tag:blogger.com,1999:blog-59918635765181875872024-02-01T23:08:01.096-08:00I'd rather be outsideAnonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.comBlogger50125tag:blogger.com,1999:blog-5991863576518187587.post-73595969806889034672014-11-12T14:24:00.001-08:002014-11-12T14:24:30.752-08:00The burden of diabetes?Burden is such a negative word, however the daily burden of diabetes care is not the part of diabetes that I want to talk about. The burden of diabetes I'd like to discuss is the burden of proof required to make a consensus decision that nutritional therapy is the most powerful intervention available.<br />
<div>
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsG6zBgMMeYl9dRixbaL7FhzOxjhKNcVdIoj4d1HR_dDIn2IFCzEEKtGWYyCqJ-Hfu1oeDPrtUOkohP2Q9Ryi-kUBAScfvHLhFfmYfODhz-vzah1OAkN4jP9OhHiJj_QDpA-laNYnwEScQ/s1600/1441400_10202605902258020_50046595_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsG6zBgMMeYl9dRixbaL7FhzOxjhKNcVdIoj4d1HR_dDIn2IFCzEEKtGWYyCqJ-Hfu1oeDPrtUOkohP2Q9Ryi-kUBAScfvHLhFfmYfODhz-vzah1OAkN4jP9OhHiJj_QDpA-laNYnwEScQ/s320/1441400_10202605902258020_50046595_n.jpg" width="320" /></a></div>
<div>
<br />
<div>
<br /></div>
<div>
Diabetes is expensive. I'd like to rant on that topic for a moment since I believe that the cost of the disease, both personal and systemic, are related to the larger burden on the evidence of proof required for organizations such as the ADA to prioritize the most powerful intervention (a low carb diet) as the standard of care for diabetics. That is a burden.<br />
<br />
Diabetes is physical burden, but the fact that following a low carb or even a ketogenic diet as I have to manage my diabetes is at odds with the established (and failing) convention adds to my mental burden. <br />
<br />
[To reinforce this point on the burden of diabetes, my OmniPod insulin pump just went to the flat-line tone indicating that I need to do an equipment change at this very moment.... break to change Pod]. </div>
<div>
<br /></div>
<div>
...And I'm back. Diabetes can definitely interrupt your life, but it can also suck you dry. Even with the best insurance I could afford, I just paid $250 for 3 months worth of test strips and another $100 for 50 days worth of insulin. That's on top of the $400 for a 3 month supply of the actual insulin pump's pods need that I stick to my body but am required to replace every 80 hours. Then there is the adhesive enhancers, tape, alcohol wipes, lancet needles (which every diabetic should replace more often), batteries. </div>
<div>
<br /></div>
<div>
I don't want to get too distracted by my rant of the personal financial challenge, but I'm as frugal as I can be with my diabetic expenses. Why my insurance doesn't cover more is a topic for another morning, but when you value your health to the same degree as I do, it's easy to justify expenses in your own well being. It's unfortunate that those "medical expenses" take away from the part of my budget dedicated to the intervention that has the greatest positive influence on my health (food), and will reduce my risk of supposedly inevitable diabetic complications. Those complications would then spiral off into new realms of expenses. How much is an open-heart surgery these days? $40,000? A hospitalization for diabetic ketoacidosis, which is a condition where a diabetic can go into a coma as a result of high blood sugar that can happen while following an ADA style diet). I'm sure that stay wouldn't be cheap. In a perfect would, my insurance would be paying 80% of my grocery bill enabling me to source the highest quality food. I know I can eat a lot, and at times I could have expensive taste - but it would be nowhere near the cost to my insurance company of covering the cost of the pharmaceuticals involved with diabetes. This argument is even stronger in the case of type 2 diabetics, which are an rapidly growing group suffering from a disease that can be reversed in most cases with early detection and nutritional intervention. (rant over...for now)</div>
<div>
<br /></div>
<div>
So here I am, a very motivated diabetic... I've figured out how to manage my blood sugar numbers with a precise standard of "tight control" with a nutritional intervention. But because the ADA was on the wrong path regarding their understanding of low-carb intervention, they have been slow to make the announcement that a low carbohydrate diet is an acceptable (excellent in my opinion) for of intervention for weight loss for up to 2 years. </div>
<div>
<br /></div>
<div>
Why 2 years? Because that's how long the 2 year study proves the intervention works. You can assume if the study goes 3 years then the ADA would be able to recommend 3. Sounds reasonable when you are adhering to evidence based standards. That's actually ironic. There was very little evidence supporting the ADA recommended low-fat way of eating. Now there is a burdon of proof to prove that a nutritional intervention works. I have my own anecdotal evidence. I've been diabetic for almost 2 years and I have been able to achieve an A1C of 5.1% which places my blood sugar control below the diabetic range.<br />
<br /></div>
<div>
</div>
<div>
<div class="separator" style="clear: both; text-align: center;">
</div>
My 5.1% is average for an average non-diabetic person. But among type 1 diabetics, my achievement of a 5.1 is a 3 sigma event, which means it's 3 standard deviations from the norm. To brush off your statistics knowledge, 1 standard deviation puts you in the 67th percental. 2 sigma is 97 percent. 3 sigma? 99.9th percentile. That's right, I've won the lottery! What is my prize?... health. I am happy and grateful for my health. Health is a prize and it is worth pursuing. The same health the average American takes for granted, but that's not you, right?<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjOEX6lBhPnXTy7d6wmdD9EqMWVt892z6TYmJnE7qnDhQx-dUy2lW5MXUIfbHqt6n2Ff_B2IZnjMlhJgG9A-SJgin469SgVwpcQWBOnzEmDpZP1j07FhJGRwmyQyfuLNQt0Q77o4WUhavF/s1600/a1c+histogram.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="191" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjOEX6lBhPnXTy7d6wmdD9EqMWVt892z6TYmJnE7qnDhQx-dUy2lW5MXUIfbHqt6n2Ff_B2IZnjMlhJgG9A-SJgin469SgVwpcQWBOnzEmDpZP1j07FhJGRwmyQyfuLNQt0Q77o4WUhavF/s320/a1c+histogram.jpg" width="320" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
I've achieved diabetic control better than 999 out of a 1000 diabetics? In two years? In college I was only a B+ student. In soccer I made it to All-conference, but never All-State, or All-American. In triathlon I was happy to finish in the top 10% of the field. I dedicated decades of my life to those pursuits, why am I so exceptional with diabetes after only 2 years? There are incredibly diligent diabetics out there with years of experience who assuredly care about their health as much as I do. But it's rare to see an A1C under 6%, an in all actuality, most doctors would reprimand a type 1 diabetic for pursing an A1C less than 6 because of the underlying assumption (based on the blood sugar variability typical of a high carb ADA diet), that tight control leads to severe hypoglycemic episodes.... an issue that I am yet to experience. I've never been surprised by a low. Never had a low I couldn't treat myself. So why am I so good? It's not ability. It's not talent. It's simple. It's food. A very low carbohydrate approach should be the first approach. It was for me.</div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
It is my own decision to not wait for the burden of proof. Large organizations like the American Diabetes Association and the American Heart Association are like big ships that take too long to turn around. Diabetes and Heart Disease are icebergs near on the horizon. The ship started turning last year. If that ship is like most medical knowledge it will take another 15 years before those ships end up on a better path. </div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
I'm enjoying this analogy. Consider me man-overboard. I have chosen my own path. Luckily, I am a strong swimmer.</div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
For more information from respected MD's and PhD researchers who are blazing this path well ahead of the curve, please check out the most current research from Feinman et al., in journal Nutrition. This article discusses the unfair burden faced before conventional medicine will fully support and endor</div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<h1 class="articleTitle" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 24px; font-weight: normal; margin: 0px 0px 15px; text-rendering: optimizelegibility;">
<a href="http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/abstract?cc=y">Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base</a></h1>
<div>
</div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
</div>
</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-59421426694214641892014-10-04T19:46:00.001-07:002014-10-05T14:39:04.563-07:00BIG NEWS.My first announcement is in regard to this past year. Only some of you may know that I have become a Nutrition Counseler following my recent diagnosis with type I daibetes. Managing my Type I Diabetes is my first job, and now teaching others how to avoid continuing onto the path of Type 2 is my new job. I deal with patients with other health issues as well, but it's shocking the high and ever increasing fraction of people who are heading that way! And the damned thing is, that this epidemic is due to previous nutritional advice to avoid saturated fat, eat whole grains, and consuming sugar is harmless. ALL THREE OF THOSE STATEMENTS ARE FALSE! We have all become sicker as a result. I am so happy to be able to sit down and work with people on how to reverse this. Prior to my diagnosis, I never would have guessed how wrong the conventional wisdom regarding nutrition actually was! Seriously, this health issue affects nearly everybody. I'd hate to see my friends miss out on the benefits that I have learned. You are my friends (and family). I care about your health. Consider this my Public Service Announcement - for my friends.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjp-fPSON6shEQlanHz0JxyH4n1eof3HWTji0E1QW0xF2zfIhuhmjpaPVJbFm0-MZHJEAkX0jvHpSydi2misI-7Y4tzvxHkFJjMUN5IjgvWlM-nzWaVgzGEQUM7r5KEVMqUbpp8t2XsCdGe/s1600/RidingOnInsulin1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjp-fPSON6shEQlanHz0JxyH4n1eof3HWTji0E1QW0xF2zfIhuhmjpaPVJbFm0-MZHJEAkX0jvHpSydi2misI-7Y4tzvxHkFJjMUN5IjgvWlM-nzWaVgzGEQUM7r5KEVMqUbpp8t2XsCdGe/s1600/RidingOnInsulin1.jpg" height="169" width="320" /></a></div>
<br />
<br />
So with that important announcement out there, onto my second BIGGER announcement. (Again, some of you may already know). But next year I will be participating in my 5th Ironman triathlon - and my second since diagnosis with Type I Diabetes. On September 13, 2015 I will race Ironman Wisconsin and FUNDRAISING for a nonprofit called RIDING ON INSULIN. I will have 38 other teammates with type 1 diabetes along with a few others who are closely connection to the diabetes world (parents, family, friends - members we consider "Type Threes"). To learn more about it go to www.ridingoninsulin.org/ironman. Funds raised will help kids with type 1 diabetes go to camp.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgh6nZhXFVHLDJXYE0Q5A6HKIPOW7QoQoh0td9WK-xW_mT00J9lWm8VORMcx-HuW6gR0KW-QmXrQaOfQjZC_gYz48DA2PkgElxu9hnsFkFVHbjyQkWYW_COfN8-gp-8QuzW4B5XF-bfw12f/s1600/_1500_wedge___2006_by_wheelgenius-d41v8bt.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgh6nZhXFVHLDJXYE0Q5A6HKIPOW7QoQoh0td9WK-xW_mT00J9lWm8VORMcx-HuW6gR0KW-QmXrQaOfQjZC_gYz48DA2PkgElxu9hnsFkFVHbjyQkWYW_COfN8-gp-8QuzW4B5XF-bfw12f/s1600/_1500_wedge___2006_by_wheelgenius-d41v8bt.png" height="200" width="86" /></a>My FUNDRAISING GOAL is $1500 as soon as possible! I'm not dragging this fundraising thing out to keep pestering people, $1500 between the number of caring friends I have out there should be achievable. I'm asking my closest friends to donate $100 (minimum), especially you Epic folk. As for those of you who I only see periodically I'm hoping you'll help to chip away at the total, How's $20 bucks sound? That's enough so that next time I see you in person you don't have to uncomfortably avoid eye contact. And if this message is shared with you through a mutual friend...? $10... $5? Thank you!<br />
<br />
<br />
Donate to my effort here! <a href="https://www.stayclassy.org/fundraise?fcid=334383">https://www.stayclassy.org/fundraise?fcid=334383</a><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSp5hE7-eJLiJAM_sRHeE6fQ-n5aGnUZx8DnmhHt6hBuuR3rK41VoRiheidMOtkJ1bRYGSZ2d_7OGRvhqkLflkx0y_yF5m4vo5WMcv-ZNU6d4jVswyfJS6HXh2lvORQHCbOchJcfVH3aDR/s1600/1402440309.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSp5hE7-eJLiJAM_sRHeE6fQ-n5aGnUZx8DnmhHt6hBuuR3rK41VoRiheidMOtkJ1bRYGSZ2d_7OGRvhqkLflkx0y_yF5m4vo5WMcv-ZNU6d4jVswyfJS6HXh2lvORQHCbOchJcfVH3aDR/s1600/1402440309.jpg" height="86" width="320" /></a></div>
<br />
My PERSONAL GOAL is to demonstrate the advantages of the nutritional advice which I counsel. I'm putting my money where my mouth is. In my first Ironman as a diabetic I finished comfortably in the 13 hour range and fast walked most of the run. My goal for this second effort isn't necessarily to go faster, although there is time to be gained from my walk with Bernice... My goal in 2014 is to repeat my successful blood sugar management. If you read my race report from IMAZ 2013, you'd know I managed to maintain my blood sugar between 70 and 130. Those numbers may not mean much to my non-diabetic friends, but it's damn impressive! My goal here isn't to brag, but most diabetics would be happy to have that level of control on a day where they do nothing. Managing such tight control isn't due to that fact that I'm super smart or gifted, or even necessarily all that athletic. It's simply due to the foods that I use to fuel myself. It's actually quite simple. Coincidentally it tastes delicious. It's admittedly different than from what I thought "normal" food was, but knowing what I know now, even if I wasn't diabetic, I'd choose to continue to eat this way. <br />
<br />
My goal is to share with a much larger diabetic audience, what I have learned that allows me such amazing stability. I'll share it wiith anyone who asks. I have a stable HbA1C of 5.1%, and my other metabolic markers have improved from already good, to better. Of course I'll share this. If this can work for me it can work for anyone. I won't pressure anyone - <u>I know no one like's that guy!</u> I hope to simple demonstrate what I have learned. Everyone should have the option to try this if they'd like - currently it's not even mentioned during treatment! It's not for everyone, but for those interested in athletic endeavors, I'd argue this way of eating provides performance advantages. I do it for health reasons since it's enabled me to manage spectacular control though every event I have done since. For example, while I wasn't incredibly happy with my time at the Big Swell 2.4 mile swim this summer, I entered the water with a blood sugar of 82, and finish the race 1 hour and 14 minutes later with a 90. That was fun!<br />
<br />
So to summarize... Fork it over. It's an excellent cause. I'm not looking to make money here - it's for KIDS for crying out loud!!! I was diagnosed as an adult, but I wouldn't have wanted to be the only diabetic kid at camp, nor would I have wanted to miss out! I know some of you may not like kids... j/k. Seriously, it's for kids, fork it over! $100 close friends, $20 to be spared an awkward next meeting. :)<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9ltvk_kc-k26KZelhbuhhiJ8eJjdjiYz36wz4CUCV0jUPF4UX2wWhn3ffm8HCLRdjC27OPXU0_fqc-nPIL6BHZhJpz_6EcQbTXscldE7qGaS6nRvNHJMig9m3DuwnsGNy0E73oFPGjGgh/s1600/ROI-e1334612917843.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9ltvk_kc-k26KZelhbuhhiJ8eJjdjiYz36wz4CUCV0jUPF4UX2wWhn3ffm8HCLRdjC27OPXU0_fqc-nPIL6BHZhJpz_6EcQbTXscldE7qGaS6nRvNHJMig9m3DuwnsGNy0E73oFPGjGgh/s1600/ROI-e1334612917843.jpg" height="213" width="320" /></a></div>
<br />
<br />
Again, donate here: <a href="https://www.stayclassy.org/fundraise?fcid=334383">https://www.stayclassy.org/fundraise?fcid=334383</a>Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-27023956506068810332014-08-19T22:30:00.000-07:002014-08-20T08:17:02.945-07:00Thumbs up - Crisis is Opportunity.I wrote this post on my Kindle because I can only Swype - but not type right now. I'm a bit new to the device but it's my best option for the simple reason that my right thumb is bandaged up and throbbing. Earlier today while chatting with my girlfriend I promised to start getting my blog back going again and I wanted to hold up that promise - and I hope to return to my blog more frequently.... girlfriend? Yes.<br />
<br />
There has been a lot of change in my life this year. My closest friends know much of the story, but I'm only left to assume most of my friends, of which I am blessed to have many, have been left on there own to figure out where I've disappeared to this year. <br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0IErxl8QTHooKTARNa6xaMsMVcPeQBpgi7NrNlEmnDxq04oI1luO1fxnLDKpCYd8jS54sa_zf1O2v3hnNODsP_nTqFfhtVSBSdma-QBr7fLOSHj7hBDsbUgw5OqGpEDNmkfZEL4TYJzhG/s1600/Chinese_word_for_crisis.svg.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0IErxl8QTHooKTARNa6xaMsMVcPeQBpgi7NrNlEmnDxq04oI1luO1fxnLDKpCYd8jS54sa_zf1O2v3hnNODsP_nTqFfhtVSBSdma-QBr7fLOSHj7hBDsbUgw5OqGpEDNmkfZEL4TYJzhG/s1600/Chinese_word_for_crisis.svg.png" height="400" width="394" /></a></div>
<br />
To put it mildly, this year featured some major challenges for me. Many of those challenges are things which I never would have chosen to experience if I had a choice in the matter. But perhaps the greatest lesson which I have learned is that control of one's own path is an illusion. I've rolled with the punches very well, took a few licks (and while I'm by no means able to claim that all of those experiences are well in my past....) I have emerged, already at this point as a stronger person as a result of those tough experiences. I remember learning (although this fact my not actual be true) that the Chinese symbol for crisis is the same as the symbol for opportunity. Perhaps that's not exactly true and a good reason for me to avoid tattoo parlors, but I believe the concept is sound.<br />
<br />
Since my last post a lot has changed. Honestly even back in February a lot had already changed which I wasn't entirely comfortable publicly admitting, a lot of changes were already in motion. Prime example, I got divorced, which was entirely not something I ever wished for or wanted. Perhaps it's for the best but I am not one to quit, especially not on someone I had promised to love the rest off my life, alas the lesson is that I was not in control of that fate. I tried to delay the process and wait for cooler heads to prevail, but even that effort back fired and further upset my now ex wife to the point that the only conversation I've had with her in the past 6 months was in a court house. <br />
<br />
As if that wasn't shock enough I lost my job at about the same time. That situation turned ugly as well and led to the loss of someone which i had considered to be one of my closest friends. Meanwhile, the only thing I could control (diabetes) was going just fine. I felt selfish putting my health first in the situation, but had I not been selfish with my health, I would have been unable to be at the point at which I now find myself.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC2s2k_3mB1Z9Pb0p6mGKTw8YPfIg4Xx5tVozsPxL7DGQCszn9_mbT_UA7HNQTSJEguxjK1uPXkoheZG8lL7FLmnB13xDsZjwgETMvjZDB_0z9f2BrWpIk0zdza0mfMC74x6bdO24sbZyc/s1600/anxiety-broken-promises-change-depression-Favim.com-723150.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC2s2k_3mB1Z9Pb0p6mGKTw8YPfIg4Xx5tVozsPxL7DGQCszn9_mbT_UA7HNQTSJEguxjK1uPXkoheZG8lL7FLmnB13xDsZjwgETMvjZDB_0z9f2BrWpIk0zdza0mfMC74x6bdO24sbZyc/s1600/anxiety-broken-promises-change-depression-Favim.com-723150.jpg" height="256" width="320" /></a></div>
The combined losses (as well as the subsequent financial damages) led to the opportunity for me to move in with my parents into a mutually beneficial situation. Through serendipitous good fortune I quickly stumbled into a new career path where I now am able to counsel much needed nutritional advice under the guidance of a brilliant Integrative Health M.D.. Living at home has enabled me to reconnect with both of my parents on a new level. While I have experienced loss, that loss has helped me learn to appreciate the important things that remain in my life.<br />
<br />
I spend the early mornings drinking coffee and sharing bacon and eggs with my father. His symptoms from advancing Parkinson's disease are much milder in the mornings. And while he may struggle with the fork, getting out of a chair, or visual aberrations. He's been is sound and his memory remains (for the most part). I'll take what I can get. His fine accepting of my nutritional guidance and has experienced some dramatic improvement when he adheres closely to the plan. He's even had days where he's been back on his bike, rising circles around the neighborhood. Not every day is a good day, but well both take what we can get. As he learns Rio understand what we been working toward, my hope is that his well-being will continue to improve.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGx7IlzbopI9BJEmo4CTIIpTaTKnoqszCl36iqdCJ3_ZQzSF4Xl514JK-SQYcZw3LtrGy2x-cyWIS7tYQCLtpHz7WqO_aAW0zMkaIAX_iNA26yuyMvsT6egZZufL7G7njOpcLq4jJLyKWz/s1600/dad+on+bike.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGx7IlzbopI9BJEmo4CTIIpTaTKnoqszCl36iqdCJ3_ZQzSF4Xl514JK-SQYcZw3LtrGy2x-cyWIS7tYQCLtpHz7WqO_aAW0zMkaIAX_iNA26yuyMvsT6egZZufL7G7njOpcLq4jJLyKWz/s1600/dad+on+bike.jpg" height="180" width="320" /></a></div>
My late mornings are spent in the car, a wonderfully reliable VW Passat. Each direction of my commute is 100 minutes, but I've learned to use that time wisely. I download academic lectures to my iPod, and have explored several new books thanks to Audible, and surveyed a variety of entertaining podcasts available on Stitcher. My commute is through the scenic back roadsand feature farmland, windmills, lakes, the occasional horse pulled buggy, and rolling hills. I arrive to work at 9 am wide awake and relaxed, ready to take on the world.<br />
<br />
Taking on the world describes my work very well. I lucked into a job with a doctor with whom I see very much eye with regarding our nutritional approach to health. For over 30 years he has been marching to his own tune practicing medicine with a standard of care rarely seen. Initial consults last 90 minutes, during which I am part of the conversation. I am learning a level of detail well beyond what I would in a conventional medical practice. Following their meetings with Doc, clients meet with me for several in depth discussions on how to best modify their dietary intake to enable them to heal and/or optimize their health to their greatest potential. I am free to counsel and on all aspect health. My primary focus is nutrition, but the best part of the Integrative/ Functional health approach is the view of the body as a system. Already I am seeing massive improvement in their health whether it's qualified in pounds lost, improvements in bio markers, or simply improvements in mindset and energy with which they can approach each day.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.watershealthcenter.com/"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuj-vFMOuPpqtwsg396SiKXerpp9j08FLicJBMMtV1qfGzt3gyKgPJFLh7zyYDsr-ovmjfQdCyYQLnjsRENonpQt2OivxZBC4pBazSVgFkSbZ-ozYrxZ4D2J1oDgbFWTN31SDzdsjj5GD7/s1600/1375294452.png" height="73" width="640" /></a></div>
While conventional medicine focuses on the narrow specialties and sub specialties, the functional approach looks at the bigger picture resulting from the interactions of the each of these specialities. It's easy to argue that conventional medicine is far superior with urgent care and trauma, but the functional approach excels with complex cases where symptoms affect multiple organ systems. Functional medicine also excels with its ability to proactively address preventative health. I get to spend multiple hours establishing a relationship with each unique members and coaching them towards new behaviors that can have very powerful long term influences improving the long term quality of life as well as their ability to continue to perform both physically and mentally.<br />
<br />
Each day I met exceptional individuals and am openly humbled by their personal stories of struggle and their intinct to fighting for their health above and beyond a point where the establishment has given up on them. Issues range from chronic fatigue, Adrenal fatigue and/or failure, Lyme, auto immune disease and all to often, cardio vascular disease and metabolic syndrome. Every day I'm learning. As a smaller clinicc we are adaptable and able to explore new fields of opportunity to best serve the health needs of our clients. I was educated in the conventional method as a scientist and biochemistry researcher, only to now witness the advantages of a more individually tailored and personal approach to health and medicine.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi33kIkYM_MnEMJQIjuymsv5ltcTThGiV95n-yz1qxyXx1yeqFETOc8XNu6D_u6XcFwE-pVkGL5VGBKKk4vZJGUpQmqE4iBPn2t4crvfx2QIwbvxjjfzULNHZExs3RKsYNfhAP6e3T-pHhb/s1600/Quotation-Jean-Vanier-weakness-growth-Meetville-Quotes-185458.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi33kIkYM_MnEMJQIjuymsv5ltcTThGiV95n-yz1qxyXx1yeqFETOc8XNu6D_u6XcFwE-pVkGL5VGBKKk4vZJGUpQmqE4iBPn2t4crvfx2QIwbvxjjfzULNHZExs3RKsYNfhAP6e3T-pHhb/s1600/Quotation-Jean-Vanier-weakness-growth-Meetville-Quotes-185458.jpg" height="218" width="320" /></a></div>
Every night I settle in front of a stack of reading which can range from the latest findings from PubMed, or the numerous books published by other functional medicine practitioners eagerly share they wisdom, or even a variety of cookbooks through which I search for nutrient dense yet approachable meals that may best suit each of my unique clients needs. I have been enjoying the process immensely.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUsv3Jvw9mHPn6p5_l35efXSN3FXHkQjrAuj8pWS03XIjekQEsbQ_UcL3kg3dS85kb6tnl9x7SplCnR5gAUFq7CM4TdCjsOq_AUi3q02uLW2qnxssqtJ6fvibohmaXg3HDNw2BNH-Rh_-4/s1600/grit.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUsv3Jvw9mHPn6p5_l35efXSN3FXHkQjrAuj8pWS03XIjekQEsbQ_UcL3kg3dS85kb6tnl9x7SplCnR5gAUFq7CM4TdCjsOq_AUi3q02uLW2qnxssqtJ6fvibohmaXg3HDNw2BNH-Rh_-4/s1600/grit.jpg" height="121" width="400" /></a></div>
I have found very little time for unimportant activities such as tv and movies, or the tv news. I have learned to utilize Facebook s a powerful social networking tool which allows me to connect with other Type 1 diabetics interest ed in obtaining the same level is tight blood sugar control for either themselves or their T1D children. I catch what I can of the news through NPR podcasts on my ride home, but try not to stress my mind with problems over which I have little to no control. I leave it to my mother to keep me abreast of any of the worlds problems, the score of the brewer game and the weather report as I prepare our evening meal together. She has been coming around to change her food habits since experiencing significant improvement in her blood sugar control and losing nearly 20lbs through eating as much (of the right food) as she cares to eat, including copious amounts of butter. She still enjoys a slice of gluten free udi bread periodically but has come to her own realization that she has better energy, less digestive issues, greatly reduced joint pain from her rheumatoid arthritis and the elimination of her for neuropathy by eating gluten free, greatly reducing the processed food and significantly reducing her carbohydrate intake. 20 years she's been a type 2 diabetic and I'm the first person to discuss the effects of carbohydrates with her. I try not to let that fact upset me, but we all are a little extra protective of our mothers..especially a mothers but such as myself living with my parents at the tender age of 35. I'd like to see her doing even better than she currently is, but shed likely say the same about me.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_nCeOK4KJbfSHs1M3z3hyphenhyphenLRiQmHmxU-EPS4r-McMO9xW-MVHH8JSTx9NxqxXgcb1sNg-erWOodPUIga45ENAPGxnqBidQOvGGMZlw7oukABGepUCxC4TQ1uU_13vfvBs7_PJ3cdloWi1n/s1600/mom+and+me.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_nCeOK4KJbfSHs1M3z3hyphenhyphenLRiQmHmxU-EPS4r-McMO9xW-MVHH8JSTx9NxqxXgcb1sNg-erWOodPUIga45ENAPGxnqBidQOvGGMZlw7oukABGepUCxC4TQ1uU_13vfvBs7_PJ3cdloWi1n/s1600/mom+and+me.jpg" height="180" width="320" /></a></div>
I've enjoyed my return home. These will be my last few days living with my parents full time. I've signed a lease in the Warner Park area of Madison which cuts my daily commute roughly in half, although I'll still be spending nearly 2 hours a day in the passat. I'll be living with a close personal friend who is fully on board with the type of healthy life I aim to live. We each bring our unique experiences to our budding roommate relationship. Neither of use enjoy living alone. We are both social creatures. He's a friend who was there for me through my crises/opportunities. We are both excited about our future impacts on health. As a bonus, he is also trained as a nurse and capable of providing excellent care should I experience any unforeseen diabetes related issues. Plus he'll teach me organic gardening and martial arts skills in exchange for lessons on bicycle repair and carpentry.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizir4zkoHjW-3E8IdLkk0IYzcywlSwrOwFNWcTdm8TK0vQJ2WnnudwDNDeP47PGDR99AGwWvTOsp9faLXgzyP3GggpVezyZOjFbg0sox_x4tTz3JAlOAzt1wQ8hhMGyzgtsiAZlMSxelGR/s1600/megan+and+me.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizir4zkoHjW-3E8IdLkk0IYzcywlSwrOwFNWcTdm8TK0vQJ2WnnudwDNDeP47PGDR99AGwWvTOsp9faLXgzyP3GggpVezyZOjFbg0sox_x4tTz3JAlOAzt1wQ8hhMGyzgtsiAZlMSxelGR/s1600/megan+and+me.jpg" height="180" width="320" /></a></div>
Living in Madison also provides another great opportunity. I can work on building a stronger relationship with my new girlfriend, Megan. She is very understanding of my emotional experiences of the post. She is supportive, compassionate, gentle, yet strong and has the most genuine smile. I'm not one to blindly rush into a relationship. My past wounds admittedly still sting. She had been incredibly understanding of those circumstances. As you can figure out from the nature and breadth of this post, I'm one to wear my emotions on my sleeve, I accept the dangers of being hurt again, of which uses feel the risks are relatively low. But I'm not going to hide from the risk of failure and miss an opportunity to enjoy a relationship with someone who has to this point only made me a better person all while accepting me for who I am despite my flaws. I'm not perfect. I make mistakes too....<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_kPvC3UABD3WT9Q1seOen0XWFxQ4wBs7o2FzLu_vEZFxROHcPoCmpFSFonCY7jOOd4-slHTR7OHGoxqUFYRB63VZJJS61wuqsW4N_WwdeDrOIffiJCMNkJoFmhKbBwA3pHYuN35a8bGs8/s1600/thumb.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_kPvC3UABD3WT9Q1seOen0XWFxQ4wBs7o2FzLu_vEZFxROHcPoCmpFSFonCY7jOOd4-slHTR7OHGoxqUFYRB63VZJJS61wuqsW4N_WwdeDrOIffiJCMNkJoFmhKbBwA3pHYuN35a8bGs8/s1600/thumb.jpg" height="400" width="225" /></a></div>
Speaking of, I probably have numerous typos and humorous and/or confusing auto corrects in this ever rambling blog. Earlier this evening I lopped off a good sized piece of skin from my thumb while excitedly slicing my gigantic Kolrabi which I just harvested from my garden. Just in time to have to move a bunch of boxes and build a lift for my bed in the new apartment. Perhaps this is an opportunity to lean to be more ambidextrous.<br />
<br />
<br />
<br />
post-script: I'm including a link to my latest adventure and likely the topic of many of my upcoming posts. I am raising funds for the organization "Riding On Insulin". I signed up to join nearly 50 other Type 1 diabetics competing together at Ironman Wisconsin 2015. My goal is to raise $1500 by the end of September.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKtqonIv0kLUajWO3QnMjt8bF4mbVCZKjGh7kGD6_Q0pnDdhkOWxGsp8eQOHJZz-Dgk6ThBssvEFowyAAmZJ6GuK6FRTPEYexEznnDdQ6h6vB_gK0DKQU4cz9cgKB-7vNvYDcLulr4AcW8/s1600/1402440309.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKtqonIv0kLUajWO3QnMjt8bF4mbVCZKjGh7kGD6_Q0pnDdhkOWxGsp8eQOHJZz-Dgk6ThBssvEFowyAAmZJ6GuK6FRTPEYexEznnDdQ6h6vB_gK0DKQU4cz9cgKB-7vNvYDcLulr4AcW8/s1600/1402440309.jpg" height="86" width="320" /></a></div>
<br />
<div class="" style="clear: both; text-align: center;">
<a href="https://www.stayclassy.org/fundraise?fcid=334383">Donate Here.</a></div>
<br />
<!-- Blogger automated replacement: "https://images-blogger-opensocial.googleusercontent.com/gadgets/proxy?url=http%3A%2F%2F4.bp.blogspot.com%2F-lFF8c0XYXIw%2FU_S7ayTjvZI%2FAAAAAAAAD08%2FTuOtMO1rENY%2Fs1600%2F1402440309.jpg&container=blogger&gadget=a&rewriteMime=image%2F*" with "https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKtqonIv0kLUajWO3QnMjt8bF4mbVCZKjGh7kGD6_Q0pnDdhkOWxGsp8eQOHJZz-Dgk6ThBssvEFowyAAmZJ6GuK6FRTPEYexEznnDdQ6h6vB_gK0DKQU4cz9cgKB-7vNvYDcLulr4AcW8/s1600/1402440309.jpg" -->Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-82732728218052473422014-02-28T13:59:00.003-08:002014-02-28T13:59:39.723-08:00Gluten cross-reactivity testing.Here's my vent for the day. Even with all the right things that I do, things still get messed up sometimes. I know I have food sensitivities - a few that I haven't yet figured out. I'd like to know for sure if I need to give up coffee, same for dairy. My life would be much cheerier with both :). Whose wouldn't?!<br />
<br />
I work in a Integrative health center and was going to get a food antibody test done (gluten cross reactivity assay...Cyrex Assays 2 & 4). I know I have issues with gluten already (not celiac, but definitely not tolerant). I read that if I don't eat gluten for the test it would likely report a false negative. So I ate gluten yesterday, but then was too busy at work to get the blood lab done. And I felt fine yesterday, but today I feel rather crappy and my insulin requirements have doubled and I'm getting bloated, achy and stuffy nose.<br />
<br />
Sucks that I have to actually do something bad to myself to test these things out. Maybe it's best that I have more time between my gluten exposure and the test. Maybe that will allow more time for my body to produce the antibodies that the test is looking for. Looking for the silver lining.<br />
<br />
I'm still managing to keep my BGs around 120mg/dL, but that's rather high for me. I feel much better at 80 - but again, that's just me.Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-85514247442499533572014-01-22T19:55:00.000-08:002014-01-22T19:57:07.446-08:00Endurance training meets Integrative Health<div style="color: #222222; font-family: arial; font-size: small;">
<span style="background-color: white;"><a href="http://www.cbc.ca/player/News/TV+Shows/The+National/ID/2430858170/">Less is more for elite athletes and cancer patients</a></span></div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
The above link should take you to a 5 minute video on cancer and improved recovery with targeted aerobic exercise. The 'zone' they discuss is optimum to train in is based on blood lactate accumulation vs clearance rates as measured in the blood while exercising at progressively increasing rates of work.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
Warning. There is a full minute worth of commercials before the video.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
Lactate testing and aerobic metabolic testing are the aspects of endurance training that I enjoyed studying the most as a coach. I haven't been able to get my hands on that type of equipment. We used an alternative protocol to successfully estimate those same zones without the blood testing. I think being able to do the full testing like in the video would be very interesting.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
An athlete could use the Respiratory Quotient (RQ) to calculate what fuels were being used at particular rates of work. Makes for great targeted training, but more importantly, from the ratio of CO2 v O2 exhaled you can tell whether fat or carbs are being burned. It's an insight into the metabolic state of the mitochondria.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
I had a test like this done on me in Vancouver before my diabetes diagnosis. It showed that despite my massive cycling endurance, I was a heavy carb burner, even at low efforts - over time (like several hours) I'd bet I had be getting into fat burning, but I only did metabolic tests lasting for 15 minutes or so. The maximum exertion tests are not very fun. Suffocating. Reaching maximum effort on a automated ramped protocol where the resistance increases by 30 watts every minute while cycling. While breathing through a tube. </div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
So why do I want to have this tested again? I bet I would see a massive downward shift in my respiratory quotient. Ketones burn even cleaner than fats so I'd predict that my RQ would be significantly lower for each level of increasing work.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
For training and racing I can use this info to figure out what fuels were being burned during an event so that I know what fuels (protein, fat, carbs..) to replace to optimize performance. The ratios of the fuels depends on the level of exertion for the intensity of each event. Athletes train for events of a variety of distances, therefore each event will have a different fueling plan. I'd also be curious to figure out basal metabolic rates by monitoring respiration at complete rest. With that information there would be a more complete picture as to the total daily energy expenditure. </div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
That number could be used to figure out the amount of fuel (calories) that needs to be replaced. While I'm not a believer in the classical calorie in, calorie out philosophy I believe that the amount of energy obtained form each fuel source, whether it's from protein, carbohydrate or fat is variable depending on the state of the metabolism. Variable to a particular individual at a particular state of health.</div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
Beyond athletic performance, what these numbers really are a look into is the metabolic health and efficiency of the mitochondria. Mitochondria are everything for health! I cannot emphasize that enough. They are our energy producing furnaces, treating them poorly can be a factor in nearly every chronic modern disease, especially those affecting the brain. </div>
<div style="color: #222222; font-family: arial; font-size: small;">
<br /></div>
<div style="color: #222222; font-family: arial; font-size: small;">
The shit of it all is that when something is affecting your brain, rarely are you able to notice it until it is too late. Having a measure of your mitochondrial efficiency is likely an insight into your overall health and vigor (endurance).</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-9944950013230513582013-12-24T21:53:00.000-08:002013-12-24T21:53:00.325-08:00Favorite Christmas memories.Patches.<br />
<br />
I remember coming home from the school bus and decorating the pine trees in the front yard with lights. Walking circles around the trees, using a pole I devised with a wire hook to hold the string and reach an extra 10 feet. These trees were probably 20-25ft tall so I also got to play around and learn how to safely lean a ladder on a tree, while on a hill. One year Dad got extra into the decorating with me and suggested we do the 40 ft pine tree. Man that took forever! A 30 ft extension ladder, my lanky frame reaching with a pole, barely getting the top, and then figuring out how to circle around. It was so much work coming down each time and moving the ladder! At one point I remember balancing on the ladder, and then our cat Patches climbed the ladder and jumped on my shoulder while I'm trying to work. That cat had serious skills.<br />
<br />
Giant snow mouse.<br />
<br />
When I was a little kid I loved the mouse Fievel from American Tail. Pretty cool character back then. So what. I also liked seagulls, my teddy bear and a stuffed puppy. You got a problem with that? Didn't think so.<br />
<br />
Somehow this fondness for Fievel manifest into building a 12 foot tall snow Fievel in our front yard. What would you have made if your goal was to make something 12 feet tall?<br />
<br />
Certain ornaments and decorations.<br />
<br />
I admit I'm a sucker here too. There was a white porcelain figurine that wound up and spun slowly as it played Silent Night. My favorite Christmas Song.<br />
<br />
As for ornaments, I didn't know the full story behind most of them but as the 5th and youngest child in a family with a 20 year head start before I entered the equation, there were a lot of odd shaped ornaments. Now most people would consider them gaudy, but several were hand made. Nothing really matched but all came with a story.<br />
<br />
The Living Room.<br />
<br />
We had so many gift opening in that same living room, but it was great that I can remember so many of my family members fitting into the seats and couches. With a big family and some very generous parents the room was always knee deep in presents. I was seriously spoiled, but both of my parents really enjoyed giving gifts.<br />
<br />
Extended family cameos.<br />
<br />
Not that I have a cousin Eddy (Christmas Vacation movie reference), but Uncle Bob would make a pretty solid substitute. Many of these relatives wouldn't be seen that often, especially now with everyone either getting older or just spreading their own way, but both of my parents have 5 siblings as well so there was always a fairly large extended family on these occasions. <br />
<br />
Aunt Rosies cherry cheesecake.<br />
<br />
As a kid I didn't like cherries, but this was an exception. This treat was always at my Dad's brother Randy's and Aunt Rosie's party. Randy could always be counted on to provide the punch with sherbert. I don't think our punch ever got spiked, but my cousin Steve will never outlive his puking in the chex-mix after consuming too many whiskey-balls (cookies).<br />
<br />
Wooded Hills luminary display.<br />
<br />
After church we always took our time to driving the entire subdivision display of streets and drive ways lined with candles burning inside of white paper bags. This is also when Santa would time his arrival at our house.<br />
<br />
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-55297623687869504252013-12-16T19:56:00.000-08:002013-12-16T20:17:31.948-08:00No one is perfect. Mistakes are part of the learning process.Well I wouldn't be honest if I all I wrote about were my successes. So here's a little bad news, just to remind me not to make that mistake again.<br />
<br />
I've slipped up on my diet before. To remain in nutritional ketosis it's usually recommended to consumer fewer than 50 grams of carbohydrates per day. This value varies depending on the individual, the amount of exercise done during a day and excess protein certainly has an effect on this as well. I learned to not overindulge with protein earlier this Spring after an all-you-can (but probably shouldn't) meal at Samba Brazilian Grill. <br />
<br />
Six weeks prior to IMAZ I got into a bag of Halloween treats, but that was a rather minor slip-up. This time my slip up was more agregeous. I found myself on the UW campus near the lab where I used to work. That lab just happens to be across from the Babcock Dairy Store. <br />
<br />
For a variety of reasons, the primary one being that I am human and prone to mistakes and poor judgments - but there are a few others that I won't get into now - I'll just say that it's been the most stress filled week of my life and leave it at that for now. But for a variety of reasons I slipped. Slipped and fell face first into a bucket of Chocolate Peanut Butter Ice-cream. This used to be treat I would indulge in a couple of times per week. Triple scoops on my lunch breaks after a nice swim workout - Michael Phelps style! (I didn't know better at the time - it's not like it ever made me feel sick).<br />
<br />
So I walked in, bought a half gallon and by the middle of the next day I ate the whole damn thing. It was like crack to me, I knew better, but you know what? - I didn't care. I tried to cover the massive amount of sugar with the right amount of insulin - which was probably more than I use in a normal week. <br />
<br />
My numbers only peaked in the mid-200's. For me that's unbelievably high. The last time I had numbers that high was in February when my my insulin had expired while and I was sick - well before my foray into ketosis. Blood glucose in the mid 200's is bad, but not hospital bad or anything. I'm actually curious whether I'm still at as high of a risk of DKA, seeing as my body and brain are able to use ketones I doubt they would build up high enough to cause acidosis. The one blood ketone test I did actually showed my ketones to be very low at 0.3mM. <br />
Knowing that I've made similar mistakes in the past I adjusted my basal insulin to a higher level and eventually I've stabilized. But wow! It's amazing how long lasting the metabolic changes from that one day of gluttony last.<br />
<br />
For the entire week my basal insulin level has been increased from 0.3U/hr all the way up to 2.0U/hr. On top of that I also need to increase the amount of insulin to bolus and cover meal-time carbs. Suddenly I'm quite insulin resistant. I knew this is what would happen. <br />
<br />
Like any mistake it is a learning experience. These are the same adjustments that I would need to make if I ever come down with the flu. Side note: I haven't been sick at all this year. Although doing this during flu season might have been reckless as this leaves my immune system impaired.<br />
<br />
Other negative results of this: poor sleep, goobery eyes when I wake up, headaches, lethargy, inability to concentrate (compared to the great focus I have while solidly in ketosis - but still doing better than before my diagnosis), I think I even have some funky body odor, an increase in ear wax (sexy, right?!), cramping in my calves and feet, aching joints, neuropathy in my arms where they arm numb/asleep when I wake up - which I also experienced a lot of pre-diagnosis, , nerve pain in my feet while working in the cold - another symptom I remember experiencing as far back as 2011, and my appetite was rampant! One week later and I'm 15 lbs heavier, from 215 lbs all the way to 230 lbs - talk about inflammation!<br />
<br />
But I'm not going to dwell on this mistake. Like I said, it was a hell of a week. I'll definitely learn from it. As a result of the lethargy and instability (and the damn cold weather) I hadn't been exercising very much, I imagine exercise would have mediated some of those negative effect. I'm back on track now.<br />
<br />
Did some yoga yesterday (inflammation has had a negative effect on my flexibility), and got in an hour long swim today. The swim actually felt very good. My goal will be to swim as often as possible as swimming seems to have the greatest positive influence of reducing my insulin requirements back to where they should be. It will likely take me another 2 or 3 weeks to get my basal insulin level back down to below 0.8U/hr - hopefully all the way back to 0.3U/hr - we'll see. This will be a good test for how well swimming actually will work for that. Plus it will give me something to focus on during the holidays. <br />
<br />
One thing is for sure - I won't be tempted to indulge in any more sweets and treats. Lesson learned.Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-91270850504101283132013-11-23T09:25:00.001-08:002013-12-04T06:10:44.519-08:00Race Report Follow-up: What about Bernice?Seems like everyone enjoyed the cliff hanger to my race report. So lets get back to Bernice. <br />
<br />
When we parted ways I left Bernice with my bib number in hopes that we'd be able to connect in some way. I assumed she wasn't on Facebook so with a bib number she'd be able to track down my full name. I'm pretty easy to find in google due to the unique spelling of my first name (thanks parents!).<br />
<br />
Bernice's story was a bit of a cliff hanger to me as well. A large part of me hoped to stick around until midnight and catch her finish. However, the reality was that asking Michael and Merri had a dog at home that needed to be let out and my Vancouver friends who had finished hours earlier than me needed to leave. I learned that they had to be back to the race site early the next morning. Victoria had placed 2nd in her age-group and could not miss the podium ceremony, nor did she want to miss her opportunity to sign up for Kona.<br />
<br />
As I left the race site, I saw that she had actually sped up a bit - probably running a few sections. This left her with a good cushion. As I got home after a long drive I was able to confirm that she had indeed finished her race! She finished in 16:35 with 25 minutes to spare. Her marathon pace was a steady 15:45 per mile. 25 minutes to spare! That's a difference of less than one minute per mile over the distance. <br />
<br />
A couple of days following the race I was contact via email by Bernice's daughter, who eventually got my email address to Bernice. On the Tuesday evening following the race I received one of the greatest emails I've ever read:<br />
<br />
-----------------------------------------------------------------------------------------------<br />
<br />
<span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">Hello Kory!!!!</span><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">Thrilled I got your email. I have a debit of gratitude to give to you. I've been telling everyone that I had a guardian angel with me for 13 miles of the run. How you kept me focused on the positive when the pain kept clouding my focus. How kind and gentle you were with me... How we did a mile of quiet (well most of it I kept) in dedication to your friend. How you calculated my time of arrival to the finish line. On and on and on.</span><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">I am a FIRM believer that when the " student is ready the teacher arrives" I have many examples in my life of the "teacher". I'm not sure I would have crossed the line before midnight with our your help. I trained real hard to succeed and help me accomplish that personal goal. By the way I took your last bit of advise, drank the flat coke and my stomach nausea left!!!....</span><div>
<br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">...One last thing my daughter Courtney is friends with one of your friends, Mike McLean....she said he's a great guy. Isn't it a small world?</span><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">How was your finish???</span><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;" /><span style="background-color: white; font-family: arial, verdana, helvetica, sans-serif;">Bernice</span><br style="background-color: white; font-family: arial, verdana, helvetica, sans-serif; font-size: 12px;" /><br />
------------------------------------------------------------------------------------------------<br />
<br />
Too read this words made my heart swell. The gratitude goes both ways between us. I am grateful to have had someone to keep me company. I was honored to have been able to do what I loved most during the race. While I easily could have become frustrated that I wasn't 'racing', I was doing something that I enjoy even more. I was coaching! To be able to coach someone from within a race is an experience that I will never forget - especially a first timer. I remember the joy of my first finish, there is nothing to compare it to. I am honored to have been a part of her day.<br />
<br />
I hadn't thought to ask if there was any chance Bernice knew Mike McLean, although I knew they both resided in St. Louis. To bring this story full circle you can read back to my November 16th Diabetes Awareness Post. When I was diagnosed with Type I, I was riding in a fundraiser for Mike's non-profit, L.I.F.E. My emergency identification tag that I wore during the Ironman Arizona and nearly every day since diagnosis is an orange L.I.F.E. bracelet. <br />
<br />
While I was doing my best to motivate Bernice during her race - I was silently remembering words spoken by Mike's brother Eric in his last interview posted before his passing. Eric's courage and strength have been my inspiration for a while now, and he's bravery will continue to inspire. www.givetolife.org</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-50395117354043093062013-11-22T22:29:00.001-08:002013-12-04T06:10:44.513-08:00My 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.<br />
<br />
There are two types of participants at an Ironman: Those who are racing the clock and those whose goal is to finish.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
Here's the back story:<br />
<br />
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. <br />
<br />
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.<br />
<br />
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. <br />
<br />
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).<br />
<br />
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. <br />
<br />
To the training:<br />
<br />
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. <br />
<br />
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.<br />
<br />
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. <br />
<br />
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.<br />
<br />
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. <br />
<br />
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. <br />
<br />
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.<br />
<br />
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. <br />
<br />
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. <br />
<br />
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.<br />
<br />
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.<br />
<br />
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. <br />
<br />
Now for the actual race report I'll have you continue to Part Two.Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-6600859329583199662013-11-22T22:29:00.000-08:002013-12-04T06:10:44.516-08:00My Ironman Arizona 2013 Race Report - PART TWOI'll finally get to the race report part. I couldn't do the telling of my race justice if I hadn't included the prior post, but hopefully this part will be more entertaining.<br />
<br />
Remember back to Part One where I described the difference in participants. Normally when I'm racing I'm focused narrowly on the clock, I've never stopped at special needs, I've only briefly stopped to hug my mother during my first Ironman. I usually finish in the low 11 or high 10 hour range. I feel my potential is to finish in the low 10 hour range - of course that was before diabetes. I'm starting all over now.<br />
<br />
My goal for this race was set a baseline. I need to prove to myself that my choice to pursue a ketogenic diet was not a mistake. My priorities on blood sugar management out ranked any interest I had in a fast time. I am an endurance athlete for my health. I'm not going to harm myself in the process of racing - it just doesn't make sense. Previously I enjoyed pushing myself to the limit, although I never found a limit, I really don't want to find one now. My goal was to finish comfortably and conservatively. Conservative means smart and safe. <br />
<br />
It was a lot of extra work setting up for this Ironman compared to previous efforts. I'm an OmniPod Insulin Pump user. I stashed extra pods, insulin, emergency glucose tablets and testing supplies in each special needs bag, as well as specific supplies for each transition bag. I had to write out the plan several times. I had a program built into my control unit for my insulin pump. <br />
<br />
I had to fine tune my insulin levels for the event. I knew the pattern it would follow, but found it interesting that my swim focus taper was doing wonders for increasing my insulin sensitivity. This is a great sign for overall health and my blood sugar for the entire week was amazingly stable and my diet was delicious but also perfectly balance with my goals - even with the travel. It was interesting trying to get my Wholly Guacamole past TSA in Chicago, but I managed. The downside of the increased insulin sensitivity was that if I didn't adjust my plan, the insulin levels that had been successful in the workouts leading up to the event may now be too high, which could cause my blood sugar to go dangerously low during the event. Things needed to be tested again. <br />
<br />
The Friday before the race I did a 30 minute swim the rates that worked the week before. I started the swim with my BG in the 90s and I tested post swim on the pool-side and it said 56! Ah, that was only 30 minutes - Warning Danger!! But then I realized something. I felt 100 percent fine. When I entered the locker room and dried off and tested again. 73. Phew. The culprit was wet fingers. The moisture on my figures pool-side had diluted my blood and caused an inaccurate reading. 73 was still lower than I'd hoped so I made two decisions. I was going to reduce my insulin a full one hour before the race rather than just 30 minutes, and instead of lowering it to 0.15U/hr I would err on the side of safety and set it to 0.1U/hr.<br />
<br />
As for the rest of my insulin program I figured out that instead of setting up a Temp Basal program - which limits me to setting only one flat level for up to 12 hours I would personally build a basal program specific for the day. My fear was that if a Temp Basal expired after 12 hours, my insulin flow rate would default to a level higher than what I'd handle. Smart choice. I also set that base level to 0.05. The plan was to turn it back up to 0.1 for the run, but I enjoyed the safety of knowing that if things took longer than planned my pump would default to a safer low rate.<br />
<br />
The night before the race I felt the best I've felt all year. It had been so much fun to visit with my godmother and to catch-up with my UBC Tri Club friends. It's been a challenging year and it was a gift to be able to spend this week with such wonderful people. <br />
<br />
Before bed I took a nice bath in epsom salts and was asleep by 9pm. The alarm was set for 3:30 am - I didn't want to rush in the morning. I was awoken randomly around midnight by an Amber Alert of all things on my phone, but eventually fell back asleep. The brief midnight wakeup was good for one thing. I used it as an opportunity to turn on the basal insulin program that I mentioned above.<br />
<br />
I woke up before my alarm at 3am feeling wide awake and ready for the day. I tip toed to the kitchen and made my breakfast of 4 eggs and 1/2 an avocado, gathered my special needs bags. I ingested a little carbohydrate in the form of half of a serving of Generation UCAN, applied sunscreen, taped up my nipples, donned my timing chip and pinned it in place for safety. Everything on my morning checklist was addressed and I had time to spare. Merri had woken up to send me off - she's a very calming presence that I will forever be grateful for. I even had time to do 10 minutes of yoga while I waited for Brendan, Winston and Victoria to pick me up.<br />
<br />
Once on the race site I had lots of time to drop off my special needs bags, attach my garmin to the bike and check everything over. Nice and relaxed. I made the realization that I had to wait until 6am until I could put my insulin controller unit into my T1 bag. Again this was a bit of an audible, but I figured I'd wait until my hands were drier in transition before testing my BG out of the water - but the important realization that I made was that I still needed to be in proximity of the unit at 6am while the program sent the signal to change from my overnight 0.25U/hr setting to my swim setting of 0.1U/hr. Once that was done I felt much better. I still used the monitor I affixed with velcro onto my bike's stem to double check my blood sugar. It was a reasonable 114 - just a little bump from that UCAN I consumed at 3:45am.<br />
<br />
I found Winston near the dry clothes bags and we walked to where the line would form to get to the swim start. There we found Brendan lined up with the pros. Victoria was apparently a few feet away but neither of us found her. She had her game face on so it's probably best she be left to focus anyways. It was fun to see Brendan off with the Pro Start. Once it came to Winston and my turn we were probably two of the first 20 people in the water. I love swim starts, especially when I find people who enjoy getting in early with me. We sang the anthem and joked around. I didn't even pick on Winston for probably not knowing the words.<br />
<br />
I lined up for the start a bit more aggressively than I planned. I had planned a 1:15, but since swimming has been going so well, combined with the narrow and overcrowded course I decided it would be better to start up front and go a bit faster. The 1:15 crowd is usually a cat-fight complete with finger nails. Once the cannon fired it was pretty easy. Still crowded considering I was swimming with 3000 people, but I eventually settled in on a manageable pace. Nothing eventful. It's and out and back. The out portion is directly into the sunrise but we were blessed with low clouds blocking the sun. Plus I found a guy who was a right breather (I breath left). We used one another to set a straight course just 10 yards off the buoy line. I thought we were friends, but at about the 15 minute mark when someone squeezed me on my right my friend had no problem clobbering me in the face for a few strokes as I crowded into him. I can take a punch, no harm done.<br />
<br />
The water temp was great at 65. The water didn't taste bad, but it was too murky to see my hands, nor the feet I wished to follow. This created a little problem on the backstretch when a guy have me 5 consecutive ankle grabs. My limit is 3 before I set off some rather thunderous kicks. I used them to bridge up to the next set of feet, but suddenly everyone was also 5 yards wide of me. Message received. I didn't kick to hurt anyone, I just wanted a little space. I knew I was swimming a bit faster than planned and didn't have much training so my shoulders eventually felt a little tired, but not bad. I didn't look at a clock as I climbed the ladder. I make it a rule to avoid the swim out clock in all races.<br />
<br />
In transition I tested at 99. My volunteer asked if that was good. "[Explitive] Yeah! That's good!" T1 was slow as I had to put on a deep pocketed cycling jersey. I had my nutrition and backup nutrition in my pockets and I had to put my pump controller away in a protective race belt. I needed it accessible if I needed to make any changes to my insulin rates, and also for it to make it's programmed change to 0.05U/hr for the remainder of the day. <br />
<br />
For testing on the bike I configured a clever system with a smaller meter on my stem with a stabber jabber and test strips in my bento box. I knew there was a chance of dropping these items during the race so I wisely attached them to elastic tethers which actually worked to save me at least once that I remember - a little trick I learned from reading mountaineering books.<br />
<br />
The bike ride is a 3 loop out and back course. My plan was to go very easy on loop one and wait for my metabolism to kick in. I'm still not sure why it takes so long for my body to reach that point but I know the pattern and respect it. I felt a slight twinge of hunger at the 5 mile point so took one of my 200 calorie packets of Almond Butter. At about mile 10 I decided to test my levels. I eased to the right and sat up, tested and as soon as I saw a 102 I was happy. And then I realized I had just flatted. Turns out I pulled to the far right along a stretch of median with lots of cacti, definitely a cactus thorn puncture. It only took about 3 or 4 minutes to change. Between the slow transition, my easy pace and now the flat I had just let the bulk of the main field catch up to me. The course was now miserably crowded with huge draft packs as the bulk of the field had caught up to me. Everyone was going much faster than they should.<br />
<br />
I was patient and waited. I talked to a few of the amoral souls and discussed the ethics of their choice to sit in a group and draft, but I knew my kind advice fell on deaf ears. It really is a shame. Sure it was crowded, but I was able to ride clean. So could everyone else if they chose to. Shameful indeed.<br />
<br />
I reached the turn-around on the bike just in time to see Michael and Merri walking to the course. Without that flat tire they never would have seen me. Another blessing in disguise. After the turn it was downhill. I made a big pass on pack of about 50 riders and settled in to a comfortably easy pace again, it only took a minute for that entire pack to pass me back. There were 100lb women in the group... passing me at 215lbs... on a downhill?! Arggh. <br />
<br />
My plan was to take the downhills easy and use them as an opportunity for my metabolism to catch up. As much as I wanted to drop the packs I restrained myself. Midway back I tested again at 109. Took a stinging insect to the face, but took stock that I was lucky it wasn't the eye. I dislike wearing sunglasses, but after that I put them back on.<br />
<br />
I started loop two feeling stronger, I hadn't spent much time training in aero so I stretched as often as possible, but held my position well. I tested at about the same point on the course again. 98! I wasn't hungry but figured if I was going to eat anything sooner is better than later. I had a second packet of almond butter. This packet had a maple flavor (the store was out of plain) so I bumped up again to 115, but that's the highest I'd be on the bike all day. <br />
<br />
Lap 3 things finally spread out. I was getting sick of riding the same flat course, but my body actually felt it's best at this point. I started the lap with a BG of 95, feeling the diesel now! Finally all those people who had gone out too hard (or had drafted their way ahead of me) started to get reeled in. I felt superhuman. I didn't even get stiff. Everything was working well. I was passing masses of people on the final uphill portion. Saw Micheal and Merri one last time at the turn around and then eased it back towards home.<br />
<br />
As per my plan I pulled over to the side at the mile 100 marker. There I rested my blood sugar with my pump meter, 93. Knowing that the transition to running spikes me by about 30 points, I took a bolus of 0.5U of insulin at this point (presumably 45 minutes from the finish of the ride). This is the trickiest decision to make because I feel that adding insulin at intensity is akin to playing with fire. If I got another flat and was delayed it could backfire - although I knew I had backup carbs on hand (in every possible location), my goal was to not have to rely on them. My goal was to manage my blood glucose with my insulin rates, not with corrective carbs. That is how I trained and that is how I planned to execute this day as well.<br />
<br />
I entered the transition to the bike and my blood-sugar was now down to 66. That might sound low but that's exactly what I wanted. Technically I wanted 70, but that's damn close. I had a great T2 volunteer who laid everything out and really knew what he was doing. That's so nice. I already had my insulin controller on the belt around my waste. The volunteer handed me my race number, hand water bottle, helped me with my shoes and my change of shirt. Again another slow transition due to the full change, but I wasn't going to bounce around with all the gear in my cycling jersey.<br />
<br />
I always enjoy the hands of the sunscreen volunteers as well. With their help and that of my wonderful cowboy hat I was safe from the sun all day.<br />
<br />
I ran the first 2 miles at 10 minute pace as planned. They did not feel good. I wasn't expecting them to, but I had a little bit of discomfort in what I could only described as my kidneys. Danger Warning!! I stopped at mile 2 to test. BG now 90! Bingo again, I nailed that part of the plan, but I did not feel good. My heart-rate was higher than I planned.<br />
<br />
Looking back this is probably a result of a combination of factors. I was a bit undertrained. I probably should have been more conservative on that last loop of the bike, but I was having fun. I have spent almost no training on my tri-bike this summer so I definitely used different muscle group than I had trained with and I knew I was gambling with the bike choice, however I just couldn't bring myself to sit up on a road bike on such a flat course. My triathlon bike definitely is a more quad dominated pedal stroke. Another factor is that I hate to admit I probably let myself get dehydrated. Without taking in my usual volume of liquid calories on the bike, combined with the dry desert air I had a likely cause for the heart rate increase. I had consumed about 7 bottles of water on the bike, but this may not have been enough.<br />
<br />
Since there was some concern about the ache in my kidneys I decided to walk until that went away and to let my heart rate reduce to a point where my body could catch up. While I was walking I realized something. I liked the view. I've never really slowed down in an Ironman before. I can still walk plenty fast and my garmin read 15 minutes/mile - but without pushing myself I was able to take in the full experience.<br />
<br />
This is where I connect the early part of Part One of my race report to my experience. As I walked and once I settled in I really began to enjoy myself. I ran a few more sections and they started to feel better, but I made a decision to give myself a break and enjoy the marathon. I knew I wasn't going to meet any long standing goals. (I still want to run a 3:40 Ironman Marathon). So even if I did run and manage a 4:30, I've already done that or better several times. I saw no harm in the change of my mindset. I really enjoyed being able to catch views of all my friends on the course, and even stop and chat with a few.<br />
<br />
I believe I finished the first lap of the marathon in 2:50. When I reached the 2nd loop the temp was starting to cool, my body felt much better and I was ready to run - however just as I was about to run I stumbled across a woman who was walking just as fast as me. She was just starting her first lap. I believe I started a conversation with her about her wonderful walking pace (most walkers are incredibly inefficient shufflers / aka death march). As we were talking a girl I met earlier in the week passed with her insulin pump on her waist - she asked about my blood sugar. <br />
<br />
I reported back that I was starting to peak at about 130. I had previously consumed another half serving of Generation UCAN in hopes of running this second loop. And although my blood sugar tested at 118 when I consumed it I was curious if some carbs would make me feel any better. That's how things used to work before I was diabetic.<br />
<br />
Meeting this fast walking woman was when my goal changed. I started talking with Bernice. She's a 60 year old retired nurse from St. Louis. She was adorable, complete with a Boston Accent. She signed up with her husband and a small group of friends also racing. This was to be her one and only Ironman. She was incredibly nervous that she wouldn't make the midnight cutoff. She was one of the last few riders off the bike course and her stomach was killing her after following her trainers advice of consuming 300 calories per hour on the bike. Yikes.<br />
<br />
But she was walking a great pace. 15:30's per mile. We started talking. She shared her experiences and I shared mine. We bonded pretty quick. There was no way I was leaving her. It was much more fun to have company. Plus it gave me an opportunity to do what I love from within the race. I am a coach after all.<br />
<br />
I helped her keep an eye on her posture while walking. She was worried about the pain in her feet so I had her focus on the tempo of her arms. She couldn't take in any more nutrition and had a stomach ache. I waited for her at the potty stops and did what I could to distract her from the discomfort. Before long she was at mile 8. She was worried that she should be running, but I told her she could always choose to run later, and that if she ran too soon she might not be able to even walk later. We did the math together and calculated that if she held pace she'd finish with 20 minutes to spare. She could always run at the end if she needed to. Her goal was to finish - and I had the pleasure of helping her.<br />
<br />
It was a bit sad that we had to eventually part ways. Over nearly 3 hours we had a lot of fun. I had finally gotten her to eat a few bites of solid food near mile 10 for her and 23 for me. We discussed how she'd manage the rest of the race on her own. We did a few Yeehaws under the acoustics of the underpass. Shared a mile 23 in silence to honor Jesse Alswager. I advised her to try to get some food in once her stomach settled, and that some flat coke could actually help her stomach near the end. I was confident that if she stuck with what we discussed she'd do just fine. I had even debated walking an extra third lap with her, but Merri was too excited to see me at the finish line to do that. <br />
<br />
When we parted ways I finally started to run. It probably was upsetting to those around me as I felt great running that last half mile. I was so well rested from my nice long walk that I comfortably holding 8 minute pace. Not a single ache in my body, and I was feeling very good about how I had chosen to spend my day. <br />
<br />
I had no expectations for the clock. Before I left for the race I told my friends to expect me in the 13 to 14 hour group. But while I was carefully calculating Bernice's paces and finish times I hadn't actually thought about mine at all. I was a bit surprised to realize that I still managed to finish in 13:07 despite walking nearly the entire marathon. <br />
<br />
When I crossed I found Merri, got a chance to call my mother and let her know I was safe and hear my father's voice, which always makes emotional.<br />
<br />
I was surprised I couldn't find any water at the finish line. only muscle milk?! I walked through the food tent to get water. I didn't see any food I would choose to eat there either. Surprisingly, I wasn't hungry anyways. I had just gone 140.6 miles and consumed only 450 calories and I wasn't hungry? It's a strange new world.<br />
<br />
Now to repeat myself. I choose my management strategy for my own personal reasons and I do not advise anyone out there to try to follow my plan. The calories that I burned on the day were the ones stored in my cell, primarily my body fat, my own glycogen reserves and other intrinsic sources. I still likely burned 6000 or more calories. My ability to perform for 13 hours on less than 20 grams of carbohydrates is only because of how I've adapted my body to function on ketones. <br />
<br />
I realize that my walking leaves questions unanswered. Could I have ran with this nutrition strategy? I think so had I managed to train better and avoided getting dehydrated. My blood sugar while on the marathon course was between 90 and 130 which is actually a bit higher than had it been while I was training. I have a theory that I actually run best when my blood sugar is in the 70-80 range. Higher blood sugar seems to have an inhibitory effect on the liberation of ketones for fuel, although I'm not sure how to prove this beyond what I feel and how my heart rate in training and perceived exertion is lower when my blood sugar is in that lower range. Perhaps I should have adjusted my temp basal level for the run to 0.15U/hr. Questions for another day...<br />
<br />
I'll aim to slay those demons at my next event which will be a 50k ultramarathon on some very challenging mountain trails on February 2nd at Orca's Island. But for IMAZ I achieve all I had set out to do. Sure I look back and see the success I had and it's tempting for me to be greedy and think, what if I actually ran? But I'm not really concerned with 'what ifs'. What I am concerned with is what I consider amazing blood sugar control over the course of 140.6 miles by someone who has only just begun their journey as a type I diabetic endurance athlete.<br />
<br />
I will be able to race more in the future with confidence that I can build on this success. I know what worked best in my training and I learned a ton about my body. I'm excited for the future but I don't care to rush things. I have the goal of competing in Ironman Wisconsin again in 2015 which should give me time to really dial things in and perhaps then I will have the confidence to push myself hard.<br />
<br />
Below I will include a few notes as far as my basal rates leading into the race as well as my blood glucose tests during.<br />
<br />
10/6 Basal rate: 0.4 (0.3 from 10pm to 6am) - Normal<br />
10/12 Basal rate: 0.8 - I had gotten into some Halloween candy- hey, I'm human.<br />
11/4 Basal rate: 0.6<br />
11/6 Basal rate: 0.4 (0.3 from 10pm to 6am) - Back to normal<br />
11/14 Basal 0.3 - Swimming really seems helps<br />
11/17 Basal Program: <br />
Midnight to 6am: 0.25<br />
6am to 8am: 0.10<br />
8am to midnight: 0.05.<br />
1pm Temp Basal set to 0.10 for run.<br />
<br />
Blood Glucose History for the day:<br />
Midnight- 86<br />
3:20am- 90<br />
5:15am- 107<br />
6:00am- 115<br />
8:11am- 99 (T1)<br />
8:27am- 102 *consumed Justin's Almond Butter (and flatted)<br />
9:13am- 109<br />
9:52am- 98 * consumed maple flavored Justin's Almond Butter<br />
10:38am- 107<br />
11:15am- 115<br />
12:09pm- 95<br />
12:42pm- 93<br />
1:28pm- 66 (T2)<br />
1:58pm- 90<br />
2:29pm- 90 (consumed 1 serving of UCAN)<br />
3:09pm- 119<br />
3:40pm- 118<br />
4:27pm- 131<br />
4:45pm- 131 (bolused 0.2U)<br />
5:10pm- 115<br />
5:45pm- 101<br />
6:35pm- 98<br />
7:02pm- 92<br />
8:17pm- 102 (Finish Line. The increase is due to running)<br />
9:30pm- 109 (Bolus 0.25 for a gyro sans pita)<br />
11:15pm - 116<br />
<br />
Breakfast:<br />
4 eggs scrambled in 1T coconut oil. Half an avocado. 1/2 serving of UCAN<br />
<br />
Race nutrition:<br />
8:20am: Justin's Almond Butter:<br />
10:00am: Justin's Maple Almond Butter<br />
2:30pm: 1 serving of Generation UCAN.<br />
<br />
Post Race Food:<br />
4oz of PHD brand protein drink (0g CHO) * I may want to consider protein during the race)<br />
Naked Gyro: Meat, lettuce, onion, tomato and dill cream<br />
<br />
Dinner: Guacamole and cheese.<br />
<br />
Recovery Basal Rate: 12:45am- 7:45am Temp Basal set to 0.15. <br />
Woke up at 98.<br />
<div>
<br /></div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-57714254830100138942013-11-22T16:13:00.000-08:002013-12-04T06:11:20.086-08:00One week of diabetes awareness posts.<div class="MsoNormal">
<span style="color: #37404e; font-size: x-small;"><span style="line-height: 20px;">The post below are from my Facebook wall. I've decided to preserve them on my blog as well in hopes that this information will reach as many people as possible. I've received a great response from people in regards to these posts. Diabetes can be a complicated topic to discuss, but the discussion is important. Diabetes affects a significant and rapidly expanding portion of the population. These facts are important so please feel free to read, share and discuss!</span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;">Diabetes Awareness Fact of the Day - November 9th, 2013</span><span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: x-small;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e; line-height: 115%;">November 14th is World
Diabetes Day. It will also be exactly one year from my diagnosis with Type I -
Latent Autoimmune Diabetes of Adults (LADA). In one year I have lowered my
hemoglobin A1C from 11.2% to 5.6%. A1C is a test measuring your red blood cells
average blood glucose exposure during the past 3 months. 11.2% correlated with
a average blood sugar of 285. 5.6% correlates with 114.</span><span class="apple-converted-space"> <span class="textexposedshow">Each day this week I
will post some basic information about diabetes.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">The goal is to raise awareness of this increasingly
prevalent disease. Admittedly and despite having family members living with
both type I and type II diabetes, I knew very little a year ago.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Type I is a condition where the body no longer
produces it's own insulin requiring either insulin injection with syringes or
in my case an insulin pump. Type II is a condition where your body produces
insulin but your cells no longer respond to it. Type I account for only about
5% of diabetes cases - but both types are on the rise.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">If you have any questions about diabetes, please
ask.</span><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 9.0pt; margin-top: .75pt; mso-line-height-alt: 8.4pt; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">· </span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 9.0pt; margin-top: .75pt; mso-line-height-alt: 8.4pt; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">How did you know
something was wrong at first?<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 9.0pt; margin-top: 0in; mso-line-height-alt: 8.4pt; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">·
</span><!--[endif]--><span style="color: #4e5665;"> </span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 9.0pt; margin-top: 0in; mso-line-height-alt: 8.4pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">I finally
figured out something was wrong when I felt really ill after WCRC. I was
starting to cramp often on the bike that week (I never cramp). Of course, I
went home after my race and thought I had the flu and was craving sugar... so
chocolate milk, o.j., and coke to try to settle my stomach. Oops. Then by mid
week I realized I couldn't read the projector at SBR, but assumed the projector
was out of focus, so I finally set a Dr.'s appt. There were so many subtle
clues that I had been looking past. And some not so subtle. I had 'passed out'
after drinking 3 or 4 beers earlier in the day. I passed out a 2nd time at
Lindsey's after eating half a plate of caramel brownie deliciousness - along
with a few aforementioned Mai Tais. I had been waking up at night thirsty and
chugging milk only to wake up later to have to use the bathroom. Craving sweets
like never before! I had horrible allergies all summer, along with random eye
and sinus infections. I even had been waking up with numbness in my arms but
assumed I had just been sleeping on my arms funny. I can probably even
attribute my weakened ankles which easily sprained a few times playing soccer,
as well as tendon pain at the bottom of my forefoot. All of those symptoms have
since cleared. I can't believe I didn't put it together earlier, but I use the
analogy of boiling a frog, the water temp raises slowly enough that the frog
never jumps out of the pot. (not that I've ever cooked a frog, but it would fit
my low carb diet).</span><span style="color: #4e5665;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 13.5pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><br /></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 13.5pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><br /></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 13.5pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><br /></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 13.5pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;">Diabetes Awareness
Fact of the Day - November 10th, 2013</span><span style="color: #37404e;"><br />
<br />
</span><span style="color: #37404e;">Blood
sugar is a measure of the amount of glucose in a person's blood. If blood sugar
is too high, the condition is called hyperglycemia, and lOw blood sugar is
called hypO-glycemia. Get it? hypO = lOw. A healthy fasting range is 70-100
mg/dL. That's milligrams per decilter, or about 1 gram per Liter. The average
person has about 5 liters of blood. 4-5 grams in an average body, which equates
to just over 1 teaspoon. </span><span style="color: #37404e;"><br />
<br />
</span><span style="color: #37404e;">If
a diabetic is hyperglycemic, they have too much sugar. Moderately high blood
sugars of 125-180 are not immediately dangerous, but chronic exposure to these
levels increase risk of many degenerative disease. The higher the level the
more serious the risk. </span><span style="color: #37404e;"><br />
<br />
</span><span style="color: #37404e;">Hypoglycemia
(low blood sugar) can be more immediately dangerous, which may lead to loss of
consciousness and death. Lows can be treated with glucose pills, sugary juice
and other fast acting sugars or in severe cases, with an emergency injection of
a hormone called Glucagon. Glucagon stimulates the person's own liver to dump
it's stored glycogen (the body's storage form of glucose) into the blood
stream. </span><span style="color: #37404e;"><br />
<br />
</span><span style="color: #37404e;">Either
way, if you come across an unconscious diabetic, treat them with sugar first.
Even if you're wrong, it won't do any more harm.</span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;"><br /></span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #3b5998;"><b>- </b></span><span style="color: #4e5665;">If someone is unconscious, the FIRST thing you
must do is call 911 and get the EMT on their way to the unconscious person. NOW
... how will a stranger know if you may be a unconscious diabetic? Wear a
medical alert bracelet!! Your RoadID is not just for when your training or
racing.</span></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="background-color: white; color: #37404e; font-family: inherit; font-size: x-small;"><br /></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="background-color: white; color: #37404e; font-family: inherit; font-size: x-small;"><br /></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="background-color: white; color: #37404e; font-family: inherit; font-size: x-small;"><br /></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<br /></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;">Diabetes Awareness Fact of the Day - November 11th, 2013</span><span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;"><br /></span></div>
<div class="MsoNormal" style="background: #FAFBFB; margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 8.4pt;">
<span class="apple-converted-space" style="color: #37404e; font-family: inherit; font-size: x-small;"><br /></span></div>
<div style="border-top: solid windowtext 1.0pt; border: none; mso-border-top-alt: solid windowtext .75pt; mso-element: para-border-div; padding: 1.0pt 0in 0in 0in;">
<div class="MsoNormal" style="border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;">
<span style="background: white;">Insulin is a
hormone produced by the pancreas. Insulin serves many roles within the body,
but the primary role with concern to diabetes is that it's proper functioning
enables glucose from the blood stream to enter cells of muscles and the brain.
Once inside the cell, the glucose can either be used, or if the supply of
glucose exceeds demand, it is stored as<span class="apple-converted-space"> <span class="textexposedshow">body fat.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">In type I diabetes insulin in absent, in type II
diabetes insulin is produced (often at a high level) however the bodies cells
are desensitized (insulin resistant) and don't respond to it's presence.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Insulin resistance can be caused by poor diet, a
sedentary lifestyle, obesity, inflammation, illness, stress, sleep deprivation
along with genetic factors. The more insulin resistant a person become, the
more insulin is required to achieve the job of getting glucose into the cells.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Since insulin is also a fat storage hormone, the
high levels of insulin required in an insulin resistant person cause the
metabolism to shift towards storing more energy as fat. In fact, if a type I
diabetic were to chronically inject large amounts of insulin into the same part
of their body they can develop a localized fat deposit at the injection site.
This same fat storage occurs in the body of an insulin resistant person with
high levels of insulin through-out the body.</span><o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
</div>
<div style="background: #FAFBFB; border-top: solid #EBEBEB 1.0pt; border: none; margin-left: -9.0pt; margin-right: 9.0pt; mso-border-top-alt: solid #EBEBEB .75pt; mso-element: para-border-div; padding: 7.0pt 0in 0in 0in;">
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin: 0in 0in 0.0001pt 0.25in; padding: 0in; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">· </span><span style="color: #4e5665;">Not bad but a couple
of corrections needed. Many T2's take insulin too because the beta cells just
wear out and don't produce enough or any insulin. Although T2 is connected to
obesity, (We're seeing T2 in children now because of sedentary lifestyles and
poor dietary habits), genetics plays a major role in T2 development and should
be emphasized more than it is.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin: 0in 0in 0.0001pt 0.25in; padding: 0in; text-indent: -0.25in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;"><br /></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin: 0in 0in 0.0001pt 0.25in; padding: 0in; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: inherit; font-size: x-small;"><span style="color: #4e5665;">· </span><span style="color: #4e5665;">Thanks again Ed. I
appreciate it, I'm trying to be informative enough that someone with little
previous knowledge can learn enough without overly complicating and confusing
things, but it's great to have another set of eyes out there making sure I
don't miss any pertinent details.<o:p></o:p></span></span></div>
</div>
<br />
<div style="background: #FAFBFB; border-top: solid #EBEBEB 1.0pt; border: none; margin-left: 0in; margin-right: 9.0pt; mso-border-top-alt: solid #EBEBEB .75pt; mso-element: para-border-div; padding: 7.0pt 0in 0in 0in;">
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;">Diabetes Awareness Fact of the Day - November 12th, 2013</span><span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;"><br /></span><span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;">
<br />
<span style="background: white;">Diabetes is much
more prevalent than many would ever imagine. At the bottom of this post I will
share a link to the statistics from the American Diabetes Association website.
It can be difficult to put<span class="apple-converted-space"> <span class="textexposedshow">numbers into perspective, but as
of 2011, 23 million Americans are diabetic - 8.3% of the population. The
scarier number is that another 79 million Americans are Pre-diabetic, that
another quarter of the population! 1 in 4 people!</span><br />
<br />
<span class="textexposedshow">Pre-diabetes – At least 50 percent of people with
impaired glucose tolerance eventually develop type 2 diabetes, and there is an
increased risk of heart disease even if diabetes does not develop.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Impaired fasting glucose is defined as a fasting
blood sugar level between 100 and 125 mg/dL. Impaired glucose tolerance is
defined as a blood sugar level of 140 to 199 mg/dL two hours after an oral
glucose tolerance test.</span><br />
<br />
<span class="textexposedshow">When is the last time you had a fasting glucose
tested? This test is usually done when you get your fasting cholesterol test.
I've often wondered if that statistics really project that 1 in 4 Americans are
pre-diabetic, then why aren't glucose levels tested at every doctors
appointment similar to blood pressure? Why not ask your physician to check?</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">You can take matters into your own hands and get
your own meter and test yourself and your family. Meters are often less than
$20 and a test strips are usually about $0.50 a piece, which is cheap compared
to the chronic expense of diabetes.</span><br />
<br />
<span class="textexposedshow"><a href="http://www.diabetes.org/diabetes-basics/diabetes-statistics/" style="cursor: pointer;" target="_blank"><span style="color: #3b5998; text-decoration: none; text-underline: none;">http://www.diabetes.org/diabetes-basics/diabetes-statistics/</span></a></span><br />
<br />
<span class="textexposedshow"><a href="http://www.amazon.com/s/ref=nb_sb_ss_i_1_4?url=search-alias%3Daps&field-keywords=accu+chek&sprefix=accu%2Caps%2C264" style="cursor: pointer;" target="_blank"><span style="color: #3b5998; text-decoration: none; text-underline: none;">http://www.amazon.com/s/ref=nb_sb_ss_i_1_4?url=search-alias%3Daps&field-keywords=accu+chek&sprefix=accu%2Caps%2C264</span></a></span><o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span data-reactid=".r[3rcjx].[1][3][1]{comment10102645105619017_20653964}.[0].{right}.[0].{left}.[0].[0].[0][3].[0]"><span data-ft="{"tn":"K"}" data-reactid=".r[3rcjx].[1][3][1]{comment10102645105619017_20653964}.[0].{right}.[0].{left}.[0].[0].[0][3]"><span data-reactid=".r[3rcjx].[1][3][1]{comment10102645105619017_20653964}.[0].{right}.[0].{left}.[0].[0].[0][3].[0].[0]"><span style="color: #3b5998;"><b>- </b></span><span style="color: #4e5665;">Another
scary fact is that 25% of those who have diabetes don't know it.</span></span><span style="color: #4e5665;"><o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="color: #4e5665;"><o:p><span style="font-family: inherit; font-size: x-small;"><br /></span></o:p></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="color: #4e5665;"><o:p><span style="font-family: inherit; font-size: x-small;"><br /></span></o:p></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><br /></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;">Diabetes Awareness Fact of the Day - November 13th, 2013</span><span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;"><br /></span><span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;">
<br />
<span style="background: white;">Since yesterdays
post focused on the statistics of diabetes, today I'd like to focus on why
those statistics matter so much. The complications of diabetes are serious.
There are dangers of hypoglycemia among those treating their diabetes with
insulin, but there are also numerous consequences resulting from the high blood
sugars experienced in the millions o<span class="textexposedshow">f people that are either un-diagnosed or not managing to control their
high blood sugars.<br />
<br />
<span class="textexposedshow">From the NIH website: "If you have diabetes,
your blood glucose, or blood sugar, levels are too high. Over time, this can
cause problems with other body functions, such as your kidneys, nerves, feet,
and eyes. Having diabetes can also put you at a higher risk for heart disease
and bone and joint disorders. Other long-term complications of diabetes include
skin problems, digestive problems, sexual dysfunction, and problems with your
teeth and gums.</span><br />
<br />
<span class="textexposedshow">Very high or very low blood sugar levels can also
lead to emergencies in people with diabetes. The cause can be an underlying
infection, certain medicines, or even the medicines you take to control your
diabetes."</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">While this sounds like any simple disclaimer you might
hear at the end of a prescription drug ad, these risks are serious. When they
say kidneys think dialysis, when they say nerves think loss of feeling in limbs
and neurological disorders such as alzheimers as you age. When they say feet,
think wounds that may never heal, gangrene and possible amputation. These can
be serious - but because they are a result of long term exposure it can be very
easy to not take the risks seriously until it is too late. And beyond your own
personal health, the management of these problems will have a crippling effect
on our entire healthcare system. I don't want to dwell on the negative, but
this cannot be ignored. It's the unlucky 13th today, tomorrow I'll focus on the
positive.</span><o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span class="textexposedshow"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e;"><o:p><span style="font-family: inherit; font-size: x-small;"><br /></span></o:p></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span class="textexposedshow"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e;"><o:p><span style="font-family: inherit; font-size: x-small;"><br /></span></o:p></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span class="textexposedshow"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #37404e;"><o:p><span style="font-family: inherit; font-size: x-small;"><br /></span></o:p></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><br /></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;">Diabetes Awareness Fact of the Day - November 14th, 2013</span><span style="background-color: white; color: #37404e; font-size: x-small; line-height: 18px;"><br /></span><span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;">
<br />
<span style="background: white;">Thank you for
following along with my posts all week. I could continue with information for
the entire month and if there is anything you'd like to ask please do so, but
today I want to shift the focus<span class="textexposedshow">.<span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Hopefully everyone is aware of the story of 5 year
old Miles,who is in remission from Leukemia. Through the Make-a-wish foundation
along with 11,000 people in the San Fransisco area, Miles lived his wish
yesterday to save the city as Batman.</span></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><span style="background: white;"><span class="textexposedshow"><span class="textexposedshow"><br /></span></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<span style="font-family: inherit; font-size: x-small;"><span style="color: #37404e;"><span style="background: white;"><span class="textexposedshow"><span class="textexposedshow"><span style="color: #3b5998; cursor: pointer; text-decoration: none;"><a href="http://www.buzzfeed.com/ryanhatesthis/everything-you-need-to-know-about-the-make-a-wish-foundation" style="cursor: pointer;" target="_blank">http://www.buzzfeed.com/ryanhatesthis/everything-you-need-to-know-about-the-make-a-wish-foundation</a></span></span><br />
<br />
<span class="textexposedshow">This amazing victory for a new generation of Batman
reminds me of another heroic batman near and dear to my heart - Eric McLean.
Eric passed way on August 23rd of 2012 after a 10 year battle with Leukemia.
His brother, a</span><span class="apple-converted-space"> </span><span class="textexposedshow"><span style="color: #3b5998; cursor: pointer; text-decoration: none;"><a data-hovercard="/ajax/hovercard/page.php?id=143665982319863&extragetparams=%7B%22directed_target_id%22%3A0%7D" href="https://www.facebook.com/WisconsinTriTeam?directed_target_id=0" style="cursor: pointer;">Wisconsin Triathlon Team</a> </span>alumni and friend
founded the organization L.I.F.E. on his brother's behalf. L.I.F.E. is the
Leukemia Ironman Fundraiser for Eric. L.I.F.E. carries on as a successful
501(c)(3) charity.</span><br />
<br />
<span class="textexposedshow">L.I.F.E. is the charity that we at</span><span class="apple-converted-space"> </span><span class="textexposedshow"><a data-hovercard="/ajax/hovercard/user.php?id=1462042970&extragetparams=%7B%22directed_target_id%22%3A0%7D" href="https://www.facebook.com/sbr.coaching?directed_target_id=0" style="cursor: pointer;"><span style="color: #3b5998; text-decoration: none; text-underline: none;">Sbr Coaching</span></a></span><span class="apple-converted-space"> </span><span class="textexposedshow">were
raising funds for one year ago at our annual Wisconsin Cycling Relay Challenge
(WCRC) when I first realized that something was wrong with me following my leg
of the relay, leading me to the doctor's office to investigate the reason for
my blurry vision, constant thirst, and frequent urination.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">I feel odd admitting this, but when I learned that
I had Type I diabetes, I thought to myself, at least it's not cancer. I am
blessed to have begun my journey with diabetes with the great physical strength
of an endurance athlete and a background in biochemistry that allowed me to
understand the physiology, as well as an interest in food and nutrition- as
well as a passion for cooking. I am an incredibly lucky person. Diabetes will
not hold me back in L.I.F.E. Eric has played his role as well, inspiring me
along the way.</span><br />
<br />
<span class="textexposedshow">If perhaps I have inspired you, please feel free to
donate on my behalf to L.I.F.E.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">You can learn more here:</span><span class="apple-converted-space"> </span><span class="textexposedshow"><a href="http://www.givetolife.org/index.php/about-life" style="cursor: pointer;" target="_blank"><span style="color: #3b5998; text-decoration: none; text-underline: none;">http://www.givetolife.org/index.php/about-life</span></a></span><br />
<br />
<span class="textexposedshow">Miles story further reinforces that the world is
full of amazing people. We may get distracted at times along the way, but we
are all this world together. We are all connected and it's easy to see.</span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Tomorrow I will be taking the 23rd mile in silence
out of respect Jess Alswager, another hero linked to my favorite number, 23. If
you wish to donate to support diabetes or learn more about Jesse, follow along
here:</span><span class="apple-converted-space"> </span><span class="textexposedshow"><a href="http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.jessepalooza.org%2F&h=vAQHSNNL0&s=1" style="cursor: pointer;" target="_blank"><span style="color: #3b5998; text-decoration: none; text-underline: none;">http://www.jessepalooza.org/</span></a></span><span class="apple-converted-space"> </span><br />
<br />
<span class="textexposedshow">Thank you Jesse, Eric and Miles.</span><o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
<div class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; border: none; margin-bottom: 0.0001pt; padding: 0in;">
<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-58253945036991751112013-11-15T08:19:00.002-08:002013-11-15T08:23:38.935-08:00Improved insulin sensitivity and a bit of my TSS plan for IMAZ.Quick one this time. I'm in Arizona tying up all the loose ends before competing in Ironman Arizona on Sunday. My training has been atypical in comparison to any Ironman races I've done before.<br />
<div>
<br /></div>
<div>
With the importance of setting up my metabolism, along with dealing with a few bumps in the road in the lead up my approach will be non-traditional. Normally when I would have been building peak training, I rested and then past 2-3 weeks when I would normally be tapering I have been doing base training. </div>
<div>
<br /></div>
<div>
I've come to this through listening very carefully to my body and understanding the importance of a what I'm doing metabolically. First off, I'm not out to set a personal best at this race so the gains from being fully tapered and rested really aren't important to me. I will not be racing at the intensity where that should affect me. </div>
<div>
<br /></div>
<div>
What has been interesting is that while I've really put my focus on prioritizing consistency in training, and especially due to the increased focus on swimming I've noticed a dramatic improvement in my insulin sensitivity. Along with that I've also reduced the inflammation in my body. My face is less squishy, my and body weight is a few pounds down - this is not due to me burning more calories as my energy consumption has more than matched my output. </div>
<div>
<br /></div>
<div>
The most significant improvement has been my insulin sensitivity. I have had to reduce my basal insulin rate back down to 0.3U/hr, which is very near the level it was at when I was assuming that I was 'honeymooning'. This is great news to me, however there is only one downside. As a result of this improvement I need to re-evaluate the insulin rates that I plan to use during Sunday's event. To err on the side of safety I plan to reduce the temp basal rates from 0.15U/hr down to 0.1U/hr. </div>
<div>
<br /></div>
<div>
Technically, and probably only of interest to other OmniPod users I'm not setting a temp basal, but creating my own basal program for the event day. The race starts at 7am. My overnight basal will be set to 0.3U/hr until 6:30am at which point it will change to 0.15U/hr until 8:30am. The plan is to target a BG of 80-100 at the start of the race - there will likely be a spike due to adrenaline as well. (I will also have emergency carbs taped inside my wetsuit since you never know.). </div>
<div>
<br /></div>
<div>
Without an adrenaline spike my blood sugar should settle to about 70-90 as I excite the water. Then run into transition will likely spike this up again by a minimum of 10 points putting me in a great range on the bike.</div>
<div>
<br /></div>
<div>
At 8:30am I should be just settling in on the bike at which point my basal program will further reduce to 0.1U/hr when it will remain for the rest of the day. I had the ability to ride part of the course with a PowerTap yesterday. I'm comfortable targeting 210-230 watt average on the course depending on the level of incline. This effort should keep my heartrate in the mid 140's at (for me) is a nice aerobic level.</div>
<div>
<br /></div>
<div>
For power geeks my FTP is usually 360. Yes that is a big number but factoring that I'm 215 pounds that's 3.6 watts/kg which is a much more humbling way to look at it. I haven't done an FTP test lately since I've been intentionally avoiding them due to their potential for instability. I have been able to comfortably hold 320 watts at what felt like 90% effort for 40 minutes so I'm sure my FTP hasn't changed too much from season's past. For safety sake I'll enter a conservative 340 watts for my FTP into the calculator.</div>
<div>
<br /></div>
<div>
I should do just fine on this flattish course. Three laps with a gentle uphill on the way out and a gentle downhill on the return. I'll be riding the uphills near 250 watts and likely be able to drop that to 180 watts on the downhill and still hold speed just fine. This will likely net me about 18 mph average (judging from yesterday's 2 hour simulation ride on the course, which leads to about a 6 hour total ride. I'll be spending slightly more time on the uphills than the downs. My numbers are still loose calculations but these efforts should put me at a conservative 270 TSS points for the entire ride. Plus or minus a loose twenty points and I should feel nice and fresh coming of the bike, especially since the finish is after a downhill leg and I'll be able to recover.</div>
<div>
<br /></div>
<div>
In addition to these theoretical estimations, I'll be relying on the bike computer between my ears that has served me so well during my many years of cycling. I'll definitely have the option to back off and play it even safer than that. This is the first Ironman in which I'll be recording my power output. This will be incredibly useful for figuring out the details of future races. I'm interested to see how the PowerTap and the computer between the ears compare. </div>
<div>
<br /></div>
<div>
Eventually I'd like to get some metabolic efficiency test done and then together with a power meter I will be capable of developing an incredibly detailed nutrition plan to suite my new requirements. I won't be basing my race on the power numbers but it will be fun to look at the data once the dust settles. </div>
<div>
<br /></div>
<div>
It helps me to write these things down. Normally I'm a notebook person, but now that I've taken to blogging I'll likely be including more of those details here.</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-18703026352478581362013-11-08T22:07:00.003-08:002013-11-08T22:07:47.294-08:00Birthday Challenge Update.Hmm. I wrote this post on June 26th, but just now realized that it's been sitting as a draft. Whoops.<br />
<br />
---------------------------------------------------------------------------------------------------<br />
<br />
June 23rd has come and gone. I have a tradition of treating that date as an opportunity of challenge myself. This year is no exception, however I had a new idea. My original idea for my birthday challenge was to train to race a 200 Butterfly.<br />
<br />
Actually, the whole goal was to train a total distance of 10,000 yards of butterfly (in small sets and then I'd be ready for the 200). I have to admit that I wasn't able to get the full training in. No regrets however, I'm at about 40% of the way and I'm enjoying my butterfly training so much that I plan to continue it through the remainder of the season. The butterfly sets have been making me a much better swimmer overall - but I've only been able to make it to a total of 100 yards consecutively. 200 Butterfly is going to be a challenge. <br />
<br />
A 200 butterfly should take me somewhere around 3 minutes. That's 3 minutes of high intensity (despite trying to relax as much as possible). The anaerobic demands are currently beyond what I'm able to tap into. I'm not providing an excuse, but it's a challenge with my current fueling strategy. Aside from my 2 or 3 sets of butterfly per week the bigger priority in my life has been optimizing my aerobic endurance. This side of my training has improved greatly - so I modified my birthday challenge to indulge in what I enjoy most.<br />
<br />
Following up on my successful ride at the 200km HHH - I knew I'd be safe to head out for my first big solo ride in a long time. I love long rides - they've never failed to make me feel good. For my birthday I decided to check out a few roads I haven't ridden in a while. I let nature choose my course. Starting out into the wind (always makes for a better ride home).<br />
<br />
Down to Paoli, I start to feel really good as I watch my CGM numbers drop from 120 to 60. This steady drop seems to be the trend during my warmup period and lasts about 45 minutes. I climb Observatory feeling strong - my GCM numbers level out - once I recover from the hill I feel the stronger than before. I head out Hwy A with the goal of heading west.<br />
<br />
I wasn't in the mood for Blue Mounds, but perhaps Blanchardville? I really enjoy the large roller in that area. On Hwy A I found very smooth new pavement, caught a bit of a downpour, but really started to feel good. As the rollers grew bigger, my body responded with more energy. And despite the headwind and hills and drinking only water and not consuming any carbs, I got to Gratiot in 5 hours, feeling strong. I've been to Gratiot before and randomly found my way here again. I had hopped onto 39 to Mineral Point and then had to take 23 south considering the number! Beautiful roads. At the convenience store in Gratiot did my blood sugar test. 70- I ate some salted cashews and bought some hard peppermint candies just in case. <br />
<br />
I recently stumbled upon an old blood-work from 2003 and my way back fasting blood sugar was 80. And a reminder than my meter reports 8 points falsely low (compared to whole blood draw). Riding my bike with a BG of 70 isn't as careless as it seems. To the traditional diabetic rider it probably sounds like a level at which one would have absolutely no energy. But I was humming along. Long climbs of 4-5 minutes at a time - plenty of time out of the saddle, really putting the burn into my legs.<br />
<br />
I could build up to a rather high level of work. My legs seem to wake up the longer I went. 10 hours round trip. 156 miles. Wind, rain, hills. My CGM had me at 60's, my meter had me in the 70s. To compare this to last week's HHH, I chose not to drink any UCAN this ride. That difference explains the 30 point difference in the level of bloodsugar my body can keep up while I'm riding. What's not clear is whether I felt stronger with or without the higher bloodsugar.<br />
<br />
Considering it's not the carbs that are fueling my mind and muscle, I'm not sure how important worrying about bloodsugar really is. I'm really growing in my confidence. If my body can keep up for 150 miles already, as I continue to train and follow this diet I'm only going to improve at the level of intensity that I can maintain for that duration.<br />
<br />
A very cool feature that I'm figuring out. Once I start to do a cooldown from my workouts, when I reach a point where my heart-rate is in the 120's, my blood sugar (according to my CGM) begins to raise naturally. Over the twenty minutes of cooldown and 40 minutes of standing around the house, my numbers rose from the low 60's to mid 90's. All on it's own. It didn't even overshoot this time. My dinner was totally carb free. There was meat.<br />
<br />
Now for the part I'm quite excited to announce. I spent the entire day of June 23rd free from insulin. Not a drop for the entire 24 hours. Within that time, my numbers according to my meter were between 70 and 130.<br />
<br />
Not every day is perfect, but June 23rd was pretty close.<br />
<br />
<br />Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-78576872549429451132013-11-08T21:53:00.004-08:002013-11-12T15:09:14.055-08:00World's Longest Slowtwitch Post.<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">So I don't read Slowtwitch as much as I used to. Okay, I used to read it a lot when I had free time between experiments in my previous lab job. These days I rarely read it, and if so it's for the articles and no longer the forum. But today I stumbled across </span><span style="background-color: white;"><span style="font-family: Verdana, Arial, Helvetica; font-size: x-small;">a thread titled, </span><b style="font-family: Verdana, Arial, Helvetica; font-size: small;"><a href="http://forum.slowtwitch.com/gforum.cgi?post=4847972;do=post_view;do=post_view#last" target="_blank">The Official Diabetic Triathlete Thread</a>. T</b><span style="font-family: Verdana, Arial, Helvetica; font-size: x-small;">alk about great timing! I was looking for info on IMAZ water temps - but instead being</span></span><span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;"> able to communicate with a bunch of other diabetic triathletes, including another diabetic coach who authored <a href="http://www.ironguides.net/triathlon-on-a-low-carb-high-fat-diet/" target="_blank">this article</a> on a low carbs strategy for IM. </span><span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Talk about a gold mine. I ended up posting my 'intro' which turned into a manifesto, which I figured I may as well share as a blog post. So here it is:</span><br />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;"><br /></span>
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;"><br /></span>
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">I'm</span><span style="font-family: Verdana, Arial, Helvetica; font-size: x-small;"><span style="background-color: white;"> 34. Was diagnosed almost exactly a year ago, type I - LADA. I've raced 3 IM in the past, more HIM than I can count, tons of endurance cycling etc. I'm racing my first diabetic IM next week in AZ and planning to use it as a learning experience. </span></span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">I think it's great that resources such as this thread allow us all to find another and discuss these topics. It really is amazing the progress. I'm am incredible grateful for those who have tested the boundaries and been brave enough to achieve the success that they have had. Every diabetic is different, physically and mentally. Hell, I'm different depending on the day - but that said I'm also going to vouch for Vinnie and the benefits of being low carb and ketogenic adapted. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">I have also been pursuing this strategy, admitted I'm new to the scene so I know my place. However, how I choose to care for myself is my decision. I'm not here to pressure anyone else to do things my way, but it works for me. My goal is to try to preserve my beta cells - hell I'll openly admit that I'd love to reverse this thing. Even if that's an unrealistic or unobtainable goal it still leaves me with my health. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">I'm not saying it's unhealthy to treat your diabetes in the traditional manner, but for me I want to pay due respects to the 80 year old future me. I don't want to (in my opinion) risk my long-term healthy by exercising with BG's in the 140's. I am able to train in the 80-100 range very well. I do not experience any rapid hypos, and if I do ever go low I can just stop or slow down and my body will auto-correct. Vinnie's comments about the law of small numbers is only part of the benefit. The real benefit in my view is that being adapted to burning ketones as a primary fuel source means that my body can handle them and actually use them. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">There is more to it than just 'low carb'. I've trained by body to burn fat (in the form beta-hydroxybutyrate). So not only do I not get high BGs from food, although high intensity intervals do cause a bump, I'm protected from lows. I guess I can't prove this, but I am putting my life on the line that I am more protected from lows. I haven't ever been low to a point where I haven't been able to think clearly and care for myself (again, this is year 1 so knock on wood) It's not a hypo unawareness issue, it's that my brain and body aren't choked off from their only fuel source. There was an interesting study I read about in "Good Calories, Bad Calories" where they took patients who they ketoadapted through starvation for a couple weeks and then administered enough insulin to take their BG's below 20, and they apparently suffered no neurological deficit - I think this was in the 1930's since you can't fund that study these days! Not that it's my goal to ever go that low, but if I do I'd rather not go into a coma. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">My blood ketones are consistently in the 0.5-2.5mM range, no where near the 15mM DKA risk category. I feel better and perform better at 80 than over 140. I get stronger as a workout duration increases - I feel like a big diesel engine. Admittedly I'm probably a small portion of my anaerobic metabolism, but I've also upregulated my aerobic (just through diet!). I should do a VO2 max test and measure my respiratory quotient - been waiting on that since the first year of diagnosis is $$$. But I can tell I'm more aerobic while swimming and require less air, etc. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">A note about CGM's. I use a dexcom G4, but it doesn't seem to tell me much. My theory is that this could be unique to the whole ketoadapted thing. It's great when sedentary, but once I'm 40 minutes into cycling workout the CGM shows that I've dropped below 50 while blood values show me still in the 100's. This could be related to my ketoadaptation, either way it doesn't tell me what I need to know for it to be a reliable tool during exercise. Maybe my interstitial glucose values really are 40's, but I was knocking out killer hill repeats feeling very strong the last time that occurred. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Other benefits beyond and up-regulated aerobic capacity is that I'm noticeably less inflamed now. No more allergies - I can breath though both nostrils at the same time! My flexibility increased which I thought was crazy (I got better at yoga while not actually practicing?! ), my energy is very steady - I can miss a meal and not be hungry and have stable BG values, I could fast for a day and train just fine. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Now again, I'm not forgetting that I'm still new at this. I was likely honeymooning a bit, and hopefully I still am and will continue to for the rest of my life. Right now I'm using an OmniPod (no tubes!) and run a 0.4U/hr basal. I set a temp basal of 0.15u/hr for aerobic efforts. I turn that temp basal on 30-45 minutes pre-workout before swim and bike, but time it at the start for runs. I experience similar BG effect that I quoted from Vinnie above. For high intensity workouts or short runs I don't reduce a temp basal. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">With my first diabetic ironman next week I did 4400 swim yesterday. By swimming a comfortable easy pace my BG dropped from 90 to 70 and my splits where nice and consistent. Normally I'd do that distance in about 65 minutes - but yesterday's pace time was 75 minutes. Then for shits and giggles I did a hard anaerobict 200yd effort to finish my workout. By the time I was dressed I was back up to 90 from the intensity. That's pretty cool in my mind. (using my own glucagon rather than injecting). </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">As for losing 10 minutes in my swim - I don't care. I'll be stopping to test on the bike. I'll be happy with a 6hr+ split (where as I know I could probably ride sub 5:15, at least I could pre-diagnosis). And I'll just be happy to finish the run. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Its funny how I feel a little pressure to prove that this strategy works by actually going all out, but it's not worth the risk to me. I have a much longer term vision. Maybe I'll go harder in IMWI'15. There is hopefully going to be a big group participating. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Oh, and more details. My A1C after my first year is down to 5.6%. I eat mostly fat. Typical meals: Breakfast is either bacon and eggs with kale in coconut oil or lard. Lunch (if I need it) is a salad with olive oil and vinegar dressing perhaps with avocado and sardines on top. Dinner is usually a home-made soup from bone broth with non starchy veggies, maybe 6-8oz of pork, fish, or steak (sometime liver). Snacks are almonds, macademia nuts, or a spoonful of coconut oil with nutbutter and/or chia. Dessert is coconut milk chia seed pudding with cinnamon and cocoa powder mixed in. And I admit to putting kerry gold butter in my coffee if I'm in a hurry. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">Sorry for the length of my post. Again, I think it's amazing that we can all share this info. I'm so happy to read what Vinnie has posted because it reflects what I too have learned and experienced. We all have a choice in how we care for ourselves. And even if you choose the HCLF strategy, your better off than someone who chooses no strategy and doesn't exercise. We are all doing the best we can. I'm just glad to have the choice. It was hard for me to find info on choosing this method so hopefully my words (and Vinnie's) will help explain this option to anyone else that might be interested. </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">If you sadistically want to read more about me I do write a blog at koryseder.blogspot.com. I think I'm just going to post this as a blog as well - wholly manifesto! </span><br />
<br style="font-family: Verdana, Arial, Helvetica; font-size: small;" />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica; font-size: x-small;">I'm not on ST much anymore, just happened to check in for info on AZ (water temps, etc), but I'll follow this thread - good timing I guess! And from my blog address I'm easy to find on FB. Good luck everyone! I know how afraid I was a year ago - and it's due to the work of all of you that I have the confidence to continue on in the sport that I love, hopefully for a long time to come. </span>Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-19835883018333419712013-09-18T19:03:00.000-07:002013-09-18T19:03:32.514-07:00Measuring KetonesI finally started doing something that I should have done a while ago - measure my ketones. It's something that I initially thought I was doing by using ketostixs, which are cheap and easy to use. All you do is pee on a stick, wait 15 seconds and then match a color. But there's more to it than this.<div>
<br /></div>
<div>
The method above is quite crude. It's actually not too far from how they used to measure blood sugars not too long ago. Measuring anything in the urine can be easily thrown off by hydration levels - and considering that I have a sweat rate measured to be more than twice the standard person, it can really get thrown off. Plus anything measured in the urine is old data if you're really concerned about what going on in the blood. </div>
<div>
<br /></div>
<div>
And finally - ketostix actually measure Acetoacetate (AcAc), which is only one of the three types of ketones produced by the body. When I initially began my ketogenic journey I was measuring very high levels on the ketostix, but after a couple of weeks, my ketones barely registered. This is likely due to the fact that over the first couple of weeks of ketoadaptation, things change. It seems that initially AcAc is produced, but eventually you start to make a greater proportion of the ketone called beta-hydroxybutyrate (BOHB). The kidneys also change their ability to filter out or hold in different ketones. Together this may explain why I wasn't seeing much for ketones in my urine, but judging by my performance I'm rather confident that I was still making them. </div>
<div>
<br /></div>
<div>
While ketostix measure AcAc, a blood ketone detected such as my newly acquired Precision Xtra measure the blood concentration of BOHB. BOHB is the ketone that is preferentially used by the muscles. Much of this info I learned from the Phinney & Volek books "Art & Science of Low Carb..." I also learned the actually levels that I should be aiming for. </div>
<div>
<br /></div>
<div>
It appears that there is a physiological curve where ketones are most useful. Most people produce some level of ketones - pretty sure that less than 0.2mM. In order to be considered to be benefiting for the physiological benefits of ketosis, a person should be targeting a concentration between 1-5mM with 5mM being the peak of benefit, but then the benefit tapers off beyond that. Ketone levels supposedly aren't as variable as blood sugar levels, but I'm still learning how they vary as an effect of both diet and exercise.</div>
<div>
<br /></div>
<div>
I've been testing for a week now. My first test was last week after I ran 18 mile over the course of two runs during the day. That test showed 2.3mM. Bingo! Then I continued to test over the course of the week - still running each day - distances ranging from 6 to 12 miles, but each day the ketones in the evening measured less and less. 0.9mM, 0.6mM, and then last night 0.4mM. </div>
<div>
<br /></div>
<div>
While I'm very relieved that the numbers are on the conservative side, I was concerned that I might be doing something wrong. I'm able to run for 2-3 hours at a time without carbs, with stable blood sugar and consistent energy (all done at an easy aerobic pace). I'm confident I'm in ketosis - and I feel very good, but 0.4mM is pretty low. </div>
<div>
<br /></div>
<div>
But then today I got in a 5 hour ride. Easy pace again, reduced my temp basal to 0.1U/hr and achieved very steady blood sugar numbers ranging from 75 to 90 mg/dL - energy felt fine. I haven't been spending much time on the bike since I've been focusing on my running lately - so I didn't feel incredibly strong on the bike, but I felt good. I should could have stopped for more water and perhaps packed some salt, but I managed fine in the cooler weather. It was just an easy ride - a good opportunity to finally log some miles on the tri bike.</div>
<div>
<br /></div>
<div>
I ate some dinner post-ride since I was hungry. I'm learning to manage my habit of post ride eating. I'm still used to the urge to have to eat right when I finish riding, even when I'm not actually hungry. I have to be careful with what I eat post workout since my insulin levels are much lower than usual, even a small amount of carbs would spike me - I would love to have a nice green juice but even the carbs in that would spike me pretty quickly. So I found a nice dinner with plenty of fat. And then I enjoyed a nice cup of home made chicken broth to replace some of my electrolytes. Feeling good now!</div>
<div>
<br /></div>
<div>
What did the long ride mean for my blood ketones? 3.2mM! Boom. From 0.4mM last night up to that. Now higher isn't always better - their is no benefit to running blood ketones higher than 5mM. But I'm also nowhere near the levels that would be a concern as far as the dreaded diabetic ketoacidosis, which can be found in the range of 15-20mM. </div>
<div>
<br /></div>
<div>
I had planned to run afterwords, but I'll save figuring out how to transition from bike to run for another day. That task is going to have some nuance to it as well.</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-13245233749492836032013-09-10T18:51:00.000-07:002013-09-10T18:51:04.234-07:00Inspiration & ResearchIt's the week after Ironman Wisconsin - an inspiring event for sure. I did not race this event this year - this year was about coaching for me. The whole week leading up to the event is full of excitement. It's a celebration of ambition - certainly a cause I can get behind.<div>
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjv6WJqMRrQknzVHVkdo9xdYPGxBMbGvjkUfbMSUmu6hyQYsreEubwqMLXKa6iNjxf1G2Bqa83vjUKeOSjZSHHwSb0GXGTRL0g8Cxajgt85N4PqCcNaR4V2LbrMhTWHi5-r7E-LFJAG33hG/s1600/imwi+logo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjv6WJqMRrQknzVHVkdo9xdYPGxBMbGvjkUfbMSUmu6hyQYsreEubwqMLXKa6iNjxf1G2Bqa83vjUKeOSjZSHHwSb0GXGTRL0g8Cxajgt85N4PqCcNaR4V2LbrMhTWHi5-r7E-LFJAG33hG/s1600/imwi+logo.jpg" /></a></div>
<div>
<br /></div>
<div>
<br /></div>
<div>
The weekend was a great success. I am very happy with how my clients did. Very, very happy. If I had to compare the nerves of actually doing the race myself, verses coaching, cheering, and spectating - I will definitely admit that I was more nervous on race day about how every would. I guess I've always found it easier to stay calm when I'm the one actually doing the work. As a coach I was anxious - hoping that I properly prepared my athletes for the day.</div>
<div>
<br /></div>
<div>
In a sense I'm much more relaxed when I'm the one actively working towards the goal. I'm approaching my third year as a coach - and I'm gaining confidence in my abilities. However, like many others with high ambition I set a high standard for myself and even when things go very well I am always thinking of ways that they could go even better. </div>
<div>
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4YlmTMUUJyQ67c94Qtl_Vv0a_UYJkve0-tptFnPqdln2lp_Huiop6P56gmOBbrOgJosUaw1y27sS_V5DqY1PzXTYvYvA4XuWsIh0sfSD3e5hagGr8TzgbLPt04oz8kHWdcsPemAd11Dfy/s1600/1239395_10151575654272100_2100867383_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4YlmTMUUJyQ67c94Qtl_Vv0a_UYJkve0-tptFnPqdln2lp_Huiop6P56gmOBbrOgJosUaw1y27sS_V5DqY1PzXTYvYvA4XuWsIh0sfSD3e5hagGr8TzgbLPt04oz8kHWdcsPemAd11Dfy/s320/1239395_10151575654272100_2100867383_n.jpg" width="320" /></a></div>
<div>
<br /></div>
<div>
<br /></div>
<div>
It's such an inspiring event. I started the day at 4:30am scoping out a spot to cheer on the helix and stayed at the finish line until just after midnight! I'm so glad I stuck around. Without even knowing the story I witnessed a very inspiring moment. Father and Son duo, Dan and Zack Rotert respectively dove across the finish line 7 seconds after the finish-line clock showed the 17 hour cut off. Why do you never quit? Because sometimes the finish line clock is wrong. That night it was running 9 seconds fast. Regardless of the technicality of it all - the can rightfully call themselves both Ironman. The back story here is that Zack had a very had day - it was his first time racing the Ironman distance. And he's a fellow Type I. Can't find anything more inspiring than that. </div>
<div>
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyhM-AGzym5Ke4B8kpjZ4VBQpkwC8ILQbRbqDOcXY-UHzChhiCg4nO2OEKx-K9nCZaQoJA2WXrTfKGQtYIe_zen1KQwd0AvMQNd3CU640JAVSgYtgH_3Js-aAks1KaDE2Pu8fA1DCf21kL/s1600/zack+and+jen.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="239" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyhM-AGzym5Ke4B8kpjZ4VBQpkwC8ILQbRbqDOcXY-UHzChhiCg4nO2OEKx-K9nCZaQoJA2WXrTfKGQtYIe_zen1KQwd0AvMQNd3CU640JAVSgYtgH_3Js-aAks1KaDE2Pu8fA1DCf21kL/s320/zack+and+jen.jpg" width="320" /></a></div>
<div>
<br /></div>
<div>
<br /></div>
<div>
That said and not to be critical because we are all coming to this sport with different levels of ability - my goal is to NOT suffer in the same way that Zack did. If I had the same difficulties and put myself through that same amount of suffering when it comes time for me to race my next race - to be honest I'd pull out. Don't get me wrong, for Zack to claw his way across the finish line was amazing. That was his goal and he laid it all out there to get there. However, for me my goal (bigger than racing) is to be healthy. This has been a realization that has been difficult for me to come to terms with. It's in my nature to push as hard as I can - but in reality I know that that thinking is very dangerous. </div>
<div>
<br /></div>
<div>
Perhaps after I build on a couple racing successes I'll trust my body enough to push it harder, but until then I am only willing to push at a safe level. Some might call that wimping out - others might call it maturity.</div>
<div>
<br /></div>
<div>
Regardless of it all - man it was exciting! Even with the approach of Ironman Wisconsin I was inspired to really take my own training back into my own hands. I've experienced some spectacular success with my nutrition and my training. I've even managed to knock out approximately 70 miles of running this week - where did that come from?! I'm amazed at my bodies ability to perform aerobically and recover well. I really have some amazing endurance considering that I haven't really been focusing on it. I truly feel that I have unlock a key to endurance that I never would have expected. </div>
<div>
<br /></div>
<div>
My running has still all been on the treadmill (for safety and for controlling conditions), and my running has not been fast. I've been walking plenty, but I'm laying down some good distance. It's mostly 10 minute miles for now, but I'm listening to my body. Right now it feels great. I've never recovered from a 16 mile run so well in my life. Today I'm taking my first rest day in 12 days - tomorrow I'll be back at it.</div>
<div>
<br /></div>
<div>
And while all this inspiration surrounds me, I hate to not mention the 'Research' part of the title of this blog. My recent reading list has consisted of "Good Calories, Bad Calories" by Gary Taubes - which has been doing a rather in depth review of the flaws in modern dietary thinking. It's the detailed book before his much easier read "Why we get fat & what to do about it" which was a much easier read.</div>
<div>
<br /></div>
<div>
The other two books that I'm excited about are from a pair of researchers, Jeff Volek & Stephen Phinney. I just finished "The Art & Science of Low Carb Performance". Pretty easy read that does a great job of discussion the how to's and benefits of low carb. Very nicely organized and it does a great job of keeping things simple. I'll probably be digging through their cited resources for a good long while now. I'll also be reading their prior book "The Art & Science of Low Carb Living". Judging by the one I read first, it's telling where my priorities are at!</div>
<div>
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEvGrJrnftRYn9sNodBw2QxQncibr-7nXbQZHzqgUi6a0t_dVxtAs6_lx1khK_w1NPaXvpf2OIYTeIiU8e4z9uj6WVM2Pn6mR0SXQXIV0r6zMWOLP_jwK7hlN5ktX_UkLCkJx2OSv6DS4N/s320/performance.png" width="213" /></div>
<div>
<br /></div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-37449258424375782242013-09-02T17:43:00.000-07:002013-09-02T17:43:31.001-07:00New Paradigm - and success: and a bunch of details that are probably only important to me.I'll be honest. I have a few unpublished blogs that I'll be saving for myself. It's been a tricky summer with the management of my diabetes. I had things well figured out - as I had it with both my riding with HHH and my birthday ride. But as I'm learning as a diabetic novice - things change.<br />
<br />
<h3>
The paradigm-shift: I must have been honeymooning.</h3>
<br />
Turns out that I likely was 'honeymooning', meaning that my body was still making a trace amount of insulin. Likely, but not proven. Ideally I could get all the necessary tests done to measure the levels of endogenous insulin production vs what my pump provides - but in reality I could not convince my health care provider to pay for additional tests. I look back at my initial test of my insulin levels and I guess it seems fair to assume that I held onto my ability to produce a very slight amount of insulin. And this makes sense when I consider my ability to ride and swim for long workouts with my basal pump rate set to zero. <br />
<br />
I am always open to learning more. I have been doing well on my high fat, moderate protein, low carb nutrition. But despite that my stability took a nose dive at the start of July - it took me a while to figure it out. I questioned whether it could have been my choice of the ketogenic diet, whether it was something specific I ate, stress or lack of rest, etc. In restrospect I really can't be sure. But regardless of the cause I've got the train back on the tracks. And honest confession, I feel some guilt believing that my instability was a result of an overindulgence of chocolates and sweets - but whatever the cause the result is what it is. My body now seems to make absolutely no insulin. (Again, I'd like to get this tested but that request is denied).<br />
<br />
I make this assumption because of the changes which I've had to make to level things back out. Previously I would set my daily basal rate to 0.2U/hr. During my period of instability I had to get to 10x that - it was crazy. But now I've been settled for over a month at a rate of 0.8U/hr. And I'm stable. My insulin sensitivity has lowered a bit, and that could be due to my low carb diet - something I just read about on Mark's Daily Apple. But assigning reasons is really just educated guessing without the ability to test myself. All I can really say is that 1U of insulin does not seem to go as far as it used to. (It used to be 1U:40grams). I don't really know what it is now since I don't plan to test - since I don't really ever eat that many carbs anymore - but I'd guess I'm about 1U:25g judging by my corrective use. I guess I could do those tests at some point.<br />
<br />
<h3>
Lets get to the success:</h3>
<br />
But back to my successes - it's always fun to talk about what works. Running has been the biggest challenge for me. I attribute it to my size. There is no way around the fact that I'm 6'5 and 225#, although my weight ranges lately and I was much leaner a few months ago. I don't put too much stock in my body-weight but that is a topic for another day. Running more so than swimming and biking has a greater physical demand due to gravity. Swimming can be done at very low intensities and lots of breaks at the walls, cycling provides a range of gears. Plus I'm much more efficient mechanically as a swimmer and a cyclist.<br />
<br />
Running has always been my favorite discipline, but for those reasons above, also one of my more challenging. I was just starting to build confidence in my abilities. I had broken into the 19:3X's for my 5k, gotten my mile time to 5:20. Most of that progress I made without doing much for actual speed work. I was focused on running economy and ultra distance running - not only was it a low injury risk for me to run the trails in Vancouver at slower than 12min/mile pace, it was great fun. It was supposed to be NOW that I was planning on increasing my intensity, hitting hard track workouts and finally building to long set goals such as a sub-40 10k, hoping that those increases would translate into faster marathon times.<br />
<br />
But running has been the discipline that my diabetic diagnosis affects the most. Most of my runs have caused me to destabilize. At first my runs would cause the expected drop in blood sugar values, but now that I've become very fat adapted the reverse has actually been the issue. Due to the greater physical demands of running my body, through whatever mechanism, would actually produce more blood sugar than it needed. Total mind bender on that one - and the only way around that would have been to head out running with my full basal rate flowing - not something I wanted to get wrong alone... so I put those trials off until now.<br />
<br />
But as I said, there has been success. I've had to relegate myself to the safety of the treadmill, but it's been working. Right now I'm doing a lot of walking, which provides opportunities to test my sugars as I go, as well as let my body's fat metabolism catch up to the demand. And I'm just running slowly for now. Logged a total of 16 miles today! That's on top of 10 miles last night, and a few shorter runs of 3-6 miles earlier this week. I don't want to ramp too fast, but I'm on a cushioned treadmill running very slowly so I'm not too concerned about doing too much too soon - but I do know better.<br />
<br />
<h3>
Details....</h3>
<br />
What worked today in case anyone is interested, but more for my own record, was:<br />
<br />
Started running at the same time I turned my basal down from 0.7U/hr to 0.35U/hr. Kept repeating segments of walking 5 minutes at 3mph and running 10 minutes at 6mph. Like I said, not fast but I'm focusing on building the base right now and need to be very patient - stability is way more important.<br />
<br />
What I was hoping for was that by started to run at the same time I turned my insulin down, the insulin that was in my system would cover the BG spike that I'd been seeing when my body adapts to the demand. And it worked, perhaps a little too well. My body's response (spike in BG) seems to increase when I start running too fast too soon. So this 5 min walk - 10 min run seemed to mitigate that. <br />
<br />
I figured it would take about an hour for the reduced basal rate to start to balance out, so I wasn't too shocked to see that after 30 minutes my BG was down to 71. I was feeling fine so I kept on going in hopes of figuring out where my bottoming out point would be. This is assuming that my fat metabolism would kick in at some point as my insulin level reduced. I tested my BG during every walking break.<br />
<br />
I noticed a few other things worth recording. My heart rate while walking at 3mph would drop to 120bpm after one minute and would be down to about 100bpm after 5 minutes. My HR while running at 6mph would stay between 148 and 150. The longer I kept running, the lower it would actually be (which I'm contributing to fat adaptation. As for nutrition: My breakfast was 6 slices of bacon, 2 eggs (4 yolks) served over a bed of lettuce 4 hours prior to running. No calories were consumed during my run, just 3 bottles of water.<br />
<br />
After my initial drop to 70mg/dL each successive test was steady in the mid-60's. After about 90 minutes I had a reading of 62, but since I felt very good I decided to turn my insulin down further from 0.35U/hr to 0.10/hr and keep going. Sure enough I kept repeating my 10 minute miles and despite no calorie input my numbers started to balance out closer to 70. Luckily I find this whole process entertaining since I did spend upwards of 3 hours on the treadmill - thank goodness for podcasts too. <br />
<br />
It was a fun experiment. 3 hours of running without carbs sounds rather crazy - and not something I recommend, but I never got hungry. I actually spent the entire run breathing through my nose as well - which has become my fun way of ensuring that I'm training at an aerobic level. I counted my breathing rate to be about 24 breaths per minute - too bad I couldn't quantify my 02 vs C02, as I'm confident that my fat adapted state is much more efficient on that front (RQ).<br />
<br />
I'm still not all that hungry afterwards. Normally I'd be ravenous after a long run. Normally I'd be much more sore as well. I've been trying a new treat which fills my chocolate cravings and fills me up very well.<br />
<br />
4 spoonfuls of chia seeds (30g)<br />
1 cup of water<br />
microwave for 2 minutes<br />
mix in 4 heaping tablespoons of cocoa powder<br />
1 pat of grass-fed butter.<br />
<br />
It makes for a chocolate oatmeal sort of thing - hey I know it's not normal, but I like it. I've had it pre-run too and it sits very well.<br />
<br />
This time I added a little bit of raw green leaf stevia, but have also sweetened it with some almond butter and or sprinkled a bunch of powdered pecans or walnuts in with it. This is my new treat now that I've been trying to limit my usage of dairy, specifically the heavy whipping cream - another experiment for another day. Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-15318799336588429552013-06-24T07:19:00.002-07:002013-06-24T07:19:26.671-07:00Horribly Hilly Hundreds - 200km hilly bike ride.<div class="separator" style="clear: both; text-align: center;">
<img border="0" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh11JcFPPyVsb15Vovcm3tmA-ACwDAtQ3MkRMcJ-Z0yxGV_8uw5sP5I5iFkJV_b18vziS6GzQfE0ZbIr4KjIB3bSWww4Dql9i7be1s4Q9tD7AOAmjry1NqRHME5R_gK-Xc_4bb2HVMb70Qf/s320/HHH-logo-2013.jpg" width="320" /></div>
<br />
<br />
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.<br />
<br />
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<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijZ5cEgymxMZD3W2hIWjf4YoKaq157rW09e_d7QOl_tBadhsJduoHtXFTqu_4zMpCYex-f2J5aRPQXHvtU1genPw1t4_EBE18czP-wuLYcBhlUivn7Y5lHVIhAjuxXBHdNjIO5DxwbBkSE/s1600/Driftless+Satellite.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="235" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijZ5cEgymxMZD3W2hIWjf4YoKaq157rW09e_d7QOl_tBadhsJduoHtXFTqu_4zMpCYex-f2J5aRPQXHvtU1genPw1t4_EBE18czP-wuLYcBhlUivn7Y5lHVIhAjuxXBHdNjIO5DxwbBkSE/s400/Driftless+Satellite.jpg" width="400" /></a></div>
<br />
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.<br />
<br />
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. <br />
<br />
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.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJw1q9wKVm6uclIiwPVrx63Ovotw1uML4o9eWrzbn1kzq4akA53ly-Hxg33HmGr4z4aDNSEzfOJdhaw_fB1cxuETvkUa-wkpLkfUQaLCoKUIunUjxSS_1-TkaBRc374E7CICd71bTLeGFh/s1600/2013-06-15+18.32.19.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJw1q9wKVm6uclIiwPVrx63Ovotw1uML4o9eWrzbn1kzq4akA53ly-Hxg33HmGr4z4aDNSEzfOJdhaw_fB1cxuETvkUa-wkpLkfUQaLCoKUIunUjxSS_1-TkaBRc374E7CICd71bTLeGFh/s320/2013-06-15+18.32.19.jpg" width="320" /></a></div>
<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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!<br />
<br />
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. <br />
<br />
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.<br />
<br />
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.<br />
<br />
<br />Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-69886869269175120342013-05-27T10:00:00.000-07:002013-05-27T10:00:27.748-07:00DNSIt's amazing the number of acronyms and jargon we use in our lives. I have a feeling that it distances sub-groups of us, from them - and in doing so it disrupts the free flow of information. I'll do my best to spell things out.<br />
<br />
DNS = Did not start.<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjN95wUUqgN5Cuwh9ORDIqHxGMZDeaefptX2aD8LY-EosDViXfn5BqHpWHQBARlu63E6nM76Dj-eAPaonLaAEOwKh77fP8EaB5aUGJaNfPVjqFQb8siDR9CCkwIjw47pVOj2YPqAGJdoXeZ/s1600/dns.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="152" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjN95wUUqgN5Cuwh9ORDIqHxGMZDeaefptX2aD8LY-EosDViXfn5BqHpWHQBARlu63E6nM76Dj-eAPaonLaAEOwKh77fP8EaB5aUGJaNfPVjqFQb8siDR9CCkwIjw47pVOj2YPqAGJdoXeZ/s320/dns.png" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A google search for DNS. Not helpful.</td></tr>
</tbody></table>
<br />
It is a close cousin to DNF which means Did not Finish.<br />
<br />
DNF and DNS are rarely acronyms that you want to be associated with. I make an argument that it's better to DNS than to DNF, but in doing so I find my logic is diametrically opposed to my previous point of view. (But then again, what isn't).<br />
<br />
The old me (or young me depending on your p.o.v. - er, point of view)... anyways - the way I used to think was highly tied to motivation. I have been competitive - my personal identity was tied in with how I measured compared to other people. I found great motivation with this principle. I would gut it out. Push through pain, never quit.<br />
<br />
I used to think that hard work was the answer to everything.<br />
<br />
I value hard work, but now I feel that I've grown up a bit. Hard work isn't sustainable if it doesn't balance with the rest of your life. Now the new me (or old me)... err - the me that is typing right now. My philosophies have developed to work smarter, not harder.<br />
<br />
Working smarter is a theme that I see in many disciplines of my life. Working hard in the wrong direction doesn't make progress. If we speed in our cars without stopping for direction, we are not making progress to our destinations. Rushing through your job to finish a task in a hurry, only to learn that what you did was wrong and needs to be redone - does not save you time. <br />
<br />
In general, rushing and stressing over quantity over quality leads to negative consequences. More mistakes, more stress. More stress, less sleep. Less sleep, less time. Less time, more rush. More rush, less attention. It keeps going.<br />
<br />
The greatest lesson I am learning is to continue my work slowly and with deliberation. I don't need to hurry to satisfy anyone else. I will be better of to focus and produce quality. I control the internal voice that pressures me to rush. It's the same voice that also tells me I must be in a bad mood because I don't have time. There are lots of voices I don't listen to anymore. I have decided to replace what I deem to be negative voices. <br />
<br />
There are lots of negative voices - they inundate our lives. TV, radio, internet ads, billboards, songs, movies. There are a lot of influences out there. I really don't miss the noise. I listen to what I want to listen to. To this I must thank Netflix and Spotify, along with finally figuring out how to listen to podcasts with I-tunes. Thanks guys - I know you still track what I do and probably know just as much about me as Target and Walmart. As a result of tuning it out, my mood has improved. I heard there was a tornado, a bridge collapse, some bombs, etc. But I didn't hear it over and over and over. This chronic message affect us and creates Post Traumatic Stress. I feel bad, I get it. But moving on.<br />
<br />
I'm at a very selfish part of my life where I don't need to worry about that. Worrying is not productive. I feel bad about that stuff but I don't need the chronic stress in my life. I am an incredibly empathetic person. More than most people know. I care deeply, I hug often. But I have lots of things to worry about that I can actually do something about. Lets focus on those first and worry about the culture of fear later - or not at all.<br />
<br />
I surround myself with people I enjoy. I rest when I need to rest - or at least I plan to improve on this. I have plenty of room for improvement. I don't need to define my personal worth on how I compare to others. At least not all of the time. There is room for improvement here as well. But I can still justify wanting to go fast. Fast is fun and when I'm ready to go fast I will. <br />
<br />
Fast is the reward.<br />
<br />
I want to go fast. Its addictive. But going fast too soon or too often can be a detriment. It is going to take a huge amount of restraint to know that I am getting faster, but without pushing myself to prove it every day.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/PKIpCPS-oZc?feature=player_embedded' frameborder='0'></iframe></div>
<br />
Slow down to go fast. Do less.<br />
<br />
So I'm a likely DNS at Lake Mills next week. I wanted to address this openly since right now while I'm deciding to back down from a challenge, I'm concurrently writing a speech about doing the opposite. There needs to be balance - and respect must be paid to the long term goal.<br />
<br />
A note behind my logic on this decision:<br />
<br />
I'm gaining massive amounts of confidence in my steady-state and yet still aerobic portion of my fitness. This is the fitness that will crush you over the longer distances. Ironman and beyond (I have always loved this spectum of sport). Next month I'll be doing a 6 mile swim crossing of Mendota for Gills for Gilda. <a href="http://gills2013.kintera.org/faf/home/default.asp?ievent=1065844" target="_blank">Click here to donate.</a> My swimming has been going very well.<br />
<br />
I'm able to bike aerobically very well. There have been a couple of long rides now and no problems with energy. I've even gained confidence where I've gone out and run on my own. I carry carbs, but haven't needed any of them yet. I don't feel very strong when I'm not warmed up (which requires 30-60 minutes), but when I feel strong I feel superhuman. <br />
<br />
My fueling system requires a massive warmup in zone 2. The best I have felt is after 2-3 hours of easy riding that builds towards the end. Without this warmup I am not able to achieve the physiological state that is required for hard steady state anaerobic work. This means <a href="http://www.racedayeventsllc.com/content/lake-mills-triathlon" target="_blank">Lake Mills</a> If I'm going to race a sprint triathlon, I'm going to race the damn thing. Unfortunately my bigger goal is to continue to develop my all day pace with my eye on Ironman Arizona in November. <br />
<br />
So little Lake Mills will be a game day decision. Odds of DNS are high. I'm okay with that. I don't quite have things settled to a point where I'd be able to get done what needs to get done to feel confident going into that race. I'll have a greater reward to focusing on more important things this week. No reason to stress yet, my race is in November. <br />
<br />
Big picture.<br />
<br />
IMAZ goals (on a good day):<br />
1:30m/100 swim<br />
36kph bike<br />
5:30min/km run<br />
< 10 min T1+T2<br />
<br />
Carry on. <a href="http://www.youtube.com/watch?v=eQ_y-WQOU-Q" target="_blank">Skip the Pepsi commercial. Oh the irony.</a>Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com2tag:blogger.com,1999:blog-5991863576518187587.post-53183906884925362092013-05-25T16:07:00.001-07:002013-05-25T16:17:17.993-07:00I used to be fat - now I eat fat.<div style="text-align: center;">
<iframe allowfullscreen="" frameborder="0" height="300" mozallowfullscreen="" src="http://player.vimeo.com/video/45485034" webkitallowfullscreen="" width="400"></iframe>
</div>
<div style="text-align: center;">
<br /></div>
<div style="text-align: left;">
I've gone a bit underground lately because I want to be careful in what I say. In the words of Sir Charles Barkley, "I am not a role model". What I am doing in life and how I decide to pursue my treatment and care for my Type I diabetes is a calculated risk.</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
I have forgone a lot of the assumed knowledge that is out there and recommended by the FDA, ADA, AHDA - I have said to hell with pretty much every accepted authority that is out there when it comes to how to pursue my treatment.. But I'm not just winging it - I'd done a lot of reading and in the interest of my own life, I'm taking a risk that I myself am willing to accept. I've made mistakes before in life - I'm sure I will continue to make mistakes - I am not perfect, I don't know everything. I am doing this for myself. I do not recommend that anyone else make any decisions based on what they perceive as what I am doing. I am not a doctor, I am not a nutritionist, I am a person living with diabetes who is trying to live a full life as safely as possible. </div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
The above video from David Attia is however a very good representation of why I have chosen to discard conventional wisdom. If you truly are interested in the topic of nutrition I recommend you watch it all the way through. He has lots of material online that is rather easy to find if you are curious. I don't know him, but he has gained my confidence to a point that I'm pretty much risking my life on it. If I turn out to be making a poor choice, I will not hold him responsible. I will not sue him, my family should not sue him etc. I am a grown man and make my own decisions and take full responsibility.</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
Beyond Peter Attia there are many other voices out there. There are people like Vinnie Tortorich, Stephan Phinney, Ben Greenfield, Keith Runyan, Gary Taubes, Ludwig and Lustig, Sisson, Ferris etc. I'm finding more every day. Each of these people's voices are a whisper compared to the booming voice of conventional wisdom but together they sing louder than Eric Whitacre's <a href="http://www.ted.com/playlists/57/bj%C3%B6rk_6_talks_that_are_music.html" target="_blank">virtual choir of 2,000 voices.</a> The internet is a powerful tool for the sharing of knowledge. </div>
<div style="text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYqs8uBwrGLp0vlLilmMjdbFkmtbVPSRQ2NJx2fxKxtuJsLQy22Ew4MdGDoWOV_87OJRMcxcuTgYU8Ix7UPiZ5DRLuB65shYY6jjKuRcQkRwVPlkXMEc9QKzEMqw6rF7t16A9lbvEpBd5q/s1600/paula+dean+apidra.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYqs8uBwrGLp0vlLilmMjdbFkmtbVPSRQ2NJx2fxKxtuJsLQy22Ew4MdGDoWOV_87OJRMcxcuTgYU8Ix7UPiZ5DRLuB65shYY6jjKuRcQkRwVPlkXMEc9QKzEMqw6rF7t16A9lbvEpBd5q/s320/paula+dean+apidra.jpg" width="237" /></a></div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
And a further word on disclaimers. </div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
I was in the waiting room of the clinic awaiting my last nutritionist appointment and thumbing through the latest issue of Diabetic Living when I saw an ad for a drug called <a href="http://www.apidra.com/" target="_blank">Apidra</a>. It was endorse by newly diagnoses Type II diabetic and Food Network chef Paula Dean. Not only am I amazed that she's been able to cash in on her diagnosis, but of equal amazement was the list of side effects of an injectable drug the company can only say 'may' reduce your high blood sugar, but also might do this....</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
"The most common side effect of insulin, including Apidra®, is low blood sugar (hypoglycemia), which may be serious. Some people may experience symptoms such as shaking, sweating, fast heartbeat, and blurred vision. Severe hypoglycemia may be serious and life threatening. It may cause harm to your heart or brain. Other possible side effects may include low blood potassium, injection site reactions, such as changes in fat tissue at the injection site, and allergic reactions, such as itching and rash. Less common, but potentially more serious or life-threatening, is generalized allergy to insulin, including anaphylactic reactions."</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
I find this irony particularly thick when I'm rather confident in saying that type II diabetes can be controlled without oral or injectable medication with drastic and unthinkable actions such as eating a diet devoid of added sugar and exercising regularly. She knows how to cook after all.</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
And a side note. I went for a nice 70 mile bike ride today during which I only consumed 5 grams of carbs and my BG remained between 80-96mg/dl. (higher at the end). My breakfast 4 hours before the ride consisted of 2 eggs and an avocado and two coffees with cream and cinnamon. I rode easy with a friend and kept my HR between 90-130 most of the time.</div>
<div style="text-align: left;">
<br /></div>
<h3>
</h3>
<div style="text-align: left;">
<br /></div>
<div style="text-align: center;">
<br /></div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-3023801856024185022013-05-16T19:54:00.000-07:002013-05-16T19:54:22.583-07:00Thank you.Life is funny. We all know there are good days and bad days, but some days can be a bit of both.<div>
<br /></div>
<div>
I've been managing very well lately, yet despite this there are times where I'm just not able to be my bright sunshiney self. This morning was one of those times - sure I managed my diabetes fine, but for reasons I don't care to go into here - I still managed to ruin my morning. Totally my fault. Totally mental. </div>
<div>
<br /></div>
<div>
I know that my attitude is totally under my own control - I do choose to be happy. I choose to be positive - but I'm not perfect. I fail. I probably fail as much if not more than anyone else. This morning was one of those failures - I can be such an idiot. Sometime in the moment my mouth runs faster than my heart. </div>
<div>
<br /></div>
<div>
It's easy to lose perspective, it's easy to be angry. It's easy to be stupid. Hopefully no permanent harm was done. I can only hope.</div>
<div>
<br /></div>
<div>
That was the morning. I was still able to buckle down and finish what needed to be done. Even when I misread the pool calendar and showed up to swim (having turned off my pump 2 hrs ahead as usual) to prepare for a swim where I planned to expel all of my rage. I looked at the wrong day on the schedule and the pool wouldn't be open for another 3 hours. Simple enough mistake if I didn't live a life where scheduling is everything.</div>
<div>
<br /></div>
<div>
I figured it out. I found an outlet for my feelings - managing to workout in another means, despite tired legs. Had the chance to come home in the early afternoon and reassess. </div>
<div>
<br /></div>
<div>
It's become harder and harder not to believe in karma, or fate or who knows what you call it. There are a couple of people, who know who they are, that were able to say some very kind things to me at a point when I needed to hear them the most. I have great expectations - that's who I am. I won't settle, even less so now than ever before. But I can also be very hard on myself when I feel like I'm not making progress. As a coach I know the importance of an objective outside view - as good as I think I know myself there are people out there that know me better.</div>
<div>
<br /></div>
<div>
Thank you. </div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-44166728658022748762013-04-30T07:44:00.000-07:002013-04-30T07:44:00.530-07:00Management and MeasurementAs with many things in life, if you are hoping to manage something you better have a way of measuring it. Whether it's watts of power on a bike, the food you take in - or in this case the management of my blood sugar.<div>
<br /></div>
<div>
It's been a bit over a month since I've switched from multiple daily injections of insulin which I calculated based on the blood-sugar reading of my Accuchek Nano Blood Glucose meter. While I was using I was pretty good at holding steady at 100 mg/dL... according to that meter.</div>
<div>
<br /></div>
<div>
Then I switched to my OmniPod for my insulin pump. The PDM (personal diabetes manager) works both as the controller for my pump, and also as a manual blood glucose monitor. Right when I switched, the scientist in me knew well enough to check the consistency of the readings between meters. </div>
<div>
<br /></div>
<div>
I would use the same drop of blood and test it on both meters. Different meters have different margins of accuracy at different ranges. Some are more accurate for measuring high values, etc. I guess that's handy for those people who want precision in their poor control - not really my goal.</div>
<div>
<br /></div>
<div>
There has been a consistent off-set between these two meters. The difference was usually as much as 25 points. The Accuchek always read higher. That's a significant margin of error. 70 or 100 won't kill me, but 40 vs 70 is a big deal. And it's tricky to guess which one was actually right.</div>
<div>
<br /></div>
<div>
Functionally what this means is that I wasn't sure whether all my work of the past month with the OmniPod in which I've been able to hold a steady monthly average of 105mg/dL, may have been in fact a less than stellar* 130mg/dL (by my standards which are higher than most).</div>
<div>
<br /></div>
<div>
So after all this worry I finally got some blood labs done with a meter check. They drew about 20mL out of my finger tip in the lab. I was amazed at how well the lab tech milked that much blood so easily from a fingerstick - it actually hurt less than my stabber-jabber although upon further inspection her lancet cut a bigger slice.</div>
<div>
<br /></div>
<div>
The results came back. The omnipod read 92 mg/dL. The Accuchek read 124mg/dL. The lab values were 100 mg/dL (BULLSEYE!).</div>
<div>
<br /></div>
<div>
Implications. Accuchek should rebrand as in-accucheck. The OmniPod is much more accurate and it will measure me as slightly lower than what my bloodsugar actually is. So my avg of 105 might be more like 113 mg/dL. </div>
<div>
<br /></div>
<div>
Looking back. Makes sense why I was feeling gassed trying to workout with my Accucheck - similar to the fuel gauge on my Firebird which always showed 1/4 tank left when I really only had only enough to get me 20 miles.</div>
<div>
<br /></div>
<div>
Looking forward. I'd like to target my actual blood values when resting to be 90 mg/dL - so I'll play around with lowering my set-point to the low 80's (which will be a real world value of 90).</div>
<div>
<br /></div>
<div>
What a relief.</div>
Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com2tag:blogger.com,1999:blog-5991863576518187587.post-79701809604415167782013-04-27T18:36:00.000-07:002013-04-27T18:36:28.357-07:00Crazylegs Race ReportI used to love writing race reports. Some of them are hopefully still archived on the UW Triathlon Team forum. I've fallen out of the habit over the last few seasons and have only written reports on a handful of races. However, they are a useful tool for tracking progress. Great insight for what went right, and where to improve.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBE_9bguoh0o_RR69k57CaAo79nkHko8X8YXUGLP4j0UTjo00j1NZND-hVHwxiNwQ-7i2di5_ljIf2U_hXdv6Q8RH-hva885UwFjcmssXs6JdUJRtTcUe8qw9iUXsD-u5IFBZ-V9OFdeYo/s1600/obelisk+of+balls.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBE_9bguoh0o_RR69k57CaAo79nkHko8X8YXUGLP4j0UTjo00j1NZND-hVHwxiNwQ-7i2di5_ljIf2U_hXdv6Q8RH-hva885UwFjcmssXs6JdUJRtTcUe8qw9iUXsD-u5IFBZ-V9OFdeYo/s320/obelisk+of+balls.jpg" width="211" /></a>Crazylegs is a big event. It's an 8k and pretty early in the season, but it's a huge fundraising event for the UW athletic department. Hey, those obelisks aren't going to build themselves.<br />
<br />
It seems like all the run events in Madison follow a very similar course due to limitation of traffic flow on the isthmus. The variation to Crazylegs is that you get to run up a little hill about 1/4 mile in. Then at mile 1 you get to do the switchbacks up Bascom Hill by Helen C. Despite the early uphill, the first mile overall is net descent. I'm always amazed at how fast people take out the start of this race. <br />
<br />
These couple of early hills aren't something that I'd normally be concerned about - but they sure are now. Technically this was actually my first race. Sure I jogged the Burbee Derby, but I wanted to try to race this one. But for me to perform I need to try to stay as aerobic as possible. Part of this is related to the limitation due diabetes, and part of it is due to the fact that I haven't been training the anaerobic component of my running and biking. <br />
<br />
I'm currently tweaking a few things that should allow me to raise the aerobic component of my fitness. I'll get into those details in the future, but for the time being I'm pretty much locked into training the low aerobic component of my fitness. Doing a race with early hills doesn't really fit into this goal. But it's Crazylegs! It's an institution of its own. I'll get to why I love it so much at the end of this post.<br />
<br />
The race itself.<br />
<br />
Fighting weight: 214. Halfway between where I've been bouncing between. The trend has been on the way down over the last few days so that along with the way in which my wedding band and gummy bracelet fits indicates that the inflammation I'd encountered has been on the way down.<br />
<br />
Strategy: I needed to get a good aerobic warmup. Travel logistics are tricky in a 20,000+ person race. I don't know the official count, but it's on the huge side. To get around this I planned to ride my bike in. Seeing as it's a point-to-point run I planned to park near Camp Randall. I rolled up to the Police station across the street (complete with patrolling officer - safest bike rack in the city). But I forgot my lock which I was going to use to lock my bike and backpack together. <br />
<br />
Backpacks. Whoa. Now every backpack is a security threat. I'm gaining frustration with the little things in life that have become non-sense. But that's the world I live in (unless I defect). For the race's website I knew I couldn't bring my bag into the stadium. I didn't think it would be a problem to leave it by the police station, but go figure - it's a problem. I eventually figured out to leave it in the SHELL locker room. <br />
<br />
The trick here is that timing is everything. For any athletic activity - even the bike commute I have to reduce my pumps flow of insulin. It takes about 90 minutes for the reduction to have effect. I've been getting better at balancing that - but it's tricky. <br />
<br />
I need all my pump supplies with me. No way in hell was I going to put that in a dry-clothes bag to trust others to transport to the finish line. I also had my backup carbs if needed post race. Maybe I need a purse - luckily no one has done a purse bomb. The ladies would be livid. <br />
<br />
With the warm weather I did't want to run in my jacket so no pockets. And no fanny pack in the race swag this year... bummer. But I got it figured out. I'd run with my backup meter tucked in my tights, carry a couple kiwis with my as I run to the start line to get a good running warm-up. That all went pretty well, except the kiwis were rock hard, under-ripe and inedible. I also had tucked two hammer gels in my tights... which were getting a little too tight with the mobile science lab. So I ate the gel.<br />
<br />
I hate that.<br />
<br />
Sure it works as fuel, but it's not in line with what I'm trying to do. Maltodextrin isn't the worst thing for me, but it's on my watch list of items that have been causing my inflammation issues. Not the maltodextrin per say, but there are other things in there that I'd prefer to avoid: fruit juice, natural grain dextrins, natural flavors, they might be as benign as they sound but I've lost confidence in most 'nutritional products'. Which they'd say which fruit, wtf is a natural grain dextrin, and natural flavor leaves me wondering which flavor. I don't need flavor or color - I need clean fuel. <br />
<br />
But I ate it.<br />
<br />
A hammer gel usually takes about 40 minutes to peak in my system. 20 minutes before the start I consumed 1/2 a gel. Not wanting to carry a gooey half a gel around I decided to err on the side of going high and finishing it off before the start. <br />
<br />
Side note: I can't wait until my continuous blood glucose monitor arrives. I'd love to know what my glucose trends are rather than trying to guess. In everyday life I'm very in tune with the sensations of different levels, but its tough while running.<br />
<br />
Race starts:<br />
Everyone goes so damn fast on the first mile - partly because the next downhill. But mostly due to excitement at such a big event. I started at the end of my starting group with the plan of taking it out as easy as possible. I'm feeling that once I figure things out fuel wise I should be able to run a 32 here which is about 6:20 pace. Back in 2008 I ran a 35 while sick and I'm a much better runner since then.<br />
<br />
I wanted to take it easy for a 7 minute first mile - which I was close. Even taking it easy and walking at the top of the first hill I managed a 6:48. But my heartrate was higher than I want it to be still and had that damn switchback coming. I crested the second hill with a 171 heartrate - not horrible, but I was only able to get it down to the low 160's during my sort walk break.<br />
<br />
It was this point in the race that I had premeditated the decision to actually race or just have a hard workout. It sort of became a hard workout at that point. I didn't totally pull up since I wanted to find out if I could pull things together, but my expectations and pressure for a time were no longer a priority.<br />
<br />
I held my HR at just about 170 for the rest of the run. Took a few walking breaks when it reached 173. Man I feel great when running when my HR is just a few beats lower, but I haven't trained to a point to hold that level of aerobic fitness. I pretty much averaged 7:15's for the rest of the race - that's including the walk breaks.<br />
<br />
Mile 4 was the hard part. That section is usually hard for me. It's a bit of no mans land going under University Avenue and back up a little hill that always feels bigger than it is. This part of the course makes me reminisce about IMWI, but I started to feel rather awful. And quiet honestly - strangely emotional. Tough to tell what kind of awful. And the emotional thing could be a blood sugar crashing cue as well. Not knowing whether I was feeling 'normal running fast awful' or 'low BG awful' or 'high' and not wanting to take 2 minutes to stop and test I decided to err on the safe side again and take my last emergency gel<br />
<br />
Mile 5 is my favorite. I can always pass people on this part. I've always had the ability to finish a race hard. I good at burying myself. Unfortunately, that's much easier to do when burying is metaphorical and not a realistic possibility. It's hard to run with doubt in your mind. <br />
<br />
I shook off the doubt knowing I was only a few minutes from the finish. A little rocky music and some fun people drinking beer and tossing footballs brought me back to the state of mind I normally race this section with. I picked up the pace and the legs felt good... for about a minute. But then the reality started to kick in. Yes I'm strong, but my muscles couldn't fuel to keep up. Normally I'm the other way around. This is the limit I have to deal with right now. Shitty.<br />
<br />
Still a great day and a great event. I still finished in 36 something, but I sure didn't race. I ran. It's a step up from my jog at Burbee Derby and it lets me know where I'm at - but unfortunately it lets me know that I'm not where I was hoping to be yet. I always preach patience - it's time for me to do just that.Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-92012761999844548092013-04-21T06:35:00.000-07:002013-04-21T06:35:00.557-07:00Breaking point.I feel like I'm on the verge of a breakthrough here. So very close. During the past 2 weeks I've had a unique experience twice. Both while traveling to Austria, and then again to Fond du Lac, I've experienced a dramatic reduction in what I can only describe as inflammation.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh01ZSb44ZF7IccyRKd3hSiSaviTkjJZJOa4KryH_LeIVY9P1EM3iXYoC4K4DU5ppCHs6gcb22PE1wTns1uqGoXXQIl18KyXsH1Ixaw7RF50UsYt6EzeYeKpqLg1ZgIMpxdIBUDpBqVKwKQ/s1600/AtlasShrugged.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="226" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh01ZSb44ZF7IccyRKd3hSiSaviTkjJZJOa4KryH_LeIVY9P1EM3iXYoC4K4DU5ppCHs6gcb22PE1wTns1uqGoXXQIl18KyXsH1Ixaw7RF50UsYt6EzeYeKpqLg1ZgIMpxdIBUDpBqVKwKQ/s400/AtlasShrugged.jpg" width="400" /></a></div>
<br />
<br />
I've twice bounced between 220 and 207 lbs. I'd love to think that it's related to calories, but I know that it's not. 13 x 3500 calories... no way - that's enough to power me through 3 ironman distance races. I was working out less than 5 hours per week.<br />
<br />
My wrist band fits looser, my wedding band almost slid off my greatly reduced knuckle. I've always had gigantic knuckles (along with the entire big banana hands thing). I've attributed the swelling of my knuckles to my career as a soccer goalkeeper. I've recently dislocated both of my pinky fingers playing soccer from easy shots on goal. I feel as if all of the joints in my body had been stiffening up on me. But for a brief period of time following travel, my joints all shrunk. And they felt good.<br />
<br />
I wasn't dehydrated. I felt great, experiencing a level of clarity in my thoughts that I have rarely been able to achieve. It really felt great. I want it back.<br />
<br />
It's difficult to figure out what the difference is. I'm thinking through all the food variations. Peanuts? I eat a lot of nuts. I don't think it's milk, but I've traded in my low fat dairy. I still eat dairy, but only full test.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/dBnniua6-oM?feature=player_embedded' frameborder='0'></iframe></div>
<br />
It could be fructose. After watching all 90 minutes of "The Bitter Truth" by Dr. Robert Lustig M.D. - actually I had to watch it a couple times to brush the rust off of my signaling pathways. If you'd like to dig into it but don't have the full 90 minutes, I'd recommend starting at 56:30 or 1:04:30.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnastOZoAcXdmPt8SHmTzUoOxjde2RrD1nISUAzhZGPILJTpYYNG-Y94fw51Tf-MwIMl5_xFFH-LB0Z7eVLhmn_pBLgQyE2V2Rt9N75cwb3VBmld0SjI7QJZlsW5qlwGr6mrjLHTKKVC2v/s1600/cityHeader.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="89" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnastOZoAcXdmPt8SHmTzUoOxjde2RrD1nISUAzhZGPILJTpYYNG-Y94fw51Tf-MwIMl5_xFFH-LB0Z7eVLhmn_pBLgQyE2V2Rt9N75cwb3VBmld0SjI7QJZlsW5qlwGr6mrjLHTKKVC2v/s640/cityHeader.jpg" width="640" /></a></div>
<br />
<br />
It could also be the water. <a href="http://www.cityofmadison.com/news/view.cfm?news_id=3816##" target="_blank">City of Madison - News Release</a>. That would suck. I drink tap water. But I've noticed a significant difference in Fitchburg as compared to what I drank in Vancouver. One thing I've noticed is the overall mineral content. We use our steamer often to prepare rice and veggies. While in Vancouver, I observed the mineral deposits on the heating element reduce and eventually become totally clear. However, upon return to the Madison area, that same steamer is now clogged with deposits. Same story with the coffee makers.<br />
<br />
It could be coffee? Oh like hell - it better not be.<br />
<br />
Could it be the dogs? Wouldn't be able to really change anything about that. Nor would I even consider.<br />
<br />
I started to find this list of possibilities getting almost impossibly difficult to figure out. So close that it's just ticking me off. Talk about dangling a carrot in front of me. I want to feel that good again - but failed attempts have become frustrating.<br />
<br />
A break was needed. I loosened the belt and gave myself a break from tight control this weekend. Yup, it feels rather awful physically, but mentally it's been a vacation. A break from poking my fingers 10 times a day, a break from constantly thinking about diabetes. <br />
<br />
But that break was yesterday. Today is a new day - the swelling in my knuckles is motivation enough to get back at it. Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com0tag:blogger.com,1999:blog-5991863576518187587.post-32887460932958077812013-04-14T22:28:00.000-07:002013-04-14T22:28:10.255-07:00Home.Spent the weekend with my family in Fond du Lac this weekend. It's so easy to get wrapped up in my 'busy' life and not make the time to go so my parents. But my life is only as busy as I make it, so that part is really up to me.<br />
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_7QCMlSzaCUrDlg7vOPCLtceNqDhFAU6VhXcxJTeIGyjrOSB7kN-CujNxdGZJ8edEy7mweiaRKTVToNS9CFjhWaUoSJhN2Bp4liI9NUjBFZmXsMpMaqa5qvZE94WCbCGGGgZ_0zsFSrrE/s1600/Too-busy22.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_7QCMlSzaCUrDlg7vOPCLtceNqDhFAU6VhXcxJTeIGyjrOSB7kN-CujNxdGZJ8edEy7mweiaRKTVToNS9CFjhWaUoSJhN2Bp4liI9NUjBFZmXsMpMaqa5qvZE94WCbCGGGgZ_0zsFSrrE/s320/Too-busy22.jpg" width="320" /></a></div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
This week I decided I need to make my parents a higher priority on the list. Sure I'm still working on things for myself, however - barring losing my PDM for my pump, I've got this diabetes thing completely under my control (for normal daily living). My daily management is simple enough where it no longer requires so much conscious focus. I've passed the test of traveling and managing - the only part to work on is training and racing nutrition - but in a very bad analogy... that's just icing on the cake. (coconut oil on the kale?)<br />
<br />
While daily living is settled down, there is still an unlimited amount of info that I'm pursuing. But not all of it has to do with me. Now has come a time where I'm much more capable of helping those around me. I know several of my family members could benefit from what I have been learning. The challenge to them is to not overwhelm them with my intensity. My new goal is to serve as a resource where anyone can come to me when they're ready. I'll introduce a few topics, but I know that I can't make someone change - but I can support someone when they make an effort.<br />
<br />
While on vacation and the 70 some hours of flight time, not counting the U-rail time, I was able to read through several of the books I packed. One goofy one caught my attention, "Reverse Parkinsons Disease" written by John Pepper, a South African guy who has been living a very happy life with Parkinson's for the past 30 years. He's not any sort of scientific expert, he's not selling anything. He's just a guy. Another canary in the coal mine.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4fNVGKPfMOPA-RmQNIBSW8trjW-BqVL33PqN-OpBv6oXCBxLI8NltEstwIW2H1wKF-CDQbkmx_AgHXHamWp2DXOQ069902ZdYBgRkEH9wVyqrSAYtpMvxCbb8egST6Zaqbe4LQStZkXbK/s1600/PJ-AW352A_LAB_G_20100809191016.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="303" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4fNVGKPfMOPA-RmQNIBSW8trjW-BqVL33PqN-OpBv6oXCBxLI8NltEstwIW2H1wKF-CDQbkmx_AgHXHamWp2DXOQ069902ZdYBgRkEH9wVyqrSAYtpMvxCbb8egST6Zaqbe4LQStZkXbK/s400/PJ-AW352A_LAB_G_20100809191016.jpg" width="400" /></a></div>
<br />
<br />
I learned a lot about Parkinson's, but what was also interesting is how it tied into the previous book that I read "This is your brain on Music" by Daniel J. Levitin. I came across the music book thinking it would be a fun interconnection to my old interest in Neurobiology (who isn't interested) and Kim's Musicology pursues. What I didn't expect was to make connections from Music to Parkinsons. The brain is amazing. Neuroplasticity, parallel processing, conscious control and mindfulness. These few books have renewed a lot of hope in simple solutions.<br />
<br />
The simplest solutions are the most elegant. I now know better how to prompt my father into consciously focusing on the task at hand. What I'm realizing is the problem with Parkinson's is that a PwP (Person with Parkinsons) still has many of the motor functions and muscle strength to do a task, what they lack is the ability for their 'subconscious' to do it. <br />
<br />
For example: This morning I knocked back a cup of coffee. I then realized I had to pee. I stood up, walked through a narrow hallway and maneuvered effortlessly to the toilet, had a nice pee (won't be too graphic), changed out of my pajamas and jumped into my jeans. All told, probably less than 1 minute (not that I was racing). During that minute - I didn't one think about what I was doing. You wouldn't either.<br />
<br />
The problem for a PwP is that the tasks that we normally relegate to doing without thinking, simply don't happen. If my dad wants to walk across the room - HE CAN - but he has to concentrate on every little step. Pick up your leg - push off the toe of the back leg - swing your arms - choose the clear path. He cannot let himself get distracted by the dog or by the smell of the food or the conversation. He CAN do it. But he can only do it well when he forces himself to focus on it. There are reasons for this and it has to do with using other parts of his brain rather than the 'subconscious'. <br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA_FoieMiw4GPgf5m5tC9meRehn23zbNYRfwhPCi5CeqXv9u3vnSdHLhdfCiPDml0jgWDr4gyVukN-zOE2rMXQwnItQvqnA7VZjHJeeOf_3qGgiH5z1m4Jx4VGVvL0Tf23eUqT71SiPvB2/s1600/Parkinsons_Disease_Frequently_Asked_Questions.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA_FoieMiw4GPgf5m5tC9meRehn23zbNYRfwhPCi5CeqXv9u3vnSdHLhdfCiPDml0jgWDr4gyVukN-zOE2rMXQwnItQvqnA7VZjHJeeOf_3qGgiH5z1m4Jx4VGVvL0Tf23eUqT71SiPvB2/s1600/Parkinsons_Disease_Frequently_Asked_Questions.jpg" /></a></div>
<br />
<br />
Note: I use subconscious similar to how John Pepper does. What he really means is the specific structure that is under attack and no longer producing dopamine - I forget whether it was the Nucleus Accumbens, the Substantian Nigra, Cerebellum etc... I'd look it up in my book, but my mom took it from me so that she can read it tonight. :)<br />
<br />
Over the past 2 months both of my parents are doing so well. I wish I could have contributed more to their help, but it has a been a team effort with all of my siblings stepping up to the best of their abilities. Together we make a pretty good team.<br />
<br />
Even my mother is doing well. She was very open to letting me do the cooking this weekend. I was able to prepare her food the filled her up with tons of nutrients, but also satisfied her appetite. No added sugar for this lady any more - she's learning how good she can feel when she's in control.<br />
<br />
She's doing so well in fact, that it was fortuitous that last night she instinctively skipped her bedtime insulin and relied upon her oral medication alone to move her from 180 to 80mg over the course of the night. And while those numbers don't sound amazing - they are a huge improvement. Now that's she's addressing diet, she's going to have to make adjustments to her medications.<br />
<br />
Currently she is taking 14U of lantus in the morning - and that covers her well. She exercised in the afternoon and dropped a little low (mid 60's), but correctly that perfectly with 4oz of juice (I made a carrot orange juice). Then after a good dinner she again rose up to about 180 before bedtime. She is going to skip her evening Lantus again tonight since we predict that the oral meds will likely drop her again. <br />
<br />
Obviously I do not want her dropping below 80 overnight and she will discuss the continuation of her oral medication with her doctors. She had exercised harder the previous night than she did today so perhaps she won't drop as much. She has a banana by her bedside and will plan to check her blood sugar when she gets up in the middle of the night. We've already discussed that it may be better for her to exercise post dinner rather than post lunch, since that is when her morning dose of Lantus is wearing the thinnest. This change alone would prevent her from having gone low in the afternoon and high in the evening. But low & high are relative - 80 to 180mg/dL is a huge step as far as control for her.<br />
<br />
It's been fun to hang out with my parents. And success is also fun - so I enjoy seeing the success that both of my parents are experiencing. I'm blessed that they are both open to my ideas and are willing to take control over their lives. How can that not make me feel happy. <br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBoECwMVfq62XbLhhEA1gom3AZW2oTBK0CQ_Z0TT1tj-EuBBaVuFcv0_TKFdacc8twD8zbOD5f4LkZHNmEwt5azlBkUPr3v4ZXxPqGVc3bNElAB4TW5ZOMlRtLDAX9HBva3ek2omkdWbHd/s1600/smileyface.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBoECwMVfq62XbLhhEA1gom3AZW2oTBK0CQ_Z0TT1tj-EuBBaVuFcv0_TKFdacc8twD8zbOD5f4LkZHNmEwt5azlBkUPr3v4ZXxPqGVc3bNElAB4TW5ZOMlRtLDAX9HBva3ek2omkdWbHd/s1600/smileyface.gif" /></a></div>
<br />
<br />
<br />
I'll be damned if this hasn't been one of the more rewarding weekends of my life.<br />
<br />
4/15/2013 - Barb Seder set the goal of getting herself off of insulin. Anonymoushttp://www.blogger.com/profile/04774174617712678292noreply@blogger.com1