And the Russian judge only gave me a 4.5 ....

I'm not a big fan of the treadmill.

As an engineer, I think it's ingenious - if you can't move relative to the ground due to space or weather etc, then have the ground move relative to you. As a doctor, I love it becuase it can literally be a lifesaver - it's recognized as the most effective piece of exercise equipment to get your heart rate up to "training levels". It's also pivotal in cardiopumonary stress testing, etc.

As a runner, who's more of a plodder, I hate it.

It feels artificial; it's noisy; it's boring. And as a few days ago, it almost killed me.

Well, not really, but let's just say it was a wild ride.

When I run on the treadmill in the way-too-early morning at the Y, I sometimes feel like the 6 million dollar man. I wear my insulin pump on the waistband on one of my hips that has small tubing that snakes under my clothes to the infusion port on the other upper buttock. On the same buttock that the pump resides I have a continuous glucose sensor tegaderm-ed to me that beams blood sugar readings to my pump every 5 minutes. Under my shirt and against my skin, a Polar heart rate monitor fits snugly around my body just under the chest. I wear the heart monitor watch on the left wrist (I hate wearing watches). I put my iPod on the treadmill stand itself and the ear phone cords are plugged snuggly in my ears. I usually wear a baseball hat because I have the worst "bed-head" imagninable every morning. And I occasionally attach the little safety thing from the treadmill to my shorts, in case I fall off - that is called foresahdowing.

About two weeks ago I was trudging along. Thump, thump, thump. Green Day was blasting away through my headphones and the talking heads from Fox news on the tv on the wall were blathering about something - however, whoever was typing the closed captioning obviously didn't have English as their first language.

I started to feel a little lightheaded which sometimes can mean that my blood sugar is dropping. I was wearing my sensor that morning, so instead of stopping the tradmill or straddling the belt, I decided to see what the pump meter display said while I still running.

Instead of unclipping it from my gym shorts waistband, I thought it'd be easy just to twist to the right and glance at it in mid-stride.

This caused me to veer a little to the left but I caught myself and quickly corrected. However, by turning my head to the right, it caused my iPod to pull a little bit off the treadmill stand and it was now dangling close to the edge.

In what was a bad decision, I whipped my head around to try to catch my iPod as it stared to fall and I tripped over my own feet.

Never do that on a treadmill.

While it's going at 6 mph.

I saw the iPod hit the treadmill deck and it was zipped out of sight. I was heading face first into the deck myself but was able to put out my hands at the last instant.

As soon as my hands hit the moving treadmill, they whipped out of the way and I was now forward rolling on to my back (instinctively tucking my head, thank god). I landed on my back, upside down on the treadmill and was instantaneously shot off the back of treadmill onto the floor of the gym where upon landing, I think I yelped like a little girl as the momentum flipped my over onto my stomach where I came to rest, facedown.

I quickly got up and mentally checked for blood and broken bones and despite a little rugburn on my back, I was fine.

I was in the back row of the treadmills because I am very antisocial at that time of the morning - so there is nothing behind me, thank god once again. There had to be 30 other people in the gym at that time, but no one saw it. Or maybe no one admitted it because this is Minnesota after all.

I started to laugh as I picked up my stuff off the floor. The "safety stop" cord was still attached to the machine and was dangling straight down - it had failed miserably in what it was supposed to do, instead of flinging me across the room. I was now fully awake, that's for sure. I got back up on the treadmill and slowed it down to an easy walk. I couldn't help just chuckling and shaking my head - like most people do when they have near death experiences.

After a minute I realized I never got a chance to see what my blood sugar was. I almost instinctively did it again - contorting my body instead of stopping and looking at the screen like a normal person, but I stopped myself at the last minute - I straddled the belt, unclipped my pump and was happy to see that my blood sugar was in the normal range.

I think I'll go back to the rowing machine next week.

It's the bitch of living ...

Ok - I need to rant a little.

Sometimes in life, you can do everything right and still get screwed. Now, I don't pretend to do everything right, but I try most of the time. And believe me, it's tiring.

I woke up at 5:40 am to go to the gym before work (so I can spend time with Peter and Laura after work). I did 26 minutes of cardio on the treadmill, then another 26 minutes of circuit weight training, followed by stretching and an attempt at core work. I ate a relatively healthy breakfast and then hydrated with non-carb fluids all morning. I thought I was living the diabetes straight-edge.

Around 11am, I felt crabby. Not just a little crabby, more like set-a-basket-of-puppies-on-fire-and-then-put-out-the-flames-with-my-urine crabby. It didn't help that I had a run of particularly trying patients that were pushing all my buttons.

I knew I had to test my blood sugar. My CGSM said 110. No way. Uhn-uh. That can't be right.

I pricked my finger and the numbers glared back at me: 399.

Fuck.

I don't test for ketones, because I luckily don't produce them too easily, but I new I had to change my infusion site, put on a new CGSM patch, give myself a shot of novolog in the butt and spend the rest of the afternoon checking and chasing my blood sugars. All while continnuing to perform my job at a high level with intent and compassion.

I'm normally pretty resiliant, but my "highs" have been starting to take the wind out of my sails these days. I think I'm "burnt out" on my diabetes. I spent the next few hours not giving a crap.

But, too f'in bad. Even if I want to give up and take a holiday from my diabetes, I can't.

I can't because the diabetes never takes a holiday from me. If I ignore it, it doesn't ignore me - it slowly breaks blood vessels in my eyes, ruins neprons in my kidneys, causes inflammation and plaque in my arteries, overloads my nerves causing them to short out, messes with my emotions and makes my nights fitful and sleepless.

So, I felt sorry for myself. Then I felt angry that I have to deal with all of this. Then I felt envious of those who can go work out and play and be active without ever having to worry about getting low or wonder if you have a power bar in your back pocket if you do. Then I bargained with God that if he lets me win the lottery, then I'll be the healthiest person he had ever met. I never felt denial, though - I've had this too long and that emotion has been played out and dried up for years.

But, as I always do in these little moments of crisis, I then felt acceptance which brings me some peace. I take a deep breath, give myself a little insulin and figure out what to eat at lunch that won't be too bad for my sugars.

It't the little grieving process that I (as well as others with type 1) go through about once or twice a week. It's brought on by highs, lows, good blood test results, bad test results, good doctor's visits and bad doctor's visits.

It's the bitch of living. But, I guess it could be worse. I have a good job and a beautiful family and that's alot.

So ... rant is over. For now.

Peace.

Happy D Blog day! Hope I only have to wish it to myself ...

I don't blog about my diabetes that much because as an Internal Medicine physician, I see the stark reality of diabetic complications everyday at work. I'd rather focus on, what are to me, the more interesting things that happen in my life in my blogs.


Don't get me wrong - I don't ignore my diabetes or hide it from anyone - I wear an insulin pump and a CGSM and I will check a fingerstick anywhere (restaurants, movie theatres, church, bar) at any time. My A1c is inthe 5.3 to 6.0 range consistently through a lot of hard work on my part.


But I don't go out of my way to tell people. I'll answer truthfully if they ask - I wear my pump as a tool, not as a badge of honor. I'm one of those people who classify themselves as "having diabetes" not as someone who is a "diabetic".


I not knocking anyone who labels themself in either way, but we all have our coping skills and I'm comfortable with mine. Enough on that.



Anyway, I'm dealing with my diabetes (and all the fun it brings) and I accept the that responsibility even when I fall off the exercise wagon or knowingly scarf down an extra piece of pizza at a luchtime meeting that will send my blood sugar northwards of 250 for the rest of the afternoon. I am also dealing with the fact that some very minor complications are creeping into my life despite a "normal" A1C.

I'm a big boy - I was diagnosed 14 years ago when I was 25 and in my third year of medical school. I (hopefully) have the wisdom and wit to deal with what I have to do each day in order to live a long and healthy life.


But my son isn't a big boy. He's 20 months old and I'm deathly afraid that he'll develop diabetes someday.

Thanks to a crappy mutation in my genes, he has a 5 to 8% chance of getting type 1 diabetes. While he may have inherited my brown eyes and infectious laugh, he may have inherited my propensity for auto-immune diseases. That ... truly ... sucks.

Everytime he has a fever or gets a sniffle, I worry, in the back of my mind, that six months later he'll start demonstrating the signs and symptoms that I was too blind to see when I was diagnosed - the thirst, the urination, the fatigue, the weight loss.

I think I'm able to get a hold of my diabetes because I got it relatively later in life than most folks. I think it would be hell to have to grow up with diabetes - many people do, but I wouldn't wish that on my worst enemy let alone my 20 month old toddler. He shouldn't have to worry about shots and finger sticks - he still has to learn how to ride a bike and spell his name and watch "Pingu" on Sprout.

So, every milestone he celebrates, my mind rejoices that he's diabetes-free. However, the pessismist in that nagging diabetic portion of my brain asks, "but for how long?".

My wife and I have looked into the blood testing (islet antibodies, et al) that can be performed to see if my son is at increased risk for developing type 1, but wow ... talk about implications! If it's negative, then whew ... but what if it's positive? There's nothing to be actively done at his point - maybe some "gene therapy" if this was 20-30 years in the future.

I guess it comes back to coping mechanisms. Would you want to know if it was your health on the line? Some people want to know, while others are more comfortable without knowing. As a parent of a child that is still totally dependent, I'm going to remain in the dark for now. Life is short enough and I don't want to waste it worrying about something that may or may not happen. For now, life will be what it should be for a 20 month old - easy and care free. We often unknowingly load a lot of "baggage" on our kids as they grow- he doesn't need this.


For now, Peter is strong and funny and smart. He plays hard and laughs easily. He has a wicked sense of humor and curiosity. I hope all he knows about diabetes as he gets older is that his "old man" has it and is doing ok.


========================================

So, happy D Blog day! Enjoy the other blogs and I hope I posted this right. I don't think it matters too much, because I think only my niece reads my blog - and then, only when she's bored. Hi Alissa! see you at Thanksgiving.

Peace.

It's fun to stay at the ...

... YMCA.

I guess the only time a stright guy (yours truly) can extol the virtues of the YMCA is when he talks about working out - which also sounds a little gay if you think about it.

Ok - off to a bad start, I don't want to sound like a homophobe and a lazy bastard at the same time.

Especially because I am a lazy bastard.

I'd like to lay around, watch TV and eat cheetos after work, but I can't if I want to live "well" to a ripe old age. By living well, I mean not being blind, on dialysis and with all limbs intact.

These things are a concern to me becuase I have Type 1 Diabetes.

Type 1 is the type that kids usually get and is a result of an autoimmune process. The body is exposed to something (aka as an "antigen" usually a virus) and in the process of fighting it make antibodies against the antigen. Unfortunately sometimes these antibodies (in susceptible people) do more than they're supposed to after the antigen is gone. They go looking for more antigen to destroy but find normal cells in the body that are familiar to the antigen and these antibodies start to kill off these normal cells. In the case of type 1 diabetes, the normal cells in question are the beta cells in the pancreas - the cell that produce insulin. So, several months after the body is exposed to the antigen (usually manifested as a "cold"), the antibodies have been slowly knocking off the beta cells and a critical mass is reached whereby the beta cells can't make enough insulin to cover the body's need and the body develops diabetes. Diabetes, in lay-man terms, is when there's too much circulating glucose in the blood stream - in the type 1 case because there isn't any (or enough) insulin to help this glucose to get brought into the cells to use as fuel. Exercise is one of those rare body functions that allow the cells to suck up glucose without the need for insulin to help them.

Don't worry - the physiology lesson is over for now.

So, as opposed to someone who wants to lookgood in therir bathing or birthday suits, I need to work out to stay healthy. And, yes, I'm just vain enough that I wouldn't mind being the "hot dad" at the soccer games.

So, back to the YMCA.

I'm used to the dingy, grungy basement work out rooms and the chlorine baths they called pools of my youth. So I was in total shock when I visited the YMCA across the street from my work last week. It was beautiful; light and airy; no visible fungii walking around in the showers; all the treadmills had a little screen hooked up to cable! (seriously!)

There's free daycare for 2 hours and the kids were ecstatic to be there - doing crafts, playing games. Hell, I want to spend an hour there, have some milk and then lay down for a nap!

So, young man, were do are going? Everybody - It's fun to go to the Y-M-C-A ayyyyy.