The Atlantic Rowing Race, Neil Hunter
I am a 37 year old type 2 diabetic requiring insulin and have been a keen sportsman for the vast majority of my life, starting with rugby from the age of 8, and playing at various levels. I stopped playing around six years ago when I started to break bones and my body was in a perpetual state of recovery. Since then I have taken part in a multitude of activities including several half marathons, a full marathon, two mountain marathons and various trail and adventure races. My main activity, however has been mountaineering and it is through this that I came to the rowing project.
I was based with the Royal Navy on the west coast of Scotland for eleven years and spent a lot of that time in the surrounding hills. Wanting a taste of something bigger, I went on an expedition to the Himalayas. It was on this trip that I came to meet my rowing partner, Scott McNaughton. We ended up being the only two on the trip to summit both peaks attempted and on our return there was a hunger for more. With this, Scott returned to the Himalyas in 2006 and summited Everest in late May. I had to settle for something a bit smaller in the shape of Mont Blanc but on his return we got together and were discussing his next major project when he asked me to partner him on the Atlantic row.
I joined the Royal Navy in 1991 as a Marine Engineer and after a four year apprenticeship, went on to serve in the submarine service for twelve years.
I transferred to surface ships in 2005, but before I had the chance to go back to sea I found out I was diabetic through a routine medical examination. This came as quite a surprise as I had no symptoms, no family history and also no knowledge of the condition. My initial concern was how I was going to continue in my sporting activities and what impact it was to have on my career. The RN have a policy of not allowing diabetics on submarines and not on surface ships if injecting. I was initially put on medication, taking Pioglitazone, soon to be combined with Gliclazide. This would have allowed me to serve on large ships with adequate medical facilities if my sugars were stable, but they kept on rising and so the medication dose was stepped up too until I was on the maximum dosages allowed.
During this time my career was put on hold and assessed by medical board to see how suitable I was for continued service. Because my condition was in a continuous state of flux, it was decided to wait until things were stable. This stability only came when I had to make the decision of either continuing with elevated blood sugars or moving onto an insulin regime. It was no-brainer as far as I was concerned, but obviously it had career implications. I started using insulin to control my diabetes in October 2006 and due to the RNs no sea service policy for injecting diabetics, and with the five years left to serve, they medically discharged me with effect from early September 2007.
As soon as I started on insulin, my blood sugars became very well controlled and it was a good feeling being more in control.
My insulin requirements were initially set at 10 units of slow acting glargine at night and to take one unit of quick acting novorapid for every 10g of carbohydrate at meal times.
With regards to dealing with my diabetes when excercising, it was initially a case of trial and error, but after being told by my specialist about the runsweet site, this opened my eyes to how other diabetics dealt with their insulin regimes during periods of exercise.
After this trial and error period, I found that if,for example I was going out on a long hill day, I would lower my night time dose to 8 units, take a normal dose with breakfast and then snack throughout the day without injecting and this would see my blood sugars at around 5-6 mmol/l at the end of the day. If I were to use the gym for a general workout of weights combined with 45 – 60 minutes cardiovascular, I normally used to either drink 200ml of sports drink or eat half a dozen dried apricots both without insulin before hand and repeat the same at the end of the session. This almost always had my blood sugars at around normal levels on completion, so I also applied this to times when I went running, varying quantities with the duration of the run, normally with success.
This was all very well when exercising with reasonable bouts of recovery, but when faced with our rowing project, I needed further advice.
Preparations
The bi-annual Atlantic rowing race starts in La Gomera in the Canaries and finishes 3000 miles and approximately 60 days later in Antigua. The race starts in early December in order to avoid the hurricane season! The boat is approximately 23 feet long and 7 feet wide and we were to row around the clock in a 2 hours on, 2 hours off routine.
The effect of such an endurance event on a diabetic was largely unknown, so this led me to Dr Gallen, who offered advice and back-up leading up to and during the race. We were also fortunate enough to have the services of Maximuscle, the sports drink company who provided sports drink powders for us to make up some of our calories.
Our training regime took the form of two or three weights sessions per week, each lasting around two hours and using all muscle groups. Also we were using rowing machines as our mainstay, combining threshold, recovery and long rows of typically one and a half to two hours with tempo rows, and in order to break things up, long slow runs and bike sessions were added in too. I applied the same policy as I did whenever visiting the gym with the addition of a sports drink to graze on due to the increased length of each session.
The problems we faced, apart from the hurricanes, sharks, tankers, etc… were based around the calorie intake and insulin requirements, so I took some blood sugar readings during a 2hour on/off spell on both the rowing machine and at sea on the boat. It was intended to do a trial, consuming some sports drink for the duration of the 2 hour session without any insulin and to observe blood sugars. This would allow us to see what CHO I was burning unaided during a session of two hours.
Using the machine, I found that if consuming sports drink with 75g CHO content, I was unable to keep my blood sugars up, so this was increased to around 110g CHO and my sugars were then more or less the same after the two hour session as before.
However slow you try to go on a rowing machine though, it is very hard to simulate the real thing, so a set of sugars were taken on our last training weekend at sea and 2on/off trial, and these showed that if the 75g CHO were consumed during the two hour shift and without insulin, then blood sugars were the same after the row as they were previously. This was constant for the duration of rowing these shifts for over 24 hours and along with consuming other foods with normal doses of insulin. My night-time dose was reduced to 8 units too.
This gave us a datum to work from and start out with, but the cumulative effects of this routine on my blood sugars were unknown, and it was expected that I would come to require very small quantities of insulin as the trip went on, so it was very much a work in progress from the start line, but as mentioned, Dr Gallen kindly offered to be on hand to provide advice and support from the UK.
The Crossing
During the crossing I took my blood sugars every two hours using the Accu-chek compact plus monitor, both before and after each rowing shift and these were uploaded onto our laptop computer using specially adapted software provided by Axon Telehealthcare. The results were beamed back to a server in the UK by use of a satellite phone and this allowed me not only to have my results continuously monitored, but to be able to ask for advice if needed and get feedback as required. The software also gave results in graph form so that trends could be seen.
We originally set out with the intention of consuming up to 7000 calories
per day, mainly consisting of our Maximuscle sports drinks. In order to consume this many calories, it was to be consumed in the form of 570 calories and 130g CHO per two hour session, taken with two litres of water (almost twice the amount from our trials). The session was to be followed by a recovery sports drink consisting of 290 calories and 55g CHO.
Also there were three re-hydrated meals at approximately 425 calories each with
the rest made up by a chocolate bar, protein bar, cereal bar, pepperami
stick and mixed nuts. The intention was to take insulin with all of the above with the exception of the sports drink consumed during the two hour session.
It was very apparent that from the beginning that this was not sustainable
as not only was there an uncomfortable need for the loo very frequently, but
the two hour sessions were not CHO neutral as I was taking in more CHO in order to boost calories and taking quick acting insulin for the excess CHO during the two hours was impractical. In reality, the ocean rowing is less intense and also harder to
get any consistent periods in. Blood sugars were significantly higher after
each session than before, so the sports drink was reduced to 86g CHO as of day 2. A further reduction was thought necessary the following day to 64g CHO per two hour session. This seemed to give the best blood sugar results after each row, maintaining the blood sugar at a level similar to that before the row.
I also found it difficult to consume the third meal each day, and mostly only consumed two. The rest of the food packs were eaten as and when.
I also found myself only taking on two or three of the recovery drinks
per day and sometimes none at all.
This all gave quite a hefty reduction in calorie intake per day (around
3200 less).
Even with this, I did not see any dramatic weight loss at first, although there was
some which was to be expected, mostly from the excesses of La Gomera in the
form of beer and Chinese food! By the end though, I had lost around 15kg of bodyweight!
Overall, my blood sugars were reasonably stable when doing all of the above and did not change for the duration of our crossing. On only three occasions did I feel mildly hypo and each of these was quickly rectified with a chocolate bar.
I also increased my Lantus dose from 10 to 12 units as of the 6th day, but I was
fluctuating between these two dosages for a long time anyway.
I didn’t feel overly fatigued with this amount of calories , but felt tired
as expected due to the sleeping patterns. I used my finger tips for testing and they hardened quite a bit due to testing 12 times a day, even with rotating fingers, making it harder to draw blood but this was probably down to using surgical spirit on my hands to stave off the blisters (which seemed to work).
Other issues we faced were the possibilities of hypos and hypers. My rowing partner, Scott sought advice on this, again from Dr Gallen and his team, and was instructed in the use of a glucagon kit to deal with a severe hypo. On the other end of the scale, if my sugars were to have risen along with ketone production, I would have had to increase my insulin and food intake and ensured I consumed lots of fluid, but in the event of not being able to keep anything down due for example to seasickness, we took a small quantity of saline bags and Scott was also taught how to administer a drip.
Marine Life
Initially wary of sharks, but although most probably there, never saw any.
Otherwise, saw around six pilot whales on first day, then nothing for a few weeks until we were treated to a 30 minute acrobatic display by around 30 or so dolphins at dusk. We were visited by dolphins again on several occasions including one night when you could hear but not see them.
Whale sightings became common, seeing what we believed to be pilot whales on several occasions. Like the dolphins, we were visited during the night which was quite eerie, and on one occasion we were circled for over two hours. The highlight of the whale sightings was on one morning when a large humpback whale broke the surface at quite a speed, totally escaping the water and then crashing back with great force. This took place at around 200 metres away, but we could clearly feel and hear the power of the whale. It was moving away from us at a great speed, but made us wary of the fact that it could smash us to pieces if we were in the way!
Flying fish were quite remarkable creatures too. We encountered these from entering the trade winds right up to the last miles. They leave the sea at an incredible speed before skimming along the waves for anything up to 100 metres before re-entering. This is unless they happen to find an ocean rowing boat in their path, or to Scott’s misfortune, an ocean rower. He was targeted on several occasions and I got away lightly by only getting hit once. Often we would find several dead fish on the deck when daylight came.
Around 1000 miles from the end, we came across a large turtle. It was going the other way, but turned around to investigate us and almost broke our rudder with its shell.
We were surprised to see a turtle so far away from land.
Also saw a couple of rays and scores of large fish, some very colourful having purple neon-like heads.
From very early on we were visited every day by a small bird which we found out to be a storm petrel. They follow ships, living off the scraps thrown overboard and with the meagre offerings we had it had to be very patient. It also visited at night and gave the appearance of being bat-like. They skim the waves and keep above by trailing a leg to gauge where the water is. We saw this several times and they give the impression that they are running along the waves.
During the last few days we saw frigate birds, which when observed from below look more like pterodactyls.
Weather Conditions
Treated to some pretty large waves from early on at around 20-30 feet high, but got a real treat just after New Year with the largest we experienced (40+ feet). These almost had us capsized. The boat was fine in these conditions so long as the waves didn’t break on us. Unfortunately one did when we were side on to it and hit us with great force. The deck of the boat was totally submerged and we heeled over at quite an angle. Frantic bailing and our bilge pump working to capacity saw us on an even keel soon after, but we felt quite vulnerable at this point. Once righted, we discovered one of the oars had broken but the experience gave us great confidence in the boat.
The heat sometimes became very intense – midday being almost unbearable at times and being in the cabin was like being in a sweat-box. The latter stages saw plenty of rain squalls which came in 10 minute batches but with quite an intensity at times, flattening the sea and bringing nil visibility.
The waves would also throw some surprises at us. Mostly you could gauge where a wave was going, but sometimes they would change direction at the last minute, swamping the deck. Occasionally we would get rogue waves hitting side on, again swamping the rower and sometimes knocking us clean off our seats.
We did get very benign conditions at times which allowed us to get in the water for a swim and also to scrape the hull free from barnacles. After checking for sharks, one of us would get in with the other holding a rope tied onto the swimmer. This could take some time and a constant vigil was required incase of a hungry shark.
When the squalls came, they would often bring strong winds with them, but not always in our favour. This was also the case of the trade winds, which at the latitudes we were in were supposed to be blowing in our favour. They were very inconsistent and brought about frustration by driving us away from our course for days at a time. When they were in our favour, we could get some good mileages and also some fun by surfing the waves brought with them. During the periods where we couldn’t row against the conditions, we would deploy our sea anchor, which is basically an underwater brake which when filled looks like a giant jellyfish. It allows you to sit relatively safely by keeping the boat pointing in the direction of the waves, yet slowing your drift down considerably. The down side of this, apart from lack of progress is that two of you have to share a cabin barely large enough for one! Discomfort is added to the frustration of not making progress, so these times weren’t the most enjoyable.
We experienced some spectacular lightening clouds on the horizon at times and were regularly treated to shooting stars, twice seeing meteor showers. Also saw fast moving objects in the sky which we gather were satellites and not UFOs!
Shipping Hazards
We encountered a few ships at the very beginning when close to the Canary Islands, always at night, but a call on the VHF ensured we avoided each other. Thereafter we saw several ships when crossing the shipping lanes, all passing by at a safe distance. We had technology on board which allowed us to detect any shipping giving us the speed and course it was on. This only helps when the ship is alert to being hailed over VHF which wasn’t the case on our last night at sea. We became aware of a ship bearing down on us during the early hours in the dark and could see its navigation lights getting closer and closer. After several attempts to make contact over VHF, we set off a flare to alert them. Fortunately this got their attention and they changed course, avoiding any mishap.
We also saw several yachts at a distance and were visited by the safety yacht three times to check all was well.
Health
My diabetes management was great. This was largely due to the support I received from the UK via the Axon software which allowed me to beam my blood sugar results, which I took every two hours, back home via satellite phone to be analysed by Dr Gallen. I could also see the trends myself, but the time we spent working out my carbohydrate intake and insulin regime before departure paid off as my blood sugars were relatively constant throughout. On only three occasions did I suffer mild hypos, but each time I was able put things right with a fix of chocolate.
Our general health was very good throughout, although the body took quite a pounding. All muscles ached as we were constantly thrown around, but worst affected was our fingers which when not in use, clawed up and became quite painful to use. Our backsides became very sore too, especially in the last third of the crossing where constant soakings caused salt sores and wouldn’t allow us to stay dry for any length of time. This gave us the feeling of sitting on sandpaper during each rowing shift and this only got worse as time wore on.
Mentally, we were subjected to sleep deprivation from our routine of two hours on and two hours off around the clock every day. This led to mild hallucinations, mainly audio. We heard barking dogs, ducks and rattling keys and on one occasion I saw a jelly baby cycle past! The sleeping patterns would also lead to comedic moments where the non-rower would get up and prepare for his turn on the oars or stare at his watch unsure of what he was doing, only to discover he was an hour early. This brought great amusement to the guy on the oars, but when on the receiving end, led to much confusion.
Boat and Provisions
The boat performed well for us and after our big-wave incident gave us great confidence as long as we were in it. One of the other teams pulled out of the race after only two days when one of them was washed overboard and spent 45 minutes in the water before being rescued. This showed how vulnerable we were, but we ensured this didn’t happen by wearing surfers ankle leashes tethered to the boat. We were happy that our preparation contributed largely towards our success, and part of this was down to the spares we carried. These allowed us to make repairs to or change any piece of kit that broke. In total we broke four oars, (two of them twice), two rowing gates and a set of seat wheels. We also had to make running repairs on our footplate steering system, but overall we were happy with the boats’ performance.
The duration of our crossing went past our expected time and as a consequence we ran out of our daily food parcels. We carried 64 days worth and as we came in on day 68, we went without the goodies contained in these for four days, but didn’t starve as there were plenty of dehydrated meals left over from the days when we could only consume two of the three meals on offer. As well as the food parcels running out, so did the loo roll, which fortunately lasted up to the very last day! The stove also decided to stop functioning on the last day too, so we were very lucky we arrived when we did.
Antigua
We finally crossed the finish line after 67 days, 10 hours and 10 minutes of rowing just as the sun was setting.
As English Harbour was an hours rowing away, we came into the harbour in darkness. This wasn’t for long, as once we were past the harbour entrance, a hooter went off and flares went up, lighting up the harbour fortifications and other yachts moored up. People were whooping and cheering all about the place and we set off a few flares of our own. Once at the harbour wall, we were met by over 30 people including family and other rowers. Getting onto dry land was a struggle with legs still being in sea going mode, so our first steps were extremely wayward. Champagne and Guinness was handed over and celebrations began.
Software to support this effort
Neil had some serious monitoring technolgy. Axon has developed application software which runs over the Internet. The system is referred to as the Axon

T4NET. The core software modules are a spin-out from technology developed at the Computer Laboratories at Kent University Canterbury.The system runs on a standard PC with an Internet connection.

Software

The T4NET software has been loaded onto a laptop PC

Hardware

Provided with a military grade laptop PC with built-in GPS.Accu-Chek blood glucose reader and an Accu-Chek Smart Pix device reader
Upload of Data to PC
The upload of data from the blood glucose meter involves pointing the Accu-Chek blood glucose meter at the Accu-Chek Smart Pix. Tell the Axon T4NET that you are uploading data. Press two buttons and wait for upload to be completed. Neil enters his insulin readings and CHO amounts into the Axon T4NET diary. The glucose results and diary entries are consolidated and Neil sees the results in graphic format instantly. Data is stored on the Laptop PC.
Upload from PC to Axon File Servers
The satellite phone is connected to the Laptop PC via a serial port cable. The satellite phone then works as a modem to send all of Neil’s data via Satellites in orbit onto the Internet and to File Servers

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