Twas the night Before

After a long day of travel by plane, train, and automobile, I have finally settled into my home for the next few days. Paul and the guys at Key Lime Sailing Club have been working all afternoon to get the boat ready and it is more than I imagined. She looks great and is ready to sail first thing in the morning.

I have 26 nautical miles to cover tomorrow so it should be a long day. And God brought the perfect weather to start out, sunny and warm and a nice five knot breeze. Just enough to get used to a new boat.

I had a rough start with my blood sugars last night with a site that didn't work and a 1am replacement site that got all bent up. By the time I put in the next site at 4:30, it was time to get up to catch my flight. IN the security check at the airport, I got called into secondary because of my insulin pump and Dexcom, but the search wasn't as much of a grope as I thought it would be.

I spent 30 minutes doing laps around Terminal 4 at LAX and a few squats and lunges in a back hallway to get my sugars down and keep them stable for the five hour flight and three hour drive.

I realized as I got up to leave the flight, that sitting just two seats over was another pump wearing diabetic. When I asked if the tubing I saw was an insulin pump his reply was "Its the same kind as yours" Now why didn't he say something earlier? I sure could have used a good diabetic conversation to pass the time.

Official Rules for the 2011 100-mile Solo Sail

Someone else has developed most athletic endeavors you sign up for. You choose a marathon or a triathlon or, if you are really up for an extremely daring undertaking, you sign up for the Florida Challenge, a 1200-mile paddle around the whole state of Florida.

The rules are set, the course is chosen, and all you have to do is show up. You are given a copy of the rules so you know the criteria you have to meet to consider yourself a winner or even a finisher.

With my own sailing challenge, I need to set up some rules to make sure I achieve what I set out to achieve. Some of the rules are for safety purposes, to ensure I stay on the boat long enough to make it to Key West. Others are to make sure I don’t take the easy way out when things get rough. And still others are there to make sure that everyone who is watching is able to enjoy the journey as I take it.

So here they are, the Official Rules of the 2011 Insulindependence Florida Keys Challenge.

Challenge

1. Erin Spineto (heretofore called Sailor) must take a 22’ Catalina from the Key Lime Sailing Club in Key Largo Florida to Garrison Bight Harbor in Key Largo Florida in the four days bounded by 22 February 2011 to 25 February 2011.

2. There shall be at no time any passengers aboard save for the mosquitoes that are known to haunt the area.

3. It will be considered necessary to sleep each night on the boat, despite available hotel rooms with fresh, dry linens and warm motionless beds.

4. It will be deemed acceptable to stop each night at a boat slip and use marina facilities, but any other stops during the day will be prohibited. It will be acceptable to restock supplies at each stop and to eat one hot meal at a restaurant at each stop.

5. The motor will be allowed to dock and leave dock if deemed necessary but sailing into and out of port will always be preferred. The motor will not be used for any other purpose unless it is for safety concerns.

6. At each checkpoint, some object of significance will be left to signify Sailor’s accomplishment.

Media

1. Sailor’s location will be shared with those following her progress on http://www.mapmytracks.com/events/race/sail-for-insulindependenceorg/diabetic-solo-sail. Sailor’s GPS position will be posted to the map every thirty minutes.

2. Sailor will hourly tweet some 140 hopefully deep and inspirational characters, although they will probably turn out a little more sarcastic and silly.

3. Sailor will try to upload two videos to her blog www.diabeticsailor.com each day. She will try to make them more than just a bobbing horizon line that will cause the viewer to become seasick. Maybe she will even capture a manatee to share with the world.

4. Sailor will try to post blog updates nightly on the day’s activities assuming the sunset had not stolen her last bit of attention before she passes out for the deepest and most restful sleep one can get after spending the day bobbing on the water and retiring to a floating bed for the night.

Safety

1. Sailor will wear a life vest at all times when underway. This life vest will be tethered to the boat to prevent her from falling overboard with no one left on board to turn the boat around to rescue her. This way her husband and mother will be reassured of her continued safety.

2. In the very rare chance (let’s hope it’s a negligible chance) that the boat sinks, Sailor will wear a Personal Locating Beacon which will report her sunken status to the Coast Guard who will hopefully respond by sending a highly trained team to rescue her from the water.

3. An “All OK” text will be sent to shore contact every three hours to reassure those onshore that there is no reason to worry about Sailor’s condition and that her diabetes is well controlled and she is doing just fine.

4. Sailor will do all things necessary to prevent heat exhaustion in the lovely seventy-degree weather with tropical sunshine beating down on her all-too-fair Irish skin. This includes limiting herself to one, count that, one, Diet Dr. Pepper each day.

She will need to drink actual water (something quite difficult for her on land) and Propel during her time on the water. She will wear sunscreen and a hat and resist the temptation to work on her tan, knowing that she will only turn into a creature resembling the nightly special at the restaurant attached to the fancy hotel where she will not be staying.

5. Sailor will check the weather report twice daily and will use the weather prediction skills she has taught to countless sixth graders in her Earth Science classes while laughing to herself that she was, in fact, right when she told them that they would one day really use this stuff.

6. Sailor will not be too proud to admit if the weather has gotten too dangerous for her to continue and will console herself by finding the closest pub to grab a bite and work on the memoir she is writing about this very trip.

She will watch the skies and wait for a weather window to try to make up for lost time, but will not beat herself up for things that are beyond her control, reminding herself that had she not gotten gravely ill last year when this trip was originally planned, she would have been sailing on the very day that the first hurricane of the 2010 season hit.

7. Sailor will try to enjoy herself at all times and realize what an amazing opportunity this is to take on a challenge like this.

Managing Diabetes On Board

BREAKFAST

As I get closer to launch day for my sailing trip, I have been focusing more on my diabetes management plan. One of the things that I have been concentrating on is my breakfast. It has always been one of the harder meals to get right because of the different hormones that circulate in the body and bring you from a sleeping state to a fully alert state. Most of these hormones make the body less sensitive to insulin. The result is that you usually need more insulin to cover the same amount of food eaten at a later time in the day. The other problem I have is that I love breakfast foods. I would eat them for breakfast, lunch and dinner if I could (and sometimes I do).

I’ve changing the ratios of my breakfast foods and have achieved some degree of success lately by making breakfast a low-carb, high protein meal. This has lowered that morning spike in my blood sugars and also leaves me feeling fuller. After four weeks eating the new protein based breakfast and finding much success with it, not only in better controlled blood sugars, but, also with the bonus of weight loss. SOME RESEARCH

I came across a study published recently. It was a study of type 2 diabetics (different from type 1 diabetes, I know, but interesting all the same). In the study, the researchers gave the patients a high-protein, low-carb breakfast and found that it lowered their morning blood sugars, which should be obvious.

We have all known that carbohydrates have a far greater impact on blood sugars than proteins do. But what they also found out was that the meal caused their body to replenish their glycogen stores with the sugar instead of storing that sugar as fat.

So the way the body reacted to the sugar changed in addition to there being less of it. If the carbs were later added to a morning snack the patients did not see the same blood glucose spike as when they ate the carbs as their first meal of the day.

I always have to laugh when scientists spend thousands of dollars and hundreds of hours of time to figure out the same thing I figured out in two weeks with my own body. It is nice to have real evidence to back me up, though. And, of course, they can publish their work and make safe recommendations to other people based on their science. I can only change what I am doing, knowing that every diabetic is different and may not react in the same way I did to changes in their diet.

PROTEIN IN THE HEAT I want to continue this high-protein breakfast on my trip, but it presents some slight problems. One of my main morning proteins is eggs. Eggs, however, are very hard to eat if you don’t have a stove or any source of heat. I am all about protein, but I am not going to go Rocky-style and down them raw. I tried that once when I was eight and never will again. I could do a protein shake but after consuming those for breakfast and lunch for four weeks, I have found them very hard to swallow without gagging. So, I have settled for a cheese stick wrapped in turkey slices as my plan for now, but I don’t know if that will work in the long run and I’m not sure that sounds too appetizing first thing in the morning. LUNCH AND DINNER My other meals will certainly include carbs. I am in no way opposed to carbs; as an athlete, there is no way I could be. I will just have to include some of those high-carb breakfast foods I love later in the day.

SITTING STILL One of the other morning issues I will be facing is one that I have more experience with in long car trips early in the morning than I do with sailing. Sailing involves a lot of sitting around. Your body becomes more or less sensitive to insulin based on how active you are throughout the day. I have found that if I take a long car trip starting early in the morning, my blood sugars will race up very high and stubbornly stay put no matter how much insulin I give as a correction bolus to bring them back down. Once I get out of the car and start moving around for an hour or two this problem is quickly remedied. To fix this, I simply have to put in a good workout before getting in the car, and stop every two to three hours for a quick five to ten minute burst of exercise.

PLANNING FOR ACTIVITY While in the Keys, I will have to work-out each morning before I take off for the day. Most days I will go for a quick three to five mile run. When I stay at Fiesta Key for the second night, I get to use their Olympic size pool to put in a quick mile swim. One of the rules of the trip is that I won’t stop until I reach port each night, so I will have to find some way of doing those ten minute bursts of exercise on board. I won’t be able to run or even be able to walk around much as the cockpit on a 22’ Catalina is only about 6 feet long and has the boom of the main sail about 4 feet off the deck.

As a result, I am stuck with calisthenic type exercises that can be done in very little space. To maximize the effect of each exercise I will need to use the largest muscle groups and use as many as possible in each exercise, all while holding onto the tiller so the boat does not go spinning in circles or run aground on one of the many sandbars lurking just below the surface of the water. Included in my workouts will be squats and lunges, which recruit a lot of the larger muscles of the body. Adding to the exercise schedule will be calf raises, which will round out the lower half of my body. I may be able to pull off some push-ups on the seat of the cockpit while holding the tiller still with my foot. EVENING WORKOUTS To round out the exercise regimen, I will need to get some activity in after I dock for the night. This shouldn’t be much of a problem since I will be in search of a warm meal and a view of the old Keys, Florida as it used to be.

Even with all of this physical activity, I will still have to make some adjustments to the basal rate of the insulin, constantly supplied by my pump, to take care of normal bodily functions. The first day I will try a bolus increase of 125% and adjust as needed. FINAL ANALYSIS Each night I will go over my blood sugars and my maintenance plan and will reassess for the next day. Hopefully by the end of the trip, I will have developed some sort of protocol that I can use in future sailing trips, so I won’t need to use myself as the living guinea pig. WHAT'S NEXT As you plan your next adventure, you might want to do two things. First, analyze what you do at home and figure out how that will change as you take off to new places. Second, make a plan to keep your activity level and food roughly the same so you can avoid those whoops! moments while adventuring.