I'm so grateful for all of the comments I get on this blog, but I've always been partial to Al's. Why? Because he's not a diabetic. His son is and he reads my blog for insight into how to be a better parent. As a parent of two little riddles, myself, I soooo get that.
At any rate, Al posted a great comment last week:
"Have you always been so successful with controlling your bg levels? My son really does "care" about his diabetes, but struggles with roller coaster bgs. In your early 20's at college, were you as successful controlling your diabetes as you are now?
He adds: Right now he is very scared of lows and therefore runs high a lot."
Since going on the pump eight years ago, I haven't had an A1C over 7 that I can recall. Before that, I had tons of 7's with a smattering of 8's. During phases in my life where I didn't test as often, I'd rarely go beyond 8 but do recall a few 9's and one time (I think it was college) being over 10.
For me, the huge turning point was going on the pump. Prior to that I rode the NPH rollercoaster. Simply put, a diabetic with a big enough dose of NPH can get along OK - the NPH will usually bring you down within shouting distance of normal.
But when I went on the pump, it all made precision-like sense to me. Every meal, every dose could be calculated precisely. The "potential" negative to all of this, though, is that precision requires discipline. Unlike my roller coaster NPH shot, a pump patient at 300 is going to stay at 300 until they bolus extra. But I never minded, because it finally made sense.
Still, through all those years of testing once per day (or less), I was still generally in the 7's. Since being diagnosed 25 years ago, I've had only 2 ambulance rides for lows (and one additional ambulance visit) and none in the past 17 years.
I used the phrase "caring diabetic" in my last post and I think it's an important one, because I want to believe that diabetics who care about their diabetes stand a better chance of being complication-free. Here's what that phrase means to me:
1) A caring diabetic knows that there's always a reason for their blood sugar reading. My kids will tell you that nothing makes me angrier than when they do something dumb, I ask why, and they say, "I don't know." Give me a crappy reason, but there's always a reason. I have heard diabetics say "I was low/high and don't know why," and the same grumpy guy that yells at my kids tends to call bullshit on that. There's always a reason.
The "caring" diabetic makes a calculated guess to the reason - your infusion set was in too many days, you exercised too much/too little, you guessed your carbs wrong, etc. and goes with it, knowing they'll be smarter next time.
2) The caring diabetic corrects. This seems elementary to me, but I've known diabetics who don't correct highs. If you are high and you have no insulin on board and you're not going to be exercising, your blood sugar isn't coming down unless you care enough to bolus.
3) The caring diabetic tests. If you're on a pump, you test a lot. If you're not on a pump, you still test.
4) The caring diabetic doesn't worry about last week, last month or last year. The only blood sugar you can control is this one (and somewhat the next two hours). I don't understand diabetics who get down because they've had a bad week of blood sugars. Live here. Live now.
5) The caring diabetic analyzes last week, last month and last year. Notice I said you don't worry about it, but you do look at, study it and correct for it.
6) The caring diabetic looks for comrades but understands they're an island. I've seen soooo many diabetics succeed doing things that I couldn't or wouldn't do. Listening and learning from them is invaluable, but in the end how I respond to medicine, food and exercise is unique and always gets higher weight than anything anybody else has done. George Sheehan said, "We are all an experiment of one." He said it about running and I'd say it fits just as well for diabetes.
To this point, this shouldn't be taken as a universal post about what a "Caring Diabetic" is. It's only what it is to me. You might think a caring diabetic doesn't drink beer or eat candy, but I've never met a Peanut Butter Cup I didn't like and what's made Milwaukee famous helps me pass the hours. More than anything, I think what makes sense is to figure out what works for you and then make sure you stay on that path as much as possible.
Wednesday, November 11, 2009
Friday, November 06, 2009
Not My Diabetes
When I was in high school, I was one of 4 diabetics (that I know of). This week, the second one of the other 3 died of diabetic complications.
And yet, even writing that, it sounds absurd. After all, I'm sitting here, more than 25 years into this thing, without a single complication and a nearly non-diabetic blood sugar of 137, 30 minutes after eating a bag of chips.
There's a lot I don't know, but probably the biggest thing I don't know is why this disease is fairly easy for me, compared to so many Type 1 diabetics. On one hand, I could take the credit - say I *care* more than others, or stay up on the technology more than others or say I can count carbs faster and more accurate than others. Those things could be true.
But on the other hand, maybe I'm just lucky. Maybe my body chemistry causes me to process artificial insulin the way the chemists intended. Maybe my fat content is ideal for sticking a thin needle in me and delivering the goods. Maybe running 30-50 miles a week feeds something besides my ego.
Truth is, I don't know.
This month is National Diabetes Month and diabetics all over the Web are slapping logos on their blogs and Twitter accounts so that... well truth is, I'm not sure why they do it, but they do. And there's a piece of me that wants to say, "Really, it's ok. I'm alright. We're all alright. Give your money, your time, your sympathy to the homeless. Or cancer patients. Someone who needs it more than I do, for crying out loud."
But then I think about the fact that 50% of my diabetic classmates are gone and I realize that there are plenty of reasons why it's as good a cause as any, even if it's not because of me. In fact, it might very well be a great cause, despite me.
And yet, even writing that, it sounds absurd. After all, I'm sitting here, more than 25 years into this thing, without a single complication and a nearly non-diabetic blood sugar of 137, 30 minutes after eating a bag of chips.
There's a lot I don't know, but probably the biggest thing I don't know is why this disease is fairly easy for me, compared to so many Type 1 diabetics. On one hand, I could take the credit - say I *care* more than others, or stay up on the technology more than others or say I can count carbs faster and more accurate than others. Those things could be true.
But on the other hand, maybe I'm just lucky. Maybe my body chemistry causes me to process artificial insulin the way the chemists intended. Maybe my fat content is ideal for sticking a thin needle in me and delivering the goods. Maybe running 30-50 miles a week feeds something besides my ego.
Truth is, I don't know.
This month is National Diabetes Month and diabetics all over the Web are slapping logos on their blogs and Twitter accounts so that... well truth is, I'm not sure why they do it, but they do. And there's a piece of me that wants to say, "Really, it's ok. I'm alright. We're all alright. Give your money, your time, your sympathy to the homeless. Or cancer patients. Someone who needs it more than I do, for crying out loud."
But then I think about the fact that 50% of my diabetic classmates are gone and I realize that there are plenty of reasons why it's as good a cause as any, even if it's not because of me. In fact, it might very well be a great cause, despite me.
Monday, October 26, 2009
Moving Forward...
I really don't blog much these days, so hopefully you've been finding some good things to read.
As I hinted a few weeks ago, I've climbed out of my post-marathon-blow-up and yesterday, started training for my 4th marathon, which isn't until the middle of May.
So how does someone go from saying they're done with the marathon to beginning a 26-ish week plan for one? Welll.... a few things happened.
1) I'm stubborn and stupid. If you're a runner, you know that's a big part of it. Don't discount it.
2) I'm not a bad runner. I just ran a particularly crappy race. In the month following the marathon, I had a 5k PR and a near half-marathon PR. Those short races helped me believe that while my marathon hadn't gone well, I'm not that old or fat, yet. This weekend, I'm going after a 5 mile PR, and I frankly like my chances.
3) An offer I couldn't refuse. After my last marathon, Missy Foy reached out to me, and offered help in getting over the Boston hurdle. While I would've jumped at the opportunity if Missy WASN'T diabetic, the fact that she is made it the absolutely, positively, no way I'm going to say no opportunity that it is.
4) Realization that I have plenty of things to try. My last plan had no speed work, cross training or core work. I'm ok giving up if I've done everything I could, but I haven't. Not yet, anyway.
And so here we are. I started with a 7 miler yesterday, including 3 miles fifteen seconds faster than marathon pace. It's a long way and a long winter until May. But I'm ready.
As I hinted a few weeks ago, I've climbed out of my post-marathon-blow-up and yesterday, started training for my 4th marathon, which isn't until the middle of May.
So how does someone go from saying they're done with the marathon to beginning a 26-ish week plan for one? Welll.... a few things happened.
1) I'm stubborn and stupid. If you're a runner, you know that's a big part of it. Don't discount it.
2) I'm not a bad runner. I just ran a particularly crappy race. In the month following the marathon, I had a 5k PR and a near half-marathon PR. Those short races helped me believe that while my marathon hadn't gone well, I'm not that old or fat, yet. This weekend, I'm going after a 5 mile PR, and I frankly like my chances.
3) An offer I couldn't refuse. After my last marathon, Missy Foy reached out to me, and offered help in getting over the Boston hurdle. While I would've jumped at the opportunity if Missy WASN'T diabetic, the fact that she is made it the absolutely, positively, no way I'm going to say no opportunity that it is.
4) Realization that I have plenty of things to try. My last plan had no speed work, cross training or core work. I'm ok giving up if I've done everything I could, but I haven't. Not yet, anyway.
And so here we are. I started with a 7 miler yesterday, including 3 miles fifteen seconds faster than marathon pace. It's a long way and a long winter until May. But I'm ready.
Thursday, October 15, 2009
The Makings of a Dynasty....
At the end of the day, I'm an age-grouper. Though, I've never read a definition, here's what that means to me:
1) You'll never see my on the "podium" after a race. I'll never take home money and never be in the Top 3 overall.
2) However, depending on who shows up on the starting line, I might sneak into an age-group award. Age group awards are particularly whimsical. I won first place at a local 4 miler in 2008, only to come back and finish 6th a year later. I should add, I actually ran faster the second year. Like I said, whimsical.
That being said, Knoebels Lumber 5k has been my bitch since 2007 when I showed up and said, "Isn't there anybody here my age??" And apparently there wasn't, as I ran a 20:30 the day before a 20 miler.
In 2008, I did the 20 miler the day before and allowed myself to "let it all hang out" on the 5k. But there ain't much to hang after a 20 miler, and I came in 20:11, but also good enough for the second age group award in a row.
This year, I had it all lined up: the marathon was behind me and my job and family actually required working and familying, as they sometimes will, which meant I came to the line tapered, rested and ready.
The result? 19:46! Now those of you who read this blog religiously may recall my 19:25 in the spring, but the fact is: that course wasn't 5k. Heck, it was barely 3 miles. I knew it then and so when people asked me my 5k PR, it was always 19:25, buuuuut....
But this course was true... and I ran it well, a full 1 second under my official 5k PR and good enough for first place - once again - in the 35-39 group.
Equally as cool, I came in 7th out of 172 overall, once again bested by six high school kids... which has also been the story for the past two years.
Truth is, if I could convince the Knoebels people to do this when those whipper-snappers are in school, I could be looking at a REAL podium, not something dictated by my birth certificate.
Hey, a man can dream, right?
1) You'll never see my on the "podium" after a race. I'll never take home money and never be in the Top 3 overall.
2) However, depending on who shows up on the starting line, I might sneak into an age-group award. Age group awards are particularly whimsical. I won first place at a local 4 miler in 2008, only to come back and finish 6th a year later. I should add, I actually ran faster the second year. Like I said, whimsical.
That being said, Knoebels Lumber 5k has been my bitch since 2007 when I showed up and said, "Isn't there anybody here my age??" And apparently there wasn't, as I ran a 20:30 the day before a 20 miler.
In 2008, I did the 20 miler the day before and allowed myself to "let it all hang out" on the 5k. But there ain't much to hang after a 20 miler, and I came in 20:11, but also good enough for the second age group award in a row.
This year, I had it all lined up: the marathon was behind me and my job and family actually required working and familying, as they sometimes will, which meant I came to the line tapered, rested and ready.
The result? 19:46! Now those of you who read this blog religiously may recall my 19:25 in the spring, but the fact is: that course wasn't 5k. Heck, it was barely 3 miles. I knew it then and so when people asked me my 5k PR, it was always 19:25, buuuuut....
But this course was true... and I ran it well, a full 1 second under my official 5k PR and good enough for first place - once again - in the 35-39 group.
Equally as cool, I came in 7th out of 172 overall, once again bested by six high school kids... which has also been the story for the past two years.
Truth is, if I could convince the Knoebels people to do this when those whipper-snappers are in school, I could be looking at a REAL podium, not something dictated by my birth certificate.
Hey, a man can dream, right?
Wednesday, October 07, 2009
The Nearly 1/2 Marathon PR, Apidra & Other Stuff...
As a reader, I can tell you: sporadic blogs suck. When I'm enjoying reading someone, I expect them to post regularly, and I haven't.
But as a writer, I made a deal with myself a long time ago: I write what I want, when I want. There's no need for another chore in my life because, believe me: I've got plenty of them.
But still, I do have some things to say.
First up, running. Last weekend was the Hands on House 1/2 Marathon, one of the bigger 1/2 marathons I do and my 3rd time on this course. It was also my first race since my marathon melt-down three weeks prior. While I expected to be a little tired, I was also a little eager to repair my ego.
Due to construction, the course was re-routed and that led to some problems, most notably when the 4th mile marker gave way to the 5th after only 1/2 mile. Yes - you heard it correct: the course was off by more than 1/2 mile.
From that point on, the pack was made up of 2 kinds of runners: those who were amazed at their fitness and those who were annoyed to be shorted on the course. The most discernible difference? The second group was made up of those of us with Garmins.
In the end, I finished in 1:30:11 -- converted to a true half marathon, it was about a flat 1:35, just 20 seconds off my PR. Considering that's 3 weeks after the marathon, I was pretty pleased with the deal.
Soooo after the race, I had to jet so my wife and daughter could get to a baby shower. At work the next day I was told I had been called for an age group award and according to the website awards packet, I did sneak into third. And yet, when I called the sponsor, they feigned indifference. Well, my wife said, it's not the trinket, it's the fact you won, right? Yeah, I said. Exactly.
So there you go - denied the chance to have a true PR and denied an award. Kind of a bummer, but what are you going to do?
In other news, I've been on Apidra for about 3 weeks now. What have I noticed?
a. It's more potent. My total insulin dosage is down about 30%
b. The lowered dosage hasn't done much to my weight. I'm still trying to trim 5 pounds and haven't had much success with it
c. Apidra supposedly has fewer occlusions - short periods where the pump tube becomes clogged. I used to think this was marketing BS - the times I've had "No Delivery" warnings on my pump are sooo few and far between, and yet I've noticed something since being on Apidra: my between meal blood sugars are like a dead man's EKG - flat, flat, flat. With humalog, I get slow gentle waves, but with Apidra, I am F-L-A-T. I'm guessing this is what occlusions really mean in the real world. So all in all, I'm an Apidra fan.
Next up, the Knoebels Lumber 5k this weekend. There, I'm the reigning two year age group champ and lemme tell ya - I'm STAYING for the friggin' awards.
But as a writer, I made a deal with myself a long time ago: I write what I want, when I want. There's no need for another chore in my life because, believe me: I've got plenty of them.
But still, I do have some things to say.
First up, running. Last weekend was the Hands on House 1/2 Marathon, one of the bigger 1/2 marathons I do and my 3rd time on this course. It was also my first race since my marathon melt-down three weeks prior. While I expected to be a little tired, I was also a little eager to repair my ego.
Due to construction, the course was re-routed and that led to some problems, most notably when the 4th mile marker gave way to the 5th after only 1/2 mile. Yes - you heard it correct: the course was off by more than 1/2 mile.
From that point on, the pack was made up of 2 kinds of runners: those who were amazed at their fitness and those who were annoyed to be shorted on the course. The most discernible difference? The second group was made up of those of us with Garmins.
In the end, I finished in 1:30:11 -- converted to a true half marathon, it was about a flat 1:35, just 20 seconds off my PR. Considering that's 3 weeks after the marathon, I was pretty pleased with the deal.
Soooo after the race, I had to jet so my wife and daughter could get to a baby shower. At work the next day I was told I had been called for an age group award and according to the website awards packet, I did sneak into third. And yet, when I called the sponsor, they feigned indifference. Well, my wife said, it's not the trinket, it's the fact you won, right? Yeah, I said. Exactly.
So there you go - denied the chance to have a true PR and denied an award. Kind of a bummer, but what are you going to do?
In other news, I've been on Apidra for about 3 weeks now. What have I noticed?
a. It's more potent. My total insulin dosage is down about 30%
b. The lowered dosage hasn't done much to my weight. I'm still trying to trim 5 pounds and haven't had much success with it
c. Apidra supposedly has fewer occlusions - short periods where the pump tube becomes clogged. I used to think this was marketing BS - the times I've had "No Delivery" warnings on my pump are sooo few and far between, and yet I've noticed something since being on Apidra: my between meal blood sugars are like a dead man's EKG - flat, flat, flat. With humalog, I get slow gentle waves, but with Apidra, I am F-L-A-T. I'm guessing this is what occlusions really mean in the real world. So all in all, I'm an Apidra fan.
Next up, the Knoebels Lumber 5k this weekend. There, I'm the reigning two year age group champ and lemme tell ya - I'm STAYING for the friggin' awards.
Friday, September 25, 2009
Reboot, Rebuild, Retry...
So here we are, two weeks after the marathon. In no particular order:
1) I'm back to a decent workout level, but certainly not recovered. I ended up doing more than 15 miles over two workouts last Sunday (that probably wasn't brilliant), and while I was initially excited about that, I found I wasn't fresh enough to run again until Wednesday. So Thursday, I hopped on the bike (which I hadn't done for over a year) and banged out a nice lunch time ride). I'm planning on running trails over lunch today, resting tomorrow, and knocking out 8 or so on Sunday.
I'm going to make it an effort to cross-train 1-2 days per week for the time being so that I can keep up my fitness while my legs recover from marathon pounding.
2) I am hopeful I get a little spring back in my step, as I'm planning on doing a half marathon next weekend, followed by a 5k the following weekend. The distance won't be a problem, but I'm a little curious if I'll have any speed.
3) I'm testing out a vial of Apidra insulin. Because I'm a lucky diabetic, I have rarely switched insulins. Simply put, whatever's on the market tends to work for me. 20 years ago, I was still on Pork and Beef insulin when it was discontinued because there were so few diabetics who hadn't switched to human.
One of the reasons I wanted to try out the Apidra was a hope that a newer more efficient insulin would require a smaller dose. Less insulin usually results in lower weight retention for me (my cayenne pepper experiment notwithstanding), and I would like to lose five pounds and get back to my PR weight (without actually dieting).
Three days into it, I'm a fan. My CGM line has never been more level and my basal dosage is down 20%. Whether or not that will translate to weight, time will tell.
And yes - Apidra is more expensive. Thank God for good insurance.
My doc also gave me a bottle of Novalog to test and I wish I would've tried that first, because it is a bit cheaper, but I decided to try the newest and coolest stuff first, and I'm not sure I'll be interested in trying something less new and sexy. (And what's it say about me that I'm referring to the sexiness of insulin?)
4) I must be dumber than I thought because I'm pretty sure I'm going after another marathon next spring. After my last disappointment, I was seriously considering putting the marathon thing on hold, but the past few weeks have given me perspective and an extremely generous offer for some coaching from someone I highly respect.
Coupled with the fact that the training would mostly occur Jan-April, when I usually run a lot but don't have much opportunity to race and you're left with an opportunity for a guy who's too stubborn for his own good to go for Boston one more time.
But my very long ramp-up for that isn't scheduled to start until October 31, so for now I'm still in the serious contemplation mode.
So that's that -- thanks for all of the comments, particularly those after the marathon melt-down. It's good to see I'm not the only moron on the roads. ;)
1) I'm back to a decent workout level, but certainly not recovered. I ended up doing more than 15 miles over two workouts last Sunday (that probably wasn't brilliant), and while I was initially excited about that, I found I wasn't fresh enough to run again until Wednesday. So Thursday, I hopped on the bike (which I hadn't done for over a year) and banged out a nice lunch time ride). I'm planning on running trails over lunch today, resting tomorrow, and knocking out 8 or so on Sunday.
I'm going to make it an effort to cross-train 1-2 days per week for the time being so that I can keep up my fitness while my legs recover from marathon pounding.
2) I am hopeful I get a little spring back in my step, as I'm planning on doing a half marathon next weekend, followed by a 5k the following weekend. The distance won't be a problem, but I'm a little curious if I'll have any speed.
3) I'm testing out a vial of Apidra insulin. Because I'm a lucky diabetic, I have rarely switched insulins. Simply put, whatever's on the market tends to work for me. 20 years ago, I was still on Pork and Beef insulin when it was discontinued because there were so few diabetics who hadn't switched to human.
One of the reasons I wanted to try out the Apidra was a hope that a newer more efficient insulin would require a smaller dose. Less insulin usually results in lower weight retention for me (my cayenne pepper experiment notwithstanding), and I would like to lose five pounds and get back to my PR weight (without actually dieting).
Three days into it, I'm a fan. My CGM line has never been more level and my basal dosage is down 20%. Whether or not that will translate to weight, time will tell.
And yes - Apidra is more expensive. Thank God for good insurance.
My doc also gave me a bottle of Novalog to test and I wish I would've tried that first, because it is a bit cheaper, but I decided to try the newest and coolest stuff first, and I'm not sure I'll be interested in trying something less new and sexy. (And what's it say about me that I'm referring to the sexiness of insulin?)
4) I must be dumber than I thought because I'm pretty sure I'm going after another marathon next spring. After my last disappointment, I was seriously considering putting the marathon thing on hold, but the past few weeks have given me perspective and an extremely generous offer for some coaching from someone I highly respect.
Coupled with the fact that the training would mostly occur Jan-April, when I usually run a lot but don't have much opportunity to race and you're left with an opportunity for a guy who's too stubborn for his own good to go for Boston one more time.
But my very long ramp-up for that isn't scheduled to start until October 31, so for now I'm still in the serious contemplation mode.
So that's that -- thanks for all of the comments, particularly those after the marathon melt-down. It's good to see I'm not the only moron on the roads. ;)
Monday, September 21, 2009
Running More is Overrated...
Well, that's probably not true, though it seems to feel that way to me this year.
During this year's marathon plan, I averaged 46 miles per week and ran a 3:33. Last year, I averaged 32 miles per week and ran a 3:23. In 2007, I ran 30 miles per week (plus two days on the bike) and ran a 3:18.
Sort of flies in the race of that, "to run faster, run further" talk, eh?
Honestly, I don't know. I'm eager to blame the poor day on a lack of speed training, but am still wrapping my head around it all.
The best part about blowing up your marathon plan so early in the season is that it leaves a lot of fall to race in. I'm looking forward to the Hands-on-House 1/2 Marathon in two weeks (where I have my current 1/2M PR) and a week after that will try to defend my title of two-time age group champion of the Knoebels Lumber 5k. Big dreams, folks, big dreams.
Technically, the 1/2 marathon is three weeks after my marathon, and you're supposed to wait a month before racing, so I'm not so certain how that will go. However, I really like the course and I'm very eager to see if I'm truly as bad as my recent marathon performance dictated, so what the heck. I'm going to go out at seven minute pace and see what happens. I've run this course before to know that the first four miles will be fine and are followed by four curious miles of crazy uphills and downhills. After that, you limp home with what you got left. But I've done that race in 1:34 and would really like to see if I can shave just a little off my time.
During this year's marathon plan, I averaged 46 miles per week and ran a 3:33. Last year, I averaged 32 miles per week and ran a 3:23. In 2007, I ran 30 miles per week (plus two days on the bike) and ran a 3:18.
Sort of flies in the race of that, "to run faster, run further" talk, eh?
Honestly, I don't know. I'm eager to blame the poor day on a lack of speed training, but am still wrapping my head around it all.
The best part about blowing up your marathon plan so early in the season is that it leaves a lot of fall to race in. I'm looking forward to the Hands-on-House 1/2 Marathon in two weeks (where I have my current 1/2M PR) and a week after that will try to defend my title of two-time age group champion of the Knoebels Lumber 5k. Big dreams, folks, big dreams.
Technically, the 1/2 marathon is three weeks after my marathon, and you're supposed to wait a month before racing, so I'm not so certain how that will go. However, I really like the course and I'm very eager to see if I'm truly as bad as my recent marathon performance dictated, so what the heck. I'm going to go out at seven minute pace and see what happens. I've run this course before to know that the first four miles will be fine and are followed by four curious miles of crazy uphills and downhills. After that, you limp home with what you got left. But I've done that race in 1:34 and would really like to see if I can shave just a little off my time.
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