Chasing Perfect

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Craig: From Beta Cell and JDRF, this is Lunch Break, the midday live streaming show about people living with type 1 diabetes. I'm your host, Craig Stubing. We have people now watching on Beta Cell's Facebook page and JDRF Twitch channel. We'll be taking questions from our viewers at the end of the show. Send them our way in the chat. I'm here today with track and field athlete, Kate Hall. Hey, Kate.

Kate: Hi.

Craig: Joining us from Maine.

Kate: Yes.

Craig: When did you stop going outside? Do you have checks on the wall? Have you been counting down the days since you've been stuck at home?

Kate: I haven't been counting down the days because I've been going outside and just doing some workouts and stuff. Luckily I've been able to stay somewhat active and busy. It hasn't been totally bad. It's been a huge change going from really busy every single day, going places all day to just having so much downtime and being inside so much. It's a huge change.

Craig: Has that affected your training? Because you can't go to gyms, right? Are gyms closed in Maine like they are here in Los Angeles?

Kate: Yes, gyms are closed in Maine, but luckily, my uncle, he works at a summer camp and there's no one there right now. There's a gym at the camp. I've been going and working out in this gym at the camp. It's actually amazing because there's a lake right there, and it's kind of like a log cabin. I was like, "Okay, this is this pretty nice here by myself just working out." I've had some access, which makes it easier.

Craig: A literal training camp?

Kate: Yes.

Craig: Personal for you. You have an interesting training regimen, right? Is that how you would describe it?

Kate: Yes, for sure.

Craig: It's not a lot of the typical types of weightlifting exercises. When you're communicating with your trainer now, is he able to come to the camp, or are you doing all that virtually?

Kate: He's sending me the workouts. Every day he'll check-in to see how I'm doing and then we'll figure out what I'm doing for the day. I'm not really doing any track workouts right now because I'm not really supposed to go into any tracks, they're all locked up. He'll send me the weight-room workouts for the day. I'll go and do them. Luckily, I know all the exercises by now, so it's fine going by myself. It's not too bad.

Craig: Is it harder to stay motivated?

Kate: Yes, some days just because before, I had just my routine from day-to-day, and I had a plan and goals for the season. Now it's just like all of that's thrown out the window, my routine is completely gone. I still enjoy working out every single day, but it's hard not knowing what's ahead. There are so many unknowns. That's what's so hard about the situation.

Craig: Unknowns in the sense of being able to plan future workouts, plan your meals, plan anything really?

Kate: That and also I don't know how long this is going to be going on for and when I'm even going to be competing next. The plan was to compete this month and then throughout the whole summer but now that's not even on the table anymore. There's just so many unknowns about when I'm competing and training and everything. That's definitely the hardest part about this, but I'm still working hard every day and that's what matters.

Craig: For people who don't know you, your sport is long jump, right? That's your bread and butter.

Kate: Yes, long jump.

Craig: You hold the high school record in long jump and you have your two NCAA titles for long jump?

Kate: Yes.

Craig: For competing this summer, what you meant is you are going to be going to the Olympic trials, hopefully doing well and then going to Tokyo?

Kate: Yes.

Craig: I'm sure once this all happened in the back of your head or somewhere in the US Olympic team group chat that I imagine there is, people were wondering if the Olympics were going to happen, right?

Kate: Yes. Everyone was wondering, because as soon as this started happening, they were postponing and canceling like NHL and NBA. That's when we were like, "Oh, what's going to happen with the Olympics?" It started to get worse and worse, and then everyone wanted it postponed, because it's like, we can't even compete this summer to try to hit the Olympic standard. We need to have that time to hit it so that we can go to the Olympics. Without that time, it's not really fair to the athletes. We're also worrying about just the safety and the health of ourselves and everyone else in the general public. We were hoping that it was going to be postponed just-- It's the fair thing to do, it's the right thing to do and it's the safe thing to do. We were happy to hear that news.

Craig: It's interesting that you would be relieved because I feel like most people would assume everyone would be really disappointed that they wouldn't be going this year.

Kate: Yes. We were all very disappointed that it didn't turn out the way we had planned for however much time it's been for the past a year or more, but considering the circumstances, the right thing to do was to postpone it. I think the hardest thing was just having to sit and wait, not knowing if we were going to be competing or even be given the chance to hit that standard. Once we found out that it was postponed and we had a year to keep training and to try to hit that standard, then I think we felt better about the situation.

Craig: Does that worry you or excite you? Because I can imagine, on one hand, you have a whole nother year of more training that you can just focus on this, but on the other hand, it's another year, anything can happen. You're older, more injuries. How do you balance that expectation with the, I don't know if fear is the right word, but just that knowing in the back of your head that it's 12 more months?

Kate: I've been trying to keep a positive attitude throughout all this. I think the positives in this is that, yes, it's a year away, but I'm also young. A year from now I could be in better shape or competing better and jumping better. Usually, I think the peak age for long jumping is probably 27, 28. I'm still pretty young. I could be better next year. Just another year, it gives me more time to get stronger, faster, more powerful. I'm just trying to keep that positive attitude and keep working towards that.

Craig: For people who don't know you very well, you have this high school record in long jump, went to college and the training in college didn't quite match what you were doing in high school, right? They were trying to-- Do you want to just talk a little bit about what that was like?

Kate: I think most high schoolers who are going to college with planning to compete in a collegiate sport, I think they have really high expectations. I think that they're going to go and it's going to be the best coaching they've ever had and the best experience ever, and they're going to accomplish all their dreams and it's going to be so amazing. I was really wrong. I went to college and it was completely different than what I thought and it wasn't about the athletes at all. It was about scoring points and winning titles and making money.

I know that the coaches, they didn't have the athlete's best interests at heart. They didn't care that I had diabetes. They were in charge of getting all my supplies sent to me. At one point, I had one box of pods left, I'm on the Omnipod. We were supposed to be leaving for the NCAA championships the next day, and they were supposed to get them sent to me. I had one pod left in that box. I got it the day before, the shipment the day before.

That was totally unacceptable because I'm supposed to be worrying about competing and the little things like staying hydrated and eating well and sleeping well, but now I'm stressing about whether I'm going to even get my supplies and be able to compete.

It was a combination of that and just complete overtraining where my body felt like it was breaking and five hours a day of practices were just way too much and not the individual training that I was used to. I made the change, left college a year early, and went back to train in Maine with my coach who knows about type 1 diabetes and knows what works for me. It's been amazing so far.

Craig: How much has he learned about diabetes from training with you?

Kate: He has been my coach since I injured my hamstring back in middle school. It's been a very long time that I've been working with him. Throughout those 10 years, I don't know exactly how many. He's done a lot of research on type 1 diabetes and recovery that athletes need because type 1 athletes need more recovery than just any other athletes. He's learned a lot and taught me a lot too about type 1, which I think is pretty cool. We have a pretty good team going right now, so it's great.

Craig: Talk a little bit about why type ones need more recovery time. What's different for you compared to when you were in college like your teammates?

Kate: When I was in college, I felt like during practices that I was at 80% when they are at 100%. Every single day I felt this. When you're consistently training at 80%, you're going to be competing at 80%. I felt like I needed that extra day that I wasn't able to get, to get back to that 100%. The reason for that is because it's harder to get your body into a rest and recovery mode or parasympathetic tone because there's all these stressors going inside your body from high and low blood sugars constantly, so you can't get your body to recover as easily.

I think that might be one reason why I don't always sleep super well at night too. It's because I can't get into that parasympathetic recovery tone. There's actually pretty good research out there on this topic. Once I found that research and my coach found it, we're like, "Wow, this makes complete sense why I always felt I was just a little bit behind my teammates in college." Now we can plan my workouts what works for me and get the recovery that I need from day-to-day.

Craig: What does that change really result in just more rest time than maybe your teammates or other people you're competing against or getting?

Kate: The philosophy that we have is I'm going to train really hard and really high intensity workouts for one or two days in a row. Then after that, I'm recovering for a day or two. Which doesn't always mean just nothing. It means active recovery or even some slower runs just to get the heart rate up. I'm still technically training, it's just more recovery workouts. Then after a day of recovery, then I'll go back to a hard track day and a hard lift the next day and we cycle through that. It's pretty cool. It works really well for me.

Craig: When you were in college, did you ever feel you were at a disadvantage? Here you are, you have type 1. Everyone you're training with everyone you're competing against doesn't. Did that feel like a disadvantage, like you were going in with a handicap?

Kate: At some points I did. Usually with me, I would start out the season feeling really good and then after going through so many hard workouts for months at a time, it started to set in with my body where it's like, "Okay, you need to stop, you need to recover more," and then my performances would just go downhill. I think at that point that's when I realized my body, it needs rest and needs more recovery because I'm type 1. I think that's really the time where I would feel like I was at a disadvantage.

Craig: Do you think even with that extra time that you're not training because you have to recover you're still able to compete against the best?

Kate: Yes. With that time that I could be training, I always felt like I was losing some of my time really because I could have been recovering like I was supposed to, and then I could have trained more and then I would have been able to compete a lot better at the same time. It didn't really work that when I was in college. It was tough.

Craig: I know. From my experience, I had played ice hockey basically until I was diagnosed with type 1. I was about 13 years old. Then I didn't really do any competitive sports until after college I got into running, which was about, I don't know, five or so years ago, five or six. When I was training for a race like a marathon, I had my plan. It was this day I have to run this much, this day I have to run this much, this day I have to run this much. If that plan ever had to change because I went low halfway through a run and I decided to stop because I just felt terrible or I had to walk a couple miles, it always felt like I was failing, I guess. It felt like diabetes had won. I can't be as good as I can be because I have this. How do you mentally get over that? How do you convince yourself that you do have what it takes?

Kate: It's a lot easier now that I'm in a much better training atmosphere with a coach that knows about type 1 and trains me individually. I think what really works well is that we don't have a plan from week to week that set in stone. We don't say, "Okay, Monday is going to be this, and Tuesday is going to be this, and so on." What we do is we take things just one day at a time depending on how my workouts go, how I react to those workouts, how I feel the next day.

If I have too high intensity days in a row, if I'm feeling awful the next day, then we'll just be like, "Okay, instead of doing a temple run to get the heart rate up, let's just take it completely off and just do some stretching and rolling or a massage." Or if I'm feeling good, then we'll say, "Okay, let's come in and we'll do this for workout."

That works really well for me because I feel if I had a plan set in place from week to week and I wasn't able to do exactly what was on that plan, I think I would really struggle and I would feel like, "Oh," like, like you said, "I failed." It would be hard, but there's no plan set in place. It's just one day at a time doing what feels is going to work for me for that day, and that really helps me a lot.

Craig: That's a good philosophy in general. Instead of having a system that you have to meet, just get rid of the system and now there's no expectations. Do you find that that has found its way into your diabetes management?

Kate: Yes, for sure. I think something I used to struggle with is I would try to, I think, overanalyze things when it came to type 1 and try to figure out how to make all these changes, and it would just be overwhelming. Now I have the mindset, "Well, let's just make one change at a time. Let's try this one thing and see how it works." If it doesn't work well, then I'll go back and say, "Okay, well, maybe let's try this instead." Or if it works well, then it worked and it's good.

That way it's just takes away that stress and I'm not overanalyzing anymore. I think taking things one day at a time, it's similar with type 1 where it's just focusing on one thing at a time and changing one thing at a time, and it's worked really well for me.

Craig: I imagine that's helping right now amidst this pandemic you don't know what's going to happen and when you're going to be able to go out and train again. Is it just one day at a time, you wake up and just see what the day has in store?

Kate: Yes, exactly. Actually, I'm writing a blog on it now, and it's funny because I've barely watched any Netflix throughout this, and I love just finding a good series on Netflix and watching it. I've been taking things one day at a time, but I'm taking this time to do things that I never really had time to do before like some home projects. We put a backsplash in the kitchen the other day and started gardening.

I've actually been staying really busy and been feeling pretty good through all this. It's just coming up with some plan and then just taking things one day at a time and doing things that I haven't been able to that I wanted us to do because I've been so busy in the past, and I think that really helps with all of this.

Craig: Being flexible, right?

Kate: Exactly.

Craig: You mentioned your blog and you had a post last year about the struggling diabetic. You being, I'm just going to say, a superstar athlete, you might not like that term, I think people expect you to be perfect all the time not just when competing but with diabetes. Is that true?

Kate: That is true. That is very true. That blog post that you're talking about is my all time favorite one that I have written, and I do a lot of talks and go and give speeches at JDRF events. I never used to speak about anything negative in my talks, really. I only would like to focus on the positive just because I think just growing up I was a somewhat positive person and I didn't want anyone to see any emotion from me.

One night I was really struggling with high blood sugar where I didn't know why it was high that night. I just thought, "Wow, I don't like this. I wish I didn't have type 1." I started writing that blog that night and I realized because people would come up to me after my talks and ask, "Well, have you ever struggled? What's something you struggled with in the past?"

I would always wonder, "Why did they want to know what I struggled with when I just gave this speech about like some cool things that I've done," because I thought that's what they wanted to hear. I realized they want to hear the raw side of me because they see me as this perfect athlete and perfect diabetic when that's not the case at all and honestly, there are things I could be doing better every day with diabetes.

I thought it was important for other people to know that I'm struggling just like everyone else and just like every other diabetic out there, I'm not perfect at all. I think that's important for many people to know. It's that I could be better, and I'm struggling, and that's okay because every single diabetic out there struggles every single day, and that's normal and that's okay.

Craig: Do you feel a pressure to be perfect if maybe from your doctors, from yourself, from social media to be the perfect diabetic?

Kate: I think I used to in the past, I would go on social media and I would see a post where someone was writing about their A1C and sometimes I would feel bad, "I wish my A1C was that good or my A1C was better," and I would let that get to me. Now I don't really let it get to me just because I know that it's okay to not be perfect with this, and it's okay to struggle, and I'm still going to do what I can to improve. It's about learning from the struggles to get better and to improve in order to become just a better person and better diabetic.

Craig: I'll say that there's few times that your blood sugar is crazier than when you're doing something athletic, right? You're either dropping low or the adrenaline shooting you up. I know if I try and run my fastest 5k race, I'm ending that race and my Dexcom's got one, maybe two arrows going straight up. It's not conducive to maybe being a perfect diabetic, but it's something you have to come to terms with if you want to do the thing that you love to do. How crazy do your blood sugars get when you're competing? You've got an Omnipod I seen on your arm, you've got a Dexcom I believe, right? I've seen the pictures. How do you use that tech to not just pass out at the end of a jump?

Kate: It's gotten a lot easier for sure just because of the new technology that's always coming out. Before, I struggled with lots of lows when I was working out, not competing, and when I was training. Pretty much any time I exercised in any way, I would just go low immediately. I would even have a snack before and it didn't help. I just talked to a couple of people and tried to get some advice from others who were struggling with the same thing.

I tried setting a temp basal about an hour and a half before my workout decreasing by like 50% or 40%. That just completely changed everything and made a huge difference where I wouldn't have a low during my workout or after my workout. It just worked so well. It's so cool that this technology, you can do these things where I wasn't able to do this however many years ago when I was diagnosed.

Then when I'm competing, it's just the other end where if I go really high because of the adrenaline, but that's still something that I'm learning about because I don't really go high until midway through the competition. I start out the competition with a really good number, usually like 140. I think, "Oh, perfect, I don't need to do anything," but then midway through the competition, I'll hear the beeping in the background, "Oh no, it's happening," and sometimes I'll end the competition with like 300, 400 blood sugar.

I'm still learning about that. One thing I'm going to try is setting a temp basal to increase it. We'll see how that works for me. Every time I compete and train, it gets easier because I'm learning more and the technology out there is better and it's going to continue to get better.

Craig: That's something else that you have to deal with. It's not just the physical diabetes, it's also the mental energy when you're there thinking about your blood sugar, when everyone else is just warming up, just clearing their mind. You're actually filling it with more and more stuff.

Kate: I think the other day when I was training, it was one of the first times that I was training where I didn't even think about my blood sugar and what it was doing. My blood sugar was good the whole time. I didn't even look at my number at all and I finished the workout. I'm like, "Wow. I didn't even think about diabetes or when my blood sugar was, and it felt amazing." I think it's only going to continue like that as it gets easier.

Craig: That happened during this whole craziness, being stuck at home?

Kate: Yes.

Craig: It's almost like you've eliminated all the other things in your life and you were able to just focus on working out.

Kate: Exactly.

Craig: You mentioned talking to other people, having a community. Do you know lots of people with type 1 in your area, or how have you made friends with type 1?

Kate: I don't really know many in my area at all. Any friends that I've made have been pretty much over social media. Which is cool about type 1 because there are lots of type 1s out there and I can reach out to them on social media and they can reach out to me. I have these connections on social media where I might go to ask someone a question or they'll ask me a question. It's pretty cool to have that.

Craig: You find that that is as helpful as-- It's being able to have a team, a care team in between those three-month endocrinologist visits. You can just be like, "Oh, I'm shooting up at 400 at the end of this competition. What should I do?" and people can--

Kate: Exactly.

Craig: Do you feel being stuck at home, even though you're not necessarily tied to your workout routine every week, has the change in your routine affected how you manage type 1? I imagine you're sitting like me on the couch a lot more, not moving as much.

Kate: Actually, I've had really good blood sugars, which I didn't think I would at all. Because if I'm sitting around a lot, then they will go high. Because whenever I've taken a break from working out in the past, I usually take a break like once a year for a couple of weeks or a month, my blood sugars will skyrocket throughout that whole break.

I have been able to stay pretty busy at home. Like I said, I've been doing some gardening and some projects around the house. For the most part, my blood sugars have been pretty good and a little bit on the low side, which is very surprising. I was talking to my doctor on the phone the other day and he's like, "Well, if you're doing a lot around the house, then that makes sense." I was like, "Okay, I'll just try to keep staying busy so I don't have high blood sugars."

Craig: We have a question. Someone's daughter is nine years old and type 1. They want to know what age you're diagnosed with. You're diagnosed 10, right? You were playing soccer, basketball at the time, right? Any tips for a nine-year-old?

Kate: I think just set goals. Work hard every day. Just do what normal kids do. Tell everyone about it. When I was diagnosed, I was scared that my friends were going to think that something was wrong with me because I had type 1, and I was scared to tell people at first, but once I told someone, they were actually amazed and I realized that other people thought that I was in some ways like a superhero because I was this young kid who had diabetes, but I would go out and just be like a normal kid and play and play sports and be active. I thought, "Wow. People actually think this is pretty cool that I had diabetes and still be a normal kid." I actually started telling everyone, and I got so much support and help and it was amazing. I think that's one thing that's important for sure.

Craig: I have two more tech type questions. Are you looping?

Kate: No.

Craig: Any interest in looping?

Kate: I am waiting till be pod HORIZON, which should be next year. I am anxiously waiting for that. I cannot wait.

Craig: I'm curious what it will do when it sees your crazy blood sugars, mid competition if it will know what to do.

Kate: I know. That's something I'm wondering too, but I cannot wait. I'm so excited for that.

Craig: Another question, have you tried using Afrezza the inhalable insulin to deal with highs while competing?

Kate: I have not. I have seen other people trying that.

Craig: I'm one.

Kate: Really.

Craig: Yes, I'm a puffer.

Kate: What do you think?

Craig: I love it. I love it for sports stuff because it's out of your system really quick. It's only in you for like 90 minutes whereas liquid insulin usually sits in there a long time, so I can eat something pretty much right before I work out. It hits you really fast. If I'm high, just take a little puff and then 30 minutes I'm back down.

Kate: Definitely have to try that.

Craig: I would definitely look into that. That's all the time we have for today. Lunch Break is a production of Beta Cell and is produced by me, Craig Stubing. Thanks to everyone watching on Facebook and Twitch. We'll be doing episodes every day at noon Pacific this week, so tune into watch live, or you can hear the next day on the podcast available on iTunes, Spotify, Google, and wherever else podcasts are found. Our website is betacellpodcast.com. There you can find every episode of all of the Beta Cell shows, I think we're up to six now, to help get you get through staying at home.

Beta Cell is a listener supported show, which means that we rely on people like you to help pay our expenses. Don't get money from corporations. You can do that by joining our fan club. As a thank you, we have a show just for our fan club members and this Friday, we're doing a virtual hangout, much like this, just to chat with our fan club. You can find that also at betacellpodcast.com.

JDRF, who we're doing this with, is the leading global organization funding type one diabetes research. I still meet people who don't know what JDRF is, so look them up. They need your help to do the important work of improving the lives of people with type 1 through accelerating life-changing breakthroughs to cure, prevent and treat type 1 diabetes and its complications. You can get involved with your local chapter or donate at jdrf.org. They also have a page full of Coronavirus updates for people with type 1, definitely bookmark that.

Lastly, Kate, you post a lot of videos of doing your own workouts on your Instagram. We've all been sitting a lot at home the last few weeks. Can you give us a tip to stay fit while we're at home?

Kate: Yes. I definitely recommend doing some body weight workouts, like push ups or lunges, anything like that would work. I actually love body weight workouts, so I've been doing them at home, so definitely give it a try.

Craig: Thank you, Kate. Thanks, everyone, for watching. We will see you tomorrow. Go wash your hands.