I found out this evening that my first cousin has terminal stage 4 lung cancer.  She’s in her late 40s with three kids, the youngest of whom is in 10th grade.  Just, why?  We aren’t close.  She lives in upstate NY, like most of my mom’s family.  With parents and siblings in NYC, Roanoke, Richmond, Houston and San Francisco, Albany is just not high enough on the list to make it out there.  If I was a better person or just despised travel and flying less, I’d see more of my extended family.  But I’m not, so here we are.  But I just like the Nolans – all of them, my cousins, aunts and uncles, and my now deceased grandparents.  They are and were great, just kindred spirits in some way.  I miss when my grandparents were alive and we could sit together in the living room or dining room of someone’s house and just talk about this or that.

But what happens now?  Well, most likely she dies, and the only question is how quickly.  I can’t help but hope maybe she’ll “beat this thing.”  My grandpa was diagnosed with late stage cancer in his 40s and survived thanks to cutting edge medicine (for the 70s) less several organs, including his bladder.  There have been major developments lately in cancer, but it hasn’t really started to have an impact.  Is it possible that it could help my cousin?  Probably not, but I can’t help but hope.

You’ll remember my uncle died of terminal colon cancer with a side of covid earlier this year, diagnosed in his 40s.  My grandpa barely survived cancer diagnosed in his 40s.  My aunt is a survivor of colon cancer diagnosed in her early 50s.  Nolan genes are honestly a cesspool.  (This is also where the diabetes comes from.)  Selfishly, a big part of me is just relieved it’s not my mom.

I’ve been thinking of running a marathon for a very long time.  If you’ve known me for decades, you might (but probably don’t) remember when i decided to run the Dublin Marathon in 2019.  I built up to about 15 miles, but when I got Ireland, I decided I’d rather drink, be merry, socialize and travel.  Honestly, I have no regrets.  I remember the weekend of the marathon – I spent it traveling around Donegal in the rain with three friends.  (The weather was brutal that weekend.)  But Donegal is a wild, crazy place, a very long drive from Ireland’s airports, and I’m so glad I spent some time there.  Since then, there’s always been a reason not to run a marathon.  Usually work, but also pregnancy, babies, etc.  I’ve always felt that if I was going to run a marathon, I wanted to do it “right” and train for it properly, not merely survive.  But this idealistic approach has basically meant I will never actually run one.

Now is a good time, but far from perfect.  I ended up deciding I could not afford $27 per hour for a subpar nanny or $35 for a good one.  But that is another blog entry.  The bottom line is that I have a decent amount of time this fall.  We are vacationing in Hawaii, and I are preparing our house in Kent for sale, hopefully for a November listing.  But the kids are in school, and S seems to like stroller running for the most part.  I didn’t run much over the summer, though.  I’d say I maybe averaged barely 15 miles per week, so I have very little base.  So yes, not a perfect time.

Seattle doesn’t really have any great marathons.  We have, in fact, one major annual marathon in the whole state, if you can call the Seattle Marathon over Thanksgiving “major” with 1600 finishers (as compared to Houston’s 7000 or Chicago’s 45,000.  Seattle has apparently changed their course to reduce the elevation gain to around 1000 ft, compared to the 2000 ft it used to be, which is definitely an improvement.  High likelihood of rain is also an issue; I don’t fancy running a marathon in the rain.

Normally Victoria and Vancouver, up in BC, would be an issue, but Canada is still very much canceling large events, and they’ve yet to have a large race in BC.   Portland is another option, but I couldn’t be ready for it in October, and honestly, it doesn’t have a reputation as a very good race.  There really aren’t any other options within convenient driving distance with over 1000 finishers.

If I’m going to get on a plane, I’d prefer to stay on the west coast.  CIM is pretty much the preeminent marathon on the West Coast, and the timing in early December is convenient.  7000 finishers – big but not too big.  Mean temperature of 47 F with an average high of 56 F.  Slight downhill course – 400 ft elevation gain, 700 ft loss.  Close enough to flat to “count” but pretty much optimal for a course profile.  (Also, findyourmarathon.com is seriously an awesome site.)  Really, the only major problem is that it’s in CA and I have to get on a plane to get there.

Covid is obviously a constant specter.  I will not run a marathon wearing a mask, so let’s hope they don’t impose a mask mandate on the race.  Or outright cancel it.  They usually have pace groups, and I would seriously love it if they’d have a 4 hour pace group I could just latch on to.  I honestly think that would make a huge difference, but most races, at least in blue states, have been eliminating pace groups due to Covid.  So we’ll see.  If it’s canceled due to Covid, back up options would include Rock ‘n’ Roll Arizona, Houston, Rock ‘n’ Roll New Orleans, and the Ventura Marathon (in CA).  All of them are on the warm side and some require a significant travel, time changes, and may or may not fill up before I had a chance to register.  So I hope that CIM goes off as planned.

I’m definitely super nervous about it, but also excited.  I’m glad to be doing something I’ve always wanted to do.  I’m worried I’ll get injured or have some kind of health crisis halfway through.  The idea of running 26 miles is just wildly intimidating.  But it’s time to give it a go.

Interesting article in the Sydney Morning Herald on diabetes.  As you all know, I had gestational diabetes during pregnancy.  During my pregnancy that ended in miscarriage in 2019, my A1C was measured at 5.6.  (5.7 is considered prediabetic, and 6.5 diabetic.)  My A1C was measured a year after this most recent pregnancy again at 5.6.  Then, I had it measured again recently, roughly two years after pregnancy at 5.5.  Not terrible, but definitely not great.

I read pretty extensively about diabetes when I was pregnant, and the number one knob you can turn is to reduce the amount of fat you have, especially around your abdomen.  As far as I know, it’s not really possible to control where the fat on your body goes, so if you want to reduce fat around your middle, you need to reduce fat, period.  I have always stored a disproportionate amount of my body fat on my abdomen, and this trend has only increased with time.

The closest proxy for body fat is weight, or BMI.  (Given your height is constant, for an individual, there is no real difference.)  Reduce your weight, and your body fat will in general go down.  Obviously if you lift weights or engage in some other muscle building activity, you might be able to reduce body fat while maintaining your weight.  Studies have shown that more muscle reduces risk of diabetes.

You read a lot about how obesity causes diabetes.  This is true in some ways.  Given that for any individual, more body fat means for that person they will require more insulin to process sugar after eating, and will have higher glucose in their blood, if the body weight of a population is increased across the board, more people will get diabetes.  There is probably no other illness, not even heart disease, affected as profoundly by your weight (as a proxy for fat) as diabetes.

However, I do think this generalization obscures a very important fact.  Every individual has a body weight they can maintain (given a % fat) which will allow them to avoid diabetes.  Let’s assume we’re talking about people who are 5’6″ (my height).  For person A, that weight might be 130 pounds.  For person B it might be 150.  For person C it might be 200 pounds.  Person D might be able to maintain 280 pounds with no blood sugar issues.  Genetics is an incredibly powerful force.

Rather than harping at people about the dangers of obesity, I think it’s more important to tell people to get their A1C tested.  If you’re reading this, you’re probably over 40.  Get your A1C tested!  Figure out if your weight is acceptable for your body.  Believe me, you don’t want to get diabetes.   For me, the most important quote from the article was this:

Taylor said the results “demonstrate very clearly that diabetes is not caused by obesity but by being too heavy for your own body”.

Life is not fair.  Some of us need to be skinnier to avoid diabetes.  Some of us can be fatter but will have to work much, much harder all the same to maintain that non-diabetic weight.  But I’ve watched my relatives deal with the health problems that diabetes causes, including vision loss and amputations.  I also did not enjoy the finger-pricking, and I’m sure injecting insulin sucks as well, not to mention watching your diet all the time.

As for me, I’d let my weight creep up close to 140.  That’s technically a “normal” weight, but it’s just not healthy for me.  Based on my life experience, I believe my optimal weight is probably 120 to 125.  (That’s still more than I weighed in high school and college.)  So, I’ve been working on losing a few pounds over the last couple months, and I’m down to about 134.  It’s annoying.  I want to be able to eat whatever I want, especially since I’m exercising a lot, but that’s just not how it works for most people.  Hopefully, I can get to my goal weight and have my A1C tested again and see some improvement.

A friend of mine has Type 2 diabetes.  He was overweight, probably technically obese when diagnosed.  Maybe not.  You certainly wouldn’t have seen him on the street and thought him excessively fat.  He’s less than 5 years older than me.  He got diagnosed when he started losing his vision.  He started exercising and losing weight, and being a data nut, was able to chart the decrease in his fasting glucose and A1C as he dropped the pounds few years.  We are friends on Strava, and I know how hard he works to maintain his health, but it’s working.  His numbers are close to mine at this point.  (He also cut back his work hours drastically to no more than 40 per week, which I’m sure was critical.)