Living Well With Diabetes

Once again, this post is a summary of two days of riding.

Yesterday, I rode from Gearhart, Oregon to Raymond, Washington. It was cloudy, cool and windy all day. The clouds made it kind of an uninteresting day for photo-taking, but I took some essential ones like photos of the Astoria bridge and the sign welcoming me into Washington.

Just after I crossed the bridge into Washington from Astoria, I met up with two cyclists also heading north. (Most touring cyclists are headed south because of the prevailing winds from the northwest.)

I expected to only say hi to them before they went their own way at their own speed, but it was only a matter of minutes before we realized we were riding at roughly the same speed so we might as well ride together and have someone to talk to for a while. Shaun and Doug were college friends, but now live in Minneapolis and Seattle respectively. Shaun, as it turns out, went to Minnesota State University in Mankato, Minnesota which is about twelve miles from where I grew up and went to college. He was nearing the end of his five week long bike tour from Boulder to Seattle. He and I took essentially the same paths across Oregon so we exchanged stories about places we had both been, separated by a few days.

Shaun has been keeping his own blog on his trip:

http://denver-seattle2000miles.blogspot.com/

Shaun and Doug and I rode together most of the day — about 45 miles. We arrived in Raymond in time for a late lunch. We shared a pizza at the very first eating establishment we came across. We were pretty hungry and polished off a large pizza pretty quickly. After pizza, we said goodbye and wished each other safe travels. Shaun and Doug were riding twenty more miles north on highway 101 which began with what looked like a fairly large climb. I, on the other hand, turned the corner off of highway 101 and downhill towards the campground (actually, an RV park) where I would be staying.

I cooked dinner at my campsite. The RV park was a clean, quiet place. In other campgrounds and RV parks I’ve stayed at, just like this one, the tent sites don’t have electricity, but I always managed to find some way to suck a little electricity off the grid to charge batteries, etc. Not this place, however. They had it locked down pretty tight. Even access to the bathroom was controlled. When you registered, you were issued a key to the bathroom. God help you if you lose it! There was one electrical outlet in the bathroom, but it was just a teaser — it was dead.

Of all nights on my tour, this was the one when I really could have used some electricity too. Late in the evening, my Dexcom continuous glucose monitor started beeping at me about a low battery condition. I had to listen to that thing beep at me about the low battery hourly through the night and all the next day.

I woke up this morning to a very light mist. I was concerned about riding in the rain all day, but I spoke with a couple tenters in the spot next to mine. As it turned out they lived in Olympia, Washington and they were in this area for some kayaking. I asked about the rainy weather and he looked up at the sky and said “This is actually a nice day.” He went on to explain that this was a common summertime weather pattern. He predicted it would be cold and misty in the morning and the clouds would burn off by early afternoon. He was exactly right. The longer I rode today, the dryer it was and by early afternoon, as I was coming into Aberdeen, there was some blue sky. Not much, but it was there.

From here, my grand plan was to continue north on highway 101 to Amanda Park, then Forks, and then finally Port Angeles — a ride around the Olympic peninsula and the Olympic National Forest. Forks and Port Angeles are large enough to offer enough lodging options that you can be sure of finding a place to stay. Not so with Amanda Park. There are only a handful of lodging options (including campgrounds). This being the summertime anda weekend, none of them had a spot available for me.

So, that left me with plan B. Actually, I didn’t have a plan B until about 15 minutes ago. Not riding the Olympic peninsula gives me a couple extra days now to get myself to Bellingham by July 25. So, instead of cycling the Olympic peninsula, tomorrow I will be heading west on highway 109 for an out-and-back trip to Ocean Park. After that, I’ll continue to head for Bellingham via highway 101 on the west side of the Hood Canal.

Comments(1)

I didn’t have internet access last night so this is another posting which is a summary of my rides from yesterday and today.

Yesterday, I got an early start leaving Wilsonville because I knew I had a big day ahead of me &mdsh; about 80 miles through the Coast Range — trying to get to the coast in one day.

In the end, I didn’t quite make it to the coast. But, I made it to the Pacific Coast Highway near Beaver, Oregon which is close enough. In fact, it wasn’t until about 44 miles into today’s ride that I got a clear view of the ocean unobstructed by bays, harbors, cars, trucks, trains, trees, private residences, or businesses. It seems there’s always something in the way.

To get to Beaver yesterday, I took the Nestucca River Road from Carlton. The Nestucca River Road has been designated at one of Oregon’s top ten bicycle rides so I couldn’t resist even though it was a little bit out of my way. The last twenty miles or so of it are mostly downhill on a forest road running parallel to the Nestucca River. There was little to no traffic on it once I left Carlton. Of course, there was a price to pay to enjoy the good part of the Nestucca River Road. That price was about 20 miles of difficult riding at the beginning. Just outside of Carlton, there were steeply rolling hills. As I got closer to Meadow Lake, the grade steepened dramatically. I measured four sections where the grade was 10+ percent and one of those was a tortuous 13% and a quarter mile or so in length.

Not knowing where the summit was or how many more climbs there were, I was getting a little worried about my water supply. Fortunately, the 2000-foot summit at Meadow Lake was the only summit to speak of and the remainder of the ride was mostly downhill. When I got to Beaver, I only had about 500 ml of water left.

I stayed last night at a campground just north of Beaver, Oregon. This morning, I slept in to 6:15 AM — the latest I’ve slept in on the entire tour — because it was cold and cloudy outside. Boy, that was something new. Up until today, it has been sunny and hot every day of the tour. The number one priority for me has been to do whatever I needed to do to keep cool. And that meant getting up at 5 AM or earlier in order to get started, carrying as much water as I could, and when I’m done riding, keeping cool in any way I could.

Here are some photos from yesterday’s ride:

Today, for something completely different, I struggled to keep warm as I broke camp. I started riding wearing leg warmers, a fleece jacket and a windbreaker. It wasn’t until noon that I took off the fleece jacket and leg warmers and put on sunscreen.

There was one difficult climb today through the Oswald West State Park. It was not much of a climb compared with yesterday’s ascents through the Coast Range, but it was made more challenging because of the amount of traffic on the road and the narrow width of the shoulder.

The biggest challenge today was my blood sugar. For some reason, I’ve been struggling with keeping them under control today and to a lesser extent yesterday. High blood sugars while I’m riding are so unusual for me that I decided there must be something wrong. The usual suspects when this happens are 1) infusion site problems, 2) insulin supply, 3) an undetected pod malfunction, and 4) human error.

So, I switched to a new infusion site yesterday. Since that involves a new OmniPod, I could eliminate 1) and 3) as a possibility. Well, my problems continued again today. In fact, I did the first 45 miles of my ride today on water, 8 ounces of juice, half an Odwalla bar and a couple spoonfuls of peanut butter (that was breakfast). Still, my blood sugars hovered in the 150-200 range. I’m usually hovering around 100 and I’m eating pretty freely when I’m riding. About lunch time, I abandoned my usual cycling basal delivery profile (reduced by 30% from my normal rate) and went back to my full non-cycling delivery rate. I also started bolusing for everything I ate (usually, I don’t have to bolus at all while I’m riding). Clearly something is not right.

It could be the insulin supply. That seems unlikely though because the insulin I’m using is from a brand-new bottle I purchased in Wilsonville.

I might switch to yet another OmniPod unit tonight. I’ll position it on my hip which is a location which has provided good absorption for me.

Photos from today:

Comments(4)

It was nearly a year ago when Pat and I made a visit to Portland to see her sister and also to visit our friends Dick Sass and Jane Conner who manage iSense Corporation, a startup company in Wilsonville, Oregon.

As it turned out, our visit on July 20, 2007 was just after they had moved into a new facility. During that visit Dick and Jane showed me something they had added to their new facilility: a bike rack right next to the front door. The special thing about this particular bike rack is the plaque on the wall right next to it. The plaque reads “Reserved for Peter Hoogenboom.” I have never had a reserved parking spot. Not before then and not after, so I think this is pretty cool.

As soon as I saw the plaque I knew in my mind I was going to have to sometime, somehow, park my bike in that spot. Well, today, that goal has been accomplished. I rode my bike from the motel where I’m staying, rolled right up to the rack, and leaned my bike up against it. It looks great and it fits perfectly!

Comments(2)

During this two-month long bicycle tour, I have to carry several weeks worth of diabetes management supplies with me. I’ve had a resupply sent to me here in Wilsonville, Oregon and also in Sitka, Alaska. With those two re-supply points, I shouldn’t have to carry more than three weeks worth of supplies with me. Believe me, when you’re climbing through the Cascade Mountain Range near Mount Hood on a hot afternoon, you’d just as soon not be carrying any of it.

One of my big concerns while bike touring is keeping these diabetes management supplies safe and dry. Not that it’s rained on me at all yet, but I suspect, now that I’m in the Pacific Northwest, it probably will rain on me at some point.

I thought about storing it all in some kind of dry bag — the kind you might take on a river trip — but that doesn’t protect the contents from being crushed. I thought about storing it in a hard-shell waterproof case, but they tend to be very heavy and bulky.

The compromise I came up with is a clear plastic “Lock & Lock” brand container. They’re lightweight; they claim to be waterproof. I’m not sure I would feel comfortable submerging one of these containers, but they certainly seem waterproof enough to survive a rainstorm especially when they’ll already be inside my water-resistant bicycle panniers.

Here’s the best part about these containers though: there’s a square one, 680 ml, model number HPL-851 which is about 4 inches on a side and about 3 and a half inches tall. Four OmniPods fit in it perfectly. And when I say perfectly, I mean perfectly. The radius of the corners of the containers is the same as the radius of the corners on the OmniPod packaging and four OmniPods fit inside with no extra space to rattle around. After I remove one of the pods, I stuff some napkins in to fill the empty space.

I use another “Lock & Lock” container, same width, but not as tall, to store test strips.

The ones I’m using I found at a KMart. I’ve also heard Target and Walmart carry the “Lock & Lock” brand.

Comments(1)

I intended to make it as far as Madras today. Certain events which I shall describe shortly transpired to prevent that and I’m staying in Prineville.

I arrived in Prineville about lunchtime. It had had been a long morning ride. I started it in Mitchell at about 6:30 AM. It was cool and calm and I was enjoying the moderate conditions that I knew would not last long. And they didn’t. Within five miles of Mitchell, I had started a long, hot 3000 foot climb up Ochoco Pass. Ten miles and an hour and a half later, I was at the summit. I was looking forward to a long descent somewhere during the remaining 30 miles to Prineville. Instead of a big descent equalling the ascent I had just made, it was a very gradual one to two percent grade against a wind that seemed to get stronger as the morning went on.

By the time I got to Prineville, I was pretty tired and not looking forward to the remaining 30 miles to Madras. I decided what I needed was a relaxing lunch break in the shade of a tree in one of Prineville’s city parks.

The one park I found had plenty of shade and picnic tables, but the entire, and I mean the entire, park was being watered. There wasn’t a single dry place to sit except at the very corner of the park, on the curb, next to the sign that read “Ochoco Creek Park”. No matter. It was shady and the lush green grass was too tempting.

I had just sat down in the grass to have lunch. I had even dialed in a bolus on my insulin pump. While it was delivering, I could hear the click, click, click of it’s servo motor measuring out my dose. Then, all of a sudden it stopped and a long, continuous tone began. Uh oh. That’s not a good sound. I hoped it wasn’t the pump. I looked around for a possible source. I looked at the screen of the PDM (Personal Diabetes Manager, the handheld unit I use to program insulin delivery). “Occlusion detected. Pod deactivated. Would you like to activate a new pod now?” it said, or words to that effect. A “pod”, by the way, is a one-time use insulin pump which I attach to my body and program using my PDM. When a pod is activated, a cannula is inserted subcutaneously. After three days, the pod deactivates and I have to apply a new one. This process has worked flawlessly for the entire tour. Until now.

“Well, to be honest, no, I don’t want to activate a new pod right now, but since you’re not giving me any choice, why do you even bother to ask?” was my reply, but it wasn’t listening.

Instead of lunch, I proceeded to unpack the stuff I need to activate a new pod. A pod (obviously), alcohol swabs, Skin-Prep, and insulin. I looked around, wondering if I could do this discreetly here at front corner of the park. I didn’t know where else to go and I was getting everything laid out when I decided against it. A city park is not a place you want to be seen filling a syringe, not even if it’s just insulin.

So, I made quick management decision to not ride to Madras today. Instead, I searched for the nearest motel and went to the front desk, hoping I’d be able to check-in early. Fortunately, I was, and was able to get a new pod attached. My blood sugar never got above 146 for the whole episode and I consider myself very lucky that things turned out so well.

Comments(0)