Category Archives: Life Lessons

Biggest accomplishment? No big deal.

Posted on May 16, 2013 by Jeff Mather


Today’s Diabetes Blog Week posts encourage us to “share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes.”

I won’t lie, my biggest accomplishment with diabetes is still a work in progress. It’s taken a long time to get where I am with being comfortable with insulin, and I could be even more comfortable with seeing a bolus wizard suggestion and just saying, “Okay. I can handle that amount of insulin without worrying.” Nevertheless, where I am now is much better than where I was a year ago . . . or even six months ago.

The results of “doing what I’m supposed to do” are encouraging. My A1c is the lowest I’ve had in quite a while, and I’m seeing fewer big spikes than in the past. I’m snacking less at times when I really don’t want to. Cycling with “normal” BGs is happening more often. Even eating Indian food is easier.

I am, however, having more lows than in the past and needing more (legit) snacks to prevent them, so I have some fine-tuning left to do. However, unlike in the past, I’m not treating those lows as a frustrating justification to do whatever. The changes I need to make are all do-able (By the way, I wasn’t simply flailing in the past; I was actually trying to make things better, but it was just a little hard to do that when I was adding so many other variables into the mix.)

Basically, this accomplishment is all about gaining the confidence I had needed to empower myself to do “scary” things (like taking insulin) and to enable doing more exciting things (like getting CGM no-hitters and doing half-Ironman triathlons).

Posted in Diabetes, Diabetes Blog Week, Life Lessons | Leave a comment

Crash and Burn

Posted on May 10, 2013 by Jeff Mather

Like a Sunburn: Two Mondays ago I had this conversation with my general practitioner.

“A few weeks ago I was sick, and then, a week after feeling better, I started having some pain in my leg. It felt as if all of my hairs were going the wrong way. Or as if my thigh had been scrubbed with steel wool. Everything on the left side of my body from my tailbone around my hip to just above my knee feels raw.”

“Kind of like a sunburn?” my doctor asked.

“Exactly, except that when I touch it or apply pressure it feels better. In fact, I feel best when I’m wearing bike shorts or swimming or running . . . or when my clothes can’t even brush against my skin.” By mid-week I was walking around holding my hip, which made the discomfort bearable. I could also be heard exhaling deeply from time to time to take my mind off the pain.

“But just on one side?”

“Yes,” I said. “That lasted all week, so it wasn’t just a run of the mill irritation. Then on Friday I noticed that I had a very swollen lymph node on the same side. At first I could feel it, but now I can actually see it, too.”

My doctor was starting to look like he knew what was wrong with me. What I didn’t say was that, after I found the lymph node, it was too late to get into the doctor’s office on Friday, and I kinda had a little freak out over the weekend. What was wrong with me? I didn’t have most of the symptoms of the few things I could think of. If it was a hernia, would my season be over before it started? What if it was more serious than that?

“And then I noticed a cluster of bumps on my back. They don’t really hurt, but they started around the same time. Now I have a few on the front of my thigh, too.”

“You have shingles. You’re the fifth person in the last week that I’ve seen with it. That’s really unusual.” And then he pointed to the poster from the CDC behind him on the door. It was the poster I had started to look at before he came into the exam room. On it, sad-looking, line-drawn people had shaded swaths on one side of their bodies. Then he gave me a prescription for the drug you get if you have herpes.

I was starting to feel much better a few days after starting to take the valaciclovir. I still feel a little pain just below the skin in my hip, and I’ve read that the neuralgia—which is what this kind of nerve pain is called—can last months. Yet I still feel fortunate that my shingles wasn’t as bad as some of the pictures I’ve seen or stories I’d heard.


BG Crash: Meanwhile, I was still swimming, cycling, and running. Swimming was going well, and I felt like I was getting back to my pre-illness form and speed. Running was . . . amazing! I’m still not super speedy or anything, but I noticed that at some point over the interminable winter my form improved, and as a consequence I seem to be able to run faster with the same amount of effort. Cycling is another story, since I found myself a bit off my form the end of last season. What I needed was time in the saddle. So about a month ago, I switched from mostly running to mostly cycling. I want to say that it’s been slow, but really I’m progressing pretty quickly, getting in a couple of 60-mile rides over the last two weekends. Hopefully, I’ll be speedy on Sunday for the first tri of the season and ready for the 100-mile Tour de Cure gran fondo next weekend.

One thing that has been completely different—and very frustrating!—compared to last year is my diabetes abilities in the afternoon. Almost every workout for a couple of weeks ended with me either 100+ mg/dL (5.5+ mmol/L) lower than where I started. That’s quite a drop, especially given that I had been working hard to keep my BGs in a “better” range. As a result, I was having a bunch of lows (or near misses) while exercising. No amount of pre-emptive eating seemed to fix anything. The worst was a span of three days where I had to stop cycling and running in order to treat hypos. I hate stopping.

It occurred to me that a few things were different. As I already mentioned, my BGs are bit better throughout the day, which (unfortunately) gives me less room for a drop like this. My training volume is also higher now, which means I’m more likely to use blood sugar, since my muscle glycogen might be slightly lower. And—this probably is the key—I had ever-so-slightly more active insulin in my system than last year. I remember being hungry in the afternoon everyday last summer and not eating because it would mess up my afternoon running or riding. Surely, there’s got to be a better way to balance the need to eat and the need to exercise. I should go back to my TeamWILD notes from last year to remember how much to lower a bolus for food depending on how far in advance of riding it is. Stay tuned.


An Actual Crash: Last Sunday, I went out for a little ride. It was a beautiful day; Chrissie (my tri-bike) and I hadn’t been out for a long ride together for a while; and I was feeling pretty energetic. About 20 miles in, I decided to stop at the same park I did the weekend before to take a little “nature break.” The previous time, I accidentally punched myself in the face taking off my arm-warmers. This time I didn’t even make it into the park before starting the mayhem.

Turning the corner from the highway to the park at about 10 MPH, my wheels hit sand, and I slid to a stop on my right side. Two women walking down the street saw the crash and asked if I was okay. As I stood up, nothing felt broken, although I could already feel some pain on my right leg despite the adrenaline. I’m fine. The ladies seemed dubious. So I looked at my bike and saw everything was (thankfully) exactly as it was supposed to be. My insulin pump seemed unharmed. And then I looked at my knee and shin. Blood and scrapes, but nothing that wouldn’t heal or keep me from finishing the next 40 miles. Yes, I’m okay. Thanks. All things considered, I wasn’t badly hurt—just a little road rash—although I was bleeding pretty well.

I headed into the park to do what I’d gone there to do, and then I spent a few minutes cleaning out my wounds. The bleeding from my knee wouldn’t really stop in the 30 seconds that I was willing to give it, so I used my beanie (which I no longer needed on this ride) to blot the blood and headed back out. I think I scared a few people I saw on the remainder of my loop. When I got home, Lisa didn’t believe me that it was a wolverine attack, so I had to fess up that the blood was, in fact, my own and convince her that I was, in fact, okay. After a shower it looked much better. Now, about a week later, the scabs look a bit gruesome, but the injuries they cover feel fine.


It’s been the strangest two months since the New Bedford Half Marathon, and hopefully nothing else happens between now and Sunday.

Posted in Cycling, Diabetes, Life Lessons, Reluctant Triathlete | 3 Comments

1:42:42

Posted on March 25, 2013 by Jeff Mather


Editor’s note: I wrote most of this post on the plane ride to California mere hours after my race, and it turned out a bit longer than I intended. Here’s a summary. I ran 13.1 miles in 1:42:42, a personal best and more than ten minutes better than my previous fastest. The race had its up and down moments, starting with a 44:00-ish 10K split before I unexpectedly ran out of gas in the last four miles. While I’m not disappointed with my results, I had hoped for a little better, and I have a decent idea where to go from here, which is good because the racing season has now officially started.


The New Bedford half marathon and I have unfinished business. Still.

I first ran this race two years ago, and I had a really tough blood sugar day, going hypo for the last five miles or so. Today was better, and there are whole sections of the course I remember for the first time. (Those were the parts I walked in a stupor back in 2011.) In fact, my 1:42:42 time today was my best ever at this distance. It’s just that my race was very uneven.

So what happened? First, here’s a little story.

Some of you probably noticed that I haven’t written much here recently. There are a lot of reasons—I’m definitely prone to going through periods of intense activity followed by droughts in many areas—but this time two factors stand out. First, I’m trying to get more stuff done during my days: at work, around the house, on the bike, on the sofa with a book in hand, with my head fast-asleep on a pillow, etc. Last triathlon season I was pretty sure that I didn’t help out enough with the housework, and it caused me a good deal of anxiety. This year, I’m trying to build up a reserve of goodwill (and good habits) that will get me through to October. Life is choices, and in an effort to get all of my stuff done, the dozen-or-so dispatches that I wanted to post here kinda shuffled to the bottom of the list.

But perhaps an even bigger reason for being quiet here is that I really only had one thing I wanted to talk about, and it seemed a bit neurotic to say, over and over, “Hey y’all, there’s this race I’m doing on Saint Patrick’s Day, and I’ve never been more unsure about how an event is going to turn out in my life . . . or even how I should approach it.” Beyond neurotic. Perhaps even a bit needy and insecure. But there it is: I spent most of the last 2-3 months thinking about today’s race and not wanting to talk about it.

Let’s head back toward the main part of our story.

It’s been a snowy, snowy winter. Last year, when I trained for Around the Bay, we had almost no snow all winter. Finding a place to train was so simple; just head up the bone-dry trail and out onto the suburban roads. This winter started like last year, but after Christmas all frozen hell broke loose. Before the New Year I was already doing speedwork on a snow-covered track or on the treadmill in the basement. I was moving my long run day around to get it in before the next snowstorm hit.

Then came January. And February. And early March. It snowed and snowed but never really melted—mostly because it was ridiculously cold. When the snow wasn’t too icy or rotten, I would put some miles in on the snowy trails; otherwise I did snowy loops and dodged snowplows on the state highway. Not only were these outings difficult, they kinda sapped my confidence.

I built my training plan around the 21:11 5K I ran last September to close out the season. That plan, which seemed aggressive to me, relied on a fairly normal set of distances each week run at some rather aggressive times: a 4-mile tempo run at 7:05/mile (4:24/km) pace, 4x1600m in 6:48 (4:13) each, 13 miles at 8:30 (5:17) pace. Ironically, I didn’t have much trouble hitting my marks at the shorter, more intense distances. But over the snowy, slushy, or icy roads, I quickly learned that I was going too hard on the early parts before getting to the dry roads, where I was a bit worn out. (I was very well-hydrated though, since I carried and drank lots of water.) Having one difficult long run after another kinda dragged me down and left me wondering if I had peaked too early in the season or if I would be capable of transferring my track speed to the roads over longer distances. Would I be able to run 13.1 miles at the 7:08/mile pace my plan said I could do?

Today proved that the answer was, in a word, No.

There was no real snow accumulation in the forecast for the week before the race—which of course didn’t stop us from getting a half-inch overnight on Friday—and the bike/run path taunted me by being invitingly snow-free for the first Sunday since the middle of January.

On the other hand, it was still a chilly 30F (-1C) when we left the house race morning. What to wear . . . Pants? Probably a good idea. Jacket? Probably not necessary, although I did put on a base layer below my long-sleeve shirt. By the time I was done with my warm-up, I knew I should have opted for shorts and short-sleeves. It was perfect running weather. (Although not perfect spectating temperatures. Poor Lisa.)

I got a good luck kiss from my sweetheart, settled myself into the starting corral by the 8:00/mile (4:58/km) sign, and tested my blood glucose during the national anthem. 252 mg/dL (14 mmol/L). My best efforts at having a quality BG race were derailed around 7:30PM Saturday by a low that caused a high rebound and an early morning bolus, a pre-run snack, and an 11AM race start that had me wondering how much to eat for breakfast and what insulin-on-board was appropriate for my high. I decided that the 0.8 units IOB was probably okay, but my nutrition plan of eating every 30 minutes needed modification. Basically, I was going to be a bit hungry.

The first half of the race were good. Everyone around me was running decidedly faster than I was, and I felt no qualms about watching a stream of people slowly run past me through the first few miles. I was watching my pace closely, so I wasn’t surprised to see a 6:45 show up after the first mile. By the third mile I was cruising along at 7:30/mile (4:40/km), which had been my plan coming into the race: run slower than the “official” plan called for and hope for a negative split, running the second half stronger than the first.

My (unofficial) 10K split was a new personal best just upward of 44:00. I was feeling good. A run at this pace is never easy, but it didn’t feel bad.

Then around the ninth mile, when we got to the seawall, I hit the wall. I had been battling a side stitch that felt like a collapsed lung—I imagine—for the last couple miles so I decided to walk for a minute to catch my breath and check my BGs: 152 (8.4). Much better than before. Knowing that I didn’t have low or high blood sugar gave me a bit of a second wind. The big hill for the last mile was cruel—just like last time—but the crowds were huge and so supportive.

I was so happy with my time and to be done. All things considered, it was a good race: a solid, relaxed 10K followed by a tough part that I pushed through leading to a PR. I told Lisa that it’s good that I signed up for the Baystate Marathon (in mid-October) on Friday rather than waiting until afterward, because I’m not sure I would do it if I hadn’t. But that was pre-shower. It’s amazing what some hot water and soap will do for your point-of-view.

Between now and my first marathon there’s a lot of running and swim/bike/running to do. I have new training paces and a clear need to work on hills. (I think trail running will help with pacing and strength more than anything, not to mention being lots of fun! :^) And . . . I wonder how close to 1:42 I can get during a half-Ironman. I’ll also come back to New Bedford someday to get the satisfaction I deserve.

Now if only spring would get here.

Posted in Diabetes, Life Lessons, Running | 6 Comments

Repeal It

Posted on December 17, 2012 by Jeff Mather

I originally wrote this post last Friday night and then, in a moment of doubt on Saturday morning, unpublished it. It wasn’t that I didn’t completely believe in the argument; I just wanted to make sure that it was the kind of thing I wanted to appear on this site. It is.

I try not to get political here very often. [1] But I cannot contain myself today. I am angry and heartbroken by the massacre of twenty schoolchildren and six adults in Connecticut. I think about the topic of gun violence every time there’s a gun-related mass-casualty incident, and it feels like I’ve been thinking about it a lot in recent years. Today, though . . . I just do not understand how it’s possible to perpetrate such a horrific act on such a scale. However, I do know that it would not have happened without a gun as part of the equation, and I think it’s about time we did something radical with guns.

Before you dismiss me as a knee-jerk, Eastern liberal, you should know that there were handguns in my house when I was a teenager. I shot one of them twice with my stepfather, as part of a “there are now guns in the house, and this is why you should leave them alone” campaign. After the first shot we realized that I had really good aim, despite only having one good eye. The second shot took me completely by surprise, and I dropped the gun out of fright. I can still see the damage done from the first shot, and I won’t ever forget the fear-turned-embarassment of the second. Of course, on one other occasion the same gun almost featured tragically in a situation I would rather forget.

Despite all that, in the past I was deeply opposed to gun control. In fact, on my college debate team, I twice argued passionately in favor of a right to keep guns and use them for hunting and self-defense and as a means of preventing tyranny. (Yes, I actually bought into that paranoid, militia-esque belief that a well-armed citizenry was all that kept us from a totalitarian hell state. That was a long time ago.) I believed that private gun ownership made sense in sparsely populated rural areas (like Wyoming) where everyone was a law unto himself as well as in crime-riddled urban areas (i.e., everywhere that wasn’t Wyoming).

Time has passed and now I can only see those beliefs as outdated and immature. Sure, guns can prevent some crime—and hunting, however you feel about it, is a different beast altogether—but firearms contribute to so many deaths and violent crimes. They are fundamentally different from other kinds of weapons in their ability to indiscriminately cause damage from a distance. I find it hard to justify handgun possession, since in my mind they are scaled down weapons of mass destruction. With the carnage they caused today, how can they not be thought of in the same class as WMDs?

I am tired of gun violence apologists—and let’s face it, that’s what they are—saying, “Oh, well, it’s just an isolated incident and the act of a deranged mind. We can’t prevent against this kind of event.” Not so. All of these tragedies may be uncoordinated, but there is a sine qua none that binds them together: the gun. How many repeats of the same tragedy must we have before we do something about guns? How many murders, attempted murders, and assaults do gun (ab)users have to commit before we say the consequences outweigh the supposed “benefits” of private gun ownership?

Don’t misunderstand me. I’m not suggesting that most (or even a small percentage) of gun owners are just a hair’s breadth away from homicide. But I do think most guns have only two purposes: either to project the intimidating possibility of violence to all within the bullet’s range or to actually inflict harm on another person. It’s perfectly possible to own a gun responsibly and never use it, and it’s possible to use a gun in order to prevent harm to others, but this is not how most guns in this country (when used) are used. Moreover, the magnitude of gun ownership in this country has a corrosive effect on the overall safety and well-being of everyone in the US, as we saw from today’s events.


I’m not an originalist when it comes to Constitutional interpretation—nor am I a judge—but I understand the late 18th century point of view on this issue. Guns were in the culture in post-Revolutionary America and were used during Shay’s Rebellion out in western Massachusetts (1787) and the Whiskey Rebellion of 1791 by both the groups seeking to oppose tyranny/taxation and the militias that were used to put down the anti-state insurrections. Frontier violence was a fact of life, even though the presence of guns contributed to its worst abuses. (Well, guns and liquor together really.) Hunting was also a part of life for a large number of people. (And don’t forget the fear of slave revolts.)

Times are different now. The Civil War pretty much settled the issue of how dangerous state militias can be, and the idea of private gun ownership preventing a tyrannical government with a well-trained standing army from taking away our liberties—given some far-fetched dystopian scenario where it actually wanted to—is laughable. Furthermore, handguns and assault-style weapons create a much different gun environment than even 100 years ago.

The second amendment no longer protects American citizens by providing a framework for well-regulated gun ownership and/or militias. It provides a cudgel to prevent responsible regulation of firearms. The amendment has outlived its usefulness.


It’s time to repeal the second amendment. Remove the pretext of gun ownership and/or citizen militias as a Constitutional necessity for the preservation of individual liberties and happiness, and in its absence let the people decide how much and what kind of gun restrictions we really want. I will likely come down differently than you do, but in a democracy we should all have a voice in the decisions about the kind of society we live in. Different jurisdictions should be able to tailor gun laws to the needs of their populations.

The current Supreme Court has shown that there cannot be meaningful gun control in this country while the second amendment is in force and while Congress has a pathological inability to enact sensible regulation on its own. If, after a horrific tragedy like what occurred in Connecticut today, we can’t figure out a way to change the gun culture that exists in the United States so that it protects people, we never will. Something has to give on the second amendment; either we abandon our fetishistic attachment to it as an idea that prevents any meaningful gun regulation, or the entire amendment has to go. The blood of those killed in the next “isolated incident” will be on our hands.


1 — I occasionally write about healthcare economics here. It’s an issue that I don’t feel should be politicized, but sadly it is. Affordable healthcare is important to me, and I feel the problems about access to it are totally solvable, even if it’s going to be difficult to do. [back . . .]

Posted in General, Life Lessons, This is who we are | 2 Comments

Going Nowhere

Posted on December 11, 2012 by Jeff Mather


It’s here again. Yes, it is the holiday season, but I’m talking about the time of the year when those of us who love cycling (but also have day jobs) put the bike on the trainer and do a lot of our riding indoors. For some of us it represents a fundamental, existential crisis. “I love riding my bike for hours outdoors, but I hate spinning away for hours inside. How do I survive a winter on the trainer . . . or of no riding? *shudder*” Victoria—who has convinced me to do another JDRF ride next year in Nashville—recently posted her lack of love for the trainer, and it occurred to me that I have the solution, since riding inside never seems to bother me.

Nothing is ever going to replace the amazing feeling of the air flowing around you as you push through it under your own power. You’re never going to have that thrilling feel of speed when you’re not moving at all. There’s never going to be same sense of accomplishment from climbing a mountain or going up and down little rollers when you’re staring at a wall or electrical circuit box or television or iPod or whatever might be directly in front of you. When there’s no need to change your pace, of course it’s going to feel monotonous. Two hours of not going anywhere might have same physical effect as riding outside, but it can be rather soul crushing.

Since nothing is going to compare to the real thing, change the kind of riding that you do indoors.

Tell yourself that outdoor riding is for the pure love of the bike, while indoor riding is solely to make yourself a stronger cyclist. On the roads you have fun, inside you ride with a purpose. Outdoor rides might go on for hours, but indoor training should be limited to 30-60 minutes. Indoors you do the hard work to make riding outdoors easier.

If you’ve been riding for a year or two, you should already have a solid endurance base, and you don’t need to do more workouts to target that inside. What you want is to build some strength and speed so that your outdoor rides in the coming year feel easier. Hills will feel shorter and less steep. You’ll comfortably spin along at a faster rate. (Not that speed is necessarily your goal, but it’s nice to have anyway, since you can go farther on your weekend rides in the same amount of time if you have the ability to ride a little faster, and you’ll feel fresher when you’re done.)

Here are a couple of workouts you can do indoors in under an hour and not feel like you never want to see your bike again. These are sessions that I do myself.

Every workout (indoors or outdoors) starts with 10-15 minutes of easy riding. I mean easy. By the end of the warmup, you’re probably going to be a little bored and eager to do something different, and that’s just what we’ll do. On “speed” days, you do a lot of short intervals, while “strength” workouts have fewer intervals, but they last a little longer. After the hard work, it’s time to cool down with another 5-10 minutes of very easy riding. The point is to clear the burn and give your heart a chance to settle down before you hop off the bike and get on with the rest of your day/evening.

Speed: After the warm up, ride very hard for one minute before taking an easy spin for one minute. The hard part should feel ridiculously hard, as hard as you can go while turning the pedals at 80-90 times per minute; you don’t want so much resistance on the pedals that you have trouble turning them. (Imagine sprinting rather than climbing hills.) The recovery part should feel very, very easy . . . even easier than the warmup. You should barely be working at all, since the whole point is to try to get your heart rate back down from the stratosphere. Do 5-10 intervals, and you will have done a good 30-40 minute workout. Start with fewer intervals and eventually work your way up to a full ten.

Strength: While the speed workouts are done at an intensity level that leaves you gasping for breath and bargaining with yourself to be able to finish them, the strength workouts—while still hard—are easy enough that you could imagine carrying on very short conversations. Hold back a little on the first intervals so that you can finish the latter ones at the same pace. After the warm up, ride at about 70% intensity for 2-4 minutes and then ride easy for 3-5 minutes. Do three or four, starting short and then building to longer intervals as the weeks go by.

Hopefully these workouts will get you through the long indoor months during the week and that you can still find a way to get outside on the weekends. Let me know how they go for you!

Now, if only someone could tell me how to make the best use of the treadmill.

Posted in Cycling, Life Lessons, Running | 5 Comments

Racing into New Territory

Posted on November 2, 2012 by Jeff Mather

Halloween is over, but I’m still kinda scurred.

Yesterday, I updated my running plan to account for the fact that I haven’t really done many of the long runs that my plan said I should. I could probably manage the 10 miles slated for this weekend, but the longest I’ve run recently was the 7+ miles a couple weeks ago when I went hypo on the trail. Ten miles might be slightly too big of a jump to do without risking an injury. The 8 miles prescribed in my new plan seems more reasonable.

The distance isn’t what has me nervous, though. It’s the speed. After running a 5K in 21:11 in the middle of September, the computer is predicting a 1:33:26 for my next race, the New Bedford Half Marathon in mid-March. [1] That’s a 7:08/mile (4:26/km) pace. Dang! I know that I can run that fast over shorter distances—it’s 20 seconds/mile (12 sec/km) slower than my 5K speed—but it still seems pretty aggressive for a long-distance race. [2]

Nevertheless, the plan is actually quite reasonable, with one speed session/week at paces I can already manage, one long run, and two or three other recovery runs—which I might substitute with a bike workout and/or some exercise to improve my running form. Along the way, it gradually increases both the distance and speed. I’m just having a little trouble believing the idea of running so fast for so long.

But that’s the whole purpose of speedwork and training: to get faster, know what it feels like, and be ready to give a similar effort during a race. A good coach—even a virtual one like mine—is supposed to provide a plan that spurs an athlete into territory where he or she had always hoped to be but wasn’t sure it was possible to go. And that’s definitely where I am right now; I can run the speed I need to, but will I be strong enough (mentally and physically) to do it for 13.1 miles? The plan says, “Yes.”

Off we go!


1 — I also ran a slower (but equally intense) trail 5K a few weeks after setting my post-high school PR. It rained before and all throughout the race, and the air was windy and cool, too. Basically, it was perfect cross-country running weather. The wind had blown lots of leaves onto the trail, and the rain made them quite slippery. I had an exciting moment early in the race when the lower half of my body started sliding to the right as I was trying to lean into a left-hand hairpin turn. I don’t know how I didn’t fall down, but I’m sure it looked amazing as my arms flew up into the air for balance. [Back . . .]

2 — My target pace of 7:08/mile is about 0:10/mile faster than Boston qualifying pace for someone my age for a full marathon, after all. Just saying. (Not that I’m looking…. *ahem*) [Back . . .]

Posted in Life Lessons, NaBloPoMo, NaBloPoMo 2012, Reluctant Triathlete, Running | 1 Comment

Swim Lessons

Posted on November 1, 2012 by Jeff Mather

This was in my inbox yesterday.

Hello Swimmers,

You are registered for the 6-week Tech Swim Class that begins this Saturday, November 3! I am looking forward to seeing you in the pool.

Here are a few details: Please arrive between 5:20-5:25 (doors open at about 5:20), and on the pool deck by 5:29. We will start promptly at 5:30. You need a swim cap in the YWCA pool; these will be provided. If you have a pair of training fins, please bring them to every class. If you don’t own them, I have plenty to share in all sizes. Also bring any other training tools you may have, such as pull buoys, hand paddles or gloves, etc. If you don’t bring your own fins, you should grab a pair from the coffin on the pool deck before you get into the water.

That’s 5:30 AM, y’all . .  on a Saturday . . . in a town 40 minutes from where I live. OMG, what have I done?! Well, I want to learn how to swim faster. whimper

Posted in Life Lessons, NaBloPoMo, NaBloPoMo 2012, Reluctant Triathlete, Swimming | 4 Comments

All Aboard the Fail Train

Posted on October 25, 2012 by Jeff Mather

You know how I rode through Death Valley with great blood sugars? And how I did a half ironman triathlon with no diabetes problems? And how I had an amazing ride to the top of Mount Wachusett and back with lots of power and great diabetes mojo? Yeah, the outings aren’t all like that.

This is the story that proves that—no matter how easy being an athlete sometimes might look—diabetes can be a tricky disease to manage. Worse than being difficult, it’s occasionally dangerous. The line between A-OK and disaster is a fine one. (This dispatch isn’t meant to scare anyone, and I apologize in advance if it does.)


I’m proud of the fact that diabetes doesn’t keep me from training. I’ve had high blood sugar (but no ketones) before exercising, and I’ve used the outing (along with some insulin) to bring my BGs back to a happy place. I’ve also been lower than what makes me comfortable and had to delay exercise a bit to let the food I ate kick in. I exercise at these less than ideal times because hitting the pool/gym/road/trail/treadmill and putting in the time, miles, and laps is the only sure way to get better at what I do.

Just because I don’t let diabetes keep me from starting an outing doesn’t mean that I’m necessarily going to finish it the way that I would like. Recently, as I’ve fiddled with my insulin settings and nutrition, I’ve had hypoglycemia bad enough a couple of times to make me call it a day. On my last long run before the 70.3 triathlon in Maine, I had to walk the last mile back to the office in a bit of a stupor.

Then there’s what happened last week. Lisa was in Nevada, spending some time with her mother and grandmother, and I was home alone. Being alone doesn’t really bother me, diabetes-wise. (Not having Lisa around is another matter altogether). Since I have Spanish class on Wednesday and was heading to Death Valley on Thursday, I decided to make Tuesday my long run day. I prefer to run on a weekend morning, since I find it easier to manage diabetes and exercise when I haven’t been bolusing insulin, but I’ve been doing workouts after work for years now, so I didn’t think too much about it.

And, boy oh boy, had I been bolusing insulin on Tuesday. I’m gradually feeling more confident giving myself all of the insulin that a very high carb meal requires, but I’m still kind of chickenshit. As a result, I went through a good part of the afternoon with high blood sugar after eating delicious Indian food for lunch. Because of the highs, I gave myself a small bolus just before running, and when I started what I intended to be a nine mile run down the paved rail-trail in town, I had multiple units of insulin still working their way through my system.

The beginning part of the run from my house to the trail—about 3/4 of a mile—is always enjoyable; it’s downhill, and I have to hold myself back from setting the bar too high for the rest of the run. It was just warm enough to go running in shorts if I also wore a heavy long-sleeve shirt. The shirt was was vivid yellow, and I wore a headlamp because it was going to be full dark by the time I got home.

I was having a great run through the late evening light and the twilight. I had to turn my headlamp on just before the turnarond point, 4.5 miles in. My pace was good as I ran through the tunnel of light I was throwing onto the trail. There were still a couple people on the trail on my way out, but by the time I turned around the trail was deserted.

About three miles from home something didn’t seem right. Despite having eaten a couple of times, I felt a bit lethargic. My view of the world started to look off, and I couldn’t tell if it was due to the headlamp or the darkness or something else. A half mile later I was in the deepest, darkest part of the woods on the trail. The temperature had dropped quickly when the sun dropped, and little clouds of steam shone in my light whenever I breathed. That’s about when I started seeing flickering lights whenever I blinked, a sure sign of hypoglycemia for me, and I realized that I was listing a little bit, too.

Cold, dark, alone, hypoglycemic . . . I knew I wasn’t going to die on the trail, but it was still a bit scary. [1] For one thing, I was still two miles from home and one mile from where the trail intersects a road, and I didn’t like the idea of trying to hold off the “I’m going to pass out” feeling so far from possible help. Plus, hypoglycemia triggers the fight/flight, adrenaline response, which makes me feel a bit nervy. Immediately upon stopping I ate a full tube of glucose tablets, which I admit was probably overkill, but I knew that I was already pretty low if I was seeing The Spot. All the while I was walking my baby giraffe wobble down the trail. It was too cold to really stop moving, and I just wanted to get the last two miles home out of the way. For good measure, I ate the extra energy gel that I had in my pocket.

When it became pretty clear that I was going to be okay, I ran the last half mile. In the end I arrived home about 30-40 minutes later than I had intended and pretty chilled. Perhaps the worst part of this experience, though, was the hit my confidence took. What’s going to happen the next time that I go for a run in the afternoon? What will happen the next time I exercise with high blood sugar? Should I go running on the trails after work anymore? Should I just stick to the treadmill?

Well, I’m pleased to report that today, for one reason or another, I had higher blood sugar than I would like to admit . . . and I went for a run . . . on the trail . . . (but not in the dark) . . . and nothing bad happened. Granted, I only ran four miles because it’s a recovery week, but my BGs didn’t move more than I wanted, despite the very small correction bolus I gave. Whew! Confidence restored.


1 — This is not the first time I’ve written “I knew I wasn’t going to die . . .” on this site. Unlike this time, I have some nice pictures from that first not-near-death experience. [Back . . .]

Posted in Diabetes, Life Lessons, Running | 6 Comments

Diabetes Math

Posted on October 15, 2012 by Jeff Mather

After getting basal rates that I believe, I’m up to the part of my on-going “Let’s finally figure out the right pump settings!” project where I check my bolus amounts. I have long suspected that I am over-insulinized in the morning, since I frequently need a snack between 10AM and noon to prevent a hypo. Now that I know my basal rates are correct—I can plank pretty well if I don’t eat—the fiery finger of blame points at my bolus ratios.

Last week, after my awesome endocrinologist “ooh-ed and ahh-ed” over my much improved A1c, I asked her my burning question about active insulin (a.k.a., insulin on board or IOB). “When I’m bolus stacking, when do I consider active insulin and when don’t I?” I frequently eat multiple times during any given five hour period, which means that I have multiple doses of insulin working on their respective meals. I’ve noticed that sometimes I have to take that insulin into account, since its “long tail” will continue to lower my blood glucose for a bit longer. Other times, if I subtract out that IOB, I see high blood sugars later because that insulin was still needed for the previous meal/snack. What to do?

Her advice to me (and this supposes that my pump’s “active insulin” setting is correct) was to subtract out the active insulin if the bolus was three or more hours ago, since digestion should have finished by that point. This is when I’m already near my BG target and have IOB.

(Since I’m often back into the lower part of the “happy” range 2-3 hours after a bolus and/or I didn’t see much of a rise at all, this is probably another indicator that I’ve been taking in too much insulin. That and the fact that bolusing frequently comprised more than 70% of my total daily dose, which is higher than the 40-60% that most recommend. As a result I was eating a lot of “defensive” carbs to prevent lows, which seems to be leading to highs later in the day.)

I had been trying less aggressive bolus ratios over the weekend with some success, but acting on hunches and suspicions is bad form, so today I decided to be a bit more rigorous. Armed with my endo’s advice, a measuring cup, notebook, and pen, I set out to figure out what my bolus ratios need to be. Here is the data through lunch:

05:03 - 164 -       - Wake up... yawn.
05:45 -     -       - Swim 1000 yards in 20 minutes. Disconnected for 35 minutes.
06:21 - 121 - 2.9 u - Granola bar (24g) = 2.6u + 0.3u correction (using 1:9 ratio)
07:34 - 149 - 6.5 u - Cereal, milk, eggs, sausage (64g) = 7.1u (but I know this is too much)
10:18 - 104 -       - There was a bit of walking around in the previous hour
11:15 - 104 - 1.0 u - 1/2 donut from the box next to the printer (19g) = 2.3u - 1.3u IOB
12:00 - 120 - 8.3 u - Sandwich (35g), Yogurt (18g), Apple (~20g) = 75g = 8.3 (using a 1:9)

This morning looks pretty successful. Let’s try to reverse engineer a possibly correct bolus ratio. I ate 24+64=88 grams of carbohydrates for breakfast, and delivered 9.4 units of insulin. That yields, let’s see here, 1 unit for 9.4 grams, or about 1:9. But we know that’s too much from past experience (including this morning).

The 9.4 units of total insulin includes whatever insulin was needed to make up for the 35 minutes that I was disconnected from my pump while swimming and a correction of 0.3 units, which may or may not be the same. Let’s run the numbers again a few different ways.

Not taking correction into account: (24 + 64 g) / (2.9 + 6.5 units) = 9.4 g/unit

Just using the correction: (24 + 64 g) / (2.9 + 6.5 – 0.3 units) = 9.7 g/unit

Using the time off pump: (24 + 64 g) / (2.9 + 6.5 – 0.9*(35/60) units) = 9.9 g/unit — 0.9 units/hour is my basal rate at that time in the morning.

What’s the lesson here? What ratio should I use? 9.4? 9.7? 9.9? Since my pump only works in whole units for the ratio, it’s a choice between 1:9, 1:10, or carrying a calculator/MATLAB everywhere with me. (The pump version one generation after mine does allow fractional ratios.) The 1:9 ratio is clearly too aggressive given what’s been happening to me, so I’m going for 1:10, which has a certain easiness to it, too.

Let’s see what tomorrow brings.

Posted in Data-betes, Diabetes, Life Lessons | 4 Comments

Welcome to our POOL. Notice there is no “CGM” in it. – Wednesday, 5:45AM

Posted on September 19, 2012 by Jeff Mather

Three of my last four CGM sensors have done really well, living longer than expected and giving really accurate readings until almost the very end. Each of those good ones had lasted at least a week before giving up the ghost. The one I started on the New York Thruway on my way to ride around Cayuga Lake with Scully went strong until the day before my half-Ironman two FULL weeks later.

Unfortunately, the most recent two sensors didn’t “die” so much as “drown.”

Usually, I can swim and my CGM sensor comes along for a little underwater trip, safely held in place by a Tegaderm dressing. But if the tape has a little gap, suddenly my CGM transmitter/sensor is flapping in the underwater breeze.

I knew before I left the house this morning that I should have changed the Tegaderm, but I was running late and still had to get the lawnmower out of the garage so that it could get repaired this morning. Wednesdays are crazy days at the pool, and I like to get there early to stake a claim on (part of) a lane before the place fills up. So I forgot to resecure the dressing. (But at least I remembered to put out the lawnmower . . . unlike a couple weeks ago. Oops! There’s a jungle growing out behind the house.)

Twenty-five yards into my 2,250 yard swim this morning I felt a little tugging on my midriff, and by the time I returned to where I started at the other end of the pool after a nice push-off from the wall during my turn, my CGM was barely holding on. This was the closest I’ve ever come to having it come off and drift to the bottom of the pool. (Let’s hope that never happens, BTW. I’m terrible at diving down to the bottom of the deep end.) At the end of the first of my 45 laps I had to stop, peel off the last bit of tape, and place the CGM sensor and transmitter on the pool deck. I checked every lap or two for the rest of the swim to make sure that someone hadn’t accidentally thrown away the $2,000 “trash” at the pool’s edge, which didn’t help my lap times much.

Here’s hoping the one I just started—my last one until the re-up arrives—survives Friday’s swim.

Posted in CGM, Diabetes, Life Lessons, Swimming | 2 Comments

What I’ve Learned about my CGM

Posted on August 22, 2012 by Jeff Mather

I’ve been using a Medtronic Minimed continuous glucose monitor (CGM) for a little more than a year and a half now, and here’s what I’ve learned about it.

  • Having CGM is the greatest thing. It’s a decision-support tool, a dashboard, and a security blanket. I’ve learned so much about my diabetes from it, and it’s provided the data I needed to make some important changes to my self-management. I wish everyone had it.
  • The BG values it reports are delayed by 15 minutes. This is a fact of life. The CGM looks at “interstitial glucose” between cells (ISIG) instead of blood glucose, and there’s a lag time between the two. Don’t expect the BG numbers from your meter and your CGM match unless your having very stable BGs.
  • The most important factor in getting believable CGM readings is calibration. Wait until your interstitial glucose (ISIG) is the most stable before calibrating.
  • If my BG is on the move but the system says I need to calibrate it, I’ll let it go past the “Meter BG Now” deadline and look at the “Sensor ISIG” values on the CGM information screen. When this value isn’t changing much, that’s when I’ll calibrate.
  • Lots of things affect ISIG values and therefore CGM accuracy: the rate of change of BGs, the level of hydration, and the wetness of the sensor (both too wet and not wet enough).
  • I find that if I keep my sensor and transmitter covered, I get a longer sensor life and better readings.
  • Tegaderm film works the best for me. Unlike IV-3000, it doesn’t come off when I’m swimming or sweating a lot from exercise; it doesn’t leave behind a lot of residue; and it’s stretchy enough to cling nicely and create a good barrier.
  • Hydration matters a whole lot to accuracy. If you’re dehydrated, the sensor will read incorrectly, or perhaps not at all.
  • Don’t calibrate first thing in the morning. There’s too much going on. Almost everyone is slightly dehydrated when they wake up, and I’ve noticed that the very act of waking up and getting moving causes my CGM sensor to give inaccurate readings for about a half hour.
  • Don’t calibrate right before or after exercise. For me, my blood sugar usually is on the move during the first bit of a workout and immediately after it. Plus, the chance of BG swings is greater while exercising, which is bad news for calibration.
  • I find that sometimes I can count on my CGM values when I exercise, and other times I can’t. The lag is a little less during exercise, but my hydration is also different so it’s less accurate. Sometimes it catches big BG swings, and sometimes it doesn’t.
  • Swimming: I find that I can swim for at least an hour without affecting the sensor or transmitter. But I also find when I swim three or more times in a week, the off-label lifespan of each sensor is noticeably shorter.
  • Sensor life: The longest-lasting sensor I’ve used that produced reliable BG estimates is 12 days, which is not too bad for something that’s only supposed to work for three. (Just tell the CGM that you’re starting a “new” sensor when it says “Sensor End,” even though it’s the same one and not new at all.) Because my transmitter battery requires a quick recharge after 6 days, I have to very carefully peel off the Tegaderm I put over the sensor and transmitter, give the transmitter a charge for 15-30 minutes, and then reattach it and apply more Tegaderm.
  • Occasionally, the sensor values will just drop out after the three days; they might come back to match my BG, and they might not.
  • When the CGM graph gets really noisy, the sensor is dying.
  • Sensor freshness matters. A sensor getting close to its expiration date won’t last as long and seems to give less accurate readings.
  • Treat the number after finding a “Lost Sensor” with some skepticism. I find I often need to recalibrate 30-60 minutes after reacquiring the sensor.
  • To avoid “CAL ERROR” messages, I don’t calibrate if the CGM and BG meter values are very different.
  • The Medtronic CGM does some curve fitting, so it often doesn’t “snap” the CGM values to the calibration value when they’re very different. I hate that. Entering another, new BG value usually gets them closer, though.
  • Post meal, a period of flat BG values followed by a rise 1.5-2 hours later almost always means that the meal bolus was too small. (There are a lot of other trends you can spot, but this one was the most consistent.)

Do you use CGM? What have you noticed?

Posted in Data-betes, Diabetes, Life Lessons | 9 Comments

NYC Triathlon – Dead Fish, The Henry Hudson Parkway, and Running Dehydrated

Posted on July 12, 2012 by Jeff Mather

Sunday I finished the Olympic-distance 2012 Aquaphor NYC Triathlon in 2:40:55, 886th best of the 3485 finishers.

This race was my longest triathlon to date and was the one that got the whole “triathlon thing” started for me when Caroline asked in 2010 if I would do a tri with her and a friend. While I didn’t get picked in the lottery that year, she and I volunteered to cheer for all of the triathletes running up 72nd Street. After more than 20 months of thinking about it while swimming laps, I finally completed it.

The “NYC Triathlon” = “NYC” + “Triathlon.” Let’s break this up into two parts.

Logistics: This trip to New York City was stressing me out hardcore. Usually, I’m pretty mellow about these things, but I’ve learned that, when it comes to situations where I might look the part of a fool—or a tourist or newb or whatever—and I can’t think of the right way to handle the situation in advance, I get pretty stressed out. How was I going to handle the bike + check-in + Midtown valet parking + crowds issue? What about the late check-out on Sunday morning after the tri? How would I get my bike and stuff to transition, which was 2.5 miles from the hotel? Furthermore, Lisa isn’t a huge fan of New York; how was I going to avoid her murdering me at 4:00AM on Sunday morning when the alarm was set to go off?

Turns out, I am not the first person to come to New York City to do this event, so I needn’t have worried. The hotel wasn’t completely given over to triathletes—a pack of hundreds of young teenage girls from some exotic locale annoyed the ever-lovin’ humanity out of everyone—but our special circumstances weren’t that special. The race organizers—who really thought of everything—had a place to check my bike before hotel check-in while I attended my pre-race briefing. It was straightforward (but not convenient) to get my stuff to and from transition. (If we were true New Yorkers, we would have taken a cab to save some time on the way there with my bike. We did take the Subway back on Saturday because it was too damn hot out there for another long walk. So, good on us. Yeah, whatever.)

(With all that said, the event really is much more manageable—and much, much less expensive—for people who live in or near NYC. It’s a great race for locals and for people who want to travel to the Big Apple and don’t mind the expense and everything else that comes along with it. It’s a great race, and I enjoyed the race itself very much. I’m looking forward to doing another Oly again some day, just probably not NYC. It’s not you, New York; it’s me. I mean it. I had a great time on the course and interacting with the volunteers and staff. Plus, they say if I can make it there, I can make it anywhere. Now I just have to go and prove that Old Blue Eyes was telling the truth.)


Diabetes Logistics: The only really special circumstances that the race organizers didn’t plan for was my diabetes. The transition zone (where we switched from swimming to cycling to running) was a mile from the swim start. I needed to meet my insulin pump in transition, but I couldn’t be disconnected from it for too long. The time between when everyone had to leave transition to the start of my swim wave was unknown—due to the nature of the “time trial start”—and turned out to be close to three hours. I probably could have asked some of the race staff for help as a physically challenged athlete, maybe having someone shuttle my pump to the transition area after my swim start, like they did with other athletes’ wheelchairs, etc. But in comparison to people without the use of limbs or sight, diabetes ranks kind of low on the “challenged athlete” hierarchy, and I don’t like to make a big deal out of it. As a result, I treated diabetes like I normally do: a pain in the ass to be worked around and managed the best I can without special dispensation from event organizers.

Eventually I struck upon a plan involving my backup insulin pump that seemed like it would work. I would fill both of my pumps with insulin, leave the backup in transition on the morning of the event with all of the settings exactly the same as the other one, and wear my regular pump + CGM to the start. My plan was to eat the pre-race breakfast that had been working for me earlier in the week just 20 minutes before the start, deliver a small insulin bolus for the meal, give Lisa my newer pump just about 10-15 minutes my swim start, hook up my older pump after the swim, and rock the rest of the tri. Having Lisa there was a real help, since it meant that I could keep everything with me until the very last minute.

It was an excellent plan. Unfortunately, it was also the source of my undoing later in the race.


The Swim: — 1,500m (0.9 miles) in 22:31 = 1:21/100 yards.

Let’s talk about swimming in the Hudson River. Everyone joked about it. It’s dirty. It’s radioactive. I’ll get out with        (insert your favorite disease here). Blah blah blah. The only real advice I got came last year from someone who just finished (stay to the right where the current is faster) and from this year’s athlete’s packet (it’s saltier than you might expect).

We had to leave transition by 5:40AM for the swim start, which was not a problem. Our 4:45AM bus from the hotel was met with gridlock at 72nd street by Riverside Park. Ah, the city that never sleeps. . . . Except that we went to bed at 8:00PM the night before, which might technically be against the law. Someone next door woke us at midnight by taking a shower. A half hour later an enormous thunderstorm rolled right over us in Midtown. I knew my bike was getting drenched, but I was happy knowing that I hadn’t left anything else there.

After setting up my transition area—I’m a minimalist, and I keep as much stuff as I can in the shoes that I need to wear during the next event—Lisa and I walked the mile up to start. While we waited for my turn to get in the water, we watched the river flow by, carrying twigs and leaves and driftwood along with a dead fish here and there. I was promised a PR because of the current. The course record was 9:00 . . . for 1500m. Some people don’t run that fast. (My typical mile time is 32-35 minutes.)

We waited and waited. Along the way, we saw the pros and elites start . . . and almost everyone else. Not knowing when I was going to start made me nervous, and I ate my breakfast too soon. My plan was to do what I had tried earlier in the week a couple times: eat a Clif Bar 20 minutes before starting the swim, bolusing a small amount for it. Instead, I ate almost an hour before my swim wave. By the time I got in the water, my BG had risen from just under 200 mg/dL (11.1 mmol) when I awoke to around 350 (19.5). For those of you without diabetes, that’s very high, which threw off my whole nutrition plan. More about that later.


I jumped in the water (literally) at 7:45AM. Every twenty seconds, fifteen of us hopped into the water, our times starting as soon as the timing chip strapped around our ankles left the timing mats at the edge of the starting barge. The whistle blew, I held my nose to keep the saltwater out, and I hoped that my goggles had a good seal.

Slightly more than 22 minutes later I was being helped out of the river by burly guys. That’s a PR by over ten minutes! I know the current helped me quite a lot, but I was really happy that I passed people all along the way. Lisa followed my progress down the river and took a lot of pictures of me. “And there’s the person you kinda swam over. . . . And there are people doing the backstroke. . . . And there’s the dead fish you probably grabbed and jokingly thought was a piece of driftwood that you could use as a paddle. . . .”

Looking at these photos afterward, here’s what I’ve learned. (1) I over-rotate when I breathe. (2) I need to keep my head pointed downward more. (3) When my hand enters the water, it’s not ready for a good catch. (4) Etc. Still, I’m really happy with my swim.



The Bike — 40K (24.8 miles) in 1:16:04 = 19.6 mph.

My ride was the strongest discipline of the day and the one I enjoyed the most. I had a plan to stay near lactate threshold—the place where muscles switch from aerobic to anaerobic energy—based on my heart rate monitor, and only go over for short periods of time when going up hills or passing. The idea is to put the maximum sustainable effort out there on the course and refuel along the way to keep the energy up.

Having driven along the eastern shore of the Hudson River several times on my way to and from the George Washington bridge, I knew that the course would be hilly. The route mainly used the northbound side of the Henry Hudson Parkway / West Side Highway from 79th Street north into the Bronx and onto the Mosholu Parkway before turning around at Gun Hill Road and returning all the way back to 57th Street, where we did a U-turn to reenter Riverside Park at 79th. (Look at me sounding like a local.) Being a highway, most of these grades were shallow and long. But having touched 40 mph on the downhill, I can tell you that some of the climbs, especially the Bronx were the real deal.

As in most races, I passed a bunch of people, partly because I started so far back in the swim and partly because I had a really good ride. About two or three dozen passed me, and many of them went past me like I was barely moving. They were mainly from the 30-35 age group and had some seriously aggressive aero going on. I was in my own aerodynamic tuck most of the time, too. I really only got out of it when climbing a few big hills and when I was drinking. It was also the first time I ate on the bike in the aero position; I actually think that might be easier. (I’m also kind of amazed at how many people I passed who were riding tri bikes like mine but who weren’t riding in aero. Maybe I just caught them at a bad moment.)

Speaking of eating and drinking, I didn’t drink enough water. Nor did I eat as I had planned because of my high blood sugar. These mistakes were to be my undoing during the run on this hot, humid day.


The Run — 10K (6.2 miles) in 52:21 = 8:26/mile.

Before I jumped in the water, the announcers reported the men’s winner. Lisa reminds me that it was humid and warm even before his wave started, but when he crossed the line at 7:20AM, it was still fairly cool. By the time I finished my swim around 8:00, the air was warming right up. By 9:30, as I was running up 72nd Street into Central Park, it was hot. I had dumped some of the water I didn’t drink on the run over my head before leaving transition for the last time, but I was still warm. I drank from my palm-held bottle until I ran out around 5K in the park, but by then I was already starting to realize I wasn’t going to be able to make up the debt I racked up on the bike.

I have a bad habit of not pacing myself well and heading out too fast when I run. So I tried to be mindful of that, running by perceived exertion and HR and giving the best effort I could without going into the red zone.

In case you didn’t know, Central Park is hilly. It’s hilly where I live, too, but these hills demoralized me a bit. Running a hilly course for the first time is never fun. I was feeling good through the first 5K, averaging about 7:30-7:40/mile, but then I hit the wall going up a hill. The combination of dehydration, too little food, and high blood glucose (over 380 mg/dL, or 21 mmol) was too much. I kept running, but I slowed. My leg muscles hurt like they were full of lactic acid because of the blood sugar, and the world was starting to look bleached because of the lack of water.

As I grabbed more water at the remaining aid stations, I hoped I didn’t look as bad as I felt, since I didn’t want to get pulled from the course so close to the end of my race. I thought about walking a couple of times, but I pushed on until just before mile 5. On a hill just uptown of the Metropolitan Museum of Art, I let myself walk. I was tired and trying to figure out whether I was going to pass out. After about 3-4 minutes of walking, I felt better—not perfect, but well enough to run again. I was running when I heard Lisa cheering for me. I gave her a smile and a wave and picked up the pace and finished the last little bit really strong.


Recovery: I pumped my fist crossing the line, happy to have finished on my feet, already thinking about the lessons I could take from this race and use in Maine for my Ironman-70.3. A young woman handed me a cool, soothing, wet towel that I put over my head. It was so wonderful! I think I would have kissed her if I weren’t in that “if someone touches me I might pass out (or worse)” phase—well, that and I’m married, you know. Another woman smiled at me and put a finishers’ medal over my towel-covered head and around my neck. Then there were bottles of cold water and a chocolate milk-like recovery drink and a banana, all from happy volunteers.

By the time that Lisa caught up with me and we had walked back to transition to get my bike, all of the sparklies and worries about needing medical attention were gone, and I felt really great. We talked about the race and the weekend on the way back to the hotel. It was a great experience . . . logistics, dehydration, and diabetes notwithstanding. I’m super excited about Maine next month!


Posted in Cycling, Diabetes, Life Lessons, Reluctant Triathlete, Running, Swimming | 5 Comments

Trials – Monday, 5:45AM

Posted on July 2, 2012 by Jeff Mather

I. Monday morning swims are always the hardest. Technically, Monday is a rest day on my plan, but the pool is only open three days a week during the summer, so I find myself getting up at 5:00 on my rest day to get ready to go to the pool—which I admit has been a little harder to do recently than normal. I’m usually a bit worn out after the previous day’s long bike ride, and Monday reminds me that swimming, while mostly upper-body, really is an activity that uses each of the major muscle groups: arms, legs, and core.

The first swim of the week is often a speed workout, which involves lots of short, all-out sprints. Just like track workouts, the idea is to tax the body’s anaerobic system so that the fast-twitch muscle fibers strengthen, resulting in greater speed the rest of the time. The rest is just short enough to clear out the lactic acid and “reset” the anaerobic system. (“You get faster by going faster” is one of the basic rules of endurance training.) For example, today called for two sets of 5×100 yards with 30 seconds of rest between each 100. Those thirty seconds are just long enough to catch my breath before starting the next sprint. The two minutes of rest between each set is heaven. I lean back against the wall with the water up to my chin, letting it cool me down while I come back to myself. Eventually I resume noticing what’s going on at the pool around me, since I usually get very focused during these intense efforts. Then it’s time to start the intense effort all over again.

I’ve slowly been getting a bit stronger and faster during these speed sessions. Each 100 is a little bit faster than at the beginning of the season—maybe 5-10 seconds—and my 50s are much faster than before. It’s nice to see everything coming together. Now I just need a little more slipperiness and efficiency in the water, and I’ll be keeping up with the cool kids at the pool . . . or at least watching them lap me fewer times.

I don’t think a lot during these speed sessions. Unlike the endurance swims, where my body follows the line on the bottom of the pool while my mind drifts all over the place—trying to remember what lap I’m on, looking around at the people and noticing what they’re wearing and how well they’re swimming, thinking about Lisa and my friends, visualizing my next race, computing fractions and percentages of the swim that I’ve done, being mindful of my form and stroke efficiency, singing along to inappropriate lines from hip hop songs that stick in my head—when I’m doing strength and speed workouts, I’m mostly fixated on pushing as much water past me as I can and trying to remember how many times I’ve touched the wall in the deep end since I started this part of the set. It’s nice to be so single-minded.

This morning while I was warming up and then as I recovered between sets, I thought about the U.S. Olympic trials that Lisa and I have been watching nightly for the last week. I love watching the swimmers, runners, and field athletes doing what they do so well. (I’ve also watched a bit of the gymnastics trials, but I have to admit that it’s hard for me to get into it. I respect the difficulty of what they’re doing and how they make it look effortless, but with the exception of doing a plank or two in my day I don’t feel a lot of connection with the sport. I do like the drama of the events, although NBC could dial it back just a smidge.)

It occurred to me the other day that, while I’ve always had a good understanding of how hard it is for the track athletes to do what they do, this is the first Olympiad where I can really appreciate the swimmers’ technique and times and not just the drama of who is going to win. I’ve never run under 5:00 for a whole mile, but I ran 800m back in the day near 2:15 and some 2-mile track races around 11:00. It was never fast enough to win, but it was fast enough to know what it’s like to run really fast. I know what air moving past me at 4:30 pace feels like, and it’s great. I’ve only done a handful of bike races, but I know what it feels like to descend at 50 MPH and to make that face when riding. That look is the 5 MPH difference between what I do for part of a workout and what they do for hours.

As I was leaning against the wall having done five 100-yard sprints at between 1:40 and 1:45 for each, I was thinking of the women and men I watched at the Olympic trials on TV the night before who swam 200m of freestyle in the same amount of time that I took for my 90-ish meters. The fact is, I have no idea what it feels like to swim fast. (Don’t get me wrong; I’m not complaining. I’m so much faster and stronger than I was just a year ago.) While I do well versus my peers, there’s another group of swimmers out there that have more than just the skills and speed that I lack; they have also had swimming experiences that I’ve only dreamt of.

I’ll never swim as fast as Ryan Lochte or Missy Franklin—or run as fast as Galen Rupp or Allyson Felix or ride as fast Jens Voigt or Kristin Armstrong—but it’s fun to think about maybe getting halfway there. It certainly makes those 100 yard sprints feel better.


II. Each trip to the pool is also an opportunity to fine-tune my insulin for the swim. Based on a few weeks of data, I can definitively say that if I don’t eat, lower my basal rate, or bolus any insulin before speed or strength workouts, my blood glucose will go up. But if I go to the pool or lake and do an endurance swim of a half-mile or more, it will go down. How much insulin do I need on a speed day to prevent going up? How much food (and possibly insulin) do I need on an endurance day not to drop very much? These are questions I’m asking myself and trying to answer three times a week. With NYC coming up on Sunday, finding the answer is a bit more urgent, which is another good reason not to sleep in on Monday.

This morning was a perfect opportunity to search for answers and gain extra confidence.

My BG at 4:30 this morning was 120 mg/dL (6.7 mmol). An hour later before my swim it was 108 (6.0). Those are pretty close to perfect for me for fasting readings. That perfection made “doing the right thing” more critical. I didn’t want to waste an opportunity to gather good, usable data by changing too many things at once, and I didn’t want to act too aggressively and possibly go low in the pool. Choices, choices, choices.

I was hungry, I didn’t have a lot of headroom for going low, and I had an energetic swim ahead. What to do? I decided to simulate this weekend . . . minus the endurance aspect, which I hope to account for on Wednesday or Friday. I set a 0% temp basal rate 40-45 minutes before I knew that I would start swimming, I ate an energy gel (20g of carbs) 10 minutes before the swim, and I delivered an almost insignificant 0.3 units of insulin to “cover” the food and the swim. (This follows the same ratio of roughly 65:1 that I’ve been using when I bike in the morning. It hardly seems like it should matter, but it does. And no, I don’t divide by 65. I say, “ClifBar = 0.6u, and a gel is half a ClifBar, so 0.3u.”)

What happened? My post-swim was 112 (6.2), basically unchanged from before the swim. That sounds like something very promising to try again. Later this week, I’ll try a longer, aerobic swim with similar fueling and see what changes I need to make.

Things might finally be starting to come together.

Disclaimer: Obviously, this is something that worked for me . . . once. Take a big ole grain of salt, don’t consider this as personal advice or copy it outright, and talk to your diabetes peeps before making any changes. Yadda yadda yadda.

Posted in Data-betes, Diabetes, Life Lessons, Reluctant Triathlete, Swimming | 1 Comment

Tri FAQs

Posted on June 22, 2012 by Jeff Mather

Over the last couple years, my friends, family, and acquaintances have asked me lots of questions about triathlon. I love answering these questions; it shows that they care about what I’m into and that I might have something to offer. Here are some of the most commonly asked (and answered) questions.

Why triathlon? Because (as Lisa said) the first one I tried didn’t kill me, and I knew that I could do better! Well, that and it’s a lot of fun to combine a few different things that I like doing all at once. I like to run, but I love to race. Most of the time when I’m on the bike for a training ride, I’m thinking about my next event. And it’s challenging. I like a challenge.

Do you wear a wetsuit? Yes. Always. I have a history of freaking out in open-water without a wetsuit. Plus, I’m a faster swimmer when I wear one. (It’s the extra buoyancy in the hips and legs.)

What do you wear under your wetsuit? Nothing! Just kidding. (For some reason, people always assume that we’re naked under there.) I wear whatever I’m going to wear for the bike and the run (minus shoes, of course).

What do you wear when you race? I wear a tri-top and tri-shorts. The top is a rather tight fitting, sleeveless bike jersey with a couple of very small pockets in the back that are pretty much only big enough to hold my pump (in a zippy bag) in one and an energy gel and a tube of glucose tablets in the other. (I tried running in a bike jersey once and everything bounced around way too much.) Tri-shorts are similar to regular cycling shorts except that the padding is a little smaller and lined so that there’s less friction. Most of the time, I don’t even notice the padding when I’m running. They’re also a little shorter than my regular bike shorts, and my tan lines look super-stupid when I’m wearing them.

How do you prevent chafing with less padding? I use lots of Body Glide, which is basically a paraffin wax-like substance in a deodorant stick-like container that your slather wherever you think you might chafe, which isn’t just the obvious places. It’s important to put it on your ankles and neck to help with the wetsuit. (And yes, I know that the name sounds like something naughty you would buy in a store with lots of neon signs and boarded up windows. I see you smirking out there.)

Where do you practice your open water swimming? I swim in Ashland Reservoir with half-dozen or more people from my tri club. It’s on my way to work, which is very convenient.

Where do you change clothes before work? In the parking lot of the boat launch where we all meet to swim. Obviously. :^) I’ve gotten quite adept at changing out of my wet swimsuit and into my work clothes under a beach towel. Sometimes, it’s nice being a dude.

How do you see in the water since you’re so blind? I have a couple pairs of optically corrected swim goggles that you can buy from the Tyr website. One pair is clear, while the other is tinted to block out some of the morning sun. I can’t read with them on, but then again, I don’t need to. They’re good enough that I can see where I need to go.

Why do you wear a swim cap? A few reasons. It makes it easier for boaters and my fellow swimmers to see me in the water; it simulates what it’s like on race day; it keeps my hair out of my face and water from sloshing in my ears; and when it’s cooler out, it keeps my head warm.

How long is each race? So far I’ve done sprint triathlons, which don’t have a standard distance but tend to be 1/4-1/2 mile of swimming, 10-15 miles of cycling, and 3-5 miles of running. I am registered for an Olympic-distance race (1500m, 40km, 10km—or 1 mile, 24 miles, 6.2 miles) and a 70.3 “half-Ironman” (1.2 miles, 56 miles, 13.1 miles).

How long does a race take? The sprints take a bit more than an hour. (My last race was 1:08.) I expect the Olympic is going to take between two and three hours, if all goes well, and the 70.3 will be between six and seven hours.

What’s on the calendar for this year? On July 8th, I’m doing the NYC Triathlon, which is an Olympic-distance. And August 26th is the Rev3 70.3 in Old Orchard Beach, Maine. That latter one involves an ocean swim, which kinda makes me nervous. And the NYC Tri just makes me nervous in general, since NYC just generally makes me nervous. It has a very early start that involves diving (literally) into the Hudson, and we’re only there overnight. I’m actually more worried about making the hotel check-out time than anything else.

What is your favorite part of triathlon? Passing people! That and knowing that I’m capable of doing this. It’s great seeing all of the training come together. And I confess that I have a warm spot in my heart for the bike. It’s my first love.

How does diabetes impact triathlon? It has a huge impact! Everything gets extra attention because of it. Managing diabetes during triathlon is as much a part of the sport as any of the three athletic activities or getting the proper nutrition before and during the race. I’ve been working for months on making lots of small, data-driven tweaks to my basal rates, bolus amounts, and food and insulin timing so that I can get the performance I want without high or low blood sugar. I’m not there yet, but I’m getting closer. Even though training ensures that there’s never a “normal day” to use for diabetes testing, triathlon has made my diabetes self-management so much better—even if my A1c doesn’t show it. It inspires me to try harder, and I’m in a better place because of it. It also makes my transition times longer than I would like them to be.

What do you do with your insulin pump during the swim? My Medtronic pump isn’t waterproof, so I take it off before I zip up my wetsuit. I put it in a zippy bag in my cycling shoe so that it’s ready for me after the swim, so that it’s out of sight and stays cool, and so that it’s impossible for me to forget to put back on.

Are you afraid of low blood sugar while you’re swimming? Yes, of course. Well, I’m not exactly afraid, but it’s always on my mind before I start. I keep an energy gel or two in the ankle of my wetsuit just in case hypoglycemia strikes. I’ve been working really, really hard in recent weeks to get more predictability in my BGs around swimming, so that I don’t feel like I have to start out way high in order to avoid lows.

How do you test your blood sugar? So far my races have been short, and I’ve been testing in the swim-bike and bike-run transitions, where I leave my meter. It’s impossible to test wet hands—it prevents the blood from forming a droplet and ruins my test strips—so I keep a thirsty chamois-type towel near my meter to dry off my hands before I start. (That was a hard-knocks lesson from my first triathlon.) Getting test strips out of the vial takes time and gets harder when you’re in a rush, so I leave one in the meter to quickly get going. I’ve also been experimenting with using one of Lisa’s hair rubber bands—thanks, sweetheart!—to attach a couple of extra strips to the One Touch Ultra Mini I use when I exercise.

What about testing during the 70.3? That’s a challenge! 3-4 hours is too long to go without testing on the bike, and I need my meter with me on the run, too. I’ve done one experiment while riding, and it wasn’t so successful. I managed to get the test strip into the meter and had thing between my teeth while I lanced my finger before I realized there was no way I was going to be able to get the blood from the finger on my left hand into the meter in my right one without having an extra for steering. (Homey don’t ride without hands.) I suppose I could try to do that with my meter still in my teeth, but I’m contemplating a way to attach my meter to my aerobars. That seems more promising. The run should be easier.

What about CGM? Shouldn’t that solve it? My CGM receiver (a.k.a., my pump) doesn’t like to be away from the CGM transmitter for more than half an hour. When it does, it gets “lost” and then needs recalibration. This annoys me, especially since I’ve been able to trust my CGM a lot more during exercise recently.

What do you eat and drink during an event? What about the 70.3? Energy gels (such as Gu, HammerGels, and ClifShots), energy chews (like Honey Stingers and ClifBloks), and water. Ideally I take in about 20-30 grams of carbohydrates every 30-40 minutes. I carry my own water with me. For shorter races, I keep two bottles in transition. One contains Gatorade and the other plain water. The one I pick to put on the bike depends on my blood sugar. My strategy for the 70.3 is going to be basically the same . . . just more of everything. And, yes, 6-7 hours of eating gels and chews sounds nasty and boring, but trust me, the thought of eating real food gets less and less appealing as the hours pass. (Although, if I could find some Pearson’s Salted Nut Bars, I would be so all over those.)

How much do you train every week? Usually nine to eleven hours of actual training time. It depends on the distance of my long run and ride and whether it’s a recovery week or not. Every week has nine workouts: three of each discipline, split among strength, speed, and endurance training. The purpose of strength workouts (which are basically tempo or long interval runs/rides/swims) is to build the ability to work at high intensity for long periods of time on race day, while the speed workouts are all about becoming faster by doing short, high-intensity sprints. I’m not used to this much structure, but it’s hard to get the training volume needed for each of the disciplines when you have to train for all of them at once, so quality counts and doing things in the right order to prevent overuse injuries and excessive fatigue is key. I definitely enjoy the mostly unstructured, “just go long” endurance workouts best.

How much do you have to eat not to waste away to practically nothing? I eat a lot! Upwards of 3000-3500 calories every day. It feels weird to eat so much, but I kinda like it.

What’s your goal with tri? That’s a tricky one. I’d like to see how good I can get at it while still having a really good time. I also want to inspire other people with diabetes (and without, too!) not to see our disease as a limitation. People who don’t have it don’t usually get how much hard work, self-doubt, and just plain-ole bullshit we have to put up with to do our thing, but for those of us with diabetes we know. It can be pretty discouraging and even paralyzing from time to time. I want to show other PWDs, their loved ones, and yes even myself what it’s possible to do. I want to be that success story you hear about.

Why do you say you’re not a good swimmer, when you’ve been top 1/3 in your last couple races? You caught me! I am trying to stop saying that I’m not a good swimmer, even though I could be better at it. It’s simultaneously refreshing and frustrating for me to see other people who are faster than me in the water. On one hand, it gives me the freedom to concentrate on what I’m doing and not get caught up in trying to chase someone down, but on the other hand, it’s a reminder that my technique and power are still not where I want them to be. It’s a very humbling and empowering place to be. (And I am getting a bit faster.)

Are you going to do an Ironman? Hahaha! You people are funny. That would involve running a marathon, and we know that I currently have no plans to do that. Seriously, I’m not keen on subjecting myself to 14+ hours of athletic exertion, much less asking Lisa to put up with me as I train for it.


Anything else you want to know?

Posted in Diabetes, Life Lessons, Reluctant Triathlete, Running, Swimming | 8 Comments

A Year Later, I Can Do This. You Can, Too!

Posted on June 15, 2012 by Jeff Mather

A year ago, when Kim announced the “You Can Do This” project, I could just tell it was going to be an important addition to the online landscape of diabetes. A year later, it’s become bigger and more empowering than I had ever imagined.

Whether we’ve had diabetes for three days or thirty years, we all need a little reminder from time to time that we can have lots of good times in our lives with this disease and that the bad times don’t last as long as we think. It gets better and then it gets worse and then it gets better again . . . but you can do this.

After a huge reversal of my A1c back to where it was when I started trying to lower it, I’m at one of those points where the encouragement of all the people online whom Kim has harnessed with her project is so welcome. I was so heartened to see that the currently featured video on the YCDT site is by Kris Freeman, “elite U.S. cross-country skier, member of U.S. Ski Team and Olympic athlete.” Having someone like him tell me (and all the rest of us) that we can keep aiming for and achieving amazing things despite having diabetes is exactly the message that I needed to hear right now. My A1c got worse, but I’m figuring out how to make it better at the same time that I keep training and racing and enjoying my life (with diabetes). As I told y’all in my own video, “You can do this.” And I believe I can do it, too.

Thanks, Kim, for starting something so wonderfully motivating and empowering!

Posted in Diabetes, Life Lessons, This is who we are | 4 Comments