An interview with Tommy Neal

Wednesday, February 8, 2012

On January 14, 2012, Tommy Neal ran into the history books by finally bringing a diabetic runner back to Olympic Marathon Trials. Twelve years earlier, Missy Foy became the first diabetic athlete in history to compete in Olympic Marathon Trials when she qualified for and ran in the 2000 Olympic Marathon Trials in Columbia. Tommy recently spent a week at the Foy’s home in North Carolina. With questions submitted by readers of Missy’s website and from those who have been following the new Team Type 1 Running Team (who sponsored Tommy’s training camp in North Carolina), here is an interview with this rising star on the U.S. professional running circuit.

Missy: Thank you so much for taking the time to do this interview. There have been a lot of questions submitted, so I’ve tried to group them together. Before we get to the questions, though, can you start out by telling us a little bit about your running career so far?

Tommy: Well, thanks for having me out here and thanks to the people at Team Type 1 for making it happen. This has been such a help. I grew up on a farm in Missouri. I actually started running because my mom made me run a mile before school every morning to use up some energy and keep me out of trouble. I became a top-ranked runner in high school and then went on to run in college for the University of Central Missouri. After college, I finally ended up in Colorado Springs, running for the Boulder Running Company’s Adidas team and being coached by Scott Simmons and Renato Canova, one of the best distance coaching combinations in the world. I had gotten my 5K time down to the low 14s and ran 29:32 for 10K and then ran 1:05 flat for the half marathon in Duluth, Minnesota in June, which qualified me for Olympic Marathon Trials.

Missy: So, at that moment, you thought your running career was taking off, right? What happened after the half marathon?

Tommy: Yeah, so shortly after the half marathon, the wheels fell off. Actually, things had started to happen even before that but I kept ignoring it. I had problems with really low energy, a series of bad workouts and races. I just didn’t feel right. I was constantly dehydrated and went from 145 pounds down to 128 pounds [note: Tommy is 6’ 2”]. Blood work showed a high hematocrit and high ferritin levels [note: iron stores]. I tried to lower my iron levels but still couldn’t keep up with training, so I went in for more blood work. My blood sugar was so high that they sent me straight to the emergency room. I felt bad, but not that bad, so I thought they were over-reacting.

Missy: I think for all of us, that day of diagnosis gets burned into our memories. I remember thinking that my running career was over.

Tommy: Oh yeah, definitely, I thought that was it. It was the nutritionist who gave me a little hope, telling me that running was actually good for my diabetes management. But, still, I just didn’t know what to expect. I couldn’t give myself a shot. The first time, I had to touch my skin with the needle first. I was like, oh okay, there it is. I would keep touching the needle on my skin, trying to find a place that wasn’t so sensitive, some place that I could get it in.

Missy: Okay, so this is probably a good place to get to the questions. The first questions: Do you use an insulin pump? How many times per day do you test your blood sugar?

Tommy: No, I don’t use an insulin pump because I’m still producing some insulin on my own. I use two different insulin pens, one with a rapid-acting insulin and one with a long-acting basal insulin. I test my blood sugar a lot. I test 6 to 10 times a day depending on what I’m doing. If it’s a workout day, like yesterday, it might come out to be ten or even fifteen times. What did we test something like five times during the tempo run?

Missy: Yeah, I think it was five times.

Tommy: If it’s a workout day, I want to stay on top of my blood sugar and prevent ketones, which can happen when I put in the hard efforts like with workouts and long runs. For racing, I have a plan for where I want my blood sugars in the days leading up to the race and it takes a lot of testing to stay on top of that. It’s not an easy thing to do so I test just about every time I eat or do something. Basically, I test a lot because I can’t make decisions about insulin and food and running if I don’t know what my blood sugar is and what it’s doing, like what the trend is. I need to know if it’s stable or if it’s going up or down.

Missy: The next set of questions deal with racing and with being a professional runner with diabetes. What is the most difficult part of having diabetes as an elite level runner? How do you prepare for races?

Tommy: The hardest thing right now is trying to balance everything. Once I inject insulin, it’s in my system and it’s not going to turn off just because my plans change. So, I have to schedule everything. I run twice a day and I work in between that. It’s really hard to make everything fit. I end up running in the dark a lot this time of year! But, even though I have diabetes, as an elite athlete I still have to push my body harder than the other guys I’m racing. And, if I think I’m sick and that there is a limit to my potential, then there is. I have to control my diabetes but at the end of the day I have to believe that I’m better than the other guys. As far as races … that’s a work in progress right now! That’s part of why I came out here. For Olympic Trials, I went with a basic plan of taking a little bit of insulin with a small breakfast several hours before the race and then stuck with water and Powergel during the race. I usually add electrolyte tablets to my water also. We practiced a race strategy yesterday with an 18 mile tempo run, a ton of blood sugar checks along the way as you drove around following me for 18 miles, and taking in Powergel and water at certain times. My blood sugar stayed pretty good. I think it was 122 at 5 miles and then stayed between 74 and 81 pretty much the whole way. You know, that’s what it’s about – you try to figure it out on these kinds of training runs.

Missy: The next set of questions all focus on your training in some way: What are your goals with running? What is your training like and what are you focusing on? What is a typical day like?

Tommy: Right now I want to run under 28.30 in the 10,000 meters during the spring track season to qualify for the Olympic Track and Field Trials. If I can keep my training in order and things continue to go as well as they’ve been going, I want to go for a win at the Penn Relays 10K. Then, this fall I plan to run a solid marathon, hopefully going solidly under 2:15. My training is really pretty typical for top level runners. I usually run between 100 and 140 miles/week with 2 or 3 hard workout sessions. The hard workout sessions usually involve running about 8 to 12 miles worth of 5:30 mile pace and maybe part of it as fast as 4:30 pace. Training at those paces and with that kind of volume will help me be able to maintain the effort I need at longer distances like that marathon. So, let’s see what was the other part of that?

Missy: A typical day.

Tommy: Oh, okay, right. I wake up at about 7 am, check my blood sugar, and then feed and water my chickens. For breakfast before my morning run, I will have a ½ cup of steel cut oats with a little of my parents’ raw honey, nutmeg, and almond milk. By 8:30, I’m out the door for my morning run, which is typically about 10 miles. I come home, check my blood sugar … it should be under 100 by then. I then fix a protein-based smoothie and adjust my insulin accordingly. My insulin to carb ratio is about 10 carbs to 1 unit. I also take my morning shot of Lantus [note: a long-acting basal insulin] then. I ride my bike to work, which is about 4 miles the hilly way or 6 miles the flat way, and eat a small snack when I get to work, check blood sugar, insulin if needed, etc. Depending on the day, I will run home or ride my bike home after work (I don’t really care what the weather is… yesterday it was -3 degrees wind chill). I will then fix dinner and have some nuts as snacks (almonds, peanuts, and cashews) while I’m waiting for my dinner to finish (maybe black beans with some veggies and spices), watch a little TV or play some video games, check my blood sugar, take my evening shot of Lantus, and then head to bed between 10 and 11. It’s not a very interesting life! And, it revolves around checking my blood sugar all the time!

Missy: Next question: Have you had to change anything about your training/coaching since being diagnosed?

Tommy: Yes, I carry Power Gels with me everywhere, just in case I start to go to low. I also do some sprints or hard uphills if I’m low when I start out the run so my glycogen stores will kick in and take care of it right away. I guess the main thing that’s different is how strict my schedule is now and how I have this constant calculator going on in the back of my head all the time … all the time.

Missy: What advice would you give to a diabetic runner about moving up to the marathon distance?

Tommy: Learn to love your gels for a quick sugar spike! But seriously, don’t increase just straight mileage, but increase the volume of your workouts too. You want to be able to run a lot but you want to run quality mileage for a good part of it.

Missy: What would you tell a high school runner with diabetes about training?

Tommy: Check your blood sugar often! Know what activities will raise your blood sugar and which ones lower your blood sugar. MOST importantly, pay attention to your diet and stick with natural foods and with low glycemic index foods like beans, steel cut oats, and vegetables.

Missy: The last question is a tough one; it’s from a sixth grader who says he wants to grow up to run faster than you! If you were offered a cure for your diabetes, would you take it and leave the rest of us behind?

Tommy: I would take it, a cure that is, and I believe so would everyone who has been diagnosed with any sickness. I would want you to take a cure if you had the opportunity and I didn’t. There’s no leaving anyone behind. There’s an old saying, “Remember, we’re all in this together.” My Grandma Doe always told me that and, well, she’s pretty wise.

Missy: Thanks for taking the time to answer questions and give all of us a peak into your life, Tommy.