Diarithmetic

20140630_091649Diabetes is not for dummies. People who keep tight control of their diabetes must be either mathemeticians or own (and know how to operate) a Texas Instruments calculator like the one pictured on the right.

Let’s do the math: That’s one unit for every ten carbohydrates, plus one more unit for every 40 mg/dl over my target mg/dl, minus an expected value of glucose fluctuation based on “strenuous” exercise, minus the derivation of the stress coefficient when the variance is greater than the sum of the ml/dg, times the square root of pie . . . sugar-free, of course.

It’s even more difficult for us athletes with diabetes. (I count myself as an athlete with diabetes because I ride a bike and own silkscreened spandex.) Apparently, we must have a degree in physiology as well. Here’s the beginning of a long, technical article I recently read on the ADA website:

In intense exercise (>80% VO2max), unlike at lesser intensities, glucose is the exclusive muscle fuel. It must be mobilized from muscle and liver glycogen in both the fed and fasted states. Therefore, regulation of glucose production (GP) and glucose utilization (GU) have to be different from exercise at <60% VO2max, in which it is established that the portal glucagon-to-insulin ratio causes the less than or equal to twofold increase in GP. GU is subject to complex regulation by insulin, plasma glucose, alternate substrates, other humoral factors, and muscle factors. At lower intensities, plasma glucose is constant during postabsorptive exercise and declines during postprandial exercise (and often in persons with diabetes). During such exercise, insulin secretion is inhibited by β-cell α-adrenergic receptor activation.

Let me simplify the paragraph above and make it more practical for you: If you have type-1 diabetes and you exercise really hard . . . umm . . . never mind. I believe I got to >80% VO2max just trying to figure it out. I think it has something to do with something my liver does at intense exercise that’s different than when the exercise isn’t as intense, but I’m not sure what that means because now my blood sugar is really low and my brain stopped functioning properly.

Here’s what I do know: Caring for diabetes, like other things in life, is a holistic pursuit. It’s not just physical; it includes the mental, emotional, social, and spiritual dimensions as well.

Oh, and let’s not forget my favorite, the “humoral factors.” After all, laughter is the best medicine.

The Year I Was Banned from the Olympic Games

Image1972 was a big year for me–the year of the Olympic Games, and I was participating.

I was 12 years old and won 27 gold medals. At least I should have.

The other competitors, Tim Ward, age 11, and Jeff Ward, age 10, competed too. The events all took place in my backyard, garage, basement, and around our neighborhood on Matson Avenue. I designed and crafted each of the gold, silver, and bronze medals by cutting pieces of cardboard into circles, coloring them with the appropriate crayons, punching small holes in the tops, and looping pieces of string through the holes. I draped all the medals on one of my dad’s ladders that hung in our garage. As each event concluded, the top three athletes met in the garage and stood atop boxes at different levels to receive our cardboard medals. I played the National Anthem on my cassette player.

It’s true. I had a decided advantage over Tim and Jeff because of my superior athletic skills. The fact that I planned all the events helped too.

There were the usual events, such as weight lifting, 100-yard dash, marathon (once around the block), cycling (I was the only one with a 10-speed), high jump (using all of the pillows and cushions in the house as a landing mat), and discus throw (amazingly, we broke only one of mom’s plates). Then we had some “unconventional” events. These were sports I was particularly good at or ones I knew Tim and Jeff couldn’t do well. Like chess. Air hockey. Bumper pool. (I had an air hockey and bumper pool table in my bedroom). Algebra (the Ward brothers hadn’t gotten that far in math yet). Against Tim’s protests, we didn’t have the football or baseball throw. Tim was a pitcher and could throw a ball a mile. I did give in to the one-on-one basketball tournament and because of it I got my one silver medal.

About a week into the competition, I couldn’t be caught in the medal race. Tim had a bunch of silver medals and Jeff had a ton of bronze. This is when “the scandal” began. Jeff said I had to submit to drug testing. He claimed he had incontrovertible evidence that I had been shooting up.

He was right. I took insulin shots twice a day. I had been diagnosed with Type-1 diabetes a year earlier. Jeff said he and Tim had all the evidence necessary to prove I had an unfair advantage because of the “performance-enhancing drugs” I was taking. They had seen me taking shots, they had found broken syringes in our garbage can, and noticed my markedly improved performance after eating what looked like sugar cubes.

The urine samples I was forced to provide were unnecessary. My diabetes was no secret–I had told them about it so they could understand why I sometimes had to stop playing to eat some sugar. I tried as hard as I could to convince the Ward brothers that insulin wasn’t a drug and that it gave me no advantage in our competitions. I showed them the pamphlets I had received from the hospital. I had my mom testify on my behalf. I provided an official statement from my doctor. The Ward brothers weren’t convinced. It was put to a vote; I lost two to one. I was suspended for life from the Matson Avenue Olympic Games and stripped of all my medals.

I was devastated. For about two days, when baseball season started and my Little League team allowed me to play. In my first at bat, I hit a line drive up the middle, knocking Tim to the ground. I laughed when I reached first base, where I promptly ate a sugar cube and stole second base.