Kris Freeman's Triathlon with Dexcom and Omnipod
Hello everyone! This is a guest post (sorta) from former Olympic Cross Country skier Kris Freeman. Actually, this wasn't written for Arden's Day - it's from Kris's Facebook page and I am posting it here with his permission. We talk on the Juicebox Podcast all of the time about how I use Arden's Dexcom data to make small adjustments to her insulin with settings that are available on her Omnipod. When I saw Kris's post I thought, "this is the next level of those ideas" and I wanted to share his process with you. Please visit Kris on FB or his blog, he's also been featured on Arden's Day a number of times and been a guest on the podcast twice. -- #BoldWithInsulin
Yesterday I competed in and won the Sea to Summit triathlon. The race traditionally starts with a 1.5 mile swim in the Salmon Falls river, continues with a 92 mile bike ride to the WildCat MT ski area parking lot, and finishes with a run up the Tuckerman Ravine trail to the Summit of MT Washington.
Unfortunately due to the heavy rains NH has had over the previous week, a lot of fecal matter has ended up in our waterways and the bacteria level in the river was above the safety limit. The swim was canceled and the event became a biathlon.
The swim would have taken approximately 40 minutes so I had to change my insulin dosing strategy to accommodate the slightly shorter race. My glycogen stores were topped off so I was running a 24/7 basal rate of 1.0 units per hour on my Omnipod. To cover race nerves, readily available glycogen stores and carb/calorie intake I settled on the following protocol.
Hour 1 = 1.0 units per hour
Hour 2 = .7 units per hour
Hour 3 = .3 units per hour
Hour 4 = .3 units per hour
Hour 5 = .3 units per hour
Hour 5-5.5 = .3 units per hour
Hour 5.5- to finish = off
It is very difficult to estimate how much insulin I will need in an event this long. I have to guess how insulin sensitive my body will become from prolonged exertion as well as how many calories I will need to fuel myself. The program that I used yesterday ended up being a little too aggressive and I had to force feed myself at the end of the race. On the bike I drank 60 ounces of Gatorade, 20 ounces of custom Cola/Coffee mix, and 24 ounces of RedBull. I had planned to take in solid food but I was sweating buckets and my stomach was not calling for it.
The bike took me four hours and ten minutes and my glucose was 116 at the transition to running. I drank another 16 ounces of Gatorade during the first 40 minutes of the hike. At this point my glucose was 117. I decided to pull off the Omnipod that was delivering .25 units per hour as I did not want to have to overfeed to get to the top of the mountain. I was wearing two pods and the other one was delivering the minimum dosage of .05 units per hour.
I ended up having to overfeed anyway. I drank another 16 ounces of Gatorade over the next 20 minutes but my sugar dropped to 80. I had to pull out my emergency flask filled with 5 Untapped Maple syrup gels. The flask contained 105 grams of sugar and I finished it five minutes before winning the race in five hours and forty-four minutes.
Every race is a learning experience. If I could do this race over I would reduce the first hour dosage to .7 units, the second hour to .5 and then I would have run .3 up until 4 hours at which point I would have suspended delivery. The attached picture is a graph of my glucose on a Dexcom during the race. It looks "perfect" but I really would have preferred to not take on over 100 carbs in the last 30 minutes of the race.
Kris Freeman: The Arden's Day Interview
The road to my interview with Kris Freeman starts when he posts this picture on Twitter as the Sochi Olympics are beginning. The photo of Kris and his fellow US cross country teammate Kikkan Randall (say Key-Can) caused me to have two distinct thoughts, “I am significantly out of shape” and “This reminds me of a point in my life when I was afraid that my daughter Arden was too lean to wear an insulin pump or continuous glucose monitor (CGM).
I immediately reached out to Kris and inquired about using his image in a blog post that I wanted to write called “Worried Your Child Is Too Lean For An Insulin Pump Or Cgm?”. Kris, very generously agreed and then I asked him if he would be willing to do an interview with me after he arrived home from Sochi.
My interview with four time Olympic athlete and type I diabetic, Kris Freeman
Scott: When you posted the photo was this just you celebrating the games starting with a friend or did you have an idea that it would help people who wear insulin pumps and CGMs?
Kris: We were just playing around… we were both just taking off our wet shirts from training and I was like, “Hey this might be cool, lets take a picture”.
I told Kris how I wanted to use his photo to help lend Arden’s Day readers the same support that I was offered many years ago on Twitter. It was then that a woman in her thirties reached out and told me that she was lean (like Arden) and had no trouble finding good sites for her pump. That brief conversation took away my apprehension about Arden starting on an insulin pump and I wanted to return the favor . "My blog posts are fine" I thought, but this picture of Kris is certainly more inviting, informative and poignant then any words I could throw together. It really makes the point that a person can find a pump or CGM site no matter their body type.
S: The blog post that included the picture of you with Kikkan is one of the most popular posts that has ever appeared on my blog. Seeing an insulin pump and CGM working on such a lean person was inspiring for so many people who live with type I diabetes and their parents.
S: What is your average body fat when you are in competition shape?
K: I go off of a body fat monitoring scale and I range anywhere from 4 to 8 percent. The scale has some inaccuracy in it depending on your hydration level, but I harbor around 5 to 6 percent normally.
I asked Kris if he knew the average body fat for an adult, he wasn’t positive but he guessed it may be around twenty… I looked down as he was speaking and thought, “What must mine be...?”.
S: How many hours a week do you train to maintain that level of fitness.
Kris gave a complete answer about varying his effort, “Each month I’ll have two hard weeks and two easier weeks, so that my body doesn’t get used to a certain load”. “I also change the amount of volume from month to month”. He says that he trains the hardest in August and September and then through October, November, December the volume comes down but that during those months, “I train harder, I ski faster, do intervals… training my anaerobic system instead of my aerobic system”. “If you want to just know how man hours a week I average, last year I trained about nine hundred hours for the year. That includes one off day a week and illnesses that don’t allow me to train”.
I did some quick math and it sounds to me like Kris trains on average of twenty to twenty-two hours per week, or the equivalent of the amount of exercise that I did between 2008 and 2010.
K: My biggest training days are five to six hours and the smallest is one to two.
S: Since there isn’t always snow available, how do you train for cross-country year round?
Kris training on Roller Skis. Image courtesy Krisfreeman.net
K: I do a lot of dry land training, I use roller skis. They look kind of like roller blades but they attach with the same boot and binding as my skis. They are remarkably good at mimicking the muscle use of skis, it’s just a different feeling to be rolling instead of gliding.
S: When we were watching you ski at the Sochi games it occurred to me that your life is kind of like a living diabetes blog. That the simple act of you going about your day is an act of support and relief for people who live with diabetes and the people who love them. I’ve received countless letters over the years that thank me for sharing our life with diabetes here on the blog, people often say that it "saves" them. I was wondering, do you see that your presence in the public eye is doing the same for people?
I loved Kris’s answer
K: I have never set out to be a role model or an inspiration in the diabetes world. I was just doing what I love to do and I found solutions with my own diabetes care that allowed me to do it. I was alerted that what I was doing was inspiring other people and so over time I’ve embraced the image of a role model but it was never something that I thought of (about) myself.
I tried a few more times to give Kris credit for the example that he provides for the diabetes community but he remained very humble. I could tell how incredibly pleased he was that his life as an Olympic athlete is uplifting to the community, he insisted that he is glad he can inspire people but, “I’m still just me and I’m trying to be the best ski racer and person that I can be, I don’t get out the door everyday and think I’m going to be an inspiration.”
I told Kris that when we watched him compete at Sochi I was struck by the amount of effort and training that cross country requires and thought that it must seem, to most people who have diabetes, to be something that is out of reach for them. I wondered aloud if people with diabetes identify with the image of him working so hard to reach a difficult result.
S: Your life is a figurative example of diabetes. There is no end to the amount of effort that you have to put in, your footing is never secure and it almost always feels like you are slogging up an incline. I guess you can paint parallels between almost anything, but this one seems pretty obvious. It’s possible that when people are watching you ski, they see themselves in your effort. I hear it in your voice and I’ve spoken with you before… I know you're not trying to be a role model, and I’m not a big believer in role models. I don’t think that anyone should be looking to other people and expecting them to live their life in a certain way, but when it happens organically, it’s beautiful. You're living a blog… and it’s helping people.
We spoke about the interview that he did with The Olympic Zone on NBC and I remarked at how popular it was in the diabetes community.
S: The NBC interview was shared online, liked and commented on furiously. In my opinion it helped people to understand that their diabetes can’t hold them back and it takes away some of the fear that parents of children with type I may have. Seeing you on that stage doing this incredibly difficult thing, it lets parents know that their kids lives can still be all that they hoped for when they first held them as newborns. How does it feel to hear that and to have the support of so many people who identify with you?
K: For sure, knowing that people are watching and are encouraged by what I am doing is inspirational to me. Similar to the advocacy work I do with Lilly visiting summer camps*. I know that I’m having a strong impact on other people… even though it’s hard for me to believe. I know in the back of my head.
S: Does competing at such a high level change your definite of success? I know you weren’t happy with your results at the games.
Kris at ADA Camp Triangle D in Ingleside, Illinois. Image courtesy of Lilly Diabetes
K: I’ve been fourth at the world before at the World Championships, which is the same level of competition as the Olympics, so finishing in the fifties was not impressive (to me). I was not on my A game at the Olympics, I wish that I could show what a diabetic can do, but at the same time... maybe that doesn’t matter to the (diabetes) community. Maybe it just matters that I was there and that I’m a competitive athlete.
S: The difference between first place and last was only a few minutes, I guess in your world thats an eternity but I was like, “Sh*t I’d give them all a medal”. Is that kind of a finish motivation to keep going?
K: I’ve been closer in my career and I know what I’m capable of when I’m at my best and I was just not there. That happens. I missed something in training, my coaches and I still don’t know (what) but usually it becomes apparent later. The drive to be the best in the world is the same drive that gets you to the Olympics. You don’t get to the Olympics because you are satisfied with where you are. You get there because you want to be the best in the world and when you get there, you want to be the best (on that stage).
K: This reminds me of a question that I get at the camps a lot. People ask, “are you the best diabetic athlete in the world?”. I always say I don’t think about that and I don’t really care if I am or I’m not, I’m trying to be the best athlete and skier that I can be. I don’t identify myself first and foremost as diabetic person. It’s part of who I am, I’ve never been ashamed of it. I’m very open with it and I like educating people about the disease, but it is not my primary identifier.
S: How do you rebound from Sochi, is it more metal or physical.
Audio answer
S: In regards to the answer that you just gave. I see a strong correlation between it and diabetes. Do you see that as well?
Audio answer
S: Do you have Olympic aspirations for 2018 in South Korea?
K: I’m not going to rule it out but I’d say the likelihood isn’t great. I’m will only continue ski racing as long as I can stay at a very high, international level. Definitely racing next year and if I continue to race to my standards then I will continue the next year, and the next year and that year will be an Olympic year. If I’m tired and my body is not responding to training anymore, as sometimes people don’t when they reach my age, then this next year will be my last year. But I don’t expect it to be.
S: So your professional skiing goals are to keep skiing and doing your best, and see where that leads you?
K: I have higher goals than that. I’d like a top ten finish at the World Championships next year, I’d like to stand on top of the podium again at U.S. Nationals. I think that those are both attainable goals, they are also high goals. I’m not interested in staying in the sport to watch my skills slowly deteriorate. I want to stay in while I’m still competitive and I’m going to give myself another year to do that.
S: What do you want to do after skiing ends?
K: I plan on venting my competitiveness by going into semi-pro triathlon, the very next year.
S: Aside from the competitive nature of the sport, what do you love about skiing?
K: One of the coolest things about cross country skiing is that you never have to stop, you don’t get to the bottom of a run and have to get on a lift. Every time I do it I get a little better at it, a little more efficient. To just know that I can go out and ski fifty miles without being exhausted, just kind of gliding… it is really cool. I’ve been exposed to and competed in all kinds of skiing, but cross country is what brings me back.
S: I wanted to finish by sharing something with you. The day after your NBC interview Arden went to school and talked about you during her share time. She told her class that she knew a man that was in the Olympics and that he skis on “those really difficult courses”. His name is Kris and he has diabetes just like me, he even wears the same insulin pump and CGM as me.
I explained to Kris that the kids are all aware of Arden’s type I and about how we manage her BGs during the day without her ever leaving class.
Because of our level of transparency, the other children and teachers are very aware of Arden’s diabetes. Even though they see it up close, there are still many who believe that it will limit her. I told Kris that Arden was able to stand in front of her class and tell everyone (in essence) that this person who is competing at the Olympics, this guy who looks like a superhero - he’s me. I don’t have limits.
S: I’m pretty sure that if Arden did that the next day, well, I bet a lot of kids did the same and I’m certain that people with diabetes everywhere also felt that same message of hope and fearlessness from watching you.
K: I hope that’s true, I think that so many of the limits that are placed on diabetics are based more on ignorance or outdated ideas of what the disease means. I like to say that there are no limits to diabetes as long as you take responsibility and treat it.
links
Kris is on Twitter @TeamFreebirdXC
Lilly Camp Care Package - * Camps run by the ADA and the Diabetes Education and Camping Association. Lilly supports the camps by donating supplies.
Check out Scott's book, Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad
Kris Freeman, "I probably skied my last race of this Olympics yesterday"
Image from krisfreeman.net
“I want to be clear that I do not believe my subpar performances here were attributable to diabetes”
Shortly after competing in his second Olympic event in Sochi, Kris Freeman posted a 'Thank you' on his blog where he announced that his 2014 Olympic pursuits are "probably" over and that, "I am clearly far from my best right now and it would be fair to give fresher teammates a chance in the later races".
Kris speaks at length in his open letter about his training plan for the games, that he is looking forward to competing in next year's World Championships, but most of all - he wants you to know that his performance had nothing to do with his type I diabetes.
Please take a moment and go to Kris's blog to read his full message.
“I will have to adjust my training to allow for more recovery in the future”
Everyone in our family is proud of Kris and we look forward to supporting him in the future. I hope Kris knows just how much his presence at the games has meant to Arden. Such a huge inspiration!
more about Kris on Arden's Day
Kris Freeman: Men's 15km Classic
Photo Credit: FasterSkier.com - Used with permission.
Kris competed earlier today in the Men's 15km Classic, his second of four scheduled Olympic events. Reports indicate that the course for today's 9+ mile race, were less than optimal. The snow was apparently "slushy" and the temperatures warm. American Erik Bjornsen finished 38th today, Fasterskier.com quotes him as saying, "It was harder than I was expecting".
Kris had this to say after he finished 52nd in a field of 92.
“It was one of the hardest courses I think I’ve ever raced on. It’s really slow and tons of elevation, and there’s that 3-minute sustained climb there… I was racing really cautiously because you can go right off the edge so easily… I was trying not to put the hurt on myself today”
I was hoping to wake up this morning and read about Kris having the race of his life, that didn't happen, but here's what I love about the interview quotes from Kris that I read on Faster Skier. Kris never mentions his diabetes - Representing the United States in Sochi as one of the best cross country skiers in the world, Kris's successes and shortcomings are never tied to type I diabetes. He's is just an athlete competing on a world stage. It's completely invigorating, as the parent of a child with type I, to see how little of an effect diabetes has on his skiing. There is no better message to pass on to our children then the one that says, diabetes can't stop you from achieving at your highest potential and it is never an excuse for moments that don't end as you'd hope.
Kris races again soon, his schedule is on Arden's Day, link below, I can't wait to watch with Arden and cheer him on.
VIDEO: Kris Freeman on NBC's Olympic Zone
This piece begins with host Sibila Vargas saying, "For American cross country skier Kris Freeman, Sochi represents his fourth career Olympics where he'll not be only representing the United States, but also diabetic athletes everywhere."
Immediately after Sibila finished, Arden exclaimed, "That's me!"
Originally aired on NBC's 'The Olympic Zone', Feb 10, 2014 - Channel 4 NY
After the interview, Arden told us that she shared with her class today that she knew someone who was competing in the Olympics. Arden explained to her friends that the man she knew had type I diabetes and that he wore the same insulin pump and CGM as she.
I can't thank Kris enough for the example that he is setting for my daughter, and for everyone whose life is touched by type I diabetes. If I had a gold medal Kris... I'd give it to you.
Thank you to NBC for this interview, it means so much... to so many.
