Explain this oddity…?

I’ve got a story to share, that has technically nothing to do with biking – and let’s be honest, the connection to diabetes is flimsy as well. However, that never stopped me before…

In the beginning…

One bright and cheerful Wednesday afternoon it so happened, that the whole family stood inside the supermarket, admiring the racks and racks of fabulous and sparkely produce (and stuff). And the hero of this story said to his wife “Oh look – cold wax leg strips are on offer!”. And the (fabulous) wife of the hero said “You are mad as a mad hatter! That hurts more than childbirth. No one can survive the pain. And besides: It says on the packaging “Not suitable for diabetics!””.

Fuzzy mental image intermezzo…

Within the enormously fantastic brain of the hero, the following thought-bubble appeared: “Huh?!”

How come? Is the pain enough to raise blood glucose levels? Is my body hair used for storing precious hormones? Did an intern copy the wrong packaging?

Back to the trusted supermarket …

Huzzah! I always wanted to try that. A smooth, tasty, precious cyclists leg. How bad can it be? I know pain! I’ve tried a lamb vindaloo. I broke my ribs. I cut my nose while licking an envelope.

Obviously, I the hero grabbed a pack and dropped them (carefully) into the trolley. 22 strips and 4 moist towelettes perfect finish wipes!

Homewards!

In the depths of the heroes front room …

In the dark (it was hot outside), with mood-lighting on, a scantily clad hero reclines on the leather settee. In front of the hero: a glass table. Wife and child appear nearby (and look exceedingly decorative).

The wife says: “I can’t watch this” and disappeares upstairs. Filthy traitor!

The child says: “I’m going to play Kirby on the Wii and turns around”. Ignoring the hero. Filthy traitor!

Right. Back to work!

Act 1: Reading the instruction manual. A transparent little thing. Stick on, rip off. So far, so good.

Act 2: First setback: The “ready-to-use wax strips” (henceforth in quotation marks, because that’s no wax) are stuck together in twos.

Two inherent problems:
1) How to get them apart? Ha easy. Instructions included. Rub back and forth between hands until welts form (on hands or “wax strips”), then peel
2) Where to put the second strip? After all the rubbing, electrostatic change means it sticks to everything. For instance a glass table.

Sticky intermezzo

Did you know, that the glue (“wax”) used in “ready-to-use wax strips” does not come off marble with common household cleaners? It does come off glass. With a fingernail and baby oil most off the rest can be scraped off marble. Only smallish residue remains. Which turns black from dust almost instantly. Hope it dries up before someone notices…

Back to work!

Enough dawdling. Stick the first strip onto the shin. Rip off. Done.

Yes, this is mildly unpleasant. But the intense pain my wife spoke about? Nonexistent. Pfft. This is harmless.

The strip looks a bit strange now. Hairy. But the lowest part of the shin is now smooth. Nice! Can these strips be reused? No seriously.. looking at those measly 22 strips and the size of my legs, those won’t be enough. Too much surface area.

Frugal choice

The strip will have to be reused. Straight above the position of the first rip. Now looks twice as hairy, still removes everything, though. Excellent. Note the dollar signs for all the savings. Let’s continue. Next to the shin (shin hairless, obviously, by now). It’s starting to get a bit more unpleasant. And the strip is beginning to look like a kiwi fruit. Not green, obviously. Away with it!

We’ve got plenty of those!

Problem zones

This isn’t too bad… however. At the back of the calves? I can’t reach that! Especially not with an electrostatically charged strip. A little bit of contortionist practise is called for. Which is exciting, as one wrong move would mean a strip attached to the settee. And I must not do that. Safety first! Work slooooowly.

Rip slooooowly is a bad idea, by the way. That hurts a lot more and some hair stays behind. Looks funny, but not attractive. A little bit like the evil clown in “IT”.

Troubles of the packaging size

By the way: Obviously 22 strips are not enough for even one leg. On my size, obviously. One of those anorexic teenage girls in size 0 might make it work. Even with repeated use (the kiwi fruit model) a hairy fringe remains on the thigh. Like an inverted tonsure, I suppose. Bugger.

Call forth the “perfect finish wipes”. It’s baby oil. Smells like baby oil. Behaves like baby oil. Scrub the smooth areas (yes, several. Not all of them connected) of the leg. Wash. Put on trousers and return to the supermarket.

Side note:

If you were to forget something at this stage, and some “wax” were to remain on the backside of the thigh, the subsequent removal of the jeans will save one strip. Excellent! Disadvantage? Hair in da pants.

The end is near! (seriously!)

Anyway. Three packs were needed. And yes, the softer parts are quite unpleasantly painful (on top of the knees and the back sides of the thighs). However, all in all, more of a “big mess” than “incredible pain of doom!!!twelve!!11”. In the future, however, I shall aim to perform this operation in the bathroom. In the nude. In which case the glass table in the front room should be safe.

Although – in the nude might open up another problem area entirely. Mensfolk need to make sure none of those strips electrostatically cling to dangely bits. Those parts I’d not attempt to clean with common household cleaners, thats for sure..

First Brevet on the Pump

Yesterday, in the brightest of sunshine, the first 200km brevet in Bavaria (that I care about and went to, added for legal reasons) was on. Or up. Lots of “up”, actually.

Anyway. Here, let me post a fine map of the place (with the man and the thing).

Map

 

This is a semi-topografical map from GPSies.com, which has the added bonus of being draggable, zoomable and stuff. Also, there is a “fly the whole track on google earth” option. Which sounds cooler than it is, sadly. But you can see fields and some slopes.

I mentioned the weather was good? Good, because I’m about to show off those pictures everywhere. Let’s start here:

At 6 in the bloody morning!

A fence, some trees, sunshine

It was a tad frosty when I got out there. -3°C it said. Which left thick and impressive crusts of ice on nearby cars. Didn’t care about those. Did care about the clothing, though, and wore my long bibs (which make me look like this, clearly, even though they are a different make and model). And long-sleeved jersey. And gloves. My spring/autumn gloves, which cover everything and yet still are not warm enough in the mornings. The worst of both worlds!

Now the trip itself was lovely, obviously. My technology – not so much. Let’s get the important things out of the way first: The pump and glucose meter worked perfectly. The readability of the meter in sunshine is rubbish, but that’s what hands were invented for (to create shade – obviously!).

The GPS tracker was supposed to provide me with directions and record the trip. And it didn’t do anything for most of the trip. Partially, because it was mounted too close to my handlebar bag, which uses magnets to hold the lid shut. Apparently that upsets my poor widdle GPS. Bah.

Also .. my lights didn’t work. And that is rather annoying. They were new and are generator powered (good), and they have a mighty sensor, that will automatically turn them on when it gets dark (good – in theory). However, it apparently also decided to turn them off when it got bright. And that is so remarkably stupid that the developer needs to be hurt. With something blunt. Repeatedly.

What happened, was that we were descending a hill (merrily) at safe and reasonable speeds (around 50km/h or so) in the total dark. And a car came up the hill, blinding us slightly and going past. And then my lights turned off. Leaving me in the dark, with no night vision, racing towards the treeline. Luckily, the other two people I was cycling with had functional lights at that time, so I tried to go where they went, until I could hit the button for “make it light up” frenziedly and repeatedly enough. STUPID! That light shall be returned tomorrow to the shop. Probably with some harsh words. Unless I calm down enough before then.

Oh … no pictures of the beautiful starry sky, because I was using a phone to take pictures, and let’s be honest – I could just draw a black square for the same effect.

I think some of them were sweaty *nodnod* We have several of those Look at the different looks of enthusiasm Conveniently no one actually uses those roads And sunshine - loads and loads of sunshine

Diabetes-sy things:

As this was the first trip with the pump I was slightly worried about the performance, of course. Nothing wrong there. It worked. I set the initial basal rate to 30% of normal. Which worked perfectly. My blood sugar was dropping slowly, but I didn’t have to eat very much. Managed to start the trip at a level of 180mg/dl as well. Which is about perfectly what I had aimed for (and a fluke. I am not _that_ good).

Now – compared to last years cycling with a basal rate of 70-75%, that made a massive difference. I was not continuously eating without bolusing just to fight the low blood sugars.

I messed that up at the first stop as well. Assuming I’d go like last year, I just ate lunch. And didn’t bolus for it, because obviously last year I didn’t have to. Turns out that lead to a blood glucose of 266mg/dl about two hours later. Which I had not expected at all (learning effort here!). However, once that was out of the way, I just used my “Sports Bolus Adjustment” (50% off! On sale today!) for corrections and the next meals – and that worked brilliantly.

I did still get to eat stuff without bolusing for it. In total, rather a lot. 1.5 liters of coke (my preferred sugary drink, 180g of carbs), 3 cereal bars (40g of carbs), 4 Dextro-Energy Lemon Cake bars (these taste fantastic, the flavour “banana” is disgusting – 60g of carbs) and four slices of dark bread with butter and tons of salt on (I like this, it tastes nice and helps with my salt-loss: 70g of carbs).

Still a lot: 350 grams of carbs with no bolus whatsoever. But this is a rate I can handle. I even felt hungry at the rest stops and didn’t feel like “Ugh – I can’t eat any more of this sticky sweatness).

So in summary: 215km, 2785m of climbing, 12 hours+ of sunburn, 30% basal rate, sports bolus of 50%, basal rate set to 70% for 15 hours after the event.

I understand carbohydrate requirements for sports…

Which is, let’s be honest, a surprise. And I’m willing to share my information as well.

There are several things I needed. One was aquired from a sports weekend with all sorts of medical personell. They were not only incredibly helpful, they also brought along testing equipment. In this particular case, a spiroergometry. Which I had no idea what it meant, but the very short version is apparently that “it” measures oxygen inhalation, carbon dioxide exhalation and plots those over your sportive work output (or in other words: you’ll be sweating on a stationary bike with a breathalyzer over your face).

As the oxydizing of fats and carbohydrates uses different amounts of oxygen and releases different amounts of carbon dioxyde, with those two values (moles of oxygen/carbon dioxide) it’s possible to calculate the percentage of fats and carbohydrates used for exercise. I don’t actually have an English language source for that, and wikipedia only lists a vague “this might exist” part on their part.

Spiroergometry

Summary in the next mini-chapter, skip there if this bores you.

spiroergometry

I do realize this is not helpful right away. On the x-axis is plotted POWER! Which was me, struggling on a stationary bike, as mentioned above. On the left y-axis is plotted energy used per hour. In kilo-calories, because we don’t really like SI-units over here either. On the two right-hand axii (?) are plotted the percentage of energy supplied from fats and carbs and the heart rate.

Still no use without the colours:

1) Black is my heart rate. It starts low and goes to high. No surprise there.

2) Red and red dotted are carbs used for energy. Solid is in kcal/hour, dotted is in %.

3) Green and green dotted are fats used for energy. Solid again in kcal/hour and dotted in %.

4) Blue is total energy used.. which is kind of a pointless stat. Probably helps me loose weight. Pfft.. as if that was an issue. I can just go to the hairdressers instead.

Spiroergometry summary

So what did I gain from this? I learnt at which heart rates how much energy is gained from carbs. That is important, as those will need to be resupplied. Not instantly – some of them are donated from glycogen stores in muscles and liver, but those will be filled after sport finishes.

So basically: What you use in carbs, you should really eat (eventually) for a stable blood sugar.

Example for my work trip: half an hour at 225W power output (speedy, sweat inducing) will require about 250kcal from carbs.

That is a lot. 4 calories per gram of carbs means that this is 60g of carbs alone. I need to eat a full breakfast to make it to work at a stable blood sugar.

How does the basal rate play into this?

And this is where it gets really interesting. See.. in the mornings, after breakfast, I need to bolus 50% to get to work without a drop in blood glucose. My morning breakfast of 60g of carbs is therefor only “half treated” – I get 30g of carbs without insulin.

(Note: that is my napkin method right there. This summary works well, though, so feel free to use it as a rule of thumb.)

In the evenings (I have to get home from work – I don’t intend to stay there!) I need 60g of carbs without insulin.

Both of those were found out by testing. Or basically: drinking more and more coke before the trip and trying to arrive home at a stable 100mg/dl.

Basal rate changes

Pump users will likely have different basal rates during their days. Mine is much higher in the morning hours (from about 4.00h in the bloody night to 7.00h in the mornings) than in the afternoon. The difference in my case is 0.85 units/hour morning to 0.55 units/hour evening. Please note that the basal rate affecting sports is the one you had one hour ago, usually (which is why you’d reduce basal rate one hour before sports start – right?).

And there we are. The ratio of morning basal rate to evening basal rate (0.85/0.55=0.47) is almost equal to the inverse ratios of carbs used (60/30=0.5).

Results?

Yes, all this rambling is actually useful. The short version: If you have found out a carbohydrate requirement for a workout that works, you can apply it to different times of the day (with different basal rates).

The factor by which you increase or decrease the carbohydrate intake is the same as the inverse ratio of basal rates. Or in short: If your basal rate is lower, you need more carbs (this makes sense, because a higher basal rate usually means less insulin effectiveness).

Spiroergometry is not required, but it will tell you the ceiling. How many carbs can you possibly use during workout. This number is probably way higher than what some people post on the internet. Alexis posts here about getting 4g of carbs for her morning workout. That is waaaaay too low in my opinion.

 

Traffic behaviour test

The above title is, admittedly, only the polite version for post titles. Informally (and in my mind), the following test shall always be called “the asshole test”. 

And I do appreciate, that calling someone an asshole is frowned upon in polite society, but this is traffic we are talking about. All pretense of politeness has gone (probably since approximately the second person ever set foot on the same road – I wouldn’t be surprised to hear about roman road rage). 

 

Anyway, the test itself is simple.

 

As a participant of traffic (in short: driver), ask yourself the following question each time

  • – you caused distress to someone else,
  • – almost rammed them,
  • – took their right of way,
  • – cut in front of them,
  • – turned into their path without looking,
  • – honked at them for “going too slow”,
  • – or really any other illegal maneuver I forgot to mention in my excitement.

Would you have done the same, if they had been driving a loaded gravel lorry?

Image

That’s the whole test. If the answer is “yes”, then you are a bit inconsiderate or were distracted and will have to accept that you made a mistake. One that could be considered dangerous, but nothing happened today. 

If the answer is “no”, or even more likely “no of course not, that would be dangerous!”, then you are an asshole. 

I would have to admit to a “no” twice today, for pedestrians walking respectively standing on the bike path while texting. And I feel mildly bad about it. I wonder what the woman in the white estate car got as a result … 

“Winter” cycling

It’s the middle of winter (at least according to my calendar), so I thought I’d post a slight update on winter cycling. There are obviously all sorts of resources available (with my favourite being this one). But none that deal with the fantastic combination of diabetes and cycling.

So .. here we go. I am prepared this year. I got ready, early. My winter bike (which is my old bike, done up, cleaned [a bit], oiled [a lot] and dusted off) is ready to go. I even bought special gear: In this case spike tyres, warm, long bibs and waterproof socks. The socks are excellent (and also help when it’s raining), the bibs are nice enough and warm.

Which leaves the spike tyres.

Which are, let’s be honest, a pain in the rear. They are noisy, they require an inordinate amount of strength to accelerate with and they even manage to throw sparks in the forest. Which is a problem mainly because of this:

Image

 

No, not the cows. Notice the lush green grass? Yes. No snow. Or Ice. Or even cold weather. While the Americans are freezing (or melting – or both) at this time of the year, we have had a warm spell. Since winter started (I think there was one day when we almost had a bit of snow on the roads. Until about nine, when the sun came out). 

And my gear is useless. It was meant for this:

Image

Or more specifically the roads (not the slopes, so much – honest!):

Image

This is pretty much a perfect example. On those roads (lightly gritted in places where pedestrians cross, otherwise left untouched), cars compact the snow and it then sinters into a solid ice sheet. Not ideal with road bike tyres. A total blast with spikes. 

It’s like going on rails. There is nothing to slow me down. No need to. Turns? Easy! Braking? Safe! Accelerating? Well… as bad as it is on a normal road, because those tyres are heavy, but still better than with road tyres. 

So now I only need some snow. Preferrably the first day. Because that always causes a massive traffic problem, encompassing all of the city. And some of the surrounding countryside. And then I can race past everyone on my old winter franken-bike. With spikes.

 

Oh and 10% less basal rate than usual, because when it’s cold, I need more energy. And that, ladies and gentlemen, was the diabetic tip of the day. 

The intricacies of the German traffic fines

Something that bothered me. A lot, actually. 

Assume for a moment the following situation (purely hypothetical, of course): a cyclist is cycling on a bike path parallel to a road. At a traffic light, the cyclist has a green light and thus the right of way over parallel traffic (in this case: cars and lorries) turning right. So far, so obvious. Now for reasons unknown, a lorry (3.5 tons, box built – purely hypothetical of course) with a local numberplate chooses to ignore the cyclist and chooses to turn at full speed.

This is one of those situations that actually kill cyclists. There is a slight mass difference here (even calculating the weight of the bike generously, we’re talking about 35 times heavier here – for the lorry, in case that was neccessary). The metal box is also relatively hard, sturdily built and powered by a heavy diesel engine, while the cyclist is wearing spandex and a foamy helmet.

So .. in our hypothetical example, the cyclist manages to break (just – millimeters here), because he (or she!) suspects drivers to do something stupid like this. He (or she!) is then annoyed and sets off after the lorry driver, catching them up at the next traffic light, knocks on their window and shouts at the driver for a while.

It felt like a proper relief, and slight amounts of blood were coursing through the adrenaline. Hypothetically speaking, of course.

During the shouting (the driver [wisely] didn’t reply to any of it), the words “you stupid pee-head” hypothetically may have been spoken (this doesn’t sound quite as stupid in German. Honest!). 

And this is where it gets interesting. 

Because now, the hypothetical cyclist cannot report the (hypothetical) lorry driver to the police any more. Even though the act of turning without a second look (or first) is illegal, and causes DEATH!!, the fine (including the endangering of someone – and I’m not making this up) for this is 100€ and 3 points on the lorry drivers license. If he is actually fined (source for the fine here: http://www.unfall-und-was-nun.de/bussgeld-bussgeldverfahren-bussgeldkatalog-punkte/#vorfahrt [in German – what did you expect]). 

However, the fine for calling someone names in Germany are much more draconic. In the above mentioned (purely hypothetical) example, we’re talking about roughly 2000€ (source for the fines here: http://www.focus.de/auto/ratgeber/kosten/tid-31103/2500-euro-fuer-eine-alte-sau-das-kosten-beleidigungen-im-strassenverkehr_aid_984025.html [also in German]). 

I am feeling vaguely surprised about this. The bodily harm inflicted by harsh words is probably negligible, even assuming a full-fledged roar at 100dB. The mental scarring left by harsh words is hard to measure – one can only hope that in the above (hypothetical) example, some scarring occurs and the lorry driver actually uses his mirrors next time. Yet again – serious harm is hard to see. 

On the other hand, a lorry hitting a cyclist while turning usually leads to this: http://www.br.de/nachrichten/mittelfranken/unfall-radfahrer-nuernberg-tot-100.html [German – the short version: the cyclist is dead dead dead]. Not that long ago. 

 

Seriously? 100€ vs. 2000€? Something is completely wrong with traffic fines …. 

400km around Northern Bavaria

Diabetes observations in this one again. As mentioned before, don’t hold me to it. I am probably sitting in a mountain cave, making this up.

The second brevet this year was supposed to be a longer distance. I had skipped the 300km one due to family obligations (they did not want to postpone the wedding so I could go cycling *sigh*). The results were “interesting(tm)”.

The start was set for Friday evening (20.10h), and the time limit for the 400km is 27 hours. Which meant that even the slowest cyclists have to be back at the start by 23.00h Saturdays – in time to catch the last train to civilisation and allowing the organizing people to actually go to bed eventually. The weather forecast said “cloudy, likelyhood of rain 60%” – which technically only applied to the location of the start/finish and the distance was too long to check everything in advance. So I packed a jacket and some spare socks.

As the Friday was a normal work-day for me, blood glucose and insulin both were “normal”. My lunch meal still had the normal bolus. The goal: a normal blood glucose level for the starting time and then a large dinner before heading out [1]. Interesting (and I still don’t know what happened there) was the train trip to the start (leaving home around 18.00h). Blood glucose kept rising without additional carbohydrates. When I arrived, I had a blood glucose of 420mg/dl (23.3mmol/l) – which is not what usually happens on Friday evenings. Honest! I check! I can only hazard a guess: Stress, because of the unusual event caused my sugar to rise. Which would fit the previous event.

The first order of business was a correction dose of insulin then (6 I.E. for the theoretical reduction of 420->120 mg/dl (23.3->6.7mmol/l)). I obviously didn’t skip the dinner at the start (Spaghetti), but I used only 50% of the normal bolus for the carbs. The evening injection of Levemir (new insulin compared to last time – this one has an operating life of approximately 14 hours) was also on time – and I reduced it to 70% of normal (slightly less than last times 75% basal rate, which is mostly due to “even numbers only by pen”). All this lead to a remarkable 530mg/dl (29.4mmol/l) at the starting time – no ketones, so I did the same as last time and ignored it.

Abendradeln

The start was brilliant. I found a group of fit road bikers, who dragged me along in their slipstream. The first 65km (40 miles) flew past at a speed that was apparently too high for me. At the first hill after that I got dropped. Hard. My puls was too high, my strength was gone and I bonked. As the group reached the top of the hill by the time I thought “oh my, this is steep”, I thought this would be a good time to test. Blood glucose at a near-perfect 130mg/dl (7.2mmol/l). After one hour, 45 minutes. So I started to eat and drink (which I may possibly have neglected in the previous 2 hours – and which sufficiently explains the bonking [2]).

Unfortunately the lack of liquids lead to problems on the next 60km (40 miles). Cramps in the calves and thighs, lack of power and generally not feeling well. See [2], really. I can do better. Someone caught me up, though, and gave me some help and tips (like: the water on graveyards in Germany is drinking quality and can refresh both flowers and cyclists. Especially at 02.00h in the night in the middle of the countryside, where pubs are … sparse). The two of us plodded on for a bit – noticeably slower than with the original group, but apparently much better suited to my speed. We caught up to a recumbent and a HPV on a long hill, but unsurprisingly lost them again in the following descent and never saw them again.

In total darkness I finished the first 200km (125 miles).  After 120km (75miles) and 200km (125miles) my blood glucose was in the range of 100-130mg/dl (5.6-7.2mmol/l). Provided I was continuously feeding myself with bananas. And drinking. The night had gotten quite cold, but I still managed to soak the softshell jacket through.

A fabulous stop at the 200km control: We got to a small McDonalds on the side of a motorway (by the back entrance – we didn’t cycle on the motorway!). They had two people manning the restaurant in the early morning hours (we arrived around 05.00h). Around 100 cyclists, clad in various amounts of lycra, sweating and hungry, arrived over a few hours. The group of 20 (or so) arriving with me reached the till and asked for fries with lots of salt, and the girl at the till showed proper foresight, looked at the rest of the group queueing to the outside and flipped on all the deep-friers.

With the break of dawn we reached the Frankonian hills. My morning basal rate (Levemir) was reduced to 75% (again – a problem with the units in a pen) [3]. I didn’t need any bolus insulin any more, though. With a relatively constant blood glucose I continued till the early afternoon. Two more stops at another McDonalds (not pretty, but always conveniently open) and a petrol station offered savoury foods. Breakfast with salty eggs and salami rolls in this case. No bolus for either.

After about 18 hours I had to give up (kilometer 360 (225miles)). Apparently I lost so many minerals during the night/day, that I started getting cramps again – and eventually my brain decided that enough was enough [4].

Interestingly, the recovery was not as pronounced this time. I reduced the basal rate to 70% in the evening but already woke up with a slightly raised blood sugar the morning after. Definitely better than a night-time low, though.

Good things, though – the DNF was not due to my diabetes (which is nice), but due to over-excertion on the first part and not enough drinks while cycling. Could have happened to anyone.

The highlight were without a doubt the 1000g of carbohydrates that I got to eat without injections. In retrospect this obviously means that my basal rate was way too high. As the sore muscles have returned to normal, I’m looking forward to the next event, though.

[1] This still sounds like a good idea. I don’t need highs during the day before that reduce my power and send me to the loo all the time.
[2] Due to my lack of experience with long distance cycling, I’d say. All of this was new for me this year and I make mistakes. Stupid mistakes, but mistakes.
[3] I normally use 4 I.E. in the morning. 2 seemed too low, 3 is a bit too much. The new pump will make everything better. Room for improvement, though.
[4] “I do not want to cycle up that hill” and “I’m slowing down my group – they are all much fitter than I am” was what I was mainly thinking. A long break at this point would probably have done (and in fact I felt much better by the time my summoned sag wagon (i.e. my wife) arrived). However, the little village we were in at the time when I stopped wanting to go on didn’t even have a restaurant/pub/anything. It would only have been 10 more miles to the next control with a large spread of food. I need to work on mental toughness, it would appear.

200km on a bicycling cycle

Some diabetes information in this one. Not too much, so no one can intend to take it as a recommendation. By the way: If you do take my word as recommendation on anything, you’re a very silly person – and I refuse to be held responsible. Ask someone who knows what they are talking about. I could be a hermit with a lifetime of experience in yak herding, for all you know.

So anyway… bicycle cycling. I had done some commuting to work for 10 months, through the winter and snow and the autumn and rain and I think there must have been three or four sunny days as well. I thought this had me well prepared for a day-tour of 200km (124 miles, apparently, but whether those are long-miles or British thermal miles I will never know).

My insulins at the time were Lanthus (a very long acting basal insulin – which should work for about 24 hours) and Novorapid (one of those insulin analogons that lasts around 3 hours and works very rapdily). My basal insulin was injected in the evenings (around 21.00h).

The trip called “Altmühltal” (Altmühl river valley) started on a fine Saturday morning. I reduced the basal injection the night before (around 9pm) to 75% of normal [1]. The morning after I had to get up at stupid-o’clock to travel to the starting point. A large breakfast with loads of tasty carbohydrates was consumed – with slightly more Novorapid to cover for the lack of basal insulin. Morning blood glucose wasn’t too bad, actually, which surprised me with the reduced basal rate. After that: cycle to the train station, hop onto a train and check the blood glucose levels, approximately 1.5 hours after breakfast – a disgusting 220mg/dl (12.2mmol/l) was the result [2].

Commence heroic correction (yes, that was stupid)! 2 units of my bolus insulin typically bring down my blood sugar by 100mg/dl (5.5mmol/l). Meet up with all the other strange people, who enjoy cycling until it hurts, for a common breakfast at the starting line. Another blood glucose test found 80mg/dl (4.4mmol/l). Which I considered a bit low, just before sports. The correction for the “low” consisted of three pieces of cake – without a bolus injection, which turned out to lead to a high blood glucose during the morning – (which isn’t that surprising, in hindsight).

Delicious cake

Delicious cake

Start of the actual event was at 9.15h in a large group of cyclist in front of a backdrop of black clouds, sunshine and a strong tailwind. Up to the first control (places to stop and get a stamp at – to prove you went the right way) I then had to keep correcting my way too high blood glucose (I used Novorapid at 1 I.E. per 50mg/dl(2.8mmol/l) reduction – which is identical to what I use outside of sports [3]). I attempted to test my blood glucose on the bike with the Accucheck Mobile taped to my top tube – which didn’t work. At all. The lancet device requires two hands. We did, however, stop occasionally allowing me to test. For the record: The highest blood glucose tested during the beginning of the event was 500mg/dl (27.8mmol/l) [4].

After roughly 75km (46 miles) my blood glucose had dropped to 120mg/dl (6.7mmol/l) and no further corrections were necessary. The speed at which we were travelling was set to about 24km/h (14 miles/h) – brevets are not a race, more of a friendly cycletour – so I felt quite happy at this blood sugar levels.

At that time, I fell back to my normal feeding plan for cycling. Which is not ideal for weight loss, but I’m all for the “can’t have everything” motto. Approximately every 45 minutes I consumed 40g of carbohydrates in varied shape and form (all of them relatively quick: bananas, dates, coke, sport-gels) and at every control (~ every 40 miles) I added something savoury. Typically a cheese or ham sandwich, so I wasn’t forced to eat sweets all day.

The good news: blood glucose stayed stable for the rest of the day. Between 105mg/dl and 130mg/dl (5.8-7.2mmol/l) – which apparently means I did everything right! [5] An interesting (and not diabetes related) problem in the afternoon: We stopped at a supermarket to get a cup of espresso and I grabbed a bottle of Strawberry/Banana-Smoothie instead of the juice I had had in mind. This is drinkable from a bicycle bottle (barely), but it’s not ideal. At all.

There were problems, of course. A crash in our group forced two to quit due to damage to the bikes (too many broken spokes on one, a broken brake lever on the second bike). A few hailstones fell on our jerseys in the early afternoon, when the thunderstorms caught up. My elbows started to hurt (at around the 150km mark (95 miles)) and my bottom complained (starting around the 175km mark (110 miles)). Any climb over 18% (luckily there were only two) was not much fun – especially in my weight class.

Useful side effect: I noticed that my Lanthus dose worked for almost exactly 24 hours (this is apparently sometimes debatable). After 24 hours 15 minutes my blood glucose started going up, which I covered with more food and some extra bolus to prevent complete lack of insulin.

The recovery period lasted for about 8 hours afterwards – with a still reduced insulin amount (again: 75% Lanthus) and more food (which I was quite happy for at that time, I’ll freely admit).

Total time for the 232km (144 miles) was about 13 hours. With plenty of breaks and a lovely group. The plan for the next ride was to go about everything a good bit more relaxed and to not correct too much (in both directions – cake and starting sugar).

[1] A Lanthus problem. As the period of effect is 24 hours, I need to reduce the basal rate long before the sport actually started. This obviously leads to high blood glucose levels in the morning. This got better on the next attempt, using Levemir, and should not be a problem any more with the pump. Yay for technology in this case!
[2] Yes, I should have known this was only the post-breakfast high and that the breakfast bolus was still working. I probably was just too tired (or stupid, but I shall heroically ignore that possibility).
[3] And this is probably too high. Not recommended for imitation.
[4] General consensus is: this is too high to do sports. I could not detect any ketones and actually felt good, so I continued. I would definitely recommend against this, though. Blame it on my stupidity.
[5] Lest this sounds too impressive. I got lucky. My group also had a work collegue (who cycles a lot more than me and who’s got plenty of long-distance experience) and his wife (who cycles a tiny bit slower than me). They set a pace that was ideal for me with only minimal exertion. This was probably perfect for my “diet plan”. Next time I’ll be on my own and will have to eat more, as I’ll probably not be able to pace myself as well.
[6] Oh “Along the river”? A horrible LIE! The part along the river (which is by definition relatively flat) was limited to about 32km (20 miles) – the rest was a bloody up and down the surrounding hills.

Things that get hurt

Been a while since I posted here. Why not start again, now that winter is coming. And I mean that in the most literal way possible – no reference to current television content intended. 

I’ve done a bit of cycling this year. More than I thought, actually, but those are probably two or three other posts. I thought I’d get back to the original “Cycling is good for your health” theory. I suppose it might still be true, because fit and outdoors and all that.

 

However, whenever there is cycling, I’m also reminded of this: 

Image

 

And unfortunately, turns out this is actually sort of true. Now apparently everyone takes a spill now and then, and this got clearer when I switched to clipless pedals. I got several almosts. Almost fell of the bike, that is, because I stopped somewhere and forgot I was locked in. 

The really tricky bit came one day, when my bicycle decided to part ways with me. Imagine this: There you are, going along a road speedily when a queue of cars forms in front of a traffic light. You (that is me, you might be more sensible) decide to change lanes onto one of those optional bike path things to pass all those cars. And in trying to change lanes, you (me – we had that already) find a patch of ice. The first patch of ice of the year. And suddenly there is ground and it stings a bit. And then you pick up the bike, drag it out of the way, continue the way to work because nothing hurts too badly and only then realize that there are bits hanging out of one knee. Bits that should probably have stayed inside. 

Bleh.

At least I learnt that day, that bursae are optional. Or they must be, because someone decided to remove the rest of it. Queue bedrest. 

And if you thought that description was icky – sorry – but you should feel happy that I didn’t post pictures. 

Fast forward half a year (because I like to space out my injuries): there you are (well me, again), cycling on a protected bike path and you have to cross a road. It’s your right of way, you are going speedily, but not ludicrously fast and you are going parallel with traffic. And yet someone turns left from the opposite direction. Someone who should have seen you. Someone who then proceeds to accelerate while aiming their car at your bike. Well _my_ bike. The new one, as well, which I love dearly. 

I tried to brake, but once you’re on the road there isn’t really all that much room. To cross three lanes and get onto a bike path probably took the car about 1 to 3 seconds.

Now the resulting crash was interesting. For instance, I had no idea cars were such fragile little things. A moderately heavy cyclist on a relatively lightweight bike can, for instance, ruin a bonnet, a mudguard and take off a wing mirror before coming to rest on the smooth asphalt. 

Of course bicycles aren’t much more stable, so all sorts of stuff died a messy (and scratchy and bendy) death on the road that day.

Not me, though! 

Obviously – unless you believe in ghost-writing (Yeah, sorry. Groaning myself there). 

Humans have built in collapsible zones, too.

Image

Apparently ribs can bend a bit. But not too far. Then they will eventually break and snap and crackle. 

And then you can spend a few days in a lovely hospital (again), enjoy the food (sort of) and the conversation with the twelvety other people in your room (mmmm). And then you get to converse a lot with insurance companies. 

Instead of cycling.

BAH.

Someone is always out to kill you

And because that is the case (and I’ve had a beer and a week of cycling in the city again), I’ve begun to compile a list. A list of the most dangerous creatures out there!

alien

 

Let’s be honest. Alien robots don’t even appear on the list. They are completely harmless compared to the rest.

5) Commuting cyclists

recumbent_commuter

These are your friends. They know what you are going through, they know the bad spots on the road and they bring sensible gear. Their bikes are likely equipped with a pannier or they are wearing a backpack of work clothes. They will have lights and ride on the right side of the bikepath. They might have dorky reflective elements or helmet mirrors, but they are still aware and awake.

Sporty cyclists also fall in this group. Sure, a peloton of road racers will appear odd, but they know what they are doing and will clear the area quickly. Same for a dirt covered mountain biker near the forest – she’ll just have bounced over deadly tree-roots and rocks at breakneck speed. Not worried there.

4) Lorries, Busses, Trams

lorry and bike

These are the lowest on the list. Sure, if you actually crash into one of those, you’re likely going to end up dead, but the odds are surprisingly low. In all cases I’ve seen lately, crashes have been caused by the cyclist riding into the blind spot, then trying to go while the big metal object was doing a turn.

These things are also piloted by professionals. It’s their job to do this all day, they have probably dodged more cyclists in their professional career than you have met and thus they are usually quite harmless.

3) Cars

Nuernberg rush hours

Cars in rush hour behave much like lorries, really. They go reasonably fast towards a destination they have headed for about a million times. They know the path, know the potholes and probably also know the spots where cyclists cross into their way.

If the driver hasn’t had his coffee yet, you might get honked at, but at least they are reasonably awake and if angry, the adrenaline will help them avoid cyclists on time.

Cars are several stages more dangerous in the evening rush hour than they are in the mornings. In the mornings people are mentally stable, refreshed, possibly tired and angry at having to go to work. In the evenings people are unhinged by their jobs demands, tired, caffeinated and angry at anything blocking their straight path home. Mostly other cars, but cyclists weaving past only remind them of how stupid a car is in rush hour.

2) Recreational cyclists

Ah. Now we’re getting into dangerous territory. These are the people who are on their bike for fun (have you seen a kid on a BMX bike lately?), occasionally or for short distances only.

They are the ones most likely to behave like bike salmon (against the stream and all), bike ninja (I shall remain hidden in the dark) or just plains stupid. Go slowly on a busy bikepath for no reason? Come barging out of a flowerbed on a moutain bike? Spill tins of food from a badly secured plastic bag balanced on the handlebars?

Those types.

bike with stupid food arrangement

Go on, spill those tomatoes all over the road while you struggle onto the platforms in your high heels. And then ride the wrong direction down a path. You know you want to.

1) Pedestrians

This cannot be overstated. Pedestrians are out to kill you. No other group in traffic can manage the moves they do – nothing else has as little momentum to give them predictability.

Of course pedestrians walk in the middle of the path, so cyclists can choose to overtake in the shrubbery on the right or the mud on the left.

3699424168

 

And they do not think of lighting themselves. Whereas everyone else has an interest in seeing where they are going, pedestrians move so slow they are fine on a moonlit night. Which, of course, makes them a tad harder to spot.

Dark pedestrian

This is how they don’t actually look. The reflective bands at the bottom of the trousers give this photo away as staged. No normal pedestrian looks like this.

30715.strip.print

 

And we all know pedestrians don’t slap their forehead. They just turn around and walk in the opposite direction. Or better yet – at a slight angle, just to make it even harder to pass them

Now there is, of course, the option to use the bell from a safe distance to alert the pedestrian to your proximity.

It never works.

Try it.

On a single pedestrian it will invariably lead to them moving towards the path you intended to take.

On a pair, it will lead to them scattering, blocking the largest amount of space on the path.

On a larger group, some of them will notice, alert the others by tugging on their clothing or speaking really loudly (thus obscuring your bell), then resulting in all of them turning to face the bell. As pedestrians can only turn around on the spot with the intent to kill a cyclist – and this group actually wants to help you – they will do this in small semi-circular movement patterns… at random… all over the path.

Nothing is as dangerous as a pedestrian.

X)

Oh well.. there is. It’s a pedestrian with a dog.

Hund~3

 

If you are lucky, you’ll meet them in the daylight. They are still insane, follow all the rules of pedestrians with the added bonus of stringing several meters of cord between themselves and a bored wolf-descendent.

If you are really unlucky, you meet them in the dark. Walking on the left of the bikepath. In dark clothing. With no reflective elements whatsoever. And on the right, halfway into the forest, with the leash wrapped around a tree trunk is a black haired dog, the size of a small cow. And the leash spans across the path and is black. Because it looks more stylish that way.

Those are the days I just throw my hands in front of my face and shout “Let go now” while barreling into the line. If I’m lucky, I’ll just get whipped by a plastic leash holder.

*shudders*