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.

Tuesday, February 12, 2013

Lows & Highs

Here is a random selection of crudite - totally unrelated to my post.

Stability has never been more important in my life.  Stable - however, can be dull. It's great to have perfect balance, but it's better to have perfect balance while doing something.  The analogy of sport is perfect.

I've been at conflict lately after coming to the realization that my goals lead me in two different directions.  Two of my major goals are at direct conflict with one another and it is not an easy for me to rank which has the higher priority.

My first goal is to continue to race and train for swim, bike, run events.  I've recently experienced some success on that front.  For this weekends WCRC relay challenge I was able to ride to within 95% of my potential.  Considering my low training volume and specifically my lack of intensity to my workouts, I consider it to be a surprising success to still be able to throw down.  

My second goal has been stability.  Three months ago at diagnosis, the test that measures my body's exposure to glucose (and also it's rate of destruction to vital organs) my HbA1C test originally was 11.0.  This translates into 3 month average blood glucose of 280 mg/dL prior to my diagnosis.  Last month I already got this down (after just 2 months!) to 6.0 - which correlates to a about 130 mg/dL average.  My goal for the test I'll take this week is to get that number to 5.3 or less.  5.3 is just about the mid point for healthy people.

Side note:  I have learned through reading the data that when test results compare to ranges in average americans, they are not specifically claiming the ranges for the 'above-average' american who is actually healthy.  It's sort of like comparing my 3:4x marathon time to the average american and calling myself an above average marathoner - while in reality I'm traveling half the speed of the winners and no where in contention of the race.  I choose to set my goals higher than the "average" american - I would rather shoot to match benchmarks in people who know what they are doing with their bodies.
So that test result is rather a big deal in my mind.  I thought at the rate I was going I had a 5.3 in the bag.  However, I've had two challenging weeks in a row.  I haven't even had time to enter my numbers and chart the results.  I know I've had higher numbers.  My average daily control is probably 100-130, which isn't bad, but it's come with a few moments of high peaks to match the increased baseline.  Realistically I wouldn't be surprised if my A1C stayed at 6.0

Part of the problem is that along with having a few bad days:  I had one vial of insulin expire and lose potency,  I've had a few sleepless nights either due to sick dogs or sick people.  I've struggled more than usual these past two weeks.  I know I can do better, but it's not that I sat still during those two weeks and did nothing.  I struggled because I was challenging myself.  I added in exercise, I added in managing unexpected responsibilities.  There were things I had to do, and there where things I wanted to do.  

I feel held hostage at times.  When I'm stressed there's nothing I'd rather do than grab my running shoes and dog leash and just run away.  My favorite way to survive Wisconsin Winter is to train my running.   But now I feel like I have a leash on me.  I can run with company sure - but the time I need to run and vent I really need to be alone.  I'll have a dog - that's all the company I can handle some days.  

When I exercise, especially at high intensity, it is amazing the amount of sugar that my body blows through.  Based on the calories from my hour on the Computrainer at work I managed to plow through over 1200 calories in 55 minutes!  There is some solid science behind that number as well.  I put out a lot of watts and my body generates a ton of heat.  How I manage this high demand for calories was the trick.

This is still a process under development but my current race fuel of choice is honey.  Honey is a disaccharide - meaning it's breaks down into fructose and glucose.  Two difference sugar molecules which enter the muscles using different transport channels.  I've already learn that at high intensity my body is able to import sugar independently of insulin - and in reality, I want my insulin levels to be safe on the low side when I race.  

I've also learned that in order to compete and train for high intensity session I need to boost the amount of sugar in my blood to meet such a high demands.  To me sugar is gasoline, except your car still runs fine on half a tank.  Mine doesn't.  If I let my levels drop - which I can easily drop 50 points in 10 minutes at intense work levels - then I will experience a low. 

Prior to this weekends time-trial I had the pleasure of some pre-race banter with the master of all things data, Mike Wolfgram.  He was asking me about my plan and checking in on how I felt.  When he asked what it feels like to have my numbers go low all I could explain was this...  A low feels like weakness.  It feels like failure.  It feels like quitting.

A low puts my life on the line.  A low while racing truly defines the phrase "Eat like your life depends on it".  I have to gain comfort with knowing that every time I race or train hard, my life is at risk.  I can certainly minimize that risk with proper preparation, but still prefer to currently only workout indoors or with a partner.  I carry emergency fuel and glucagon pens.  


Side note #2:  If you are reading my blog this far, you must be of the opinion that you'd prefer that I live rather than die.  So if there is ever question or need...  In my pocket somewhere on me at nearly all times you will find a red hard shelled container holding a needle with water in the syringe, and a vial with powder.  Using the needle, squirt the water into the vial with the powder to dissolve, then suck that solution up, jab that needle into my butt muscle and push that plunger down.  Glucagon will stimulate my liver to produce enough glucose to revive me.  And don't worry about hurting me - I'm unconscious and won't feel a thing.
Back to the topic and the source of my conflict.  I want to race and train hard, but doing so requires that I manage my numbers much higher than aligns with my goal for my A1C.  The A1C test reveals the health of my organs and pretty much that age at which I age is accelerating.  It's a pretty big deal.

However, I find great pleasure in racing.  Tibetan monks may live to 90 years, but if they have to spend 30 years staring into space (unless it's more pleasurable than it appears), then really in my mind they are no better off than those living to 60, maybe 61 years.

Finding balance is just that.  I'll spend some time on one leg, then the other.  Holding onto a high level of fitness shouldn't come at the expense of my health.  Right now I'm worried that it does.  I can race quite well with my bloodsugar in the 180-200 mg/dL range, consuming 6 oz of honey per hour.... but is it wise?

I can't quit racing, but I'll save that level of intensity for special days.  In the meanwhile I'll probably slug through my workouts with my numbers on the conservative side, knowing that I'd be stronger/faster if I ever choose.  Sandbagging perfection.

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