It hit me again last night when I was working out. 

It’s pretty amazing that I’m still alive.

It’s something that I realized a long time ago and kind of carry with me all the time, but sometimes something happens and I look it straight in the face.  If I had been born before insulin was discovered/invented/derived/produced/manufactured, I wouldn’t be here.

I see it in my diagnosis picture.  I see how close I was.  I know how that felt, and my heart breaks for everyone who came before me who knows how that feels and who didn’t have the fortune I have had.

Stopped at home after my doctor diagnosed me. On my way to the hospital for my four day stay.

I think about the researchers who spent their professional lives making insulin something we could all benefit from.  I know they didn’t know about me.  I wonder who they did know, and who they were working to save, and who they were unable to save.  I wonder if they ever thought about how those of us today would feel about them.

I see how small the vials of insulin are, and how miniscule a unit seems when it’s in a syringe or priming out of my pump catheter.

It doesn’t feel that small to me.

I looked down yesterday at my legs as I was doing a squat.  I saw my leg muscles and I saw my little pock marks that scar tissue caused after ten years of injections in the same two square inches in my thigh. 

But I also saw legs that have supported me as I crossed countless finish lines, and carried me up thousands of hills, and have grown physically and mentally stronger with every experience.

I thought about the people who don’t need to know insulin exists.  I thought about how many of them don’t realize they are incredibly fortunate to have a body that functions naturally and how very few of them take the time to treat their bodies the way they were intended to function: by moving.

So many of us are doing such amazing things with our lives with diabetes.  I think it’s important to recognize how special it is that not only have we been given the opportunity to continue to live because of the hard work of so many to discover and deliver insulin, but to also recognize that we are special individuals: we have been given a chance to really live our lives. 

So while I don’t enjoy the stretch marks I have from the weight I re-gained so quickly after I was diagnosed and started on insulin, and I don’t enjoy the scar tissue or the ratty fingertips, I see them for what they are: signs of hard work and innumerable rewards. 

It’s weird to say to people who are no longer with us, but I need to say it anyway: thank you for working hard to find a way to keep me alive on insulin.

I have one body and it’s been through a lot.  But through that, I have thrived and my body has thrived. 

Let’s keep going.

A great workout partner can be really tough to find.  You want someone who you enjoy spending time with, who can work out on the same schedule as you, who is in roughly the same fitness level, someone who has roughly the same goals for their exercise as you have for your exercise, and someone who is special enough that you don’t care what they think of you as you huff and puff by their side.  For me, I also require a workout partner to be someone who understands that sometimes I need to stop for a bit and eat some glucose.

Like I said, it’s a tall order and a tough combination to find.

I’ve had two really great workout partners, yet they could not be more different from each other in the way they exercise and they ways they have helped me exercise.

In high school, one of my best friends and I decided we should join the gym.  We joined the Y, went through the orientation on the weight machines, and went together a few times a week. 

We’d be on the treadmills next to each other and catch up on school that day, or whatever came to mind.  She would look over at me huffing and puffing, shake her head and say “why do you think running is important?!” and I’d look over at her walking along and clutching the display for dear life to stay on her treadmill (that she had set at the maximum incline) and shake my head and say “why did you set the incline so high you can’t stay on without holding on?!”

But we’d go together or meet there and know there was a friend at the gym who was on our side.  All the time.  If one of us got sick, the other one would still go, but it wasn’t the same.  Our workouts couldn’t have been more different, but we were still workout partners.

Belonging to the Y with her made me less self conscious when I went and helped me go more often.  I tried out a class or two, knowing she was there and would be supporting me even if she wasn’t in the class.  Sometimes the support involved laughing at what she saw the instructor had us do, but it was still support. 

It’s important to have support in all areas of your life, and exercise is no exception.

The other workout partner is someone I run with.  She’s naturally a much faster runner than me—she’s one of those people who looks like she glides when she runs.  I think it’s amazing to watch.  I often can’t believe she’s willing to run with me, but I see that she gets something from running with me, too.  I think she depends on me for my dependability—I’m always happy to discuss skipping a run, but I rarely actually skip it.  She knows I’ll be there even if she doesn’t make it that day.  I think sometimes that knowledge gets her out there with me.

I also don’t badger or think differently of her at all whether she is there or not—she’s my friend and my workout partner.  No judgments, no criticisms, just sweat and appreciation of what we each bring to the workout.

We ran together today and apparently had an unspoken pact that thankfully we only disclosed to each other after we were done:  neither of us wanted to disappoint the other.  (It is a trait we share– the thought of her disappointing me is frankly impossible yet she’s still concerned that she might just disappoint me somehow.)  When we got to a hill that we would have each walked were we running alone, we each thought the other one wanted to run it, so we both ran up that hill and kept going. 

I had sent her the route I planned last night, and today she made me stick to it when there were several times during the run I offered new plans that would cut the run short.  It was great today, but I know that if either one of us needed to walk for a bit, the other one would probably have walked too—or not—and it wouldn’t have changed a thing.

A workout partner can offer you a lot of support and understanding and simultaneously push you farther than you’d push yourself.  They are very hard to find, but keep an eye out—someone might just be looking for you, too!

You may have read about “high intensity interval training” or HIIT in the news.  It’s the latest thing coming to the forefront of cardiovascular training.  What makes it fantastic is the little time it takes compared to the results it can deliver.  

But is it really new??  Seems like we all do this type of training instinctively. 

High intensity interval training.  “High intensity” means your max effort, one you cannot keep up for longer than even a minute, and barely a minute at that.  “Interval” in terms of training means a period of time at an increased heart rate alternated with a period of time at a lower heart rate.  I’ve included two of my heart rate reports from previous workouts—one treadmill interval session and one HIIT workout.  You can see what my heart rate goes through as I work out like this.

I remember when I was a kid, I’d run full out and then have to stop and gasp for air.  I see kids do it all the time; they don’t have a plan to get them wherever they’re going—they just GO—and have to stop if their body isn’t conditioned to keep at the pace they started.  I think the only reason most adults don’t do the same thing when they get back into exercise is their maturity seeking a plan to get them wherever they are headed.  They know they can’t get there by keeping themselves that massive effort so they usually slow down before they have to stop and gasp.

Sounds like a full effort, then a recovery to me.  Kind of like an interval workout.

I remember when I weighed 175 pounds and hadn’t exercised in years.  I got on the treadmill and couldn’t go fast or far before I had to slow down.  I worked up to a minute running followed by a minute walking. 

Kind of like an interval workout.

So why is HIIT receiving so much press these days?  I’m not sure.  I think because they are now recognizing that the physical gains (increased fuel efficiency at a cellular level in the mitochondria and improved reserves in muscle cells to help raise lactate threshold to name two big ones) are earned even with fairly short workouts.  In an age where time is everything, being able to see results from a shorter workout is huge.

I cannot tell everyone to go out and HIIT it; everyone will be different and you each have your own physical needs and situations.  What I can say is don’t be afraid to go out there and work really hard for a short period of time and then give yourself time to recover from that effort.  The more effort you expend, the greater your physical reward.

I try and fit in either a HIIT workout or an interval session on the treadmill once a week.  They are exhausting, and I try to change my body with each one, so more is not better when it comes to this kind of workout. 

You will absolutely need to have your insulin figured out (take less) because you shouldn’t really be able to eat and go to your max effort simultaneously.  (I’ll stand far back if you attempt it when I’m around.)  You also need to be vigilant about watching for a low; this is likely to happen when you first start out with these extreme efforts so you need to have glucose very nearby.  

Additionally, watch for lows 90 minutes to 6 hours after you finish an interval session.  They take a lot of energy and your body takes several hours to make the changes you’ve worked for.

After that, enjoy yourself and work hard—one of my favorite combos! 

HIIT workout

Intervals on the treadmill

Lucky us!!  Summer is here!!  We now have daily opportunities to get outside and really breathe in some fresh air as we exercise.  How great is that?!

I think running outside is a lot of fun.  I also enjoy the treadmill, sometimes, but that’s a different post.  Today is about ways to make your run or your walk outside more intense so that you earn some results from your exercise. 

Keep in mind that when you change the intensity of your workouts, your blood glucose levels will change along with the intensity.  Since you’ll be outside, remember to bring glucose with you each time you go out.  (Sometimes, if I know I’ll be around shopping areas, I’ll bring some cash too in case I need to buy a juice or something.)

You also should be aware that along with the change in the weather, your blood glucose levels will change in the heat.  For me, the first run I do in hot weather requires me to have less insulin in my system—the additional energy I expend keeping myself cool as I run in the heat is an added drain on my blood glucose so I keep the really hot weather runs short and literally, sweet. 

I am someone who gets bored quickly.  If I’m bored, I have time to focus on negative self-talk: how slow and heavy I feel, how many pounds of force I must be exerting with each step, how hot it is, how far away I am from home, how long I’ve been out running, you name it.  If it’s miserable, I’ll hear it if I’m bored.

So.  Let’s not be bored.

Intensity is a quick fix to eliminate boredom.  You have to be concentrating in order to exercise at such a level.  There is no automation in an intense exercise session.  There is no room for mental wandering.  If you lose focus, you’ll slow down, your heart rate will slow down, you’ll just be out there not really doing as much good for your body as you can. 

In order to get the most out of your exercise time as you can, you need to focus.  Focus on being intense and reaching a level of sweaty effort that helps you sleep at night and helps you know you did your best.

If you’re out for a walk, go for the same changes in intensity and speed.  If you are in a neighborhood with street lights or blocks, alternate between a faster and slower speed for each block, or between each lamppost.  Next time, go fast for two segments and slow for one segment.  Alternate those two workouts for about a month and see how you feel. 

Find a nearby hill with a good elevation change to it (hopefully about 100 feet), or find a parking garage with some outside stairs (hopefully at least three levels).  Go up and down the hill or the stairs 7-15 times.  By the time you’re done and heading home again, you should feel like you worked hard! 

Your actual speed doesn’t matter here—it will be as individual as your nose.  What matters is you reaching a level that makes you out of breath, that makes a conversation difficult, and that makes you sweat not only because it’s hot, but because you’re working.   

Enjoy that effort.  You are on your way to making a change in your body and a change in yourself—you can do it.

Every now and again someone publishes an article about a high-level athlete living with diabetes. 

It’s nice.

Since this is the start of World Cup 2010, I went in search of the same type of article highlighting a World Cup player with diabetes.  I didn’t find it, but I didn’t look long or hard so I still think there are some out there.

But I did find one article about two college soccer players who both live with type 1 diabetes.  http://tinyurl.com/yal3ytg

I’m the kind of person who can’t easily get past the practical aspect of things.  I don’t like to shop for something if I don’t know where I’m going to PUT it.  I can’t get behind a plan unless I can see the major parts fitting together from the very start.  So articles like this about athletes with type one diabetes require me to understand: (1) how do the athletes take insulin: shots or pump and (2) where do they put their pump. 

If they are on a pump and don’t wear it during games, do they leave it in their locker and simply disconnect?  Do they leave it at home and remove the entire infusion set?  If they leave their pump in the locker, has the professional athlete told the support staff what that crazy beeping is that comes from their locker every 15 minutes??  If they are on shots, do they even have a pump?  Do they have “pump days” and non-pump days?

I played rugby for a season, and took off my pump for the games.  My grandpa sent me an article about a Chicago professional football player who takes shots.  I think there are two professional baseball players on the same team who both live with type one.  I don’t think they wear a pump during games, either.  Or maybe they wear that newer Omnipod pump without tubing.

I think it would be hard to be a professional team athlete competing while wearing a pump.  My pump tube catches on door handles as I walk down the hall (only when I’ve forgotten to tuck the tubing in my waistband)!  It doesn’t usually bother me to roll around on my sites themselves, but when I roll over on my pump the corners and edges hurt sometimes.  I’m sure a football player has padding and extra protection for all his tackles, but still.  I don’t think I’d wear mine during a football game.  If I were a baseball pitcher or batter, the pump would get in my way unless I could secure it someplace behind me; but then what if I needed to see what it was alarming for??

I guess if I were a professional athlete I’d have a lot of incentive to figure it out. 

Playing sports is a passion when you get started and I admire those who are committed and talented enough to make it and turn it into a job at such a high level.  As a person living with type one diabetes, I appreciate those athletes who get special recognition for doing it all while living with the disease.  I can’t say I admire them any more than any other person I know living with type one and figuring out how to make it all work, but it’s still fun to know they’re out there.

Go team.

There isn’t any beating around the bush today (or any day): living with diabetes is tough.  Every day. 

Sometimes I think if I could just stop eating for a few days, I could maybe get a handle on it.  The constant peaks and valleys (even on the days the peaks aren’t very high and the valleys aren’t very low) are draining to see and physically draining to experience day in and day out for decades.  I won’t even start (today) with the emotional toll it can take.

Or, if I had a hormone meter that would tell me where all of my hormones are at, so I could take insulin to respond in a more proactive way and keep my glucose levels in range without having to guess at my hormones.  Having some tools beyond my own imaginary self-sensors to help me out would be nice.

Or, if I had a miniscule camera under my skin at my pump site so I could see if there was a kink in my catheter or if I had put it into a section of scar tissue that meant hours of delays in insulin delivery (and of course the resulting high/low glucose levels for the next day or two).  Being able to see that would be nice.

Or, if I didn’t have taste buds and the food industry telling me high sugar content foods and high fat content foods were fun to eat.  Or if I had a better willpower to not purchase the food and bring it into my life.  If I could go to a Starbucks with a coworker and not have to parade in front of the pastries in order to get an iced tea.  That would all be really nice.

If I could live my life every day without feeling like something so basic and essential as feeding myself was also the thing that made everything so complicated; that would be very nice.

But.

Since none of those options are realistic or feasible at this point, we each need a way to cope with the struggles we face in our lives with diabetes.  A way that doesn’t end up hurting us, or costing us a ton of money, or damaging our other organs, or requiring us to deny what is actually happening in our bodies.  We need some safe and effective ways to cope.

In case it hadn’t occurred to you before now, one of my best ways to cope with living with diabetes is exercise.  Lifting heavy weights, sweating on a treadmill running faster than I knew I could run, or hiking in the shady oak and pine trees in nearby hills, or running through as many cities as I can on a single outing, or whatever I feel up to that day.  It’s a great way for me to accomplish a lot of things simultaneously.

I get the multiple physical benefits of exercise.  I get fresh air.  I get distracted from the blood sugar worries.  I get to eat a bit of the junk food and not worry so much about it.  I get my body functioning and flowing and my metabolism higher so I can take less insulin.  I get tired and sleep better when I exercise.  I get to vent some of my frustration and anxiety.

Exercise is really a pretty nice tool.  I highly recommend it.