Obviously I haven’t been into blogging so much lately, and I’m not sure when I’ll be motivated to start posting again. Truth is, I’ve been a little burned out on sharing my experiences and feelings about type 1 diabetes. Sometimes it’s cathartic, but sometimes I just don’t want to give diabetes any more attention than I have to. No matter how busy I am, I can never take a vacation from testing my blood sugar, counting carbs or taking insulin - but sometimes it helps to take a vacation from writing about it all the time.

My apologies and thanks to any faithful readers who still check in from time to time, I’ll be back eventually. Hopefully with stories about races won, obstacles conquered and A1Cs in the 5s. Many thanks to all the regular d-bloggers out there who continue to comfort and inspire me every day, I’m really grateful that not everyone is as much of a slacker as I am. May 2009 be a year filled with new technology, hope, and stem cells. Lots of stem cells.

I went to Diabetes Training Camp with high expectations, after hearing others talk about their experiences there. But I was still totally blown away. I had no idea it was possible to pack so much knowledge, physical activity and laughter into a single week, and although the camp is still in its infancy the staff were incredibly organized and well prepared.

My diabetes-themed vacation started right away when my seatmate on my flight to Chicago introduced himself by saying “you have an insulin pump, right?…” and pulled his own pump out of his pocket. Apparently he’d seen me bolusing in the boarding line, and fate had put us both in the same row. An exit row, to be exact. I think I heard the flight attendants nervously whisper “…diabetics!” as they walked past us.

Upon arriving at camp, I was suddenly thrust into a strange and wonderful environment where diabetics were the majority. The air was filled with the sound of meter beeps and pump alarms, and a trail of test strips marked the path to the dining hall like breadcrumbs. As a group we bonded instantly, and the laughter and chatter began as soon as people started trickling into the dorm lobby on the first day.

The training sessions started at 6:30 am and continued until 9 pm or so, interspersed with lectures and massive quantities of food. I had every intention of participating in some of the running and swimming sessions, but found myself not wanting to miss any of the cycling sessions because I was learning so much. I went in to camp as a relatively inexperienced cyclist, with no bike handling skills to speak of. I’d heard great things about Nicole Freedman, their cycling coach, but I was still amazed by how much she managed to teach me in a week. In addition to being a great coach, Nicole was also quite a character and had me giggling constantly. I don’t think I’ll ever be able to go around a sharp corner or do a steep descent again without hearing her little voice echo through my head, shouting “Get low! Lower! C’mon, be like a cheap white trash Camaro!!”

Another great thing about camp was the VO2 max test (that’s a measure of how much oxygen you consume at your max heart rate, which gives you a basic idea of your athletic potential). I’d been wanting to have this done, but hadn’t been willing to shell out the money to do it at home so I was really psyched to have it included with camp. It was especially nice to be able to go over the results with doctors and coaches who were diabetes experts, and who could tell us how to train and fuel not only from an athletic standpoint, but from a diabetes standpoint as well. We were lucky enough to review our graphs with Rick Crawford, coach to Team Type 1, who was really outstanding although he had just spent a sleep-deprived week traveling in a van with the TT1 RAAM team. And I was encouraged by the fact that he did not burst out laughing when I told him I wanted to get into racing.

It’s hard to describe in words the feeling of being immersed in that camp environment, I’ve been back for a while now and I sort of feel like I’m still processing it and adjusting to being back home. It was so weird to be surrounded by people who understood what it feels like to be 53 or 378, and who were dealing with and overcoming the same challenges. Within a few hours I felt like I’d known everyone there for years, and I was surprised by what a difficult and emotionally charged affair it was to say goodbye at the end of the week. I’m already trying to figure out how to get there next year.

I’ve been a bit burned out on the diabetes front lately. After I returned from Diabetes Training Camp (which was amazing, and will be described in detail in a future post) I was a little sad to be back in the real world and have been putting off blogging about it and uploading my weeks of Diabetes365 photos as a result.

I returned from camp inspired and ready to put all my new knowledge to work, if a bit dehydrated and emotionally drained. I had a schedule planned out for basal rate testing, a training plan to get myself into racing, and a renewed drive to fine tune my control even more. Instead, the past week has been a mess of long, stubborn highs and sudden, unexpected lows. I have been putting in some good mileage on my bike, but for some reason I’m not seeing my body’s normal response of increased insulin sensitivity. In the past four days I have been through twice as many infusion sets as usual, tried two new bottles of insulin, and given myself more injections than I would normally do in 6 months. What the hell is going on?!

I’m sick of it. Sometimes it seems almost effortless to control my diabetes, but then there are the long stretches where nothing I do seems to be working, and I just want a break. Unfortunately, I’ve learned over the years that it’s really not an option to pretend I don’t have diabetes. So, I’m ignoring it as much as I can by spending all my spare time in the garden or out on my bike instead of doing things that make me think about diabetes. Fortunately I have a CGMS to remind me that I’m out of range ALL THE TIME, so I can’t help but continue to test my blood sugar frequently. But even the CGMS has been uncharacteristically unreliable lately, I have pulled the last two sensors after only a few days (when normally they last at least a week).

I’m going to try to turn my frustration into enthusiasm for playing Diabetes Detective. There are so many possible variables to consider, I don’t even know where to start. Did my insulin go bad? Not likely, since I have tried a few different bottles. Clogged infusion set? I don’t know, is it common to get 6 in a row? Maybe I’m suddenly allergic to the insulin I’ve been using. Maybe I’m coming down with something or fighting an infection. Maybe my immune system is suddenly launching a full-on attack on every sensor or infusion set I put in.

Maybe tomorrow will be better.

I do a lot of cycling, both for pleasure and for transportation, and I consider myself to be pretty safe and quite cautious when riding in the vicinity of cars. Although I am lucky to live in an area that has either wide bike lanes or separate bike paths along most roads, and most drivers are very courteous and aware of bikes, I always take the defensive because the laws of physics just aren’t on my side in the event I collide with a car. So, I pretend that everyone on the road is there for the sole purpose of trying to kill me - this way I am aware of everything going on around me and I don’t really get that mad on the rare occasions when someone cuts me off or drives aggressively.

Still, it’s easy to forget that you aren’t always in control and that freak accidents do happen. A couple hours ago, I narrowly escaped a nasty accident that probably would have landed me in the hospital - at the very least my carbon road bike and I certainly wouldn’t have been in any condition for camp next week. Fortunately, I am fine and so is my bike.

This afternoon I went out for a little training/errand ride, after riding out to Superior to pick up my contact lenses from the eye doctor I headed back towards downtown Boulder to pick up a check from one of my PT jobs. I decided to take Cherryvale, a scenic country road on the east end of town that is great for interval training, thanks to its long straightaways, low speed limits and wide shoulders. Just after I passed Baseline Road, I approached a construction zone and slowed down a bit as I merged to take the full traffic lane. A green Volvo station wagon (see how I pay attention?) pulled in close behind me, but not aggressively so, as I approached the work crew. Just as I was coming up to a huge “ROAD WORK” sign on a metal easel, a sudden gust of wind kicked up and I watched in horror as the sign started to fall forward and tumble directly at me.

I remember every detail of the next few seconds, recorded in slow motion and burned into my memory. I heard myself saying “nnnNNNNNNNOOOOOOOoooooooooooooo” as I helplessly watched the sign falling towards me, unable to do anything except continue pedaling on my course towards certain death. In my mind’s eye I saw the sign hitting my bike, getting stuck in the spokes and laying me out on the road right in the path of the Volvo behind me. Instead, I watched as the point of the diamond-shaped sign collided with my upper thigh just as I reached the top of my pedal stroke. The sign bounced just far enough away so that it didn’t hit my bike as it landed, and I was stunned to find myself still on my bike and still pedaling as the sign clattered on the ground behind me and the Volvo’s brakes squealed.

I’m still amazed at how lucky I am. If I’d been two inches ahead of or behind where I was at that exact second, things probably would have ended very badly. As it is, I escaped unscathed except for a bruise on my thigh, a small hole in my knickers, and an extreme aversion to construction zones. From now on I’m going out of my way to avoid them.

This weekend, I’m shipping myself and my bike out to Chicago for Diabetes Training Camp. Needless to say, I’m stoked - but I have so much packing and finalizing of the details to do that I’m a little frantic. Not to mention that a significant portion of the next few days will be spent celebrating an early Father’s Day with my family and attending the wedding of a childhood friend.

I can’t wait to work with the coaches and doctors at DTC, who I have heard so many wonderful things about. I think they can help me a lot with my bike handling skills and help me formulate a training plan for the rest of the season. Not to mention the whole diabetes side of things. I’ve never worked with a coach or even had my max vO2 tested, so I think this week will give me a much better idea of what I can accomplish as an athlete and what my goals for the next year should be.

I should have web access from camp and will be posting regularly from there (probably moreso than when I’m home). Also, I recently took the plunge and joined Diabetes365 (still need to get a link up on this site) so check back for camp updates on both!

In the nearly 15 years I’ve had type-1 diabetes, I have been lucky enough not to have had a low that I wasn’t able to treat myself. However, there have been some frightening close calls over the years - the worst of which is not only one of the scariest things that has ever happened to me, but also one of the most bizarre and hilarious.

It was the first day of high school, and being 14 I had to be up at 5 in the morning so I could spend an inordinate amount of time making my hair look exactly the same as it did when I woke up. My parents, like all reasonable people, were still fast asleep.

This was in the days before fast-acting insulin, so when I tested my blood sugar and saw that it was in the high 200s I took my shot of Regular and NPH and jumped in the shower. After that I remember getting dressed and wrapping a towel around my hair. Then I remember standing at the kitchen counter, pouring milk into a bowl and realizing I’d forgotten to get the cereal from the pantry. And that’s about it.

Suddenly, I found myself sitting at the kitchen table, drenched in sweat. My towel was on the floor, and on the table in front of me was an impressive array of carbohydrate-laden snacks. There were several empty applesauce containers, grapes, a decimated pan of brownies, 3 different types of crackers, licorice, and a half-eaten banana. There was also an almost-empty bowl of milk (most of it spilled on the table), complete with two spoons - but no cereal to be found anywhere. A dim memory bubbled up to the surface, and I saw myself trying to eat milk from a bowl using two spoons (because that was so much more efficient), while simultaneously trying to keep the towel from falling off my head. Evidently I failed miserably at both.

Other than the rebound high (which had me in the mid-400s that afternoon), I wasn’t any worse for the wear. I’m amazed that I somehow managed to make several trips to the fridge and pantry despite being completely out of it, and I’m grateful that my body’s autopilot response was to keep eating. I can only hope it’s hard-wired in case I ever have a low that bad again.

A few days ago, I tried putting a glucose sensor in my thigh for the first time. At first it worked out beautifully - the readings were accurate, it didn’t get in the way very much, and the placement of the sensor and removal of the needle wasn’t the harrowing one-armed ordeal it usually is when I put them in my arms.

The true test came on Saturday when I went out for a 50-ish mile bike ride. The sensor was spot on, and didn’t bother me at all during the ride. Then I got back home and started to walk up the front steps, and suddenly it felt like the sensor was being twisted around in my leg. Along with a burning chunk of metal too, perhaps.

I  was about to pull the sensor when the pain stopped just as abruptly as it started. Since I was going to be home for a while, I decided to leave it in for the time being. And it was totally fine for several hours later, until I was running out the door to go to dinner, when it started with the searing pain again.

The pain was infrequent enough, and I was stubborn enough, that this went on for another day because the sensor wasn’t even 3 days old, and I couldn’t let it go that easily. Finally yesterday afternoon I had enough and yanked the sensor out when it started bothering me right before a bike ride.

Ever since, I have been taking a break from my CGMS. I have been using the thing pretty much constantly since I got it last fall, and it’s a little weird to not be using it because I’m reminded of how much I have come to rely on this little piece of technology. In the past couple days the lows have been lower, and the highs higher and more frequent. On bike rides, I’m no longer able to glance at the graph on my pump and head off a low without missing a pedal stroke. Instead, I end up getting off the bike to test when my legs start feeling weak and my blood sugar is already down to 71 - then I kill 15 minutes and a few test strips waiting for it to come up.

Sometimes it takes a break to realize how you really feel about something. As frustrating as it can be for me to wear a CGMS and get constant, nagging reminders every time my BG is out of range, it’s more frustrating to be in the dark. So tomorrow morning, I’m starting a new sensor. The CGMS vacation is over.

There are many times when diabetes gets in the way, thwarting my best laid plans and forcing me to pay attention to it when I’d rather be doing something else. Like the other night, when a kinked infusion set sent my blood glucose soaring towards a mind-numbing 325 mg/dl minutes before I had to perform in a piano recital.

But as frustrating and scary as these unplanned challenges always are, sometimes the flip-side can be beautiful. Every once in a while, I am in the right place at the right time solely because of my diabetes, and I witness something incredible.

Several hours after the 325 mg/dl I was in bed reading, trying to stay awake long enough to make sure my blood glucose was stable since I’d overcorrected and spent the last hour fighting lows. It was almost 2 am, and I was fighting a losing battle against sleep.

As I tried to focus on my book, I caught a slight movement out of the corner of my eye. I turned my head and focused on the vase on my nightstand. A few days before, I’d been cleaning up the yard and accidentally lopped off a stalk of irises that were almost ready to bloom. I’d put them in some water, hoping they might still have a chance.

Now, before my eyes, the petals quietly began to part and move slowly downward, like little elevators. Moving so slowly that I almost wondered if I was seeing things. I tore myself away and ran for the camera.

I spent the next half hour riveted, watching my iris bloom and occasionally snapping pictures of its progress. I was no longer fighting to stay awake, and by the time I closed my eyes again my blood sugar was stable and I had a fragrant purple iris on my nightstand.

Life is funny like that. Just when I feel like I’ve had all I can take, and I can’t fathom the thought of poking my finger one more time or eating one more glucose tablet, I catch a glimpse of the silver lining beneath it all and suddenly I’m refreshed and ready to fight again. And in place of all my fears and frustrations, all I can feel is gratitude for the life that I have. Even if that includes a bum pancreas.

I had an amazing time in California. The week seemed to go by in a blur, but fortunately I managed to snap a whole lot of pictures despite the fact that I, being an idiot, brought only one memory card.

My mom, sister and I spent the first night in downtown San Francisco. We had a perfect view of Coit Tower and Alcatraz from our hotel room, and even on the 26th floor we could hear the faint roar of the ocean and the clang of cable cars on the streets below.

Unfortunately we only had one night in the city so I didn’t get to do much exploring. We started off the evening strolling around Chinatown and Nob Hill, and then enjoyed cocktails and appetizers (and a stunning view) at the Top of the Mark, followed by a delicious dinner at a place called First Crush. I “enjoyed” a lot of glucose tablets and gels that night too, and started to wonder if I’d really been as excessive in my packing of diabetes supplies as I thought (and no, I hadn’t).

The next day we were off to wine country to visit some family friends in Glen Ellen. We spent the afternoon with my mom’s friend Sue, hiking through the Armstrong Woods, a beautiful grove of ancient redwoods. I heard my mom calling my name, looked around for her, and finally spotted her down inside a “goosepen” - a burnt hollow inside a redwood tree caused by fire damage (apparently ancient settlers kept geese in these). I promptly joined her, and before I knew it all four of us were inside the tree. It was a little tight and very dark, but we had plenty of headroom. This is what the ceiling looked like:

That night we had a delicious dinner at Sue’s place, a beautiful old house on a little vineyard in Glen Ellen. Her husband David makes some great wine, and the best olive oil I have ever tasted. After dinner we enjoyed a late-harvest Viognier, which was absolutely amazing. I’m not normally a big fan of dessert wines, but this one was totally worth the crazy blood sugars later that night.

Sue and David have three lambs (Alfalfa, Marjoram and Rosemary), who mostly hid in their shed when we went to visit them. “They’re a little shy because they just got sheared,” Sue explained.

As we enjoyed a glass of wine on the porch before dinner, the discussion turned to the mental capacity of sheep. “They’re not as dumb as you might think,” Sue said. “Here, watch this.” We followed her to the edge of the porch, where the sheep were visible about 100 feet away. “ROOOSEMAAAARYYYY!” she called. Immediately, one of the lambs looked up and answered her with “BAAAAAA!” “ALFAAALFAAAAA!” To our amazement, Alfalfa (easily identified by her missing eye), stood up and bleated back. Finally, Sue called “MAARJORAM!”. The last lamb wandered out of the enclosure and said “BAAAAAAA!” Incredible.

We spent a good part of the next day touring the Korbel winery, which included some beautiful century old gardens, several different varieties of champagne, and the biggest casks I have ever seen.

That afternoon we were off to our old hometown, San Ramon. A lot of old family friends that I haven’t seen in years still live in the area, so it was great to see them all and explore the area where I spent my first year (although I don’t remember it much, and I’m told it has changed. A lot).

One of the many highlights was finally getting to have Dim Sum with my mom’s friend Cynthia, who is one of the funniest people I have ever met. I grew up hearing my mom’s stories of having Dim Sum with her (which usually included the eating of things like chicken feet) and was excited to finally experience it myself.

Cynthia was thrilled to discover that Anne and I would try pretty much anything, and promptly ordered a round of chicken feet. “They’re my favorite, but nobody will eat them with me!” she said excitedly. They weren’t terrible, but definitely not my favorite. They basically tasted like chicken skin and batter, with a sweet licorice sauce.

Our mom begrudgingly took the last chicken foot from the plate at our insistence, causing the somewhat squeamish lady to her left to promptly turn white as a sheet and push her plate of chow mein away. I really wish I’d taken a picture of her face when Anne said “Mom, just bite the toes off and spit out the bones.”

Anne had to fly back to Colorado a couple days before we did, so mom and I spent our last full day visiting Carmel-by-the-Sea.

After a scenic drive and a delicious lunch, we took off our shoes and walked along the beach. “You know, the last time we were here you were just learning to walk,” my mom said. “And you wanted to go in the ocean in the worst way. We couldn’t let go of you, because you would always head straight for the water. Like a little lemming or something.” I guess some things never change.

After lunch we visited the Carmel mission. I filled up my memory card yet again, but still failed to capture the beauty of that place through my camera lens.

The trip was over too soon and I was back in the San Francisco airport before I knew it. Ironically, the only time I encountered a problem with TSA was when I was heading home and hardly had any supplies left. Going through security in Denver, I had a bag full of little bottles and packets of liquid glucose, and a liter of water. When the security guy motioned me over, I held out my doctor’s note and got as far as “I have type-1 dia-” before he smiled and waved me through. I ended up running low most of the trip, and was really happy to have so much stuff with me. The liquid glucose was especially nice to have during repeated nighttime lows, when I couldn’t fathom the idea of choking down glucose tablets. As a result, I went through almost all of it and went through security on the way back with just a few stray tubes of glucose gel, a small bottle of juice, and a sealed 16 oz bottle of water.

The woman working security puffed up her chest a little “you’re allowed to take juice, that’s all.” “I have water, insulin, and glucose gel too. My doctor’s note says that’s okay. They didn’t have a problem with it when I flew out here.” She scrutinized the note and sighed. “Okay, see what the guy on the other side says.” Great.

The guy on the other side of the x-ray machine read the note, looked me up and down, and read it again. Apparently deciding I didn’t look like a terrorist, he finally waved me through. Before I knew it, I was back home, and missing the ocean.

With finals behind me, I’m off for a short vacation with my mom and sister to San Francisco in the morning. I haven’t been there in almost ten years, and I’m really excited to go back. I can’t wait to see old family friends, check out the restaurants, and explore the city of my birth. And wine country.

Although I’ll only be gone about a week, I am traveling with enough supplies to last for three. I know I won’t need half this stuff, but it’s worth the space in my suitcase to know that I’m prepared in case my sensor gets pulled out, my infusion set goes awry, or my pump suffers some fatal catastrophe and I have to go back on Lantus. I also have enough glucose to treat a hypoglycemic army.

I do like to be prepared. But to tell the truth, my primary motivation in bringing so much stuff (especially all the tubes of glucose gel and the big bottle of water) is that I find the TSA restrictions really annoying. And thanks to the ‘betes, I have a doctor’s note saying I MUST be allowed to take all sorts of forbidden items in my carry-on, like bottled water and juice. And sharp objects. So I intend to be as obnoxious about it as possible.

You just have to take advantage when you can, you know?