As a runner regardless of the distance you will always have a support team that either directly or indirectly will be there to support and help in your journey to achieve your goals. As part of that support team (Running, life, health) you will want to have a good medical individual/s. Your head doctor or endocrinologist is key and one of the main source of information around diabetes management, new approaches to deal with the condition. It is very important to be able to have and form a good relationship were there’s a partnership. This partnership should go and work both ways in communication and plan of actions.
There are key elements to find a good doctor or a capable medical expert that can work with you and understands your goals in terms of the broad health, running aspirations and how to deal/relate with your diabetes. In hand you as a runner have to understand that you need to listen, share and participate, with the mutual understanding that you don’t have to do every single suggested or proposed plans. It is not knowledge there is got to be compatibility to be effective. Medical personnel are also human and they will provide, from their perspective, that medical expertise for you to use to enhance your life, health and hopefully aligned to running goals.
I just recently, sat down with my endocrinologist to discuss my current diabetes state and upcoming plans. Of course as many other visits, we go about recent labs results and other general info. But after that, is where the conversation start getting more productive. We both looks at the graphs, CGSM numbers/graphs and meter reading looking for trends pre, during and after runs. We start comparing notes in regards of my short and long runs, activities and time of day, rest and diet. We talk about what was going on at that time and about my next running goals. We talked/review eating habits changes and how it could be affecting more. We had a conversation about how to improve or hone the insulin delivery plan. We did compare with previous numbers from previous visit and notice that some aspects of the previous plan were making some improvements, while others did not made much difference. Then we proceeded to talk about the next step and develop a plan. We did not talk about to whether the numbers were great, good, bad or worse. We always talked about honing, improving, regardless. We had a common goal and that was to improve my health so I could perform better in my life and running.
This effective collaboration is a two way conversation, a conversation were ideas and suggestions are shared and respected by both sides. Ideas on how to handle trends either drops or rising sugars at certain run or mileage. How the routine changed and whether there is something that we needed to do pre-training/racing and after completion. We jot some of the notes together and kind of agreeing to any adjustments that we will do. The frequency of the conversation depends on your goals and your current starting point. I have gone having the conversation every three month conversation to then every six months back to three and back to six months. Both need to agree on the frequency and when you want to make changes. For how long do you need to test the new plan and when to roll back the changes. Then to follow up to check new A1C values. After that collaboration, you need to start holding yourself accountable to the agreed upon plan and execute taking notes. Keep in mind in reality you are the one agreeing and making the commitment with yourself. Since you are the one that will benefit and control the outcomes and actions.
For example we had a conversation about what I was eating at night and when resting. One of the main things for me is that I need to have better stable sugars since it is very important during this critical period since it affects how quickly I can recover for my next workout. This came to me when I realized last year that this is about one of the most times that was impacting my ability to actually being able to do a good run the following day of long or hard workout. By not having a good quality recovery, the most following workouts has been very painful or very hard to complete with few occasions in which I was not able to meet the goals of the workout. In summary your doctor is an integral part of your support team, working together and having a respectful two way conversation is crucial to help you be better at running and managing your diabetes.
I have gone through few doctors in the search of a good team member. The first few weren’t really a good fit for me. They weren’t listening and they were not willing to work with me. Soon after figuring that out for the next sessions I’ll find someone else. By searching on the web, asking friends and family and talking to others I was able to find a doctor that was willing to work with me and was more in align to my approach to life and health. I was forced to look for another doctor when I moved from the West Coast to the East Coast. I started once again searching for the right medicals team member. A doctor/endocrinologist that will be able to help me achieve my plans/goals. Asking, doing research and trying couple possibilities I found a pretty good one. Currently we are able to work together perfectly. It may just take some time, sometimes one of the parties will get frustrated but you need to find somebody that can work with you with and your life style. Someone that will help you in achieving your life and running goals.
Here are a few things I learned so far about my medical team support member.
- Look for a partnership instead of just expertise
- Strive for a two way conversation rather than just one talking and the other listening all the time
- Understand your goals and translate those to your new support team member
- Understand you history and come prepare to have a productive conversation
- Know yourself, know your numbers and understand your trends
- Find someone that will be willing to try different approaches
- Find someone that can respectfully disagree with you but he/she is also open to understand others point of view
- By the same token be open and be respectful, remember this is a partnership not a dictatorship
- It is very important to be honest about your numbers and knowledgeable about your behavior. Excluding, modifying the information due to embarrassment, fear, being judge or lack of attention will only prevent you to create the best plan to move you forward.