Ironman Arizona

Sometimes having diabetes SUCKS! This is what 10 year old triabuddy Ryan said at the Triabetes documentary premiere on Saturday. It was a phrase I kept thinking to myself as I couldn't get a handle on my blood sugars for half of the day. I'll try to make this short, but no promises. This blog will probably make sense to someone with diabetes, again no promises to those of you without.
I change my insulin pump site Saturday night around 7 or 8pm, I open a new bottle of insulin. I put an extra site in, just in case. I go to bed with a bg of 189,(normal 70-120) I bolus 2 units take half a Unisom(pre-race ritual, if I ever hope to sleep at all before a race like this)and hope for at least 4 solid hours. What I did not know was that I had a kinked cannula, for those of you without the betes, that means I was not getting any insulin delivered to my life line. To make matters worse, when I wake up my reservoir is no longer in my pump, it's dangling at my side, so naturally I blame my 430 Bg on this, not knowing that I also have a kinked cannula. What are the chances, welcome to my life, seriously, 2 people in my family commit suicide...you get the point, this is my luck. I bolus 8units and know my breakfast of a bagel, banana and Boost will have to wait. 30 minutes later accucheck is 360, I bolus 4 more units, I have hope. 20 minutes later hoping that I will be able to eat, 410. OK, WTF, I blame adrenaline, 2 more units. I'm already feeling like sludge is running through my veins, in reality it's lots of sugar not being able to be utilized by my cells. We head to the race, blood sugar never goes down, I'm still blaming adrenaline and being without insulin all night for my resistance. So stubbornly stupid. I feel happy and excited to start this race, Miley Cyrus comes on my Ipod and I sing and laugh. There's a party in the USA, I change the words, There's a party in Tempe today. Life is good despite these crazy sugars.
There is a table set up before the swim start where we will be able to leave our pumps and accuchecks, Sarah another athlete, diabetic, friend and volunteer for Triabetes is there. She suggests that she give me 2units via injection so that we know it will work. Good plan, 2 units in, Bg still 400+ but since I now took what I thought was another 2 units, I feel confident to eat half a banana. Who starts an Ironman race with some Diet Coke and half a banana....that would be me, the diabetic idiot. Swim goes well, no hyperventilating for once in a mass of 2200+ athletes. Imagine I'm worried about going low thinking I have all this insulin on board that is bound to start kicking in when I swim. I swim with Skittles in my wetsuit sleeve and 2 Gu's that Anne gave me, because my morning dry clothes bag ripped and I lost some stuff out of it, yeah that's all that great luck again. I realized later the reality was that I only had 2 units from about 7 or 8pm the night before, surely ketones were starting to kick in, that would explain the constant peeing in my wetsuit, never had a cramp, never got too cold, just kept warm by peeing. Despite their bad reputation, ketones ARE good for something. I exit the swim 1hr and 40minutes later, bg is 263, I feel confident that sugar is on the right track , I drink a Boost at transition and bolus(so I thought) 2 units. 30 minutes into the ride I am not feeling right, I notice my breathing is way off, sugar check 330, eff, I take 6 units and increase basal to 150%, this is Ironman and I need to start pounding some calories. A year ago my body would not respond so poorly to these high sugars, but this year is different, my body now reacts poorly to highs. I drink lots of water and decide to add some electrolyte tabs to it, I'm in the desert, gatorade is not an option with a sugar like this, nor is any more calories until I can get a Bg less than 200. I start thinking about Ryan's statement, "Having diabetes sucks", yes sometimes it does, especially today. I have trained all year, spent tons of money to get here and this is how it's going to end. I start thinking about different scenarios, I entertain myself with my horrible blood sugars. I am convinced I will be the dumbass Triabetic out on the course that goes into DKA. Surely, Peter will want my certificate that says, "Master in Diabetes", back! What a joke I am. I try to stay calm, the nausea sets in, surely ketones. This ridiculousness goes on until mile 45, I keep bolusing, sugar is constantly above 300, I keep stopping to pee. At about mile 40 when it is evident that my site or insulin is not working, I am not sure which one at that point, I try to switch to my spare site. IT DOES NOT CLIP IN, the connection won't work.Yes, all my great luck again. This has happened to me before, it is like a piece is missing and you can't click it together. I start to really get nervous, I am almost halfway through this freakin bike with no nutrition and now definitely no insulin. I have no backup plan. I realize I have had exactly 2units of insulin since 8pm. DKA here I come, UNLESS I can find a Triabetic out here that still injects...Bill or Kevin are my only immediate hope. Well at about mile 45, Bill sees me on the side of the rode trying to connect to my spare site, still with no success. He asks me if everything is OK, I am sure I look panicked, I was craving insulin, any diabetic knows that feeling. My body needs it, my muscles feel heavy, I am nauseous and I neeeed freakin insulin. I will never be without a syringe again, tough lesson after 24 years with this disease. He kindly stops, anyone who does not know Bill... Bill is fast and he slows for me, he is my superhero, he gives me a syringe with 15units, I take 9 and save the rest for later. My race is saved, this Ironman thing will surely happen today. Bill is my hero. He was my hero before, for all of his accomplishments, he was the first type 1 diabetic to do an Ironman back in the 80's. Now he has saved what feels like my life, surely my race. By mile 56 at my special needs bike bag...where I should have placed an extra site change, I am in the high 200's, I decide to drink my Boost and say goodbye to my frozen Snickers, my sugar is still high but coming down quick, I need the electrolytes in the Boost and I only have 6units in a syringe, I must choose nutrition wisely. This is where having diabetes does suck, not a moment goes by that you don't have to calculate the after effect. I really wanted that Snickers, but I sadly said goodbye to it. Still nauseous anyway, but just throwing a Snickers away, is so wrong. The cool part of this story is that at the final turnaround my Triabuddy Delaney was there, who happens to be a Minimed pump user also. She has a extra infusion site. It's not one that I've ever used so she helps me insert it. How cool was that, this great 12 year old is able to help me. John Moore is there also, another fellow Triabetic,diabetic Ironman and he gives me his bottle of insulin, so cool,now I know I have no more insulin worries. My people have saved me. Any other race their would not have been tons of diabetics on the course racing , volunteering or spectating, but this race was special, it was why I was there. My day was saved by diabetics all over the course, how amazing was that. I think my dad and brother must have been looking out for me too, they were not going to let All-e and I go down without a fight.
Unfortunately, Delaney's infusion site was not long enough to stay in a meaty girl like me. I try some "hockey tape," yes that is what a rest station gave me when I asked for medical tape to try to save the pump site, but sugars were never an issue again, and with a syringe and insulin, my mind was at peace. 19 miles before the end of the bike as I am ready to head back out, I see Heather approaching the last turnaround, I stay and wait for her and her meter has broken, so now it is my turn to help another diabetic out on the course. We laugh, curse and talk the last 20 miles in, life was good. As we head onto the run together she has a quicker pace than me, I tell her to go, it will be a long 26 miles and at that moment I needed to be slow. I catch her at mile 7ish, we run about 7 or 8 miles together, then we separate. My sugars are never an issue again and I only need to take 2 more units the entire race. I cross the finish line not nearly in the time I wanted, but as my friend Nick says..."It's not about your time, it's about the time you have while you're out there." Delaney is there with flowers, Aaron is there with his smile, gosh I love that smile. My day is complete. I have completed my fourth Ironman. This was a great race with other type 1's all over the course, I got to run and ride with a friend who I call my diabetic sister. Until this this year I never had a support system of other diabetics, now I have what feels like family. Anne gave me her Gu's, Sarah gave me an injection, Bill gave me a syringe with insulin, Delaney gave me a insulin pump infusion set and flowers, John gave me a bottle of insulin, and who I call my diabetic sister, Heather, gave me her friendship out there on some lonely miles. I know I have said this before but I must say it again, Triabetes has changed my life, it has changed the way I manage my diabetes, I no longer see renal patients in the hospital and think I might be one of them someday. I now have the tools to avoid all the complications of diabetes. When I think I'm doing a good job managing my diabetes, all I need to do is hang around other type 1's to realize I can do better. I love this organization for what it has done for me, it's ironic that one year ago I had poorly managed sugars and not many tools to change how I managed it, and my last race with all the other Triabetic captains would start with these crazy sugars with no workling pump sites and end at a perfect 92, with Bill's extra syringe, Delaneys help and John's insulin, more tools than I needed. The irony of life I suppose. I think it was just a reminder from up above that even though this race is over, I need the diabetic community in my life, they are my people and always will be. We are a little different than the rest of the world, I guess just a bit sweeter.