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.

—–

IMG_0653.jpg

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.

DSC_1742.JPG
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! 

DSC_1755.JPGIt 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.

—–

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.

hello, good morning, how ya do? what makes your rising sun so new? i could use a fresh beginning, too . . . all of my regrets are nothing new.

[…] i’m dying to breathe in these abundant skies.

hello, good morning, how ya been? yesterday left, my head kicked in. i never, never thought that i would fall like that, never knew that i could hurt this bad.

i’m learning to breathe, i’m learning to crawl […]

learning to breathe, switchfoot

 

I will be completely honest that I have been very much out of the groove since the beginning of September. At first, I blamed it on readjusting to the new routine of school. Then I was crazy busy, and blamed that. Then I went to California. And we all know what happened in California [and, unfortunatley, did not stay in California].

I’m not intending for this to be a bitchfest post. I’m intending it to be an accountability point. While it is one thing that two or three weeks ago, doing stairs was still really hard, I am slowly getting back to where I want to be. The fact that I haven’t been working out lately prior to the asthma exacerbation is nothing’s fault but my own. I am the one who makes those choices, and I have not been making those choices. So, it is going to be doubly hard to get back to doing what I know I need to be doing exercise-wise because I’ve probably already lost a fair amount of where I was at the beginning of September from simply not being intentional. Yes, I’ve been busy, and yes, recently I’ve been sick. The latter is a reason . . . the former is an excuse.

Since I lost my Fitbit [seriously. It was honestly super depressing when I discovered it was MIA. The people at Fitbit are awesome and are sending me a complimentary replacement], and am constantly in need of some kind of motivation, I joined MeYou Health’s Daily Challenge site–I’d love for you to join me! I receive simple challenges every day to motivate me towards just making one small choice that . . . when added up . . . can make a big difference. It also helps with that intentionality bit by asking a few questions to help evaluate your current wellness–I’m hovering at 80%, likely because of some nutrition and physical activity issues, and dipped down today because I have been feeling stressed this weekend (see also: Darwin paper). The questions are simple, but really make me realize how I am feeling about things, which is awesome.

I get things narrowed-down in a nice little screen like this, helping me to see what I need to work on.  Emotional health dropped like 19 points I think just due to the stress factor. The physical health thing is quite obvious due to my state of physical activity and asthma lately.

Wellbeing Scores

The healthy behaviours bit, let us explore that a bit more:

Healthy Behaviour Score

Each domain can be outlined like this, giving some concrete ways of how to improve health in the determined area that might need some work. So, once again, this one is all about those little choices that add up . . . and the little choices that are dragging me down in some of the other domains adding up.

I know part of the exercise aversion is that I’m scared of two things, one being that I won’t feel good while doing it [which is basically a given at this point that it will be harder to breathe than usual] and two being that I’ll make myself sick again [which is, at this point, unlikely I would hope, but it comes with the package deal of having a wicked exacerbation, apparently]. The only way to crush those feelings though . . . is to try it.

Goals for the week:

  • Get rolling on the backpack snacks again.
  • Do what it takes to get more intentional about the nutrition on the whole [I might try the picture-taking method].
  • Give exercising a go again–take it slow, but try. Even if I make it ten minutes on the bike, that is much better than nothing.

 

i got my scars, i been to hell and back again. born for the blue skies, we’ll survive the rain. born for the sunrise, we’ll survive the pain.

we’re singing wait it’s not over now, we’ve been down but we’ve never been out . . .

we found a way out, the city takes everything it can. but outside the crowds, i can feel my lungs again. . .

dark horses, switchfoot

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!

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.

Winnipeg-20120827-01595.jpg

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.

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.

How not to train:

  1. Miss a month of workouts for no good reason. Sometimes there are reasons. Sometimes there are stupid reasons, but those are still reasons. Kind of. No reason at all, though, is the stupidest reason of all to miss an entire month of workouts. And, from July 18th to August 18th, I did just that.
  2. Register for a race. Forget to use that race as motivation. I go into so many races with the mindset that I am going to rock training for the race. That I am going to train to be able to do the race distance comfortably, rather than dragging myself across the finish line.
  3. Let previous goals slip.
    1. Nutrition is a goal that I’ve been trying to build on slowly, or else I know I overwhelm myself. Part of nutrition is not only ensuring I’m eating proper things, but now includes that damn iron supplement that makes me feel yucky. However, in order for me to be able to exercise properly, my body needs to be able to transport oxygen to my muscles. And what’s responsible for that? Hemoglobin. Iron. Boom.
    2. Asthma. I am good at taking care of my asthma when it needs to be taken care of. I’m good at the morning and evening inhalers. I am not so good at doing the evening inhalers on time on weekdays, or the morning inhalers on time on weekends. This is not a huge deal, but it DOES have an impact on how I feel in those spans of time. I am also not doing so well at taking my Atrovent regularly. I need to get it in my head that when I am exercising, i need to be taking my Atrovent four times a day so that I feel good and want to keep doing it.
    3. Regular training. I need to once again focus on the fact that anything is better than nothing. If take half an hour and slide a few kilometers in, if I take ten minutes and do some yoga, if I take 3 minutes and do some push-ups. It all adds up.
    4. Active choices. I got a new bike in the Spring. Part of the hope with the new bike was that I would ride to/from work. I didn’t think that goal through well, as it worked fine in the spring but when summer hit I realized getting to work all sweaty and gross would not be awesome. Once again, that is only an excuse, as
  4. Make a training plan–ignore it. I made a beautiful, colour coded, training plan for this race. Had I followed it, I would have built up to 10K slowly and easily over about six to eight weeks. Instead? I have a passionately-exercising binge for the last two weeks following the race. If nothing else, I hope this is getting me back in the groove for when school starts again.
  5. Be unaccountable. During the July/August exercise lapse, I probably told myself at least three times a week I am going to exercise today. I didn’t. I did not make the choice to hold myself accountable to my decision by putting that decision into action. The hardest part of exercise is often putting on my shoes and getting out the door/on the trampoline/to the gym.

I have an amazing, beautiful community of people around me to help keep me accountable. However, I have to rely on myself, and I have to let this amazing community know what my ambitions are so that they can hold me accountable. Even if I simply tweet my plans to work out, it is that much harder to back out of those plans because I know that somebody read it, and later that night somebody could shoot me an @ reply saying: “Hey, how was your workout today?” — “I didn’t work out” is an awkward answer. Making an excuse is an awkward answer. “It was awesome, I felt so much better after!” is not an awkward answer. Even if I am only going out for a ten minute walk, even if that does not spill into longer than ten minutes, I can almost guarantee that even if it is short, it will still be sweet, and I will still feel better after.

Race training has not gone well. That does not mean the race will not go well. So long as I don’t get as sick as I did following my last 10K, I am okay (two years ago I did my first 10K and I had a ridiculous asthma flare that evening, and had I not been fortunate to have a nebulizer at home would have required intervention, read: an ER visit. Put that in the awkward category!). Tuesday I did a 7K training walk, needed my inhaler at about 5.5K and again when I finished, but had few residual symptoms. I am hoping this is the case on race day pending I post-medicate as well. Mostly, though, I know I can handle the asthma. I just need a better idea of how I’ll handle the rest of the distance that I know my body is not adequately prepared for because of being a master in How Not to Train.

The ultimate in accountability though is having a training partner to get out on those long walks with. Because it’s not like you can get lazy and go home early when someone is out there slogging through that same distance with you. Tomorrow is practice 10K day, and I am going to accomplish that with Danielle.  One week until race day.

I’ve rocked the fundraising. I’ve kicked up the training in the last week. I’ve gotten my head in the game. Now I’ve just gotta get myself out there and make it happen.