By David Weingard, Husband, Father, Person With Type 1 Diabetes And Founder/CEO Of Cecelia Health
It is 3 days before my wife Andrea and I race the Casco-Bay Swim Run… swimming and running across state of Maine islands across rocks, up/down paths, in/out of the 60 degree water for an expected 5+ hours. We will be wearing special wet suits, wearing hand paddles, strapping pull buoys to our body etc. It is a point to point race, so we swim/run in our sneakers and on top of all of this are tethered together by a rope testing our athletic prowess and also the strength of our marriage 🙂
Five years ago, on another milestone birthday, I asked Andrea to run across the Grand Canyon together and we had an amazing time, now this new adventure.
I feel excited though very concerned at same time. I know we have the running and swimming training down…. Though this sport is new to us and in our last ocean practice we got tossed all around in the waves, I lost my goggles and all my diabetes supplies got soaked (in their waterproof bags). I doubt anyone with Type 1 diabetes has done this race due to the complexity of pulling it off with diabetes. If my blood sugar goes too low, I can pass out. Too high and I am slow and groggy. And all my diabetes supplies need to be with me from beginning to end, through all the swims and runs.
My plan calls for detaching from my insulin pump and switching to multiple short acting insulin injections. Short acting insulin lasts in body between 2-3 hours. My specific plan is below* for those interested in the detail.
During the race, I need to test my blood glucose levels several times and then eat/take insulin to carry a “basal” level of insulin in my body. I would be a lot calmer if, in practice, the “waterproof” iPhone cases didn’t leak water and ruin the pen and testing strips. I developed my first backup plan idea last week and emailed the race director a few times to see if I could leave the diabetes supplies with people who would be at aid stations. No response. Rule #1 in these races and in life with diabetes. Be self-sufficient, expect the worst and no support. I have a new backup plan of a waterproof bag wrapped around my waist while I swim. It arrives today via Amazon.
Friday Aug 10, 2018
Three good things happen regarding diabetes and the race today.
- The race director emails me and agrees to keep one of my backup waterproof diabetes supply bags at the mile 4 aid station. This happens to be very helpful as the “water proof” bag that I swim with around my waist gets filled with water on race day.
- After brainstorming with my wife Andrea and explaining how I always need to have insulin in my body to function/live… it leads me to decide to inject 2 units of long acting insulin into my body the morning of the race. Way less than my 9 units per day, it gives me confidence that should all else fail during the race with the short acting insulin… I will always have some in my body.
- Andrea also points out that if I carried an unopened vial of insulin, it should remain waterproof. I put an unopened vial, along with some syringes into 1 of our “waterproof pouches.”
Sunday Aug 12, 2018
The Cole Classic Swim race course includes 7 ocean swim segments totaling ~3.5 miles mixed with 7 running segments totaling ~12 miles on trails and every other kind of terrain. One running segment of 0.5 miles was actually climbing across boulders before jumping yet again into the 62 degree water. And, as I mentioned earlier, Andrea and I were tethered together for all the swims.
We learned that the Cole Classic was founded in 2014 replicating a Swedish race. There are only two of these swim-run races in the USA and the roughly 400 participants came from across the USA (and the world). The founder Jeff Cole passed away earlier in 2018. Lars (his race management partner) and Jeff’s family and friends made heartwarming tributes and celebrated life’s memories of Jeff at the pre-race briefing.
In this race, one can’t expect everything to turn out exactly like on the web site. The race director, Lars, made course modifications based on nature through the race weekend (in our case, everything was or seemed longer)
Marriage takes kindness, patience, fortitude to thrive. For some people this complex combination of behaviors comes easier than others. I am fortunate to be blessed with a wife, that together we share so many great/positive moments though like everyone else we have our challenging times too. I am also fortunate that my wife, Andrea, shares my passion for triathlon and other sports adventures. She is actually faster and better than me in all of them.
Swimming straight in the open water (also called sighting) is critical to pacing the body’s energy and of course leads to the best race times. Compound sighting with the changing tide, swimming through packs of seaweed (yes really) and getting to the end point that you want without wasting too much energy is an “interesting” experience for most of the racers (except ex-college swimmers).
Andrea, being the stronger swimmer, led and had to sight in the open water swims. This was where the race became a learning experience for me especially given that my race partner was my wife. What I intended to say in the moment during 1 of the more “tide heavy” swims where our destination seemed to vear right/left continually and remain distant for way too long.. wont’ be mentioned here.
Instead phrases like “Hey buddy, swim toward the white house please” somehow came out of my mouth. We had to focus on the goal and not get caught up in any side distracting emotions. This didn’t work so well when we were running, and she was complaining about chafing from her wet suit and I recited my mantra “stay focused on the goal.” Empathy would have had a better result than the frostiness I received. Thankfully a kind word and joke later, we were back on track.
My buddy, Andrea also helped me with my diabetes as all my backup plans were in play. At miles 4 and 8, Andrea helped me get out my blood glucose meter, test strips, insulin pen and needle. Unfortunately, the constant rain didn’t enable me to test my blood sugar without a dry finger or to get working test strips. I actually went through the entire race without knowing my blood sugar (I highly don’t recommend this to anyone). I took my insulin and food per my plan and finished the race with a blood sugar level of 125 which is excellent. All those with type 1 diabetes, and their families, reading this know that the odds of having a perfect blood sugar after 5+ hours of exercise, insulin and food have odds of 1 in 1000.
I can’t recommend enough the value and benefit of having a diabetes plan and pre-race simulations. Even though parts of my plan didn’t work, enough did. Someone above was looking after me on race day in addition to my buddy. We made all the time cutoffs and somehow finished with a smile on our faces and holding hands (and still in the rain). See picture below.
I am truly grateful to have competed this race, now eighteen years after being diagnosed with my own diabetes. To my life partner, race buddy and diabetes supporter… Andrea… thank you and I love you.
*David’s diabetes plan. Goal optimal BG, no lows and run mildly high as precaution.
4 AM: Wakeup
4 AM: Disconnect from pump, bolus 3.2 units of short acting insulin to cover an electrolyte drink mixed with carb pro and basal that would have received. Food is 40 GM and 200 calories.
4 AM: (added) take 0.2 long acting insulin
4.45 AM: Go on boat to starting line on an island somewhere in Maine
5.45-6.15 AM: Test blood sugar (BG). I should have missed 0.8 units of basal insulin being disconnected from pump. Hopefully my BG is normal. Take injection of 1 unit of short acting insulin and eat 1 GU energy gel
6.30 AM: Race starts
7 AM: Reality, the race start gets changed to 7 AM that morning and my pre -race blood sugar is 265 at 630 AM. I take 2 units of short acting insulin and ear 1 Gel with 22 GM of carbs.
8.10 AM: This should be around 4 miles in of running and swimming. (yes, it all takes longer than normal on rocky roads with all the stuff and open water). Test BG and if normal, take another 1 unit of insulin and eat another 1 GU energy gel. If low, add bag of sports jelly beans
9.50 AM: This should be around mile 8 after the 3rd swim. Test BG and if normal, take another 1 unit of insulin and eat another 1 GU energy gel. If low, add bag of sports jelly beans
~12 PM: Finish. Hopefully with Andrea and I smiling and high-fiving. Should be out of insulin in body. Take large injection ASAP to cover the lapse in body and eat and SMILE