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A New Outlook on Training for a Marathon with Type 1 Diabetes

Each week I attend a long run hosted by the Heartbreak Hill Running Company. These weekly runs have been central to my training for the 2016 Boston Marathon. As I mentioned in my previous blog post, these runs are an opportunity to spend time with my fellow Team Joslin runners and the time we spend together each Saturday morning is a tradition that I look forward to each week.

Over the past few weeks, my runs have varied between 14 and 18 miles. These runs require intensive diabetes management from start to finish. At miles six and 11 of these long runs, I test my blood sugar. I slow down and stop on the side of the road. I prick my finger and wait for my glucometer to return a blood sugar. I then calculate how much fuel I need to eat to keep my blood sugar at a safe level. If I take too long of a break while checking my blood sugar levels then my muscles will start to cramp or I will lose momentum.

Water is also an integral part of my long runs. Dehydration causes my blood sugar to go high – and stay high. Water does not directly raise or lower my blood sugar. A lack of water while running long distances will negatively impact my blood sugar, though, so I am always sure to drink water each time I prick my finger.

On these runs, I often find myself hurting, my legs shouting at me to stop or slow down. My body tells me to stop miles before I have completed each long run. I often want to stop or slow down emotionally, too. Just a quick walk would make me feel better, right? But I do not stop or slow down. I keep going – despite the pain and the exhaustion I keep going because of the people with whom I run with. I feel a strong bond to my teammates and an obligation to refuse the opportunity to quit in the face of difficulty. And for the past few months, I have kept going. I have kept running.

Learning How to Run with Type 1 Diabetes

There is no playbook for people with type 1 diabetes who run marathons. There is no set of guidelines regarding diabetes management before, during or after a marathon. When I started running, there was nowhere to turn to learn how to run with type 1 diabetes.

It would have been extraordinarily easy to stop running before I even started running. The lack of resources at my disposal could have served as a great excuse to avoid running. But I refused to allow that to be the case. I refused to allow my diabetes to prevent me from accomplishing this deeply important endeavor. So I did the only thing imaginable. I decided to learn how to run marathons – by running marathons.

I continue to work with my family, friends, and physicians – whom I now affectionately refer to as “my team” – to help manage my diabetes during training. We have collaborated to develop a rudimentary playbook, a basic set of best practices, which enable me to run marathons.

When we started working together in preparation for my first marathon, we knew enough to know what to do on a mile-to-mile basis. But we were short-sighted in our ability to navigate the training process – both physical and emotional – required by a marathon.

What They Don’t Teach You and You Can’t Learn

But now as we are just weeks away from the Boston Marathon, there is an added amount of stress and anxiety that accompanies my training.

We are just weeks away from the event for which I have spent many months and countless hours, training. We are weeks away from the event that plays a central role in my life as I work towards a future free of diabetes.

All of a sudden, the 2016 Boston Marathon feels real. Something about my perspective on training has switched and I am no longer just training. I am training for a marathon that feels to be just around the corner.

Every run that I complete has a new sense of urgency. Every ache and pain is amplified, not in pain but in importance. I no longer have months at my disposal to rest and recover from the weekly long runs or the aches and pains. I have but only a few weeks. Every step I take during my training runs feels more important.

The 2016 Boston Marathon will be my fourth marathon and my third consecutive Boston Marathon. I have learned how to train for a marathon. And I have learned how to complete a marathon with managing type 1 diabetes.

But now, as we approach the Boston Marathon, I realize there is one lesson that is still a work in progress: how to manage the anxiety of the weeks just before the marathon.

Each member of Team Joslin runs for a deeply personal cause. Each member of Team Joslin is passionately committed to the Boston Marathon. It is, truly, an honor to be amongst a group of people who are so strongly committed to the future of diabetes.

Each member of Team Joslin pours their heart and soul into the Boston Marathon. We train together, and we shape the future of diabetes together. But it is a superbly unique experience to be so committed to such an extraordinary event that requires countless hours of preparation, yet only lasts a few hours in duration.

Check back next month to follow along my journey with Team Joslin as we continue to run towards a diabetes cure in the 2016 Boston Marathon.

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