A Tale of Two Halves: The Philadelphia Marathon

“The Marathon Will Humble You.”

-Bill Rodgers

I’ve written about this before, but I believe that in many ways diabetes and distance running are similar. Both take dedication and commitment to manage well. Both can be quite difficult. And both can return unexpectedly poor results despite our best preparation.

The race weekend really started for me on Friday evening. The Girlfriend and I went into the city to meet up with a bunch of folks in town for the race and the Insulindependence educational symposium which was to take place the next day. Dinner was… okay. Honestly it was a restaurant I’ve never been to before, and will almost certainly never go back to, but seeing everyone was fantastic and made it all worthwhile. Saturday morning after an easy 3 mile jog to keep loose I headed over to the previously mentioned symposium and cannot speak highly enough about it. This year the speakers were:

Scott Johnson – Well known diabetes blogger and advocate, Scott was this year’s Insulindependence Athletic Achievement Award winner. Scott’s “everyman” approach to living with diabetes was fun and motivational.

Gary Scheiner – Author of Think Like A Pancreas and current Diabetes Educator of the Year, Gary gave a great presentation on managing glucose during exercise. It’s easy to see why he has such a great reputation!

Anna Floreen – Anna gave a fascinating presentation about her experiences with the Bionic Pancreas. I was fortunate enough to sit through a presentation by Dr. Steven Russell on this project back in August, but to hear the patient’s perspective took it to a whole new level of excitement. I know we’re still a long way from this being a reality in the marketplace, but I can’t help getting a little bit excited!

Dr. Matt Corcoran – Dr. Corcoran is the founder of Diabetes Training Camp, and as such has a remarkable amount of experience looking at the physiology of endurance athletics and diabetes. I learned from every presentation, but this one had me re-thinking how I do some of the things I do.

Suffice it to say it was well worth attending. I even got to finally meet some folks I’d previously only known online (I’m looking at you, Kunik!).

Anyway before I knew it I was sitting at the kitchen table eating breakfast at 3AM Sunday morning so my bolus insulin would have time to clear before the start. An hour later I woke up The Girlfriend. An hour after than we were in the city. An hour after that we had met up with several other IN runners. An hour after that we were on our way!

The first few miles were uneventful. Mostly spent trying to move past people that had clearly started in the wrong corral. As is the norm for me, I wasn’t wearing a watch, but I knew the course would have a clock at each mile marker. Personally I try not to know my exact time when I race, as I think it can be limiting. If you’re running along and feeling good, then you find you’re running faster than you thought you were, the natural tendency is to panic and slow down even though up until that point you felt fine. In other words if you think you can’t, you can’t. So to avoid this as best I could I tried to not pay attention to what the clock read when I crossed the starting mat. If I’m honest, I still had a fairly good idea of my pace, but even still when I caught up to a pace group around mile 9 I was pleasantly surprised. The group was for a time I thought I could realistically finish within, so at that point I was content to slow it down a touch and stay with them. As it happened, a woman running in the group noticed my singlet and struck up a conversation. Turns out her husband is a type 1 iron distance athlete and coach! We chatted for a bit until some other runners drifted between us, but it was reassuring that I could still hold a conversation while we went through halfway. One thing I did notice, but didn’t think much of, was a bit of twitching in my calves.

By mile 14 the twitching had become more pronounced.

By 16 the twitching had become full-on cramps.

Toe-curling, leg-crippling cramps.

By 17 a volunteer asked me if I wanted medical attention.

By 18 I found myself sitting against a guardrail questioning everything. In retrospect that moment may well have been the lowest moment I’ve ever had in a race. All those lonely miles. All that time spent away from my friends, my family, The Girlfriend, and even my dog. They had all led up to me sitting on the side of the road unable to run more than a few steps without my lower legs seizing completely. And as I sat there, head hanging between my knees, I did something I’ve never done before – I gave up.

But then something remarkable happened: I began to walk.

At first I told myself I was just walking to a place I could more easily be picked up, but as I continued I began to think. I thought of my friends Vic and Lindsay who, at that very moment, were in the middle of Ironman Arizona. I thought of my friend Danielle who was told a few years ago that she may never walk again thanks to her diabetes and was at that very moment in the midst of another half marathon. I thought of all the love and support I’ve been given by the diabetes community, even people I’ve never met face to face. And I began to run.

Then my calves cramped again.

But I continued to walk. Finally I was able to jog a little. Then jog a little more. By mile 22 I was jogging more than I was walking, and by 23 I didn’t have to walk at all provided I kept the pace very slow.

I crossed the finish line over 45 minutes after I expected to, but I crossed the finish line. Suddenly I was filled with conflicting emotions – relief, joy, pain, and a bit of soul crushing disappointment. But then I heard my name, and The Girlfriend was there, on the other side of the barrier, smiling and looking at me with such pride that I couldn’t help but feel like I had just accomplished something amazing. Then, after I made my way out of the finishing chute, she gave me a hug that made it all worth it.

Then I got sick in a bush next to the sidewalk. Hey, it’s not all puppy dogs and rainbows. ๐Ÿ™‚

Philly Marathon

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I’m back, but I wish I weren’t!

I’m sure many of you have found yourself asking recently, “Huh, I wonder where that runningwithinsulin guy has been?”

Wonder no longer!

The truth is that I’ve been away in the wilderness of Montana. As some of you may know, I have been a volunteer “captain” for Insulindependence for a while. Mostly this has involved leading monthly local events, representing the organization locally, and just spreading the diabetes love. The culmination of the program, though, was mentoring a young diabetic “junior captain” at a week longย  trip canoeing the Missouri River in the previously mentioned Montana wilderness. (Note: I feel like saying “Montana wilderness” is redundant. Kind of like Street Road.)



It’s not hyperbole for me to call this a life-changing trip. Spending time completely off the grid learning so much about myself and my own diabetes while watching young people do the same was humbling and inspiring. Oh and I also got to spend more quality time with The Diabetic Camper, so there’s that.

To give some details on the trip itself, the amazing guides from Wilderness Inquiry took care of the details like boats and food, and we spent six days on the river paddling just short of 50 miles. We camped in many of the same places the famed Lewis and Clark expedition camped at, and even read some of the journal entries Captain Lewis wrote from those very spots over two hundred years before. On one of the days we laid over without paddling and took a hike to the Hole In The Wall:

There's a hole in that there wall!

There’s a hole in that there wall!

During the hike we reached a point where the trail went a little, shall we say, vertical. While people were a little nervous, everyone came together and encouraged one another to make it up the small climb. In retrospect, this was the defining moment of the week. The support everyone gave each other and the looks of accomplishment afterward left me nearly moved to tears. Just awesome.

On a more directly diabetes related note, paddling seems to make me insanely insulin sensitive. There were a couple of days there during which I was using less than half my typical total daily dose and eating decidedly NOT low carb. It almost became a running joke between myself and the CDE that was with us that at any given time I was shoveling carbs into my mouth while my basal rate was 70% down. I found this especially interesting given the fact that in daily life I am far from a sedentary person. Maybe I should become a river guide! (note: I am not becoming a river guide)

So that was the trip. Well, actually that was only part of the trip…


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Getting Started

I truly believe that an active, healthy lifestyle is critical to a happier and more fulfilling life. That’s for everyone. For a diabetic the benefits can be much more immediate and much less philosophical. Even after a short walk you can expect to have a reduction in blood glucose levels with improved stability and insulin sensitivity lasting up to 24 hours. From my own experience I can say that when I was injured and therefore not exercising regularly good control was a much bigger challenge. Looking longer term, people with diabetes are at significantly higher risk of stroke and cardiovascular disease than the general population. Regular exercise can minimize these risks, allowing you the opportunity to enjoy life longer into your “golden years”. More anecdotal, I know a fair number of long term active diabetics and not one of them has serious complications.

So the real question is: what’s stopping you? Now I understand that if you’re reading this there’s a high likelihood that you’re already active. Sedentary people tend, in my opinion, to avoid blogs with the word “running” in the title unless it’s “runningfromzombies”. Or something. Anyway, in case someone out there has been on the fence I thought I’d put down a few words on getting started.

Step 1: Get off the couch and out the door.

Seriously that’s it. Turn off the television. Put down the iPad. Open the front door. That big bright thing? That’s just the sun. It’s cool, you’ll get used to it. Now start walking. It doesn’t particularly matter where you walk, it’s the walking bit that’s important here. You don’t even need to walk far at first. If to the mailbox and back is all you can manage today that’s great. It’s a start!

Step 2: Do it again. Perhaps longer this time.

There is a subtle theme here. Simple consistency. The best exercise is the exercise you actually do. So if a 10 minute walk around the block is all you’re physically or mentally capable of right now that’s fine, but do it at least three times a week. I mean the zombies are still likely to get you, but it’s baby steps, right?

Step 3: Explore.

I run. I like to run. I also enjoy hiking, climbing, cycling (mountain and road), scuba, and even yoga. The point here is that tedium leads to boredom, and boredom leads to a reversion to old, comfortable habits. Always wanted to try tennis? Go learn! Looking to take up golf? What’s stopping you? (extra points if you ditch the cart and walk 18) Watched the Olympic and want to give Curling a go? Live the dream! (seriously – I’ve done it and the sweeping part is work)

Step 4: Enjoy a healthier you.

One of the amazing things about being fit and healthy is you no longer think “Oh I could never do that.” You begin to realize all of the amazing things you can do. You may also find that you’re getting sick less, that you have more energy, that your lab results are better than ever, and that your overall mood has improved. You too can be one of those annoying people that’s usually in a good mood!

And if you’re already active and healthy? Odds are you know someone that could use a little more “outside time”. Get them out there. Don’t be preachy. Don’t judge. Just show them that exercise doesn’t have to be a chore or a punishment. (I still take issue with coaches in school using running as a punishment – way to instill early bad habits!).




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Why we run.

I have a good friend named Ed. While both of us are fairly healthy, active people we go about it in very different ways. Ed is a power lifter. When I try and imagine lifting the absurd amounts of weight he effortlessly hurls away from the earth it makes my brain cry out in pain. I, on the other hand, am a runner. I have the upper body of a T-Rex. More to the point, a T-Rex that got sand kicked in it’s face at the beach by the other T-Rexes (Rexi?) because it had such puny, useless arms. To put it into practical terms: when moving furniture it’s probably a better idea to call Ed. Also he has a functioning pancreas. So there’s that.

Anyway Ed just posted a link to a comic on my Facebook page. The comic is The Oatmeal which is consistently excellent and we should all read it more, but this particular comic was about we he (the author) runs. It goes on for six pages and it’s perhaps one of the most eloquent and thought provoking pieces I’ve read on the subject. His reasons are deeply personal, as I imagine they are for most people, and while they don’t necessarily mirror my own reasons there is enough Truth in them for anyone who has been running for a while to really relate. Just as we don’t all run the same types of races, or even races at all, I think there is more overlap than not in our reasons, and they are all valid.

So the direct link to the comic is here, but I urge you to take a while and look around.

I think at some point I’ll likely post more about my own reasons for running and my shocking lack of upper body strength, but for now I think the link speaks on it’s own.

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Running Naked

No, I don’t mean running with no clothes. I mean really, who thinks that’s a good idea? All your floppy bits… flopping. It just sounds uncomfortable (though a brief nekkid jog around the house never hurt anyone). And as a diabetic on a pump the logistics would be a nightmare.

So what is naked running? According to The Naked Runners, it’s all about ditching the distractions. Lace up your shoes, head out the door, and run. Leave the iPod, heart rate monitor, GPS, even your watch. Stop worrying about splits and pace. Stop counting miles. Run until you don’t feel like running anymore. Now don’t get me wrong, I’m as big a fan of technology as the next guy and more often than not I have my Garmin strapped to my wrist, but sometimes I think letting go of all that can help make us better runners. It brings us back to the primal nature of the activity and in some ways reminds us that we’re really alive.

Now want to take it to the next level? Race naked. I truly believe that too often the limiting factor in our racing is not our fitness, but our perception of what we think we are capable of. More than once I’ve run much faster in races than I though I could given my training at the time simply because I didn’t know how fast I was going. If I had I almost certainly would have slowed down!

So there you go: running naked. Try it. You just might like it.

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It’s A Trap!

c'est ne pas une trap?

c’est ne pas une trap?

As we embark upon any challenge there are pitfalls and traps that we should attempt to avoid if we wish to attain success. Marathon training, and running in general, have more than their fair share; probably far more than I could comfortably list on a blog post. That having been said, here are a couple that I’ve been thinking about a lot lately and wanted to touch on.

Trap the First: Racing Your Training.

When training for a race (as opposed to just running to keep fit) every run should have a purpose. Spend enough time around runners and you’ll almost certainly hear the phrase “periodization” tossed around. In simple terms, periodization is the systematic planning of training periods, with different specific training added each period and the aim of “peaking” at the right time. As it applies to endurance athletics (again, speaking in general terms) the periods tend to be:

  • Base – This is where we build our aerobic engine. There are lots of differing opinions on this phase (from Lydiard‘s 100 miles per week to Maffetone’s somewhat more controversial thoughts) but what’s clear is that the base phase is what gives us the endurance and aerobic conditioning to prepare our bodies for the more demanding training to come.
  • Build – We’ve built the engine, now we have to tune it. Here is where workouts such as hill repeats or speed intervals are added. For the marathon traditionally one or more long runs per week are added.
  • Taper – A planned reduction in training volume over a short period of time leading up to the race allowing maximum recovery so you get to the start line fresh and sharp.
  • Race – The thing you’ve worked toward. Self explanatory!

(Unless you’re my friend Jeff who likes the “base… taper” school of thought, but that’s a post for another day)

If you’d like more information on this sort of thing there are a TON of great books out there. Perhaps soon I’ll put together a list of my favorites. Anyway the point here is that by understanding which phase we are in and what that phase is intended to accomplish we can break it down to an individual workout level, and that’s where we learn to avoid the trap of Racing Your Training. For example I am currently smack dab in the middle of my base training. The intention of base training is (in my opinion) not to make you faster, but to build the leg strength and aerobic endurance to prepare your body for the more demanding training to come while also developing your body’s fat burning process. Running fast, relative to your current fitness, accomplishes none of these goals! In fact, it’s probably putting you on the path to injury. Now is when you can slow down and just enjoy your runs. Find someone to run with that you can talk to. If your speech gets choppy, you’re going too fast! Now please don’t take this to mean you should always run slowly, after all during the build phase there should be one or more quality speed-focused workouts every week, but even then we need to slow WAY down on our recovery days. Whenever I read about a western elite runner spending time in Kenya or Ethiopia they consistently remark that the key difference between how the African runners train and the Western runners is that the Africans go faster on their hard days, and much slower on their easy days.

Trap the Second: Becoming a Slave to the Numbers.

This has always been a tough one for me. I love me some stats. What I have often found myself doing in the past would be going out for a run that was a planned distance and when I didn’t really feel it forcing myself to complete the distance even at the expense of future runs. Or, even if I DID somehow manage to bag a run early and save myself a little I’d find myself looking at the planned weekly mileage and trying to either squeeze in additional runs or add those miles back to another run. Sometimes I’d get lucky and it would all work out, but usually not. We need to learn to listen when our body is trying to tell us something. Running 45 instead of 50 miles probably won’t have any real effect on our training, but picking up an injury most certainly will (ask me how I know!).

So to summarize – run your slow runs slower than you think you should, run your fast runs faster than you want to, and listen to your body. Now if I can manage to listen to my own advice I might actually have a decent set of races this year!

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First things first:

Go Watch This Right Now.

I love running. I’ll run nearly anywhere. I’ve even mentioned before how much I enjoy running through new cities as a way to see them. That having been said, I find myself increasingly drawn away from all the roads and sidewalks and towards the trails. I think the above linked short film does a fairly remarkable job of explaining the reasons why without ever speaking a word. I, on the other hand, don’t currently have the time or resources for a short film of my own, so words will have to suffice. And maybe a photo or two…

Trails: better than Suburbia.

Trails: better than Suburbia.

See that? That’s a photo I took on a trail run with the girlfriend a couple weeks ago. It was only five miles, but I think it was one of the most enjoyable runs we’ve ever been on together. When you leave the noise and traffic of the roads you can afford to be much more present with your running and those you run with. When you are distracted, it’s not because you don’t entirely trust the invisible fence keeping that dog from inspiring an unplanned fartlek session, it’s because you want to stop and admire everything around you. And when we run through such places, pushing our bodies, we often find that we’re no longer observing but taking an active role in the nature around us. By this simple act of running we can somehow become less civilized (in a good way!).

So if you’ve read this far and aren’t nodding knowingly you may be tempted to give the whole trail running a try. If so here are some tips and caveats:

  • If you think there aren’t any trails near you, you’re probably mistaken.
Ooooohhhh pretty....

Ooooohhhh pretty….

This is another photo from our run the other week. What you may not realize is that these were both taken within the city limits of Philadelphia. If places like this exist within the limits of the fifth largest city in the country, I’m very confident you can find something where you live.

  • Carry more than you would for an equivalent road run. This is doubly the case for an insulin dependent diabetic.

If you’re on the road and you step off a curb and turn an ankle, the odds of starving to death or being eaten by a bear (or Grue) are still remarkably low. Depending on how far out you go, something as simple as a turned ankle can become life threatening on the trails. Carry at least some nutrition, water, and phone. Diabetics should consider a test kit and additional carbs.

  • Don’t forget to enjoy the view.

Seriously. That’s the whole point! If you don’t slow down (or even stop!) every now and again to take in the air and the scenery, you may as well stick with the (probably) far more convenient roads.

Running, or any exercise for that matter, can be viewed as a chore to be slogged through or an end unto itself. Enjoy the journey.

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Better Than Naked

Okay okay… Get your mind out of the gutter. I am of course referring to the Better Than Naked line of apparel from The North Face. Specifically in this case, to their running shorts.

I should start by saying that in my opinion one of the greatest things about running is it’s simplicity. There is strong anthropological evidence suggesting that we have been distance runners (or “persistence hunters”) for most of our evolutionary history. Today, there are a small number of tribes in the world that still practice this (Dr. Tim Noakes touches on this in his excellent “Waterlogged” to be reviewed soon). These tribes, or even the children playing in parks and back yards all around the world, don’t need the latest in motion-control footwear or wicking light-weight fabrics to run. They just run. In fact as a side note I strongly encourage you to watch a group of children run; it’s remarkable. They instinctively have great form, and run with no fear, but rather complete joy. Afterward compare and contrast with the adults at your local running park. Scary stuff indeed!

Where was I? Oh right… So while all one really needs to run is a pair of shoes and a path, for the diabetic runner this becomes slightly more complicated. At the very least many of us need to carry a pump. For anything longer than a few miles I often carry a CGMS with me and for a really long run I’ll also pack a meter and strips to double check. Add to that the need to carry carbohydrates – remember, for someone with a functional pancreas carbs may be required for optimal performance; for a diabetic they’re required to prevent a visit to the emergency room and soon you’re looking around for a Sherpa to help out. Anyway the point here is that while in my mind going out for a run is an exercise in minimalist simplicity the reality of the matter is I have to carry stuff. For long stuff I usually rely on my trusty Spi-Belt, but for my more run of the mill stuff I’d rather not wear it. So with that in mind a year or so ago I was cruising the REI outlet website (which I L-O-V-E!) and I saw the Better Than Naked shorts on sale for a price that was hard to pass up, so I bought a pair. My expectation was that they would be reasonably well constructed, lightweight, and comfortable. I’m please to report high marks to the shorts in all three. What I didn’t expect was how perfect these are for the diabetic runner.

Really, it’s all about the pockets:

Like a glove!

Like a glove!

See that? That’s my pump fitting perfectly into one of the side pockets. There’s an identical pocket on the opposite side perfect for a CGMS receiver (at least for my Dexcom 7+):

Also quite convenient...

Also quite convenient…

Finally in the back there is a third, larger pocket that holds enough nutrition for a decently long run (note: there appear to be two versions – one has a zipper pocket in the back while the other has an open top stretch pocked similar in construction to the side pocket. I have not yet had anything fall out of either). All of these pockets are cleverly integrated in such a way that provided I’ve tied the shorts drawstring tightly enough I get nearly zero bounce. I’ve now used them in everything from a fast(ish) 5k to marathons and they’ve held up flawlessly.

Final word: after initially purchasing just one pair, I have since purchased about half a dozen more and run in nothing else. Highly recommended!

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Running with IN

My friend Brennan tweeted this earlier:

That got me thinking. Since November I have done the following races:

  • Philly Marathon (with Insulindependence)
  • Carlsbad Marathon (with Insulindependence)
  • Ragnar Del Sol (with Insulindependence)
  • Ragnar SoCal Ultra Team (with Insulindependence)
  • ODDyssey (without Insulindependence)

So… there’s that. ๐Ÿ™‚

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