Given the promising way the season started and the dismal way it developed I am a serious contender for the most volatile and inconsistent skier on the world cup.  Recognizing this I am going back to the drawing board on my diabetes care regimen.  I have already been fitted with the latest Dexcom continuous glucose monitor and thus far it seems very promising.  I am also interviewing with new endocrinologists to get any more data and suggestions that I may have overlooked.  Over the past two years I had such tunnel vision towards the Olympics that I stopped integrating new developments in diabetes treatment into my glucose management.  I was more focused on training.  Clearly this was a mistake.  I cannot fully utilize my training when I have glucose issues.

I have been asked why I have had difficulty with 30k and 50k races over the last several seasons but not in the years directly following my diagnosis.  Type 1 diabetes occurs in people when the immune system mistakenly attacks the islet cells on the pancreas.  No one knows why the mistake happens which is a big reason there is no cure.  It can take a long time for the attack on the islet cells to be complete.  In my case it took about seven years after my diagnosis to have no insulin production.  Over those years I had to change my insulin regime every season to accomodate the constant decrease.  In 2002 I only managed my bloodsugar at night and at meal times.  I did not need to take a basal insulin during the day or when I was racing (basal insulin is a long-lasting insulin that is injected in order to manage the sugar the body releases between meals).  By the 2003 season I needed to use basal insulin during the day and for races.  The amount of basal needed increased steadily during the gradual erosion of my pancreatic function.

By 2006 I was having problems managing sugar on the road when I got sick or tired.  Activity makes the body more insulin sensitive which makes glucose management less difficult.  When I got sick I could not train and I would begin to lose control of my sugars.  So I would continue to train when it was not prodcutive for blood sugar management.  This was a recipe for long lasting fatigue.

At a 30k in Rybink Russia in 2007 I was taking more basal insulin than I ever had and my bloodsugars were climbing rapidly anyway.  I suffered from Hyperglycemia during the race.  At this point I knew I would need to change my insulin management strategy.  I began to use an OmniPod insulin pump which allowed me to change my basal rate at anytime.  Before using the pump I would have to decide on one basal dose that I would be locked into for 24 hours.  The OmniPod gave me the flexibility to change basal rates for varying race distances and has given me the freedom to rest when needed.

My switch to the OmniPod took place shortly after my pancreas finally tapped out.  The good news there is that I no longer have to deal with ever decreasing natural insulin.  The bad news is I have no natural insulin to bail me out when I miscalculate.  I have developed a very effective insulin regimen for 10 and 15k races.  My 30 and 50k strategy still needs a lot of work.

I am hoping the continuous glucose monitor will help me map out exactly what is happening in my body during longer races.  The device gives a reading every five minutes that I would like to use to chart my glucose fluctuations throughout a race.  If this technology works the way I hope it does I should be able to tailor a reliable insulin strategy for longer races.

In the meantime I have been skiing at home at Waterville Valley.  Skiing is therapeutic for me and was the only thing that could get me out of the house once I got home.  I probably skied too much last week but I needed to be out on the snow to stay sane.  This week I will structure my training to prepare for the supertour finals in Maine at the end of the month.

http://today.msnbc.msn.com/id/26184891/vp/35329776#35329776

As the most popular xc skiing site in North America I think this is very important. Developing athletes should know what is going on in the skiing world without the mythical context that used to plague much of North America’s xc ski journalism.

When I was coming up as a junior I heard rumors that American skiers couldn’t ski Bjorn Daehlie’s 10k pace for 100 meters. I heard that US skiers could never again achieve what Bill Koch did in 1976. I heard about incredible training plans that the Scandanavians followed, 1200 hours with level four intervals everyday etc. These rumors made believing that a US skier could be a red group skier let alone a world or Olympic medalist difficult to believe.

At my first Olympics in Utah what I learned about international ski racing is that all of my competitors are just men. They train, they race, some win, some lose but they are all just men.

This realization was very important to my subsequent racing career. I was able to ignore over-blown hype about mythical Norseman and German “ski-gods.” I could focus on real training plans and focus my energy on succeeding at the highest level.

Over the past decade I have seen the xc-skiing climate in America change as more and more racers have seen through the fog of hype that has surrounded international racing. Clear focus has enabled the US Ski Team to post stronger and stronger results. There is no more excitement around simply scoring world cup points. The excitement is gone from a top 20 finish. A top 10 is met with congratulations but only a medal is met with true jubilation as it was for Kikkan last year in Liberec. This is the way it should be.

XC skiing in America holds itself to higher standing than it has in several decades. It could be seen this past weekend in Canmore when the nations group wasn’t here to gawk or spectate but to put there heads down and race. I saw a focus and confidence from our skiers that I have not seen in my nine years with the ski team. I hope every skier in the US will have this kind of focus soon. There is no more time for hero worship, its time to become heroes ourselves.

climbing

I came into Canmore thinking I would do better than I have.  I had no real reason to believe this though.  I stayed at home for as long as I could because I like the stable training environment there.  The sacrifice for the long stay was that I gave up acclimation time in Canmore.  I focused on getting myself into a stable level of fitness at home.  I trained relatively large volume and had no incredibly hard intervals.  When Zach and I laid out this plan he told me the only down side to it was that I would be flat in Canmore.  I didn’t believe him but he was right.  In the 15k I raced a solid strong race without any fire.  When I tried to dig deep I felt like I had to blast away a layer of granite to get to the gritty stuff underneath.  Zach told me he expected that I would not have my top gear but that the race efforts in combination with a set of intervals in Vancouver will get me my top gear back.  I have always been a fast adapter to intensity work and neither Zach nor I wanted to come into canmore red hot only to flicker and fade in Whistler.

I am not worried.  I have been 20th place when I was dead tired and laid everything on the table and I have been 20th place when I have been simply strong and flat like yesterday.  Strong and flat is usually an indicator that I am about to be strong and fast.  Whistler is a totally different course, elevation, and will most likely have unpredictably crazy snow conditions.  I have been dreaming of these Olympics for four years and in a way for my whole life.   The “show” is about to begin.

18 months ago I switched  from using injections with lantus and humalog insulin to a pump that continually provides humalog insulin. The pump allows for much tighter control.  Most of my testing and most of my races have been for the 15k event since I made the switch to the pump. Because of the compartment syndrome surgery I had in early March last year I had to cut my season short.  As a consequence I only raced 30ks twice last year and both were hampered by the compartment syndrome.  This renedered the data fairly useless.

I always learn the most about how to dose insulin from racing. Testing while training or time trials is informative but nothing can truly simulate a race. Shortly after the problems I had in Rogla I resolved to do something during a race that I had never done before. I would stop and test my glucose during the 30k at Nationals. I decided that even if it meant sacrificing a national title any data I could gather to help my performance at the Olympics would be worth it. Also Based on how I had been skiing I believed that I could sacrifice 30 seconds for a test and still win. Cocky? yeah.

I arrived home from period one on the 21st of December and felt pretty good. I took a couple of days super easy and then on Christmas day I went for my first real training session, a three hour skate. About 8:00 PM that night I started feeling nautious. I went to sleep. At 1:00 AM I woke up and vomited violently.  My entire Christmas dinner came out my mouth and nose.  After puking I was literally blowing broccoli out of my nasal passages.  I went back to sleep.  I woke up at 2:00 and threw up again.  At 3:00 I literally hugged the toilet bowl like it was my best friend and curled up on the bathroom floor in the fetal position.

I went back to bed and slept for 28 of the next 36 hours.  When I woke up I felt OK. My fever was gone and I was hungry, a great sign.  My first ski wasn’t until the 28th and it was a timid hour of shuffling.  I felt fine but was weak and my heart rate was 20-30 beats high.  I improved slowly over the next three days.  On the 31st I had to decide whether to go to Nationals or not.  I’m a ski racer and I love to race so I decided to go and flew out to Anchorage on the 1st.

By the 3rd I was feeling pretty good and I was still improving every day.  The problem with feeling better every day is that it means you were not at 100 percent the day before and it is very likely you are not at 100 percent currently.  My energy was good though and I raced the 15k free at Nationals.  I felt flat and rushed but my energy held up fine.  My expectation was that after having a hard effort I would feel better for the 30k two days later.  It didn’t work out that way.

It snowed all night before the race and was about 30 degrees farenheit.   The tracks were slow and leading was not at all advantageous.  I wasn’t moving well and my heartrate was pegged by about 12k.  James was skiing more relaxed than me and I knew I was in for a battle.  Initially I decided to scrap the testing idea but when I skied by the coaches at the predetermined testing site it was clear to me that they were not happy with my decision not to stop.  I yelled next lap after skiing by and hoped I could pull ahead of James to give myself a cushion to test with.  I pulled ahead and felt like crap.  I made James take  the lead.  When I came to the coaches on the next lap I stopped to get the test and lost about 30 seconds in the process.  Second and Third places passed me while I stood on the side of the trail.  I pursued them in a self induced rage and passed them quickly and began reeling James back in.  About four k later I had closed the gap to James to 6 seconds.  I took a deep breath of relief and then blew up.  James still looked relaxed and strong and buried me over the last 2k of the race.

I limped to a second place finish and tested my blood sugar again.  The good news was that the much less aggressive insulin strategy that I had devised worked perfectly.  I consumed five 6 ounce bottles of gatorade and skied with my heart-rate near max for over half the race.  My glucose was 108, exactly where I want it.  I will duplicate this strategy at the Olympics and I am relieved to have confidence in this plan.

I tried really hard to be a gracious loser but I really suck at losing.  I have seen pictures of myself on the podium and I look like my dog just got run over and my girlfriend dumped me in the same minute.  I need some acting lessons.

I am genuinely glad that James is skiing well.  He has been a great teammate at world championships and the Olympics in the past and I will value him as a teammate in Vancouver.

The day after the 30k I tested skis for the upcoming classic sprint.  I was tired and questioning my reasons for racing again.  Basically I like to win and I wanted to go out and win.  That was the only reason to race.  The reasons not to race were that instead of being fird up by racing this week I have gotten more and more tired.  I was obviously depleted.

I decided I would race anyway.  Racing is fun.  Then my entire coaching staff got the flu last night, all five of them.  I am as vulnerable to a new infection as I can be so I scratched from the sprint.  I don’t feel very good right now and I am just hoping I can get back home in one piece and get my feet firmly on the ground during a three week training block at home.

As a diabetic I have to balance the “fight or flight response” on my own. I get nervous before a race and release sugar just like everyone else. Unfortunately my regulatory system is broken and I have to give myself the appropriate amount of insulin. This is where things get tricky.  How nervous I am affects how much sugar I release into my body:  more Nerves equals more glucose . The difficult  part is there is no real way to monitor how nervous I am.

For the Norwegian Cups I skied in a few weeks ago I made my usual  adjustments to my insulin before the race and my blood-sugar remained constant. I followed the same insulin protocol for the World Cup the following weekend.   But lying in bed three hours before the start, my sugar went from 150 to 260 over the course of an hour. This rise in blood-sugar created even more anxiety because I had to get my glucose level back under 150 while testing skis and warming up prior to the race. During this process I took too much insulin and dropped down to a glucose level of 56 only 20 minutes before the race. I was able to raise the sugar to 70 by the start and finished with a glucose of 149. This is great control but the stress of the balancing act certainly did not aid my race and compromised my warm-up

The lesson I learned here was that I obviously care more about World Cup races than Norwegian Cups. I always try to approach every race with the same preparation and routine. Part of the routine is to stay calm calm and relaxed which is easier said than done.  I like to listen to music or read prior to races to keep my mind from fixating on the race. My girlfriend thinks that my pre-race music is too heavy and says I should listen to Mozart to calm myself down. She may be right but I was listening to Alice in Chains which I think is pretty mellow already.

This past weekend in Kuusamo I used the lesson I learned in Beitostolen and raised my basal insulin rate by 50% three hours before my race. My bloodsugar remained constant as I lay in bed waiting fo the race start and reading  “The Cider House Rules.” Without any highs or lows to correct before the race I was able to focus more energy on my warm-up than on the previous weekend.

This is not the first or last time I will learn lessons about my blood-sugar.  I have known for years that various levels of competition affect my nerves and glucose differently.  I once came home from the World Cup and competed in a NENSA race the following weekend.  I used the same insulin dosing that had been working in Europe only to feel my glucose plunge before the race in Vermont.  I had to drink a quart of Gatorade (60g of Carb) to get my glucose high enough to race.  Obviously I don’t get nervous for New England Cups anymore.  Apparently I don’t get nervous for Norwegian cups either.  In the future I hope that my subconscious will get used to World Cup caliber races as well. In the meantime I will continue to search for calming psychological techniques and document the accompanying glucose fluctuations.