Saturday, July 8, 2017

Running 9-to-5

I was in a team that ran a working day on Wednesday. The 'Running 9-to-5' event raising funds for MIND. 


Aside from running for 8hrs this was 8hrs lapping a building. A glass structure surrounded by cars and with a concrete path. More reflective surfaces than a budgies paradise.


It was, as it turned out, hot too. Really hot. Getting on for 30c and with no shade or breeze and reflections everywhere probably even hotter. 


We started, there were 7 of us, at 9am. A few runners had signed up to join us and they started lapping with us 2/3 km around with 9m of elevation. Lap after lap. We probably started a bit quick but then who doesn't! Around 7.5 miles in the first hour. The morning continued to go well with marathon distance in around 4hrs.


I took a break for lunch, heading indoors to eat a sandwich and try to cool down a bit. It was the afternoon where I suffered. I forget how much I'd run but as I approached the hill I felt my stomach turn and stopped myself being sick. I carried on but had to walk. Nausea really hitting me. My afternoon continued with great difficulty. 


I was trying to run but was done in. The heat was sapping everything I had. This was new, while I haven't raced in the heat, I have run plenty of times when abroad in some warm climates. I've never struggled like this. 


Honestly the afternoon is a blur. On reflection I should have probably stopped. I also shouldn't have succumbed to some gentle peer pressure to run the last couple of laps. I was hot and spaced out. 


We finished at 5 o'clock. We'd covered as a team of 7 around 266 miles which was 660 laps! It was awesome. 


A couple of the runners covered big distances in the 40's. the third was at 40. I was behind in 38.5 miles then most awesome, the two female members of the team each hit 35 miles. Witnessing the birth of two ultra runners was a beautiful thing (prior to this the most they had run was a marathon). 


The final member of the team covered 30 miles and had been fighting the conditions all day. 


There was massive elation at the end and really, physically at least, no one was broken. No soft tissue injures or worse. 


On the day the most significant factor was the heat. 


My struggles through the afternoon were down to more than the climate. On the Monday I started with an insulin pump. 


The omni pod. 


I spent Monday at the hospital setting it up for me and left to return the next Friday to do some tune ups. 


What I never realised is that all the basal I had added to the machine were not saved. Rather than 7.5 units of insulin as background over 24 hrs I was getting 1.2. 


I should stress that this was user error and not the Omni Pod in any shape or form. 


That's a significant drop off in insulin requirement and has an effect. Blood sugars rise. What this meant in reality for me was that I could not temporarily reduce my basal rate as it was already too low. In the circumstances I suspended all insulin.  For the morning this was fine. I was running and so, and I'm not sure what the technical term here is, but I was using the sugar. I was eating and my blood sugars were around 5-6mmol. This is good! In the afternoon once I was walking more than running my blood sugars increased. At the end of the run my sugars were 10mmol. Later that evening they were 20 and rising. There was though, remember, no basal. 


When I relayed this to my support team this was the response I got.


"...Your sensitivity is much more increased when on a pump and it is more likely that you needed basal insulin even if it is just a very small amount therefore your blood glucose was elevated a few hours later.

 

That’s why they recommend you are not off the pump or no basal running through for longer than an hour. Again, because you have increased sensitivity you reacted to high blood glucose levels by feeling sick and nauseous than you normally would on insulin pens. Did you think about checking ketones?.

 

Next time try the temporary basal reduction now you know turning off the temp off setting will help, even if the pump is only running at 10% will make a positive difference..."


This is the TOTAL opposite of what I did previously. When i was on pens I'd use my basal and the manage my bolus down to accommodate the impact of training. Now on a pump I need to reduce the basal and bolus as normal. 


Took me a while to get my head around that one. 


My physical recovery was actually pretty quick. A couple of hours and I felt well enough to function. Initially we finished i tried to eat but just couldn't. I managed to eventually get food in me around 10pm. I think the last time I ate before that was 1pm. 


The only carb I had consumed in that intervening period was a bottle of Tailwind. I couldn't eat and my blood sugar was going down. It wouldn't stabilise and I needed something to bring it up. 


The answer was a friends Tailwind - don't ask me what flavour it was!! I made a 500ml bottle of it and it did the trick. My blood sugars rose to 7 mmol and I could press on with some confidence. Tailwind might very well have saved my life a little bit!


Going back to the Omni Pod, at my hospital follow up on Friday it was identified that my basal settings had not saved. We unravelled the issues and everything made sense. Issue corrected the pump is working brilliantly for me now. I will be doing a 'sort of' long run tomorrow to test it out.


It won't be laps and it won't be 38.5 miles either. 


What all of this made me realise, as if there were any doubt, is what running means to me. I cannot articulate it fully but I know that without it I'm just not who I am. 


Diabetes will never stop me running or for that matter doing anything.


That's a fact.