Tuesday, August 01, 2006

Soccer season

This spring I started playing for a new soccer club as I moved to far away from my old club, which by the way also ended last fall by totally closing their women’s department, so it was a good time to move! My new club, DSIO, is located just across the street where I live now, and I have had no problem settling down with my new team mates. Though we lost the two last games of the spring season, we stayed in the regional series of Funen (Fynsserien), bringing 2 points to our score in the fall tournament. This is actually quite an achievement, as I learned that the team just advanced to this series this year! Newly advanced teams usually have a hard time finding their feeds in the first season, but we managed to go through with only two lost games and three draws (out of 9 games in total), placing us in the top of the table until the last two games. We start the fall season as no. 4 of 6 teams, due to the transfer of points from the spring season, so we have to work to stay in the regional series. I should be possible though. We play each team twice, home and away, and the pool winner will advance to the national series (Danmarksserien), whereas no. 2 will go into two play-out games for possible promotion to this series as well. The number of teams that will advance to the national series depend on the number of teams from Funen that are relegated from this series, though. I don’t believe that our team is qualified to play in the national series anyway, so I think that that it would be fair for us to “just” aim for the 3rd or 4th place this fall.

Today practice starts for the soccer fall season. We have had the possibility to play a bit once a week during summer, but I haven’t gotten off to that, so I look forward to start again, although it was nice with the 1-month break :-)

In a previous post, I wrote about my discussion with my diabetes nurse about how to handle blood sugars during, and especially after, soccer games. We agreed that I should try wearing the pump during the games, mingling with the basals to see if that would solve the problems that I experienced in the spring season. Though I am still not that comfortable with wearing the pump during a game, I think that I ought to at least try it, and then if it doesn’t really work either, I will go back to shots at least on game days – that I know how to handle!

I am not all satisfied with the fact that I will have to figure out how to wear the pump and what the adjustments of the basals should be during games only. However, as I haven’t had the same issues during and after practice, I really have no choice but to try to figure the basal thing out during games. Where to wear the pump on the other hand I plan to experiment with during practices. This will probably also allow me to get an idea of the temporary basal level during at least the first part of a game (until adrenalin takes over and mess things up. My guess is that if I play a full game – 90 minutes – after approximately 30 minutes of warm-up, I will probably have to increase my basals slightly during the second half of the game, while the excitement and gearing up to hard work during warm-up and first part of the game will likely render a lower basal rate necessary). I plan on starting out with rather severe decreases of the basal rates (probably going down to at least 25-30 % of my normal rates) during the initial practices until I find the right level. In spring I went low several times during the last part of our 90-105 min. practices. This is quite annoying as the last half hour of our practices are usually devoted to games and shot practice, neither of which can be performed adequately when hypoglycaemic, but because I really want to be in those activities, I will usually end up just taking a 5 min break to swallow some glucose tabs before continuing. That is of course not ideal, I know, but I can’t help it, it is so hard to accept that diabetes should interrupt in this way and keep you out of the game for 15 minutes or more.

Finally, some question for those of you pumping and playing contact sports wearing the pump: 1) Where do you typically place your pump and tubing during games and practices? 2) How much to you decrease/increase your basals during and after games? 3) How long before and after a game or practice do you run on temp basals? I know that I will have to find my own answers for these questions myself, but it doesn’t hurt to listen to, and possibly learn from, other people’s experience :-)


Scott K. Johnson said...

Hi Heidi!

It's frustrating because it can be so trial & error - and as you talked about, for me, it's really hard to get my body back to feeling strong & quick after dropping too low. The lows just wipe me out.

I'm playing full court basketball at least three times per week for two hours each time. Basketball is contact, but I don't think anything near how physical soccer is.

To wear or not to wear: I have found, as you suspect for you, that I need to go back to my 100% basal about an hour into the exercise. I think my body is using it's alternate fuel sources, usually spilling ketones (from the fatty acids), and making me a bit more resistant to my insulin. Maybe it's not that complex, and is more due to adrenaline, etc. - but the end result is the same. I need my insulin.

So, with that in mind I found that I can't just take the pump off, or I run really high afterwards.

I start a temp rate of 30% basal for three hours, starting 2 hours before I start (did you follow that?). You have to make your basal adjustment far enough in advance so it will have time to take affect.

I still usually need to drink gatorade during, which is Ok, to keep from dropping too low. That is usually from having some hangover of my breakfast bolus still working. I'd like to make some changes to my routine on those mornings, but hey, one thing at a time right?

On where to wear the pump. I have a couple ideas, just based on what I do for basketball.

My favorite place to wear my pump is using an elastic strap with a "pump pouch" purchased from one of the online pump accessory shops (pump wear inc or unique accessories, etc). I would wear the strap around my chest region, and place the pump just under my armpit area. I felt I could protect the pump there, and that it was not exposed to much trauma.

But, that didn't work for long. The place I started playing basketball uses a "system" for teams based on shirts or skins. So, one team will have their shirts on and one team will have their shirts off. Makes it easy to know who's on your team, as they change all day long based on how many folks are there.

You can imagine that wearing my pump around my chest would not work too good when I have my shirt off! Not so much the strap or the pump, but rather the tubing running from my pump down to wherever I have my set placed! It would be easily "snagged" and yanked off.

So, I started simply wearing my strap around my waist, underneath my shorts, and tucking the tubing in my shorts too. I will often have my sets placed on my lower back, an inch or two above my beltline, so there is a little tubing exposed, but it's never been caught on anything or anybody.

With the strap around my waist, I place the pump just to the left or right of my "center line", if that makes sense.

We have, I think, a natural instinct to protect our delicate genital & abdomen areas if we start to fall or something - you know, you usually will tuck and try to brace for impact, taking what you can on your arms/legs, etc.? So, the pump feels like it would be very safe there.

I hope you find some of this helpful! That is, if you are still awake after my long comment!

Take care!

Heidi said...

Thanks for your comment and ideas, Scott! - And I am still awake ;-)

I am planning to shop around on the net today to see if I can find some alternative pouch/straps to wear the pump in during soccer. I tried wearing it in my sports bra under my arm for practice yesterday, but that didn't really work out. It moved too much around, and I ended up disconnecting after about an hour in which I had used every small break to try get it back in place :-/

I think it may be more comfortable wearing it at the waistline instead, which will, as you say, also ease the hiding of the tubing.

As for the basal settings, I started out with a temp basal of 50 % yesterday. I generally have a low basal - the lowest of all my basals - at 3.30-6.00 PM (our practice is from 5.00-6.30/6.45 PM) because I tend to go low late in the afternoon. Yesterday I was 5.2 (94) just before practice, so I ate a banana, and otherwise just drank water during practice (as it was the first of the season, we had a rather light session). I was 7.4 (133) afterwards, despite having been disconnected for approximately 45 min, so that was okay.

art-sweet said...

Hmmm, I do karate, and am dreading the day I take a kick or punch right to the infusion site. I generally use my stomach for my sites and tuck the pump into my sports bra w/o too much movement. But my sports bra is a serious high compression affair and the pump is pretty well wedged in between the "girls." As far as rates go - I find that I also tend to swing high afterwards if I don't have any basal going at all, even if I'm only off pump for 1.5 hours. I do very very low (15-30%) temp basals while exercising intensely and then go to 90-95% for that night.

I was interested to see Scott's comment that he thinks his insulin resistance goes up after exercise. I've also noticed some post exercise highs.

Heidi said...


My nurse actually also suggested to place the pump between the "girls", as you call them. I don't think that is ideal though, as occasionally I bring the ball under control using my chest and/or stomach, which could result in some pretty hard punches to the pump from time to time. Although, I would imagine that it wouldn't move around as much being placed there :-)

Tonight is another practice, and at the moment I am battling a bit with myself whether to try to use the velco-strap waist pouch that I normally use for sleeping (until the sports pack I ordered yesterday arrive next week to test), or just disconnect as I used to do in the spring.....