Ride: 12/?/17: The Maze

December something, 2017. It was going to be a good afternoon. Three hours to ride, with a half hour cushion in case of problems. The babysitter would arrive at 2:00 for some fun with my three year old son. My wife would return at 4:30. It would be dusk at 5:30. Best to be home before the trails were too dim for safe riding.

What would I have for lunch? For a person with type 1 diabetes, exercise takes careful planning. Too much insulin with a meal equals hypoglycemia, dangerous anywhere but especially when one is alone in the woods. Too little insulin equals hyperglycemia, the silent but ugly essence of diabetes, the monster that eats kidneys, vision, lower legs, bank accounts, hearts, and families. A slip too far in either direction almost always leads to over-correction with more insulin or more carbs, which then spirals off into more bad blood sugar readings, frustration, another over-correction, and self-recrimination. Too much or little is a difference of just a drop or two.

At 1:00, my blood sugar was a near ideal 128 milligrams a deciliter (mg/dl). Taking into account the insulin still floating around my system from breakfast, I ate what seemed optimal for the upcoming strenuous ride: a turkey sandwich with cranberry relish and two carrots on the side, approximately 60 grams carbs, an injection of 2 units insulin. Just before I started pedaling, I would eat 4 big medjool dates—approximately 40 grams carbs. Ideally, my blood sugar would be up around 180 by the time I set out, then slowly go down through the ride.

Unfortunately, it wasn't working out the way I planned. The perpetually annoying finger stick test at 1:50 said 134 mg/dl. This sounds good, but was too low for the start of a ride. From experience I knew that, soon after I started my exertion, my blood sugar would drop, probably precipitously. At 5 points a minute, 20 minutes without a correction could leave me at 34 mg/dl, about to fall into a coma on the side of the trail. To compensate, I drank a cup of mango lemonade with my dates, another 70 grams carbs total, enough to raise my blood sugar to the astronomical high of 400 mg/dl if I were to sit around on the couch. But I was about to ride over two ridges. My endocrinologist would have counseled me to wait until my blood started its inevitable sweetening, but I was psyched and ready to go, and babysitter time comes at a premium.

Down the gravel road from our gate I sped, up 300 yards of pavement on Gibney Lane, then onto the old dirt and sand fire road through Jughandle State Park. I accelerated past the house with the stinking stacks of crab traps, thankful their pit bull was on a leash. My hardtail splashed through the trickling streams of early winter and edged around gullies, skidding to a stop so I could inspect a couple of wormy matsutake mushrooms. In the saddle again, I had to bank high to avoid a large puddle of unknown depth. Roots knocked me off my line and into the water, but I kept my balance and cranked out of it, only soaking my left shoe. A little further on I returned to the pavement for a half mile of Mitchell Creek Road, then headed back onto dirt and into The Maze, a hodgepodge of trails and off-road vehicle tracks punctuated by rusty vehicle parts, broken beer bottles, and dumped old TV sets.

I'd been through this stretch numerous times, but not recently and usually from the other side. Something felt wrong. I dropped a short steep incline staircased with roots, slogged out of a sand trap handily, then got off to lift my bike over some deadfall manzanita. The sun shone orange through a break in the incoming storm clouds, but even at this mid-afternoon hour, it was shadowy in the forest. Riding hard by more soggy mushrooms, I came to a four way intersection. Confident of my bearings, I shot through and down, riding another fifty yards before realizing I was not on the correct sidehill. I turned around, cranked hard for another few minutes, through a number of intersections, by a randomly discarded length of fire hose and a cat kennel I didn't dare look inside, when suddenly I was back at the same spot on the same wrong sidehill.

Frustrated, I figured it was time for a blood sugar reading and hopefully an apple--if I wasn't already too high. “Shit fuck damn!” The words burst out upon looking at my meter. 62 mg/dl. Way too low. No wonder I was quasi-confused and a wee bit lost. The human organism is nothing if not unpredictable. I considered my options: turn around and hopefully return home, but not in some sloppy circle back to where I was standing now; or try again to make it up through The Maze to Wuss Hill and onto 508. The problem with the first option was that it just was no fun, but the second option would involve greater exertion, better route-finding, more blood sugar, and a slight chance of deeper hypoglycemia, with its attendant risks.

I had to keep heading up. Once I am set on doing something, it's a matter of pride not to turn back. I did the carb/insulin/blood sugar calculation in my head and came to the conclusion that there was no way I should be so low, so I tested again, hoping for a higher reading: 59 mg/dl. Even worse. In that case I reasoned that I should soon be rising substantially into the safe zone, but ate a Peanut Butter Lara Bar and a large apple anyway: approximately 43 more grams of carbs, which should equal a rise of over 170 mg/dl. Mounting up and starting to worry about the waning afternoon, I pedaled as hard as I could, and this time made it out the other side of The Maze, past a recently dumped stack of marijuana-grower pots on the side of the road, up Wuss Hill and past the yellow gate. Feeling strong again, I veered left onto 508, an especially smooth and speedy two mile stretch of rolling single track that once had been a logging spur. It was now 2:55, not too late for the whole loop, but I would have to hurry. Three miles later at the junction with 408, the dirt road running 12 miles from Mendocino to Highway 20, I stopped to test again, sure I would be heading into the 200s.

Click and poke went the lancet needle, and this time it stung. A little crimson fountain sprayed from my fingertip, then beaded enough to be sucked into the test strip. The meter beeped: 61 mg/dl?!? I was dumbfounded—I usually feel a low in the 60s—and pissed. I'm not supposed to be doing this. Alone and low blood sugar way out in the forest. Plus, the general consensus now is that deep lows affect your brain like concussions. Too many could possibly leave one with something similar to CTE—chronic traumatic encephalopathy. I had had hundreds of lows, perhaps thousands, since my diagnosis in 2009, and already felt like my memory and mental acuity were diminished. I try really hard to stay in a good blood sugar range, but the variables are many and, for some reason, beyond my navigational ability.

I had followed practically the same meal plan as on a ride a few days earlier, and never went below 175 mg/dl that day. The unpredictability was maddening. I wished I had a juice box or something liquid with me, but no, only a bunch of the chalky, artificially flavored glucose tabs diabetics use to raise blood sugar quickly, and two Lara Bars. I ate four of the former and one of the latter: 44 more grams carbs, theoretically another 176 points rise, then rode on.

Road 408 is especially enjoyable, lots of ups and downs to take my mind off the glucose calculations. I wound through the ridge top redwoods for a few miles before my planned loop took me West, onto Road 640 into the Caspar Creek drainage, a long fast descent that culminates in a sweet roller coaster into an off-camber switchback that, if you're not careful, can throw you from the road. Below that I leveled out and made a gradual 2 mile climb past red alders, willows, and coltsfoot to The Caspar Scales, staging area for countless rides and many great races.

From there, my original plan was to head back up Road 500 to the top of Wuss Hill, then head down through The Maze (much easier from above) to home, about one hour's ride. But I was worried that my earlier wrong turns had set me back too much. The prudent but much less exciting option was to head down Caspar Orchard Road to Highway 1, up Gibney Lane--only 30 minutes to my front door.

Calculations calculations. Time and blood sugar would decide. 4:00 pm and the late Autumn shadows were long. I poked myself again: 73 mg/dl. Still quite low, but at least a bit higher. It made no sense. I couldn't remember giving myself more than 6 units insulin in the previous 8 hours. I had eaten enough carbs to raise my blood sugar 800 points. By no reasonable explanation should I be so low, but there it was. I couldn't force myself to eat more. The thought of anything else sweet turned my stomach.

My endocrinologist's tense and staccato voice played in my head: “Never take risks or make important decisions when you're below 75. Stay put and give yourself time for your blood sugar to recover. Never drive.” Good advice, but impossible to follow in my world. Anyway, each low was unique. I felt cogent and strong, and I seemed to have a high tolerance for lows. And... I really wanted to finish my planned loop. I stood there for a moment, then decided on option 1, up the hill, banking on the hope that I would soon be up in the 200s or 300s.

I cranked up 3.5 miles to the top, smelling the first drops of rain bouncing off the dust, hearing the knocking of a pileated woodpecker on a hollow snag, the hoots of a couple other riders passing in the forest as they descended Ride-Through-Tree trail. At the turnoff to Wuss Hill, I couldn't bring myself to test again. I just wanted to keep moving. The Maze streamed by, and this time I saw where I had taken the wrong turn, right where one good matsutake mushroom—perhaps the last of the season—pushed up slyly through the duff under a huckleberry bush. I skidded to a stop, brushed it off, put it in my pack for dinner, then charged down the last three miles, finally up the dirt road to my gate, beneath the towering tops of purple cumulus clouds.

Different day, same problem.

In the kitchen at 5:05 with my wife and son, a cup of Bengal Spice tea warming my hands, I tested again. 193 mg/dl. About time.