WW50 with an insulin pump (OmniPod)

The Wendover Woods 50 miler on Saturday (25/11) will be my second ultra since being fitted with an OmniPod insulin pump.

The first was quite an experience. I had started on the pump only a few days before and was taking part in a charity run. The charity was MIND and the run was a 1/3 mile loop at work. We, there was a team of us, were to run a working day from 9-to-5 and complete as many laps as we could. This was on July 5^th and was in the middle of a seriously hot spell that we were having. Temperatures were well into the 30’s for the day and there was no breeze and little shade.

At the start I felt great and was using a libre to monitor my blood sugars. I had been advised to reduce my basal rate for the duration but when I tried to do this via the pump it wouldn’t allow me as the doses were already very small. I know I have small doses of insulin generally so just assumed that this was correct. I started running and for the morning was ok. Energy and repair both doing ok. What was happening though was my blood sugars were going down too much and I was struggling to get them healthy. A combination of heat and exertion.

I actually suspended insulin for a period and as I went into the afternoon started to feel empty, incredibly weak and tired. I had to go  and take a lie-down at one point and am sure I nodded off. I was in much more of a state than I was expecting to be based on previous experience and figured it must just be the heat. My blood sugar levels then started to rise and I switched the basal back on. This made barely a dent and the trajectory continued through to the end of the event. I was quite broken at the end but had covered just short of 40 miles in that state.

A couple of days later I had a hospital appointment and one of the people I was with was describing that their pump had not been set-up correctly when they left the start-up appointment and had caused them some problems. I checked mine and it was the same. I wasn’t getting anything like the level of insulin I should have been as the set-up was just a low scale one. A default one I assume. I set-it properly and from that point on it worked! 

I had, though, managed to cover 40 miles with barely any insulin in me.

This Saturday will be different. The pump is set-up properly and I know how to manage things. On pens it would have been straight forward. I would have reduced my Levemir by 50% run and eaten all day and not had any issues! This will be different. My strategy will be to reduce my basal by 80% for 10hrs at the start. I will then monitor my sugars over the day using a libre and adjust as necessary. I still plan to eat everything I can and with barely a care as, frankly, ultra running is the closest thing I get to feeling like I did pre-diabetes.

I have been experimenting with reducing my basal in this way over the last few months and it works. It took me a while to accept this as a way forward as was contrary to what I would do on pens. What this has enabled me to do is where I am planning to run for a couple of hours, I reduce the basal by 80% and then I only need maybe one gel or one pack of shotbloks and my blood sugars are on the low side of 4-7 when I finish. When I extrapolate that across 10-12 hrs of running this weekend then I will be eating more and testing more. I also know that the line is not straight! It’s not a case of a gel every two hours and bingo I will need to be consuming more and more regularly than that schedule. I did reach out through the power of the web to Robin Arzon of Instagram fame who is type 1 and has run ultra’s including a 100 miler. I asked her what she does with her insulin over these events and reassuringly the answer was the same as what i have been advised to do and what I am planning.

With that in mind the libre will be key for me this weekend, faffing about with cold hands trying to squeeze blood onto a strip will not be easy and while I will do blood tests to be able to just scan my arm as I move will be great for on the move data.

It’s 2 days away now and I have gone from, at the beginning of the week, thinking that I’m not ready to actually feeling pretty good about it and actually a little excited. A day running in the woods? What’s not to like.

As someone with type 1 diabetes there is a risk attached to completing this type of event. There is for everyone but maybe for a type 1 you could argue they are more significant. I acknowledge the risk and am not gung-ho about this at all. What I do know is how to manage. I have lots of experience of training and taking part in events over a number of years and, in fact, realised recently that other than my first marathon (in 1997) everything I have done subsequently has been as a type 1 diabetic. That includes half marathons, marathons, ultra’s, a marathon swim and triathlon/duathlon. The key to this is knowledge; when I am training it is not only my physical well being in terms of muscle and endurance that I am training it is also my understanding of my diabetes. 

I am aware of it every step of the way and know how it feels and what to do. I know my responsibilities and do not ignore them. I sometimes even consider it an advantage as while other competitors don’t have that worry they are also unaware of a key part of their physiology that could affect their race. 

Hitting the wall is, after all, just a low blood sugar.

WW50 Kit List

It’s been a while since I did an ultra, in fact this will only be my 4th event this year after the Cheltenham Challenge half, the 9-to-5 charity run and Boddington 50km. Even by my standards this is a slow year. 

I’m going to try and write a few blogs this week on the lead up to the event. 

For the approaching trail 50miler through Wendover Woods there’s a proper kit list. I will need to pack and prepare. For me this normally means a lot of disproportionate fretting. I really do over think this stuff. 

My kit list will essentially be...

• Race vest (10ltr Salomon)
• Bottles (x4) 2 in drop bag
• 2xu shorts
• Brooks shorts
• Salomon jacket
• Buff (x2) 1 in drop bag
• Salomon beanie
• Patagonia cap
• Salomon Cup
• Nike fleece top (in dry bag)
• Petzls x2 + batteries
• Run gloves
• Buff beanie (in dry bag)
• Adidas Terex
• Salmon speedcross (in drop bag)
• CEP socks x3 (1 in dry bag and one in drop bag)
• Road ID
• Run tops (tbc)
• Gels etc plus some food in car to eat post race
• Barrier cream (applied liberally at start and then in drop bag for emergency)

The route is 5 laps of 10 miles and has 9,500ft of gain and descent in total. I thought I’d done a good copy of this at the weekend with 10 miles through the woods and 1,500ft. This was hard enough and actually falls around 400ft short of a lap come race day. 

With a 15hr cut off it could be a looooooong day. 

Why do you run?

There's so much written about why we run. Comments range from "it allows me to eat cake" through to "it stops the crazy".

I'm not sure those are really an answer. They are an articulation of what might be an answer in the absence of being able to fully answer it. 

I run and I do like cake but it's not why I run! If I didn't run I'd probably still eat cake. I say probably I mean definitely. As for the crazy there may be something in that. 

That's not to say it stops me or anyone from going crazy but maybe it's a moment where you're just alone and not multi tasking. Unless listening to music or whatever while you run counts as multi tasking. 

When you're running it's just that. A physical act. An expression of what we are capable of. Something that feels right. It's also a time when, largely, you cannot be interrupted or distracted. No phone calls, emails, social media, kids, partner, work - the list goes on. 

It must feel right as it isn't easy. At least it isn't when you start but once people can run it seems to be what they want to do. What they have to do. 

Maybe it's addictive? People talk about endorphins and runners high - I don't think I've experienced that other than against the environment I'm running in. I run to work and rarely do I get home and talk about that run. Even if I have deviated a few miles to make it more of a session. It's a practical run. It gets me home. I enjoy it and it makes me feel good but is just functional. 

Put me somewhere different though and the experience is different. Totally different. I ran in Central Park NYC a couple of times this summer and loved every step. It was new, exciting and had some element of exploring in it. Same was true in Annapolis and even Amsterdam (it's been a good summer of running). 

So why do I run and why do so many of us run? 

I'm not sure there's an answer beyond it feels good and is addictive. I truly think it's addictive. Ultra running is full of people with addiction issues. The standard line being they have replaced one addiction with another. 

You can see this in the behaviour of a runner; life becomes about their running and when they can next run. It becomes about planning the run. Day dreaming about it. Surrounding yourself with other runners and talking about it. The new gear. The tech. The whole immersive all consuming aspect of running. It consumes you.

This is why it is hard for a non- runner to understand. How can you really explain to someone that 'yeah right now it feels hard and hurts and you're struggling but keep going and you'll just get it'. Invest in it and you'll get it. 

This is where perhaps modern culture doesn't allow for running. In an era dominated by talent shows and reality TV stars why do we need to invest in anything other than the desire to be famous. We are taught and teaching through TV and social media that it can happen instantly if you're in the right place or you do the right thing. Don't worry about working for something because you'll just get it. 

Running, like pretty much everything in actual reality, flies in the face of this. No-one leaves the house and just runs like a gazelle elegantly down the road. But..... you can get there if you start, invest and develop as a runner. 

You might not have the answer as to why you run but you will be asked the question.