Kris Freeman

This summer I have spent a lot of time and effort dialing in the right insulin dose for 30k and 50k events with good success. I also revamped my strategy for 15k length races but have not had the opportunity to test it much. It was necessary to change this strategy because my glucose levels were dropping perilously low directly following my races. These low blood sugar episodes annihilated my immune system last season.

Briefly, the new strategy is to frontload my insulin dose before the race instead of during it. I take a 30 minute extended bolus 30 minutes prior to the start of the competition. An “extended bolus” means that the dose of insulin my pump gives me is spread out over a half hour instead of given all at once. In the past I would give myself this dose directly before the start of the race.

The strategy was changed because the synthetic insulin I use does not reach its full effectiveness or “peak” until 45 minutes after injection.

This is a simple timing change but still requires testing and trial and error to do properly. The first time I employed the new method was at New Zealand Nationals in a 15k classic with the Canadian National Team. I took three units 40 minutes prior to the start of the race. I finished with a blood sugar of 240. (Normal blood-sugar range is 70-120, high blood sugar increases lactate production)
I made a note that my sugar was high with this dose and that I should increase it to four units for my next max effort. I also decided to move the dose timing up by 5 minutes.

My next race effort in the 15k range. was the Whiteface Hill climb roller-ski race. I took 4 units 35 minutes prior to the start. I had a good race but my blood sugar control was terrible and very disconcerting. I was at 350 and had a lactate of 12 to go along with it. Clearly I had way under-dosed again.

Whiteface was supposed to be my last 15k max effort before going to Finland but I decided I needed to test the new dosing strategy one more time. Mt Moosilaukee is only 25 minutes from my house and Ruff Patterson was nice enough to add me to the start list when his team did their annual timetrial on Sunday. This time I upped the dose to 6 units and took it 30 minutes prior to start.

It was cold out and misting. The rocks on the bottom half of the course were slick. About half way up I hit the snowline and the footing actually improved. The trail was a nice firm snowy bootpack. My heartrate was bouncing between 175 and my max 181 the entire way. I finished up in the clouds to find that I had run a new course record 35:16. The previous record was 35:23 set in 1998 by Marc Gilbertson. That wasn’t the best news of the day though. My bloodsugar was 105 at the top. I have found the sweetspot so to say and just in time.

 

I like the first month of my training year to be as unspecific as possible.   I will begin roller skiing and strength work next month.  The following is my first month of training for the 2015/2016 race season.  AM is my morning workout and PM is my evening session.

May 28th AM 1:15 run, PM 1:45 kayak

May 27th AM 100 mile Road Bike (5 hours 20.2 mph)

May 26th AM 1:3o run with 4 x12 min Level 4 running intervals on hilly road (4×2 miles), PM 1:30 kayak,

May 25th 4:30 Hike and Telemark ski at MT Washington’s Tuckerman Ravine

May 24th 1:00 kayak

May 23rd – AM 2:00 run, 1:00 kayak

May 22nd – 100 mile Road Bike (5 hours 20.0 mph) 

May 21st – AM Running track intervals 5 x 800 meters at 5 min mile pace with 400 meter recovery, 2:30, 2:30, 2:29, 2:30, 2:25, PM 1:45 kayak

May 20th – off

May 19th – 3:00 run

May 18th – AM 2:15 run (Franconia ridge up Falling Waters Trail and down Bridle Path), PM 1:00 kayak

May 17th – AM 1:45 kayak, PM 1:15 run

May 16th – Spoke at JDRF Summit SLC/travel home

May 15th – AM 3 hour run/ PM travel to Salt Lake City

May 14th – AM 1:45 kayak (got my new boat awesome Stellar surf ski), PM 1.:30 run

May 13th – 100 mile Road Bike (20 mph average)

May 12th – 1:00 run

May 11th – AM 1:00 run with track intervals 12 x 200 meters at 33 seconds (final interval 31 seconds),

PM 1:00 kayak

May 10th – AM 1:30 kayak, PM 1:30 run

May 9th – 4 hour hike/telemark ski at Tuckerman’s Ravine

May 8th – Slash concert (fantastic)

May 7th – AM 1:45 run with 1 x 15 min Level 3 and 1 x 12 minute L4 up Welsch and Dicky Mountains

May 6th – 4:15 road bike 88 miles at 20 mph

May 5th – AM 2:00 hike and telemark ski at Cannon, PM 1:00 kayak

May 4th – 3:00 run to Ragged Mt Bulkhead

May 3rd – 1:00 run, spoke at JDRF summit in New Orleans

May 2nd – travel

May 1st – AM 1:00 run, PM 3:00 road bike

Total Training Time = 75 Hours

After taking some easy days at home I ramped up the intensity in my training and cut the volume way down. I have had very good short term improvement in my performance using this method in the past. With a little over a month to the Olympics it is time to start getting the most out of my body.
I planned a low key race at the Craftsbury Vermont Opener last weekend but it was canceled due to the ice storm. I am not one to be deterred by weather so I recruited Pat O’brien from the Green team to help me clear debris from the race course so we could do intervals together with my coach Zach. We did 5 times 2.2kms at above race pace with a one minute recovery between intervals. We thought we were done after the 5th, but Zach made us do a surprise 6th interval after taking five minutes of recovery. The last rep was my fastest. I have never done intervals while ducking to dodge heavy ice coated branches and swerving to skid around fallen trees. It was pretty fun.
Two days later I followed up the session with another max effort intensity and felt better than I have all year.

Since the Olympics I have been formulating a plan to prepare my insulin dosing stategy for 30k and 50k races.  I decided that the best way to do this was to do four to five time-trials over the course of the off-season.  The first timetrial was two days ago in Bend Oregon.  I set my basal insulin at my current resting rate which is .5 units per hour.  For reference the basal rate I used at the Olympics was 2 units per hour, or four times the dose I just tested.  I planned to ski 30k with the first 20k at just above threshold with maximal effort over the last 10k.  The effort I put in was reflected by my lactates.  My heart-rates were very low due to suppression from heavy training.  My hypothesis was that my blood glucose would remain constant for the first 20k and then rise over the last 10k due to the anaerobic nature of a maximal effort.  To my surprise my glucose remained constant throughout the effort.  I fed an average of 10 ounces of Gatorade per 5ks.   Throughout the test I also compared the data that my new continuous glucose monitor  (cgm) gave me to the results I got from my blood testing Lifescan glucose monitor.   The numbers were close enough that I am now confident in the use of the cgm during races.  All of the data from the test can be found below.

I skied thee 7k loops followed by four 3k loops.  I stopped at the end of each loop for blood testing.

May 31, 2010 Bend, Oregon
44 F, Light rain
30km Pursuit TT
Kris Freeman

KM,       Time In,      Time out,    Split,      HR,    CGM,     BG,       Lactate,      Feed

Start                                                              106,     100
7km,        18.11            19.41,        18.11,    146,      88,        105,         5.6,          10 oz
14km,      37.11            39.12,        17.30,   155,      84,        119,          6.7,          11 oz
21km,      57.01           58.31,        17.39,    152,      96,        107,         5.8,          5 oz
24km,      1.06.30       1.08.06,     7.59,     155,      89,        108,         9.0,          7 oz
27km,      1.15.23        1.16.50,      7.17,     156,      96,        112,         8.9,          12 oz
30km,      1.24.26       1.25.56,      7.36,    157,       100       100,        9.1,          12 oz
33km,      1.33.17                            7.21,    160,      105        125,        10.3

Switched to skate at 14km

My brother and I went to the track to run 6 x the mile this morning. I wanted to target five minute miles with equal recovery between intervals. I knew the pace would be hard, especially since I have not done any running specific workouts in over a month.

Justin was there to pace the effort. He hits the track at least once a week and has had a good summer season of running. He ran a personal record in a 10k a few weeks ago with a time of 31:18. It isn’t much of a stretch to call him the best runner in New Hampshire.

It was pouring rain with occasional wind gusts when we started our warm-up. Fortunately it was almost 70 degrees out so we were never cold. After about a half hour of easy jogging we dove into the first mile. The pace felt fast but easy enough for the first 1200 meters but then I started working pretty hard. We finished the mile in 4:59 but I already knew that I may have bitten off more than I could chew.

Five minutes later we started the second mile. I started hurting half way through. With 200 meters to go I had to get on my toes to sprint in order to make pace. I ran 4:59 again but it had taken more effort than was sustainable for four more miles. As I jogged around the track I saw that I had hit a heart rate of 179 beats per minute. That was the highest heart rate I have seen all year. My previous high was 176 which I hit the week before during a roller-ski time trial with the Canadian National Team at Soldier Hollow. The fact that my heart rate was elevating easily is a good sign for my overall fitness. When I am tired or out of shape I cannot get my heart rate much over 170, However the fact that it was so high early in the workout did not bode well for the remaining four mile repeats.

I faded slightly on the third mile and crossed the finish in 5:01. Lactate was accumulating in my legs and I knew the arbitrary goal of running five minute pace for all six miles was probably out the window. Justin was annoyingly unaffected and chipper. He was clearly working pretty hard but as he happily pointed out, not as hard a me.

Justin accidentally took the first lap of the fourth mile out a few seconds ahead of pace. If I were a runner this would not have hurt me that bad, but because I don’t do speed with regularity my efficiency gets exponentially worse the faster I go. My legs were loaded. At the half mile mark I was falling apart and Justin gapped me. I ended up limping across the line in 5:08.

I had only completed four out of six miles and I had blown up. I asked Justin what I should do. He asked how bad I was willing to hurt. I responded that I was up for a lot of pain. He suggested that he pace me for another 5:08 mile. I agreed and away we went. It was amazing how much more efficient my running became simply by slowing down 2 seconds per lap. I was comfortable for the first 1200 meters and then had to enter the pain cave once again to hold pace to the finish. I ran 5:08.

For the last mile Justin agreed to pace me for the first half mile and then we would go as fast as we could to finish the workout. At 800 meters Justin took off and dropped me hard. I held on to finish the last mile in 5:09 though.

Despite falling short of my pacing goal, I had a good interval session. I blew up at the hallway point of the workout and was able to adjust pace to keep the workload high. Whenever Justin breaks me running I like to point out to him that I was the faster runner when we were both ski racers. Maybe I’ll focus on running someday but not today.

Check out Zach Caldwell’s write up of yesterday’s workout.

Race Practice with Kris, Noah, & Tad

I have not been planning to race the 50k freestyle event tomorrow. However Eric Bjoernson got sick this morning and I was offered his race start. I am far from my best right now. Over the last week I have consulted with our team doctor and several physiologists who all told me that I needed at least three months of rest for my body to properly recover from it’s current state of fatigue. When I was offered the start I asked our doctor for his advice as I do not want to damage my body. He gave me the green light and said “Go for it, this is the Olympics!” So that is what I am going to do, “Go for it.”

As a  diabetic, balancing my blood sugar during races is critical for a good performance.  This is a difficult task given the numerous factors that can affect glucose in the blood stream.  For this post I am only going to focus on one such factor. .. terrain.

Through extensive testing I have learned that when I am in an anaerobic state my glucose rises significantly.  When I am in an aerobic state my glucose drops.  The rate that it drops increases with the intenisty of the effort.  I am at peak sugar burning mode at threshold.  Once my heartrate climbs into level 4 and level 5 territory my glucose suddenly begins to rise.

In a normal ski race I am constantly bouncing between a threshold effort and maximal effort.  My heartrate peaks at the top of a hill and slows as I go down the other side.  Thus my glucose levels rise and fall throughout the race until I put in a final anaerobic surge over the last few kilometers of a race.   A normal glucose level for a non-diabetic ranges from 70-140 during a race.  At below 70 a racer would be experiencing a “bonk.”  So it is important that I do not use too much insulin during a race.  However it is just as important that I do not use too little insulin.  My lactate level starts to rise unnaturally when my sugar reaches a level of 240 or more.  The margin for error is small, but thanks to testing on the Center of Excellence treadmill and many races and timetrials I have developed an inuslin dosing strategy that generally gives me a glucose level of 160 at the finish of a 15k race.

There are two types of insulin dosing, basal and bolus.   Insulin is delivered in measurements called units.  A basal insulin is a constant drip that is delivered into my bloodstream 24 hours a day by a mechanical box called an insulin pump.  The pump I use is called an OmniPod.  The bolus insulin is also delivered by the pump and is given at meal times or at any time a significant amount of carb is consumed.  I progam the pump and override the program when need be.  It is not an automated devise.

My basal rate depends on many different factors that I am not going to go into in this article, but for reference lets assume  that I am using my most commom basal dose of .7 units per hour in the days leading up to a ski race.  My pre-race dosing strategybegins 1.5 hours before the start.  At this point I double my normal basal insulin dose to 1.5 units per hour.  Twenty minutes before the start I bring the basal rate up to 5 units per hour.  I keep the basal rate at 5 units per hour until the completion of the race.

Yesterday’s Race to the Castle on Whiteface and other hill-climb timetrials present a different challenge for me.  Because there is no significant terrain variation there is no place to recover.  I am in an anaerobic state for over 50% of the race.  Thus my bloodsugar constantly rises unless I take even more insulin than in a conventional race.  During yesterday’s race my non-racing basal rate was .5 units per hour.  During the race I increased my basal rate to 7 units per hour and I still finished the race witha a relatively high glucose level of 204.  I have not documented any ill affects from racing at this glucose level but there is definately room for improvement in my controlm durin hill climbs.

Sometimes planning just doesn’t work out. After finishing the Ruka Triple World Cup in Kuusamo Finland on Sunday, I spent all of Monday in Rovaenemi to let myself recover and make sure that my blood sugar stabilized before flying today. I woke up with my glucose at a perfect 110 and ate breakfast. It stayed constant at 120 through check-in, security, takeoff and landing in Helsinki. Then it plummeted as I walked to my connecting flight to Norway. I was left sweating and jittery for about 10 minutes before I could get enough glucose into myself to climb out of the hole.

I know from experience and from medical texts that low blood sugar episodes are extremely stressful to the body and it was the last thing I wanted to happen. I traveled separately from the US Ski Team today specifically to avoid this occurrence. It is another blow to my confidence coming off of a lackluster weekend. With the 15k classic being held on the World Cup in Lillehammer this Saturday, I have been striving to attain the world class form that has eluded me thus far this season. At gate B23 of the Helsinki airport, I sat with my head in my hands, shivering from my clinging sweat soaked T-shirt. I couldn’t help but wonder what I am doing. Is striving to win a World Cup race a realistic endeavor for me? My diabetes opens up so many pathways for my fitness to be buried under fatigue and frustration. It would be so easy for me to say that I have had enough and that my body and mind is tired of calculating the short term consequences of diabetic episodes with training and racing stress loads. But then I think of my work at summer camps for kids with diabetes. How can I tell a child suffering from diabetes not to give up on themselves and their dreams if I compromise my own goals?  I will not give up because of this disease. I preach that you should never give up what you love to do because of adversity. And mark my words, I love ski racing.

The last two weeks have been very busy.  I have been training hard and making preparations to travel back to Europe for a World Cup in Toblach Italy before flying to Sochi on February 3rd.  Yesterday I flew to Munich and then drove to Italy.  This morning I skied to the high point of the Toblach pass and felt great.  I am very excited to compete in the Olympics in only two weeks!

I got a lot of great media coverage.  Here are the most notable stories…

http://www.diabetesforecast.org/2014/feb/behind-the-scenes-with-skier.html

http://espn.go.com/blog/olympics/post/_/id/3876/kris-freeman-gets-fourth-olympic-nod

http://sportsillustrated.cnn.com/-olympics/news/20140120/kris-freeman-diabetes-sochi-olympics-cross-country-skiing/

http://www.npr.org/2014/01/20/264050641/u-s-olympic-skier-finds-team-spirit-minus-the-team