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Things were not going along "swimmingly" for Gary Hall Jr. in 1999. He recalls feeling "like I had the flu. I'd get better, then shortly I'd get sick again."
Next, his vision began to change.
"I'd be driving and couldn't see the street signs until I was in the intersection," he told members of the American Association of Diabetes Educators at their annual meeting in August 2001.
When Hall went to a doctor in March 1999, he learned that he had a fasting blood-glucose level of 310 mg/dl—and type 1 diabetes.
Doctor Said, ‘Give Up Dreams of Competition'
Hall's first reaction upon being diagnosed with diabetes? "I wanted to fall down on the floor and have a temper tantrum like a little kid," he told the educators.
As if getting diabetes wasn't enough, his first endocrinologist told the world-class swimmer he might as well give up his dreams of competition.
"Swimming," said Hall during a recent telephone interview with Diabetes Health, "was my source of insurance—my source of income. Not to mention everything I had dedicated my life to."
After getting hit with the double-whammy of learning that he had diabetes and that it could end his career, "I packed up my insulin, my needles and my dog," he says, and he and his girlfriend headed south to Costa Rica.
Elizabeth to the Rescue
In Costa Rica, Hall says, "I had my head under the blankets in bed, just kind of doing everything I could to cope. "
It was actually Elizabeth—Hall's girlfriend, who later became his wife on December 2, 2001—who went out and got all the books and researched information on the computer.
"She was putting information into my hands and saying, ‘Read! Read!’"
What Hall read about diabetes was frightening.
"To this day, I am scared." However, he adds that the specter of complications looming "became a motivating factor to maintain tight control. The end result was very positive. It forced me to face this thing."
Finding an Endocrinologist Who Believed in Him
While Hall was still in Costa Rica, his father worked on finding another endocrinologist.
Dr. Ann Peters of UCLA "came recommended as the very best," Hall says. And she was willing to take on the task of helping the athlete develop a regimen that would allow him to continue in world-class competition.
Indeed, five months after his diagnosis, Hall swam away with a gold medal at the Nationals, beating his own best time.
Hall recalls that Dr. Peters was at the 2000 Olympic trials and at the Olympics in Sydney, Australia. "According to her, it was in case something went wrong. But. she was instrumental in getting me to that point. I wanted her to be there just because she'd been a part of getting me there. I loved having her there to see the whole thing."
What Dr. Peters saw was a man—who had been told that he would never compete at that level again—swimming away with bronze, silver and gold medals.
Staying in the Best Control Possible
Although Hall says that he has "a pretty good understanding of what needs to be done" in order to manage his blood-glucose levels so he can compete, he doesn't always achieve perfection.
"It's a challenge that I have a hard time with," he admits. "On days that I compete, I compete in the morning and at night. That challenges refueling."
His insulin regimen consists of matching NovoLog to his food, along with an injection of Novolin N at night.
"Since being introduced to NovoLog," he explains, "I've been able to eliminate my daytime basal."
NovoLog dosages depend on how much he eats.
"I think the key to my management is being able to adapt. My schedule is always changing, and following a routine isn't always possible."
Changing schedules also equal changing test routines—from five or six tests on a normal day to 14 or so when he's competing.
Hall doesn't feel like eating before a competition, citing nerves and butterflies in his stomach. But, he says, "it's important to eat after you race. Then you need to eat again—lunch—and give yourself more insulin. You have to figure everything out again. Nobody I compete against has to think about their pancreas."
Hall walks a delicate tightrope: eating far enough in advance of a race so that he's not hungry, yet balancing food and insulin in order to avoid episodes of low blood glucose.
He isn't always successful.
One memorable time occurred about 45 minutes before a race—at the Good-will Games in Australia in the summer of 2001—when Hall became hypoglycemic. The consequences were disastrous on two levels.
"I drank a bottle of PowerAid" to correct the low, he recalled. "The under-water camera was in lane six—the one I was racing in—and I threw up on international television."
He also lost his first-place advantage. "I was on my way to winning," he asserts.
Surrounded by a Positive Team
Hall may be on his own during swimming competitions, but he's anything but alone when it comes to taking care of his diabetes.
"I have a lot of support, especially from Elizabeth. Usually your mom or somebody in your family takes on that role and goes through the learning process with you. The person who was strong and supportive when I was down was Elizabeth. I need somebody like that."
He's also surrounded himself "with a very positive team: my endocrinologist, diabetes educator and nutritionist."
Getting the Message Out
Now Hall is working on producing a video for certified diabetes educators and communicating a positive message so that they can put the tape into the hands of people newly diagnosed with diabetes.
"A ‘welcome to the club you don't want to be a part of.'"
The video is expected to urge people with diabetes to take advantage of the medicines and technology available today. Hall also wants to send the message that "if I'm able to be the best in the world in swimming, you can certainly go out and play a game of pick-up basketball or go camping for the weekend."
Hall looks forward to the chance to be a positive influence on people with newly diagnosed diabetes, as well as donating revenues from the video to certified diabetes educators. Right now, he's meeting with producers about the video and looking toward the beginning of competitions in the summer.
And hoping for a cure.
"It's my belief that we're rounding the corner on a cure," Hall said. "I don't care which one gets there first - just as long as somebody does it."
In the meantime, Hall has been taking the same advice he gives others:
"Try to stay positive and. take advantage of all the advances that are taking place in diabetes research. Just stay on top of it."
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.