Howdy From Santa Barbara,
This place really, really rocks!!! Sunny, warm, and great riding. I have a great place here, staying with Gina, and her family. They have been very gracious to put me up. Gina is part of the team, as is her son Sean!! http://www.apidra.com/real_people/stories/Gina.aspx
Big thanks for the warm Welcome to Santa Barbara:)
Thanks to everyone for the solid advice and comments. It has been a fun game to play, and have been learning a bit. Believe it or not I actually enjoy the confusion. Why? I imagine that if I had to do the same thing each and every day, I might get a bit bored, and then what fun would it be? But with all these changes, it constantly allows me to learn more, and sharpen this little brain I am stuck with...
What are some of the new theories? Well, kind of like Kerry said, as well as my buddy Tim Johnson- the body changes. it becomes more efficient at using fuel, so may need additional help (insulin) to get the fuel to where it needs. After having dropped my basal from 15 down to 12 last week, I have now raised it back up to 14, and will do 15 units of Lantus tonight. Instead of 3 units of Apidra for my 150gms of post ride Pasta, I am now doing 7 units. Where as last Saturday, I could eat 200gms of carbs on .5 unit of Insulin, today, I am going to inject 4 units of Apidra for 60gms of carbs.
I have another theory too... I had been sleeping in an Altitude tent each and every night. When I first got in, I slowly started reducing total daily insulin requirements, as the body burns more at night while in the tent. For the past 2 weeks, over the holidays, I have been in and out, and mostly out. Could this have lead to the higher insulin needs? Maybe? I just ordered a new tent from Altitudetech Inc. le and should have by early next week. I will make sure to let you know how that effects my insulin requirements.
Training camp is getting closer, and it is somewhat the talk of the town out here. We are going to have some of the top endos in the country at camp, as well as the top 27 athletes (who ride a bike) with type 1 in the world (that we know of.) This is a very exciting culmination of 4 years of work to get to this point, and just the beginning for Team Type 1, and the super beginning for Team Type 2.
Also, I am starting to get learn more about Twitter. So as I begin to travel the world more, and spend less time from the computer, I will try to do updates. If you would like to follow that way, please check: http://twitter.com/PhilSoutherland
More news to come, as I figure this part of the game out.
Thanks for reading, and Have a GREAT day!
Phil
www.teamtype1.org
Friday, January 9, 2009
Monday, January 5, 2009
Interesting game....
Howdy From HotLanta:
This will be my last post from the South, as on Wednesday I am moving to Santa Barbara for final preparations for the season. Will get to train with teammates, Ken Hanson, Jesse Anthony, Joe Eldridge, and a few other fast guys to get moving quicker...
A few answers to some questions from the last post:
Sandi: I like to have my blood sugar at around 150 for the start of rides. Does this always happen? No, but it is a good goal. I usually prefer an upward trend. To get this, I will not give any Apidra (rapid acting insulin) for 2.5-3 hrs before my rides. 30 minutes before walking out, I will eat a minimum of 60gms of carbs. That will get the arrow going up on my Navigator. Then in the first 10-20 minutes, I usually am eating food to level it off. If you are starting at 200, that is great. If you are dropping rapidly, then more food earlier would be a good start. Dex4 Liquid Blast, banana, or granola bar in the first 20 minutes will help. Eat a lot in the first hour, and see how it goes. Please keep me posted...
This past week has been very solid training. Did VO2 testing with Matt Russ on Tuesday. Numbers were good! Then a 5 day block of about 18 hours with intensity. Last week, I was riding tons, with next to no food and slowly increasing my insulin doses. More for basal, more for bolus. It was crazy. Then this week, another flip/flop. Obn Wednesday I ate the normal oatmeal pre-ride, went out for 3 hours, and had to eat. Thursday, I did 4 hours hard, and was eating lots. Basal was dropping, boluses dropping. I was now confused. Friday morning I was back down to 13 units of Lantus, with no bolus for breakfast, and a lot of carbs. Friday was 12 units, HUGE breakfast (200gms carbs) with only a .5 unit bolus, and highest blood sugar on the ride was 151.
I am awaiting call backs from my doc right now to try and learn what is going on. I am used to changes happening, but not so much the flip flop. But this is the game we all play, and no two days are ever alike. Better to accept that, and make the adjustments, than to wonder about the past. That is how I see it.
I hope all is well. Happy New Year to all!
Have a great day.
Phil
www.TeamType1.org
This will be my last post from the South, as on Wednesday I am moving to Santa Barbara for final preparations for the season. Will get to train with teammates, Ken Hanson, Jesse Anthony, Joe Eldridge, and a few other fast guys to get moving quicker...
A few answers to some questions from the last post:
Sandi: I like to have my blood sugar at around 150 for the start of rides. Does this always happen? No, but it is a good goal. I usually prefer an upward trend. To get this, I will not give any Apidra (rapid acting insulin) for 2.5-3 hrs before my rides. 30 minutes before walking out, I will eat a minimum of 60gms of carbs. That will get the arrow going up on my Navigator. Then in the first 10-20 minutes, I usually am eating food to level it off. If you are starting at 200, that is great. If you are dropping rapidly, then more food earlier would be a good start. Dex4 Liquid Blast, banana, or granola bar in the first 20 minutes will help. Eat a lot in the first hour, and see how it goes. Please keep me posted...
This past week has been very solid training. Did VO2 testing with Matt Russ on Tuesday. Numbers were good! Then a 5 day block of about 18 hours with intensity. Last week, I was riding tons, with next to no food and slowly increasing my insulin doses. More for basal, more for bolus. It was crazy. Then this week, another flip/flop. Obn Wednesday I ate the normal oatmeal pre-ride, went out for 3 hours, and had to eat. Thursday, I did 4 hours hard, and was eating lots. Basal was dropping, boluses dropping. I was now confused. Friday morning I was back down to 13 units of Lantus, with no bolus for breakfast, and a lot of carbs. Friday was 12 units, HUGE breakfast (200gms carbs) with only a .5 unit bolus, and highest blood sugar on the ride was 151.
I am awaiting call backs from my doc right now to try and learn what is going on. I am used to changes happening, but not so much the flip flop. But this is the game we all play, and no two days are ever alike. Better to accept that, and make the adjustments, than to wonder about the past. That is how I see it.
I hope all is well. Happy New Year to all!
Have a great day.
Phil
www.TeamType1.org
Monday, December 29, 2008
Diabetes Game- Mild Confusion
Howdy From Hotlanta,
The end of the year is near, which will bring to close a great one on so many levels. For the time being things are slow, which is nice, but also boredom can set in. I am looking forward to that, as have had none of it in a long, long time.
So last week. Got to spend time with my brother Jack driving down to see mom for Xmas. It was really, really nice to have the family back together!!!
As for riding, 3hrs Tuesday, felt really tired. 3hrs Wednesday, felt good for 1hr, then really tired for 2.5 hours. Tired the rest of the day, tired all day xmas. It was kind of strange. So I took 2 days, where I just rode 1 hour to try and recover. Friday's 1 hour day was good. I have still been tinkering with this food and ride thing. I had gone up to 9 units of Lantus at night, which had been the highest in some time.
Saturday AM woke up for the WBL, winterbikeleague.com in Athens GA. I ate a big breakfast doing 2 units of Apidra (www.Apidra.com please check out, lots of cool new video of TT1 on the site,) which I rarely do before rides. Blood sugar started going up, and up, and up.... I usually like to sit in for the first part of these rides, and let the body warm up. But since the trend was going up on my FreeStyle Navigator kept going up, I decided to pull. I went to thr front with my buddy David Crowe, who has been punishing me for 8 solid years. Can't really believe I have been doing the WBL's for 8 years now... Lots of great memories of fun, suffering, more fun, and more suffering. So we pull for sometime which levels me off at 290. I am drinking water, and not eating. Then I slowly start coming down, and about 2 hours into the ride, I am at 240. At the store I drink a diet coke, diet red bull, and some water. Leave the store and get to the front with my boy Murph Dog (John Murphy) and he laughs at me as I pull. Pull for a while, get back in, then pull again, then sit, then pull... Oh yea, all this time on the front, so was John... He is flying right now, and prolly gonna impress some folks this year.
Pretty tired by the end of the ride, but so was everyone. Ate some good food, and saw Morgan Patton's new pad in Athens. She will like the town, as she can hang out/ride with people her age.
So the ride and food... 4 hours, pushed pretty hard, and 0 calories intake. Finished the ride at 190. So what am I thinking? I need more basal, and it would be better to eat. I do my 2nd dose of Lantus to 4 units to make it 13 total for the day, along with 6 units of Apidra to eat. Ate some food, stayed up there, and then did another 3 units in anticipation of a 2nd meal. We head to the GRit, no blous, but ate a salad, and some pita bread. Drive home, not much food, and then had 2 more salads, with Filet!!
9 units Lantus that night. Wake up high at 150 or so, bolus 2.5 units, eat oatmeal, go straight up, and then hit 180 before coming down. Ate 50gms of carbs for 3 hr ride, 6 unit bolus after, and 150gms carbs, 40 protein. Blood sugar on ride was 120-180, which was better. I decided I am going back to once a day Lantus, to test it out. To make the switch, I was doing a lot fo 1 unit boluses to reverse the upward trend. Did Yoga last night, and at 8:30 did 13 units of lantus, ate a bar, and went to bed. This am, woke up at 150, so I am going to do 14 units tonight.
Not sure what my body is burning for fuel on the rides right now, but it is not carbs. I am curious if i have gone ketonic on the rides, and thus would be burning fat. Does it take 4 weeks of exercise for the non-diabetic to do this too??? Studies to come.
Happy NEW YEAR! Time to make next year the best year ever! What are your goals? I have a few...
Ciao
Philpott
www.TeamType1.og
The end of the year is near, which will bring to close a great one on so many levels. For the time being things are slow, which is nice, but also boredom can set in. I am looking forward to that, as have had none of it in a long, long time.
So last week. Got to spend time with my brother Jack driving down to see mom for Xmas. It was really, really nice to have the family back together!!!
As for riding, 3hrs Tuesday, felt really tired. 3hrs Wednesday, felt good for 1hr, then really tired for 2.5 hours. Tired the rest of the day, tired all day xmas. It was kind of strange. So I took 2 days, where I just rode 1 hour to try and recover. Friday's 1 hour day was good. I have still been tinkering with this food and ride thing. I had gone up to 9 units of Lantus at night, which had been the highest in some time.
Saturday AM woke up for the WBL, winterbikeleague.com in Athens GA. I ate a big breakfast doing 2 units of Apidra (www.Apidra.com please check out, lots of cool new video of TT1 on the site,) which I rarely do before rides. Blood sugar started going up, and up, and up.... I usually like to sit in for the first part of these rides, and let the body warm up. But since the trend was going up on my FreeStyle Navigator kept going up, I decided to pull. I went to thr front with my buddy David Crowe, who has been punishing me for 8 solid years. Can't really believe I have been doing the WBL's for 8 years now... Lots of great memories of fun, suffering, more fun, and more suffering. So we pull for sometime which levels me off at 290. I am drinking water, and not eating. Then I slowly start coming down, and about 2 hours into the ride, I am at 240. At the store I drink a diet coke, diet red bull, and some water. Leave the store and get to the front with my boy Murph Dog (John Murphy) and he laughs at me as I pull. Pull for a while, get back in, then pull again, then sit, then pull... Oh yea, all this time on the front, so was John... He is flying right now, and prolly gonna impress some folks this year.
Pretty tired by the end of the ride, but so was everyone. Ate some good food, and saw Morgan Patton's new pad in Athens. She will like the town, as she can hang out/ride with people her age.
So the ride and food... 4 hours, pushed pretty hard, and 0 calories intake. Finished the ride at 190. So what am I thinking? I need more basal, and it would be better to eat. I do my 2nd dose of Lantus to 4 units to make it 13 total for the day, along with 6 units of Apidra to eat. Ate some food, stayed up there, and then did another 3 units in anticipation of a 2nd meal. We head to the GRit, no blous, but ate a salad, and some pita bread. Drive home, not much food, and then had 2 more salads, with Filet!!
9 units Lantus that night. Wake up high at 150 or so, bolus 2.5 units, eat oatmeal, go straight up, and then hit 180 before coming down. Ate 50gms of carbs for 3 hr ride, 6 unit bolus after, and 150gms carbs, 40 protein. Blood sugar on ride was 120-180, which was better. I decided I am going back to once a day Lantus, to test it out. To make the switch, I was doing a lot fo 1 unit boluses to reverse the upward trend. Did Yoga last night, and at 8:30 did 13 units of lantus, ate a bar, and went to bed. This am, woke up at 150, so I am going to do 14 units tonight.
Not sure what my body is burning for fuel on the rides right now, but it is not carbs. I am curious if i have gone ketonic on the rides, and thus would be burning fat. Does it take 4 weeks of exercise for the non-diabetic to do this too??? Studies to come.
Happy NEW YEAR! Time to make next year the best year ever! What are your goals? I have a few...
Ciao
Philpott
www.TeamType1.og
Wednesday, December 24, 2008
Diabetes Game: Exercise Resistance?
Howdy From Atlanta,
The game has taken a twist. If you recall, about 10 days ago I would have to eat everything in site, and then some on rides. Insulin was being cut drastically. I think that was my body being inefficient at fueling on the bike, as a major switch has happened.
I have had to increase basal a touch, and think I am going to get it up some more. The past 3 rides I have done, eating the normal goods before hand, oatmeal, my blood sugars have skyrocketed. I have been getting up to 250 on the rides, and then a slow drop down to the 180's, and if I eat, BS goes right back up. Yesterday for example, I had a total of 40 grams of carbs on a 3 hour ride.
I think my body is now becoming more efficient, and I may be able to add some additional basal, or I may need a very small bolus (.5 unit of Apidra) with meal before ride. Today I am driving home to see mom, and should be on the bike by 11am for a 4hour ride. I am going to eat my oatmeal, with .5 units, and see what the reaction is. I do enjoy not having to stuff my face on the rides, however, I would much rather be between 140-180, than 180-220.
It is great having the FreeStyle Navigator, so I can really monitor these adjustments, and know immediately if I made the right call.
Although, I initially thought this is crazy, thinking back it happens every year. Insulin drop, drop, drop, and then all the sudden, add, add, add... If I can keep the training going without interruption this will be very helpful for racing, as I won't be stressing about low's.
It is also good for training, and my pockets won't be so stuffed full of food, and bars for my rides.
This is the start of week 4 of training post hamstring break. It took 2.5 weeks for the switch to happen. Could this be the same for non-diabetic metabolism? Has anyone out there with diabetes had similar experience with fueling?
Also, working with some top docs on potential research studies, and trying to find out more info for you. More details to come!!!
Very exciting step for me here, now time to fine tune it a little more to ensure I am at the best on the bike with both legs, and blood sugars.
Have a great day.
Merry Christmas, Happy Holiday, and Happy New Year to ALL!!!
Phil
The game has taken a twist. If you recall, about 10 days ago I would have to eat everything in site, and then some on rides. Insulin was being cut drastically. I think that was my body being inefficient at fueling on the bike, as a major switch has happened.
I have had to increase basal a touch, and think I am going to get it up some more. The past 3 rides I have done, eating the normal goods before hand, oatmeal, my blood sugars have skyrocketed. I have been getting up to 250 on the rides, and then a slow drop down to the 180's, and if I eat, BS goes right back up. Yesterday for example, I had a total of 40 grams of carbs on a 3 hour ride.
I think my body is now becoming more efficient, and I may be able to add some additional basal, or I may need a very small bolus (.5 unit of Apidra) with meal before ride. Today I am driving home to see mom, and should be on the bike by 11am for a 4hour ride. I am going to eat my oatmeal, with .5 units, and see what the reaction is. I do enjoy not having to stuff my face on the rides, however, I would much rather be between 140-180, than 180-220.
It is great having the FreeStyle Navigator, so I can really monitor these adjustments, and know immediately if I made the right call.
Although, I initially thought this is crazy, thinking back it happens every year. Insulin drop, drop, drop, and then all the sudden, add, add, add... If I can keep the training going without interruption this will be very helpful for racing, as I won't be stressing about low's.
It is also good for training, and my pockets won't be so stuffed full of food, and bars for my rides.
This is the start of week 4 of training post hamstring break. It took 2.5 weeks for the switch to happen. Could this be the same for non-diabetic metabolism? Has anyone out there with diabetes had similar experience with fueling?
Also, working with some top docs on potential research studies, and trying to find out more info for you. More details to come!!!
Very exciting step for me here, now time to fine tune it a little more to ensure I am at the best on the bike with both legs, and blood sugars.
Have a great day.
Merry Christmas, Happy Holiday, and Happy New Year to ALL!!!
Phil
Sunday, December 21, 2008
Diabetes Game- closer to the solution
Howdy from Atlanta,
How is everyone doing? Great question from Stella's mom, about why I wasn't back on the pump. In diabetes, there are a million ways to skin the cat. I had raced for 6 years on Lantus, and made a lot of mistakes, but more importantly learned a lot of lessons. So when I was on the pump, I found I was having a lot more lows on the bike, and then off the bike too which was causing me to eat way too much food. With Lantus, by making a 1 unit adjustment of Lantus/day, I can essentially make a .05 unit/hr basal adjustment, which is a big deal. I change my basal daily, and doing this on the pump for me is too much manual labor. I have done over 50,000 injections in my life, so 5-7 more a day, to me, is no big deal.
Also, why does exercise = less insulin: When exercising, the muscles become more sensitive to insulin, both basal and bolus. The body will naturally burn more calories per day, which means less basal needed, and the muscles are much more sensitive to insulin post exercise which = less bolus/meal. Not sure if there has been a science experiment, and I could be wrong, but that is my guess, and I have not had a doctor argue yet...
So the diabetes game: Last weekend I cut it a bit, and on Sunday was good. Blood sugars were up in the 200's, and I was eating a bit, but felt good. I have decided to start doing my 2nd shot of Lantus after my rides. So it is kind of a temp basal. Lately I have been doing 6 at night, and 3 in the afternoon. Tuesday I did that, and went pretty high on the ride up to 257, before I started trending down. I only had to eat about 400 calories on a 3 hour ride, and I was flying. Wed, I had a bit more basal, 7 units night, 3 in am. I went up to 220, before dropping to 150, and was eating a bit more. 800 calories on a 4 hour ride. After that ride I kept dropping, so I that night I dropped Lantus dose again to 6 units. Had to do a small bolus of .5 unit of Apidra in the middle of the night. Thursday was a 3 hour ride, and I can't really remember what was going on...ha Lots of activity this week. I have done yoga on Tues-Thurs, and Sunday this week. Stretching every am. Friday I only road for 1.5 hrs and was real tired, then Saturday did a mountain bike ride with my buddy John Martin!!! I figured this was going to be hard, and slowly rose my BG to 200 at the start. Within 20 minutes I ate a king size snickers, and 15 minutes later some other bar. Blood sugar was 220 trending up said the Navigator! So I began to drink water, until at some point I saw 287. For the last 2 hours, I did nothing but drink water, and dropped to 215. These #'s are a bit higher than I would like. I am obviously under insulinized, so I think the switch needs to be 7 units at night, and then 3 after ride of Lantus.
But the higher blood sugars are making me feel very, very good on the bike. But I don't want to completely sacrifice a good A1C for performance. If I could raise it to 5.8-6.0, I would be happy. Higher... not so sure. But that is me.
Yesterday a good friend got some great news, and I am happy for her. I got some bad news, and it was a rough day. All will be ok in the long run... The work week was pretty stressed. But the thing is, making time every day to ride, really, really helps. No matter how much crap is piled on, I have not given an inch when it comes to my riding, and yoga. So for anyone out there if the stress seems to pile up, I would encourage you to get out and ride a bike, take a walk, or bit the gym, as it puts everything else at ease.
Thanks for reading, and sorry for the jumble of #'s.
Have a great night, and Happy Holidays!!!
Phil
How is everyone doing? Great question from Stella's mom, about why I wasn't back on the pump. In diabetes, there are a million ways to skin the cat. I had raced for 6 years on Lantus, and made a lot of mistakes, but more importantly learned a lot of lessons. So when I was on the pump, I found I was having a lot more lows on the bike, and then off the bike too which was causing me to eat way too much food. With Lantus, by making a 1 unit adjustment of Lantus/day, I can essentially make a .05 unit/hr basal adjustment, which is a big deal. I change my basal daily, and doing this on the pump for me is too much manual labor. I have done over 50,000 injections in my life, so 5-7 more a day, to me, is no big deal.
Also, why does exercise = less insulin: When exercising, the muscles become more sensitive to insulin, both basal and bolus. The body will naturally burn more calories per day, which means less basal needed, and the muscles are much more sensitive to insulin post exercise which = less bolus/meal. Not sure if there has been a science experiment, and I could be wrong, but that is my guess, and I have not had a doctor argue yet...
So the diabetes game: Last weekend I cut it a bit, and on Sunday was good. Blood sugars were up in the 200's, and I was eating a bit, but felt good. I have decided to start doing my 2nd shot of Lantus after my rides. So it is kind of a temp basal. Lately I have been doing 6 at night, and 3 in the afternoon. Tuesday I did that, and went pretty high on the ride up to 257, before I started trending down. I only had to eat about 400 calories on a 3 hour ride, and I was flying. Wed, I had a bit more basal, 7 units night, 3 in am. I went up to 220, before dropping to 150, and was eating a bit more. 800 calories on a 4 hour ride. After that ride I kept dropping, so I that night I dropped Lantus dose again to 6 units. Had to do a small bolus of .5 unit of Apidra in the middle of the night. Thursday was a 3 hour ride, and I can't really remember what was going on...ha Lots of activity this week. I have done yoga on Tues-Thurs, and Sunday this week. Stretching every am. Friday I only road for 1.5 hrs and was real tired, then Saturday did a mountain bike ride with my buddy John Martin!!! I figured this was going to be hard, and slowly rose my BG to 200 at the start. Within 20 minutes I ate a king size snickers, and 15 minutes later some other bar. Blood sugar was 220 trending up said the Navigator! So I began to drink water, until at some point I saw 287. For the last 2 hours, I did nothing but drink water, and dropped to 215. These #'s are a bit higher than I would like. I am obviously under insulinized, so I think the switch needs to be 7 units at night, and then 3 after ride of Lantus.
But the higher blood sugars are making me feel very, very good on the bike. But I don't want to completely sacrifice a good A1C for performance. If I could raise it to 5.8-6.0, I would be happy. Higher... not so sure. But that is me.
Yesterday a good friend got some great news, and I am happy for her. I got some bad news, and it was a rough day. All will be ok in the long run... The work week was pretty stressed. But the thing is, making time every day to ride, really, really helps. No matter how much crap is piled on, I have not given an inch when it comes to my riding, and yoga. So for anyone out there if the stress seems to pile up, I would encourage you to get out and ride a bike, take a walk, or bit the gym, as it puts everything else at ease.
Thanks for reading, and sorry for the jumble of #'s.
Have a great night, and Happy Holidays!!!
Phil
Sunday, December 14, 2008
Ride ride ride... Diabetes game is back
Howdy,
How is everyone? I appreciate the comments on my last post. We shall see what gets done. In regards to where the money may come from, we now have $14b not going to automakers, so why not make some good of it?? J/k
Training seems to be back on track. I have not done anything too crazy, but spend about 30 minutes every am doing exercises, then 2-3 hours on the bike, and 1-1.5hrs of yoga 3x a week. This has all really helped, as I am feeling smooth on the bike, and using muscles I didn't know existed... I have tried to stay ahead of the curve in the insulin drop, which has been good and bad. The good being, I have 0% below target for what is now 2 weeks of training. The bad being that blood sugars will run between 130-150 at night. I have cut my morning dose of Lantus to 3 units, and my PM dose is now 8 units of Lantus. I did do a 4.5 hour 87 mile WBL yesterday. It seems if I have 12 units of basal while riding, no matter what I start at, blood sugar will trend down, and I have to eat A LOT on the bike. Yesterday for example. I had eating the legendary Waffle House breakfast of a pecan waffle, grits, and 2 eggs. Did 3 units of Apidra at 8am, for this carb stacked breakfast, and from 8:30 to 10, I had a slow rise in blood sugar to 177 by the time I got on the bike. Road for 15 minutes to the start, and hung out for a few minutes. Look at my Navigator to see 128 with an arrow straight down. Banana, Dex4, and 500 calories of bars in the first 30 minutes of the ride to stop the drop and settle around 90. This is where I stayed. I continued eating appx 80gms carbs+/hr for the ride. At the store stop, I drank a coke, had a snickers, and then another snickers 20 minutes later. Stayed between 85-100... I did most of this group ride with 100 or so people talking to my buddy Steve Sevner. Sevy was one of the best back in the day, and is coming back to do an ironman. He gave me a lot of great advice for when the going gets tough in the races, and help me stay strong between the ears. Going to put that into use today as well.
Now those blood sugars are not all bad. The ride was not that hard, so I didn't need BS to be higher, and learning to train at that level, and push at that blood sugar will be good practice for if I do go low during a race, which is bound to happen at some point in time. But it is not where I want to be. Today comes a new test. I am going to skip my Lantus dose this morning. Which means I will have 8 units of basal on board, effectively giving a temp basal. My goal is that after I eat my 80 gms of carbs for breakfast with no insulin, and head out on the bike that I will get up to 220 or so, and proceed a slow drop to the 150's, where I will snack, but more along the lines of 20-40gms of carbs/hour. This ride will be similar to yesterday, with a little more time spent at the top end.
Stay tuned for the experiment results. New lessons every day, and always trying to get better. Real goal here is to see exactly how much basal I need, so that when race season comes, it is dialed in 100%!
Thanks for reading. Have a great day.
Phil
How is everyone? I appreciate the comments on my last post. We shall see what gets done. In regards to where the money may come from, we now have $14b not going to automakers, so why not make some good of it?? J/k
Training seems to be back on track. I have not done anything too crazy, but spend about 30 minutes every am doing exercises, then 2-3 hours on the bike, and 1-1.5hrs of yoga 3x a week. This has all really helped, as I am feeling smooth on the bike, and using muscles I didn't know existed... I have tried to stay ahead of the curve in the insulin drop, which has been good and bad. The good being, I have 0% below target for what is now 2 weeks of training. The bad being that blood sugars will run between 130-150 at night. I have cut my morning dose of Lantus to 3 units, and my PM dose is now 8 units of Lantus. I did do a 4.5 hour 87 mile WBL yesterday. It seems if I have 12 units of basal while riding, no matter what I start at, blood sugar will trend down, and I have to eat A LOT on the bike. Yesterday for example. I had eating the legendary Waffle House breakfast of a pecan waffle, grits, and 2 eggs. Did 3 units of Apidra at 8am, for this carb stacked breakfast, and from 8:30 to 10, I had a slow rise in blood sugar to 177 by the time I got on the bike. Road for 15 minutes to the start, and hung out for a few minutes. Look at my Navigator to see 128 with an arrow straight down. Banana, Dex4, and 500 calories of bars in the first 30 minutes of the ride to stop the drop and settle around 90. This is where I stayed. I continued eating appx 80gms carbs+/hr for the ride. At the store stop, I drank a coke, had a snickers, and then another snickers 20 minutes later. Stayed between 85-100... I did most of this group ride with 100 or so people talking to my buddy Steve Sevner. Sevy was one of the best back in the day, and is coming back to do an ironman. He gave me a lot of great advice for when the going gets tough in the races, and help me stay strong between the ears. Going to put that into use today as well.
Now those blood sugars are not all bad. The ride was not that hard, so I didn't need BS to be higher, and learning to train at that level, and push at that blood sugar will be good practice for if I do go low during a race, which is bound to happen at some point in time. But it is not where I want to be. Today comes a new test. I am going to skip my Lantus dose this morning. Which means I will have 8 units of basal on board, effectively giving a temp basal. My goal is that after I eat my 80 gms of carbs for breakfast with no insulin, and head out on the bike that I will get up to 220 or so, and proceed a slow drop to the 150's, where I will snack, but more along the lines of 20-40gms of carbs/hour. This ride will be similar to yesterday, with a little more time spent at the top end.
Stay tuned for the experiment results. New lessons every day, and always trying to get better. Real goal here is to see exactly how much basal I need, so that when race season comes, it is dialed in 100%!
Thanks for reading. Have a great day.
Phil
Tuesday, December 9, 2008
My RANT: Trips to pharmacy
Howdy everyone!!!
First, thanks Angela for the bit about sleep before midnight. It had been a few years since I last heard that. Makes it all crystal clear now, and I feel good about waking up the roosters:)
Second, training is going good. The lantus drop has been good. 5 units in the am, 7 units pm, and Blood sugars have been perfect. Saw the eye, and endo docs yesterday. All results were perfect. I had a better A1C than my endo, Bruce Bode...ha Sitting at 5.5 now with only 2% below target in 28 days. Best #'s ever. Ride on Sunday was amazing. Doing exercises every morning, yoga 3x a week, and massage and the difference is noticeable. I am very excited, and very motivated!!! Bigger week this week, with a few small tests. My guess is that by Saturday, total Lantus dose will be less than 10 units/day.
Ok, so now for the rant. I have been going to the pharmacy once a month for my entire life to get supplies. Every month I get the same thing: Apidra, Lantus, Freestyle Strips, Syringes, and Pen Needles. I get the same quantity every time, yet for some reason each and every time I go in the pharmacy, I never leave in less than 30 minutes. It has always been like this. I am not going to name bash, but they all seem to be about the same. Yesterday I went in to get the same 5 items as always, that I called in and requested, and then verified via phone before going in, and then I get my order minus 2 big boxes. No Syringes. I ask the guy, and he said insurance isn't covering them.
"Excuse me" I say.
"Well, your insurance isn't going to pay." he says
"I still need the needles" Wondering here why he didn't tell me this was the reason I had no needles instead of just not giving them to me.
"You have to pay cash"
"Ok, I want to keep my eye-sight, I will take the needles..."
So I pay my $30/box for needles, but decided to prolong the trip by calling my insurance company, United Health Care, who initially denied the coverage. The ironic thing is on the on-going message while I was on hold, the first thing it said was "Properly managed diabetes can significantly reduce the risk of complications, such as blindness." I found it quite funny that they are telling me to properly manage my disease, but refuse to pay for syringes that I need to give injections to ensure I do not have complications.
The lady on customer service was very nice, and ended up taking care of it, so I waited another 20 minutes while the "script" was filled, and then got my boxes for $15 a pop. All in all, just getting the diabetes supplies was $250, and this is the same cost every month.
I hope President Obama does act on his plans to help people get the tools. I have faith that he will. What if it was an underprivileged family, who could not swing $60 for needles, or didn't have a cell phone to call the insurance company, or even worse, did not have insurance to pay for the supplies???
I know exactly what would happen:
The person would be forced to check less, due to cost, not desire. He/she would be forced to do fewer injections, use inferior insulin, and/or use dirty needles, which could cause infection. This person probably sees an endo 2x/year at best, and has an A1C over 10, purely because of $$.
Diabetes, as you know, is a disease where management is everything. We have to take care of it, and having the best treatment (insulin) and technology will enable us to avoid complications.
Not having the tools is not an option, and if any reader out there has a contact in the House, Senate, or Oval Office, I would truly appreciate an introduction to try and make change.
I propose a $26 Billion Dollar "Supply Campaign" where we provide supplies to people with diabetes around the world, provide the best cancer treatment to those in need, and help people who cannot afford to help themselves. Maybe we start here, and see the impact it has, and then move outwards.
Together we can do it.
Thanks for listening to my RANT.
Have a great day.
Phil
First, thanks Angela for the bit about sleep before midnight. It had been a few years since I last heard that. Makes it all crystal clear now, and I feel good about waking up the roosters:)
Second, training is going good. The lantus drop has been good. 5 units in the am, 7 units pm, and Blood sugars have been perfect. Saw the eye, and endo docs yesterday. All results were perfect. I had a better A1C than my endo, Bruce Bode...ha Sitting at 5.5 now with only 2% below target in 28 days. Best #'s ever. Ride on Sunday was amazing. Doing exercises every morning, yoga 3x a week, and massage and the difference is noticeable. I am very excited, and very motivated!!! Bigger week this week, with a few small tests. My guess is that by Saturday, total Lantus dose will be less than 10 units/day.
Ok, so now for the rant. I have been going to the pharmacy once a month for my entire life to get supplies. Every month I get the same thing: Apidra, Lantus, Freestyle Strips, Syringes, and Pen Needles. I get the same quantity every time, yet for some reason each and every time I go in the pharmacy, I never leave in less than 30 minutes. It has always been like this. I am not going to name bash, but they all seem to be about the same. Yesterday I went in to get the same 5 items as always, that I called in and requested, and then verified via phone before going in, and then I get my order minus 2 big boxes. No Syringes. I ask the guy, and he said insurance isn't covering them.
"Excuse me" I say.
"Well, your insurance isn't going to pay." he says
"I still need the needles" Wondering here why he didn't tell me this was the reason I had no needles instead of just not giving them to me.
"You have to pay cash"
"Ok, I want to keep my eye-sight, I will take the needles..."
So I pay my $30/box for needles, but decided to prolong the trip by calling my insurance company, United Health Care, who initially denied the coverage. The ironic thing is on the on-going message while I was on hold, the first thing it said was "Properly managed diabetes can significantly reduce the risk of complications, such as blindness." I found it quite funny that they are telling me to properly manage my disease, but refuse to pay for syringes that I need to give injections to ensure I do not have complications.
The lady on customer service was very nice, and ended up taking care of it, so I waited another 20 minutes while the "script" was filled, and then got my boxes for $15 a pop. All in all, just getting the diabetes supplies was $250, and this is the same cost every month.
I hope President Obama does act on his plans to help people get the tools. I have faith that he will. What if it was an underprivileged family, who could not swing $60 for needles, or didn't have a cell phone to call the insurance company, or even worse, did not have insurance to pay for the supplies???
I know exactly what would happen:
The person would be forced to check less, due to cost, not desire. He/she would be forced to do fewer injections, use inferior insulin, and/or use dirty needles, which could cause infection. This person probably sees an endo 2x/year at best, and has an A1C over 10, purely because of $$.
Diabetes, as you know, is a disease where management is everything. We have to take care of it, and having the best treatment (insulin) and technology will enable us to avoid complications.
Not having the tools is not an option, and if any reader out there has a contact in the House, Senate, or Oval Office, I would truly appreciate an introduction to try and make change.
I propose a $26 Billion Dollar "Supply Campaign" where we provide supplies to people with diabetes around the world, provide the best cancer treatment to those in need, and help people who cannot afford to help themselves. Maybe we start here, and see the impact it has, and then move outwards.
Together we can do it.
Thanks for listening to my RANT.
Have a great day.
Phil
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