Welland Triathlon Report

The first triathlon of 2015 is officially in the books.

The short version of the story goes something like this

Start swimming. Think "Omigod I forgot how much I loved open water swimming!!". Enjoy a strong swim where I am passed by two people but I pass at least 15 others. Turn at the last buoy and head for shore. Think "The swim is almost over. That's sad. Now I have to hop on the bike for 30k. Bloody hell". Cycle the first 15k thinking "wow, I'm faster than I thought I was. All the half marathon training and winter cycling on the trainer must have paid off". Turn around at 15k and think "nope, that was just a nice tailwind". Cycle 15k into a pretty strong headwind and think "my shoulders and my a$$ are killing me". Finish the bike ride, pull on my running shoes and think "it's only 7.5k. That's like 1/3 of a half marathon and you rocked a half marathon last weekend. You got this!". Run 7.5k without stopping at a strong and steady pace and think "this is the easiest triathlon run I've ever had. I feel great. I love triathlons!" Cross the finish line with a smile on my face and think "when's the next one!"

The longer version is, well, a little bit longer.

We got there super early because this crazy girl decided a 1pm the afternoon before the race that she needed to buy her very first wetsuit. Why?!? Because at 12:30pm she read the race report online and learned that the water temperature in the canal was 15C/59F. The wetsuit mandatory cutoff is 14C and there was no way I was getting there in the morning and finding out that I couldn't swim. So I sucked it up, drove to our local triathlon store, said "do you have any wetsuits in my size?", spent 15 minutes trying to get the damn thing on, felt ridiculous in it and yet walked out with it anyway, a few hundred dollars poorer.

So we got to the race 90 minutes early so I could a) pee a bunch of times before putting on the wetsuit, b) put on the wetsuit and c) swim in it for as long as it took to feel comfortable. Doug, the smart man that he is, set up his transition zone and headed back to the car for 45 minutes where it was warm.

I racked my bike as several other triathletes were arriving. They were all new to the sport and asked me a bunch of newbie questions that made me smile as I remembered wondering all of the same things not that long ago. One of the newbies noticed my pump and proudly showed me his Animas pump. Spotting another T1 in the wild means instant bonding and we kept cheering each other on every time we saw each other during the race.

The donning of the wetsuit went much better the second time. It helped that I knew what to expect, I came prepared with a plastic bag to wrap around my feet (to help them slide more easily) and I was in and zipped (by myself) in less than five minutes. I made my way down to the water where a bunch of folks were milling around trying to decide whether or not to go into the now 16C water. I greeted them all and walked right in. I forced myself to simply tread water for a few minutes while the cold water seeped into the wetsuit (what a strange feeling that is) and I made sure that I wasn't going to start panic-breathing. The water felt cold but manageable and I had no issues getting used to the tighter feel of a wetsuit. I swam a few hundred metres, made sure I wasn't going to freak out and then happily floated around chatting to all the others who were brave enough to get in.

I had a few diabetes issues to figure out at the last minute. First of all, tucking emergency carbs into the pockets of my triathlon suit was not going to work because there was no way to get to them once the wetsuit was on. I ended up stuffing two packages of fruit chews and a ziplock bag with two dates into the arms of my suit. It felt weird but worked fine.

I had also planned to be able to stalk my continuous glucose monitor (CGM) in the time leading up to the race but, once I put the suit on, I could no longer see Rose. And, even if I could, it would not have mattered anyway as she lost the CGM signal, not to be found again until I was finished the swim and took off the wetsuit. So I went on feel and had one date (with salt) 30 minutes before the start and one  (again with salt) a minute or two before going in.

When the race started, I swam hard. I felt like I was swimming really fast and I had been told that I would feel that way but I wasn't sure if I just felt fast or if I really was fast. I passed a bunch of swimmers but that's typical for me. Swimming is definitely my forte in a triathlon.

Getting out of the wetsuit was tricky and awkward but I'm sure, with experience, it will be easier. It added a minute to my transition time but I wasn't too worried about that.

The bike ride was easy and fun for the first half and tough on the way back when I hit the headwind. I obviously have not had enough training on the bike and my body could feel it during the last 10k. I'll have to make a point of riding more and riding farther in the next month so that the 40k olympic distance ride doesn't feel quite so never-ending. I did have two dates (with salt) on the bike ride and drank a lot of NUUN in an effort to keep my electrolytes up and prevent a blood pressure crash on the run.

The run felt great. I approached it the same way I approached the half marathon last weekend. Run at a strong and steady pace, watch my heart rate and don't stop running. It worked well and, as I picked off the kilometres one by one, I enjoyed the moment rather than waiting for it to end.

I crossed the finish line with a blood sugar of 12. Not bad considering that I hadn't checked it before or during the race and had just done it all by feel. I had set a race day basal profile that was supposed to allow me to eat before the swim and during the ride which is exactly what I did. A glance at my CGM when I got home showed me that I had climbed pretty high (16+) during the bike ride but had dropped back down again by the end. So lows were not a problem but I hate being that high during a race. I'll have to tweak those basal numbers before the next race.

Here are the results for this year's race:
Swim 14:38.9 1:57min/100m (Overall 89/240 Gender 27/90 Category 4/18)
Bike 1:13:05 24:62km/hour (Overall 210/240 Gender 74/90 Category 13/18)
Run 51:43.7 6:53min/km (Overall 221/241 Gender 79/90 Category 15/18)
T1 3:23
T2 2:31
Total 2:27:50 (Overall 220/240 Gender 79/90 Category 15/18)

Compare it to the one I did two years ago:
Swim 14:30.00 1:55/100m (Overall 120/296 Gender 43/128 Category 7/20)
Bike  1:03:17 28.44km/hr (overall 224/296 Gender 81/128 Category 14/20)
Run 55:33:00 7:24min/km (Overall 262/296 Gender 105/128 Category 17/20)
T1 2:30
T2 2:39
Total 2:20:45 (Overall 243/296 Gender 99/120 Category 16/20)

The swim times are almost identical. Two years ago I was at my swimming peak, doing master's three times a week and super hardcore. This time I was nowhere near that level of swimming fitness but I did have a wetsuit. So perhaps it did make me faster.

The bike was a lot slower this year - no surprise there considering my lack of practice.

My run was 4 minutes faster which is great. It felt much better too. I remember really struggling in 2013 during that run.

No personal best and I obviously have some work to do if I want to place high on the bike and in the run but it sure was fun.

After a few days of trepidation last week I'm happy to announce that triathlon girl is back!!

Here are a few photos taken from Multisports' Facebook page, the fine folks who organize these great races.

Niagara Falls Women's Half Marathon - Third Time's a Charm!

Yesterday was the fourth annual Niagara Falls Women's Half Marathon. It was my third go at this race since I missed the second year due to injury. It's a great race that gets better every year and it's organized by a friend of ours so I am more than happy to support it.

Having run it twice before, there is a comfort in knowing what to expect and when to expect it. I know where the hills are, where the orange slices and jelly beans will be handed out and where those "will they ever get here' turnaround points are.

This year, I went in with more apprehension than I usually do. My training had been so fraught with tough long runs, blood pressure plummets and ear plugging fiascos that I was not sure what to expect. All I knew is that if the blood pressure stuff started too early, there was a chance that I'd have to walk a good portion of the race or, heaven forbid, not finish. Doug was out there to make sure that my blood sugar was taken care of but there wasn't much he could do for the blood pressure issues other than be there and, if necessary, drive me home. 

My plan? 

Forget any goal times and run to finish. Keep my heart rate under 165 at all costs, take salt tablets and electrolytes at every water station, and don't stop running if at all possible. 

Oh, and wear my type 1 diabadass shirt for a little extra boost of confidence. 

And that, my friends, is exactly what I did. 

I ran easy. I kept a steady pace between 6:50-7:10 min/km, even when I felt like I could pick it up. If my watch alarm beeped to let me know my heart rate had climbed above 165, I slowed down until it came back down. 

I stopped at every water station, had a salt tablet and either two edisks with water or some Powerade. 

Guess what happened? 

My ears did not plug. 

My heart rate did not spike. 

My blood pressure did not plummet. 

My blood sugar held steady between 4.5-6.5 the entire time. 

My energy held and I never once took a walk break (other than when gulping a cup of water or powerade of course).  But my typical 18k crash never happened. 

I ran the same pace at 19k that I ran at 2k and I felt fine from start to finish. 

I finished in 2:33:52. Not my fastest time ever but certainly in the 2:30:00 give or take ten minutes range that I typically finish in. 

I stood at the start line not quite sure if I would finish. 

And I finished what turned out to be the easiest half marathon I have ever run. 

Those pre-race jitters never do get any less jittery do they? 

This might be my favourite running photo ever. Living life well with diabetes indeed! 

All done! 

A1C and Salt Licks

Last Friday I went to see my endocrinologist.

Out of all of my doctors and diabetes support team folks, she is by far my favourite.

She doesn't waste time going through things we don't need to go through and she spends lots of time talking about the things I want to talk about.

So, in my 20-minute appointment, we talked diabetes for about two of those minutes. And we talked running and blood pressure and other things for the rest of the time. Because that is what I needed.

Diabetes? Well that's going just fine thank you very much.

I printed off the latest report from Diasend and we reviewed the last month worth of data from Rose, my trusty insulin pump/continuous glucose monitor.

Having the ability to prevent lows before they arrive and catch sneaky highs before they get too high has made such a difference in my overall diabetes management. For example, in the last month, I spent 81% of the time with a blood sugar between 4-10. I spent 4% of the time with a blood sugar below 4.0 and 15% of the time with a blood sugar above 10.0. That, my friends, is pretty freakin' fabulous.

And it all payed off.

My A1C result clocked in at 6.3. I believe that is my lowest one ever and it was reached with fewer lows that I have ever had. So yay!

(Anyone out there considering a Dexcom CGM, take it from me. It's absolutely worth the cost and having to wear extra cyborg parts.)

We spent a lot of time talking about the strange blood pressure drops I've been having on long runs and the alarming increase in them this year. I used to have them every handful of long runs. Now I'm having them on almost every run, sometimes as early as 7k in.

Turns out that this little girl is not getting nearly enough sodium in her diet. Doug and I eat very little in terms of processed food so my typical diet is naturally low in sodium. In fact, when I input my food into My Fitness Pal, I was only getting 1300mg(ish) of sodium on any given day. Significantly lower than the 2300mg that most people struggle to stick to.

Add to that the fact that Doug and I have been making a concerted effort to remove almost all processed foods from our cupboards and I was getting even less sodium, other than the naturally occurring sodium found in veggies etc which, as it turns out, is not very much.

Add to that the fact that, for the past few years, Doug and I often ate out on Friday evenings, the night before long runs, and I would often choose more salty choices (like a side of fries) because I was burning plenty of calories the next morning. We still eat out most Fridays but I was opting for salads and other naturally low-salt foods instead meaning that the pre-long run sodium intake my body was counting on wasn't happening either.

Add to that the fact that I am a very active person who is also a heavy sweater who also happens to be a very salty sweater and it turns out that my diet is dangerously low in sodium.

"You need to start salting your food" she told me.

"That sounds crazy to me" I said "even though I know you're right".

So I went home and had a saltier than usual dinner on Friday night. Saturday's 10k run was a hot and humid one. It started off ok but, by 5k, I knew in my heart that one salty dinner wasn't enough to make up for months of not enough sodium. I had two pickles with my lunch and added a bit to my dinner as well.

I have a handful of days left until race day. I have salt tablets for the race if I need them and I'm trying to make sure I get a little more sodium in my day - without going crazy and ending up with the opposite problem.

I must say, it would be very nice if the solution to my long-run woes turns out to be as simple as having a plate of french fries on Friday evenings.

Off to the Endo I go

I've uploaded the last month's worth of CGM data from Rose.

I've printed a summary of that data. Complete with pretty colours, pie charts and graphs.

I've breathed a sigh of relief after seeing how lovely my average blood glucose stats were. I then proudly saddle up beside Doug to show him so he could express his delight (or at least make supportive sounds as I clicked through the pages of data).

I have my blood pressure log with detailed notes about each pre and post long-run blood pressure fiasco. I also have my blood pressure meter set out on the counter.

I have my list of questions ready.

It's that time again.

Endo appointment time.

Here's hoping it's a little more helpful than my diabetes centre appointment was a few weeks ago.

I'll let you know next week how the A1C turned out and what her thoughts are on the blood pressure drop accompanied by heart rate spike that keeps happening during long runs.

Not Much Help

I went to the Diabetes Centre on Monday, armed with 7 days worth of food logs printed from My Fitness Pal and a few weeks' worth of pre and post workout blood pressure readings.

I had my list of questions.

I was ready!

We started with my food diary. I asked about some of the vitamins and minerals that people with type 1 diabetes are notoriously low in - primarily calcium. I said that, according to My Fitness Pal, I get 100% of the daily recommended dose of calcium most days without taking a supplement.

"My doctor recommended that I take a supplement" I said. "I will if I need to but, if I'm getting 100% of my daily calcium from my diet, is that enough? Or, as someone with type 1 who also has a family history of osteoporosis, do I need more than 100%?"

"Well, if your doctor said to take a supplement, you should listen to your doctor" was the reply.

"Yes, but my doctor never asked about my diet so she has no idea how much or how little calcium I am getting. In your opinion, should I take a calcium supplement on top of the calcium I get in my diet?"

"Well, if you doctor said to take a supplement..." was the reply.

Sigh.

Moving on to blood pressure.

I explained the trend I had noticed where my blood pressure drops during long runs, sometimes dramatically, and that, when that happens, my ears plug up. I also mentioned that, if I make a point of drinking a lot during my run, my blood pressure does not drop and my ears do not plug up. I even showed them some of the before and after readings.

"That's really fascinating" they said.

"Yes it is" I replied. "Do you have any thoughts about this? Am I on the right track? Should I be concerned? Are my low blood pressure readings dangerously low?"

"Well, that is very interesting" was the reply and then they checked my blood pressure (which was 120/80 or something. End of discussion.

Did I mention that I was speaking with a very experienced diabetes nurse and a registered dietician?

Did I mention that, while I knew the nurse from previous visits, I did not know the dietician.  I had to introduce myself to the dietician a few minutes into the appointment because, the second I sat down, I was being asked a bunch of questions without even knowing who I was taking to?

"I'm Céline" I interrupted "what's your name?" She told me and I said "well, I figured we should be properly introduced before I start sharing all the private information in my insulin pump".

Every year I go through this routine. I come armed with information and questions and I leave knowing no more than I did when I went in. It feels like an exercise in getting their form filled out as quickly as possible so that they can meet their requirements and confirm that I quality for pump funding for another year.

"That's because you know more than they do" Doug said when I told him.

"Well, that may be the case but their care is not at all person-centred" I said. "They don't seem to be willing (or able) to provide any medical advice whatsoever and they only give vague answers, if any, to my questions. If I were them I think I would love a patient like me - keen, knowledgeable, willing to work together to find answers."

I just hope that, for people who actually go there for help, that they get it. Because if I really needed help on Monday, I am not confident I would have received it.

I do take comfort in the fact that I am going to see my endocrinologist in a few weeks and can ask her all of my questions. She'll answer them and be absolutely candid when she does.

With her I always leave her office knowing more than when I went in.

Type A Diabetes

I have an appointment at the Diabetes Centre next week.

It's one of the appointments where I meet with a nurse and a dietician. Not the appointment when I meet with my endocrinologist.

So no blood work is required but I do need to arrive with a two-week food diary that tracks everything I ate.

When I need to keep a food diary I usually just print out a few pages worth of charts and then carry them in my purse for two weeks, dutifully writing down every little thing I put in my mouth.

This time I decided to see if I could print out reports from My Fitness Pal. My Fitness Pal is the food tracking app that I've been using faithfully now since last December. The one that has been keeping me honest and showing me without a doubt that I need more protein in my diet.

Turns out that you can indeed print from My Fitness Pal.

There's a nice little printable report you can generate that allows you to pick a date range, say the last two weeks, and then print all the food you ate (broken down by meals) as well as all the key nutritional info (carbs, protein, fats, sodium, fibre, sugars etc). It also shows any exercise that I did that day.

Sweet.

Add to that the reports I'm going to print from Diasend to show my blood sugar trends and I'm going to show up there with all sorts of fabulous data for us to comb through together.

Oh, and I can't forget my blood pressure data that I've been tracking for the past few weeks (before and after workouts as well as at random times during the day).

They are either going to love me...or put a note in my file that says "Watch out, this girl has Type A diabetes".

(De)hydration experiments

Last Saturday I did my 18k training run for the Niagara Falls Women's Half Marathon I'm doing in June.

After the 16k run the week before, when my ears plugged and my blood pressure tanked, I decided to be a little more focused on hydration.

Usually I don't bring any water with me when I'm running 12 or 14k. Once I hit 16k, I still don't usually bring water but Doug often comes out to meet me two thirds of the way through my run and I drink then. In fact, no matter how far I'm running, I only tend to bring water with me when it's a) really hot out or b) Doug isn't meeting me en route with water and snacks.

This time I wore a water belt with a full bottle of water and a full bottle of Nuun (electrolyte mix without any sugar in it).

My watch beeps every kilometre and the plan was to take a sip of water or a sip of Nuun every time it beeped.

I stuck to the plan and, by the time Doug met me at 13k, I was completely out of Nuun and just about out of water. I refilled my water, had two edisks (electrolytes with a bit of sugar) and continued home still drinking every kilometre.

Guess what happened?

I ran 18k without my ears plugging.

My pre-run blood pressure was 112/78 and it was 104/56 when I got home.

Still a drop but much better than the 112/80 to 78/52 drop of the week before.

Also, my heart rate was much easier to keep in check. Instead of struggling to keep it under 170 like I did last week, I was able to keep it under 160 for most of it, only reaching 170 in the last 2 kilometres.

This Saturday I'm slated for 20k so I'll do the experiment again and see how it goes.

Blood Pressure Droppings

I mentioned yesterday that I had checked my blood pressure before and after my long run.

What I didn't mention was that Doug and I bought an at-home blood pressure monitor a few weeks ago. We thought it might be a good idea and I liked the ability to check my blood pressure at different times to see what it does.

I thought it might also give me a clue as to why my ears plug up on longer runs, particularly in warmer temperatures.

I noticed a few things pretty quickly once I started testing.

I noticed that my blood pressure seems to drop when I exercise. My readings were consistently lower after a workout than before.

I also noticed that my readings at home are always lower than they seem to be in the doctor or the dentist office. Not sure if its mild stress of being in a medical appointment or slight differences in monitors but it is nice to see that my blood pressure, at home at least, it always below 120/80.

Sunday's run though was a little freaky.

I was 112/80 right before I headed out for my run.

The run went well in terms of energy but it was a struggle for a few reasons. My heart rate stayed in the high 160s no matter how slowly I ran. My ears plugged up starting at about 10k and kept filling for the rest of the run. By the time I got home I felt heavy and sluggish even though my legs still felt pretty fresh.

Post-run blood pressure: 78/52 (I checked it twice more to be sure)

That seems to me to be a pretty significant drop.

An hour later, it was 90/59. An hour after that it was 93/58 and two hours after that it was 102/67.

I'm not sure what any of this means. When I look up 'blood pressure dropping with exercise' I read that it can be anything from heart disease to dehydration.

I think at this point I'll continue to do before and after exercise checks to see if this happens again and I'll keep track of the numbers. In May I'm back at the diabetes centre so I'll see if they have anything to say.

The Weekend in all of its Colours

What an interesting weekend. What a lovely weekend. What a tough, tiring, peaceful and inspiring weekend.

We drove to Fergus and spent a lovely evening with friends, chatting about health, house renovations and our favourite iPhone apps.

I got up before the sun on Saturday and drove to Listowel where I had the honour of speaking to a roomful of ladies with type 1 diabetes. I met some wonderful people, made a few people cry, and discovered how many people share similar diabetes journeys.

I headed home after my talk via a slight detour that allowed me to enjoy a 2 1/2 hour coffee with a lovely lady that I met at a presentation I did a few months ago. She's relatively new to the world of type 1 and is adjusting to its ups and downs with grace and humour.

I ran 16k on Sunday morning. Due to several factors beyond my control, I didn't do any short runs last week and had not done any exercise for three days. So running 16k was tougher than it should have been. Toss in some warm temperatures, mild dehydration from the day before and 16k took me longer to run than 18k usually does. My heart rate was higher than I liked throughout the run and my blood pressure dropped pretty significantly from start to finish. Happily, my blood sugar held steadily and, with only one date and a clementine, my numbers were stable the entire time.

After my chores were done, I managed to sneak in a bit of colouring time and got to try out the new markers I got the weekend before. Wow! Markers leave less options when it comes to shading and depth but they sure do boost the colour saturation. It incredibly rewarding to watch the colours take over the page and bring the picture to life.

Colouring with pencil crayons for those days when I feel like taking my time and finessing the shades.

Markers - for the days when I don't want to think too much and I want to be rewarded with rich, gorgeous colours in exchange for very little work. 

And through it all, we watched the Masters. We watched hours of incredible golf and we got to know this year's winner, Jordan Spieth. He's an old soul - a 21-year old with wisdom and composure way way beyond his years. I'd love to be able to channel his focus and his ability to manage nerves under incredible pressure. Not that I have terrible nerves or incredible pressure but I am joining a ladies' league and the thought of playing in front of ladies I don't know does make me a little bit jittery.

Happy Monday. Here's to another great week!

Blood Pressure

I had two medical appointments yesterday.

I had an appointment with my family doctor because I went to renew a prescription last week only to discover that I had no more repeats on it. They were nice enough to squeeze me in so I could get another six months' worth of a prescription that I will be taking for the rest of my life (sigh).

While I was there, they checked my blood pressure.

It was 127/72.

They said nothing other than to speak the numbers out loud.

I left, prescription in hand, and headed down the road to my dentist for my 6-month cleaning and check up.

When I got there, they tested my blood pressure.

It was 119/80.

"That's pretty much perfect isn't it?" I asked. "120/80 is the magic number right?"

"No", replied my dental hygienist. "120/80 is the highest you want it to be. So you're just on the edge of too high." "Your heart rate is really low though. It's only 55 beats per minute" she said. And then she proceeded to scrub my teeth within an inch of their life for 45 minutes...which gave me 45 minutes to think.

I realize that blood pressure fluctuates for all sorts of reasons. Stress, movement, time of day, the way they did the blood pressure reading etc.

So I'm not particularly bothered by the difference in my readings.

What I am bothered by is the fact that my family doctor didn't bat an eye at 127/72 (and she is the type to prescribe medication even before it's needed) and my dental hygienist's comment seemed to indicate that I was teetering on the edge of problematic blood pressure.

After CoreFit and a late dinner I went online to do a bit of research. Here is what I learned.

The top number indicates the systolic blood pressure which is the pressure in the arteries when the heart is pumping. The bottom number is the diastolic pressure which is the pressure in the arteries in between heart beats. With me so far?

According to the Heart and Stroke Foundation of Canada, low risk blood pressure is a top number  below 120 and a bottom number below 80. (uh oh)

Medium risk is a systolic blood pressure of 121-139 or a diastolic blood pressure of 80-89.

High risk is 140+/90. Unless of course you have diabetes and then it's 130/80.

Bloody hell!

I looked up what the Heart and Stroke Foundation recommends for lowering blood pressure.

• Eat a low sodium diet (stay under 2,300mg/day) - I don't get anywhere near that number most days. I typically hover around 1,500mg. 
• Eat a diet low in saturated fat - again, no problem there. 
• Exercise 150 minutes per week - I do several times that most weeks.
• Don't drink more than two alcoholic drinks per day - I hardly drink two per week
• Don't smoke - you couldn't pay me enough to pick up a cigarette
• Keep stress to a minimum - I have a pretty stress-free life most of the time and work hard to keep it that way. 

Well, I have six more weeks until my next appointment at the Diabetes Centre. They're really good at answering my questions so I'm sure they'll give me a good sense of a) what my readings mean and b) if I need to do anything about them. 

In the meantime, I'll keep on doing all the things I do to stay healthy and I may just pop into the local pharmacy for random blood pressure checks. For research purposes.