My first distance race of the year - should be back ashore Sunday mid-day. Going back over some of my old notes on packing. I may work on a new packing list if I find any changes need to be made.

http://kws.kattack.com/kattacklive/offshore.aspx?FeedID=509

Sail fast.

As I’ve mentioned before about “feeding the basal” (taking more Lantus, or basal in the pump than is required to sustain a BG).  I do this so I can eat small snacks throughout the day and not need to test/bolus for everything I eat.  My PDM rarely comes out of its plastic bag, and never comes topside (it always stays down below in my bag).

This weekend we are headed for a 150 mile sailing race.  Should be a 24-30 hour event.  I’ll put a new Pod on 12-24 hours before heading out.

Diabetes Packing List

• Waterproof bag 1: PDM w/vial of test strips & pricker
• Waterproof bag 2 (backups): meter, test strips, pricker, lantus & novolog pen + pen needles
• Waterproof bag 3 (Pod backup): 2x backup Pods, vial of Novolog, alcholol wipes
• Secret Stash: 1x bottle coke, small candy, Gu

Notice that this is not a lot of stuff.  My sailing gear takes up 98% of my bag – no room for excess stuff that I will not use (but I could live for a week in survival mode with what I bring).

I found this guide made by Gatorade for the NFL (and football players in general):

Beat the Heat – Gatorade

It’s a pretty good guide and very informative using football references to make their points on heat safety.  The points are quite clear — prevent, prepare, hydrate, and plan.  I have to admit, my plan for heat stroke would obviously not to hit that point, and to be aware enough before that point to seek professional help, since I usually train alone.  But for preventing, knowing the symptoms are key.  One thing I did not realize is that it can take 10-14 days to acclimate to warmer conditions.  However, the biggest point is to hydrate regularly and properly.  Replacing electrolytes and sodium (and sometimes carbs too) seem like a no-brainer these days, but it was not too long ago when that was not as common knowledge.

Personal Story
As a kid, I once had the unfortunate experience of an ambulance ride and ER visit.  During the summer months of June, July and August from a young age, we learned how to race sailboats.  All day, every day; with a break at noon on land for lunch.  One day I passed out during lunch.  An ambulance was called, and the people around me knowing I was a Type 1 Diabetic, the EMTs instantly administered Glucose via gel under my tongue.  However, by this point I was already coming to (since I was being fed Coke from the fountain).  Upon being admitted to the ER, I learned that I was both dehydrated AND had low sodium.  A disastrous combination – with a slightly low, and at that point in the ER I was trying to lower my BG after way too much soda and Glucose gel while they got fluids into me by IV.

Learning Experience
Stay hydrated, watch the color of your urine.  And make sure you urinate regularly.  And test frequently (like I really needed to say that).

As a diabetic I have to balance the “fight or flight response” on my own. I get nervous before a race and release sugar just like everyone else. Unfortunately my regulatory system is broken and I have to give myself the appropriate amount of insulin. This is where things get tricky.  How nervous I am affects how much sugar I release into my body:  more Nerves equals more glucose . The difficult  part is there is no real way to monitor how nervous I am.

-Kris Freeman, 12/2/2009

This post by Olympian Kris Freeman really gets me thinking.  How to monitor your nerves to find out how much the natural release of sugar into your body? It’s not just elite athletes like Kris that have this happening, this happens to me all the time on the bike, on boats, or even heading into a big meeting.  Your body has a physical response to a mental stimulus. 

I personally have found some correlation in the length of time I spend “nervous” – basically preparing and how long/how high the BG can go.  In sailing, there is a half hour-to-fifteen minute period to the start where I will spike.  When cycling or running, it really depends how long I am waiting around to start.  The more time spent standing around, the higher I will go (the more time I have spent thinking rather than doing).

It would be interesting to see if any breathing or relaxation exercises have any effect.

 Sailing comes in many opposing variations — sometimes we go for a short cruise, or a long cruise.  Sometimes we race around the buoys for a few hours.  More often than not I am finding myself on the water all day racing  with a couple of 20-30 minute breaks between races.  And every now and then I am involved in much longer distance races (50, 90, 185 mile) that can take a day or two to complete.  Although I have yet to be talked into it — this years’ Bermuda race (635 miles from Newport, RI to Bermuda) took a solid 5 days of sailing — one of the slower years for the race.

While racing sail boats, your movements are mostly confined to specific, pre-defined areas.  Therefore, the most important part of the whole day is going from land onto the water.  You need to be stable – limited Carbs on Board and limited Insulin on Board with a normal BG since there is limited access to gear.  Although I normally run somewhat high BGs before boarding — mostly due to adrenaline of getting out to the race course.  That normally settles itself without any correction since there is plenty of work to do to get the boat race ready.

Longer races of 1-2 days are a little more interesting and require backups - I have never needed to do a site/Pod change at sea.  However, I always bring backups, as well as Lantus and Novolog pens so that I could switch should I have a failure of some sort.

To temp basal or not?
For me, I do not temp down.  Typically, the work on a sailboat are quick bursts of energy and undetermined times.  However, I also eat rather irregularly onboard a boat (mostly with small snacks).  Rarely do I bolus for these snacks unless it is something like a sandwich.  A cookie or chips will simply raise my BG as I am hopefully feeding the basal.

I raced most of my life on MDI, and find it much more comfortable for sailing.  However, trying to give yourself an injection in heavy seas trying not to get knocked around too badly is a bit of a fight.  As in life, there are positives and negatives to everything.