Archive for October, 2010

I Know In My Head It Will Be Fine

October 15th, 2010

Yesterday was an interesting day on the Diabetes Outside Facebook page.  If you haven’t checked it out, please do!

I wrote yesterday about sharing management of my disease by asking for someone else’s help when I am low.  Even if I don’t need the help, it’s nice to know someone else is going to get me juice!  But through the day different topics came up: (1) is it a responsibility you share if you ask someone to bring you juice and (2) would you ask anyone for help or just certain family members and (3) how do you handle telling others you have diabetes and you are low and you need sugar.

I don’t have answers for any of these questions, only responses that change with every situation and every person.  But before I could start in with thinking about writing about those answers, something came up for me that you may identify with in some way.

I am going on a long run tomorrow (20 miles, my longest before the marathon on 10/31).  I have been absolutely dreading this run.  I tried it two weeks ago, went out barely 2 miles and turned around and went home.  I even walked the 2 miles home.  I repeated this process every morning for three days in a row before I realized there was no physical problem—I was sick of running and needed a break.  So, I took a break for the rest of the week and did not let myself run. 

I felt better last week and running felt good and fun again, but I didn’t have the time to run 20 so I cut it to 14.  Let me tell you, 14 miles is completely different than the 26 miles I need to get through at the end of the month.

So when I got an email from a man I know from bootcamp yesterday asking me how my training was going and offering to run with me, I jumped at the chance.  He is a very fast and experienced runner and marathoner and is signed up for the same event; he is a bootcamper at a different location but he knows me from the weeks I’ve been at his spot.  He is a great guy and I’m looking forward to our conversations through tomorrow’s miles.

I’m really excited to run with him and to go on a route I’ve never seen.

But it brings up a question for me: what do I do if I’m low or need to check during our run together.  I already feel badly that I’m a slower runner than he is, and I don’t think he is as likely to stop and walk as I am.  I think he knows I’m diabetic but he isn’t a normal bootcamper of mine so he probably hasn’t seen me eat or check during class very often. 

If I am low or need to check I will absolutely stop and do so—it is never worth trying to make it through a run of any length without admitting I need to deal with some aspect of my disease.

Now, I have friends I run with who I have run with for years and who know that when we run together, I may need to stop and walk.  We’ve talked about it and I am comfortable that they are comfortable with that plan.  I know that if I run with someone else, I really really truly do not care that they may naturally run slower than I run.  (Most of the time, I’m perfectly okay with that!)

Yet I still am a little nervous for tomorrow.  I don’t want to disappoint him when we run together

I’m sure I won’t, and I have to remember that I will run 12 miles to his house before he even starts running in the morning so he will likely have realistic expectations of my abilities at that point.

And still.  I know in my head he will be PERFECTLY FINE if I need to walk and check or walk and eat.  I know that.  And I’m still a bit nervous that I will disappoint him.

See, I told you I don’t have any answers.

It Happened Again Yesterday

October 14th, 2010

This is such a small thing I can’t believe I feel compelled to blog about it.  Then again, maybe it’s a huge thing.  So who knows.

But it happened again yesterday.

I went to visit my parents after work last night because my dad had shoulder surgery yesterday and he needed ice for his cold machine.  I went to the grocery and got 4 ten pound bags and carted them in.  I went to the frozen yogurt shop and brought him some frozen yogurt for when he got hungry.  I got him orange juice, no pulp, for when he got thirsty.

And when I took all the stuff in and sat down to chat with them, I realized that I hadn’t eaten much all afternoon and I was low.  I announced “I’m low” right after I sat down.

That’s when it happened.

My mom asked me if I’d like her to get me some juice.

And (this is the little/big deal) I said “yes, please.”  And I sat there until she brought me the juice.

I’m slowly realizing that I have said “no, I can get it” for decades now when I’ve been low.  Decades.  And I’m finally realizing now how unnecessary all of that has been.

I don’t know who I’ve been trying to impress, or what I’ve been trying to prove, and I certainly don’t know who I’m trying to prove something to—probably it has been to myself.  And, many times I just want to take care of the low instead of facing the worried expressions and frantic scurries that result from my explanations of what I need.  It’s not bad, but it doesn’t feel normal, either.

But sheesh.  Here I am, devoting my evening (quite happily, I assure you) to making my parents more comfortable and when I am in an overall minor medical predicament I want to refuse help? 

I can count on one hand the number of times I’ve had someone else that I am not related to bring me low food or juice.  I just don’t usually let it happen.  Yet I know that every time I have accepted the help I really appreciate it, and in a lot of ways it feels like a vacation. 

So I decided yesterday I’m going to ask for more help with my lows.  Not because my lows are any worse than they ever have been, and not because I necessarily “need” the help.  But because I think it would feel precisely what it is: help

I could use some help with my diabetes.

We all could.

So Much Talking!

October 13th, 2010

While I was at the DYF Fall Education Retreat this past weekend, I observed the family interactions throughout the days and during various activities.  I was really kind of pleased with what I saw!

The families were relatively young families, with kids ages 3-13 for the most part.  This means that for the most part, kids were still on speaking terms with their parents… the Teen Years hadn’t fully hit yet!  (There was a simultaneous teens-only program running in the same place, but I wasn’t involved in that one.)

What struck me the most was how many conversations parents were having with their type one kids.  As an adult I don’t really have many conversations at all about the numerous diabetes-related decisions I make in my day.  If I did have them, I would have a LOT of them, and the person I had them with would have to be just as knowledgeable about the disease as I am.  What a tall order!

As an important aside: I can see, too, how these conversations throughout every day (starting with: what did you eat, what was your number, do you want to check, how much insulin did you take, how much do you want to take, are you going to play kickball, and on and on) with one kid can affect the other kids in the family who do not themselves have diabetes.  I remember being very young and jealous that my sister got to go to art class and piano lessons and go out and do activities and come back and report on them around the dinner table; I wonder how the jealousy manifests itself around a dinner table affected by type one diabetes.

I’m never one to say it is easy to live with type one diabetes.  I’m never one to say it is easy to be a parent of a type one kid.  But I hope I’m often one to applaud (quite loudly but never loudly enough) those who are making the best of either situation.

So, no matter what, keep talking.  Keep talking as long as you can.  Even when they stop responding, and even when you wish they hadn’t responded in a way they just did (I heard “who is this thing and what did they do with my adorable child” a couple times this weekend in pre-teen talks), keep it up.  Keep it up if only so they know later that you are there if and when they need someone to be there.

Yes, it takes a lot of thought to be a type one kid.  It takes a lot to be a type one adult.  It takes a lot to be a parent, and a parent of a type one kid. 

And yes, it’s all worth it.

It’s All In Your Mind

October 12th, 2010

Do you remember those super-oxygenated waters?  The American Council on Exercise studied them in 2001 and concluded that they did not live up to their “scientific” claims that the body would absorb the extra oxygen in the super water and the drinker would have improved stamina and athletic performance, reduced recovery time, and better mental clarity.

(Heck, I’d buy it, too, if that were the result!)

But scientists being scientists that wasn’t enough for them.  A few years ago they used the same “scientific” claims and tested two groups of runners.  One group got regular water and the other group got regular water, but they were told it was super water.

(I love that; how many of us have ever thought a Starbucks coffee was inherently better than a different coffee?)

The group of runners ran three times and interestingly, those told their regular water was super water ran faster.  The really interesting thing was that their heart rate, blood lactate levels, and rates of perceived exertion remained constant despite the increased speed.  They in fact said they felt lighter on their feet and were ready to purchase the super water.  Too bad for them—it was just regular water, but the mental game had changed

They believed they had an advantage and that belief on its own was enough to generate the very advantage they thought the super water supplied.

This study simply points out something I’ve seen time and time again with my bootcampers and with myself: this exercise thing?  A lot of it is in your head rather than your muscles.

Those words “I can’t” don’t mean much to me as a trainer.  They really mean “I don’t want to” more often than not.  If I believed everyone who said they “couldn’t” do something and let them stop trying… well, I think I wouldn’t be a very good trainer.  Sometimes, sure, “I don’t want to” is a fair statement and it has its place in life and in exercise.  But make sure you can differentiate between “I can’t” and “I don’t want to try.”

So here’s the thing to learn from this study: not only are you possibly shortchanging yourself by underestimating your abilities, YOUR MIND can change the circumstances.  Notice the physical effects of the subjects running faster were identical to them running a slower pace.  This shouldn’t happen physically—your heart rate, perceived exertion, and blood lactate levels should increase with the increased stress of running faster.  But here, their bodies thought they were having an easier time with the run because their minds thought so, too.

I think that’s a pretty neat thing to learn.  Get your mind on your side, and the world opens up for you. 

Now get going.

Having Someone Else Check Your Blood

October 11th, 2010

I was at a Diabetic Youth Foundation event this weekend and my brain is so full of ideas and experiences I’m struggling to write today because they all want to dash out! 

There are so many families out there who are doing great things for their kids with diabetes.  Great job, everyone, in learning what it takes to make diabetes work in your family!

One mom shared that, although her 11 year old daughter is beginning to assert her independence, there are times she asks her daughter if she checked her blood sugar.  When her daughter, laying on the couch, sighs and says “no” sometimes she also says “will you do it?” and sticks out her hand.

How great is that?!

Of course, the mom is thrilled to help her daughter with this “little” thing that, when added together over the course of several times every day for the rest of our lives, is in actuality a humungous thing.

And the best part is the daughter gets a break from the job.

Cool deal for all involved.

So then I started to think about what it would feel like if I asked my husband to check my blood sugar.  He worked up at camp and did midnight checks on the campers all the time, so I know he knows what to do.  He’s also seen me do it maybe a kazillion times in the twelve years we’ve been together. 

But I still think his eyes would bug out and his eyebrows would hit his hairline if I randomly went to him and said “you know, I’m tired of this; can you do it for me?”  It’s a pretty entertaining mental picture.

And, I’d have to get over the assumption that he’d do it completely wrong.  ;)  He’d probably do just fine!  But it would really be weird.

When I donate platelets (not whole blood anymore; it took too many days for me to recover when I lost that much fluid through donating so I only do platelets now) they do a finger stick to check my iron levels.  I always want to grab the lancet and just use mine instead.  They never let me—I’ll never understand why not!  And they always jab me in the middle of the pad of my finger so it hurts more (I’m an edge kind of girl).  AND they put a band-aid on the spot!  For someone who does a finger stick multiple times a day they are doing nearly every part of that process plain old WRONG.

But maybe next time it feels like too much, I’ll ask my husband to check me.  Or maybe I’ll ask him to do one or two before that so we can talk about how to do it the “right” way.

It’s good to have him as a backup every now and then.

Candy Candy Candy!!!!

October 8th, 2010

I must write on this topic T.O.D.A.Y. because I have had the magazine article next to my keyboard all week long and omg.

The magazine article (Self magazine October 2010) gives tips for to Conquer Candy Temptation.  The article of course has photos of Halloween candy all over it, so I’ve been looking at these photos every time I’m at my computer all week.

If only those tips helped me.

See, I’ve had this theory for a really long time that people with type one diabetes just have a nearly encyclopedic knowledge of candy.  (Just try telling someone not to eat something and see what happens.)

Fortunately, the message has been altered since insulin pumps and carbohydrate counting became mainstream.  However, it’s still a big deal when we eat candy and other people are around.  They are watching and they don’t seem to hesitate asking us what we’re doing.

So yes, I admit it.  I eat candy.  Yes, I’m a trainer and yes I watch what I eat because I don’t want to gain back any of the 45 pounds I lost eight years ago.  But I still find space for candy.

If you’re interested, the four tips the article provided are:

  1. Stock up on lollipops.  (They take a lot longer to eat and don’t tend to have as many calories as chocolate or other candies.)
  2. Rock a cute costume.  (If you know you have to squeeze into a certain outfit on Halloween you may be more motivated to avoid food you know won’t help you look good.)
  3. Eat treats after 4pm.  (What?!  The RD says really to avoid eating candy in the morning since you’ll crave it all day long if you start too early.)
  4. Be candy-free November 1.  (Donate extra treats to Operation Gratitude a nonprofit that sends packages to overseas military personnel.

I decided a while back, after I learned that I don’t gain or lose more than a pound or two throughout the year, that I’m okay with my candy habit.  It’s not a big deal, I cover the carbs with insulin, and I try hard to not feel badly about what I eat.  I’ve got a lot of other stuff going on in my life and making myself feel badly over eating a piece of candy seems like a lot of wasted energy going someplace not very useful.

And of course now that it’s Candy Corn season again, whenever I’m low I reach for the bag and have 11 pieces.  The white tips are the best! 

There is always a place to fit food in, somehow.


October 7th, 2010

My  quote on Facebook  this morning was a Spanish proverb that translates: A man too busy to take care of his health is like a mechanic too busy to take care of his tools.

Someone mentioned how easy it is to lose sight of how important it is to take care of our health.  It is so easy I think we all could use a little reminder most days!

But I think having diabetes, either type one or type two, just complicates the idea.  First of all, do we consider ourselves “healthy” to begin with?  And secondly, we can never escape taking care of our disease so don’t we get credit for that?  (Of course we do!)

I think oftentimes we feel like we “fight” diabetes in our own bodies.  The explained and unexplained blood sugar changes have spent years teaching us that our body really is a battleground.  The weapons on both sides include finger pokes, needle jabs, low sweats, high dry mouths, dropping anxieties, climbing moments of apprehension, expired insulin, scar tissue, beeps, alarms, dried up jelly beans, cans of Coke, old test strips, and a zillion other minute and ever-present aspects of our lives with diabetes.

So isn’t it enough that we fight that fight every moment of every day?  Why should we have to fight even MORE to take care of our bodies?

Well, I don’t really have a good answer for that.  I think the best thing for each of us to do is simply shift our perspective on what life is like when we live with diabetes. 

We have a constant “fight” with diabetes that will never go away.  There are a load of ways we can equip ourselves for the battle, though, and assure our victory.  Most of them are not quick fixes and will take some continual tweaking over the course of our lives, but it’s good to get a start as soon as we can.  Diabetes doesn’t take a break and neither should we if we want to keep the upper hand.

I think first off, we need to learn to accept the disease.  One of the parents in the video about Bearskin Meadow Camp and the Diabetic Youth Foundation said he learned how much better it was for him to see a high and deal with it rather than agonize over the why behind every single one: it’s a high, there will be more, and let’s take care of it as soon as we can so that we can continue with life.  Keep management of the numbers as realistic as you can, and forget the concept of “control”—it isn’t possible to control any aspect of our diabetes.  If you were the boss at your job, would you think you controlled your employees??  Kick the notion to the curb and pick up the idea of “management” instead

After that, we need to also take care of the rest of our bodiesJust because we have this “fight” with our disease doesn’t mean that we can ignore our muscles and bones any more than we can ignore the dirt and grime in the bathroom just because we’re doing a great job at keeping the kitchen clean. 

Life just doesn’t work like that.

We can work together and get your body up to speed when it comes to physical fitness since the strength of your physical body will certainly help you succeed in battle.  You need as good a support team as possible to keep up your fight!  The health of your body depends on it.

Getting Off to a Great Start

October 6th, 2010

I know some of you have toyed with the idea of starting to run… but how?  You see my mentions of these crazy-sounding 15-20 miles and two of your friends just ran a 10k… but you’re feeling stuck at the thought of running down the block!!!

First of all, it is critical for you to realize every single person you see running started running by taking a step or two.  It was someplace a heck of a lot slower than what you see and a heck of a lot harder than it looks like now.

Which is all good information to have: we have all been there. 

Second point: some runs are good ones and some ones aren’t so good.  Don’t go out expecting to feel fantastic each day… that’s not the way the cookie crumbles.

Third point: running requires self-motivation.  I can’t make you enjoy running if you hate it, and I can’t make you lace up your shoes and keep putting one foot in front of the other.  That stuff comes from YOU. 

Last point: learn from others.  You will have to figure out what works for you and your diabetes, but overall, there are a ton of knowledgeable runners out there.  No need to (ha ha) reinvent the wheel.

In keeping with that last point, I post here an excerpt from Jason Karp, Ph.D.’s newsletter.  You can find Dr. Karp at

For beginners, the most important part of running is to make it consistent.  The focus should be on getting out the door every day to run.  Once you have developed a running habit and have a solid base, it’s time to add some quality to your running to increase your fitness. Start by adding one quality workout per week.  Do that for a while and then you’re ready to train using a planned training program.  Rather than follow a generic plan, however, look for one that is skewed to your strengths.  If your strength is endurance, focus more on mileage and tempo runs and less on interval training.  Run longer intervals, trying to get faster with training, such as 1,000-meter repeats at 5K race pace, increasing speed to 2-mile race pace or decreasing the recovery as your training progresses.  If your strength is speed, focus less on mileage and more on interval training.  Run shorter intervals, trying to hold the pace for longer with training, such as 800-meter repeats at 2-mile race pace, increasing the distance to 1,000 meters or increasing the number of repeats as your training progresses.  Work your strong points and train using the whole continuum of paces, from slow running speeds to very fast speeds to enhance both your aerobic and anaerobic abilities.

The Medal

October 5th, 2010

So it has really only recently (within the past two years) come to my attention that there is a MEDAL.  I could get a MEDAL for living with diabetes for 50 years.

Well, then.

I have run more miles than I care to count just for a single medal.  I’ve gotten on a plane, flown across the country, frozen my tuchis off, run 26 miles, and nearly crashed on the ice on the ground at the water stations for a medal!

But this one would be a pretty cool one to earn.

It’s the Joslin medal.

I think the history is critical to understand why they even count years with diabetes… keep in mind, I am really only in the third generation of type one diabetics who did not receive a death sentence along with their diagnosis.   I remember my grandma cried for days when I was diagnosed and I never understood why.  Now that I’m old enough to understand what a type one diagnosis meant to her, it makes more sense.  Maybe she remembered seeing kids in hospital beds, wasting away.

That has never been a part of my disease.  My disease doesn’t have a time limit. In fact, I quite honestly have never really seen many limits for myself related to my type one diabetes.  I know I faced one when I realized I could never be a commercial pilot… and when I realized I needed special permission for some things… but other than that… yeah, I kind of draw a blank.

Now, I understand there are limits out there.  I just don’t choose to see them. Why limit myself??  I’ve got limits in terms of time, space, means, ideas, geography, practicality, gravity, financial… with all of those limits out there why would I let my diabetes add one??

Yes: Be smart.  Learn.  Plan.  Figure.  Calculate.  Estimate.  Determine.  Be flexible.

But never stop.  Stopping will not only shrink your world, it will cause you to impose needless limits on your own life.

They don’t award medals for that kind of behavior.  Nope; they award medals for those people who have gone out and done their best amidst some daunting adversary conditions.

I’m thinking I have 27 years until I get that medal.  Maybe I should download the application now, just so I have it.

OMG I see they have a 75 year medal too!!!  Now I want that one too!!!!  :D

How long before you earn YOUR medal??

Why Is My Blood Glucose Sometimes Low after Physical Activity?

October 4th, 2010

I’m  going to try and run 20 miles this morning since yesterday’s run was a bit of a bomb (my foot, knee, and hip weren’t feeling like they had 20 safe miles in them!) so I’m stealing from Joslin since I won’t have time to write a blog today (20 miles takes a while).  This is good information to have in your brain when it comes to exercise… the more you know, the better you’re able to handle what life throws at you!


Low blood glucose is defined as a blood glucose level below 70 mg/dl if your meter measures whole blood, or 80 mg/dl or below if it measures plasma glucose (a plasma blood glucose of 90 mg/dl or below with symptoms is also a sign of hypoglycemia).

One of the most common causes of low blood glucose is too much physical activity. In fact, moderate to intense exercise may cause your blood glucose to drop for the next 24 hours following exercise. This post-exercise hypoglycemia is often referred to as the “lag effect” of exercise.

Basically, when you exercise, the body uses two sources of fuel, sugar and free fatty acids (that is, fat) to generate energy. The sugar comes from the blood, the liver and the muscles. The sugar is stored in the liver and muscle in a form called glycogen. During the first 15 minutes of exercise, most of the sugar for fuel comes from either the blood stream or the muscle glycogen, which is converted back to sugar. After 15 minutes of exercise, however, the fuel starts to come more from the glycogen stored in the liver. After 30 minutes of exercise, the body begins to get more of its energy from the free fatty acids. As a result, exercise can deplete sugar levels and glycogen stores.

The body will replace these glycogen stores but this process may take 4 to 6 hours, even 12 to 24 hours with more intense activity. During this rebuilding of glycogen stores, a person with diabetes can be at higher risk for hypoglycemia. Here are tips for safe exercising.

Guidelines for preventing exercise related hypoglycemia

  • Check your blood glucose before exercising to make sure your blood glucose is sufficient and/or consume an appropriate snack.
  • Avoid exercise at the peak of your insulin action.
  • Avoid late evening exercise. Exercise should be completed 2 hours before bedtime.
  • Avoid alcohol consumption prior to or immediately after exercise.
  • Avoid hot tubs, saunas and steam rooms directly after exercise. These continue to maintain an increased heart rate and may continue to lower your blood glucose.
  • Limit your exercise sessions to 1 or 2 per day. Additional sessions increase the likelihood of hypoglycemia.
  • In the past, it was believed that injecting insulin into exercising muscle increased absorption of the insulin resulting in hypoglycemia; now it is believed that the timing and action of the insulin are more likely to be the key factors.
  • Check your blood glucose immediately after exercise to prevent low blood glucose from occurring hours after exercise. It may also be necessary to check your blood glucose more often for 2 to 4 hours after exercise. Moderate intense exercise may cause your blood glucose to drop for the next 24 hours following exercise

If blood glucose is less than 100 mg/dl immediately after exercise

  • Follow post-exercise snack guidelines. If you are not scheduled for a snack or a meal for 30-60 minutes after exercise, 15 grams of carbohydrate should be sufficient to prevent a low blood glucose. If no meal or snack is scheduled for more than one hour, take 15 grams of carbohydrate and 7-8 grams of protein.
  • Increase carbohydrates before exercise.
  • Decrease the dose of active insulin for the next exercise session.
  • Consider decreasing the insulin dosage following exercise.
  • If your blood glucose at bedtime is still less than 100 mg/dl, double your bedtime snack, or if possible, decrease your insulin dose acting during bedtime.

Guidelines for unplanned exercise

Sometimes exercise or physical exertion occurs spontaneously or is unplanned. You may need extra food at these times in order to maintain the balance between your insulin or oral medication and the energy needed to exercise. A number of factors will determine if you need food and how much food is necessary.

  • Snacks may be necessary for exercise beginning 2 hours or more after your last meal.
  • Snacks may be needed for exercise lasting 1 hour or more.
  • Long duration or all-day activities may require both a snack adjustment and an insulin adjustment.
  • If you are attempting to lose weight, adjust your insulin or medication rather than eating extra food.

Be sure to talk to your diabetes educator for more information about how exercise will work best with your diabetes.