So a while back I announced that the Omnipod and I weren't getting along and I had switched back to my Medtronic pump, coupled with my Dexcom.
I'd also announced that I hoped to try out the Medtronic sensors to determine if maybe I should just renew with Medtronic (I am still "out of warranty," which is the insulin pump user's version of being a free agent).
Incredibly, it's taken six weeks to get Medtronic to set me up with a sensor test. First up, I had to get my Dr. to sign off on it. She was on vacation for a week. But since then, I've gotten a nearly weekly call from Medtronic asking me if my local rep had followed up with me. Each time, I was like, "Uh no," which caused them to respond with disappointment.
The whole thing got to be a little odd, as if I was telling on the Medtronic rep for not doing his job.
At any rate, the rep IS finally scheduled to come to my office this Friday afternoon. Not sure how many sensors I'll try but I plan to run it head to head against the Dex, so I can do a decent evaluation. If I like how the Medtronic runs, I plan to re-up with them. If not, I'll probably sit on the fence and wait for the long-anticipated Animas/Dex integration.
Monday, September 20, 2010
Monday, September 13, 2010
Susquehanna Super Hike & Ultra-Trail Run Race Report, the Diabetic Perspective
Friday night heading into Saturday's ultra, I did something I've never done before a big race: went to bed at 9:30 and slept perfectly. I suppose this is what happens when you go into a race without putting any pressure on yourself. I liked it. And when I woke up at 3:30 with six hours of sleep under my belt, I felt like I'd gotten at least an hour more than I expected.
Though I was far more calm than usual before a long race, I still had some adrenaline going, which led to the blood sugar being 200 when I woke up. Not good, but not horrible. Also, with a drive to the finish line and a bus to the start, I knew there was no need to eat, yet. I bolused for the the correction and drive to the finish.
I made the first shuttle bus to the start and the drive went relatively quickly. I spent most of the time talking to a "Marathon Maniac" making her way around the 50 states for the second time. In many ways, her story was identical to mine - a road runner with little to no trail training whom had signed up for the distance and figured the trails would just "work themselves out." Incidentally, that's really not a good idea for this course.
Registration went fine and the sun finally came up. This was much appreciated since this race didn't over drop bags (one of very few oversights) so most of us were dressed minimally to account for the temperature, which would be close to 80 by race-end.
Thirty minutes before the race, my blood sugar had fallen to 145, so I had a Mojo bar for breakfast. This would end up being my only diabetic "mistake" of the day. A Mojo bar is 25 g. of carbs and my usual PowerBar is 43. I guessed, however, that 25 g. would be enough, thinking the race adrenaline would continue to run me a bit higher than usual.
I set the basal rate on my pump at .2 u/hr and did a double take when I set the duration for seven hours. I've set a lot of temporary basals in my life, but never one for seven hours.
I'd found training parter, Dave, at the start and we settled in for the long haul. During the first five miles I came across a handful of runners I was used to beating on the roads, but was also aware that they had done something I hadn't done - train on trails. It wasn't easy for the ego, but I let them go, which would end up being one of the smarter things I did all day.
With all of the technical trails and hill climbs, we found ourselves running a lot of 12 minute miles, considerably slower than the 7:30s we'd pound out on the roads. Like many trail runners, our plan was simple: run the flats and downhills, walk the uphills.
About fifty minutes in, I thought my blood sugar might be running a bit low, but held off testing until we'd clocked the first hour. With such a long day ahead, I was pretty determined to take things one hour at a time. Sure enough, my test at one hour revealed a 64. Not good with 23 miles to go. Rather than the one gel I'd planned (25 g.), I had 2.
You'll notice I mention that I tested. What about the DexCom? As CGM users know, the technology is amazing when it works, but it doesn't work all the time. And despite several weeks of reliable sensors, the particular one I'd been wearing for the past five days was throwing me frequent "???" results, which is DexCom's way of saying, "Beta," or worse, impersonating the Twitter Fail Whale. Unfortunately, ??? would be the default setting for most of the run, making my trust blood sugar meter a real hero.
Incidentally, this development would've been crushing in a road marathon, where I don't have seconds to spare. In an event this long, with three aid stations and much walking, it wasn't a big deal at all. In fact, more than once I caught myself happy to have to pause and test.
By the time we rolled into the first official aid station at 9.5 miles, Dave and I felt great, well ahead of our planned 15:00/mile pace. My blood sugars were now at 120 and would stay between there and 137 for the next several hours.
Somewhere before or after this aid station, Dave & I, jabbering like school-kids, made a wrong turn. Dave quickly discovered it and though we only went .1 or so far, we came back to the trail to see we'd given up a good 15 or so places, most of which we caught back when the course turned for a brief mile in the road.
At this point, the course was doing something that would ultimately be my undoing - climbing 600 feet for a period of three or so miles, and then descending the same amount over the next three. It was then, around 13, that I told Dave my quads were starting to feel a bit more jiggly than I'd like, even though my overall health and fitness was strong.
At the aid station at 14.5, we were still very encouraged to find ourselves ahead of pace, particularly since the course now had a full three miles on the road. Of course, these 3 miles decided to be almost entirely uphill. While we didn't lose any time, we didn't gain much either. But at this point, we were more than half-way, and that's a great place to be: when you start counting down instead of counting up. At this point, I was still sticking to my nutritional plan, eating one gel every hour and snacking on a cookie or small piece of PBJ at the aid stations, plush drinking plenty of water from my Camel-Bak and taking a few Endurolytes every hour. By now, I was also carrying my blood sugar meter, as it had come un-velcroed from my belt a while back (thankfully recovered by another runner).
The course turned back to trail soon enough and it was here I realized two things: either the course was getting worse or I was. My quads were really getting jiggly, making downhills difficult to run. I also noticed on the uphill walks that Dave (who, truth be told, does things beside run for fitness) was making better time than I. Still, we stayed together and made our way into the final aid station.
At this point, I couldn't believe how thrilled I was. We were at the top of Pinnacle Point, just 7.8 miles from the finish and at this point were an astonishing fifty minutes ahead of goal! While I'd been warned the final stretch would be the hardest, I couldn't in my wildest dreams believe there was any way we'd give back fifty minutes.
Of course, basic math and endorphin-laced hysteria couldn't hide the facts: my quads were utterly shredded by this point. Over the next half mile we descended nearly 500 vertical feet and my thighs were absolutely crying. It was painfully clear at this point that I was holding Dave back and I told him to go but he didn't. Good training partners are like that, I guess, and so are good friends.
Things continued to deteriorate for me after that, though. More and more people were passing us and Dave wasn't just hiking slow. He was stopping for me, which made me feel old and pathetic. I think he was a little concerned about my blood sugar, so I tested it (it was 137) and I told him, "I'm fine! I'm just a wuss! Would you get out of here?" And finally, he did.
The last six miles by myself were hilarious in a God-I-hope-I-don't-kill-myself sort of way. Boulders and cliffs that I'd greeted with excitement and awe hours ago were now greeted with, "Are you *&*(^^% kidding me??" I made my way over them like an arthritic old man, and tried not to notice the relatively steep drop-offs that have a way of accompanying cliffs.
My final blood sugar test (around mile 23) was 161, and this turned out to be a blessing, as my stomach was now less interested in consuming food. I tried eating some of the Clif Protein Shots, but had to spit them out, gagging a bit. I decided that I was going to try and make the last five miles without eating. Given that I was 161, I thought the chances of making it without going low were good.
It's an amazing feeling being in that place, 5 miles from the finish, nothing left in your legs and literally wondering, "Can I do this? How will I do this?" It's a feeling I've had in most of my marathons and while it's not as great as the one you get when you're nailing your splits, it's pretty cool. At that point, it really is about how stupid or tough you can be. I kept moving forward a step at a time, as others continued to pass me.
Despite the fact that the Super Hike & Ultra-Trail Run is almost entirely a technical hike, the course actually ended with nearly two miles of mostly flat running. And though my quads wouldn't let me run downhill anymore, I hit the pavement and vowed to run those two miles, albeit slowly.
It was good for the ego... Those last miles alone on the trail, I'd been passed by ten or more people, but back on the streets, I slowly hauled in a half dozen or so, showing that while my quads were done with the hills, I still had a little left in my tank. I came into the finish, easily spotting my wife and daughter cheering for me. My son was nowhere to be found. He was hunting crayfish in a nearby stream, as all 11 year-olds should do when confronted with a stream.
In the end, my final time was 7:21:02. Amazingly, I had managed to expand my fifty minute advantage into a twenty minute deficit in those last 7.8 miles. If that ain't humbling, I don't know what is.
Even so, I wouldn't trade the experience for the world. Considering I haven't run trails in nearly a year and have barely done any hill work in months, a 7:21:02 was a gift from above, only made possible by my aerobic fitness and a good portion of flat terrain. I even correctly predicted I could finish those last miles without fuel, testing my blood sugar immediately afterward and nailing a 101.
My buddy, Dave, slipped in just under our goal time with a 6:58, which was awesome. I was very happy for him.
In the end, I came in 88th out of 400 starters. 327 runners finished under the 12 hour time limit.
All in all, it was an outstanding event, top-notch in every way. Some people would've appreciated drop bags. I would've appreciated more sugar free drinks at the end, because after seven hours of gel, anything sweet sounds pretty horrible. But I'm being picky. I can't imagine better organization for the event.
As for me, I'm not sure what the fall will bring... certainly more races, and perhaps a decent half marathon in a month or two. But for now, I'm happy to bask in the glory of completing my first ultra, if for no reason than I can't do anything BUT bask at this point. Running is impossible and walking is complicated. But this, too, shall pass.
Though I was far more calm than usual before a long race, I still had some adrenaline going, which led to the blood sugar being 200 when I woke up. Not good, but not horrible. Also, with a drive to the finish line and a bus to the start, I knew there was no need to eat, yet. I bolused for the the correction and drive to the finish.
I made the first shuttle bus to the start and the drive went relatively quickly. I spent most of the time talking to a "Marathon Maniac" making her way around the 50 states for the second time. In many ways, her story was identical to mine - a road runner with little to no trail training whom had signed up for the distance and figured the trails would just "work themselves out." Incidentally, that's really not a good idea for this course.
Registration went fine and the sun finally came up. This was much appreciated since this race didn't over drop bags (one of very few oversights) so most of us were dressed minimally to account for the temperature, which would be close to 80 by race-end.
Thirty minutes before the race, my blood sugar had fallen to 145, so I had a Mojo bar for breakfast. This would end up being my only diabetic "mistake" of the day. A Mojo bar is 25 g. of carbs and my usual PowerBar is 43. I guessed, however, that 25 g. would be enough, thinking the race adrenaline would continue to run me a bit higher than usual.
I set the basal rate on my pump at .2 u/hr and did a double take when I set the duration for seven hours. I've set a lot of temporary basals in my life, but never one for seven hours.
I'd found training parter, Dave, at the start and we settled in for the long haul. During the first five miles I came across a handful of runners I was used to beating on the roads, but was also aware that they had done something I hadn't done - train on trails. It wasn't easy for the ego, but I let them go, which would end up being one of the smarter things I did all day.
With all of the technical trails and hill climbs, we found ourselves running a lot of 12 minute miles, considerably slower than the 7:30s we'd pound out on the roads. Like many trail runners, our plan was simple: run the flats and downhills, walk the uphills.
About fifty minutes in, I thought my blood sugar might be running a bit low, but held off testing until we'd clocked the first hour. With such a long day ahead, I was pretty determined to take things one hour at a time. Sure enough, my test at one hour revealed a 64. Not good with 23 miles to go. Rather than the one gel I'd planned (25 g.), I had 2.
You'll notice I mention that I tested. What about the DexCom? As CGM users know, the technology is amazing when it works, but it doesn't work all the time. And despite several weeks of reliable sensors, the particular one I'd been wearing for the past five days was throwing me frequent "???" results, which is DexCom's way of saying, "Beta," or worse, impersonating the Twitter Fail Whale. Unfortunately, ??? would be the default setting for most of the run, making my trust blood sugar meter a real hero.
Incidentally, this development would've been crushing in a road marathon, where I don't have seconds to spare. In an event this long, with three aid stations and much walking, it wasn't a big deal at all. In fact, more than once I caught myself happy to have to pause and test.
By the time we rolled into the first official aid station at 9.5 miles, Dave and I felt great, well ahead of our planned 15:00/mile pace. My blood sugars were now at 120 and would stay between there and 137 for the next several hours.
Somewhere before or after this aid station, Dave & I, jabbering like school-kids, made a wrong turn. Dave quickly discovered it and though we only went .1 or so far, we came back to the trail to see we'd given up a good 15 or so places, most of which we caught back when the course turned for a brief mile in the road.
At this point, the course was doing something that would ultimately be my undoing - climbing 600 feet for a period of three or so miles, and then descending the same amount over the next three. It was then, around 13, that I told Dave my quads were starting to feel a bit more jiggly than I'd like, even though my overall health and fitness was strong.
At the aid station at 14.5, we were still very encouraged to find ourselves ahead of pace, particularly since the course now had a full three miles on the road. Of course, these 3 miles decided to be almost entirely uphill. While we didn't lose any time, we didn't gain much either. But at this point, we were more than half-way, and that's a great place to be: when you start counting down instead of counting up. At this point, I was still sticking to my nutritional plan, eating one gel every hour and snacking on a cookie or small piece of PBJ at the aid stations, plush drinking plenty of water from my Camel-Bak and taking a few Endurolytes every hour. By now, I was also carrying my blood sugar meter, as it had come un-velcroed from my belt a while back (thankfully recovered by another runner).
The course turned back to trail soon enough and it was here I realized two things: either the course was getting worse or I was. My quads were really getting jiggly, making downhills difficult to run. I also noticed on the uphill walks that Dave (who, truth be told, does things beside run for fitness) was making better time than I. Still, we stayed together and made our way into the final aid station.
At this point, I couldn't believe how thrilled I was. We were at the top of Pinnacle Point, just 7.8 miles from the finish and at this point were an astonishing fifty minutes ahead of goal! While I'd been warned the final stretch would be the hardest, I couldn't in my wildest dreams believe there was any way we'd give back fifty minutes.
Of course, basic math and endorphin-laced hysteria couldn't hide the facts: my quads were utterly shredded by this point. Over the next half mile we descended nearly 500 vertical feet and my thighs were absolutely crying. It was painfully clear at this point that I was holding Dave back and I told him to go but he didn't. Good training partners are like that, I guess, and so are good friends.
Things continued to deteriorate for me after that, though. More and more people were passing us and Dave wasn't just hiking slow. He was stopping for me, which made me feel old and pathetic. I think he was a little concerned about my blood sugar, so I tested it (it was 137) and I told him, "I'm fine! I'm just a wuss! Would you get out of here?" And finally, he did.
The last six miles by myself were hilarious in a God-I-hope-I-don't-kill-myself sort of way. Boulders and cliffs that I'd greeted with excitement and awe hours ago were now greeted with, "Are you *&*(^^% kidding me??" I made my way over them like an arthritic old man, and tried not to notice the relatively steep drop-offs that have a way of accompanying cliffs.
My final blood sugar test (around mile 23) was 161, and this turned out to be a blessing, as my stomach was now less interested in consuming food. I tried eating some of the Clif Protein Shots, but had to spit them out, gagging a bit. I decided that I was going to try and make the last five miles without eating. Given that I was 161, I thought the chances of making it without going low were good.
It's an amazing feeling being in that place, 5 miles from the finish, nothing left in your legs and literally wondering, "Can I do this? How will I do this?" It's a feeling I've had in most of my marathons and while it's not as great as the one you get when you're nailing your splits, it's pretty cool. At that point, it really is about how stupid or tough you can be. I kept moving forward a step at a time, as others continued to pass me.
Despite the fact that the Super Hike & Ultra-Trail Run is almost entirely a technical hike, the course actually ended with nearly two miles of mostly flat running. And though my quads wouldn't let me run downhill anymore, I hit the pavement and vowed to run those two miles, albeit slowly.
It was good for the ego... Those last miles alone on the trail, I'd been passed by ten or more people, but back on the streets, I slowly hauled in a half dozen or so, showing that while my quads were done with the hills, I still had a little left in my tank. I came into the finish, easily spotting my wife and daughter cheering for me. My son was nowhere to be found. He was hunting crayfish in a nearby stream, as all 11 year-olds should do when confronted with a stream.
In the end, my final time was 7:21:02. Amazingly, I had managed to expand my fifty minute advantage into a twenty minute deficit in those last 7.8 miles. If that ain't humbling, I don't know what is.
Even so, I wouldn't trade the experience for the world. Considering I haven't run trails in nearly a year and have barely done any hill work in months, a 7:21:02 was a gift from above, only made possible by my aerobic fitness and a good portion of flat terrain. I even correctly predicted I could finish those last miles without fuel, testing my blood sugar immediately afterward and nailing a 101.
My buddy, Dave, slipped in just under our goal time with a 6:58, which was awesome. I was very happy for him.
In the end, I came in 88th out of 400 starters. 327 runners finished under the 12 hour time limit.
All in all, it was an outstanding event, top-notch in every way. Some people would've appreciated drop bags. I would've appreciated more sugar free drinks at the end, because after seven hours of gel, anything sweet sounds pretty horrible. But I'm being picky. I can't imagine better organization for the event.
As for me, I'm not sure what the fall will bring... certainly more races, and perhaps a decent half marathon in a month or two. But for now, I'm happy to bask in the glory of completing my first ultra, if for no reason than I can't do anything BUT bask at this point. Running is impossible and walking is complicated. But this, too, shall pass.
Friday, September 10, 2010
Ultra-Eve
The 28.4 mile Susquehanna Super Hike and Ultra-Trail is tomorrow. As a matter of fact, my best guess is that I'll be finishing it around this time tomorrow.
Here's my back-of-napkin math:
1. In a road marathon with no elite competition, I'd finish about an hour behind the winner, around 3:30.
2. Last year's winner of this race did it in 4:05, so the course is roughly 90 minutes slow.
3. Buuuuut - last year's course was 25 miles. This one is 28.4.
4. I expect the winner to be around 4:40.
5. Because it's so much longer and I haven't run trails in a looong time, I expect to be about 90 minutes behind the winner: 6:20.
6. I haven't run more than 15 miles in months.
All of which goes to say I'm putting in a goal of 7 hours and hoping that's relatively easy. If all goes well, a 6:45 isn't out of the question.
But here's the thing: a 7 hour race, to borrow a phrase, isn't really about running. It's a distance nutrition competition, measured in time. And as a diabetic, it's a much different deal because I'll have to maintain an even blood sugar along with my energy level.
On a course with no bag drops and just 3 aid stations, which have claimed to have "snacks," whatever that means.
So here's my plan:
1. Monitoring. I'll be wearing my DexCom CGM. However, I'll also carry a back-up blood sugar meter. Between the two, I'll check my blood sugar level at least every hour.
2. Insulin. Tricky. Tricky. This could go either way. On one hand, a high adrenaline level before the race will dictate a high basal rate. On the other hand, I'm going to be moving for 7 hours. The plan right now is to go with a basal of about 40% of normal. That's enough insulin to allow me to eat a lot, too, which is good. In addition, I'm planning on having a back-up infusion set on my belly in case the first tears on tree limbs, boulders, etc. I pondered carrying a third infusion set, but have decided not to. I'll probably take a bottle of insulin and a spare syringe just in case things go very bad.
3. Food. My plan right now is to have a 25g. Clif Gel every hour for the first 3 hours. After three hours, I'll want to have some protein, so I'll switch to a Mojo energy bar or snack on Clif Protein Bites. Of course, I'll balance this with whatever I find in the aid stations.
4. Hydration. I'll be carrying my Camel-Bak, filled with water. This is a definite switch, as I haven't trained in the Camel-Bak for a while and usually carry a bottle of Perpeteum. However, I didn't want to have a carb drink in a backpack, where I didn't know exactly how much I was consuming, so water it is. As I'll probably be between aid stations for a good two hours or more, this is a great way to make sure I stay hydrated, too.
5. Supplements. None of my gels have electrolytes, so I'll be taking a few Hammer Endurolytes every hour. Also, I'll have a few FRS chews at the beginning for a small energy boost.
6. How will I carry all of this crap? My Race-Ready Shorts and my Spi-Belt. I'm not 100% certain it will all fit, so I may have to get creative with Gels and safety pins.
7. Shoes? My trusty Inov-8's.
The best part? My nerves. In many ways, I'm woefully unprepared for this event - both the distance and the terrain. But that's given me a certain freedom to not put much pressure on myself. I'm looking forward to the event, and know that I've got enough miles in me over the past months that it won't be impossible. Probably just really painful.
Here's my back-of-napkin math:
1. In a road marathon with no elite competition, I'd finish about an hour behind the winner, around 3:30.
2. Last year's winner of this race did it in 4:05, so the course is roughly 90 minutes slow.
3. Buuuuut - last year's course was 25 miles. This one is 28.4.
4. I expect the winner to be around 4:40.
5. Because it's so much longer and I haven't run trails in a looong time, I expect to be about 90 minutes behind the winner: 6:20.
6. I haven't run more than 15 miles in months.
All of which goes to say I'm putting in a goal of 7 hours and hoping that's relatively easy. If all goes well, a 6:45 isn't out of the question.
But here's the thing: a 7 hour race, to borrow a phrase, isn't really about running. It's a distance nutrition competition, measured in time. And as a diabetic, it's a much different deal because I'll have to maintain an even blood sugar along with my energy level.
On a course with no bag drops and just 3 aid stations, which have claimed to have "snacks," whatever that means.
So here's my plan:
1. Monitoring. I'll be wearing my DexCom CGM. However, I'll also carry a back-up blood sugar meter. Between the two, I'll check my blood sugar level at least every hour.
2. Insulin. Tricky. Tricky. This could go either way. On one hand, a high adrenaline level before the race will dictate a high basal rate. On the other hand, I'm going to be moving for 7 hours. The plan right now is to go with a basal of about 40% of normal. That's enough insulin to allow me to eat a lot, too, which is good. In addition, I'm planning on having a back-up infusion set on my belly in case the first tears on tree limbs, boulders, etc. I pondered carrying a third infusion set, but have decided not to. I'll probably take a bottle of insulin and a spare syringe just in case things go very bad.
3. Food. My plan right now is to have a 25g. Clif Gel every hour for the first 3 hours. After three hours, I'll want to have some protein, so I'll switch to a Mojo energy bar or snack on Clif Protein Bites. Of course, I'll balance this with whatever I find in the aid stations.
4. Hydration. I'll be carrying my Camel-Bak, filled with water. This is a definite switch, as I haven't trained in the Camel-Bak for a while and usually carry a bottle of Perpeteum. However, I didn't want to have a carb drink in a backpack, where I didn't know exactly how much I was consuming, so water it is. As I'll probably be between aid stations for a good two hours or more, this is a great way to make sure I stay hydrated, too.
5. Supplements. None of my gels have electrolytes, so I'll be taking a few Hammer Endurolytes every hour. Also, I'll have a few FRS chews at the beginning for a small energy boost.
6. How will I carry all of this crap? My Race-Ready Shorts and my Spi-Belt. I'm not 100% certain it will all fit, so I may have to get creative with Gels and safety pins.
7. Shoes? My trusty Inov-8's.
The best part? My nerves. In many ways, I'm woefully unprepared for this event - both the distance and the terrain. But that's given me a certain freedom to not put much pressure on myself. I'm looking forward to the event, and know that I've got enough miles in me over the past months that it won't be impossible. Probably just really painful.
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