chasing failure and dealing with risk in artistry

Chasing failure

If the project I'm doing is guaranteed to work then it's probably not worth doing.

I appreciate the tolerance shown by my readers over the last week as I have been unpacking the failure of the full time RVing experiment. I'm legitimately not discouraged by it. If anything I feel much better for having made a decision and being able to cross something off my list. This enables me to focus on the next project. It too, might fail. This fills me with excitement and yes, hope.

Risk and suffering are key ingredients in the process of creating art. I know that running and hiding from these inevitabilities is the fastest way to stop creating something that can change the world. Note my use of the word can in the preceding sentence. It might not work.

The important question is what is worth the risk, the likelihood of failure?

That is where my current struggle is taking place. I have things to say, things to share and show--but there is fear. Fear that a removal of the filter could destroy so much that I and many of you have labored to create through this community. Conversely, there is an intense curiosity about what change--what impact could be generated from no longer caring what people think? Better yet, what could come from challenging what people think with intention?

chasing failure in order to make a change in the world

I know deep down what is worth doing. Waiting for permission is not a characteristic of something worth doing.

I feel as though what I do here is a lot like spinach. If you give it to Popeye it gets things done. Leads to action. Stirs things up. Alternately, if it sits in the fridge just a little too long it gets watery, soggy and limp. There's a really narrow edge I am walking between impact and drivel. The reality is that the world isn't changed by climbing.

The onus is upon me to make sure I am saying something that needs to be heard or the climbing just becomes fluff instead of a vehicle for an important message of change. Visibility for it's own sake is useless. What is on the billboard and is it worth reading?

This is a game of pursuing failure with intention. If I start playing my hardest, I just may win that game. That's partly what I'm afraid of.

ketogenic diet and hypoglycemia

Ketogenic diet and hypoglycemia

I wanted to write a technical post about a question I keep getting regarding the ketogenic diet and hypoglycemia. Even if you're not into the keto diet, I think you may find some useful ideas to make low blood sugar less invasive in the short term. I recently shot a series of videos about the ketogenic diet and diabetes as part of my daily YouTube vlogging and you can check those out and subscribe here.

My general goal in my diabetes management is minimalism. Minimal intervention, treatment and daily impact. The most basic manifestation of this is to aim for the use of less insulin, which can create greater blood sugar stability. This strategy led me to a low carb diet. The need to have athletic performance in addition to the blood sugar stability led me one step further to the keto diet.

Using less insulin and eating fewer carbs means that lows do still happen but less frequently and they are easier to handle. Consider driving an empty truck down a hill. It's going to be easier to stop than if it's loaded down and has greater momentum. The same concept applies to insulin loads and slowing the "drop" of blood sugar. Simply lightening the load can simplify control of the vehicle.
When a low blood sugar occurs, the treatment ideally involves matching an increase in BG to the proportionate decrease in order to balance the two out. Therefore all hypo treatments are not created equal, or one treatment does not fit all lows-- since different methods of raising blood sugar work differently.
One of the biggest obstacles to blood sugar stability is over correction of lows. Over correction can result from either the source of the treatment, the quantity of the treatment or a combination both factors. In other words, you don't have to eat the entire pantry to overcorrect and spike. Sometimes following the 15x15 rule (eat 15g fast carbs, wait 15 minutes, test, repeat as necessary) can still yield the dreaded spike--which is now that much harder to bring down because you don't want to overdo it and crash out--again.
The ideal treatment for a hypo is the smallest possible one. The hard part is figuring out how little you can get away with when you're churning with adrenaline, in a cold sweat and panicking.
I'm suggesting that instead of always prioritizing the fastest treatment, prioritize the method of least intervention--when it's possible to do so. There are certainly times when I'll take glucose tabs or "fast sugar" of some kind, but those are typically emergency lows, not more benign lows. I classify my low blood sugars based on how fast I'm dropping because that correlates directly to the severity. Fast lows are treated as an emergency with emphasis on survival. Slow lows are treated with and emphasis on controlling the spike. In my 17 years I've used direct sugar sources (juice, glucose tabs, honey, candy, shot bloks etc)  about 10-12% of all my lows, probably fewer than 150 "fast-low" incidents.
I draw on that experience to inform me as to what methods I should use to treat lows. This allows me to still correct low blood sugars without having them bounce high. I should add that as I've been on the Keto diet in the last year I've had ONE low that required fast sugar. The rest were managed with slower treatments that better matched the insulin action, resulting in little or no rebound spike (over 180mg/dL)
My go to treatments are all ones that CDEs would reject for having too much protein or fat: cashews, peanut butter, dark chocolate, ice cream (if I need more sugar but with a slower release), beef jerky. Obviously these won't work with large doses of insulin and their corresponding BG fluctuations. When you bring the doses down, fluctuations narrow down and you find that these types of foods will work better in parallel with the action profile of the insulin.
I've tried fast sugars in much smaller amounts but they always cause a spike and that rapid increase makes me feel like there's a brick in my stomach.
The question of how various hypo treatments impact ketosis leaves room for simple sugars as well as my preference of slower sugar. The amount of sugar (fast or slow) that it takes to raise a low while eating keto is relatively small and should not do more than possibly diminish ketosis for a few hours. I can frequently use protein to treat a low on the keto diet. Remember, more than the minimum required intake of protein will get converted to glucose--this is a sneaky fact that often wreaks havoc on unsuspecting people with diabetes! Treating a low blood sugar suspends ketosis temporarily and doesn't require you to go back through the arduous process of keto-adaptation. You can resume ketosis in 12 hours or less with no major adverse effects.
Treating diabetes is risk management. Tighter control creates its own risks as does loosening up and letting the numbers stray a little further from the ideal. Knowing when to shift gears is key and building the experience gradually and carefully is an important investment in long term health. This isn't a magic wand that will fix your blood sugar. It's self experimentation that will help you calculate your risk more effectively--but never eliminate it. I can't overemphasize the importance of looking at this process as an experiment. I'm presenting my results to encourage your own experimentation, not to replace any portion of it.

You can call me diabetic

You can call me diabetic

You can call me diabetic if that's what works for you. I won't call the language police to shut down communications. Silence doesn't help those of us living with this condition and it doesn't help the outside world deal more gracefully with admittedly difficult subject matter.

I'm not saying that words don't matter. Words do matter--not because of an inherent value in the words themselves but because of the context. Words matter because of how we interact with them. Trying to protect ourselves from terms themselves is asking the wrong question. Leaning into the effort of influencing context and controlling the narrative is proactive. It's something for which we can take responsibility. We can change what words mean through action. That starts with taking ownership in our own life. The point of this exercise is to change our perspective. The benefit to us is a better life, independent of the willfully ignorant.

Scrutinizing semantics shifts the focus outside of the things we control. Asking how we can break underlying ignorance seems closer to the mark. Person with diabetes, climber, diabetic, diabetic climber--are all accurate. None of those words makes me who I am. They don't define me--I define them. Doing that work is something I own--it's not something I'm willing to outsource. The heart of being successful with this disease involves questioning everything and being independent enough to formulate your own rules based on what works for you, not playing by rules handed down from internet authority figures or arcane medical tropes.

I'm aware that I'm asking you to freely reject my position as part of my platform. I'm no authority figure. I'm just one person. I'll choose to define the value of diabetes for myself, thank you. That includes all the words and the nomenclature that comes with it. It's my disease and I'll paint it any color I want.

controlling type 1 diabetes

Measuring what matters: effort over outcome

We do a lot of measuring in diabetes--but are we measuring what matters? As you may know, I've been on the east coast for about a week or so and I've been doing a little "experiment" that I'd like you to participate in. I am sharing a video each day--on my YouTube channel. It's been a great opportunity to work on my video story telling (starting with some lighter "cat videos" to get warmed up!) as I prepare for a big climbing project this fall and it's the pathway I am following as I push the message of empowerment and redefining the limitations of life with type 1 diabetes. I'm still sharing blogs because those are good outlets for photographs, opinion pieces and technical discussion-- but the play by play of my adventures--well, that's moving to a different stadium with more seating. I truly hope you'll subscribe to our channel and be part of a new frontier (new for LivingVertical) that we are navigating. These forays are always way better with friends.

During my time in New York City, I had a chance to meet up with a good friend and we did an informal interview for the vlog. It got me thinking about some of the common complaints and touch-points that I've been noticing a lot in the community. There's a tension between a segment of the diabetes community who think diabetes isn't that hard--and others who think it's basically impossible. I have been looking for years for a way to bridge that gap and inspire those who are burnt out--and borrow from the success I have had in order to equip those willing to fight on.

I know that it's cathartic to hear leaders in our community say that it's impossible to control our blood sugar. While I don't disagree with this assertion, I believe it's an incomplete message without equal priority being given to the things we can control. Effort is the focus. Effort is good or bad. Effort should absolutely be judged--because effort is one of the things we can control. Clear black and white language must apply to our self-review or else we will create loopholes to escape our responsibility.

I write this as a flawed, lazy and impatient person who spends a good deal of creative energy trying to trick my "future-self" into doing the right thing from the comfort of what will soon be the past. I'm not advocating open season on judging each other--since that process is already working out beautifully on Facebook in this harmonious political climate--but I'm saying that it's worth holding ourselves accountable. We are not delicate snowflakes that will wilt under the duress. We will grind our teeth at times and soldier on, better off for having done so.

I would ask you to stay the hands reaching for your pitchforks and torches--because the quality of the effort is not determined by the outcome. You can do everything right and get the wrong results. I've seen it happen in climbing, in losing friends to their own demons, in diabetes too, of course--and the only refuge we have is knowing that our best effort was given in the fight. Sometimes that must be enough.

I'll give a quick example. When I started LivingVertical, I got some pretty hateful comments from people who were complete outsiders. They judged my desire to use climbing to empower and inspire as being a flimsy publicity stunt that would ultimately detract from getting funding for real, meaty solutions like a "cure". My initial reaction was to say "What the hell?! I show up trying to give people this gift and I get kicked in the teeth?" It's true that my critics were trolls and they were completely out of line. It's also true that encountering that judgement gave me a moment to pause and examine what I could be doing or saying to increase the clarity of my purpose. It made me that much more committed to examining my own intentions. I avoided a lot of pitfalls because I did not want to do anything to validate the trolls.

Adjust expectations and emphasis to favor the effort and let go of the outcome. Then, choose your battle and fight like hell.

I was going to write about my switch to Toujeo...

I had pretty high hopes for a recent switch in my basal insulin. I've discussed it a bunch in my Vlog on YouTube and I promised to write about it here and give a full report. So here is my experience of Toujeo: it's Lantus in a different colored pen with an even sillier name. I didn't experience weight gain or an increase in the dose like some detractors had warned me about online. I didn't experience better or more stable blood sugars as some proponents had predicted. It was basically the same--same dose, same action, same stability. If there were any advantages gained in my switch they were imperceptible.

The one thing that this trial DID reinforce is the very perceptible benefit of splitting the dose of Lantus or Toujeo. I started off taking a full dose of Toujeo and found that it did exactly the same thing as Lantus in a single daily dose: lows up front then increasing blood glucose from hour 18-24. This left me chasing my numbers up and down the spectrum for more than half of the hours in a day. Once I returned to splitting my dose the stability in my numbers followed with it.

One needn't look very far on social media and diabetes forums to find people who will tell you that "injections suck" and that using a pump is inherently superior. I find that many of those who hold to this view never experimented with the nuances of basal insulin and failed to dial in their dosing. I readily admit that's why I didn't have a great experience on the pump. I took the "starter" settings and didn't get far beyond that point. Turns out that's a pitfall that occurs when using injections too.

My purpose in writing this isn't to compare shots vs pumps. I've already done that in this blog linked here. It's to share that in my experience, many times over, splitting a basal insulin into two half-doses daily makes a massive difference in terms of blood sugar stability. I have noticed more and more pumpers taking "breaks" and going back to injections and this technique could be very useful--and it's surprising to me how many doctors don't recognize that. I'd love to see a day when insulin that is advertised as "24-hour" insulin actually lasts that long. Come to think of it, I'd love to see a day when medication isn't wrapped up in marketing, period. In the interest of full disclosure, I am currently moving to trying Tresiba in hopes that it may at least be able to give me that full 24 hour duration. If there's anything to report, I will.

Ready for my disclaimer? Here goes: this blog post isn't paid content and all the opinions here are my own. I am 100% certain that the companies which manufacture and all of the drugs referenced here do not condone my blasphemy in the form of non-FDA approved usage of their products. They haven't asked me to provide an opinion nor have they paid me for this service. They also haven't paid me to shut up, so I'm still here ranting about how we can use older, cheaper therapies to get better results with a little ingenuity.

Is full time RVing even worth it?

As we are concluding the hateful process of replacing the car and preparing to get back on the road after a MONTH of crazy pitfalls the question of "why" keeps coming up--as in 'why are we bothering to do this?' Is full time RVing really worth it? Is there a better way to enjoy travel and adventure--by balancing the spectacular with the mundane? These are tough questions because we knew from the beginning that there would be hard days--weeks even.These types of difficulties are the "stress-testing" of this type of lifestyle.

I don't know what the right choice is going to be for our family in the long run. I fully intend to ride this out and make a solid year of it before considering plan "B" (pull the ripcord and bail). It's totally possible that we just had a rough patch and will pull through it brilliantly and won't ever want to consider quitting again. The question always comes down to quality of time spent together on adventures--which is not always congruent with quantity of time spent in pursuit of adventure! If there is anything I've learned from the last month it's that being out on the road can actually slow you down and kill a lot of time when things go wrong. That's not just inconvenient and costly, it slows down momentum of climbing and creative projects that I am working on to change the landscape of type 1 diabetes.

Like most difficult decisions I believe the answer will be some form of compromise--choosing the downside that allows for the greatest upside. The option for no downside at all doesn't seem to exist. Accepting the realization that a sacrifice must be made under the best circumstances is the best way to make deliberate decisions rather than being victimized by mishaps. This is a major part of my view on life with type 1 diabetes. The time we have is an investment and death and discomfort will come to us all sooner or later no matter our choices or station in life. It's better to figure out what is worth suffering for than trying not to suffer.

Diabetes and driving: what I've learned about stereotypes

The ability to drive is a lot like your pancreas, it turns out. You don't miss it until it's gone and then suddenly you're lost without it. I recently discovered that having diabetes can put a major cramp on the ability to maintain a drivers license in some states--when my license was suspended for not mailing in a yearly doctors note certifying "compliance". Here's where it gets tricky. The state in which I have my license is Utah. The state where I get my healthcare is Massachusetts.

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Our tiny home "commute"

It's always harder to come back out west to our tiny home from the east coast--losing time in the air and re-acclimating to a small space all contribute to the challenge. To some, the idea of flying back and forth across the country all the time and working on the fly may seem desirable. I wouldn't call it unappealing--but it definitely comes with certain sacrifices and challenges. I am thankful to be working for myself though--check out my freelance media work if you have a small business and need help getting your name out there!

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Can you Spare a Rose on Valentines Day?

I make it a point not to publicly advocate for a lot of fundraising efforts--even on my own behalf--but the Spare a Rose campaign is worth an exception. I believe that it's really important to empower people with diabetes and show a proactive approach to this condition--and more importantly, to show that we have a choice in the way we approach its daily challenges--because many of us do. The elephant in the room is the obvious fact that not everyone enjoys that type of access to care and medicine.

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What's it like in a tiny home?

I've had more than a few people ask 'what's it like in a tiny home'--or more specifically for a virtual tour of sorts. We moved into the trailer recently and the progress is slow but steady--and what better time to invite you in for a look. In this video I think you will get a sense (thanks to the ultra-wide angle GoPro lens) for how small the interior of the trailer is. Nevertheless I promised a tour and that's what you'll get!

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