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Re-Motivation

June 23rd, 2011

Have you fallen out of your exercise routine?  Do you need a figurative shot in the arm when it comes to your workouts?  Are you afraid of getting your hopes up and then dropping out of a new class or new plan?

You aren’t the only one.

In fact, you are so completely NOT alone that people write about it in nearly every fitness magazine out there.  They write about it because it’s a fact of fitness life: our minds can work against us.

Runner’s World included a tip list in their May 2011 issue from runner Kara Goucher about how to get started and stay strong when it comes to running.  I of course know not all of you are runners, so I’ll include the tips I think are multi-disciplinary in their approach.  (Did you forget I’m a lawyer?) 

Talk It Through

New runners think it’s not “real” running unless you’re gasping for breath.  Not true.  If you can’t talk, slow down.

AG: I say, if you’re working hard, you’re exercising.  Try to go faster on some days and always push yourself, but don’t worry about actual speed and try to keep at least 80% of your workout where you could have a conversation of at least 5 words at a time.

Take Pride

A lot of people think they look slow, or fat, or sweaty.  Don’t let any of that stop you.  Among runners, you are golden.

AG: How true how true.  Do you care what someone else looks like when YOU are exercising?  Didn’t think so.  Get out there and be kind to yourself and the work you are doing!!

Have a Key Word

Use your key word when things get tough during a run.  Or use it before your run if you don’t feel like heading out.  Say it to yourself, mantra-like.  A word I used during a really tough time in my career was fighter.  That was what resonated for me, and it worked. 

AG: Have a phrase or way to encourage yourself and keep your mind strong during any workout.  Anything encouraging will work.  I have used “keep going” “you can do this” and always smile at “suck it up Buttercup.”  (Like I said, anything encouraging will work.)

Focus on Yourself

If you think about other runners, you’ll end up thinking, She looks faster than me. Keep things inner directed.  Be aware of others, but keep yourself front and center.

AG: You aren’t exercising for the person on the stationary bike next to you.  You aren’t exercising for the person with the locker next to yours.  You aren’t exercising for anyone else’s body: keep yourself and your goals front and center.  You are there for YOU.

It’s easy to let what others are doing get to you.  It’s easy to compare your blood glucose or A1c to that of your friend’s.  It’s easy, and it’s potentially damaging when something your body does or needs differs than what someone else does or needs.

Take the high road on this one, challenge yourself, be kind, and reap the rewards of your efforts.

You can do it, Buttercups!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

When It’s Crazy Hot

June 22nd, 2011

We are having a bit of a heat wave in my area. I personally love the heat, but it definitely requires a different strategy for exercise.

My friend and I tried to beat the heat yesterday and we went out for a run at 7:20am after bootcamp. We planned a good, difficult 8.8 miles… and we thought we could beat the heat.

We were sorry to be wrong. We cut our route short and added in a load more walking than we intended.

Sometimes heat will do that to you!

It was the kind of heat where I had 30 grams before I started running, lowered my basal lower than I usually do for a run, checked 30 minutes in and was 98. I had a 25 gram gu, ran another 15 minutes, checked again and was 99. Normally, I would have maybe had 20 grams that entire run, and a more normal temp basal for my run.

I’m telling you, it was HOT.

(When we got back, I needed an immediate nap. I slept for 90 minutes! My friend told me she still feels wiped out today—normally that route would have been no big deal for either of us.)

So what can you do when it’s a zillion degrees out, shade is nearly nonexistent, you are sweating as soon as you open your door, but you still want to get in a workout??

Many runners suggest starting a run as early in the day as possible to avoid the heat. I think tomorrow I may try a before-bootcamp run, if I can get to bed early enough tonight. Some say wear a hat to protect your head from the sun. Everyone says to keep hydrated by drinking a lot of water and electrolytes during the day.

But what if getting outside is simply not feasible for you and you still want to work out??

Here’s my latest suggestion. Try something new INSIDE when it’s crazy hot. Check out a workout via Netflix Instant.

If you have air conditioning and you have space, any regular cardio workout is great. If you don’t have A/C, try the coolest spot you can find and go for a short stretch or yoga workout.

It’s fun to keep things interesting and try new things despite the weather.

You’ll find the Netflix workouts in the “Sports & Fitness” genre, Workouts. You can try an Ab, Glutes, & More workout, a Yoga, Low Impact or even Qigong!

The 10 minute Solution workouts are nice because, well, if you don’t like them, you’ve only got 9 minutes left. (Although I’ve also just stopped and tried another option.) I’ve also heard good things about the Crunch Candlelight Yoga workout. What’s the risk involved in trying it out on your instant queue?

I’d try Yoga Booty Ballet or Yoga Zone workout if I were willing to wait for a DVD. I’ve done some of the Yoga Zone workouts and they are okay. I also like Rodney Yee, and always appreciate the blissful beaches where they film.

Read the member reviews and check out the star ratings—you never know what will work for you and what won’t work as well. Remember if it is a new activity for you, your insulin needs will probably be lower than normal even for exercise, and on hot days you may need more or less overall; be smart about what you’re doing with your insulin and keep some juice nearby. Always have water within reach and be sure to stay hydrated as you work, A/C or no A/C.

Close the drapes and ban others from the room (if they aren’t joining you) and then just bust a move. It’s fun, and safer on crazy hot days!

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Posted in Living with Type 1 Diabetes, My Workouts, Random Musings, Uncategorized

Amazing Benefits of Exercise

June 21st, 2011

You feel better when you exercise.  It helps you manage your diabetes.  It helps you lose weight or keep your weight in check.  It helps you fit in your clothes.  It helps your heart stay strong.  It helps your blood fat levels get to and stay in a healthy range.  It keeps your bones strong.  It helps you manage stress.

AND it helps you stay young.

I’m telling you, exercise is an amazing thing.

I think I blog more about cardiovascular exercise than I do resistance training, mainly because what I do for my cardio exercise is more interesting and exciting to write about.  (I mean, did you see yesterday’s blog?!)

When it comes to resistance exercise, however, I’m a huge fan and wish I were able to devote more time to it (marathons have taken precedence for the past two years).  Resistance training to help me stave off muscle loss as I age is crucial.  I also have one body so it’s hard to do everything I want to all the time. 

I’m sure you understand.

So you can imagine how fun it is for me to spread the word about TELOMERES. 

Telomeres are little pieces at the end of our cells’ DNA.  With every cell division, a tiny bit at the end of that telomere is lost. 

You can imagine how this story ends up.  If you can’t, look at your grandparents.

With every cell division snipping off a teensy piece of DNA, we are on a limited time budget.

The 2009 Nobel Prize in Medicine was awarded to three scientists whose work showed that telomeres are vital to protect our cells’ DNA.  Not only did their work show that the longer our telomeres the biologically younger we are, but they showed that the telomeres of middle-aged people who exercised regularly were only marginally shorter than those telomeres of people half their age who didn’t exercise regularly.

Gotta love scientific proof that regular exercise (and of course good sound nutrition) help our bodies significantly slow the aging process.

Just add it to the list of the amazing benefits of exercise.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

How Do You Take Insulin For THAT?!

June 20th, 2011

I ran one of the oldest and most famous trail run routes on Saturday.  It didn’t feel like a lot of running—it felt like a lot of huffing and puffing and “omg how am I supposed to get THERE from HERE?!”

I’m doing it again on Saturday.

It’s the Dipsea Course in Marin, north of San Francisco.  I ran the “Double Dipsea.”  It’s beautiful and varied and generally amazing.

And then you realize you have only gone 0.8 miles and there are 13.2 more miles to go…and you start to wonder.

When I do this next weekend for the official event, I’ll start at the ocean and run inland—the biggest dip at the center of this elevation map is where we begin on Saturday, so my map after that one will be a wacky cut-in-half mirror image.

It will be GIANT hill, huge hill, huge hill, GIANT hill.  Not the other way around. 

So let me begin by saying, in case you aren’t familiar with the way trail runs go for the mere mortals like me who just go out and try and have zero hope or expectation of coming close to being the fastest out there, that over the course of the 14 miles I probably only ran maybe about 7 miles, in the traditional sense of the word “run.”  The 14 miles that should take me less than 2½ hours to complete on a road will take me closer to 5 hours on Saturday’s terrain. 

 

It’s a lot of hiking, a lot of climbing, a lot of little strides and a lot of cautious steps and fingers crossed that you won’t miss a step or turn an ankle on a root or stone.

I’m telling you, it’s fun.  (In its own special way.)  But it isn’t easy.

If you go into this without experience, you might think “run” and know “less insulin” and go from there.  But you can probably see from this elevation map that my insulin needs vary along with the course.  I need less insulin/more fuel for the inclines and less for the declines.  The slower I go, generally the more insulin I need… but not when I’m climbing. The faster I go, generally the less insulin I want… but not when I’m barrelling down a hill.

It’s a lot of trial and error, and a lot of learning, and a lot of being prepared for whatever happens.

I mean, I got stung in the shoulder blade by a bee through my shirt on a trail run half marathon once.  Wacky random stuff happens out there, and the best we can do is prepare for what we do—and do not—expect.

So because I know I will face the giant hill first (with names like “steep ravine” and “insult hill” and with my favorite section just like the Ewok village of Return of the Jedi) I will make sure I have enough fuel and an inadequate amount of insulin (I’m thinking 20-30% of my normal, as 40% was too much the first time) to help me reach the crest.  I’ll need to fuel up again midway down the giant hill in order to prepare for the huge hill.  Since I won’t have much time between reaching the bottom of the steps at the bottom of the huge hill and literally turning around and heading back up all 671 of them, I’ll need to be checking and continuously aware what my blood glucose is doing so that if I need to eat I’ll be able to do that when I won’t endanger other runners who aren’t thinking I’ll stop on a step. 

It gets complicated, of course.

But it’s an amazing adventure.

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Posted in Living with Type 1 Diabetes, My Workouts, Random Musings, Uncategorized

Fun Fitness Friday!

June 17th, 2011

Happy Friday!!  Let’s make today “Fun Fitness Friday”.  Walk at lunch, walk after dinner, play some backyard soccer while the veggies are roasting on the grill.  It doesn’t take much to make it Fun Fitness Friday… just a little imagination and a carefree attitude!!

Want to play some catch?  What about heading to your neighborhood park and snagging a stray tennis ball a player couldn’t find and start lobbing it against a wall or backboard?  If you’ve got a buddy, you throw they catch…

Want to breathe in some summer evening air?  Head out on a little bike ride around the neighborhood.  Take a look at a map before you go and try to make your route look like a star.

You know those houses in the ritzy neighborhood?  Take a quick trip to that neck of the woods and head out for a walk and check out the yards and houses.  Which one would you move into if you won the lottery?

Feeling overheated?  Head to the closest pool and see how long you can tread water… or how many times you can push yourself out of the pool and sit on the edge (turn right just as many times as you turn left to switch from your front to back sides).  If you’re a diver, have someone toss some coins to the bottom and clock how quickly you can gather them all.

Too hot to head outside?  (Is there such a temperature??) Take care of some active chores (Clean the bathroom! Vacuum! Laundry!) for 15 minutes and then spend 3 minutes on each: pushups, squats, sit ups or crunches, planks, and a wall sit.  Go for as long as you can, take a little rest, and get back to it within that 3 minute window.  (If you’re anything like me, the less I want to do something the more important that timer is.)

I’m not the best with fun ideas so please tell me what you think would be fun, and what you’re up to today!  Post it as a comment here or on facebook so we can inspire each other!

Play mini golf.  Go bowling.  Toss a Frisbee or football around.  Head out for a little hike.  No matter what you do, HAVE SOME FUN. 

It’s Friday, after all.  Fridays were made for fun!

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Posted in My Soapbox, My Workouts, Random Musings, Uncategorized

Living A Dangerous Life

June 16th, 2011

Ah, Life.

Life is so dangerous when you live with diabetes. 

It’s so dangerous it’s amazing we make it out of bed.  It’s so dangerous every time we take a shot or prick our fingers we might get an infection.  If we don’t we live in fear of long term complications.  If we need sugar we need it immediately or we could die. 

It’s dangerous.  It’s immediate need just on the other side of our consciousness at all times.

It’s scary.  It’s serious.  It’s a full time job without any breaks.  We count everything.  We don’t eat without thought.  If we do, we are living on the edge.

We need to have emergency supplies of quick sugars, emergency supplies of medication, extra medication in case the original supply gets too hot or too cold or randomly goes bad.  We need to carry emergency syringes in case our pump konks out.  We need to be within an hour of insulin at every moment of every day.

It’s dangerous.

It’s complicated, and it’s quiet. 

Living with danger.

 _______

I tell you; just writing the above few sentences exhausted me. 

I don’t deal well with articles or mentions or people who feel a need to highlight the dangers of hypoglycemia or the dangers of hyperglycemia or the dangers of whatever or the struggles we face every day.

I really don’t deal well with it at all.

I’m not saying I ignore any of the above dangers.  Yes, I know what could happen.  I also know what could happen when I cross the street or get on a plane. 

I just don’t agree with highlighting it all the time—we’ve all sat in a medical office and heard the lectures; we’ve read the articles; we’ve answered the questions. Heck; we all get into our cars multiple times every day despite the dangers involved.

When it comes to life with diabetes, we’ve felt most of those dangers, too.

And, amazingly enough, we’ve kept on keeping on. 

It isn’t the people living with diabetes who highlight those dangers, I don’t think.  It isn’t those of us who have felt what a blood glucose of 27 or 538 feels like.

We don’t need to mention it—we’ve felt it.

And I, for one, continue to keep on keeping on; doing my best every day to live my life.  With and without the danger attached to living with diabetes.  I can’t see it as “dangerous” when it’s my daily reality.

Maybe I should get myself a leather jacket and a Harley—I’m such a thrill seeker. What do you think?

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

You-Choose Self Improvement

June 15th, 2011

I think we all have a long list of things we’d like to improve on in our lives.  It’s something we discuss every January first and by now have probably long forgotten.  We’ve watched our kids graduate from kindergarten to first grade, from eighth grade to high school, and endured countless (never ending) baseball games and dance recitals along the way.

As life goes on, making these dramatic changes we wanted six months ago now feels like an impossible task.

So here’s a little list of ways to make small achievable goals work for you.

1. Start small.  If you put yourself at the foot of a “lose 50 pounds” mountain and keep your eye on that prize, every day you haven’t lost 50 pounds can feel like a failure.  But if you say to yourself “I’m going to do what I can today to get closer to my goal” and take small steps, you can get there.

2. Be kind.  Of course you can’t change yourself overnight; if we could, we would all do it!  So be very kind to yourself about any and all progress you make—and recognize that a few steps in the other direction doesn’t mean you’ll never reach your goal.  Refocus and be kind to yourself if you want to reach your goal.

3. Stay small. I can’t stress enough how important it is to make little changes before you make big changes.  A big change is stressful; a small change is almost imperceptible.  If I had you lift 20 pound dumbbells on your first day, you probably wouldn’t be able to do it for long.  But if you start small with 5 pound dumbbells and keep at those until they don’t feel as heavy, you may not notice that change to 8 pounds.  Eventually, you’ll be able to use 15s or even 20s if you keep your changes manageable.  

When I say “small goals” I mean a goal like “I’m going to stretch for 8 minutes three days a week.”  (That’s the commercial time for a half hour show if you watch TV in real time!)  Or, “I’m going to treat my lows with juice instead of candy this week.”  It’s all relative, but keeping them small keeps them manageable.

4. Be consistent. Although you will falter along your way, keep your goal in mind: you need to still keep your goal in sight if you want to reach it!  A step to the side or even backwards is fine and not going to derail you—if you stay consistent and don’t let it be the end.

5. Write it down. I think this is the one we all skip.  But if you’re a list-keeper, don’t you feel like you get more accomplished on the days you write a list?  I’ve been known to write things on my list I’ve already accomplished, just to enjoy crossing it off.  But writing a list of where you want to go that includes the small steps along the way will help keep you focused.  It’s worth a piece of paper.

6. Look back.  If you are on that mountain and climbing but feel like you’re lagging or that you’ll never reach your goal, absolutely take some time to think about where you’ve been and what you’ve already accomplished.  You’ll probably amaze yourself—and that may be just the boost you need to keep going.

7. Move forward. In general, movement in any direction is better than standing still.  When it comes to goals, though, moving forward is essential.  Moving at a glacial pace is fine, so long as you keep moving toward your goal.

The bottom line is: you are the one who chooses the goals you set.  You could have no goals and not change at all—but because you want more out of your life, you are going to put in some effort and get where you want to be.

That right there is pretty awesome, if you ask me!

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Posted in Living with Type 1 Diabetes, Random Musings, Uncategorized

Residents and Fellows and Doctors, Oh My!

June 14th, 2011

So I learned recently (because I never looked it up or remembered before now) that you are a med student, then an intern, then a resident, then a fellow.  I’m sure there are a few more (HA!) steps involved, but super basically that’s it. 

This means that the fellow I saw last week at my doctor’s office has had at least 7 med-school years behind her.  And I must say that if she wants to work with patients with type one diabetes she probably should spend some more time learning before she goes one-on-one with a patient with type one.  She seemed like she had a lot to learn, despite knowing a lot of the calculations and science behind my pump readouts.

As we all know, it’s a lot to learn.  A LOT.  I’m sure for a physician it’s even more to learn than the rest of us!

(That doesn’t sound very fair, and that’s not how I intended that to sound: I don’t have any particular issue with her— but I was glad she isn’t my doctor.) 

For one thing, the fellow kept looking at my doctor for answers to her questions about my diabetes instead of looking and listening to ME. 

Yes, I am the rock star in the room at my own visit!

Which was fine; she hadn’t ever met me before and she was there working to learn from my doctor.  And, my doctor knows a lot about type one diabetes.

But then the two doctors started discussing my sensor.  Saying things like “a representative told me it didn’t work very well with pressure” that they thought would be a help for me to learn.  At that moment it really hit me like a ton of bricks in a crystallized vision I hadn’t seen with such clarity in a while.

They don’t understand what it’s like to live with diabetes. 

Really, truly, LIVE in the mundane, somewhat silly yet important ways that teach us something with every experience, every day.

Most of us with a sensor who has worn it on their hip and fallen asleep at 200 and woken 30 minutes later to a false “low” alarm knows that it doesn’t work when you’re sleeping directly on your sensor.  Any of us who have worn it underneath tights or (gah!) nylons and have been alerted to a false low can tell you: the sensors don’t like pressure.  (It makes sense, given that the sensor uses measurements from your interstitial fluid, that if your circulation of interstitial fluid is impeded by your body weight or by compressing clothing, that the sensor won’t work as it was designed.)

So the fact that neither of these women had worn a sensor for 3 days (ever, I imagine) seemed off to me.  If I was a physician and I could try something that might give me an insight into my patients’ daily life with their disease, I would like to think I’d try it out. 

Then again, what’s the point of wearing a sensor if your pancreas works?  They wouldn’t ever get an alarm, much less any of the 13 I got between 9:30pm and 5:00am last night.

Maybe it’s that I want to think my doctors WANT to know what it’s like to live with diabetes… which is kind of strange, as I tend to think I’d never wish diabetes on anyone. 

As we all know, life with diabetes takes a heck of a lot of knowledge and everyday teensy things that end up teaching us more and more. 

No matter how many years of school and training they put in, it’s beyond me why we consider our doctors the “experts” in diabetes.  Sure, they know a heck of a lot and are incredibly skilled and talented in their own right… but I have to consider myself the expert when it comes to my diabetes.

23 years of daily life is longer than any formal medical education, anyway.

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

1 page of 76

June 13th, 2011

I’m still confused by the fact that exercise is one of the cornerstones of my diabetes management and the topic gets one page out of the typical 76 pages of Diabetes Forecast magazine published by the American Diabetes Association.

I don’t think I’m off the mark to consider exercise a cornerstone of diabetes management for anyone with type one or type two diabetes. 

Several people profiled in 50 Secrets of the Longest Living People with Diabetes agree with me.

The book includes “secrets” on various life and living topics, but exercise is the one “secret” to being successful at living long and well with diabetes that came up the most consistently as one of the top ones regardless of how long people had been living with the disease, according to authors Sheri Colberg PhD and Steven Edelman, MD.

I knew it!

Exercise helps any insulin work better—be it insulin manufactured inside your body (type 2) or outside of it (type 1) and injected in.

Exercise helps food work better—rather than being stored for possible use in the future, exercise helps us use our food as energy now, before it gets to storage.

Exercise helps us manage stress—that daily moment to moment inescapable stress of calculating and figuring and evaluating and checking and projecting and reviewing and anticipating and worrying.

Exercise helps us stay active and mobile to keep us healthy and young as long as possible.  It’s simple—staying active every day helps us achieve our diabetes goals by helping to keep our blood glucose levels in check.

Exercise helps our bodies and hearts stay healthy and helps ward off cardiovascular disease that is one of the leading health complications of type one or type two diabetes.

So why only one page?

It probably isn’t as photogenic as a fruit salad with accompanying recipe.  It probably isn’t as profit-generating as an advertisement for a new (or old) insulin, medication, delivery method, socks, ID bracelet, shoes, lancet, or blood glucose meter.

But it’s a heck of a lot more effective in the fight against an unhappy unhealthy life, if you ask me. 

We all need to re-orient ourselves when it comes to our diabetes management.  Think beyond “food” and “medication” and add in an invaluable tool you have already in your Diabetes Management toolbox: your own body. 

Use it or lose it!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Picking Up Heavy Things & Moving Them Around

June 10th, 2011

I know I’ve mentioned the importance of weight and resistance training before.  I may sound like a broken record and for that I apologize—but I really think this one is important.

I think resistance training often takes a backseat to cardiovascular training because it doesn’t seem as simple as cardiovascular exercise.  Weight training requires weights and some degree of knowing what to do; cardiovascular training merely requires putting one foot in front of the other and repeating for X amount of time.

Yet the fact remains that resistance training is an essential element of fitness.  It helps you stay young and helps your skeletal structure keep healthy and strong. 

And when you perform both cardiovascular or aerobic exercise and resistance training, you can help diminish your risk of cardiovascular disease. 

A review of 34 studies conducted over the past forty years demonstrated significant improvement in hemoglobin A1c levels, blood pressure, cholesterol levels, and overall body composition.  Although the review of the studies was aimed at type two diabetes, the same holds true for improvements for people with type one diabetes and with no diabetes at all.

Looking at how much you would need to pay for drugs to help you manage type two diabetes, lower your high blood pressure, lower high cholesterol, and keep your weight and body fat to healthy levels for even two years is a staggering figure.

We won’t even discuss how great you will feel and look if you work consistently to improve your cardiovascular exercise as well as your strength with resistance training.

So, and I truly do apologize for this one, what are you weighting for??

Contact me with any questions about your own exercise program; we can work together to get you moving in a healthy and fit way and help you manage your health no matter where you are!!

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized