Pretty good day!

A little high after lunch, but so far so good!

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I'm still here..... barely!

So after a long 5 weeks with no posting I figured it was about 4 weeks past due! I have failed at blogging......

Within a day of my last post I was running a temperature anywhere from 97-101, had most of the minor flu-like symptoms, and felt terrible! Like most people with diabetes, the common cold makes managing my diabetes very difficult. My basal rates can get thrown out the window. My insulin to carb ratio's can get flushed, and my insulin correction sensitivities need Midol!

After a few days of high temps and nausea it migrated into the a head cold that would not budge. For about 4 weeks I have been a mucus coughing/spitting machine, feeling less than stellar. I missed all 5 remaining cyclocross races (although 3 would have been missed due to work schedule changes anyway). So the only exercise I have gotten has come from hikes with the dogs since the Shedd Park race. This has been somewhat self inflicted with the Holidays and all.

Shedd Park Cyclocross Report

photo by someone in the J. White clan, maybe
 Jamie he was done well before me!

So the guys on the team decided that for this weeks race we should all ride in the same category so we could represent! Jamie, Glen, David, Rob and I all lined up in our black Racer-X jerseys and shivered until the race promoter blew the whistle. High temps for the day were scheduled for 39 degrees, but it was more like 34 when we started at 9:45am! It was chilly but managed to bundle up enough to stay warm until I got in a couple mile pre-ride and a warm up lap on the course.

This was my first race in a while (about a month) and my first on the new Omnipod insulin pump, and Dexcom CGM (continuous glucose monitor). I had in stalled my pod last night on my left under arm

My new tools...

Here is my new insulin pump PDM, and CGM (continuous glucose monitor). The PDM, on the left, has a built in Freestyle glucose meter that I check my blood sugar with. The CGM is on the left and shows current blood sugar, trend arrows, and a 1-24 hour graph tracking my blood sugar. I only need to carry the PDM when I am going to bolus insulin. Bolus insulin is insulin given to correct a high blood sugar or to cover crabs eaten. The PDM sends the basal programs to the pod, and the pod will remember it on its own. Basal insulin is the small about per hour of

Doctor report and new tools!

I have been working a lot and have not had a ton of time to keep up on the blog, or ride for that matter! But alas, I have much to tell! Mostly on the agenda is a report about my appointment at the Joslin Diabetes Center with my new CDE (Certified Diabetes Educator). Oh, and also I made a major change in my CGM (continuous glucose monitor) and Insulin pump..... as in I got new ones!

Catch up!.....

Not the kind I like to put on most foods...

So it has been a couple weeks since I have written a post, and in a way I am glad! Lets just say it has been a while since I last worked. 16 months to be exact. I have now been back to work for 4 weeks, and it feels great! I have a paycheck, adults to talk to, problems to solve, and time to manage!

Kingdom Trails Again!

 Kingdom Trails in East Burke, VT have to be some of my favorite since moving to Boston. It's a 3 hour drive up, but is worth it! A few weeks ago the trip to Kingdom Trails was a bit of an adventure with my blood sugars, as I could not get my sugar up even though I was taking in plenty of carbs. Just one of those days!

Finding a Doctor

I may have found a Doctor. After going to see 3 endocrinologists, and 2 CDE's (Certified Diabetes Educators), and one primary care doctor since moving to Boston, I may have found the one...... but I won't know until Nov. 3rd! And, that's Ok.....

I want to try to start this entry by giving credit. I will have had diabetes for 21 years this Thanksgiving. In that amount of time you meet a lot of doctors, CDE's, specialists, pharmacists, salesmen, etc. By far, hands down the best healthcare professional I have ever had the fortune to work with is Leigh MacHaffie. She works in Colorado at a small endocrine clinic that I had the fortune of being a patient. Leigh is largely responsible for me utilizing technology to take control of my diabetes. She was a motivator for me to take care of myself and never showed any doubt that I could tackle the bike riding I wanted to do. She took all the time that I needed to make sure I understood what was happening with my pump, continuous glucose monitor (CGM), and more importantly the data that I was receiving from these tools. She even put me in touch with some semi-pro racers with Type 1 that could help me with specifics of long rides and such. After being in Boston for nearly a year, I am about ready to fly back to Colorado (with my bike) for appointments just so I can see Leigh again!

Willowdale Ride

So I haven't really been on a ride since my FOMBA adventures last week. I have been on a few hikes with the dogs, but nothing to blog about. I went for a short ride out at Willowdale today. It was about 10 miles (full loop), and it was the same course as the race on 5/21/2010, with a little extra single track at the end. Legs were not feeling that great when the ride started, it took me about a half hour before I really felt warmed up. In addition, my glucose sensors have not been real accurate in the last couple weeks, and today was no exception. I suppose this is an entirely separate issue/post, but the sensors have not been recognizing rapid or drastic changes in blood glucose, which is kinda one of the main features! I was using sensors that were a tad on the old side, so a new one will be inserted tonight for a Sunday morning calibration and hope for better results this week.

Basically how the glucose sensors works is that there is a transmitter that wirelessly transmits blood sugar data to my insulin pump. Attached to the transmitter, and inserted into my abdominal area, is a sensor. It has a tiny tube that, after insertion, lies in ythe interstitial fluid and measures blood glucose. There is a possible slight lag in the glucose readings from the interstitial fluid and actual blood glucose (blood sugar) levels, but Medtronic says 20% accuracy. That means if the sensor reading says your blood sugar is 100, and actual finger prick reading should be between 120-80 roughly.

So I started my ride at 185 mg/dl. That's a good place to start a ride, it usually drops like a rock in the first half hour for me even though I have temp basal rate set. Today I set a 55% temp basal, and I did it 1.5 hours before ride start. I normally do it 1 hour before ride start, but I am trying to work on the 'drop like a rock' blood sugars in the first half hour! My sugar stayed elevated today, even up to 209 according to the sensor 50:19 minutes into the ride. I was running a little low on energy so ate a GU. Do you really eat those? They really can't be chewed, or swallowed whole... I guess it's more like chewing gum with no dentures! I digress. So the ride was finished by 1hour 17 minutes, and sensor was still hanging at 205. I checked with the glucometer and it said 274! Ouch! I took 3 units for correction, and another 3 an hour later, and threw the sensor away and opened a new box.

All in all it was a good ride, although the 274 says why I wasn't feeling that great. I got in around 10 miles, mostly single track, and rode for about 1:17. I did take 11 minutes off my time from the race on 5/21/2010 on the same course so I was pretty pleased with that! Might have to time trial this in  the weeks to come for a good spring to fall fitness comparison!! Go ride!

Roller Coaster @ FOMBA

So I had the bike ready, the backpack packed, food & water ready and I hit the road by 6:30am. Blood sugar at wake up was 133, and my CGM said 135 which was really accurate. On the drive to the trails I got a low alarm (89) on my insulin pump. Odd.... I had already set a temp basal and had a Cliff Mini, and took bolus insulin for the carbs so I knew it wasn't low. I checked with a glucose meter and it was 190. I calibrated my CGM hoping it would be accurate by ride time. Not the case. I checked with a glucose meter again at the start of my ride and it was still 190 with CGM at about 100... I started the ride and within 45 minutes I was feeling low. I ate a Cliff Mini, and a GU 15 minutes later, but CGM said I was now trending up above 150! Grrrr.

On a bike note, I was seeing all the rocks, big roots and the lines I wanted to take. Problem was I was riding into all those obstacles head on, often nearly endo-ing into next said obstacle! It was one of those days! Blood sugar up and down and MTB skills like Jamie.... I was on a MTB Roller Coaster!

The day wouldn't get better as I would have to stop 10 miles into my planned 3 hour ride. I had a strange pain on the top oh my hand above my right wrist. I tried to shake it off (literally), and I felt something pop. After this point I couldn't grip the handlebar with any control and the pain was hardly tolerable. After navigating the rest of Lady Slipper with a couple close calls, I decided to call it a day. I couldn't squeeze a water bottle on the drive home or grip the steering wheel.

I got a total of 10 miles in out of a planned 20ish so I was bummed. I planned to finish with Fireline in both directions, and I didn't get to ride it in either direction. My blood sugar was up to 260 at this point, so I was again bummed. My pace was 1 mph faster at that point than my previous rides at FOMBA so I was headed home to soak my sorrows in an ICB (ice cold beer).

Here is my graph from the last 12 hours, you can see the roller coaster! Although not a fun one, these days will happen now and again and you need to take them with a grain of salt! I still got in an hour and some change on the bike, and I was in the forest! I also didn't die, and after an ibuprofen and a nap my hand is oddly enough feeling almost 100%! Cross bike ride to come soon and hopefully with better blood sugar and less amusement park!

Another rest day, sort of!

Blood sugar has been running on the low side for the last couple days. Not sure why. I'm on a new statin medication, but I don't think that is one of the side effects. Went on an easy 2 hour hike with the dogs (no temp nasal, but I never do for dog hikes), and was planning on hitting up the Specialized demo day at Willowdale State Forest. We'll see if I feel like plugging through traffic to get there, also need to get the sugar up! If I go test a new 29er you'll be the first to know!

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Rest day today!

Maggie had to work, and I had a rest day planned for the most part. I took the dogs on hike at the park, but that was short and they spent most of the time swimming (didn't set a temp basal). I also moved a bunch of stuff to our new storage unit down the hall, and that took more effort than I planned. I got low a few times throughout the day (never less than 80) and probably could have avoided that with a temp basal while hiking/moving storage units. Here is my daily log. Much better day today!

Kingdom Trails 08-27-2010

So Kingdom Trails lived up to the hype! Really nice and well maintained single track. It had a few sections that had me thinking I was in Fruita, CO with a Jungle view! I will be back and hopefully sooner than later! We rode 18.9 miles (via wheel magnet) and David said we only hit a portion of the trails. Here is the GPS info:



As for the diabetes control.... I have to say it was a tough day for the blood sugar. It didn't help that Maggie and I went to a last minute BBQ/wine party at our apartment complex and stayed up until 1:30am. Nonetheless, it was an off day, maybe still feeling the effects of the 6hr race from last Saturday.

I set a temp Basal of 65% at 9:45am (ride time ended up being 11:10am) and had a breakfast of 1 peanut crunch cliff bar at 8:15am, and had plenty of water (100oz) on the 3hr drive up. Here is my daily log from the glucose sensor (you can also see it on the Glucose Logs page at 2010-08-27). After begining the ride, I fast approached a low sugar (down to 100 from 161) within the first 45 minutes, and began to mow on Clif-mini bars every 15 minutes for the next hour as the sugar would not come up. Mixed in with a full bottle of Endurox R4 (52 carbs, 2 scoops) and 2 GU gels (25 grams of carb each), I still could not get sugar out of the 90's. This was VERY strange, and was actually more carb intake than I had at the entire 6 hours of the VT race last weekend. We took a good 20 minute break and sure enough it started to come up fast! We continued to ride, but I took an easy pace and by the time we finished my sugar was 150. Secretly, my legs were killing me, still feeling the effects of last weeks race. I did a post ride bolus of 4.5 units (higher than normal because of the food intake) and canceled temp basal for now. Had subway for lunch within an hour and headed home. Set temp basal at approximately 9:45pm for 8 hours.

Heading to Kingdom Trails Tomorrow

Tomorrow a few of the riders from Racer-X are heading up to Kingdom Trails in Burke, VT. From what I have been hearing, this is a MTB mecca for the Northeast! We are headed out early and plan to get a few hours of riding. Hope the legs are feeling good after the 6 hour race last Saturday at the VT30. Full ride report to follow as well as nutrition and glucose log.