Monday, September 08, 2008

Ironman 70.3 Rhode Island, July 13, 2008

Sorry it has taken me so long to get this report up. Like everyone, I get a bit backed up sometimes - training, racing, traveling, working, speaking, creating a new design for my website (stay tuned!), writing a book on Finish Line Vision (it’s going to be great!) and most important . . . spending time with my wife and beautiful 16 month old daughter.

Ironman 70.3 Rhode Island was a race of firsts. (I still can’t get used to saying “Ironman 70.3” instead of Half Ironman, but it’s the race organization’s new thing so I guess I’m stuck with it. An Ironman is 140.6 miles so a half is 70.3 miles. Get it? But have you ever heard someone run a “marathon 13.1?” I haven’t either.) It was the first year for this race, my first flat tire in a race, the first time I had to wake up at 2:30 a.m. (ugh!) for a race, my first triathlon (after 8 years and almost 100 triathlons worldwide) with separate transitions for T1 and T2, 56 miles apart. Besides that, it was a normal race. Here’s how it went.

I’d spent the week before the race in Massachusetts at Camp Joslin, a summer camp for boys with Type 1 (insulin dependent) diabetes, just like me (see other post). I thought why not bring my bike and do the new half Ironman race in nearby Providence, R.I? By the way, this Southern boy is used to training on wide open spaces and lonely mountain roads, so it is amazing how “nearby” everything is in the Massachusetts, Rhode Island New England area. One bike ride and I cross 3 states!

The race started about 40 miles south of Providence on the beautiful Rhode Island beaches of Narragansett, and finished in downtown Providence. T1 was at the beach in Narragansett and T2 was 56 miles away at the finish. Unlike most races where everything starts and ends around one transition area, this one was strung out across the whole state of Rhode Island. That meant a long drive the day before the race in summer beach traffic to check my bike into T1, but it gave me a chance to drive the bike course on the way back to my hotel in downtown Providence. I’m glad I did because the bike course was a challenging maze of hills, turns, and once near Providence, busy intersections and pot-holed (landmined) city streets. At least I knew what to expect race day.

It was an eeaarly wake up call at 2:30 a.m. to catch the shuttle at 3:30 a.m. in downtown Providence for the ride down the coast for the 6:00 a.m. start. I’ve always said that the early wake up call is the 1st event in a triathlon, and this one was so early I might as well not have slept at all. I think they wanted to start the race so early to beat all the city traffic on the bike course, but that didn’t really work (more on that later). It was an amusing collision of time zones as some of the Saturday night Providence bar crowd heading home encountered hundreds of nervous triathletes gathered on the sidewalk at 3:15 a.m. Their day was ending when ours was beginning. Two worlds collided.

How does a type 1 diabetic eat and keep a stable blood sugar for a half Ironman getting up at 2:30 for a bus ride? Requires some planning. I carried my bagel with peanut butter on the shuttle and ate it right when I arrived at transition around 4:30 a.m. As always, I had to carefully plan when I ate and took my insulin to try to keep my blood sugar stable prior to the start. I was not particularly happy that I had to be in transition this early, and then wait over 2 hours until my wave started at 6:50 a.m. I was in the 12th of 13 waves, so I had to watch almost the entire field start and finish the swim before I even started. I had the longest warm up swim of my career, then paced the beach like a spectator in a wetsuit.

They like to start the slowest athletes first and the fastest athletes last (usually males age 30-44) so that everyone is off the bike course sooner. Makes sense, but it means I would spend the whole day passing the field in front of me. My blood sugar was pretty stable between 100 – 150 mg/dl in transition and prior to the start. I reduced my basal to 50% of my normal basal rate right before I left the transition. My first mistake. In the past I usually reduce my basal by 50% on long workouts and races over 3 hours, but lately I've been encountering high blood sugar in races. I was a little afraid it would drop during the swim after this long delay so I drank a little extra of my high carbohydrate drink in the last 30 minutes before my start. My 2nd mistake. I guess I drank too much because my blood sugar was way too high after the swim. That set me up for the blood sugar roller coaster that can destroy my day.

The ocean was pretty choppy and with rolling swells but nothing I had not seen before. The wind was very gusty and strong (and would be especially strong later in the day on the run). I had an okay swim, not pushing too hard, but trying to stay in visual contact with the best swimmers in my wave. That was hard after the first 500 meters with the windswept chop and swells, so I just settled into a somewhat solitary 1.2 mile journey, occasionally passing slower swimmers from waves ahead and others in my wave. I came out of the water in 32 minutes, top 20 in my wave of 150, feeling really good, a decent time considering the wind, current and chop, but it was hard to tell where I was in the main field given that most everyone had started and left long before me.

My Omnipod insulin pump stayed rock solid on my left triceps (see photo). T1 was deserted and eerily quiet since 90% of the field was already gone. I checked my blood sugar quickly on my One Touch UltraMini meter – 250 mg/dl! Ugh! Way too high! I clearly had drank too much carb drink right before the swim, trying to prevent a low. Now I had to make that awful split-second decision, “do I give myself insulin to bring it down, but risk a disastrous low blood sugar on the bike?” or “do I hit the bike and hope it comes down from the activity, but risk 2 hours of high blood sugar?” I knew I had to consume about 60-70 grams of carbs per hour on the bike, mostly from sport drink and a Clif Bar, so I would have to keep eating/drinking carbohydrates for fuel. But if I consumed carbs with my blood sugar already so high, it might never come down and I’d be nauseous, lethargic and probably dehydrated in 2 ½ hours when I would start the half marathon run. Ugh. Diabetes sucks sometimes.

In that split second in transition, I chose not to bolus insulin and hope my blood sugar would come down on its own from the exercise.

The first 20 miles of the bike were flat and fast, with mostly a tail wind coming off the ocean. I was riding my disk wheel on the back and felt great, averaging 25 to 30 mph for much of these stretches, passing hundreds of athletes from waves in front of me. After about 1 hour at around mile 25 the hills started, a gradual stair step of rolling hills and a few steep inclines. Because my blood sugar was too high, in the first 1 hour I drank mostly water and very little of my carbohydrate sport drink. The temperature started to reach the mid 80s and I knew hydration would be important for the run, so I kept drinking. My blood sugar was a big mystery at this point. I could bring my One Touch Ultra Mini meter with me, pull off the course, stop, and prick my finger to check, but I’m not sure I would do anything differently even if I knew what the blood sugar was. I had to get carbs in me to race. I started drinking more of my sport drink and even ate a Clif Bar around mile 35. I continued passing hundreds of athletes who started in front of me, and was passed only 5 or 10 times in the first 50 miles. My right quad started cramping a bit around mile 45 but I knew most of the hills were over and I only had about 10 miles to go. I now entered the congested section of the course outside of Providence, full of cars and turns and pot holes.

At mile 50 I started a long fast descent , doing about 30 mph, mentally preparing myself for the run in about 15 minutes when . . . psssssssss, thump, thump, thump. Oh no. My disk flatted. Ugh! I pulled over quickly, onto a sidewalk and parking lot next to what looked like an abandoned building of some sort. Nice area for a bike race. Athletes I’d passed miles before began to whiz by me as I started the tedious task of removing my disk wheel, ripping the tire off the rim, removing the spare taped under my seat and stretching it around the rim, lined up perfectly on the rim with glue, then filling it with air from my CO2 cartridge. Sounds a lot easier and quicker here than on the side of the road 50 miles into a bike race, when you’re hot, tired, and frustrated. The whole process probably took me at least 10 minutes or more in the hot sun, while at least 150 athletes zoomed by me. I finally remounted and had to take it slow and easy on all these turns because my spare tire would not be as secure on my disk rim since it had less glue. This was also the ugly section of the course with lots of traffic and turns and pot holes. It was a “bad” section of town and the car traffic was not happy about cyclists in the road and police blocking intersections for us. Some intersections had only about 4 feet for us to ride while cars zoomed passed us, scaring me at any moment one would abruptly turn, weave in front of me, or open a door.

I finished the bike in a disappointing 2 hours, 44 minutes. Very bad. I know I lost about 15 minutes changing my flat and taking it so slow the last 6 miles. I got even more bad news when I checked my blood sugar in T2 – 290 mg/dl. Ugh! Still way, way too high. My stomach was definitely feeling it now, and the temperature was in the humid low 90s, making it even worse. I gave myself a quick bolus of insulin from my Omnipod pump of only 1.5 units. Normally on a non-race day, I would take about 4 or 5 units of insulin for a blood sugar that high, but I knew the 13.1 miles of running should bring it down and I could not risk taking any more. I started the run feeling pretty nauseous.

T2 and the finish were right at the steps to the capitol building, with thousands of people packed around it and the streets. My legs felt good running. But my stomach did not. It was all due to the high blood sugar. At mile 1.5 we hit the massive hill, an 8% grade for about ½ mile straight up. I pushed hard to keep running even if slowly up this grade. Many athletes were walking. After about 3 miles the course flattened out until the descent of this same hill at mile 6 and I returned to the finish line area to do it all over again on the 2nd lap. The heat was stifling now, around 90 degrees, and the wind was fierce, gusting up to 30 mph around the finish area. My stomach was in shambles from 4 hours of racing with a high blood sugar. I really struggled on the 2nd lap, barely able to jog even an 8 or 9 minute pace, walking through each aid station to douse myself with water and any sport drink I could keep down. I lost even more time here, but I knew I was well out of contention long ago. Now I just wanted to finish as best I could.


I finally made it to the finish in a miserably slow time of 5 hours, 23 minutes, about 45 minutes slower than my usual time for a half Ironman. Very bad race for me but I know it was all from my flat tire and high blood sugar nausea. I think I will try the next long race at my normal 100% basal rate. Next for me is some shorter triathlons in August and September, leading up to my late season push with the South Carolina Half Ironman September 30 and US Long Course National Championship October 18 near Las Vegas. I’ll have better days to come! Stay tuned!

2 comments:

Bernard said...

Jay

Congratulations on finishing, despite your high blood sugars. That must have been really hard. Do you think you overdid the carb loading? If you were doing it again, what would you do differently.

I'm doing my first tri this coming weekend. Let's call it the Farrellman 18.1, since it's only a sprint. I'm a little nervous, since I'm usually just a cyclist. So my aim is just to finish.

Best of luck on your next half Ironman at the end of the month.

David Weingard said...

Jay, thanks for sharing the experience. I raced Ironman Rhode Island as well; wish I knew that you were there so we could meet up in person.

Although, my race times are a bit longer than yours, I had a very good BG day and have learned a few things from simulations over the last few years + incorporated guidance from diabetes coaches at www.fit4d.com

Perhaps we can connect and share what we have learned together and with the other diabetes athletes/Tri community?

Some things that come to mind immediately that may be useful to readers of this blog are:
- mount a meter on the bike. I have a Bayer Contour meter between my aerobars with a canister of strips on the tubing. This helps me manage my BG while not getting off the bike and losing time. Knowing my BG during the longer bike rides of half and full IM has been invaluable to me staying on track/correcting highs etc.
- I take a "replacement bolus" after the swim to cover the time in the water/tranisition. This is in addition to the insulin required for food. I eat 1/2 my first Powerbar after 15 minutes to give the insulin time to work itself in and the other half 30 minutes later. This helps eliminate spikes.
- The insulin that I take in T1 to cover food is delivered using both normal and SQ wave on my pump. The amounts leverage simulations in training and match a pre-programmed schedule / diet.
- I find that I am very sensitive to the heat and maybe lost additional electrolytes due to BG highs... so I take more insulin and wear a hat in the run. In Rhode Island, I put cold water in my hat at every water stop

Hope that readers find these tips helpful.

Best regards, David Weingard
dweingard@fit4d.com
www.fit4d.com