Category Archives: Exercise

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I Ran a Half – Check Out my Medal!

Must be early in the race if I'm still almost smiling...

Smile and pretend you’re fine 🙂

After finishing an 8k with Insulindependence last fall I talked myself into completing a half marathon in Seattle and committed to doing so on live internet radio (it’s also recorded, so I couldn’t pretend it didn’t happen).

I trained, and trained, and trained, and was feeling good until about three weeks before the race when I hurt myself (turns out I didn’t pay enough attention to proper running form early in my training).

I tried to work through it, I tried to rest it, I tried pretty much everything except going to the doctor until I couldn’t take it anymore (two days before leaving for ADA, 11 days before racing). Diagnosis? Proximal hamstring tendinopathy.

Injured

That’s a fancy way of saying a high hamstring injury. Treatment? Acute physical therapy, with no hope for recovery or relief in time for the race. But the doctor was so cool about it.

“Of course – run the race. You have to run the race, we’ll rehab you afterward.”

I didn’t talk much about the injury online beforehand, but I was totally freaking out. It totally threw off my training plan, which, in turn, really shook my mental confidence for completing the event.

It’s one thing to push yourself hard through an event you know you’ve trained properly for. It’s something completely different to do an event when you know you haven’t.

Holy mind games, Batman.

Enjoy the Experience

But I was all in. I was going to do the race and just take my time. Slow down if I hurt, walk if necessary, and just take in the experience. And that’s exactly what I did.

I enjoyed Seattle, had some wonderful quality time with Dana Lewis & Scott Leibrand (#DIYPS), saw some old friends (hi Ghosn’s!) and met some new ones (hey Terri & David!). Oh yeah, we raised some money for the American Diabetes Association along the way, which is pretty great, too. Thank you, all, for helping make that happen.

I earned a half marathon medal, and it’s something I’m very proud of. I wore it all the way home and was congratulated a few different times. That felt pretty awesome. And you can bet your green, orange, and yellow bracelets that I’ll be wearing that medal at Friends for Life next week, too.

Why? Because if I can do this then you can set a goal and do it, too.

Picture of me with my finisher medal after the race

Check out my medal, yo!

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Chillingly Familiar Graphs

November 10, 2010 the FDA and NIH held a public workshop to discuss progress towards a semi-automated insulin delivery/ glucose monitoring system.  This workshop was “webcast” meaning anyone with internet access could watch and listen from their computer.

Screenshot from the FDA - NIH Public Workshop This workshop lasted all day, and I was only able to watch a few hours of it.  It was well worth the time to me, and I thought it was pretty cool to be able to get a glimpse of some of the dialogue from all sides.

There are many emotional hot spots around this project, and I’m ignoring all of them for the purpose of this particular post.  What I’d like to talk about is something that hit me hard while watching, and has stuck with me ever since.  It is also closely tied to my last post about those we’ve lost to diabetes.

I think I’d like to talk about this briefly, then stick the fear and sadness back in a box until something else cracks open the seal again.

During the presentation there was a section showing CGM graphs from those who died in their sleep.  It took only a second for my heart to stop and for a cold chill to run through me.  I couldn’t hear what the man was saying, I couldn’t read anything on the screen.

I was stuck looking at a graph I’ve seen a thousand times on my own CGM.

Picture of my Dexcom graph going dangerously low at night.

Of course it didn’t look exactly like mine, but it was close enough to register with me that any of these “cases” they were talking about could so easily be me or you or any of us.  What made me wake up, but these others not?  We were looking at CGM graphs, so they had the same tools I do.

That low I had was long, and at just after Midnight, and it looks like it took me a while to wake up and test.  Just like them.  Except they didn’t wake up.

I was talking to a friend of mine from the YMCA yesterday.  He’s a pastor at a local church here, and we were talking about prayer.  He asked me about my prayer life, and I shared that every single day I thank God for waking me up again.  I talked about the deaths that have been on my heart and mind lately, and how diabetes can sneak up and take us so quickly and quietly in our sleep.

He thought a bit, and to his credit was really trying to understand the layer of terror that diabetes wraps us in as we go to bed.  He tried to liken it to walking outside and being killed by a bus, or getting in a car accident due to someone else’s bad driving.

In the moment I thought that yes, that sort of fits, but it’s not quite the same.  It doesn’t carry the same weight for some reason.  But why?  A freak car accident is just as terrible as a nighttime low, maybe worse.  I don’t know.  I just can’t put my finger on why that analogy doesn’t sit well with me.

I think I should feel safe if I’ve made it through the day into my bed.  I’ve managed to avoid all of the hazards out there and am safe now.

But sometimes it’s the scariest thing in the world.

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My First “Red Rider” Experience: Part 2 – GO RED RIDER!

You can check out Part 1 here: My First “Red Rider” Experience: Part 1
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Even though it was pretty early in the morning, around 7:30 AM or so, the park was very busy.  Tons of people and tons of bikes, all getting ready to ride for us, those living with diabetes.  I got pretty emotional.  But I was also excited, and so very gracious.

OLYMPUS DIGITAL CAMERAAs self-conscious as I was after trying on my Red Rider jersey the night before (seeing belly hanging out below the largest shirt they MAKE does wonders for your self-esteem…), all of the worry melted away as soon as I got to the park.

There were tons of people, everyone was there to support all of us with the Red Rider jerseys.  Nobody paid any attention to how the shirt fit.

Here’s a picture of Auntly H and I, early in the morning, before the ride started.  I am forever grateful to Auntly H for getting me back on my bike after over a decade of not riding.  I will be blogging my thanks to her forever,  and just you wait until we complete the 62 mile ride in two years!  We might have to throw a party!

The weather was threatening rain, so we spent a few minutes putting baggies on all of the things that couldn’t get wet (BG meters, Dexcom receivers, car keys, wallet, phone, etc).  I understand that rain is a recurring theme with the Pancremaniacs, so my group was well practiced with the whole baggy exercise.

Image of Scott with his cycling helmet onBefore you knew it, we were pedaling away!  It was really something special, to see a big stream of people cycling along, many Red Rider jerseys, and even more friends and family.

I couldn’t help but to grin.  I was having fun riding, but the atmosphere put it over the edge.  I couldn’t wipe the grin off my face for the whole day.

Every time we saw a Red Rider jersey, we shouted “Go Red Rider!”, and every time other riders in the tour saw Auntly H and I in our Red Rider jerseys, they belted out the battle cry too.  It was really something special that boosted the energy of the ride.  You can check out the story behind the whole “Red Rider” movement in Part 1.  It’s really a powerful story from a powerful woman.

It wasn’t long before we were cooking along at a pretty good pace.  I had to start breathing through my mouth, which meant that I sucked down at least one bug along the way.  After that first bug I told Auntly H that we should keep a tally of swallowed bugs.

Just after the halfway point, we were flying down a hill, and Auntly H screamed out because a bug flew right into her eye!  After we made sure she was alright, I told her a bug in the eye does not count towards the end-ride total bug-swallow tally.  Unfortunately for the entertainment value of it all, I only swallowed one bug (that I know of).

Minneapolis Skyline from Stone Arch Bridge

I really enjoyed the route, and got to see some parts of Minneapolis that I’ve never seen before.  I also really enjoyed a lot of the views and perspectives of parts of Minneapolis that I am familiar with.  The picture above shows us riding across the Stone Arch Bridge, which goes over the Mississippi River, heading towards downtown Minneapolis.

I rode most of the way with Jim, Auntly H‘s dad.  He was an awesome riding partner.  This guy bikes to work, about 4 miles each way he said.  Even in winter.  That makes him a hardcore, badass biker dude.  He was a really great guy, and I’m glad that I had a chance to get to know him a little bit.

A great example of Jim is the Franklin Avenue hill.  This is a hill that seems (to the uninitiated, like me) to go forever.  Auntly H and another Pancremaniac were in front of us, and they just blasted right up the hill.  As I was pushing to get up the hill, Jim was behind me saying “take your time, you’re not in a race”.  Which was a perfect message for me to hear as I watch half of my riding group zip off towards the horizon.

Once we got up to the top of the hill, it took me a little while to recover.  When I was ready, I told Jim “Okay, I’m ready to kick it down and catch up to them”.  We started cranking away, and before you knew it we had almost caught up to them.  As we got closer, Jim said “you know what would be funny?  If we just blew right past them!”.  I thought that was a funny idea, so we did!  As we passed them, Jim turned to his daughter and said “eat my dust Red Rider!”, and all of us cracked up.

Image of Scott and Heather after the rideThe ride was over a little too soon for me.  We took on the 25 mile course, which was actually 28 miles.  We’re going to go ahead and call that 30 miles of biking.  We kicked ass.  This picture is Auntly H and I after finishing the ride.

I felt great.  We’re riding the 45 mile course next year, and the 62 mile course the year after that.  I’ll need a lot of training, and for the long course in two years I’ll need a road bike (versus the modified mountain bike I rode this year).

But I’m excited for all of the training rides, I’m excited about the idea of being out on the ride for a little longer next year, and I’m excited about rewarding myself with a new bike in a couple of years.

By the graces of the diabetes gods, my blood sugars were pretty good for most of the ride.  I had a bit of a pre-ride anxiety spike, but it fell into line pretty quick.  I was able to keep it pretty steady by eating a little bit at each of the rest stops, which seemed to work out almost perfectly. I ended up running a little low after the ride, which you
can see in the graph too.  My CGM was reading WAY high during the spike early in the ride – it read 363 mg/dl when my BG test was 195 mg/dl.  I knew I wasn’t that high, because I’ve experienced the SUCK of exercising with a blood sugar that high. I was feeling pretty good, so I knew the sensor was reading way high.

Image of dexcom seven graph during ride

You can see where I entered my blood sugar into it, and the graph line snapped right to where it should have been, and it tracked very accurately for the rest of the ride.

We had a team dinner that evening, which was also fabulous.  Below is a picture of the three Pancremaniac Red Riders for 2010.  Gary, on the right, rode the 62 mile course.  Go Gary!

The Three Pancremaniac Red Riders

At dinner Jim was talking about how cycling is an exercise that is
relatively gentle and easy on your body.  From what I can tell, he was right.  The next day I felt great.  I was not sore, my joints did not hurt (like they sometimes do after basketball). My muscles were “worked”, but not hurting.  I even got on my bike, twice, to ride around the neighborhood with the kids.  The next day (Monday), I went out and pedaled for another 12.7 miles.

I am loving it.

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With A Bullet In My Foot…

undoDo you ever wish you could “undo” insulin? After you’ve sent it inside you, and it is working away to lower blood sugar and store calories, and you realize that you didn’t need as much insulin as you took — wouldn’t an “undo” button be awesome?

Today I met with Rachel and her husband, who were stopping through Minneapolis on a road trip. We had a great brunch, then it was time for them to hit the road again.

We met out near the Mall of America, so after they left I headed over there to do a bunch of reading and writing. I wanted to mix in some walking and people watching too. Instead I spent the day second guessing myself and cramming food into my mouth.

It is all Auntly H’s fault, and I thank her for it!

I first met Auntly H last year, when Allison was in town. Auntly H was talking about her team (The Pancremaniacs) and their 2009 ride. For some reason, I said “Hey – that sounds pretty neat! I’ll ride with you next year!”

Well, “next year” is suddenly two weeks away, and I’m in the worst shape of my life (again). Thankfully, Auntly H has pulled us together for a few “team training rides” over the last few weeks. It has been a really great thing to get out on my bike again, and because of those rides I’m not feeling so intimidated anymore.

Yesterday we went out for a long ride. I think we did maybe 18 miles? We pushed pretty hard too. No, scratch that. SHE is a badass bicyclist who rides FAST, so I was pushing pretty hard to keep up. I think we were pedaling for just over an hour or so. It was exhausting, but a really great ride.

All of that exercise did me great, but I totally underestimated how long it would crank up my insulin sensitivity. Turns out that I needed maybe 1/4 of the dose I took for brunch.

I started walking around the Mall and within 5 minutes I was just not feeling right. I glanced down at my CGM, and sure enough I was heading low. I spent the afternoon being low, eating, waiting for the rise, rising, thinking I was safe to walk a bit, walking a bit, going low again.

I had cookies, regular sodapop, a cinnabon, frozen yogurt, more regular sodapop, ice cream, pretzels. It was crazy how much stuff I ate. Yet I was stubbornly trying to get my walk in. Ridiculous! After a couple hours of that I was frustrated and just went home. I didn’t get any writing done, very little reading done, and only tiny spurts of walking done.

I intended on walking to take the edge off of a high carb brunch. Instead of going high, I was low all day! No walking needed! Maybe if I went for a hard bike ride a few days of the week I could skip half of my insulin!

P.S. – We would love more riders! If you are interested in joining us, we’d love to have you!

P.P.S. – I’m liking the Dexcom so far!

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Another thing I just don’t get…

I had a lot of trouble playing basketball today.  My blood sugar was running high (240’s) and wouldn’t come down quick enough.

My muscles were shot, I couldn’t get enough oxygen into my lungs, my brain was foggy, my coordination and reflexes were anything but coordinated and “reflexy” (…?).  It was awful.

I have also had some experiences on the other end of the spectrum, when running low during exercise.  Those suck too, but in a different way and are for me usually less disruptive to what I am trying to do.

I don’t get that.

Low blood sugar = NOT ENOUGH GAS IN THE TANK = muscles working fine, coordination alright and reflexes decent.
High blood sugar = PLENTY OF FUEL AROUND = everything is all effed up.

I know, I know, insulin is the key, blah blah blah.  It just seems like one of those weird “diabetes means the opposite of what logic would tell you” things.

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I Didn’t Know What To Do…

It was one of those notable moments, one that I knew as soon as the self talk went through my head that I would have to blog about.

It was a perfect example of feeling lost.

I didn’t know if I should drink my Glucerna shake before basketball, or go without it.  I tried to examine and weigh the possible outcomes of each action, but it was like trying to predict the future.  An exercise in impossibility, which quickly frustrated me.

I play basketball usually three days of the week, and I have fallen into a pretty solid routine for the mornings of those days (through a lot of trial and error).  When I wake up I take my symlin bolus.  About 15-20 minutes later I eat a package of oatmeal and program an extended bolus for the 33 grams of carbohydrates for 90 minutes.  I’ll also add in (or take away) any correction bolus for my current blood sugar (which is often different than it was when I woke up just a few minutes earlier).

My basketball basal profile starts tweaking my basal insulin about an hour before I play ball, and about 20 minutes before I get on the court I’ll have a glucerna shake (17g cho, 17g pro) to keep things good during ball.

Today?  Things just didn’t work out.

My blood sugar was awesome when I ate my oatmeal – 109 mg/dl.  Based on that super blood sugar and all of the past times I’ve done this, I didn’t check again until right before walking out the door to play ball.  At that time I was very surprised to see a 204 mg/dl result on the meter!

As I was walking to my car I was trying to figure out what the heck happened?  When I got to my car, not having figured a damn thing out, I found myself very conflicted on whether I should drink my usual Glucerna shake or not!

I was confused by and a bit angry at my blood sugars not following their past behavior, and I felt very lost on what to do next!   Because I can’t predict the future (if I didn’t drink it, would I go low?  If I did drink it would I be running high?), I felt I had to pick the lesser of two evils (risk a low or risk a high).  Both options stink!

uncertain

I ended up drinking the glucerna, and I did run high during basketball (no fun).  It wasn’t the end of the world, but that’s not the point of this post.

The point of this post is that no matter how much experience you have (28+ years for me), diabetes is still able to deal you a WTF situation anytime it wants.  Let me tell you, it sucks to feel so vulnerable and unsure of what to do.

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Bad Time For That…

They have been playing basketball over lunch at this YMCA for longer than I have been alive.  So as much as I dislike using the “shirts vs. skins” method for telling teams apart, who am I to rock the boat?

I have to keep this in mind when placing my infusion sets.  Depending on my site change schedule, I place my sites (one for insulin, one for symlin) out of the way.  I often use the sides of my abdomen, my lower back, and high on my rear end, just below my belt line.  I don’t use the front of my abdomen because I think there is a better chance for them getting snagged (by me) when I’m working to get a shot off.

On Thursday my sites were on my lower back.  After one play me and another guy kind of crashed and brushed off of each other, right where those sites were.  As soon as we separated I knew my site had been pulled loose.  I reached back and felt the tape loose and pulled it off.  It was soaked with blood.  Damn.

A gusher on the basketball court.

My friend was behind me and saw all the blood.  He called time-out while I went over to my gym bag.  I let them know I would need a few minutes to stop the bleeding and that they should get a sub to fill in.  It was about time for me to leave for the day anyway, so after I completely soaked through a couple paper towels I headed off to the locker room to shower up.

It was amazing just how much blood happens when you have a gusher (it is an inevitable part of pumping, glad to say that it is pretty infrequent though).  It seems that they never stop bleeding.  I suppose my heart pumping at a zillion beats per minute from playing ball just made it that much more blood!

In about three years of playing basketball at the YMCA, this was only the second time my infusion set has come out.  It was just a bad time for a gusher.  Strangers (an even casual acquantences) get a little freaked out by massive amounts of blood leaking everywhere.  At least I didn’t spurt any out onto the court.

I was glad to have my symlin pump site available to plug my insulin pump into after showering up.

On another note, I had a lot of fun trying a different style for my latest dLife article.  Check it out and let me know how you like it!

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“That’s a bit elevated isn’t it?”

I’ve been playing basketball at the YMCA for a little less than three years now.  It’s great fun, even better exercise, and I’ve gotten to know many of the guys that come down to play ball.

There is one guy there who does some work in type 1 diabetes research.  I’m not very clear on the details, but this guy is brilliantly smart and his work has something to do with islet cell transplants.  He’s the kind of guy that you enjoy playing with or against.  Good sportsmanship and a hard work ethic.

I feel very good having someone in the gym who knows more than the average person about diabetes.  I trust that he can and will help me if I get into trouble with a low blood sugar that I can’t treat myself.

In between games today (yes, my foot is mostly better) we had a chance to talk for a few minutes.  He asked me what my blood sugar was and I showed him my log (i.e. a yellow “post-it” note).  I was very happy with a nice steady 155 mg/dl.  Over an hour earlier I was at 145 mg/dl.  With intense full court basketball in between those tests I felt it was a day I could mark in the “Victory” column!

Image of Xzibit "Seriously" memeThis guy looks at it, sees my 155 mg/dl, and says “that’s a bit elevated isn’t it?”.

Can you imagine the look in my face?  A slight shock and confusion, mixed with annoyance and uncertainty.

I guess I took it for granted that this guy would know a little more about how diabetes works in real life. Now my initial impressions were shaken a little bit.

Any other type 1 diabetic on the planet would have given me a high five for keeping my shit so steady during such intense exercise!

As I start to recover, remembering that this guys experience with diabetes comes from a laboratory and not from real life, I try my best to explain that during exercise like basketball I am perfectly fine having a little “fudge room” with my blood sugar, otherwise the exercise would make me go too low.

I fully understand (and agree) that my performance, both physical and mental, is better with a perfect 85 mg/dl blood sugar.  But my experience has taught me that no matter how perfectly I balance all of the ingredients (planned breakfast, basal rate adjustments, sport shake beforehand, strategic sips of Gatorade during exercise, etc.) the recipe does not always yield a stable blood sugar that is so close to the low range, especially during exercise (which is impossible to quantify).

Many days I play basketball I am happy to walk off the court on my own two feet without experiencing any play stopping lows.  I’d rather be high than too low.

Book diabetes and real life diabetes are so different aren’t they?  I hope I was at least able to give him a glimpse into how diabetes affects my life.

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It’s All Relative ( A Tale of The Perfect Blood Sugar )

image of a glucose meter displaying 104 mg/dl

104 mg/dl – just like the meter boxes and commercials!

It was a perfect blood sugar.  Absolutely perfect.  104 mg/dl.

Yet, as the meter beeped and the number showed on the screen, a muttered “mother fuck” escaped my lips.  The irony of it all struck me, and I would have grinned if I wasn’t so busy planning my next move.

My blood sugar well over an hour earlier was 133 mg/dl, and I had thrown a Snickers candy bar AND a Pearson’s Nut Roll down the hatch.

I was about 45 minutes away from stepping on the basketball court, and I was just not high enough or heading in the right direction.

I had been struggling with running nasty lows during this evening basketball, and quite honestly I never really figured it out this year.  Seemed like I was either running way too high, or fighting nasty lows.  Both of those suck major donkey butt when trying to compete.  Some other time I will go through all of the things I experimented with in search of the perfect recipe of variables.

I slammed down a can of Coke (leaded), brought a couple spares with me, and headed off to basketball.

As I was heading towards my car, chuckling to myself about being so upset about that “perfect” blood sugar, I knew I just had to blog about it.

The perfect blood sugar…  for a fasting reading or post meal check.  But not perfect at all for pre-exercise.  It’s a great example of how everything in our lives is so relative.

There is so much more that goes into each and every minute of our existence.

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Don’t bother me with the details…

DetailsI play basketball over my lunch break three days a week. It’s a blast. I do it because I really enjoy it, and the fact that it is great exercise is an added benefit.

Playing that often, I have developed a bit of a routine. Everything from getting my clothes ready, mixing my Gatorade, making sure I have my shoes, etc.

I usually wear my pump when I play. I have found that I need a fair amount of my basal rate at around the halfway mark. I wear it in an elastic waistband that has a Velcro pouch for the pump. It works great. I tuck the tubing into my shorts, and nobody even notices the pump unless my site is above my belt line (we play “shirts & skins” to keep the teams straight).

I recently forgot to pack that ever important elastic strap, and that little omission from my routine caused a fair amount of trouble for me.

Details!! They’ll get you every time!

When I realized I forgot it, I tried to figure out some other options.

I thought about just sticking it into my shorts or underwear, but that wouldn’t hold – the pump would fall out and trip someone (probably me!) with the infusion set tubing! Can you just see it? The pump slips out, catches the tubing around my legs and does like a tether-ball on a pole as it wraps my legs up as I’m running down the court!

Not to mention the site being ripped out or any possible physical damage to the pump itself.

Maybe I could use the tubing to my advantage? Maybe I could rig up some kind of “leg thing” or iPod like arm band with it? You know, wrapping the tubing around the pump and my arm or leg to hold it in place? Again, didn’t seem like a great idea.

I settled on just disconnecting it. I thought that I would be Ok with just testing a little more often and connecting up to deliver a quick bolus every now and then.

It didn’t work out so great. It also didn’t help matters that I started a little higher than I would have liked too.

I ended up running high 200’s for most of the time. Getting pretty aggressive with the boluses as the games went on. But in the back of my mind I was so scared of going low while playing, that I still ended up backing off too much.

I think that I was using the mind-set of correction boluses and forgetting to include missed basal rate insulin.

It’s really hard to play competitive basketball (or any sport I imagine) when your blood sugars are not in a good range. When I run high like that I find my reflexes are slowed down quite a bit, and I’m just not playing smart. When I run low, my brain is telling my body what to do, but my body just wont cooperate. It’s like trying to drive a car with no gas. Doesn’t matter how hard you mash on the gas pedal, the car is not going to move!

In the end, I survived. But it now sounds like a really good idea to stash a spare waistband in my gym bag somewhere.