Thursday, May 6, 2010

Some background

How "the betes" arrived in my life ...

I grew up being a "jock" - I ran track, cross country, and swim team. I would probably consider myself a sprinter, as I always did the shorter distances. In college I continued to run track, then later, in my mid-twenties while I was in veterinary school, I joined Masters Swimming and really loved getting back into a regular exercise program, meeting others with the same goals, and entering competitions again. I met some great people and was introduced to triathlon during that time. I did a few sprint tris and one or two olympic distance tris.

Next up came kids ... three to be exact. I began my veterinary career and children entered my life as I turned 30. I developed gestational diabetes (GD) and pre-eclampsia with my first child. I wasn't too alarmed, I had a family history of type 2 diabetes, or adult-onset diabetes, so I knew I was at risk. The gestational diabetes resolved when the pregnancy ended. Unfortunately, I gained nearly 30 lb since being healthy and fit in my mid-20s. The second pregnancy, unsurprisingly resulted in GD as well. I gained another 20 lbs. I led a sedentary lifestyle, was under a great deal of stress, and turned to food for comfort. I was in denial about my physical condition. During this period I started a veterinary practice and took on even more obligations and stress. I had 2 girls and thought I'd like to try for a son, however, I wasn't conceiving, which had never been an issue for me.

I remember feeling pretty awful around that time. I was always SO tired - I actually called it "Rip Van Winkle Disease" as I just hand no energy and wanted to nap constantly. One morning, I arrived at work, having only had a cup of coffee. As I sat awaiting the arrival of my first client of the day, I had a lightbulb moment: PU/PD (medical jargon for drinking a lot, peeing alot), polyphagia (eating a lot!) and some recent weight loss - like 5 lbs, but for no explicable reason. These are hallmark signs of diabetes (DM) and I'm not unfamiliar with the disease and educating clients about it, as many cats and dogs develop the condition. I walked to our lab and got out the glucometer ... blood glucose (BG)= 511. OMG. OMG. I had moved to a new town so I had no GP, no endocrinologist. It was a Saturday. I did, however, have some humalog in the fridge, for our diabetic patients. I used this over the weekend to bring down the BG. I scurried to get a GP, then got into an endo within the week. Yes indeed, I had full-blown diabetes. This likely explained my trouble conceiving. He put me on some oral hypoglycemic medications and asked me to hold off on trying to have a baby for 3 months to see how I responded to the medication. He also sent me to a nutritionist. I had to face the reality of the damage I'd done to myself ... unlike type 1 diabetics, I had real culpability here. I seriously ate tons and tons of crap. Sugar, sugar, sugar. It resulted in insulin resistance. This is one of the particularly difficult issues I face - my culpability in the development of this disease. Oh, btw, my a1c was = 11.6. That's TERRIBLE. They want you below 6.5.

Over the next 3 months my numbers improved. I began to feel better. I got the go ahead to try for child number 3 and lo and behold, there he was. Now I needed to go back to insulin to manage it. This baby was big! Born 6 weeks early, he was 6 lbs 8 oz - the biggest preemie in the NICU by far! He was delivered via C-section.

The next few years were a struggle as well. The economy tanked, my business was struggling, my marriage was struggling, I was unhappy and unable to stick to the nutrition and exercise I needed to manage my disease in the best possible way. I made some difficult life decisions during this time.

Around 2006 I finally got that motivation I needed to begin a fitness program. It actually started when I was watching Biggest Loser! I had topped off at my biggest non-pregnant weight at a little over 200 lbs. I'm 5' 2". I had been 120-125 at my healthiest. I began working out with the motivation I got from watching Biggest Loser. I committed myself to exercising any time I was in front of the TV. The weight started to come off. People were noticing! I was creeping back down toward a healthier weight.

In 2009 I started to train for a half marathon with a friend. In the spring I began running 5K races - one or two every weekend. At first I was slow, but my goal was to improve my time with each race. It was happening!! Then came race day and I DID IT - I ran a half-marathon! Two weeks later I did another, and dropped 17 minutes on my previous time. I was getting pretty excited about re-entering the competitive arena. It was more of a personal journey now, as opposed to the competitive days of my youth. I was setting personal goals ... and achieving them!! Now to set my sights on the big one, a marathon! I had signed up the year before, but was sidelined with kidney stones, so it was a no-go. This year, 2009, I was going to enter and run the Columbus Marathon in October!

In June, I volunteered at a small local triathlon to help out a race director I know. That day, I got bit by the tri bug once again! I raced home to look for the first sprint triathlon in the area and it was 2 weeks away. I signed up and dove head first back into triathlon! Next up, olympic distance - check! Impulsively I set my next sights on a half-iron distance triathlon, also known as a 70.3 triathlon. In September I was thrilled, and proud, to tackle and accomplish my goal of finishing a 70.3. In October I did complete my first, and second, marathon. Go big or go home, right? I felt good, healthy, and was injury-free. My body was adapting and feeling good after these events. I needed some tweaking in the BG department, so that was on my list, but otherwise, feeling fit and mentally good about my fitness goals.

This journey was complicated by the challenges of managing my diabetes. I am learning how to deal with carbohydrate metabolism, insulin dosing, and ultra-distance races. It's in inexact science. When things go badly in a race, due to my BG level, that is called a "bonk" - well technically you can bonk due to dehydration, electrolyte imbalance, or high or low BG, but the end result is: TROUBLE! I was lucky to have an endo doc that put me in contact with his Medtronics rep, Molly. Molly offered to let me wear a CGM (continuous glucose monitor) for 5 days surrounding a challenging triathlon. Valuable data was collected during that time and it allowed me to make changes that would be more beneficial for race day. I was doing things opposite of what was needed - stopping the oral meds and just relying on Lantus insulin (long acting) to maintain BG, but what was needed was the oral meds just before my races. I'll tackle insurance issues in a future post, but to clarify, this opportunity was of no charge to me or my insurance co., but a free opportunity to use the device and collect valuable data. I am grateful.

Enough for now ... next up: Triabetes and what 2010-2011 means to me.

1 comment:

  1. Fantastic story, Tiffany!
    Concerning culpability, I'd like to let you off the hook. As the ADA says, "Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight."
    There is almost always some heredity involved in diabetes. There are always factors beyond your control.
    Nobody deserves to get diabetes.
    You should commend yourself for what you've done since you got the 'betes, without blaming yourself for getting sick.