A rebirth of my blog tracking my attempts to fulfill my new mission statement:-
1) life does not stop with a diagnosis of type 1 diabetes
2) showing the benefits of exercise for a type 1 diabetic
3) how to go about it, managing training and diet based on my experiment of one
4) report back on my training progress and the occasional race I manage to compete in
5) share my travels around the globe having a great time in the name of work (yes, I like my job)
So who else
managed to make a whole weekend out of one day’s race?
started on the Thursday when I headed up from the flatlands of North Cambridgeshire
to the equally wild but much more hilly Kirkby Stephen in Cumbria where my parents
live.The keener eyed among you may have
spotted the reference to Thursday there, correct.I just didn’t fancy two long consecutive
drives and of course it gave me the opportunity to hone my taper week and carb
loading with a good old pub meal, followed by a pub quiz and then back to my
folks’ for a nice single malt nightcap.Friday morning dawned.
The rest of
Friday was not particularly momentous and certainly involved a lot less booze
and one important decision.My parents
decided to have a day out and come and watch the race, which meant that I
needed to be at Glenbuck for about 8:15 rather than Dam Park for 7am, net
result being an extra hour in bed.
dawned much more brightly than Friday, at least in my mind; it was much greyer
out than I’d been expecting, with forecast high teens.It looked more like 5-6 out there with a
wind, low cloud and general greyness.
A couple of
eggs on toast for breakfast, starting the race mentally and medically.This is where I start managing blood glucose
with intent.The insulin pump gets
turned down to 30% for the next 3 hours to Glenbuck, then again on arrival for
the expected race duration plus 2 hours. Breakfast bolus was down to the minimum.All of this to pre-empt the experimentally determined
massive BG drop in the first 5km if I don’t, brought on by the combination of
increased insulin sensitivity and the switch on of additional glucose transport
mechanisms like GLU4 when we exercise. Plus I’ve spent years training the fat metabolism,
which you can’t utilise with excess insulin whanging around your system.
Still grey and
nasty on the drive up to Glenbuck, with fog, low cloud, rain, not looking like
a nice autumn day at all. Eventually find the carpark, final kit checks, decide
to wear the day-glo buff as a beanie to start with, check carbs, water bottle,
blood glucose again – high, but where I was expecting it, with a drop to follow
soon.Last minute nervous chatter, trips
to the bushes, more chatter, photo calls and then 9am finally arrives in front
of the sculpture.
off.Having no experience of this race
whatever, of this race, I settle down into the train with a couple of markers
that appear to be around my target pace,
only they weren’t, they were much quicker than I ought to have been for a
40-miler.Time for the race plan to kick
in, 25 minute run/5 minute walk, absolutely stuck to.That 5 minutes being used to check blood
glucose, eat if necessary to maintain target, take in electrolytes and give the
muscles something of a rest.Long
experience tells me that if I don’t enforce it I go out too hard for a
sustainable pace over the 40 miles.
experiment I need about 20-25g carbs every 30 mins to maintain stable blood
glucose, and was not planning to stop until the second drop box station, so had
the pockets of the camelback full of dried bananas, and gels with other stuff
in the two drop boxes at the farm and Annbank.Hydration would be at the water stops, quick gulp every time, and carry
a 750 ml bottle of concentrated electrolytes to sip as I went.All was going well until about 8km in when I
started to feel soggy down my left hand side only to find at the next slurp
from the bottle, it had a 2” split right down one side.Enforced strategy revision then; grab a 500ml
bottle of water at each stop to keep me going until the drop boxes where I had
more electrolyes waiting.
By this time
my delusions of grandeur had disappeared and I was back to my 25/5 schedule and
about 5:50-6:10/km, just where I should be.
appeared eventually after two minor routing errors, with my first drop box
sitting happily waiting for me with a nice lunch of cheese filled bagel, double
expresso gel and after dinner mint to go with what I had left in my
pockets.Only trouble was I forgot the electrolyte
tabs in my hurry to keep moving.
For me the
next section with a lot of road was quite tedious, and my feet were starting to
ache a bit to be honest.I’d expected
hard ground, but the gravel path with the 1” stones was particularly hard on the
feet.Everything else was feeling good
by this point though and pace was still going well, swapping places with two or
three other runners every time I went through the run/walk cycle.I made absolutely no attempt to run up those
nasty little short sharp climbs with energy conservation in the latter stages
being more important than pace.
arrived a lot earlier than expected and I was definitely psychologically lifted
when I was told that it was only about 8 miles to go as my left hip and knee
(mainly ITB) were starting to play up, but with less than 14km to go, there was
no way I was stopping.Restock and off
again, but this time unable to keep to 25run/5 walk, it was down to closer to
parity, with more walking creeping in and the pace drifting the wrong way.Mental calculation telling me that the 6hr 30
mark was gone, but 6hr 45 was still a possible, and sub-7 was an absolute cert
unless I had a complete meltdown.
This is where
the race becomes mental for me, not physical, forcing the now protesting knee
to keep running for an extra 45-30-now 15 seconds at a time until I’d got to
2min on/2 mins off. One last routing
error at the bypass had me sandwiched between two runners I’d passed around the
40-45km mark, and that’s where it stayed to the end with the 300 yards of the
stadium separating one from the other over a distance of 62.9km for me in 6hr
still running, just about
absolutely chuffed at that given the knee troubles and the routing errors, as
it was over an hour quicker than my previous 40 miler PB and the RAW was a
tougher course to me.
just 300 yards between us after nearly 40 miles
damage two days later, calves OK, Achilles OK, quads knowing they’ve been in a
race, shoulders tight, but unlike previous endeavours walking is not an issue,
blister on my left big toes that I didn’t feel during the race. Last time I was
struggling with stairs for a week afterwards, so something went right in the
training and conditioning this year.Only
thing complaining is my big toe joints.
For some reason
my cannula for the insulin delivery was giving me grief all through the race as
well, kept catching a nerve or something with sharp pains in the area if I
twisted or moved wrongly.I’d had a
cuple of twinges the day before but decided not t change it.It got so bad that I almost stopped and
replaced it mid race with the spare in my bag, but oddly enough it stopped
hurting later in the race.When I looked
at it in the shower, the cannula was full of blood and it was quite sore and
bruised for a few days.
Only fly in
the ointment was Sunday evening after driving home, I was pressing some apples
and pears (juice now fermenting nicely) when I managed to drop a 5kg weight
disc on my left big toe joint.
Time / Pace /Avg HR / Max HR
1 / 25:51/ 5:10 / 156 / 170
2 / 28:00 / 5:36 / 157 / 167
3 / 28:52 / 5:46 / 157 / 166
4 / 30:16 / 6:03 / 153 / 162
5 / 31:47 / 6:22 / 150 / 164
6 / 31:54 / 6:23 / 147 / 161
7 / 37:52 / 7:35 / 143 / 160
8 / 31:51 / 6:22 / 146 / 157
9 / 35:34 / 7:07 / 148 / 160
10/ 34:43 / 6:57 / 143 / 154
11/ 37:14 / 7:27 / 140 / 156
12/ 38:08 / 7:38 / 134 / 150
13/ 19:40 / 6:47 / 144 / 152
/ 62.9km / 6:33 / 147 / 170 / elev gain 460 / loss 725
Came in 24th of 47 finishers
Blood glucoses for those that were interested (using a 30%
basal rate in the pump for three hours before, during the race and two hours
after, with novorapid insulin)
Prebreafast 6.1, 35g carbs, 0.6 Unit bolus
Plus 2 hours 11.3 – much higher than normal, but I know it’s
going to come down
???is because stupidly, I’d not got enough battery in the BG
meter to last race distance.Bloody
stupid and dangerous, and if it had happened earlier in the race would have
meant pulling out.Another good learning
point, but luckily I had a good idea of how much I need to eat by now.
Post race, meter recharged, 6.4 an hour later and a 40g
snack with 0.5 units insulin (50% of normal, as I know by experience that
several hours later my BG can drop rapidly).Instead I let it go higher (but not intentionaly as high as the 13.7
this time, and adjust downwards), but still by bedtime I was needing to take a
couple of snacks to stop dropping into hypo territory.
If you are in any way sensitive,
don't like naughty language etc, then stop reading right now.
Background - I work in the oil
and gas industry, including working offshore, occasionally as an auditor.
That involves me walking around the platform, accompanied by a person from the
operating company, looking at stuff and asking questions. I also carry a
digital camera as I take photos of stuff that I see, to use in feedback sessions
at the end of the audit. Overall therefore, what I do is actually pretty low on
the risk scale.
One of the things that I need to
do is every four years, go through a training course on offshore escape and
emergency training, involving basic fire fighting, escape from smoke filled
buildings, escape from submerged and capsized helicopters etc. I
also need a medical.
Pre diabetes this was every two
years. In their wisdom Oil and Gas UK have determined that as a T1
diabetic, I need to do this every year. Rant number 1 - why the
fuck, as a well controlled diabetic should I be subject to a full medical on an
annual basis when I have two other significant engagements with the medical
system in terms of annual reviews as a pump user and with my consultant.
Surely the most effective basis here would be for me to submit my HbA1c
information, a letter from my quack and then determine on the basis of that,
what my risk as a T1D is, and then decide if I need an annual medical. But what
the fuck would I know, I only do it every day.
Get ready for rant number 2
This year, my now annual medical
expired on 22nd August, I therefore arranged my appointment with my offshore
doctor on 27th July, assuming that would be plenty of time. I arranged it early
because, and get ready for yet more pointless bureaucracy, I need every single
platform I may visit identified on my medical certificate and the company
doctor of every operator needs to give consent for me to go there, and, before
I go the medic on the platform needs to give his affirmation that he is happy
for me to visit and can deal with potential complications.
You'd have thought with an HbA1C
of 42, no history of hypo unawareness and no history of needing assistance to
deal with hypos, and a consultant's letter detailing how well I manage the
condition (yes, in diabetic terms I'm in the top 10%, sun shining out of my
arse etc) I'd have no problem.
Well, 4 weeks down the line and
looking to go offshore next week I can tell you, I'm mightily pissed off, to the
extent that I'd be happy right now to tell the offshore medical community to go
and do things to itself in anatomical terms that only the medical community is
likely to understand.
Pulling directly from an e-mail
sent to me (names redacted to avoid litigation)
have had discussions with [operator XXX]. There are some issues to
overcome before a decision can be made as the battery operated insulin pump is
often not certified as ‘intrinsically safe’
the auditing work he is undertaking involve going outdoors i.e. outwith the
his job would involve going out on deck can he forward evidence that the
insulin pump is ‘intrinsically safe
the problem is that your company doctor is conflating the medical clearance in
terms of is my diabetes controlled and am I a health risk with process safety
risks. They are asking, wrongly in my view, questions about the pump and
whether it is intrinsically safe etc which has absolutely no bearing on my
ability to manage diabetes as a medical condition.
My view is
that control of the ignition risk is an issue for the platform management
through ISSOW and other risk control channels. In fact the pump is an IPX8
rated device, so suitable for Zone 2 environments and is powered by one AAA
battery, which will not be changed outside the accommodation. We routinely use
digital cameras outside the accommodation, with gas detectors, permit to work
etc, which is exactly what I have done elsewhere in relation to the pump.
started on the pump I have been to XXX LNG, YYY Tunisia and a handful of
other North Sea installations, all under the conditions I describe above.
My view here is that the doctor is overstepping the bounds of both his
responsibility and knowledge
What the fuck are you talking
about? You are a doctor, not a process safety specialist. Your company
employs me because I am a process safety specialist. Do you
have any fucking idea why you are asking that question, or what intrinsically
safe actually means? Do you have any idea of what goes on offshore and
the equipment that people take outside the accommodation? Do you really
think, as a process safety specialist I would put myself and others at risk
Wind your fucking neck in and stick
to what you know about. Am I medically fit to go offshore or not.
Leave questions about managing safety risks to those that know how to do it.
No pun intended there, but an accidental double tagging.
Having gotten fed up of my Garmin 310XT losing its memory, I
decided enough was enough, flogged it on flea bay and bought myself the new
920XT instead.This watch really is the
dogs-danglies, taking all the concepts that were introduced in the 310XT,
adding a load of new stuff from the Fenix range and ending up with an even
better package overall.
Battery life is much better, with a variable tracking
option, built in run walk, does swim, bike, run (I’ve tried all three so far) and
gym.Only thing that’s a retrograde step
is removing the interaction with gym equipment, but you can’t have everything. The
GPS connects much better than the 310XT, even when amongst buildings in
Aberdeen. It’s also a functional, if a bit
chunky watch with a very strident alarm.One of the best things is that unlike the 310XT, you can upload the
resulting .FIT files directly to Garmin Connect via the USB charge cradle. Photos
will follow once I’ve played with it a bot more.
So far I’ve used it on several runs, including the Bob
Graham recce where the altimeter proved to be pretty accurate, and on several
bike rides.Even used it in the pool
where it correctly picked up my stroke rate.And most important, it’s nice to me – at the moment it’s telling me that
my VO2max is at the top of the scale, above the 95th centile for
someone 20 years younger than me.
The other part of watch this space is the growing
trepidation as this year’s silliness arrives quickly – the Riover Ayr Way race,
on 19th Sept.Last long run tomorrow,
using the predesigned run/walk feature on the Garmin.I’ll plan it as 25min run/5 min walk,
normally something I try and do to conserve energy through the race and to stop
myself going off too hard with the adrenaline at the start.Planning my drop-bag strategy as well for the
10-mile-ish aid stations that have food as well as water. Not planning on carrying
much, some just in case and then concentrated electrolytes.
Pack list is being jotted down as well on my desk pad as
things come to mind.Along with
nutritional needs etc.
The third and final part of watch this space?I’m trying to build myself a website.I’m getting so many questions and requests
for advice on managing diabetes as an athlete that I don’t have time to answer
them alongside the day job, which now that I’m on the leadership development
plan will only get busier. So, a website, all about me, managing diabetes, a
few nice piccies, recipes, link to my blog, a chance to ask me more questions
etc.Pretty basic and will be
self-built, but it’s a start.
So, to the final bit of this episode, last long run before
the RAW, strictly controlled as 25min run/5 min walk using the function on the
Garmin 920XT.Overall worked very well,
80% off road on the lanes and bridleways around me, flat mainly of course, but
then RAW is overall downhill losing about 250m in the 40 miles or so.
One thing I did find, which is of course relevant for the
BGR later is that my calves reacted more to the walking than the running,
particularly the outside of the shins – more massage needed there I think.Overall though 34.5km, no issues at all, legs
feel absolutely fine with no discomfort at all on the Monday or Tuesday
following.Pace stayed pretty much the
same all through and if sustainable could see me putting in a decent time. The strict
run/walk tends to stop me going off too hard and then blowing up later in the
race.All comes down to rest times and
pace drop off in the last 10-15 miles.Touch wood, I’m not carrying any injuries this year, unlike the last two
Stats for the run
Total 34.8km / 3h 23:39 / 5:51 pace / AHR 146 /MHR 160
BG in good control all round, with approx. 100g on the run,
30 g before and 20g straight after, so sticking around the 30-40g/hr that I
seem to get by with.
Splits / Time / Cumulative Time / Distance
/ Avg Pace / Avg HR / Max HR
Blimey, time flies yet again, but much has been done since
At the beginning of July I went to Majorca on holiday with
wife and daughter and took the advantage to take in a bit of cycling at the
same time, so the lead up to that was to get out on the road bike again.That meant a few rides of 2-3 hours getting
used to the handling again as it’s quite a lot different to either the
recumbent or mountain bike which I’d been riding since about March.One of those rides led to the now infamous
bee incident which has caused much hilarity amongst family and colleagues.Riding back up the road into the village
after about 75km or riding, with no more that 2km to go, I spotted a haze
across the road. On closer inspection, at 20mph, it turned into a swarm of
bees.Now if there’s one thing not to
underestimate it’s the impact of a swarm of bees on human flesh at 20mph, and then
you have the fact that after having ridden through the swarm, you now have
about 2-dozen pissed off bees clinging to your shoes, socks, shorts and jersey,
and the little buggers have stings.I
think I took about three stings on one leg before I managed to flap them all
off of me, but not without veering over the road almost into the path of a
van.Who knows what he thought when he
saw an apparently demented idiot of a cyclist coming towards him waving his
My leg was swollen for about a week.
On holiday itself, I managed to get some decent rides in, up
into the mountains and coasts of North Eastern Majorca.Three longs rides of 70, 100 and 120km and a
short 20km test ride after I’d rebuilt the bike.All involving a decent amount of climbing and
some fun descents, with a new max speed on the bike of about 60km/h (about
38mph).One thing underestimated was the
heat, having left the UK in the middle of a heat wave it was over 40C in
Majorca when we arrived, luckily abating to the mid-30s later in the week, but
still needing to be on the road by about 7:30 to avoid the heat of the day.
At Cap Formentor, I'd just come down that road
Near Lluc, taking a break before the descent
All were done with a fairly consistent 30g/hr of carbs with
good BG control.Typical reduced bolus
at breakfast to let the BG rise a bit, especially as the reduced basal would
not have kicked in by then having only 90 mins from waking to riding.Typical 30% TBR used as normal.As an example, the 98km ride, perhaps the
most challenging with a decent amount of climb in it went like this; -
Lluc tour reduced bolus at breakfast
Pre breakfast 5.7, 35g carbs and 0.2 U novorapid, pre ride
9.5 45min 5.6 20g early 20g at the test, 90min 5.9 20g, 135min 4.8 10+20g, 180min 5.7 20g, end 5.0 20g, +30min 7.3, I think I had grilled squid and chips for lunch
Since then it’s been a bit manic to be honest with two weeks
off and then straight back into an offshore trip, and with another one planned
today that’s my 5th this year, and no diabetes issues at all so
far.In fact at my recent pump review, and
recent offshore medical the main remark was how healthy I was, still that didn’t
stop one client in Algeria declaring me PNG because I’m T1. TBH I’m not that fussed
as it’s not the most glamorous of assignments in any case.
The other thing going on at the moment is planning for a Bob
Graham Round attempt in June 2016, that’s 42 peaks and 65 miles in the Cumbrian
fells in 24 hours.I have the maps and have
the route fully plotted on paper, but of course that’s nowhere near sufficient
for an undertaking like this.
So last weekend, after having been working up in Lancashire and
Cumbria I headed to my parents in Kirkby Stephen on the Friday, ready to do an
on-the-ground recce of sections 1 and 2 of the BGR.The plan was to start at 8am at the Moot Hall
Keswick on Saturday, do the first leg of Keswick-Skiddaw-Great
Calva-Blencathra-Threlkeld in about 4 hours, meet my parents in the camper van
at the pub car park, restock and set off for the second leg along the ridge to
Helvellyn and then Dunmail before heading round to Honister to meet a mate from
my village who was attempting a full round, and cheer him on a bit.
First things first though, a cannula change before setting
off as the one I inserted on Thursday was catching a nerve, last thing I need
is pain from that while running 25 miles.
Let’s just say that was a valuable learning experience.Probably 3 important lessons there
1)Nav is key.This section is going to be difficult at night with little in the way of
routing clues and quite a bit of open fell to cover at night with almost no
running possible.Overall three detours
cost me an hour, so while my pace was good while moving, going anywhere off
route has a punishing effect on the overall schedule even if moving well.
Looking at my Garmin trace I spent far too long stationary as well, reading
maps, but that’s the point of a recce. 2)Nav point number 2 – I lost my compass somewhere
between Great Calva and Mungrisdale Common, my own stupid fucking fault as I
forgot to tie it to my pack 3)Nutrition - I need to stop carrying too much
food, BG control was good even at 5km tests rather than half hour, eating
typically 25g/hr on the move but supplemented either end. I basically need to
get over the fear of hypos and only carry what’s needed plus a bit of spare. It
wont lighten the load much, but is less bulky. During the 5 hours I was out
there I ate a few dried bananas, dates and 2 gels. 4)I will definitely need a new head torch
Overall it took me 5 hours to complete what I was planning
in 4.The main cause being three detours
between Great Calva and Threlkeld.The first
when I took the wrong route down off Great calva adding 4km to the route to the
river crossing, then another km lost over Mungrisdale common and the final km
added by a routing error into Threlkeld. Should have been 12.25m/20km in total, but I
ended up doing 17m/27km on that section, and that 7km cost me that extra hour.
By that time I was so thoroughly pissed off with it that I
called it a day and had lunch with my parents, went into Keswick to replace my
compass and then off to meet my mate.Turned out he had his own disaster as his support crew was 75 mins late
to the second checkpoint and then he had a really tough third leg and stopped
there.We were waiting at the end of the
No bones about it, this will be a tough challenge.
River Ayr Way race coming up in Sept though, but no
opportunity to recce that one.42-ish
miles, to be used as prep for the BGR.
So far it’s been about 6 months since I started on the
Insight pump and I’ve put in quite a bit of hard work in learning how to trim
the pump to trim the pump for exercise. Learning the timing of run vs bolus,
how much to reduced bolus for imminent exercise, use of temp basal in terms of
scale and timing of reduction etc and it’s starting to pay dividends, to the
point where I can now consistently manage a 10km run or hour bike session on
little to no additional carbs, typically 10-20g and I’ve managed one session of
an hour and 15 mins on the bike with no carbs at all.
With an eye on the Autumn ultra marathon in the plan, I’ve
started to up the length of longer runs looking at getting back to ten
miles/16km for now and then building from there.I have to say though that it’s not always
going according to plan.Overall the legs,
feet, musculature, achilles are all still feeling good and I think I’m being
more proactive in massage and mobility exercises which will help.But sometimes despite all that it just
doesn’t quite work, and it’s those failure that are sometimes the most valuable
Take an example of a recent run after lunch.The lunch was low carb so no bolus taken and
the basal was being managed as expected.Al that done, I set out on the planned 15-16km run intending to keep an
easy, steady pace with a low-ish heart rate, but it never felt right.Worst of all I felt sick, had to stop two or
three times at the side of the road and nearly threw up, I really couldn’t
stomach the carbs I needed to take onboard.I did need to stop for the toilet twice – lucky for public toilets, the HR
too high, pace too low, and for the first time in over 6 months developed a
stitch.Overall one of the worst runs of
my life, and I contemplated finishing it early more than once, but eventually
stuck it out to 14km.Looking back at it
there is nothing specific that I can lay my finger on in terms of activities
before it, and the only thing I can come back to is eating too heavy a lunch
before the run
Contrast with next few weeks where it all went swimmingly,
and last week with 5 days consecutive, totalling 32 km run and >160km on the
bike split over 5 sessions.So what was
different?Not really sure, maybe just
taking a bit more time to prepare, I probably had a bigger gap between eating
and running by just an hour or so, and maybe that made all the difference. More
experimenting needed I think
I’m also starting to plan for my holiday where I’ll be
taking one of my upright bikes and trying to get at least two decent rides in,
so that’s necessitating training in between. I’m also putting a slightly lower gearing on
it as it’s a bit hillier than the wild Fens, although probably not as windy if
last week was anything to go by.
I've bought myself copies of the maps for the Bob Graham Round as well, starting to look at the route, with a view to an atttempt about this time, maybe mid June next year, but first I need to
make a plan to train/familiarise.
Otherwise, garden is coming on a treat, veggies romping away
both outside and in the greenhouse, and the bonsai are also starting to look
very good again.Here’s an example of a
maple that I’ve been growing for the best part of 15 years, from a
seedling.The overall shape is about
where I want it now, although the left-right balance needs some adjusting and
the trunk needs more time to develop a better taper.Give it another ten years or so and we’ll be
This week has been something of an interesting
experience, from a running and diabetes control point of view.I’ve been offshore on a floating platform, so
running on a treadmill which is never the best, but made much more interesting
when that treadmill is also moving side to side and back and forward as the
vessel moves.Diabetes control has
needed a different mindset around the exercise as the evening meal tends to be
early offshore, typically 6pm, which is when I’d normally exercise, so it’s
swapped the order of things around.The
strategy I’ve adopted, reasonably successfully is to do a normal basal
reduction ahead of the run, and minimal bolus at the meal - a typical reduction by 75%, then run about 30-45
mins later before BG has jumped too high.As usual test during the exercise and take on carbs appropriately depending
on where I started and where I ended up.Starting at 8.x needed carbs mid run, and ended in the low 4.x, starting
at 10.x brought me down to about 5.x with no carbs.
The running this week, more to come at the weekend, was 8km / 43:25 / 5:17 per per km, Ave HR 133, Max 144 10km / 51:26 / 5:09 per km, Ave HR 136 , Max 150 10km / 51:19 / 5:08 perkm, Ave HR 138, Max 150
Those of course are all on a treadmill, I'm not going to do laps of the helideck after all. Today was a mixed on/off road locally and when you take the vagaries of wind and terrain into account, for the same pace the average HR was around 145 over 12km.