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.

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.

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?

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.

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.

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.

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?)

IMCDA, the short version

So this is how the short story goes:

I woke up race day at 4 AM with high BGs, ate breakfast and got my BG's down somewhat before the race. I thought they were falling but apparently not. I was using my race day basal rate profile, that becomes less and less throughout the day, ending up at 0.05 U/hr. I ate 2 gels before the swim, and 2 mid-swim and was high for the first 2 hours of the bike, during which I didn't eat. My swim time was 1:55. I felt great on the bike and maintained a heart rate in mid-zone 2 (aerobic zone). By the end of the bike, my blood sugar was steady at around 140-150, and the Dexcom was working great. My bike time was 7:04. I started the run and felt strong for the first 7-8 miles, at which point I started to deteriorate. When I noticed increasing cognitive symptoms, I decided to stop at the aid station (mile 9). I rested there and took some insulin and drank 1 cup of Gatorade during that time. I felt well enough to resume running after 30 minutes. My BG, which was rising before I stopped, went up, then down and then up again by the end of the run. I think it would be interesting to try and correlate my mile splits with my BG! My heart rate during the run was hovering between zone 1 and 2. I finished the run in 5:22, and the race in 14:42, with no episodes of hypoglycemia. However, the high BG's left something to be desired and, as I discovered, can have a much more negative impact on longer events such as IM than on shorter races such as marathons and half-Ironman distance triathlons (which are not that short I guess!).

I had a fabulous group of friends and family cheering me on in Coeur d'Alene and via the Internet elsewhere. Every time I crossed one of those timing mats, I felt a little cheer coming from those following the race on ironmanlive.com. Thanks, everyone!