Last Call From Her Brain (A fictional story of an ultra runner with type 1 diabetes)

I wrote this fictional story of an ultra runner who has type 1 diabetes for a Creative Writing class I am currently taking from the University of Alaska Fairbanks taught by Diana Saverin. The story is also posted in my fiction section. The final for the class will include a revision of this story and I will re-post the new and improved version.

I met Diana while I was in Sitka, Alaska and she is the writer for an interesting follow up story on Chris McCandless (Into The Wild). The story appeared in Outside Magazine. Click the box below:

Old Pueblo Endurance Run Aid Station

Last Call From Her Brain

     “If I can just reach Melendrez Pass”, mumbled Kelsey as she quietly shuffled her trail shoes along the dusty dirt path, high in the Santa Rita Mountains. At 5,784 feet the pass is not a high one, but one that she had worked hard to attain. While dimly realizing she still had about nine miles of rough, desert terrain to battle.

     Unfortunately, her battle was much deeper, more personal than those limited miles depicted on her ruffled race map.

     At the age of three, Kelsey had been living the normal life of a child growing up in Helena, Montana. Some tantrums, swirled in with laughter, pulling the cat’s tail and a quizzical nature that made Kelsey a walking textbook of childhood life.

     Then life took a turn, that caught the Jackson family off guard and Kelsey had been losing weight, drinking extreme amounts of water and had a bewildering lack of energy. Life should not be sucked out of someone so young and usually vibrant. Her body was doing the only thing it could do in this extreme situation. Flush out the extra sugar as she now had type 1 diabetes and her pancreas was no longer making insulin, a hormone that helps the glucose in your blood get into your cells to be used for energy.

     Kelsey looks back. No one is in sight. She has been running on her own for the last couple of hours. The start gun went off promptly at 6 am and she was joined by Brad as #105 and #134 rambled forward in the dark as the Old Pueblo Endurance Run adventure left historic Kentucky Camp as the headlights bobbed and the footsteps headed north, on a chilly Arizona morning. Brad, ever complaining about sore knees, had dropped out at the Gardner Canyon Aid Station suggesting that he would rather be at home, eating pizza than enduring a ‘sufferfest’ that he actually had paid to be a part of. Kelsey had trained and felt ready for the event but there would be a few question marks as the race drew near. “You Go Girl!” yelled Brad as he stepped into the aid station. An untied shoe and an open trail running pack, with a few items that had found a new home along the course, seemed to sum up Brad’s mentality. On to conquer pizza while the K machine said a quick goodbye and strode toward the next aid station at Cave Creek and the brief thought of whether she had enough food in her pack to cover her for the coming stretch of climbs and distant aid stations. She quickly did a swipe on the last section of the table and grabbed two more Hammer Nutrition gel packs.

     This was a challenging race as Kelsey and Brad had contemplated their options for races in the Southwest for the coming season. Due to extreme temperatures during the summertime, this race had an early March date. Runners would encounter the mid 70’s which for many stumbling out of the frozen north would feel severe.

     Kelsey had been successful with 50k races and leaned toward an event that would further challenge her and maybe give her success that she initially felt she could never achieve while having diabetes. She had been a good steward with the diagnosis and had taken care of herself as well as possible and she was enjoying better blood sugar control with an insulin pump and a cgms (continuous glucose monitor system). A cgms is an advanced way for people with diabetes to check blood glucose readings in real time or monitor glucose readings over a period of time. The combination of these two made exercising and endurance events easier to control.

     In most people with type 1 diabetes, the body’s immune system, which normally fights infection, attacks and destroys the cells in the pancreas that make insulin. As a result, your pancreas stops making insulin. Without insulin, glucose can’t get into your cells and your blood glucose rises above normal. People with type 1 diabetes need to take insulin every day to stay alive.

     The weight of this diagnosis had sent shockwaves through the Jackson family. Kelsey’s father, John, had very limited knowledge of the new discovery that Kelsey would have the rest of her life. What he knew about diabetes could be written on a small post-it note with room left over. What he did know is that the condition is usually genetic and that no one on either side of the Jackson family lineage had diabetes. So much for that theory. For the next twenty-seven years, John and Cynthia and their other children Sara and Jake would support Kelsey as she

     Besides some extra sugar in her system, Kelsey also has a dose of grit coursing through that 5-foot 6-inch frame. She knew that that would be her insurance ticket if she needed to cash it in. Now, where was Melendrez Pass?

     People with type 1 diabetes are more likely to get heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage, and gum disease. Untreated type 1 diabetes can cause coma. It can even kill you.

     While annoying, the ‘beep, beep, beep’ coming from her insulin pump was meant to relay important notices from the mechanical wizard that relied so heavily upon. It could be a warning that her sugar was getting low, the battery needed changing, she was almost out of insulin, or that the cgms sensor needed to be changed. The beep continued while Kelsey juggled the pump, while she ran, to see what the message was. She had an unsettled feeling, deep inside, of what this particular sound might signify. ‘Sensor Expired’ is what the screen indicated. With the rush of packing necessary food, supplies, gear bags for two aid stations, and a monumentally bad night of sleep, the all-important status of the cgms had not been checked on. Now she would rely on old fashioned blood sugar checks with a glucose meter. She shuffled through her bag for the meter. And shuffled some more. No meter. She yelled in anger and frustration. Her words tumbled down the mountainside.

     Kelsey had been consumed by too much at the same time and was could not remember what her last blood sugar was. She was tired, now stressed, alone, and still a distance from the finish. She began to panic. Nearly forty miles into a difficult trail race, she had expected to be extremely tired and there might be some ups and downs in her blood sugar, which would likely affect her energy level. The fatigue had a grip on her and it was now seizing her thought process. Were her blood sugar ok?

     She continued labored motion forward, ever so slowly. Unfortunately, the next aid station was unmanned, but she had faith that there would be a good selection of gels, treats, bananas and maybe even some solid, healthy food if someone had bothered to load it into a 4 wheel drive for delivery.

     Kelsey now lacked awareness of what was around her and the beauty that was around her went by, even more slowly, as her loping run became a staggered walk. After some effort, she ripped the running pack off of her back as it fell to the ground. For a moment she stood still, not knowing what to do. Her brain needed glucose to operate and it was functioning on fumes. She had made the difficult task to deal with the pack in search of some carbohydrates in case that she had low blood sugar. She was not sure of what she needed, but it was better to eat and be wrong than to not eat at all. She knew what the consequences can be of not taking care of a low blood sugar. The sad reality is that she had easy access to the glucose packets in the front of her pack. Her mind was now on hold.

     She trembled, and slowly reached for the pack. This effort made her dizzy and she stumbled onto one knee. The thought urgently streamed across her dysfunctional organ of soft nervous tissue that she needed food now or...

     Now stretched across the dirt road she collapsed and had the pack behind her and now useless as her mind lost connection with the rest of her body. She was now in a coma and would rely on her grit and a helicopter flight to see her back at the starting line of the Old Pueblo Endurance Run the next year.

  

Oracle Rumble - A tough race, but I did cross the finish line

The morning was chilly and dark, and I was sleepy, slumped on a bus crammed with strangers as we rolled toward a nondescript parking area near Winkleman, Arizona. Our bus ride began at Oracle State Park (Oracle, AZ) and we were being shuttled a long distance North of where I had hoped to receive a medal, signifying that I had survived the Oracle Rumble. Our legs or a savior vehicle would take us back to the park and I would find out which method of delivery that this race would unveil. 

Matthew Nelson (Race Director) addresses the runners at the start

I had haphazardly jotted my name into the small section of the application that mentioned long distances, remote areas, headlights, medical care, etc, etc. that was the Oracle Rumble 50 mile race. I felt really good about this decision, at least on paper.

Bus chatter revealed that the two closest runners to me were from San Diego and Seattle. I felt blessed that I lived a mere 1/2 hour from the start line but knew that would have no bearing on whether I would finish, only that if I was in pain and anguish, I would be home soon.

Aid station at 8 miles

I overheard some details of the race from the year before (first year of the event). It was 11 degrees at the start line. Another blessing as it was in the balmy mid 30's as we pitched our warm clothes and extra gear into the vehicles heading back to Oracle State Park. 

While the Race Director, Matt Nelson had tooted a rifle around the grounds of our start area, he gave us the preparatory speech at the start line with no rifle in sight. I anticipated a fired off rifle to start our episode across the desert, but, was disappointed. Maybe the rifle was for any runners who might start their journey before the countdown. 

The remote aid station at 15 miles

My race started off well, but took a crash dive about 20 minutes in. My insulin pump began beeping at me. An annoying tone that was a message to Dave that there is an issue and that he needs to take care of it, immediately. My immediate response was the realization that while the pump whined that the battery was almost dead I was 27 miles from a AA battery. I had checked the pump battery situation the evening before and it was over 1/2 full of power. I should have swapped batteries at that point but have not had a battery lose over 1/2 its gusto overnight. Another lesson learned and I turned off my CGMS (Continous Glucose Monitor System) that was giving me readings of where my blood sugar was. Rather important stuff for a person with type 1 diabetes running an ultramarathon. I would have to take blood sugars with a blood sugar monitor. That extra time would crush my hopes and plans of winning this race. Oh wait, I still do not have that speed. Maybe next year.

Decision time

I am pretty good at adapting and plodding forward through epic craziness. As I watched my blood sugars go from 119 while on the bus to 222 and 298 (about 3 miles in). This hyper supersonic action of a rising blood sugar was not a result of eating anything. Nerves? Not sure, but another factor that I would overcome. 

Galiuro Mountains in the distance

The blood sugar would slowly crawl down to a good level and I gained some extra mojo now that I was almost 'normal'. The course was not in the normal category as it did start with a downhill trend, but would become a real up and down affair. I never did see the actual feet gained on this race but I did read a number of accounts from mountain bikers who had raced the length of the Arizona Trail (almost all of the Oracle Rumble is on the Arizona Trail) and I saw many who stated that this section is the most difficult one that they encountered.

Galiuro Mountains in the distance

I trooped forward, mile after mile and was creeping toward the aid station at about 27 miles. I had started to feel the cramps developing and knew from my previous ultra that I dearly wanted to avoid cramps. I had spent a considerable amount of time stretching and taking longer runs but my genes were living the wild life in the cramp department.

Oracle State Park

I sat down and fed my face, my cramps and my muscles at the aid station and made a decision to exit the 50 miler and settle for the 32 mile event. Actually, the decision had been made a number of miles ago and I knew it was the right choice and I was very glad that I had taken on the challenge and finished 32 miles. I knew that a lot would have to come together for a 50 and that 32 miles ain't bad. While I hover at an age where I shouldn't be doing what I am doing (and with type 1 diabetes) I have done 2 ultramarathons, a 24 hour team mountain bike race, crewed for the Race Across America (bicycle) and will be doing a bungee jump at the Grand Canyon in about 10 days, all within the last year and a half. Live life fully! 

By Mile 33

After the Peterson Ridge Rumble Race - Sisters, OR (35 miles) with Matt Score
A story I wrote on the Peterson Ridge Rumble experience:

"BY MILE 33"

In a quest for new adventures, I pulled out the current Trailrunner magazine and
scanned the list of races that would challenge me, travel through terrific scenery, take me
one stop beyond the marathon and provide me with that all important, valued race
t-shirt. A $35 check in the mail and I was on the registered list of suffering
wannabees for the Peterson Ridge Rumble, a 37-mile ultra marathon run on the trails
near Sisters, Oregon. Due to a generous supply of snow, the course was rerouted and
shortened to 35 miles. They did promise that suffering would not be in short supply
and as luck would have it, race t-shirts would also be in short supply.
I ended up working the day before the race, so Matt Score, my partner in
extreme adventure, and I would slide into Jamie’s home in nearby Bend after midnight.
Jamie, who also has diabetes but may possess more sense (he did not run), would
have his own adventures this day working backcountry ski patrol on Mt. Bachelor.
By 5 a.m. we were up and…well…we were at least awake.
The snowy, jagged peaks of Central Oregon were at their grandest as we sped toward escapades unknown. The Rumble is a low-key affair for those who like to run a really
long way and are not overly concerned about receiving a cotton prize at the end. These
are truly the diehards of the sport. If I did finish, I would receive a pair of screaming, loud socks. Very loud. But first I had some miles to cover.
Our friend and supplier of our secret carbo stash (Pear and Paley Energy Bars), Jeff
Warren, shook his head, wished us well, and shook his head again as we strolled to the
starting line. With little fanfare, we were on our way, and I would start my 34-mile “kick.”
A threatening evening and dismal forecast had us wondering what the conditions
would throw at us. Throughout the day, we would encounter snow, rain, hail and cloudy
conditions--but all-in-all it was a great day to be running (and running and running).
I was continually encouraged by the ever-present camaraderie of these incredible
individuals involved in their self imposed battles of physical ability, emotions, will power, conditions, mental challenges…not to mention the cute blond (Christel) who kept passing me. One extra battle I would be dealing with: my blood sugar was not coming down very quickly. Not the start that I had hoped for, but this disease has often presented extra me with obstacles and I chose to keep moving forward.
By mile 26, I had found my gear. I was still stalled in second gear, but I had the blood sugar where I wanted it and I continued to dig a little deeper. As the skies unleashed, we pulled into the only checkpoint that I had arranged for a supply drop. Considering myself lucky, I pulled a jacket on and continued ambling toward the finish. Cramps would kick me back to first gear and I encouraged Matt to run his own race. Christel would painfully pass me one last time.
Hours of striding through a beautiful forest allowed for some deep reflection.
I thought about how fortunate I am to have chosen a life of participation. To live
life as full, big, and fat while seeking those challenges that stretch me, pull me,
and transform me.
The last 300 yards were on a running track. Coming upon a pair of hurdles, which were set up in the outer lanes, I contemplated an impressive act, but realized that I had had a stellar day and did not want to end it sprawled out on the ground in lane 4, 100 yards from those prized socks.