The first JDRF Ride to Cure Diabetes of 2019 is in the books. 650 riders in La Crosse, WI raised more than $2.1 million for type on diabetes research. Here’s the start of our day.
More than 30 years ago I was a pilot. I held a private pilot license and flew gliders, with most of my 125+ flights in the Schweizer 2-33, Schleicher Ka-8, Blanik L-13, and Grob G103. Because of type one diabetes, I wasn’t able to get a medical certificate needed for power flight, so my seat time in planes with engines was limited to flying with friends in a variety of 1940s-era taildraggers.
The FAA will now grant exemptions for private pilots with T1D* and this sparked my interest in going back to flight school. After research into medical waivers and local flight schools I booked a discovery flight with Elon Aviation at Burlington-Alamance Regional Airport (KBUY). My goal for the flight was to get reacquainted with flying and see if it’s something I want to pursue.
First, props to Elon Aviation for a great experience. I booked my flight in a Cessna 172 that was well-equipped and maintained, and that had seen some serious cross country flights. My instructor, Nick, quizzed me about what I wanted out of the flight, walked me through the preflight checklist, and then laid out the plan: I’d taxi, he’d take off, and once we reached 500 feet I’d take the controls.
Taxiing to runway 6 reminded me of how much I don’t know. Coordinating throttle, rudder and brakes turned out to be the most challenging part of the flight, though it was easier on the return trip to the hanger.
Nick quickly had us airborne and after we passed 500 feet I took the controls. One memory from 30+ years ago came back: The workload involved with flying a plane. At first I focused on getting the feel of the controls as we climbed and making coordinated turns. After we gained altitude I turned toward Greensboro, dodged clouds, practiced climbing and descending, turning to headings, and managing the throttle. And I kept reminding myself to keep my eyes outside the cockpit and watch for traffic.
Then time was up and Nick said, “You fly the pattern.” A lot of credit goes to Nick for talking me through my approach, but the experience of juggling throttle, carb heat, flaps, yoke and rudder while maintaining our glide slope (not perfect, but close enough) and staying on the runway centerline was a confidence booster. Nope, I didn’t get to fly the landing; I passed controls back to Nick short of the runway.
So what’s next? I have some unfinished business with flying, and the next step is a medical waiver. It’s not a simple process, so it might be a while before I know whether I can get back into the cockpit and continue training.
*There’s an alternative to the private pilot license for people with T1D–the light sport certificate, which requires a drivers license but not a medical exam. I’m not enthusiastic about the light sport rule, because it includes a long list of limitations about what, where and when you can fly, as well as a prohibition on passengers.
I wrote this article for Heidi Armstrong’s Injured Athletes Toolbox. Heidi is a friend and tremendous resource for athletes who are struggling with the mental aspects of an injury.
This was my July: Recovering from a bicycle accident that left me with a broken clavicle and rib. Suddenly, I couldn’t ride my bike, and couldn’t run or engage in any of my other normal activities. A long, unhappy summer stretched out in front of me.
My recovery had one additional component: Type one diabetes, or T1D. I was diagnosed 42 years ago, and though I’m active, healthy and free of complications, T1D casts a shadow over the recovery process. Athletes with T1D can face distinct physical, emotional and spiritual challenges related to our disease. Understanding those challenges and learning how to adapt to them are essential to not only becoming whole, but maintaining health during the recovery process.
Those Pesky Numbers
Type one diabetes is a numbers game. Good health demands monitoring blood glucose (BG) numbers and the quarterly A1c, which provides insight into average BG numbers for the past three months. Regular exercise is a critical part of maintaining stable BG numbers within a target range. Athletes with T1D who are regularly active have a higher, more consistent sensitivity to insulin. This consistency removes some of the unpredictability about T1D from decisions about how to manage insulin, nutrition and activity.
Eliminating exercise triggers a series of cascading problems. Insulin sensitivity decreases; more insulin is needed to have the same affect. This can throw BG management off until the athlete recalibrates their bolus and basal doses to adapt to a lack of activity.
Athletes have to immediately adapt to this change in sensitivity following an injury. Whenever possible, they should look for opportunities to build mild activity into their recovery plans. Even a twenty minute walk following dinner can have a profound impact on increasing and stabilizing insulin sensitivity, and managing swings in BG. And, transitioning back to a normal training routine will be easier to manage if the athlete takes steps to stabilize insulin sensitivity.
Apart from keeping BG in range, athletes with T1D need to be conscious of other physical complications. In the case of my clavicle injury, keeping my arm in a sling placed me at risk for adhesive capsulitis, or frozen shoulder, a common complication from T1D. My recovery plan included progressive stretching as soon as I was able, to maintain my range of motion.
The Emotional Side of T1D
The emotional side of T1D is less understood than the physical side, but it’s coming into clearer view for those who study the disease. Athletes can see training and competition as essential to their health and well being. Take those things away, and depression and stress may take their place.
Both have a powerful impact on athletes as they navigate the recovery process. They also have a physiological effect on athletes with T1D. Stress triggers the release of counter regulatory hormones that increase blood glucose. These episodes can be intermittent or ongoing. Either way, they can lead to a roller coaster of high and low BG, complicating management.
How we manage the emotional side of T1D is as individual as the athlete. For me, focusing on interests that had been sacrificed to time on the bike and reconnecting with friends were two tactics that helped me manage stress while I recovered this past summer. More than distracting me, those activities felt productive and fulfilling.
Time in recovery gave me time to think creatively about new projects. Difficult as it was, when I realized that I would spend at least six weeks not cycling, I embraced the opportunity to do deep work that I had been putting off, and appreciated the value of having uninterrupted time to think and plan.
Like everyone who goes through recovery from an injury, I had my tough days. The best antidote for those was to rest on the couch with my dogs and read a good book.
When an Injury Becomes an Existential Crisis
T1D is a chronic disease, and there can be a dark outlook associated with it. Those of us with the disease are aware of the possibility of possibly fatal complications, diabetic ketoacidosis , and life threatening hypoglycemia.4Injury can cause an athlete with T1D to suddenly confront, in a tangible way, evidence of their fragility and mortality. It becomes an existential crisis that threatens our identity as athletes and shakes faith in our ability to manage the disease.
That’s the spiritual side of recovery. Athletes with T1D can respond in several ways, including: Meditation or other contemplative practices, turning to faith, or despair. July and August were an opportunity for me to press pause on a busy life and use my time to be intentional and ask big questions about my goals as a cyclist and how the sport fit into my life. Even when a powerful sense of fragility was staring me in the face, I could look at the answers from those big questions and see a path back to wholeness.
Don’t Neglect Your Team
I’ve read here that recovery is a team effort. That’s particularly true for those with T1D. Injury brings the importance of having a team into sharp relief. I’m fortunate to have a network of athlete friends with T1D who I can call on for support, health care providers who understand and encourage my cycling, and family and friends who stand behind me. Having that team, before I ever needed them to help me though my injury, made all the difference.
- Type one and type two diabetes are distinctly different diseases. For information about T1D read http://www.jdrf.org/about/fact-sheets/type-1-diabetes-facts/.
- A BG of 90-120 is a typical target, though this can vary depending on the individual and their activity.
- Basal insulin is either fast acting insulin administered in tiny doses via an insulin pump, or slow acting insulin injected once or twice a day. Bolus insulin is a single dose of fast acting insulin given to counteract food that is consumed.
- Diabetic ketoacidosis, or DKA, is a result of extreme uncontrolled high blood glucose. Hypoglycemia is low blood glucose.
During the JDRF Ride to Cure at Santa Fe last fall, I was interviewed for this video highlighting the relationship between Ford and JDRF. Apparently the producers thought my hobo chic was a good look.
I’m riding again this year to raise money for the prevention, treatment and a cure for type one diabetes. Please consider a donation.
“Paris is a museum,” said the Paris-based filmmaker I’d been chatting with over beers.
Look beyond the monuments, museums, tourist traps, and other obvious must-sees and there’s vibrant everyday life. It may be a museum, but the people behind the scenes are fascinating to watch. It’s all about choosing your perspective.
They’re now here.
Let’s get this out of the way: There is no one, perfect travel camera. There’s only the best camera that works for you. Or in this case, the one that works best for me. First, some history.
I’ve shot with SLRs and DSLRs for about 40 years. In 2010 I traveled to the UK with a bag of Nikon bodies and lenses. I was shooting for a client, but I also carried that gear as I walked around London on my own. The images were good; the experience was miserable.
Three years later I was packing for a trip to Paris and looked at my big bag of gear. I remembered lugging it around for two weeks. Instead, I packed my Ricoh GR and two spare batteries.
The Ricoh GR, if you’re not familiar with it, is a wonder camera. For some people. It has an APS-C sensor (the same size you’ll find in many DSLRs), and a range of features that allow users to focus on making great images. The lens is a fixed 28 mm f2.8 (35mm equivalent) that encourages getting closer to subjects. It also fits in a pocket. And that’s all I carried for a week and a half in Paris. You can see a few of the results below.
Since then, I’ve flirted with other cameras. My Fuji X100T often travels with me (and is a much better camera in marginal light), but I keep gravitating back to the Ricoh GR that’s been in my collection for five years. Here’s why:
- It’s small and lightweight. The advantages of this are obvious.
- That lens. It’s better than a camera at this price point has any right to be–sharp, with little fall off or softening at the edges.
- Snap focus. If you’re familiar with zone focusing, this is essentially the same thing. When walking around I leave the focus point set at 1.5 meters (and aperture at f5.6); when I’m ready to snap a street pic the camera is already focused. There’s no lag. If I need to change the focus point I can simply press the AFL button on the back and it autofocuses.
- Superb JPEGs. The internal processor is excellent, and I don’t have to deal with large RAW files. The resolution is high enough to print high quality 11″x14″s.
- Custom settings. I have three custom settings that are changed on the top dial: Street color, street black and white, and square format black and white. I can switch between them quickly and without a lot of thought.
- It’s unobtrusive. People around me often don’t notice it, and don’t have the same reaction to it that they would have to a larger, more “serious” camera.
- It’s relatively inexpensive. I carry mine on my bike, and in situations where it might get beaten up. But it’s not so expensive that I worry about it. That way I can stick to the first maxim of cameras: The best camera is the one you have with you.
The GR has always been a cult camera, so much so that Ricoh periodically sighs (as much as a corporation can) and admits that there are enough photographers in love with the GR that it deserves an upgrade. The latest version is similar to mine, other than the addition of WiFi connectivity. But, there’s a Ricoh GRIII due early 2019 that’s going to be smaller and have a higher resolution sensor. The perfect camera, for me, might become more perfect.
During our recent trip to France our son, Eli, and I were discussing our shared interest in visiting WWI monuments. That led, in turn, to a day trip to the area north of Amiens, where the Battle of the Somme took place. I asked my friend Murray, who recently wrote about notable books about the Great War, for advice on things to see. These are my impressions, shared with him, and with you.
I can’t get that Fussell quote you shared out of my mind:
“The idea of mass graves seems to pertain especially to the twentieth century. There are 2500 British war cemeteries in France and Belgium. The sophisticated observer of the rows of headstones will do well to suspect that very often the bodies below are buried in mass graves with the headstones disposed in rows to convey the illusion that each soldier has his individual space.”
The conflict along the Somme River in 1916 appears, to this lay historian, a savage lesson in what happens when tactics fail to keep pace with exponential growth of the killing power of armaments. Eli and I walked through the trenches at the Newfoundland Memorial in Beaumont-Hamel; at some distance we could make out the high point where German machine guns were sited. The Danger Tree–and there’s an understated name–sat in the middle of no man’s land, marking one of the deadliest places on the battlefield.
July 1, 1916 at 8:45 a.m. the Newfoundland Regiment’s 22 officers and 758 soldiers climbed out of their rear position trenches and moved (ran, walked, marched?) toward the German machine guns that looked down on them. Within half an hour only 110 of them, none of them officers, were left alive. Only 68 made roll call the following day.
The Newfoundland government and the families of those who died were deeply shaken. But the overall death toll of the Battle of the Somme, 1.2 million combatants by some accounts, challenges me to put those 670 lives in proper context.
Two years ago I stood on Omaha Beach, Pont du Hoc and the cemetery at Colleville sur Mer and felt their historical weight. There’s a belief that good and evil clashed on those Normandy beaches in 1941; the neat headstones at the American cemetery tell a powerful story of noble sacrifice that changed the arc of history for the better. I expected to see something in Somme that would trigger the same sentiments.
No, the Great War was the outcome of regional squabbles and awkward alliances, and those who fought for the Commonwealth–roused by Kitchener’s appeals–were young, inexperienced and motivated by love for King and country. Their officers were arrogant and dismissive of their foe. Yet despite soldiers’ cynicism about their leaders and fate they dutifully swarmed out of their trenches to be cut down, day after day.
They mostly died in fields that had been farmland until shells began falling. I stood in some of those fields on a wet, cold December Tuesday and tried to imagine how a 16 year old, brought to that place by his patriotic fervor, would have felt as he crawled out of a muddy trench and began moving toward the German lines, knowing the odds of making it through weren’t on his side. Then I walked through several of those 2,500 cemeteries Fussell wrote of, with their perfectly straight ranks of headstones masking the necessity of mass graves for those million-plus souls who died, and felt the weight of their sacrifice for a cause that was at once unnecessary and hugely consequential to the future of Europe.
Murray, a side note: Eli and I made a point of visiting the field where Manfred von Richthofen crash landed his triplane after being–pick your side of the argument–shot down by Roy Brown or hit by Australian anti aircraft fire. It’s adjacent to the brickworks in Saint Colette which stood at the time of his death. There’s a metaphor in this, somewhere–arguably the most legendary combatant from among the 70 million who fought, meeting his end in a wholly unremarkable field, in a vague, contested way, witnessed only by a few.
One more thought about the Somme: It may be a trick of memory, but we’ve talked at length about Pat Barker’s Regeneration trilogy and how the Great War blotted out most of a generation of great writers and poets. There isn’t a museum or monument to their memory, at least to my knowledge, but there should be.
Update (12/20/19): Here is a gallery of photographs from our day at Somme.