Sunday, November 30, 2008  

Fasting Glucose 93
Weight 184
Blood Pressure, Resting Pulse 117/71, 56

The greatest pleasure in life is doing what people say you cannot do.   
        Walter Bagehot

The unbelivable weather continues. On this last day of November, it was sunny all day, and temperatures were in the 60s. With winter fast approaching, you would think there would be at least a hint of fall in the air, but there wasn't. The people exercising outdoors were in short sleeves and short pants.

In the morning I went to the gym and did a weight-training workout, then followed that up with an aerobic workout, then sat in the newly-reopened spa for a while, trying to loosen up my muscles from the weight-training and yesterday's 10-mile run. 

I think I'm getting better at judging the weight-training thing. That is, I don't seem to be hurting myself with it anymore, although I feel just enough of an afterburn in the muscles to know that I did myself some good with it. I only want to feel a faint soreness in my muscles after a workout, I don't want to be handicapped by the experience.

The day was too beautiful not to spend at least part of it outdoors, so I went for a walk in the state park. Although we've only had a little bit of rain, it's been enough to get the grass sprouting, and that dresses up the trails very nicely.

A friend told me about a trail with a view that I hadn't been on before; today I checked it out. The faint blue hill in the distance is the one I live on. It's not as far away as it looks; there was a bit of haze in the air. 

Saturday, November 29, 2008  

Fasting Glucose 89
Weight 185
Blood Pressure, Resting Pulse 124/72, 59

Learning is not compulsory... neither is survival.   
        W. Edwards Deming

When you take part in a big organized running or cycling event, there is usually an official photographer, who later tries to sell you expensive prints of yourself grimacing or wiping your nose as you approach the finish line.

I don't know if I'm going to buy a print of the one they took of me at the race in San Francisco on Thanksgiving, but in this one I'm not grimacing, or wiping my nose, or even looking fat, and that combination is so rarely achieved that perhaps I should buy a print just to reward the photographer and encourage more picture-taking of this sort.

As for the faint resemblance to Saddam Hussein just before he was hanged, I guess that can't be helped.

I happen to live near the top of a 900-foot hill. Sometimes that means I'm up in the fog when the town below is not. Sometimes (this morning, for example), I'm up in the sun when the town below is fogged in. 

When I left home to drive to the state park to do my 10-mile run today, I started in sunshine and then drove downhill into a lake of dense fog. It was like flying a plane, except that I didn't need to be instrument-rated.

The first 3 or 4 miles of the run were cool, damp, and gray, but as I was going through a heavily-wooded canyon, which tends to be dark and spooky even on the sunniest days, I started to see beams of light shining through the forest canopy overhead, and when I emerged from the woods near the top of the climb, the air was almost entirely clear. It made for a beautiful view at Lake Ilsanjo (made even better by the last little remnants of fog, which were brilliantly lit by the sun).

It's too bad I can't carry a camera when I'm running. In theory I could wear a bike jersey, and stick the camera in the big pockets in the back, but my camera is fairly heavy, and I'm not interested in having that thing banging against my kidneys for 10 miles. When I'm running in the park, I often wish I had the camera; when I hike in there to take pictures (as I did yesterday), I wish I were running. I guess there's no pleasing me.

I was on a route which I hadn't tried before. I thought it would be about 10 miles. If it turned out to be a little longer (as measured by the Garmin GPS unit on my wrist), I would switch from running to walking when I got to 10 miles. If it turned out to be a little shorter, I'd tack on a small extra loop to bring it up to 10. My guess turned out to be pretty good: I reached my car at 9.9 miles, and then did a little jaunt to the end of the parking lot and back to complete the thing. It's silly, I realize, to treat 9.9 miles as being not close enough to 10.0 miles, but if you allow yourself to treat 9.9 as close enough, pretty soon you're treating 9.5 as close enough, and then 9.0. So, I usually don't accept anything less than the full distance specified on the marathon training schedule.

The 10-miler is, in a way, the start of my marathon training. Anything up to 9 miles is the sort of thing that I often do as a matter of course on the weekends, at least if I'm running on trails (on streets, I tend to get bored faster and I don't usually do super-long distances). However, the schedule drops back to 7 miles next weekend (it drops down like that every third week). Then it rises to 12 miles the weekend after that. Then 13. Then it drops down to 10. Then 15. And so on, ratcheting up in stages, until I do a 20-miler (the longest training run) on February 7.

I didn't have any trouble with the run today. 10 miles is long enough that I do feel it a bit afterwards (just a slight soreness in the hips), but no real problems. The challenging runs will come later.

Ordinarily I would go to the gym and sit in the spa after a run longer than 9 miles, but my gym has closed the pool and spa for maintenance this weekend. That's okay -- but the spa had better be open when I do the 20-miler in February!

Friday, November 28, 2008  

Fasting Glucose 91
Weight 187
Blood Pressure, Resting Pulse 123/78, 48

It's not the will to win that matters...everyone has that. It's the will to prepare to win that matters.   
        Paul "Bear" Bryan

More dreadful weather here in the wine country:

But that was today. After a rainy Wednesday, Thanksgiving morning began cool and foggy in San Francisco's Golden Gate Park, where the Turkey Trot (a 5 mile footrace on unpaved trails) is held:

However, the fog burned off quickly, and half way through the race the sun came out. My sister and I ran in the race, finishing together in 53:08 (there were 677 runners, and only 402 of them were faster than us!). Then we high-tailed it to her place for the family Thanksgiving gathering. I suspect most people would say they don't have time, on Thanksgiving of all days, to start the day with an exercise event. However, if you can make time for it, it's a pretty good way to start the holiday (especially considering how many calories you're going to be taking in later).

I might was well admit that I wasn't at all careful about either calories or carbs yesterday. Crab dip with chips, molasses bread, potatoes, cranberry sauce, turkey, gravy, cornbread stuffing, pumpkin pie -- I didn't say no to any of it. I might not have stuffed myself to the point of immobility, as I would have in the old days, but no diabetes educator on earth would have watched me yesterday and admired my sensible restraint.

Amazingly, I seem to have got away with it, if a fasting test result of 91 this morning is any indication. I didn't test after dinner yesterday, and it's hard to believe the result would have been good if I had, but however high I might have gone after Thanksgiving dinner, I got back to normal by this morning. So, to the extent that I really did get away with it, how did I get away with it?

Not by starting yesterday with a 5-mile run, though I'm sure that helped. What probably helped more is that a 5-mile run is not an unusual event in my life now. On most days I run at least 4 miles, and on the weekend I usually do a trail-run in the 7 to 9 mile range. Also, I've lately been doing weight-training again, and that's especially helpful in restoring lost insulin-sensitivity. As a result of all this, I have a certain amount of "head-room", meaning that I'm not just barely getting by any more, in terms of glucose control. I can now challenge my system with a heavy carb load once in a while, and it can cope. In other words, I can handle parties and holiday dinners now. I don't have to slink off into a corner and nibble on a sprig of rosemary while everyone else is having pie.

The trick is not to abuse the privilege. If I rely too heavily on my ability to get away the occasional indulgence, I will gradually lose that ability. On the other hand, you wouldn't be human if you didn't have a need to relax your usual rules once in a while, and Thanksgiving is that kind of occasion. Even if I couldn't handle Thanksgiving dinner, I might approach it as recklessly as I do now, in the interest of not going nuts. Which is why I'm looking so unconcerned here, after eating that big meal -- not a thought in my head (except the thought that the 2005 Estate Zinfandel from Chateau Montelena is just as good as that wine critic claimed):

Today I went on a hike in the hills, taking pictures, and then went to the gym for a session of weight-training and a half-hour on the elliptical trainer. If that sounds like a lot of activity, it's really not. Tomorrow will be a bigger challenge: a 10-mile trail run. I'm entering the stage of marathon training where the weekend runs start getting longer than what I'm used to doing. (The weekend distances will work themselves up to a peak on February 7, when I'll have to run 20 miles; after that, the training schedule tapers off until the actual race on March 1.)

Tuesday, November 25, 2008  

Fasting Glucose 88
Weight 187
Blood Pressure, Resting Pulse 118/73, 57

If absolute power corrupts absolutely, does absolute powerlessness make you pure?   
        Harry Shearer

It was cloudy and cool during my lunchtime run today, but it didn't start raining until minutes after I finished the run. It was as if the clouds got together and said, OK, he's done; we can get on with it now.

My usual running buddies (my fast running buddies, who give me a stiff challenge when I run with them) were unavailable this week. So I started out the run alone. However, I soon caught up with another co-worker, whom I have seen running but have never run with before. He used to be pretty slow (and pretty heavy) but he's been losing weight lately, and running often, and gradually getting faster. Instead of passing him after I caught up with him, I decided to keep pace with him, and chat.

It turned out that he's a little faster than it appeared. I caught up with him on a downhill, and he's reluctant to go fast downhill for fear of hurting his knees (a legitimate concern, actually, but I have less problem with that than a lot of runners do). He later turned out to be a pretty good climber on the steep uphills, except that he would exhaust himself and have to walk for a while before he reached the top. I'd circle around at the top and get back in synch with him.

We started chatting about our running programs, and inevitably settled on the subject of running and health. I told him why I was running. He then told me why he was running, and it turned out to be pretty much the same reason. He had been diagnosed with "pre-diabetes" in the summer, and will soon be going back to his doctor for another test to see if he's improved the situation or not. I told him that he probably has improved it considerably, seeing as he's lost weight and developed a regular exercise routine. But I also explained that, although he was lucky enough to catch the problem early (while it was still easy to get under control), the underlying problem is the same one that any Type 2 patient has, so he'll always have keep an eye on it, and manage it carefully.

He has a couple of advantages that a lot of Type 2 patients don't have. One is that he's never had a problem with blood pressure; even when he was a lot heavier, he would measure 110/65 (even in the doctor's office -- no White Coat Syndrome for him!). The other is that he used to be pretty athletic, and for that reason he doesn't have a confidence problem about becoming athletic again. His daughter just participated in a triathlon, and he's now setting himself a goal of participating with her in the same triathlon next year. It sounds like a great idea to me, combining as it does the two important principles of (1) setting ambitious goals for exercise and (2) making exercise a social or family activity.

So maybe I've got a new running buddy now. He wouldn't want to try to keep up with my usual partners, but when they're not around we might get together.

Apparently I'm not doing my part! A new study, funded by a grant from the Centers for Disease Control and Prevention, says that "People diagnosed with diabetes spend over $4,100 more each year on medical costs than people who don't have diabetes, a gap that increases substantially each year following the initial diagnosis."

The study estimates that "a 50-year-old newly diagnosed with diabetes spends $4,174 more on medical care per year than a person the same age who doesn't have diabetes. For the person with diabetes, medical costs go up an additional $158 per year every year thereafter, over and above the amount they would increase due to aging-related increases in medical expenses."

This doesn't seem to describe my situation at all accurately. According to the figures quoted, I ought to be up to about $5400 a year by this point. However, my diabetes-specific health costs consist of nothing more than test strips for my glucose meter, which cost about a dollar apiece (and I usually test only once a day, so that budget item amounts to less than tenth of what I ought to be spending). I'm not on any medications, and I am not beeing treated for any diabetic complications. Once a year I see my doctor, and I have the same lab work done that anyone of my age and family history would have done, but that's all the "treatment" I get; the rest is self-administered.

You could argue that there's a hidden cost here -- the money I spend on exercise. After all, I belong to a health club, and buy athletic clothes (good running shoes are not cheap!), and sign up for footraces and other sports events that have substantial registration fees. Before I had diabetes I didn't do any of those things, so aren't these really medical expenses? Well, maybe they are. But at least what I'm doing is preventive medicine! If I have to spend money, one way or another, I'd rather spend some money avoiding kidney disease than spend a lot more money trying to survive kidney disease.

Monday, November 24, 2008  

Fasting Glucose 82
Weight 185
Blood Pressure, Resting Pulse 126/79, 48

In archaeology you uncover the unknown. In diplomacy you cover the known.   
        Thomas Pickering

Monday is my rest day, but I did go to my yoga class, and we did some arm-strengthening exercises (including a challenging one that looks a bit like doing one-handed pushups on your side), so it wasn't entirely a day of rest. But pretty near. I still hold to the T-shirt rule: if it isn't wet, you didn't exercise.

It wouldn't have been a bad day to run -- sunny and in the high 50s. Tomorrow, when I actually will be running, there's a good chance of rain. I'll run anyway, rain or shine, but I've had a lot of opportunity to compare rain and shine. Shine is better. Way better, as a matter of fact.

This is, of course, the week that begins the official overeating season, at least in America. I've signed up to run the "Turkey Trot" race in San Francisco on Thanksgiving morning, but this year the race is only 5 miles -- not enough to entitle me to much in the way of overindulgence. A piece of pie, maybe, but that's about it -- and I'm afraid I'm going to be indulging myself to a slightly greater extent than that piece of pie. Well, at least eating too much after running 5 miles is better than eating too much after not running 5 miles.

Oh, good, we have some more maddeningly vague science news from the American Diabetes Association! But their report comes from Reuters Health, and Reuters may only be quoting a maddengly vague report from the research team involved, so it's hard to say whom I ought to be annoyed with.

Stable Blood Sugar Curbs Diabetes Complications, says the headline. "In people with type 1 diabetes, adequate control of blood sugar over the long haul helps reduce the risk of diabetes-related eye and kidney disease, new data suggest. The findings stem from a look at 1,441 type 1 diabetic patients followed for roughly 9 years as part of the pivotal Diabetes Control and Complications Trial (DCCT)."

I don't know who is running the pivotal study, but the article quotes Dr. Eric S. Kilpatrick of Hull Royal Infirmary in Hull, England; either he's in charge, he drew the short straw.

Anyway, they analyzed hemoglobin A1c levels over time. "The researchers observed that increasing variability in hemoglobin A1C heightens the risk of new or worsening diabetic retinopathy (damage to the retina) and diabetic kidney disease. Specifically, for every 1 percent increase in hemoglobin A1C, they found that the risk of retinopathy increased more than twofold and the risk of diabetic kidney disease increased nearly twofold. The findings suggest that the long-term stability of blood sugar, and not just the average blood sugar control, predict the risk of these complications."

Now, wait a minute. First they say that variability in the A1c results increases the risk. Then they say that higher A1c results increases the risk. Which is it?

At this point in history, announcing that higher A1c results increases the risk of diabetic complications is like announcing that exposure to sub-freezing temperatures increases the risk of frostbite. I mean, nobody's going to be short-listed by the Nobel committee for discovering that.

Therefore, if there is anything newsorthy in the results of the study, it is the claim that variability in A1c results matters as much as how high those results are. But the only evidence given in the article that is even remotely specific relates to how high the result is, not how much it fluctuates. So where is the news here?

Kilpatrick is further quoted as saying "It is probably another reason to aim for stable good glycemic control rather than only good glycemic control". Okay, we're back to stability again. But if stability in A1c results has a significance that is independent of how high those results are, we are not told how that significance was detected, or what might explain it.

Maybe Reuters is guilty of distorting what Kilpatrick told them, but judging from what I see here, this is a case of boringly preditcable findings being dressed up as a dramatic revelation, in order to justify whatever money was spent on collecting them. Is there really such a shortage of challenging scientific problems that researchers must go to work on proving the obvious, and then trying to make the result look like a surprise?

I read once about a study which concluded that career problems and financial problems tend to be more common among drug addicts than among non-addicts. And I thought, wow. Who knew

Sunday, November 23, 2008  

Fasting Glucose 95
Weight 186
Blood Pressure, Resting Pulse 126/75, 55

I used to do drugs.  I still do, but I used to, too.    
        Mitch Hedberg

Fasting glucose up instead of down, after a 9.3 mile run yesterday? No mystery there. After the run yesterday I thought I could get away with a big, carb-heavy dinner. 95 isn't high, strictly speaking, but I try to stay below 95, and preferably below 90. As I get into the routine of marathon training, I will have to cope with the temptation to overeat after the longer runs. Next weekend it will be 10 miles. Maybe the best solution will be to have on hand a good supply of healthy food that's prepared (or quick to prepare) so that, after the run, I won't grab something less advisable just because it's convenient.

Today was even more gorgeous than yesterday, if such a thing is possible...

The wine-country tourists vanish at the end of October, which is mighty odd if you ask me, because November is when the local landscape is most beautiful.

During the summer, Sonoma County is not terribly colorful (you're not going to see much in the way of green grass after May), and even in the fall the trees don't put on anything like the kind of display you see elsewhere. But by November the fields and hills are starting to turn green, and the one place where we do have colorful autumn leaves is in the vineyards. If I were coming to California to make a tour of Sonoma and Napa, I would do it in November.

Although I obviously did get outside for purposes of photography today, my exercise for the day was done indoors. That's not normally my preference, but I was due for some weight-training, so I went to the gym. Anyway, after yesterday's long run I thought I should do a gentler aerobic workout (on an elliptical trainer). After all that I sat in the spa outside. By then it was twilight, and what a luxury to sit down in hot water, outdoors, in the cooling air, and watch as Venus and Jupiter become visible in the darkening sky. At least, I knew the brighter one had to be Venus, because nothing else looks quite like it; I thought that the other one was Jupiter, but I wasn't absolutely sure. I had to verify that on an astronomy web site just now -- it turns out I had it right:

Thank you, Sky & Telescope. My other search hits were all for astrology sites, which turn out not be very helpful in terms of telling you where to look in the sky if you want to see the planets for yourself. They do provide extra information on such topics on numerology and "past life", but that's no use to me. I don't think I had a past life. I'm not even sure I'm having this one.

Anyway, I think real things are more interesting than made-up things 99 times out of 100. And for me, sitting in hot water outdoors on a fine fall evening, looking up at the real sky, and seeing real planets millions of miles away with my own eyes is more interesting than trying to figure out whether the movement of Venus into Sagittarius makes this a really bad time to buy pants.

Saturday, November 22, 2008  

Fasting Glucose 82
Weight 186
Blood Pressure, Resting Pulse 120/76, 54

Retribution often means that we eventually do to ourselves what we have done unto others.   
        Eric Hoffer

Another beautiful day. Sunny, calm, and in the low 60s. When I got to the park this morning, everybody was out walking and jogging around the lake.

I wasn't feeling quite ready to run (it seems to take me a long time to digest breakfast), so I killed a little time, walking around and taking pictures.  The water birds were especially cooperative today.

Then I did a 9.3 mile trail run. It was a great run -- I felt good, even on the steep climbs (of which there were several), and I didn't get tired. My hips were a little stiff at the end, but nothing serious. However, I'm starting to get into marathon training mode (next weekend my long run will be 10 miles), so my body will have to start absorbing more and more punishment as the winter goes on. In marathon training, when you start getting into the longer distances, you feel increasingly sore after each run, but you need to keep the situation under control -- you don't want to be at a level of pain that indicates you have a serious injury.

Exercising for your health is always a bit of a balancing act. If you don't exercise hard enough to feel at least slightly stiff and sore afterwards, you don't get stronger because the body has nothing to adapt itself to. If you exercise so hard that you are constantly having sports injuries of one kind or another, sooner or later you'll be incapable of exercising at all.

I'm very dependent on exercise to keep my blood sugar under control and my cardiovascular system strong, so I can't afford to exercise so hard that I do myself serious injury. On the other hand, I can't afford to be a wimp, either.

It's hard to find the middle ground between those extremes, but I guess that's my assignment.

Friday, November 21, 2008  

Fasting Glucose 83
Weight 186
Blood Pressure, Resting Pulse 111/67, 57

It isn't the mountain ahead that wears you out - it's the grain of sand in your shoe.   
        Robert Service

This time there was no waiting for the fog to burn off -- the air was brilliantly clear from dawn to dusk. We had a nice run at lunchtime, with a distance of 4.5 miles. We don't get a whole lot of the fall-color phenomenon in Sonoma County, but there are some maples in the neighborhood around the workplace that put on a pretty good show, and it was nice to see brilliant red leaves standing out against a deep blue sky. I like to have something like that to focus on when I'm huffing and puffing up a hill.

Because it was sunny in the morning I assumed it would be warm, and I packed a very light running shirt in my gym bag. It turned out to be about 58 degrees, a little too cool for what I was wearing. It's so hard to judge these things during the fall. Well, I generally feel better when I'm dressed a little too lightly than when I'm dressed a little too heavily, so it was okay.

It was a stressful week for various reasons, but right after work I went to a yoga workshop on "restorative" poses that help you relax. Basically it amounts to lying on the floor in various positions, propped up by folded blankets and bolsters, in a darkened room, and half-way falling asleep. Apparently it worked, as my blood pressure is way down tonight.

Uh-oh! Everybody's getting sick...

A cold virus is sweeping through my circle of acquaintances. Friends, family members, co-workers, and running buddies are succumbing. How long can I hope to escape it?

I have been told that the surest way to avoid getting a virus is to keep your hands away from your face. Good advice in principle, I suppose, but telling me to keep my hands away from my face during flu season is like telling me not to urinate until next Thursday.

So, I have to assume that a cold virus is probably going to succeed in establishing itself within me sometime soon. What will I do then?

Apparently the standard medical advice to people with diabetes is to rest up (and avoid exercise) during sick days. That used to be the way I approached sick days, and other days too, for that matter; for a long time I considered resting up and avoiding exercise to be the very definition of normal living. Whenever I detected the usual signs that I was coming down with a virus (sore throat, fatigue, feeling chilled), I succumbed to the virus entirely, taking to my bed and covering myself with a heavy pile of blankets. I would be absolutely incapacitated for several days, and the recovery process would take a very long time.

Since I was diagnosed with diabetes, and began to depend on exercise to keep my blood sugar under control, I developed a different strategy for dealing with a virus. My strategy, which I think of as "scaring the virus away", is to try to ignore the warning signs that a virus is establishing itself, and to push on with my usual exercise program, even if it means running outdoors in the cold and rain. Sometimes this means forcing myself to exercise when I feel lousy and am in great doubt about being able to complete the workout -- but the usual result is that I finish the workout feeling better than when I started it. Typically, the virus recedes after a day or two.

Of course, there are times when I feel bad enough to know I can't work out, and I have no choice but to take a day off work and deal with it. But even then I don't go to bed and shiver under eight blankets; I'm more or less up and around.

Since I was diagnosed with Type 2 in early 2001, I don't think I have ever missed more than two days in a row of work (or working out) due to a virus. Most years I don't take any sick days at all. What seems to happen is that I catch a virus and my immune system fights it off before it can get far enough to be incapacitating. I think what has made this possible is my exercise program, which apparently has strengthened my immune system.

Now that I've bragged about my success record, I suppose that the laws of irony will now catch up with me, and I'll get a virus tomorrow which will knock me on my ass for a week and a half. We'll see! 

Thursday, November 20, 2008  

Fasting Glucose 85
Weight 186
Blood Pressure, Resting Pulse 117/71, 56

In heaven all the interesting people are missing.   
        Friedrich Nietzsche

More unexpected weather. It was raining early this morning; that stopped around sunrise, but it stayed foggy. We went running at lunch, and over the course of the run, the fog broke up entirely, and we finished in sunny weather. It was cool (in the 50s), but that's about right for running.

This time I had someone else to run with, and we did the same 4-mile route that I ran yesterday; this time I was faster by 2 or 3 minutes, just because I was keeping up with another runner. I need someone to pace me or I slow down.

That's three days in a row with fasting blood sugar of exactly 85. It's not likely that I was really at 85 three days in a row (or that the meter would read it that way if I were). A likelier scenario is that the real values were 81, 84, and 90, and that the meter happened to read 4 points high, 1 point high, and 5 points low on those days. My blood sugar must have been fairly stable for the result to be that consistent, but exact consistency is pretty unlikely. A glucose meter doesn't know how to be as consistent as that.

Glad to see that my blood pressure is down compared to yesterday. I think that's possibly because I got some problems resolved at work that were worrying me.

I had been thinking of doing another weight-training workout at the gym tonight, but I'm still feeling sore from Tuesday, and I don't think it's a great idea to strain muscles that are already feeling overstrained. I must not have found quite the right intensity level for myself for weight training yet; if my muscles feel this sore after two days I have to have overdone it. Not that I'm in agony, or incapacitated, but the upper-body motion of running today made my upper arms and chest feel pretty sore. I think what gets in my way with weight-training is that I see the amount of weight that some of the other guys in the gym are lifting and I feel embarrassed about not being to lift half as much, so I try to lift as much as I can, to minimize the disparity. Not a sensible way to look at the matter, I realize, but it's hard to avoid comparing yourself to others, especially in the gym.

For a long time I assumed that some of us had "the gene" for Type 2 diabetes and some of us didn't; those who didn't have "the gene" could get away with being a morbidly obese couch potato, and those who did have it couldn't get away with much of anything. Only recently did I find out that the picture is not as simple as I had imagined it to be: there are quite a number of different genes that have been implicated in Type 2.

Not only that, it now turns out that genetic testing is not significantly more accurate at predicting whether or not a patient will become diabetic than a doctor taking a health history. The New England Journal of medicine published two studies yesterday in which the researchers looked at 18 different diabetes-related genes, and found that the genetic data didn't have much more predictive power than a doctor asking simple questions about weight, lifestyle, and family history.

I suppose that part of the explanation for this is that "family history" already gives away a lot of information about diabetes-related genes. Most people with diabetes have at least one relative with diabetes, because of the genetic factor. But it's possible to have diabetes-related genes without being aware of any relatives with diabetes, which I guess is why a genetic test can be at least slightly better at forecasting diabetes than an interview. Not enough better, apparently, for the test to have enough clinical value to justify the cost.

Wednesday, November 19, 2008  

Fasting Glucose 85
Weight 187
Blood Pressure, Resting Pulse 130/78, 53

The difference between a moral man and a man of honor is that the latter regrets a discreditable act, even when it has worked and he has not been caught.   
        H. L. Mencken

Well, the the weather forecast was wrong this time. The heavy fog this morning never burned off. It was gray all day. When I went running at lunchtime, the temperature was 50 degrees, which is a bit cool for running shorts and a light top. For once I was glad that the neighborhood I run in is so hilly; the hard climbing kept me warm.

I was running alone, though; none of my running buddies were available today. I would have gone faster if I was trying to keep up with someone else. When I'm by myself I always relax into a more comfortable pace, even when I'm trying not to.

It was a social evening, or really two social evenings: dinner at an alehouse with friends, then off to an Irish pub to play music with another set of friends. The evening wasn't quite the pub-crawl I'm making it sound like; I had nothing to drink at all at the second place, and was comparatively restrained at the first.

But it's late and I can't fit in any more commentary right now... 

Tuesday, November 18, 2008  

Fasting Glucose 85
Weight 186
Blood Pressure, Resting Pulse 119/76, 53

Try to learn something about everything and everything about something.   
        Thomas H. Huxley

Another beautiful day. Sunny, clear, and calm, but not quite so warm -- in the 60s. The forecast for the week? More of the same.

I had a good run at luchtime, but not a very long one; it was four miles. As we were climbing the big hill, we overtook a runner we knew -- a manager at our company. The reason we overtook him was that he stopped running on the steepest part and walked for a while. He was wearing a heart monitor, and was trying to keep his heart rate below some maximum number. From what he said I wasn't sure if he was just trying to keep his heart rate within the so-called fat burning zone, or if he was trying not to overstrain his heart. Maybe it was a bit of both.

That is one nasty hill. When I first tried running it with a heart monitor on, I occasionally got as high as 180. My doctor didn't like the sound of that, and told me to slow down enough on the hill to keep it below 170. Now I can usually keep it below 160 without slowing down (your body makes that kind of adaptation to exercise if you keep at it long enough).

I had planned to go to the gym in the evening and do a weight-training workout, but after I got home I dithered about it for a while. I didn't feel like going -- not that that counts for anything; once you have been diagnosed with diabetes, your life consists very largely of doing things you don't feel like doing. I was trying to negotiate with myself: come on, it doesn't have to be tonight, I can go tomorrow night. Except that I'm busy tomorrow night and I won't have time...

What finally got me off my butt was taking my blood pressure and finding that it was 130/80. That used to be considered good, but now 120/80 is the new normal, and I was dissatisfied with 130/80. I figured my blood pressure would come down if I lifted some weights. So anyway, I went to the gym, did the workout, and came home. An hour after the end of the workout I measured my blood pressure again, and it was down to 119/76.

Weight-lifitng increases your blood pressure while you're doing it, but then brings it down to a lower level than you started with, and this effect persists for a long time. I don't know how that works, but it does.

A new study says that diabetes costs the United States $218 billion dollars a year, accounting for about 10% of all health care spending by goverment in the public. The rate of diabetes continues to increase, and the disease is expected to be the country's biggest health problem in the future. Some are suggesting that maybe there ought to be some kind of serious effort to prevent the disease.

Well, good luck at prevention. The only people who pay attention to diabetes are people who already have it. People who don't have it seldom think about it, so it's hard to see how any prevention project is going to get off the ground.

Even people whose blood sugar has been rising above normal levels often refuse to take the issue seriously. They hear the term "pre-diabetes" and they think it means "not nearly bad enough to be called diabetes", when for all practical purposes it means "diabetes that hasn't progressed very far yet". It's only when a doctor says "you have diabetes" that they begin to get curious about what diabetes is and what it might do to them. And even then, their first thought is usually "how can I deal with this disease without changing any of the habits that set me up for it in the first place?".

Denial is a powerful force, and any program to prevent diabetes is going to have to overcome that force. I'm skeptical that it can be done. No matter what efforts are made to prevent the disease, I think people with diabetes are going to have plenty of company in the years to come.

Monday, November 17, 2008  

Fasting Glucose 91
Weight 186
Blood Pressure, Resting Pulse 127/73, 48

I don't think anyone should write their autobiography until after they're dead.   
        Samuel Goldwyn

On Sunday the weirdly warm weather continued. Fortunately I was able to get started on my trail-run early enough in the day that it wasn't too warm. I chose an 8-mile route through the state park. It was a beautiful day (clear warm air, blue skies, no wind) so the park was busy again, with lots of hikers, bikers, runners and horses on the trails. A few snakes, too, come to think of it, but they were little guys, no big threat. They weren't rattlers -- some kind of thin black garter snake.

The hills are starting to turn green (in California the hills are brown most of the year -- it's a semi-desert environment), so all in all yesterday seemed more like spring than fall.

After I washed up after the run, I drove down to San Francisco to play some Irish music...

This was at the Plough and Stars, an Irish pub on Clement Street. I'm the fiddler in the brick-red shirt.

I would have thought it would be cool in San Francisco at least, but the same Indian-summer thing was going on down there. You couldn't put on a light jacket, it was too much.

Fiddling doesn't count as exercise, no matter how fast the tempo. Sometimes I wish it did, because music-making is one of the many things which compete with exercise for my time. In February, when I attend the annual winter retreat of the San Francsico Scottish Fiddlers, I will be in the middle of marathon training, which means I will have to tear myself away from the jam-session by the big fireplace at the ranch house to go for a 12-mile run (very possibly in the rain). However, after I get back from that long run and take a hot shower, that jam-session by the big fireplace will still be going on, and I will enjoy it more than I would have done if I hadn't gone for that long run.

Hard exercise does make you feel good (at least, it does once you're used to it). Last night I wasn't feeling at all tired from the 8-mile run earlier in the day; it wasn't a problem for me to drive down to San Francisco (which is about 60 miles away) and back, and I didn't get tired of playing, either. I would have stayed till 2 in the morning if didn't have to work this morning.

Although I exercise a lot now, 8 years ago I was quite sedentary, and the odd thing is that in those days I was tired all the time, and now I'm not. It's the great paradox of exercise: the more you do it, the less tired you are.

Today was my rest day from exercise. I did go to yoga class after work, but it was an unusually easy class. I imagine my glucose will be up a bit in the morning for that reason, but tomorrow I'll go running at lunch, and that will probably take care of it.

Saturday, November 15, 2008  

Fasting Glucose 85
Weight 186
Blood Pressure, Resting Pulse 119/78, 51

Finance is the art of passing money from hand to hand until it finally disappears.   
        Robert W. Sarnoff

My day began at the farmer's market, near the county fairgrounds in Santa Rosa.

I have lately been reading a lot of snide, or at least critical, commentary on farmer's markets and on the movement to buy food that is grown locally (and preferably organically). Apparently this whole approach is supposed to be a bunch of sentimental nonsense favored by liberals with too much time and money on their hands. It is also held to be "elitist", and not as good for the environment as people assume.

I'm sure that ingenious arguments can be made against the local-food movement, and you know what? I don't care. I just don't accept the idea that my healthiest option is to buy my food from a corporation which shipped it here from some distant third-world hellhole with no child labor laws and no chemical regulations. It may be sentimentality, but I think I'd rather buy my tomatoes and peppers and onions from somebody who grows them locally, such as Hector Alvarez here (whose farm is within easy bicycling distance of my home):

To be sure, in November the selections available at the farmer's market are not quite so varied as they would be in the summer. There's not a large amount of fruit on offer, for example. On the other hand, the fall vegetables (such as squashes) are beautiful to see.

I asked the lady who sold me an acorn squash if there is any method of cutting them in half that doesn't involve great risk of bodily injury. She gave me a good tip: put the squash in the oven first, without cutting into it. Then, after 20 to 30 minutes of cooking have softened the squash, take it out, slice it in half (which will be easy at this point), scoop out the seeds, and return it to the oven to complete the cooking.

In the late afternoon, I finally did get to together with my running buddy at the park. However, as he had his two-year-old son with him, we decided to do 4-mile loop around Spring Lake on the paved footpath, rather than the longer trail-run I had been thinking of doing originally. It seemed like a very easy run to me, but then I wasn't the one pushing the stroller...

I am still determined to get a long trail-run in this weekend, so I guess my remaining opportunity for that is tomorrow morning. Here's hoping I can get up early enough to fit that in.

Friday, November 14, 2008  

Fasting Glucose 85
Weight 184
Blood Pressure, Resting Pulse 129/74, 54

The true secret of happiness lies in taking a genuine interest in all the details of daily life.   
        William Morris

Wow -- sunny and 87 degrees when I went running at lunch. I felt like I'd better carry water with me, even though the route was only 4.1 miles. Even now, at 9:30 PM, it's still 73 degrees outside.

The forecast for tomrrow? More of the same. Some November this turned out to be!

I've noticed that my stress level over the course of a workweek often starts out high on Monday, rises to a peak on Wednesday, and subsides to a minimum on Friday. I don't mean that my attitude changes based on how close the weekend is -- I mean that whatever problems I'm coping with during the week tend to get resolved by Friday, one way or another. So it was this week. This wasn't just true of work-related issues. A big part of what was stressing me out all week was the unresolved situation with my auto loan, which the credit union was holding up because of a false comment on my credit report claiming that I'd filed a bankruptcy petition. It finally got resolved today, and the credit union has agreed to make the loan, at a lower interest rate than what the car dealership was offering. So, that's settled. Also, my company announced its quarterly earnings this morning, and they were suprisingly good -- we're making big profits, and as a result I will be getting a big profit-sharing check. (Everyone knows it won't last -- that we're going to have hard times ahead, because our customers are -- but for today, at least, the picture is rosy.)

So, I seemingly ought to have a lower blood pressure result tonight than I did last night, and instead it's higher. Oh well, there's nothing more mysterious and unpredictable than blood pressure. And 129/74 is really not that bad. It used to qualify as normal, actually, but we have stricter standards these days.

Tomorrow I'm going to try again for a trail-run with my old running buddy, who couldn't do it last weekend because he'd just come home from a business trip to Korea with a bad cold. (But I know he went abalone-diving today, in the frigid waters of California's north coast, so we'll have to see what kind of shape he's in tomorrow.) Anyway, he wants to run in the afternoon rather than the morning, so that will leave me time in the morning to go to the farmer's market and get some nice produce. Sunday I'm planning to go down to San Francisco to play Irish music at the Plough. So, if all goes according to plan, I'll be doing three Real Things over the course of the weekend: buying locally-grown vegetables, running on trails in the woods, and playing live acoustic music. So much of modern life is about doing Fake Things that we need to savor the opportunities to do Real Things which happen to come our way.

Thursday, November 13, 2008  

Fasting Glucose 80
Weight 185
Blood Pressure, Resting Pulse 119/74, 58

When you're through changing, you're through.   
        Bruce Barton

Sunny and in the high 70s today, at least during our lunchtime run. Lately it feels like autumn in the morning and evening, but at mid-day it's more like summer. Fortunately, I was aware that it would be warm today, and I brought lighter running clothes this time. We did a hilly 5-miler. I couldn't stop sweating afterwards for at least an hour. And it's supposed to be still warmer tomorrow.

In the evening I went to the gym to do a weight-training workout. I hadn't done that since Saturday, and I was hurting for days afterwards. It turns out that there are two schools of thought on this. One of my running buddies says that, if you're aching after a weight-training workout, it means you pushed yourself too hard and should use lighter weights next time. Her husband, whom I ran into at the gym tonight, told me that if you're not aching after a weight-training workout, it means you didn't push yourself hard enough. He was sort of joking, and sort of not.

I know that the goal of weight-training is to strain your muscles enough to cause a little bit of damage to the muscle fibers, so that the body will refurbish them, and build them up thicker in the process. What I don't know is how much damage qualifies as a little bit, and how much is too much. Certainly I was hurting more during the three days after Saturday's workout than I am willing to hurt on a routine basis. I tried to back it off a bit during tonight's workout. I'm not feeling sore at the moment, but the test will be how I feel tomorrow and the next day. If I'm feeling downright injured, I'll have to back way off, and do a much lighter workout next time.

When I was weight-training before, I remember feeling a milder soreness on a routine basis -- something that wasn't really unpleasant, just a constant reminder that my muscles were getting used more these days. But what I felt earlier this week was more uncomfortable than that; I felt harmed, and also handicapped. It can't be a good thing if your weight-training program is making it hard for you to get any use out of your muscles when you're not at the gym.

Still, I think it will be useful for me to get back into weight-training. Not only does it improve your performance in sports that I do (running and cycling), it also is helpful with weight control and diabetic control. The only reason I gave it up was that I had a rotator-cuff problem in my left shoulder that was making it hard for me to lift; now that my shoulder is better, I have no excuse for not going back to it. I'll just have to find a way to do it that doesn't make me hurt all day.

Wednesday, November 12, 2008  

Fasting Glucose 86
Weight 184
Blood Pressure, Resting Pulse 119/73, 53

You probably wouldn't worry about what people think of you if you could know how seldom they do.    
        Olin Miller

When I went running at lunchtime, it was sunny, and a little warmer than I expected (high 60s). I was trying to keep up with a faster runner, so it was a pretty hard workout. The distance was 4.6 miles, and I finished it in 44:46. That's a pace of 9:44 per mile -- which is isn't bad if you take into account how hilly the route was. I slow down a lot on the climbs, and try to speed up enough on the easy stretches to compensate. Not that I really can, but I do my best.

This time of year, it's very hard to know what kind of running clothes to bring with me to work. The outfit I brought today was too warm for the weather we got (aterwards, I couldn't stop sweating for an hour or more). The weather forecast is for the next five days to be sunny, with temperatures ranging from 77 to 83. What kind of November is this? I thought it was odd enough to be getting that kind of weather in October; to be getting it in mid-November is ridiculous. Well, I'll unpack the summer running clothes that I thought I wasn't going to need again for several months.

I made a vegetable curry tonight with broccoli, tomatoes, and shitake mushrooms. I love shitake mushrooms -- the firm consistency seems to make them  more substantial than any other mushroom I've tried. Too bad about the name, though.

The drawback of a curry is the high-fat sauce. I've been experimenting timidly with a pressure-cooker as an alternative way to cook vegetables, with mixed results. The problem with pressure-cooking (apart from the ever-present threat of grave bodily injury) is that you have to get the timing just right. When I tried cooking putting three different vegetables in the cooker at the same time, I found that after 8 minutes the Brussels sprouts were a bit overcooked (too soft, although just a little firmer would have been fine), the small red potatoes were a bit undercooked (too firm, although just a little softer would have been fine), and the ear of corn was perfect. Expert cooks can stay on top of this sort of thing pretty easily, but I'm still feeling my way. Sometimes I feel as if I should be wearing body armor when I use that particular piece of kitchen equipment, but I guess I'll get used to it eventually. The nice thing about pressure-cooking, of course, is that it's fast. You don't use up as much time and gas as you would otherwise. The not-so-nice thing about it is the fear and uncertainty. Oh well, nobody said this healthy-living thing was going to be easy.

Tuesday, November 11, 2008  

Fasting Glucose 74
Weight 185
Blood Pressure, Resting Pulse 115/69, 55

An autobiography is an obituary in serial form with the last chapter missing.   
        Quentin Crisp

Okay, so is that fasting result of 74 legit? I think it is, more or less. That is, I think my fasting level was pretty low this morning, though the normal variability of my meter may have overstated the case. I didn't exercise yesterday, apart from yoga, but I had a pretty low-carb lunch and dinner, so it would make sense for me to be low this morning.

Unthinkingly, I had a low-carb breakfast, too, and later in the morning it sudenly occurred to me, as I was about to leave for my lunchtime run, that I might be courting an attack of hypoglycemia during my workout. After all, I started out the day low, and I added very little sugar to my system since then. To be on the safe side, I grabbed a snack before I left, to get some sugar into my system. Whether or not the snack was the reason why, I didn't have any trouble during the run -- except for the usual problem of keeping up with my running buddies.

Being pressed for time today, I finished the run at the front gate to the work site (making it a 4.1 mile route); my running buddies looped around to the back gate, which adds an extra mile.

I rarely have a problem with hypoglycemia (unless I'm on a very long run), but every once in a while I have a low that feels alarming, and I try not to set myself up for that. Other people with Type 2 report that this is a big problem for them, and they have to worry about it every time they work out. However, I think these are people who are on diabetes drugs. Not being medicated, I'm relieved of a lot of concerns of that sort. However, even if you're not on any meds, you can still have a bad day occasionally, and there's no point in bringing it on.

I'm trying to make myself aware of foods which taste good without a lot of high-calorie sauces and spreads on them. I think we often assume that certain foods "need" to have butter or sour cream or melted cheese on them, simply because they are often served that way. If you try these foods without the traditional condiments, you sometimes find that they taste pretty good that way.

For example, a lot of people automatically put butter on an ear of corn, or on a baked potato. But both an ear of corn and a baked potato can (if they're cooked just enough) be delicious without adding any fat to them. Salt and pepper, maybe, but fat is really not required. Admittedly, these are both high-starch foods, and some might assume they are unsuitable foods for people with diabetes. Well, they are available in small sizes. I think most people with Type 2 can handle a small ear of corn, or a few golf-ball-sized potatoes rather one gigantic one. Small red potatoes, or other small varieties such as the Yellow Finns, are my preferred type of potato.

Monday, November 10, 2008  

Fasting Glucose 84
Weight 185
Blood Pressure, Resting Pulse 113/69, 48

In carrying out this system, it is well to remember that very few travelers know anything more about the places they have visited than the names of one hotel, two points of interest, and perhaps one street. You can bluff them into insensibility by making up a name and asking them if they saw that when they were in Florence.   
        Robert Benchley

Despite the length of my trail run yeterday, I still feel a little wicked about taking a rest from exercise today.

During the first few years of the exercise program which I adoped after I was diagnosed, I usually took two rest days a week, and I greatly looked forward to both of them. Eventually I cut it down to one rest day a week, but I looked forward to that rest day even more.

Lately, though, I have got to a point where daily exercise just seems like the natural thing to do, and skipping it simply because I am due for another rest day seems almost decadent, especially if it's a weekend and the weather is nice outside. Yesterday was such a beautiful day that, if it had been my designated rest day, I would have felt compelled to go out in the fresh air and exert myself somehow -- taking a walk at least.

Today the weather was a not quite so nice, and I was busy, so I wasn't too tempted to work out anyway. I did go to my yoga class in the evening, but I don't really think of that as exercise. It's maintenance, really; a little refurbishment of the muscles and tendons.

I needed refurbishment today, as it happens. Not because of yesterday's 9.2 mile run (which actually wasn't hard on me, and didn't leave me stiff or sore) but because of Saturday's weight-training workout. Maybe I'm trying too hard at that. I've been trying to pick up where I left off, after a long layoff from weight training, instead of starting with lighter weights and building up slowly. I'm feeling pretty sore in the arms and shoulders today. My left arm in particular feels as if it's planning to make me relive the hell of that frozen-shoulder problem I had a year and a half ago. Well, I don't intend to go through that again, so I'm doing some physical therapy exercises to take my shoulder repeatedly through its whole range of rotation.

The trouble with weight-training is that it's so hard to tell how much is too much. The people who do it seriously all seem to think that it's essential to push yourself to the limit, and choose an amount of weight that is very difficult for you. In other words, if you're doing a set of repetitions and there isn't any real doubt in your mind that you can complete it, you're going too easy on yourself. Weight training gets results when you are straining your muscles up to (or beyond) the limit of what they can do.

However, I'm beginning to think that, if your weight-training workout leaves your muscles sore for two days or more, there has to be something wrong. After my muscles stop hurting and I go back for another round of weight-training, I think I'd better try less challenging weights, and see how that goes. 

Interestingly, my legs aren't bothering me at all, even though I used several weight machines which exercised the leg muscles. It's not hard to guess why that might be: I've been doing a lot of running and cycling lately (forms of exercise which strengthen the leg muscles and nothing else). I've done very little that strengthens the upper body. Maybe if I was lifting lighter weights but doing it more often, the end result would be better.

Sunday, November 9, 2008  

Fasting Glucose 87
Weight 186
Blood Pressure, Resting Pulse 117/74, 47

A lot of people mistake a short memory for a clear conscience.   
        Doug Larsen

My planned trail-run didn't come off yesterday, largely because of the rainy weather, so yesterday afternoon I did a gym workout instead (weight-lifting, followed by half an hour on a cardio machine).

However, the weather today was beautiful, so I went to Annadel State Park to run. There's a road outside the park boundary where you can park your car for free, and get on the trails.

It was a perfect day for a long run. It was sunny and clear, with no wind, and the air was cool without being cold. Because of the recent rains, grasses were sprouting everywhere -- the landscape was starting to turn green after a long summer drought. Because the weather was so beautiful, the park was an extremely popular destination today. There were large numbers of hikers, runners, cyclists, and equestrians everywhere in the park. For the two hours or so that I was there, I was able to enjoy the illusion of living in society in which everyone, young and old, is in the habit of going outdoors and exercising whenever the weather is nice.

Today I did a trail run with a distance of 9.2 miles. The run didn't feel difficult today; sometimes exercise just feels good, and today was one of those lucky days. I didn't get tired, or develop any aches or pains.

Later in the day I went to an Irish music session in Cotati. I found myself taking great satisfaction in the event. Doing the long run earlier in the day seemed to enhance the experience somehow. I wasn't tired from the run; I was energized, actually, and I seemd to be more relaxed, more open, more sensitized.

I think I've allowed my attention to be diverted away from music too much lately. Time to get back on track. I was in danger of forgetting how important and rewarding music-making is for me.

We are very distractable creatures, we humans: always ready to forget what matters to us, and focus on what doesn't. Sometimes I think the real cause of Type 2 diabetes is distraction. We're "too busy" to adopt a healthy lifestyle, but what that means is that we're too distracted to appreciate the pleasures that are involved in healthy living, and instead pursue whatever is more obvious, more easy, and more empty.

Friday, November 7, 2008  

Fasting Glucose 81
Weight 185
Blood Pressure, Resting Pulse 122/74, 59

To be without some of the things you want is an indispensable part of happiness.   
        Bertrand Russell

A highly stressful day -- and it was a day off work! I would have had a much more serene experience if I had been at the office.

I took the day off with the purpose of accomplishing a specific mission: buying a car. And I thought I had done everything necessary to ensure that the transaction would go smoothly. I had done enough research and comparison-shopping to be confident that I knew what kind of car I wanted to buy. I had a price-quote on it, in writing, from the dealer. And I had obtained, two days before, a loan approval from my credit union. What could go wrong? I was sure I'd be done with the whole process before lunch.

Then it turned out that a credit agency had put a black mark against my name, because of the bankruptcy petition I had filed on my credit-card account, and now I was going to have to pay an interest rate twice as high as expected. This development surprised me greatly, seeing as I had never filed a bankrupcty petition in my life. My credit-card lender says that they don't know anything about this -- their records show no bankruptcy, or any other problem, on my account. You would think that this problem could be pretty easily resolved, considering that the credit card account is with the same credit union which was supposed to do the auto loan. However, it appears that the credit-rating agencies hold such sway over financial institutions that it is possible for a lender to be persuaded that I have unpaid debts to them even if their own records say otherwise.

I spent all day trying to get this settled, and never really did. I was able to drive the car home, on the basis of a provisional loan from the dealer which will be replaced by one from the credit union next week if they ever get their heads out of their colons. But it was a long, long, frustrating day.

So, I came home feeling very tense and upset, and I'm sure my blood pressure was way up. And I was faced with a problem of personal responsibility, too: I had not yet done my daily workout, which I had assumed I would be doing during my free afternoon, but had not been able to do because I wasted the whole day on the car-loan problem. When I got home (after dark) I was, to be perfectly honest, not in the mood to go to the gym and work out. I was more in the mood to drown my sorrows, actually.

However, I knew that I would never be able to relax (or bring my blood pressure down) if I didn't exercise. When stress takes over your body, you can't get rid of it by eating, drinking, or stretching out in a reclining chair. There isn't enough food, alcohol, or soft furniture in the world to accomplish that task, if you don't exercise. So, I went to the gym and worked out. An hour after that, my blood pressure (which I had been afraid to check before I went to the gym) was down to 122/74, which under the circumstances is a superb result.

So then I felt entitled to treat myself to some nice wine (Coppola 2006 Russian River Valley Viognier). I earned it, I really did.

Tomorrow, if I can arrange it, I'm going to go trail-running with a friend of mine who used to work at my company. He was on a business trip to Korea this week, however, and although he's expected home tonight, it's not clear whether or not he's going to be up for running tomorrow. If I were in his place, the trans-Pacific flight would probably be enough to discourage me from doing a trail-run the next day, but in addition he's been suffering from a cold. Well, if he's not feeling up to a trail run, he said he might be persuaded to do a bike ride. It would likely be a bike ride of modest proportions, with his his 2-year-old son riding in a trailer in the back, but I'll take what I can get. 

Exercising with others is, at least in my opinion, an important part of the active life. When exercise becomes a part of your social life, it feels more natural to do it, even when you're doing it by yourself. It's too easy to feel as if exercise is an optional extra (a kind of hobby) rather than one of life's basic necessities; the best way to combat that feeling is to do at least some of your exercise with friends or family members, and I do that whenever I can.

Thursday, November 6, 2008  

Fasting Glucose 83
Weight 185
Blood Pressure, Resting Pulse 113/65, 60

I may not be a first-rate composer, but I am a first-class second-rate composer.   
        Richard Strauss

It was a clear sunny day, with temperatures in the 60s. Again I rode my bike to work, and did a 4-mile run at lunchtime. During the run I wore a heart rate monitor. I found that my heart rate while climbing the steeper hills was in the 150s, and I only hit 160 momentarily, at the top of the last hill.

The bike-ride home in the dark had an agreeably spooky quality, especially on the unlit road through the trees which leads up to my place. There was a small circular patch of light on the road from the beam of my headlamp, but everything else, in every direction, was darkness. There was something unreal about the experience; it brought back memories of scuba-diving at night in Cozumel many years ago. But the impression soon vanished, as the house came into view, and I was back in the familiar world once again. I like the way outdoor exercise gives me these little out-of-body experiences (well, out-of-reality experiences, anyway -- I'm very much inside my body during most exercise).

Once gain, a very good blood pressure reading this evening, to which I think the bike-ride contributed greatly.

One of my co-workers, who also organized and ran with our team in the big relay race from Calistoga to Santa Cruz in April, ran in the New York Marathon on Sunday, with a time of 4:07:45. She said it was a great experience, with large crowds lining the streets and cheering on the runners in every neighborhood. She recommended the race highly, but warned me that, contrary to expectation, the New York race is just as hilly as the San Francisco one, and even has the extra challenge of ending on an uphill.

For the first time since 1994, the New York Marathon involved fatalities. Three runners had heart attacks following the race, and two of them died. There was also a fatal heart attack in the San Francisco Marathon the year I ran it. This makes it sound as if marathon-racing is a very dangerous undertaking. To keep it perspective, though, thousands of people participate in these events. On Sunday in New York, the number of runers who completed the race was 37,899, and the number of runners who survived it was 37,897. They included an 83-year-old woman and an 87-year-old man.

Obviously, running 26 miles is a great physical challenge, and if you're on the edge of having a heart attack without realizing it, a great physical challenge just might push you over that edge. The risk is pretty small, though, based on the statistics I've seen. The average runner doesn't have much reason to worry that the race will prove fatal.

I read a comment about statistics last night, in the form of a joke about three statisticians who go duck-hunting. Two of them fire at a duck in flight at the same time; one bullet passes six inches above the duck and the other bullet passes six inches below it. Whereupon the third statistician yells, "We got it!".

I thought the point of this joke was obvious, but the two people to whom I repeated it seemed baffled, so here's my attempt at clarifying the point: statisticians are too much inclined to take an average of various numbers and then act as if the resulting average represented something real (such as a direct hit on a duck which in fact flew away unscathed). In medicine, the statisticians tend to construct an imaginary straw-man known as The Average Patient, and to assume that what is true of this hypothetical patient is true of all the real ones. Which is problematiic, considering that The Average Patient has one ovary and one testicle. Be careful about presuming that what reportedly happens to The Average Patient is going to happen to you.

Wednesday, November 5, 2008  

Fasting Glucose 86
Weight 186
Blood Pressure, Resting Pulse 111/71, 66

All men are frauds. The only difference between them is that some admit it. I myself deny it.   
        H. L. Mencken

As planned, I rode my bike to work this morning, and as I sped down the steep hill I live on, it occurred to me that I had forgotten an important step in preparing for the ride: putting on some gloves. The temperature was about 40 degrees, and when you're speeding down a hill, the wind-chill factor makes it seem a good deal colder than that. The rest of me was warm enough, but my exposed fingers felt as if they were getting frostbite. Well, a minute ago I tossed a pair of gloves into the bike helmet that's sitting by my front door, so in the morning I won't forget the gloves again (unless, this time, I forget the helmet as well).

I live very close to where I work, so the ride is too short to count as my workout for the day. I went for a lunchtime run (one of our easier routes: 4.3 miles and only a few hills). 

I knew it would be dark by the time I was riding home, but I had a small flashing light to pin to my backpack, and a bright headlamp as well, so I didn't feel that the ride was unsafe. (I actually think I'm much easier for drivers to notice at night, if I'm properly lit. Also, for most of the way home I'm on a bikepath beside the road, not on the road itself.) As for the steep climb going home, it was a relief to be doing it in cool weather; the climbing seemed easier than it had during the summer months. It's still a very tough climb -- probably the most intense exercise I ever do, even though it doesn't last very long. I think that climb was the reason my blood pressure was so low when I measured it tonight. Your blood pressure does shoot up during that kind of maximum-intensity exercise, but afterwards it falls below your usual average, and lingers there for a good while.

Thought for the day: why is it so easy for us to reach for the most convenient and least effortful way to get somewhere, and so hard for us to reach instead for the way of getting somewhere that actually makes you feel good? Both the ride to work and the ride home brought me to my destination feeling invigorated (an effect which driving certainly doesn't have on me), but driving always feels like the natural thing to do, and the temptation to take the easy way out is ever-present.

Tuesday, November 4, 2008  

Fasting Glucose 88
Weight 186
Blood Pressure, Resting Pulse 129/71, 61

Whole schools of unpleasant art have been built on the idea that only the ugly is real.    
        Judith Martin

A frantic day, and not because of the election. There was too much going on at work, and I also had to get to the dentist for a little emergency repair work. But somehow, despite everything, I did manage to get outside for a 4-mile run. It was sunny but cool (in the 50s), and there was an invigorating breeze. Pretty much perfect running weather. My running buddies were doing 5 miles, but I had to cut it a little short to be sure I made it to my dental appointment on time.

Here's my number one rule about diabetes management: 90% of it amounts to exercising when you don't feel like it and don't have time.

Voting wasn't a problem for me, because my neighborhood has no polling place, so I'm obliged to mail in an absentee ballot, and I did so a couple of weeks ago. I was apalled to hear about the ordeals that a lot of Americans have been going through to vote this year (standing in line for several hours in a lot of places). It seems to me that we must not really want to have everyone vote in this country, because if we wanted that we would make it easier. The fact that we hold voting on Tuesdays (when Sunday voting is the norm everywhere else) pretty much tells the whole story. 

I'm planning to ride my bike to work tomorrow, so I hope the weather forecast is accurate (it should be cool but dry). I have a cycling raincoat, so maybe I'd better wear that just in case. And I'd better remember a headlamp, as it will be dark by the time I'm riding home. Leading the active life takes a lot of planning sometimes...

Monday, November 3, 2008  

Fasting Glucose 99
Weight 185
Blood Pressure, Resting Pulse 124/80, 52

Anyone can do any amount of work, provided it isn't the work he is supposed to be doing at that moment.   
        Robert Benchley

My somewhat elevated fasting test result today has a simple explanation -- I think the phrase "party food" pretty well covers it. (Home-baked bread was placed within reach of me last night, and that's a temptation against which I have no defense.) It's okay, I'll get back on track shortly.

I did have a good run yesterday (6 miles), on Ocean Beach in San Francisco. There was a lot of fog, at first, which broke up dramatically as we ran. There was no rain, fortunately; the big storm on Saturday night was over by Sunday morning). 

If you value fresh air when you're running, air doesn't get any fresher than a nice cool breeze blowing in off the Northern Pacific, so the beach was a nice place to run. There were a few minor obstacles, though. The heavy rains the previous night had carved the normally featureless beach into a kind of miniature golf course of small canyons, cliffs, and water-hazards. Also, I'm not used to running on sand, which does require you to work harder (much harder, if it's loose dry sand, but only a little harder if it's wet and has had time to settle pretty firmly -- this wasn't too bad). The beach was littered with bull kelp, jellyfish, and crab shells, but nothing you couldn't step around. At one point there were a bunch of seagulls pecking away at the bodies of two of their comrades who had departed this life. I had never thought of seagulls as cannibals, but this bunch were definitely the kind of characters you wouldn't want to turn your back on during a camping trip.

Today was my rest day for the week, which is just as well, because my running buddies ran without me at lunchtime, and they got caught in a heavy downpour and were soaked to the skin. The weather will supposedly be better tomorrow, so I'll plan to run with them tomorrow, and hope that they don't hold it against me that I wasn't suffering with them today. If it's true that misery loves company, it's even truer that misery hates being stood up.

I did go to my yoga class tonight, and my teacher chose to do a set of poses that were designed to open the chest (that is, to spread the chest and shoulders wide, rather than to let the upper body collapse into a concave shape, as we do so much of the time). She said that she thought tomorrow's election was getting a lot of people keyed up, and she wanted us to think of these poses as being about "opening our hearts" to accept whatever the outcome is, regardless of whether it was the outcome we wanted. It sounds like a good plan to me. Open the heart.

However, opening the champagne (because the outcome is exactly what we wanted), sounds like an even better plan. I hope that's what I'll be doing tomorrow.

Saturday, November 1, 2008  

Fasting Glucose 85
Weight 184
Blood Pressure, Resting Pulse 119/71, 56

The average, healthy, well-adjusted adult gets up at seven-thirty in the morning feeling just plain terrible.   
        Jean Kerr

A very rainy day, and with gusty winds as well. Not a day for exercising outdoors if you have an alternative, so I decided to work out in the gym instead -- some weight-lifting, but not a lot; mostly working out on an elliptical trainer. The windows in front of me gave me a view of the outdoor swimming pool, in which a two guys were swimming laps. Now, there's an odd phenomenon: my instinctive reaction was to feel sorry for them, for being out there in the rain. This reaction does not stand up well to scrutiny. The guys in the pool really weren't getting any wetter (or even any colder) than they would have done if they'd gone swimming on a sunny day. But on a sunny day they would certainly have had a lot more company in the pool. It makes sense, we think, to swim when it's hot and sunny, but not when it's raining -- even if the purpose of the swim is exercise rather than relief from summer heat. Maybe we're not thinking very clearly about these things.

I suppose I reacted that way because I usually exercise outdoors, and was taking refuge from the weather myself today. You might ask how much sense that decision made, of course. Running generates a lot of excess body heat, and runners sweat even when the weather isn't at all warm; wouldn't running in cool rainfall be an improvement? Well, actually, in some ways it can be; once your clothes are soaked through, and you can't get any weater than you already are, the cooling effect of rain can be pleasant if the run doesn't last too long. But if the run is a long one, you can become extremely tired of having cold water fall on you. And an even bigger disadvantage is that, if your running shoes get soaking wet, it's going to be a long time before they dry out, and running in wet shoes can be an uncomfortable thing.

I'm planning to run a 6-miler tomorrow, and there's still a 50% chance of rain. If it rains, I'll live with it. I have a cycling rain-coat which ought to serve well for running as well. My shoes will get wet but I'm not going to use my good ones -- I'll use an old pair that I've "retired" but sometimes take out of retirement on special occasions.

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