Wednesday, April 27, 2016

Multi-day Ultramarathon with diabetes


I was diagnosed with Type 1 diabetes I September 2001, some 15 years ago. This coincided with the period of my life where I was the most active. In my 30's I took part in a number of triathlons and obviously needed to train to be fit enough to be on the start line and do them. Whenever I have done a race or event whatever the discipline I have always wanted to do my best. I have never had an expectation of winning but that has never stopped me being determined to do the best I can do.

As a Type 1 Diabetic one of the things I hear a lot, aside from being asked why i'm not overweight (because I am type 1 not type 2), is how do I manage my diabetes and isn't it dangerous to do these sports with diabetes. My response to this might seem flippant, but it is far from that. I am always reluctant to engage on the diabetes topic as a negative - I don't want to hide behind it or use it as an excuse or reason. It isn't one, at least it isn't for me. Diabetes has never given me a problem that has stopped me starting or finishing anything.

I have over the last couple of years turned my sporting attention to ultramarathons. A race of any distance over the marathon distance of 26.2 miles is called an ultra marathon.

On the weekend of 15th-18th April I did something I have not done before, a multi-day ultramarathon. Over a period of four days running 142 miles (29/35.5/45.5/31). It wasn't a race but a charity event raising money for Winston's Wish. This was the unknown for me, while I have run a couple of 50 miler ultra's and done some long back to back runs in training I have never done four days at distances close to those.

Prior to the W2C event i had arranged an appointment at my diabetes clinic, i wanted to discuss what i was planning and seek some advice. I didn't have specific questions i more wanted a discussion around it and some guidance. The team at Cheltenham General Hospital were excellent but admitted that what i was doing and planning to do was outside what they could reasonably advise on. They suggested a referral to Dr. Robert Andrew who operates out of Taunton Hospital and is the authority on sport and diabetes. 

They managed my expectations suggesting that an appointment before the W2C was unlikely. 

I committed to the W2C reassuring those around me that if i started to struggle or have complications i could and would simply withdraw. In my mind it is important to note that i never saw this happening. The closer it got to the event the more my nerves were being replaced by confidence. I started to visualise that i could and would do it. 

In the week before the W2C i received a phone call from the secretary of Dr Robert Andrew, there had been a cancellation and i was offered an appointment Tuesday of the following week. I snapped it up, my confidence could be transferred to those around me. I was pretty excited driving down to Taunton as Dr.Andrew is the authority on diabetes and sport. I arrived and was shown into his office, there was quite a crowd. Aside from Dr Andrews there were a number of dietitians, trainees and nurses. I think there were maybe 6 people and me in the room. 

We had a long conversation about the sport i do and how i manage it. Specifically the ratio's i use and how i adapt based on the exercise undertaken. There was a lot of interest in my diet as i explained that i eat a predominantly vegan diet and that this in itself was as a result of extensive reading around the sport of ultramarathon running and how it can be beneficial to recovery and durability. Something i have definitely experienced. what i really wanted was some guidance on how to manage blood sugars overnight after hard efforts. Previously after long and hard runs i have had hypo's overnight and have started to manage this by ensuring i go to bed with a high blood sugar of around 12-14mmol.

With advice regards how to adjust my levemir (slow acting) and how to approach my novorapid during an event like this i left reassured and with confidence high. Even more pleasing was that i was given really positive feedback on having gotten this far with my training by myself. Essentially without extensive medical support. 

The longer i run the less diabetic i am...
Diabetes is a condition that is always on your mind, when you get up, before you drive, before work meetings all the time you need to understand where you are with carbohydrate, insulin and blood sugar levels. This so that you can predict what will happen next and when. This is even more necessary before sport. The impact of sport on blood sugar levels is also something that you need to understand. This comes with experience. When i say the longer i run the less diabetic i feel this isn't that i can switch off from it, far from it, but more that i eat a significant amount and don't need any insulin. I have tried to quantify what i eat during a typical ultra but in the moment of running it is too hard. On the third stage of the W2C which was 45 miles from Reading to Swindon over the Ridgeway I ate more or less the following...
  • Breakfast was a vegetarian full English with toast and cereal (with fruit juice poured over it rather than milk)
  • I was on course for around 9 hours and probably ate the following, 7 or 8 gels, 2 Nine bars, 2 packets of crisps, half a dozen Jaffa cakes, 2-3 cookies, 500ml of SIS energy drink, half a loaf cake (Jamaica Ginger), a couple handfuls of jelly babies and liquorice allsorts.
When I tested my blood sugar at the end of the stage it was 6.8mmol. A day on the trails eating everything and anything and within tolerance when I stopped.

It doesn't last and immediately afterwards when I eat I administer insulin with a round a -50% adjustment to my ratio's in acknowledgement of the impact of exercise.

I managed my blood sugars over the W2C pretty well, I was higher overnight than I should have been waking up on the three days with blood sugars of around 12mmol. I took this as less problematic as during the day I was burning it up and struggling to keep pace. Imagine an old steam train going flat out (ok I wasn't going flat out) and the engineer struggling to get the coal into the burner quickly enough - that's me running an ultra.

I was acutely aware of this as I had experienced a low blood sugar during the Green Man Ultra in early March. It was easily treated but I was keen to avoid it happening again. I definitely opted for the eat what you want and deal with it afterwards.

W2C has given me such a lot of confidence to not only tackle more races but also to push myself a bit more in each of them. My running averages over the 4 days of W2C was 12:02 per mile - on shorter ultra's I want to try and up that not by going gung-ho but by being consistent in the early part of the races and finishing strong.

In the day or two after it was all over I felt invincible and could do anything. This has made me feel more like an ultra runner. I did it, I did it well, it never broke me and I know I can do better. Maybe I am just a little invincible afterall ;)

Friday, April 15, 2016

W2C Stage 1

W2C Stage 1 - Westminster to Slough
Friday 15th April
29 miles 

The day was finally here, after a significant amount of planning and preparation it was stage 1. It felt a little unreal, when you've been planning something like this I guess that's inevitable. But we were actually going to do it. It was happening.

On the coach to London there was a lot of nervous energy at least at the start of the journey. Spirits were high, they settled in the middle and as we got closer picked up again. It flew by. 

Once in London there was a coffee stop some photos and then we were off. Stage 1, next stop Slough. We quickly became two groups, Rob, Jez and I pushing on and Trevor, Dale and Malc travelling at a slightly slower pace. 

As the team left London the sun came out and it looked like it might be a great running day. This was short lived as within 6 miles or so the dark clouds gathered and what was a sunny day became a grey day and then an incredibly wet and rainy day. Thinking it just a shower we decided that it was not worth putting our jackets on. The rain persisted but wet through we decided that to put them on would just make us uncomfortable. Basically we would be wet inside and out. 

Followed the route out of London along the Thames Path what was most striking was the number of building developments. Flats overlooking the Thames clearly a premium business. That and the pubs. Lovely looking proper London puns on the river banks. There was temptation to stop but it was fleeting. 

As the path got more rural the designer flats were replaced by industrial units and derelict warehouses. Remnants of the time when rivers and canals were essential infrastructure. 

We were making good pace and had a nice rhythm. When we needed a walking break we took one, our pee stops became synchronous, it just flowed. Unfortunately so did the rain. It was constant with the only variable being the intensity. After about 20 miles we stopped under a bridge to put our jackets on. Accepting that however wet we were we needed an additional layer to provide some insulation. This worked and for a period after we picked up our pace a little. Perhaps a mental lift if not a physical one. 

We were now seeing lots of birds, moorhens, swans, ducks and geese. Most got out of way, the swans and geese were not phased by us In the least. There was lots of talk of shopping trolleys in canals and odd places, we saw two in the canal and one inside a house, mysterons, the hood, that bit in only fools and horses when they drop the chandelier. Talks of races, injuries, routes. 

Still the rain fell. 

There was a point on the route where we needed to exit the canal and take the Slough arm. We were struggling with the directions. We made a slight error and as we corrected there was a heart stopping moment. Jez, taking the lead, slipped on a sleeper that had been used to make a stair. He fell in a split second hard on his side. That it happened so quickly probably helped as it meant he could not try to break his fall possibly doing more damage. Luckily his run was not over but he'll be a bit bruised for a little while. A reminder that you need to concentrate as it can all be over that quickly.

The last part of the course was interminably long. There was a path that was flooded by long,  wide muddy puddles. So much water. Avoiding them was difficult and treacherous, Rob nearly took us all into the river a couple of times, so run through the we did. 

We reached the turning that was to take us into Slough. So close now it was frustrating to see that there was still a mile to go. We were now, cold wet and hungry. It had been a long day and conditions were awful. We just wanted it done. 

As we ran through the town we hit school run traffic, cars and kids in Blazers everywhere. The distance meter ticked slowly down and we reached the hotel. We'd done it. Stage 1 was complete. We were intact. 

Jen, one of the support team them appeared like an angel with bananas and red bull! 

As we approached the check in desk we were given a serious sideways look. We asked to check in and were asked if we had a car in the car park!

In the rooms hot showers, food and drink all making us human again.

It had been a cracking day of running, a great course and some good laughs along the way. The second wave came in not that long afterwards, Trevor came in followed by Dale and Malc. Our bags were then delivered by Rachel and Giselle who had driven down from Cheltenham with them. 

Team planning had worked a treat!

The team then had massages before an evening meal where the day's events were unravelled and retold. Great fun. 

Everyone knows it was only day 1 of 4 but rather than get to hung up about tomorrow we enjoyed today. 

Friday, April 1, 2016

W2C Ultramarathon Challenge

​Between 15th and 18th April I will be part of team "W2C".

A team of six runners that are planning to run from Westminster-to-Cheltenham (W2C). A distance of 138 miles over 4 days. This is not a relay we are each planning to cover every mile.


The itinerary is as follows... 
Day 1 Westminster to Slough - 28 miles
Day 2 Slough to Reading - 34 miles
Day 3 Reading to Swindon - 44 miles
Day 4 Swindon to Cheltenham - 30 miles

Whilst this is an undeniably tough challenge it is achievable. Training has gone incredibly well over the past few months with consistent mileage of >60 miles a week and no (touch wood) injury issues.

There are also plenty of stories to draw confidence and inspiration from not least of all Eddie Izzard's recent heroics in South Africa.

As a team we wanted to do something for a children's charity and decided to support Winston's Wish (
http://www.winstonswish.org.uk) which is a charity supporting bereaved children. Many people now do many things all seeking to raise funds for incredibly worthy causes.

How do you decide which one to support or not? It would be great if you could support this but I don't want you to feel under any obligation to do so. Maybe a penny a mile - £1:38? That's less than a cup of coffee and if everyone did that it would soon mount up.

If you wish to donate then you can do so here http://uk.virginmoneygiving.com/team/w2c.

You can also tweet encouragement or incredulity to the team at http://twitter.com/w2cultra. We will be using this account to update our status on the road.

We also have real time tracking via racedrone whch will be active here.. http://www.racedrone.net/event/w2c-138-miles.

Thanks for reading this - see you on the road!