25 July 2014

I Need a View of Something

     I finally went back to the pool last week. I wanted to test out how the new Untethered Regimen would do in the pool. I was hoping it would fix the long-time post pool highs I had been struggling with for the last six months.
     I woke up early, ate a good breakfast, and drove to the pool with Tony. I was planning on doing a 2500 meter swim. After months of doing 6000 meter swims, a 2500 should have been simple. I scanned my card at the gate and walked in.

     The moment I saw the pool, my heart sank. My muscles got tired and there was nothing I could do to fix them. I was having a hard time stomaching the thought of putting my head down to stare at the bottom of the pool for an hour straight. 

    In training for the Swim Around Key West, I swam more than 100,000 meters. That's a very long way when all I had to look at is the bottom of a white pool. Sure, music helps, but it is still too much time looking at nothing.

    Maybe it was because I had some high blood sugars overnight. Maybe it was because I had begun running (even though I hate it) and was taxing new muscles. Maybe it was because I was still not recovered from my race. Or maybe it was because without an impending race, I have little motivation to torture myself again like that. 

    I still love swimming, but it might be a while before I can do long sets like I used to. I think I will wait a few more months to try that again.

21 July 2014

Our Next Challenge- 100-Mile SUP Adventure

   What do you usually do after a race? Bask in the glory of a goal achieved? Wallow in the pain brought on by that long race? Or get right on to preparing for your next race?

    Before I finished the Swim Around Key West, I knew I would need my next challenge on the books to avoid those post-race doldrums. I have been tossing around a few ideas of my next adventure, but it was time to commit to one of them for next summer.

     I was sick of burying my head under the water for hours on end and wanted to look up at the horizon once in a while.  I have tossed around the idea of doing an ultralight running/backpacking trip with just a credit card and some sugars, running a huge distance over several days, stopping at hotels and friends' couches along the way. Kind of like fast backpacking without the backpack.

    But I just hate running, so I wasn't sure that was the way to go for this year. A Stand Up Paddle board might be a better vehicle for the trip. 

    Whenever I am getting into a new adventure that I don't feel like I know enough about, I go to the experts for advice. And I just happen to know one of those experts here in town. Wade Wiliford is a WPA Certified Instructor and is also PaddleFit Certified. He has been racing SUPs and outrigger paddling for 5 years and has quickly become a racing phenom.

    Wade and I sat down at Jamba Juice in La Jolla last Saturday morning before he headed out to give a SUP lesson in Mission Bay. I have some experience in SUP'ing, but I am still at the point where I don't even know what I don't know. And Wade is perfect for this. We sat down and he began talking.

    The first thing I learned was that I vastly underestimated the speed of an average SUP'er. He said that the average speed of a beginner was 3.5-4 mph. (He can probably also tell you the average airspeed velocity of an unladen swallow, if you wanted to know.) 

     I had estimated only 2 mph. Like I said, I am on a huge learning curve. So that turns my little 50-mile paddle into a 100-mile paddle over three or four days, which for some reason makes my head spin. 

     Wade gave me info on boards and paddles and media people and people who have paddle adventured the Carolina's and paddling technique. There was so much info that as I left I began to doubt if I could, in fact, pull this off. 

  And that is a good thing. If the adventure is too small, and I am 100% sure I can pull it off, it won't be big enough to inspire me to make the sacrifices needed to make it a success. 

  After a few days of letting the data sink in, I am ready to start planning. And ready for the challenge to spark the diabete fires. I can't wait to see how the new Untethered Regimen stands up to eight-hour days paddling, how my body handles huge training volumes in a new sport, and I can't wait to see who will end up joining me on this journey. 

   Stay tuned...

16 July 2014

Untethered- The Perfect Hybrid

     The past seven years of my diabetes care haven't been stellar. My A1C's were way beyond my comfort zone and they hit all-time highs that I thought I would never reach. 
     I consoled myself with the fact that I was dealing with Hyperthyroidism and needed to focus on fixing that before I could attack tighter blood sugar control. In my experience my thyroid levels are intrinsically tied to my blood sugar levels.
     In January, I declared the thyroid problem fixed and spent the last six months training for my 4-mile leg of the Swim Around Key West. It was a hard six months of rebuilding a body that had been torn down to nothing. 
     I thought that my blood sugars would respond as well as my cardiovascular and muscular systems did. And they did get better, but not nearly as good as I had hoped.

     While in Florida I learned that many of my traveling companions had given up the insulin pump in favor of Levimir and Humalog shots. This was mind blowing because I always considered the pump the only way. But these were well-educated, athletic diabetics who weighed their options carefully and chose to go back to shots. 
     They were so convincing I had to take notice and ask myself if it was something that would work for me. When I returned from Florida I started to research the situation. I talked to my doctor (who was no help. He told me that the pump was the only way for me, but that I could take a pump break if I wanted.) 

    I had concerns though. I am incredibly forgetful. I knew I would spend more time searching for my lost insulin kit than I would giving myself shots. And I would forget shots altogether. I have to stash extras of my thyroid medicine at work because I was sick of having to drive home during lunch because I had forgotten my morning dose.

    And my schedule is always changing. I may plan to have a workout in the afternoon, but that may change when Shea reminds me that she has a huge report due the next day, or that Eli breaks his arm. So to plan a lighter basal dose of insulin in the morning because I expect to workout just wasn't going to work. 

   But I could not stay on the pump full time either. I was having huge problems with my 2+ hour swims that would leave me without any basal insulin. During the swim it was no problem. I would come down to 100 and stay there during the whole swim, but the moment I got out of the water I was in for a seven hour HIGH. Even with a 200% basal and correcting at 150% my usual dose, that HIGH would not budge. Until exactly seven hours later when I would go plummeting to 55.

This is after a long swim. I got out of the
pool at 7:30 and my b.s. goes sky high. I
corrected at 8:30, 10:30 and 12:30. Then,
magically, at 3:30 everything drops.
It was the same for every single swim.

I was also having absorption problems. I knew my basals were right because I would have a few great days in a row and then I would have horrible days that would not respond to corrections. I use a limited area skin for my pump sites which I share with my Dexcom sites so the tissue there is a little sick of working so hard.

  I thought I remembered a friend's son going on some sort of hybrid solution, so I texted him. He had been doing the "untethered regimen" put forward by Dr. Edelman. I researched it some more and realized it is the perfect solution to my problem. 

     It takes the best of both worlds and combines them beautifully. I now take 75% of my basal through a Levimir shot in the morning and one in the evening. So I can tie in the shots to bedtime and waking up, making them easy to remember. I don't ever have to take insulin with me and since it stays on my nightstand, I never lose it.  

     The other 25 % of my basal is through my pump which allows me to attain the huge differences I have in morning afternoon and nighttime basal rates that my body needs. 

     It also allow me to detach the pump when I workout giving me just a 75% basal, which is what I would usually turn down my basal to during land based workouts. Now I have the basal in the water for longer workouts and the ability to time that to whenever I actually get to working out. 

It also gives me a backup if I forget my morning insulin shot. On my Minimed pump, I can have multiple basal profiles. So I kept my Pre-Levimir profile and if I forget my Levimir, I just flip back on the pump to the old profile. 

   I still get to bolus through my pump so I don't have to pull out a syringe at the table. I like the discreetness of the pump. I have shot up plenty in public and have no issue with it, but I like not having the extra attention directed my way. I'd rather be the diabetic super spy. 

    I started the new regimen July 2 and so far I have been very impressed with it. I have had days where my highest sugar was 180 which, for me lately, is incredible. I have had days in the past where I was in the high 300's for more than half the day. And I have yet to forget a dose. 

Post Levimir 6 hour on the Dexcom.
Some of my 24-hour charts looked just as nice. 
    I like bring able to be at the beach for four or five hours without having to take on and off my pump to get wet. I now can jump in the ocean anytime I want without all the hassle. I have another month before I can test out the real results with another A1c, but from what I've seen so far, I think they might be back in my I-love-it range.

    And I think the process of switching things up has renewed my diabetic mind. I was excited about the challenge and the trial and error of getting my nasals right. And I like success. It has given me enough of a boost to take better care of myself.

     When was the last time you made a big change to your diabetes regimen?