Thursday, September 22, 2016

A Little More Personal Than Usual

Attending the Diabetes Hands Foundation Masterlab Conference in July reenergized my diabetes advocacy efforts. One of the sessions that really struck a chord with me at the conference was a presentation by Dr. Mark Heyman from the Center for Diabetes and Mental Health titled “Don’t Forget About You: Taking Care of Yourself While Advocating for Others.” As excited as I was when I was offered the scholarship to attend the conference in Orlando, I was under a lot of stress. In fact, I almost had to pass up on the offer.

I had given up a steady paycheck and health insurance when I resigned from a job in February. It was a huge gamble, but I had to do something drastic to get my career back on track. My savings dwindled quickly while I looked for the next opportunity. I went to work for my family's small business where I love what I do, but do not pull much of an income or benefits to afford the insulin and medical supervision I need to stay alive with type one diabetes. I doubled down and invested money to keep the fledgling business alive only to find myself struggling to break even. In the meantime, I relied on a stockpile of diabetes supplies I hoarded in anticipation of this phase.

I started lowering my expectations, applying for jobs I knew were no better than the one I left. One such position invited me to interview on a date that conflicted with the Masterlab conference. I attempted to reschedule or arrange alternatives like telephone or Skype, but the prospective employer was too rigid to consider. I decided to accept the scholarship and fly across the country to attend the conference. I convinced myself that the networking opportunity was worth turning down an interview for a position I really did not want anyways.

During Dr. Heyman’s presentation at Masterlab, he talked about how if you want to be an advocate, you have to remember to take care of yourself first so that you may be of service to the community. I noticed my posture changing as I became defensive and pessimistic about my situation. As an ultrarunner, I am nothing if not persistent. Although I consider myself a lifelong recreational athlete, my raw athletic talent is limited. However, in running and in life, I do not give up. I find a way. I take pride in my scrappiness and resilience. I met a lot of interesting people at the conference, fellow advocates and a variety of diabetes industry representatives. Nonetheless, there was no immediate relief from my real life stress.

I came home more determined than ever. I kept searching and applying for work. I did my best to keep the family business afloat. I didn’t panic, but harnessed my anxiety as motivation to get stuff done. Of course there are better sources of energy, but sometimes you just have to burn what is available.

McWay Falls at Julia Pfeiffer Burns State Park
Several months in advance, Jenny and I had committed to crewing/pacing our friend Mitch at the Tahoe 100M. We made a week long road trip out of it, taking the coast up California with overnight stop in Big Sur. Before we reached Lake Tahoe, I received a call from a job I was really interested in and had already interviewed. I got an offer! I was thrilled, but waiting on a scheduled interview for an even better opportunity. To skip ahead on this part of the story, I would eventually land the job I most wanted. I’ll come back to that shortly.

Mitch's Crew at Tahoe 100M
At Lake Tahoe, our friend Mitch was unable to finish his race. He had a problem with his calf muscle that made it prudent to stop at mile 50. We still had a great time with friends. During this peaceful and scenic getaway, Jenny and I discussed getting married. We had talked about it previously, but I was reluctant to propose until I secured a job again. A few weeks later, after accepting a new job, we told our families and I got down on one knee to formally propose.
Moments after giving Jenny the ring
The reason I bring up that aspect of my life on this blog about diabetes and endurance sports is that healthy relationships are such an integral part of overall well being. Fortunately, we are on the same page as far as balancing demanding schedules with maintaining a healthy lifestyle. We love to eat well and exercise together regularly. In fact, one of our most memorable days together was running Bryce Canyon 50M in June. She is a very supportive part of my everyday diabetes management plan. I’ll leave the topic of exploring diabetes and relationships more in depth for another time. Suffice it to say for now, that I am extremely grateful to have her in my life and to move towards starting a family together by getting married.

Going back to my employment situation, I was lucky enough to get the job I most wanted after all. The health insurance benefit kicked in on September 1st. That same day, I filled a prescription for a three month supply of medications for literally pennies on the dollar compared to retail price. I don’t like to cry poor even in tough times because everything is relative. There are too many people who die or suffer greatly for lack of access to proper care. I knowingly stretched my resources this year. For the foreseeable future, I no longer have to worry about running out of  insulin, needles, test strips, or other meds.

Now that I am once again able to take good care of myself, it’s time to give back. This humble blog is one of the ways I strive to accomplish that. I love endurance sports. I can swim, bike, and (especially) run ridiculously long distances. It’s a hobby that became a lifestyle and identity.

The blog seeks to share my thoughts and experience safely navigating these adventures. I hope aspiring diabetic athletes can learn something from either my success or failures. I hope to connect with likeminded people to feel part of a larger community. Perhaps even those who have no interest in endurance and would rather play a different sport or just add a short walk to their daily routine can gain something from this forum. With proper management, diabetes doesn’t have to limit you in any way.

My sixth Dwight Crum Pier to Pier finish
Had a chance to check out Badwater 135M

Monday, July 11, 2016

Spring Update

March- Solvang Century  
My cousin Claudio and I made a weekend of one the West Coast’s most popular century rides. Solvang is a small California town in Santa Barbara County with quaint Danish architecture and bakeries. Growing up, it was one of my grandparents’ favorite daytrips. The landmark windmill brings back memories of freshly made waffle cones and ice cream.  

Claudio, Kurt, and me
This year, the cycling expo featured a talk by Kurt Searvogel, the world record holder for riding over 75,000 miles in a year. That's more than 200 miles per day for an entire year! The record is most impressive for being an incredible feat of endurance AND athleticism in the sense that he had to ride fast in order to get the necessary mileage and still have time to sleep a couple of hours each night.  

The weather at the 2016 Solvang Century was great. Fortunately, predicted rain hit on the early side of the forecast and cleared in time for Saturday's ride. The main remnant of the storm was especially green picturesque countryside.

My strategy was to minimize stoppage time so I skipped all the aid stations until mile 75. I carried a pack with plenty of water and fuel in the form of a new, multiple serving Gu gel container. I should have poured that product into flasks, but I just carried it as it was packaged despite directions to the contrary. I dropped the lid and it ended up oozing all over one side of body while I rode. This caused me to reduce my consumption, resulting in my blood sugar dropping coming into the mile 75 aid station.

Century rides are not races, but my cousin Claudio and I had an unspoken friendly competition. We got separated in the crowd at the start. I assumed he was far ahead of me the whole day. To my surprise, he was entering the mile 75 aid station as I was leaving it. He and a group he was riding with caught up and invited me to join them for the last stretch, but I was utterly unable to match their pace. I was busy catching up on calories as best I could with supplies I picked up at the aid station. I felt better soon enough, and tackled the last climb feeling reenergized.

Also in March- Hiking in Yosemite
Just a fun trip to Yosemite on the last days of Winter. The waterfalls were raging and there was a little bit of snow at the higher elevations.

April- Ahmanson 12k

I often equate trail running with ultrarunning. However, some ultramarathons take place on tracks or roads and there are plenty of trail races shorter than all day ventures. Ahmanson 12k was the shortest trail race I have ever participated in. The race is put on by Race Director Nancy Shura-Derwin’s Trail Run Events. They are best known for the newbie welcoming Ultra Ladies training group and the infamously hot Bulldog 50k.

Jenny and I got there before sunrise. We volunteered at the registration table, earning comp entries. My goal was to run a decent pace considering the short, runnable course. This effort
was out of my comfort zone, but a great workout.

May- Ironman Saint George 70.3  

Jenny, me, and Martin at the finish
I signed up for this race to commemorate five years since competing in the 2011 full Ironman Saint George with Insulindependence Triabetes, a team of 10 type one diabetics from around the country. I hoped some of them could join me, but nobody was able to make it after all. I was not alone, though, as my friend Martin came along to complete his first Ironman.  

Jenny, Martin, and I left Los Angeles on Thursday bound for a one-night pit stop in Las Vegas. We were about two hours into the drive when I realized I forgot to pack my Levimir, the long-acting basal insulin I use. What happened next is nothing short of a miracle.  I posted about my dire situation in a Facebook group called “The 1’s” which is a subgroup of the Los Angeles chapter of JDRF. I have previously shared test strips and insulin with online acquaintances in need. I guess that built up some good karma because not only did I get multiple offers of assistance from complete strangers, but the very first response came from someone who was literally just a couple of miles away.

Jamie graciously dropped what she was doing to meet me in a supermarket parking
lot and give me a whole vial of precious insulin and needles. Jamie, I can’t thank you enough for your generosity. Just know that I will continue to pay it forward. Thank you!  

Martin and I went on a couple of training rides and runs, but I always had an excuse not to hit the pool. In fact, I only swam once or twice in the past year. Not surprisingly, I struggled in the water. It took at least 15 minutes before I gained any sort of rhythm. Once I did, though, I felt good and could have easily continued another mile around Sand Hollow Reservoir.  Before the swim, my blood sugar was high. I had eaten an even bigger breakfast than usual and may have under bolused Humalog, the fast acting insulin I use. Also, it was my first triathlon in years, so I can’t discount the effect of normal race anxiety.  

My morning blood sugar was high enough that I had to give a correction bolus before the swim. For safety reasons, I carried two gels under my swim cap. In case I went low, I could just flip onto my back in the water and eat the gels. Actively managing my blood sugar, nutrition/hydration, and exertion is a constant task. I usually get it right, but it’s impossible to always do so perfectly with all the variables involved, both external and internal. I learn from experience and try to be prepared for whatever the day may bring.

It started to sprinkle a bit while in the first transition. Once on the bike, I noticed a woman riding in her wetsuit. I laughed to myself, but not for long because it soon started pouring rain and got really cold. I regretted not wearing a rain jacket or gloves. To make matters worse, I dropped my sunglasses which despite the lack of sun were serving the purpose of shielding my eyes from the rain.

What slowed me down considerably was needing to pull over constantly to pee. I had stabilized from the morning high blood sugar, but this was the lingering effect. The run was similar, I felt good but needed to pee constantly. My friend Martin caught up to me at mile 2 and we ran together until around mile 10. He did really well for his first 70.3. It’s racing etiquette to stay with a friend or fellow competitor to the finish if you run the majority of the race together unless that person insists that you pull ahead. Martin did just that, so I happily revved up the pace for the last few miles. It’s always nice to finish strong.  

Like I mentioned, I did this race to commemorate the 2011 Saint George experience as a Captain with Insulindependence Triabetes. Forgetting my basal insulin and leaning on the diabetes online community (DOC) for support encouraged me to renew my involvement as an advocate. My contribution or platform is to share my experiences participating in endurance sports as a type one diabetic. I may seem to glance over the diabetes management process at times because when things go right, which is thankfully most of the time, it really feels like it happens in the background. If I emphasize my mistakes, it’s to draw attention to potential pitfalls and demonstrate that most problems have a solution.

June- Bryce 50M
Jenny and I flew into Las Vegas for a few days of rest and relaxation before driving the scenic route through Zion to Bryce. This would be Jenny’s first 50 miler and yet she picked a very difficult course. Not only is there a good amount of climbing, it all takes place at high elevation. Running at high altitude is tricky because it requires that you slow down and pay extra attention to hydration and nutrition.

I agreed to run with her the entire way, basically acting as a pacer for 50 miles. Pacing or crewing your significant other can be especially challenging, more so than doing the favor for another friend or training partner. You know that they will suffer and yet the task is to push them to continue despite exhaustion, pain, and moments of self-doubt.

Jenny did amazing, though, keeping steady throughout the day despite her feet blistering before we even reached the halfway point. She persisted, able to tape up her feet at an aid station and continue. We tried to keep our stops short, but made sure to properly refill our packs. Some of the aid stations were fairly spread apart, but they were really well stocked and the volunteers were awesome. They had the usual sports nutrition products, old school “real food” options, and even homemade baked treats.

Another cool feature at Bryce 50M and all RD Jamil Coury’s Aravaipa Running events is that they are proudly “zero waste” events. Trash is seperated into organic matter, recyclables, and miscellaneous garbage. Afterwards, they turn the garbage into compacted solid material that is used for construction projects in economically depressed tribal lands.

I had as perfect a day as possible in terms of diabetes management. Everything went so smoothly that I have little to say about it. I was sipping water constantly, eating every 30 minutes, and grazing at aid stations. I only deviated from the schedule once when my blood sugar crept up a bit. I just skipped one gel and things got back into good range.

As impressed as I was with Jenny’s performance throughout the day, her best moment came at the very end. GPS watches are very accurate nowadays, but can be less reliable in certain areas where the devices lose reception. In any case, the finish line seemed an extra mile further than we expected. We were sure that we’d finish, but as her pacer, I wanted to complete the course under the official cutoff time. Jenny accepted the challenge which meant she needed her last mile to be the fastest of all. We crossed together with just three minutes to spare. Congratulations, Jenny!

July- Masterlab Diabetes Advocates Conference

I had the opportunity to attend the Diabetes Hands Foundation Masterlab conference in Orlando, Florida. In the past, I have connected with groups of type one diabetics with the common interest of either running or triathlon. This time, it was a collection of fellow t1d’s with a variety of platforms. 
We heard from experts in nutrition, diabetes education, psychology, legislative insiders, lawyers, and industry. Spending time with fellow advocates made me reflect on my own efforts at managing my condition and making a positive impact on the community. Masterlab takes place immediately before and in the same location as a much larger conference, Friends for Life, for children with diabetes and their families. Being part of such a large, diverse event was inspiring. I certainly take strength from feeling part of a resilient, optimistic community.

In my application for the generous scholarship which allowed me to travel across the country for this conference, I depicted myself as a dedicated endurance athlete living with type one diabetes Spending time and resources on training and racing can feel like a selfish endeavor. I do it because it helps keep me healthy, physically and psychologically. I share my experiences on this blog because it provides an outlet for me to dream aloud, stay accountable to my commitments, learn from my mistakes and generally share the journey with anyone who may take some inspiration from it.

Friday, February 19, 2016

2016 Off and Running

My last race in 2015 turned out to be my first DNF. In a way, it was an important achievement. Usually, my biggest strength in endurance sports is being incredibly consistent. I would never claim to be fast, but I have been ultra consistent. While that trait is mostly a good thing, I intentionally set out to run closer to the edge in 2015.

For example, in April at the Leona Divide 50M, I went for a PR. I failed, finishing an hour and a half slower than the prior year. I ran a great 50k, blew up and walked the last 15 or 20 miles. I succeeded, though, in finding the courage to go out harder than usual. My fitness just wasn't there, but part of the mission was accomplished by going after that PR.

Later in the year, I was able to finish the Angeles Crest 100 Mile Endurance Run for the  second time a full forty minutes faster than in 2012 despite minimal training. Without worrying about the clock, I was running almost the same exact splits as in 2012. I made up time at the end by finishing stronger over the last 20 miles. Even the recovery went much smoother. 

I've started off 2016 with some fun races. I haven't worried about my times at all. The focus has been on having fun and enjoying the social aspect of racing and training. 

At the Boney Mountain 21k, I ran like my old self. Conservative, but well-paced throughout.I sat around with some Coyote Running friends after the race and felt great about the day.

Also in January, I rode the Palm Springs Half Century with my brother in law. It was flat, and we cruised fairly easily through the desert. We had signed up for the full century, but since neither of us had really been on the bike at all leading up to it, we dropped down to the 50M. The ride was fun, and it was a great weekend escape. I even won enough money at a local casino to cover my expenses for the weekend.

February started off with a scare. I took a friend visiting from out of town on a 20 mile route at Mount Wilson. I sprained my ankle on a rocky descent. Judging from the loud crack of my bones when I landed awkwardly and the immediate intense heat that flooded my foot, I thought the injury was going to be serious. We kept moving another 8 miles to reach the car. Later that night, my girlfriend's family helped me apply some medicinal oils and alternate soaking in hot and cold water.

A week later, I ran the Redondo Beach 10k with my roommate and some of his friends. Surprisingly, my foot was fine and I experienced zero pain. I started off slow and revved up a bit towards the end.

Friends at South Bay Running Club and with the title sponsor at the Skechers Los Angeles Marathon were able to get me a comp entry to this year's marathon. I was disappointed to pass on the opportunity due to being sick. A high fever and inability to eat solid food in the days leading up to the race kept me on the sideline. This year, Los Angeles hosted the US Olympic Marathon Trials. It was amazing to see the country's best vying for a spot on the olympic marathon team.

Thursday, December 10, 2015

Santa Barbara Red Rock 50M (DNF)

Lunch stop in Santa Barbara
I have completed about 75 races ranging from flat road 5k’s to mountainous 100 mile ultramarathons, local sprint triathlons to one of the toughest Ironmans on the circuit, low key charity rides to challenging centuries and beyond. Previously, the only time I have ever failed to finish a race was once in a triathlon when my bike wheel collapsed and became unrideable. Until now, that is. The 2015 edition of the Santa Barbara Red Rock 50M defeated me. First legitimate DNF- did not finish.

Pretty cold, but at least it didn't rain
Originally a 40 mile race and extended to 50 miles in 2013, this course was already the most difficult I have faced. I love the Santa Barbara backcountry and was back for the third consecutive year. Race Director Luis Escobar had to change the course due to some trail closures and the result was to make it even harder. It featured nearly 15,000 feet of climbing.

I could make excuses for giving up, but the truth is that I was too out of shape and heavy to continue past the halfway point. I had the option of grinding out a few more miles for a ~50k finish, but after stopping for a while I got very cold and just couldn’t get moving again. Instead, I spent the second half of the day volunteering, tending to exhausted runners coming through that aid station for the second time after a huge 3,000 foot climb. It was fun to hang out with other volunteers who are all accomplished local ultrarunners.

Next up, I will prepare for a Spring half ironman in Saint George, Utah. I need to rebuild my cycling and swimming base entirely from scratch, as it’s been a long time since I trained in either discipline. I signed up for a couple of century rides to commit to a few long rides and am also planning cycling trips with friends.

The first half of 2016 is lined up. I don’t know yet what I’ll do with the rest of year. I’m considering another 100M run, ironman, or new marathon PR. A Boston qualifying time of 3:10 or better is beyond my immediate reach, but who knows? No matter what I decide to focus on, I need to drop a few pounds and gain strength. Towards achieving those goals, I am keeping a food log and doing different types of workouts than just endurance training.

On an unrelated note, I recently had the opportunity to visit Portland, Oregon. Here’s a couple of short videos of waterfalls in the Columbia River Gorge area:

Friday, November 20, 2015

Ray Miller 50M Race Report

Photo by Louis Kwan at start
Managing type one diabetes while participating in endurance sports requires the ability to adapt while on the move, balancing insulin, nutrition, and pacing strategies.

I usually don’t go into details about insulin dosing or even blood glucose levels. I will say that even when I run long distances, I give my full basal dose of long acting Levemir insulin. And if breakfast is at least two hours before the race start, I also administer a normal bolus of fast acting Humalog insulin. My preferred breakfast is toast, eggs, a cup of coffee, and juice or fruit. Additionally, I might eat a snack on the way to a race venue, like a Cliff bar and sip on an electrolyte drink or water. During the run, I generally stick with liquid calories. I have tried different products over the years with similar success. Luckily, my stomach tolerates a variety of options. I have thrived on simple things like maltodextrin and Nuun tablets, Pacific Health Endurox, and recently, Hammer Perpetuem. I also take Saltstick salt tablets as conditions and effort dictate. I carry gels to sporadically bump up the calorie count and sometimes enjoy the fat and protein of a Justin’s almond butter packet.

My plan was based on maintaining a fairly easy level of effort, moving consistently throughout the day. There are days when everything goes according to plans, but today the key to completing this 50 mile course with anywhere from 10 to 14 thousand feet of climbing was adaptation. I was momentarily brought to a stop from a slight miscalculation of insulin potency.

About 45 minutes before the start, my blood sugar was high. It presented a dilemma because although I never like to be out of range, even the smallest amount of fast acting insulin could drop me too low while running. I chose to give some insulin and run the first few hours extra conservatively in terms of pace to minimize the exercise effect on insulin potency. It seemed to work, but I finally crashed while approaching the halfway point. The mile 23 aid station could not come soon enough. I struggled through a flat section instead of cruising. Eventually, I reached aid a mile or two later than expected. I reluctantly sat down and took the time I needed to ingest enough sugar to stave off the low. Course tip: mile 23 and 43 aid stations are further out than they are listed.

I lost some time there, but I was able to stabilize and resume my slow yet steady pace for the remainder of the race. Many thanks to aid station workers for encouraging me to wait until I felt better before proceeding. Immediately ahead of this aid station was the biggest climb of the day, two thousand feet up the mountain to Sandstone Peak.

The course description on The Ray Miller Trail Races site accurately depicts a scenic treat that is surprisingly remote for the Southern California Coast. It was well marked, though I managed to take a slight detour once before quickly realizing my mistake and going back on course. This is a Fall Ultramarathon and I typically finish in the nighttime. Tonight, the sky mystified the scene at the finish. A surprise missile test from nearby offshore puzzled many spectators.
Photo by Jenny Chow at finish line