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.

Friday, November 22, 2013

My Ironman Arizona 2013 Race Report. PART ONE.

To many people finishing an Ironman distance triathlon is a lifetime accomplishment.  Each year thousands of people sign up for these events for a variety of reasons.  Among the masses, the participants can be viewed in a few major groups.  For my purposes here I'm going to speak in generalities.  I fully understand what is lost by oversimplifying and generalizing, but this post will be long enough so allow me to try to keep this argument as simple as possible.

There are two types of participants at an Ironman:  Those who are racing the clock and those whose goal is to finish.

The group racing the clock doesn't only include the professionals athletes and elite age groupers.  There are athletes in all time ranges from the 8hr finisher to those crossing near midnight that still have the goal of a finish time in mind.  Often their success on the day is measured by what that clock says.  A few minutes one way versus another means the world to this group.  This group sees the event as a race, and I agree that it is.

The second group of participants isn't motivated by the clock, other than making sure they meet the 17 hour cut-off.  They are still aware of the existence of time, but their success isn't defined by it.  You can assume that many of the people in this group are novices that aren't yet confident enough to 'race' the event (and you might be right).  However, there is more to this group of athletes than just novices.  Some of these folks are just as fast as the aforementioned group, however their experience can be totally different.

Again I'm speaking in generalities so this argument is easy to pick apart, but you get the point.  I've had this topic on my mind because while I was staying in Arizona, I was hosted by my godmother Merri and her partner Michael.  It was both of their first times spectating a triathlon - this two group hypothesis was actually Michael's observation.

This is going to be a very long post.  I'm not only going to discuss my experiences on the day, but also my experiences over the entire last year of managing my diagnosis as a type I diabetic, how that affected my training and how it's all come together.  I'll get back to my earlier discussion of how Ironman can be experienced differently but my reason for introducing the topic is that I've always identified myself as the athlete racing the clock.  This year however has been so tumultuous, that I've found myself resigned to joining this second group.

Here's the back story:

When I signed up for Ironman Arizona, I did so from the lobby of the Dean Health Clinic.  I had been diagnosed with type I diabetes less than a week prior.  I believe I've discussed this topic before, but I bring it up again to make this story complete.  When I was diagnosed with diabetes I was initially miss-diagnosed as a Type II diabetic.  I had been taking the oral medications prescribed and despite eating very few carbs had absolutely no reduction in my 300+ blood glucose level for the entire week.

I am aggressive when it comes to advocating for my health.  I was confident that I had been wrongly diagnosed and over the course of that first week probably called 5 different doctors and nurses hoping for an accurate diagnosis which would enable me to begin insulin therapy, which was required to get my blood sugar under control.  I had even taken myself to the emergency clinic at St. Mary's with my BG at 350+ one evening, only to be discharged an hour later after receiving nothing more than the administration of IV fluids. By the end of the week test results would confirm my type I diagnosis, but I was still not provided a means to bring down my blood sugar.

Over the weekend I took myself into Urgent Care (during a Packer game).  It was dead quiet in the clinic, I was one of two people there.  I remember begging, pleading and eventually arguing to the point of tears with the doctor on call that I desperately wanted him to administer insulin to bring my levels down.  The argument was that they wanted me to wait for the proper training and that an appointment for that wasn't set until next Tuesday. I still do not understand the delay and why I was ever released from emergency care.  Not only would I have to suffer with extremely high blood sugar for several more days, but I had also learned that it would likely be 3 months before I could get in to schedule an appointment with an endocrinologist.

I didn't take my frustration out on doctors and nurses, I knew their personal limitations and that my issue was with the flawed system.  So I continued to contact those doctors and nurses in hopes that they could advocate for me and somehow expedite the process.  You catch more flies with honey than vinegar because on that Monday morning I got a call that my endocrinologist could see me that day!- and the appointment was ironically set at the exact time that IMAZ registration went live online.  The odds of the race selling out quickly were high (and it did in a record time of 5 minutes).

I guess its fair to wonder why IMAZ was still so important to me.  I had committed to a close group of friends and training partners from Canada that I would compete in the event.  In a way the experience of diagnosis was so overwhelming that it didn't sink in how naive it was for me to consider such grand adventures.  I refused to accept diabetes as a limiter from the beginning.  I knew there were diabetic Ironman athletes, hell, I had just finished IMWI in September of 2012 already unknowingly suffering from diabetic complications.  But truthfully - I signed up because it provided me with hope and a sense of normalcy. I am an endurance athlete.  It is what I do.

To the training:

I've discussed this to a high level of detail in my previous blogs, so the nitty-gritty of how I managed my diabetes can be found there.  But I want to discuss my training in a general sense.

I am not just and endurance athlete.  I am an Endurance Coach.  I know what I'm doing when it comes to training athletes to achieve their goals.  I treat my clients as individuals and tailor their training to suit each ones specific needs.  I've used a variety of strategies and understand there is more than just one way.  However, consistency is a common strategy.  It was the consistency that would be my greatest challenge.

My training involved teasing out more variables related to diabetic control than focusing on any specific training volume or intensity.  I had to accept my physical limitations with regards to diabetes.  Training alone presents some serious safety obstacles.  So this obviously had an impact on the amount of volume I could do.

As a result of how I set up my metabolism with a high fat diet, my body would handle effort of low intensity for a very long duration quite well.  It was actually the shorter more intense efforts that had to be cut from my training.  In a perfect world I would just train 5 hours every workout, but the reality is that I have a job - admittedly an awesome job.  I have commitments to the athletes that I coach, I have classes to lead and a life outside of training just like everyone else.  My coaching job keeps me very busy in late summer.  Many of my athletes are training for marathons, triathlons and Ironman races themselves.  I need to be there for them - as they are my highest priority above and beyond my own performance.

But the training season slows down in Wisconsin following our local Ironman in September and I finally found some time to figure out a few details that enabled me to begin training in earnest.  Yes you are reading that right.  I didn't really start my training until September.  It's a little bit of  "do what I say, not what I do" from the coach.  I know my body incredibly well.  I not only know my weaknesses, but I know my strengths as well.

I had figured out the details of swimming early on in the year as I trained in earnest for a 5 mile open water Gildas Club Fundraising swim across Lake Mendota that never happened.  But I completed the 2.4 mile swim distance in open water a couple of times in training, and for my goals in Arizona I decided that was enough swimming until the race approached.

Most of my cycling was either easy commuting miles or low intensity effort with the cycling classes that I lead.  I usually log 5-7000 miles a year on the bike, this year I doubt I rode 2000, and none of it was on my triathlon bike since I find it difficult to coach from a time-trial position.  I didn't even log my mileage.  I have reached my capacity for logging anything beyond blood glucose for a while here.

Running was my biggest challenge.  Running was the most destabilizing influence on my blood sugar out of the three disciplines.  Each time a workout destabilize me (usually spiking my bloodsugar, which seems counter-intuitive) I feared I would lose the protective benefits of my ketoadaptation which protected me from the dangers of lows - I'm not sure that this is true since I never had the displeasure of suffering any major lows, but the highs (anything over 130) never felt good.  Eventually in the first week of September I resigned myself to the glory of the treadmill and started hammering out the details.  I set the pace to 10 min/mile and experimented with different insulin strategies until I found a pattern which worked.

For about 6 weeks I put in consistent running volume, eventually peaking at 50 miles in one week.  Again, slow your roll coach!  To build from nothing to 50 that quickly can't be smart - yes, it wasn't.  It was slow and low intensity on a soft surface, but I indeed suffered some lower back pain which might (although I'm not certain) have been a result of the bounce of the treadmill.

That back pain also coincided with an untimely staph (or cellulite) infection in my elbow which needed to be treated with antibiotics.  I was very unhappy with this setback.  During a time when I would normally be peaking in training volume for a race, I found myself side-lined.  But I had to listen to my body, infections like these don't happen to healthy individuals - I though it wise to take a step back.

In a way that break was a blessing.  5 weeks out and I took 2 weeks off.  Not your traditional time for taper, but considering my goals it actually worked for me.  I am more stable when my body is consistently training.  The break gave me time to think about how I wanted to set up my body for the final 3 weeks.  Instead of a traditional taper, I figured that it would actually be best to build into the race.  Figuring that my goal wasn't to push myself to a personal best performance, going into the race slightly fatigued would have little consequence on my overall result.

The finally two weeks of training involved knocking out a couple more long runs just to make sure I knew what my body was doing, but it focused primarily on low impact swimming again.  I needed a great deal of confidence in my levels going into the race in order to be able to relax enough in the water to maintain control.  I consider myself very blessed as an athlete to have a swimming background.  In the week prior to the race I swam 3 sets of 4200 yards on alternating days to confirm my insulin strategy.  The first set I swam the distance in 1:20 and took breaks every 20 minutes to check my levels.  The next two sets I swam in 1:15 without breaks and felt strong.  I was confident.

Now for the actual race report I'll have you continue to Part Two.
Post a Comment