(I've written an explanation elsewhere of why disclaimers of this sort may be necessary.) 

Sunday, May 31, 2009  

Well, that's good: after a sick day with no exercise apart from a low-speed walk, my fasting test was only 81. I hope my glucose meter hasn't just programmed itself to tell me what I want to hear. (If it has, my blood-pressure meter is in on it.)

I woke up this morning thinking "Oh, no". The cough was a little worse -- and it included a little of that burning sensation that I associate with bronchitis. But it's still not a very bad (or frequent) cough, and I felt much better than I did yesterday. Certainly I felt more energetic. I was sure I could handle a serious workout today. I went down to the state park and started a trail run, thinking that it might be a short one if it didn't feel right. But it did feel right, so I ended up doing an 8-mile run that included a big steep climb. Even during the hardest part of the climb, I felt better today than I did yesterday just trying to climb a flight of stairs.

The beautiful weather helped. It was a nice afternoon here in the wine country.

The vines are already hard at work making next fall's grape harvest.

For years I've been reading about conflicts of interest in the world of medical research. Most such research is so heavily financed by the pharmaceutical industry that it's nearly impossible for scientists to operate as anything other than mouthpieces for that industry. Often scientists have a direct financial interest in the drugs they evaluate, and they may even be contractually bound to report only positive results (if one study says a drug works and six say it doesn't, the one positive report is published, the six negative ones are buried, and the scientistis involved are legally restrained from blowing the whistle on the operation).

But today I learned about a new scam that tops anything I'd heard before. The Australasian Journal of Bone and Joint Medicine, a publication which appeared to be an independent, peer-reviewed medical journal, turned out to be owned and operated by the pharmaceutical company Merck, and all of the papers that this journal published were positive reports on Merck's products.

Now it turns out that at least six other medical journals are of the same kind: phony journals set up by pharmaceutical companies for the sole purpose of publishing enthusiastic reports on the effectiveness of the drugs those companies make.

To make matters more depressing, some legitimate doctors and scientists accepted money for being listed as members of the advisory boards of these fake journals, even though they had no actual involvement.

The rampant corruption which seems to permeate the world of medical research may go a long way toward explaining how we came to be where we are in terms of diabetes therapy. Most diabetes patients are being sold expensive drugs of doubtful safety and effectiveness, while cheaper alternatives that are known to work better receive little attention. I would be tempted to say that the problem needs to be solved by having government pay for the research -- except that we've seen, time and time again, that government agencies tend to become the playthings of the industries over which they have theoretical authority. If the government were financing the research, Merck would have to find someone new to pay off, but the game would probably continue very much as it's played today.

Saturday, May 30, 2009  

Well, there's no doubt that I have some kind of respiratory bug, but it's pretty mild. I'm not coughing very frequently, there's only a little congestion, and the cough isn't painful. I wasn't feeling very well, but I could function. I even went to work today for a while, because I had some unfinished business on a project which I needed to hand off to someone in Israel, who will be working tomorrow (Sunday's an ordinary workday there.) When I went into the office, I had to climb a long flight of stairs, and that seemed so difficult today that I knew I wasn't going to be up for a run later.

I usually don't skip a workout, even when I'm feeling ill, if I think I can do it. Today, I didn't feel confident that I could do it. I couldn't just do nothing, however, so I went for a walk in the evening (about 2 miles). That made me feel better rather than worse. My guess is that, if I don't feel any worse than this on the second day with a virus, I'm probably not going to feel any worse than this. So, I'm pretty sure I'll do a workout tomorrow -- how hard a workout remains to be seen. I'd like to do a serious run if I feel better tomorrow.

The virus didn't elevate my fasting glucose, but going without a workout will probably make raise it a bit tomorrow.

It's too bad I couldn't run today: it was a nice day for it. The fog lingered until the early afternoon, and then it was sunny but very mild (in the low 60s).

I got some vegetables at the farmer's market today, and to loosen up my lungs I made a very spicy stew of them for dinner (with a Serrano chile, cayenne pepper, and a Vietnamese hot-and-sour soup-base). Spicy food is my favorite cold medicine. I'm sure I've read some theoretical explanation of why it's helpful, but I can't remember the details. All I know is that it's helpful.

What definitely isn't helpful to me, when I have a virus, is to crawl into bed under multiple blankets and lie there feeling sorry for myself. Surrendering to a virus makes things much worse, at least for me. I need to be doing something, even if it isn't very physical. Today I was mostly concentrating on things I can do indoors.

Friday, May 29, 2009  

Oh no! One of my running buddies told me today that she had seen her sister and her brother-in-law 2 days ago, and they both have bad cases of contagious bronchitis. Now she thinks she's coming down with it, too. And I'm afraid I am as well! So far it's a mild cough and a milder malaise. Maybe I can fight it off. I hope so; I haven't had bronchitis in years, but I well remember what it felt like -- a powerful burning pain in the upper chest every time I coughed, which lingered for many days. I do not want to go there.

I haven't had too much trouble with respiratory infections since I took up my exercise program; often I get through the winter without ever becoming ill enough to have to take time off work. My immune system seems to be strong enough to fight off most cold and flu bugs. I'll feel mildly ill for a day or two, and then get over it. I hope that's what happens in this case!

I don't know why my fasting test was so low this morning, but if I'm coming down with a bug I bet it will be higher tomorrow.

A tiny new piece of the Type 2 diabetes puzzle has been identified at the University of California at San Francisco. The UCSF researchers were studying the GLUT4 transporter, a tiny structure within muscle cells which serves the function of dragging glucose molecules from the bloodstream into the muscle cell when stimulated by insulin.

In patients with Type 2 diabetes, many of the GLUT4 transporters are abnormal and do not respond to insulin. The UCSF researchers identified a protein called CHC22 which regulates the formation of the GLUT4 transporters, and is apparently responsible (in some way) for the flawed formation of transporters which occurs in Type 2.

What makes this newsworthy is that the CHC22 protein is found only in humans, not in mice. Most studies of diabetes at the cellular level rely heavily on observations of what goes on in mice. If mice don't produce CHC22, then scientists are going to have to find another way to study the problem. Weirdly enough, a team at Harvard is producing genetically engineered mice which do have CHC22, so that mice studies can continue as before. I'm not sure how valid it is to draw conclusions from what goes on in a Frankenmouse containing some human protein, but maybe they know what they're doing. 

Thursday, May 28, 2009  

Wow -- blood pressure is down from 132/79 last night to 116/65 tonight. Why the big improvement? I think mostly it's because I don't have the same thing hanging over me tonight that I did last night: my phone conference with India this morning. I'm very relieved to be done with that. It wasn't a terrible experience, but I didn't enjoy it and I hope I won't have to repeat it. There is only so much time anyone should have to spend helping his foreign replacement get the hang of his job. (Especially when his job was outsourced 5 months ago!) Normally this kind of prolonged handoff couldn't occur, but I am still working for the same company, just in a different job, so the people in India know where to find me when they want me. I've asked my new boss to issue some kind of ruling about how much more time I have to spend helping them. I'm hoping his answer will be "none", but we'll see.

Anyway, tomorrow I don't have to have meetings with anybody anywhere, so maybe I can relax and do my job.

I went for a fairly difficult run today. It wasn't as warm as yesterday, so it wasn't too hard on me. As usual, I didn't feel like doing the run. As usual, it didn't matter whether I felt like doing the run or not. As usual, I went ahead and did the run, and I felt better during and after the run than I had before.

That is pretty much the story of my life, these days: (1) don't feel like it (2) do it anyway (3) feel better. Diabetes management is about doing what you'd rather not, and then being glad you did.

So far, I haven't allowed myself to fall into the dangerous habit of assuming that what I feel like doing is important. Maybe, after doing this for 8 years, I'm not in too much danger of drifting in that direction, but it may be that that danger is simply built into human nature and I'll have to fight it forever. Well, not quite forever: there's always death! I don't mean to be macabre, but the time you're going to be spend being alive is pretty brief compared to the time you're going to spend being dead, so even if you have to exercise and eat your vegetables for the rest of your life, it's still not a very long assignment. I guess we might as well get on with it and stop whining.

The Buddhists believe that human unhappiness results from daydreaming about the way you wish things were, instead of accepting the way things are. (A variation of this is the view that what upsets people is not what happens, but what they think it means). I'm not sure I can get entirely behind the Buddhists in thinking that people should accept whatever conditions they find themselves in. After all, it's the people who didn't accept things as they were who outlawed slavery and witch-hunts, and introduced sewers and vaccination and the Bill of Rights. Still, I think the Buddhists are on to something: we suffer a lot from our unwillingness to accept the inevitable, and diabetes patients are particularly prone to living in a fantasy world in which they can still get away with living a "normal" (that is, "gruesomely unhealthy") life. This fantasy tends to get in the way of the reality -- by which I mean the requirement to do what you don't feel like doing, because you know damned well that you have to. I'm going to be trying very hard not to fall prey to that particular fantasy.

Wednesday, May 27, 2009  

I think I know why my blood pressure is up: tomorrow morning I have to do something at work that I don't want to do. I'm having a phone conference with the new employees in India who replaced all the American employees in the department I was working in 5 months ago. Apparently the new people in India are having difficulty with the assignments they took over from us, and they want me to give them a little more coaching. I really don't know how much help I can give them with the tasks they are trying to accomplish. These are complex tasks which I haven't done (or thought about) in 5 months, so I'm feeling rusty and unprepared (and I'm in the dark about any technical or organizational changes that happened since I changed jobs).

Anyway, I think we already did our best to help them take over these tasks; if our methods aren't working for them, they really need to find their own way to get the job done. When American jobs are outsourced to India, why is it up to the replaced American workers to make the outsourcing decision look like a great idea? If am at all successful in helping them tomorrow, I will only have reinforced the impression that I can easily be replaced by anyone, anywhere, and nothing will go wrong. It's not a very inspiring goal.

But I have to get up early for the meeting, so I'd better get to bed.

Tuesday, May 26, 2009  

Well, not my best test results ever, but not bad after a holiday weekend in which I was taking it easy and not worrying too much about diabetes management. I figured that, after my impressive results on the OGTT test I gave myself on Sunday morning, I was entitled to relax and enjoy the holiday.

At a party in Berkeley, I had a meeting of the minds with a our host, and found that there are some things on which a fiddler and a mandolinist can agree. The very nice Sauvignon Blanc from the Everett Ridge winery was one of them.

Our host had lived lived for a spell in Barcelona, and he made for us a Spanish (or rather Catalan) specialty: paella, prepared in a grill pan on the barbecue, with mussels, shrimp, calamari, peas, and rice. A very fine dinner. Not low-carb, obviously, but this wasn't my weekend for worrying about that.

It was surprisingly chilly in Berkeley, so after dinner was ready we ate it indoors, and then had a nice cosy music session around the fireplace. Later we moved the party to San Francisco, and went to join in the Irish session at the Plough & Stars. There were some amazing players there, and one of them showed off an impressive and very difficult musical skill: continuing to play well when it's 1:30 AM and you're drunk off your ass.

The weather was warm today (almost 80), so my lunchtime run left me pretty sweaty even after I showered and returned to my desk. This gets more embarassingly conspicuous when we have a real summer heat-wave; for right now it's sort of under control.

I got to play music tonight too, with friends in Sebastopol (a town halfway between here and Bodega Bay), and we're playing again tomorrow night. I take my music-making opportunites where I can find them, and sometimes they bunch up a lot on my schedule. All the musical activity right now doesn't leave me a lot of time for blogging, but I'll try to make more detailed posts when I've got a little more time freed up.

Update: Sunday morning, May 24, 2009  

I did an OGTT (oral glucose tolerance test) this morning, following the standard protocol. I got up early, did a fasting test, and then dissolved 3 glucose gel packets (for a total glucose dosage of 75 grams) into a glass of water and drank it down. I then measured my blood glucose at intervals of 30 minutes, 60 minutes, and 120 minutes after drinking the stuff. (The result that counts is the one at 120 minutes, but I was curious to see what went on before that point.)

The test result (120 minutes after oral glucose) is interpreted as follows: <140 mg/dL is normal glucose tolerance; >140 mg/dL indicates impaired glucose tolerance; >200 mg/dL indicates diabetes.

My fasting test this morning, immediately before I drank the glucose, was 76. I'd done a very long trail-run on Saturday evening, so this low number wasn't surprising.

After 30 minutes (which I figured would probably be the peak, because oral glucose is absorbed into the system so rapidly), my test result had gone up to 117. A 41-point increase.

After 60 minutes, my test result was 113. Still elevated, but not nearly elevated enough to be considered abnormal.

While I was waiting to take the final test, I suddenly became very hungry. I guessed that my blood sugar was dropping rapidly. I expected that the final test result (at 120 minutes) would be almost down to my fasting level of 76. The actual result startled me: it was 60. Because that seemed improbably low, I repeated the measurement to confim it (and got 61; obviously it was a legitimate reading).

Wow. Not only was I well below the diabetic range, I was low even for a non-diabetic person. My system had gone to work so hard on processing the oral glucose that it had got carried away, and pushed me into mild hypoglycemia.

If that's a problem, it's the sort of problem you want to have (at least if you're Type 2 and aren't taking any meds). That I'm capable of going that low after a big dose of oral glcuose suggests that my pancreas is actually in pretty robust shape at this point, even though I'm 8 years past diagnosis and, according to the experts, my poor pancreas ought to be fading fast by now.

I imagine the test results wouldn't have been quite so low if I hadn't done such a long run yesterday, but surely there's a limit to how much the results could have been skewed by that. What I conclude from this test is that I'm essentially non-diabetic at this point, and becoming less diabetic over time, thanks to my exercise program. Maybe I can't get away with this forever, but I'm going to keep at it as long as I can.

So now I'm going to enjoy the rest of my holiday weekend and not worry about diabetes. 

Saturday, May 23, 2009  

Good blood pressure tonight -- no doubt that's because I did such a long run earlier in the evening. Fasting glucose is back to 80, which seems to be my home base now (it's been my fasting average over the last two weeks). If I have time tomorrow morning I'm going to do a do-it-yourself Oral Glucose Tolerance Test, and see what I can see.

I'm not very good at doing nothing. Supposedly it speaks well for you if you can feel relaxed and happy about spending all day not doing anything in particular, instead of fretting about the wasted time. Well, I can spend all day doing nothing, all right, but I can't help feeling bad about wasting a nice sunny day. (Rainy weather would have made it easier.)

I do have activities planned for this holiday weekend (for one thing, I'm going down to Berkeley and San Francisco for some music-making tomorrow), but none of these activities were happening today. Having nothing scheduled, I slept late, and then I got up and did almost nothing that I can remember. I did go down to Heart & Sole to buy a new pair of running shoes -- I guess that counts as an activity (almost an adventure, in the circumstances). I also changed the strings on my fiddle after I got back from the shoe store. I was a regular Tasmanian Devil of activity today, all right.

So, by the time I went to the state park (around 5:30 PM) to do a run, I was starting to think that the only way I could shake off the awful feeling of being lazy and useless was to do an extra- long run. I had done a pretty hard run yesterday, so I was planning to make today's run a little shorter, but when I got to the park I decided that I was in the mood to do more instead of less, and physically I felt capable of it. So, I ran a 9+ mile route with loads of steep hills to climb. I felt better and better as I went along, and I swear I wasn't tired at the end. Some days you have it, that's all I can say. This run was easier on me than the 4-miler I did on Thurdsday.

(Let me note in passing that I'm pleased to see all these little groups of seniors hiking those trails. Over the past year or so it's become such a fad among older people that the 70-something hikers are starting to outnumber the 20-something mountain bikers. I say more power to them!)

Anyway, today's run felt great. I admit I had a moment of doubt, though, when I came over the ridge on the Canyon Trail and faced west into what should have been a dazzling panorama of the valley lit up by the evening sun. A startlingly cold breeze spilling over the ridge told em that the conditions were changing even before I got to the top. And then I got there: the valley was being filled by a gray wave of fog rushing in from the ocean. If it reached me before I finished the run, I was going to freeze my butt off.

As it happened, the air warmed up as soon as I got down off of that ridge, and I got to my car before the fog did, so I was pretty comfortable all the way to the end. And then I drove home and had a wonderful hot shower. People who don't do endurance sports have no idea what a luxurious experience a hot shower can be. (I'm not sure they fully appreciate the bathrobe and slippers, either.)

Anyway, doing that challenging run allowed me to shake off the melancholy feeling I'd had all day, that I was doing nothing and was therefore a useless lump. I'm doing nothing now, other than writing this blog post, but that's okay because I ran 9 miles through the woods a little while ago. Doing hard exercise at some point during the day makes it feel okay to take it easy afterwards -- you've done your part, so now you can relax. That's why my afternoons at work are invariably better than my mornings -- my lunchtime runs make it feel okay to be sitting in front of a computer for hours. I think that's why a lot of people like to get up very early and exercise before they go to work. They say that they just like to "get it out of the way", but what I think that really means is that, if they work out first thing in the morning, they don't have to spend any portion of their workday feeling like Jabba the Hutt.

Friday, May 22, 2009  

As soon as I did my fasting test this morning and saw that the result was 73, I had a delayed superstitious reaction to my boasting yesterday about how low my results had been lately. What if it was all a mistake? What if I was bragging about results that were phony? 73 seemed almost implausibly low, and it dawned on me that I hadn't seen a result above 90 in more than 2 weeks. What if there was something wrong with my meter, and it was giving results in the vicinity of 80 no matter what was actually going on with my blood sugar?   

I thought I needed a reality check of some kind -- an indication, however tentative, that my meter actually does read higher when there is reason to think my blood sugar is higher. So, I had a rather high-carb dinner (a sizeable vegetarian burrito), and I did another post-prandial test. This time it was 110 rather than 80. So, at least my meter is capable of showing me a result in the triple digits. It's still a good result, but it's not a too-good-to-be-true result. 

That's enough to reassure me, for now. Maybe my meter reads on the low side, but I don't think it's broken and is simply giving me results around 80 no matter what. I'll find out the next time my doctor does lab work on me. I always do a test with my glucose meter at the same time, to check it against the lab. I'm resisting the temptation to compare my meter against someone else's meter. You know the saying: a man with one watch knows what time it is; a man with two watches can never be sure. If I'm going to compare my meter against anything else, I want to compare it against something that is known to have a better accuracy spec. If I'm just comparing it against another home-test kit that's equally questionable, there's not much point.

Despite the continuing absence of my running buddies, I was able to talk myself into a pretty tough run today: 5.7 miles, and a lot of very steep climbing. The weather cooperated -- it was sunny and clear without being hot. The run felt good despite the difficulty of the thing. It was a nice interlude in a dreary day. Then I had to go back to the office, where some of the layed-off employees are already gone, and others are still serving their time before their exit dates, and even those who aren't going anywhere, so far as they know, are looking sad and worried. I don't know how I would cope with this if it weren't for my daily exercise.

Thursday, May 21, 2009  

After a day in which every meal seemed to include some kind of carbohydrate-rich food which many people with diabetes would classify as forbidden fruit (cereal in the morning, rice at noon, potatoes in the evening), I figured I ought to do a post-prandial test and see what my blood sugar is doing at some time other than the early morning.

I usually just do fasting tests these days, because my control has been so good lately, but I know it's foolish to rely on that entirely. When your glycemic control starts to go, the fasting test is not necessarily the first place you're going to see the signs of trouble brewing. It could be that my glucose is low in the morning but high after meals. For that reason, I recognize that, no matter how well I seem to be doing with diabetes management, I should occasionally do tests after a meal -- to make sure I am truly handling all these carbs as well as I think I am, and not just fooling myself.

The result after dinner was almost amazingly low: 80 mg/dL! There was a time when I would have been surprised and delighted to get that as a fasting result, let alone as a post-prandial result. I guess that means it's time to celebrate!

Now, you know I'm kidding. That picture is from Cake Wrecks, a site devoted to examples of careless, overambitious, or downright weird cake-decorating

So how come, eight years after diagnosis with a disease which is notoriously "progressive" (in other words, it inevitably gets worse and worse over time), I'm able to get away with consuming more carbs than I was before? How does it happen that, after all this time, I can see a fasting test of 79 instead of 174, and a post-prandial test of 80 instead of 212? How exactly am I managing to break the laws of physiology?

It's impossible to know what the explanation is, but it's also hard not to want to take a guess. I doubt that this improvement happened simply because all this exercise and weight loss has reduced my insulin-resistance. I can't help wondering if my improved health-habits have also, in some mysterious way, stimulated my pancreas to start producing more insulin than it used to do. I should be cautious about claiming this, because the consensus of opinion among medical researchers seems to be that it's impossible: once your pancreas starts to reduce its insulin-producing capacity, nothing can reverse the decline. All right, then, it's impossible. But if, after 8 years with Type 2 diabetes, I can have cereal for breakfast, and rice for lunch, and potatoes for dinner, and then get a post-prandial glucose reading of 80, for crying out loud, then some kind of major improvement in my physiology simply has to have occurred. I leave it to the experts to tell me what that change was, if it couldn't have involved an improvement in the functioning of my pancreas. But something changed in a positive direction, and the change wasn't small.

Of course, 8 years is still a comparatively short time when you're talking about a chronic disease. Maybe things will get a lot worse in year 10, or 15, or 20. There are no guarantees in life, and particularly in the medical aspects of life. But so far, I'm happy with the way this is going, and I'm pretty determined to keep it on track.

By the way, I don't want you to get the impression that I was drowning in carbs today. I did eat cereal and rice and potatoes, but the cereal was comparatively low-carb (and high-fiber), and the servings of rice and potatoes were not large. Also, each meal happened either just before or just after some kind of exercise (biking to work, running at lunchtime, biking home). So I wasn't behaving quite so recklessly as it might appear. Still, I was certainly consuming high-carb foods today, and getting away with it, and I thought that fact was noteworthy, whatever it means in the last analysis.

Wednesday, May 20, 2009  

My running buddies were unavailable today. That shouldn't be a big problem, but some days running alone is fine with me, and sometimes I really don't feel like it. 

Not that it matters whether I feel like doing it or not. Being diagnosed with diabetes is a little like being inducted into the armed forces: as of that day, what you feel like doing is, officially, no longer relevant. So, of course I was going to run today, whether I was in the mood for it or not.

I planned to do a longish trail-run after work. However, being in a lazy mood, I procrastinated a bit, and got a later start than I should have -- considering that I was also planning to go play music with some friends after the run. When I was running through the woods, about three miles from my car, it dawned on me that I hadn't given myself much time to finish the run, get home, take a shower, get dressed, grab my fiddle, and show up on time and ready to play. And I was right -- I hadn't given myself much time. So I tried to run faster. I'm sure that saved me several seconds, maybe even tens of seconds. Anyway, I ended up getting there on time -- maybe a mintue late, which doesn't count as late if you're not in Germany.

A lot of people complain about how difficult it is to fit exercise into the overscheduled lives most of us lead these days. I recognize that it's difficult, but sometimes I enjoy the challenge. I kind of like showing up at some other activity with my hair still wet from the post-workout shower. I don't always brag about it anymore; sometimes it's enough for me to think quietly about the strangeness of engaging in social music-making when, an hour ago, you were running in the woods with only the deer and rabbits for company.

Tuesday, May 19, 2009  

After the heat on Sunday, I was a little shocked at how foggy and cold it was this morning -- especially considering that I was biking to work. Riding fast down that hill this morning, my un-gloved hands got pretty chilled (but it's too short a ride for that to matter much). By 10 AM the sun came out, and when I went running at lunchtime it was in the low 60s, which is pretty much perfect as far as I'm concerned. It's fairly standard around here for warm sunny days to start out gray and chilly; you'd think I would be used to the pattern by now, having lived in Sonoma County for 13 years.

A running buddy who used to work at my company, and who still lives very near my workplace, arranged by e-mail to join us on our lunchtime run today. That brought back memories of when we used to run together, some years ago now. These days I'm starting to have nostalgia flashbacks about workouts in my past; I keep being reminded of gyms I used to belong to, bike rides I've done, races I've run. I haven't made much progress in terms of athletic ability, but at least I haven't been losing ground. A more typical guy my age is in mourning for the athlete he used to be, and I'm at least a little better than I was before. I guess that's one of the perks of being a late bloomer where exercise is concerned -- you don't have to live up to a reputation you've outgrown.

What is the actual prevalence of diabetes in the U.S.? The general impression I get from news accounts is that America has a diabetes epidemic on its hands, that millions of us have the disease, and that millions more are on the way to developing it. But when I try to get a more precise picture of all this, I have a hard time making any sense of the information I'm able to find.

For example, here's what HealthDay News has to say:

"The most recent analysis of data on diabetes in the United States finds that almost 13% of adults aged 20 and older have the condition, 40% of whom have not been diagnosed. That's a larger proportion of diagnosed patients than noted in a previous study, although the percentage of undiagnosed individuals has remained the same. 'We can say for certain that diagnosed diabetes has increased significantly between the two surveys, from 5.1% [in 1988-1994] to 7.7% [in 2005-2006],' said Catherine C. Cowie, director of the Diabetes Epidemiology Program at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. 'On the other hand, the prevalence of undiagnosed diabetes and pre-diabetes [around 30% of the population] is generally stable, and that's really good news,' she said. 'If undiagnosed diabetes has stayed pretty much the same and diagnosed diabetes has gone up, then we're doing a better job of detecting diabetes.' "

Wait a minute -- how do we know how many undiagnosed diabetes patients there are? Isn't that, by definition, something we can only guess at? In particular, what justifies the claim that the prevalence of diagnosed diabetes is going up but the prevalence of undiagnosed diabetes is stable? For all the breezy talk about doing a better job of detecting diabetes, I don't understand how there could be a change in one of those numbers and not in the other. Also, there's enough carelessness in the language here to make it impossible to pin down what is being stated -- particularly in regard to that "30% of the population" that is undiagnosed. 30% of what population? The general population? The population of people who actually have diabetes whether they know it or not? How does this fit in with the other figures already quoted? I've tried to make it fit, and I give up.

Anyway, it seems that a lot of people have diabetes or are suspected of having it -- I guess that's the take-away message here. But I knew that before. It seems to me that it would be possible to describe the conclusions (and the basis for them) a little more clearly than this, but it seldom seems to happen.

Monday, May 18, 2009  

Yesterday's Bay To Breakers race across San Francisco involved something like 65,000 people. It's a pretty crowded affair:

It's hard to think of this race as an athletic event; for the most part it's just a big silly party, with more walkers than serious runners. This year, following a blitz of pre-race publicity about a supposed police crackdown on disorderly behavior, the contingent of serious drinkers was smaller than usual, or at least more discreet. The contingent of nudist runners was about the same as usual, and as always the cops along the route ignored them. I would have, too. In fact, the police weren't the only ones looking the other way. The nudists I saw may have been less ugly on average than last year's crop, but that didn't mean you necessarily wanted to look twice. (Whatever it is that makes these people want to run naked through Golden Gate Park past crowds of tourists from Iowa, it can't be popular demand.)

This year offered something new and different: warm sunny weather in a city which is, to put it mildly, not known for that. I've done that race several times before, and I certainly don't remember it ever being this hot. Climbing up the Hayes Stree hill was sweatier work than usual.

It was a little cooler at Ocean Beach, where the race ends, but only a little. My shirt was wringing wet after the race.

I didn't go fast, but I felt good during the race -- running felt comfortable, and it didn't seem like hard work. Then, immediately after I finished, my left hip started hurting, and in the afternoon it got worse, to the point that even walking slowly indoors made it hurt like blazes. I didn't know what the problem was, and I still don't; the pain went away last night and hasn't come back. I'm not feeling any soreness at all in that hip now. The human body is a mysterious thing. Maybe it's just as well that this is my rest day from exercise, and that my yoga class tonight put a lot of emphasis on leg and hip stretches.

I had a lot of party food after the race, so I'm relieved that my fasting test today wasn't any higher than 86. My fasting test (and weight) might be up a bit tomorrow, as I didn't work out today, but if that happens I know what to do.

Friday, May 15, 2009  

Well, that's good: fasting glucose, weight, and blood pressure results all look good today. Maybe the effect of biking to work, on top of my usual exercise regimen, is helping me with these things. I rode my bike to work again today. I don't know how often I'll do that in the coming months, but I might as well, at least on days when there isn't some practical reason not to. I do rather dislike coming home sweating heavily from the hill-climb, but maybe I can just learn to take that in stride. The ride home is so short that it doesn't seem worth changing into special clothes for it -- but so steep that it doesn't feel right to do it in work clothes, either!

Somebody on the dLife forum, newly diagnosed and upset, was asking/complaining about the gloom-and-doom, diabetes-is-always-progressive, might-as-well-roll-over-and-die message that people with Type 2 usually receive from the medical establishment. I didn't dare post a reply (I've pretty much given up on posting anything on that forum, after someone who can't exercise bitched at me for mentioning the E-word). But it did get me thinking about the official pessimism surrounding the disease, and the effects that this pessimism has on people. I think it's time for a fresh perspective on this.

All the scary reports we've read about diabetes are based on what happens to The Average Patient. That's a problem if you are The Average Patient, all right -- but you don't necessarily have to be. To some extent (and probably to a pretty large extent) that's a choice you get to make.

Two doctors have told me that almost none of their diabetes patients make any significant change in the way they are living following diagnosis -- they don't lose weight, they don't exercise, and they don't rethink their attitude about donuts. They'll take the pills, but that's it. Now, you and I don't have to be like those people -- but whatever you and I do, those people are going to outnumber us.

Their case histories, not ours, will dominate the statistics, and the results they get will provide all the evidence anyone needs to conclude that diabetes inevitably goes from bad to worse. And so, all those dangerous self-fulfilling prophecies about the hopelessness of controlling diabetes will continue to be issued, actively discouraging Average Patients everywhere from trying to become any other kind of patient.

If you feel like breaking the cycle of self-fulfilling prophecy, you should certainly have a go at it. Make a decision that you're going to refuse to be The Average Patient, so that you can get better results than The Average Patient does. However, you need to prepare yourself for a mixed reception. You're not going to get as much encouragement as you would expect. Some of the compliments you receive will be very much of the left-handed variety. You will be told that what you're doing is great...  for you... but you will also be told that your example is so singular (in other words, so freakish) that it has no bearing on diabetes in general. Nobody should try to learn anything from your experience, because your experience only applies to you. Nobody should compare your results to The Average Patient's results, because that would muddy the otherwise beautifully clear picture of how the disease progresses.

It's a lonely thing, being an outlier; not located on the bell curve where you belong. The general consensus is that someone like you doesn't matter and shouldn't be heard from. That you exist at all is a minor annoyance, a stastical glitch, a bookkeping error -- best dealt with by ignoring it.

Obviously this attitude is an obstacle to finding what is or isn't possible for people with diabetes. Every goal is impossible until somebody does it, and then the rules change -- but not in the medical world, where the rules are permanent because no one wants to hear about the exceptions. Of course you should try to be an exception -- just don't count on a lot of support from people who are already committed to the idea that exceptions don't exist.

I'm not trying to promote magical thinking here -- obviously some things really are impossible. But how do we find out which ones are, and which aren't? You certainly can't find it out by watching to see what most people do, and what happens to them as a result. A lot of "impossible" things are merely difficult, and every difficult thing is effectively impossible if you start from the assumption that the difficulty is insurmountable.

My advice is to start from the assumption that making your health better rather than worse after a diabetes diagnosis is possible (not easy, possible), and keep working at it despite all the pessimism that's in the air, and all the difficulties you encounter. Presume it can be done, unless and until you prove to yourself that it can't. I don't know whether your probability of success with this approach is 10%, 50%, or 90%, but I know for sure that it's 0% if you don't presume it can be done.

If this approach works, and your health gets better instead of worse,  just enjoy your success, and try not to get too upset that you're regarded as a weird statistical fluke. It's better to be a weird statistical fluke who's healthy than an Average Patient who's in a world of hurt.

Thursday, May 14, 2009  

Bike To Work Day found me ready; I was able to get the bike pumped up and ready to go in time. The morning ride was easy (downhill almost the whole way). The ride home in the evening is vastly more difficult -- I have to climb a steep hill (at least 500 feet of elevation gain over a very short distance) -- but the climb, hard as it was, didn't seem to be quite so bad as the last time I did it. I was a few pounds lighter this time, which is probably the reason it was easier. I haven't been cycling lately, so my pedaling muscles weren't primed for the ride by any means. The running I do (even on steep hills) doesn't really build up the muscles you need when you're on the bike. So, I guess I'll continue riding to work, to even out my training a bit.

Way back in 2003 I did a little experiment to discover the effect of exercise on my blood pressure. I rode home from work on my bike, up that murderous hill, took a blood-pressure reading as soon as I got in the house, and repeated the measurement at 15-minute intervals. Immediately after I got home, my blood pressure was an outrageous 190/80, but it dropped fast, and when I showed the numbers to my doctor he thought they were fine under the circumstances. (Apparently the guidelines for normal resting blood pressure are not meant to be applicable during heavy exertion.)

In 2008 I repeated the experiment, and got better numbers. Today I decided to do it once again, and got still  better numbers:

Time after
the climb
BP 2003 BP 2008 BP 2009
1 min 190/80  179/85 170/79
15 min 133/81  124/74 114/70   
30 min 130/73 121/75 111/72
45 min 121/71 117/69  113/75

This time my blood pressure was down to 114/70 (which is normal by every definition I've heard) only 15 minutes after I completed the ride.

The relationship between exercise and blood pressure is a complicated one. Exercise pushes your blood pressure up while you're doing it, but causes it to be lower the rest of the time (so, on balance, your blood pressure ends up being lower overall if you exercise regularly).

My "pulse pressure" (that is, the difference between the systolic and diastolic values) was 91 immediately after the ride, and then dropped to 44, then 39, then 38. From what I've read, these seem to be perfectly acceptable values (in normal, healthy people, the difference can go up to 100 during hard exercise, but is supposed to be in the neighborhood of 40 the rest of the time). I'm typically a bit over 40, but not in the 60+ zone that is said to be a risk factor for heart disease.

My apparent loss of 2 pounds since yesterday is probably an illusion -- just water loss from the long run last night -- but even so, I think I'm making at least a little bit of progress there. And my fasting test result of 75 is also excellent.

Wednesday, May 13, 2009  

Wow -- very low blood-pressure, for me. Two things contributed to that: a problem at work that was upsetting me was resolved today, and I went for a long run this evening. But it used to be that a reading of 102/67 was unthinkable for me, even under ideal circumstances, so I must be making progress on blood pressure somehow.

The run in the state park was very nice: the weather was sunny but not too warm, the landscape (still green from the recent rains) was bathed in golden light, and in general the world looked the way Hollywood cinematographers want us to think it does. There were hikers, runners, mountain-bikers, guys teaching their kids to fish. Also: no rattlesnakes or mountain lions.

Time to get my bicyle out of the shed. Tomorrow is Bike To Work Day, which is a useful event in that it reminds you that the winter and spring rains are over, and it's time to get back to cycling. They make a big fuss over Bike To Work Day where I work; a lot of my co-workers commute by bicyle regularly.

A surprising obstacle to my commuting by bicycle is that I live too close to work -- about a mile and a quarter. How is that a problem? Well, it's a problem because the ride isn't long enough to count as a workout (and it's all downhill on the way there in the morning). But on the way home it's a brutally steep climb, so I come home drenched in sweat, and yet I still can't count it as my workout for the day. I guess my feeling is that, if I'm going to have to work out at lunchtime or in the evening, I shouldn't also get that sweaty just getting home from work. It's sort of a mental block that I have on the subject. Still, it must be admitted that riding a bike to work starts the day off a lot better than driving there ever does. So, assuming I can get my act together early enough tomorrow morning, I'll join the bike-to-work crowd tomorrow, and maybe thereafter.

Tuesday, May 12, 2009  

I read an article somewhere recently (by "somewhere" I mean on some website, the identity and estimated credibility of which I cannot recall at the moment) claiming that eating sardines provides great health benefits. Reading this reminded me that I haven't eaten sardines in a long time, so I bought a tin of them (the water-packed variety -- no need to make a calorie-bomb of the thing) and had them for dinner. I can't remember exactly why sardines are supposed to be good for us, but I think it has to do with Omega-3 fatty acids, minerals, and a lot less mercury than you get from other kinds of fish. I eat a mostly vegetarian diet, but when I step outside that zone I prefer to do it with seafood. If sardines are a healthy, cheap, convenient form of seafood, I might as well take advantage of it. Fortunately I like sardines; not everyone does. I even like anchovies, a little.

Trying not to let the vegetables I bought at the farmer's market on Saturday go to waste, I gave a bunch of them the wok treatment. Just olive oil and spices, no other sauce. I steamed the greens separately and then tossed them into the wok late in the game. But when I poured the water out of the steamer pot afterwards, it was bright green; I hope that doesn't mean I poured all the vitamins down the drain. I guess I'd be better off not cooking my greens, but I'm not sure I'm ready for that. A lot of them (especially kale and chard) seem to me to need a little softening-up.

It's been 9 days since I was involved in an organized athletic event, so obviously it's time to start planning for the next one, and the one after that.

The first one is easy: the Bay to Breakers race in San Francisco is on Sunday. It's a huge race...

...but it's not an especially serious one. It's more of a costume party (with nudity being one of the most popular costumes) than a footrace, and more people walk it than run it. Getting around the walkers is pretty hard, so there's no way to run the thing fast unless you're a Kenyan and they place you at the starting line. You just run it as well as conditions allow, and then you go have a real party (by which I mean one at which none of the guests are ugly strangers who showed up naked). The distance is 12K (7.5 miles); there's one hill, but it's not as tough a hill as you'd think from hearing people complain about it.

After that one, I have to make a choice between two 10K races I've done before, but which both happen on the same morning (June 7). There's the "Fitch Mountain Footrace" in Healdsburg, and the "Hit The Road Jack" race in Sonoma. I'm leaning toward the latter, because it's flatter and easier to do; it also has more participants and that tends to make a race more exciting.

Next: the Kenwood Footrace (another 10K) on the 4th of July. That's a hard hilly race, but I've done it several times and I want to see if I can improve my finishing time in it. I was slow last year, owing to a sharp pain in my right hip which suddenly flared up during the race; I'm hoping things will be different next time.

Mapping out my short-term future in terms of athletic challenges is useful to me, because it tends to motivate me in my daily workouts. Of course, my daily workouts already have a pretty respectable motive (preventing diabetes from disabling or killing me), but it doesn't hurt to have another motive that's a little more fun. 

Monday, May 11, 2009  

Normally Monday is a rest day for me, apart from my yoga class (which I don't count as exercise). But I couldn't skip exercise today, because yesterday I was taking it easy.

The main activity for Sunday was wine-tasting at the vineyards along West Dry Creek Road in Healdsburg. All of our long training runs for the Napa Marathon were along that road; we thought it might be nice to go there and not run -- so that, for once, we could actually stop in at the tasting rooms we kept running past from December through February.

And a fine day it turned out to be for this particular form of exercise. The valley was looking its best (and also tasting its best).

Then down to Cotati to play for a few hours at an Irish music session.

Then an evening walk -- not long enough to count as exercise; just enough to serve as a reminder that Sonoma County is a lovely place to live, and that those of us who do live here should not forget to appreciate it.

Saturday, May 9, 2009  

I was signed up to play fiddle tunes with some friends at the farmer's market in Healdsburg this morning, but I got up early enough to do something else first. Not a run (that was later in the day), but I knew there was a big 10-kilometer footrace that would be going through Spring Lake Park this morning, and I wanted to try photographing it before I took off for Healdsburg.

I thought I had been rather cunning in picking the vantage point from which I would photograph the runners when they came by. It turned out that I was wrong in my expectation of where the the sun would be at 8 AM, so the sun-angles were more difficult than expected, and I had to improvise. At least the runners got there about when I figured they would.

I ran in this race last year, and I found it a frustrating event. There are a lot of fast runners, slow runners, and walkers mingled together, and much of the route is on a narrow pedestrian path. The slowest people ignore the rules and place themselves up front, so they're in your way and there's no non-violent way to get around them; your finishing time ends up being considerably slower than it would have been if you'd had freedom of movement. For that reason I didn't feel like participating again this year. Still, it is kind of exciting to see a running event of this size (about 10,000 runners) taking place in our town. The race is a fund-raiser for various local charities.

It's not a wimpy runn -- there are some steep hills to climb -- but the climbs are short enough that they don't set anyone back too seriously. People who can run at all can handle it, even if they have to walk up some of the steeper parts.

Even though I wasn't running in it this time, I liked the spirit of the event, and liked being around to absorb it.

The culture of community athletic events (running, cycling, swimming, walking) is huge, but not especially visible to society at large. Probably most of the local residents were unaware that the race was going on at all, unless they got up early and were within 2 miles of Spring Lake, and even if they did see the race they probably won't know what the event was until they read about it in tomorrow's newspaper. And yet, 10,000 people were involved in it. And trust me: not all of them are serious athletes.

Because we are so influenced by what other people are doing, I think big charity races of this sort are a good influence on society. Knowing that your friends and co-workers are participating in a race makes the idea of participating in it seem less strange. Maybe some of the people who ran this morning, and who are not in the habit of doing any such thing, will start to get the idea that exercising is a normal human activity -- not a specialist hobby reserved for those who are naturally good at it.

I went to the farmer's market to play music -- which was fun, because a lot of people were there with very young children, and they tended to gather around us. Toddlers are the ideal audience when you're playing fiddle tunes: they get fascinated watching the bow, and they do a lot of spontaneous dancing, which is sometimes so funny that you don't dare look at them while you're playing. I always like to play for kids who are so young that nobody has yet taught them what they're not supposed to like.

We had a break while somebody was doing a cooking demonstration, and I went around and bought a bunch of vegetables to take home. Now I just have to make sure I use them all before they go bad. I got a good start with tonight's dinner, which included a lot of greens. I think at this point I'm probably capable of photosythesis. We'll see -- it's expected to be sunny tomorrow... 

Friday, May 8, 2009  

All of a sudden it's summer...

I don't know where this warm sunny weather was last weekend, when I was running in the relay race and really needed it. But it's here now. I might as well enjoy it -- but couldn't it have shown up a little earlier?

I usually go for a lunchtime run on Fridays, but I seldom feel very energetic on Fridays, and I didn't today. That didn't matter -- I got the job done. Diabetes management is about doing what's necessary, and definitely not about doing what you feel like doing. Anyway, despite feeling tired, I came closer to keeping up with my faster running buddies today than I have done in a long while. My sore rib-cage (from an injury two weekends ago) was pretty much painless today; I think I'm really over that one now.

My fasting glucose result was excellent today, and my blood pressure result was very good too. My weight is slowly recovering from two weekends in a row of life on the road surrounded by snacks. Everything seems to be on track. All I have to do is not blow it.

I received an e-mail from a reader today, asking me what I am going to do when I get to the point that I can't exercise anymore, and have to find another way to control my diabetes. It's an interesting question, all right.

Right now, what I'm doing is still working after 8 years (and working better than ever), so I'm not under a lot of pressure to come up with a fallback plan, but that doesn't mean I will never need one. Sooner or later I'll probably have to develop a Plan B, either because I've developed some kind of disability that prevents me from exercising the way I do now, or because my insulin production has dropped to the point where my blood sugar is elevated no matter how much exercise I do.

I have to admit that my focus has been almost entirely on making my current system work. I haven't thought much about what alternative system I will adopt when the need arises -- partly because that day might be many years from now (and medical science might have come up with some new options for me by the time I need them).

Still, I guess I can give a rough outline of my Plan B:

Having said all that, I am mainly interested in continuing to do what I'm already doing, for as long as I can make it work. There will be plenty of opportunity to re-think my Plan B over the years to come.

By the way, if it does come to the point that I need to give up my unmedicated approach, I won't feel that the years I spent controlling my diabetes without medication were a waste of time, or that they had ended in "failure". That something doesn't work forever does not mean it's not worth doing. When it comes to human health, nothing works forever. But some things work better, for longer, than other things -- and I think I am getting a lot of benefits from my current approach that I couldn't obtain any other way.

Thursday, May 7, 2009  

Cool -- my fasting test is down to 78! I imagine the long trail-run last night had something to do with that. The apparent loss of 2 pounds is probably attributable to the same thing, except that it's largely an illusion -- water loss rather than fat loss. Blood pressure is down as well, and that's for real.

It was sunny today, and a little warm for my lunchtime run. I was making an effort to improve my running form, because I had just looked at a bunch of videos my team-mates took during the relay race over the weekend, and I was very unhappy at what I saw in the videos of myself. Once gain, I wasn't kicking my heels up enough, and it looked like I was speed-walking rather than running. Today I tried to correct that -- even though it feels very unnatural and uncomfortable for me to run the way people are supposed to run. The result was that I was a lot faster than usual, for a while (when my fastest running buddy caught up to me, he asked "Are you sprinting for a reason?"), but it was very hard to concentrate on forcing myself to run that way, and after a while I stopped doing it and slowed down.

I guess the lesson is that I can run faster, if I focus on correcting my form. The trick is to find some way to keep doing that for more than ten minutes. If I practice it enough, some day it might start to feel natural to me. The way I'm running now is certainly inefficient, and I'm probably working harder than other runners a lot of the time, even when I'm running a lot slower than they are. If I'm going to work hard, at least I should get some speed out of it.

Another disappointing diabetes drug has been approved! Cycloset, a "new" diabetes drug, is actually an old drug (bromocriptine mesylate) which has been used to treat neuorlogical disorders such as Parkinson's disease. The drug boosts levels of dopamine, a neurotransmitter. For reasons unknown, boosting dopamine levels improves glycemic control in Type 2 diabetes patients, and the drug has just been aproved for that use.

The bad news is that the drug causes nausea, fatigue, vomiting, headache, and dizziness. We are told that these side effects are not "serious". However, about a quarter of the patients taking part in the clinical trial dropped out of the study because they couldn't handle the side effects; this suggests to me that the side effects might have seemed just a little "serious" to those who actually experienced them. That's the usual story with diabetes drugs: they make your numbers look better, but they make you feel worse -- and you're supposed to keep taking them forever, no matter how they make you feel.

What makes Cycloset seem more promising than most drugs for Type 2 diabetes is that it reduces heart-attack risk. Most diabetes drugs give patients no help in that area (and some even make the situation worse), so it's nice to hear that there's a diabetes drug available which actually does something about the most dangerous health consequence of diabetes. However, the finding that Cycloset reduces heart-attack risk may later turn out to be the sort of thing that only shows up in studies paid for by the drug manufacturer. It sounds promising -- let's hope it's for real.

But let's not forget that regular exercise also reduces heart-attack risk, and probably a lot more than Cycloset does. So, I think I'll keep running.

Wednesday, May 6, 2009  

Nice to see my fasting test result dropping back down so soon afer the dietary excesses of the relay weekend. I had told myself that I wouldn't overeat this time, but it was a promise I couldn't make myself keep. When you spend almost your whole weekend literally on the road, and you're riding in a crowded van full of runners who are handing around home-made brownies and other treats, day and night... well, it tends to weaken your determination. Another thing that weakened my determination was the running itself. After I finished the last of my three runs, I became ridiculously hungry, and when we got to the Mexican restaurant, for our post-race lunch, I was past the point of no return. And yet, my fasting test the next day was no worse than 94, and now I'm down to 80. I guess all this running is doing me some good. I know I couldn't remotely get away with this kind of self-indulgence if I weren't doing hard exercise on a regular basis.

I had a busy day at work and couldn't get out for a run at lunchtime, but I did make it to the state park around 6 PM, and that left me enough daylight (and rain-free daylight at that!) to fit in a 7.3-mile trail run. At first it just seemed like hard work, and I wasn't really in the mood for it, but by the time I got to the top (up by the dam at Lake Ilsanjo), I was feeling good. The trouble with exercise is that the feel-good rewards don't come until after the feel-bad effort, and it's hard to have faith in the former when you're in the middle of the latter.

One of the other runners from the weekend sent me this picture of myself, during the first and rainiest of my three runs. It'a a little goofy, but I like it, I guess because it makes me look thinner than I actually am. And how many photos can you say that about?

Tuesday, May 5, 2009  

There's still some afterglow remaining from the big relay race over the weekend. We're all exchanging photographs and videos. I now have some pictures that I couldn't have taken myself, because I was busy running at the time. This was from a video of me completing my third and most difficult run, in the Santa Cruz mountains:

My relief at being finished is pretty visible here, I think. Not only was I done with the race as a whole, I had just completed a 1144-foot climb, and I was mighty glad to see the top of that hill.

There were also a bunch of post-race group photos -- including this one of the six runners who were in my van:

It's a troublesome aspect of this race that there are twelve people on the team, but you see very little of the six who are in the other van. You see them at the start and finish, and you cross paths with them during the race three times (when you hand off from one van to the other), but apart from a few cell-phone calls you're not really in touch. Maybe we need to do more with the cell phones next time, or find some other way to be sharing the experience better.

There were several blackmail-worthy photos taken of myself and others falling asleep whenever and wherever it became possible to do so. If you ever want to know just how sleepy it is possible to get, try entering a relay race that runs continuously over a 2-day period.

The lack of sleep is the one thing I really dislike about the relay. I did better at fitting in naps this year than I did last year (and there are photographs to prove it), but I still finished the weekend in a more sleep-deprived state than I think I should allow myself to reach. Maybe that's just the nature of the event, and I should either accept it or decide not do the relay. I don't think the basic problem is going to go away.

Fasting glucose was down to 85 this morning, even though I didn't work out yesterday -- which is what I expected. I figured that the lingering effect of my running over the weekend would outlast the lingering effect of my eating over the weekend. But the effect of exercise only lingers for a day or two, so I figured I had better get out there for a run today. I felt sluggish, and I certainly wasn't fast, but I finished the run and felt okay, and that's what matters. Maybe I'll do better tomorrow.

Monday, May 4, 2009  

The relay race is done!

There were 227 relay teams, each with 12 runners who divided up the total 199-mile distance. The event is a fund-raiser for organ donation. Typically a team will consist of employees from one company, as in our case. Some teams are also drawn from running clubs, social clubs, and people whose friends are good at talking them into stuff.

It's very hard to describe the logistics of this very complicated event to anyone who hasn't participated in it. The basics are:

Why do this, you ask? Well, maybe you'll just have to take my word for it that it's more fun than it sounds. There's a party atmosphere to the thing -- but there's also a feeling of adventure and physical challenge. We all need to have a little adventure now and then. Not climbing Mount Everest, necessarily -- just some kind of experience that's rather extreme and unfamiliar. The sheer oddity of finding yourself running on a country road in the middle of a dark, rainy night is inherently exciting. You feel very alone, and at the same time you know that there are hundreds of other people involved in this event, and that your support team in the van is not far away, so the experience is not frightening, just very much out of the ordinary. If you're scared of anything, you're scared of letting your team down. So, it's a limited adventure -- a cozy adventure, and you get to share it with your friends

Our team finished 133rd, with a total time of 30 hrs, 30 min, 38 sec. Google's ultra-serious team came in first, as usual, with a total time of 21:26:35, but this year (for once!) they had some serious competition. A team organized by a chiropractor in Los Gatos was only a minute behind them -- and to put that in perspective, the second-place team is usually well over an hour behind them!

Our team was not ultra-serious. I'd say that most of the teams were not ultra-serious, judging from the team names they made up for themselves: "Spongebob Nochance", "Know Us By The Trail Of Drugs", "Yo...Taxi", "Cheaper Than Therapy", and so on. A team of software developers called themselves "Runtime Exceptions". A team of twelve women called themselves "24 Bouncing Boobs" (with team T-shirts to match.) Our team name ("That Wasn't A Mile") was an in-joke which I don't have time to explain.

As predicted, it was a wet weekend. As the first part of the route (in the Napa Valley) duplicated the route of the Napa Marathon on March 1st, and it rained on both races, the feeling of deja vu was pretty strong: "Well, here we go again -- same road, same rain!". And same difficulty in keeping cameras dry, if you wanted to photograph your runners along the route.

For this race the roads were not closed to vehicle traffic, so we had to watch out for our own safety.

Wet weather can have its compensations. Scenery is sometimes improved by rain, mist, and gray skies -- for example, when Marin County is trying to do its best imitation of western Ireland:

A lot of the route was on remote backroads. Even those had their share of traffic. After sunset we wore reflective vests and carried flashlights or headlamps.

Wearing headlamps and reflective vests doesn't make it easy for anyone to take a good picture of you when you're running at night (especially in the rain). Here I am as a ghostly apparition, exiting the pedestrian lane of the Golden Gate Bridge at 1 AM.

Despite some remaining soreness in my rib cage, from the fall I took while trail-running on April 26, I was able to run all of my assigned segments of the route. It so happened that my three routes were progressively more difficult, with the third being a continuous hill-climb with over a thousand feet of elevation gain -- and yet, the running felt better and better, not worse and worse, over the course of the weekend. I could certainly tell that the third run was the hardest, and my pace was slower for that reason, but I didn't feel bad. What makes this odd is that I did feel bad before I started the second and third runs -- I felt as if I were coming down with a virus, and I was very worried that I wouldn't be able to run. Once I started running, though, things were okay. It was the anticipation that was making me feel bad.

When you're doing a lot of hard running, day and night, and you're in a crowded van loaded with snacks, dietary restraint pretty much goes out the window. No doubt that's why my fasting test was up a bit this morning -- but 94 still qualifies as normal, and I assume it will be lower tomorrow even though I didn't work out today. Now I have to work on getting my weight back down to where it was in April. I hope I can now experience a stretch of several days that don't revolve around food!

Friday, May 1, 2009  

How's this for a revelatory headline? From Diabetes News: "Managing Your Diabetes Living with This Chronic Illness Can Be More Daunting in Tough Economic Times". Can you beat that?

I'll bet you had been assuming that managing a chronic health problem becomes easier once you're broke and you lose your health insurance. And now it turns out that it actually becomes harder instead! Who knew? If it were not for the headline writers, I don't know how we would make any sense of this world.

Not much time to write tonight -- I'm getting ready for the relay race (see yesterday's post), which starts tomorrow morning. The weather promises to be wet. It rained hard this afternoon; now it's just sprinkling. The forecasters give it a 70% chance of rain Saturday, and 80% Sunday. Oh well. Those are the chances we take when we sign up months in advance for outdoor events.

My remarkable weight-gain this week is driving me crazy with frustration. I had no idea that my holiday from dieting last weekend could have this kind of impact. (Not much impact on my glucose meter, but plenty on my bathroom scale.) Now I'll have to be careful not to make the problem worse during the relay weekend. I'm only running a little over 13 miles all told, in three separate segments -- which is certainly not enough exercise to give me an excuse to sit in the van eating snacks whenever I'm not running. Unfortunately, this weekend is going to be in some ways a repetition of last weekend: I'll be away from home, on the road, with my usual daily routine completely disrupted, and all my time will be spent in close quarters with a bunch of other people who have brought lots of high-calorie goodies with them and will feel compelled to share. That, not the running, is going to be the real challenge of this weekend for me. Endurance sports don't intimidate me anymore; dietary temptation still does.

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