Archive for June, 2010

Are you ready to HIIT it?

June 16th, 2010

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

“Special Accommodations”

June 15th, 2010

(I know that a lot of you might feel differently than I do on this subject.  I’m okay with that.  This is just me saying what I have on my mind, not necessarily making recommendations to you about your situation… just think about what I’m saying a little and I’ll be happy.)

Well, shoot. 

I guess I’m in denial or something.  It never occurred to me that I needed special accommodations to take a state exam. 

To me, special accommodations are for people who need extra time, or who have a real reason to have a different exam than the masses.  I never think about myself in that situation.

But today I was looking at the exam rules for an upcoming exam I’m taking and lookee there: no food is permitted.


So now I have to fill out a special form and endure the lady’s questions “why didn’t you put that you needed special accommodations on your application?!” just to be allowed to have my meter with me and some food nearby.


I don’t want extra time.  I don’t need a special desk to allow for a physical disability.  I don’t need anyone to read the exam questions aloud.

I just don’t want to be hassled by the proctor when my pump beeps and they’ve told us it must be silent in the room.  If I for some reason go low during the five hour exam, I want to be able to drink some juice without being accosted by a proctor or have my exam thrown out.

Why is that called a special accommodation?

Now, granted, I understand that they need to know I have type one diabetes and they need to know why I might beep.  I understand that they don’t want food in the exam room.

I just can’t figure out why I need to send this form to my doctor just so I can take an exam.  It isn’t like this is something I’d make up.

Maybe I’ll send them a copy of the form I sent to the California Bar when I took the bar exam.  That’s the only other time I’ve needed to request permission in writing to have food with me.  But that exam was three days long, so it seemed worth it.  This one is only 200 multiple choice questions! 

I guess I’m fortunate to be as confident in myself that I mentally need no special accommodations for any test or competition with others.  My disease simply doesn’t enter that kind of picture to me.

Does that mean I’m in denial?  Maybe.  Does it mean I consider myself “normal” and only want the special treatment for what I really do need? 

You bet. 

I guess I don’t see how treating a kid with diabetes differently during a spelling or math test (when the test isn’t timed and they aren’t going low) helps them out at all.  Maybe parents are in denial when they teach their children how they can bend the rules “because of their diabetes.”  Maybe parents don’t know how easy it is to manipulate our own blood sugars… just a little more candy, a little more insulin, presto change-o there you go: wacky number on demand.  (It’s the non-wacky numbers that are truly difficult.)

I don’t want special treatment.  Just treat me the same as everyone else.  I work pretty hard to make my playing field level with everyone else.

I wouldn’t want it any other way—how else would I know that what I’ve accomplished is what I’ve really accomplished??

Get going and SUPERCHARGE your workout!

June 14th, 2010

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.

Puuuuuuump! Doesn’t have quite the same ring to it as “Goooooaaaallll!”

June 11th, 2010

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.

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.

Hey! Parents!! Your Kids Are Paying Attention.

June 10th, 2010

Often, kids pay more attention to their parents than I think parents realize.  It’s weird how being a parent must totally mess up your brains.  (No judgment here: I really think it’s weird.  I guess a good weird, but still, weird.)

Do you remember things about your parents from when you were a kid?  How many of the things that you remember about your parents are things based on the way they did something, or how they sat during dinner or how they yelled to get you to come home after playing outside?  (My mom reads my blog so I’m not sharing any of the things here that I remember about either parent from when I was little.  You’re welcome, guys!)

I think kids pay more attention to parents when parents aren’t watching than parents realize. 

This matters because like it or not, what you DO matters when you are a parent.

Even if you are a parent to a teen.  You know they fight with you and you know they pretend you don’t exist when others are around and yet you should also know, THEY ARE WATCHING.  (They’re kind of creepy that way.)

Even if you are a parent to an adult.  You know they aren’t around as much to watch you doing what you do, but they know and unconsciously record what you’re like so they can anticipate what they will be like.

But it absolutely matters if you are a parent to a non-teen or non-adult.  You need to pay attention to your own nutrition, your own health, and your own exercise. 

I will say, I remember (and only talking about my dad here since I don’t think he reads this daily like my mom does) when my dad was diagnosed with high cholesterol maybe a year or two before I was diagnosed with diabetes.  He changed his eating, nearly overnight. 

It was pretty amazing.  We had fish a lot more, we had vegetable stir-fries a lot more, and we had our formerly weekly Sunday night submarine sandwich or bratwurst a lot less.

He also started exercising.  At the time, he found someone to play tennis with, and went a couple times a week.  He went to the track and even invited one of us to go with him a few times.

And you know what?  His cholesterol went down.

So I’m just saying: I’m pretty sure he didn’t do any of that so that he could set a good example for me.  I’m pretty sure he just did it because that’s what his doctor suggested. 

But even that—even following his doctor’s suggestions—was a way he set an example when I wasn’t even with him at the visit. 

Now, he goes to bootcamp every day.  He started going when I was still living at their house (so you know that was a long time ago!) and pretty much goes every day now.  (And since he’s not a reader, I’ll share with you that he is now officially a Senior Citizen.)  My mom started at bootcamp around when I went to camp for the first time.  (And she is a long way from 65.  A really really really long way away.)  They both have made exercise a part of their daily lives.

Both of my parents set a pretty good example for me by doing what they can to keep themselves healthy.  I appreciate that.

So, sorry to rain on your fantasy parade, parents, but your job is never over.  Ever.

How Do You Cope?

June 9th, 2010

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.


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.

Diabetes is EVERYWHERE

June 8th, 2010

So.  I’m not sure if this is something that everyone else has noticed in their lives, but sometimes it just hits me.  DIABETES IS EVERYWHERE.

Yeah, I know it’s everywhere because it’s a part of me and I look at my pump or check my blood glucose or think about it or I eat something or wonder what my number is nearly constantly. 

It’s a little strange to imagine my life without it.  I wonder what else I’d think about, if I weren’t always going through a body check.

But then I realize that not everyone is like me.  Some people hear “diabetes” and have their own thoughts of what that means based on some random TV show or advertisement on the side of a bus or newspaper article about using some mouse’s pancreas or whatever. 

There is a load of misinformation out there.

I can only hope to positively shift the non-diabetic’s perception of the disease each time I have the opportunity to interact with them.  I want to be a source of some truthful tidbit for each person who speaks with me about diabetes.

Yes, it takes time.  Yes, I’m not always thrilled with taking that time.  I know some perceive it as a personal intrusion (I don’t).  Sometimes, it’s pretty rude.  But really?  I’m not that important that I can’t respond to a genuine question someone has about diabetes.  Maybe they’re just trying to mesh the random bits of information they’ve accumulated in their years of living without diabetes.

I don’t like the other option I have, either.  I don’t want that guy who asked me why I was wearing my garage door opener on my belt really thinking I was wearing my garage door opener on my belt.  I want my pump to just be there, and the only way I think I’ll ever get to that point is by explaining to anyone who asks what my pump is, what it does, and why.  So, I say with a laugh: “No, it’s not a garage door opener; it’s my insulin pump.  I wear this so I don’t have to take shots for my diabetes” or something equally bland and truthful.

I love it when people ask me questions.  I’m not kidding that a few minutes ago I had to call Intuit to get my software registration code; the lady asked me the name of my business and when she heard “Diabetes Outside” she mentioned her coworker’s eight year old son was just diagnosed and the family is overwhelmed and her friend is in his mid 40s and she thinks has the other type but he’s in denial and won’t talk to her about anything.  So we talked and I answered anything she asked me about what she had heard about diabetes, A1c, and what the different types are.

I love that I spent twelve minutes on the phone with her accomplishing something that probably should have taken less than three.  Maybe I helped her to understand a little bit more what we all live with and think about without end. 

Maybe.  For today, that maybe is enough for me.

Be Smart, Be Safe Out There

June 7th, 2010

I admit it.  I have a lot of soap boxes.  I’m sure you’ll get to know some of them shortly and hopefully not get too sick of me standing on them too quickly.


I think it’s important for all of us with diabetes to exercise in a smart way.  Shoot, I think we should act in all aspects of our lives in a smart way.  But exercise, in particular, needs to be done with some advance thinking and advance planning.  After that, go for it.

And be smart about what you haven’t planned for.  Oxymoronic that you’re supposed to plan for something you can’t plan for, but there it is.

I used to wear a MedicAlert bracelet when I was first diagnosed, then I had a necklace (that I sometimes wonder about—I wonder if it is still stuck in the heating vent in the loft of a church in Lake Tahoe that I lost it down when I was on a youth group ski trip when I was 13), then I wore nothing and then I had a different bracelet that I wore for ten years.  When that one wore through, I figured that my pump should be enough of a notice to EMT that I have insulin dependent diabetes.

But then I started running and could see how having something else, something that would tell anyone, what I need and who I am even if they’d never seen an insulin pump before, is a really smart idea. 

So I got myself a RoadID. 

I wear it on my shoe.  It’s completely unnoticeable to me as I run—it’s very lightweight and thanks to its Velcro closure, doesn’t flap or make any noise.  It’s pretty innocuous, which I love, yet so many people wear them that EMT are taking notice.

I have a friend who wears the ankle one, and another friend who swears by the wrist one.  For me, the shoe option is the best. 

I also love that there is enough room to write a saying on it.  My current one says pretty much the only phrase I ever need: Keep Going!

Over Memorial Day Weekend, the company posted a link to some possible sayings people have thought up.  I loved the “Suck it up, Buttercup” one so much I had to order another ID.  Every time I look at that thing I will giggle.  Shoot, just thinking about it has me grinning!  

Anyway, I got this second ID and they sent me a coupon to send to my friends.  I’m sharing it here, in case you have been looking for something that works for your active self.  The company is a pretty good one, and they let you donate proceeds they receive to the JDRF.  Up to 20 people can use the coupon, so:

Coupon Number: ThanksAmanda765271

The coupon is good for $1 off any Road ID order placed by 07/06/2010. To order, simply go to or click this link.  If you prefer, you can call them at 800-345-6335.

Thanks for listening to me and my Road ID soapbox.  I’ll move on to a different box tomorrow!

Opportunities to Learn and to Teach

June 4th, 2010

My friend and webmaster made this comment on a post earlier this week.  It is such a great story I wanted to set it center stage.


I cry when I think about camp too! Bearskin Meadow Camp does have a certain magic. The summer I was there and had packs of kids teaching me how it is to live with diabetes. They got a huge kick out of doing a blood check with me (non-diabetic) and then discussing with the doc how much snack I should get if any!

One of many completely and unbelievably awesome memories:

I have a fear of needles (one might question the logic of me working at this particular camp, but let’s set THAT aside). I have a SUPER big fear of needles. I tremble, I breathe fast, just when I’m around them wrapped up in their sterile packages.

First day of camp, it’s time for everyone to check their blood before dinner. A camper asks a simple question, “Why are you not checking?” I say, “I don’t have diabetes.” He says, “So?” Excellent point.

So I stand in line with him, we check together, we tell our results to the doc who draws up insulin for him and the same amount of saline for me. My little Blood Buddy (our names for the next weeks) pinched some skin on his tummy, took his insulin and looked at me…. standing there holding a syringe of saline. It’s one of those moments in life when you have to step up, but I was having trouble not shaking.

“It’s not that bad. You will barely feel it” he said. He stood close, explained where he takes his shots, why some places were better for him than others, but really it’s best not to think about it too much and just do it, etc.

I took that shot. And it was no big deal. And neither were all the other shots we took together that session. It would have been a much bigger deal to not check and not take the shots. I would have stuck out like a sore injection site.


I have been thinking about that kid all week.  Can you imagine what it must have done for his confidence to get to tell a camp counselor how to take a shot?? 

I highlight this story for another reason:  I know many of you whose children and loved ones have diabetes may not know how you can really support them.  It really doesn’t take much.

Be there, be willing, learn from them, and let them lead the way sometimes.  Your caring will come through.

We are in this together.

Camp is An Adventure in Living with Diabetes

June 3rd, 2010

I met this author when she was a Counselor in Training, my first summer at camp and her twelfth summer.  We all learn from each other at camp!


As a young child, I remember counting down the days every year until I went to camp in June. By the time May came, I was so excited I could barely sleep at night, opening my window wide and imagining how the night mountain air would smell and the joy of seeing my friends who also had diabetes like me.

I was diagnosed with diabetes in 1985 at 5 years old, and 6 months later in 1986, I spent my first summer at Bearskin Meadow Camp. Primarily, my time at camp taught me how to succeed at living with diabetes and encouraged me to try new ways to manage my condition (for instance, I began using an insulin pump at 15 because I had seen so many others at camp using them). Throughout my summer adventures at camp, I shared my experience of having diabetes with hundreds (perhaps thousands) of others who were experiencing the same challenges as I was. An additional benefit of being a part of camp was that at camp, I felt secure and calm in a way that I had never felt in my home life; at camp, I was wrapped up in a safe cocoon of friends and caregivers who eventually became like a second family to me. This feeling of security inspired me to try new things that I never would have done had I not become a part of the Bearskin family, like climbing Mt. Whitney, a mountain nearly 15,000 feet tall in California, and traveling to Bearskin’s sister camp in Chile to work as a counselor.

Undoubtedly, I could never have become the successful 29 year old professional I am today without my experiences at camp. Not only did camp connect me with others who can truly understand me because they also live with diabetes, it also transformed my life by exposing me to new life paths, some of which were related to diabetes but some of which were not. I continue to lean on the support of my friends from camp today and plan to continue my connection with camp for the rest of my life.


If you have the opportunity to give someone you know the chance to go to camp, please take it.  It may be a word of encouragement to nervous parents, or a whisper in a child’s ear that these places exist for them to think about.  If you’ve been to camp and have had a similar experience, share it here, or share it with someone in a position to share your experiences beyond the people you know, like a doctor or other medical professional.  You never know how sharing your experiences can benefit someone else!

If you don’t know someone who could benefit, consider the Diabetic Youth Foundation or Iron Andy.  These nonprofit organizations exist to send kids to camp and improve their confidence, expand their horizons, and enable them to grow and be happy with themselves while they learn ways to cope with life and living with diabetes.  You really can change their lives for the better.