Tuesday, July 29, 2008

Vineman 70.3 or maybe 70.8

A couple weeks ago I did the Vineman 70.3 race up in Sonoma County. This course is nearly identical to Barb's Race, which was my first half-IM distance event in 2005. I did Vineman 70.3 in 2006 on a hot, difficult day, and came in much slower than my Barb's Race time of 6:01. So, this year, I was wondering, would I beat that time? Could I come in under 6 hours? The race was exactly 4 weeks after IMCDA and I thought it would also be a good test to see if I'd recovered.

I've had to keep my basal rates lower after IMCDA even though I am about 5 pounds heavier right now. I don't get it but that's how it is sometimes. So planning out insulin for the race was a bit of a guessing game. I decided to really amp up my swim/early bike basal rate, from 0.9 to 1.3 U/hr. I was going to take care of that bike spike once and for all! A couple hours before the run, I would lower it to a level I though would keep me steady. After reviewing my IMCDA basal levels, I settled on a rate of 0.2 U/hr.

We were staying close to the start, so, on race morning, I meandered to the transition area about an hour before my wave went off. Soon enough I was swimming, not sighting too well, but happy to come out of the water with a few minutes' improvement over most of my 2007 swims. I hopped on the bike and, after about 15 minutes, checked my blood: 155. Great! I felt good and was happy to have some overcast skies. I noticed that neither my cadence or speed were getting picked up. That meant I would not have mileage either. I decided to just go by heart rate, targeting heart rate zone 3 for the bike and run.

I tested a bit later and was surprised to see my BG climbing fast, again. Hmmm. I thought my 1.3 basal would have taken care of this. I checked again a bit later and it was still rising merrily into the 300's so I took a small bolus to knock it down a bit. I backed off on the calories but still did drink a little Perpetuum because I was getting hungry. Around mile 25 or so, I pulled out my meter to test and somehow dropped my velcro-laden lancet. I kept riding. There was no way I was going to stop to get it. Bah! I kept riding some more and then my reasonable mind reminded me that I still had a long way to go, and that my BG's were not stabilized yet. I grudgingly peeled off to the left to turn and look for it. I had a nice comment from one of the riders, who called out, "Once isn't good enough for you?" I had words for him but muttered something and rode past the spot where I had dropped it. I slowly rode back up the road, eying the ground for a gray lancet with red velcro. I couldn't find it. Well that was time well spent! Oh well. I figured I could test by just squeezing my fingers hard enough to make them bleed. I usually bleed from a couple spots when I test, anyway! (The problem is, I don't seem to bleed from multiple spots unless I prick a new one!) I was able to test one more time and then just went by feel and past experience. I figured I would start to come down, and assumed this was the case when I started to feel better.

I had no idea of my mileage or average speed, but was familiar enough with the course to think that I might be able to break 3 hours. For most of the ride, I felt good and was enjoying riding on familiar ground. My heart rate was on target and the weather was pleasant. After the one big climb at Chalk Hill, I knew the end was in sight. I kept pushing through the end and was happy to see 2:59 on my watch. Fun! I was glad my little lost lancet incident hadn't pushed me over the edge.

Once on the run, I discovered my BGs were not only high but rising from my end-of-ride food fest. I had finished off the Perpetuum and eaten another 25 g of carbs in anticipation of my usual drop at the beginning of the run. I had also lowered my basal rate a bit earlier and a bit lower than I did in Coeur d'Alene. All of these factors, as well as not being able to test, contributed to another spike over 300. I waited a bit to see if it would fall; it didn't and I took another small bolus. After several additional miles, it seemed to be settling around 250 and I decided to leave it there. I felt so much better not being on the brink of a bad low all the time and it gave me energy and confidence to push the pace a bit. My heart rate was theoretically in zone 2 so I guess I could have pushed even harder; still, it felt like the right effort-level for the distance and conditions. I guess it would have been good to nudge the BG to somewhere below 200 but I was stable, felt good and, with an hour to go, just left it alone.

Although it got a bit warmer when the sun broke through, I tried to hold my pace; I didn't have to do 2 loops, after all! (That was the theme of the day: only one loop for each leg! yay!) I was pretty excited to see that I would likely be able to finish in under 6 hours, and pushed the pace through the finish, for a finishing half-marathon time of 1:57 and a total time of 5:56. And the cool part was that my average heart rate was 165 compared to 178 three years ago with a time that was 5 minutes slower. Yay for progress! And it was a great relief to realize that, unlike last year, my recovery was going well, and that I would be able to continue to train well for IM Wisconsin. And speaking of IM Wisconsin, I can't wait for that race, where I will not only have spare lancets but spare meters out on the course. Fantastic! In the meantime, I think I'll try some string as a back-up to velcro.

Friday, July 18, 2008

A Few Ramblings...

Good luck to everyone racing in Lake Placid this weekend! Ed Liebowitz will be doing his first Ironman. Go Ed!! I also have a slew of friends from San Francisco racing; many of them helped me to get started with triathlon in the first place, and a couple even came to cheer on Jill and myself this past June in Coeur d'Alene. Good luck! Some race numbers to keep an eye on: 2550, 1377, 683, 286, 598, 2108, 859, 254, 416, and 341! I hope I didn't miss anyone. And if you have a chance to come across #683, check out his calves--they're legendary! You can follow the action live on Sunday at ironman.com.

I'll be catching the race in the afternoon after I do the Vineman 70.3 race up in Sonoma County. I was on the waiting list and got off so I am in! I've raced the course twice before and done many training rides up there, so it will be a familiar route for me. Sunday will be four weeks post IMCDA so the race will be a good test on how my recovery is going. I feel pretty good other than the fact that my weight bounced up several pounds within days of Ironman and has been fluctuating a lot since then. My first 80-mile ride was pretty painful but I felt pretty decent riding 90 last weekend with a short run after. I am starting to think that I have recovered after all; because of my experience last year, I had been sort of expecting a sudden disintegration in energy and motivation at any moment! Having the motivation to race with my Triabetes teammates in September has been very helpful this time around.

And if you are riding in Sausalito in the next few weeks, be careful at the intersections and crosswalks. The police there have nothing better to do than to conduct stings to ticket cyclists who don't stop for pedestrians at crosswalks. I had heard about this before and stopped quickly at a crosswalk when I saw a pedestrian on the other side of the road put one foot onto the road. The guy riding behind me a little bit (and to the side) continued through and was given a ticket. I hope they do stings for cars, too.

Friday, July 11, 2008

Jen Alexander Swimming Northumberland Strait Today

Cheer on Jen Alexander as she swims the Northumberland Strait today. Her plan, according to a quick email this morning, is to swim from Prince Edward Island to New Brunswick and then to Nova Scotia. Wish her warm thoughts, calm water, and clear skies! You can follow along at her blog or track her real-time at her Britech site. Also give her cell phone a call if you have the number, and they will post your name on a board that she will see every now and then. Go Jen!

Thursday, July 10, 2008

Dancing with the World

I saw the first one that this dancing guy Matt Harding made a couple years ago. This one is, perhaps, even better. Enjoy! It's better if you go to YouTube and watch the high-res version; also make sure to listen to the sound at some point.

Sunday, July 06, 2008

Don't Waste a Low BG

I'm just wondering who else out there, when you have low blood sugar, will spend an extra 5 minutes to find that yummy treat you've been stashing somewhere but can't find because you are low in the first place? It makes me just want to cry if I have to eat a vanilla GU when I'm low, especially when I just know I have one last bag of Luna Moons somewhere. (And it's even worse if I just finished a 5-hour bike ride fueled by GU! Ack!)

Wednesday, July 02, 2008

Ironman Dreams

Last night I was asked to give a speech at the Greater Bay Area JDRF Chapter's annual family day at the Giants. (The Giants won, by the way.) I pondered what I might say to an audience of kids, teens, and adults recently and longer ago diagnosed with diabetes, as well as their family and friends, and this is what I wrote. It is meant to remind myself as much as anyone else not to sell oneself short because of perceived limitations from diabetes or other challenges. Also it is a reflection on the strength I have gained from a community of friends and, in particular, the diabetic community. This includes everybody, actually, since if you know me, that makes you a "type 3" diabetic. (No doubt you have spent some time as a captive audience hearing about diabetes from me, which is qualification enough.) I was reluctant to post the speech here; however, since a friend requested that I do so, I have posted the text with some pictures below.

I also had the great pleasure of meeting my IronKid, Marissa, and her family and friends. (Hi!) Steve Ahn might be jealous because I was also able to meet his I'Kid Sam last night as well. Please consider supporting Marissa and the other IronKidz at http://triabetes.org/support.html if you are able.

Here's the talk:

June 24 of 2007 I lined up with over 2000 other triathletes, all clad in black rubbery wetsuits, ready and anxious to start Ironman Coeur d’Alene. Beginning at 7 AM and ending before midnight of the same day, an Ironman race consists of a 2.4 mile swim, 112 mile bike ride and 26.2 mile run—otherwise known as a marathon. The cannon went off and, with a little trepidation and a lot of excitement, I plunged into the water to begin my first Ironman race adventure.

Swim start Ironman Coeur d'Alene 2008 (photo by Julia Bavely)

Training for an Ironman triathlon takes a lot of time and a love of the sport. During the heaviest training periods, I spent more than 20 hours per week swimming, cycling, running and weight training. The race itself is equivalent to starting here for a swim past Treasure Island, a bike ride to Monterey, and a run past Walnut Creek.

Why would I choose such a goal? The bottom line is that I love to swim, bike and run and I love the way it makes me feel. It’s hard to wipe the smile off my face after a ride through the hills of Marin, or a good run through the Golden Gate Park. And it gives me some satisfaction to know that if I had tried to escape from Alcatraz, I could have (most likely) made it safely. An Ironman seemed daunting, but I had friends who had started out like me and done the work to get there. I just thought I might be able to do it myself.

Reach for your goals and do what you love to do

Setting goals and reaching for my dreams have been important themes throughout my life. At first, when I was diagnosed at the age of 14 as a high school freshman, I wondered how diabetes might impact those goals. I had experienced the typical symptoms of type 1 diabetes and knew something was wrong when I joked with my best friend, “I must have diabetes or something!” Ha ha. Well, I did have diabetes and I soon found myself in the hospital, learning how to inject insulin into an orange, and then myself. I remember testing my blood sugar at home for the first time. Sitting at the kitchen table, it took me 15 minutes to press the button on the lancet. It seemed so wrong to have to do that!

I wondered how my life would change. Would I still be able to do the things I loved? Some things did change. I was on a fairly rigid insulin schedule and no longer slept in on weekends in order to get my morning shot on time. I learned to count food exchanges and how to treat low blood sugar. But the rest of my life went on. I continued to play flute in the high school band, and to take piano lessons. I continued with my goal to earn my way to college and was able to achieve this with a full scholarship to Boston University. I studied Biomedical Engineering in college and earned a fellowship for graduate school in the same field. After taking up running in high school, I had learned to love that as well, and carried that with me throughout college, graduate school and working here in San Francisco. After 10 years of trying to qualify for the Boston Marathon, I finally did so and returned to Boston in 2006 for a celebration of reaching that goal. Managing diabetes has remained a challenge with ups and downs, but it has not taken center stage in my life nor has it prevented me from pursuing the dreams of my heart.

In Boston, getting acquainted with the finish line.

After moving to San Francisco nearly 6 years ago, I still thought there was no sport to rival running; I soon discovered, though, that I could actually learn to swim and enjoy it after all these years and that cycling came naturally to me and even rivaled skiing in my book. That’s quite a complement given that I grew up skiing on the powdery slopes of Utah.

My first triathlon was an Olympic distance race called Wildflower—a race was so tough for me during the run that it brought me to tears. But I made it through and somehow, despite the challenge of the course, was hopelessly hooked to the sport. I continued with Olympic distance, then ventured into half-Ironmans and then knew it was time to sign up for my first full Ironman Triathlon.

After finishing the swim of my first Ironman race, I exited the water. One of the biggest perks at an Ironman is the army of wetsuit “peelers” who sit you down and yank off the very tight wetsuit. A couple peelers pulled mine off, tossed it at me, and off I ran to prepare for the bike. I dried off a bit, tucked my pump into my back pocket, threw on my shoes and helmet and grabbed my bike. I was off! I tried to stay mellow for the bike portion, and felt comfortable for most of the ride. After struggling with some high blood sugars early on, I was happy to settle down around 130 to 140 for the rest of the ride. I had a few periods of fatigue but overall felt good.

It’s hard to imagine looking forward to a marathon after exercising straight for 9 hours, but finishing up 112 miles on the bike is a happy moment. I threw on my running shoes and was off. I loved to run and felt happy with my pace. About 9 miles into the run, though, my race started to unravel. I stopped at an aid station; my brain felt tired. I felt like it would be unwise to continue, that my race was over. What had gone wrong? My muscles still felt strong. But I felt like my blood sugar had hit rock bottom when it was actually above 100. An astute medical guy suggested that I might be low on insulin. I saw that I had suspended my pump and that my blood sugar was on the rise. I took more insulin and within another 20 minutes, felt strong enough to begin racing again. I completed the last 17 miles of the race, a bit uncomfortable but running. I had done it. I had finished an Ironman race.

Build a community

Throughout the years I have been fortunate to be surrounded by supportive family and friends. My parents encouraged me to reach for my academic and athletic goals, and I always felt their confidence in my abilities. I have to say, though, that my mom was a bit concerned about my sanity when I told her I would be doing 2 Ironmans this year. I’ve had good friends over the years who patiently slow down when I need to test, and stop if I need to wait a bit for my sugar to come up. My teammates and co-workers humor me with my “guess my blood sugar” game—which, incidentally, they tend to win more than I do. And I have sought out other friends who also are positive role models to me in my life.

More recently, in the past few years, I have re-discovered the diabetes community. After hearing about the JDRF for years, but never participating in their activities, I decided that I might as well put some of my endless miles on my bike to good use and signed up for the Ride to Cure Diabetes in Whitefish Montana. What I received in return was far more than a beautiful ride in Montana—although I enjoyed that plenty. Being with a group of people, both with and without diabetes, all united in a common goal to find a cure, was overwhelming. I was able to connect with other type 1’s who were athletically inclined, and to begin to realize that some of the problems I had were not so unusual. I had just assumed over the years that I was a “bad diabetic” for not always being able to keep my blood sugars within the windows prescribed to me when newly diagnosed. And for a few magical days, I felt like the mental burden of the disease was lifted. We were all in this together and it was a comfort to just be around people who really understood what it was like. It was really life-changing for me.

With one of the many amazing parents riding for their kids

My experiences at the JDRF ride further confirmed to me that I had made the right decision to join a group of type 1 athletes to compete in Ironman Wisconsin 2008 as part of a documentary and exercise research project called Triabetes. Meeting up with several of the Triabetes athletes last December in San Diego reminded me of that same feeling I had in Whitefish. It was just a relief to run with some other diabetics who were also carrying a lot of extra gear and didn’t ask me if I really needed to carry all that sugar for an 8-mile run. And it was inspiring to be able to run with Bill Carlson, the first type 1 to ever do an Ironman 25 years ago, and to see, that even after all of these years, he is incredibly fit, healthy and able to do the things that he loves to do.

Meeting some of the team in San Diego at the TCOYD
Triabetes/Insulindependence booth.

I was able to meet up with Triabetes athletes again at Diabetes Training Camp down in Santa Barbara this past March. At the camp, run by an endocrinologist, Matt Corcoran, I learned about exercise physiology and made some discoveries about why I might have had such a tough time at Ironman in 2007. I learned new strategies about how to improve my training for the coming race season and practical methods for implementing those strateiges. I met with the filmmakers of the Triabetes documentary and met their daughter Elisa, who also has type 1 diabetes. I connected with my Triabetes teammates and enjoyed riding up through the Santa Barbara hills as a team, and made new friends from around here and all over. And I learned that, despite my own self-criticism, I hadn’t done so badly on my own over the years. But, better yet, I felt like I was finally developing both a medical and support network to help improve my diabetes control and to allow me to maximize my potential as an athlete. Plus, I discovered, type 1 athletes—even those just starting out on the path—are pretty cool people.

Inviting some younger adventurous types to the Triabetes project was the next step with the IronKidz program. Ten kids were selected from across the country to team up with one athlete each in a summer mentorship partnership and some fundraising, culminating in a canoe trip for the kids a week before Ironman Wisconsin this September. I was just able to meet my IronKid today and look forward to visiting with her more over the summer as she and I both prepare for our trips to Wisconsin, and to having her there on the course. (Hi Marissa!) I can’t tell you how helpful it is to have support during a race like this, and it will definitely keep me going when it gets tough (as all Ironman races do) to know that she will be there, pulling for me. Thanks Marissa for your enthusiasm in being part of the IronKidz project.

With my IronKid Marissa, chilling out at the Giants game.

I also hope that the kids doing this can continue to be a part of the diabetes community—even after they are too old for Bearskin Meadow Camp—and don’t spend years trying to figure it all out on their own, as I did after high school.

After signing up for Ironman Coeur d’Alene 2008, I didn’t tell anyone for a month. I was afraid people would tell me I was nuts for doing it again! But I knew after the 2007 race that I could do better. And after learning from my first experience, and from the insights I’ve gained by connecting with other athletes and experts in the diabetes community, I am happy to report that I came across the finish line a week ago Sunday, smiling, feeling victorious to have taken almost a full hour off my time. I still didn’t have a perfect race, but had some big improvements; I was pretty excited to see a blood sugar of 149 midway through the swim, and a finishing blood sugar of around 110. And throughout the race, I knew that my friends, family, Triabetes teammates and others in the diabetic community were behind me 100%.

Knowing that I will be racing with 11 other type 1’s and will have a team of 10 IronKidz cheering for us along the way will make Ironman Wisconsin 2008 an experience of a lifetime. It might even be enough to wipe away the tears of my 34th birthday 2 days before the race! I can’t wait to see the smiles and tears on the faces of my teammates as they cross the finish line (assuming I beat all of them of course)! Keep posted for the documentary which will tell the whole story.

This is how I have tried to live my life.

When I look back over my life so far, and try to think about how diabetes has played a role for the past 20 years, I have a hard time. I don’t think of my life in terms of diabetes, but rather I remember those experiences that have shaped who I have become.

I have tried to continue to do those things that I love to do, and to reach for goals that may seem just beyond reach. Along the way, I have been supported by friends and family who have given me help when I needed it and quiet confidence that they were there even when I felt strong on my own. I’m not saying that diabetes has always been easy, but for the first time in the past year, I feel just a little less anxious for a cure because of how much I treasure becoming part of this community.

Best wishes to you all as you pursue your own Ironman dreams, whatever they may be.