Living on Lock Down in California

Starting two days ago, all of Sonoma County has been issued a 'Shelter in Place' order to help slow and possibly prevent the spread of the Coronavirus. I've been thinking a lot about what this means for each of us, including families with young children. Just exactly how do you work from home, take care of your kids, keep your parents who live with you also isolated from the virus, process this crazy time, and try to mitigate your own exposure as a person with a chronic condition?

Well - let me know if you figure it out. In the meantime, I'll share with you the little things I am learning and doing to help make it through this time, keep ourselves and the rest of the community safe, and not lose hope.

First, a few things to consider if you have diabetes:
- One study in China indicated that people with diabetes (whether type 1 or 2) have approximately a 7% mortality rate. Not so good
- Another yet to be peer-reviewed medical study looked at the people in China who had come down with the Coronavirus and estimated that people in blood group A have a higher risk for contracting the virus. The research has yet to be reviewed by peers.

Now, how are we going to get through these times together, and keep our sanity in place, and our hope as well?

1. If you can, I highly recommend exercise. I'm hoping to hold an afternoon run with my son around the neighborhood, so he can start to run with me more and a yoga class for my soon to be 79 year old mom. Keep moving if you can!
2. Garden - early on, one of the first things I did was to get my hands in the dirt, dig up some beds, plant, and spend time in the garden. It was very very grounding, and made me feel like I could so something still.
3. Clean up the garage - this is just an idea, hasn't been done yet, but soon hopefully. Or maybe not
4. Keep the same work schedule as much as you can. I know this can be very hard, but maintaining routines is key in times of stress.
5. Visit the parks near you. They are still open, and many of them are offering free admission. Follow social distancing rules when you are there, but go!
6. Listen to music and read books. Most book stores may be closed, but pick up some good ones, settle down, and read
7. Take it as an opportunity to pause in a big way and reflect on things in your life that normally  you are too busy to stop and think about. I've been really trying to stay still and look at the big picture without getting overwhelmed

Barb's Race

I was going to do a race report about Barb's race, which was a 1/2 iron distance on July 30th. It was a lot of fun, but I was really tired on the run. I finished in 5:40, which was 12 minutes faster than last year, but the run was 19 minutes slower! Swim was 33 minutes, bike was 2:55, and run was, acckkk, I forget, like 2:02, plus transitions. At any rate, I didn't eat enough on the bike, and made the big mistake of doing an intramuscular shot into my arm in the bike to run transition. BIG mistake. Insulin arrives too fast! and I did 2 units, and should have done one.

One thing that worked was to leave my insulin in a cooler out the night before in the T2 area. I think I'll do that again. And, I think now, for the bike, I'll just bring a bottle with me. I want to figure out a way to mount my meter with velcro onto my bike when I need it.

At any rate, more soon.

At it Again????

September 11, 2011, that's the date for the full Rev 3 in Cedar Point, Ohio for another full triathlon. I can't believe I'm doing it again, but I'm really looking forward to it. After Ironman St. George, a few of my Triabetes teammates signed up, and I was convinced that it'd be another wonderful experience.

So, we are getting closer.

In the meantime, I've learned a few things about diabetes in the last few months.

1. Stacking insulin shots on top of one another makes it hard to control blood sugars. Dr. Bernstein had suggested not taking correction shots or additional shots to cover meals within the time that there is still unused insulin in your system and when I am consistent about being careful about that, it really works.

2. Your body is serious when it tells you to relax. I got a warning about 2 weeks ago, when I thought my kidneys were hurting, but now, I think it was muscle soreness, then this past weekend, after a long hard ride, starting out on a run, my kidneys (but really it was my back muscles) hurt again. Then, on Sunday, I was doubled over in pain, and having a hard time even walking. Went to the doctor, talked to people, rested, put on ice, heat, and rested some more, and now it's almost gone, but I need to listen and rest.

3. Diabetes is a thinker's disease. I saw a shirt or heard about a shirt once that said that, and I really think it is. You have to constantly to weighing and considering multiple factors.

That's it for now. I hope to get back to the regular posts soon.

What Does it Mean to Take Time Off?

Well, first of all, I guess I recently learned that it doesn't mean 'easy rides' or easy swims in the pool, like I thought I was doing. I was supposed to be taking time off, and really haven't been doing that at all. I had been doing easy rides, and easy swim, and it was driving me crazy, but I still thought that it counted as 'time off'. And I found out that it really doesn't. Now the worst part is that I would have done so much more if I knew that it wasn't time off. So, it makes me want to go out and run right now, I guess I still can since technically my time off doesn't start till Wednesday. It is going to be hard to take 4 days off. Wednesday, Thursday, Friday, and Saturday are all supposed to be time off. Wow, that's hard. And I do have to examine the mental part of why that should be so hard. It's that I don't have a direction, a goal for what to do. But shouldn't my goals be coming from other places than just physical activity?

It's good mental and physical exercise I think to change things up and force yourself to do something that is not necessarily comfortable. Partially I thought that since sitting on the couch Craig said I'd produce about as much lactate in my blood as easy riding, I figured that I was taking time off.

Well, it'll be a hard few days, but necessary. So, what it means is just exactly what it means, to actually take time off. And the way my mind works is to constantly try to find a way around that and bend the rules, but sometimes I just have to do what is asked of me and have the faith and the grace to take it and listen.

So, right now, since I still have today and tomorrow that are officially 'not off' I think that I'm going to go out and run or do some of the things I've been wanting to do! More soon on this lactate diet that I'm on.

A little more context: I got my blood lactate tested on Friday, and found out that, while, I was in pretty good shape overall, my body was tired of all the lactate in my blood, and really needed a break from it, so now I'm on a lactate diet is what I'm calling it, and taking the time to give my body a break from it, and hopefully make my body less tired of it, by clearing some of it out of my system.

The mental difficulty of taking time off is something that I'm really going to explore and write about in the next few days, so if you are interested, stay tuned.

Ironman St. George

Friday night was an awesome evening of fun, getting to see the Triabuddies, who had been camping for the last few days. Keaton was a trooper, surviving on very little sleep, still bright eyed, and so positive.

Went to bed early, and didn't sleep too well. Woke up at 3:45 AM and caught the bus to the start. I wondered around quite a bit observing people, getting excited, and before I knew it it was time to start!

The swim felt pretty good overall. It was a bit cold (56 degrees was the unofficial but official temperature). The swim went well, 1:16, which is just a minute over what I was expecting. Halfway thru I got a little cold and realized I had better speed up if I wanted to warm up, so I did.

In the swim to bike transition, I realized that I had forgotten to take my Lantus (long acting insulin), which was a bummer. So, started out high, and began thinking about what to do. I came up with the following.

1. Find the Lantus bottle and syringe in bike jersey

2. Bite the orange cap off of the syringe and hold in your mouth

3. Put insulin bottle in your mouth

4. Stick syringe (have to aim well) towards your mouth to land in the rubber area of the top of the insulin bottle

5. Withdraw 5 or so units

6. Shoot out 2 units or so

7. Wait till your opposite leg (from the hand you are taking off the handles) is up

8. Inject your leg muscle when cadence is right.

9. Repeat as needed.

I guess I also could have just stopped the bike and given myself a shot, but this was kind of a new challenge. And I forgot my salt tablets, which was a total bummer, because I was thinking that I really needed them most of the bike.

The bike ride was harder than I had expected. There was a LOT of wind, and I was really slowed down by that, plus I felt worried about the lack of salt, my water bottle cage didn't hold the flimsy bottles they handed out, and bottom line, is my legs felt tired. I'm not too sure why, but they did. Could have been that I wore compression socks for the first time, hmmm...

At any rate, I barely made the cut off time (with 21 minutes to spare) and was so happy to get off the bike, and onto the run!

The run was also a bit harder than I had anticipated. It was still pretty hot when I was doing it, and I also felt a little tired. But not too muc hurt, basically I was just tired. I walked a lot, but ran down the hills. It was actually kind of relaxing to talk with people, and not feel in such a rush.

Finishing was awesome!! And going by the triabetes aid station gave me a ton of new energy too. I can't express how inspiring it was to know that as I came up to the aid station, I'd see Keaton, Julianne, Chris, Rachel, Ed, and everyone else who ran with me. What a difference that made. And, seeing my mom and Juan get excited and cheer, really honestly carried me the rest of the way.

Here is the official video of the Ironman St. George, where Brian of Triabetes made the cut! The big question now, is... will I do another one? I am having a hard time finding focus, but it's still only been less than a week. I need to think about it some more.

Also, here is a link for a recent Press Democrat Story too.

Dexcom Sensors

Since I've begun using the Dexcom sensor, I have to say, it's been amazing to see the direction that my blood sugar is taking. I can see when it's steady, heading up, or heading down. It totally affects what I do, and how I anticipate lows.

Then, I used my last sensor, and didn't have it, and had a low of 28 the other morning. That's pretty low, and I didn't even feel it coming on. So, my first thought was 'great, hope that goes towards the case of getting Kaiser to support my Dexcom sensors' - that's kind of sad to think that way, but it really was helping prevent lows.

This morning, I woke up and it was 42, same thought.

I think I'm having all of these lows, mostly because I am still needing less insulin. But the affect of knowing what direction my blood sugar is going, and how quickly it is moving in that direction, which is what the Dexcom provides is really amazing. Hopefully insurance companies will figure out that it actually does improve their bottom line to have diabetics have them and consequently have less lows. But for now, I guess we just keep making the case. And documenting those low blood sugars.

Experimenting with Lantus and Exercise

After talking with a few people, I've tried increasing the amount of Lantus (long acting) insulin that I take on days when I plan to be exercising a lot. The idea is that, if I have more baseline insulin active, then what I eat during a long ride or run can be covered by that without having to inject short acting insulin. It's had mixed results. One day, two weekends ago, it worked pretty well, then last weekend, I still go high, and had to take 1 unit of Humalog. I think that the idea is good, and hopefully I can do that.

I have to remember that while exercising, I should be an athlete first, and a diabetic second. meaning basically that I shouldn't wait for my low blood sugar or decreasing blood sugar to prompt me to eat, but rather eat as anyone who is doing what I'm doing and doesn't have diabetes would do. That's hard when you've been riding for 3 hours, and blood sugar is stable or rising, because then you should eat, but the question is, if you eat, do you have to take humalog, or will the basal rate lantus cover it?

I don't always have the answer, and the answer probably changes, but last weekend I got pretty wiped out the next day and I think it's because during my ride I didn't eat enough. Better that happen now than on race day. So, lesson learned I think is to eat, even if it means taking insulin to do so.

Also, I discovered how SUPER fast insulin acts when injected directly into a muscle (especially one that you are using). I was pretty high on my ride on Saturday (300 or so, I can't remember). I took 1 UNIT injected directly into my leg muscle where I knew I'd be using it as I continued the ride for 4 more hours, ate a bar, drank some whatever electrolyte drink, and rode on. In like 1 hour, it was 75! Wow. Good to know.

Also, I've been having more lows lately. Monday morning it was 28. And then this AM 42. I'm wondering how many lows one has to have to get insurance to cover Dexcom sensors. That's crazy but when I have a low now, I think, 'wow, here's one more for the case for them to cover the sensors. That's totally ridiculous, but true.

Hoping to recover some, and then feel fresh for May 7, which is coming right up!