Tuesday, December 3, 2019

The Game Changers - a response to the responses..

I have been thinking a lot about the response to the The Game Changers documentary that was released in the last month or two. The response I have seen, as part of the vegan community, is that this is nothing new. It’s almost an I told you so sort of response. The benefits that the hero of the film describes and experiences being what many vegans have experienced and continue to do so. I include myself in that. Anecdotal it may be but that doesn’t make it wrong and let me tell you that to me it those benefits are incredibly real.

The other response has been to debunk the claims in the film. The tipping point for me was the Joe Rogan podcast (episode #1389) where Chris Kesser spent the best part of 3hrs debunking the claims in the film. I started to listen as I thought I was interested in the counter point. I managed about 20 minutes and then thought why am I listening to this? It’s not going to change my mind and if anything I will just get frustrated by what I am hearing.

You come to a realisation that it’s just a different view point and worse it’s just people arguing a point of view. The objectors to The Game Changers site the lack of scientific evidence or the selective choice of scientific evidence to support the claims that a plant based diet would be better for all. The naysayers seek to debunk the science. 

I am no expert but I am pretty sure you can find a scientific report or reference to justify more or less any stance you want to take (with the exception that the earth is most definitely not flat!). The Game Changers, much like Cowspiracy and What the Health before it, offer a perspective that there is another way. The reality is that many or maybe most people do not realise that.

The other facts are that, particularly in the USA, but the Western world has epidemic levels of heart disease, type 2 diabetes and other conditions labelled as lifestyle conditions. Obesity rates continue to rise and with it health has maybe never been worse.

Whatever we have been doing to date is clearly not working for an increasing number of people.

Considering this further you realise that there are no pro-meat or pro-dairy documentaries. There are millions of pounds of advertising and vast amounts of marketing telling us that milk, meat and eggs are good for us. That we should consume for protein and strong bones and teeth. 
  • that what our pizza really needs is more cheese in the crust 
  • that what we need in our burgers are extra patties and bacon oh and more cheese
  • that milk has calcium that makes our bones strong
  • that eggs are full of vitamins. 
It goes on and on. You then realise that this marketing has existed forever. Or certainly in my lifetime. If you are of a certain age you grew up in a world where consumption of this type was totally normal without there really being a viable alternative.

Where’s the film that describes how a vegan, we’ll call him Jack, who weighs in at barely 9 stone, has a pallid complexion and no energy. He has tried to sustain himself on plants but it’s just not working. He is vitamin deficient, his skin is dry and his hair brittle. Then someone in a white coat looks at his diet and suggests that he starts eating steak and eggs and maybe drinking cow’s milk. Over the coming weeks and months his body builds, his energy and vitality returns and the once barely 10 stone Jack is now a heroic 12 stone of muscle and confidence.

That film does not exist. That film will never be made.

That for me is the crux of the argument. Debunkers want to have their say as they want to protect their way of life and a film like The Game Changers questions that. It shines a light on behaviour that has always been that way. As a culture we grew up on meat and two veg. That was then and this is now. Where are the videos of celebrities and athletes that continue to eat meat telling us that? There aren’t any. Maybe they don’t need to as they consider that normal, it was and has been so for many years, you could argue that it’s been that way almost forever. The Game Changers represents a challenge and shift to that normal.

There is a lot of emotion bound up with food. We use food to celebrate and commemorate. We share our tables with friends and family and commune around food. A small subtle change to that makes everyone question their behaviour whether they want to or not. Then the response is an emotional one, people that continue to eat meat feel they need to justify themselves. That’s what I see the debunking as. An emotional response to something external that actually doesn’t warrant it.

It’s nothing more than choice. If you eat a traditional diet and watch that film and it makes you maybe change your behaviour a little then great. If it doesn’t have any affect on you then move on. The point of view offered by meat eaters is just a different point of view. Their normal is being challenged and they don’t like it.

Normal is being redefined. There really isn’t anything normal anymore.

Thursday, November 21, 2019

Nike running shoes (no not the 'next %')

If you had told me 5 years ago that I would one day be running in Nike shoes for not just road but road and trail I would have frankly laughed at you. I had one experience with Nike running shoes some years ago and it was frankly terrible. That was, truthfully probably more than 10 years ago but it has only been the last year that I have tried them again and that they have become my go to shoe.

It started with a Black Friday deal in November 2018 where I bought a pair of the Nike Epic React Flyknit road shoes. I bought them as they were advertised as being super-cushioned and I like soft running shoes. I assumed that they were the Nike version of the Adidas Ultraboost which I had been wearing for a couple of years and was not too far wrong. Whilst they are similar in terms of cushioning they are very different shoes. They are my go-to road shoe, I love the styling, the fit and comfort. They are also pretty responsive and feel and perform fast when they need to.

Nike Epic React Flyknit
Things I like;
  • Styling; I always associated Nike with street wear rather than technical specification and while these shoes have both they really do have great styling. The first ones I had were the PRS ones designed for the Paris Marathon, then some light coloured ones for summer and now some grey black ones with the weather changing.. the style is a personal thing but you can go as basic or as funky as you like with these off the shelf and that’s without NikeID where you can personalise them. For me the black sole unit looks awesome and I like that the outer sole is in pieces rather than covering the whle underside of the shoe adding weight. There is heavier sole protection around the forefoot and the heel.
  • Comfort; I wear a size 9 running shoe and these are no exception. I find the fit really excellent but I do have narrow feet. If you had wide feet you might want to try a pair in a store rather than buying online as not sure how that would work out. The lacing system is perfectly fine and doesn’t add any pressure to the foot at all. The upper is knitted and really sleek with no seams or edges to catch your toes on. It’s the sole, though, which is really the clincher. Its soft enough that I can run in them every day without that residual fatigue that you get and that I have had from other shoes.
  • Durability; I am all about shoe-durability! I want value for money so I am looking to get the top end of the recommended 500miles shoe life. In the two pairs I have retired I have got to closer to 550 miles in each of them with at that sort of wear my left knee, it’s always the left, starting to feel it. Of course durability is good but vfm is determined by what you paid for them
  • Cost; when these shoes came out they were advertised for £129.99 – pretty steep but commensurate with a lot of running shoes these days. As much as I wanted to try them I wasn’t going to spend that money on a trial when I was a little unsure. Black Friday it was where I paid around £70 for a pair. My thinking being that even if I didn’t like the I hadn’t wasted too much money. Out of the box I knew they were awesome and wasn’t disappointed. I mentioned above that I am now onto my third pair and have not paid more than £70 any of them. They end to have them at Nike Outlet stores and provided you can fnd a colourway you like the shoe is the same. That’s value!
  • Downsides? I don’t really think there are any downsides. At full price they are quite expensive and some may be put off by that but then look around and you will pay closer to half the book price.
  • Verdict; this is a 9/10 shoe! For me it ticks all the boxes I care about, comfort, style, durability and price.

When I found myself shopping for some new trail shoes I looked at what I had and why I was looking for new. I have some Adidas Terrex that are a couple of years old (low mileage) and whilst a good, sturdy shoe it feels exactly like that. More a shoe than a trainer. I keep them but will use them for dog walks up the hill rather than any actual running. I also have some Salomon maxi-cushion shoes, I forget the model. They were awesome but I find that on long runs they rub my feet a little. Never in training, only in racing. Thinking at how much I liked the Nike road shoes I looked at the trail offerings and saw that the Wild Horses were getting a fair bit of attention and good reviews. Based on that and added that I liked the styling I thought why not?

Nike Wildhorse 5’s
Out of the box there were two things that struck me;
  1. The styling and colourway
  2. The size of the toe-box
I did think that I may have picked the wrong colour as they are predominantly white and they are a trail shoe. They look good though and rule 1 is that you have to look good isn’t it? I liked the toe box without trying them on because I was a little concerned that maybe they had put some aggressive tread on the road shoe and seen how it goes. That was patently not the case.

I have worn these shoes on a number of trail runs now with a mix of terrain and they are really a great. They shoe comfort is excellent, the farthest I have run is a little over 20 miles in a race and there were zero issues, no rubbing, no hot spots and no blisters. The shoe is probably not as grippy as others out there the tread being reasonable rather than aggressive. I have used them on lots of terrain types from wet leaves and mud through gravel and sandy trail and they can handle all of that without issue.

In terms of my criteria;

Styling; awesome! Bold and brash – better than a lot of their competitors. With so much kit being just black and red why not a pair that are white? Love them and they look even better now they are a bit dirty.
Comfort; excellent, soft foam upper, good solid rubber outsole and knitted shoe. Protection on the, very wide, toe-box for stones and other debris.
Durability; I get good vfm from trail shoes as most of my running is on road. With more events planned for 2020 I think I will probably be giving these a sterner test than I have many of my other trail shoes.
Cost; the retail price for these is around £105 but I have seen them for £88. You could argue this is cheaper than the current market for similar shoes. I bought mine from Sportsshoes.com for £105 a few months ago.
Downside; I guess the colour could be considered a down side but ‘m not sure that’s enough. Much like the Epic React Flyknit I cannot see a negative. I am like this though, if I like something I don’t really see the negatives and these are no different.
Verdict; so far so good. I have run around 70-80 miles in these. They are grippy, tough, I like the toe box and I love the styling. Quality shoe.

I have said it before but when I review products I am generally really happy with them. If I am interested in something new then I will research it and get a physical look at the product before buying. By the time it arrives I am a little bored of it already as I know a lot (everything) about it. This applies for everything and anything whether it be running socks or a race vest. That said my experiences are not false and that I really like these products and have invested more than once in them speaks volumes.

The Epic React Flyknit is my go-to road shoe. I use it as a workhorse for most of my road running. This can be anything from 2.5 miles through to 20 and beyond. The shoe is just comfortable and on the occasion where I demand more performance it can respond and give me what I want. That’s not to say that there may be better shoes that are more specific, a racing flat or a workhorse for commutes, but for a workaday shoe that you can race in or put down some speed this is that shoe.

I set my half marathon PB some 10 years ago, at Tewkesbury, with 1:27:15. Earlier this year I ran the Cheltenham half marathon finishing in 1:27:48 (this was for the course I actually did 1:27:01 for the half marathon distance) the point being that I am 10 years older and whilst I am generally in better shape and better trained I am still 10 years older and still ran a similar time. Oh and I was wearing a pair of Epic React Flyknits.

Friday, November 15, 2019

right here right now

I have talked about how i struggle with the aspect of racing that is the mental side. When things are not going as i want or maybe the miles are not ticking over quickly enough i start to focus too much on that rather then the why i am out there in the first place. I experienced this a little at Roly's Run only last weekend. It's like race-fatigue really but i don't race that often at all... anyway those clever people at 33Fuel have a blog about this very topic and one of the strategies is to focus on what you are doing in that moment. 

This is a central tenet of mindfulness and "right here right now" will be my mantra as i head into the Broadway Marathon this coming Sunday. 

The 33Fuel blog is here by the way; https://www.33fuel.com/news/mental-tricks-to-turn-your-race-around/

Tuesday, November 12, 2019

Roly's Run (9th November 2019)

I was talking to someone who had done the 20mile edition of this new event, it being the farthest he had ever run. It was now Monday morning some 48hrs after this race had started and he was, in his own words, “still buzzing”. That sums it up perfectly.

Roly’s Run, a beautiful race with an even more beautiful sentiment.

I am not going to go into that here but would urge you to read the About from the race website here; https://www.rolys.run/about.html. The race HQ was Swanmore, a place I have never heard of and am thankful to the sat-nav for getting me there. This is one of those places where, for me at least, I actually have no idea where I was with any accuracy, somewhere between Basingstoke and Southampton being the best I can do.

There were three race options; 15, 20 and 40miles. Routes that were expertly devised and were predominantly on trails but with a real mix. There was woodland, exposed ridge-line, steep hills, muddy paths, farm track, an electric fence to climb over(!), stony trail, some compacted gravel path, and a small section of good old fashioned tarmac. 


Add to that fact that there was some +2,700ft of elevation gain in the 20mile race and it made for a really challenging course. That this was RD Carlos’ first race in the role was quite a feat.

The 20mile distance was quite an interesting one for me because, and this is all about context right, it’s not that far. I had the route on my watch and not having used this before saw that there was a number on the display. I wasn’t sure if this was counting up, down or even if it was miles or kilometres. It turns out that it was counting down and was in miles. Over 20miles I really liked this feature and it did give me a psychological boost on more than one occasion, “it’s less than 5 miles to go…”.

At the race briefing before the start there were some words from Carlos then Rich’s dad spoke and read an email that he had received from someone in the aftermath of Rich’s passing. The email he read was one I had written and sent to them. This floored me and I went through a range of feelings but mainly felt like an impostor of sorts. Whilst I knew Rich I didn’t know him well, something I made clear in the email, that said I did see him more or less every day and we did speak every day. There will be people that knew him far better than me which I think is why I feel a bit of an impostor. It was a lovely moment and I will be forever proud, in a small way, that I made a contribution.

The best words though were reserved for Anna, Rich’s sister. With the crowd having moved from the hall to the start line she told a story of how Rich if he heard someone moaning about how they couldn’t do something would always mutter “not with that attitude” – this got a loud cheer. Everyone stood there had the right attitude for sure.

With that we were all off – a mass start with a lap of the field before heading into the woods and off.

As much as I like to take part in events and races I struggle with them a little. I pretty much want them to be over and start counting down immediately. I do not know why I feel this way but it happens every time. I have thought that maybe it’s because I don’t race enough because when I am training I have no issue whatsoever with the running and will run all the time. I am definitely intrinsically motivated and like doing my own thing. If anyone can shed some light for me please do!

Much like the Cheltenham half I found myself running alone, not fast enough for the lead pack but faster than the throng behind me. This suits me though, I train mostly alone and am comfortable with that.

The woodland sections were a highlight for me, running along twisty trails and jumping over roots and puddles is great fun. There were a couple of sections like this and they reminded me of some of the more pleasant aspects of running the Wendover Woods 50 a couple of years ago. Running in the woods always feels fast, maybe it’s the proximity of the trees and bushes or the agility and responsiveness that you need to avoid the obstacles that come at you with no pattern. Stride length and rhythm cannot be consistent as you adapt to the terrain just to keep each step as sure footed as it can be.

The aid stations were amazing and well stocked – as was the race HQ with tea and coffee flowing, cake and enough fruit to keep this vegan happy :) – the Marshall's were all lovely and super-positive on what started as a bitterly cold day for them and ended as a bitterly cold and wet day as the forecast rain moved in. 

The rain started with a bit of drizzle and I had around 3miles to go. I did think about stopping and putting my jacket on but figured that would be hard as my hands were frozen and it would be a lot of faff for what would be, hopefully, 25 minutes. I can cope with being wet for 25minutes. It was the right decision but by the time I reached the race HQ it was coming down pretty heavily. I was so grateful I finished when I did as for the rest of the day it was relentless and would have been miserable for anyone still out there.

That’s why we do this though isn’t it? This is not a unique thought but we spend so much of our time sat in comfy chairs and comfy environments that to truly know what you are about and what you are capable of takes disruption. Moving from a heated car to a heated office or home is nice sure, we all like that, but really what does it tell you? It takes real determination to finish something when it hurts, remind yourself that you paid for the privilege to be there, your suffering is what you paid for. You get it done not because you paid, that’s the last thing on your mind, you get it done because it matters and because giving up is not an option. It doesn’t matter if it’s a 5km or a 50mile it’s your discomfort and what you derive from that which keeps you moving. The joy on finishing makes it all worthwhile and pretty soon you will be looking for the next event.

The people that don’t get it are missing out. 

I often find myself getting lost in races. I stop looking for the signs and switch off a little. I had the route on my watch which vibrated every time I veered slightly off course (these were minor adjustments rather than wrong turns) but there was so much signage and route marking it was pretty impossible. Again, Carlos and his helpers did a fantastic job.

The 20mile included an out and back up Old Winchester Hill. Quite a climb in two parts with an exposed ridge line joining them. The wind on that ridge was howling and cold. Fortunately it wasn’t a particularly long stretch but for those coming along an hour or more later when it was raining that would have been horrible. At the top of the hill there was a stretch over some softer terrain to a checkpoint where it was then a case of turnaround and head back. This meant that you could see other runners coming through on the 20mile course as you passed them over this 5 or so miles out and back. What surprised me most was that there weren’t more runners. I am not sure what the split was of 15/20/40 mile runners but I didn’t see as many as I would have expected. It would be a long day for some.

Back at the final checkpoint and into the last 5 or so miles to the finish there was possibly my favourite section. Having commented on how running in the woods is great fun. There was a section on whati assume was an old railway line or something similar. Flat, straight and tree lined it was a beautiful stretch of trail with just the occasional dog walker. There was time for one final sting in the tail with a short sharp climb on wooden steps up from a field onto the lanes and the way to the finish.

The finish was in the field where we started. The rain was now coming down pretty heavily and yet there were a couple of hardy souls cheering and shouting. Possibly the most enthusiastic man I have ever met shouted my finish time as I crossed the line. I thanked them for cheering as I ran in then made my way to the hall to change and get some food.

In the hall there were a few finishers sat eating and talking about their races. I grabbed a veggie chilli (really tasty!) and some coffee, sat and ate. After a litre of 33Fuel energy drink and a couple of 33Fuel gels something savoury was welcome.

I ran this race at a high limit, based on heart rate, I was certainly working hard all the way around and did the whole thing on a litre of energy drink and 2 chia gels. I keep saying it but the products from 33Fuel are just excellent. No stomach issues and easily palatable. I am running the Broadway Marathon this coming weekend and will adopt a similar nutrition strategy. As for my diabetes, I started with a blood sugar of 12mmol and finished with a sugar of 5.9mmol. Nothing too excitable all the way round and, more importantly,  no issues. I set my Omnipod to a -50% basal rate for 7hours and used my phone to read my Libra patch as  ran. Perfect! In my kit bag I was carrying the libre reader (in case my phone died), my PDM for the Omnipod and also insulin pens (both Levemir and Novorapid). I have been in a situation before where on a really cold day the Omnipod has failed and I didn’t have any pens or anything in my kit bag. I often talk about the do-learn-do mantra and this is something that I definitely learned from. The other tp, and this was from the people at Omnipod, was to actually wear the pump on the abdomen when doing something like this as it is less exposed than it would be on the arm so less likely to succumb to colder temperatures. Needless to say I did this and it worked a treat.


Back in the hall I was handed a goody bag with some chocolate, a cap (Rich always wore a cap when he ran), a discount voucher for a run store and a rock.

The rock is significant as, and this is taken from the race website;


so everyone that participates will get a rock instead! Some time ago when Rich (Roly) and I were packing for an 86 mile coast-to-coast hike I saw a huge rock next to his backpack with a smiley face on it. I asked Rich what it was and he said "...oh that's 'Boris the Rock' ... we're taking him with us". His pack was so heavy that he sometimes had to be pushed up to his feet to get him going!

No-one knows what happened to Boris, but every runner/walker will get a 'mini-Boris', as a memento of the race. Feel free to carry it around with you on your next big run/hike!

Someone near opened their back and took the rock out. Each piece of rock was personally engraved. A lovely personal touch that frankly capped (see what I did there) a fantastic race and even better event.

I did ask Carlos if this was going to lead him to a new career as an RD to which he answered no but he did say that he would continue to put this race on. I, for one, will be there next year.

Friday, October 4, 2019

Cheltenham Half Marathon - September 2019

Whenever I race I over think it. I am constantly doing calculations in my head, “at this pace it will take me this long to finish” and “I am this far from the finish which means I need to run an x minute mile to hit my goal.” I know I should just relax and be in the moment but I rarely if ever am. This is a total opposite to when I just run for my own fitness, recreation and training. I like to make sure I am not dawdling but just work within the time constraints I have. If I have an hour or two I fill it. If running was split into two parts, training and racing I am much more about the training and the process of that than I am the racing. I don’t race often and probably for that very reason.

So to the Cheltenham Half.

I started over thinking it when I saw the weather forecast. It was forecast to be wet and windy. Not just wet, thunder and lightning. I fretted and stressed deciding that while it might be wet the temperature would be ok so I was going for a t-shirt, a gilet and cap. That made sense and was sorted. I reconciled that if the rain eased then I could probably pack the gilet into my flip belt. Inside the race village I bumped into someone I knew who said that the weather had changed and there was some blue sky there now.

Panic. No sense of perspective whatsoever. I didn’t even check for myself, and there was time. I just retrieved my bag from the bag drop and put my gilet and cap away.

It actually turned out to be the right decision but cost some mental energy before we had even started.

The race was due to start at 9am. The crowd made their way out there ahead of this to warm up, do any final prep and find the right starting chute. I joined the 1:30-1:45 start. I was hoping for sub 1:30 but wasn’t really confident enough to join that group or to put it out there formally. After a slight delay due to a car being on the course the race started and we were off.

There was quite a crowd for the first part and I settled in behind the 1:30 pacers. My initial thinking being that if I could hang with them for a few miles I could then push on if I felt able. Being ahead of them would guarantee a sub 1:30.

This plan lasted about 500 metres. It actually, weirdly, felt very slow. I guess that was a combination of adrenaline and that the start is downhill. A quick rethink and the plan changed to being; if I get ahead of the 1:30 group I can push on - if they then catch me I know what I need to do to get to sub 1:30. Off I went and put down a 6:38 for mile 1. I maintained this tempo and had a pretty comfortable and uneventful race really. I went through 10km in around 38:30 and that was when I started with the sums again. I was trying to calculate a finish time and how much I could afford to slow down. More mental energy.

The crowds through the town, particularly Montpellier, Leckhampton and  the Suffolks were great. I had a lot of shout-outs as I had found myself running alone. I was behind a group of around 50 or so that were leading and the rest of the field were behind me. The strong start I was having being not quite enough to get me to the front but quick enough to keep me from the masses. It was great to see friendly faces out there and particularly those from the Bath Road Beers run club massive!

This was the first race I have done as part of a run club and it was really good fun doing so. It was good to head to the course with the group and then meet with others once there. At the finish there were volunteers from the club handing out medals, water and even a hug!

Back to the race; it was around mile 10 that I started to struggle a bit, the course loops up and down and crosses the roads around Pittville Park. This was quite demoralising as the racecourse represented the finish and yet it was out of reach with yet another loop. It would get worse.

I hit the racecourse and really ran out of power. Mile 10 had been 7:07, mile 11 was 6:58 then 12 and 13 were 7:02 and 7:04 respectively. While they are good mile times in context they are a drop off from where I was at the start. I had paced totally wrong and was running out of juice. To make it even worse as I hit the race course with some 2+ miles to go I heard the announcer call out the winner! Brilliant!

The section around the racecourse was pretty grim. Some short muddy intersections to exposed tarmac service roads where the wind just blew into your face whichever way you were facing. It was only 2 miles on this section and I was again doing maths to calculate what I’d need to do. In the end I was glad it was over and felt like I trickled over the line. I did get a shout out from the announcer as I did though which was cool.

My finish time was texted to me pretty much instantly; 01:27:53. Good but 38 seconds outside my PB set at Tewkesbury around 10 years ago. Closer inspection of the Strava file revealed that my half marathon time was actually 01:27:01 with the race coming in at 13.23miles and not the regulation 13.1. 

It is around 10 years since I last ran a half, my finishing time then was 1:27:15. Whilst I was really happy with the time I know I can do better if I can do it smarter. There is also that feeling of dread that comes with a race like this. Running hard for 13.1 miles is, well, hard. I run a lot, most days in fact, yet rarely get close to sub 7 minute-miling. That I averaged 6:38 is, to me at least, quite something. I have generally been able to turn a pace when needed and this is not through specific training just through strength of running. The fact that I run a lot and have some strength from that means I can turn a pace – it’s just not something I do very often. I also have for the past few years not done any events where I needed to run fast. Ultra’s being about getting it done, for me, and not racing.

A lack of experience told for me in this race. I didn’t really understand what my race pace could and would be so just ran. Knowing what I know now I would start at around 6:40/45 pace for the first 3-3.5 miles or so and then look to up the pace finishing stronger. On that basis I think I could take a minute off that time as while I was spent at the end of this I was strong for the majority of it. Better pacing would have helped that.

I also need to relax a bit (a lot); I run all the time so not sure why I find races so stressful. Maybe because I don’t race often I always feel like I have to do something. When I say something I mean against the context of my own performances. I am still chasing PB’s and want to do well. I have an uneasy relationship with being competitive. I don’t consider myself competitive but I clearly am. I hope that this doesn’t manifest against people I know and run with because ultimately what I want is only to do the best I can. What goes on around me is almost irrelevant I am only racing myself in these circumstances.

Tuesday, May 14, 2019

Do you use an insulin pump? Then check your prescriptions...

Not that long ago you would have probably had an MP3 player of some sort, a phone, a GPS for the car (one of those that you fixed to the windscreen), a camera, books of paper maps and maybe something like a palm pilot that worked when you were in WiFi.

Now you, probably, just have a phone that does it all. All your eggs (insert plant based alternative for this metaphor to work) are in one basket.

I found myself in this position on Friday evening.

My OmniPod needed changing something I did very efficiently (it takes me so little time to do this now). Within a minute of completing the POD change the PDM displayed an error screen advising me that the POD was not working and should be removed. I removed it as instructed but then found the PDM screen to be frozen. None of the buttons worked and it wasn’t going into auto-shut off as it normally would. I called the technical support line and spoke to a chap that helped me through the reset function. After a few attempts where the reset was not working the decision was taken to supply me a new PDM. In view of the weekend this would be provided to me by Tuesday.

The tech support guy asked me if I had backup kit that I could use to which I confidently answered yes.

I was only partially right! I have insulin pens that I carry all the time just in case. However what I had not realised was that the Levemir I use was out of date by 6 months, something I only realised after I had injected it, it didn’t do anything bad to me, in fact I don’t think it did anything at all as when I woke in the morning my sugars were at 17mmol – unheard of for me even when I was struggling with overnight sugars. The NovoRapid by comparison was in date but by a matter of days. This was now Friday night close to 10pm – how would I get prescriptions updated in time?

I called NHS 111 and felt like a total fraud as this was not an emergency or something medical this was a lack of preparedness on my part.

I explained the situation and was advised that a Levemir prescription would be available for me at a specific pharmacy for the morning and that I should contact them first thing. The Pharmacy opened at 8:30 and I was at the door when they did. They had no record of my prescription at all and suggested that it might have gone to my normal pharmacy that I use for this. They opened at 9am. I waited int ha car and called them as soon as they opened. They had nothing either. I went back to the 111 service and they promised to chase it up within an hour and get back to me.

An hour passed and I called them, they had no record of my call so we went through the process again. This did yield a result with the out of hours doctor calling me and saying that a prescription would be at the original pharmacy within the hour. I went back to them on the hour and there was nothing that had come through. They were now close to their closing time so issued me an emergency prescription using a paper based facility that they had. I had my Levemir that was in date!

The other issue was that I use my PDM to test my blood sugars too. With this not working I needed to find a spare meter. I had one with a nearly full barrel of test strips. Over the weekend I was fine on insulin pens and using my Accu-Chek Aviva Expert. However I then realised that I did not have any spare test strips.

All of which takes me back to the first point. Technology is great when it’s working but with increasing reliance and seeming reliability comes complacency. I have used an OmniPod for a couple of years and bar the occasional pod failure have not had any issues. The PDM failing is more serious than that. Not only is it my insulin delivery method it’s my blood testing method too. Without doubt the two most important technological dependencies that I have. 

My health and well being depends on it.

The lesson has been well and truly learned. I have now got (or have on order) prescriptions for insulin pens for Levemir and NovoRapid, I will check the expiry dates of these and add them to my diary so I know when they expire and do not get caught out again. Similarly I will have a couple boxes of test strips for my backup monitor and if they have an expiry I will do the same. It took a lot of chasing around and calling on resources that are over stretched to try and sort this on a Saturday morning, something that was wholly avoidable had I been prepared.

The issue isn’t that the PDM malfunctioned or that NHS 111 couldn’t get a prescription through its that I never thought about it. I thought I was prepared with spares for what I needed but as I have not really needed them I wasn’t.

If you are an insulin pump user you need to do this (assuming like me you haven’t already);
  1. Check your backup kit – do you have pens/needles/test strips and insulin
  2. Check the expiry date on the insulin and either order replacements (making sure to throw away the old stuff) or add the dates to your calendar/diary so you don’t miss it
  3. Make sure you have back up test strips and that your meter works (and that you have batteries for it) 
Technology is remarkable these days, things do not often just fail. This leads to complacency which is exactly where I found myself. In a jam because of that. Hopefully, if you’ve made it this far into the post, you can avoid this!

Massive shout out and thanks to the people at MyOmniPod support, Spa Pharmacy and NHS 111.

Thursday, May 9, 2019

Winchcombe Cross Marathon - 5th May 2019

 Advertised as a marathon with +2,500ft of elevation.

Well, the distance is right (although I got lost and did an extra couple of miles) but the elevation is way off. Closer to +3,400ft! The Winchcombe Cross is a set of race distances all run in the same day on similar courses. A half marathon, marathon, 37 mile ultra and 50miler. 

I was doing the marathon having made the decision earlier this year to not do ultras for this year at least. 

Registration opened at 7:30 with a start time of 8:30. I was up early and stressing about the day so headed over earlier to catch the Ultra start and see Rob who was doing the 37miler. 

Training for this event has been good from an overall mileage perspective (around 600 so far in 2019, but distinctly lacking long runs. I’d done a 15 and a 20 miler prior to the event and have been averaging maybe 38 miles a week. 

There was a race briefing at 8:20 before we started at 8:30. 

The route starts with an easy section down to Winchcombe high street, across the road down a hill then onto the trails. Leg 1 was an out and back to Temple Guiting, I was surprised at the amount of tarmac but the views were stunning. 

The weather was perfect really, slightly cool with some cloud but dry and little/no wind. 

The field strung out as runners settled into their own pace. I had a plan to run 9min miles for as long as I could figuring I could get to 20 miles at that pace and then just finish the last 10km by any means. 

I had a thought that I could do something between 4hrs and 4.5hrs. Come the end I was slower than that but happy enough with my day. 

Heading into Temple Guiting I somehow missed the arrows marking the course and ran past the turn for the checkpoint. By some distance too, maybe by 3/4 of a mile. Realising my mistake i turned around ran back but knew that any chance of hitting my targets just got harder. 

I was doubly disappointed though as at the point I went wrong I was in 2nd place. I only knew this as I had crossed on the route with Rob who told me. By the time I righted myself on course I was way back, it was only 7 miles in and so there were plenty of runners piling in behind me. I don’t know if there was a bit of distraction in hearing I was in 2nd and believing my own unfounded hype. I was trying to just keep my pace steady and stick to targets because it was early in the race and genuinely as much as I would love to do well in a race I don’t ever have expectations of doing so.

To compound the issue, I then went wrong leaving Temple Guiting! Just not paying attention and thinking too much about how to make up lost ground rather than focusing on the moment I was in. Another turn round when I realised and more emotional drain. The physical impact would happen a little later in the race.

Making my way back to the race HQ for the next leg I made up ground on some runners and was pretty comfortable. I went through the checkpoint as quickly as I could, keen to continue to make up some ground. It was at mile 15 that I had a physical problem of sorts. There were runners ahead of me and as I crossed a field that was pretty rutted I took my eye of what was in front of me for a second and twanged my ankle. I say ankle but on reflection and examining where I have some soreness it is actually on the outside of the shin a couple of inches above the ankle bone. My foot gave way and I felt my leg twang, like elastic as I corrected the instability on the ground. The pain shot up through my leg and for a second I thought that was it.

It calmed down and I set about walking to see if I could just walk it off. I have had situations like this before and have the mindset that provided it’s not hanging off I will finish. This is primarily borne of not racing a lot and so when I do, I want to finish. I think that if I maybe raced more often I would be less concerned. I walked a bit and it eased. The rest of my race would fall into a pattern of run walk, running on tarmac and downhill was quite sore but uphill and flat was fine (although I walked the uphills too!).

Leg 2 was, for the marathon, a loop. Running through leg 2 and then rather than coming back, if I was doing the ultra, continuing around into leg 4. This made for a better running experience as while the terrain was stunning it’s nice not to retrace your steps. Plus the 4th leg took in the famous Belas Knapp.

As I approached this there were more people around as this is a spot for tourists and walkers. Up to this point there had not really been anyone around other than those in the event itself. As I got to Belas Knapp I did think about the ultra-runners coming up that way. The climb out of Winchcombe is pretty brutal gaining close to 750ft in the space of maybe a mile or two. Running down this was hard enough.  

As you pass Belas Knapp there’s a steep field that takes you down to a small wooded section, you clear that then it’s downhill past the cricket club and back onto the high street. Running down through the field I could hear thunderous footsteps behind me. My first thought was that cannot be one of the event runners? It wasn’t. It was a small bout maybe 10 years old running full tilt through the long grass and having the time of his life. His sister, slightly older, was behind him and much more tentative. He stopped just in front of me and as I got close I asked him if he was racing me. He replied that he was and took off again. So fast! I think that even if I had not run at all I could not have let the handbrake off enough to run like he was.

He was just running down hill without a thought for his knees and ankles or anything. It really made me smile and was quite uplifting. When you try to explain to someone why you run it’s because sometimes it feels like that. That being an intangible thing really, something you have to experience to understand. A combination of being immersed in the moment without a thought in your head, a flow state where the action of running is for that moment all consuming. You’re doing it but it doesn’t register as conscious thought or physical feeling.

Reaching the woods I knew the route back having run this previously. It’s a short hop to the high street then up to the aid station and the finish.

I crossed the line with 4:57:20 on my watch. The total distance I covered being 28.75 miles and with +3,471ft of elevation gain.

It’s not often I finish something and think I want to do that again but for this one I really did. I think it’s because I know if I didn’t get lost I would save around 15 minutes and if I do more longer runs I can probably take another 20 minutes or so off that time and maybe get closer to the 4:30 I thought achievable.

My blood sugar control through the event was excellent. I was up at 6am and tested with a blood sugar of 5.5mmol. I had something to eat undercutting the carbs count by around 50%. This meant I would be higher by the time I got to the start line but not an issue as once I start running it drops pretty-quickly. I also put in place a -50% temporary basal for a 7hr duration. Because the doses of insulin that I use are quite small this is the maximum reduction the pump can accommodate. At the start of the race my blood sugars were 14mmol, high but for a short period and not concerning.

Nutrition strategy was pretty simple and a combination of 33Shake gels and Tailwind with a couple of bars with me just in case. The plan was to sip tailwind and have a gel every hour. At the half marathon point I tested my blood sugars and they were 7.2mmol. Perfect!

I set off again and did not test until the leg 2/4 checkpoint where they were 5.5mmol. This was probably the most stressful blood test I have done. There was an ambulance crew there and one of them spotted what I was doing and came across to check. He was stood on my shoulder watching. I have never felt under so much pressure to deliver a good reading. When it popped up with 5.5mmol I was so relieved. He just said “that’s perfect” and seemed happy enough.

Because I was out for longer than expected the pump notified me when the temp basal had ended. I set another -50% for 3hours and continued. My blood sugars at the end were 11mmol. A combination of my slowing pace and probably taking on too much food. There was a creeping upward trend for a couple of hours but it soon righted itself as I had something to eat and administered correct bolus amounts.

Later in the evening I set a -25% basal for the overnight period as knew from experience that I would go low otherwise. This was borne out with a waking blood sugar on Monday of 3.1mmol.
I was using the OmniPod through the event and had no issues. In fact, for this race an alert that a temp basal had finished and then being able to set up another while still moving was pretty awesome. There is no fire and forget that you get with pens. I had the pod on my arm but the conditions were such that it was not over exposed at all so performed as it should. The facility of being able to administer reductions on the fly proved invaluable not only during the event but in the period post event and then through the night.

I really enjoyed the event, the course was beautiful, the conditions couldn’t have been better really and the organisation was perfect. I want to do it again next year and that’s a first for me really. No higher praise?

Thursday, May 2, 2019

Bit of an update; diabetes, carbs and running

I have been in a good run with my diabetes of late. There have been some unexpected spikes but the biggest change has been my overnight sugars and the changes I have made to achieve this. This post will be validated or blown out of the water on Wednesday when I get my blood test results and the all import HbA1c number. 

At the time of my last check up I was struggling with blood sugars overnight. Too high as evidenced by waking levels of regularly >10mmol and in reality an average of around 12mmol. These days it has been much more between 5-8mmol. A significant change borne of two main changes that are wholly related. I now trust my going to be blood sugar levels and can do this as I am eating a lower carb meal in the evening.

Previously I would test my blood sugars before going to bed and if it were less than 7mmol I would worry then eat something without insulin and then wake up with a high reading in the 10-12mmol range. What I do now is trust the levels as I understand them better. The understanding and trusting the insulin on board calculation. If my blood sugars are 6mmol but with no IOB at bedtime then I trust that and go to bed. When  wake my blood sugar levels are similar.

I have been able to achieve this through eating a lower carb evening meal and doing this much earlier in the evening. The last point being particularly important as I tend to be an early to bed early to rise kind of guy. My evening meal now comprises around 20-30g of carbs and does not include anything remotely related to bread, pasta or rice. While I am not low carb (I am  a long way from sub 50g of carbs a day) this small change has made such a difference that it is something I will be extending to my lunchtime meal. I just need to figure out how to transport salad in a rucksack when I run to work so that it is still edible at lunchtime!

The bread, pasta, rice thing is very interesting and has been a source of problems for me. This is as it relates to the evening meal specifically. If I were to eat pizza or rice my blood sugars would spike significantly later on the same night. I have counted the carbs and tried various combinations of extending the insulin delivery (a feature of the OmniPod) by an hour or two except that this resulted in high sugars followed by  a significant drop. It’s just been easier (and I feel better for it) to not eat those foods at night.

The other aspect of my blood sugar control I have gotten a grip on has been the use of the temp basal feature. As someone that run-commutes I have struggled with afternoon blood sugar drops. I could be at 8mmol leaving the office at around 5pm and after an easy 30minutes of running my blood sugars would be sub-4mmol. I have started the temp basal reduction earlier in the day and also worked to not have any insulin on board from lunchtime or afternoon snacks. Oe of the issues here is that I can only do a temp basal reduction of 50%. The pump cannot accommodate a greater reduction as my insulin levels are so low. I have experimented with suspending insulin but this makes me nervous and I am unsure of how long to reasonably do this. Should I start this an hour before I am due to be exerting myself or just for the period of exertion?

This is where a feature of scheduling on the OmniPod would be awesome. The features to reduce insulin delivery for time periods is great and what would be even better would be a facility to schedule the reduction. I have given this some thought and think something like the following would work incredibly well for me. On an assumption that I will be running at 5pm I would look to do the following.

3pm :: Temp basal reduction of -50% (this being the current pump limit. If this could be smaller I would do a -50% for 3-4pm then -80% from 4-6pm)
5pm :: run home (I would want my blood sugars to be around 7/8mmol and have no insulin on board. I may also need to eat something (around 15g of carbs) before leaving.
6pm :: the temp basal of -80% would finish
6pm-9pm :: I would look to have a -25% temp basal reduction and depending on the intensity of the 5pm run may even extend this to a 4-5hr period

I did this, sort of, just last night. On Wednesdays I run with Bath Road Beers Run Club.  We set off for the club run at 7pm. Earlier in the day, at 4:30pm, I applied a temp basal reduction of -50% for 4 hours. At 1800hrs my blood sugars were 8.2mmol. I ate around 25g of carbs without insulin. I ran a pretty hard 6miles and when I tested my sugars at just after 8pm, when I got home, they were 4.2mmol. I had an evening meal quite a bit later than normal that was around 45g of carbs (a little higher than normal as I had a vegan protein shake with it). When I went to bed at 10’ish my blood sugars were 12mmol. I had insulin on board and new that I had the effects of the run still in me. I set up a temp basal of -25% at 9pm for 5hrs to cope with this as I have had situations where I have gone low over night.

When I got up this morning my blood sugars were 8.8mmol. A little high but, I think, managed quite well with lots of variables to contend with.

As I mention above the impact of low carb in evening meals has been incredibly significant and something I want to explore further. My reticence only being that I train a lot and while I never feel under powered (my April numbers have been really good; 151 miles run at an average of 7:52 per mile and an average run length of 7.22miles) I am a way off being a fat adapted runner and this takes time to achieve. Something I am not sure I have the patience for. It’s also worth noting that my weight has been pretty stable for the last couple of years at around 150lbs. A weight I am comfortable with. It had though, recently started to creep up and only a couple of weeks ago I was at 156lbs. Still not massive but the wrong trajectory.  Three weeks on lower carb evening meals and I am back to 151lbs. I need to make sure it doesn’t go too far the other way now but as an experiment of 1 it shows that this works.

It's funny as I have always thought of myself as a good diabetic. Recently I have felt much less like that and struggled a bit with the emotions that throws up. I want to keep the OmniPod and that was at risk following my last appointment as my blood sugars were not showing an improvement that warranted the investment that having this device comes with. I am hoping for an improvement on my HbA1c numbers as having to give it up will be a very bad situation to find myself in. Fingers crossed!