I’m reserving judgment about Des Moines until tomorrow. I’ll just say this: Usually when I think of Des Moines, I’m happy . . . because I’m not there.
But so far so good. I had a fun evening today with Kelly Rawlings and her son in Des Moines. The city is starting to seem a bit more urbane and less like all of the rest of Iowa writ large. But then again, I was in the newly hip part of town and not the frequently methed out part.
Let’s see what happens tomorrow.
I have been listening to a lot of “Fresh Air” podcasts over the last couple days. I stopped listening to nonmusical podcasts at work a while ago, and I’ve really fallen behind with my subscriptions. I’ve been catching up as I put a lot of miles on the rental car and a bunch of hours on the iPod.
I like a road trip. I like going somewhere, seeing new places and things, and being with people I know and like. Sadly, Lisa isn’t with me on this trip, so I’m getting all my conversation via “Fresh Air” in the hours between when I’m with my family and diabetes peeps.
Today was a short driving day, starting with a half-hour trip to see my brother. We hadn’t seen each other in a few years. It wasn’t a particularly easy visit, but it was good to finally catch up.
After that I got back in the car and followed the easiest Google Maps directions of all time. “Go west on Hwy 2 for about 2 hours and then turn left and right and left and you’re there.” Or something like that.
What followed was a fun afternoon and evening with Kim, Aaron, and Billy the corgi, involving food, ice cream, conversation, gossip, and barking. Now we’re relaxing and watching cartoons animated features on television while Kim weaves her Texting My Pancreas magic.
Tomorrow I’m going to see my mom and even more of my relatives. That’s worth at least five more hours of NPR interviews.
I’m ready for a ride. I packed the bike last Thursday after a fast interval session, and I’ve been thinking about it ever since. Most of that is just the general desire to go for a ride, but a bit is because I’ve been trying to figure out where I was going to get a torque wrench to put it all back together again after my flight to Minnesota on Saturday. And then, once I picked it up from the enormous REI store in Bloomington (which I had called to hold one for me) I started wondering where I was going to get the hex drivers for my new wrench.
Fortunately, Scott Johnson, everyone’s favorite diabetic hugger, suggested that we look at the Sears at the Mall of America. (Voilà, all set.) We were at The Mall to meet a bunch of his local Minneapolis peeps with diabetes. I met a bunch of fun people, and I think we all had a great time. Scott’s a great guy with a great family, and I’m so thankful that he kept me entertained between the time that I arrived yesterday and when I left for Iowa today. Thanks again, Scott.
I’ll be in Iowa for most of the next week visiting my family and some more diabetes peeps before the Twin Cities Tour de Cure ride next Saturday. Today, I spent time with my father’s side of the family, most of whom I hadn’t seen in three years. Tomorrow, after a short ride in the morning, I’m going to visit my brother.
It’s strange being back in Iowa, a place that I feel I should like more than I do. I was born here. It’s where I passed the first fifteen years of my life and where much of my family still lives. It’s also—most importantly—the place where I went to college and met Lisa. And it’s pretty . . . in a very Grant Wood kinda way.
Until next time, here are some pictures.
Today I rode 87 miles from my house to the top of Mount Wachusett and back. I’ve done this ride a couple times before. Well, not exactly this particular route but something similar, each one just a little different.
I’ve been yearning to do this ride for quite a while. Recently, I had been building up distance on Speed Junkie and then following that up with a shortish ride on my road bike, cobbling together 45, 55, and then 65 miles before taking a week off for the triathlon. I love going fast on my new bike, but I enjoy a good destination ride even more. Now that the triathlon is over and the century is less than two weeks away, it was time to get some good distance in the legs and see how they feel.
They felt pretty good. 100 miles should be totally doable, although maybe not at today’s crazy pace. I hadn’t meant to ride this fast—not that it was super-fast—and by the time I was home I was wicked tired.
Let me back up. I left the house around 6:45, headed northward over the rolling hills, and averaged about 16.5 mph. Then I got to the mountain.
I went slow. It was my plan. Technically, it was my recovery week, and I didn’t want to overdo it, so I sat in—well, if there were a pack I would have “sat in”—geared down and just took it easy. And then I heard the telltale signs of someone coming up behind me . . . on a bike. He didn’t seem in any rush to pass me, and I didn’t feel any particular need to look back and see the inevitable. Eventually, he pulled even, we chatted briefly through the pain, and then he finally passed me on the last, final kick to the top.
Turns out, the guy (Scott) lives one town over from me, so we decided to ride back together. Since he passed me on an uphill, I let him know that I might be a bit slower than him and that it’s no big deal if he needed to drop me and get on with the rest of his ride. He said not to worry.
So we bombed down the mountain road (which is still closed to traffic until next Saturday) occasionally hitting speeds in excess of 45 mph and headed south and east. I was testing my blood sugar at the summit when we made our introductions, so we talked (when the road was wide and had a shoulder) about diabetes and his celiac diagnosis last decade and how chronic illnesses suck. When the road was narrower or busy, I did my best to pull, but mostly I drafted. Well, that is until I started getting dropped. The guy was nice enough to periodically slow a bit and let me catch up, but I started to fade after the 70th mile. My plan to have an easy trip home turned into me gritting my teeth and having a two-hour tempo ride, as I tried to hold his wheel, lost it, and then cranked to get back to him. Oh well.
Five miles from home, we exchanged phone numbers and said that we should go for a ride sometime. Maybe next time I’ll be in a little bit better form.
Until then, I have a century to ride with Scully and Heather and Scottie J—which I plan on doing at a more reasonable pace—and a training plan that I’m going to stick to more closely . . . well, except for the century.
Here it is: the last day of this year’s Diabetes Blog Week. It’s been a good selection of topics, and I’ve enjoyed reading everyone’s posts. Today, we talk about heroes.
I’m going to confess that I don’t really have any heroes. Some people do fantastic things that need to be shouted from the rooftops, and there are nonprofit groups and NGOs who do the amazing, selfless work that’s the traditional domain of heroes. But being a “hero” is a big ask for anyone.
With that caveat, I’ll say this: I really admire all the athletes of Team Type 1 and the idea behind the team. The cyclists, runners, and triathletes—some of whom are among my very best friends—are such inspirations. They show that it’s possible to do the same amazing feats of athletic derring-do with diabetes that people without it can do. After I learned about them, I bought one of their (older) jerseys, and I wear it often to represent for my peeps.
In my heart, I want to be one of them.
Today in Diabetes Blog Week is snapshot day. Last year I had a lot of fun with this when I was in DC. This year, I’m being a little more traditional.
Friends, I have been having the worst period of prolonged high blood glucose that I can remember. All the “rules” are wrong; nothing is working the way it should. Basal rate, bolus ratios, the effects of exercise—they’re all messed up. There could be any number of reasons: ineffective infusion set locations, lower training volume or intensity than before, no longer being overtrained and in glycogen debt, different eating choices, bad insulin, etc. Who knows? The result is that last night my 7-day average of all readings was 199 mg/dL (11 mmol/L). I don’t think it’s been this high since I was discharged from the hospital when I was diagnosed.
I’m working on figuring everything out again, almost from scratch. These snapshots are all from today, which was full of a lot of things that lowered (and occasionally raised) my blood sugar.
(You can click on any picture for a larger version.)
Today started with a interval workout on the track that actually raised my blood sugar. I’ve been using a foam roller to help keep my IT band in check, since it’s starting to feel a little injured.
After my run, a little stretching and the foam roller.
This is how Kitty spends the majority of his day.
Since I was still high, I decided to bolus and mow the lawn. I was wearing my heart rate monitor from my run, and I checked in from time to time. 120 BPM to mow the lawn. Ha!
After my run, it was time to mow the lawn.
Our irises are going gangbusters this year.
After lunch: housecleaning. It always lowers me a bit (supposing I bolused enough for lunch).
The carpets needed a good hoovering.
After vacuuming, it's time to clean the dining room.
Usually the vacuum cleaner makes him run for the hills.
Meanwhile, Lisa was doing battle with the shrubbery.
Lisa needed a tall person.
Different piece of furniture, same result.
Time to take the clippings to the transfer station
It was a warm day. That calls for ice cream before doing more housework! (Of course, we’ve also been known to go to the ice cream shop during a snowstorm.)
A Treat after all that yardwork
The office needs a good going through.
Lots of bike riding recently
I’ve been jonesing for a long bike ride for quite a while. Tomorrow is the day. We’ll see if that can’t knock these highs down a bit.
Tomorrow, I'm going for a little ride. Maybe that will help.
Simon Brown gave an interesting lecture on “Agile Architecture,” entitled The Frustrated Architect at GOTOCon. Here are some notes and reactions:
Dear Diabetes Blog Week readers, we’ll be back to our normal programming tomorrow. Stick around. (I don’t post techie stuff like this very often.)
Wow, time has flown by! Diabetes Blog Week is almost over. Today’s prompt: “What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?”
I feel like I should have something profound to say here, as if after almost thirteen years of diabetes—has it really been that long?—I should be some kind of sage. But when it comes down to it, living everyday with a chronic illness renders it rather banal.
Doing all of the diabetes things (checking the blood, using insulin, changing infusion sets, looking at CGM graphs, being mindful of all the factors that affect blood glucose, and doing so many other activities) becomes just another part of living. It’s an unwanted part, to be sure, but those of us living with the disease integrate it into the fabric and rhythms of our life because we have to. Sartre and Camus would remind us that we’re always making choices, but practically our options are severely constrained when it comes to either accepting this disease and making it part of who we are or deciding to ignore it and face the consequences.
What this means is that we live life in multiple ways. We have the “normal”/”healthy”/non-diabetic portion with jobs, commutes, families, hobbies, and obligations, not to mention anxiety, joy, boredom, failure, and success. And then we have the part where we pick up the slack for our malfunctioning endocrine systems. This brings its own tasks, obligations, diversions, emotions, friendships, and opportunities to be better than yesterday. Diabetes is just another “thing” that we do. And like other things in life, sometimes it’s surprisingly easy, while other times it’s cruelly difficult. Sometimes we use these challenges in life and diabetes as a springboard to transcendence, and other times we just can’t wait for them to be done so that we can say, “Well, that sucked. Let’s never fucking do it again if we can help it.”
Diabetes just is.
It’s an aspect of my life that I manage (or mismanage) like any other part. Could I have better BG numbers and be less afraid of insulin? Yes. Could I also sleep more, floss regularly, and worry less? Yes to all. Do I mostly do alright with the diabetic and nondiabetic parts of my life? Absolutely. Diabetes isn’t a separate thing from me, but it is also not an essential, defining part of who I am. Just as I would never say, “I’m a toothbrusher,” it seems ridiculous to assume that my diabetes shapes the essence of my life any more than my toothbrush. I would rather say that I’m a husband, a software engineer, a triathlete, and an international playboy, and I just happen to do all of these things with diabetes.
That’s what I would say to people with or without diabetes: This illness is just another part of life, so don’t expect it to be our top priority or our defining characteristic. There’s more to us than that. It is, nevertheless, an important part of our lives, and it’s going to have an impact on what we choose to do and how we do it. Occasionally, it’s going to mess everything up. Try to be as Zen and thoughtful in your acceptance of this part of us as we are trying to be ourselves and as you would be of any other aspect of our lives.
“Stuff” is one of the evergreen topics of diabetes. What we use, the features we would like from pharma, and why we don’t have the amazing toys yet—we never seem to get tired of discussing it. Today in Diabetes Blog Week is the day that we talk tech, in particular our “fantasy diabetes devices.”
I think you can divide fantasy devices into (at least) two broad categories: (1) things like what we have now, and (2) things that act like an endocrine system. I’d love the latter, with its promise of a system or implant that behaves like a pancreas and gives us back normal glycemic response without any work. It’s going to take a while before we have replacement beta cells that don’t die . . . or CGM sensors that are accurate enough to make life and death decisions without our input . . . or control system algorithms that can handle all of the crazy variables that go into blood glucose.
So I think we’re on our own for a while longer, and we will need devices that help us make better decisions. I’ve said it before: we generate so much data that never gets used, and I’m sure that device manufacturers could build more decision-support, trend-spotting, and CDE-like functionality into our devices. And these devices should all talk to each other using standard, open protocols (like ANT+) so that they can integrate with all kinds of other devices—like my Garmin bike computer or running watch—and third-party software, which I would totally write if it were easier to get at the data.
Ideally, these decision-support systems would remember what’s happened over a long, ever-growing history, know what’s happened earlier in the day, and give suggestions about what to do next. The less work that I have to do the better.
After starting with the good news yesterday, today in Diabetes Blog Week we look at the flip-side: What could be better? What could we start doing today to make it better?
Friends, I am very good at spotting possible trends in my BG readings. Yesterday, I reported how morning swims are almost always amazingly consistent BG experiences. I have also noticed that I go up most afternoons around 2:00 and then drop a bunch during my afternoon workouts. I’m observant enough to have seen that evenings are higher than mornings. And I believe that I fall slowly overnight before going back up a bit before dawn. Some of these trends are good, others less so, and some just are what they are.
(Recently I’ve also been noticing more trends like the one shown below: awesome trend lines reported by my CGM. That 7:00 bolus there is for pizza, my friends. Half of a large pizza.)
What I’m not good at doing is acting on those hunches. When I suspect a pattern, I could should make detailed observations, adjust a few things, and test whether that made it better. But I don’t. Well, I do, but it takes longer than it should. (I also forget to write down the awesome things that worked, and I sometimes have to start over from scratch.)
“Why?” you might ask.
I believe some might call it “procrastination.”
“But that’s not a reason,” you say. “It’s likely just an effect of some kind of disordered thinking. Why not make the changes?”
Because, my dear friends, it’s hard to make changes to something that (mostly) works, that keeps away the lows and lets me exercise when I want with (mostly) good results. Because it’s hard to fiddle around and possibly make things worse. Because starting to make changes like that requires an active commitment to start, and I just haven’t carved out the time to do the basal testing (again!) or kept up with my BG+food+exercise journaling. Because, despite having done my NPH exorcism almost two years ago, that fear of the lows is still very much with me, and getting closer to the good place means getting closer to the edge of hypo more often. (At least I tell myself that, even though I’m not convinced it’s true.)
But today is a new day, and it’s the day I can stop procrastinating on these trends.
The other day, Scully posted a picture of her cycling shoes, which are pretty sweet. Here are the two pairs that I switch between:
On the left is my new, super-nice pair. I really like the Boa closure, and they’re so light! The other pair are my tri shoes; the big velcro strap stays open and the loop at the heel makes these shoes very, very easy to get into and out of. (It also looks like they could use a bit of cleaning. :-/ )
What do you wear?
Today in Diabetes Blog Week we’re talking about the things we do spectacularly. I’m not a superstitious man—except for throwing spilled salt over my shoulder—but I’m keenly aware of hubris or karma or whatever you call being too sure of yourself. I’ll do my best to get past it for today’s post’s sake.
Yesterday evening on the way back from the grocery store, I asked Lisa what she thinks I do very well when it comes to diabetes. Her answer—after saying that I’m often too hard on myself about diabetes, “which is understandable because it’s difficult”—was this: “You’re really good at exercising with diabetes. You do it a lot, and you’re not hypo all the time afterward. So I guess it’s that.” Then she asked if I’d read the post from Kerri about the elliptical and lows and juice boxes and whatnot. (I admit, I had a moment.)
So, I guess it would have to be that: exercising. In particular, I’d point at swimming. My stupid-high BGs before the triathlon Sunday notwithstanding, swimming is usually the easiest and most predictable thing I do with diabetes.
I get up at 5:00AM. I set a temp basal rate for 0% for 1.5 hours. I swim from 5:45 to whenever (usually 30-40 minutes). I go back to my locker and silence the “OMG!! THE SENSOR SIGNAL IS WEAK. WEAK!!!1!! I’VE LOST MY SENSOR! IT’S SOOOO LOST! WTF AM I GOING TO DO??!!!?” alarm on my Minimed pump. Get ready for work. Test. Deliver 1.0 units of insulin or so. Drive to work. And have a perfect-ish BG morning.
If I’m below 130 beforehand I’ll have a little snack. Otherwise, it’s like a little early morning gift delivered three times a week.
I can only imagine the internal body dialogue that might be causing this night swimming pre-dawn / early morning swim phenomena:
Human Growth Hormone: Yo, Epi, are you awake?
Epinephrine: YES! I’m always awake. And I’m amped and ready to go. What do you have in mind?
HGH: Let’s go wake up Liver and see how much glycogen he can spare.
Epi: YES!
HGH: Hey, Insulin. ‘Sup? Your blood sugar?! Haha. I’m just teasing. Seriously, though, WTF man? You just keep chillin’ for a little while longer. Epi and I have some unfinished business with Liver.
Insulin: Wait . . . what? Oh okay. I guess I’ll just stay here for a little while. Um, guys. Am I disappearing?
Epi: YES!
HGH: Hey, Liver. Wanna go swimming?
Liver: Let me grab my towel.
Epi: SWEET!
It’s Diabetes Blog Week again . . . yay! The last couple years were great, helping me meet so many wonderful people online with diabetes (POWDs?). Once again, Karen has done a fantastic job creating the topics and organizing the logistics. Kudos to her! Today’s topic invites us to “find a friend”—or rather, to share a friend with you, the reader.
I have met so many wonderful people with diabetes through their websites, Twitter feeds, and Facebook posts, that I don’t feel right naming just a few names. I have been fortunate enough over the last 18 months to meet several of these wonderful people and even call some of them my very best of friends. They’re not just people who really get diabetes and are there to share the triumphs, disappointments, and everyday shenanigans that is blood glucose. No, they’re also wonderful people with lives and interests and passions, and they’re most interesting (to me) when they share those other, “normal people” parts.
There are, however, a few people I read everyday because (a) we’ve met in real life, had a wonderful time, and grown close afterward, (b) they post several times a week, and (c) if I miss a post, I’m missing out on what’s going on in my friends’ lives, the same way that I would if I’m on vacation and cut off from the normal connections that bind friends together. That is to say, there’s no difference between these Internet friends and the ones across town; we just communicate differently. So Céline, Jess, Kim, Scully, and Victoria, here’s hoping others get to know how awesome you are. (And Caroline, I would totally put you in this group, too, if only you posted more often. :^) [Update 23 May 2012: Oh! Here it is!])
There’s someone I’ve never met in person and whom I’ve only just recently started following online. I think y’all should give her posts a look. Scully introduced me to her fellow Team Type 1 rider Becky Furuta’s awesome blog, Avec Délectation. (Don’t worry, ‘Mericans; it’s at least 99.44% English.) She’s smart and funny and thought-provoking. Her posts prompt me to think differently about diabetes . . . more matter-of-factly, more holistically, more—I dunno—post-hippy-Boulderite-like. If that’s not a good enough reason for having the Diabetes Online Community around, I don’t know what is. Oh, she also likes pounding diabetes into the ground as she rides her bike fast. She’s my kinda gal. One day, we will have to meet.
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