Ironman Wisconsin – September 11, 2011
Karyn Brown – Type 1 diabetic for 21 years
This was an amazing experience! From when I signed up to every minute until the race I kept track of how my body reacted to different heart rate zones, activities, weather, foods, etc. I have become more aware of my body and my diabetes than ever before. When I signed up and up until a month before the race I did not honestly believe that I could complete 140.6 miles in one day. On race day I believed my chances were as good as 60% (not great odds). KathyZ asked me, in July during my visit to Madison, 'why' I would even attempt if I didn't think I could do it. I didn't have a good answer then and I still do not. However, I am SO glad that I tried – even if I had not succeeded in completing the race I got more than a medal out of this experience with Team WILD!
The Saturday prior to the race I signed up for a timed 2.4 mile swim to get me prepared for the longest swim of my life. I got about 1/10 mile out from the shore, had a complete panic attack, and swam back to the start. My confidence was shattered. I called Carrie Cheadle (http://www.carriecheadle.com/) and we discussed strategies for erasing this bad memory and calming myself for a swim with 2700 other people. This Ironman race starts in the water. You (and EVERYONE else) goes out and treads water until the cannon fires and then everyone starts swimming, kicking and hitting each other all at the same time – quite intimidating.
Saturday (the day before the race): I went to the lake early in the morning with Jen Ahn and Heidi-Jane to see what the swim start would be like at 7am (race day conditions). I went for a quick 15 minute swim and then a 15 minute bike. All went well. I put in a new infustion site and a spare. I did plan on doing a test bolus through the spare but completely forgot. I decided that rather than have to mess with temp basals during the race that I would set a RACE basal pattern and not need to worry about it. I carefully sat down on Saturday afternoon and calculated my -40%(swim), +30%(bike) and +20%(run) basals and labeled the basal pattern as 'exercise'. I felt ready.
11:30pm – woke up to go to the bathroom and turned on the 'exercise' basal patter knowing that it was the same as my 'normal' pattern from midnight to 5:30am.
Sunday- Race Day
4:15am Woke up; blood glucose=231
4:35am Ate Breakfast – 2 pieces of whole wheat toast and 1 Tb of peanut butter (30 CHO). Typical food bolus = 1 unit, typical correction bolus = 2.4 units. My plan was to do 50% food bolus and 25% correction bolus – I wanted to have 200+ blood sugar going into the swim as my BG usually drops when I look at a body of water. I bolused 2.5 units – according to pump history. I have no idea what I was thinking......
5:15am BG=229, Arrive at the start, body marking, dropped nutrition and CGM at T1/bike and nutrition at T2.
6:25am Headed to get into the water, and checked my blood one last time, 271. Confident in my plan and the insulin on board (approx 1 unit) and knowing my usual habit of going low in the water but going high with stress (like race starts) I let it go and headed down.
Swim 2.4 miles= 2 hours 2 minutes (prediction was 2 hrs) I entered the water with KarenL and we chatted and watched the sun rise (beautiful!) and waited for the race to begin. Without paying much attention, the canon went off and away we went. I was relaxed and enjoyed most parts of the swim. I had planned on eating a Gu after the 1st lap but 'felt high' so I did not eat the gel.
T1 (9:02-9:13) -Running up the helix was quite an experience. I saw KarenL's family as I ran up to it and they waved and smiled. KarenL ran out of transition as I ran in. A quick high five and she was on her way. They screamed my number and a volunteer picked up my bag, took me into the changing room and asked if I wanted her to dump it on the floor.... Of course I did. Next thing I knew my bike helmet was put on my head by someone else while I put on socks and tested blood sugar. Blood sugar 224, not bad coming out of the water within 50 points of going in. No carbs, a 1 unit correction bolus (normal correction – 2.25 – but I am for 50% corrections during races), I started 20 minute timer on watch (to remind me to consume my nutrition) and off I went!
Bike- My CGM showed that I was in the 300s almost the entire bike. I felt terrible. I was thirsty and tired with no energy. I 'blind' bolused 1 unit at 10:30am (1.5 hours into the bike). At 1:15pm I reach the special needs bike bags and I stop. BG=327, normal bolus – 4.3 – I bolus 1.5 units due to insulin on board from earlier bolus. I set a +10% basal rate and get back on my bike. I still feel AWFUL. My body is not processing the fuel I am giving it. I am slowing down. At 3:15pm I still feel terrible. I 'blind' bolus 1.5 units. I know that my +10% basal is active until 6:15pm (I set it for 5 hours when I stopped). I continue on.
My carb intake on the bike is 60 CHO/hr. This is done through a concentrated mixture of Carbo-Pro with TheRightStuff (electrolytes) mixed in. I take a drink every 20 minutes as my watch timer alerts me to. In the case that I need more carbs I have done many long workouts using the brand of gels provided at the aid stations – I did not need to do this.
Aid stations were every 12-15 miles, I was able to grab a water bottle at EVERY single one and consume it before the next aid station! I kept hydrated and my electrolytes were in my nutrition bottle so I was getting those as well!
I had a glucose meter with me on the bike but did not use it. I trusted my CGM instead (which appeared to be correct)
Bike 112 miles = 8 hr (predicted 7 hours 45 minutes)
T2 (5:13pm-5:17pm)This was a much faster transition as I knew more what to expect (3:51). I had the volunteer dump my bag on the floor. I changed my socks and left. I did not check my blood sugar as I knew I could use the blood glucose meter in my race belt for that while I was moving and it was late, late in the day – I did not think I could complete the race (there are cut offs at various places with the final cut off being midnight – 17:00)
Run 26.2 miles = 6 hr 32 min (prediction 6 hr 37 min) I started the run and immediately checked my blood sugar – still confused as to why my 'normal' basals for exercise weren't working the way they normally do/did... but this is diabetes so I've learned not to question much or for too long. BG=225 (at 5:25pm). I do nothing and continue walking for the first 6 miles to keep my heart rate low. About 30 minutes later I do a 'blind' .5 unit bolus because I feel terrible and my CGM indicates that I'm still 200-ish. Ugh. At 7pm I set my basal to -20% as my CGM indicates my BG is dropping. At 9pm I have double arrows down on the CGM and set my basal to -30% until the end of the race (midnight). I had my Carbo-Pro/TheRightStuff mixture and intended to drink on the timer beeps for a total of 50g CHO/hr. I finally start feeling better around 6:30 but now my neuroma (in my right foot) is bothering me instead. I check at 7pm, BG=136 (FINALLY!!!). About mile 14 I take a demerol for the pain in my foot and don't remember the next mile or so but a woman starts talking to me and says I look like I could use some company – would I mind if it was her? Her name is Judy. She is 60 years old and her back is cramped so that she can't stand up straight. We walk the remainder of the race together. I stop at several aid stations and get cola, powerade and bananas! Ah, bananas, you are my friend. Judy asks me how the diabetes is doing.... I check at 9:20pm, BG=133! I am doing fantastic. She is getting more and more crippled/bent over but keeps up with my 14:00-15:00/mi walk. We HAVE to keep up the pace or we won't make the final cut off. As we round the capitol square some of her friends join her and I hurry along in front – I want my 'own' finish chute experience and she is slowing down as she can hear she is 'done'. The finish chute? AMAZING. I walked around the corner and then started a slow jog. I was the final Team WILD finisher so most of our team members and supporters were lining the chute. I got many high-fives and soaked in every minute of this experience – you can see it in my face in my photos.
11:47pm FINISHED! (16hr 47min 12sec)
About 5 minutes after finishing, I checked my blood, 132!
Mari tracked down Tucker to let him know where I was and he brought me my Endurox which I had brought from Colorado for just this – recovery drink! I drank it up and chatted with Jen Ahn and Eric (Jen had finished a few minutes before me).
Conclusions -
- Follow the plan. Nutrition and racing plans (and diabetes, in this case). I had zero GI issues due to this and am thrilled.
- Um, make sure your basal pattern you set (while nervous the day before) is correct and turned on (the morning of the race). Mine was NOT. I ran my 'normal' basal pattern that day which explains the HIGH BGs on the bike. I wish I would have double checked at T1 or T2, at the very least.
- Anything really is possible.
- Enjoy the finish chute – how often do you have that kind of a finish line??
- It's almost ski season... I gotta get my gear out and wax my skis.
1 comment:
wow! I really did read that! I don't understand half of it but needless to say, you still amaze me!
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