Archive for January, 2011

I Don’t Know How You Do It

January 31st, 2011

I know many areas of the country are feeling badly pummeled by the weather gods these days, and all I can say is: my hat is off to you.

I’ve lived in California since I was three years old.  Yes, it’s expensive to live here, and yes it gets hectic at times, but I can tell you this: I don’t know how you do it anyplace else.

I mean, really?!  I whine at 39 degrees or a drizzly rain.  (It is incredibly rare that both of those occur simultaneously.)  A cloudy or overcast day puts me in a sad mood.  I don’t know what it would be like to talk about “teens” or “wind chill” or any other such phrases I thankfully know nothing about.

I’m incredibly impressed by the ways you people in other parts of the world stay active during winter.  (Oh, and no way am I pardoning those of you who use the weather as an excuse to avoid being active.  Not a chance!)

I figure you do it by joining a gym where you can use the machines or brave the winter weather when it’s feasible to do so.  In fact, I have a friend who recently completed an indoor marathon… that was 95 times around an indoor track (larger than a traditional quarter mile track).  I can’t even sing from 99 bottles of beer on the wall to 95 bottles; much less from 95 to one!  Yikes.

If I lived someplace that experienced crazy cold temperatures (and yes I do wonder these things) I know I’d get myself outfitted for running in snow.  I’m not sure what all that would take, but I’d do it.  And I’d get myself a set of snowshoes.  I like snowshoeing.  And I’d join a gym so I could get treadmill time.  I like running intervals on a treadmill! 

Aside from that, I’d likely keep at my home workout routines.  I just wouldn’t open the doors for fresh air while I worked out.  I guess I’d maybe have a basement and set up something in there and exercise in my basement.  (I don’t understand basements, either, as a result of my California living.)

That basement thing would be kind of fun.

I know I wouldn’t worry so much about the bozos running and walking in the mornings as I drive to bootcamp.  (I call them bozos because I can’t tell you how many of them wear navy hooded sweatshirts; come on!  Help me out a little and help me see you!!)  I don’t think the bozos would make it out in the snow, and if they did I would probably see them better against the whiteness.

Then again, I wouldn’t be doing bootcamp the same way either.  D.O. it Bootcamp! is outside every day no matter what.  It is awesome; I love that!  We have some rain shelter but that doesn’t mean I don’t make my participants run in the rain.  (I’m kind like that.)  We all go home and shower anyway, so what’s the difference if we get a little damp?

Again, it isn’t always comfortable, but holy cow it is balmy compared to many parts of the world right now.  Yeesh.

Although, it isn’t Hawaii either.  (Now that is someplace I could hang!)

From the Inside

January 28th, 2011

I was driving home this morning and listening to the radio; they had an ad about refinancing a home.  I thought about a couple people I could recommend this specific place to, saying I had heard their ad on the radio and if all were what it seemed, it could be a good deal.

But then I realized neither homeowner I had in mind would be very receptive to such a comment, and it made me curious.  I know as we get older some things become more and more taboo among friends for some reason. 

I may know it, but I don’t have to like it.

And then I thought of my friends with type one diabetes.  I don’t think anything is taboo with them.

They have an instant place in my heart where there isn’t any judgment—really; there isn’t.  No one asks questions that require explanation about a certain number, no one really even asks much at all: we each know what the daily struggles are and the ins and outs and in betweens.

It isn’t to say my other friends aren’t a million loads of support to me (seriously I wouldn’t want to make it through my day without them!) or to say that I ever want my health to be taboo.

I just want to acknowledge that living with diabetes is a pretty individual thing and someone who doesn’t live with it doesn’t always understand what it feels like—from the inside.

So my hats off and hugs around each of you who I know and each of you whom I don’t yet know.  You’re doing an awesome job being, well, awesome and living really great lives with diabetes.

You rock.

We All Have Excuses

January 27th, 2011

Adults aren’t the only ones who have excuses for avoid exercise.  The following are the top five perceived barriers to physical activity in overweight and obese children.  Yes, CHILDREN. 

Do any of these sound familiar to you?

  1. Too much homework and not enough time for physical activity.
  2. Self-conscious about looks and body when doing physical activity.
  3. Don’t have anyone with whom to exercise.
  4. Feel too overweight to do physical activity.
  5. Chosen last for teams.

This is killing me; a kid has too much homework that they can’t get outside for a half hour and throw a ball or ride a bike?  Yikes.

The thing that really gets me is this: if you are too busy to take care of yourself by eating well and exercising when you are still growing… what kind of life do you think you’ll have when you’re older?  I expect (and current medical science agrees with me) that you’ll be spending all that time later in doctors’ offices and in hospitals.

Clearly I am not writing to the kids right now: I want to address parents and aunts and uncles and friends and teachers and church members who know these kids.  Maybe this isn’t the time to sit back for fear of offending someone (who is most likely just not sure what to do).

Maybe now is the time to do something.

Invite the kid to play catch in the yard, or to play Wii fit in the living room (no couches please).  Maybe this is the year they get the chore of mowing the grass or raking leaves.  Maybe this year the whole family goes skiing together instead of heading to the double feature.  Maybe this is the year you all join a gym and take a class on weight lifting or other group fitness.

Maybe this year their bike takes them to and from school instead of a car.  Maybe you put up a full-length mirror on the back of the bathroom door. 

You can certainly start by re-considering a “good” parking space to be one furthest from the entrance instead of closest.

The above excuses to avoid exercising and eating better to maintain a healthy weight are very simply off the mark.  Sure, it’s easy to excuse ourselves out of exercise.  But the payment for those excuses is often charged too late—when the physical damage is already done and arteries are hardening and insulin isn’t working as it should. 

The end goal is to live a healthy and vibrant life—not one that involves cholesterol medication before the age of twelve. 

I challenge you now: what are you going to do to help out a kid you know?

Pay Attention to What You Look Like As You Run

January 26th, 2011

I think most of us regular non-competitive runners probably have the same response to this one.  I think the response is something along the lines of “hey; I’m out there and I get the job done before I go home and take a shower.  You want me to care about how I LOOK while I’m running?!  You’re crazy.”

Let me clarify: I don’t care what you look like aesthetically, I care what your body looks like as you run.

I saw a lady last night on my way home after teaching bootcamp who I admit I’m not sure was jogging or power walking.  She was working, though, and had a pretty impressive gait. 

It just wasn’t really designed very well for what I presume she was trying to accomplish.

She swayed her hips so far left to right she looked like she was dancing.  It was actually pretty cool—I knew I’d have fun if we went out dancing together!

But she was expending a lot of energy in directions different than she intended by swaying side to side as she moved forward. 

If the straightest point from A to B is a straight line, it follows that any lateral movement would make that line literally wiggle.  A wiggly line is not the straightest point nor the most efficient or economical.

Paying attention to your form as you run tells you how efficiently you are running.  If we are all secretly lazy bums at heart, we care about efficiency!  (Why work harder than we have to if it won’t get us anything more?)

I know when I run I hunch my shoulders and widen my elbows as I get tired.  I know this because years ago I belonged to the Y where they had treadmills inches from the mirrors and I spent hours running into myself.  I paid attention.  (There wasn’t much else to do aside from watch Crazy Running Girl knock out several miles on her treadmill as she trained for Boston.  Little did I know I would soon be a lot like Crazy Running Girl myself!  But not as fast; maybe as crazy though.  Your call.)

So I know that in order to maximize my investment of my energy expenditure as I tire out, I need to tighten that up: elbows in, arms moving forward and back rather than side to side.  Relaxing and pulling my shoulders back and standing up straight with impeccable posture.  Opening my lungs to facilitate air flow. 

Ha; it all sounds sooo easy as I type.  Talk to me at mile 23.

(If you’re interested in what the experts say, check out Runner’s World: The Perfect Form.  It gives great pointers and things to think about.)

Food is Complicated (No Duh)

January 25th, 2011

Last week I had food poisoning.  While that itself was amazingly sucky, it was pretty cool for that first day when I couldn’t eat or drink.

You should have seen my blood glucose levels.

They were so steady!!!  I’m serious; I stayed between 85 and 105 for more than sixteen hours.


Of course, I went back to my typical swings once I started eating again and my digestive system recovered. 

Diabetes would be so much easier if I could make it through my day without eating.


See, there are so many aspects in the world fighting to complicate our lives with diabetes that removing a major one even for a few hours was pretty cool.  (And knowing how sick I really was, the fact I could be amazed as I was so sick should tell you how great it really was.)

I was continuing to read “Mindless Eating” today; Wansink discussed how our minds and stomachs don’t know how much we have eaten.  He said we look at external cues like “I cleaned the plate” rather than “that plate is twice as large as it needs to be”.  We can trick ourselves to over-consume by drinking out of a short wide glass instead of a tall skinny one.  Waiters who clear our empty bottles and dishes facilitate the same over-consumption of food.

Having diabetes and dealing with unknowingly over-consuming calories and carbohydrates is just part of our daily lives: we can’t help it even if we know all there is to know about the way food preparation and presentation can affect what we consume.  Sure, there are some tricks and tips we can all use to steer ourselves to healthier eating, but it will never be 100%; we’ll always have those times where we missed our carbohydrate counts by 20-30%.

Likewise, we’ll always have the unexpected delay in insulin absorption or medication metabolism.  I elect not to fight those unexpected highs or lows that blindside me—just like I can’t fight food poisoning all the time no matter how careful I am.  I do my best to anticipate them and I try to be as prepared as possible, but I can’t do it all 100% of the time.

Sometimes, life happens.  It’s part of the deal.  We just need to keep at it, and keep on keeping on.  Sure, some days that’s easier than others and other days we are flat on our backs knocked out by a bug.  Life is ups and downs just like our blood glucose levels.  

As great as I’m feeling this week compared to last, I know this is an upswing.  I’m riding it as long as I can and trying to enjoy every minute of it: I never know when the next wave will hit.  It’s not an anxious feeling for me—it’s acceptance.

Knowing in a new way now how much I am trying to manage when it comes to eating and how that affects my disease, I have a lot to accept. 

Good thing I get more practice with each meter reading!

Thank You Jack LaLanne!

January 24th, 2011

Nearly everything I do every day wouldn’t be like it is were it not for Jack LaLanne.

96 YEARS is a really long time to live.  It makes me smile to think about it!  Can you imagine??  Awesome.

Next, imagine CHANGING THE WORLD.  And smiling the entire way along that journey.

Now, combine those two.  That right there is a lucky man.

Thank you, Jack LaLanne!!

Imagine nearly everything I’ve blogged about exercise over the last 10 months stemming from major heartfelt efforts made by one man doing what he dedicated his life to: exercise for everyone.

Jack LaLanne was a truly special man.  He was so passionate and so dedicated and so vibrant we would all love to be just like him, I think.

He explained his exercise-generated enthusiasm years ago:  “…it’s a lifestyle, it’s something you do the rest of your life.  How long are you going to keep breathing? How long do you keep eating? You just do it.”

Thank you, Jack, for letting us share in your passion for LIFE.

Searching for Reasons

January 18th, 2011

I did an amazing thing the other night: I went to bed by 9pm.  It was so exciting!  (I wake up at 5 every day so this would mean I was about to get 8 hours of sleep.  So thrilling.)

Except then my insulin hit: 56 before my head hit the pillow.  So, okay, except that I had a zillion units of active insulin still coming down the pike. 

Instead of juice, I had a soda to counteract the onslaught. 

And, 15 minutes later, I’m 76.  Still with the active insulin pending.  So, I ate an entire sleeve of saltines.  Alright.

And then 20 minutes after that I was back to 64. 

Another Sprite.

So, the entire time I’m trying to sleep and not able to fall asleep and I’m drinking and eating and geez.  So completely NOT hungry, and two full-sugar sodas are just not good for any person ever.  I don’t get to sleep until eleven.  (Now I’m down to 6 hours if you are counting like I was.)

And I’m thinking: why do I not want to announce that this is what is going on when I’m yawning at my bootcampers in the morning?

I realized the answer lies in a very natural reaction: I knew that anyone I told would wonder and ask WHY.  It’s the most natural response, of course, and yet that’s a major cornerstone of living with diabetes: sometimes there isn’t a very good answer to WHY. 

I think once you can accept that there isn’t going to be a single reason to answer each blood glucose number or each random response or insulin reaction, you’re on your way to accepting your life with diabetes.  Yes, it’s annoying.  Yes, it’s frustrating.  Yes, all of those things we don’t like because they mean we aren’t in control. 

Of course, a lot of times there are great and very important reasons for figuring out WHY: to avoid a future needless high or low, to avoid repeating dangerous patterns, to help us actually get enough sleep, to simply feel like we are living more normal or predictable lives.

But really, we aren’t living normal or predictable lives.  We always need to keep watch over ourselves and our physical needs.  With that, each day, we do our best and we have to be okay with that being enough.

I think that on the whole, we are all doing a durn fine job, thank you very much, dealing with all of the expectations and explanations that are a part of living with diabetes.  And if today or this week isn’t your greatest week, that’s okay.  Do your best and forgive yourself.  You deserve it. 

Every day.

(To address this for some of the more analytical and engineering types: there were about five or six things I believe all contributed simultaneously to my lows last night.  They aren’t worth listing, but it isn’t that I haven’t asked myself the question.)

Please ignore those little graphs

January 14th, 2011

News flash: Men and women have different bodies! 

Just kidding.  Or am I?  Did you realize that almost all data used in calculating those numbers and little colored graphs pasted on nearly every treadmill, stair climber, stationery bike, and elliptical in gyms across the land about maximum heart rates (HRmax) has been data on male subjects.  Same with calorie counts on those machines… !!

Finally someone thought to study FEMALE subjects to come up with more accurate data for us about our maximum heart rates.  Now, I learned a couple things when reading about this study: (1) I learned that the American Heart Association publishes a medical journal entitled CIRCULATION- love that- and (2) I learned that the belief most trainers have shared for years has scientific merit.  (I love that too.)

I took a class a few years ago about maximum heart rate.  Basically I learned at that class that age-related slowing of heart rate is NOT a natural law: it’s more a factor of deconditioning, not of age.  (Ever since I have been curious to see what my friend’s 70-year-old triathlete mom’s heart rate is and compare hers to mine.)  Clearly, that class knocked the age factor on the little colored graph out for me. 

But this study did something with gender, too, and that I think is information worth sharing.

The study found that the widely used recommendations (that the class I took destroyed with facts and data) for a woman’s maximum heart rate is in fact higher than necessary

     You’ve seen or heard of the formula the graphs use:

               220- age = HRmax

     Well, this study said in fact that for asymptomatic women, the formula should instead be:

               206- (age x 0.88) = HRmax

For me this means that the older male-based formula would say my HRmax is 220-33 = 187, yet the newer female-based formula says my HRmax is really 206 – (33 x 0.88) = 177.

(If you’ve ever hit either of those heart rates you know this is a BIG DIFFERENCE.)

 But then there’s that darn reality again: my HRmax is much higher than 177… or 187… and I haven’t keeled over with a heart that maxed out. 

So the moral of the story is that one’s Maximum Heart Rate is very individual, the entire idea of a maximum rate is conceptual rather than literal (how do you ever exceed your maximum?  Don’t you just get a new maximum?), and those little graphs mean very very little.  Very little.

Go by how YOU feel when YOU are exercising, or invest in a heart rate monitor to tell you what rate you are at, but only if you want to train in certain heart rate zones for specific training.  (The vast majority of heart rate monitors and calorie machines that tell you calories burned are a massive crock, too.)  

Your own awareness of your breathing, energy and exertion level is a far better indicator for you than almost anything else. 

Better yet, your awareness works when you get off the machines and head outside instead!

Is Diabetes Really Your Reason?

January 13th, 2011

Do you ever use your diabetes as an excuse to get out of doing something?   

It sounds dorky and pious, but I used it as an easy excuse to get out of drinking alcohol in high school and college.  (It meant I didn’t have to tell my friends I wasn’t interested in being as stupid as they were when they got drunk.  And I didn’t have to deal with my parents learning I ever drank.)

I know several people who have used their diabetes to skip lines at amusement parks.  I myself love that I always have an excuse to have food with me at places where no food is allowed… even if I’m not low and don’t need the food. 

I’m not talking about necessary reasons to avoid going to work or school if you are in DKA or need to do something for your health; I’m talking about knowing you actually can do something you’re supposed to do, and using diabetes as an excuse to avoid doing it because you simply don’t want to do whatever it is.

Those are the excuses I’m talking about.

I think we’re lucky that life with either type of diabetes doesn’t mean life in a hospital or a life with restrictions.  Yes, we need to pay super attention to things few others need to pay any attention to whatsoever.  Sure, it’s a difficult and draining thing to live day in and day out and watch every morsel of food and calculate and guess and be wrong much more often than we feel right…

… but it isn’t like our daily lives require us to avoid stairs or that we need help breathing.

I think other people living with other diseases and other physical limitations have it tough, too.  Like I always say, my diabetes is a thing… and we all have things. Some have a tortuous childhood, some have a missing limb, some have an incurable infection.  We all have things.

I will never forget the man in front of me at my first marathon who ran that dang thing on one leg.  I mean, who am I to complain I had to stop to check my blood sugar when this guy has one leg running twice the distance either of mine ran.  Sheesh.

People do some amazing things.  I use their words about excuses and limits to put some perspective on my life with diabetes:

I never want to hear that I have limits; I want to push the envelope every day.”  – Brian Boyle, a 2004 car accident victim who was in a coma for 2 months with a narrow chance of surviving.  He had to relearn how to talk and walk… and who now succeeds at Ironman competitions.

“Setting goals… helps when your life has been turned around twice.  It’s kept me out of the pity pit.–Nick Roumonada, a man who lost his leg to bacterial meningitis at age 13 and who at age 31 developed focal dystonia which impairs motor skills.  He manages his symptoms with running and marathon training.

 “…I worried about falling [as I ran the 2008 New York City marathon with 2 guides].  But I’m glad I did it.  I need to keep moving forward.” –Yuki Goto, a man who was in a 2006 car crash that left him with traumatic brain injury.  He still suffers from seizures, poor balance and double vision.

These are some amazing folks.  I think one of the most amazing things about each of them is that they probably don’t think they are very amazing at all!

Have a great day out there.  Don’t let anything hold you back!

It’s So Emotional

January 12th, 2011

Yesterday I went to see my diabetes doctor.  (I somehow like that term better than “endocrinologist.” I like the alliteration!)  I’ve been a mess for the past few days because I knew I was going to see her.  I was a mess driving over to her office.  I was a mess sitting in the room waiting for her.

As I sat in the room I could hear a man in a nearby room speaking to another doctor.  (He was speaking dramatically louder than “classroom voice” so it isn’t like the walls are thin.)  He had a woman with him, perhaps his wife, and I could hear her nervous laughter as he spoke to the healthcare provider.  He spoke of boluses and blood pressure and over-corrections and all sorts of pump- and diabetes-related topics.

My anxiety levels skyrocketed as I listened to him speak. 

He didn’t seem normal.

He seemed incredibly anxious.

I recognized it from my own doctor visits and my own emotions just this week.

I don’t know what it is, but the visits I have had with my diabetes doctors have always felt emotionally superchargedI’ve observed it in many other people living with diabetes, too.

I can’t figure it out: the good medical providers are there solely to help.  They want us to be as healthy as possible, and they want to support us in our efforts to achieve the same. 

So what’s the deal?

The only reason I’ve been able to come up with this afternoon is that perhaps we feel like we don’t need to explain anything about the disease to these medical experts: we expect they know all of the intricacies and daily difficulties of living with the disease.  We expect they will be able to understand our difficulties better than a layperson.  Maybe they are the only ones we feel comfortable will listen.

Or maybe we do our best every day and it still doesn’t feel like we’re doing enough.  Maybe we assume our medical professionals think we should be doing more, or better, or smarter work with our disease.  Maybe we doubt ourselves because we know, if we just said “no” to that cookie or took our medication at a different time that day or if we had just managed our holiday stress a little better we would be healthier and we wouldn’t need to be sitting with a medical professional.

It sounds so illogical when it’s written, doesn’t it?

Yet it’s that dang double-edged sword again: telling someone they have the power to keep their diabetes under control often results in that person feeling like a failure when it doesn’t stay there.

I know my doctor kindly teased me I’m trying to be a perfectionist, and that is certainly true (although I told her I’m just MOTIVATED).   I’m sure I’m being less than logical when my anxiety creeps in and I think “I should be able to do my diabetes better.”  I do my best all the time!  And my body does amazing things in response, and I don’t have much to complain about when it comes to my diabetes.

But because living with diabetes is so constant there isn’t a good way to separate all emotion from management.  Minimizing the emotions by recognizing all blood glucose readings are simply “data” from which to make educated decisions and do not carry any judgment with them at all is a major step in the right direction—a direction we would all benefit from taking. 

We all need to remind ourselves that our best is enough, and the right medical professionals aren’t judging our efforts.  The good ones are in fact trying to provide additional tools we can use to make our lives easier and healthier.  Maybe they’ve got some tricks up their sleeves they want to share.

I fortunately think my doctor is doing exactly that, if I’d just stop with my own stuff and listen.

I bet that guy in the other room could say the same.  I hope, for his sake, that he can.