Week Two - A New Normal...ish

So that's the end of week two (though you could tell me it's month two and I'm not sure I'd argue with you).

It's been another week of adjustments.  Like many people, I'm now running a school timetable five days a week and it's instantly made me realise how hard being a teacher must really be. 

I think we did a passable job of it this week.  We decided that even trying to replicate a school timetable (or have all the same stuff every day) was impossible.  It's anchored around some of the amazing online stuff that's cropped up (PE with Joe Wicks on YouTube and English Live! with Holly on Facebook) but there's a lot of flex around our diaries so we can 'teach' a bit and put some variety in alongside Maths, English and Reading.

It definitely felt like a long week at work - I was emotionally exhausted by 5pm on Friday.  It's hard to work out how best to pace yourself when working, sleeping and living all really take place in the same four walls, but I'll get there with time.

I've been out for my state-sanctioned walk every day (even fitting in some Plastic Detectives with Violet a couple of times - full back catalogue to be uploaded), and that feeling of fresh air (and even some sunshine) can't be over-estimated right now.  I even managed a 'run' on Sunday - now seems as good a time as any to try and get back into it, however slowly.

What's struck me is how quickly behaviours have changed when you go outside.  On the pavements everyone moves out to the edges, even stepping into the road to keep a safe distance.  Walking down the gennel near our house, people wait at the end or press themselves tightly up to the fence to let someone pass.  We're actively thanking people for keeping away from us which feels like a big behaviour change in a fortnight.

I've kept away from the news pretty well over the last week.  I've stopped watching the daily briefings live and just pick up the main points afterwards.  I've also decided it's no good to think about how this plays out in the long term and really just try and do a day at a time.  Estimates for how long some elements of our current lives could continue vary a lot and I don't see the point in trying to dwell on something so uncertain.  Last year's Stress Control has evidently been good for something!

Finally, it was good to see the nationwide reaction in support of the NHS this week.  I've got friends and family working there, all balancing the same challenges the rest of us are, but alongside the daily work to care for people.

Until next week.... stay safe, wash your hands

Food Glorious Food?

I don’t have a good relationship with food.   I have to work harder at eating more than I do almost anything else.  I know that’s true for many  people with type 1 diabetes, and why wouldn’t it be? 

It’s a mental calculation every time we even think about putting something containing carbs in our mouths.  What’s my blood glucose now?  When did I last take insulin?  Do I need to correct?  How many carbs does this have?  Is it going to spike my levels or take a while to absorb?  And after all that, you either have to stick a needle in you or fish out your pump and dose appropriately.   That’s not a normal relationship by any standards.

My experience with food feels more complicated than that (if it’s possible!)  Four years ago, I weighed 215lbs (almost 98kg or nearly 15.5 stone).  I’d let my weight creep up and ignored what I was eating as long as I could get decent blood glucose readings.  This was less than 6 months after I’d somehow run the London marathon (weighing a lot less).  My reflection in the mirror finally persuaded me to do something about it and in three months I was down to 182lbs (83kg or 13 stone).

I’d always thought that losing weight was the hardest thing to do when you’re dieting, but actually maintaining any kind of progress really took it out of me and eight months later I was almost back where I started, feeling totally demoralised.  And so I did nothing about it for about 12 months.  Along with all the complexities that diabetes adds to eating, I started to view food as an enemy.  But of course the thing many of us reach for when we feel a bit low is food (because it’s delicious) and if you’re in a position where food is your best friend and nemesis at the same time, your relationship with it becomes more complicated.

Finally, something changed – I can’t remember what it was.  Another unflattering glimpse of my reflection most likely, coupled with a desire to change.  I’d entered another marathon and was determined I could run faster than my exploits over two years before.  I decided that actually losing a lot of weight would help me more than anything else.  Not lugging extra kilos of body fat around makes a big difference.  I embarked on a diet with a really strict calorie intake and a lot of exercise, and it worked!  I lost 45lbs (20kg or over 3 stone) by the end of the year.  It was hard work, but I actually felt good about myself for the first time in a long time.  I was at my lowest weight since I’d been diagnosed over 12 years previously, my blood glucose control was good (and I was running faster than ever too).

Now came the hard part – sustaining weight loss.  I’d tried once before and hadn’t managed it and I was determined to do better this time around.  I decided that I was probably at too low a weight to make sustaining it sensible in the long term.  I was eating around 1400 calories a day, running 20-30 miles a week plus other ad-hoc exercise.  I allowed myself a bit of a rise to keep some semblance of quality of life, but focused on what I was eating (and portion size too).

And it kind of worked for quite a long time.  Putting aside blips for holidays and Christmas, I managed a fairly steady weight for almost 18 months, eating pretty well, exercising regularly, and actually feeling pretty pleased (and dare I say, happy with my own body image).

Recently it fell apart again.  I had a running injury that stopped me exercising as much as I used to, which in turn pushed me back towards my comforter-in-chief… food.  A lot less exercise and a lot more food pushed my weight up at the start of this year to a point where I avoided the bathroom scales because I knew I’d hate the reading it gave me.  That reminded me of how I was with my diabetes about six years after diagnosis… I stopped testing because I didn’t feel in control of the results and I put it all out of my mind.

I know from experience that nothing good comes from that denial.  I felt (feel?) guilty about what I eat if it’s full of calories, but eating something like that gives me such a rush it’s hard to stay on track.  It’s almost like an addiction in some senses, and sticking to a plan of eating healthily requires an incredible amount of willpower.  Trying to convince yourself you don’t need one more hit of fat, sugar or salt takes a lot of effort.

My weight is currently back on the way down, and that feeling of control has returned (with my weight, and diabetes in general).  I feel like I can only operate at extremes though – full on culinary hedonism, or the strictest diet I can imagine.  Having a metabolism that seems to not need much fuel to keep the lights on doesn’t help either.   But even having lost 11lbs in the last month, I still look at my reflection and think I could probably lose a couple more…

I don’t think it’s easy to interact with food when you have diabetes.  I don’t know how typical my experiences are when it comes to the frustrations of balancing my intake with how I see myself.  I think as a community we talk a lot about managing the highs and lows of blood glucose (and the everyday aspects of diabetes), but we talk less about how food makes us feel… Maybe it’s because most of us don’t need to.  Or we don’t know how to.  I might be an outlier when it comes to managing food, but I suspect I’m not.

I’ve delayed writing this blog for a long time – mostly because I wasn’t sure I had the right words to express how it affects me.  That said, ‘guilt’, ‘denial’ and ‘frustration’ are words that are all too familiar when it comes to diabetes so perhaps they were there all along.

This blog also appears on the Diabetes UK blog site - you can read my most recent posts there by viewing my bio on their site

Let's Get Back On Track

I've neglected this blog for a little while.  Not necessarily because I don't have things to say, but because life's gotten in the way...

"Let's get back on track".   That was the sombre advice from my Garmin app this morning after yet another appalling attempt at running.  "Let's get back on track"...

The truth is, I feel pretty broken at the moment.  For once in my life, the only thing that seems to be taking relatively little effort on my part is having diabetes.  That's a strange thing to write really - the thing that's a 24/7 fixture in my life is the easy bit.

As usual, there's a lot going on (which is of my own doing), but it all seems to have fallen at once so I'm stumbling from one thing to the next without much time to think.  That's not always a bad thing I guess - the pressure of working on a few, quite different things is interesting and definitely keeps me on my toes.

But it does mean a few things are getting squeezed out (I've not found a way to add a few extra hours in the day yet).  Worryingly, it seems to be any kind of exercise which I'm sacrificing at the moment.  Given my pathetic metabolism, that means I've invariably put on weight, and I seem to be obsessing about it rather a lot.

I look back at where I was 12 months ago, and I was running 100 miles a month, at my lowest weight for about a decade and feeling invincible.  Now I'm struggling to run 4 miles (partly due to a stubborn knee injury I sustained mid-April), I'm about 12lbs heavier than I have been in ages and quite frankly it's making me miserable.

I seem to have developed some kind of weight obsessed insomnia as well and I'm finding it tricky to switch off, which is a little frustrating given how tired I actually feel at the moment.  There's a lot running through my mind every night but I seem to go back to how frustrated I am that I can't run, and the effect it's having on me.

I've been travelling a lot lately for various reasons (social and otherwise) - London and back three times in six weeks (with another three in three weeks at the start of July)...

To be honest, I don't think there's much of a point to this blog, other than to write all this stuff down so it's one less thing in my head.

I should be able to shift some of this unwelcome weight which will make me feel a lot happier.  Body image problems can't be over-stated in my opinion and it's something I wrestle with a lot more than I let on.   I know my knee will come back to being somewhere partly sensible so I should be able to get out and find the enjoyment I got from running last year.  And hopefully I'll get some sleep too.

At least diabetes isn't causing me too many problems.  For once.

Until next time.

Weight watching

Mondays pretty much start the same way for me every week… The alarm goes off around 5:45am, and, silently cursing, I take stock of how I’m feeling… light-headed (hypo), a bit stiff (hyper) or just tired (‘in range’)?  I drag myself to the bathroom and stand on the bathroom scales.  And I sigh.

 

Diabetes is an enormous daily battle that I won’t rehash for the millionth time here and now.  I’ve lived with diabetes for long enough now to be able make most days ‘better’ days, though I’m not impervious to the bad days by any means.

 

I’ve started writing this blog post a few times and I’ve held back – I’m scared of straying into unchartered waters and accidentally throwing opinions around on things I (and many other people) don’t really understand.  But here we go.

 

I can tolerate Type 1 diabetes most of the time, but where I struggle every day is with my weight.

 

About 18 months ago I devoted a huge amount of energy and effort to tackling my weight and lost 3 (and a bit) stone to get to a position I was vaguely happy with.  I cut my diet back to about 1200 (net) calories a day, ran 20-30 miles a week as well as doing four or five mornings a week on my exercise bike.  It was exhausting and took over my life, but I did it.  But that’s when it started to get difficult…

 

I’ve always found it (kind of) manageable to lose weight, but I’ve equally found it far too easy to put it back on again within a few months.  This time I feel like something is a little different.  I’ve had fluctuations obviously, but I’ve pretty much avoided piling the pounds back on.  But it’s much harder work than it was to get to this position in the first place.

 

What I’ve discovered is that actually, my body only really needs around 120-1300 (net) calories a day anyway and regularly eating above that means I’ll put weight on.  My diabetes consultant refers to it as being a ‘thrifty phenotype’ – basically if there’s an apocalypse, you’ll probably starve before me (sorry), but basically I don’t need a lot of food to keep ticking over.

 

This creates a number of problems for me.  The first, and most obvious one is that I LOVE food so I feel like I’m constantly faced with the choice of skipping one meal in favour of another.  Or I have the chance to go out and run 6 miles to be able have something.  Whilst I both love and loathe running (it feels like life support to some degree), my life doesn’t allow the same number of opportunities a week to pound the pavement, so more and more I feel like I’m choosing breakfast plus one other meal.

 

The second problem is food guilt.  I’m sadly not immune to the temptations of an occasional takeaway.   Having skimped on calories for the rest of the day (and/or been for a run), I’ve been known to dabble in a chicken chow mein from time to time.  The thing is that pretty much as soon as I’ve eaten it, I have an overwhelming feeling of guilt about what it’ll do for my weight and I’ll compensate for days afterwards too.  I have genuine regret about something I’ve treated myself to, and I’m pretty sure it’s not healthy (the guilt that is, the takeaway definitely isn’t…).  If I’m eating out at restaurants, I’ll pick a salad more often than not because it’s not a guilt-inducing.  Having a hypo is a nightmare when I feel like this – I’m eating calories that I don’t want to correct it and I resent them for it. 

 

The last problem is how it makes me feel.  I’m writing this after stepping on the scales to find out I’ve put an improbable 4lbs on this week, and it’s pretty much all I’ve thought about all day.  I knew last week I would have put a few on (about 3lbs) as I’d been away for Easter and it’s a lot harder to stick to a calorie goal while you’re away.  But being back home hasn’t improved things.  I know I used to be a lot heavier, but I look in the mirror and I’m fundamentally unhappy with how I feel.  I hate the nagging from my inner voice before I eat anything…

 

I’m used to seeing food as numbers – it’s impossible not to when you’re doing mental arithmetic before you eat anything.  But I see calories everywhere too, and calories scare me a lot.   Having diabetes puts me at a greater risk of stroke, heart disease and cardio vascular disease, than people who aren’t ‘in the club’.  I’m about twice as likely to suffer from one or more of those as a result of my diabetes, and being overweight doesn’t help my chances much either.

 

I’ve noticed that gradually, I’ve stopped cooking new things almost entirely because I know I can rely on the knowledge that what I eat most days, falls into safe zone and I don’t want to stray from that safety.  I know when I do stray, I’ll have put weight on. And when I put weight on I’ll be miserable until I’ve lost it all.  I feel like I’m resigned to logging everything I eat for the rest of my life to be able to stay at a healthy(ish) weight, and the though of that exhausts me.

 

I wrote recently about how a day off from having diabetes would be nice.  Having a day off from this food guilt and unassailable obsession with my weight would be nice too.

DPC16 - Impressions from Day 1

DPC Day 1

This is the standard ‘my first impressions’ blog about attending the Professional Conference.  I appreciate it’s probably a bit cliché, but hopefully it adds context to the rest of what you read about the conference.  Blogs on specific sessions will follow throughout the week (and probably into next week too).

No matter who you talk to, how much past experience you try and take on board, nothing can really prepare you for how BIG the Diabetes UK Professional Conference (DPC) is.

I felt like I’d had the benefit of a gentle lead into the chaos, having spent the day before the DPC at the Young Diabetologist & Endocrinologist Forum, running a couple of workshops with Kelly (@DiabeticQueen1) on what it’s really like to live with an insulin pump (I’ll save that for another time).  I’d had a day to get my bearings for the most part and I’d been through the session planner a week in advance so I had a good idea of what I wanted to see.

But DPC is BIG.  There’s over 3000 people at the conference, many of them great leaders in their fields, others desperate to hear them speak, even if it’s just for a short time.  Typically, there’s six sessions running concurrently with a few coffee breaks sprinkled in throughout the day in the huge exhibition room.  It sounds chaotic but it’s not.  It’s busy, but it’s an incredibly well-oiled machine.

Having hunted down our badges for the week, we piled into the main auditorium for the first round of lectures.  At this point it’s worth explaining how the day is split up – it sounds like overkill (and it’s a bit long to read here), but I think the context is important…

There’s roughly four big time blocks per day, each between 60 and 90 minutes long, each with an overarching theme.  There are six rooms that each run one of those time blocks concurrently.  And each time block contains two or three lectures.  That means in any given day, you’re likely to hear 10-12 individual talks across a variety of topics.  The 2016 Programme is here if you’re more of a visual person.

For the first day, I tried to split between things I had some interest in (it makes it easier to try and understand/write about), and things I felt were of a wider appeal.  Day 1 consisted of 14 individual talks:

Opening Plenary lecture session

•           The Relative Effectiveness of Pumps over MDI and Structured Education (REPOSE) – Simon Heller
•           Peptide Immunotherapy for Type 1 Diabetes – Colin Dayan
•           Exercise for beta cell preservation in Type 1 diabetes: The Exercise for Type One Diabetes (EXTOD) trial – Rob Andrews and Parth Nardendran

Multidisciplinary approaches to managing admissions for DKA session

•           A combined diabetes case manager and mental health approach for supporting people with multiple hyperglycaemic admissions – David Simmons
•           The role of emotional wellbeing in DKA and one care pathway approach – Kirsty MacLennan
•           Walking the tightrope of hyperglycaemia: education is not enough – Clare Shaban

Diabetes education: reaching the masses session

•           Taking Control campaign – Bridget Turner
•           Making the case for diabetes education – Charles Gostling, Helen Hopkinson, Alison White
•           Getting people there – Vivien Coates, Anne Scott
•           Adding options to the education menu – Sarah Newall, Rebecca Owen, Kingshuk Pal
•           Addressing specific local barriers – Tahseen Chowdhury, Seonaid Morrison

What’s new in hypoglycaemia session

•           Cardiovascular effects of hypoglycaemia – Simon Heller
•           Evidence based pathway for the management of problematic hypoglycaemia – Pratik Choudhary
• 
  
• Mary MacKinnon Lecture

•           West Hampshire Community Diabetes Service: re-commissioning community services and beyond – Kate Frayers

Fourteen talks across five broad subjects is a lot of information to take in.  I feel incredibly lucky to be here at the conference (and to have had the opportunity to speak for a few minutes within the Taking Control session) but it takes a lot of brain power to be on the go all the time.  Hopefully those of you following me (@BroomOwl) or the hashtag (#DPC16) on Twitter have got some sense of the huge amount of information being shared.  So back to the day…

The conference centre is big and you often find yourself rushing from one session into another, trying to grab a coffee on the way if you’re lucky enough.  The exhibition hall is where people tend to gravitate between sessions, though I’ll confess I’ve not actually taken a close look at anything there yet.

What really struck me was the mix of passion and knowledge on show, as well as the desire to make overwhelming change to the lives of people with diabetes.  That sounds a bit obvious really, but the sheer number of people devoting their time outside seeing patients to research, service changes and sharing best practice is really incredible.  It’s inspiring as a person with diabetes, I imagine as a healthcare professional it’s very motivating.

I’m writing this in the hotel bar at the end of the first day, reflecting back on what feels like a week’s worth of information I’ve had shoved into my head within the space of eight hours.  I’m trying to pick a favourite session, but it’s genuinely difficult.  I’ll freely admit some of them were very fast paced, and whilst I got the main messages from some, I couldn’t explain the research to you well enough.  Some (like REPOSE which I was a part of), were personally important to me, others, like the whole DKA session gave me something entirely new to think about.

Perhaps the one that struck the biggest chord with me was the education session.  REPOSE had shown in the morning that people using insulin pumps do no better than people on multiple daily injections (MDI) when proper high quality education is given.  The afternoon session showed that there were a huge group of committed individuals across the UK looking to deliver that message out to as many people as possible.  I’ll follow that up in a separate blog.

Thanks for reading my opening post, and thanks if you’re following along on Twitter.  Hopefully you’ll understand that a huge post on each lecture (or even session) is a bit impractical.  I’ll try and do one in detail and summarise some of the others along the way.

Libre Intentions

This will be quick - I've got to get a munchkin ready for a party in 30 minutes...

My first Freestyle Libre arrived in the post on Friday.  It's currently sat in its partially opened boxes on my sofa.  I'll probably take the plunge this evening - but right now, I'm filled with a sense of apprehension.

Not just because of the intimidating packaging (and thanks to those of you who've reassured me), but more because I'm not sure why I've got one.

There's no doubt it's popular among the online community - I've seen plenty of tweets and blogs about the virtues of it's quasi-CGM ability, and I've met a few people in real life who are incredibly complimentary about it too.

But I know my control is actually pretty good overall.  And I know I have the moderately addictive personality that could mean I can't just use two sensors and revert to conventional testing.  I've held off for so long because I want to make sure I'm going to use if for the right reasons for me.

Regardless of all the basal testing I've done, I know that at some point between 10 and 11am, my BG takes a dip.  Not always a huge one, but something strange happens around then and I'm hoping I can start to visualise what that is.

I also do a lot of exercise, and whilst I've worked hard to be able to manage my diabetes and run as much as I do, I've got a genuine curiosity about what happens to my BG whilst I exercise.  Again, the Libre should help me out there.

Lastly, I'll have some evenings where I eat late, and things don't behave in the way the usually do.  Last night was a prime example, where, despite meticulous carb counting and appropriate insulin delivery, I woke up around 16.5.  Not much cop is it?  Hopefully I can understand how that happens, so I can learn what to do about it in the future.

What I don't want to do is become someone who chases flat lines on a graph with temporary basal rates and huge doses of insulin.  I know from DAFNE that a more patient and informed approach is more likely to give better results and understanding in the longer term.

As you may know, I got to listen in on a few sessions at the Association of Children's Diabetes Clinicians conference on Friday, and two talks there really captured my attention.

Firstly, Dr Peter Adolfsson talk about how, in his native Sweden, patients (particularly paediatric patients) are introduced to continuous glucose monitoring before they start pump therapy.  Indeed it turns out, not all patients want or need pump therapy once they've understood how the glucose reacts to different situations.  This gave me hope I was making the right decision with a Libre.

The second talk was from Prof. Kath Barnard, who spoke brilliantly (and candidly) about the lack of psychosocial support for people using diabetes technology like CGM, and how many that self fund, do so and ignore a lot of the information they receive (e.g. cancelling/ignoring alarms from devices).  This made me feel more cautious with the Libre.

Am I getting myself into something I fully understand that will give me the information I want, without changing my existing attitude and approach to managing diabetes?  In short, I don't know.  But there's probably only one way to find out...

Exercise

This blog first appeared on the Diabetes UK blog site on March 26th 2013

Like many people, I have a love/hate relationship with exercise.  And like many people, I suspect I'm not the only one who finds the hardest part of it is actually getting up off the sofa in the first place.

My particular weapon of choice when it comes to exercising is running.  I remember thinking when I got diagnosed that it was the end of my dream of running the London marathon.  I couldn't see how I could manage something as complex as diabetes whilst doing something as gruelling as a marathon.

Thankfully my specialist care team at the time helped me see that diabetes doesn't have to be a barrier to things if you don't let it.  Whilst I'm sure he might already be one of the most famous diabetics, Sir Steve Redgrave is someone that probably personifies that attitude more than anyone else.

Training for a marathon is a pretty tough business as you can imagine and adapting that regime to take into account diabetes makes it that little bit more complex.  I started by working out a plan for how often I could expect to run.  I suffer from a few other, less glamourous, conditions (mild asthama and shin splints) that hampered me a bit but it gave me a place to start.

After that, I was back speaking to my specialist care team and trying to understand what effect my training plan would have on me.  This was back before I'd been on a DAFNE course so a lot of the information felt brand new (despite how long I'd been diabetic).

The upshot of it all involved running with one pocket full of jelly babies and the other with my blood glucose tester packed in a little plastic zip-lock bag so I could monitor how I was responding to the exertion.  Happily I found I could do about 10 miles before I needed an energy boost and that 4 jelly babies would get me about 4 miles.  That made running on the day a lot simpler!

I learned a few important lessons from that training which I think can apply to any kind of exercise you're thinking about:

• Always have fast acting carbs with you.  I learned that one pretty quickly after having to abandon a run when I went unexpectedly low
• Speak to your care team before you try something new, be it a marathon or any kind of physical activity. The hour I spent with a dietician made a world of difference
• Monitor your BG.  I found that even having pretty good control before I started training, my routine mean things changed (e.g. my sensitivity to insulin at certain times) and monitoring is the only way to understand that
• Don't be afraid to adjust your doses.  While I was on my two insulin regime, I'd never appreciated I could adjust my basal insulin (nor did I know by how much).  If you're doing lengthy exercise, this could help
• Do some research - websites like Runsweet are packed with information and tips for all kinds of exercise
• Make the most of the opportunity.  I was incredibly well supported and raised £1500 when I ran the London marathon.  If you're taking on any kind of challenge, then encouraging people to sponsor you can provide extra motivation for you whilst raising money for good causes.

I think the most important tip is to find something that works for you.  I know that running isn't for everyone but I genuinely believe that  20 minutes of something a couple of times a week not only makes you feel better but can have a significant impact on your quality of life as a diabetic.  I finished the year on an exercise bike in front of the TV as I couldn't run comfortably and that was just as good as dong miles on the pavements.

I'm happy to report that I completed the marathon last April in a respectable, if not earth shattering 5 hours 30 minutes (about 30 mins slower than I would have liked).  My plans for this year are a little more modest, but do include some unfinished business with the Sheffield Half Marathon in May (an injury training for that race in 2008 set me back a lot) as well as four 10km races.

As always, I'm raising money for DiabetesUK and The Children's Hospital Charity in Sheffield (specifically to raise funds for a summer camp for children with diabetes).  I'm aiming to raise £500 this year and if you'd like to contribute, you can do so by visiting my fundraising page (note all money is split 50/50 between the two charities)

Diabetes by numbers

This blog first appeared on the Diabetes UK website on 29th November 2012

When I got diagnosed, I remember the Specialist Nurse telling me that really, my lifestyle shouldn't be different to that of any other normal, healthy individual.  Walking out of the clinic, laden with insulin pens, needles, test strips and other paraphernalia I was sceptical to say the least but of course she was right.

A low fat, low salt, low sugar, high fibre diet with plenty of fruit and veg is probably what most of us should be eating most of the time.  I suppose the difference is that the consequences of not eating sensibly are a bit more severe for diabetics.

What I didn't grasp at the time (and perhaps only subconsciously realise now) is all the diabetes maths involved in managing my condition - it really can be an overload of numbers at times..  I've recently been dieting having put on a lot of weight and lot of my waking hours are spent devoted to all the figures I need to keep on top of things.



What do you see?  2 slices of toast?  190 calories?  31g of carbs?  3 units of insulin?


On a daily basis I'm remembering and adjusting numbers for:

• Long acting insulin
• Quick acting insulin
• Carbohydrate content of food
• Blood glucose levels
• Calorie content of food
• Exercise time

I'm also doing calculations in my head to make sure I can keep my blood glucose level throughout the day.  I think diabetes gives you a new way of looking at things and a new appreciation for how your body works.

It seems quite daunting at first - and it can be even now.  One unexpected hypo or BG level in the 20s has me going back over what I've been doing to try and understand where I've gone wrong.  I've noticed this a lot more recently as my exercise regime has made my blood glucose levels a lot more sensitive to insulin.

In the 11 years I've had diabetes a number of things have made life a lot easier, and not just advancements in medication and testing.  I use a phone app to track my daily diet which helps me monitor both my calorie and carb intake (and therefore my insulin doses).  Eating out is no longer something that worries me as I can usually find nutritional information for most restaurants online.

It's easy to forget that whilst there are so many fellow diabetics, the way in which everyone manages their condition is completely different.  It took me a long time to organise myself into a daily routine that allows me to stay on top of my condition without it becoming a full time job.  There's a lot of support out there fromplaces like the Diabetes UK Careline, GP, Specialist Nurses and from other people with diabetes themselves.  Finding the right routine for you is the key to making all the numbers a lot less stressful and just another part of your day.

Finally, I was recently offered a place on a two year clinical study comparing the effect of the DAFNE course on people with multiple daily injections (MDI) and insulin pumps.  I'll find out which group I'll be in (staying with MDI or getting a pump) nearer to Christmas.  Hopefully I'll have more to share on that next time.

Birthday post - but no cake

Hi

Apologies I've not posted for a while - September seems to have flown by.

Having officially said goodbye to running for the year, I've turned my attention to trying to shift some weight.

As my exercise post-marathon has been sporadic at best, I've put on a fair bit of weight in the last 4 months.  I've spent a bit of time trying to ignore it but predictably that hasn't worked very well so now I'm actively trying to do something about it.

Obviously there are a number of benefits to this.  Being able to fit more comfortably in the clothes I own is one.  Not feeling knackered every time I have to exert any kind of energy is another.  And keeping my diabetes under control is probably the biggest benefit I'll get.  I've got my annual(ish) review at the hospital in October (I rescheduled from September because I knew I'd get a kicking) and so being in a bit better shape when I go will be good news.

My plan is fairly simple - try and lose 2lbs a week between now and Christmas.  The means I should lose about 2 stone by December 25th which would be pretty good.  I know the reality of that will be a bit different but it's worth a shot.  Weight is generally easier to lose when you're carrying a lot extra (as I am at the moment) and I know that come mid-December, I'll be into Christmas mode, but it's worth a go.

I'm using MyFitnessPal to track my calories and exercise on a daily basis.  If you're unfamiliar with it, you give it some information about yourself (height, weight, age, gender) and then tell it how much you want to lose and at what rate (between 0.5lbs and 2lbs per week) and it calculates a daily calorie allowance for you.  There's the option to add exercise into the mix as well.

Based on my current and target weights, I have a daily calorie allowance of 1440 per day (though I earn a few extra each day from exercise).  While that sounds like a fairly low number, it's essentially what I eat most days as long as I cut out the snacking that I'm incredibly prone to.

As I mentioned in my last post, I've invested in an exercise bike and I'm trying for 2 sessions per day on that to aid weight loss and boost fitness.  At the moment I'm doing 20 minutes 6 mornings a week and between 30 to 40 minutes each evening. On average that burns off about 550 calories per day.

After one full week of calorie counting I didn't lose any weight, but I'm attributing that to a general 1 week lag in diet/exercise showing in my actual weight.  Hopefully Saturday morning will show a reduction when I step on the scales.

What I have noticed is that my blood sugar levels have come under control very quickly and that my reliance on insulin has reduced significantly.  I'll talk more about that next time.

I've made my daily diary available for public viewing if you're so inclined.  As with the running, making this a bit more public gives a bit of added motivation so I hope you'll forgive the slight dullness of this post.  I've got some more interesting ideas kicking about for future blogs - don't worry.

Finally, the title refers to the fact that this blog is one year old now.  Thanks to every that's read some or all of the posts.  Hopefully you'll keep coming back.

Take care

Andy

A Bientot Running

Hello again

As many of you know, I've had a love/hate relationship with running over the last year or so.  If you're unfamiliar with that, you might want to re-read the opening post of this blog and the one describing my finest hour (but don't feel obliged).

Tonight will mark my penultimate run of 2012, with my grand finale being the Great Yorkshire Run on Sunday.  It's a difficult decision to turn my back on it for a while, but it's the right one to make.

In truth, I've not felt right since the marathon in April and I've held on to the notion that having races like the upcoming 10km at the weekend will keep me fit and solve all of my problems.  The reality is much different.

Without rehashing old ground too much, I've found myself back at almost the exact same place I was a year ago.  I'm not as fit as I was in March and my inability to find any kind of consistent exercise has meant I've piled on about 2 stone since the end of April.  I'm probably a bit better off in the sense that my diabetes is more controlled than this time 12 months ago (though it's still be no means perfect).

I'm also battling quite severe shin splints.  No matter how much I try and convince myself it's not a problem, I know deep down it is.  I'm at the stage where a long drive in the car causes me pain from holding my foot on the accelerator in the same position.  Fortunately I rarely drive more than about 30 miles at a time.

The only real treatment for shin splints is rest and so I find myself in the situation where I'll be stopping my running adventure for this year when I cross the finish line on Sunday.  I suppose if I was less stubborn, I wouldn't even bother on Sunday, but I've paid my entrance fee and with the opportunity to get a medal as well, I'm not prepared to give up (I'm all about the glory really).

Instead I've turned my attention to a low impact form of exercise and I've bought an exercise bike which is currently in front of the TV in my living room (much to my wife's disdain).  I'm on a mission to lose around 35lbs by Christmas all being well and I'm hoping that 2 bursts a day on the bike will help with that.  It'll be more regular exercise than I've had in years so I'm hoping the "little and often" approach will work.

Of course I'll never manage twice a day every day, but if I keep my targets realistic then I'm confident I'll start to see a difference eventually and I'll allow my body the time it needs to properly recover.  I managed 7km before breakfast this morning and hopefully that can continue alongside a longer burst in the evenings.

I know I'm going to have a certain amount of jealousy when I see other people out running but I'm trying to look at the positives and come back fighting fit in 2013.  The date of the Sheffield half marathon is 12th May 2013 and I'm determined to finally beat the distance.  I'm aiming to start training after the New Year so I've got 4 months of cycling and dieting to get me into the right position for that.

My sponsorship page for the Great Yorkshire Run is still open and you can find it by following this link.  I've not actually raised anything yet, and I feel a bit cheeky asking people to dip into their pockets again given how incredibly generous people were at the start of the year, but if you have two quid spare, then The Children's Hospital and Diabetes UK would be really grateful of it.  I'm going to stagger over the line come what may and I'm optimistic of beating my 10km time from three weeks ago (68 minutes).

Before I go, I should wish Dan and Ben all the best for Sunday as well.  I know they're both running and will do a much better (faster) job of it than I will.  I'd also like to mention Sam who's running the Berlin Marathon on 30th September for Children With Cancer.  I'm sure Sam will attest to the fact that distance running isn't without pain and suffering and you can follow her journey on her blog.

Thanks to everyone who's supported my running/fundraising efforts this year - I do appreciate it all so much.  Hopefully I'll be back next year asking for your money and support again.  The blog will continue in the meantime...

Take care

Andy

Concerning Sport

Hello

After a ridiculous absence I'm back.  It's not been a conscious decision to stay away - I've just struggled to find something meaningful to write about.

The last few weeks saw the country gripped with Olympic fever and I was no exception.  I was fortunate enough to get tickets to 4 events (football, tennis, handball and volleyball) and I was so enthralled with the buzz of the Olympic Park that I signed up for Paralympic tickets as soon as I got home.  I'll finally get to go inside the Olympic Stadium this Friday for two sessions of athletics.

I took my daughter to the tennis at Wimbledon as well and she was remarkably well behaved for a 2 year old.  I wanted her to know that she'd been part of this great spectacle, even if she wasn't necessarily ever going to remember it herself.  Aside from being asked to leave Court 2 at one point for walking around and shouting, she survived a full day of sport unscathed.

Last weekend, the football season returned to fill that void left by London 2012.  A number of people (including journalists far and wide and those at the FA) were quick to note the differences between top flight footballers and our Olympic athletes and 'demand' something be done about it.  Privately I think I was one of those people too.  Having been a follower of football (in one way or another) for a good 27 of my 31 years, it's fair to say I'd forgotten how brilliant other sports can be, and how humble and gracious other sportspeople can be too.

Football is a worldwide "brand" (I hate that term) and due to it's lucrative appeal it has over a number of years descended into a soap opera of sorts.  For those less familiar with this, you only have to look at Sky Sports' self-parody of a Transfer Deadline Day to see what I mean.  I've tried to stay away from "articles" about what Rio Ferdinand tweets or who Ashley Cole has dinner with - such things fill me with an inner rage that isn't good for my health.

Compare the daily, relentless, in-your-face minutiae of football with the Olympics and the difference is so refreshing you'd think someone had thrown a glass of water in your face.  As you'll no doubt be aware, our Olympians work incredibly hard for a fraction of the recognition (and for the most part, a fraction of the financial reward) of top flight footballers and, it seems, do so with a graciousness you'd be hard pressed to believe.

And so, for the first time, my enthusiasm for the start of the football season was subdued.  This is the first year I've ever had a season ticket for my club (Sheffield Wednesday), and yet somehow I was struggling to motivate myself submerge myself back into football. 

Admittedly, a lot of that went out of the window on Tuesday night as I turned up at Hillsborough for our first home game of the season.  I sang as passinately as I've always done and shouted as loudly as ever when we scored, but it felt a bit different watching the game.  Seeing players (ours and theirs) shouting at the referee for calls that were never going to go their way seemed cheap somehow.  My Dad turned to me at one point and said "you wouldn't have see that [player rolling around on the floor after a 'foul'] at the women's football the other week".  And he was right.

I don't mean this to sound like some incredible revelation - it's quite the opposite really.  To anyone who's not a football fan (and to a lot that are) this is old news. 

Football is, and will always be, my first love.  I've been going to Hillsborough for about 26 years now and I'll keep going as long as I can.  But I think the Olympics has changed my view of it as a sport - in the short term at least.  There's a good chance that the spirit of London 2012 will die away (the reasons for that are numerous and probably another post in their own right), but for now, the daily gossip columns and "Breaking news" stories can go whistle.  I've long understood that football is only a part of llife, but now, more than ever, I'm starting to insulate myself from the trivialities of it all.

My best football memories make me smile - I haven't cried about football since I was 9 years old - but I'm still not yet past the stage of watching Jessica Ennis win the 800m without welling up.

Whether London 2012 inspires a generation remains to be seen.  It's inspired me to look at my sporting life differently and that feels like a good thing.

I know this is just a set of random thoughts, but I felt like I needed to write it down.  If you made it this far, then thanks.

I'll be back again soon no doubt.

Andy

P.S. As part of my final fundraising attempts of 2012, I ran a 10km the weekend the Olympics finished.  I worked out if I was 2.5 faster, I'd give Mo Farah a run for his money.  My Olympic dream may be over.  I'm running my second and final 10km next Sunday (2nd September) and like the other one, I'll be doing so in quite a bit of pain, having struggled badly with shin splints since the London Marathon. This will be my last run of this year as I'll be switching to low impact exercise afterwards to give myself some proper rest ahead of training for a half marathon next year.  I won't post a fantastic time, and it'll hurt like hell, but I'm going to do it anyway.  If you want to put a few quid towards my attempts to raise £200 then you can do so by following this link to my fundraising page.  Thank you.

17626

Training miles completed this week: 9
Total training miles completed: 232
Training miles left: 0
Training runs left: 0

Hello again. Welcome to my last pre-marathon blog post!  It feels a bit surreal writing that to be honest.

I completed my final training run tonight -  a steady 3.5 miles (in a torrential downpour) over my old route as a wind down in preparation for Sunday.  I managed another 5 miles last Saturday night although the inclines are still causing me some shin-splint esque pain.  I'm still hoping that the flatter course will make the difference there (aided by pre-race paracetamol as well I think).

At the start of the week I was considering how it felt to be at the end of my training, to have done my last bit of race preparation, and to be honest, it's quite emotionally overwhelming.  I went back and read some of my earlier blog posts from September/October time, and I can't quite believe the progress I've made since then.  Going out and completing a mile (with a number of walk breaks thrown in) was a massive achievement back then and now it hardly feels woth going out to do less than 5 miles.

It also feels strange that I've wanted this so much since my Dad ran the marathon in 1988 (ish - I'll confirm that when he finds his medal) and now it's only a few days away.  I guess I'll not be focussing on that too much at the start on Sunday - I expect I'll be somewhat over-awed by the occasion and I'll be buzzing from the adrenaline a fair bit.  However, I do expect that when I turn down The Mall and finally see the finish line, there's a good chance I'll turn into some sort of blubbering emotional wreck (though I don't want to spoil my finisher's photo so I'll try and hold it together a bit).


I'll take injuries (most notably these shin splint pains that I can't shift) with me to the start line but as I said in one of my first ever blog posts, my aim is to get to the start line intact. Once I've done that I know I can get to the finish one way or another.

I promised you a bit of a Marathon-By-Numbers post last week and so here's what I've come up with:

17626 - my marathon running number.  I'll be going from the blue start at Blackheath
30,000 - number of other people also starting at Blackheath on Sunday
232 - number of training miles I've run since 18/10/2011 (just shy of 9 full marathons)
183 - days since my first training run.  It's been fully 6 months of training to get me to this point
4,500 - approximate amount of pressure (in tonnes) that I've put through my body whilst training (the "average" person sends 500 tonnes of pressure through their body over the course of a marathon run)
2-3 approximate difference in centimetres  in your height between the start and end of the marathon - compression of the discs in your back means you lose about an inch in height over the course. I'm going to test this on Sunday.
72 - the number of people to date that have parted with their money to sponsor me for the marathon
26 - people I've never actually met or spoken to (excluding the realms of the internet) that have sponsored me - thank you
1128 - the amount of money I've raised for Diabetes UK and The Sheffield Children's Hospital Charity to date
10.91 - my average minute mile since I started tracking my time on New Year's Eve
36 - total number of hours I've been out running throughout my training
6 - number of scheduled training runs I've missed in the last 6 months
5.25 - my projected finish time (in hours) for the marathon this weekend
1724 - (at the time of writing) the number of hits the blog has had since it started

I'm not sure what I'll do with this blog when the marathon is all over and done with.  I'll obviously be back next week to let you know how it all went, but after that.... I don't know.  I'd like to keep writing something, but I don't want to be one of those people that thinks having a blog equates to having a right to force their opinion on everything/anything on the world.  I have a Twitter account for that.  I'll guess we'll see eh?

I'm travelling down to London on Friday to get to the Expo to register and collect my running number and shoe tag and then I'm meeting up with my closest friends in the evening and we're seeing a show in the West End.  Saturday my lovely wife and I are having the laziest day possible (mostly hanging around the cinema in Leicester Square I think) before the race on Sunday.  I'll try and fire off a few tweets before the race starts if I can to show the start area and the build up etc (@BroomOwl if you're interested).  I'm not planning on doing anything during the race other than texting my family when I'm roughly half way round but I'll let you all know how it went afterwards. 

There's not much left to say now I think except a huge thank you to every one of you that's read the blog, sent me words of encouragement or clicked on the fundraising page to donate some money (you can still click on the link to donate if you want to).  Reaching my target with a week to spare has been a fantastic achievement and I won't let you all down now.  The support you've all shown me over the last few months has been incredible.  My Dad and brother-in-law are travelling down on Sunday morning to watch so I'll be looking out for them around Wapping and I'm so grateful they're making the journey down to support me.

I also owe my wife a massive thank you too.  Even though she doesn't actually read this blog at all ("it's too long"), she's made a number of sacrifices over the last year or so, and I really honestly couldn't do this without her and I hope she knows how thankful I am for everything she's done.

Thank you everyone.  I'll speak to you again from the other side of the finish line.

Take care

Andy

The final countdown

Training miles completed this week: 15
Total training miles completed: 223
Training miles left: 9
Training runs left: 2

Hello again

I'll start with an apology this week.  I didn't write a post last week and that was essentially for no other reason than I was sulking a bit about not running.

A day or so after my 20 mile run, I started to feel a bit of pain in my foot so I took a conscious decision to miss a run and let it heal a bit.  There's obviously no point running for the sake of it - an injury this close to the marathon needs to be looked after.  I thought I could miss one run and be back out to properly start my tapering.

Unfortunately I got a migraine which floored me for about 4 days (I think I've mentioned these before) and so I ended up missing another training slot.  That left me feeling a bit downbeat about the whole thing and I didn't feel that blogging any of that negativity would be particularly cathartic.  But I'm back now with my penultimate blog before race day.

I've managed 3 runs this week totalling 15 miles which is encouraging.  I did 4 miles last Thursday and followed that up with 5 and 6 miles.  It's a bit of a twist on the taper plan I had in mind, but I need to bear the injuries in mind and so I've opted for an extra shorter run rather than doing, say, 12 miles and reducing down after that.  I just need to make sure my legs still worked and I'm happy to report that they do.

Skipping the two runs last week has meant I've developed a bit of a complex about being underprepared.  I'm not sure how much of that is the "to be expected" pre race nerves, and how much of it I really believe.  By the time I get on a train to London at the end of next week, I'll have already run 232 miles - equivalent to about 9 full marathons.  I'd like to think that stands me in good stead but at the same time I have a nagging doubt that having done no great distance for a few weeks will be a bit of a set-back.  Hopefully it's the former.

I think nerves are natural at this stage.  I'm venturing into the unknown in more ways than one.  Obviously I've never run a marathon before and equally, I'm running on a route I'm wholly unfamiliar with.  I've also not run with anyone in this sort of race environment for about 17 years (The Rother Valley 10k for those of you in Sheffield).  All this is easily overcome I suppose - I'd just not really considered all these factors until recently.

I'm going to have to focus on my pace in the early miles - I don't want to set off too quickly and burn out too soon.  I know the first 5 or 6 miles can be done at around a 10 min/mile pace and I should hopefully be able to replicate my 11.5 min mile (ish) time to 20 miles.  That gives me a good guide to where I should be and when.  As I've stated all along though, as long as I get round before the medals run out (6pm) then I'll be ecstatic.

I'm considering Google-mapping the route before I set off.  I'm not sure if that's a bit OTT or whether I'll genuinely feel calmer for having visualised the route at least once before I set off.  In all likelihood, I'll probably get bored/frustrated after 2 miles of trying, but it could be worth a shot.


There's been some movement on the fundraising this last 2 weeks which is excellent!  Current total is £837.50 which is another £130 since I last blogged.  The generosity everyone has shown has been incredible!  I do still have some more donations that I've been promised as well so I hope I'll be able to get very close to the £1,000 target.  If you're thinking about donating then please know that even a couple of quid will make a difference - you can click on the subtle fundraising link above, or the less subtle one at the end of this post to donate.  Again, I can't thank people enough for what they've already done - I couldn't have wished for more. 

As always, all money that I raise is being split equally between Diabetes UK and The Sheffield Children's Hospital Charity - two very worthy causes. The Children's Hospital money will be going to help fund a summer camp for children with diabetes which is very worthwhile.

I'll blog next week after my last training run which in itself feels like quite an emotional milestone.  I'm going to do a bit of a "Marathon Training by numbers" post which will either be a bit interesting or not half as fun as I thought it would be - who knows?

As with the running, I feel a bit rusty with the blogging so hopefully this has been a moderately interesting post for me to return with.  As I say, I'll try and sum everything up next week and perhaps talk about where this blog goes after the marathon is all done, because to be perfectly honest with you, I don't have an answer for that just yet.

Thanks for sticking with me today and if you've been with me since the start, thank you for making it this far.  I really appreciate all the support you've all given me.

Take care and have a good week

Andy

You can donate at any time by clicking on this fundraising link

Pain management

Training miles completed this week: 16
Total training miles completed: 188
Training miles left: 25 + taper off period
Training runs left: 8

Hello again.

There's only 31 days left until I'll be lining up to start the marathon.  It feels like yesterday I remember the countdown being 180 days and thinking I had all the time in the world to train and prepare.

Training is definitely beginning to take it's toll now, with pretty much every day spent ignoring some form of pain.  I think that it (being in pain) has been so much of the norm for me over the past 4 years that I'm surprised that I can still really feel it at all.

But I can feel it and the major battle I've had this week has been in my mind.  For those of you who know me, you'll know that I'm a bit stubborn from time to time, and training is one of those areas where I'm the most bloody-minded of all.  I'll try and explain...

I've come to terms with the fact that it's unlikely I'll ever really lose the aches and pains in my foot if I want to continue any form of running based exercise.  It's the new, less familiar pain that I'm struggling to get used to.  When I did my 4 mile run last week, I had a bit of pain in my ankle joints and in my legs, but I passed it off as lack of proper stretching and warm-up.  I did 16 miles on Saturday morning and the pain was there again but I ran through it and it disappeared after about 4 miles.  (I managed the distance in 3:04 and I felt like I could have kept jogging/walking as well which was pleasing)

I Googled shin splints when I got in as it seemed to be the only condition I could think of that would make sense.  And reading through the causes and symptoms, it does make a lot of sense.  I'm not going to visit my GP for it as I know the answer is rest.  I also don't want someone to tell me I can't run because I've worked too hard to get to where I am.

On the other hand, I constantly remind myself that I've already done less training than someone preparing for their first marathon should do and so missing any distance at all never really seems acceptable to me.  I'm into the mindset that I'm 'only' doing 6 miles so it shouldn't be a problem, not really letting myself understand that 6 miles is a distance that means I need to take care.

Ultimately, my goal is to do the marathon and if that means cutting back on my training and resting sensibly then that's what I should do, no matter how hard it might be.

I've decided to skip my 6 mile run for tonight in favour of resting and keeping my 20 mile run on track for the weekend.  Whether that turns out to be a sensible decision or not, only time will tell but it feels like a good compromise.  I think I wrote some weeks back about saying that I'd cut down to one run a week if that's what I needed to do.  There's only 4 weeks left and I think getting this close to race day and feeling ready to compete is an achievement in itself.  If I only do 4 more runs instead of 8 then it doesn't really matter - I just need to convince myself of that.

I've conquered my battered ankle, (possible) shin splints, at least one stress fractured toe (possibly two) and now I just need to get the better of my own psyche.

I managed my blood sugar really well again on the last 16 mile jaunt (reaffirming my belief that the 18 mile run was so painful because I got things wrong).  I'm convinced now that 8 miles and then 4 jelly babies every 4 miles will get me round comfortably.  I'm glad to have one less thing to worry about.

There's been some more fundraising money in this week which is good news!  Current total is £575 and I'm hoping I can break the £700 barrier before April 22nd.  I'm becoming a bit more direct in terms of sponsorship requests now (as the people in my office will be finding out this week) so I'm still hopeful of making at least £700 before I top up the rest to £1000.  The generosity everyone has shown has been incredible!

As always, all money that I raise is being split between Diabetes UK and The Sheffield Children's Hospital Charity - two very worthy causes. The Children's Hospital money will be going to help fund a summer camp for children with diabetes which is very worthwhile.

I had an interesting conversation with my daughter this week.  She came up to tell me that she had a poorly tummy and she needed an injection to feel better.  She sees me injecting before meals and asks what I'm doing.  I tell her it's because I'm not very well and I have to take medicine.  It's hard to see her mimicking what I do because one of my big fears is that she'll end up the same way.  But I don't see the point in hiding it from her either.  Fortunately, this only lasted a couple of days this time.

Finally, a word on another blog you might enjoy.  A friend of mine has entered the Tough Mudder event in November and has started a training regime that will ultimately put me to shame.  You can follow Sam's progress here - it's a great read.  We seemed to have a bit of a virtual running club on Twitter at the moment and it's great to get support and chat things through with people doing the same thing.  A really valuable way to stay sane.  Thanks - you know who you are.

Have a good week - hopefully next time I'll be able to report on a decent 20 mile slog.

Take care

Andy

You can donate at any time by clicking on this fundraising link

Self doubt and inner voices

Training miles completed this week: 22
Total training miles completed: 172
Training miles left: 47 + taper off period
Training runs left: 10

Hello - happy Wednesday

Arduous, brutal, crushing, exhausting, punishing and tortuous.  I think I used the word 'grueling' last week to describe how running 16 miles felt.  These new words are more appropriate for how 18 miles feels.

I managed the distance in a not-utterly-unacceptable time of 3hrs 35minutes - essentially a 12 minute mile average.  But the actual run was possibly the most agonising thing I can remember doing.  The first 9 miles was OK (1hr 37mins) but the second half was best summed up using one of the words above.  I got to about 15 miles before I really felt like it'd beaten me - legs felt heavy, ankle felt stiff, agonising pain in my back and persistent cramping in my calf put me on the verge of tears.  I was in no fit state to really measure but I think I ended up running about 100 yards at a time and walking for distances inbetween.

I got in and for the first time actually said "I don't know if I can do this" out loud.  Fortunately, my incredibly understanding wife was able to talk some sense into me.  The doubt was there for a few minutes though and it didn't feel good. 

I'm absolutely under no illusions now about how difficult this is going to be, no misconceptions about how painful it will be or how mentally exhausted I'll be when I get to the end.  Making myself run when my mind is telling me I can't is beyond draining.  It goes against all sense and logic but I need to keep going now.  There are 38 days left until the marathon - that's not long at all and I need to stay focused until then.

Whilst that 18 miles gave me plenty to think about, there were a few positives that came out of it, and they need to be mentioned as much, if not more, than the battle with my demons.

Firstly - I actually finished the distance.  I may have walked a lot more than I would have liked, but I did it.  If I had to walk another 8 miles then I (probably) could have done.  Secondly, where I was convinced last week that I'd possibly brusied the bone in my foot, I managed the whole distance without even so much as a slight jolt of pain from that injury.  That's really encouraging.  Finally, for all the training I do, I know I can't replicate the actual event itself.  I'm hoping the crowds, the change of scenery and running alongside other people is going to give me a boost that I'll be able to put a decent performance in one the day.

For those considering backing me to win it (or to finish inside 5 hours) you might be best advised to keep hold of your money...

I think one of the reasons the run was so tough was that I got my blood sugar levels completely wrong at the weekend.  They were at a similar level when I set off to what they were the previous week.  But the level didn't drop at all as I expected and I managed the entire run without a single jelly baby to keep me going.  Whilst I may have hit the wall at around mile 15, I don't feel like I ever really got into a decent rhythm and I think my sugar levels might have something to do with that.  I've got 2 big runs left to try and sort that problem out.  Worst case scenario is that I have to test my levels around London, But I'd like to avoid that is possible.

More fundraising money has come in this week which is good news!  I've finally got a paper sponsor form to carry around, and my wife is drumming up support in here office as well.  Current total is £545 and I'm hoping I can break the £700 barrier before April 22nd.  I've given my close friends and family enough time to think about donating and now I'm actively calling that money in so I hope I'll be able to report another increase next week.  A number of people that follow me on Twitter have also pledged to donate which is incredibly kind of them.

One of the things that's really struck me is how unwavering the support has been for what I'm doing, particularly from people I've met perhaps once or twice, and in some cases, not at all.  Their belief and encouragement has been fantastic, and their willingness to donate money on the scale they have is out of this world.  It's that kind of thing that really keeps me going as the end comes into sight.

As always, all money that I raise is being split between Diabetes UK and The Sheffield Children's Hospital Charity - two very worthy causes. The Children's Hospital money will be going to help fund a summer camp for children with diabetes which is very worthwhile

I'd also just like to thank Ellie from Diabetes UK and Tonya from Sheffield Children's for all their help this last week - they do a great job deserve to be well recognised.

16 miles this weekend before a psychologically huge 20 miles the weekend after.  I can vaguely remember looking at those distances on the plan back in November and thinking how far away they were and how incredible it was to think I could manage those distances. 

The end is in sight now and I'm detemined not to let anyone down.

Thanks for reading - your support is incredible

Take care

Andy