Saturday, February 28, 2009  

That's as much carb-loading as I think I can handle. Maybe my blood sugar will be up in the morning, but I needed to build up some glycogen in my muscles for the marathon tomorrow. Sometimes you have to do what the non-diabetic people do.

There's a law of nature that says, after months of training for a marathon, you will start to have some sort of pain or stiffness just before the race. At four o'clock this morning I woke up with a long, agonizing cramp in my left leg -- one of the worst I've ever had. I was feeling sore there most of today. However, I made sure I walked around on it a lot, and I think that loosened it up. I've also been massaging it. But that's not all! My right ankle suddenly became sore today for no reason, in a way it never has before.

I think pre-race jitters are the likely explanation for this sort of thing -- you get so afraid of developing an injury before the big race that, somehow, your body converts your fears into painful symptoms. At least it gives me something to worry about besides the weather.

Not that there's a whole lot of doubt about the weather tomorrow. The weather forecasters are quite firm in their prediction that it will be raining all morning tomorrow. However, what's predicted is light rain, without much wind, and that's not so bad. What I've been worrying about is strong winds flinging heavy rain in our faces (which is what the people who ran this race in 2006 had to deal with). If all I have to cope with is light rain and light wind, I'll survive.

Well, I'd better get to bed. It's very hard to sleep the night before a marathon, but I'm going to try. I have to leave the house at 5:30 AM, and it would be a good thing to get some rest between now and then. 

Friday, February 27, 2009  

Signs of the apocalypse! Earlier in the week, this chair, designed by Eileen Gray, sold for $28 million at a Christie's auction of the estate of Yves Saint Laurent:

Apparently this is the highest price ever paid at auction for a piece of furniture resembling a garden snail. That there are people out there with enough money, in these desperate times, to spend $28 million on a goddam chair, of all things (whether it has an oozing molluscan appearance or not) suggests that we are now re-enacting the story of late 18th century France. Get ready for guillotines!

On a slightly lighter note...

Now I have to struggle between two incompatible goals: to start carb-loading for the marathon on Sunday, and to keep my blood sugar under control. My dinner tonight was not quite so high-carb as it sounds (the spinich lasagna was more spinach than pasta), and lunch was definitely low-carb. But my total carb intake for the day was on the high side. I'm guessing my weight and blood sugar may both be up a bit tomrrow.

Well, marathon weekend is a special occasion, and I think I'll just have to throw most of my diabetes caution to the winds. Tomorrow I'll have a big pasta dinner, which is traditional before a marathon. The idea is to get a good supply of glycogen stored in your muscles, so that they won't run out of the stuff before you get to the finish line. That's a common danger in endurance sports; once your muscles run out of stored energy, you become profoundly exhausted and it's all you can do to walk, much less run. And if that happens, it will take a few days to recover from it, so there won't be any possibility of finishing the race.

I'm not a very fast runner, so I won't be burning up energy at the same rate as the elite racers at the front of the pack; you might think that would eliminate the risk of running out. However, because I'm slower and we're all going the same distance, I will be running longer than the elite runners, so my muscles will have more time in which to exhaust their fuel supply. So, I do face some risk of "bonking", as the problem is usually called.

I will carry some sugar with me, and will swallow at least a little sports drink at each of the water stations along the route. Still, precautions of that kind offer you only so much protection; it's considered a safer bet to eat a lot of starch before the race, and get your muscles loaded up. I've never heard any guidance on how to reconcile this goal with diabetes management. I've just worked on the assumption that, on balance, training for a marathon and running it will both do my health a lot more good than harm, so if I have to overdo the carbs on the marathon weekend itself, that's okay.

I'm feeling a little keyed up, partly because of the marathon, and partly for the same reasons that everyone else in the country is keyed up. So, my blood pressure is not exactly stellar. Actually, the diastolic values have been good lately, but the systolic values have been high, so that there is a wide gap between the two (and a wide gap between the two is apparently a bad thing, although I'm not sure exactly why). Well, the numbers aren't that bad. Maybe that's the best I can do under the circumstances. I think the marathon itself, and the relief of being done with it, will probably help bring the numbers down.

Thursday, February 26, 2009  

Wild rice isn't really rice, as it turns out. (Already I'm thinking of that old Peter Cook routine: "And I'll tell you another interesting fact: the whale is not really a fish at all! It's an insect.") Not only is wild rice not rice, it's apparently not especially wild, either, considering that I am able to find it in the bulk-foods aisle.

Unlike true rice (genus Oryza), wild rice is of the genus Zizania. The species usually sold as wild rice is Zizania palustris, which is native to the Great Lakes region. The plant grows in shallow rivers, with most of the plant submerged, and American Indians used to gather it by paddling around in canoes and using a stick to whack the grains into the boat. (I don't think the stuff I bought was harvested in that way, though.)

I bought wild rice with the idea in mind that wild rice is nutritionally far superior to true rice, and far less glycemic. Actually, I found from subsequent research that the difference is not nearly so great as I had imagined. Wild rice has significantly more protein than true rice, but otherwise it's not so different. It certainly tastes better than true rice, so I'm not sorry to have tried it. But I might have had too much of it -- if my fasting result is elevated tomorrow, I'll know be more careful with the stuff in the future.

The current weather forecast for Sunday (marathon day) shows a chance of rain. Specifically, a 90% chance of rain.

Well, okay, I can handle that if I have to, even though I'd much rather not have to. Looking on the bright side, if the weather is wet during the race, I will have less of a problem with dehydration than I did last year, when the weather was sunny, dry, and windy. What I'll miss is the beautiful sight of the rising sun gradually lighting up the hills and vineyards of the Napa Valley just south of Calistoga. Maybe the valley will look beautiful in its own way under wet gray skies, but it would have been nice to have the kind of weather and scenery that this marathon more often provides -- as it did last year:

I'm taking no chances with injuring myself before the race, so I did my exercise in the gym today, even though it was sunny and it would have been nice to run outside. The training schedule calls for me to rest both Friday and Saturday, but I never take two days off exercise in a row, so I'll do another gym workout tomorrow. I'll rest on Saturday, and spend the time getting some rain gear together for Sunday...

Wednesday, February 25, 2009  

It was a cloudy day, threatening rain all morning, but we went for a run anyway at lunchtime. It did sprinkle on us a bit, and the sky was getting ominously dark, but we lucked out -- the real rain didn't start until we finished our run and were safely back indoors, enjoying a hot shower. Well, at least I enjoyed it -- I shouldn't speak for my running buddy, as she was in the women's shower, and didn't report back to me about the experience later.

I've been running at lunchtime with coworkers for several years now. Some of my former running buddies no longer work there, unfortunately. Over the years we have worked out various standard running routes through the neighborhood, of various lengths, so every run always begins with a brief discussion (or negotiation): where to, this time?

Years ago there were basically two choices ("School? Or hospital?"). But we don't really do those routes now, at least in their original form, because they're too short (about 3 miles, or even less). Nowadays the basic choices are different ("Golf course? Montecito? Fountaingrove?"), and we also have variations on those, for when we need to tack some extra mileage onto them. (Lately, marathon training has forced us to tack on quite a lot of extra miles -- combinations such as "Golf course with the Cross Creek option" or "Fountaingrove plus Montecito".)

Strange as it seems, these routes can evoke a lot of nostalgic feelings. I run them, and I remember a lot of the times I've run them before, perhaps with people I haven't seen in a long time. The hospital route always reminds me of the time that Paul, a likable eccentric with an extremely loud voice and no sense of personal boundaries, ran that route with us, and chose the occasion to make an off-color joke -- and then to explain it, at the top of his voice in a quiet neighborhood, to Takashi, who was recently arrived from Japan and was unfamiliar with American humor about prostate-exams. That was years ago. Paul was layed off, and Takashi moved back to Japan; I haven't heard from either of them in well over a year, but I think of them when I run that route. Jake, who was also there, is gone too, but in his case, at least, I'm still in contact with him, and still run with him once in a while.

Today we did the Montecitio loop, and my running buddy remarked that she hadn't done that one in a long time. I had, but not on days when she was running with me. The memories that the run brought up today, for me at least, were about the many times in the past when I was finding it a difficult route, and couldn't remotely keep up with her. I kept up with her almost all the way this time, except on the steepest hill. But I caught up quickly! That was a sign of progress. It was also a sign of progress that I didn't have a sense of suffering during any of it -- it wasn't a punishing experience. Exercise can seem very punishing indeed when you're out of shape, and it takes a long time to get past that. I seem to have got past it. I felt good during today's run, and I've been feeling good during most of  the marathon training. I'm cautiously optimistic that I'll feel good during the marathon itself.

The trouble with having a breakfast that consists only of cereal is that it's very low in fat -- which means that it's digested rapidly, makes your blood sugar rise and fall steeply, and makes you feel hungry (and a bit weak) by mid-morning. I was afraid that I wouldn't have enough energy to run at lunchtime. So, I ate an apple about an hour before the run to make sure I wouldn't get hypoglycemic during the run. This approach worked fine for me today -- I felt good during the run, and I wouldn't have without the apple. Or so I imagine. It's hard to know how you'll actually feel during a run until you actually do it. But I know that I don't want to start a run feeling weak and wobbly from the outset, so I'm glad I had the apple.

On marathon morning, I'll try to make sure that whatever breakfast I have isn't carbohydrate and nothing else. I certainly don't want to have a heavy breakfast of bacon and sausage, but I do want to have some fat and protein mixed with the carbs, so that the breakfast continues to give me some energy after the race starts. It's hard to get breakfast just right before a marathon, but I'll do my best to find a good solution.

Tuesday, February 24, 2009  

The weather was dry today -- at first, sunny and beautiful, but by the time we got outside to run at lunchtime it was clouding up ominously. Still, we finished the run without getting rained on. It was a good run. I felt fine; nothing was hurting. Now I just have to keep it that way until the race on Sunday

Tomorrow is likely to be rainy, but oh well. We do what we have to!

The cafeteria at work had a Mexican buffet today; I skipped the main courses and just settled for beans and rice, the classic staples of the poor in Latin America. For excitement I tossed some slices of purple onion on top, and of course a generous amount of hot sauce. Ice-water to drink. It was about the cheapest lunch I've ever had in that cafeteria. I think I'm going to concentrate more on the cheap "side dishes" in the future, and skip the high-priced, high-calorie main dishes. I think one of the problems we have as a food-culture is that we don't appreciate simple dishes, especially vegetable dishes. Whatever meat is on the plate is what matters; the rest is mere accompaniment. It's only when there isn't any meat on the plate that we can appreciate whatever else is there.

When I made that spicy Vietnamese soup the other night, there was too much broth; I saved a bunch of that, and used it to make another soup tonight with a different combination of vegetables. These were fresh vegetables, mostly from local organic farms: celery root, Romanesca cauliflower (that's the green cauliflower with hallucinatory spirals in it), kale, hothouse tomatoes, asparagus, chiles, and the splendid but unfortunately-named shitake mushroom.

Oh no -- America is losing its edge! Apparently the UK is catching up with the US in terms of diabetes. We still have the lead in terms of pecentage of the population with diabetes, but the rate is increasing faster among the British, so it is only a matter of time before they leave us behind. Apparently the reason for the increase is the rising rate of obesity in the UK; the increase is in Type 2 diabetes only (Type 1, which is not lifestyle-related, shows no such trend).

The British seem to be getting rather concerned about this. Douglas Smallwood, Chief Executive of Diabetes UK, said in a press statement: "This research is a sad indictment of the current state of the UK's health. It is imperative that we raise awareness of the importance of eating a healthy, balanced diet and doing at least 30 minutes of physical activity a day if we want to make any headway in defusing the diabetes time bomb."

American officials seem not to be quite that worked up about the issue. Perhaps the reason is that America has never quite accepted the idea that public health is a public responsibility. The American attitude tends to be that of Ebenezer Scrooge: "If they would rather die, they had better do it, and decrease the surplus population."  Of course, some people (even in America) are tying to raise the alarm about our society's unhealthy habits, but they don't have billions to spend on advertising, and the junk-food industry does.

Monday, February 23, 2009  

Another rainy day, which was OK as I wasn't planning to run today anyway. Tomorrow I will do a short run, but it's supposed to be dry tomorrow. Then more rain for the rest of the week. That doesn't matter. This is the "taper" phase of the marathon training; all the runs this week are so short that it wouldn't be a problem to do them on a treadmill.

The goal now is not to hurt myself in any way before the race on Sunday. I want to be feeling fine in every department when the race starts -- no pulled muscles, no sore joints, no raw chafed skin. I was slightly worried to wake up this morning with a bit of lower-back pain, but the stretching I did in the yoga class tonight made that feel better, so I'm pretty sure I'll recover quickly from whatever went wrong there. (It's pretty likely that what went wrong there was too much slouching in front of the computer, and I can remedy that if I remember to think about it and sit up straight.)

Lately I've been reading some alarming accounts from people who developed Type 2 diabetes even though they (1) aren't overweight, and (2) have been exercising regularly all their lives. I can imagine how frustrated they must get when they hear from people like me, who tell them all they have to do is lose weight and get a lot of exercise. For most people with Type 2, that really is an adequate solution, even though most of them don't put it into practice. (One doctor told me that "about 1%" of his Type 2 patients lose a significant amount of weight after diagnosis.)

But what must it be like if you've already been doing exactly what you were supposed to be doing, and you became diabetic anyway? I imagine it's a little bit like being one of those lung cancer patients who never smoked. In a way it's worse, because in this case there's a remedy -- which works for everyone but you! Imagine how outraged you would be, as a non-smoker with lung cancer, if you found out that the smokers could get rid of their lung cancer by giving up smoking, but you, who never smoked in the first place, were stuck with it.

These exceptional cases make me wonder whether Type 2 diabetes isn't really a set of similar diseases rather than a single disease. When I read discussions on the dLife forums, I'm constantly struck by how different the disease seems to be for different people. It's as if everyone's experience of the disease is different. Maybe their experiences are different because they don't really have the same disease. Maybe, with regard to diabetes, we are today where the 18th century was with regard to infectious diseases (when they spoke of "fever" as if it were a specific disease, to be treated the same way in all cases).

I guess what bothers me about these people whose blood sugar zooms out of control, even though they're living right, is that whatever happened to them might happen to me. What if my body just decides, some day, that it wants to be diabetic, no matter how diligently I have been running and eating organic vegetables?

Worrying about this possibility won't help me, but I suppose it's good to keep the possibility in mind, if only for the purpose of becoming more sympathetic with the people to whom this sort of thing has happened.

Sunday, February 22, 2009  

A very wet day here; the view from my porch never got any brighter than this:

The rain didn't really matter -- knowing that rain was expected today, I made sure that I got my 8-mile training run out of the way yesterday. Today was a non-running day. I just did an easy aerobic workout at the gym.

I know this sounds silly, but one of the advantage of eating vegetarian meals is that you end up eating your vegetables. In theory, it would seem as if you could eat your vegetables just as easily if you also ate meat as you could if you didn't. And yet, if you don't make some kind of effort to reduce or eliminate the meat from your diet, all of your meals end up revolving around meat (or eggs, or cheese, or some other animal food), and vegetables get short shrift. You go to the grocery store and you buy both meat and produce --  but which of those do you actually end up using before it spoils?  

If you decide that you're going to avoid meat, all of a sudden you have to start thinking seriously about using whatever vegetables you buy -- because otherwise you're going to be going hungry. Always a powerful motivator, that.

I bought a bunch of vegetables at the farmer's market yesterday; today I went to the local Asian market and got some ingredients that will help me make better use of those vegetables. Spices, sauces, a few vegetable foods that aren't easily found elsewhere. I bought a Vietnamese soup-base, and used it to make a vegetable soup for dinner (it was very good). I also got some chana dal, which looks like yellow split peas, but is actually a small-sized variety of chickpeas (which is said to have an extremely low glycemic index and is recommended to people with diabetes for that reason). I also picked up some "nori" sheets, which are those dark green sheets of dried seaweed that are used as the outer wrapping for sushi; it seems like a good low-carb thing to wrap other foods in.

I don't have any aversion to exotic foods -- and if I did, I'd be trying to get over it, because anyone with Type 2 needs to be willing to try out different foods and find those that work.

And now comes a reminder of everything we don't want to be...

Larry H. Miller, who got so rich selling cars that he was eventually able to buy a sports team (the Utah Jazz), died on Friday of complications from Type 2 diabetes. He was 64. Miller's diabetes had already caused him severe health problems, including a 2008 heart attack, a long hospital stay, and the amputation last month of both legs below the knee.

The Associated Press describes Miller as "a tireless worker with a knack for the most minute details". I suspect that those details were always business-related. His tirelessness as a worker may not have left him much time for the minute details that are  involved in staying healthy. I'm not just guessing here; on the occasion of Miller's 2008 heart attack, his family members were quoted as saying that he had long neglected his health, and was now paying a price for it.

I refuse to accept that Miller's fate has to be my fate. A lot of people with diabetes seem to see it that way. Or rather, they see their fate as being entirely out of their hands. Maybe something awful will happen to them, and maybe it won't, but there's no way of knowing if it will or not, and no way to prevent it, so there's nothing to do but to wait and see. 

I say that's crap. There are things you can do about this. So do them, already!

Saturday, February 21, 2009  

The weather-guessers said that a storm was heading in from the Pacific, but the morning began so bright and sunny that I thought it would stay that way all day. I had some errands to take care of -- going to the farmer's market, getting a haircut, getting my kitchen knives sharpened -- and didn't get to the state park to start my trail run until early afternoon. By then it cloudy and threatening rain. However, luck was with me -- it stayed dry. It was a nice run; the trails weren't too crowded, because other people were worried about getting caught in the rain. The trails were a bit muddy, because of all the rain last weekend. Not muddy enough to be a serious impediment.

I was extremely focused, all during the run, on one issue: not hurting myself. The marathon is a week from tomorrow, and I know from experience that nothing is more frustrating than to spend months training for a marathon, and then have to cancel because of a last-minute injury. I hardly looked up from the trail at all, so concerned was I to avoid tripping on a rock or tree-root, or slipping in the mud. Also, I was maintaining a moderate pace. This is no time to be pushing myself. I'm taking it easy at this point.

It just occurred to me how strange that probably sounds. There was a time in my life when it would have been unthinkable for me to do 8 miles of running on steep trails in the afternoon, and then to sit down in the evening and describe this as "taking it easy". That's really how it seems to me, though, so I'll let it stand.

Friday, February 20, 2009  

Well, my blood pressure's better than yesterday. It helped that I just got back from a special yoga workshop on "restorative poses" -- that is, resting poses designed to quiet the mind and relieve stress. I spent 2 hours lying on the floor in various positions, draped over various combinations of bolsters, sandbags, and rolled-up blankets. It's relaxing, all right. Pretty hard not to fall asleep during it. I drifted off repeatedly. I hope I didn't snore. (Probably not, as I heard no laughter.)

It's been a stressful week, but it ended calmly enough. I hope next week will be calm from the start. That does not often happen, but the possibility cannot be ruled out.

The marathon is little more than a week away. I need to do an 8-mile tomorrow, but after that the exercise schedule becomes extremely light. I expect I'll do a little more exercise than the training schedule calls for, just to keep my blood sugar and weight from going up. It makes sense, in a way, to rest up before the big race, but there's only so much rest I can afford to indulge in.

Not an especially vegetarian diet for me, today -- my sandwich at lunch had turkey in it, and my salad at dinner had salmon in it. Well, I'm not a vegetarian of principle, I'm a vegetarian of convenience. I eat vegetarian meals when they're handy or I'm not in a hurry. Today I was a bit pressed for time and I went with what I could conveniently get. I should do less of that, though, especially now. It's when the marathon training starts tapering down before the race that it's easiest for me to gain weight -- and gaining weight never helped anybody run a marathon. This is not a time when I can afford to be eating a heavier diet. Back to plant foods tomorrow! I'll probably have time to go to the farmer's market in the morning, and make sure I'm stocked up with alternatives to meat for the coming week.

Thursday, February 19, 2009  

Why is my blood pressure up so much from yesterday? Well, that's not hard to explain. I'm stressing out about a couple of issues, and I didn't work out hard enough today to make up for that. I'm not going to be working out all that hard tomorrow, either. I'm going to go to a yoga relaxation workshop tomorrow evening, though, and maybe that will help. My blood pressure hasn't been this high in a long time, and I can't let this continue.

The cafeteria at work usually offers a variety of food choices, but today they had only one offering, an Italian lunch which was, of course, rather heavy on the carbs. At least I didn't take the dessert they offered me. But later, in the office, there was a little gathering for the birthday of someone in the cubicle next to mine, and it was pretty much impossible not to partake. At least the pastry I had was pretty small.

It was a nice day for running -- sunny, clear, breezy, not too cold. The run was a mile longer than the training schedule called for, but the marathon is still more than a week away, and I don't want to cut back on exercise so much that I'm not doing the right thing by my diabetes.

I'm not unwilling to use the phrase "my diabetes", even though, by all standard definitions of diabetes, I don't really have it. The confusing thing is that diabetes is the name of a symptom (chronic hyperglycemia), which I no longer have. But the word is also used casually to refer to any disease which causes that symptom. Often people say that they "have diabetes" without specifying Type 1 or Type 2, which is sort of like saying that you have a gender. Anyway, when I was diabetic, in the sense of having chronic hyperglycemia, the specific disease known as Type 2 diabetes was what was giving me that symptom. Now that I no longer am exhibiting that symptom, am I still "diabetic"? No, not really. Do I still have "diabetes"? Well, I still have the underlying metabolic problem that caused me to be diabetic before, and that problem is usually referred to as Type 2 diabetes. So, it could be said that I'm no longer diabetic, but I still have diabetes. (Don't blame me -- it's not my fault that people use these words so loosely!)

On the dLife forum, we keep having the same futile discussion of this issue, every time a newcomer asks if it's true that Type 2 can be "cured". A bunch of people always say no, it can't be cured, you will always be diabetic. Then I try to add a little more nuance to the discussion, and say that the underlying problem can't be eliminated, but that doesn't mean you have to remain "diabetic" in the symptomatic sense. And then everyone tells me I'm wrong, and accuses me of saying that the disease can be cured when everyone knows it can't be.

What bothers me is what we're losing sight of: it is possible for people with Type 2 to improve their health so much that they no longer have the symptom of chronic hyperglycemia, even if they're not taking any meds. That's a good thing -- and it ought to be the goal of everyone with Type 2 to get into that situation, or as close to that situation as they can. But what do we call that situation? It's not a "cure", because the underlying cause is still lying in wait, ready to stir up more trouble later. Still, the symptom known as diabetes is gone, and there ought to be a word for this state of affairs, which everyone with Type 2 diabetes is supposed to be trying to bring about. And yet we have no way to talk about it!

What kind of loser mentality are we suffering from, if we don't even have a word for the success we are seeking? Trust me, there are no athletes who don't have a word for "win", and no CEOs who don't have a word for "profit". But people with Type 2 diabetes have no way to refer to the situation that they want to be in. If they try to talk about it, people get upset with them (for implying that Type 2 can be "cured"). Well, what are they allowed to say? Surely there needs to be some way to talk about this. It's too important a subject to leave undiscussed just because discussing it gets a bad reaction from some people.

Wednesday, February 18, 2009  

The weather was better today -- no rain, partly cloudy, a bit breezy, temperatures in the 50s; pretty good weather for running.

The marathon training schedule called for 6 miles today, which may sound like a lot, but is down from 10 miles only 2 Wednesdays ago. We're now "tapering" -- reducing the mileage so that the body has some recovery time before the marathon on March 1. So, the intensity of the training runs is dropping fast. There is an 8-mile run on Saturday, but that's down from a 20 mile run only two Saturdays ago. And an 8-mile run on the weekend is pretty much standard for me even when I'm not training for a race. In a sense, marathon training is already over for me at this point, because I'm not doing any more running than I would be doing anyway.

The route we ended up running at lunchtime is just about the hardest one we do with any regularity -- extremely steep climbs, on a road which is called "Skyfarm Drive", and is called that for a reason. (It would probably be illegal to put in a road that's any steeper than that one.) I think I did better on those climbs than I ever have in the past. I'm hoping that means the hills that I'll have to run during the marathon on March 1st will be easier for me than they were last year.

It was actually a relief to me to be doing such a hard run at lunchtime, because after lunch I had to go to a meeting which I was afraid would be very difficult to get through. I was stressing out about it, and really hard exercise is the best stress-buster I know of. I don't want to tell the story here, but I expected the meeting to be unpleasant and embarassing. It turned out to be fine. I had got myself worked up over nothing. (I have a lot of practice at that. It's one of my skills.)

Tomorrow, the training schedule calls for a run of only three miles. That was once standard for me, but I now tend to see 4 miles as my minimum acceptable distance for a run, so I'll probably do that much. The training schedule I'm using is really designed more for marathon novices, and this will be my fourth marathon, so I think it's fine to exceed the requirements of the schedule if I feel comfortable about doing it.

A study headed by  Dr. Angela D. Liese of the University of South Carolina in Columbia found that "people who eat lots of red meat, low-fiber grains, cheese and certain other foods may have an increased risk of developing type 2 diabetes". The results of the study, reported in the journal Diabetes Care, "also suggest that these foods promote diabetes, in part, by increasing inflammation in the body."

Type 2 diabetes is often, but not invariably, associated with obesity. However, there are indications that people with high levels of certain inflammation-related proteins in their blood (plasminogen activator inhibitor-1 and fibrinogen) have an elevated diabetes risk -- independent of their body weight. The researchers found that, among 880 middle-aged adults, those who ate large amounts of certain foods -- red meat, cheese, refined grains, tomato products, eggs and fried potatoes -- tended to have higher levels of these proteins. What's more, they faced a higher risk of developing type 2 diabetes over five years. Compared with adults who ate the implicated foods least often, those with the highest intake were four times more likely to develop diabetes.

The findings suggest that increased inflammation is one reason this particular dietary pattern raises a person's diabetes risk. The "flip side," according to Dr. Liese, is that a well-balanced diet -- including fruits and vegetables, high-fiber grains, low-fat dairy and healthy sources of fat like olive oil and nuts -- is probably preferable and may lower diabetes risk.

Well, I've been trying to follow a diet of that sort lately, and it's certainly been helping me with weight control. In the past I've always gained weight during marathon training, but this time I've been losing weight instead, apparently because I've been centering a lot of my meals around vegetables. It's the simplest diet trick in the book; I'm surprised more people don't take advantage of it.

Tuesday, February 17, 2009  

I spent the holiday weekend in the country, at Bishop's Ranch near Healdsburg, a facility which is normally used for church retreats. I was there for the annual Winter Weekend of the San Francisco Scottish Fiddlers. Although we have a planning meeting there on the Sunday afternoon, the event is otherwise agenda-free. We're just there to make music together and relax. Although the surrounding territory is lovely, people weren't much tempted to spend a lot of time outdoors this year, because it was either raining or threatening rain the whole weekend. Of course, for those few of us who went outdoors anyway, the weather simply gave the landscape another way of being beautiful.

I probably spent more time outdoors than anyone else, because I did a 12-mile marathon training run on Saturday. It was raining when I left, so the people who saw me go were almost unduly impressed by my dedication. Actually, it only rained on me for the first two miles or so. After that it was mostly dry. And the world was very green.

The hot shower after the run restored me wonderfully, and I had no difficulty throwing myself back into the music-making. The place we were staying had various buildings with spaces suitable for musicians to gather and play together. People collected in various small groups, depending on what sort of music they were interested in. It wasn't all Scottish. I arranged some Irish sessions; there were also sessions for American traditional tunes, folk songs, and even a Broadway session after dinner on Sunday (it startles me to realize how many of our fiddlers know all the words to "Get Me To The Church On Time".)

The best acoustic was in the chapel, of course. Tremendous resonance in there. That was the space I commandeered for the Irish sessions. One fiddle sounded like five in there -- five fiddles from an earlier century, with a ghostly air about them.

Bishop's ranch is on a hill overlooking the Russian River Valley, where all those nice Zinfandels and Pinot Noirs come from. The landscape is a lovely mixture of hills, woods, and vineyards.

I had to come back to reality today. It was raining so heavily (with hail predicted) that I couldn't face doing today's run outdoors, especially as my running buddies at work weren't ready to face it either. I ended up doing the run on a treadmill at the gym. I dislike treadmill running, I guess because I miss the fresh air (not to mention actually going somewhere instead of running in place), but I managed to get the job done on the treadmill today.

Tomorrow's six miles, but the weather is expected to be dry tomorrow, so I can do that one outdoors.

After I got back from the run, our CEO's announcement of our quarterly results was broadcast to us. The results were grim, of course. He announced a round of layoffs -- 600 people affected. So far as I can determine, I'm not one of them. However, there will very likely be more layoffs to follow these, so nobody's relaxing at this point.

I'm surprised that, under these scary circumstances, my blood pressure is so low. Maybe the long weekend in the country did me some good!

Thursday, February 12, 2009  

Once again the weather was episodic, but our lunchtime run happend to fall into the middle of a clear, sunny period. The temperature was about 40 degrees, which is pretty chilly for running in shorts (I hadn't brought long pants; the sunshine early this morning had fooled me). However, it ended up being okay. After the first half-mile or so I started warming up enough to feel comfortable. Also, the cool air was invigorating -- I suspect that cool air, being denser, provides a little more oxygen per lungful.

Our route happened to take us by that open field which I described on Tuedsday's blog (see February 10 below), the field where we thought we saw a mountain lion in repose, but also thought that we might just be squinting at a log. Well, guess what: the "log" wasn't there today. Hmmmmmmm.

From the start, the problem with the "log" theory was that the elongated object we were squinting at was not lying near any trees or tree stumps. Nothing was around it but grass and rocks. Logs, in my experience, don't arise spontaneously from the ground; it takes a tree to raise a log, as the saying goes. Another thing that logs don't do, in my experience, is to wander from the spot where you saw them on Tuesday.

So, whatever we were looking at the other day was apparently a large animal. And it sure didn't look like a deer. In terms of the local fauna, that really, really narrows it down. Apparently it was a mountain lion, lying still as it waited for a deer to wander by. And it probably wouldn't have had to wait long. We saw a deer there today, emerging from the very same line of trees which the mountain lion had seemed to be watching on Tuesday. Whether the deer would have stepped into the field if there had been a lion stretched out there, trying to look like a log, I don't know.

The thing is, this fiield I'm describing was right off the road, in a suburban neighborhood, a stone's throw from many homes. We weren't in the middle of the wilderness, we were in the middle of town. A mile or so from where I work, and two miles or so from where I live.

This isn't going to make me stop running (the risk/benefit analysis is not that hard to do: the number of sedentary people who get heart attacks exceeds, by a factor of millions, the number of active people who get eaten). It's going to make me worry about mountain lions, though. Not as much as I'm worrying about layoffs, but some. I've had a couple of vivid nightmares on the subject of unemployment lately, and none so far on the subject of feline predation. Unlike a lot of people, I am unable to distract myself from probable threats by brooding about improbable ones.

I don't think I'll be blogging again until Tuesday -- I've got some activities planned for the long weekend which will keep me pretty busy. If I don't post anything new for a while, it won't be because a mountain lion ate me.

Wednesday, February 11, 2009  

The weather was oddly rhythmic today: waves of rainclouds, interspersed with waves of clear air, kept sweeping in from the Pacific. Brief intervals of sunshine, followed switfly by longer intervals of rain, kept raising false hopes that the storm was over and running in the rain wouldn't be necessary.

The marathon training schedule called for an 8-miler today. My two training buddies at work were both unwilling to run it in the rain -- they said they'd do it on a treadmill in the gym this evening. I couldn't face that. 4 miles is about my limit on a treadmill, before the boredom, and the feeling of being trapped, becomes more than I can take. I would be afraid of turning permanently into a hamster if I attempted to do all 8 miles that way. Also, although treadmill-running bothers me more than it bothers most runners, rain-running bothers me less than it bothers most runners. So, I hit the road.

Fortunately, I had the kind of clothes I needed -- long running pants, a thick long-sleeved top, and a running rain-jacket with a hood. For the first part of the run I regretted not having gloves, but after the first mile my core temperature went up enough to warm my hands, so that was okay. It rained on me pretty hard for most of the first four miles, but then the skies cleared. Mother nature was taunting me: "Look how dry you could have been if you'd started your run later!", she was saying. Well, I had a meeting scheduled in the afternoon, so I really couldn't have run later -- and even if I had started later, I would have finished later, and by then it would have been raining again anyway. I didn't hold mother nature's teasing against her; she's been letting me have it pretty easy so far as running weather goes over the past three months. (The 12-miler on Saturday might be rainy as well, but I'm okay with that.)

I couldn't help noticing that nobody else was out there running today (a highly unusual circumstance in this neighborhood), and when I got back to work I had the locker room pretty much to myself. Are people so afraid of getting wet? You bet they are. And, to be honest, if I hadn't been training for a marathon I would have skipped running in the rain, too.

I'm trying hard to be better prepared for this marathon than I was for last year's -- because I want to enjoy the experience more than I did last year. During the last few miles of last year's marathon, I was swearing to myself that I'd never, ever do this again. Later I came to feel that I could have handled the situation better, and made it a more comfortable and enjoyable event for myself. I had made a couple of costly mistakes (gaining weight during the marathon training, and underestimating the amount of water I needed to drink during the race). My theory is that, if I avoid making any such mistakes this time, I won't be suffering and cursing my fate during the concluding miles of the race. Like any theory, it needs to be tested!

So far I've lost weight instead of gaining it during the training period, and I'm feeling stronger and more comfortable on the long runs. I'm optimistic that this marathon will go better for me than any of my three previous ones did. There's always the possibility of an unpleasant surprise on race day -- that's what builds a lot of suspense and tension into the marathon experience -- but I feel better going into this than I have before. I hope my optimisim is justified. We'll soon see! 

Tuesday, February 10, 2009  

Okay, that's more like it -- fasting glucose under 95, which is where I try to keep it. (And after a rest day, no less.) My blood pressure wasn't quite so stellar, but it wasn't terrible either. Well, I'll be doing a long training-run tomorrow; maybe that will bring it down.

Today I went running with my too fastest running buddies, and although I couldn't totally keep up with them on the climbs, I didn't fall too far behind, and I caught up with them on the descents. I was feeling pretty good.

Then we ran past a big empty field, with a line of trees on the far side, and one of my running buddies stopped to squint at something which was lying in the field, far enough from us that it was very hard to say what it was. He said it looked like a mountain lion -- but one that was lying down, stretched out, and maybe dead. Mountiain lions are the same kind of background concern for California runners that great white sharks are for California divers -- they don't eat very many of us, but they do eat some of us, and we worry about it.

So we stopped and tried to figure out what we were seeing in that field. I wanted to just keep running and get away from the thing, whatever it was -- but if it was a predator, and I ran away and they didn't, maybe I would only be making myself a more appealing target. So I stayed, and took part in our little three-person debating party about what that thing in the field was. Maybe it's not a mountain lion, but something that was killed by a mountain lion. A deer, perhaps. Okay, but isn't it the wrong color for that? Doesn't it look more like a mountain lion? And if it's a dead deer, shouldn't there be a few vultures on the scene? But if it's a mountain lion, why would it be stretched out that way? Do they nap in the open, at noon, like that?
So I'm squinting at it, trying to see some definitely recognizable feature on it, and starting to convince myself that it's moving. I want to run like hell, but maybe that's exactly the wrong thing to do at this moment. And then, just as I'm starting to imagine the headlines describing my imminent mauling, one of my two running buddies suddenly calls out in a loud voice, "Here, kitty kitty kitty!". I could have killed him. I thought hard about it, in fact. But the thing didn't move.
Eventually we continued the run, with me thinking every few seconds that I heard a predator's claws clicking on the pavement behind us. We all agreed that it was probably a log, and that we had just imagined that it looked like an animal stretched out in the field. But I want to go by there tomorrow morning (in my car, not on foot) to see if I can still see it and figure out what it is. Maybe I should take my camera. I'll take a closeup of it, and probably it will be a log, and look so much like a log that we'll wonder how we could have let him convince us it was an animal. But if it's gone, I think I'm going to have some bad dreams over this.

Oh well, I guess if I'm going to do distance running, I might as well learn to appreciate the adventures that are occasionally involved. I've encountered rattlesnakes too. It gives you something to talk about at the office.

Monday, February 9, 2009  

I'd had a pretty good winning streak going there for a while on fasting glucose (average result was 88 over the last 2 weeks). Why did it go up to 101 today? Probably several factors contributed. I was very hungry yesterday, after the 20-mile training run the day before, and I ate a lot -- but the light workout I did was not enough to make up for it. I had dinner later than usual. Also, I overslept this morning and woke up in a panic (that usually gets my glucose up a bit). Of course, the increase was within the margin of error of the meter, but I try not to blame the meter for unexpected readings, especially when they're high.

Today was a total rest day (except for yoga, which I never count as a workout), but I was a little more restrained in my eating, so I hope tomorrow's fasting result will be down a bit.

There is a small chance of rain tomorrow (when the marathon training schedule calls for a 5-miler) and a near-certainty of rain on Wednesday (when it calls for an 8-miler), but that's okay. If you put on multiple layers, running in the rain isn't that bad. And so far, in this whole cycle of marathon training, I've only had one long run that took place in heavy rain. Mostly I haven't had to put up with anything worse than sprinkles. (Unfortunately, the reason for this is that California's in the midst of a drought and we haven't had much worse than sprinkles, day or night, for months.) I almost welcome the prospect of running in the rain on Wednesday, if only to see the amazed reaction of my coworkers. Running in the rain is the sort of thing that impresses bystanders out of all proportion to the actual hardship involved. They don't realize that the hard part is the running and not the rain.

My blood pressure's up -- I think partly because I didn't exercise today, and partly because I'm allowing myself to worry about some things that I can't control. So now I'm worrying about my inability to control my worrying...

Sunday, February 8, 2009  

The 20-mile marathon training run is done! I did it yesterday, and I'm feeling fine.

After a rainy Friday, Saturday morning was sunny and beautiful:

When we started the run, at 10 AM, it was still cool enough to qualify as perfect running weather. Strange as it might seem, I actually felt pretty good during the run. During the last 3 miles I was tired, and very ready for the run to be over with, but I wasn't really exhausted, and I wasn't hurting. I could have run farther if I'd needed to.

Of course I was a little stiff and sore. Climbing into the car to go home, I certainly felt it in my hips and abdominal muscles. Later in the day, I also felt some soreness in my quads when walking down stairs. Both of those things are simply inevitable when you do a run that's that long, and anyway they were very minor discomforts. I can remember being considerably more stiff and sore after 8-mile runs, earlier in my exercise career, than I was after yesterday's 20-miler. I guess I've done enough endurance-running by now that my body has become adapted to it.

We weren't running fast, so it took 3 hours and 38 minutes to finish. The Garmin wrist-device that I use to keep track of miles estimated that I burned 2397 calories during that time.

We knew we couldn't carry enough water for a 20-mile run, so we split the run into two 10-mile loops and returned to the car for water refills after the first one. I made an extra effort to drink lots of water during the run, and I think it paid off. If I'd been seriously dehydrated I would have been feeling really awful at the end. Instead I was feeling relaxed and fairly comfortable. After cleaning up, we had a nice picnic at the Paradise Ridge winery, and life was good.

You might think that the picnic would have been just as good without our having run 20 miles beforehand, but actually it wouldn't. The endorphin high you get from that kind of exertion is like nothing else. It heightens every pleasant sensation. The late-afternoon light on the hills was more beautiful because of it; music sounded better. (This effect hasn't quite worn off a day later. I played at a jam session today, and I found that, because I was so relaxed, I could improvise harmonies and counter-melodies without effort.)

I slept well last night; I didn't have any pain or cramping. The only after-effect of the run that bothered me at all this morning was ravenous hunger. It's a good thing I burned so many calories yesterday, because I'm afraid the breakfast I had at the cafe this morning set some kind of caloric record. This afternoon I went to the gym for a light non-running workout, more to loosen up my muscles than anything else.  Certainly it didn't make up for my monster breakfast. I'd better eat lighter tomorrow, because it's going to be a rest day.

Friday, February 6, 2009  

Tomorrow morning is the peak of the marathon training: a 20-mile run. I figured I had better do some carb-loading to get myself ready for that, so I had a rather high-carb dinner. Endurance runners usually have a big plate of spaghetti, or something equivalently starchy, the night before a long run, to make sure that their muscles are fully stocked with glycogen. Obviously I am not in position to be pushing a program like that to the limit, but I carried it as far as I thought was prudent. Anyway, much of the day I felt hungry and weak, and I certainly don't want to go into a 20-mile run tomorrow feeling that way.

It was raining today. I didn't have to deal with it, as I did my workout in the gym rather than outdoors. I usually have lunch after my mid-day workout rather than before, but I made an exception today, because I felt a bit hypoglycemic in the late morning, and because it was a light lunch anyway. So I had my salad and then went to the gym, hoping that I would feel stronger by the time I got there.

As usually happens, the exercise made me feel better. The exercise machine I wanted to use was taken, so I had to settle for one which I liked less, and which was placed directly in front of a TV set with a news channel on. There was no sound. However, the broadcast was close-captioned, so I had a chance to be reminded once again of how unbelievably low the quality of the captioning is. To be fair, it does tend to heighten the interest of the broadcast, because you have to stare at the preposterous words appearing on the screen and try to imagine something which could actually have been said and might have sounded a little like that. What on earth is a "tough cell"? Oh -- I get it, he probably said "a tough sell". And what's all this talk about "barometer", especially since it's in the poltical coverage rather than the weather forecast? (It took me a long time to figure out that this was "Barack Obama".) You have to wonder what kind of impression deaf people are getting from this kind of news coverage. Apparently we have president who is also a weather instrument, and his economic stimulus plan is going to be a tough cell. I suppose that whoever does the captioning uses something like the machine that court reporters use -- a simplified keyboard which captures approximate sounds rather than actual letters ("juj" for "judge" and so on). If so, I hope the nation's court reporters are doing a better job of it than network captioners are doing, because I wouldn't want the appelate court to receive a transcript of my trial that was garbled as much as today's news broadcast was.

Today I completed my first week on the new job. It went fine, and I like the people on the team, but starting a new job is always a bit exhausting for me. Trying to learn a bunch of new stuff in a short period of time is, for me, more wearying than the marathon training that I'm now engaged in. And I'm having to learn complicated new stuff. For example: did you know that the new 3GPP LTE standard for cellular phones uses Orthogonal Frequency-Division Multiplexing for the downlink, but uses a Single-Channel Frequency-Division Multiple Access scheme for the uplink in order to improve the peak-to-average power ratio? Well, you heard it here first. (Your cell phone doesn't work that way, at least not yet, so I can excuse you for not knowing.)

So, all in all, I'm glad that this week is over. And I'll be even more glad when tomorrow's 20-mile run is over. The theory is that, if you can run 20 miles, you can run a marathon, so that's as long as the training runs get. After that, things taper down pretty quickly. 12 miles the following Saturday.  8 miles the Saturday after that. And the next weekend is the race.

Thursday, February 5, 2009  

We finally got a little bit of precipitation. A light rain fell during part of my lunchtime run -- not enough to bother me. What bothered me was the sudden gust of wind that occurred just as I was running beneath some big, wet oak-trees. The trees shed all the cold water that was clinging to them, like dogs shaking themselves dry. I don't know why raindrops get so much colder when they're clinging to leaves than when they're falling from the clouds, but it seems to be that way.

The run was good -- I was running with my fastest running-buddy, and I kept up with him much better than I usually do. Still, the mileage has really piled up at this point in the marathon training schedule (20 miles over the past 3 days), so I'm glad that I won't be running tomorrow. I'll do a light gym workout tomorrow.

This is the fifth time I have gone through the marathon-training process. (One of those times I wasn't actually able to participate in the event, because of an injury just before race day, so I've only run three marathons so far.) Looking back to the first time I went through the training, I remember that, at this stage, I was feeling very much overwhelmed, and even depressed, by the amount of running I was doing. It seemed as if I wasn't doing anything else, and to be honest I felt like a fool, to be punishing myself so cruelly. Why was I doing this? Other people weren't doing this. Other people had lives! What the hell had got into me, and made me sign up for a marathon?

I'm feeling much better about it this time. Because I'm experienced at it now, I'm much more able to relax and accept the experience for what it is: a difficult challenge which seems to go on for a very long time but is actually fairly brief (I train for 3 months) and is certainly doable. I've been less stiff and sore after the long training runs than I was during any of the previous training periods. Even better, this time I have been losing weight rather than gaining it as I train. And the weight loss (small though it is) has made me feel more comfortable and energetic while running.

The longest training run of them all (20 miles) happens on Saturday, so I shouldn't congratulate myself prematurely on having got through the training unscathed. Still, I'm not all that worried about it. And after Saturday the running tapers off considerably.

After the race is over, I'm sure I'll be relieved at being done with the marathon training, but to some degree I'll miss it. To be in training for a marathon gives your life an intense focus -- it makes each day purposeful. The difficulty involved adds a touch of drama to your daily life. It also gives you something to share with others (I'm training with 3 other runners for this race, so we have a lot to talk about). 

Wednesday, February 4, 2009  

It was hazy today, with a light overcast, but the sun got stronger as the run went on, and the temperture was comfortable (in the low 60s). The marathon training schedule called for 10 miles today, and I had thought I would probably need to split that into two separate runs. I figured there wouldn't be time at midday to do all of it, so I'd have to run 6 or 7 miles at lunchtime and make up the rest at the gym after work. But it turned out that there wasn't a schedule problem today, so I just did the whole 10 miles in one go, to get the whole assignment over with.

It was a tough run (with two hill-climbs that were difficult and one that was inhuman), but I felt pretty strong today, and I enjoyed the run. My pace is improving since I lost a few pounds; I'm surprised how much difference that makes. I hope I can lose a few more before race day.

My blood pressure was remarkably low today, mainly because I did a dificult run, but also perhaps because I'm settling in a little more comfortably in the new job.

Of all the controversies about diabetes, the most heated seems to be the one about how the word should be pronounced. Does it rhyme with "Wheaties", or does it rhyme with "meet us"?

Most dictionaries accept either pronunciation, but a lot of people feel passionately that the "Wheaties" pronunciation is the only acceptable one. Needless to say, these people tend to be driven up the wall by Wilford Brimley using the "meet us" pronunciation in television commercials.

My feelings about the matter are largely unrelated to the issue of what is "correct". After all, it's a made-up word, and we don't know for sure how the ancient Greek doctor who made it up (Aretaeus of Cappadocia) pronounced it himself, so "correctness" hardly enters into it. What does enter into it is the emotional coloration of the two pronunciations.

To me, the "Wheaties" pronunciation, which sounds so silly, also sounds correct for that reason -- you sort of expect the correct pronunciation of a medical term to sound silly. But the "Wheaties" pronunciation takes silliness to a whole new level. It sounds like baby talk. It sounds as if we're talking about a cute disease, a teentsy-weentsy, itsy-bitsy widdle diseasie what mommy calls the die-a-beeties! I mean, let's be honest: even "cooties" sounds dignified compared to that.

And so, even though I have been trying to train myself to use the "Wheaties" pronunciation lately, I wince inwardly at the sheer, unspeakable awfulness of the sound that's coming out of my mouth. And most of the time I still blurt out the "meet us" pronunciation anyway, which sounds incorrect and uncultured precisely because the sound of it comes more naturally to anyone who grew up speaking English and doesn't go in for baby talk.

I guess the problem is unsolveable. Maybe it's only fair: people certainly don't agree on what the word means, so why should they agree on how to say it?

Tuesday, February 3, 2009  

The weather continues to be ridiculously un-wintry... 

Even in Califrornia, it isn't supposed to be 70 degrees in early February. I brought a long-sleeved top to wear for my lunchtime run, and I ended up feeling overdressed for the conditions, and even a bit overheated and thirsty.

It was a good run, though: I was running faster than usual, and doing a better-than-usual job of keeping up with my running buddies, even on the hills. I've only lost a few pounds, but apparently that's enough to make a difference.

Two stories in the news about diabetes-related decisions (or nondecisions) both illustrate the remarkable willingness of established bureaucracies and organizations to put their own interests ahead of common sense and human life.

First, a state judge in California ruled that schoolchildren with Type 1 diabetes cannot be given insulin shots while at school by anyone except a school nurse. Why not? Because the state's Nurse Practice Act says that those are the rules. There's a tiny hitch, though: there are very few school nurses in California. Those that exist usually divide their time among multiple schools; they will certainly not be reliably on hand to give insulin shots to children who need them. The state (which has a $42 billion dollar budget deficit) is not likely to hire large numbers of school nurses to solve the problem. The decision effectively makes it impossible for most insulin-dependent children to attend school at all, unless the parents themselves are available to go to school with them. How this makes the world a better place for anyone (even for nurses, who are presumably the intended beneficiaries of this policy) is hard to say.

Second, it seems that the Hemoglobin A1c test (the only test which can reliably detect diabetes) has never been approved for use as a diagnostic test for the disease, because the various diabetes organizations have never agreed on how it is to be used (that is, what range of test results is defined as diabetic or non-diabetic). But never fear! These organizations are now thinking, after years of inaction, of getting off their asses and coming to an agreement on the subject (with 6 months, according to Matt Petersen of the American Diabetes Association). Well, better late than never. But for years now, doctors have been told to rely on the notoriously volatile glucose test to screen for diabetes -- a test which often misses diabetes because patients are often tested between highs. And the result has been that vast numbers of people with diabetes have gone undiagnosed for long periods, and have severely undermined their health while waiting for the truth to be discovered. With the Hemoglobin A1c test, you don't have to hit it lucky -- the test reflects average glucose over long periods, so it doesn't matter what day you take it on. Last year, as an experiment, Massachusetts General Hospital in Boston gave the A1c test to all adult patients who checked into the hospital for any reason, and they found that nearly one in five had undiagnosed diabetes. Following up a year later, the hospital found that 85% of these known diabetes patients had not yet been diagnosed as diabetic by their physicians, simply because they hadn't yet failed a glucose test. Using the unreliable glucose test as a screening tool, when the reliable A1c test was already available, was obviously the wrong thing to do, but that is what was done. (And is still being done.)

You have to wonder what would create a sense of urgency (and practicality) within bureaucracies and professional organizations, if matters of life and death are insufficient to do so.

Monday, February 2, 2009  

Why did I have a cookie bar, you ask? Especially on a day when I wasn't exercising? Because it was my first day on the new job, and one of my running buddies who works in that division already (and is a highly talented maker of desserts), brought in a batch of cookie bars to welcome me aboard. Only the most heartless cad would refuse to try one under the circumstances, as I'm sure you will agree.

I think my diet for the whole day was probably too high in carbs, considering that I didn't work out (yoga doesn't count -- I classify that as maintenance, not exercise). My fasting test tomorrow might be up a bit tomorrow, but I'm hoping it won't be. If it isn't, no problem -- I'll be doing a 5-mile run tomorrow, and I'll cut down on the carbs, so that ought to take care of it.

I was disappointed that my fasting test wasn't any lower than 93 this morning, as I thought I had controlled the carbs pretty well yesterday (and I did a pretty solid workout). But I didn't get enough sleep over the weekend, and that probably had an impact. Well, if I'm going to get enough sleep tonight, I'd better sign off at this point. Probably I'll have more to say tomorrow, or at least more time to say it.

Sunday, February 1, 2009  

We're still enduring the hardship of a California winter -- sunny and 68 degrees:

That was later, though; when I went running in the morning it was still cool, and there was even some frost on the ground.

This was not supposed to be a running day, according to the marathon training schedule; after yesterday's 14-mile training run, I was supposed to do a little cross-training (that is, some kind of exercise other than running, to give my running-muscles a break). However, I had been trying to make a running appointment with a friend who used to work with me, and today was when we were both free, so I figured I'd make the appointment, and take a chance on whether or not I'd be in shape to run when it came time to do so.

I had great doubts about being in shape to run when I got up this morning. The miles are really piling up at this stage of the marathon training. Since last Monday I had run almost 34 miles total, and 14 of those miles happened just yesterday. I was feeling tired and my quadriceps muscles were feeling a bit stiff and sore. Also, I had been traveling on Friday and Saturday, and was short of sleep. I really didn't feel like I was the picture of fitness and energy when I met my friend at the trailhead, but I decided that if I just pretended to be ready for a run, and charged into it without complaint, I would soon start to feel better. It worked. I actually felt pretty good once we got going. I was glad that the run wasn't any longer than it was, but I was glad I hadn't backed out of doing it, and I felt better after the run than I had before it.

However, I went home after the run and fell asleep almost as soon as I could arrange to do so without falling. I desperately needed a nap. Then I really felt better, and went for a walk. Strangely enough, the world outside was anything but deserted, even though this was that religious holiday, supposedly observed by every American household, known as Superbowl Sunday.

Actually, it turned out that not everyone was home in front of a TV eating nachos. Lots of people -- even whole families -- were out there enjoying the sunshine instead.

Can it be that large numbers of people are more interested in doing things themselves than they are in watching strangers do things on a TV screen? If so, I think it's a hopeful sign.

Tomorrow I start a new job -- not with a new company, but with a new divisision of the company, and a new boss, and new co-workers, and working on a different kind of project. Ordinarily, I would be worried about whether or not I'll be able to fit mid-day exercise into my work schedule as easily as I've done it in the past. I'm actually not worried about it, though, because two of my running buddies work in that division already, and one of them reports to the same boss, so I know enough to feel confident that I'll be able to arrange things.

I keep recommending daily exercise to other people with Type 2, but I try not to forget that I have it a lot easier than they probably do. For a lot of other people -- who have long commutes, inflexible work schedules, unsupportive family members, and other obstacles to cope with -- the hardest part of working out is finding enough time in the day for it. The exercise itself is the easy part. I'm glad my circumstances are better in that regard, and I hope I can keep it that way.

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