The expanded result sheet says it all. At 11.25 kilometers, Kris Freeman was in 23rd place, in the lead pack, 10.9 seconds behind Lukas Bauer (CZE). At the next time check, 1.35 kilometers later, Freeman was 47th, just under three minutes off the pace.
Freeman crashed, but not in the usual way. “I went from feeling fine and relaxed to ‘oh this is hard’, to not standing, in three minutes,” Freeman told FasterSkier. And just like that Freeman’s Olympic dreams took another hard blow.
Suffering from Type 1 diabetes, Freeman suffered a blood sugar crash that took him out of the race – one minute he was one of the best skiers in the world, the next he knew he wouldn’t even be able to make it back to the stadium without a significant dose of sugar.
Lying in the snow, Freeman called to spectators, looking for some type of food or drink to raise his blood sugar. Tor Arne Hetland, the retired Norwegian sprinter, and now a German coach, responded and provided Freeman with a Gu and a 20-ounce Powerade.
Freeman got it all down, and though he described himself as being “pretty delirious,” he was still “fired up to race.” He also said that it crossed his mind that getting back on the race course would be the fastest way back. He got under way, but obviously from a race standpoint, the damage was irrevocably done.
All told Freeman estimates he was down and out for 2-3 minutes. “I crashed at the bottom of the big hill, and by the time I got going again, the lead pack had already been up and around. I saw them coming down.”
Freeman said it took him a good twenty minutes to start feeling ok again, at which point he was able to pick up the pace, picking off several skiers after he switched to skate, and posting some decent splits despite the trauma his body had just undergone, and the fact that he was no longer in position to be racing for results.
“Once I was able to start skiing again, I was pissed,” Freeman said. “I needed to burn that off.”
Freeman described this type of blood sugar crash as “like a bonk, but faster, and when you bonk you can still keep skiing.”
As a diabetic, Freeman’s body does not produce insulin. He needs insulin in order to access sugar in his blood, and if his dose of insulin is too high, he can deplete his reserves. But if it is too low, he can end up with too much sugar in his bloodstream.
For more information on how Freeman manages diabetes while racing, read his blog post on the subject.
Freeman wears an insulin pump – specifically one called the “OmniPod” – that administers insulin. He can program it ahead of time based on his expected needs. Since his pod was already set, it would keep releasing insulin into his blood stream during the rest of the race.
“I either needed to tear it off my body [to stop the insulin], or keep getting sugar.”
After the crash he fed twice as often as planned and ultimately consumed two Red Bulls and a liter of Gatorade over the last two laps.
While his 15km race on Monday did not go well, his blood sugar was fine. Freeman has had his greatest success in that distance. Since switching to the insulin pump form injections, he has done at least 25 15km races at a World Cup effort. This has allowed him to dial in his insulin dose, and the overall race protocol.
On the other hand, today marked only his 4th 30k since the switch. “I obviously don’t have it dialed in…It came on really fast and I don’t know why.
“I’m talking to my doctor and coach and am trying to figure it out.”
One issue is that there is no test environment that accurately simulates a World Cup race. Time trials don’t work. Nor do regional events where Freeman usually wins easily. “You can’t simulate the adrenaline and pace of a World Cup race,” Freeman explained.
So this limits his ability to try out different doses. He used the 30km at US Nationals for that purpose, stopping midway through to test his blood sugar. That move dropped him from a shared lead with James Southam, back several places. He skied back up to 2nd, but never caught Southam. But he was willing to sacrifice a shot at another National Championship to prepare for today’s event.
“I ran the same basal rate as in Anchorage [at US Nationals], and in Anchorage it worked.”
Freeman is clearly confused and obviously devastated.
“I’m crushed. I don’t know what’s happened. I’ve been working towards this for four years and it’s my worst nightmare.”
While today seemed to be a clear case of insulin issues, Freeman didn’t rule out fitness.
“One thought is that maybe I am out of shape. But a bonk doesn’t come on that way [so suddenly like his crash today], and all indicators are that I am in shape. Fitness doesn’t just go poof. I had a solid race just two weeks ago in Canmore.
“I don’t know what to do.”
Freeman will not race the team sprint – the US has named a team of Andy Newell and Torin Koos for that event. Had he been racing better, he would have been a candidate for that event.
“My plan was to come in here, be a top-10 skier, and earn a spot in the team sprint, Obviously that didn’t happen.”
There are two other possible starts – the 4x10km relay and the 50km classic. The 50km is a done deal. “Nothing is going to keep me out of the 50 except pneumonia.”
But the relay remains a question. On the one hand it would give Freeman another opportunity to evaluate his fitness. He would be racing a distance that he has dialed in with regards to insulin, and should see if his body is where he wants it to be. On the flip side, he could skip the relay and enter the 50 very well rested.
He told FasterSkier that his inclination is to race the relay, but that at this point everything is up in the air. He also said that if he has another performance the likes of today, there is a good chance he would skip the spring World Cups while he tries to figure out what is going on.
And to add injury to insult, Freeman suffered a back spasm after the race and will not be able to ski tomorrow. He does not expect the spasm to keep him out for long.
In the meantime he will work on recovering from today’s race. Based on his experience, he feels that a sugar crash of the type he experienced today takes a significant toll on his body and slows recovery. The 4×10 is just four days away, on the 24th.
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Topher Sabot is the editor of FasterSkier.
February 21, 2010 at 2:28 am
You are truly an inspiration to me. I raced against you at an Eastern Cup race this year, and that was the most significant moment of my ski career. Your fight against Type 1 diabetes has been an inspiration to me and many other people. What you have done on skis is not only amazing, but unbelievable. I am crushed that you had to suffer through a problem with your blood sugar like you did today. I know that you have worked so hard to get to this point, and even with this unfortunate bonk you are still my skiing hero. The greats like Northug and Cologna are impressive, but you truly represent what it takes to be role model to skiers of all abilities. I couldn’t choose any other skier that I would rather have represent the USA more than you. Thank you for being an inspiration to me and the rest of the USA skiing community. Stay strong and go get them in the 50km. We know you came to Vancouver meaning business, and I have no doubt that you can show us what you really came there to do.
Thanks again Kris,
February 21, 2010 at 3:03 am
Kris, you’re amazing. Judging from your blog, you’re not one to lean on excuses. But man, you are doing incredible things! I see so many young people who don’t take their diabetes seriously and they end up in the ICU with DKA because they didn’t use their insulin; or permanent brain damage from prolonged low blood sugar because they used too much insulin before going to sleep. Too often it is because they just are just too lax about their disease. I can’t relate to what it is like to have diabetes, but I bring you up often as an example of someone who has taken control of their disease and competing at the highest level. Sorry about your race, but I still think you are heroic. Cheers and thanks.
February 21, 2010 at 11:19 am
Kris, I was wondering if you factor in ambient temperature when managing your insulin. The temperature of your patch pump site could affect the pharmacokinetics of your Lispro with one study by Raz et. al. suggesting a faster peak with higher temperatures. Certainly the ambient temperature at US nationals was much lower than the conditions yesterday. The heat strain on your body could further alter your glucose metabolism and blood flow to your subcutaneous tissue. You do a remarkable job managing your diabetes considering the complexity of the physiology involved in blood sugar regulation especially during exercise. Good luck in your upcoming races!
February 21, 2010 at 2:17 pm
Kris, your are a tribute to the best in human endurance.
May I suggest a good approach to deciding between two races or one?
When in doubt go for the rest day. It is more satisfying to have one good race than two fair ones.
Go get ’em. Rick
February 21, 2010 at 2:44 pm
You are an inspiration! I am 17 and this summer my family and I rode across country on our bicycles. We rode over 4100 miles and I couldn’t have done it without a pump and a continuous glucose monitor. The continuous glucose monitor reads my BG continuously so I can see a trend of my sugars dropping or going high. It also can be set to alarm for a low and for a high range. I would love to talk to you about this technology. My friend just got one for a dog sled race she is competing in at Fort Knox. You are amazing and we look forward to watching next week. No matter what happens, you are a star in our book! Check out our adventure at rebeccasride.blogspot.com and after the Olympics maybe you can visit us in Bar Harbor. We do a walk for JDRF in the fall and would love to have you as our guest speaker…it would be truly motivating! Save the date…10.10.10 @10am!!! Go get ’em Kris!
February 21, 2010 at 5:07 pm
As a type I diabetic, I really feel for what Kris is trying to do! Unfortunately, our bodies and our reactions to carbs, insulin, and exercise change regularly. Thus, just when you think that you are getting things dialed in, something like this happens. I can’t imagine how frustrating that must be in the biggest race of one’s life. I applaud Kris and the extraordinary measures that he is taking to live his life safely, but on his terms. He is an inspiration to all of us, and a reminder that we should never use our diabetes as an excuse. I hope that he can overcome this disappointment and continue to be a great example to all of us. I don’t think that he’ll ever be ‘dialed in’ the way he’d like, but I couldn’t be any more impressed with the constant effort and excellent results. Good luck, and THANK YOU!
February 21, 2010 at 6:19 pm
It was very impressive how Kris continued with the race and finished when it would have been easy to drop. He courageously demonstrated the motto, “If I can not win, let me brave in the attempt.”
He went by us just before he collapsed and it was amazing how quickly the wheels fell off. Rob Whitney sprinted up the hill to aid his former rival. I was impressed with the patience that Kris exhibited as many of us fumbled through our packs to get him some sugar.
America has a right to feel proud of the effort and courage Kris put forth yesterday. Best of luck and I hope you recover quickly and get the blood sugar dialed in for your next race. Congratulations also to James Southam who fought gamely to stay with the pack and continued to attack throughout the race.
February 22, 2010 at 5:10 am
Kris, I took the liberty of writing about what happened yesterday on my blog (www.diabetes24-7.com)
You are an inspiration to many people, not just because you are an incredible athlete – but because you refuse to quit.
February 22, 2010 at 9:34 am
Is temperature the final variable? I hope the logs show this to be the case, thus solving the mystery of the pursuit. That is a great lead, if it has not been previously considered & adjustments implemented. C’mon Kris! I don’t know how people lose faith in Kris Freeman. When I read this, his stock goes way up in my book. Fear Kris, because when he eliminates the variables (& he will)…