Brekkie

Diabetes Blog Week Banner

I intended to post this last Friday for Day 5 of (the now past) Diabetes Blog Week, but life got in the way.

“Write a post documenting what you eat in a day! Feel free to add links to recommended recipes/shops/whatever. Make it an ideal day or a come-as-you-are day – no judgments either way.”

Last Friday I did my typical #FridayLongSwim at the pool. All of these workouts are at least 3,000 yards, and many of them are just endurance swims without any real structure except swimming continuously. I figure—if nothing else—I’m building mental fortitude for the Ironman swim. Friday’s swim was 4,525 yards long (4,138 meters), and I was powerful hungry by the time I got to work. (I almost ate my lunch on the drive there.)

Mmm... Breakfast

Mmm… food. Lunch (seen below) was a little more sedate, and dinner was spaghetti with sauce. There might have been ice cream.

Mmm... Lunch

Posted in Diabetes, Diabetes Blog Week | Leave a comment

Deferents and Epicycles

Diabetes Blog Week Banner

Hey, we’re halfway through Diabetes Blog Week 2015! So far so good. I’ve been doing my best to write to the prompts this year, but I think I’ve taken a few liberties. Anyway, I think I stuck close today.

“Today let’s talk about changes, in one of two ways. Either tell us what you’d most like to see change about diabetes, in any way. This can be management tools, devices, medications, people’s perceptions, your own feelings – anything at all that you feel could use changing. OR reflect back on some changes you or your loved one has seen or been through since being diagnosed with diabetes. Were they expected or did they surprise you?”

I’ve been doing triathlon for five seasons now. Tri training is all about cycles. There are two big cycles that last many months: the training/racing season and the off-season. During the main training season from March to September, there are smaller cycles of 3-4 weeks. These build and then have a recovery week. And each week is a kind of cycle, too, with hard and easy days, peaking on the weekend. The “off-season” is really a misnomer, since I still do about 7-10 hours of exercise per week; it’s just unstructured and fun.

Each of these cycles requires a change in how I manage my diabetes. The harder I train, the more insulin-sensitive I become and less I have to dose. And the more I train, the more I eat, which means more insulin . . . but not too much, of course. Saturdays and Sundays are my long run and ride days, and I’m most insulin-sensitive on those days and Monday, too . . . even though it’s my rest day. On recovery weeks, the 25-30% reduction in my training volume really shows up in increased insulin needs.

Add to this another pair of cycles related to insulin. Every three days I change my infusion set and insulin reservoir. I’ve noticed that the insulin loses a bit of its potency by the last day. (I’ve heard various reasons: insulin starts to stick to the tubing; the tissue around the infusion set changes; the insulin in the reservoir gets a little warm and less potent; etc.) Insulin definitely works best when the vial is new, and sometimes it almost seems not to work very well at all by the time the bottle is empty.

Finally, I swear that my body has its own cycle with the occasional week when—all other things being equal—I’m extra insulin resistant. Maybe it’s the accumulation of training stress. Maybe it’s hormones. Maybe it’s just the psychological pendulum swing that happens when I have several bouts of low blood sugar, which leads me to be more conservative with my insulin, which leads to higher blood sugar and the need for a little more courage and insulin. Who can say?

Being an athlete with diabetes—just having diabetes, actually—definitely requires a lot of flexibility and adapting to changes.


For an explanation of this post’s title, see the animation on this page.

Posted in Diabetes, Diabetes Blog Week, Reluctant Triathlete | 1 Comment

Swim Selfie

Last month, someone from my college sent me a little gift in the mail. It happened to arrive the same day as some new goggles.

Excellent mail day

Naturally, I had to thank her with a picture of me making the most of it:

In the pool

Enjoy your Thursday!

Posted in I am Rembrandt, Swimming | Leave a comment

In the Cupboard

Diabetes Blog Week Banner

Here we go: day 3 of Diabetes Blog Week.

“Yesterday we kept stuff in, so today let’s clear stuff out. What is in your diabetic closet that needs to be cleaned out? This can be an actual physical belonging, or it can be something you’re mentally or emotionally hanging on to. Why are you keeping it and why do you need to get rid of it?”

Last April, I posted some pictures of all my diabetes stuff. One of those photos still seems like the most appropriate response to today’s prompt.

All of the diabetes stuff

Since I took that picture, I got rid of some of the stuff I knew I wouldn’t need. But it’s tricky because with diabetes you never know. So now my diabetes cupboard looks like this:

My Diabetes Cupboard

What’s in yours?

Posted in Diabetes, Diabetes Blog Week | 1 Comment

Impromptu Masters’ Swim Workout

Last week I posed my tri-peep Alex this riddle: “Guess what we call Mondays, Wednesdays, and Fridays in the Mather house.”

Alex thought about it for a moment and said, “I dunno. What?”

“Bath day!”

She feigned horror and then laughed before starting the next set of her swim.


Usually Alex and I spend our Bath Day mornings swimming near each other but not actually with each other. This is the way things work at my pool: Everyone shows up, stakes a claim to part of a lane, and then swims his or her own workouts. Usually there’s a single lane divider in place to create a very isolated section for some of the oldest/slowest swimmers, but for the rest of us, it’s the Wild West. Pool Guy is fond of saying that if we all would just circle swim, he could easily accommodate twice as many of us; it never works out that way, though, when he tries to make it happen. Mostly because we’re all doing something different and going at different paces. This chaos is nothing like a typical masters’ swim workout. It’s pure anarchy three times a week.

When the pool is not crowded, it’s no big deal. Six lanes with one person on each side of the black lane line means that twelve people fit comfortably into the pool. Some people tend to swing a bit wide, especially when they’re doing the backstroke. You just figure out whom you want to swim near and/or avoid when picking your spot, and it all works out. People finish their swims and leave, and new people show up, taking their place. Occasionally we shuffle around a bit when space gets tight, but usually it’s just switching from one side of the lane to the other.

This morning everything was Tutli-Putli (as Lisa and I say). There just wasn’t enough space for the two high school swimmers who wanted to swim together. After finishing my warm-up and watching them hesitate for a few minutes and eventually sit down on the pool deck to wait for someone to leave, I scooted over to where Alex was catching her breath.

We decided it would be nice to circle swim so that the girls could get some time in the water, too. Our only difficulty was deciding on a workout, since circle swimming more-or-less requires that we coordinate our laps. I needed about 2,800-3,000 yards today, and Alex’s plan sounded flexible so we went with this:

  • 500 yards as 25, 50, 75, 100, 100, 75, 50, and 25 yard segments, each with 15 seconds rest
  • 300 yards pulling with buoy and ankle strap
  • Repeat

Alex pushed off first, and I waited for her to get 2/3 of the way down the pool before starting so that we would have some separation. Then I proceeded to chase her for 500 yards. We’re pretty equal in speed—she’s a bit faster at the lake, but I’m quicker off the walls—and we ended about as we started. For the pull set, we decided to each stick to one side of the lane line, since this would make turning easier for us both. For this set, we started at almost the same time so it was a bit like a race, each of us trying to keep up with the other; she would catch me about halfway down the lane after my fast turn, and I would work to keep up with her the rest of the way. (One lane over I could see the high school girls making us both look super pokey.)

This impromptu masters’ swim workout was great! The 1,600 yards passed quickly, and I felt I pushed myself a little harder than usual. When we finished the second set, Alex hopped out, and I swam another 500 straight through to round out my morning. Before she left, we decided to do more of these workouts in the coming months.

Happy Bath Day!

Posted in Swimming | Leave a comment

A Secret Is Something You Tell Another Person

Diabetes Blog Week Banner

On today’s installment of 2015 Diabetes Blog Week, we talk about secrets.

“Many of us share lots of aspects of our diabetes lives online for the world to see. What are some of the aspects of diabetes that you choose to keep private from the internet? Or from your family and friends? Why is it important to keep it to yourself?”

I don’t really have a lot of diabetes secrets, but I do downplay some things or keep them within a small group of people (usually other people with diabetes).

The nature of diabetes is that we’re usually not too sick to do all the same things that people without it do, and then it can totally knock us down. Often people fixate on one aspect or the other. Some expect only the best out of us, based on the awesome things we do, and are surprised to find out that we have high BG readings or the occasional debilitating hypo or undesirable A1c results. Because we’re doing things, we seem to have everything “under control,” and it’s mentally disorienting that we can easily switch from high to low. Others latch onto the variability and wonder how we can go out and do stuff at all.

“What does this have to do with secrets or sharing?” you might ask.

When people ask me how my diabetes is going, I wonder what kind of answer they expect to hear or what new thing I can say about it. My diabetes doesn’t change very much. I still go high after breakfast and slide into lunch on the lower side. I can still more-or-less get my blood sugar to do what I want when I exercise in the morning. I still drop more than I want when I exercise in the afternoon. I still haven’t figured out what I need to do have good diabetes mojo when I race. My A1c is higher than I would like, despite my efforts. My diabetes isn’t what I would like it to be, but it has a sort of predictability that I appreciate.

Honestly, I’m not sure this is what people want to hear when they ask about my diabetes. I suppose I could say what I just wrote, but I’m not that articulate most of the time. Or perhaps I should ask them what they want to know. But mostly I just keep my diabetes to myself.

Posted in Diabetes, Diabetes Blog Week | Leave a comment

NE Season Opener 2015 Pictures

The always awesome Lisa took these pictures at the NE Season Opener triathlon on Sunday. Click on any of them for a larger version. Aren’t they great?

Posted in Cycling, I am Rembrandt, Reluctant Triathlete, Running, Swimming | 2 Comments

If You’re Here, You’re Awesome.

Diabetes Blog Week Banner

Hey, hey! It’s Diabetes Blog Week again. Last year I missed it, but I’m going to try my best this year.

“Lets kick things off this year by looking at the positive side of our lives with diabetes. What have you or your loved one accomplished, despite having diabetes, that you weren’t sure you could? Or what have you done that you’ve been particularly proud of? Or what good thing has diabetes brought into your life?”

This afternoon I went to the bike shop a few blocks away from my office for them to look at my handlebars. My hope is that the little bit of adjustment they did—along with the grippy paste they put where the handlebars meet the stem—will do the trick for a few more years.

In the repair section of the shop, they have a sign I love. It says, “If you’re here, you’re awesome.”

That’s pretty much how I feel about the diabetes online community: If you’re here, you’re awesome. And you’re the best thing about diabetes. I’ve met so many great people, had so many wonderful conversations, and generally just enjoyed myself in your company.

Tomorrow I’ll try to be a little less mushy.

Posted in Diabetes, Diabetes Blog Week | 2 Comments

Warmer than Expected – NE Season Opener 2015

Sunday, I did my first triathlon of the season. In fact, it was my first race of the year since the biathlon in March.

Because it was so short—1/3 mile swim, 10 mile bike, and 5K run—it was a pretty chill race for me. And that’s good, because, all things considered, if I’d put a lot of mental energy into it, I would probably have been disappointed. :-)

After the longest winter and latest spring ever, the last 10 days or so have been ridiculously warm and beautiful, which warmed the water up 8-10 degrees in a week… all the way up to 61°F (16°C). This morning’s air temperatures were in the 70s, and we were all sweltering in our wetsuits while waiting for our chance to enter the water.

I had a really good time in the swim (8:12, or about 1:35/100 yards) and it probably could have been a bit faster if I’d swum a little straighter and tried harder to draft. I didn’t really feel super-competitive today and was more interested in just having a good time. Also I wasn’t feeling very well. (The reason why will become obvious later.)

I headed out for the bike with the early part of my wave—after being cheered on by my sometimes training partner Katrina, who was volunteering at the bike mount line—and was making good progress through the field. My heart rate stayed high, as I never really tried hard to settle into a long-distance pace. Even though I was out to have fun, I still wanted to race as fast as I could. I love it when I feel like I can do both. The winter was not kind to the roads, which had a large number of potholes and patches that needed repaving. I missed most but managed to hit a softball sized divot squarely while (fortunately) slowing for a turn midway through the ride. This caused my handlebars to wrench downward to the point where it would not be safe to ride my bike at all. I pulled onto the sidewalk just around the corner, got out my multitool, adjusted the handlebars, and was back on my way, having lost about a minute and a half back to all of the people I had just passed. I finished the hilly course in a respectable 33 minutes.

(Loud Guy, who last year accused me and a fellow rider of drafting, was there again this year and within the first two miles was already having loud, angry words about drafting with someone passing him as they both went by me. What a clown! I thought about him a few miles later when it was pretty obvious that someone was sucking my wheel. After a few checks behind me, I gently suggested, “If you’re going to pass, now is a good time,” and that was all it took to get him to fall back. See, Loud Guy? That’s how you do it.)

Before the race I had told Lisa that I really like the Season Opener run course because it’s hilly and hard and partly off-road. It can be totally demoralizing. Other people I’ve talked to don’t like it, but that just makes it better for me. As I ran out of transition, I was beginning to wonder if I was going to like or dislike this year’s run. I was feeling sluggish and tired and hot. I was, however, steadily picking off people on the uphills and the flats and blitzing the downhills.

It wasn’t my fastest time ever, but it got the job done at 1:09:21 for 8th out of 24 in my age group and 126th out of 370 overall. (I would have jumped up about 20 spots without stopping for the repair on the bike or needing to call a volunteer over in T2 to rack someone’s bicycle which had fallen into my space.) My blood sugar picked up right where it left off last tri season, going very high during the bike and run. The 411 mg/dL (22.8 mmol/L) that I saw afterward explains a lot of the unpleasant/blah feelings and lethargy of the race. This is (frustratingly) different than what happens when I swim or ride my bike or run when it’s not part of a race. Clearly I have some things to figure out and try out in the races leading up to Ironman Wisconsin. Hopefully I’ll get there.

Mechanical issues, bad diabetes mojo, and transition shenanigans notwithstanding, I had fun. I love racing, and I love that Lisa comes out to support me. She’s a sweet girl. She wore her bright orange “Team Jeff” T-shirt, and I took the opportunity to ham it up for her camera a bit. (This is how I know I could have raced harder if I’d wanted to.)

This morning I was back at the pool, with my second recovery week behind me and only 18 more weeks until the Ironman. Tomorrow I will post some of Lisa’s pictures.

Posted in Cycling, Diabetes, Reluctant Triathlete, Running, Swimming | Leave a comment

Recovery

It’s hard to believe, but week 8 of Ironman training is upon me. Hard to believe because eight weeks means I’m almost 1/3 of the way through the training plan. It’s also hard to believe because the last recovery week (#4) seemed like forever ago. I’m not yet at the “tired all the time” stage, but I feel it getting closer.

I was reading triathlon coach Joe Friel’s blog entry about supercompensation and recovery this morning while eating my breakfast (first breakfast, actually). It seemed especially relevant to my upcoming week.

[It’s] during these easy days when the body actually becomes more fit. That’s because a high-dose workout only produces the potential for fitness. It’s realized in the subsequent low-dose (“easy”) day, which may be either a day off from exercise or a short and low-intensity session. This process of alternating stress and rest is necessary to become more fit. . . .

The bottom line is that if your workout is hard enough to produce fatigue then you must include a recovery (“adaptation”) day soon thereafter. Otherwise, there’s no reason to do hard workouts. Strenuous exercise without recovery is play, not training.

Posted in Reluctant Triathlete | Leave a comment

March and April Round-up

I workout. A lot. It seems to have become what I do.

It all started in 2009 when I started cycling and running again. And then it really ramped up when I started doing triathlons. Now, with Ironman training, I’m working out as many times as before, they just take longer. My Ironman plan started on March 16th, and I’m now finishing week 7. (Next week is a recovery week, and I’m really happy about that!)

At the end of February I recapped the first two months of fitnessy fun. For those keeping score at home, here are the details for March and April.

March — 36 workouts

  • Swim: 10 times, 8:13 (One of those was merely five minutes long because the fire alarm went off. Exciting!)
  • Bike: 4 times, 5:43 (One of these rides was outside! Of course, I forgot to wear my helmet over my balaclava . . .)
  • Run: 13 times, 10:48 (About half were outside.)
  • XC Skiing: 4 times, 3:48 (All of those happened in the first 8 days of the month, including a biathlon!)
  • Strength: 5 times

April — 38 workouts

  • Swim: 11 times, 10:58
  • Bike: 6 times, 13:29 (All outside!)
  • Run: 13 times, 11:56 (Includes one run to the store to buy sausage for dinner.)
  • XC Skiing: None. (Sad face. Part of me wants to get roller skis, but that would mean less running?)
  • Strength: 8 times
Posted in Cycling, Reluctant Triathlete, Running, Skiing, Swimming | Leave a comment

Reading: Machine Learning and Diabetes

Currently reading:

Posted in Data-betes, Diabetes | Leave a comment

Boston Marathon 2015

Monday was the Boston Marathon, and for the first time I was at the finish line in Boston.

My cousin from Wisconsin qualified for Boston and stayed at our house on marathon weekend. Sunday, we all went to the expo—which was huge—before taking a short tour of the Back Bay and Boston Common. It was a beautiful day. Monday—race day—was cool, windy, and intermittently rainy . . . not exactly the weather we had hoped for.

Lisa and I dropped my cousin in Hopkinton and then headed to Heartbreak Hill in Newton where we watched all of the leaders go through mile 21. Some college classmates were manning the water station at the top of the hill, and it was a great place to watch the race. We then took the T and headed into the madness that is the finish. It took us forever to meet up with my cold shivering cousin, who did really well, especially considering the conditions: 3:40.

Here are some photographs from the weekend!

Posted in Photography, Running | Leave a comment

The Scientific Method – Part 1

Diabetes data


My little notebook of diabetes and exercise details is turning out to be really helpful. (My own diabetes software tools have been invaluable at aggregating all of the information and helping me retrospectively look at it.) Tuesday night I gathered all of the data I had written down about my diabetes and swimming. Here it is.

2014-12-03 AM: 0.0u IOB -   0g        -  1:03 -->  -3 mg/dL (outlier?)
2014-12-05 AM: 0.0u IOB -   8g @-0:10 -  0:58 -->  -9 mg/dL
2014-12-30 AM: 0.0u IOB -  26g @-0:20 -  0:44 --> +52 mg/dL (Easy day)
2015-02-11 AM: 0.0u IOB -   0g        -  1:00 --> -65 mg/dL
2015-02-13 AM: 0.0u IOB -  41g @-0:20 -  0:24 --> -30 mg/dL (outlier?)
2015-04-06 AM: 0.3u IOB -   0g        -  0:30 --> -62 mg/dL
2015-04-08 AM: 0.3u IOB -  25g @-0:15 -  0:58 --> +11 mg/dL 
2015-04-10 AM: 0.3u IOB -   0g        -  1:01 --> -76 mg/dL
2015-04-13 AM: 0.0u IOB -   0g        -  1:07 --> -66 mg/dL

I noticed a trend and made this hypothesis: “If I don’t eat and have no insulin on board (IOB), then my blood glucose seems to drop about 1 mg/dL for each minute I swim.” Along with this related hypothesis: “If I eat about 20-25g of carbohydrate, I go up just slightly when I swim for an hour.” I resolved to test one of these based on what the morning presented.

After an otherwise very stable night of blood sugars in the low 100s, I woke with a 172 mg/dL on my meter. “Time to check the ’1 mg/dL/minute without food’ hypothesis, ” I thought. I swam for 1:04. The workout was fairly tough: 2,800 yards total with a main set of 4×500 yards, descending in time with each 500. On the last one I was supposed to hold my “best 300″ pace for the full 500 yards. I didn’t quite make it. Like I said, it was a tough one. Oh well.

My BG at the end of the hour-long swim was 110 mg/dL. Over 64 minutes of swimming, my BG fell 62 mg/dL. Sounds like more evidence in support of the hypothesis! :-)

Before my run on Wednesday afternoon I decided to try another experiment (n=1) based on my results when I run.

2014-10-05 AM: 0.0u IOB -  20g @+0:22 -   65% basal @-0:20 -  0:48 --> +10 mg/dL
2014-12-04 AM: 0.0u IOB -   0g        -  100% basal        -  0:52 --> -15 mg/dL
2015-02-14 AM: 0.0u IOB -  25g @-2:00 -   60% basal @-2:00 -  0:36 --> -95 mg/dL
2015-04-03 AM: 0.0u IOB -  25g @-0:30 -  100% basal        -  0:34 --> +40 mg/dL
2015-04-07 PM: 0.2u IOB -   0g        -   60% basal @-2:15 -  0:45 --> -16 mg/dL
2015-04-09 PM: 0.3u IOB -   0g        -   60% basal @-2:15 -  0:30 --> -18 mg/dL
2015-04-11 AM: 0.0u IOB -   0g        -  100% basal        -  1:00 --> -28 mg/dL

I hoped that if I ran about 45 minutes in the afternoon with a tiny bit of active insulin but no food, I wouldn’t see much of of drop. Unfortunately, that’s not how it turned out:

2015-04-15 PM: 0.4u IOB -  0g -  60% basal @-1:45 -  0:51 --> -106 mg/dL

Oh, well. More data.

Posted in Data-betes, Diabetes, Running, Swimming | Leave a comment

Boston Strong

The 2015 Boston Marathon starts in exactly five days as I post this dispatch. My cousin is running it, and Lisa and I will be watching it together for the first time and for the first time near the finish in Boston.

Like every year, I’m very excited to watch the race and to be part of the day. Today, I’ve also been rather sad, thinking about what happened on this day two years ago. An online friend wrote about her experience running the 2013 marathon, which reminded me of what that day was like, and it’s been hitting me harder than I would have expected.

This afternoon I’m doing a rare after-work run from the office, and I think I’ll head down to Route 135 and run part of the marathon course. #BostonStrong

Posted in Running, This is who we are | Leave a comment