Wednesday, 24 April 2019

Ten Eight Fifty

"Only 26.2 miles to go!" - so says the banner as you leave the London Marathon Running Show at ExCeL in London.  Only.

Most of my blog posts end up forcing some slightly tortured metaphor into a comment on living with diabetes, but not today.  Diabetes is shit, hard work and makes nearly everything more complicated that it could possibly need to be.  There endeth that lesson for today.

The beginning

Training for the marathon has been a rollercoaster and then some.  Having put aside the shock of actually getting through the ballot in the first place, I vaguely rediscovered my love of running, only to end up with pain in my knee that slowed me down quite a lot.  Having managed that, I found some of my old rhythm, but pulled a calf muscle at the start of what ended up being a 10 mile run and took most of December off.

It's fair to say training was as up and down as most of the routes you can find to run around Sheffield.

January came and brought with it new trainers that immediately fixed the burning pain in my shins, and then training got pretty serious.  I had a plan (of sorts) though I daren't write in down for fear of jinxing myself further.  I'd not opened the London Marathon magazine I got in October because it felt too scary to properly face up to it.  Instead I stuck to three runs each week, trying to find routes around London (and Taunton and Liverpool) while I was away with work and sticking to a long run on my old routes while I was at home.

The middle

I think the sweet spot will always be training up to about 16 miles.  It's over half-marathon distance, but it's not so ridiculously far that you dread lacing your shoes up to train.  Once I got to 18, 20 and 22 miles, I'd pretty much fallen out of love with it, and that sense of self-righteousness/smugness that came from doing 12, 14 or 16 miles was replaced with a mix of loathing and nausea.

But something unexpected had happened... I'd somehow managed to do those long distances, up hills and through the countryside at a pace faster than my best time over a marathon course.  By blind luck, will power and some sense of training, I'd actually done something pretty positive.  Doing it, and doing it well seemed like a real possibility!

But nothing is really that straightforward and it all fell on it's arse pretty soon after that.  The start of my first full week of tapering began with a pleasant 8 mile stretch along the Norfolk coastline.  I'd picked up my fifth and sixth blister by this point so was managing pain and discomfort in a variety of ways already.  A couple of days later I went out to repeat the same route - after all it's rare you get to run by the beach in Sheffield.  And then something went.  Not with a bang or crash, but with a twinge and a "ah bastard" muttered under my breath.

I walked/limped the last three miles home, convinced that I'd blown it, that six months of training, pain and sacrifice had been washed away like the tide on the beach.  The last three weeks have been filled with ibuprofen, Deep Heat, massage, phyio and acupuncture - anything to get me ready.  What's been missing is running, and with that comes doubt.

The end

The marathon is three days away and the build up to race day is like the build up to your exams at school.  "Have I done enough?", "What if I just tried a bit more?", "I don't think I'm ready" - all that stuff floods your mind and really it becomes a battle of your own mental state, not your physical one.  I've been preparing myself for the worst because I'm a glass-half-empty person a lot of the time.  It's easier to imagine the bad stuff than the good stuff.  It's easier to think that my leg will give way inside the first mile, rather than think that if I get to Tower Bridge and the halfway point, I've done the worst of it and it's running home from there.

The physio has narrowed my pain down to tight hamstring in my right leg, but is supremely confident that if I'm sensible and leave Mo Farah to run his own race, I'll get round mine.  And she's right. Of course she is.  No it won't be pain free, but it wasn't going to be anyway.  It'll hurt, but I can make it from start to finish.

This is me

What's been hardest to stomach is that fact that I'd put myself into an improbable position that at a month before my 38th birthday I could have run a personal best for a distance I'd not seriously considered until six months ago, didn't really start training for until four months ago, and that I last did 5 years ago.  That's gone now - I know that - but as we're all our own worst critics, I can't stop beating myself up for it, even though it's completely out of my control.

Too many people have put their faith in me for me to not make it round.  Too many people have donated their money to a cause and a charity I care so desperately about for me not to finish.  Too many of my colleagues will be around the course on the day to cheer me, the other 145 Diabetes UK runners, and the other 40,000 people for me to fail.  I might fall a little short of my own standards or expectations, but theirs are the ones that count the most.
Only 26.2 miles to go...

I'm raising money for Diabetes UK because I've lived with Type 1 diabetes for something like 17 years and it's crap.  I manage it pretty well, but it's devastating condition that can lead to sight lost, lower limb amputation and a whole host of other dreadful things that nobody should have to live with.  If you'd like to donate to them, you can do so via my fundraising page, and please believe me that every pound makes a massive difference.  While I work for Diabetes UK, I have no control over how your donation is spent.
If you want to follow my progress on the day, you can download the London Marathon app and track me using bib number 10850, or look out for updates before, during and after on my Twitter

Monday, 25 March 2019

Back again

I've dusted off my password and come back to write something.

If you've been keeping up-to-date with any of my social media, you'll know I'm running the London Marathon in just under five weeks.  Whilst this post is loosely based around that, it's also some thoughts on change.

I was in a similar position seven years ago as I prepared to line up for my first ever marathon.  Back then it was all unknown territory for me - how do you run 18, 20 or 26 miles?  How do you do it whilst managing a health condition like Type 1 diabetes?  How do you keep going when it's easier to give up?

Thankfully I managed to find answers to all those questions, and now I find myself reflecting on what's changed, and what's stayed the same since 2012.

Well, I'm still not built for running so I'm fairly sure my training schedule isn't keeping Eliud Kipchoge or Mo Farah awake at night.  And of course I still have diabetes to contend with, which is very much the added X-factor when it comes to long distance running (for me at least).

What's changed?

Of course lots of things have changed too.  For my first marathon, insulin pens were my treatment regime and so reduced basal injections the night before and the morning of the run were vital for keeping my bloods under control.  Looking back now, it seems pretty crude, but it definitely did the job.  By 2014, for my second marathon, I'd switched to a pump and the added level of finesse to tweaking basal rates was hugely helpful.

Technology has come a long way since then, and so this year I'll line up with a flash glucose monitor sending my blood sugar readings to my watch every five minutes (assuming it holds up under a sea of Bluetooth interference).  That should help even more as I should be able to ward off any signs of low blood sugar a long time in advance.

'Score one for older and wiser...'

I've also not managed to defy the aging process and so I'll head off a month shy of my 38th birthday and feeling every single day that I've aged since last time.  It's clearly affected my memory as well, because I'd forgotten how unrelenting the training is to be able to run/walk/shobble/stagger over 26 miles.  That said, the wonder that is Facebook's "on this day" feature told me my recent 20 mile run was 30 mins faster than my first attempt over that difference way back in 2012.  Score one for 'older and wiser' there I think...

I've changed jobs since my last effort too, and so there's an added layer of tiredness to factor in beyond a) the actual training and b) being nearly 40.  I'm usually travelling around the country once or twice a week, so earlier starts and fitting runs in early before work, or after a long day have become the new norm - but a manageable norm.

'How do you keep going when it's easier to give up?'

For me, the big question was the last one I posed at the start... "How do you keep going when it's easier to give up?".   Of course, that's really a life question, not just a running one, though it definitely applies when you're feeling sick after 18 miles.

It's invariably a diabetes question too, and I guess the answer is really the same for everything - "I don't really have a choice".  It's not a cure for Type 1 I'm desperately after, it's a day off.  It is utterly relentless and at times it's all consuming.  The advent of technology I celebrated a few paragraphs ago also brings with it some tougher aspects.  If it's hard to switch off from a chronic condition when you're connected to an insulin pump, it's basically impossible if everytime you unlock your phone, there's a blood glucose reading staring you in the face.

Sometimes it's OK.  Sometimes it's mocking you for a bad decision you made a few hours earlier.  But it's always there.  I've long thought that diabetes has me so tight in it's Stockholm Syndrome-like grip that I'd be lost without it in my life.  But when that's all said and done I'd take a 24 hour respite in an instant.

So... how do you keep going when it's easier to give up?  I guess the answer is 'by any means necessary'.  On marathon day, it'll be the promise of a medal (and my first bit of proper junk food in months).  With diabetes I fundamentally don't have a choice and it's remembering that I'm doing the best with the tools, knowledge and wisdom that I've got.

Anyone can have a bad day, and we'll always be our own worst critic, seeing ourselves in a crueller light than anyone else ever would.  I'm not going to compare my finish time to anyone else's, and I won't do the same with my health.

I'm running the London Marathon on Sunday April 28th for Diabetes UK - a charity very close to my heart for a lot of reasons.  If you'd like to support them by sponsoring me, you can visit my JustGiving page to donate, and to get regular updates on my training as the day approaches.  Despite working for Diabetes UK, I have no say over how your donation is spent.

Monday, 13 November 2017

Diabetes Is...

November 14th is World Diabetes Day.  I'd been thinking about this post from March 2016 a bit recently and wanted to offer a different perspective when talking about the hard facts of living with a chronic condition.  I've lived with Type 1 diabetes for a little of 15 years and every day throws up new challenges and new things to learn.

Diabetes is sitting in your kitchen alone at 2am, eating because you've woken up shaking as your body alerts you to another episode of hypoglycaemia (low blood glucose).

Diabetes is lonely.

Diabetes is feeling like every snack and every meal is a challenge to be overcome.  Counting carb values, measuring blood glucose, calculating insulin doses and sometimes just hoping for the best.

Diabetes is relentless.

Diabetes is sticking yourself with a needle about 50 times a week, whether it's finger-prick tests for glucose levels, or a cannula in your stomach to deliver insulin.

Diabetes is invasive.

Diabetes is desperately searching for a shop that sells batteries, because your insulin pump is almost our of power and without it you'll almost certainly be hospitalised inside 12 hours.

Diabetes is frantic.

Diabetes is trips to your GP, to eye screening appointments, to hospital clinics, and to pharmacies.

Diabetes is clinical.

Diabetes is that unquenchable thirst, stiff joints, that shattered feeling and the blurred vision that can only mean your blood glucose is way too high.

Diabetes is tiring.

Diabetes is doing the same thing two days in a row and getting hugely different results for reasons you can't possibly figure out.

Diabetes is frustrating.

Diabetes is being reminded of your own mortality whenever you go for a check up.  Your eyesight, kidneys function, feet, and overall sensation are all things you fight to protect and preserve on a daily basis.

Diabetes is serious.

Diabetes is being stereotyped by media more concerned with headlines and sensationalism that science and fact.  It's being the punchline to jokes that simply aren't funny.

Diabetes is misunderstood.

Diabetes is planning and packing a bag full of supplies (and spares) for even one night away from home, let alone a proper holiday.

Diabetes is not for the spontaneous.

Diabetes is being susceptible to your environment - knowing that the temperature, time of day, or your level of exertion (to name just three) can affect your blood glucose.

Diabetes is all encompassing.

Diabetes is treating yourself to a takeaway on a Friday night and hoping you get your insulin dose correct otherwise you'll be paying for it in the middle of the night.

Diabetes is hard.

Diabetes is a huge strain on your mental well-being - and with all these things to contend with every minute of every day, it's hardly a surprise.

Diabetes is exhausting.

Diabetes is having friends to rely on who help you through the tough days, and celebrate the successes with you.

Diabetes is a community.

Diabetes is celebrating small wins - like waking up with a 'normal' blood glucose reading which never seems to happen as often as it should.

Diabetes is a success (sometimes!)

Diabetes is an individual condition and doesn't affect everyone in exactly the same way.  What works for some doesn't work for others.

Diabetes is like this (for me).

This isn't to suggest that it's doom and gloom the entire time because it really isn't.  I can eat what I want, do what I want and manage to look after myself pretty well.  But diabetes is very much an "invisible illness" that needs 24/7 management and that's a huge amount of self-care for anyone to take on.  It might look easy but it takes a lot of hard work to make it appear that way.

If you've got this far, thanks for reading.  Happy World Diabetes Day!

Wednesday, 1 November 2017

A smashed glass

Have you ever smashed a glass whilst putting the dishes away?  I expect you reacted in the same way I did - a modicum of cursing under your breath, thinking you could've had a tighter grip on it, and that you'd watched the whole thing play out in slow motion from the moment it slipped out of your hand.

Now have you done that same thing at a friend's house?  Whilst you probably reacted in the same way - the social embarrassment making it worse if anything - think about how your friend reacted.  Hopefully with some sense of concern ("are you OK?"), context ("it's only a glass") and compassion ("don't worry, it's not a big deal - I did the same last month").

So what does that mean?

The last blood glucose reading I was unhappy with was about four hours ago.  I was frustrated and angry with myself.  I'd started the day in double digits for the first time in over two weeks and I'd had to guess at carbs because I'd not brought weighing scales on holiday with me.  Much like the glass slipping out of my hand, I watched this unfold in slow motion.

The combination of waking up around 12mmol, simply putting my feet on the floor, and eating cereal where I was, at best making an educated guess about the carb content set off an all too familiar chain reaction.  Nothing overly catastrophic happened (I stayed in the 11-13 range for about 4 hours) but in the context of the previous fortnight of near-perfect levels, it felt rough.

I played it over in my mind, trying to work out what I should have done differently ("should" not "could" feels like a subtle but important semantic argument I think many of us are familiar with).

I should have waited until I'd dropped into single figures before breakfast because I know eating when I'm in double digits only perpetuates the problem.

I should hhatave been a bit more generous in my carb counting estimate because I know I have to force my levels down when I'm high first thing.  The chances of a hypo were remote.

But I didn't do any of that.  And so I silently berated and chastised myself all morning.  I kept checking my levels for any sign of a change in fortunes and had that feeling of being withdrawn from things more than usual.

And when the shoe's on the other foot?

Now I think about the last time I talked to a friend who had a similar experience with high blood glucose.  I didn't berate them, I didn't tell them to skip a meal and I didn't make them run through a mental list of things they should've done.

I was empathetic.  I know how crap it feels when you're struggling with this kind of thing.  I know how it feels trying to manage 'difficult' food and come out relatively unscathed a few hours after your meal.  I know how tough and unrelenting managing diabetes is.  I told them how I hoped they were feeling better soon, that I know how hard it can be and that however confident you feel, sometimes food will kick you when you least expect it.

What does this all mean?

So back to the glass and it's place as a metaphor for diabetes management (however clumsy it may be...).

It's easy to be overly critical, set higher standards and demand more from ourselves than we'd reasonably expect from others.  Whether that's related to doing the dishes, our working lives, or managing a chronic condition.   If we find it so easy to show empathy and be compassionate to others when they're having the kind of bad day we're all so familiar with, why is that self-compassion so hard?

Things are hard sometimes, and if we can acknowledge that for others, we should be able to do that for ourselves.  That self reflection is harder, and I think that's because we believe that knowing all the factors in play means we should have total control over them all the time.

That's all certainly true for me.  That's not to say it's easy to flick that switch and be fair and compassionate towards myself.  If it was something I could consciously turn on, I'd have done it ages ago.  That self-reflection takes time and practice but does make a difference.  Being objective and rational when looking at our own actions definitely isn't easy - our emotions always run high and make it harder, but the more we try, the easier I think we find it to get through our tougher days.

This was inspired by a short post I read on the idea of diabetes and self-compassion by Leann Harris which you can read on Diabetes Daily if you follow the link.  I'm also thankful to my colleague Odette for encouraging me to write again after about six months out of the game.

Tuesday, 18 April 2017

What did I used to know?

Before the world began to teeter on the edge of nuclear annihilation and every media outlet imaginable turned into Politics 24/7, I was thinking... "what did I used to know?"

I used to know a lot of stuff.  I've studied, been to places, met people, cooked food, heard music, and many other things besides.

Credit: Anchorman and Google and whoever made this pic
But I'm fairly sure there's stuff I did know that's kind of... seeped away.  Not important stuff obviously - I still know the words to every Arctic Monkeys song, most of the dialogue to Terminator 2 and my daughter's name.

Well I couldn't, but....

But I genuinely think my brain has given up on some stuff.  I found my Master's dissertation the other day and whilst the general topic was vaguely familiar, I don't remember a word of it.  I agonised over that, read papers, had meetings... I even went to the library!  (This was before the internet was really a thing...)

So what has all this fantastic(!) knowledge been replaced with?  Carb values - that's what.

Slice of medium bread?  15g - 18g of carbs.

Decent biscuit (like a chocolate digestive)?  10g of carbs

Rice Krispies?  85% carbs mate.

It's like living in the Matrix for all intents and purposes - you see the numbers floating in front of you everywhere:

Banana? 25g - 30g 

I mean of course this is slightly dramatised for effect, but I think we're so accustomed to seeing food as numbers (and recalling those numbers on a daily basis) that it certainly feels like the stuff we used to know has simply disappeared.

I'd ask you what you've all forgotten since you started being able to recall carb values on command, but I bet you can't remember...

Until next time, hasta la vista baby.

Saturday, 25 March 2017

Sometimes it doesn't quite go to plan

Last night I had a hypo.

Nothing overly unusual there really. Whilst thankfully not a daily occurrence, low blood glucose does play a frustratingly regular part of my life. This time it was different.

Since gate-crashing the last day of the Diabetes UK Conference a few weeks ago, I've been trying (with a modicum of success) to get back into some better habits with my diabetes. As with anything, it can be easier to slip out of a routine than stick to it.

So Friday night rolled around and in some vague celebration of us both being at home on the same evening, my wife and I settled on a Chinese takeaway (hurrah!) "It'll be 45 minutes" they said. I figured this was another good opportunity to get back into the habit of pre-bolusing for my meals. Takeaway is a bugger to get right at the best of times but I figured I'd give myself a fighting chance and get out in front of it.

To cut a potentially tedious story short, the food arrived late, I didn't check my levels before I took my insulin and I had an utterly rotten hypo. I've had a few bad ones before. I've sat on the bathroom floor at 2am for an hour chomping on Glucotabs like there was no tomorrow. I've eaten jelly babies and watched my levels go down instead of up. But I've always remembered those experiences - cautionary tales are often the best right?

This one was different. I remember eating a couple of marshmallows that my wife brought me (but I don't remember eating the others she gave me from the bag). I remember accusing her of stealing my glass of water (which I had in my hand) and I remember picking my dinner back up (but don't ever remember putting it down). It was almost like an out of body experience in a way. I knew I was hypo the entire time, I remember going through the motions of fixing it all, but at the same time I feel like I can't remember any of it. The best I can liken it to was like waking up from a dream.

This isn't a sob story by any means. Just another cautionary tale to add to the list. Taking my insulin without checking my blood glucose was, at best, misguided; more likely downright idiotic. Not checking my glucose until the food arrived was equally foolish. Trying to fix a hypo with chicken chow mein is simply an experiment that need never be repeated.

Image boosted from the Wikipedia article in the link below

It's a reminder to me, at least, how fragile the equilibrium with diabetes can be. It's the saddle point we're all subconsciously trying to ride as much as possible.  It doesn't take much to knock us from that point of safety.  As is often the case, my idiocy was my downfall this time.

I'm not blogging as frequently on here.  I maintain it's only worth writing when I've got something to say.  My Diabetes UK blogs still get published roughly once a month and if you're interested, you can find them on their blog site

Tuesday, 15 November 2016

World Diabetes Day 2016

As part of World Diabetes Day on November 14th 2016, I posted regular Facebook updates about what it's like to have Type 1 diabetes. Those posts are presented here