Type 1 diabetes and my first 40 mile ultra-marathon (plus the Great North Run 2016)!

As you’ll know if you’ve read my earlier blog posts, this year is made up of 5 events covering 130 miles raising funds for JDRF (Juvenile Diabetes Research Foundation) justgiving.com/craigwaugh1. I’ve already completed the Manchester Marathon and Yorkshire Three Peaks Challenge in April and May whilst my September challenges were the Great North Run then just 6 days later the 40 mile River Ayr Way Ultra-marathon! Yes, you read that correctly, four zero, 40 tough miles across the beautiful Scottish countryside and let me tell you some of those miles really were tough!! But first let me tell you a bit about the Great North Run just 6 days earlier…

Great North Run 2016

My preparation this whole year has been hampered by injury and my long runs had maxed out at just 16 miles due to some knee pain (I’m still waiting for an injury free period) but I knew that I had a steady half marathon distance in my legs and decided to use the Great North Run as a final training run prior to the ultra-marathon. This was my fourth Great North Run and I knew pretty much what to expect so went into this one quite relaxed, what a contrast to just a couple of years ago when I was anxious about going hypo or carrying enough energy gels. I decided to run at an easy pace, reducing my insulin pump basal by minus 80% and taking on two energy gels plus a few glugs of energy drink over the duration of the race.

It was great to be able to take in the atmosphere at a nice steady pace and soak up the support from the crowds whilst feeling confident about my type 1 diabetes related preparations. Blood glucose levels remained between 5 – 9 mmol the whole race and I surprised myself with a finish time of 1hr 54min. Just over a minute outside my PB from last year, wow! This gave me the much needed confidence going into my first ultra-marathon just 6 days after the Great North Run, albeit a massive step up to 40 miles, what was I thinking even signing up for this one?!!

40 mile River Ayr Way Ultra-marathon

Words cannot describe how anxious I was about this 40 mile ultra-marathon! Since my type 1 diabetes diagnosis at the age of 31 in 2012 I’ve ran three marathons, four half marathons, numerous 10k races and the Yorkshire Three Peaks Challenge but none of those achievements could prepare me for 40 miles of running from the source of the River Ayr at Glenbuck Loch, Ayrshire, Scotland to the Dam Park Athletics Stadium on the coast at Ayr.

I’m fortunate to have family living in Ayrshire so could relax in the comfort of wonderful Scottish hospitality in my preparations the day before the race. I’m always eager to avoid a hypo the day before a big race as I find that if I do hypo I’m more prone to another within the following 24 hours and really didn’t fancy that out in the Scottish wilderness on a course I know nothing about. So, a couple of sandwiches and an evening meal of fish and chips at a local restaurant the night before the race going easy on the insulin kept my blood glucose levels hovering around the 6 – 10 mmol range through the night waking up at around 8 mmol. A slice of toast with full insulin bolus 3 hours before the race was all I managed in the morning. Then it was time for my pre-race checklist once again:

My diabetes related ultra-marathon pre-race checklist:

1. Hydration vest stocked with enough carbs to get me to the water/food stations and checkpoints (where my drop bags were located with more carbs, energy gels and energy cereal bars)
2. Dexcom G4 continuous glucose monitor (CGM) with at least 5 days of calibrations
3. xDrip sending my CGM blood glucose readings to my watch
4. Blood glucose meter fully charged (finger prick tester)
5. My Animas Vibe insulin pump (attached to me obviously)
6. A 20% basal rate for 2 hrs prior to race (or minus 80% on Animas Vibe) – this is what works for me, remember your basal rate should be adjusted to suit you as we’re all different when it comes to these adjustments, remember to trial, error and record!

Onto the race!

In terms of nutrition and fueling myself I planned to eat a 40g carb cereal bar immediately prior to the race start followed by another every hour plus energy gels whenever I needed to nudge my blood glucose levels up rapidly. Great plan, eh? Yeah, well sometimes plans don’t go to… errm… plan! More about this later….

I arrived at Glenbuck Loch just after 8am to a gentle buzz of the first few runners arriving ready for a 9am race start. I quickly picked my race number up (no. 77) and hung around for my mate Andy who I ran the Manchester Marathon and Yorkshire Three Peaks Challenge with earlier in the year. Now, Andy is a damn quick runner (much quicker than I am) running marathons around the 3 hour mark but with this being a first ultra-marathon for the both of us we’d agreed to run together at a steady pace and take in the scenery, another great plan, oh the naivety!!

By 9am we’d chatted away to a few more seasoned ultra-runners who did their best to offer anything from advice to support to banter to basic abuse (all in good taste). I knew we were going to fit in with this lot! I should have known when I said to Andy “the good news is its overall downhill” and got the response “aye, right!” with a knowing grin from a passing runner who’d run the course the previous year. Technically as a source to sea course it was indeed overall downhill, just with some fairly steep uphills, mud, bogs, grass, roads and even ladders thrown in along the way! Certainly can’t say we didn’t get variety.

And we’re off…

9am arrived and there was no going back now, Andy and I settled into the middle of the pack and headed off at around a 10 minute / mile pace. I was feeling pretty good enjoying chatting away until just 2 miles in when I went hopping up a couple of steps and felt a sudden “ping” and burning sensation just above my left knee (my “good” knee up to this point as it was my right knee giving me trouble during training). On the flat the knee was fine but any uphill or downhill caused some pretty intense pain, something I’d know a bit more about by the end of this race.

Andy and I continued ticking the miles off and when I said to Andy “that’s 10 miles mate, only 30 to go!” I was still feeling pretty good despite the knee.  By 12 miles we’d passed the first couple of water stations and arrived at the first of 4 checkpoints. I was happy to see fresh fruit, haribo and chocolate at the checkpoint as my coconut cereal bars weren’t going down too well. A handful of fresh strawberries did the trick in nudging my blood glucose levels up and I refilled my hydration vest bottles with water and carried on along the river valley through some woodland before being met with some muddy patches that we had to run through. The wet muddy areas were not something I was used to as all my previous races were on road up to marathon distance. The mud and wet shoes were now starting to take their toll on my feet and I could feel a bit of blister pain appearing.

When the going gets tough the tough get going!

By mile 15 the 10 minute / mile pace had headed out towards 11 then 12 minutes / mile and I’d developed some pretty nasty blisters along the balls of my feet and big toes due to wet shoes and socks from running through the boggy patches.  I think I’ll always remember mile 15 of my first ultra-marathon as my first proper “downer” during a race. My knee was burning, my legs were aching and my feet felt like a fiery inferno with the blisters. Over a marathon distance I might have just ploughed on knowing there were around 11 miles left but the thought of running another 25 miles (almost a marathon to go) felt impossible so I told Andy to run on and I’d see him at the finish if I could sort the blisters out. A little bit of “I’m not leaving you”, “please just go” soap opera drama ensued before Andy agreed to head off into the distance after I promised to text him at the next checkpoint.

I ran on to the water station just before 18 miles and decided to stop, take stock, tape my blisters up with rock tape and ask one of the volunteer race marshals if there was a cut-off time for the race. A very lovely lady wearing glasses just said “Dam Park Stadium closes after 8.00pm, don’t worry, keep going, there’s plenty behind you, enjoy yourself”. That lovely lady wearing glasses may never know it but I think she saved me from my first ever DNF (Did Not Finish) in a single sentence! To that lady, “thank you, thank you, thank you!”.

The rock tape did the trick, it took the edge off the blister pain and just the few minutes rest gave my legs enough of a boost to get going again. The knee still hurt on the uphills and downhills but I could live with that. I continued on for a few more miles passing checkpoint 2 at around 22 miles and picked up my drop bag with extra cereal bars and energy gels in it. By now I was thinking “I’m over the worst, you got this!”…… really, just really! My next learning curve was just around the corner in the form of “one cereal bar too many”. The coconut cereal bar I was trying to chew and swallow just wouldn’t go down, in fact it was more interested in coming back up if anything. I left that bar half eaten for a grateful looking cow and dumped the wrapper in the dump pocket of my hydration vest. I thought about that cow a fair bit later in the race……..

Emotions…

I’d read a bit about ultra-running so knew that emotional swings could be pretty common during long endurance runs but I’d convinced myself this was “only” a 40 miler, the shorter end of ultra-marathons so I was unlikely to experience this….. wrong again!! Remember the grateful looking cow? Well I started to feel sorry for that cow, I started to wonder if cows should eat coconut cereal bars. I wondered if that cow might get ill and the farmer would be mad at the River Ayr Way ultra-runners. Then I remembered that I didn’t see the cow actually eat the cereal bar so maybe I’d just littered the beautiful Scottish countryside with half a coconut cereal bar, are coconut cereal bars biodegradable? Surely something would eat it. Maybe whatever ate that coconut cereal bar really enjoyed it…….. and all of a sudden another couple of miles had passed.

No word of a lie, I was getting choked up about a cow and a coconut cereal bar, seriously what was happening to me! Then the real thoughts came through, the kids, my wife, my family, the dog, close friends and relatives that had passed away, oh jeez, I’m going to have to walk for a bit I’m nearly emotionally spent! Then all of a sudden just up ahead was a long flat straight and bang, I was fine, completely fine as if none of those thoughts had entered my head! A very weird experience and not something I’d experienced during my road races.

I was now counting the miles down approaching mile 30, the furthest I’d ever run…. ever! I’d now got to the point where I wasn’t seeing other runners for miles and miles at a time and when I did see another runner it was the same two or three faces (which I didn’t mind). Another runner called Allison and I had jockeyed for position a few times since around 10 miles in, I think I was catching her on the flat and road sections then she was catching me on the uphill / downhill sections. Each time we came level with each other we’d have a brief chat and I told her about my diabetes and that it was my first ultra-marathon. Allison probably didn’t know it but she was a real help, explaining the course to me as she’d completed the race the previous year. Just knowing the terrain and turns ahead allowed me to focus on clocking those last few miles off. Allison had a bit more left in her legs than I did by checkpoint 3 at 32 miles and off she went.

The end is nigh…

I spent those last 8 miles running when I could run and walking when I couldn’t, even the early twinges of cramp weren’t going to stop me completing my first ultra-marathon. With just a couple of miles to go it dawned on me that I’d not been anxious at all about my blood glucose levels, not once during the whole race. I put this down to previous trial and error with my insulin pump basal rates resulting in feeling confident with my chosen reduced basal whilst running (20% of normal basal). This coupled with xDrip sending my CGM readings to my watch meant that I could see how my blood glucose was responding to my effort level and carb intake. My blood glucose remained between 6 – 9 mmol the whole race which I was ecstatic about.

At around mile 37 I started to hear the muffled noise of traffic and people, a sign I was getting close to Ayr. Suddenly I shot out (by “shot” I actually mean staggered) alongside the main road into Ayr and followed it a short distance before returning to the riverside trail and over a bridge towards the impressive University of West Scotland’s Ayr campus and into Dam Park Stadium for a lap of the running track and over the finish line to cheers from a few of my Scottish family and Andy (who had finished impressively over an hour ahead of me). 40 miles completed in 9 hours 3 minutes! Feet blistered, shoes and legs caked in mud, face salty from sweat and legs heavy and aching but I’d done it, I’d completed my first ultra-marathon…. with type 1 diabetes!

Would I do it again? Just try and stop me! I’m coming back next year to go sub-9 hours!

Finally, a huge thanks to the organisers of the River Ayr Way ultra-marathon along with the volunteer race marshals. The organisation of the race was fantastic and the marshals were friendly, encouraging, helpful and seemed to know just what to say to keep me going when my legs were saying otherwise. I would recommend the River Ayr Way ultra-marathon to anyone crazy enough to attempt it, if not for the reasons above then for the stunningly beautiful Scottish scenery and the elation experienced crossing that finish line. I may just be hooked on ultra-running!

Now onto the Yorkshire Marathon on the 9th October to complete my events for the year.