Total 3 - JwqgKmP
Wild Rumpus Sports
 

Cyborg

Racing with diabetes presents many challenges but simply living on the road can be difficult as well. It is well documented that I had some severe low blood sugar while I was racing last year but to compound that I was also having low sugar while at rest. It was not uncommon for me to have sugars falling into the 50’s during travel or while sleeping. Having low blood sugar wastes adrenaline and leads to long term fatigue.

I started using a new tool called the Dexcom Continuous Glucose Monitor this Spring.

Dexcom Continuous Glucose Monitor

I insert a small wire into the subcutaneous fat in my abdomen. The wire has a transmitter attached to it that sends data to a hand-held receiver. Every five minutes it sends my glucose level to the device and graphs it. Each dot on the picture above represents a glucose reading. The dotted lines going across the graph represent glucose levels of 180 and 60. If my blood sugar is not between those two data points my receiver will vibrate and beep. This is a very important feature for sleeping.

The device requires frequent calibrations from actual blood samples and displays information that it is about 10 minutes behind what my actual glucose is. This combined with its relatively large size (hopefully a watch will be developed soon) make it impractical for racing. However I may carry it on a triathlon race belt, in an ipod case, for 30k and 50k races.

Using the Dexcom device in conjunction with the Omnipod insulin pump means that I have two medical devices in my skin 24/7. My friends have joked that I am turning into a Cyborg. I embrace this, as I am grateful that the diabetes industry continues to innovate and make my life easier. In the picture below you will see the Omnipod on my chest and the Dexcom transmitter on my Oblique.

Cyborg Impression

The display on the Omnipod “Personal Diabetes Manager” shows the many program options on the device. The PDM communicates wire-lessly to the pump on my chest.

Maintaining a relatively normal glucose level is critical to the longevity and consistency of my season.  I look into every innovation that comes out in the diabetes world and decided that this combination was the best for me.  I will use it to tackle every race that comes my way this year.  I considered skipping longer races this season as well as the tour.  But I know I can perform well in those formats.  Living scared is no way to live.  I am going after the 30k.

Little Perspective

I had a great start this weekend in Muonio. It feels awesome to be skiing fast and to beat a lot of the best guys in world. But this is just a warm-up and I won’t place to much stock in the results. If history is any lesson, there will be huge shifts in performance by many athletes next week in Sweden. Its impossible to say where the efforts I had here would place me in a full world cup field. What I can say is that I feel fit and my new strategy for controlling my glucose levels worked seamlessly this week. It feels so good to be skiing strong . I am looking forward to next weekend.

Moosilaukee Timetrial

This summer I have spent a lot of time and effort dialing in the right insulin dose for 30k and 50k events with good success. I also revamped my strategy for 15k length races but have not had the opportunity to test it much. It was necessary to change this strategy because my glucose levels were dropping perilously low directly following my races. These low blood sugar episodes annihilated my immune system last season.

Briefly, the new strategy is to frontload my insulin dose before the race instead of during it. I take a 30 minute extended bolus 30 minutes prior to the start of the competition. An “extended bolus” means that the dose of insulin my pump gives me is spread out over a half hour instead of given all at once. In the past I would give myself this dose directly before the start of the race.

The strategy was changed because the synthetic insulin I use does not reach its full effectiveness or “peak” until 45 minutes after injection.

This is a simple timing change but still requires testing and trial and error to do properly. The first time I employed the new method was at New Zealand Nationals in a 15k classic with the Canadian National Team. I took three units 40 minutes prior to the start of the race. I finished with a blood sugar of 240. (Normal blood-sugar range is 70-120, high blood sugar increases lactate production)
I made a note that my sugar was high with this dose and that I should increase it to four units for my next max effort. I also decided to move the dose timing up by 5 minutes.

My next race effort in the 15k range. was the Whiteface Hill climb roller-ski race. I took 4 units 35 minutes prior to the start. I had a good race but my blood sugar control was terrible and very disconcerting. I was at 350 and had a lactate of 12 to go along with it. Clearly I had way under-dosed again.

Whiteface was supposed to be my last 15k max effort before going to Finland but I decided I needed to test the new dosing strategy one more time. Mt Moosilaukee is only 25 minutes from my house and Ruff Patterson was nice enough to add me to the start list when his team did their annual timetrial on Sunday. This time I upped the dose to 6 units and took it 30 minutes prior to start.

It was cold out and misting. The rocks on the bottom half of the course were slick. About half way up I hit the snowline and the footing actually improved. The trail was a nice firm snowy bootpack. My heartrate was bouncing between 175 and my max 181 the entire way. I finished up in the clouds to find that I had run a new course record 35:16. The previous record was 35:23 set in 1998 by Marc Gilbertson. That wasn’t the best news of the day though. My bloodsugar was 105 at the top. I have found the sweetspot so to say and just in time.

Human Guinee Pig

Since the Olympics I have been formulating a plan to prepare my insulin dosing stategy for 30k and 50k races.  I decided that the best way to do this was to do four to five time-trials over the course of the off-season.  The first timetrial was two days ago in Bend Oregon.  I set my basal insulin at my current resting rate which is .5 units per hour.  For reference the basal rate I used at the Olympics was 2 units per hour, or four times the dose I just tested.  I planned to ski 30k with the first 20k at just above threshold with maximal effort over the last 10k.  The effort I put in was reflected by my lactates.  My heart-rates were very low due to suppression from heavy training.  My hypothesis was that my blood glucose would remain constant for the first 20k and then rise over the last 10k due to the anaerobic nature of a maximal effort.  To my surprise my glucose remained constant throughout the effort.  I fed an average of 10 ounces of Gatorade per 5ks.   Throughout the test I also compared the data that my new continuous glucose monitor  (cgm) gave me to the results I got from my blood testing Lifescan glucose monitor.   The numbers were close enough that I am now confident in the use of the cgm during races.  All of the data from the test can be found below.

I skied thee 7k loops followed by four 3k loops.  I stopped at the end of each loop for blood testing.

May 31, 2010 Bend, Oregon
44 F, Light rain
30km Pursuit TT
Kris Freeman

KM,       Time In,      Time out,    Split,      HR,    CGM,     BG,       Lactate,      Feed

Start                                                              106,     100
7km,        18.11            19.41,        18.11,    146,      88,        105,         5.6,          10 oz
14km,      37.11            39.12,        17.30,   155,      84,        119,          6.7,          11 oz
21km,      57.01           58.31,        17.39,    152,      96,        107,         5.8,          5 oz
24km,      1.06.30       1.08.06,     7.59,     155,      89,        108,         9.0,          7 oz
27km,      1.15.23        1.16.50,      7.17,     156,      96,        112,         8.9,          12 oz
30km,      1.24.26       1.25.56,      7.36,    157,       100       100,        9.1,          12 oz
33km,      1.33.17                            7.21,    160,      105        125,        10.3

Switched to skate at 14km

feeling better

After two fevers and a sinus infection in the space of three weeks I underwent a battery of tests with my doctor. We tested my blood, stool, and urine for every illness we could think of. Thankfully every test came back normal.

Since my doctor could not come up with a diagnosis I came up with my own. For the past ten weeks I have been suffering from acute wussitis exacerbated by two extreme hypoglycemic episodes.

I finally have some life in my legs again and I have been enjoying some runs and telemark skiing.

Yesterday I made the trip to Mt Washington’s Tuckerman’s Ravine. I started the day by driving over the kangamangus highway at well over the speed limit blasting the new “Slash” cd. The trip left me in a perfect mood for making the hour hike up to the base of the ravine. It was about 30 degrees and windy on the slope. All the loose snow had been blown onto one narrow section of the face. I did not notice this at first so I hiked up what is usually my favorite run. Once I got high enough that I could no longer turn around, it was apparent that my planned route was very icy and would be no fun at all to ski down. Unfortunately there is no way to put your skis on in the middle of the Tuckerman head-wall, so I kept hiking till I reached the top of the run. I had to traverse and two foot about half of the descent on the sheer slope and in all honesty I scared the crap out of myself in the process.

After that experience I followed the snow and had three great runs in windblown powder. The ski back down to my car was the highlight of the day though. The winding trail was a mile and half of soft moguls that left my thighs totally blown.

It is great to be outside and on skis again!

beat up

I went directly home after the Olympics. I trained easy distance for a week and a half and started feeling like myself again. Then I got a fever in the middle of the night. Three days later I was feeling better and even considered going for another ski but I didn’t. That night I had a violent vomiting attack. I spent about five hours rolling on the floor and worshiping my toilet. At that point I only had four days left until the 50k. It was pretty obvious my season was over, so once the second illness subsided I started tele-skiing everyday. That lasted about five days and then I got a sinus infection. I am now on antibiotics wondering what I did to my immune system.

Picking up the Pieces

Over the last four years I have done everyting I could think of to prepare for Vancouver.  The Olympics were obviously a complete disaster for me.  I was so emotionally and physically exhausted after the 50k that my coaches strongly reccommended that I go home and recover, not go onto the world cup.  I protested initially but soon realized they were advocating a good decision.  Whenever I have had poor performances, trying to push through to the other side has lead me to illness.

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.

Ignore the Headline

In the article “skis not fitness doom freeman” fasterskier blamed my wax techs for bad skis in the last race. That was not my intention when I gave the interview. I am not blaming my skis. I am blaming myself for decisions made in the last hour before my race not anyone or anything else.

stunned

I plowed through the media after my race today because I don’t know why my race was so bad today and I knew I would get that question. Whenever I have choked in my life I at least knew what I choked on. I have no answers today.. I am just embarrassed.

Today Show

I was on the Today Show this morning. Check out the link for a two minute clip.

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

No More Hero Worship

I check fasterskier regularly because I love this sport and there are frequently informative updates and news on the website. Over the past few years it has become a legitimate, unbiased site that has moved away from worshiping Norway, Finland or whatever other country was having dominate results at the time.

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.

Canmore

climbing

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.

Rolling With It

I had the most successful first period of world cup racing I have ever had this year. All of my races were either good or excellent except for the final 30k in Rogla Slovenia. I tried a different insulin dosing strategy that did not work. I was forced to stop at 22.5k with a blood sugar of 49 (many people lose consciousness below 60). I was obviously disappointed with the race but I needed to experiment with my insulin strategy in 30k events.

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.

Thanks Boulder Nordic Sport

I took fourth place last weekend in the 15k classic world cup. It was my best finish on the world cup ever. I paced the race exactly as I planned too and had the fastest last 5k lap. I have skied on Fischer for nearly ten years so I have a very healthy collection of favorite race skis. I recieved several new pair this year from BNS after their swing to Europe to pick skis out for their clients. I was pleasantly suprised to find that one of those pairs was outperforming all of my klister skis in Kuusamo. I raced on it . Anyone that says that the best skis in the world arent available in North America hasnt shopped at BNS. No one is as nerdy and specific about skis as Zach and Nathan. thanks guys

Nerves of Sugar

Race nerves have a dramatic effect on blood-sugar. As anxiety rises during race preparation a small amount of adrenaline is released in the body which triggers the liver to dump sugar into the bloodstream. This is the fight or flight response. If someone was walking through the woods and knew they were being stalked by wolves the body would prepare itself for an escape by mobilizing sugar. The islet cells on the pancreas would compensate for the increase in glucose by releasing insulin. The insulin would then bond with the sugar and be taken into the muscles so that it could be used as extra fuel to escape the wolf pack with.

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.

Beitostolen

I had a good first weekend of racing. I took fifth two days in a row against most of Norway, Italy and Switzerland’s top skiers. I traveled very well rested and had not overly exerted myself in training for a week prior to the trip. The more I compete the more I realize how important it is to being happy, healthy and ready to go.
I celebrated my successful weekend by cleaning the bathroom in the small apartment Torin, Lars, Andy and I share. It was a… humbling experience. Living quarters are tight and there is no regular maid servince so we have taken it upon ourselves to clean up after each other on our days off. Surprisingly no one had decided to tackle the bathroom yet.
I am looking forward to next week’s world cup opener. Being fit and ready is my favorite feeling.

Gliding Balancing Act

As a  diabetic, balancing my blood sugar during races is critical for a good performance.  This is a difficult task given the numerous factors that can affect glucose in the blood stream.  For this post I am only going to focus on one such factor. .. terrain. 

Through extensive testing I have learned that when I am in an anaerobic state my glucose rises significantly.  When I am in an aerobic state my glucose drops.  The rate that it drops increases with the intenisty of the effort.  I am at peak sugar burning mode at threshold.  Once my heartrate climbs into level 4 and level 5 territory my glucose suddenly begins to rise.

In a normal ski race I am constantly bouncing between a threshold effort and maximal effort.  My heartrate peaks at the top of a hill and slows as I go down the other side.  Thus my glucose levels rise and fall throughout the race until I put in a final anaerobic surge over the last few kilometers of a race.   A normal glucose level for a non-diabetic ranges from 70-140 during a race.  At below 70 a racer would be experiencing a “bonk.”  So it is important that I do not use too much insulin during a race.  However it is just as important that I do not use too little insulin.  My lactate level starts to rise unnaturally when my sugar reaches a level of 240 or more.  The margin for error is small, but thanks to testing on the Center of Excellence treadmill and many races and timetrials I have developed an inuslin dosing strategy that generally gives me a glucose level of 160 at the finish of a 15k race.

There are two types of insulin dosing, basal and bolus.   Insulin is delivered in measurements called units.  A basal insulin is a constant drip that is delivered into my bloodstream 24 hours a day by a mechanical box called an insulin pump.  The pump I use is called an OmniPod.  The bolus insulin is also delivered by the pump and is given at meal times or at any time a significant amount of carb is consumed.  I progam the pump and override the program when need be.  It is not an automated devise.

My basal rate depends on many different factors that I am not going to go into in this article, but for reference lets assume  that I am using my most commom basal dose of .7 units per hour in the days leading up to a ski race.  My pre-race dosing strategybegins 1.5 hours before the start.  At this point I double my normal basal insulin dose to 1.5 units per hour.  Twenty minutes before the start I bring the basal rate up to 5 units per hour.  I keep the basal rate at 5 units per hour until the completion of the race.

Yesterday’s Race to the Castle on Whiteface and other hill-climb timetrials present a different challenge for me.  Because there is no significant terrain variation there is no place to recover.  I am in an anaerobic state for over 50% of the race.  Thus my bloodsugar constantly rises unless I take even more insulin than in a conventional race.  During yesterday’s race my non-racing basal rate was .5 units per hour.  During the race I increased my basal rate to 7 units per hour and I still finished the race witha a relatively high glucose level of 204.  I have not documented any ill affects from racing at this glucose level but there is definately room for improvement in my controlm durin hill climbs.

Pain in the a*# er… foot

I have had a hot spot on my right inner heel for the past six months. It started bothering me more and more in the past few weeks so I finally broke down and called a podiatrist. I was hoping he would give me a cream that would make it instantly dissolve and I would be on my way. The simple fix was not to be.
It turned out that my “hot spot” was a plantar wart a little larger than a nickel with two satellite infections on the middle and inner heal that were the size of dimes. I was informed that I had two choices given the severity of the virus embedded in the flesh of my foot. I could undergo an acid removal process that would take two months and three to four office visits or I could have the doctor take a scalpel on the spot and hack them out. The benefit to the surgical approach is that I would be rid of the infection instantly , the downside is that I would have three bleeding holes on the bottom of my foot. I opted for the cutting remedy and I was injected with a copious amount of novicane (Due to many ill-advised adventures as a youth I have built up an immunity to normal quantities of novicane).
The doctor scooped the growths out of my numb foot and sent me home. As I drove home unable to feel the gas pedal, a novel sensation, I wondered if my foot would be too sore to train on later in the day when the drugs wore off. I know it was stupid to even consider training but I can’t help myself sometimes.
Any ill-conceived thoughts of training went out the window when I got home. I took my shoes off and walked upstairs to the bathroom. Then I turned around and saw that I had left a trail of bloody footprints. I still couldn’t feel my foot so it had not occurred to me that I could have bled through my bandage. Apparently the heel is very prone to bleeding.
I am sitting on my recliner now watching King Arthur. The novacane has worn off but I am in no pain. I’m just anxious to get back on my feet and train. Maybe I should have opted for the acid treatment. It would have been far less invasive but it would have also extended into my racing season. Making decisions and living with them is no fun. sometimes.

New Zealand Time-Trial

We raced a 10k skate time-trial in New Zealand yesterday. The course was five 2k laps.

lap1 lap2 lap3 lap 4 lap 5 Finish
Freeman 4:37 4:35 4:35 4:40 4:32 22:59
Flora 4:41 4:49 4:53 5:01 5:01 24:25
Newell 4:45 4:56 5:03 5:07 4:59 24:50
Koos 4:38 4:55 5:04 5:16 5:25 25:18

I had good energy and my legs felt good.

New Zealand

My trip to New Zealand has been very productive so far. I have been pleased with my new post surgery legs. Skating feels very natural and the range of motion in my ankle has increased vastly. I have mostly been training four hour days with about two thirds of the hours coming from classic.

I competed in a classic sprint time-trial with Newell, Koos, and Floras several days ago. It was my first race effort since surgery so naturally I was a little nervous about it. The effort went extremely well for me though. The times for qualifying were as follows: Newell 3:50, Freeman 3:51, Koos 3:52, Flora 4:00.
In the quarterfinals I edged Koos by a boot length for first, In the semis Koos and I finished in an undetermined photo finish for a tie for first, and in the Finals I passed Newell in the final stretch for the win.

We are all on different training plans and were carrying various amounts of fatigue into the workout. By no means do I think I am sprinter now because I had a good day against my teammates. I will say that the workout was a good indication that I haven’t lost anything from surgical recovery time.

My feeling on snow is positive. I am enjoying every minute on the snow. My energy is high and the bar at the lodge makes an excellent cappucino.  Can’t beat that.

finally skating again