For those of you who have not read my story about competing in the Solo division of RAAM in 2007, I have decided to share my story below that I wrote over a year ago. You might ask Why Now? Well I hope that it might help some people out there Type 1 diabetes who are struggling with the day to day challenges of this insidious disease.
And now that we have become bloggers I want to let people know about what Solo RAAM did for me looking to the now.
So ....As they say Hindsight is 20-20 look for my next blogs on how I am working towards 20-20.Race Across America as a Type 1 DiabeticTwenty to twenty-two hours a day of cycling for nearly two weeks through 14 states, across all types of terrain and in all weather conditions, all while managing type 1 diabetes. For most people, this sounds impossible. In retrospect, it does sound pretty crazy, but it is also the ultimate way to challenge yourself with what life it truly about.
I have found the words of the philosopher Eric Butterworth to be an expression parallel to how I wish to live my life…
“Why be an average person? All the great achievements of history have been made by strong individuals who refused to consult statistics or to listen to those who could prove convincingly that what they wanted to do, and in fact ultimately did do, was completely impossible.”
After competing in RAAM twice as a team competitor, the race has developed for me into an addiction that is difficult to describe. RAAM has an aura that is unmatched by any other race I have competed in, it drives you to return and compete again and again. The complexity of the challenges and obstacles that competitors and crew in RAAM endure is mind boggling, but at the same time forms an internally compelling desire that gives you no choice but to return and compete again.
This past year, I was determined to enter as a solo competitor and fulfill what seemed to me to be the ultimate personal challenge - 3050 miles across 14 states with my goal being to finish in the time cut off of 12 days and five hours. Managing sleep deprivation, keeping average speed above 10.1mph (the minimum to meet the cut off times), tolerating and consuming enough food to sustain energy and coping with physical ailments such as saddle sores, were just a few of my personal fears in undertaking this event. My additional challenge was to manage my type 1 diabetes in order to maximize physical performance - a challenge that I struggle with on any normal day, let alone while riding 20-22 hours a day.
My initial compelling reason was totally selfish and really a personal challenge for me to see if I could be tough enough and good enough to complete such a huge undertaking. RAAM is what one might classify as one of the ultimate tests in the limitations of humanity - what more can I say in regard to compelling reasons (in the warped kind of way that ultra endurance athletes think!). To simply make it to the start line of RAAM is the ultimate test in organization, determination and will power. To finish is the icing on the cake.
As the time grew closer the compelling reasons began to change, as I realized this was not about me challenging myself any longer. I was out to express to people - that those of us who are inflicted with type 1 diabetes can do anything we set our hearts and minds to. As I made my way across the country, the expression broadened not just to those with Diabetes but to all those people supporting and watching my progress. Not finishing the race was not an option. It was important to make it because my crew and people watching the race were counting on me to prove that anyone can do it, all you need is enough heart and desire, some physical preparation and a good dose of perseverance.
Preparing for the raceThe planning for the event proved to be a full time job in the two month lead up to the race.
Had I not decided to quit my job due to some personal issues I do not think I could have done it – that is the organizing or the training. As I have indicated above, to make it to the start line you deserve a medal for diligence.
Training for the event began with base endurance which was something I had been building for the past eight years as a cyclist and in general my whole life trying to live a healthy lifestyle.
Throughout the 2006-07 Winter I trained roughly 15-20 hours a week by skiing and cycling on my indoor trainer. I did a lot of long backcountry ski touring throughout the winter months, as living at 8150 feet (with average snowfall above 300 inches) makes riding in the winter pretty challenging. I classic and skate ski on groomed trails around our home, do long backcountry tours on roads and in untracked snow. As the spring and summer emerges I substitute skiing with riding, running and the occasional swim. Of course my number one choice is to ride, but the diversity keeps me from injury and overtraining (sometimes).
As the weather became warmer I began training outdoors for 25-40 hours per week. In the spring (beginning the second last week in April) I went to California for 8 days and did several 100+ mile days followed by a 3 day solo trip with a small backpack from Salinas CA to Malibu, CA. This was a key element to building mental and physical toughness as I had no-one to call and bail me out, I was on my own. Then, through the remaining weeks from the end of April until the end of May I continued with several 2 day back to back long rides such as 200 miles followed by 80-100 miles. In the weeks leading up to the race, I slowed down a little and did shorter rides at a high intensity. I also continued until about 3 weeks out from the race to run 2 times a week and occasionally swim to keep the variety and try to avoid overuse injuries.
RAAM preparation is not really only about the 9 months of specialized training prior to the race but more the end result of an ultra endurance lifestyle. I think you will find that many people who do this race may not be cyclists but are endurance athletes in a variety of sports. The training you do is a lifestyle, everyday, not just to prepare for a particular race. The lifestyle choices you make are what help prepare you for an event like RAAM. My regimen is more of a daily lifestyle choice to try and help manage my type 1 diabetes, stress and depression and of course to stay healthy.
I love to ride my bike, it is not really about racing but about the way exercising makes you feel – the training is simply a way to add some structure to daily activities which assists in maintaining healthy living with mental and physical focus.
This however is a bit of an oxymoron because it is very easy when attempting to be an ultra athlete to over train. Which in-turn causes stress, depression and lack of motivation. These are some if the challenges I have often struggled with. My training regimen could be accurately labeled as Obsessive-Compulsive. I think for almost all RAAM solo competitors they probably have many of the same OCD characteristics, usually you must suppress and control them in order to maintain other life functions, but during RAAM preparation and the race – you can let it all hang out.
My crew wagered bets on how long it would be after RAAM before I got back on my bike – for some it was a couple weeks, my Mum was the most accurate she said a week. I went home and raced in the local mountain bike series race on the back of a Tandem with my husband Stephen the day we arrived home 5 days post RAAM. Stephen shook his head and said no but I won the battle. This was a social event to simply let my friends and all those supporting me know that I was home, alive and well and it was great to feel my heart almost jump out of my throat again.
The RaceSo what happens when you ride a bike for 20-22 hours a day for 13 days straight as a Type 1 Diabetic?
Let me begin by saying ‘nothing is as it seems’. Everything we had predicted with my insulin doses did not quite pan out as anticipated, but this was not going to stop me from achieving my goal.
I began the race using a Continuous Glucose Monitoring device which was a great asset initially, but as with many new medical devices it had some quirks. The device was good, but I returned to my faithful blood sugar monitor three days into the race to help with consistency in my readings. I tested myself about 10-13 times each day and once an hour when I was not feeling the best. My long acting insulin doses (of Lantus- a stable base line 24 hour insulin) were a twice daily event. Normally an 8 unit dose in the morning and a 16 unit dose in the evening. Then short acting insulin injections at meal times throughout the day. Usually these are 3 times daily 2 units in the morning, 2 units at lunch, 8 at dinner and 4 before bed. I had worked collaboratively with my endocrinologist in lowering my insulin doses as we thought this would be necessary for the first several days until I reached a baseline level of insulin that I would need for the remainder of the race (about 50-60% of what my normal daily doses would be of my long acting insulin) and a larger drop in the short acting insulin that is taken at meal times. It was anticipated that my short acting insulin would possibly be needed in small doses when eating meals but not really while I was eating on the bike.
Things seemed to be okay the first few days, blood sugars were dropping and I was eating plenty. Then around day 4, things started going haywire. Blood sugars were rising then I would take short acting insulin and bring them down but a few hours later they would rise again – each time I ate more than 1-2 portions i.e. 15-30 grams of carbohydrate my blood sugar would rocket up. The long acting insulin doses that I take 2 times daily were not enough to cover the load. In prior 24 hour mountain bike races I have kept my blood sugars stable just using long acting insulin (at about 75% of the normal dose) with little need for the short acting insulin. This however was not the case after multiple days of constant exercise.
My Endocrinologist – Dr Peter Gottlieb from the Barbara Davis Center in Denver - after reviewing my blood sugar logs and food log seems to think that my body entered a high stress/hormone phase probably around day 4. This is when blood sugars began to rise and although the exercise intensity was still high – where-by muscle glycogen supplies were constantly being exhausted, the stresses on my body were requiring additional insulin to assist with processing food and most likely the high levels of adrenalin and hormones in my body (which also raise blood sugar levels). I continued to raise the long acting and short acting insulin doses throughout the race but in hindsight not nearly enough.
As a counter strategy in trying to bring my blood sugars back into the more normal zone and for other reasons as well as blood sugar control, I began to consume a high protein diet. My food intake initially was heavily carbohydrate loaded with ‘powerbars’ and energy drinks as the primary energy source for the first 1-3 days. Additionally, I ate trail mix, salty crackers, yogurt drinks, jerky, cheese and bread/bagels with peanut butter. After three days, I began to feel that something was not quite right and that I was lacking in energy. I had lost a significant amount of weight in what seemed like a very short period of time so my diet was changed to a very high protein content - six eggs burrito for breakfast, avocado sandwiches, chicken and cheese at other intervals throughout the day. Over the next several days this high protein content definitely helped improve my energy levels. I was also consuming bread and butter, trail mix, Powerbars and the occasional stick of licorice or jerky but the carbohydrate content was definitely not at a level one would think you would need to be riding your bike for 20-22 hours a day. My crew adjusted to this high protein diet as I had lost a lot of weight around day 4-5 and this definitely helped with some of the muscle loss I had experienced. But unknowingly it also was the right strategy for resupplying my muscles with energy while my blood sugars were in a much higher than ideal state.
My nutrition was definitely unusual and not really what I had anticipated. Thus – my diet was very high protein with considerable carbohydrate consumption but if blood sugar control had been better I may have consumed more carbs than protein. Yet another “What if “ scenario that I may never know the answer to. The strategy used at the time was absolutely successful. Fast food, cookies, cakes, alcohol, Gu’s etc are not part of my normal daily diet. The daily management of my blood sugars is a super challenge, I have made a conscious choice to not add any more variables into my diet because it tends to be fairly unmanageable as it is. I may have eaten a McDonald’s grilled chicken sandwich at the final time station in NJ (just the thought of it now makes me shiver) but this is as close as I ever get to fast food. French fries and hamburgers are definitely not on the foods that I eat list – any time, cycling or not. My diet is very healthy, but any carbohydrate consumption for a diabetic is challenging. Your body does all sorts of things with that fuel – and the same fuel from day to day can have very different effects on your blood sugar depending on the moment. Simply living is pretty challenging some days, but riding my bike is one of the experiences in life that helps me feel like I can be normal for a few moments in time, and when things are in control I can eat Powerbars – my favorite and most faithful riding, running, skiing, swimming and all round energy food.
Saddle Sores The next biggest issue apart from Blood sugars being out of whack was saddle sores.
If there was a reason to DNF my butt would have been it. My massage therapist had a role change mid race and became my crotch therapist. I tried just about every possible item you could buy to ease the pain and discomfort. Lanacaine cream and bag balm were the best as they provided a combination of pain killing with antibiotic treatment to at least prevent the abrasions from getting worse or becoming infected. My analogy of RAAM and saddle sores is - at best you will have some discomfort, at worst saddle sores can be a very real reason to DNF. For me it became a battle of mind over matter – in which I would not let the matter win! We cut apart several hundred dollars worth of saddles to help with easing some of the pressure points causing discomfort and I used an adjustable stem which allowed my mechanic to change my handlebar position as the situation developed. By the end I could only laugh at myself as I looked like I was sitting in an armchair with the arm rests displayed at about chin height – definitely for comfort not aerodynamics. The remedial bar position – a position which I kept for several weeks after arriving home until my husband ordered me to put the regular stem back on proclaiming “You are not racing in RAAM anymore, that is embarrassing to look at!”
Sleep Deprivation
Ah if only you did not have to sleep to make the most of your waking hours – RAAM would be easy – NOT. Sleep deprivation however is an obstacle you must learn to manage and keep in control. If I had not had to sleep I could have kept riding as physically my body and mind were in it to the finish, but when you are falling asleep while riding you have no choice but to stop and sleep. My originally planned 3 hour sleeps per night were not really doing the trick, and since I was falling behind the necessary pace we had already cut the sleep time to 1.5-2 hours. After a few different approaches we found 1 hour around 10-11pm when I normally would go to bed, and then another hour around 4:30-6am were working better. Then if I started weaving and riding poorly my crew would stop put a blanket down on the side of the road and I would take a 10-15 minute power nap and get right back on the bike. The power naps staved off falling asleep for 45 minutes to an hour and then I would need to do it again. Usually a couple of power naps a night until my sleep at 4:30am would do the trick and keep me safe and riding as much as possible.
Despite the fact that I was an unofficial finisher due to missing the final time cut off in Indianapolis, Indiana - I gained so much. There was overwhelming support and encouragement from people all over the world for me to continue to Atlantic City and feeling this energy and hearing messages from supporters helped me to continue. My amazing crew showed an incredible commitment to me, one that I can never repay them for and a commitment which drove my desire to continue all the way to the finish line. My goal is to continue this hope and inspire people to live their dreams and believe in the impossible. Dream it, Plan it, Live it!
The Clark Bridge a momentus crossing of the Mississippi River
The RAAM Aftermath I don’t know what you think but I had imagined that Racing RAAM was the hard part. I would have to say that the post RAAM events have been almost if not more challenging than riding my bike for 13 days. RAAM ends when you reach the finish line…Diabetes unfortunately does not.
I think I could describe my post RAAM condition as one whereby I have reached the maximum state of Insulin resistance. My body has been in a general state of protest. I stored everything I ate and gained 10 lbs. My body was preserving itself just in case I might be crazy enough to put it through the same punishment again. Body and mind in these instances are not communicating on the same plane. Even though my mind knew I would not do it again any time soon, how was my body supposed to know too.
My blood sugar control was off the wall – highs every day and they just did not want to come down. I was still exercising a bunch – maybe not full speed ahead but not really anything lower than what my normal exercise routine had been pre-RAAM training – 2-3 hours a day broken into 1-2 or 3 separate sessions. Trainer in the morning before work, run at lunch a few days a week and ride or swim after work. Then long rides on the weekend.
Well back to the Doc it was. I have worked diligently for the past 8 years with my Doctor to bring a disaster laden A1c reading of 11+ (The A1c is a laboratory test that indicates the average amount of glucose in the blood over the last few months. Roughly speaking, if your A1C is 6, you have been keeping your blood sugar around 135 mg/dL on average. The higher your A1C level is over time, the higher are your chances of developing serious complications from diabetes including retinopathy, amputation, kidney failure, heart disease and neuropathy.) Down to 7.9, but now I knew I had most certainly been on the upswing. I have been in the danger zone for complications from diabetes for several years as I have tried many different insulin regimens, exercise and healthy lifestyle habits to bring my A1C down into the desired 6.5 zone. Obviously I am not there yet and I took an upswing back to 8.7 after RAAM preparation and racing. Now however after 3 months of diligent carbohydrate cutbacks, altering insulin doses and returning to a somewhat more normal schedule I made a miraculous drop to 7.6 over a 3 month period. The nurse and Dr were practically dancing in the office when they saw my last A1C, this did not however come without a great deal of self control and more than diligent management. I am determined to make it to 6.5 in the next year and of course more importantly stay there. I have already had one period of Diabetic retinopathy treatments. As the Dr explained I am on rung 6 of the second 10 runged ladder of danger – I cannot let my guard down and must stay vigilant in reaching this goal for the sake of seeing the incredible beauty that surrounds us every day of our lives.
Defining the UNITED STATES OF AMERICA
This country is of course even more beautiful when travelled on a bicycle. My Dad describes this incredible country and the moments of RAAM with words of such eloquence I cannot help but share them with you..
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Many parts of the country have left a lasting impression on me. Just the thought of riding “from sea to shining sea” is a concept of great immensity. I find both the oceans (superior and inferior – an Australian term of course) an inspiration. I love Oceanside – such a great place to start. The pure adrenalin rush of the start is also very special. I love the California Coast Ranges with their stark outlines and lack of trees.
The desert and the Salton Sea were sights to behold and the Colorado River seems out of place when you eventually reach it. The Indian country of the Navajo and Utes was forbidding and little reward for native Americans – just like Central Australia and the aborigines. Monument Valley at sunset was very special and the Rocky Mountains need no explanation – their grandeur astounds. Your ride up Wolf Creek Pass will never be forgotten by those of us privileged to see it. The plains of Colorado and Kansas with the rolling hills of “Misery” were seemingly endless. The State Capitol at Jefferson City is as Dave puts it “the only good thing about Missouri” The mighty Missouri River and crossing the Mississippi on the Clark Bridge were special moments.
National US 40 recalls history lessons and the Covered Bridge we crossed reminds me of your Grandma Crews and her love of these old landmarks.
Just when you think it is all over then comes the Appalachian Mountains and finally the brassiness and crassness of Atlantic City.
I have left out the two which moved me most. The Tornado destruction of Greensburg, Kansas was incredible to see and the early morning in Gettysburg reminds us of how Americans slaughtered Americans in the Civil War. Both places brought tears to my eyes.
Nothing we saw compares to the sight of your relentless ride with all the courage it took to go on and on towards your goal. It was priceless to watch and indescribable in it’s manifestation of all the heart and soul which makes you the pesky fighter you are.
We love you all the more for this and thank you for wanting us to share it with you.”
The Finale...I hope that you might concur with RAAM Communications Manager, Perry Stone whose words express what I had hoped to achieve. To show the world that courage and bravery can go a long way, and that Diabetes is not the end of the world it is merely the commencement of a realization that life is not a destination but a journey…
‘I have to wonder if what Kerry White did, in some ways, isn’t grander than just becoming an official finisher of RAAM. Isn’t what she accomplished the greatest example of ‘making the best of it’, that you have ever seen?
What a wonderful world, she had the courage and bravery to show us so much. She may have come in last, but for many, she led the whole way.’
