Insights into my personal life.

This blog includes the personal details of my experiences as a recently diagnosed Type I diabetic and the impact of that diagnosis on my endurance athletic pursuits.

Please understand that I consider myself to be a work in progress. I am willing to share both my successes and failures, so please do not take my words to be professional dietary or medical advice. This is a blog, this is only a blog. I research my choices carefully, and take my health very seriously. The choices I make are my own, I am doing the best with the resources and support that I have. If you have questions or concerns feel free to comment, but please be constructive and understand that this is my life. I value it dearly.

My goal is to live a happy, healthy and active life where I can balance my internal drive to push my physical limits and the challenge of safely maintaining stability despite the challenges of Type I diabetes.

Monday, June 24, 2013

Horribly Hilly Hundreds - 200km hilly bike ride.

Last weekend was the Horribly Hilly Hundreds.  This ride is where it all began for me.  I think my first year completing that ride (200k) was 2007.  Back then I was on my Hi-tensile steel 35 pound 12 speed 1983 Motobecane Super-mirage.  Her name is Big Blue - she's currently stabled in a garage in Minocqua.  Once retired from high volume service she continued to be a reliable commuter - currently she is a retiree who only sees vacation ride time.  Enough about her, but you can tell there is an emotional connection to what her and I have gone through together.

The HHH course is southwest Wisconsin at it's finest.  Starting and ending at Blue Mounds with it's 900 foot climb to finish the day, the course hits many of the steeper climbs.  There is still plenty of flat riding between, but when you're on a hill, you know it. Many times you climb from hollow to ridge

I was a bit nervous about this ride since it usually takes me about 10 hours to complete.  It's a supported ride with 5 rest stops, each complete with a buffet of food - but previously I could eat indiscriminately among bagels and PBJ's.  Carbs away.  I've always had an iron stomach so I never realized that it was holding me back.

This edition of HHH was to be different.  124 miles with 10,000 ft of climbing, most of which is short and steep, maxing out the heartrate for several minutes at a time.  This puts my my body into anaerobic (carb burning) mode.  Good thing I went into this ride fully in a keto-adapted state.  So there would be no (or a very select few) carbohydrates fueling me on the day.

The ride went well.  The biggest challenge was the first hour.  It takes my body a very long warm-up to get primed into action.  First I need to create a demand for my body to get into fat burning mode; this usually kicks in fully after 90 minutes.  What I'm learning is that ketosis allows me access to more energy than I could ever use in a day, the only drawback is that they take a while to build up in the system.  With a 600 ft climb up Blue Mounds Park Road during the first 30 minutes of the ride, I was glad to have the company of by good friend Drew to keep an eye on me.

It was also my first ride using my new Dexcom G4 Continuous Glucose Monitor (CGM).  This device allows me to get readings on my blood sugar* every five minutes.  It has a transmitter that is inserted under my skin on my belly.  I use an asterisk about what it measures because I had been warned that the CGM doesn't measure the same blood sugar as what a finger stick monitor measures.  The CGM measures interstitial fluid.  Seems like it should be the same, but it's not.  I was warned that the CGM is good for seeing trends, but the numbers won't align with the reading from my fingers.  I'll speak more to this later.

That first climb showed my CGM values drop from 120 to the mid 60's - but the trend stabilized.  I was taking it as easy as possible and felt alright - didn't feel great (that was yet to come), but I was patient.  Once we descended back to the town of Blue Mounds I did a finger stick.  117.  Go figure.  I knew I felt okay and realized I could probably trust my perception better than the CGM - not that the CGM is bad, I just didn't fully know what it's output meant.

There is an additional point I'd like to mention here.  While I focus on my blood sugar levels, it is NOT blood sugar that is primarily fueling my body and my brain at this point.  I have adapted my body to run on ketones.  Ketones CAN pass the blood brain barrier.  I've trained my body to have access to this fuel source - this is not a fuel source that an untrained (non-ketoadapted) person can tap into.  While I have two means of measuring glucose levels - I only have one archaic way to measure the fuel that I'm relying on.

The only way to measure ketone levels that I possess is to pee on a Ketostix.  Urinary ketone analysis is crude, depending on hydration level and really only indicating what the level of ketones was a few hours ago.  Urine is not real-time data.  I do have some other indicators for the level of ketones in my body.  They make blood ketone monitors, but each test strip runs $7 - so at the level of data I would want - I'm just going to have to do without a monitor and find another way.

One of those ways for me to tell my ketone level is energy.  I know when I feel good.  When that fuel source starts to come available it's noticeable.  The other more subtle cue is an aerobic shift in my metabolism.  Once I'm fully into fat-burning mode I am more aerobic.  I can do more, with less.  I've noticed it in swimming, yoga, and cycling.  I reach a point where my breathing relaxes.  I can be stomping up hills with my mouth closed, breathing in a relaxed manor climbing a hill.  My body doesn't require as much oxygen - nice, right!

Well the ride continued.  At the 4 hour point I started to feel great.  But it was at that point I busted a spoke and had to backtrack to an aid station to lace in a replacement it.  It's a good thing to have mechanical skills.  During the short stop, since I wasn't using as much energy, my energy reserves continued to build.  My blood sugar values actually climbed from the low 100's to 130 plus I could tell the ketones were building.  Once on the road again I was flying.

What did I eat?  Some bacon & eggs for breakfast at 3am.  Two more eggs at rest 1 - and a pickle which sat well.  At half-way I had my 'gel' - which was actually a 600 calorie packet of Wholly Guacamole.  I also fueled with 2 scoops of Generation UCAN before the ride, and two scoops at the 5 hour mark.  UCAN is a very low glycemic index starch.  While UCAN is technically a carb (starch) it is an engineered multimeric starch which piles many starches together into on gigantic molecule with lots of slow releasing energy.   So far it's worked very well for me.  More on that later as well.

The rest of the story is fun.  I continued to get stronger.  No aches or anything despite not being trained for the distance.  Pinnacle is always fun, Lake View makes a man out of you.  Hwy T is always lonely and the final climb up Blue Mounds is always steep.  But it went just that fast.  I was relaxed, I had fun.  I was able to keep all my finger stick blood values between 70 and 130 for the entire 10 hours, in the end I was tired - but only in a good way.

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