sodalities in Aspen have no need for blood sugar meters, or maybe they are just trying to get rid of all the type 1s in their town. I sat there on a corner by myself in Aspen, terrified; about to break down in tears, I was afraid. I had taken in 2 clif shot gels during my walk, I knew I had a ton of insulin on board from fighting off the 300s, and could feel the symptoms of a low, I trusted my gut and figured in the short term a high was safer than a low in case I misread my symptoms.

I texted Peter, the head of Triabetes, who offered to drive a bs meter to me all the way from Denver! I thanked him for the incredible offer but told him I would try and exhaust all options before that. My phone then rang, Jen, one of my best friends in the world had called the Aspen hospital for me (who also didn't have any blood sugar meters in stock!!!) and told me that they informed her of a pharmacy 25 miles away that would have bs meters. The big problem was, none of us had a car and without my trust steed El Bastardo, my legs couldn't cover 25 miles fast enough.

Hating to have to impose my needs on someone else I texted another Darden classmate whose girlfriend and Darden graduate lives in Aspen to see if they could bring me to the pharmacy. Bucky and Kelly generously and self-lessly of course agreed to help me out and bring me there. After they picked me up Bucky also told me I should have let them know how important the meter was, since when I spoke with them on the phone I kind of just said it is important so I know what my blood sugar is, but it isn't essential that I have it right now. When I described not having my meter as a blind man walking along the edge of a cliff without a guide stick Bucky and Kelly each said that qualified as an emergency. Bucky, a former pro triathlete, skipped a Lance Armstrong book signing to bring me to the pharmacy – how awesome is that; my Darden friends are truly awesome.

25 miles later I finally arrived at the pharmacy in El Jebel, Colorado and was thrilled to find a shiny blue one touch ultra mini meter waiting for me! The day was saved; during my ordeal I had received so many text messages from my Darden friends making sure I was ok, and each gave me a huge hug when I met up with them again that night. I'm still very much learning how to deal with this disease and I don't always remember that I've had it for less than 3 years. I definitely had my "I just want to be normal," moment on this trip but with friends as amazing as the ones I have I know that no matter what I'm confronted with I can make it through. It was just pretty incredible that people were willing to take time out of their vacation to help out a friend and truly support me when I was scared out of my mind. I've had a few too many life lessons in the past six months but just like I realized in IMAZ that I'm not in this alone, I realized in Aspen that type 1, 2 or 3 people are here to support and care for me; that realization might be the best Christmas present I could ever ask for.

View From A Mountain Top

Tomorrow at 4:30 pm I fly out from Washington DC to the land where the beer flows like wine, to a little place called Aspen. I am incredibly excited for this trip; about 20 of my classmates and I are headed out for a week of skiing and drinking to celebrate the finish of our third semester at Darden. This is also the first opportunity I'll have to go on an extended ski trip in nearly two years; I went from skiing around 20 days a year to hitting the slopes just 4 times in the past two years! And hey if the snow doesn't work out maybe I can find a countess who will pay off my student loans in exchange for being her pool boy.

One of the things I'm most excited about is the view from the top of the mountain. One of the things I absolutely love about skiing is looking out onto the world from a snow covered mountain. There are no industrial sounds, the wind drowns out the voices around me and one can see for miles. The serenity of being surrounded by nature balanced by the development you can see in the towns at the mountain's edge is one of the most beautiful sights I can think of. There is something so peaceful about that view and for whatever reason it helps put everything into perspective.

There are two huge challenges when it comes to skiing and managing blood sugars (I was eventually going to have a point to this post). The first is ensuring that my meter doesn't get too cold so I'm still able to test. Last year during my two days of skiing I attempted to use my Freestyle and that worked disastrously. My sensor became too cold and stopped reporting to the receiver; I was unaware of how finicky the Navigator was at this point so for the rest of the day I had to ski without knowing what my blood sugars were. The second challenge is understanding how much nutrition to take in to have stable blood sugars. Nutrition needs vary widely due to what trails are open, how deep the snow is and how fast the lifts are moving. If I really have to push through snow to get my board moving my quads will need more glucose to fire; similarly if the terrain is pretty technical my muscles will need a lot more energy than if it's a long easy slope. For the most part I'll know what trails will be open before I hit the mountain, but knowing how fast the lifts will move is a total wild card. If the lifts are moving super quick I can get in 30 runs; if they are moving really slowly I can be limited to 10 runs – obviously the more exercise the more glucose needed.

At some point today I'll finish my paper on tax credits for renewable energy and then it's off to have some fun, run some hills in Aspen while surrounded by some great friends. I think we'll all have some sadness though as we all know, only one semester left until its back to the real world.

2010 – It Begins

Anxiously I waited for my Training Peaks account to be updated; since October 5^th, the day after the South Carolina Half Iron I was hungry to continue my triathlon journey. Triathlon in two short years has ceased to be a sport and has now become a way of life for me, it is a journey that has had people flow in and out of my life and a challenge that has brought me both happiness and despair. At the end of my 2009 season I finally realized that my love of sport, that my love of spending hours on my bike is about living in the moment and realizing how incredibly lucky I am to have the opportunity and desire to enjoy this sport – it has opened my eyes to an entirely new world. Diabetes got me into the sport; my heart and soul is keeping me in it.

Yesterday, Coach Orton finally updated my Training Peaks account! For two months I had created my own workouts like a schizophrenic on crack; intensity here, going long there, some kettlebells sprinkled in. Eric wanted me to take time off, to mentally rest and to just go out and do the activities that I enjoyed. I would go for slow runs, I would go for fast runs and would smile with each step. However, I was anxious, I was anxious to begin my 2010 triathlon journey, I was anxious to see what hidden treasures would be found during my journey to the starting line of IMCDA. With energy, enthusiasm and excitement that journey began yesterday.

For 40 minutes yesterday I rode my trainer with joy. My mind filled with how much fun training for IMCDA is going to be. I thought about the adventures I'll have in Oceanside, I thought about how amazing it will be to go through this journey more involved with Triabetes, I thought about how my good friends at Darden think I'm crazy but support me in every way possible. Classmates of mine always offer to go for runs, rides or swims with me, some have traveled to races with me and a few are thinking of going out to Idaho for the Ironman. Each of them, in some way will help get me to that starting line in late June. For 40 minutes I thought about the long journey ahead of me and promised myself I would soak in every moment and enjoy every second.

There will be times over the next year where I'll become frustrated by results, where the stresses of searching for my post-MBA job (fingers crossed, big things might be around the corner!), trying to start a small company (triathlon and diabetes led to that idea), enjoying my last semester at Darden and juggling workouts will lead to some stress. But a major goal of mine is to not let any of that get to me and to always remember how lucky I am to have this opportunity. Sport has always been the one thing that has entirely made sense to me; I so often analyzing things in life and try and figure them out, but I never have in athletics, athletics has let me bare my soul, it has let me be comfortable, it has let me, be me. As long as I remember that during each 30 hour training week this season will be nothing short of incredible.

In my e-mail exchange with Eric yesterday we talked a bit about the season and one sentence I wrote struck me for how this journey has changed me. I wrote to him that I realize triathlon isn't about beating the guy next to me, it's about pushing myself to do as well as I can, within myself, not because results matter, not because my time matters, it is because that moment matters. During college football I hardly ever worried about "winning" the play; the plays or games I did worry about that I didn't do very well. When I worried about soaking in the moment and giving that moment all that I had for me, for my teammates, for my coaches is when everything came together. In South Carolina, I only worried about each foot strike, I never worried about my time, I only thought of the journey, not the destination. This season there will be no shouting out Idaho!!! As I shouted out Placid during my 2008 training because this journey is not about beating the course, it is about soaking in the journey.

"Nature without check with original energy," that is my motto for this season. I have learned much about myself over the past two years through this sport. Over the past two years I had a lot of questions that I sought to answer, in a way that made the past two seasons about the destination; 2010 however is all about the journey. Where it will take me I have no idea, what I do know is that my goal is to do each workout with joy and passion. 2010 here I come!

I Celebrate myself, and sing myself,
And what I assume you shall assume,
For every atom belonging to me as good belongs to you.

I loafe and invite my soul,
I lean and loafe at my ease observing a spear of summer grass.

My tongue, every atom of my blood, form'd from this soil,
this air,
Born here of parents born here from parents the same, and
their parents the same,
I, now thirty-seven years old in perfect health begin,
Hoping to cease not till death.

Creeds and schools in abeyance,
Retiring back a while sufficed at what they are, but never
forgotten,
I harbor for good or bad, I permit to speak at every hazard,
Nature without check with original energy.

 

~ Walt Whitman

Song of Myself (I, II, VI & LII)

Flying & Blood Sugars

With all the travel I did in the past two weeks my blood sugars turned into an utter mess.  What I have noticed is that it seems everytime I fly my blood sugars get totally out of whack (whether I change time zones or not).  Car trips greater than 4 hours also tend to elevate my blood sugars but to a lower degree than flying does.  When I fly I make sure that I eat as healthy as possible and try to drink as much water as possible.  However, the pressure changes in altitude can change the digestion process and flying dehydrates you in general.  I haven't yet figured out a way to counterbalance the metabolic effects of flying for blood sugar management; it would be nice to not have blood sugars of 400 everytime I fly though!

Each Ironman A Story

Last week when I was at Ironman Arizona I was shocked by the difference between watching an Ironman as a person who had completed one compared to watching one as a person who was aspiring to compete in one. As a volunteer at Ironman Lake Placid in 2007 I was in awe of the athletes, and wondered if I had what it took to train for the event, if diabetes would prevent me from finishing the event and if I had the guts to push through to finish an Ironman. When I watched IMAZ last week as a person who had finished an IM I felt a silent camaraderie with each athlete. I realized that every competitor in the race was so much more than a single moment. I realized that every competitor had a year of stories just getting to the starting line, that each competitor had a support network that helped them wake up at 4am to get in a run, swim or bike. I realized that each competitor had faced their own challenge or demon and persevered through whatever it was to get them into the race.

I saw some amazing things at IMAZ, I witnessed a woman come in just before the bike cut off who needed help getting off her bike. I witnessed 16 type 1 diabetic athletes come together as a team and put on a tremendous display of courage finishing an Ironman overcoming a "silent disease." I had the privilege and honor to congratulate Rudy Garcia-Tolson finish his first Ironman. Rudy is the only double above-knee amputee to finish an Iron distance race; congratulating him on his finish was humbling to say the least. As I sat in the bleachers at the finish line I was struck by the emotion each athlete had on their face in the finishing shoot, it became apparent that each person who came down that last 50 yards had a year's worth of stories to tell and that in some way their life had changed.

In my two short years of triathlon the sport has given me so much, has provided so many life lessons and has provided an opportunity to meet some amazing people. I am anxiously awaiting the start of my third season; I can't wait to see what training for IMCDA holds. I'm realizing that each season is a book unto its own, year 1 was about proving to myself that I was still the same person I had always been even though I was diagnosed with a life changing disease, year 2 was about finding my inner self, maturing as an individual and learning to truly enjoy endurance sports, to not focus on results but to focus on how amazing it is just to compete. I won't know what year 3 will be about until after IMCDA but I do have some ideas for a motto for the upcoming season although I have some more thinking to do to solidify that.

Each person who toes the starting line at an Ironman is worthy of praise and each journey that crosses the finish line should be celebrated. I'm thankful and feel privileged to have had the opportunity to challenge myself in endurance sports and am starting to love every step I take in this sport. I never would have thought a guy who used to dread running 3 miles could love grinding out a 6 mile run before Thanksgiving dinner let alone crossing 140.6 miles in one day – yeah this sport is pretty damn cool.

Lean On Me – InsunlINdependent Family

I have one of the most amazing support networks anyone could ever hope for. My parents amazingly came to every football game I ever played in, have traveled all over the country for my triathlons and often dress my dog in a Ring The Bolus t-shirt, my younger sister cheers me on like no other, makes sure she handles my parents nerves on race day so I can focus on the race and is there for me no matter what. My close friends who I have let into my soul are incredible and I know each of them would gladly give their right arm for me. As much as they support me, they will never know what it means to be a diabetic athlete. They support me, they love me and they cheer my triumphs, they seek to learn as much as they can about the challenges I face and while my "type 3" friends and family (people who care for people with type 1 but have working islet cells!) give me the strength to face the challenges I do, they only know what I experience through my words.

This weekend I went to Ironman Arizona not sure what to expect. I woke up at 4:45 am on Friday slightly hung over and totally exhausted to drive to Richmond Airport for a flight to Phoenix. On my solo journey across the country I was going to meet a group of people of whom I had only spoken to two on the phone. One of those people, Anne Findlay, was one of my biggest supporters in the early days of my diagnosis leading up to IMLP that I couldn't wait to cheer her on for her fourth Ironman finish! At the same time I've always been kind of nervous about throwing myself out there, going into a situation where I essentially no, no one and have no control over how the situation would transpire. When I landed in Phoenix on Friday I had no clue who I would be hanging out with that night or what the weekend had in store for me.

By the time I left Phoenix on Monday at 1 pm I left with a huge smile on my face, and my heart filled with the incredible journeys I witnessed at Ironman Arizona and the comfort I felt by being surrounded by other type 1 diabetic athletes for an entire weekend. Having to manage my blood sugars has never really bothered me although I'm never like, AWESOME time for another finger prick or carbohydrate calculation. Without question juvenile diabetes is a life changing illness and while I've never asked "why me," I do understand it is a pretty big hurdle to overcome to accomplish my athletic and life goals. Having the opportunity to be surrounded by other people who face the same challenges was one of the most amazing experiences of my life.

The first night there I went to In n Out with a group of people I had never spoken with before; five of the seven people eating those delicious burgers had to test their blood sugars and bolus up before eating. The only other time I have ever eaten with another type 1 was a week or two after I was first diagnosed and had dinner with my friend's wife who was helping me decide if the pump was right for me. There was something so comforting laughing with other JDs as we tried to figure out how many carbohydrates were in a double-double at In n Out.

As the weekend progressed I laughed at how similar all of our actions were. God only knows how many test strips this group went through during the weekend. Although each of us manage the disease in an individual way we were all connected through the desire to help others manage their disease and the desire to revolution how the disease is managed. On Saturday I had the privilege to view the Triabetes Documentary, much like a 21 year old girl drinking too many cucumber margaritas while watching Steel Magnolias, I balled my eyes out (although I tried to not let anyone notice!). Here I was sitting in a theater with even more people I had never met before and couldn't help snot bubbles from forming and tears streaming down my cheeks. There were a few moments in the documentary that touched my soul – the documentary followed the journey the original Triabetes captains took while training for Ironman Wisconsin in 2008 and their Triabuddies, kids with diabetes under 18.

During the early part of the documentary one Triabuddy broke down in tears when she said "I don't want to do this anymore, I just want to be normal." That statement had tears running down my face, later in the film Brian from Buffalo, NY stated, "everytime we go out to race or train we face the risk of a low," yes Brian I've been there and done that! Dave, who has a blog titled Lowboy talked about how Triabetes transformed his life going from someone who hadn't tested in years to someone who now has an A1c below 7! And what really got me was when a brother of one of the Triabetes captains talked about how proud he was of his brother for challenging himself the way he does, the pride he had in him and how deeply his brother's diabetes had affected him. That had me crying a river as I thought about my family, friends and especially younger sister as I know they all feel the same way.

With each passing moment I began to feel closer to my fellow Triabeates teammates, people who I had never spoken with before were quickly becoming my friends. To look into someone's eyes and know they have experienced the same fears, frustrations, failures and triumphs that you have was an incredible feeling. There was an unspoken instant support in each handshake and each hug. With each parent of a triabuddy I met there was a silent thank you for the example we all set for their children. With each story about training there was a common bond. And when I finally met Anne Findlay, one of my biggest supporters whom I never met but called me after Ironman Lake Placid, who helped me understand how to train and manage blood sugars and who provided so much guidance, there was a huge hug and a thank you for all she helped me with.

On race day I could barely contain my emotions as I cheered each of the 16 triabetes members on during Ironman Arizona. I didn't have the opportunity to talk a ton with the athletes prior to the race since they were off doing pre-Ironman off your feet stuff. Heck, I couldn't even remember most of their names as they passed by in their Triabetes race kits. But that didn't matter, with each pump clipped to a fuel belt, with each finger prick, with each foot strike, I knew what they were going through. When one member stopped at Triabetes HQ for some extra food because he was going low, I knew what he felt. When each member reached transition and tested again in the changing tent, I knew what worry was on their mind. When each member ran with a smile on their face I knew it was because for a day the disease was not preventing them from doing what only a small portion of the population will ever attempt.

Over the course of the weekend I had the opportunity to meet some incredible people. I heard stories of how frustrated some people were during their teen years with diabetes. I shared test strips with someone who hadn't brought enough on race day. We compared how different foods affect our blood sugars and I found out I may in fact be the most neurotic diabetic on the planet. When fellow diabetic triathletes think you're a geek for having such an in-depth nutrition plan you may in fact truly live up to the nickname of Supernerd. I spent most of race day with three diabetics, Julie, Steven and Ryan. Julie and Steve were both awesome and each was a bit older than me but became instant friends. I constantly mocked Julie for the fact that her and her husband went to Ohio State undergrad but Michigan for grad school while Steve and I shared a deep bond of having been diagnosed about 2 years ago and doing an Ironman shortly after diagnosis (he had done an IM prior to diagnosis as well.) But Ryan was one of the most special people I met all weekend. Ryan is a 10 year old juvenile diabetic from California and was Steve's triabuddy for IMWI in '08. In a few months in Carlsbad this 10 year old will attempt a freaking half marathon, he also is a pretty sweet baseball and basketball player. Beyond the athletics thought he kid was amazing, I never heard him complain about testing, and he was as curious about me as I was about him.

During the dinner on race day the 4 diabetics, and 3 incredible type 3s went to a Mexican restaurant for dinner. I cranked my pump up to bolus for 95 units of carbs and Ryan asked with a giggle "how'd you get that number?" With his parents intently listening in I explained to him how I calculated for 20 grams of carbs in the piece of cornbread, the carbs in the side salad (about 10) and the 80 grams of carbs with my meal, then how I gave a slight discount because of the alchohol in the margarita I was drinking. Ryan laughed then went onto munching on his French fries, then asked me what I eat for breakfast. I told him about chia seeds, Odawala superfood and fruit, he then told his Mom he wanted a breakfast shake with cheerios, milk, syrup and bananas! There was just something really special being around a kid who didn't care that he had diabetes and was just going about his day without a care in the world; I've never been around a type 1 under 20 before and this was a pretty incredible experience, can't really put it into words but the conversations I had with his parents were amazing and Ryan was great – I can't wait to see them again while I'm in Oceanside in March.

Although I've never felt alone in my triathlon journey I did feel like I found my colony of bees like the girl in the Blind Mellon No Rain video. As I watched the Triabetes captains cross the finish line I knew that on this journey to the finish line in CDA there were so many others who face the same things I do. Each story that ran past me brought a new meaning to what it means to be diabetic. I went into this weekend thinking I would network with some people, hand out some business cards and become more involved with Triabetes. I left this weekend having my heart and soul touched, connecting with people on an incredibly deep level with a sense of pride and excitement for what I am now a part of. I left my apprehension about meeting that many new people at the airport and from the first handshake let myself out there. I left Arizona knowing that we all have someone to lean on and that in this battle against lows and highs there are others challenging themselves as much as I do, on my flight back I realized that my support network, the people I care about and the people who care about me got a whole lot bigger – I realized that we all really might be able to revolutionize how people look at this disease. Getting to Arizona was one of the most incredible experiences of my life and the smile still hasn't left my face.