May is Asthma Awareness Month–and this coming Tuesday is World Asthma Day. After spending a couple days together in the SF Bay Area last week, Steve and I got our networks to send out some questions, and did a very unstructured Q&A videocast to hopefully get some light shed on asthma, our thoughts, and hopefully teach some people a few new things about this disease.
exercise and chronic disease
A year or so ago, I combined some words to invent the term badassmatic. Simply, a badass living with asthma. To be used in a sentence: Steve is the epitome of badassmatic.
Today, let’s define it. It is an honour to be the first ever guest-poster at my friend Steve’s blog Breathinstephen!
Please join me over there for some conversation on music, asthma, owning your health . . . and badassery!
Throughout November, the diabetes community has been up to serious Good Things advocacy-wise for Diabetes Awareness Month. Many of my favourite things are initiatives like the Big Blue Test or Connected in Motion‘s World Diabetes Day Scavenger Hunt, that help create awareness while getting people–with and without–diabetes active at the same time.
To close off the month, Allison Nimlos offered to share some of her thoughts about exercise and type one diabetes–and how, despite the ever-constant and ever-changing variables that come into play when managing exercise with diabetes, it is worth it to persevere.
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After 19 years of living with type 1 diabetes, there are two things I know for sure about diabetes and exercise.
1) Exercise is essential for managing diabetes.
2) Exercise is a nightmare for managing diabetes.
Say what?!
No, this isn’t the Twilight Zone, but it is a fairly well-known fact that exercise is both amazing and horrible when it comes to managing type 1 diabetes. For type 2 diabetics, who rarely deal with low blood sugars, exercise is almost all good. But with type 1 diabetes, it gets quite complicated.
In managing type 1 diabetes, you’re basically a juggler. You’re juggling known factors, like insulin and food, but you’re also dealing with unknown factors, like hormones and stress, which can impact how your body responds to insulin. They aren’t anything you can control, so you just have to deal with things as they come. Exercise is sort of in between. Exercise is something you’re aware of — obviously, you know when you’re exercising — but the effects of exercising can vary from person to person, activity to activity, and even day to day!
Because of this, I’ve never been much into fitness. It’s actually easier, in some ways, not to be athletic because it’s one less variable to worry about. That doesn’t mean it’s good for you! Of course, it takes a lot of time and practice to figure out how your body responds to different exercise routines and what your blood sugar target levels should be. Diabetes is a very individual disease!
For instance, yesterday I ran a mile at the gym and ended my workout at a great blood sugar. Today, I ran another mile, and ended with a low blood sugar. Frustrating! But on the flipside, I also know that fitness helps me become less insulin resistant, which means my insulin works even better, my blood sugars in the long run will be lower and more stable, and my body will also be healthier in other ways. One of the major complications of diabetes is heart disease, so having a healthy heart and body through fitness is another excellent way to achieve that.
Here are some tips that I have for switching from being a non-exerciser to an exerciser when you have diabetes:
1) Stay observant. Diabetes changes depending on the variables, and it becomes a little easier to manage when you start paying attention to all the variables. From food and insulin, blood sugars before, during and after exercising, and even time of day, all those can impact your diabetes. Once you see what combinations are more successful, you can start trying to duplicate them.
2) Food isn’t the enemy. A lot of people don’t want to exercise because they are afraid of low blood sugars, and that means eating. But calories and carbohydrates can actually help you lose weight and be healthy. The right food is fuel! So eating does not necessarily mean you’re discounting your entire workout.
3) Be consistent. It takes practice, and a lot of people want to give up after the first workout because things aren’t perfect. But just like your first run or first time at yoga isn’t going to be great, your first time managing diabetes while exercising probably won’t be great either. You have stick with it, make adjustments, and even talk to your “coach” (doctor or diabetes educator) before you eventually get to the point where things will be easier.
There are also many inspirational athletes with diabetes that constantly remind me not to let my diabetes get in the way. From Phil Southerland, who cycled across America, to Zippora Karz, who was a prima ballerina, to Will Cross, who climbed Mt. Everest, there’s no accomplishment that is out of reach for a person with diabetes. However, one thing I have learned time and again is the need for practice. It’s like training for a marathon. You don’t just go out there and run 26.2 miles. You have to start slow, practice, train, talk to people, and learn. Only then can you be successful!
It can be so difficult to adjust to something new. Not only is it physically difficult if you’re not used to running or cycling, but it can also be difficult to stay on top of your blood sugars, because your routine is completely changed. In the long run (no pun intended!), the benefits outweigh the negatives, and I’m personally more committed to fitness than ever. Plus, with the support of the Diabetes Online Community, my endocrinologist, my diabetes educator and, of course, my husband, I know that I can manage my diabetes and stay fit.
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Thanks Allison! Allison blogs at With Faith and Grace, and is an active diabetes advocate, member of the diabetes online community (DOC) and writer for Diabetes Mine. Currently Allison is pursuing studies that will lead her towards nursing and becoming a Certified Diabetes Educator, creating for diabetes awareness at Blue Cupcake Press . . . all in addition to maintaining an active and balanced life with type 1 diabetes. You can find Allison on Twitter at @WithFaithGrace.
Things are looking a bit different around here! I won a copy of Standard Theme for WordPress by 8BIT from Chris from Canada, so thank you to both parties of that awesome partnership! I am in LOVE with Standard Theme so far! Next on the round of thank-yous is my friend Andy Darnell (also a Standard Theme user) for pointing me in the direction of Pixlr so I could make that snazzy header up there. I’ve been without Photoshop since I got my Mac over a year ago, and was doing limited projects using trial versions (I am a student, read: I am cheap). So there we go! Site looks different thanks to a bunch of awesome people!
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Yesterday Danielle and I did a long training walk in preparation for the Run for Diabetes on Monday. I will be completely honest and say that this was one of the hardest walks I have done, and I am hoping things go smoother on Monday. For the first two kilometers, I had some pretty bad pain in what i’m going to assume was my tibialis anterior on both the right and left shins and some of the flexors of my right foot. I’m really unsure what the deal was, and I am really hoping that it doesn’t resurface on race day. I stretched it out the best I could around the 2K mark, and it didn’t bug me too much more for the next 7K. I obviously have some biomechanical oddities going on here with the discrepancy between my right and left legs, but it should really be nothing I haven’t adapted for by this point in my life. Kilometres 3 through 5 were fine.
Kilometres 5-9 were brutal right up to the end, and I am hoping that there’s enough adrenaline coursing through me on Monday to have a slight beneficial effect. Once I hit 5-plus K/an hour-ish (slow? yes.) my lungs simply don’t feel okay anymore, and from kilometers 5-9 I felt like my breathing was just all screwed up [I even stopped at one point to see if that would help get things back in check]. This could be caused by a variety of things (more demand on my muscles = increased respiratory rate = increased inhalation of particulate matter in the air [aka “air crap”]; increased drying-out of the airways [obviously NOT helped by any degree of dehydration, which I was experiencing yesterday] . . . the list goes on). So, of course, I’m always trying to figure out what’s going on inside my lungs and how I can possibly mitigate it on Monday. I shot off a quick what gives! e-mail to my friend Steve, who’s a respiratory therapist who has severe asthma, and is an all around badass[matic], explaining the experience to him. Within this sentence conveys one of the many reasons this man is among my favourite people:
Hi Ms Lovely,
I think you’re having these problems because you’re an ASTHMATIC.
Damn it!
So, yeah, I just about killed myself laughing at his response. (And thanked him for the diagnosis.) He went on to say that it’s probably some degree of air-trapping caused by the prolonged exertion. [To get a better idea of what air-trapping is, take a deep breath and exhale only half of it. Inhale again on top of the air that’s stuck in your lungs. Repeat. That. Or go read Steve’s post about it.]
Anyways, so kilometers 5-9 included taking the inhaler multiple times to take the edge off of the dyspnea. It’s not preferable, and obviously I wasn’t stopping to take the Ventolin it’s not like I was giving my lungs a break to let it get in there and start working before continuing the assault. However, using the inhaler 3 times in 4 kilometers [six puffs — two of those right at the end] may have helped fend off any delayed stuff and certainly helped at least a bit during that last expanse of time on the trail.
So what am I going to do differently race day?
- Pre-medicate with a neb treatment as opposed to 4 puffs of the inhaler. Getting the bronchodilators where they need to go is super important.
- Somewhat prophylactically take the inhaler immediately when I start having issues breathing, not letting them escalate any. Will it help? Who knows.
- Light warm up with some stretching pre-race time-dependent.
- Carbs/protein, little if any fat to slow down the digestion thing. I’ve got some Gatorade Prime chews [and have fingers crossed for some free Gu!]
- H-y-d-r-a-t-e.
The last one is important. I was definitely experiencing some dehydration during this walk, and that is obviously not performance enhancing.
And is likely the reason that the consumption of 1 litre (aka 32 ounces) of fluid followed within the next half hour at the Starbucks we ended up at, and then I didn’t feel awesome.
Really, I couldn’t loose too much fluid in an two hours and fifteen minutes, right?
Apparently my body is not so cool with ingesting that much fluid at one time. But, I mean, it otherwise felt awesome to be drinking cold things [even after a refill in an en-route hotel bathroom, the water in the Dasani bottle was not cold. And also, screw the myth that cold water isn’t good for your body–about 12 seconds on Google with the more reputable sites will tell you otherwise.] [Also I got a wicked headache last night. Dehydration induced? Possibly. Things i only figure out in retrospect.] [Bracket ;).]
So I learned some stuff. Also I iced my legs for the first time ever [both anterior/posterior and some slight lateral], and they actually don’t hurt basically at all today, though they feel a little tired, so there is something to be said for that. Exciting. #kinwin. Etcetera.
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Finally, THANK YOU to everybody who has chosen to give generously and support the Canadian Diabetes Association through my fundraising page! I set that $200 fundraising goal feeling ambitious, and many of my amazing friends stepped up to the plate right away. Whether the contributions were simply to support my efforts or from a deep passion for the amazing work the Canadian Diabetes Association does for Canadians with diabetes, I am thankful that the money goes to support research and care of people with diabetes in Canada. The fun I’ll have at the walk is a bonus.
June 6th is the “Day of Visibility” for people living with invisible diseases.
Most of the time, I look like a completely healthy twenty-one year old.
And I work hard to stay that way :].
I ride my bike [complete with the classic awkward nose zit. Twenty-one, that still happens].
Get entirely too excited about doing the track at school with my friend Sam . . .
Travel . . . and jump a lot and wear ridiculous outfits.
Rock out on the beach . . .
Go for “photo shoot walks” with friends.
And generally do awesome shit.
But there’s the other part. The part where I manage an invisible chronic disease every day. The part where the only visible signs of this disease might be the medical ID bracelet that would have been on my left wrist in each of the above pictures or the blue inhaler in my pocket.
The part where I take multiple medications a day to stay healthy. The part where I inhale and snort steroids [corticosteroids] to decrease the inflammation in my lungs and sinuses. The part where I take three maintenance inhalers a day to try to keep things this way.
The part where I am working to stay healthy by taking my medicine and staying active and keeping myself in a sense of balance.
The part where I look healthy, but I’m exhausted but I am sick and fighting it out.
The part where I do the best I can, increase my meds as I’m supposed to, and still that’s not good enough.
The part where I’m ready to just say “fuck asthma”.
And the part where I cycle back to the first section.
The part where I live my life in a sense of coexistence with this disease that you can’t see on the outside.
The part where I do awesome shit.
The part where I know I can do this, even when it’s hard.
The part where I live my life.