“You Are An Ironman”

Those are words I never believed I would hear, until I realized how important it was to my kids.

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Thrown into the water with absolute chaos, I had to find my way while getting kicked and punched.  After a while, I was able to get my rhythm and settle in, and then transition to the next stage…. Settling in, I was able to breathe and felt free.  Starting to push a little into the long effort, I slipped into what was now a comfortable rhythm, and battled on.  Not realizing the hard effort was zapping me at the same time.  On through the next transition, it was all about managing discomfort and mental status.

This could easily be a day in the life of an Ironman, or someone living with Type 1 Diabetes.

At the time of diagnosis, you are thrown into the water, and have to use whatever resource available to stay afloat, move forward and gain some ground.

Once you put in the hard work and get through the initial learning phase of the disease, you get to a point where you feel like you are winning and you’re, almost, free.  Although, whatever bad habits exist and the effort itself, tend to head you to burnout.  You get to the run, and you are just trying to manage your head and stay in the game.

People think I’m looney for competing in Ironman, for taking on the challenges I do.  Maybe you just don’t understand.  The reality is, I take a drug (insulin) everyday, that if I mess up on the dose, it’ll kill me.  A little Ironman race is no big deal…….

I say that tongue-in-cheek, of course, because it was difficult.  However, once I made the decision that I was going to compete, then it was on.  The same way that, every day, I decide I am going to make the right decisions so that I can live through the day.

There were two signs I saw during the Ironman that stuck in my head.  The first was a shirt that a woman was wearing.  She was running out on a loop when I was running in.  She must have been 6-8 miles behind me, but her shirt simply said, “COURAGE”.  And she appeared to be running calmly with courage.

On the day we competed, 80 people were diagnosed with T1D across the US (according to JDRF statistics).  Those individuals, and their families, will have to show an unbelievable amount of courage.  To withstand the initial learning phase, the relaxation phase and the potential burnout phase (these are simplified, non-professional terms).  Courage to face their fears, courage to face adversity, and courage to continue on when it gets ugly.  I child with T1D has to have the courage to face each day, most of the time, without peers.  An adult diagnosed with T1D, almost always is left with minimal resources.  A mother with T1D has to have the courage to fight through the mental and physical fatigue of managing their child’s T1D, and the father of the child living with T1D, has to have the courage to assist and manage the emotions in the house without adding fuel to the fire.

Anyone with T1D has to have COURAGE when taking on new challenges, because blood glucose levels change, insulin needs change, and it can get very frustrating.

The second sign I saw was being held by a college student somewhere on a heavily populated area of the loop portion of the bike.  It said simply, “DO EPIC SHIT”.

I was forced to think about what I was doing at that point.  My wife and I had set off to set a standard of living for my children, especially in the event they are diagnosed with T1D.  I can tell them or show them.  Honestly, there is no better person than I to show my kids successful living with T1D.  Therefore, I didn’t really have a choice.

But when I saw that sign……I thought for a second about how my kids might be looking at this event.  Will they be proud?  Will it inspire them?  Will they remember this event for the rest of their lives?  That was my intention, and I sure hoped, and truly believed they would.  I had to shut down my brain immediately, because I started getting emotional.  It wasn’t time for that.
So, here’s how the race went:

Pre-Race
3:30am wake up with breakfast
Bagel with peanut butter and a few cups of coffee

5am at transition (with my friend and ROI teammate, Dan Hayward)

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6:40ish – BG was about 140ish, ate a yogurt (25 carbs) and half of a bagel (25 carbs)

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6:50am – entered the water and started treading

Swim
I was nervous entering the water, but able to keep my head calm. I don’t know if my HR was up or down, but it felt ok, as my head was calm.  When the gun went off, it was a mad rush to move and gain my own piece of water to pull in.  Very quickly I had to learn to find space between people to pull or I was going to lose ground.  And when there was space, I had to quickly take advantage and lengthen my stroke to get longer pulls and relax.

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I followed my fueling plan with a GU at 45-50 minutes into the swim.  This was hard to do, as I had to find space and time to eat it, but it worked as my BG was 117 going into T1.

The last third of the swim, I was getting angry.  I was in a sensory deprivation state, my goggles were giving me a headache and my wetsuit was rubbing my neck raw. One of those was ok, but all three had me on the edge.  It took some energy to stay focused on completing the swim.

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Transition 1
I did a good job at grabbing my diabetes supplies off the table, getting the top of my wetsuit off, getting the rest off by the wetsuit strippers and running up the helix to T1.

Mental error #1 – I relaxed when I sat down in transition to open my T1 bag.  I just flat out lost focus and it took what felt like forever to really get moving
Mental error #2 – with a BG of 117 coming out of the water, I assumed my BG was dropping and lowered my basal from .9 to .7

I should have tested again before I left T1.

Bike
The bike was everything they told me it was going to be.  They being everyone I talked to about IMWI or everything I read.  There was a large volume of people on the course so trying to pass, fuel or hydrate on the stick or first loop of the course was difficult.  I feel like I did an ok job, but need to work on easier method for any future work.
The second leg was better and pushed a little and had some fun.  Picked up a lot of time and felt ok finishing the bike.  Although I did have a little left leg muscle cramping in my groin and inside hip flexors.  My right Achilles was tight as well leading to cramping in my right foot.

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Because of my basal adjustment out of the water, I ended up with a BG close to 300 about an hour into the bike.  I made a small bolus correction of .5 units and switch basal back to .9.

About 3 hours in, I started peeking at my CGM more often, and then made the change back to .7 somewhere around hour 4. BG had come back down earlier and had fueled ok through the bike.

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Transition 2
Much better and more focused than T1.  Felt ready for the challenge of running the marathon on tired legs and headed out mentally ready.  Stopped to pee, and was well hydrated, so was happy with that. My BG was in the 90’s in T2 and I headed out on the run with another 50 grams of carbs during T2.  25 of quick acting and 25 of complex.

Run

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Headed out with the first two miles under 9 min per mile and felt good.  Although started feeling drained toward the second mile. Checked CGM and saw that it was dropping from 95.  Dropped basal rate to .5 and fueled with GU and fig newtons. Was having a hard time getting them down, so I started walking to allow the food I got in to work without the effort behind it.

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For the next two miles I fought the potential low BG with difficulty fueling.  Got to a position of running the flats and walking hills and aid stations, maintaining that for much of the remainder of the run.  Once my stomach settled and I could get fuel in, I was then having a problem with .5 basal and dropped again to .3.  I then had to drop again to .15.  Once this settled in, I was able to run the last 3.5 miles almost continuous, just walking through aid stations to fuel.

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Generally, I personally wasn’t all that happy with my run, but, the things I couldn’t prepare for…….how does your gut handle that long of an effort……what does your BG do 8 and 10 hours into that type of an effort……how do you reasonably prepare for that?  I have a job and a family?  12 hour days on weekends for working out doesn’t happen.  So, with that in mind, I prepared as well as I could have and finished as strong as I could.

AND IT WAS AMAZING!!!

I honestly can’t explain the feeling, but maybe this short video from my buddy Hank Devos (who is training and racing IMWI 2016 with T1D!) will show you……

https://youtu.be/8eFGU4z01Bw

And then I saw, and hugged Breigh, and I cried……like a baby, tears of joy for the accomplishment……It was hard, but we did it.  It wasn’t always fun, but it was worth the effort.  And then I talked to my kids, and they yelled over the phone how cool it was to see their Dad become an IRONMAN!!!!!   And I cried, again……….

In the driveway when I got home……..

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This doesn’t explain the look of pride when she first saw me when I got home…….

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But, maybe this will give you a sense of what it has done for him……..

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Post Ironman Diabetes Control

Control over the next few days was ok, with the .9 basal working well.  I was amazed at this basal especially for the first night, as I slept great.

Since then, I have maintained the .9 and gotten back to regular work and a couple of workouts.  Generally speaking, recovery is significantly different than any other event I’ve done before.  My body feels ok, but I have just been generally tired.  A few nights I have even fallen asleep on the couch.

Subsequently, into the second week of recovery, I have worked out a little more consistently, mostly rides and swims, and my basal is starting to come down a little post workout and a little through the day.

Overcoming Hurdles

“Whether you think you can, or you think you can’t – you’re right” – Henry Ford

So, what do you face every day?  What are your goals?

My wife and I face my T1D, and the potential diagnosis of our children with T1D.  Our goal was to show them they can accomplish whatever goals they choose, no matter their hurdles.  The look on their faces and the excitement in their voices when I talked to them after the race, and when I got home tell me that my my wife and I made the right decision and put the right work in.  THAT’S A WIN

I have to thank my wife, for having the foresight and patience to allow this to come together.  She, she gets the competition thing…….I’m really just trying to keep up…….

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(She’s in the center with all of her Action Wheels Teammates wearing her NJ State Road Race Championship Jersey……)

I also have to thank Action Wheels Bicycle Shop (www.actionwheels.com) and my AW team mates for all of their support.  They kept me moving throughout all of my time on the bike.

I mean, look at this rig………

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To my family and friends, your messages during the day were incredible to read when I was finished……I was SO OVERWHELMED with your kinds words!!!

And I also have to thank my friend and Endocrinologist, Dr. Matthew Corcoran.  Founder of Diabetes Training Camp, Dr. Corcoran provided me with the education and plan that proved successful for good diabetes management over the last year and a half of training and executing on the event itself.  A year and a half or changing basal rates, trying different insulin therapies, developing plans and back up plans…….most would have quit.  He hung in there with me to be a part of my team and help my accomplish my goals.  It doesn’t get better than that.

If you are living with T1D, and you’re interested in any level of exercise, you are doing yourself a disservice if you don’t go to camp.  Find out more at http://diabetestrainingcamp.com/ or check them out on Facebook.

What’s Next?

Would I do it again?  Yes.  Have a signed up yet?  No, I’m going to hang with the family for a bit.

But stay tuned for my next big adventure……..

First 1/2 Ironman – Princeton

Been a while, but here it is.

The Princeton 1/2 Ironman DID NOT derail me from my plan of completing a full Ironman in 2015.  In spite of: long transitions, unknown blood glucose levels during the swim (fine heading in, just didn’t have my continuous glucose meter with me because its not water proof), terrible road conditions on the bike and an uncooperative stomach during the run…. I still met my goal.

My goal was for my kids to see me finish one of the toughest events in sport.  Of course, not quite like the full, but they don’t understand that yet.

Planning for the worst (potential diagnosis of Type 1 Diabetes for either one of my children), I could tell them, or show them that I can accomplish my goals.

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Getting body marked.

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Heading into the swim.

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In transition.  Note, this IS proper technique.  You should stand when testing your blood glucose levels, singing along with the music playing in transition and putting on your socks.  Even if you’re wife is yelling at you to hurry up.

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Heading out on the run.  SMILING!!!  It wasn’t so bad…..

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And this was what it was all about.  My son and daughter ran in with me a little at the end of the race.  This was worth every bit of training.

The “Challenge” of Trying Something New – The Challenge Tri Overview

 

It has been a common sentiment among those living with T1D that I talk to that trying something new is a challenge.  Physical activity, when not planned, can be difficult.  “How do I change my insulin?  What do I need to take with me in case my blood glucose goes low?  How do I keep my blood glucose from going high?  How will this impact my blood glucose for the next 24 hours?”  – These are common questions/sentiments that occur when faced with wanting to do something new.

On June 29th, I, with my team mates, faced the “Challenge”.  It was something new for both my wife, Breigh, who swam the 2.4 mile first leg, and I.  My friend, Zach, has faced many marathon distance races and fared well (if you can be modest and say that sub 3 hour marathons are “faring well”), so we felt pretty confident with him as the anchor.

However, as the first time I was facing the 112 mile bike leg of the triathlon, I have to say that I was wondering to myself, “how is this going to go”?  I was thrilled to have Breigh and Zach along for the event.

So, how did this new event go?  Here it is:

It wasn’t perfect, but we did quite well.  We each put in a significant amount of training preparing for the event.  Breigh spent a ton of time swimming in both a local pool as well as open water swims so that she could get both the swim fitness she needed as well as the experience in the bay water.  Zach, too, put in the hours, and even with a strained calf muscle, adjusted his training so that he could get in the cardio, albeit on a bike, to maintain the fitness he needed and allow the calf muscle to heal.  Hours in the saddle and specific workouts on the bike proved to be successful in preparing me for the almost five and half hours on the bike leg.  The results of our efforts came from months of training.  We all had ups and downs, successes and failures in our training that prepared us well for race day.  What race day items do we need to fix?  “Stay to the right” is an instruction that needs to be followed on the bike leg.  No exceptions.  And instead of taking on the challenge of a 29-30 mile race, next time we’re going to try and stick to the prescribed 26.2 miles.

The Three Ch-Amigos

Total Time (140.6 miles): 10:22.16

Overall Relay Results: 10th/156

Category Results: 2nd/52

Swim Time (2.4 miles): 1:31.48

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(Breigh getting prepared for the race.  Note that the water temp was up, so it was not a wetsuit legal event.)

Bike Time (112 miles): 5:18.24

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(Heading out for the bike leg.  It may be a mistake in the data, but it looks like the highest point of my heart rate was right at the start……I WAS pretty excited!)

Run Time (26.2 miles): 3:22.34

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(Zach looked strong through the event.  I’m not sure what mile this was at, because Breigh and I got to the boardwalk later than expected and missed his first pass by our initial spot.)

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(Just after Zach finished!  Challenge allows relay team mates and family members to run down the finish chute with the runner!  It was pretty awesome!)

So, we were thrilled with the results!  Happy as could be with our end result after months and months of training.

I have to thank some folks, because this type of success just doesn’t happen.  While this was no world championship, it was a big step for me in my long term fitness and competition goals, and it was a great result for our team.

The other Two Ch-Amigos:  You gotta have good team mates.  It couldn’t be any better to have my wife and best friend along for the ride.  Training lasted for months.  It was tiring, and I didn’t always want to do it.  But when it hurt, and I needed to focus on certain things, there are no better people for me to have giving me the gentle, or not so gentle, push when I need it.  Thank you Breigh and Zach, for supporting me and believing in us.  THAT was a great time.  I hope you had as much fun as I did.

My Action Wheels Team Mates:  Speaking of team mates……Your support in training (Monday Night Worlds) and kind words meant more to me than you know.  Thank You!

Profile Design:  I was able to borrow a nice set of wheels for this event (nice, meaning, they cost more than my Shiv).  The Profile Design 58/78 Twenty Four Series carbon clinchers were pretty sweet.  Thanks for the partnership with Challenge, I enjoyed the ride!

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The day before, after getting the cassette switched over and the wheels put on.  Visit:  http://www.profile-design.com/profile-design/wheels/twentyfour-series-category if you want to check out the wheels I got to use.

Here they are in action:

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My JDRF Ride to Cure and Riding on Insulin Teams:  It is your stories of living with #T1D that motivate me while training and competing.  Mostly when I am training, when it hurts and I’m tired.  It is the tired look on your face when you’ve been up nights testing your child’s blood glucose.  It is the frustration in your voice when you talk about not knowing what changes to make to your insulin to make your daily life easier.  My family and have have lived, and do live this life.  We understand and hope you see that challenges can be tackled and success can be achieved.

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(My buddy Gavin, who’s parents fight like hell to keep this guy healthy.  A minute to minute, no vacation task.)

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(The Papola Family.  The true epitome of a family fighting to support their T1D member.)

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(My 2013 Hope on 2 Wheels Team Mates, post ride at Camp Nejeda in Stillwater, NJ)

Dr. Corcoran (Diabetes Training Center): Not only an endocrine who understands T1D, but understands T1D and athletics.  You’re comprehension of T1D and appreciation of my fitness/competition goals helped make achieving them easier.  Thank you!  If you are living with T1D and frustrated with high and low blood glucose levels, you should reach out to Dr. Corcoran.  http://www.diabetestrainingcamp.com/

So, if you are afraid of trying something new, put together your team and try the beet smoothie.  You might hate it, you might not be any good at it, or you might love it and screw it up.  However, what if you love it, and want to have it again?  Only way to figure it out is to try.  Exercise is the most underutilized prescription.  Take a step in the direction of your goal and try it.  There was a lot of failure in my success.

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Jake used to be small, I used to have hair, and I was incredibly out of shape.  Couldn’t run down the street without having to stop and catch my breath (and try not to throw up).

Change is good.  The beet smoothie is good.  Don’t be scared, “Fear is the mind killer” – Frank Herbert, Dune.  Make a change, you might like it.

So, what’s next?  On to the Princeton 1/2 Ironman in September.

How Much Do I Hate Taper Week?

Yeah – I know.  Sounds ridiculous, right?

Everyone LOVES taper week.  Rest, carb up and sleep in while waiting for race day.

I hate it.  HATE it.  I hate rest, and I hate the change.  For a guy who grew up focusing on keeping my blood glucose levels the same by doing the same things every day, eating the same foods everyday…..I’ve grown to hate the change.  In training, I’ve spent the last few months getting my body more efficient, using less insulin and constantly working and recovering.

So, to back off?  And relax?  Now, I have to balance less work and more insulin…..it’s an adjustment that comes less frequent, but it is so very important leading up to the event I’ve been training so long for.  And to have this change right before the event, and get out of sync with blood glucose management?  But it’s necessary to give the body rest to provide for the best possible outcome during the event.

……I feel like I’m doing a better job, though.

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(I know, not perfect, but nothing severe either.)

But it has to be good, because performance doesn’t start with the last blood glucose test before the race……it starts in training, with every workout, with every recovery, so that the muscles can get the energy they need to perform and recover.  Without insulin, the right amount, at the right time, it just doesn’t come together.

Along with the constant focus on swimming, riding and running faster, I also must focus on better blood glucose control at these important times.  The good news is that with this time on my hands during taper week, I can focus on it…..

About 35 hours to go……Challenge Triathlon.  It’s a challenge alright, but I’ve been planning for it and it’s going to be a great day!

Stay tuned for pictures and info through the day on Sunday!

Training – Can’t remember what week it is: Failure and T1D Management

So, I have been training….and spending most of my time on the bike.  Due to the fact that I have the Challenge Triathlon Relay next weekend.  I am the 112 mile bike leg.  Just so happens that I am going to complete this with two of my favorite training buddies:  my wife is going to kill it in the 2.4 mile swim, and my college team mate and good friend, Zach is going to drive it home with the marathon.

Over the last two months, I have tried something new.  I’ve been racing with the Action Wheels race team in criterium and road races.  It’s been a great group of folks to ride and race with and I’ve been having a ton of fun while hanging with them.

Here’s the interesting part….it’s another new athletic thing to tackle.  Train, recover, fuel, hydrate, and manage blood glucose levels to do this all effectively.

We’ve all seen the statements on FB, LinkedIn, and Twitter about failure.  These statements, in my world, are true….and false all at the same time.  A necessary evil, if you will.

If you have T1D and want to try something new, it means insulin level adjustments and fueling adjustments.  Not just for right now, but for the next 24 hours.  If you stack your workouts daily, or get to 2 a days for the multi-sport folks, then the off workout time gets tricky with balancing insulin levels needed now for recovery fuel but without over doing because you just had a hard workout.  Then, what if you want to go to sleep and your blood glucose level isn’t right?

I’ve heard people say that managing T1D is the only disease you manage where you deliver a drug (insulin), multiple times a day, that if you make a mistake, it could kill you.

THAT’s a strong statement.

There’s a reason I like cycling….well many, really, but it compares to T1D.  Racing a bicycle is all fluid motion.  Constant change in the group, with the dynamics on a razor thin margin just waiting to fall one direction or the other.  You have to be ready, at a moments notice, to chase a wheel or attack of the front, and then know when you need to sit in and recover.

Sometimes you feel like this (Giro Del Cielo Creiterium):

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But other times, it’s smooth, and the plan comes together and your team comes home with a win (NJ State Criterium Championships).

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Cycling is constant learning.  Pitting yourself against the other riders to perform your role for your team.  You miss a wheel here, gap a rider there, attack and stay out to long.  But these moments are banked away to be used again, so that the next time you face this situation, you adjust and make it work in your favor.

Management of T1D is the same way.  Built on experience.  Trial and error.  Failure.  Make the adjustment, try it out, make a mistake, make another adjustment and gain some success.  These incremental successes are where good T1D management occurs.  You have to be a grinder, constant learning, constant change.  If you’re a fan of cycling and know about Rule #5, it applies here.  Show me a family that lives with T1D, and they inherently know about Rule #5.

How does this work?  Have a good team.  You need to trust your physician.  Communicate your goals to your family.  Have a plan, and have a back up plan.  Test the plan.  Test it again.  Be gritty.  Don’t back down when the first failure occurs.  And it will, so have a plan. Adjust, and try it again.

Failure in T1D management is going to happen.  The plan doesn’t work, so it has failed.  But here’s the most important fact about failure:  it puts you one step closer to success.  Don’t use it as judgement, use it as data, because the data doesn’t place blame.  There shouldn’t be any.  The data will point you in the right direction, so follow the data.  Failure should not be an emotional response, it should be informational in nature.

So, next week is the culmination of many failure’s over the last two months.  I’m not going to tell you that I didn’t get frustrated, because I did.  But I’ve been training since winter for this event, so I am going to use every bit of failure as data points to make this weeks event a success.

This (Philadelphia Marathon 2010)

2010 Philadelphia Marathon

2010 Philadelphia Marathon

Plus this (healthy fueling, a constant for the last two years):

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This (blood work 3-4 times per year):

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and this (a lot of training):

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All went into the preparation that will equal the effort.  And that’s just for the 112 mile bike leg.  Wish us luck!  More to come next week after the race……