Jay Hewitt doesn't really want anyone to think of him as a superhero. But can we help it? Here's a mere mortal man -- who's had Type 1 diabetes for 16 years -- who's a champion competitor in Ironman triathlons. That's a 2.4-mile swim, 112-mile bike ride, and a 26.2-mile run, all in one day. He's a three-time member of the U.S. National Team for Long Course Triathlon, and captain of Team Joslin at the Joslin Diabetes Center in Boston, MA. On top of all that, he's both a successful litigation lawyer and a passionate motivational speaker who travels around the country talking to groups about thriving with diabetes. Whew! I'm exhausted just introducing him.
As if that weren't enough, Jay's newest venture is developing sports clinics and camps for diabetic kids, where they can get training and instruction and then participate in a genuine Youth Triathlon event in a safe and controlled environment. Jay's working with the Joslin Center and ChildrenWithDiabetes to make this dream a reality.
Superman... uh, I mean Jay... was kind enough to spend some time with me on the phone last week, hoping to pass on his message to all the folks here who may never get a chance to see him in person. Here's how the conversation went:
DM) You've stated that getting diabetes really gave you the impetus to push yourself in sports. How do you think your life might be different now if you hadn't been diagnosed?
JH) If I did not have diabetes, I'm pretty sure I would not be racing Ironman triathlons. The Ironman is so painful and difficult you must have something that is driving and drawing you to that finish line. Diabetes does that for me. You have to make the bad thing that happens to you the best thing that happens to you. I was a determined person before I was diagnosed in 1991, but diabetes gave me a whole new level of motivation and determination. Angry determination, made me want to prove that I am stronger than it is. I discovered strength I probably would not have been pushed to find, and seek goals I probably would not have sought, all to send a message to the disease that "you're messing with the wrong guy." I also would not have the incredible honor of motivating others through my speaking and website to overcome obstacles in their lives, whether it is diabetes of something else. That has been the real joy, such an honor that motivates me every day.
DM) How often do you interact with your doctor or CDE? What's your strategy for getting the most out of your healthcare team?
JH) Every 3 to 4 months I visit my endocrinologist for A1c and other blood tests. I also have an eye exam once a year. However, it is my responsibility to take care of myself everyday, not the doctor or those around me. I know my body and am responsible for the choices I make, and the consequences that day or years down the road. As an Ironman triathlete I earn the finish line not on race day, but every day, months before that when no one is watching. The same is true for diabetes. You earn your health with choices you make everyday when no one is watching, not in your doctor's office, testing multiple times a day, prepared to catch and treat highs and lows, exercising and eating well, reading nutrition labels, etc. It is unfair and selfish to place that responsibility and burden on family members and the health care system if I am not doing everything I can to control my blood sugar. My goal for every visit is for my doctor to say, "You exercise and eat well. Your A1c looks great. You make my job easy." That's my job as a diabetic.
JH) I eat and drink carbs about 15 to 30 minutes before workouts to run my blood sugar up to about 180. For long workouts over 1 hour I will eat a large amount of low glycemic carbs like oatmeal that will stick with me. For workouts over 1 hour I will eat and drink about 30 to 60 grams of carbohydrate per hour to fuel the workout and prevent lows — sport drinks and gels, sport energy bars like Clif Bar. It's easier to drink while cycling from water bottles on my bike, but it's just as critical to force yourself to eat and drink small amounts while running. Running is the most difficult event to fuel — consistent consumption of sport gels and sport drinks is the key. I just eat and drink before and after swim workouts.
DM) Have you had any particular hypo incidents or "close calls" that taught you some important lessons about athletics with diabetes?
JH) At Ironman Lake Placid, NY, a couple of years ago I was at about mile 90 of the bike segment, starting the climb up Whiteface Mountain. My blood sugar had been fine about an hour earlier so I dumped my water bottles at the base of the climb to shed weight. In fact my blood sugar was low and kept dropping, while I kept climbing . .. slower and slower. I've never suffered so much in my life. I finished the 112 miles with a 47 blood sugar, losing almost 25 minutes to my competition in just 20 miles. I had high carb drinks in the transition so I recovered slowly as I started running the marathon, but I'd lost too much time to contend in that race. A small mental mistake can cause much greater damage for us. They say the Ironman is so physically demanding, but ironically it's the smartest athlete who wins. That's even more true for a diabetic. We always have to be thinking and paying attention.
DM) What are some other things you've learned about life and competitive sports with diabetes (by trial and error)?
JH) Some say that the Ironman is 10% fitness and 90% nutrition. A bit of an exaggeration of course, but perhaps not for a diabetic. Living everyday with diabetes requires us to be more knowledgeable about nutrition, how different things affect our blood sugar - carbs and fats, insulin dosing, exercise, illness, anxiety and everything else. I've also learned that pizza causes blood sugar to rise several hours after eating it. Bananas are a great way to raise blood sugar during competition, although not quickly. Adrenaline before and during races causes blood sugar to go way up, ie. the body's "fight or flight" reaction. Taking a large insulin bolus immediately after a long (3+ hours) workout and then consuming good high glycemic carbs helps with muscle recovery.
DM) What about diabetes in your personal life? How knowledgeable and/or involved is your new wife on that front?
JH) My wife is very knowledgeable about diabetes. She can spot low blood sugar in me, sometimes before I even realize it. She also enjoys eating a healthy diet that I like and need both as an athlete and a diabetic. She always has my One Touch Ultra meter for me at the finish line of a race (I have about 8 One Touch Ultra meters!). (Editor's note: LifeScan is one of Jay's sponsors) On the race occasion that I get hypoglycemic during the night she knows how to give me OJ or other carbohydrate drinks when I'm incoherent or uncooperative. Thankfully that does not happen often, but when it does she has a calm hand and cool head to be persistent. I try to give her confidence and peace of mind by always testing and having carbohydrates handy whether I am training or just in everyday life. I owe it to her to do everything I can to prevent problems today and long-term complications.
DM) You're an active motivational speaker around the country. What's the most important message you hope to bring across?
JH) Diabetes is an opportunity, not an obstacle. An opportunity to prove how strong you are, that you are stronger than it is. It forces you to live a healthy life, with diet and exercise, so embrace it! Make diabetes the best thing that ever happened to you. Be the healthy person that others want to be, but either don't have the motivation or something forcing them to do it. You do! Visualize achieving a goal that seems a little beyond your reach — a road race, maintaining your ideal weight, graduating from college, starting your business, the family your want to raise. I call that Finish Line Visionâ„¢, and it will draw you to it like a magnet. When you succeed, it is so much more satisfying because you know what you had to overcome. Try to live your life as a non-diabetic, not in denial, but in determination that it will not stop you. They may never tell you, but one day someone will say "wow, she does all that and I never even knew she was diabetic." You will be admired and set an example for others to overcome their obstacles and not make excuses.
JH) The OmniPod has been a fantastic experience for me. It is the best insulin delivery device I have ever used, and I have been on other pumps and shots for many years. As an Ironman triathlete, my lifestyle is a bit chaotic and extreme, and the Omnipod handles it like it was made for me. Having no tube is the best feature. In the Ironman I swim 2.5 miles in the ocean, cycle 112 miles and then run a marathon, all in 10 hours. The OmniPod works better than I do some races! I've traveled to Australia and snorkeled the Great Barrier Reef, crashed in my bike in a race, and done several Ironmans all wearing the pod. It's real important to me that it's so small, secure on my skin and durable. I'm also a professional speaker, husband, lawyer and future dad, so it's great that my pod works under a wetsuit in the ocean just as well as under a business suit at a desk! I love the ability to set temporary basals or suspend insulin in the middle of race, or bolus immediately. I never notice it on the back of my arm - it does not get in the way like other pumps and tubes on the abdomen, etc. Also, it looks cool on the back of my arm with my shirt off - makes people think I'm a superhero with special power in that mysterious little pod while I blow by them! Ha!
DM) Finally, if you had just one "sound bite" to share with other PWDs (people with diabetes), what would you say to them?
JH) Make diabetes the best thing that ever happened to you. Send a message to this disease that "you're messing with the wrong guy." (Or gal...)
Learn more about Jay at his web site, JayHewitt.com. You can send your congratulations soon, too, as Jay and his beautiful wife Anna (Miss United States 2005) are expecting a baby girl next month. Way to go, Hulk!