Friday, December 21, 2007

Sights and Sounds of a Morning Ride

It was a bit tough to get up this morning at 5:15, but at least there was no rain. Today I would do my favorite local route, Sunrise Over San Quentin.

Here are some of the things I saw and heard on my way.
--Bright stars overlooking the city--refreshing after a week of rain;
--Four lanes of morning traffic coming swiftly into the City as I cross the Golden Gate Bridge;
--The San Francisco skyline from a break in the trees as I descended into Sausalito;
--Frost on the wooden bridges reflecting the light from my super strong bike lamp; water rushing underneath the bridges, filling up the tidal marshes;
--Birds calling in the dark and a few wet-looking ducks hidden in the grasses;
--My bike computer reading 8:21 for my split up El Camino Alto hill--not bad considering the added weight from my bike lamp + heavy battery. I measure my split every time I go up this hill to gauge my conditioning and motivation! I haven't broken 7 minutes yet.
--The sun rising as I rounded the first big corner on Paradise and pink morning light reflecting off of the white walls of San Quentin;
--An older man on a mountain bike who decided to pick up the pace as soon as I passed him, making me work a little to keep my lead;
--Flocks of ducks and isolated white egrets motionless, looking very cold in the water;
--Canada geese stopped on their way south, looking quite content as they searched for food;
--A screech and then loud "Thump!" which turned out to be a car smashing into the rear of a garbage truck that was double-parked;
--The City skyline again but now in full light;
--A guy getting frisked by two undercover cops in the Golden Gate Park, which was a discouraging sight;
--The last few hills to my home. I told myself I'd have to use a harder gear on the first and then could granny it for the rest (which still brought my heartrate above 170)!

My BG's behaved better today as well. Here's the data:
  • 5:34 AM 235, ate banana, 1.5 U Humalog
  • 5:45 AM start riding
  • 6:23 AM 245, no correction, no additional food
  • 7:40 AM 136 (yay!), 20 g carbs (raisins), no bolus
  • 8:23 AM 195, feeling hungry, thought I was low
  • 9:10 AM finish ride
  • 9:28 AM 226, 10 g carbs (raisins), 2.3 U (correction bolus + insulin for raisins)
  • 10:00 AM 258
My pace was moderate, average speed slightly less than 15 MPH on a somewhat hilly route (mostly rolling hills, some flats, a couple slightly longer hills, and a few very steep but short hills). It was cold--when I stopped to take the pictures, I tried to test but got the "Low T" error message. And I was pretty chilled out by the time I got home.

My guess when I tested at 136 was that I was dropping, which is why I ate. I think I was actually pretty stable or just dropping very slowly, so either should have taken a little insulin for the raisins, or just held off. Again, a continuous glucose meter is very handy for these sorts of situations. I would have been able to tell that my BG was more or less stable at 136 instead of having to guess. I wonder what the temperature range on the CGM's is.

Monday, December 17, 2007

Post-Swim Highs

Last year, I had some trouble with high BG's coming out of the swim at races and also at practices. At first I attributed it to being off the pump for an hour or more and under-dosing beforehand. But it still happened when I started wearing my pump while swimming. It doesn't happen all the time, though, so I'd really like to figure out what is going on and get a better sense for how consistent the pattern is (and how to deal with it).

Here's today's data:
  • 5:10 AM 136
  • 5:40 AM 155
  • 5:45 AM start swimming--workout included 3 fast 300's and 1 fast 600, moderately intense pace with some easier, shorter sets
  • 7:00 AM stop swimming
  • 7:45 AM 211
I didn't eat anything this morning before or during the swim, and kept my basal at its regular rate of 0.575 U/hr. My pump was low on insulin (7 U when I got up); so perhaps the rise in BG was primarily due to that, especially since my BG was rising before I got in the pool. I've suspected that, when my pump is almost empty, the delivery is less accurate due to the accumulating air bubbles in the cartridge. The workout was fairly intense and sustained, which usually causes a rise in my BGs. Next time if my BG is rising, I will try giving a tiny bolus (0.1 U) and see what happens. I should also reincorporate eating beforehand, to improve the quality of my workout and to practice race conditions. (I'm trying to lose a few pounds and have been cutting out some of my training calories lately.)

Saturday, December 15, 2007

BG Blowup on Paradise

I enjoyed a late afternoon ride with a friend on one of my favorite short routes, known as the "Paradise Loop." Any cyclist who's spent time in San Francisco will probably know of this classic ride, which goes through Sausalito and then up a 1-2 mile hill to eventually reach Paradise Drive, which loops around the rolling hills of the Tiburon Peninsula. The views from Tiburon of the San Francisco skyline, Angel Island and the Bay are amazing, and there are fewer tourists than in Sausalito. It's a perfect spot for a mid-ride snack at the corner bakery.

Anyway, my BG's (BG = blood glucose or sugar) for the day went something like this:
  • 11 AM (1 hour after breakfast): 77, ate 1 gel before a 25-minute walk.
  • 1:10 PM: 337 (yikes!) -> 1.55 U insulin + 15 g carbs. I was hungry since I hadn't had food since breakfast and was about to ride for 45 miles. I thought the insulin would cover the carbs + bring my BG down since I'm more insulin-sensitive while riding.
  • 1:45 PM: 315, okay it's coming down...
  • sometime around 2:30 PM: stopped for 20 minutes to help someone change a flat
  • 3:45 PM: 360, on the rise again. This was odd, I thought. I took 3.4 U to cover the food I was about to eat at the stop. I thought I was being overly generous and was surprised to see the BG had risen since it was previously falling and I hadn't eaten anything since then.
  • 4:00 PM: 45 g carbs estimated; in retrospect I forgot to account for the steamed milk (1 C), about 15 g.
  • 4:15 PM: riding again
  • 5:00 PM: 508! Yikes. 3.1 U at 5 and 1 U at 5:20 PM. "Did they put regular vanilla syrup in my milk?" was my first thought. Um, I don't think I can blame them!
  • 5:32 PM: 448. Okay at least it's coming down...
  • 5:50 PM: 559!? Or maybe not...finished riding.
I had changed my infusion set this morning and wondered if there could have been a problem, so took 7 U by injection at about 6:15. At 6:45 I was 464 and just now at 7:21 PM I am 255. Let's see, that's about a 400 mg/dL drop per hour. No wonder I feel a little shaky. I think it's time for some oatmeal! I have no idea how much insulin is actually active in me, but let's figure it out. If I assume that my infusion site has been okay, then I have only 0.36 U IOB (insulin on-board, or the amount of insulin I've bolused in the past 2.5 hours) from my pump. So my total active insulin is 7.36, which would cover an extra big bowl of oatmeal.

I just tested again and my BG is 213 after 5 more minutes, which means my BG is falling at 504 mg/dL per hour. Okay, I will eat now.
**
I just finished the oatmeal, and it is 7:46 PM. My BG is 137, or falling 228 mg/dL per hour. It looks like I should be okay. I am just hoping I won't be bouncing up again.

There are probably some lessons to take away from this:
1) Exercising at a new time of day can be tricky. I almost never ride in the afternoon, and can usually manage my BG's pretty well on rides.
2) Don't eat when my BG is high and rising, especially if I suspect I may be having infusion site issues. This may seem like a no-brainer but when it's 4 PM and the last substantial meal you ate was at 9:30 AM and you've been riding for 2 1/2 hours, it can be tough! When I saw the 360 at the bakery I thought it was strange but assumed my extra big bolus (for being on a ride) would do the job. Sometimes when I am riding I could eat what I ate today with maybe 1 U or less. So 3.6 seemed reasonable to cover the food and to help jump-start the BG's to fall.
3) It would be really cool if I had a gadget that could track this info for me and connect the dots before I end up at 550. I can see it now but didn't have a big picture view out there on the ride.
4) It is necessary to test a lot to figure this stuff out. Test strips should be cheaper for all.
5) I don't follow the advice given to me in 1988 to not exercise with a BG over 250. I'm not saying that it's bad advice but it is too vague to account for every situation.
6) I probably should have pulled out my insulin + syringe right away when I saw my BG had started to rise.
7) The Dexcom would have come in handy, but I have one sensor left and am saving it since I don't want to buy a new box soon.
8) Why am I blogging on a Saturday night? Don't I have anything better to do, like go shop for Christmas presents? Riding around with high BG's makes me a little tired, or maybe it's just from a really busy week. Or maybe it's just because I want to stay home and continue reading What Is the What by Dave Eggers!

Well, it's now 8:15 PM and my BG is 182. Do you think it's going up or down?

(Thanks to Blair Ryan, a triathlete who races for UCSD, for inspiring me to do a little analysis on my BG's!)

Monday, December 10, 2007

Building the Team

I had an amazing visit to San Diego this weekend for my first visit with the Triabetes team. Several of the Triabetes athletes met up at the TCOYD conference, as well as Michelle Alswager, the project founder (and an athlete herself) from Madison JDRF, and Nate Heintzman and Peter Nerothin from Insulindependence. Peter is also an athlete on the Triabetes team. Kudos go to Amy Tran, one of the officers of Insulindependence, who also volunteered all day. It was a great pleasure to meet Bill Carlson, who inspired the world by defying conventional medical advice and completing in the 1983 Hawaii Ironman and many more to follow.

In the morning, a group of us enjoyed running together along Mission Beach, starting at the south end and running up for several miles before turning around. After a bit of kelp-dodging on the sand, we moved to the boardwalk. My sock had done that annoying thing where it creeps down your foot. The pace was fast and I didn't want to stop since it would be tough to catch up. Oh, well, I didn't want my sock all scrunched up either. I stopped quickly, unlaced and fixed the sock. There was Bill C. waiting patiently. Oh great! Now I would have to run fast! I joined him and we made good time catching up to the rest of the group. We all stuck together for the first third or so and then split off, but I have to say it was one of those runs that leaves me beaming. And Nate was following us along catching some footage and taking some snapshots. Thanks, Nate! I am sorry to say that I did not win the best blood sugar contest at the end. The early intense pace had popped my BG up a little, and my 0.2 U correction bolus midway didn't knock it down. I started the run around 150, was 280 by midway when I took the correction bolus, and was about 265 at the finish. I didn't eat anything during the run, nor did I reduce my basal rate. I was a bit dehydrated, which didn't help.

It was also great meeting up with some folks from DESA and some Insulindependence members, and reminded me of the feelings of camaraderie we had up at Whitefish this September for the JDRF Ride. I look forward to meeting the rest of the Triabetes team, and working with them as we train for Ironman Wisconsin. It is going to make working out for 10-20 hours per week much more enjoyable!

Also, you can see the awesome Triabetes T-shirts in the photo above. Here's a picture of the back. Let me know if you would like one!

Friday, December 07, 2007

Triabetes at TCOYD San Diego Tomorrow

A few athletes and other members of the Triabetes group will be at the Insulindependence booth at the TCOYD conference tomorrow in San Diego. If you're in town, please stop by and say hello. We will also be selling some Triabetes T-shirts there, or you can buy one from me later if you'd like!

Thursday, December 06, 2007

Sickle Cell Mice on the Rebound

Well, it appears that mice are doing well these days. Some seem to have been "cured" of type 1-like diabetes recently and now some others are overcoming sickle cell anemia. An article in Science today describes how Tim Townes at the University of Alabama, Birmingham, and Rudolf Jaenisch of MIT (Cambridge, MA) and colleagues were able to coax stem cells derived from mouse skin cells into blood-producing stem cells, and to administer them in such a way that the mice produced only normally-shaped red blood cells. Check out ScienceNOW for a good description of the study. Thanks, mice.

Monday, December 03, 2007

Training Update

I am savoring the last 4 weeks of 2007 without a rigid training schedule. My goals for this month are to work on my nutrition, swim like crazy, and to continue building a strong base in cycling, running, and strength training. My race schedule is pretty much planned for 2008 with 2 early-season half-ironman races, IMCDA in June and then IM Wisconsin in September. My main concern for next year is being able to recover from IMCDA and then race IM Wisconsin 11 weeks later.

This fall (it's still fall right?), I have enjoyed a number of early-morning rides around Tiburon, starting in the fog or under moonlit, starry skies, and ending with a gorgeous view (or fog!) as I cross back over the Golden Gate Bridge. Fortunately for my riding (but not for the snowpack), there has been little rain so far. I enjoyed completing 3 rides as part of the Low-Key Hill Climb series--up 84 West from the Pacific Ocean to Skyline, up the "are-you-kidding-me?!" steep Welch Creek climb, and 19 miles up Mount Hamilton to the Lick Observatory. It's been fun to watch my power output gradually increase since I started doing Duane Frank's cycling classes a couple months ago. Instead of focusing only on heart rate, we set our interval intensity on % of max power output. From the beginning of the class a couple months ago, my sustainable max has increased ~50 Watts.

I checked my bike computer the other day and it looks like my little red bike is nearing 10,000 miles. I guess it's okay, then, that I've recently had to replace the rear cassette (again), chain, and middle chain ring (for the first time). This past year, I also had to change all of the cables, the brakes, and pedals. It might be time to get a new seat, as well. I'd love to be able to upgrade my wheels for this season, or to actually be able to buy a tri bike for racing. In the meantime, though, I still love my bike!

My running is going okay, although I haven't been as consistent due to my recent preference to swim or bike. But I have been running at least twice a week and went to my first track practice in ages this past week. When I am in good shape, running is generally my strongest sport; or at least, I generally rank higher in my race run times vs. bike times. Right now, I am running at a somewhat mediocre pace, but am generally comfortable.

Finally, I've designated December as my month to focus on swimming. I'd like to get in 3 practices a week, and more if possible. It took me a very long time to get fast enough running to qualify for Boston, yet I still expect to be a speedy swimmer overnight. I have to constantly remind myself to focus on how much more comfortable I am swimming; also, my great coach and swim teacher Laura Goodwin reminds me that my stroke is much improved. I've had a bit of fun working on my breaststroke, which may be my best stroke. In an effort to improve my swim endurance, I've been forcing myself to do flip turns as much as possible. For you pro's out there it's no big deal, but today I did 2 sets of 4x75 + 300 yards doing flip turns at every turn. Sometimes I come up gasping or just barely brush a toe to push off, but it's getting easier. My main struggle is to keep the flip turn together when I feel tired or out of breath.

I am truly grateful to have the health and opportunity to participate in these activities and look forward to another year of training. I am excited to see what emerges from the Triabetes project as well, and look forward to the friendships and learning that will come from that experience.

Kill off some B's to treat Type 1?

According to a news story at sciencedaily.com, Dr. Li Wen and colleagues at Yale University have been able to successfully prevent and treat early type 1 diabetes in mice engineered to express a human antibody (CD20) on immune B cells. I am trying to find the article in the Journal of Clinical Investigation but the story must have been a pre-release, since the December issue isn't available yet online or at pubmed. Anyway, B cells expressing this antibody have been targeted in rheumatoid arthritis, another autoimmune disease, with some success. It took some time to develop the appropriate tools to do this in a model of type 1 diabetes, but it seems like the results are promising. Once the article becomes available, I will try to find some answers to my many questions regarding this research.

Reference from sciencedaily.com: Journal of Clinical Investigation (2007, December 3). Treating Type 1 Diabetes By Eliminating B Cells. ScienceDaily. Retrieved December 3, 2007, from http://www.sciencedaily.com­ /releases/2007/12/071203190636.htm

Update Dec-06-2007: A link to the article can be found here.

Wednesday, November 21, 2007

Triabetes!



Several months ago I received an email from Michelle Alswager, director of the Madison, Wisconsin, JDRF branch, asking me if I would be interested in joining a group of 10 type 1 diabetics to train and race in the 2008 Ironman Wisconsin. Having just barely signed up for Ironman CDA again for 2008, and still in recovery from IMCDA 2007, I wasn't sure if I would be up for it, but knew I wanted to participate. What a lifetime opportunity, to be be able to train with 9 other type 1's! Most of what I have learned about managing diabetes during triathlon has been through shared experiences with other diabetics and through my own trial-and-error. Michelle's plan was to create a documentary out of the project to use for education and motivation.

The project has grown to include more athletes and also a research aspect to study exercise physiology and nutrition related to type 1 diabetes. There are some good resources out there, especially from Sheri Colberg, but there are still so many unanswered questions on how to maximize one's athletic potential through diabetes management practices. I look forward to building team camaraderie with the other athletes as we work towards this common goal. I'll be sure to post here as much as possible. The website for the project is triabetes.org--be sure to check it out!

The other team members behind this project include Peter Nerothin and Nate Heintzman from insulindependence, Dr. Matt Corcoran from Diabetes Training Camp, and Bill Carlson, MPT, who is also the first type 1 athlete to complete an ironman race. The documentary company is Andiamo Production, an Emmy-award winning group in Madison, Wisconsin. You can read more about all of these people at the Triabetes website.

Thursday, November 15, 2007

Path of the Cosco Busan

If you would like to see the path of the Cosco Busan as it "touched" the Delta Tower of the Bay Bridge, check out this movie from Boating SF. It can take a minute to load. This website also shows a live update of current traffic in the SF Bay.

There have been some hearings on what happened and the final story is still being determined (written?). In the meantime, here's a press release from the Coast Guard.


Press Release

Date: Nov. 15, 2007

Contact: Unified Command
Joint Information Center
(415) 398-9218
(415) 398-9621

OIL SPILL RESPONDERS COMPLETE WATER CLEAN-UP, CONCENTRATE EFFORTS ON BEACHES

Cosco Busan Oil Spill Update (Nov. 15, 2007)

SAN FRANCISCO- The Cosco Busan Incident Unified Command announced today that oil spill clean-up efforts have transitioned from on the water recovery to beach clean-up, pressure washing of seawalls and shore structures, and decontamination of some vessels and equipment used in the response.

Removal of visible oil has been completed for the following areas: Stinson Beach, RCA Beach, Agate, Kirby Cove, Fort Funston, Baker Beach, China Beach, Pier 1-39, Crissy Field, and Pacifica Pier.

Re-oiling is possible as wind and wave action can transport oil from impacted beaches to beaches that have already been cleaned. The unified command is monitoring beaches and is prepared to respond immediately if re-oiling occurs.

Removal of oil from the shorelines at beaches by trained volunteers and professional responders in San Francisco, Marin, Contra Costa, Alameda and San Mateo counties will continue in these areas: Angel Island, Ocean Beach, Brooks Island, Albany Beach, Berkley Marina, Radio Tower, Rodeo Beach, and Muir Beach.

A list of beaches where the public can assist in cleanup efforts without hazardous material training can also be found at www.uscgsanfrancisco.com.

A coordinator will be on-site to provide direction to the volunteers. Any volunteer who finds oiled material must report it to the coordinator on site.

The public is still urged to avoid areas and wildlife that are affected. Untrained volunteers can cause further damage to the environment and stress on the wildlife.

Concerned citizens should call (415) 701-2311 to report any sightings of oiled wildlife.

Members of the community without proper training should not attempt to collect the oil, since it needs to be disposed of properly to prevent broader contamination and re-introduction to the environment. In addition, exposure to the oil can be hazardous for your health.

The most recent information about the clean up is as follows:
Total personnel employed: 1399
Total gallons discharged: approx. 58,000
Total gallons oil recovered to date: approx. 16,974
Total gallons evaporated: approx. 4,060
Total birds captured: 888
Total dead birds: 830
Number beaches closed: 27
Number active skimmers: 1
Number of support vessels: 25
Number of volunteer fishing vessels (sheen cleanup): 20
Number shoreline cleanup teams: 16
Number of wildlife personnel: 169 (including 142 volunteers)
Feet of boom laid out: 27,500
Number of contracted aircraft: 2

Tuesday, November 13, 2007

Update from Senator Migden

Somehow I made the email list of Senator Migden, my state senator! Here's an alert she sent out today:

UPDATE ON THE SAN FRANCISCO BAY OIL SPILL # 2


Dear Friend:

In an effort to keep you current on clean-up activities related to last Wednesday's devastating 58,000 gallon bunker fuel spill into the San Francisco Bay, here is the second in a series of informational e-alerts:

Today, Governor Arnold Schwarzenegger issued an executive order that bans both commercial and sport fishing in the San Francisco Bay from November 15th through December 1st or until it is determined by public health and wildlife officials that the Bay is ecologically safe to resume fishing.

Clean up actions continue to remove fuel from the San Francisco Bay. The U.S. Coast Guard is the lead agency for monitoring and cleaning up the spill. A Unified Command has been set up with the US Coast Guard, California Fish and Game’s Office of Oil Spill Prevention and Response, and the O’Brien’s Group (contracted by the responsible party).

Here is the latest update on what is being done to clean-up the spill and to protect people, wildlife and the environment:

-7 miles of containment boom has been deployed to confine/collect oil in the water
-6 vessels are skimming/collecting oil on the water
-More than1,500 people are participating in spill response
-12,745 gallons of oil have been collected.
-580 gallons have dispersed naturally
-4,060 gallons of oil have evaporated (estimated)
-53 vessels are working to remediate the spill
-3 helicopters are surveying the area
-Oiled wildlife count - LIVE BIRDS – 715 (of those, 183 are washed, and 66 have died or been euthanized) -DECEASED BIRDS - 511

The latest overflight shows very little recoverable oil offshore and inshore. Cleanup efforts are transitioning from water recovery to shoreline environmentally sensitive areas.

Oil in Trash

Do not place oil from the Cosco Busan oil spill in trash receptacles. Well-intentioned members of the public have been cleaning up oiled beaches and placing the oil and oily rags and adding them into trash. Do not attempt to collect the oil, since it needs to be disposed of properly to prevent broader contamination and re-introduction to the environment. If you have collected oil, it should NOT be added to regular trash, as this may negatively impact the environment. Oil and trash containing oil (such as rags or paper towels) should be double bagged and labeled as oily waste. PLEASE CALL YOUR LOCAL GOVERNMENT'S HAZARDOUS WASTE DEPARTMENT TO HAVE IT PICKED UP.

Beach Cleanup Status (from OES as of November 13, 2007)

(These percentages are of the gross amount of product recovered. Once this number reaches 100 percent, it does not guarantee the beach will open. The cleanup of the beaches needs to be certified by local, state, and federal authorities. Clean up of beaches is progressing with the following completion estimates.)

Marin County
Rodeo Beach – 60 percent
Muir Beach – 60 percent
Stinson Beach – 80 percent
Angel Island – 25 percent
RCA Beach – 25 percent
Agate – 25 percent

San Francisco
Fort Funston – 20 percent
Baker Beach – 85 percent
China Beach – 85 percent
Pier 1-39 – 100 percent

Closed Beaches

The Department of Public Health has determined that it is unsafe to swim in some locations and therefore has closed the following beaches:
Bay Area Beach Closures Nov. 13, 2007

  • Clipper Cove Beach, T.I.
  • Aquatic Park (Booms in place)
  • SF Municipal Pier
  • Ft. Point
  • Baker Beach (Heavy Oil)
  • China Beach (Light Oil)
  • Ft. Baker
  • Mile Rock Beach
  • Kirby Cove (Heavy Oil)
  • Rodeo Beach (Heavy Oil)
  • Tennessee Valley
  • Muir Beach (Heavy Oil)
  • Angel Island (Heavy Oil)
  • Keller Beach
  • Ferry Point
  • Point Isabel
  • Baxter Creek to Lucretia Edwards Park
  • Coastal Access point to Cliffside; Pt. Richmond
  • Middle Harbor Regional Park
  • Steep Ravine Beach (Mt. Tamalpais)
  • Red Rock Beach (Mt. Tamalpais)
  • Crissy Field Beach (booms in place)
  • Stinson Beach
  • Linda Mar Beach
  • Rockaway Beach
  • Sharp Park Beach
  • Ocean Beach has an advisory posted
  • San Francisco Piers 1-39 Booms in place

Air Quality

The Bay Area Air Quality Management Board is actively participating in safety monitoring and performing air sampling along port property.

Ferry Schedules

Ferry schedules have not been disrupted.

Reporting, Helping Oiled Animals

The public is asked to report any injured and/or oiled wildlife to the Oiled Wildlife Care Network at 877-823-6926. The network recommends that people DO NOT pick up or approach oiled animals.

To Volunteer: As of this morning, the OWCN has received over 1500 offers to help volunteer from the generous public. They are not currently taking more registrations. Please check this site regularly for status changes. People interested in volunteering should check the network website at www.owcn.org for updates on volunteer efforts. The site is updated constantly.

You can also call the Richardson Bay Audubon Center & Sanctuary. Here's a note from the Audubon Director:
"We will love to have your help in a variety of ways in the coming days and
weeks. This will be a long process--don' t feel bad if you can't help
tomorrow--let us know when you can. We will need help documenting oiled
birds around the bay, talking with folks on beaches and bikepaths about how
to help, removing tar (after training!) from beaches, removing regular trash
from beaches before it can get contaminated.

I am working with our partners to create a training for the community for
oil clean up--we understand and share your frustration with not being able
to do more. We would like to train more of you to help. Check our website
in the coming days for news on this training. We hope to hold in within 10
days, at the Audubon Center.

Please encourage everyone to keep children and dogs off beaches--if we step
in the oil, we spread the contamination around.

Thanks for caring for this amazing ecosystem and all its inhabitants, so
central to our community."

Brooke Langston
Center Director
Richardson Bay Audubon Center & Sanctuary
415 388 2524 ext 109

Volunteer Opportunities
Here are additional organizations seeking volunteers:
Baykeeper: www.sfbaykeeper.org
Richardson Bay Audubon Center & Sanctuary: www.tiburonaudubon.org/index.html
Important Contact Numbers

Oil sightings & claims number: 985-781-0804
Public Information Hotline & Media Inquires: 415-399-7305
If I can be of further assistance to you, please do not hesitate to call my district office in San Francisco at 415-557-1300 or San Rafael at 415-479-6612.

Sincerely,

State Senator Carole Migden

Monday, November 12, 2007

Sorry Gav, and Little Black Blobs

This morning I attended the mini haz-com training session for volunteers wishing to help clean up the oil spill mess. A representative from the Department of Fish & Game gave the sped-up lecture which still included slides on ticks and rattlesnakes. To be fair, though, this guy had just come up this morning from Monterey to give the lecture, and hadn't had a lot of time to prune the slides. Anyway, it was mostly obvious stuff but because IFO-380 (intermedial fuel oil) is rated at 2 (out of 4) as a health hazard, by law they couldn't send people out there without the training. Rep's from the EPA and SF Public Utilities Commission were there, and about 25-30 SF PUC employees, some called up very early this morning, showed up to head teams of volunteers.

Midway through the 4-hour lecture, who should appear but our own illustrious mayor, Gavin Newsom. It was a good gesture on his part to show up, and he acknowledged the slowness of a response on the clean-up. I'm still not sure why Bevan Dufty was temporarily running the show, but it looks like the mayor is back in town at any rate. I felt a little bad for my criticism and the phrase, "If you don't have anything nice to say, don't say anything at all" flitted through my head.

We grouped up and headed out to Ocean Beach for a couple hours of cleaning. We wore white, oversized protective suits, booties, and were taped at the cuffs with duct tape. This was the first day and things were a tad unorganized but I'm sure it will improve over time. The guys leading our group were, I believe, firefighters, and were friendly. They said the full haz-com course can cost $10,000 and last a week. They plan to train more volunteers and have clean-ups every day as long as necessary.

Down on the beach, it seemed like most of the oil had been collected already by the Surfriders, who have been cleaning up all weekend; although, I still found plenty of small pieces. It was hard to distinguish the oil from small black rocks, so the beach may be down a few of those. To make things more lively, I chose to clean up next to the breaking waves.

By the end, I wasn't sure whether they organized this to appease people who wanted to help, or because they actually needed volunteers. I don't think the oil is that dangerous in the quantities we were handling, but it is very sticky and, in the end, I appreciated having the protective gear just to avoid getting messy. I kept thinking, though, that we could have just shown up on the beach at 8, been told how to put the suits on and to not eat the stuff or stick it in our eyes, and set free.

The "responsible party" who is in this case, the owner of the Cosco Busan, has the responsibility of cleaning up the whole mess. In theory, this means they should be hiring contractors to clean up all of the water and beaches and should pay for all of that. I asked one of the SF PUC guys after whether they were organizing this volunteer thing because people were clamoring to help, or whether they actually needed the help. He said emphatically that they did need the help, because picking up the oil of the beach, piece by piece, is so laborious. Also, he said that more affected areas weren't cleared until the end of today for clean-up by volunteers, since there is and endangered bird species living there.

I still think the main problem associated with this event was a lack of leadership and communication leading to a break-down in confidence by citizens that the event would be handled in a competent manner. Considering the recent disaster in the Black Sea, however, where more than 10 times as much fuel was spilled and already 30,0000 birds have died, the Cosco Busan oil spill in the Bay is looking more manageable. I wish we would be kinder to our planet.

Mayor Missing But Volunteers Finally Getting Organized

Where is our newly re-elected mayor, Gavin Newsom? At the volunteer meeting on Saturday, someone made a reference to Bevan Dufty as acting mayor while Newsom was unavailable. Huh? I wasn't sure if I heard correctly but it has been confirmed by other news source. Yet, nobody is actually reporting on where he is. Do they have some sort of arrangement? It's weird. And the lack of leadership around here definitely contributed to the abysmal organization (or lack thereof) of volunteers immediately after the spill. While citizens were watching their beaches fill up with oil tar-balls, the official word was to stay away from the beaches and some people cleaning up the mess were actually arrested.

Now at last the Dept of Fish & Game and the EPA are offering some training Monday morning for volunteers who wish to help in the clean-up (but only for a total of about 250 people). My suggestion is that they put this info online, and just have a quick in-person discussion or test to make sure people understand the procedures. Baykeeper, whose mission is to "protect and enhance the water quality of the San Francisco Bay-Delta Estuary and its tributaries for the benefit of its ecosystems and human communities," is sending out a newsletter with updates on organized volunteer activities. Also, the city of San Francisco has set up a page on its 311 site to give instructions on volunteer activities.

Friday, November 09, 2007

Many Birds Are Okay (So Far)

This morning, I went on a ride through Sausalito and Tiburon, in part to inspect the damage from the oil spill. Although tragedy to marine life and the coastal ecosystem is being reported throughout the Bay and along the Pacific Coast (especially to the north of San Francisco) I was relieved to see that at least the tidal marshes in Sausalito do not seem to be greatly (or obviously) affected. I worry that the clean-up is not happening quickly enough, though, and that the strong currents that change with the tides, could bring some of the oil to this area.

Crossing the Golden Gate Bridge before dawn, I could smell fumes and see a sheen on the Bay from the oil. It was too dark to see anything in the water in Sausalito, but I didn't smell fumes as I was riding through town. I looked at the rocks along the water on Bridgeway--if there were oil globs stuck on them, it wasn't obvious to me as I rode by. I had been most concerned about the tidal marsh north of Sausalito. The bike path runs through this area, and whenever I ride by, I see many species of birds feeding here; I'd noted the recent arrival of Canada geese. I looked at some of the pools of water and couldn't tell if there was oil in them, but they seemed okay. Riding around the backside of Tiburon, I could smell strong fumes again from the oil. I didn't have a good view of the water there, but the I wondered if residents there had been warned about air quality.

I stopped for a few minutes near the ferry stop in Tiburon and looked out over the water. I couldn't see globs washing ashore but I wasn't too close. I was bothered, though, by what seemed to be an absence of any effort to protect the area. I didn't see any of those yellow booms to collect oil, and the oil skimming ships were far off. The day before, it was reported that there was an oil slick at Angel Island, which is not too far away from Tiburon. Just tonight, it was reported that there is still a large oil slick between Tiburon and Angel Island. I hope the people in charge of this operation are competent.

I stopped to take a few photos before and as I was crossing back over the Golden Gate Bridge to San Francisco. With the bright sun, it was a little hard to see, but I could see some oil swirling around a building past Fort Baker and a trail of black goo leading east from the bridge. I saw a bird down below and it seemed to be struggling. It was hard to see from so far up, though.

Oil skimmers
Fort Baker north of San Francisco. I think those might be oil skimmer ships out there, or possibly Coast Guard.

Looking south
From the viewing area north of the Golden Gate Bridge.

Oil near Fort Baker
From the Bridge, I could see oil swirling around this outcrop.

Oil
Globs of oil have been found all over the place. I could see a trail of oil leading east from the Bridge.

Thursday, November 08, 2007

Breaks My Heart


(Picture from sfgate.com)

Yesterday morning, an enormous container ship heading for South Korea, began leaking what is estimated now to be 58,000 of bunker fuel when it rammed its side into one of the Bay Bridge towers. The Bay Bridge appears to be fine, but the oil from the leaking ship has now been found up and down the coast, as well as in many beaches and other coastal areas in the San Francisco Bay. Many sea birds have been found oiled or already dead; according to the Oiled Wildlife Care Network, the oil reduces the ability of the birds to stay warm in the cold water and they soon become hypothermic and hungry. The OWCN also states in their press release today, that for every bird that washes ashore, "an estimated 10 to 100 birds died at sea." I haven't seen any reports on marine mammals being affected, but then again the initial report relayed by the Coast Guard from the ship's operator was that the spill was about 140 gallons instead of 58,000. Ships coming in and out of the Bay hire pilots who are familiar with the area to guide ships in and out. The Coast Guard hasn't released the full story yet. I think the full environmental impact of this is yet to be determined.

Another part of this story is that a major series of triathlons was scheduled for this weekend on Treasure Island, an island in the Bay. So far, they are still planning on doing it; although if I were competing, I wouldn't want to do the swim.

Update: Google map shows the location of some of the pictures.

View Larger Map

Wednesday, November 07, 2007

Low-Key Hill Climb: Mad Cow

After warming up for 4 to 5 miles on flat to mildly rolling hills, this is what greeted 67 riders as we began the 3.9-mile, 1923-foot vertical climb up Welch Creek Road last Saturday. "Well, here we go," I thought as I laughed a little at this first hill. I had been warned it would be steep. Fortunately, though, the road had been recently paved and we had sunny skies and warm weather.

I had tested my BG's right before the race began and measured in the low 70's. Hmm, not good. I ate a chocolate GU (so yummy!) and turned down my pump for 30 minutes and hoped that would cover it. Usually my blood sugar rises during intense rides like this, although I couldn't remember starting a ride with a blood sugar that low.

I was impressed to see a tandem bike there, and lots of other very fit-looking cyclists. I knew I would be secretly or openly mocked for my aerobars on such a climb, but with all the other stuff I have to lug around, what's another pound or so? It would make me stronger! Plus I just finally got them readjusted after my bike was disassembled for the JDRF ride. Anyway, at least I wasn't wearing an aero helmet or anything. Ha ha.

As you can see from the grade profile map (courtesy of Steve Rosen), the ride started out steep and just got steeper. Those little dips below 0% (all three of them) were oh-so-brief, but much-appreciated downhill sections. Somewhere around the 2nd mile (about 3.2 km on the plot above), I saw my new friend Murali K. stopped in the road. Looking around, I soon discovered why. To our right was a large brown and white cow, munching on some grass. No problem. But on the left side of the road were two calves, who seemed to belong to that cow. (Or at least one of them did.) I decided to try and pass, but as I approached, the cow gave me a nasty stare and started charging my way. I easily got some speed going back down the hill and she backed off, and went back to her task of eating. The two calves seemed unfazed and continued to munch on sticks and what-not. I tried a few more times with the same results. I asked Murali if the cow was heading towards the calves or us and he said she was heading right towards me! Well, we didn't know what we would do until we saw Sara G. come motoring by after fixing her flat. She didn't seem bothered and cruised right along, to our amazement. The cow gave a loud, very annoyed "Moo" as she went by, and Sara responded, "yeah yeah" and made her way. But the cow didn't even move from her spot. Huh! Well, we decided to get some speed and cruise by quickly and hope she would treat us so kindly. We went down a bit and started heading up, as quickly as possible. It seemed to be working... But after we had made some progress, I looked to my right and saw the cow running alongside and above us, approaching quickly. Would I be able to ride fast enough uphill? We finally got ahead of the calves and kept pedaling like mad and the cow backed off. (I guess she was more of the short sprinter type.) But my nicely calmed heart rate was back to its former, racing high state.

I had looked at my watch when we first stopped, and then when we had passed the cows, and we had lost 12 minutes there. I was quick to admit to Murali that I didn't mind being forced to take a break (and I was glad to give my blood sugar some more time to come up), but I was glad we were able to get by and finish the ride. After the first couple miles of this climb, I knew I would be happy to just finish. My finishing time was just barely under an hour at 59 minutes, which would be 47 minutes if I hadn't taken that long break. I had stopped a few other times, briefly, to check my blood sugar or let my heart come down from it's maxed-out rate of 193 beats per minute.

After the descent down, which was tough in its own way, Murali joined me for awhile on the Calaveras Road, and then I ventured up Felter Road, down Sierra, and through Milpitas and then on Tasman back to Sunnyvale. (Thanks for the tips, LKHC-ers!) I was careful to note how much braking was required on Sierra, since it is the site of an upcoming ride. And I also noted that I saw very little evidence of last week's earthquake, which was located just a short distance off of Felter. I saw a small landslide onto the road, but with the soft ground around here in many places, those are not uncommon sights. (The green below on the Google map shows the site of the earthquake, just off Felter, which is viewable if you zoom in. The red is the start of Welch Creek Road.)


View Larger Map

I was most happy to note that my arms, rather than my legs, were the most sore the next day. Um, maybe that means I should have ridden a bit faster?

(Picture taken by Genti Cuni, courtesy of Adam Tow, this week's coordinator. More can be seen on Adam's website and photo gallery.)

Monday, November 05, 2007

Blue Lightning (Green Ray?)

I was sitting on the couch tonight, chatting with my parents about earthquakes and strange behaviors of cows (more on that later) when I was startled by a small and then larger, bright flash of blue-green light coming from west of the Golden Gate Bridge. My first impression was that it was lightning, except there was no thunder, the color was wrong, and it was too low in the sky and without the usual bolt of light seen with lightning. Hmm, well perhaps it was an explosion? But I heard no explosion, and haven't heard about any explosions on the news here. Okay, maybe fireworks? But what is the occasion? And it was 2 quick, isolated flashes, not resembling the normal appearance of fireworks. I posted a listing on the local news section of craigslist asking if anyone else saw it, and have had 2 responses so far. One guy suggested that it could be a green flash, which is a meteorological phenomenon typically occurring right after sunset. It seemed like a possibility because of the foggy, cloudy conditions tonight, but it was 2 hours after sunset, and green flashes typically occur right as the sun sets, or soon after.

I emailed an astronomy professor in London who wrote an article on green flashes. I hope he might have some insight. Perhaps it was a green ray?

Here's the basic info.
I saw it around 7:10 PM on November 5, 2007.
It appeared near or to the west of the Golden Gate Bridge, north and slightly west of where I viewed it in the approximate center of San Francisco. I would estimate the distance at about 5 miles.
It appeared to come from the same elevation as the Golden Gate Bridge, or a little lower. It appeared to originate from below and flash up, brightening the sky. I believe there was a smaller flash before the larger, brighter flash. The bigger flash was only a few seconds long at most.

I suspect some transformer could have exploded, or perhaps it originated from a ship on the Bay. But I really don't know. I find Roswell and the X-Files amusing but don't really buy into that stuff, so I'm looking for a more plausible explanation.

Did you see it?

Follow-up
So thanks to my friend Sarang, the mystery has been solved. According to the San Francisco Chronicle, a plastic balloon flew into some power lines on 2nd and Clement, causing them to spark and resulting in a power outage. Who knew a balloon could cause something like that? Here's a great youtube video of a branch falling on some power lines. These guys were lucky:


Thanks also to the two astronomy professors who humored my requests and wrote me back explaining that it could not be a green flash so long after sunset. Dr. Andy Young from SDSU was closest to solving the puzzle. He said,

"It certainly sounds to me like electrical sparks between copper conductors. Are there any trolley lines in that direction?. . . Arcs between copper wires can also be caused by falling tree limbs, large birds, etc. -- though of course wires rubbing against something they normally wouldn't can also happen in high-wind conditions."

And I particularly enjoyed the email from Dr. Mike Dworetsky, Director of the London Observatory in London, UK, who enlightened me on green flashes, cloud-to-cloud lightning, and sprites. In the end he offered my favorite explanation:

"Hmmm. Nov 5th: It's Guy Fawkes night in England, traditionally celebrated with fireworks, so maybe a long-shot guess is that a British ship was letting off fireworks at sea...or maybe a British family on the Marin peninsula or at Drake's Bay?"

I'd like to see if there was a Union Jack on that balloon!

Thursday, November 01, 2007

World Diabetes Day

The United Nations adopted a resolution in December 2006 to designate November 14 as an annual day to recognize diabetes worldwide. The International Diabetes Federation has been recognizing 11/14--the birthday of Frederick Banting, who, with Charles Best, discovered insulin in 1921--as World Diabetes Day since 1991 to recognize the growing epidemic of this disease.

The motivation behind the resolution is to bring attention to the disease and encourage the creation of public and private health organizations to address prevention, care, and a cure. Especially in developing countries, which account for 80% of all cases of diabetes, the high financial and societal costs of diabetes care are increasing. Type 1 diabetes prevalence is increasing at a rate of 3% annually, and type 2 has now overtaken type 1 in children in Japan. For 2007 and 2008, the unite for diabetes campaign will focus on diabetes in children.

Action to help young people with diabetes is urgently needed. In poor and low-income countries, many people receive inadequate care or no care at all; the life expectancy for some diagnosed with type 1 diabetes is less than 2 years, when we see people in the U.S. living >75 years with the disease.

Please become familiar with the symptoms of both types of diabetes and do all you can to prevent type 2 diabetes. Realize that type 2 symptoms may be mild or completely unnoticeable, so it is best to get checked if you are at risk. In college, I worked for a year at the Joslin Diabetes Center. Although I had no complications at the time, and still have none after 19 years of diabetes, newly diagnosed people with type 2 diabetes were being treated there for severe retinopathy that could have been avoided with earlier detection.

Take care, World.

Tuesday, October 30, 2007

5.6

Sitting on the couch, I thought at first a loud wind was blowing by. But why so loud? As I quickly realized that this was no wind, I threw the computer down (gently), jumped off the couch, and ran to the hallway. It seemed safe there. Or was it? The rolling continued, reminding me of a pedestrian bridge that sways when I run on it. It wasn't too bad but it seemed to last a long time. Would it get bigger? What was happening? Then, after the earth stopped moving, I started to shake, my heart rate racing, my voice trembling. It seemed to be over, so I decided to stay indoors. Checking the usgs.gov website, only a micro-quake (<2 on the Richter scale) was showing up near Muir Beach. Then the big red square loaded up by San Jose. Yikes!

For the people who have lived here a long time, this was nothing new. Reading through the comments at sfgate, though, people seem to agree that it was longer than normal, and some were reminded of Loma Prieta in 1989 by the initial strong jolt followed by a rolling motion (albeit much less intense).

By the way, if you ever want to kill some time, read the comments at sfgate. Just don't take them too seriously. Some from tonight:
"my books fell on my head - who do I sue?"
"Well, I am quite sure that this is somehow Gavin Newsom's fault."
"I wonder if it shook the treehuggers out of the oaks in Berkely." [The courts just ruled that the protesters hanging out (literally) in some trees on the Berkeley campus had to come down.]

But there are also some comments on whether a small quake lessens the chance of a larger quake. I think, in general, that is not believed to be true. But what do I know?

Wednesday, September 26, 2007

Thanks for the Ride

Thank you to those who made it possible for me to participate in the September 2007 Ride to Cure Diabetes in Whitefish, Montana. While raising money for the JDRF was my primary reason for deciding to do the ride, the weekend far surpassed my expectations. Not only was I treated to explore and ride in one of the country's most scenic and peaceful locations, for a few days the burden of this disease was lifted and I was reminded that it is, in fact, possible for me to live better with diabetes. Unlike other athletic events, which also motivate and challenge me, the Ride brings people together with a common goal: to cure diabetes. It was also the first event where the medical tent at the end was never used. I met many friends with diabetes themselves or who have loved ones with diabetes. And some decided to ride just because the location was so spectacular. I can certainly appreciate that. Meeting other athletically-minded type 1's helped me to realize that we often share the same frustrations. I also realized that, despite my self-criticism, I have actually managed to learn quite a bit about how to manage my BG's while exercising.

I had a few other self-realizations while chatting with others:
1. I am so averse to having low BG's while exercising that I often keep my blood sugar higher than necessary. During the ride, I learned that I could keep my exercise BG lower, and have been experimenting with increasing the amount of insulin I take during exercise since then.
2. I put a lot of energy into managing my BG's during exercise and was, for example, able to avoid low blood sugar for almost 15 hours during the Ironman. Sometimes, it seems too hard to muster up the energy for the rest of the time. But by changing a few small things, I can improve my diabetes control, and the way I feel, even when I am not exercising.
3. I used to have excellent control. I was probably the most "compliant" teenager there ever was. I had a hard time adjusting my diabetes to my college schedule, and, while starting the pump my sophomore year gave me flexibility, I also slowly changed my behavior because of it. Being at the JDRF ride, and seeing other type 1's, reminded me of how I used to be--more strict--and I finally accepted that some of my difficulties do not arise from an inability to master the art of pumping, but in the types and timing of the food I eat.

And guess what? My A1c (measure of average blood glucose over ~2 months) went down a significant 0.6% since the end of August. A lower A1c means a smaller chance of most complications as the years go on, and better health in the short-term, too.

Some pictures from the weekend...

Here I am with Anne Marie, whose daughter has type 1 diabetes. This was her first JDRF Ride. She also convinced her friend Joe to raise money and ride. We had a nice paceline going for part of the first loop.

The ride consisted of 3 loops: Star Meadow, Whitefish Lake, and Northfork. Star Meadow Loop was the longest (~50 miles) and had the steepest climbs. It was also the coldest--in the 30's at the turnaround point. I was wearing plenty of warm gear and didn't chill out too much. A day or two before the ride, there was a report of some 10 grizzly bears being relocated from rural areas in the vicinity (not sure how close). They said the huckleberry season was particularly bad this year, and that the bears were trying to fatten up before hibernating. Being somewhat grizzly-bear-phobic ever since reading Mark of the Grizzly, I expected to see one lumbering along through Star Meadow, seen here, or maybe even poking a stick through my spokes! Easy dinner.

Here I am with Matt and Andy from Team Type 1 and another friend, Lynn. The 3 of them and many others stuck around at the finish, waiting for the last of the riders to pull through. Oh did I mention that the "century" was actually 118 miles? I was happy that I made it without having done many long rides lately. Early in the ride, the TT1 guys and a friend and I rode 5 abreast on one of the country roads. We decided that we were technically riding "single file" in a different sense. I enjoyed riding with them and am pretty sure my heart rate was at least 20-30 bpm faster than any of theirs! It was exhilarating. It was also interesting to hear about their strategy (which is similar to other relay teams' strategies) for winning RAAM. Apparently, they would take turns riding very short intervals at or near all-out intensity. It sounds pretty exhausting for everyone involved.

I believe Carlos, above, was the last rider who did the full 118 miles to finish. Several years ago, he nearly lost his infant son when doctors were slow to diagnose type 1 diabetes. I was shocked that the obvious symptoms did not quickly lead to what could have been a 5-second diagnosis (with a BG check). His son was near death when doctors finally realized what was going on. At that time, Carlos felt like he "had to do something," and signed up for his first ride. His son is now biking himself, and proud of his dad for doing this for him. I think his expression sums up the whole day--triumph that we had all been able to enjoy such spectacular surroundings & conditions, support, and friendships, and that we had moved $700,000 closer to a cure.

Thank you to all those who supported me. It turned out to be much more than just a ride.

Tuesday, September 18, 2007

One Last Plug for JDRF Ride

My bike is en route to Montana, and I will be leaving Thursday for the Whitefish Ride to Cure Diabetes. If you wanted to donate but forgot, it is not too late. Just go to:
http://ride.jdrf.org/rider.cfm?id=7134
or go to
http://ride.jdrf.org and search for my name.

Thank you to all who have already generously donated. If you know anyone who might be interested, please spread the word.

TCOYD

After a last-minute decision, I attended the Taking Control of Your Diabetes conference this Saturday in Santa Clara, CA. I showed up around 8, registered and filled out the "pre-test." I was wondering how much new information I would discover given the easy scope of the questions, but tried to have an open mind. The morning talks were interesting and fun and I met up with some old & new friends at the Expo. I finally met Amy T. from Diabetes Mine and her husband and talked bikes for a few minutes. I would have loved to visit longer, but there were some eager people wanting to know more about the online scene. (I still want to plan a Diabetes OC/DESA bike ride sometime this fall for the Bay Area.) And I picked up her book, Know Your Numbers, Outlive Your Diabetes, which I plan to read soon. I grilled the Dexcom people on their pricing (which I am really not happy about) for the new 7-day sensor and tried to ask a few people if it was worth upgrading. Steve Edelman, the conference director, said yes, that it does work better. My friend Bill King said that it is better but I saw that it still skips readings sometimes. I have a box of 5 sensors to get through so I will wait for now. Mine are usually waterproof, more or less, so there is no huge advantage to me, especially if the new one doesn't come with free, improved software, and if the sensors don't last longer than the 3-day ones. I guess another advantage would be not having to reset the sensor every 3 days and missing those skipped hours during calibration.

Doug Burns spoke during lunch and told us his inspirational story. What struck me is how tough the whole movie theater fiasco must have been given his childhood. He had a rough time with diabetes as a kid, and was picked on because he was so skinny and weak. He turned his life around by working tirelessly at his goal to get stronger, and to ultimately win the Mr. Universe competition. I wonder if getting beat up by the police reminded him of those tough times. I am so sad that he has had to go through this, and whatever he decides to do (litigate or come to some mediated solution) he has my support, for what it's worth. As he told us, he was returning to the theater to get some food when the police put his hand on Doug's shoulder from behind. You just don't grab someone from behind--if someone did that to me, you bet I would whip around in a defensive posture. Sheesh. Anyway, it was great to hear him talk, even though he wasn't able to give his slides as planned.

The highlight of the afternoon was probably the talk with Dr. William Polonsky on psychological issues related to diabetes. The patients were seated on the left and the healthcare providers on the right side of the room, and Dr. Polonsky asked each side what drove them crazy about the other. I think most of the healthcare providers were genuinely caring and understanding, but there were a couple that made my blood boil (specifically, the "they have no will power" lady). Then Dr. Polonsky worked with the group to reconcile these differences and try to understand where the feelings were coming from. I am fortunate now to have a team that seems to get it, but I have had previous experiences that were negative and had a few things to say.

I was glad I went and although some of the talks were not new to me, it got me thinking to the time when I was diagnosed and I was so strict about everything. If nothing else, it reminded me that it was possible to have better control, and that many people share the same frustrations that I do. If you have the chance to go to a conference in your area, I would recommend it. And if you are like me and register late, it will only cost you $40. I think the pre-registration price is $30.

Monday, September 17, 2007

Big Kahuna Race Report

On September 9, I completed my last triathlon of the season, the Big Kahuna Triathlon in Santa Cruz, CA. I had been feeling somewhat tired and unmotivated training for the race, and felt less prepared than usual. Going into the race, I wasn't sure if I would try to run, since my running has been particularly difficult to recover since Ironman. I figured I could muddle my way through the swim, and felt more confident about the bike leg. But the run. Hmm. I told myself that I would do the swim and bike, and stop after that if I wanted to. I tried to believe that I would be okay with that.

Race morning came. I ate my oatmeal early (no milk) and headed to the race start. I was calm, more so than for most other races. In fact, this was the first race in recent memory where my pre-race BG's were less than 100 mg/dL. I was actually alarmed to see a reading of about 95 on my meter before heading down to the swim. Still, since my training volume was considerably less than during Ironman training, I wasn't as afraid of having a low BG during the race, or at least during the swim. I ate one gel and went into the water around 160.

Swimming out around the Santa Cruz Pier, I heard the sea lions barking. The water was mostly calm, with a slight current to the west (this part of the beach runs east-west). I had the usual experience of being smothered by each wave of swimmers, which unfortunately seemed to happen right as I was rounding each buoy. I was surprised at how good I felt, though. I tried to pick up the pace now and then but was mostly enjoying the opportunity to swim out in the ocean with a safety crew on hand.

There was just a little surf to push me in the final distance, and I was happy to exit the water. I found my strategically placed shoes for the quarter-mile run back to T1, and made my way. I saw others barefoot and in flip-flops and was happy to cruise along in my old Saucony's. The weather was pleasant with overcast skies and the wind light as I started out on the bike.

Most of the 56-miles bike course ran along Route 1, with majestic views of the Pacific Ocean. The first time I rode this route, the headwinds riding north were incredible. Riding north for 50 miles took me at least 90 minutes longer than the swift 50-mile ride back south. Today, however, the winds were fairly calm and I saw my average speed was almost 19 MPH. There were a lot of us bunched together and it took some effort to avoid drafting. I noticed many who didn't bother to not draft and others who were outright drafting. The race officials seemed pretty casual about this; actually I should say that the race officials seemed mostly absent. I guess they were probably up front with the race contenders. After the turn-around, I rode 10-20 miles with another guy, swapping places every few minutes. I would generally pass him on the downhills and he would gradually catch up on the uphills of this rolling course. I found him after and thanked him for the fun ride.

As I got back to Santa Cruz, I realized that I could finish my bike split in under 3 hours if I really booked it. Throwing caution (i.e., heart rate zones) to the wind, I pushed to finish those last few flat miles and crossed the mat in 2:58. Unfortunately the official results combined my bike with my T2 for a time of 3:04. But I know I did it so ha!

I threw on my run gear, hit the portapotty and was off. After the first small hill I saw my cheering friends and one of them said, "I guess you are doing the run!" I guess I was. I decided to just take it as easy as I wanted and to not worry about my time. I felt better than I expected on the swim and bike, and thought I could probably make it through the run.

The run course also goes along the coast, and has a couple of miles on a dirt trail at the turnaround. The sun came out and warmed us up a bit, but it was still pleasant. My BG's were decent and I ate a few gels along the way. Coming back to the finish line, I kept a pretty steady pace and was not horrified by my time of 2:14. My finishing time for the race was 6:19, a bit slow on a day when people were getting PR's all over the place, but a good enough time for me given my expectations.

The best part of the race for me was the realization that the Ironman training did have some lasting benefits that I hadn't been able to see in the weeks leading up to the Big Kahuna race. I was pleased that I could "take it easy" and finish in the time I did. I didn't take it easy on the bike, though, and was happy to see that I could still push myself if I wanted to. As my coach had reminded me before the race, triathlon is a lifestyle and not just about racing. I tried to take that advice to heart and had a much better experience because of it.

Wednesday, August 22, 2007

I'm back!

I checked my blog this morning to find that it was no longer available! What?! I discovered that I had been flagged as a "spam blog" by Google's blog checker. I suspect I got flagged because of my JDRF solicitations, and perhaps since I haven't posted in a while? I don't know. After about 8 hours, my blog was restored.

In other news, I am planning to do the Big Kahuna Triathlon on Sept 9 and of course the JDRF ride on Sept 22 in Montana. Other than that, I am trying to sleep and rest more. Last night, we practiced swimming into the surf at Baker Beach in San Francisco. The waves there are big (well, not Hawaii big but big for me!) My goggles got knocked off once but at least, now, I know I will survive BK if there happens to be a bit of surf in the morning. Right before we dove in, we saw a seal swimming around. Or maybe it was a sea lion. I was perturbed but forgot immediately about the little (or big?) guy once I started focusing on surviving the waves. You should have seen me running out of the water, looking back at the monster waves that were hoping to knock me down.

I am also trying to coordinate some studies with some investigators from Israel to learn more about SIPE. We are trying to spread awareness, especially within the triathlon and open water swimming community, about this potentially life-threatening condition.

Friday, July 27, 2007

Riding to Somewhere

I emailed this letter tonight:

Diabetics are accomplishing amazing things these days. Just today, an article in the New York Times highlighted Team Type 1, a group of eight type 1 diabetics organized to compete in the Race Across America. Not only did they win their division this year, they beat their own best time by 21 minutes. (And they have a longer term goal of competing in the Tour de France!) Another diabetic, Gerald Cleveland, has had diabetes for 75 years and holds the record for the oldest type 1 diabetic at the age of 91. He's planning to make it to 100, at least.

I have been fortunate in my life to be able to participate in activities that I enjoy, and reached my 10-year goal of qualifying for and competing in the Boston Marathon in 2006. And about a month ago now (time to get off the couch!), I was able to successfully complete my first Ironman triathlon--a 2.4-mile swim, 112-mile bike ride, 26.2-mile run--in 14 hours, 42 minutes. I have tried to approach life with the attitude that diabetes will not prevent me from reaching my goals, whether in athletics or education/career.

Still, the reality is that managing this disease takes constant vigilance, and even then, outcomes are not certain. I try not to dwell on it too much, but diabetes remains a leading cause of heart disease, blindness, kidney failure and a host of other tough problems. Without insulin, I would die, which is why you won't see me sending hate-mail to Lilly and Novo Nordisk pharmaceuticals. Type 1 diabetes usually strikes children and adolescents, but is also diagnosed in younger adults. The exact cause of the disease is still uncertain, and there are no known ways to prevent its onset.

The Juvenile Diabetes Research Foundation, or JDRF, is the leading charity whose aim is to support diabetes research leading to a cure and/or prevention of type 1 diabetes. They are one of the top-ranked charities in terms of efficiency and efficacy. One of their current projects is to develop an "artificial pancreas," using insulin pumps and continuous glucose monitoring to ease the mental burden of the disease and to provide greater control. Researchers are closing in on the cause, and there are many other promising avenues of research that may lead to a cure or a prevention.

I decided when I signed up for the Ironman race last year, that I would try to raise money for the JDRF in conjunction with that. In the end, I decided to do the JDRF Ride to Cure Diabetes in order to take advantage of their fund-raising resources. I will be riding 100 miles in Big Sky country, Montana, on September 22, as part of my effort to raise money for a cure. The fund-raising requirements are higher than most charity events--$4000 is the minimum required by each rider, but my goal is to raise at least $5000.

I realize that there are many demands on our resources, and that you are all already generous with yours. If you would be willing to donate any amount, it would help me to make my goal. (If there's one thing I've learned in marathons and triathlons, it's that every small step takes me that much closer to the goal, and that all I need to do is make sure I am continuing to make forward progress!) If you are able to do so, you can go to my site at the JDRF website, or simply go to jdrf.org and look up my name under the Ride to Cure Diabetes donation page. My site contains more information about my story, and shows a picture from my recent Ironman race. Donating online is available there, or you can donate by check if you prefer (just contact me). All donations are 100% tax-deductible.

Again, here is the link: http://ride.jdrf.org/rider.cfm?id=7134

Also, if you have any coworkers, friends or family who may be interested in reading more about my experiences, or in donating to the JDRF, please feel free to forward this letter or point them to my JDRF site ( http://ride.jdrf.org/rider.cfm?id=7134) or to my blog (http://annetics.blogspot.com). If you have a blog and feel like pointing people my way, that'd be welcome as well. ***If you already donated, thank you very much for your generosity--it means a lot to me. I am sending this again in case there is anyone you know who might be interested in donating.*** Also, if you are not able to or prefer not to donate at this time, for any reason, please do not feel any pressure. But, again, if you feel like you may have friends who would be genuinely interested in donating, please spread the word.

Finally, if you are not completely bored by my long email and tons of embedded links, you can read even more:
1) My top ten (or eleven) reasons for doing the Ride (please note reason #11);
2) My original post explaining why I signed up;
3) And, my plea for a cure.

Oh and if you are still killing time on the computer, you can check out some of my bike pix/stories:
Marin Headlands
Point Reyes Lighthouse

Whether or not you are able to donate, thank you for the support and friendship you have all given to me.

Wednesday, July 25, 2007

IMCDA, Here I Come (Again)

Yes, it's true. I signed up to do Ironman Coeur d'Alene again. A friend who called after I finished the race in June asked me if I would do it again, and, at the time, I really didn't know. My response was, "Not a good time to ask." But I knew that I could do better managing my diabetes and avoiding some of the problems I had on the run. Before this year's race, so much was unknown. I feared low blood glucose on the run but in fact, faced a different problem--low insulin and rising blood glucose levels. With the confidence of completing one race, I can direct more energy into ironing out nutritional/hydrational issues and fine-tuning my BG management, especially after the swim and towards the end of the run.

My race prep calendar will be much the same as it was this year--Kaiser Half Marathon in Feb, California 70.3 Triathlon in March, and Wildflower Long Course in May. This fall my focus is on the JDRF ride in September. In preparation I will do a couple local century rides and a half-ironman triathlon in September. I am considering participating in the Janus Charity Challenge next year to raise money for the JDRF; although, I will have to come up with some creative fundraising ideas to avoid annoying my friends too much.

Friday, July 20, 2007

Wake up!

It is 5 AM and I am awake now. The reason? No, I did not get up to swim today... The Bay Area was greeted this morning with a moderate 4.2 earthquake, centered 2 miles ENE of Oakland. I woke up to sounds of creaking and rattling and felt my bed shaking--it didn't feel strong enough to cause any damage. Still somewhat new to California, I still get a little anxious about earthquakes. I guess what makes me nervous is that these small ones could lead to something much bigger. It is another reminder that I should make sure I have enough supplies (food, insulin, etc.) in case services are disrupted by a more major event.

Now I have one choice facing me: try to get back to sleep or go swimming...Let's give sleep another shot, eh?

Wednesday, July 18, 2007

Velcro is better than duct tape

Before my Ironman race, I decided I needed to be able to mount my meter on my bike in a way that would make testing without stopping possible. Others had suggested using velcro, so I stopped by the local hardware store after one of my warmup rides and bought a couple feet of it in this fabulous red color. It matched my bike but also went along with the whole blood-letting theme of testing blood. (Sorry to be gory but, hey, I see a lot of blood so I can joke about it right?) I wasn't sure what the best configuration would be so I covered this Ultra Mini meter on 3 sides. I also covered a bottle of test strips and the lancing device; the lancing device that comes with the Ultra Mini is nice and compact. During the ride, I found that placing the meter on my aerobar as shown in this picture was the easiest way to keep things steady. I also stuck some velcro inside my bento box in order to secure the test strips and lancing pen when I was riding. I didn't want a repeat experience of losing either during a ride. The best time to test, I've found, is when riding uphill; I don't lose as much time as I would during a flat section and testing while going 25+ MPH doesn't seem safe to me. I've pretty much mastered the technique of testing while running, and imagine that with more practice, testing while riding will be just as easy.

When not testing, I placed my meter here in a more aerodynamic position. I'm not sure if it really makes a big difference but at least I can't blame my BG meter for coming in 20 seconds too slow! (I'll blame the red velcro fuzz on my aerobar for that!) When I'm not racing, I can also put the meter in the bento box between testing. I tested my BG nearly 40 times the day of the Ironman race, including 12 times on the bike, and was very happy with my arrangement. Oh and by the way, I bought 2 of these Ultra Mini's for $15 each at Walgreen's before I left for Idaho. They were on sale, but are still usually pretty cheap. Of course, no test strips were included.

Friday, July 13, 2007

I love SF

We've had some spectacular weather in the past few days, with highs in the pleasant 70's and cool mornings. As I rode home from my bike ride this morning, I reflected on how happy I was to be in bike shorts and a short-sleeve shirt, and to be neither hot nor cold. The sun was warm and the shade was pleasantly cool, and I felt so grateful and happy to ride across the Golden Gate Bridge, and up Conzelman Road to the top of the Marin Headlands. The one-way portion of Conzelman is incredibly steep and it would take a lot of grip strength to come to a complete stop on the bike. Careless riding could end in disaster, since some of the corners have steep cliffs over their edges. It would be a long fall into the water/rocks below.

From the top of Conzelman, I could see the Bay Bridge, interrupted by Yerba Buena Island, and the Berkeley/Oakland hills in the distance. San Francisco was gleaming in the morning sunshine and the Golden Gate Bridge, currently receiving a fresh coat of its red-orange paint, was its usual, glamorous self. To the west was the unending Pacific Ocean with occasional smaller boats and one "Hyundai" cargo ship hauling out to sea. I reflected there for several minutes, before beginning my descent and winding my way through the hills of the Headlands.

Wednesday, July 11, 2007

Cure Diabetes Now! (please)

I am tremendously grateful that diabetes, including type 1 diabetes, has received so much attention and that diabetes care continues to improve. And I am sincerely grateful that having diabetes does not prevent me from participating in activities that bring me joy. I am blessed in many, many ways, and know things could be much worse.

But sometimes, I just ache inside and impatiently cry out for a cure. When I was diagnosed in 1988, I was told, "5, 10 years at the most." I try to assume it will not happen in my lifetime, so I am not disappointed. But sometimes it seems so tantalizingly close.

Cure it now! Please.

My arms are turning into sugar crystals

Yet again, I somehow failed to deliver the audio bolus for my pump this morning. I swear I pushed the button to confirm the 8 U bolus for my big bowl of oatmeal and a correction for a high. The high BG was, incidentally, caused by an overcorrection of a 4:30-AM 45 mg/dL BG, to which I woke up in a panic, wondering why my Dexcom did not alarm even with a reading of 61. Hmph. Oh and this is after I got to bed at 2 AM from a late night at work. I got up at 7 AM to avoid getting a ticket for my semi-legal parking job, and then dragged myself to get a tooth filling that made me wonder if it was possible to get traumatic brain injury at the dentist?

Anyway! The point is that, here I am at the computer with that super-high-BG crappy feeling because I can't seem to push a button hard enough. My arms are tight and achy and I imagine blood the consistency of honey trying to squeeze through the capillaries in my muscles. Sorry, little ones (speaking to my muscles). How mean for me to put all that sugar in plain sight with no way to get in.

I just took a massive rage bolus and will hopefully not pay for it later on. We'll see what happens first: feeling returns to my cheek, or my BG drops below 300.

Wednesday, July 04, 2007

Still Doing the Ride

Fundraising for the JDRF Ride to Cure Diabetes took a temporary backseat during my Ironman training, but I am now increasing my efforts to raise money for the JDRF through this September's Ride in Whitefish, Montana.

Trivia: Hammer products, such as Hammergel and Perpetuem, particularly useful for athletes with diabetes, happen to be made in Whitefish. At least, that's what the labels say. Yay Hammer! So if you like Hammer, you like the JDRF and want to donate to help cure diabetes? Works for me. Note to Hammer: I will still use your products even if I am cured, so there is no conflict of interest!

Please read my original post to find out why I decided to do the Ride. You can click on the JDRF Ride icons on my blog or go to my JDRF website to donate now.

Ten, or maybe eleven, reasons to donate:
1) The JDRF is one of the highest rated charities out there, looking for ways to potentially help millions of people;
2) Donating is tax-deductable;
3) When you found out a gal with diabetes could finish an Ironman, you decided you ought to at least go for a walk;
4) You are an athlete and appreciate how critical it is to manage blood glucose levels for optimal performance;
5) You have a friend whose 2-year old was just diagnosed;
6) Or, you have a friend who was just diagnosed at age 33 (it happens);
7) You learn that there are many promising avenues for a cure, that it could happen in your lifetime, and you will have played a part;
8) You just don't think a 7-year old should have to give away her Halloween candy (although her 10-year old brother would be glad to take it off her hands);
9) You wonder if your child could develop type 1 and hope that we can figure out what causes it in the first place;
10) You learned that almost everyone with type 1 diabetes develops some signs of diabetic eye disease, and that diabetes is a leading cause of blindness;
11) You sorta like Anne and just want to support her since you know she really really really hates asking for money (and you don't want her to start begging). (Did I mention that I hate asking for money?)