Achilles Strain - it's not as trivial as I thought

This is sort of an unloading, a confession of sorts, a realization of reality...  I injured my Achilles and I've had a difficult time recovering. This is coupled with the final realization that I clearly am not bullet proof and am not resilient to injury.  I've had running related running injuries before and somehow I rumbled through them.  And now I'm finding that I am unable to simply rumble through my current injury as easily or smoothly as before.

I yanked my Achilles in mid September and, now January, I am still working towards healing.  And this is really, really, annoying.  Annoying because of the time it has taken and my body's seeming unwillingness to fix itself quickly.  And annoying because my ankle / Achilles still hurts 4 months later.

Having said the above, I realize that I carry 90% of the responsibility, the remaining 10% being my gene's.  I was a late starting running, having just picked up the concept of running when I was 52.  I didn't join any groups, I didn't have a trainer, I just started trying to run - and I sucked at it.  I read a lot about running, read blogs, forums, and so on, and sort of figured out what I was supposed to do and some of what I was not supposed to do, which, much to my detriment, I probably did anyway. But one of the things that I ignored was my overall fitness and conditioning.  Being already fairly naturally "fit", I didn't really think about it much, and felt that getting my miles in was *the* most important thing. How many miles did I log this week, became my mantra. So ultimately, if I had an hour to exercise, I would use that time to run instead of maybe spending 20 minutes doing core exercises and leg strengthening and then running a productive 40 minutes. No, no, no...  I preferred to just run.  That 20 minutes was an extra 2-3 miles that I could log!  Besides, those core and leg exercises were, well, boring. I'd rather run in the rain...

This (kind of) worked for a number of years. I suspect now that many of my various previous injuries could have been avoided or reduced if I had spent more time conditioning and strengthening my core and legs. And now age has really caught up with me (I'm 61...) and I've become prone to more and more "little" injuries and it is taking longer and longer to recover from these "little" injuries.

And then I did this thing to my Achilles while taking down my hurricane shutters after Hurricane Irma.  I knew that something didn't feel right when I stepped off the ladder but of course, I kept going.  I even went for a run later.  And that's when the lump on my Achilles grew to the size of a small key-lime.  And it hurt.  It hurt enough that I could barely walk.  I did all the necessary things: ice, elevate, heat, massage, repeat.... and the lump eventually reduced to more the size of a small walnut, but I still could not run without it being noticeably painful.

Yes, I went to my Doc, who did an ultrasound to make sure that I hadn't done anything super-serious to the Achilles, such as tear or rupture, and after confirming that I hadn't, gave me a script for physical therapy.  And the PT is working, my ankle is feeling better, and yes I can see that I will be running again soon (I haven't run in 4 months).

But here's the crux of the challenge: Measuring only 6 inches long, the Achilles tendon is thickest and strongest tendon in our body. It can handle almost 4 times your body weight while walking and almost 8 times your body weight when running. This tendon is responsible for manipulating the heel and thereby enabling walking, running, and jumping.  And it turns out that it is very susceptible to injury.  The health of the Achilles tendon depends on the health, strength, and conditioning of, guess what (?), all the various muscle groups in my lower extremities that I was basically ignoring.

I had anticipated that the PT work would be focused on my lower leg area, perhaps my lower calf, maybe some deep tissue massage, maybe some ultrasound therapy, heat, and some ankle specific exercises.   -- Wrong --

Yes, there has been some deep tissue massage, and yes it was uncomfortable. Ok, it hurt. But it helped.
But then, things went totally askew on me.  My PT has evolved into a broad effort to teach me how to strengthen and condition my lower extremities, from my hips down to my toes. The range of exercises and routines has been very broad, probably broader that it would be for a real runner (who knows to exercise and condition their entire body) because my lower body conditioning is so bad.  The number of exercises grows with every PT visit to the point that I mix up my daily routine to both incorporate them all throughout the week and induce some measure of muscle confusion, which I'm told is a good thing.

So far I do feel stronger, but I'm also kinda sore all the time because I'm constantly implementing a new exercise that is stressing out an area that I have previously neglected.

In hindsight, I'm amazed that I was able to run any of the distance events that I've run without out totally destroying myself... I now have a growing menu of routines that I run through every day in an effort to strengthen my core, hips, and legs and I can see that once I've been able to heal my Achilles injury that I will be a stronger and fitter runner. Maybe I will be able to run another marathon...!

Heat and Humid Running

Summer has arrived and is in full, and I do mean full, bloom.  It is hot, and in FL it is VERY humid. With Fall running events on the horizon, there is no option other than to train hard in the summer... and so we run.

Runner's World had some good articles in their August 2017 edition, all worth taking a read of.  But in the end, I feel that summer running is not complicated.  It requires some simple planing and a little thought. Done properly, I get my miles in and improve my conditioning.  From my perspective hot/humid weather running involves the following:

•           Run during cooler parts of the day,
•           Run shady routes (stay out of the direct sun as much as possible),
•           Run slower,
•           Run hydrated,
•           Run connected (with a phone or with someone),
•           Run aware of your body’s condition.

I took exception to a part of the Runner's World article regarding avoiding out and back routes; in other words, be able to bail on the run if things were to go south. At many levels I have to agree that this advice makes sense, but at it's core I disagree that runners should give ourselves a way out of a hard run. Say whaaaat???

We always have a way out of a run - we just stop the run.  We find shade, we walk instead of running, we sit down, we call for help and so on. "Bailing" should not be an option... as in "instead of doing the 10 miles that I need to run, I'm only going to do 3..."

I tend to prefer a point to point run (usually a big loop), but often do out and backs. The one advantage of an out and back is that once I get to the turn-around point, I won't be done until I get back to my starting point, and thus the impetus to keep running. This almost always works out, although I've had to bail a few times and either walk back or get a ride - it happens. But the point is that the goal is to accomplish a given distance; given the option to bail takes some of that impetus away.

So having said the above, if I'm going to run an out and back in hot and/or humid conditions, I need to plan accordingly, and yes, I do refer to my list.

Summer running is hard, but I do admit that doing it makes me a better Fall and Winter runner. I have no idea what it does to my body physically (actually I do, but not enough to talk about...), but what ever it is, it seems to be good. My biggest problem is that when I travel to the cooler north for an event, I have no idea what my pace is - and then I become pleasantly surprised! So it seems to be worth the effort!

Run cool... Summer is here...

Lazy

I got lazy. I procrastinated. About running I mean. Conflicting priorities and events pulled me away from my usual morning run routine, and then it started... the laziness, the procrastination. "Well, I didn't run yesterday, or the day before, or the day before that.... and I have things that I really need to get started on today, so maybe I'll just skip today's run..." You know - that kind of a thing.

And so a week went by, then two weeks, and so on... And every now and again I'd drag my sorry butt out the door for a short unsatisfying run.

Not that I have anything to prove to anyone by posting up consistent mileage. It's all me. I run only for myself, and general sanity. But I did notice my waistline - that little bicycle inner tube that was forming.  And the little plumpness in my gut.

I made a vow to myself seven or eight years ago that I would never, ever, let my girth precede me through a door, i.e. I did not want to grow the dreaded middle aged gut. And so far, so good.  But stop running for a couple of weeks and seeds seem to sprout...

It's not like I'm sitting on my butt all day instead of running, but it seems that the act of consistently running has helped my body keep itself together. Or maybe it's just age...  After all, I am a decade past the magic 50.

It's also interesting that in the first week or so of not running, my legs just did not feel right. Like they were antsy and restless. I kept up my stretching routine, but I'm guessing that my legs missed the runs.

I did feel a little guilty while being lazy and not running... like something was admonishing me that had not run that day. I tried not to feel guilty; I still felt like a runner; I still felt that I had earned those stripes; I just wasn't running that particular day (or the one before, and the one before that, etc...). It was odd. When I'd see other runners I'd watch them almost longingly, wishing myself out there, to get back into my routine.

But it's so easy not to; so easy to skip a day. There were appointments, meetings, different crises to tend to. Or it was too windy, too cold, too hot, too late, or too much or too little of something. There were a thousand reasons to put off the run, some of them even valid... But none of them good enough actually.

Then my father-in-law wound up in the hospital with congestive heart failure and while sitting with him I obviously heard a great deal regarding the causes and prevention of heart disease. Aerobic and anaerobic exercise are paramount.  If you are not moving, you are dying. The various doctors and nurses would compliment me on my apparent "good shape" and congratulated me on my exercise routines. "Keep it up" they'd say... Little did they know that I had become "lazy" about all that... and I didn't share that little fact because suddenly I did feel very guilty.

I had to start my running routine again - no excuses. If I'm not moving, I'm dying.

So I'm working on getting back into it -
But it has been difficult to get back into the longer runs. Not running for a few weeks seems to have sapped my endurance levels. My legs feel ok, but I seem to have no juice. So I run until I feel fatigued, then walk for a bit, wait until my heart or lungs or whatever catch up, and then run some more. I pick out-and-back routes so that I'd have no choice but to make it back. Naturally I'll challenge myself to go another 1/2 mile or more each time... And my level of impatience is such that I'd run versus walk so that I could get home, shower, and get on with my next task.

I need to get over this laziness and procrastination. If I'm not moving, I'm dying. And I don't want to die sitting in a chair or on a couch.

Not watching my pace

I've started to do my runs without monitoring my pace - and oddly enough my runs seem easier and my pace is a little faster.

Ever since I started running 8 years ago I've been a data addict: how many miles did I run, what was my pace, my time, and so on. I even keep a log with all this info. For a while I was also monitoring my heart rate, not just while running, but also tracking how long it took to get back to "resting".  I was keyed into having access to instant data. The app on my phone would announce mile markers, pace, total time, heart rate and what ever other metric I could find. For a while I was drilling down to quarter mile increments. I was getting so much information through my earbuds that I couldn't keep track of it all through my aerobic haze. It was information overload - it was nuts and absolutely not conducive to running well.

So after recovering some sense of sanity, I throttled back to just having my app announce mile markers and I would then note my current pace status on my running watch (a $19 Timex... nothing fancy). However, I do still keep a log of my miles, splits, and overall time...  That data-geek side of me is still with me.

A couple of weeks ago I turned off the announcements from my app. It still tracks my miles, route, pace, and overall time, but I no longer had anything barking in my ear.  I'm also still timing my run with my watch, but I'm not looking at it until I've finished my run. And an odd thing is happening - I'm just running...  It is awesome.

I'm running at whatever pace feels right for the distance I am going to do that particular day, i.e. a quicker pace if I'm going for a short run, or a slower starting pace if I am going long. Intuitively I can feel that I am negotiating with myself about speeding up or slowing down, and yet I seem to settle into a pace that literally just works. And my pace overall is a bit quicker, and obviously my overall times are better. And I'm not totally sure why.

Previously when I was tracking my splits I was having my app ping me every 1/2 mile, and as a result I had a pretty good idea how I was doing. So, I'm wondering: if for some reason I was off my pace (running slower), did I subconsciously and for no good reason increase my anxiety levels which in turn pushed me into increasing my effort to make up for being off-pace? There is nothing seemingly wrong with that, yet perhaps I was getting into a "speed up/slow down" cycle that was not the best recipe for a good run. In other words I was too focused on running an expected pace. I have realized that if I was running faster than whatever pace I was expecting, I incorrectly assumed that I was suddenly superman and try to run even faster, which almost always had bad results...

I've tried to use all of my available information for planning my various races, usually for events that were 8 or more miles in length. I would literally work up my targeted splits, use a Sharpie to write them on sports tape that I would then tape to my forearm, and then try to run to those goals. Hey, there are companies that will make you a specific bracelet with your splits for marathons and HM's! Therefore it must be a good idea, right?  Except in my case, sometimes I was able to run my "plan", and more often, not  :-).

So now I'm trying to run by feel... for example, today I ran 7 miles, and my goal was to run it at a good pace - not a race pace, but a good reasonably fast pace, i.e. no dawdling (is that a word?). I didn't do anything special other than start running and visualizing my course and how far I had to go. I never felt the urge to run faster or slower, I just ran with the thought that I had an approximate distance to go to my finish. I like to run my last mile as hard as I can - and without knowing exactly where my Mile 6 was, I had to take a guess and go for it - and it all worked.

Now the next question for myself is, am I willing to run an event, like a HM, without tracking my pace? It's one thing to run a 12 or 14 mile training run without watching my pace, but if I'm looking to do well in an actual race, can I execute well without my electronic help?

I donno.....  Stay tuned.  We'll find out soon.

Ragnar Adirondacks !

193.9 Miles - Saratoga Springs to Lake Placid. An elevation rise of 1,434 feet, 12 guys, two vans.  Start a runner and keep a runner moving day and night until the finish line. That's the definition of a Ragnar event.

I was invited for a second time to join a group of guys who have made running Ragnar Relay events a tradition for 10 years. My first experience with these guys was for Ragnar's Reach the Beach event two years ago. That event was a "WOW" experience for me and worthy of a repeat.

For those of you that aren't familiar with a Ragnar Relay event, it goes something like this:

• You get 12 running buddies that are comfortable enough with each other to tolerate the close confines of a stinky van for 24+ hours.
• Divvy up the running assignments into 36 legs according to the segments laid out by Ragnar.
• Start runner #1 at the appointed time (it's a wave start so that most teams finish around the same time).
• Runner #2 takes over from runner #1 at a designated transition point, and so on until the last runner crosses the finish line.
• Each runner will do 3 legs of varying distance (each leg in this particular event ranged from 2 to 9 miles) approximately 8 to 11 hours apart.
• You run during the day, night, in the rain, fog, hot, cold, whatever, until the team finishes.
• You rest (kind of) while riding in the van from one transition zone to the next, and if you are lucky, you might be able to grab a couple hours of sleep on the grass somewhere or on a school gym floor.
• It is a test of endurance, patience, camaraderie, and a very high tolerance to port-a-potties. For what it's worth, the incentive to run fast is that the closer you are to the front of the pack, the cleaner the bathroom facilities are!

So that's the set up... Here's how it went:
Van 1 with 6 guys left our rental house in Lake Placid (near the finish line) at 4:30AM to drive down to Saratoga Springs. They had a 2+ hour drive (in the pouring rain) in order to make a 7:15 AM start for their first runner.

Van 2 (the cool van - but not because I was in it), got to sleep in and left Lake Placid around 8 AM, to transition with Van 1's 6th runner. I took the baton (actually a "wrist baton") from Jon at around 10:30AM somewhere north of Saratoga Springs and took off for a rolly 7.8 miles.

The picture below was taken somewhere near mile 6.5 of my first leg. The photographer was talking to me, but I couldn't hear a word he said, so I just smiled and waved...

The one thing about Ragnar events is that they are not like other road races where the streets are closed off and there are cops on the corners of busy intersections - oh no....  Ragnar puts out some signs to point runners the way, and you are left to run on the shoulder of the road dodging cars, trucks, and buses. In some cases there are some traffic cones, or even a trail or sidewalk to run on, but for the most part it's a run on the shoulder of rural roads. If running through a town and you get to a traffic light, you have to follow the light. It's also not like a standard road race where there are masses of runners all together. In a Ragnar event, runners are very much spread out and rarely will you ever have an occasion to run with another runner. You might catch up and pass another runner (the coveted "kill", or you might be passed yourself (yeah, I got passed some - but only by runners at least 30 years younger than me... and I'm ok with that.).

Ironman Dan about to clobber a young buck

Speaking of "kills", this is a great picture of Dan, aka "Ironman Dan", one of our old bucks, setting his sights on a young buck that he is about to "kill" (pass). That poor kid probably never even knew what hit him. I think it's a great picture!

And so on we went until we arrived at Lake George, where we transitioned the running

Back Street BBQ 

responsibilities back to Van 1, then went in search of some food and fell into a place called "the Back Street BBQ". One of the reviews said "family staying at a nearby hotel, we walked to the restaurant, but the place looked so scary we kept on walking..." and that sealed the deal for us - we're in. Does this picture of the place look that scary? Basically, it is a biker bar with BBQ on the side, a crusty bartender, and a very interesting bathroom. The BBQ was "ok"... Bartender had this story that he used to offer free condoms to his customers, but his method was unique: he'd pin the package to the wall in the bathroom, but the kicker was that he'd put the pin through the center of the package. He wondered how many kids in town were "Back Street BBQ kids"...  Interesting sense of humor that guy. There's more to tell, but...

After dinner we took off to the next Van Exchange Point (where Van 1 would hand off to us) and stopped at a Walmart along the way for supplies (water, gatorade, peanut butter, bread, junk food, pillows and sleeping bags). Oh - and Tums... one of our guys was brave enough to have the baked bean soup stewed in pork rind back at Back Street BBQ, and he was not feeling so good.... no wonder. But he survived. We then found a spot at the school that was being used as Van Exchange Point to lay out in the dew covered grass for a bit of rest before our next shift. I was up next for the first night run of our shift.

Speaking of vans, some teams rent large 15 passenger vans with lots of room. Our team rents mini-vans (easier to drive and to maneuver around these country roads), but somewhat cramped for space. This is a pic of the back cargo area where we would store a cooler and bags for 6 guys. And of course every time you needed to get something from your bag (dry or warmer clothes) your bag was ALWAYS the bag on the bottom... The inside was just as cramped, although we usually "just" had 5 guys in there (one runner running...), and you can see that the designated stinky seat has the obligatory towel. What you can't see is all the crap and garbage that is strewn throughout the van... :-) The downside to the mini vans is that there is absolutely no way to stretch your legs out (think of cramps) without putting your feet into someone...  But it is an adventure!

Regarding night time runs, Ragnar required us to have reflective vests, a headlamp, a blinky light in front and one on our back. I don't believe that was enough given some of the traffic that runners had to deal with. On some roads there was not much of a shoulder to run on and on curves cars and trucks would come roaring by. I didn't hear that any bad things happened, but I know that there were close calls. I think that the next time I run a Ragnar at night I'll be lit up like a Christmas Tree.

On another little side note, the routes were marked "ok" by Ragnar, but they could have been better marked, especially at night considering that the route was literally in the woods and there is nothing for miles... and I do mean nothing. One of the guys in Van 1 mentioned that he became concerned at one point as he couldn't see any runners ahead or behind him and began to worry that he had missed a turn. Only when he happened to come across an unattended water table with Ragnar symbols did he feel confident that he wasn't blazing his own trail. This situation is actually made worse by the lack of cell signal across a lot of the course - if you get lost you can't call for help! Our van had to guide a runner back to the route after she got confused about a turn - it's dark, no street lights, few cars - who knows where she would have wound up. But remember again, this is supposed to be an adventure.

By the time our (Van 2's) rotation was over, it was around 2AM and cold (low 50's/high 40's?) and we headed straight to the next Van Exchange Point (again a school). This time, 4 of us opted to see if we could nap inside the school itself instead of battling the wet and cold grass or trying to sleep in the van. It turned out that $3 each got us a spot of the gym floor. Bargain! We walk into the darkened gym and there are perhaps 10 or 15 people spread out along the wall. We pick a spot under the volleyball nets in the middle. Lay down, set an alarm for 5AM, and I'm asleep almost instantly. At the appointed hour my phone is buzzing and I look around to find myself surrounded by other runners - the gym is packed. So packed that I have to carefully thread my way in between the sleeping bodies that are literally inches apart to get to the door.

One of the complications/challenges that we had was that as we made our way through the Adirondacks was that cell service was minimal at best. And we needed a cell signal in order to communicate with each van so that runners would be ready at the designated transition point. During our short nap time, Van 1 was in the "dead zone". But from previous messages we were aware that they were running early (we were beating our anticipated times like crazy) and we had a reasonable guess as to when Jon, the guy I would take over from, would come running into the transition zone.

My last leg of 5 miles or so was along the Algonquin River. I lucked out with being able to run as the sun started to rise and it was awesome. This is kind of a crappy picture, but hey hopefully you get the drift (I took it while running...). The sun was just starting to burn through the fog and mist and the view was spectacular. You can just see a guy in front of me that I was catching up to. With that run complete, I was done, I had run 3 legs for a total of 15.1 miles and it felt great! I could have done more, but grateful at the same time that I didn't have to.









The next 5 legs that Van 2 had were all brutal - all hilly, all going up. Bruce had an almost 400 ft consistent vertical climb over less than a 2 mile stretch right out of the gate, a rolly couple of miles, finishing with another ridiculous climb. In Van 1, Daniel had a 700 ft climb in 2 miles that was so tough that runners for that leg received a special medal! By the way, after reaching the peak, Daniel had a 700 ft drop in a bit over half a mile - that would have destroyed my quads. Tough guys, they are. Richard finished the race off for us with a 7.6 anchor leg that was super hilly and going up all the time (remember we're making our way to Lake Placid... ski country, so it's all up, not much down). You can see from the elevation chart just how challenging this thing was.

The awesome news is that we finished in 28 hrs, 6 min 12 seconds, putting us 52nd in a field of 277. From the group picture at the finish line you can tell how thrilled we were to be done! The winning team finished in 21:58:06, a blistering average pace of 6:48 min/mile. In addition, since we were mostly a gang of over 50 year-olds, we were 2nd in the Masters division. We missed first place in the Masters by a team called The Fast, the Slow, and the Ugly by 4 hrs and 26 minutes. Oh well.

But the even more awesome news is what this group of guys does for fund raising. Since they started running relay events 10 years ago, they have been fund raising for the American Cancer Society. This year this group raised over $60,000. Over the last 10 years, the group has surpassed $500,000 for the ACS. Totally awesome.

Once again, this was an incredible experience, so different than the road races that I am more accustomed to. It required a lot of organization, mostly on the part of our team captain Jerry, who did a monumental and stellar job getting us into the event, filling all the slots, ensuring that we had a place to sleep, the van's, pre-race dinner reservations, and coordinated getting everyone's arrival and departures. This is a great group of guys and I hope to be invited to participate with them again! It was a blast. Many thanks to them.

Next up: Ft DeSoto HM Oct 30.

Running is hard, but is it fun?

What is it about running that we do it? We run endless miles, we sweat, we exhaust and injure ourselves, and yet we keep doing it. Why?

There was an article in the July, 2016 issue of Runners World by Jonathan Beverly titled "Pleasure and Pain" (I can't find a link to it - I'll add it when I finally find one) where he explored to concept of whether or not running was supposed to be fun or something else. The article starts out with a co-worker, having learned that he had recently run a 10K event, asked him if he had had fun. And that's where it starts. Are we having fun running?

I like running, but does that make it "fun". The word "fun" doesn't sound like the right description - I think perhaps "rewarding" might better describe it.

When I think of "fun", I'm conjuring up something that won't hurt me or exhaust me. Maybe even make me laugh. Do we have fun when we go to the gym and push a bunch of weights around? Kind of the same thing, isn't it? It's not "fun", but yet it feels good. But maybe feeling good is what "fun" is...

When my non-runner friends ask me why I run, I feel that I have to justify my activity. They aren't runners mostly because it requires a level of effort that they aren't prepared to make - they may have tried it in the past and discovered that it wasn't "fun" in a traditional sense, but never persevered to the point of feeling the "reward" for having done so.

So I wind up having a variety of explanations:
- It's an excellent cardio/vascular exercise
- It helps me unwind
- It helps me manage my blood pressure
- It helps me manage my blood sugar levels
- It's "me" time
- and so on...  and not once do I mention that "it a fun thing to do...".

I run because I enjoy the effort and the motion of running, but probably my favorite part is the feeling afterwards. I love that flush feeling that results from the recovery from being exhausted. It's like an internal glow.

And perhaps all runners need to confess that running is, at least a little bit, masochistic. I quite frankly have no other way to explain why I would run a bunch of miles in hot, humid weather and then look forward to doing it again the next day.

Jonathan Beverly mentions runner Mark Rowlands in his article and a hill that Rowlands liked to run, if for no other reason than to prove to himself that he still could. Do to do so was a sense of accomplishment, while realizing that one day, the hill would win. Accomplishing that feat (beating the hill) made it "fun" for him.

I've never won a race, and while it is likely that I never will, I don't stop trying, if for no other reason than the fact that I believe that I could win. As Beverly writes, I will push myself beyond my body's distress signals for no other reason than satisfying my internal determination to try. And for some crazy reason in my head, I like that and repeat this effort time and time again. So because I do it, and because I choose to do it repeatedly, does that make it "fun"?

So I think that the short answer to all this is Yes. Yes, it is fun because we find it rewarding, and in that reward we find pleasure, and so therefore, if we find it pleasurable, ergo, it is "fun".
'Nuff said...

Fighting a Pre-Diabetic condition - and trying to run

Being a runner and suddenly being diagnosed pre-diabetic creates some interesting challenges, especially since I have sustained my running almost entirely on carbs. Carbs have been my best friend. Yet, six months ago I was informed by my doc that my A1c level over the course of a year had increased to 6.2, firmly making me "pre-diabetic". In consideration that there is a growing population with this issue (rising blood glucose levels), I thought others, and in particular other runners, might be interested in what I’ve learned, what steps I've taken, and the current results.

Summary for the impatient: In the 6 months since that last blood test I’ve been able to lower my A1c from 6.2 to 5.9. I'm still in the "danger zone", but at least I'm only 2% off normal instead of 3% off being full blown diabetic. Progress.

I changed what I ate, how I ate it, exercised like a demon (aerobically and anaerobically), and I took a Vitamin D supplement daily. I don’t know if one thing or a combination of any of them did it, but now my goal is to get it below 5.7 (the magical threshold to being labeled “Normal”). While I am excited to be at 5.9, I also realize that one blood test does not success make… but it is a positive step in the right direction.

My doc informed me in early October 2015 that I was officially "pre-diabetic" with an A1c reading of 6.2. At 6.5 I would be "diabetic" and my doc alluded to various things which didn’t sound attractive to me. Unfortunately, our health care system being what it is, it seems to not allow our primary care providers with the flexibility or the time to discuss the "what now" guidelines. My doc gave me her diagnosis, some very general guidelines, and I was basically left to figure it out.Notwithstanding, the prospect of being diabetic scared me enough that I took my condition seriously.

At the very top of this is the fact that I don't think that I fit the profile of a person who might be prone to diabetes. To begin with, there is no history of diabetes in my family. I'm 5'10, weigh in at around 159 lbs soaking wet, have very little body fat, I do not eat sweets and unhealthy food, and am very active. I don’t sit at a desk, I run anywhere from 20 to 30+ miles per week, I bike, I kayak, I do a lot of physical work…. You get the drift: there isn’t much grass growing under my feet. I just can’t see myself fitting into the profile of a diabetic – I could be all wrong, but that’s my illusion…

Immediately after my docs’ diagnosis I went into "pre-diabetic crisis mode". Without any guidance other than that carbs and sugars were bad, I cut out carbs almost entirely and developed an eagle eye for the sugar content in everything. I love ice cream - no more ice cream. I like my coffee strong and sweet - no more sugar.  I concentrated on proteins, selected fruits and veggies, and any carbs that I ate had to be complex carbs. I avoided anything that was "processed", came in a bag, and read nutritional labels fanatically.

Immediately after starting this new food routine I lost weight (6 lbs, maybe more?) in 8 to 10 days.  And I had no energy. I couldn't run a mile without slowing to a walk.  But it all kind of made sense to me: no carbs, no glucose, no glycogen, no energy.  In my old world, carbs were my best friend: carbs = glycogen = energy and endurance.  I kept pushing my runs, assuming that my body would figure out where to get the necessary fuel to convert to glycogen in order to sustain a run, but was unable to find it or adapt to it.  It was horrible and frustrating. As a result of all this I had to back out of a series of half marathons that I had hoped to run during the Florida winter running season.  If I couldn't run 3 miles, I clearly was not going to make it through three 13.1 mile events. Bye-bye entry fees....

In desperate need of help and full of frustration, I wandered into the offices of the resident nutritionist/dietitian at a nearby Publix supermarket and met Anastasia - and I cried for help. I am certain that Anastasia thought I was a nut case. I explained my predicament, lack of knowledge, my running goals, and so on, and in return she took me through her process of examining my food and fluid habits and activities performed. I explained my running goals and my frustrations in achieving them due to my urgent need to address the pre-diabetes diagnosis. After a couple of consults she came back with two key things: 1) I was not consuming anywhere close to enough calories and carbs to sustain my level of desired activity (duh on me), and 2) she taught me that I could eat carbs (preferably complex carbs) but that for every 18g of carbs that I ate, I had to also have 8g of a protein (more on this below). In other words combine carbs with proteins.

She also gave me heads up (and I confirmed this with my own secondary research) that 10% of the male population that is taking a statin will experience elevated blood glucose levels. That last item threw me for a loop – because I had been on statins for a long time (over 10 years), but had stopped taking them about 4-5 months prior to my last blood test (my doc didn’t advise me to, I just decided to stop taking the statins for a totally separate reason). Perhaps more importantly, I have not found any documentation that discusses that the high blood glucose level caused by statins is reversible by not taking the statins. It turns out that this is a known possible side effect, and part of the balancing act for managing LDL.

Meanwhile, I began to follow the dietary guidelines that Anastasia recommended – and it was pretty simple actually. Carbs are ok as long as I concentrate on complex carbs. For every 18g of carbs, I made sure to also eat at least 8g of protein. Stay away from pre-packaged and over-processed foods. Don’t eat junk food. For example, a meal might include whole wheat pasta or brown rice and almost any protein (beef, chicken, turkey, fish, etc…). I scrutinize labels of any packaged food (i.e. canned or jar foods) for the one’s that have the least amount of added sugars. If the label had ingredients that I couldn’t understand or pronounce I’d toss it and look for another. I found that in the morning  anything works as breakfast, as long as I follow the 18g carb/8g protein rule, i.e. multi-grain or whole wheat toast with hard boiled eggs, cheese, turkey, or peanut butter, etc., works fine. If I ate out (which happens a lot), avoid the crap food, focus on the veggies, fresh fish, and simple entrée’s. No french fries!

And as would be expected, now that I was ingesting some measure of carbs and more calories, I was able to run again. So that sort of solved that problem, but I was still concerned about lowering my blood sugar. Anastasia assured me that as long as I stayed away from simple carbs, made sure that I balanced out the carbs with a protein, and kept my activity levels up, I would see my blood glucose levels and my A1c readings go down. I have to tell you that I was running on faith.

So, for those of you that don’t know and are curious, I’ll explain what the relationship is between carbs, proteins, and digestion. As a runner, you already understand the difference between a simple and a complex carb. Simple carbs convert to glucose much faster than complex carbs. It’s that simple. And for a guy like me, simple carbs will cause sugar spikes that my system does not manage very well. Complex carbs obviously also convert to glucose, but do so much slower.  And here is where the protein part of the diet fits in. Proteins tend to slow down the entire digestive process, thereby delaying the introduction of any carbs into my intestinal system. Fats slow the process down even more so, which is one reason why peanut butter is a go-to bread topping. So by slowing down the digestive process, I’m smoothing out sugar spikes and (hopefully) allowing my system to process the glucose. [Side bar here: I’m still researching if it makes a difference if I take in the proteins first, at the same time, or after I eat the carbs…]

Ok – one more piece of the puzzle: insulin.  We’ve all heard of it. It is produced by our pancreas. Insulin is the magical hormone that we have to have in order to process and absorb the glucose in our bloodstream into something useful. If our bodies don’t do that, then bad things happen to other organs, so this is important. In my case, my system is a somewhat “insulin resistant”. In other words, my pancreas is producing insulin just fine; it's the rest of my system that is somewhat less than receptive about using the insulin the way it is is supposed to. Ok, that sucks…   More so since apparently my use of statins may have helped bring that about. Wonderful.

But Anastasia gave me another little clue that was interesting: It turns out that low levels Vitamin D play a role in insulin resistance. My most recent Vitamin D level was tested two years ago and it came in at 32 ng/mL, and apparently it should range between 30 and 100 ng/mL, putting me at the low end of the scale. I kind of thought that was odd since I spend a lot of time outside, but I’ve learned that the copious amounts of sunblock that I put on to ward off sun damage can limit the amount of Vitamin D absorbed. Interesting stuff. And so, you guessed it, I started taking a Vitamin D supplement. My doc doesn't put too much credence on the Vitamin D effect, and referred to new studies that put the normal range to somewhere between 20 and 50 ng/mL. Food for thought... I'm going to stay on it through to my next blood test though.

By figuring out what I could eat and how to combine it all together (carbs and proteins), I was able to train up for the last Half Marathon of the FL season (at least one that was near me). I was coming from behind with regards to my endurance training and was simply hoping to cross the finish line vertical and preferably running. As it turns out that event was a Personal Best for me, finishing a full minute faster than my previously best HM. I ran hard and as strong as I dared. But I should also note that it helped that the course was pancake flat and the temperature was in the perfect low 50’s! This was the first time that I’ve ever run a HM in conditions as perfect as these were.

I was concerned about using GU during my runs and trained without it. But Anastasia had assured me that it would be ok to suck down GU’s while running since my body would be begging for easy fuel and would literally want to suck all available glucose out of my blood stream, i.e. any sugar that I took in would be immediately put to use.  So on race day I sucked down one at mile 4.5 and another at mile 9. I have to tell you that the GU made me feel like Superman – it gave me a serious lift. I actually felt that I could have run harder, but was afraid to out-run my conditioning; I simply had not had enough time to train and condition. As it was, my legs were burning when I crossed the finish line.

My focus now is to get my A1c below 5.7 and I'm tuned into what I eat, how I combine those foods, plenty of workouts, and of course, my Vitamin D. To make that happen I am trying to amp up my activity levels while at the same time limit my carb intake. For example, since the HM I’ve been doing my 5 mile runs in the AM without having anything to eat prior – it is hard, really hard - and by the end of the run I am definitely running on fumes, but my illusion, in my head, I am imagining all those little glucose molecules being vacuumed out of my blood stream. I am also trying to be very conscious of the 18g carb/8g protein ratio, and err on the side of protein. This is somewhat easy when we cook at home, but when going out for dinner, it gets a bit more difficult – but doable.

The punch line to all this is that I’m convinced that one or all of the things that I did (what food, how prepared/combined, exercise, and Vitamin D) positively affected my situation. It's all intertwined. As I mentioned earlier, I realize that one good blood test does not a life make, but I am forging on…

My final comment on this is that it has not been hard to eat a specific diet, take a Vitamin D pill, and exercise, but rather that it seemed really, really hard for me to get the right information with regards to what to do, what to eat, what to avoid. With so many people with this kind of condition, this information and steps to take should have been readily available. I'm hoping that this post will provide others in this situation with at least a bit of guidance and encouragement!

Meanwhile, in 6 months I’m looking forward to reporting an A1c level of less than 5.7! Right now my next step is to look for a 10K event to run. Maybe even another Marathon next year!?