Friday, August 26, 2011

High Intensity Workout Highs - Not the Endorphine High

"Me High on Endorphins"

You'd think I would have this diabetes thing down to an exact science by now. But it would seem apparent -that I do not.

It is easy to tell others what to do with their diabetes, analyse their log book, tweaking a thing or two, but when it comes to me, damn it's hard. 

Why is that?

Or better yet; where is this post coming from?  Well, as always, I'll tell you.  I went to another Martial Arts session last night. This time, I took a wrestling/ground fighting class, and immediately after that class I took the Muay Thai kick boxing class. I know what you must be thinking; why when I almost vomited the last time? Well I just had to try it. And I didn't barf, but it seriously made managing my glucose really difficult.

Before the first hour (wrestling) class I tested my sugar and it was 8 mmol/L so I drank a diluted 10 grams carb energy drink and did the class.  One hour later I was 9 mmol/L, not to bad.  I drank another 10 gms carbs and did the second class. Post 2 hour workout another test and it was 9.5 mmol/L.  Downed a Litre of H2O and drove home. Got home tested again, and I was 13 mmol/L but seriously starving at that point so I made my self an Omelet (3 eggs) had 1/2 cup cottage cheese and a handful of blue berries. I took 1 unit to correct the glucose (1 unit for 3mmol/L  but since I had a two hour workout and it was nearing bed time I reduced my correction by 50%) I took 3 units to cover the meal, which is typical. I then read some books to the kids, had a long shower, tested again about an hour later and damn, 14 mmol/L.  Frustrating but I said to myself, it has been over a year since I've pushed myself with such a high intensity workout of that duration. So I went to bed. Couldn't sleep, as I was obsessing about the sugar level, and still a little wired from the class. Tested 2.5 hours after last bolus and still 13 mmol/L.  I am always hesitant to correct this late as I am prone to some serious lows between the hours of 2-3 am. So, I once again took half of what I would normally take or 1 unit of rapid and went to bed. This morning I woke up at 8.8 mmol/L.  Now I would prefer to wake up between 5-6 mmol/L.  Oh well, not bad really.  Now what do I do with this experience?

I am obviously thinking about it and in unison sharing it, but I'm considering a few things.....

The type of workout was very much anaerobic whereby I exerted myself intensely for a certain amount of time, say 3-5 minutes, followed by brief 30-60 second rest period. In other words not a consistent activity like cycling or running.

What effect does this have?  Well it generally causes an increase in blood glucose for me, followed by lower levels over the next 24-48 hours. Now, I usually don't go intense for over an hour.  From what I've read anything over 48 minutes and your body goes into a catobolic state or breakdown mode, tapping into fat and protein stores, and thus leading to muscle wasting, over training and injury.  To me this equals a whole lot of stress and inflammation, which I assume, leads to my increased blood glucose. If anyone out there wants to provide a juicy more accurate reason please do, I would appreciate it.

Is it increased cortisol production and gluconeogenesis causing insulin resistance, and an increase in liver out put of glucose?  Or is it simply poor balance on my part, not enough insulin?  or perhaps both?  Now I am considering hiring a biochemist or sports medicine expert to edit and add content to my blog.......and selfishly answer my burning questions.

Today, I am still "Out-of-Whack" or having hyperglycemia. Which is frustrating and confusing, however, it was the first two hour session, and based on the ramification perhaps this guy is only meant to do a one hour session, but I am stubborn and if a non-d person can do it, then so can I.

Now I am just whining. But seriously,  I think I have to try it again, take the full correction amount, and reduce my carb supplement or try a different form of carb like a piece of fruit before each session. Trial and error again and again until I figure it out. 

 I wish for a time when things can be simple, a time when I can just go do the class, and not think about diabetes, glucose levels, and the ramifications an activity may have on my health.  Oh, then again that would be called a cure.

Cheers and thanks for listening. 


Wednesday, August 24, 2011

I'm Gonna Hurl!!!

"My tough guy pose"
I have recently joined a Martial Arts Training Centre to get back into Muay Thai Boxing. And, let's be honest to get my Ass back into shape, not that I am a coach potato, but let's just say these last few years of sedentary jobs has not been good for the belly roll over the belt scenario, but rest assured I can still see my feet and other important body parts.....TMI

Anyway, so on a whim, I arrived home from work and the house was rather quiet, yes it does happen on occasion. Kids were out, little one watching barbie on the tele, and my wife taken a much deserved cat nap.

I tossed my shorts, and tank top into a bag and decided to drive out to a Martial Arts MMA training centre. This was two weeks ago now. I gear up, grab a rope and jumped right in. The classes are one hour long, and boy they are intense. 15 min warm up, skipping, shadow boxing, push ups, burpies, just think boot camp training. Okay, so I limped a bit the next day after the first couple of classes. Then last night......

WHOLLY CRAP, what the hell was that.....It was a different instructor, and I seriously thought he was trying to kill me, no seriously, between hacking, spewing and nearly coughing up my upper lung lobe, being light headed from non stop heart rate in the 200's for far too long (in my opinion) I really thought I was going to hurl.....blow chucks, vomitus uptacous, what ever you want to call it.  So did I?  Not on your life as this is a sign of weakness, in my book. 

I huffed and puffed and the warm up ended and we moved on at a much more reasonable pace, thank god, as I truly think if the warm up had of been even 1 minute longer, I would have done the run of shame to the can to relieve myself. 

Now, I suppose I should link this back to diabetes in some way.........Well I can say that training has always felt good, contrary to the above session (it does get easier) but seriously though, it has an amazing blood glucose lowering effect as our muscles and liver are refilled with glucose that is consumed and lingering around the blood stream that would otherwise be doing insidious silent damage....I know I am dramatic.

But more importantly, it is great to connect mind and body, by focusing on movement, proper technique, as I am totally in the present moment.  It is a fabulous stress relieving thing for our overly taxed body and mind. 

So I have officially joined, no backing out now. I look forward to doing the class minus the extreme urge to barf.



Tuesday, August 23, 2011

Passion = Never Giving Up

"Muay Thai Fighter's Stance, careful she
has a wicked right hook"
Hello All you Fabulous People!

Well Summer is drawing to a close, and school will soon be back into full swing with; homework, teachers, taxi service, lunches, diabetes questions and meetings. My house will indeed be cleaner with the offspring away all day but somehow the school routine still makes life equally busy, with the chaotic before school launch sequence, and the after school, squeeze all things into 4 hours before bed sequence; only to get up and do it all over again 5 days a week. I am tired mentally just contemplating the above........

So after the above run on sentence, I suppose I should get to the point post.

I read somewhere that passion and research don't mix as the passion I suspect can cloud or bias the researchers view, and therefore effect the results of the study. 

So as I was walking(Briskly uphill of course) on my treadmill, as this was easier then dragging 5 kids, and 2 dogs through the hood, I got to thinking about the above statement.

Then I pulled out my iPhone, yes I have one too, and watched a 6 part series on Dr R. Bernstein.(Youtube Link) He explains his story and how he has had diabetes for 63 plus years, how he was doing the "run-and-shoot" or "Basal-Bolus" method years ago, and how he paid 650 bucks for one of the first glucometers on the market, apparently the size of a shoe box.  This guy talks about his journey from being an engineer who attempted to sway the medical profession to look at intensive diabetes management as this was working exceedingly well for him, and to his dismay, was turned down every time, being told things like "People will never manage diabetes with a machine" hmmmmmm were they wrong.  He eventually became an MD when he was in his forties to increase his swaying power with in the medical community.

What's my point? Well, he was passionate to share with the medical community what he discovered through passion, and his own desire to improve glucose control, and prevent an early death from diabetes.  A lot of what he was doing to himself 40 years ago has only recently become mainstream.

I personally think passion is crucial to moving forward in all research since passion to me, equals motivation to act, to challenge conventional thinking and ask what can we do different or better. It is like fuel, if you believe strongly about something, this provides the energy to move forward and do something about it.

Even us individuals with Diabetes or caring for a child with D. We are I believe, Scientists, or capable of being scientists. By testing, trialing, and reviewing the results. What worked, what didn't. Being passionate about living well with diabetes.  Reading everything as objectively as possible, and using the best evidence to guide us in how we all manage diabetes. I also believe in asking questions, not just to your doctors, but to your self. There are hundreds. Will I need more insulin at forty, or less, will this Kickboxing class need added pre-carb snack compared to my bike workout, the questions are numerous, and personally provide me with the passion, and motivation to read about the topic, test, trend, experiment and improve my diabetes management. I am still learning. For instance in my twenties I was heavily into Muay Thai Kickboxing, and always assumed I'd need a lot of Carb to cover the workout. But now, 18 years later, I am realizing that it is more anaerobic and therefore, it would seem I almost need no additional carbs. Live and learn.

I guess my message is even though Diabetes sucks, beat it through passion, a passion to learn as much as possible, and keeping an open mind, become your own lab rat, if it isn't working try and try again, what ever you have to do, never give up.  I know it sounds cheesy, and I apologise, but there is truth to this. Only we, those living with it, can change and improve our health.



Friday, August 5, 2011

Low, Lower and Lowest

"Last Evening"
One word to describe life at the moment.  Actually three words. But once again, diabetes, in all its power, has this sneaky way of ripping the proverbial rug from under you.

On my way to bed last night, a little later then usual, as I was into a really good book, I did the "Security check" to ensure Rowan's sugar was at a safe level for the night.

5, 4, 3, 2, 1......beep, and 2.0 mmol/L  or 36 in US terms. 


The juice on the table beside her bed was empty, and not replenished, Shit!!!

I leaped down the stairs, retrieved a juice box, and leaped back up to her bedside. She was alert, and drank the juice, gulping it down, with her eyes closed and the sweat soaked through her PJ's.  I guided her gently back down, and just sat there. In the dark, cursing this (*&^*%^ disease. In my head of course.

I strolled down stairs super slow, feeling defeated once again. Going through the evening's events, in an attempt to account for this curve ball that was sprung on us violently out of the blue. And, nothing popped out as an obvious cause. Great I said to myself. Not even able to develop any preventative plan to avoid this attack in the future.

I think this is the most draining and difficult thing about diabetes, the unpredictable events that can't be prevented or planned for.  Those unexplained anomalies. Our only weapon is glucose monitoring, trending, proper food to insulin to activity amounts........Ya good luck with that with kids and diabetes who are bar none the most unpredictable creatures on the planet.

Mr Diabetes, this was really low of you, one the lowest for Rowan, and you remind me to never trust you and lower our guard. EVER.


Thursday, August 4, 2011

Emotional Paradox

The other morning as I was drawing up my smallest Type 1's injection she looked up to me and asked,  "Can I take my needle dad"

I paused; my thoughts were immediately mixed. I felt proud and sad almost simultaneously. Here was this small bright blue eyed sweet innocent child asking if she could stick herself with a syringe full of insulin.

I embraced the fact that she wanted to try, thinking, wow, once again her bravery astonishes me. I finished drawing up the insulin and handed her the needle.

With out a moments hesitation she pulled up her shirt and did it.  Just like that, no pause, no second guessing herself, like I see my adult patients consistently do, where they pause, then proceed, not this kid, she just DID IT!

She looked up and smiled, and said, that didn't even hurt. She was beaming with pride.

I took the needle, and said; "great job you brave princess", and gave her a high-five. Than, she ran off to get to the stuff kids do, what ever was on her mind.

This sparked a memory of when I was 9 years old, sitting on my bed, staring at the syringe my dad had handed me, only I hesitated, for quite a while, and gradually stuck the needle into my thigh. I was afraid, and I remember thinking, I hate diabetes, I hate taking this stupid needle. Why oh why? But time passed and here I was witnessing my little girl, so gracefully showing initiative and injecting herself, like it was just a normal thing to do.

I am so proud for her and also sad.

Diabetes, once again, forces its presence into my soul, causing a paradox of emotional turmoil.


Wednesday, August 3, 2011

It Would Seem that Diets are Like Fashion

They are always recyled with time.

I just finished reading a paper from the Journal of Diabetologia called Diet, Delusion and Diabetes.

Gives a very creatively written overview of the history of diet and diabetes.  Enjoy.


Tuesday, August 2, 2011

Carbs and Kids - Clarification....

Since my Blog is titled Three 2 Treat, I should clarify what the other 2 Type 1's eat; those others being my two children.

I know it's obvious what my stance on Carbs is, but I should make it clear that these are my own Food Choices and I certainly don't impose these choices on my five kids. Just in case any readers are inclined to think that I'm a crazy man that only feeds my kids eggs, meat, and veggies. Trust me my children would form a mutiny and lock me out of my own house.

A clue would be to read some past posts like Fire The Easter Bunny , taking note the Pic of my smallest Type 1 chowing down on a large (certainly not low carb) chocolate bunny.

My stance on diet and food choices is also a journey, over my 28 years of dealing with my own type 1 diabetes. Years of  food exchange diets; being told to avoid sugar, being told sugar is okay, to intense carbohydrate counting, using pocket scales, kitchen scales, and nutrient bibles.  Not to mention the thousands of miscalculated carb counts, and the extreme variability in the foods and the effect they have had on my blood glucose readings. So I am what you could call a human  Lab Rat, and I am constantly trying to figure out what works for my diabetes management. If I read compelling enough evidence, not just anecdotal that a certain method of diabetes management may work better then others, I try it.  

I read about carb reduction 10 years ago, but didn't try it, as I didn't think there was enough research regarding it, especially for Type 1 diabetes.  But now the evidence exists and promising and more and more is being done regarding lower carb, moderate protein and fat diets and the effect thay have on health.

I realize that this is my personal choice, and not for everyone, but I also feel strongly that our current lifestyle of 200 gms of CHO plus a day seems to be creating problems that can't be ignored. And, when I continue to try to understand the possible reasons, be it inactivity, genetics, food choices, and metabolic pathways, I really think we need to ask ourselves, are we eating a diet conducive to good blood glucose control and health?

I know for myself, high carb meals, lead to huge errors in carb counting (even measuring on a scale) larger doses of insulin leads to variable absorption, which leads to more extreme fluctuation in blood glucose readings, and more lows and highs. So for me it makes logical sense to reduce the carb a little or a lot depending on your comfort level, to make diabetes management a little more predictable.

As for my kids, they eat a typical kid diet. They have cookies and milk, Kraft Dinner, Mr Noodles, Ice Cream, and pretty much what they want(with in reason) We buy lots of fruit (which isn't low carb) that they have access to when ever they feel the urge. Kids with D or any child for that matter need calories, lots of em, especially active kids, but for the middle aged office worker, hmm me, I am certainly not burning the fuel like the little ones.  

The 2 little Type 1's have good days and bad days with their glucose readings, and unfortunately the bad days are the ones where the meals and snacks are higher in carbs or meals that are difficult to calculate, but this is all part of being a kid with D, I know because I was one once, and I loved my moms home made cookies and milk.