This one is a bit of a double (triple, quadruple?) entendre. This title ran through my head the other day when I was literally running. I was having a rough long run day. My blood sugars were not cooperating, my legs felt heavy, I was feeling loaded down by all the extra crap I have to carry with me, feeling nauseous from eating too soon before a run and feeling resentful that I couldn’t just roll out of bed, throw my shoes on, and run out the door like non-T1Ds can. “Train in Vain” – feeling defeated no matter how hard I try. At times this disease can feel like a runaway train or a locomotive barreling right towards you. “Train in Vain” – listen to the lyrics of that Clash song. It could be a letter to my pancreas! “Did you stand by me? No, not at all.”
I was having a pity party for sure. It’s tough to manage type 1 diabetes. It’s a a 24/7 thing. I’m sure people who don’t live with it get a little compassion fatigued hearing me spout this all the time, but it’s truth. If we make it look easy to manage, that’s just because we do it. We have no choice, we have to. Every single second of every single day. You don’t see it most of the time. We just get on with it. You don’t see it when we’re sitting there talking to you, but feeling awful because our blood sugars are a) too low, b) too high, c) rebounding, d) exhausted from lows or highs all night. Any of those can be because of something we have no control over, not poor management. I can’t tell you how many times I’ve been stuck in an important meeting or the like with a pump that died or some other issue and I’m trying to concentrate while I wait to get out and do something about it. Don’t tell me I should have just said something. Life is not always that easy. You know that.
But, back to running and “Train in Vain.” I’m currently training for my second marathon. I’m running the Chicago Marathon in October this year with Joslin Diabetes Center’s team. My rough running day got me feeling defeated and very angry that I have to take all the diabetes stuff into account every time I walk out the door. I was researching marathon training plans to see if there was anything I could add to my current regimen and came across a forum where an idiot was denigrating people who use hydration vests or belts – that they weren’t “real” runners. Honestly, that’s absurd. If you’re running at all on a regular basis from one mile to an ultra marathon, you’re a runner. It’s that same BS that is apparently abundant all over, or more to the point, the tear-down-someone-else-to-make-yourself-feel-bigger syndrome. Trolls are everywhere.
Regardless of the absurdity, the comment stayed with me and had me feeling weighted down. The Chicago Marathon does not allow hydration vests – a lot of races don’t. (In fact, make sure you check each races’s regulations well before race day!) I used a hydration vest on my first marathon last year in New Hampshire. Because I am a type 1 diabetic, I have to carry things with me on three-mile training runs and yes, marathons too, that the average runner does not.
Here’s a list of what I carry with me for a marathon – a bit less, but a variation of the same for shorter runs:
- My iPhone – it’s connected to my Dexcom CGM (Continuous Glucose Monitor), so I need it to monitor my blood sugar levels throughout the race.
- My insulin pump – it’s attached to me and I need to find a place for it and try (in vain – there it is again) to keep it from getting too sweaty or rained on.
- A mobile charger for my phone – if my battery dies, my CGM info does too.
- A blood glucose monitor – in case my CGM dies or gets knocked off me or just fails, because they do that sometimes, usually at the worst possible time.
- A vial of insulin and at least one syringe – in case my insulin pump site gets knocked off of me or just fails, because they do that sometimes, usually at the worst possible time.
- Glucose – incredibly important since you’re exerting so much energy – even with all the training, things never work the way you want them to and you have to be prepared – I need to carry at least 3 tubes of glucose tablets with me when running a marathon and I usually carry a couple packs of fruit snacks too.
- GU gels (or your preferred brand) – I need 5 for a marathon, but I bring more than that. Those tubes are hard to open and sometimes they can’t be salvaged. I bring extra for backup glucose sources too.
- Electrolytes – usually my handheld water bottle has electrolytes. That’s important for everybody when sweating, but for a T1D, it’s even more important. Dehydration can increase your blood sugar – it basically concentrates the sugar in your system, which can, in and of itself, cause dehydration as your body tries to rid itself of the excess sugar. It’s a vicious cycle.
- Water – see above. Same thing. I carry more water and electrolytes than I probably need to, but running out of either could be catastrophic for me. I carry plain water in the bladder of a hydration vest. I’ll be training with plain water in a couple bottles on a belt for this upcoming marathon since vests are prohibited. My plan is to take advantage of the early water stops and keep water on me for the last part of the race. I’m not a super-fast runner and I’ve heard some race stops start to run out or get dismantled before everyone gets through. I can’t run out of water.
Carrying all that is a pain, but the main thing that bugs me is having to stop to take care of diabetes stuff. If something is up, I have to sacrifice time. I may have to stop to give myself an insulin injection or get some glucose in me. Oh boy, did that happen to me today, Memorial Day 2019! I ran the annual 10K race that I always do. It’s a tough one – really hilly, but it’s fun! I started out great and was running sub 9-minute miles the first half of the race, but my blood sugar started to rise a bit and I had to stop several times to fiddle with my phone to see my blood sugar number and then with my insulin pump to try to give a correction bolus and take my lowered temporary basal rate off. I completely screwed that up and somehow turned all insulin delivery off for the second half of the 10K! I was 328 and going up fast at the end. I felt like crap that second half due to lack of insulin. I was shooting for a PR to finish under an hour too, but that did not happen. Still, despite all that, I crossed the finish line at a respectable 1 hour and 1 minute. That’s also a full 8 minutes faster than I ran it last year! So, I’m using that as a learning tool for future races. See above – devices fail and usually at the worst possible time.
That said, this is the stuff that really pisses me off – needing to constantly monitor and physically deal with all these things when all I want to do is just run.
