Mind, Body, T1D & Endurance

written by Don Muchow

Don running in the Honey Badger 100, 2017

If you follow my blog, you know how fascinated I've become by the role that stress plays in the management of blood sugars and other aspects of Type-1 Diabetes.  You may also know that after thousands of miles of running, cycling, and swimming, not surprisingly, I've come to believe that the mindset you have going into, through, and out of endurance events matters.  As corny as it sounds, you've got to believe that you're capable of doing Very Hard Things One Step at a Time, or you won't do them at all.

But there's more to it than just believing in yourself. Your state of mind is critically important to your physical state.

"You best unf*** yourself, soldier!"

In 2021, Don ran 2,845 miles across America as a T1D.

He is the first person & T1D to run from Disneyland, CA to Disney World, FL

That's not EXACTLY how it goes, but there's a famous scene in the movie Full Metal Jacket where a private complains about his situation and Gunnery Sergeant Hartman tells the soldier that he'd "best unf*** himself." It's a crude but profound realization that for just about every bad situation, the only viable solution is rational thought, NOT panic.

And here's the thing: it actually works. Stress activates the sympathetic nervous system, which increases heart rate, respiration, and adrenaline, all of which IDEALLY condition us to RUN!  But going all-out on any effort, especially in such a state, is a recipe for injury, fatigue, and exhaustion; and if such a state is maintained for longer than necessary, it can lead to "sympathetic overdrive" (also called sympathetic dominance or overactive sympathetic nervous system), chronic stress, and Prolonged Duration Stress Disorder.  These conditions can result in PHYSICAL consequences, including headaches, dizziness, sleep disturbances, digestive distress, loss of appetite, muscle tension, high blood pressure, and long-term cardiac consequences such as endothelial dysfunction, atherosclerosis, and the formation of calcified plaques.

Truer words were never spoken.

Tactical breathing

It's clear to me that controlling stress during epic endeavors is key to accomplishing All the Big Things without ruining your health. But how?

Well, it turns out that while stress increases respiration and heart rate, the relationship is what mathematicians call commutative, meaning it works in both directions. 

In other words, slowing respiration and heart rate ACTUALLY DECREASES stress.

Tactical Breathing was introduced in the military as a way for marksmen to manage arousal levels in order to keep steady aim, and it's widely used by Special Forces and First Responders to help de-escalate and control emotional response to stressful situations.

Personally, I've found it does wonders to control panic level when I'm swimming in open water and get caught in a current, tangled in a submerged tree, encounter a curious snake, or get brushed by chop or wake from a nearby boat.

Controlling your mind

Controlling your breathing is one thing. It's a single task, simple to do, and requires no real awareness of yourself or anything around you.

But "out there" on the open road, you NEED awareness of yourself and what's around you, because shutting out the world or simply "zoning out" is a good way to get hit by traffic. Ironically, you have to find a way to remain calm WHILE being fully aware of Just How Dangerous Things Are.

Before I set out on my runs across Texas and the U.S., I delved briefly into yoga and meditation.  While I found yoga to be a "good stretch," it really didn't do much to put my mind at ease, and it seemed to require me to stop and create an environment that was artificially calm in order to achieve a temporarily calm state.

I found meditation to be more helpful.  

Ironman Texas, 2017

Focusing your awareness

The key principle in meditation is FOCUSED AWARENESS. The idea is to pick something—anything—that can serve as a focus point for ATTENTION.  Actually focusing your attention on something PREVENTS you from "zoning out."  And it turns out it was pretty easy to do. As I set out each day around dawn in order to enjoy good visibility and cooler temps, the image of the sun on the horizon had a very centering effect. I couldn't look straight at it, so I often had to focus on a point on the horizon nearby, often a water tower a few miles away, a recognizable geographical feature like Guadalupe Peak, or just the crest line of a large hill.  I found myself thinking, "how far is that hill?" "It looks shady in the canopy of those trees" or simply "What a beautiful sunrise." 

I discovered that as I looked into the distance, PAYING ATTENTION, other sensations came in more strongly as well. The sound of tires on pavement as traffic approached, or the engine roar as a semi truck geared down to push up a steep hill. Toward the end of things, I got so good at listening to approaching traffic that I could identify the size and type of vehicle simply by the sound.  SUVs driven by distracted drivers sounded different from commercial trucks, which sounded different from tractor trailers, which sounded different from motorhomes.

I learned the sound it made when a vehicle shifted into the left lane to pass another vehicle, and to step away as it approached the shoulder I was running on from the rear.

More than once, focused awareness saved my life.

The calming effect on T1D and blood sugar

A strange thing happened to me at my first 100-miler, the Honey Badger 100 in Wichita, Kansas in July of 2017.  Since mile 50, I had been running on badly blistered feet, partly due to a lack of awareness of the effect of heat on the soles of my feet and an unwillingness to stop and attend to "hot spots" before they became skin problems. Around mile 64, an enraged motorist deliberately drove me off the shoulder and into a ditch. After climbing out of the ditch, my blood sugar skyrocketed.  I pushed on, slogging through another 20 miles, skipping fuel stops since my sugar was so high. Nevertheless, all I could think of was sitting down and getting something to eat (it turns out that this is part of the stress response also!). Finally, around mile 90, with my blood sugar hovering around 325 mg/dl (18 mmol), I couldn't take it any more. I stopped at the side of the road, sat down in the side doorway of the crew van, and ate a full-sugar, full-fat yogurt.

My blood sugar dropped like an anchor.

It turns out that reducing stress has a POWERFUL effect on regulating blood sugar.  Not only do things like adrenaline and cortisol, both present when we're under stress, RAISE blood sugar to provide energy to "escape the cheetah", but SLOWING DOWN, CALMING DOWN, and maybe just eating a little bit all activate the PARAsympathetic nervous system, the "rest and digest" complement to the sympathetic nervous system's "flight or fight" response.

For folks like me with Type-1 Diabetes, controlling stress is critical to controlling blood sugar.

And it only took getting nearly run over by a truck in the pre-dawn hours on a lonely Kansas road for me to realize that.

written by Don Muchow

I hope this helps. Stay Strong. Stay Determined. T1Determined.