24 October 2011

I Just Can't Kick You

   The disease I thought I could kick is now back with a vengeance. I had hoped it was a transient pain in the ass, but, alas, I am not that lucky.  I now have another life-long, chronic, just-another-thing-to-add-to-my-resume disease.  I tried eighteen months of drugs that I knew only gave me a thirty-seventy shot at a permanent fix. Looks like I got the thirty side.  So I am headed back into the depths of illness in hopes of turning an overactive thyroid into an underactive one or possibly being one of the ten percent who undergo this treatment and end up with a normal thyroid. At least after all this I can claim that I have been radioactive.

01 October 2011

Tip of the Day

So here's the diabetes tip of the day. Make a basal check a standard procedure every two to three months. Like I've said before, I've been struggling with blood sugars all over the place but mostly up. My first thought is always to my site failing or my pump not working properly. But rarely do I figure that maybe its my basal rates that have overstayed their welcome.

The last time I checked or changed my basal rates was at least six months ago. I keep thinking that nothing has really changed since then so why change my basal rates, but when I really sit down to think about it, a lot has changed. I have gone from working full time to ten weeks of an amazingly relaxed summer vacation and then back to work again. I have begun working out again and made some huge advancements in my overall aerobic fitness. My stress level has dropped since my kids are now going to the same school I teach at so I no longer have to fight thirty minutes of traffic while preventing fights and major meltdowns in the house and the backseat and worrying if I will make it to my classroom in time for the first bell of the morning.

And the biggest factor in all of this, my thyroid is closing in on being back at a normal level. After three years of being totally out of control, it is responding to the meds and mellowing out. Its amazing the effect it has had on my basal rates over those three years. When it was at its max my nighttime basal rates were reduced by fifty percent while still fighting off constant lows. Now I have hesitantly brought it back up to pre-thyroid levels and even a little higher since I was in much better shape before this whole ordeal started. For the first night in weeks, last night I had a good blood sugar night. Nick didn't wake me once and the clarity of mind I have found today from quality sleep is terrific.

The worst part is that I should have figured this out months ago, if I had only done a basal check. So now along with my quarterly A1C check, my TSH, T3 and T4 check and my five minute conversation with my endo, I will be performing a basal check.

30 September 2011

Fine Tuning

I have recently moved my infusion sight down to my outer thigh and have been having huge problems with it. I usually rotate the site locations depending on the season. Spring and summer, when I am in a bathing suit more than not, require that I hide the site under a bikini so it goes into my upper butt between where the pocket of my jeans is and the waistband. Fall and winter make it easier to put it into my upper thigh since I spend most of my days in jeans and skirts and the only place I get into a swim suit is at the Y to get in a workout so I am less concerned with my appearance. After three successful years of this, I have found my system faltering. My butt has developed scar tissue which hinders the insulin from getting from the infusion set to my blood stream where I can actually use it. I thought it might be time to make the switch to the upper thigh to give my butt some time to heal. 

As soon as I did I started pulling out sets when I changed clothes. I had to train myself to be careful of a new spot and then I would be fine, I told myself. After a week and ten different sites being pulled out, I got the hang of it and stopped  accidentally pulling out sites. But then I started to notice that the sites would go bad after only a day. When I first started using an insulin pump the sites I used, like mini IV's, would stay open and useful for seven to ten days at a time. I loved not having to poke myself or remember to change a set for a whole week or more. As time has worn on that period of time has been reduced greatly, mostly due to scar tissue. I have had to abandon using my stomach due to the scarring and now my thighs and butt are both showing signs of deterioration as well. I just wonder how many more body parts are viable options. Am I , in ten years, going to have to affix this thing to my ankle? Luckily my ankles have very little fat. But of course this means I can't use them as an infusion site. Maybe my chest will have to do, though, I am not sure how much Tony will like the looks of that one. So what are those other sites I have been overlooking, ones that I will not pull out easily,but have not scarred up ye?. Or maybe there's some new technological advance to erase the scar tissue so I could go back to the old reliable sites?

29 September 2011

More Days LIke This

I think paid sick days from work should be handed out on a sliding scale. Most jobs will come up with some arbitrary number of days that you can miss a year and still get paid. Maybe they should work on tightening up that formula. The standard person gets ten. Oh You're a diabetic, that's four extra days a year. So you have hyperthyroidism, that's worth three extra. You haven't seen a doctor in fifteen years and you haven't been sick a day in your life, you get two.

I have been teaching now for thirteen years. Each year we are given ten fully paid sick days a year. If we don't use them all they are carried over for the next school year. People who have been teaching as long as me usually have around fifty days stocked up by now. I have zero. I have not had a year yet in which I did not use each and every sick day I was allowed and a few extra, sometimes quite a few extra. There were the two high risk pregnancies which took me out for five and seven months. Then there was the year before I got meds for the hyperthyroidism that took me out for four months. But even on a good year, I have not been able to keep it under ten days. I suppose I should be grateful for the ten paid days, some jobs don't even offer that. But after a night like last night, I just wnaant to whine and complain and ask for more days off.

I went to bed at 9:30 with a blood sugar of 329 which I promptly corrected for. I should have been back to normal two hours later. So when Eli woke me at 12:30 after having a nightmare, I was surprised to have that high feeling. And not just a moderate high feeling, but the one where your whole body seems to be filled with that metallic taste. I tested and knew it would be bad. 404. Into the bathroom, shut the door and replace my infusion site. I've gave up on using my thigh anymore, the last fifteen tries there have been met by speedy failure. So again it is a shot in the butt to insert the infusion set and off to bed.

One- thirty comes and I am woken up by the sound of Eli walking down the hall. We have an old house and the upstairs creaks with every step. I can hear my kids the second their little feet hit the floor. So I wait for his entrance, but it never comes. If he's not the one who's walking around my house at O-dark-thirty in the morning, who exactly is it? I jump out of bed to look for the prowler that Eli has been having worried about the last few days, only to find a raccoon digging through the trash. I didn't even have the energy to scare him off, I just fell back into bed.

At two thirty Nick woke me to tell me my blood suaras were still high, 273. By now, with all this insulin on board he should only have dares wake me to tell me I had overshot the good zone and entered Low Land. But no, new site be dammed, I still was not good. More insulin. Nick has a two hour sleep button so he left me alone for a while, but right at four-thirty, he was on my case again. Still high. Damn, really?  240. More insulin, but not too much. There's nothing worse than spending a whole night at 400 and then waking up at forty.

Six a.m. comes way too soon and I curse the sun's punctuality and hop in the shower hoping to wash away the fogginess now firmly entrenched in my brain. I get out, dry off and get dressed and attempt to put on some make-up, but a whole night without insulin has done some damage on my body. My cells have not been able to get any sugar to perform any function and they are screaming about it now. I look at my makeup bag and cannot decide what to take out, so I grab the first thing I see, my eyeliner and for a moment or two I cannot figure out what to do with it. I just look at it like some sort of NASA space tool that I have never seen before. After a minute or two my mind has finished processing and brings up the right use for it and I proceed. I sometimes feel like my brain on mornings like these is working like a five year old PC that has never been cleaned out and is so crowded with programs and data that it takes ten minutes to boot up and fifteen to open any program you ask. And if you decide to open too many programs at once it will simply crash. This morning I was on my way to that very crash.

I made my way down the stairs and into the kitchen to make breakfast very slowly, dragging from the achy-ness that feels like the moment your flu aches actually become painful, when Tony comes in and gives me a big hug and asks what's wrong. It's great being married to him for so long because I have very little explaining to do for him to understand exactly what's going on. "I was high all night" I say. He holds off his teasing when it's this bad and is always the right amount of sympathetic.  I go back to trying to make breakfast for me and the kids so we can ll get to school on time, when Tony says, "Do you need to take a day?"

I usually will push through a morning like this one. I have to or I would never make it to work. I had been toying with the idea of taking the day off to recover.  I usually try to get ready for the morning before I make my decision to see if just getting up and moving around will shake the cobwebs out of my brain and body, but there are two things that make that decision very easy to make. The first is when I have to consider if I should go hang my head over the toilet because the high has now made me very nauseous and expelling the contents of my stomach is now eminent. The other is when I can't control the tears that stream at the thought of having to move my body enough to get the kids to school and then go teach 150 seventh graders all day.

When Tony asked if I needed a day, and the tears threatened to expose themselves, the decision was made, chalk one more up on that board. And everything gets easier. I can now drop the kids off and crawl back into bed by eight and sleep until ten. I can get up and eat the only meal that will do on a day like this, one that I am sure of its effects on my blood sugars, fish tacos. I can now try to find some Anti-fatigue caps from Hammer Nutrition, which are amazing at removing all the nasty metabolic by-products made by my body during a night like last night, at my local supplement store, The Nutrition Zone, and run into another active diabetic who is isolated from the diabetic community and share what Insulindependence has done for me in my diabetic life.  And  I can now write and try to find some amount of catharsis from this damned disease.
If only I had more days like this...

18 September 2011

The Lazy Man's Solution

I've been looking for creative ways to write more for this blog and I hear the lazy man will go to a meme when he is out of ideas. I have come up with some creative ways to inspire me, but as I am fighting off a headache and nausea from working in the fumes in my newly painted office, I thought a lazy way was warranted today. So here is the first meme I found (what's the point of being lazy, if it means havign to search for the best meme or one that is perfectly suited to the topic of this blog.)

1) Who is the last person you high-fived? Tony, when he finished his last tri

2) If you were drafted into a war, would you survive. I doubt it, unless I had some amazing people on my team.

3) Do you sleep with the TV on? NO WAY!!!

4) Have you ever drunk milk straight out of the carton?  I don't like to drink milk. Its only purpose is to turn chocolate for lows or to fill my cereal bowl

5) Have you ever won a spelling bee? i kant spell wurth crapp

6) Have you ever been stung by a bee? Nope. We used to catch them as a kid with dixie cups while they sat on the little flowers in the grass of our elementary school or sometimes we would catch them with tweezers as they sat on the shrubs in front of my cousins house, but I've never stung.

7) How fast can you type? not as fast as i can think which kills me when I write.

8) Are you afraid of the dark? Not unless I let my mind wander and picture that horrible, tall, skinny alien thing run behind a fence like in that movie Signs. Still creeps me out to this day.

9) Eye color: green

10) Have you ever made out at a drive-in? Nope, just a regular theater

11) When was the last time you chose a bath over a shower? This afternoon

12) Do you knock on wood? Only when I knock my knee on whatever wooden creation I am currently building which is usually followed by cussing and crying

13) Do you floss daily? I would love to say yes.

15) Can you hula hoop? Yep but not with any sort of finesse or beauty

16) Are you good at keeping secrets? Excellent. I take great pride in being trustworthy. Maybe it was having a very loose lipped friend as a kid that drove that message home.

17) What do you want for Christmas? a new wedding ring (not a new husband, mine's perfectly designed for me) just a new ring with some style.

18) Do you know the Muffin Man? huh?

19) Do you talk in your sleep? When I'm stressed.

20) Who wrote the book of love? God.

12 September 2011

Has It Really Been Six Months?

  My husband, Tony, has been doing triathlons for three years now.  He has come from a couch potato to placing very high in his age group.  Yesterday he went to pick up his race packet for yet another race, his fifth this year.  As he reached the front of the line he gave the lady behind the counter his name and the greatest thing happened. "Spineto? Is your wife that diabetic sailor girl?" she asked.
      "Yeah?" he questioned not knowing where she was going.
    "That's so cool. I follow her blog. I'm a diabetic, too." she said.
    (By the way, if you happen to be this lady, leave me a comment, I'd love to hear form you.)
     When he came home and told me this story, my first thought was of how guilty I felt for not writing in six months. well, that's not exactly accurate. I have written, I just haven't written a blog post in that long. Who knows the real reason why I haven't, maybe I am avoiding being so public with all of this, or I was rebelling against having to write on a deadline after doing it for a while.  I would like to think that maybe it was just because I was out living my life, storing up stories to write about at a later time. But which ever reason it was, I thought it was time to break the streak.
     I returned from my trip in February and took a week or so to get back in the rhythm of everyday life. In March I started construction on Come Monday, my twelve foot plywood and epoxy sailboat. Building a boat was one of those things on my "Someday I Will" list, but was never the right time mostly due to lack of space and lack of funds. Since we moved a year ago, I now had a little space in the garage next to the cardio training room, my writing studio, Tony's painting studio, the surfboard quiver and the laundry room to build a smallish boat.  My requirements were simple. The van could handle a boat up to 12 feet on the rack and I would need at least that much to float the whole family (with a little leeway if my kids ever decide to grow). So it would be a 12 foot boat. The epoxy could fix all the poor craftsmanship due to twenty year old tools and the fact that my only training was twelve weeks of seventh grade wood shop. Any pathetic cut I made just got filled in with epoxy. After two months and around sixty hours of labor Come Monday took her first voyage, across the Carlsbad Lagoon with Tony, Shea and Eli aboard. And she actually floated. Me being me, I forgot the oar locks so we paddled her with oars far too long to do it comfortably.  I am still working on her sailing rig, cutting down an old sail my friend, Craig, so kindly donated, and working on the mast and spars and rudder and leeboard.
    Come Monday showed she was seaworthy just as I was finishing up my thirteenth year teaching, which means I have been a teacher just as long as I have sat in those little desks before high school graduation. I also reached the point where I have spent as many years since high school graduation as it took me to get there. Summer came with the promise of finishing all of those projects I put off during the school year, but as soon as the days got long and hot and the kids were off playing for hours on end in the cul-de-sac, all I wanted to do was laze around by the pool and thumb my nose at my to-do list. I even dared to watch a T.V. show in the middle of the day, a true indulgence.
    My thyroid has cooperated with the meds and is getting back in line, no longer doing whatever the hell it wanted. It is listening to the rules of my body more and more which is great for my overall well being.  I have recovered enough to get back the desire to compete in triathlons again. So in June I chose one in October and began training. I had no idea though not only how badly out of shape I had become after being sick for 3 years, but of how slowly my recovery would be. My body just doesn't bounce back like it used to. Maybe its still recovering from the thyroid or maybe I'm just getting old, or maybe a little of both. Lucky for me I am good at dragging my feet at paying entrance fees, October is far too soon for a race. Instead I will shoot for the Carlsbad Half-marathon in January. Insulindependence has a team that does the race and they do it right with a whole weekend of events and parties and a great support tent out on the course. Even if I have to walk it, which I'm pretty sure my pride won't let me, (I finished the last one with a stress fracture in my foot from the obstinate thyroid) I want to be a part of it. And since there are so many great people doing the race, that same pride will drag my lazy butt out to the treadmill day after day to train so I won't have to walk it.  And my good buddy Michelle has been dragging my ass out to meet her to bike every week which has been doing wonders for my recovery. (Thanks, Michelle!)
   Although I haven't been writing for the blog, I have spent a good chunk of the last six months working on the book and it's really starting to take shape.  I figure I'm about two-thirds of the way finished with the first draft. and just as I am about to celebrate, I realize I haven't accounted for the time needed to complete my second draft and my third. I have lined up an editor, which, I am sure, is obvious I desperately need. I forgot to pay attention to these things in high school, instead choosing to spend most of the hours of my class asleep on my desk. Some days I can see the light at the end of the tunnel.  Other days I see that light receding into the abyss.
     I have had my fill of crappy diabetic days. Those days when a 300 that you cursed over at noon becomes your best blood sugar of the day. When the thought of spending some time praying to the porcelain god flits through your head and the only thing that takes away that thought is curling up in bed with your softest blanket and watching hours of a new TV show on Netflix. I have brought down my A1c's from an unacceptable range due to the thyroid and lack of exercise to a less shitty level. Still not what I want it to be or what I would be proud of, thus, why I have not mentioned any numbers. I did manage to hook up with Nick again (my Dexcom, not a sordid affair, I promise) after learning how to work my insurance plan. I have yet to get new A1C's done to prove his worth, but, I know it everyday he tells me I've exceeded my limit for sugar or when he gently nudges me in the middle of the night, telling me to storm the kitchen for some chocolate sludge.
    As for the future I have my plans, and on top of that list is to finish the first draft of the book, the second and third and get it into the hands of an agent or publisher any way I can, which of course means learning a whole new business and doing that work that goes against my own nature, self-promotion. But it will be well worth it to hear just one person say they found some thought they could use in life. Come Monday still needs her rig. I will celebrate my 35th birthday in a month and my 13th wedding anniversary to a man I am still completely in love with in a few weeks. I am determined to learn to run again. And I have started the thought processes on my next big adventure. One involves the Keys, a journey, a group of friends, kayaks, some running and swimming. One involves the family, a boat and the Intercoastal Waterway. Maybe a group of girls and a multi-part running journey bringing only the clothes on our backs, lots of sugars, and a credit card for a place to stay.  Then there's the Grand Canyon Part II, this time with running shoes and both walls of the canyon.  Or maybe flying a sixty foot hovercraft?  Then there's enjoying some football, hanging out with friends and doing a better job keeping up with this blog.  All in all it was a spring and summer well spent.

22 March 2011

Just One of Those Days

            I thought I would come back from a trip like this one with so much to say. Some new revelation about living with diabetes, maybe come back having conquered the disease. But really, I came back to the same old shit I always deal with. There is no conquering this disease. There is no point where you have become good enough at taking care of yourself that it just goes away. There is no remission. It is always going to be with me and always going to suck up my time and energy just to feel as good as what other people feel like without even trying.
         Diabetes is still the same old crappy disease it always was. I still have blood sugars I can't seem to get on top of.  I still have to fight with my insurance to cover technology they already agreed to cover but have recently denied because my A1C's are too low because I have been using the very technology they are denying. I still have to find a new doctor because the only endocrinologist that I have ever liked had to move. It took ten years to find a good doctor who understands that most diabetics really know more about their disease than the doctors. He would run my tests and offer advice where he could, but gave me full credit for taking care of myself and never talked down to me for being one of those "crazy" diabetics who don't think a moderate walk for 20 minutes is enough to satisfy their need for fun or who think that it is a great idea to go sailing off alone for 4 days. I still wonder if tonight is going to be the night when my blood sugars get low enough that I just might not wake up while my insurance sits back and denies me the safety alarm that would prevent my untimely demise.  And I still have to deal with the everyday stresses that every adult has to content with, but I have to do it without allowing those stressors to pull my attention away from managing this life-long, chronic, crappy disease.
       Maybe I should have come back from a great trip with a better outlook on Diabetes. But really I came back with a better understanding of what it takes from me and how it complicates my life in so many ways. While sailing I only had two things to take care of: keep the boat pointed in the right direction and keep my blood sugars in the right zone. There was nothing else. There was no one else to take care of, no job responsibilities, no juggling of any kind. Just me, my boat, and my Diabetes. Kind of what it was like when I first got the disease in college and had very few responsibilities. I did so much of a better job with it back then. If my blood sugars got out of whack, I would simply go take care of them, leave class for a bike ride, go for a late night run. I can't exactly leave a class of 32 sixth graders to fend for themselves because I have to go for a run to bring down my blood sugars and I definitely can't tell my kids to fix themselves some dinner and put themselves to bed because I need to go lower my sugars. My kids are terribly responsible and capable, but they are five and seven after all.
    I guess I have just been reminded of what a disease I do have. Its not a simple malady. Its not just athlete's foot or a weak knee. Its a shitty, life-threatening at times, life-altering disease that can be very good at bringing on a case of the blues or shaping one's outlook.  I know all the good things that I am supposed to write here, about how I have met great people, and how it has let me go sailing, and about how it has made me more humble and empathetic towards others, but I think I will leave that for tomorrow. Tonight I just want to bitch a little. I think after 14 years of putting up with this crap I am entitled to at least one night of self-pity. Tomorrow I will be my usual optimistic, laid-back self.

25 February 2011

Best Morning Yet

I think by far this has been the best morning yet. With a small craft advisory on for today, it has made the decision to end my trip a little early a no brainer. There is no way I'm going against NOAA. And technically I made it to Key West, its just the east end instead of the west end, but it's Key West all the same. I got to sleep in until 7 and am having a nice breakfast outside the deck of a closed dockside bar. THe sounds of the fishing charter boat captains and their clients for the day goes nicely against the background of all sorts of tropical birds chirping and the brown pelicans slapping their jaws. I have nothing in front of my except a leisurely day cruising around Key West on a rented cruiser.  After charging up my phone and laptop from the two 6-volt batteries on board (thanks Michelle for the cigarette lighter converter, it was priceless and I didn't even know I needed it), I am off to arrange for the boat to be picked up and to take some pics of Key West. First stops Tennesse Williams old house and the Key West graveyard. Its been around since the 1800's (if you don't count when all the "contents" were flooded out and had to be dug up and re-buried above ground in crypt like things.  For some reason it remind me of Tom Sawyer. Maybe because its so old it doesn't seem as creepy, like all the "people" there are just fictional characters who never really existed anyways. But, then again, maybe it will seem a whole lot creepier when I get there. After that I think I will jsut play tourist and see what I can see. All I know is, after a day like yesterday, I deserve to sit on nice stable land with no chance of dying (unless you count being run over by a scooter driven by some wild tourist) and eat a good meal and just sit for a while. I've had enough movement to last a long time.

21 February 2011

Twas the Night Before...

After a long day of travel by plane, train, and automobile, - have finally settled in to my home for the next few days. Paul and the guys at Key Lime Sailing Club have been working all afternoon to get the boat ready and it is more than - imagined. She looks great and is ready to sail first thing in the morning. I have 26 nautical miles to cover tomorrow so it should be a long day. And God brought the perfect weather to start out, sunny and warm and a nice 5 knot breeze. Just enough to get used to a new boat.
I had a rough start with my blood sugars last night with a site that didn't work and a 1am replacement site that got all bent up. By the time I put in the next site at 430, it was time to get up to catch my flight. I got called into secondary because of my insulin pump and Dexcom but the search wasn't as much of a grope as - thought it would be. I spent 30 minutes doing laps around terminal 4 at LAX and a few squats and lunges in a back hallway to get my sugars down and keep them stable for the 5 hour flight and 3 hour drive.
I realised as I got up to leave the flight that sitting just 2 seats over was another pump wearing diabetic. when I asked if the tubing I saw was an insulin pump his reply was "Its the same kind as yours" Now why didn't he say something earlier. I sure could have used a good diabetic conversation to pass the time.
Sent via BlackBerry by AT&T

09 February 2011


The journey starts in just 10 days. On February 21, I will fly to Miami to get set up for the four-day solo sail to raise money for insulindependence.org. Subscribe to my twitter feed so you can follow my adventure in real-time. To get text message updates of my progress, go to www.twitter.com/erinspineto and click on the icon of the cell phone next to the big follow button (you will need to set up a twitter account and register your cell phone to do it, but that's a  piece of cake- if you've figured out how to read this blog, you can do this.)

02 February 2011

The Official Rules

Someone else has developed most athletic endeavors you sign up for. You choose a marathon or a triathlon or, if you are really up for an extremely daring undertaking, you sign up for the Florida Challenge, a 1200-mile paddle around the whole state of Florida. The rules are set, the course is chosen, and all you have to do is show up. You are given a copy of the rules so you know the criteria you have to meet to consider yourself a winner or even a finisher.  With my own sailing challenge, I need to set up some rules to make sure I achieve what I set out to achieve. Some of the rules are for safety purposes, to ensure I stay on the boat long enough to make it to Key West. Others are to make sure I don’t take the easy way out when things get rough. And still others are there to make sure that everyone who is watching is able to enjoy the journey as I take it. So here they are, the Official Rules of the 2011 Insulindependence Florida Keys Challenge.
1. Erin Spineto (heretofore called Sailor) must take a 22’ Catalina from the Key Lime Sailing Club in Key Largo Florida to Garrison Bight Harbor in Key Largo Florida in the four days bounded by 22 February 2011 to 25 February 2011.
2. There shall be at no time any passengers aboard save for the mosquitoes that are known to haunt the area.
3. It will be considered necessary to sleep each night on the boat, despite available hotel rooms with fresh, dry linens and warm motionless beds.
4. It will be deemed acceptable to stop each night at a boat slip and use marina facilities, but any other stops during the day will be prohibited. It will be acceptable to restock supplies at each stop and to eat one hot meal at a restaurant at each stop.
5. The motor will be allowed to dock and leave dock if deemed necessary but sailing into and out of port will always be preferred. The motor will not be used for any other purpose unless it is for safety concerns.
6. At each checkpoint, some object of significance will be left to signify Sailor’s accomplishment.
1. Sailor’s location will be shared with those following her progress on http://www.mapmytracks.com/events/race/sail-for-insulindependenceorg/diabetic-solo-sail.  Sailor’s GPS position will be posted to the map every thirty minutes.
2. Sailor will hourly tweet some 140 hopefully deep and inspirational characters, although they will probably turn out a little more sarcastic and silly.
3. Sailor will try to upload two videos to her blog www.diabeticsailor.com each day. She will try to make them more than just a bobbing horizon line that will cause the viewer to become seasick. Maybe she will even capture a manatee to share with the world.
4. Sailor will try to post blog updates nightly on the day’s activities assuming the sunset had not stolen her last bit of attention before she passes out for the deepest and most restful sleep one can get after spending the day bobbing on the water and retiring to a floating bed for the night.
1. Sailor will wear a life vest at all times when underway. This life vest will be tethered to the boat to prevent her from falling overboard with no one left on board to turn the boat around to rescue her. This way her husband and mother will be reassured of her continued safety.
2. In the very rare chance (let’s hope it’s a negligible chance) that the boat sinks, Sailor will wear a Personal Locating Beacon which will report her sunken status to the Coast Guard who will hopefully respond by sending a highly trained team to rescue her from the water.
3. An “All OK” text will be sent to shore contact every three hours to reassure those onshore that there is no reason to worry about Sailor’s condition and that her diabetes is well controlled and she is doing just fine.
4. Sailor will do all things necessary to prevent heat exhaustion in the lovely seventy-degree weather with tropical sunshine beating down on her all-too-fair Irish skin.  This includes limiting herself to one, count that, one, Diet Dr. Pepper each day. She will need to drink actual water (something quite difficult for her on land) and Propel during her time on the water. She will wear sunscreen and a hat and resist the temptation to work on her tan, knowing that she will only turn into a creature resembling the nightly special at the restaurant attached to the fancy hotel where she will not be staying.
5. Sailor will check the weather report twice daily and will use the weather prediction skills she has taught to countless sixth graders in her Earth Science classes while laughing to herself that she was, in fact, right when she told them that they would one day really use this stuff.
6. Sailor will not be too proud to admit if the weather has gotten too dangerous for her to continue and will console herself by finding the closest pub to grab a bite and work on the memoir she is writing about this very trip. She will watch the skies and wait for a weather window to try to make up for lost time, but will not beat herself up for things that are beyond her control, reminding herself that had she not gotten gravely ill last year when this trip was originally planned, she would have been sailing on the very day that the first hurricane of the 2010 season hit.
7. Sailor will try to enjoy herself at all times and realize what an amazing opportunity this is to take on a challenge like this.

11 January 2011

Managing Diabetes On Board

As I get closer to launch day for my sailing trip, I have been focusing more on my diabetes management plan. One of the things that I have been concentrating on is my breakfast. 

It has always been one of the harder meals to get right because of the different hormones that circulate in the body and bring you from a sleeping state to a fully alert state. Most of these hormones make the body less sensitive to insulin. 

The result is that you usually need more insulin to cover the same amount of food eaten at a later time in the day. The other problem I have is that I love breakfast foods. I would eat them for breakfast, lunch and dinner if I could (and sometimes I do).

I’ve changing the ratios of my breakfast foods and have achieved some degree of success lately by making breakfast a low-carb, high protein meal. This has lowered that morning spike in my blood sugars and also leaves me feeling fuller. 

After four weeks eating the new protein based breakfast and finding much success with it, not only in better controlled blood sugars, but, also with the bonus of weight loss.

I came across a study published recently. It was a study of type 2 diabetics (different from type 1 diabetes, I know, but interesting all the same). In the study, the researchers gave the patients a high-protein, low-carb breakfast and found that it lowered their morning blood sugars, which should be obvious. 

We have all known that carbohydrates have a far greater impact on blood sugars than proteins do.  But what they also found out was that the meal caused their body to replenish their glycogen stores with the sugar instead of storing that sugar as fat. 

So the way the body reacted to the sugar changed in addition to there being less of it. If the carbs were later added to a morning snack the patients did not see the same blood glucose spike as when they ate the carbs as their first meal of the day.
I always have to laugh when scientists spend thousands of dollars and hundreds of hours of time to figure out the same thing I figured out in two weeks with my own body. It is nice to have real evidence to back me up, though. 

And, of course, they can publish their work and make safe recommendations to other people based on their science. I can only change what I am doing, knowing that every diabetic is different and may not react in the same way I did to changes in their diet.

I want to continue this high-protein breakfast on my trip, but it presents some slight problems. One of my main morning proteins is eggs. Eggs, however, are very hard to eat if you don’t have a stove or any source of heat. I am all about protein, but I am not going to go Rocky-style and down them raw. I tried that once when I was eight and never will again.

I could do a protein shake but after consuming those for breakfast and lunch for four weeks, I have found them very hard to swallow without gagging. So, I have settled for a cheese stick wrapped in turkey slices as my plan for now, but I don’t know if that will work in the long run and I’m not sure that sounds too appetizing first thing in the morning.  

My other meals will certainly include carbs. I am in no way opposed to carbs; as an athlete, there is no way I could be. I will just have to include some of those high-carb breakfast foods I love later in the day.

One of the other morning issues I will be facing is one that I have more experience with in long car trips early in the morning than I do with sailing. Sailing involves a lot of sitting around. Your body becomes more or less sensitive to insulin based on how active you are throughout the day. 

I have found that if I take a long car trip starting early in the morning, my blood sugars will race up very high and stubbornly stay put no matter how much insulin I give as a correction bolus to bring them back down.  

Once I get out of the car and start moving around for an hour or two this problem is quickly remedied.  To fix this, I simply have to put in a good workout before getting in the car, and stop every two to three hours for a quick five to ten minute burst of exercise.

While in the Keys, I will have to work-out each morning before I take off for the day. Most days I will go for a quick three to five mile run. When I stay at Fiesta Key for the second night, I get to use their Olympic size pool to put in a quick mile swim. 

One of the rules of the trip is that I won’t stop until I reach port each night, so I will have to find some way of doing those ten minute bursts of exercise on board. I won’t be able to run or even be able to walk around much as the cockpit on a 22’ Catalina is only about 6 feet long and has the boom of the main sail about 4 feet off the deck.

As a result, I am stuck with calisthenic type exercises that can be done in very little space. To maximize the effect of each exercise I will need to use the largest muscle groups and use as many as possible in each exercise, all while holding onto the tiller so the boat does not go spinning in circles or run aground on one of the many sandbars lurking just below the surface of the water.  

Included in my workouts will be squats and lunges, which recruit a lot of the larger muscles of the body. Adding to the exercise schedule will be calf raises, which will round out the lower half of my body. I may be able to pull off some push-ups on the seat of the cockpit while holding the tiller still with my foot. 

To round out the exercise regimen, I will need to get some activity in after I dock for the night. This shouldn’t be much of a problem since I will be in search of a warm meal and a view of the old Keys, Florida as it used to be.

Even with all of this physical activity, I will still have to make some adjustments to the basal rate of the insulin, constantly supplied by my pump, to take care of normal bodily functions. The first day I will try a bolus increase of 125% and adjust as needed. 

Each night I will go over my blood sugars and my maintenance plan and will reassess for the next day. Hopefully by the end of the trip, I will have developed some sort of protocol that I can use in future sailing trips, so I won’t need to use myself as the living guinea pig.

As you plan your next adventure, you might want to do two things.

First, analyze what you do at home and figure out how that will change as you take off to new places.

Second, make a plan to keep your activity level and food roughly the same so you can avoid those whoops! moments while adventuring.

06 January 2011

The Growing To Do LIst

One of the hardest things about planning my four-day, single-handed sail through the Florida Keys this February is juggling of all the side projects associated with the trip. Not only do I have to plan normal travel arrangements like airplane tickets, reservations, and meals, but I have to plan for the aspects of the trip that make it more of an event. There are blogs to write and websites to design and maintain. There is fundraising to do, sponsors to court, and thank you letters to write to the people who have really stepped up to help make this dream a reality.  And, of course, there is the book I’m writing, which unfortunately seems to take a backseat sometimes.
It has recently been in the back of my mind to capture this trip in a short documentary, so today I spent four hours researching how to write, plan, and film a documentary. I read books on Amazon.  I checked out video blogs from the sailors currently racing the Velux 5 Oceans race to see the ins and outs of filming on a boat.  And I watched a documentary sponsored by No Limits about three diabetics who go on a kayaking trip to see how to incorporate diabetes into the story as I chronicle my four day journey on the sea. It turns out there is more to making a documentary than just doing something adventurous and turning on the camera while you do it.  A documentary should have a theme and a vision. It should have a plot and pacing. It should have beautiful camera work that does not rock up and down (how I am going to be able to pull that off in a boat, I have still to figure out.) And all of this has to be planned beforehand without actually knowing what is going to take place during the trip.  I have now added the following to my to-do list: interview family members and friends, write the plot, figure out how to upload videos while away from my home computer and how to handle a camera to get the best picture. And the worst part of this entire documentary idea is that for a good portion of the movie, I will be the only person on film. Anyone who knows me will quickly tell you that this is pretty close to my worst nightmare. I hate to be filmed. I am shy and quiet and have a very hard time expressing myself in person. In writing, I have learned to open up and share, but in person I am still slow to speak.  To fix this, I have written out interview questions to ask myself during each portion of the trip hoping that this somehow magically lets me overcome my lifelong severe shyness and makes me into my daughter who could have eight hour conversations with the wall if she needed to.
The thing that this whole trip keeps  teaching me, though, is that I still have plenty of room left to grow as a person. I do not have it all figured out.  I have weaknesses. I have fears from childhood that need to be overcome.  If you were to ask me what my worst fear is about this trip, just after being cast out to sea and set adrift in my life raft for sixty-six days, it would be having to speak in public with a microphone or to speak on camera. Actually that one would probably come first.  As a rational adult, I know it is not a reasonable fear. I know that no harm will come if I happen to let out to the world that I am a total dork, and I know that by challenging myself to get out of my comfort zone and forcing myself to do the things that I would naturally shy away from, I will gain new skills and lead a fuller life and hopefully, as an added bonus, I will provide a little bit of motivation for another person to get out there and lead a more adventurous life in the process, which I suppose makes it worth the risk.