Monthly Archives: November 2013

Tanzawako 10-K Run November 24, 2013

Tanzawako Lake

Tanzawako Lake

I completed the Tanzawako 10-K run last Sunday. It was my first road race since I broke my fibula in March. I was and still am so ecstatic that I finished it, and within the time limit.

What time limit?

Actually, I did not realize that there was a time limit until my confirmation notice arrived in the mail about two weeks ago. When I signed up, I was so eager to enter any 10-k race by November in time for Diabetes Awareness Month that I did not pay much attention to the details. During my training, I focused only on building my mileage, which I did so slowly. So, when I saw the time limit of 80 minutes, I panicked. My husband reminded me that I’ve run races before so 80 minutes for a 10-k run should not be a problem. Of course, I reminded him back that those races were before I broke my leg. The other thing I did not realize was that the course around Tanzawako was not flat. Another lapse on my part. So, not only did I not train for time, but I also did not train for uphill and down hill running, which would affect my performance and slow me down even further.

I was tempted to crank up my speed during my last few runs before the race. But experience has taught me that I would only be courting disaster. Hence, I resisted deviating from my training plan. After all, if I didn’t meet the cut-off time, the worst they could do was ask me to run on the pavement instead of the middle of the road.

Before the race

Last Sunday, hubby and I rose at around 5:00 and left at 5:30 in the morning. Please understand that for us 5 am, on a Sunday, is the middle of the night. It took all my efforts to rise from the bed.

It was still dark when we hit the road. The sun came up while we were on the way, and the light was in a fluid flow of changing hues of orange and yellow, until the darkness dissipated and the sky was a magnificent shade of blue. As we approached our destination, we were greeted by a pinkish Mt. Fuji looming large in front of us on the highway.

We arrived shortly before 8:00 and found the car park. When I got out of the car, I was shocked by how cold it was that morning. Another one of my lapses – I decided not to take jogging pants with me and wore only warm tights and shorts. Everyone else was wearing thick sweatpants. At that point, I noted to myself that I should finally draft my checklist of things to do and not do on race day. Luckily, the day turned out to be a warm one, and so as long as I stayed in the sun, I was not cold.

On the shuttle bus that took us from the car park to the race assembly area, an elderly Japanese man started chatting with us. He initially quizzed me about the camera hanging around my neck. When he found out that my husband was British, he proudly declared that he loved visiting England, especially London. He said that he was running his fifth Tanzawako race. I saw him again after I crossed the finish line. He came in 10 minutes after the cut-off time, but he was beaming with pride for finishing the race, even if in overtime.

Reception area

Reception area

When we arrived at the assembly point, we quickly found the reception tables and picked up my bib and time chip. After pinning my bib on my shirt and attaching the time chip on my shoe, we wondered how we were going to spend the time waiting for the 11:00 am start of the 10-K race. We wandered about the small assembly area which was located at a school compound, but the place was so small that we found it hard to stretch the time by going in circles. Hubby finally found himself a small corner on a sofa inside a school building where he rested. I, however, couldn’t keep still and walked around with my camera.

Race staff

Race staff

P.G.P. man (volunteer)

P.G.P. man (volunteer)

Race tent

Some runners’ tent

I also inspected the food stalls. I made the mistake of buying amazake, which literally translates to English as sweet wine. It’s a low- or non-alcohol drink made from fermented rice. And yes, it was sweet. Obviously my brain was still asleep.

Somehow I managed to pass the time until the time came for the race to start.

Waiting

Waiting

Quick reminder of Type 2 diabetes

While waiting, I realized that a number of runners were staring at my shirt which read “ジェーンです。わたしは糖尿病2型です。” Although the literal, direct translation is “I’m Jane. I’m Type 2 diabetes.” it actually means “I’m Jane. I have Type 2 diabetes.” (Don’t ask me about Japanese grammar, but that’s what it is.)

My shirt

My shirt

Anyway, by the time of my race, I had forgotten about my shirt. A few weeks ago, I was sick and tired of the misconceptions, stereotyping, and judgmental attitudes vis a vis Type 2 diabetes in media, that I decided to have a shirt printed to tell the whole world that I have Type 2 diabetes. My objective was to show everyone that people with Type 2 diabetes come in different packages, much like ordinary people, and that you can’t tell if a person is diabetic or not just by looking at him or her.

No one approached me and asked me about it, though, so for a brief moment I was disappointed. Then I reminded myself that I was not there to engage people in conversations about Type 2 diabetes. I was there first to race, and second to show people that a diabetic, apart from the diabetes, is very much like them. So, if even one or two people got my message, then I’ve achieved that objective.

The Race

The route around the lake was beautiful. The autumn leaves were out in beautiful hues of brown, yellow, red and orange. Many parts of the lake were breathtaking.

Around Tanzawako 2

Around Tanzawako 2

Autumn foliage

Autumn foliage

By kilometer 3, however, I put my small camera back inside my waist bag as I was getting tired of holding the camera and photo taking was slowing me down. Then I saw this:

Tanzawako's Mt. Fuji

Tanzawako’s Mt. Fuji

I take this opportunity to apologize to the several photographers with tripods and heavy lenses for stepping in front of their cameras to take quick photos of Mt. Fuji. Since they secured premier spots, they must have been there since sunrise, waiting for hours in the cold for the right Mt. Fuji photo moment. I hope their patience was not rewarded with perfect photos of the back of my head!

As the race progressed, I was getting annoyed with all the older, repeat older, people running past me. I mean, they could have been my grandparents but they were faster than me, and despite the inclines and declines. Actually, the hilly route wasn’t so bad, at least not for 10-K runners, although I can’t say what the half-marathoners thought.

Speaking of half-marathon runners, they sped past me, too. We 10-k runners shared some portions of the roads with them, although they started much later than we did. That tells you how fast these guys were running, or how slow I was. They were literally flying past me.

Hence, my biggest worry during the race was that I’d be the last one to finish. My specific goal and mantra last Sunday were “Do not be the last.” The thought that every single elderly person running the 10-k would finish ahead of me spurred me on.

OLYMPUS DIGITAL CAMERA

Are you chasing me?

Well, I am happy to report that I wasn’t the last, and I was well within the time limit. More importantly, my fastest lap was the final kilometer. Somehow I found the energy and muscle strength to go faster. So, yeah, I was a happy finisher!

After the race

After I received my finisher’s certificate, I went to the free soup stall. Yes, they had free pork soup with mountain yam, radish and tofu. I devoured several bowls of the tasty soup before heading back to the car park.

While waiting for the shuttle bus, I noticed an elderly runner behind me holding what looked like a box with a trophy inside. It turned out that the man indeed won a trophy for being the fastest 10-K runner in the over-60 age group for men. I nearly fainted when I saw his time printed on his certificate. This man was a little over 20 years older than me, he was shorter than me, and his legs were much shorter than mine, yet he beat me by … a lot of minutes (I’m too embarrassed to admit by how much). I have a lot of training to do!

Today, my legs have recovered from delayed onset muscle soreness (DOMS). I read somewhere that older people have longer onset of DOMS, whereas younger people have it within 24 hours or so. So I was relieved that my DOMS set in on Monday morning, instead of Wednesday morning. This tells me that I’m not that old yet.

What’s next?

Now, I’m focusing on ski preparations while looking for my next road race.

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Three days “without” diabetes

Autumn

Autumn

I wish I can actually say I had three days without diabetes, but I can’t. But, I can say that I had three days where diabetes was not at the center of my life, as it has been for the first couple of years since I was diagnosed and for most days from the third anniversary of my diagnosis. What happened on those three days?

November 23, Saturday. My husband and I joined a couple of friends for a very pleasant lunch, and an even better time at a karaoke afterwards. There are few better ways to spend an afternoon than with people whose company you enjoy, sharing a meal, and singing songs you all love and know.

November 24, Sunday.  On this beautiful day and amidst a spectacular autumn scenery, I completed my scheduled Tanzawako 10-K run. I’ll post my report on the run later. But for now, I’m posting the photo above which I took on the way back home – trees on fire against a clear almost cloudless blue sky.

November 25, Monday. I gave speech no. 10 of the Toastmasters’ Competent Communication Manual (Inspire Your Audience). I titled my speech “Do Not Desire Mediocrity”. Based on the feedback from other members, I did fairly well. Unfortunately, I got carried away and did not pay attention to time, so I went past the time limit and did not qualify for “best prepared speaker”. That’s a bummer, but that was my fault. I should have been more aware, since I was giving my tenth speech. (I’m doing this speech again, and this time I’ll make sure that I’m well within the time.)

So, where was diabetes during those three days? It was still there, but those days were a strong reminder that diabetes is not the whole of me. I worry about it from time to time. I watch my diet. I exercise. I check my blood glucose. I take my metformin. I visit my endo regularly. I visit the DOC. But after the first couple of years or so, my life as a Type 2 diabetic has actually become mostly boring and uneventful. Maybe because I’ve settled into some sort of pattern in dealing with this condition, or perhaps I’ve gotten past worrying myself to death and assuming that diabetes is the cause of all my aches and pains, or it could be that there are other things beside diabetes worth worrying about. Diabetes will never go away, but it doesn’t have to take up so much of me either.

In fact, I noticed that the more I focused on Type 2 diabetes for most days of this month through this blog, the more I became more mindful of the wonderful, exciting and fulfilling life outside diabetes; problems and issues other than my own that are equally deserving  (if not more deserving) of my attention, time, efforts and resources; and people other than myself. It was almost as if when I focused on diabetes, the rest of me was actively resisting my inattention or what it may perceive as an inordinate amount of attention on diabetes.

But there is more to life than diabetes. I have work, family, friends, hobbies. There was also the super typhoon that devastated parts of my country, or the major earthquake that preceded it by about a month, or the great earthquake in Japan two years ago. And there will be more typhoons, earthquakes, volcanic eruptions. There is global warming. There are wars going on all over the world. There is poverty, hunger, disease, illiteracy, ignorance, religious and other forms of intolerance, and other important issues. There is also the beauty of nature and the existence of countless other species on earth. Beyond our planetary home, there is the solar system, and beyond it, a whole expanse called the universe, and I am but one small drop.

Sometimes, when I get overwhelmed by Type 2 diabetes, I reflect upon how small I really am in the universe, and how much smaller diabetes is than me (after all, it is just a part of me). Through this, I can in my mind free myself of diabetes and apply my thoughts and actions on other more important things. Even if it’s just for three days, or even just one day, at a time.

Thank you Doc!

Boat

Boat

I’ve been watching old episodes of Doctor Who (I’ve now been acquainted with the Fifth Doctor), who (in case you don’t know who I am talking about) is not a medical doctor. But the “Doctor” in Doctor Who led me to think about my doctors, mainly my GP and my endo, and their nurses and other staff.

I’m truly grateful for having a good medical team. Members of my team are more than just issuers of  metformin prescriptions or overseers of medical checks. They are part of my control over Type 2 diabetes and my health in general.

Mind you, they are not perfect, but they are as close to a dream team as I could hope for. For one, they talk to me. I mean, they actually ask me pertinent questions and listen to my answers, my difficulties, my complaints, and my little triumphs in living with a chronic condition.  They explain the results of my tests. They tell me what they think we should do if they are not happy with the results. They voice out their concerns and listen to mine.

They may never completely understand what I go through everyday, but they try. They even remind me to be more mindful of my diet during the holidays, and gently tell me not to be too harsh on myself if I slip up during December’s almost endless bonenkai (“forget the year” parties, Japan’s version of countless Christmas parties). They tell me not to quit running. They remind me to drink water and to avoid sweets, rice and noodles.

They do not know all the answers or pretend that they do, but they find out for me. They acknowledge that I would know more about my diabetes than they would ever know, let me decide the direction of my diabetes treatment and support my decisions. They trust my judgment, and I trust theirs.

They assuage my fears. They try their best to help me navigate through the pitfalls and challenges of my condition. They prop me up by reviewing my history to show me how far we’ve come.

They make me feel like they are taking this life-long medical journey with me.

Thank you.

 

How are your eyes?

Center

I have annual health checks, at least since I was diagnosed with Type 2 diabetes. My GP and later my endo both made a point of explaining the importance of health checks, what they were checking for, and why. Yesterday, I had my eye exam, the first in my list of health checks.

My ophthalmologist screens for glaucoma, diabetic retinopathy, cataract and eyesight changes. Starting last year, he added a visual field test to his checklist. I don’t look forward to the visual field test (the test for each eye goes on for only a few minutes but strains the eyes) or to the dilated eye examination (the ophthalmologist dilates your eyes, then shines a really bright light so he can look at each retina). But, I know that they are important for the early detection of eye related problems. The good news is that I show no signs of eye problems, apart from my poor vision which I was born with (but my vision has not deteriorated since I was diagnosed).

I have my regular eye checks because my doctors took the time to explain the necessity. But I’ve just read an article on Medical News Today that a large number of diabetics in the US are not aware of the risk to eye health and do not have regular eye exams. I don’t know what the stats are in other countries, but I don’t think they are that different.

A comprehensive eye exam is an important part of a diabetic’s treatment protocol because we are at a higher risk of developing certain eye diseases due to our condition.  Uncontrolled diabetes may lead to diabetic retinopathy due to damages in the blood vessels in the retina. Diabetics may develop cataract at an earlier age, or are twice as likely to develop glaucoma, than people without diabetes. These eye problems are likely to lead to serious loss of vision or even blindness.

I’m not saying that diabetes will definitely lead to eye problems. But, the chances of that happening increase if we don’t control our diabetes by keeping our blood sugar level below a certain threshold. The risk also increases if we don’t catch early signs of these complications and intervene. Hence, regular eye exams are crucial for our eye health.

I’ve just read that November is also Diabetic Eye Disease Awareness Month. Don’t ask me who declared it so, but it’s a good reminder for us to have our eyes checked. If you have not had a comprehensive eye exam since you were diagnosed, or you have not had it in a while, please put it on your to-do list, now.

No rest

No rest

No rest

World Diabetes Day (November 14 to those who may not be aware) did not proceed as I planned. I’ve been looking forward to it and to participating in DSMA‘s 24-hour twitter chat on diabetes. Despite my planning and excited anticipation, work descended heavily upon me. Thus, ironically, yesterday, on World Diabetes Day in Japan, I was so preoccupied with my job that I had little time to think about diabetes. Sure, I managed to check my blood glucose and post a short blog entry, but for most of the day, I almost forgot that I was diabetic.

That was perhaps why, on my way to work this morning, I especially noticed the signage outside one of our small neighborhood’s cleaners (for clothes). His sign said “年中無休” (pronounced nen-jyuu-mu-kyuu). It is an indication that the shop is “open all year round”. The phrase literally translates as “no rest during the year.”

This shop will accept your dirty clothes even during holidays. It is run by one man, or at least every time I walk past it, I see the same guy. If I’m not mistaken, he used to run two cleaners’ shops until he consolidated them into this one shop.  I don’t know how he does it. I swear, one day, when my Japanese is good enough, I will interview him and find out.

Anyway, his signage is so applicable to diabetes, don’t you think? We are diabetic “year round” or “7 days a week” or “24-7”. Much as we want to take a break from it, diabetes is there to stay, like a clueless unwanted guest. There really is no break. Take my day yesterday. Although, despite a heavy workload, I found the time to check my blood glucose before and after exercising for the Big Blue Test, and before and after lunch, and managed to sneak in a few words for my blog post, those moments were few and short, if you compare it with the bigger picture of my insulin resistance taking no break at all, whether or not I pay attention to it. And if I don’t pay attention to it, I will know the next time I check my BG or the next time I go for A1c test.

We can all take a break from our diabetes, perhaps by immersing in our work, exercising, or enjoying a quarterly or annual food indulgence. But remember, we can only take that break if our regular routine is one of control and management. We cannot afford to take a break from diabetes 24 hours a day, 365 days a year, unless we are purposely courting disaster, or in our case, diabetes complications.

Once a year, we have World Diabetes Day, and for a month in a year, we have World Diabetes Month. They are reminders, not so much of our condition, but of our duty to advocate to and educate others, but more importantly a reminder that we should take care of ourselves.

World Diabetes Day

Equinoxe

Here’s a toast to World Diabetes Day.

One day, I hope that we do not need a special day to advocate for research, more consistent and accurate test strips and meters, better treatment protocols, and cure.

One day, I hope that we will not need a special day to correct the myths, misconceptions and erroneous information that media, the public, and even some of our own health care providers have about us.

One day, I hope that to be able to look back and say, “We had diabetes.”

One day …

For now, we live with this disease or condition the best way we can, we educate others, and we fight it anyway we can.

Sports

Running in blue

Running in blue

My current pair of running shoes is close to dead, so at lunch time today, I sauntered over to my favorite running store. I had tried on several pairs, when the staff recommended a pair of blue men’s Brooks running shoes. I would have preferred the purple women’s counterpart but the fit was not right. The recommendation was spot on, so I went home with my first pair of blue running shoes. Then I had one of those light bulb moments – I have my next blue photo! I decided to add the few blue running apparel that I own, which turned out to be not that few after all. I had lots of blue shirts, shorts, and leggings. I gathered a few of them for today’s photo.

I also thought that this would be a good opportunity to share my views on exercise and diabetes. For me, exercise is a crucial element in controlling diabetes. The benefits of exercise to me as a Type 2 diabetic include:

  • Reducing my insulin resistance
  • Allowing me to eat more fruits, my favorite bread and Reese peanut butter cups (I’d run any distance for one Reese peanut butter cup)
  • Lowering my BG  when I’ve indulged more than I should
  • Keeping my stress at bay and my sanity intact
  • Having fun
  • Boosting my self-confidence and sense of achievement

But there’s another side to it. In my experience, and based on experiences of others as shared in diabetes online boards, exercise may result in an increase in BG during or right after exercise. I know some of you may be too conservative and scared of your BG going higher than a certain threshold (even if that rise usually goes down pretty quickly) and therefore avoid any form of exercise. 

Because I love exercise, I find it sad when people choose not to do it. I find it even sadder when people stay away from physical exertion because they think their diet is enough and they don’t need to exercise or, in the case of people with diabetes, they are so intent to not let their BG rise that they would rather not exercise than explore different exercises and different ways of exercising (for example, time of day, intensity, or duration).

I encourage everyone to find a way to minimize the rise in BG, instead of developing an aversion to physical exertion. What I’ve found helpful for me are warming up so that my body is not shocked into activity which convinces it that I am in danger and need glucose for energy, and exercising at a slower pace or intensity so that my body does not perceive me as being in a fight or flight mode, which may cause it to produce glucose. Of course, when I’m training for a race, I add speed and interval training from time to time, and accept that my BG will rise. But the rise doesn’t last long, as my BG quickly goes down. 

I’ve also noticed that the rise in my BG lessens over time, as I exercise regularly. In fact, now, my BG hardly goes up, and in many cases (even with more vigorous exercises) goes down. If I go for a few days without exercising, my BG starts to rise even if I keep my food intake at the same level. I found this out when I broke my leg. I had to go low carb to keep my BG under control while I was out of commission.

Another option is to find less vigorous exercises. Not everyone needs to run, ski, or play tennis, soccer or basketball. You don’t even need to spend money on gym membership or expensive sports gear. You can do gardening, or yoga, pilates, calisthenics, tai chi, or slow ballroom dancing courtesy of some good YouTube videos. Leisure walking and cycling are also excellent options. If you are a parent or grandparent, how about going to a public park or beach, and play tag with your kids or grand kids (good, not just for you but for the kids too, and helps with family bonding)? You are bound to find an activity that suits you. If you don’t, why not invent a new one?

Exercise is nothing more than moving. So I’m sure you can find a physical activity that fits you, your personality and your blood glucose goals. So, get moving. But whatever you do, do not forget to have fun!

Beacon

Blue windows

Blue windows

I walked down this street the other night, happened to look up and noticed the blue windows. Two words popped into my head: secret and beacon.

The scene first conjured up images of secrets. For a long time, my diabetes was a secret (except to my husband, family and a handful of other people). I had various justifications for my reticence – I wanted to learn how to deal with this on my own first, I didn’t want unsolicited advice from people who knew nothing about my condition, I didn’t want to be bugged by pyramid scammers, and it was no one’s business but mine. They were not just pretexts; they were all legitimate and true. But, there was another bigger reason that I tried to deny even to myself – I was embarrassed, guilty, and ashamed for developing Type 2 diabetes.

I bought into the idea that those who have Type 2 diabetes deserved it, unless they developed it when they get old. I’ve always seen it as an old person’s disease, so if people get it when they were not even in their 40s, then they must have brought it upon themselves, just as the “experts” said. Yes, I totally believed the public image of a Type 2 diabetic. Even though I was armed with a lot of research debunking the nonsense that Type 2 diabetes is a self-inflicted disease due to a less than ideal diet and inadequate physical activities, it took a long time, and a lot of confidence in myself and what I have accomplished, to finally shake off the guilt and shame.

At the same time, the blue windows shining in the dark reminded me of a beacon. No matter how faint the light was, it was clearly visible in the dark. It could not go unnoticed, at least not for long. This to me symbolizes the growing number of Type 2 diabetics who, through social media and the DOC, are trying to be that collective beacon to one another and other people with diabetes, to those at risk for this condition, and to those who may never develop it. To enable others to understand, empathize, support and cheer us, they must know us, and they will not know us unless we tell them or show them something of ourselves.

As more of us come out to share our stories, we will become the beacon that can guide others, give them hope, or hold their hands.

Meditation

Shoun Genkei (Buddhist monk)

Shoun Genkei (Buddhist monk)

This afternoon, hubby and I explored, on foot, a part of Tokyo we have not visited previously – a cluster of temples in Meguro, including Gohyaku Rakan Ji (Temple of Five Hundred Rakan). A rakan is a disciple of Buddha who remained on earth to serve as a role model for ordinary people.  Shoun Genki  (pictured above) was a monk and a sculptor who carved 500 rakan figures.

After our afternoon walk and an early dinner afterwards, I checked my blog and found Shannon’s response to a previous post about some of my frustrations with diabetes. She said that meditation helps her with her own frustrations.

An afternoon of learning about an aspect of Japanese Buddhism and meditation – what a coincidence!

Meditation, as described by wikipedia, is “a practice in which an individual trains the mind or induces a mode of consciousness, either to realize some benefit or as an end in itself.” From my  readings, I understand that different cultures, different times, and different religions (or even lack of religion) have their own way of meditating. My first introductions to meditation were by way of Buddhist chanting after my mother’s father’s death and praying the rosary as part of the Catholic tradition, although I don’t remember which one came first. While I prayed the rosary, and appreciated Buddhist chants as well as Gregorian chants, I came to appreciate them and the power of meditation only about a decade ago.

I’d like to thank Shannon for reminding me of this important tool in dealing with, not just diabetes, but stress in general. Being stressed once in a while is probably good for us, but going through chronic stress is not. The Mayo Clinic article on chronic stress discusses the general effects of stress and stressors on us and different aspects of our health. The short version is that chronic stress is not good for your health, especially when you are diabetic.

Meditation is one way of dealing with the stresses of diabetes. No matter how good our control is, there will be times when diabetes gets the better of us, or things do not work out according to plan, or we fall off the diet or exercise wagon. Meditation is a great way of calmly facing all these unexpected turns of event, resting our minds and recharging our batteries.

If you have not tried meditation, give it a chance. If you are of a particular religious persuasion or are not the religious kind, please do not fear that all forms of meditation are linked to some specific religious beliefs or systems. There are various approaches to meditation, and you should be able to find one that suits you and your personal beliefs. The Mayo Clinic gives a good general introduction to meditation.

I can attest to how vital meditation is in my life. I hope it becomes an integral part of your life, too.