The 2019 Boston marathon — Amy McKinnon Nutrition

The 123rd Boston marathon, April 15, 2019, the day I turn 31.

We arrived in Boston on Friday evening, giving ourselves a few days to absorb the marathon atmosphere, see friends, join pre-race shakeout runs and get some down time in.

Saturday morning we picked up our bibs, took some mandatory photos and checked out the marathon expo before meeting with friends in the afternoon for a group shake out run. Everyone was happy, positive and feeling good about Monday morning.

We even shook it out with Tommy Rivs who is an Arizonian trail runner and insane athlete who ran a 2:22 on race day.

We did another shake out run on Sunday morning with fellow type 1’s from team Novonordisk and the Boston2BigSur marathon crew who we would be seeing again in 2 weeks.

Scott Jurek even joined us for our run ;-) …. well maybe we joined him!

We spent the rest of the afternoon with our feet up, eating plant based goodness in the form of açaí bowls and homemade Buddha bowls (from the Wholefoods buffet).

Sunday night was a little restless for Alex and I. Our attempt to sleep early didn’t go so well with the excitement of what awaited us in the morning.

A 5:45am alarm got us up, showered, dressed and on our way to a VIP breakfast at a hotel close to the bus loading area to the start line.

My challenge pre-marathon is to manage my bgls with breakfast (at least 3.5hrs prior to the start time) and the adrenaline rush that also causes my bgls to spike.

As we walked the 15 mins from the hotel to the buses my sugar levels were dropping so I had 3 Clif energy bloks, too many with the 1-hr bus ride ahead.

I watched my sugar levels creep up as we sat stagnant on the bus.

On the bus, I also reduced my basal insulin dose to half of what it usually is to avoid low bgls during the marathon.

We arrived in Hopkinton with about 30 mins to spare before we were set to go.

I dropped off my medical bag filled with my spare diabetes supplies, which would be transported to the finish line, we found the last toilets before we got into our corral and then with 5 mins to spare we were ready to go.

Alex joined me in Wave 2, Corral 6 so we could run together.

By this stage my bgls seemed to have settled at around 280mg/dL.

Ideally I would have liked my bgls to be 100 points lower, but I didn’t give any insulin to see if they would come down when I started running.

10:25am we were off, Alex and I had pace bands for a 3:25. I thought that was an ambitious goal with the injury challenges and lack of speed work leading up to Boston.

I had stomach cramps from the onset of my period that morning but once we started running they miraculously disappeared.

I had warned Alex that I probably wouldn’t talk much during the race as I would be pushing harder than him to hold the 7:49min pace.

We were off to a good start, but I noticed Alex’s enthusiasm was pushing him up the hills at a stronger pace than I wanted to push so I gave him a friendly reminder of this before the real hills appeared.

I checked my bgls after the first 2 miles and gave myself 0.5 units of insulin when I saw a reading of 316 mg/dL ~ they were heading in the wrong direction.

After 4 miles and no nutrition I knew I needed a gel pretty soon or I was going to bonk, so I gave another generous 0.5 units and returned my basal rate to 100% on my insulin pump in the hope it would bring my bgls down.

By mile 6 I was around 175 mg/dL, good enough to take a gel.

I needed at a minimum 1 gel every 5 miles.

Alex and I didn’t speak much. He spoke to someone and bantered with people who commented on his poop shorts while I listened, focused on the crowd and holding the comfortable pace we were maintaining.

By mile 9 I was able to take in another gel with my bgls around 160 mg/dL.

I knew I’d probably need some more insulin and by mile 11 my bgls we’re heading back up again.

Mile 13 came and we were a few seconds ahead of our goal pace.

There were a few moments were I was struggling to keep up with Alex, but seeing him also push and hurt made me feel human and a little better.

When we passed crowds I enjoyed the cheering and reading the signs people had even if they made me roll my eyes. I got a boost of energy from loud music and watching Alex run along the Wesselly girls and high five them.

As the 2nd half of the race started to warm up we drank water at at every station and pour a cup over our bodies which was refreshingly cool.

This also gave him a boost of energy which we both needed. By mile 15 I had my 3rd gel even though I was averaging a bgl of 180. More insulin was needed.

I used to be so hesitant to take any insulin during a race with the fear of going low but I’ve learnt that my best diabetes management race strategy involves micro boluses if my bgls aren’t in range so I can consume enough calories.

I think within the next few miles I gave 1.5 units of insulin spread over a couple of separate doses.

The Newton hills came soon enough and I was actually grateful for them. We ran them all, including heartbreak hill but for some reason pushing up hill was easier on the legs than pushing the down hills.

Getting to the top of heartbreak hill and overtaking people was an achievement worth a high five with Al.

As we get to the top, Alex and I both look at our watch in sync. And he spoke what I was thinking, “you can PR but we’ve got to push these last 5 miles...”.

I didn’t answer out loud but he knew I was willing to give it my all.

These last 5 miles, I knew I had enough insulin on board to take on 2 more gels.

I talked to myself repeating the words “you can do it, I can do it, believe in yourself” and off we went.

Half the time Alex was in front with the occasional push where I would take the lead knowing he was on my tail with a turn of my head.

I knew I needed to do this for myself, for Type 1 diabetes and to know that I could push myself beyond my limits.

Those last 5 miles were the best of the whole marathon. We passed so many people and I knew I was giving it everything I had both mentally and physically.

Those last 5 miles were the fastest of the marathon.

As we saw mile 23 I knew I could keep pushing to the end. Each mile felt longer and longer and I pushed a little harder. As we approached mile 25, I wasn’t even looking at my watch coz I didn’t want to see my pace and “give up”. Coming around the corner to turn onto Boylston St Alex told me he was cramping, I hesitated until he told me to go ahead. I pushed. As we I turned right and saw the finish line I gave it absolutely everything. I looked at my watch with 0.2 miles to go and knew I only had approx 20 seconds to make it to the finish line which wasn’t possible. I turned my head and Alex was on my tail so I let him catch me in a few seconds and we sprinted to the finish line.

It was so overwhelmingly incredible running with Alex by my side knowing we both gave it everything we had in those last mile.