Going For Gold

Gary Hall Jr. is a three time Olympic swimmer out of Phoenix, Arizona by way of Cincinnati, Ohio. A product of a strong swimming lineage, his father Gary Hall Sr., uncle Charles Keating Ill, and maternal grandfather, Charles Keating Jr., all have competed and won medals in previous Olympic games.

Hall Jr. himself competed in the 1996, 2000, and 2004 Olympic Games, winning a total of 10 medals. At only 21 years of age in the 1996 Olympics, he won two individual silver medals and two team relay golds, including helping set the world record in both the 400 meter freestyle and medley relays. Hall won 2 gold medals in the both individual and relay events in the 2000 Olympics and an additional gold in the 50 meter freestyle in 2004.

Although highly decorated, Greg Hall Jr. had to overcome being diagnosed with type-1 Diabetes Mellitus in 1999 before the 2000 Olympics. He faced a decision whether or not to give up swimming entirely.

I spoke with Gary about that tumultuous time in his career.

Hall was diagnosed in march of 1999, after we underwent the very typical stages of grief and shock he says he remembers there being few diabetic athlete standouts at the time. Most importantly, there were certainly no Olympic athletes.

Two separate doctors told Hall that his diagnosis would mean the end of his career. They told him the strenuous Eight or more hours he would have to spend practicing in the pool would be too great a risk for someone having to regulate their blood glucose levels with insulin injections.

Unsatisfied with this news, the determined Hall eventually sought the advice of Dr. Anne Peters, who he credits most for her encouragement to not give up early on. The UCLA (now USC) endocrinologist and her team worked closely with Hall to utilize his strict workouts positively to control his sugars, rather than as an obstacle. Gary Hall credits Dr. Peter immensely for helping him find a routine that ultimately allowed him to continue competitive swimming at the highest level.

When he returned to swimming competitively, he broke the world record in the men’s 50-meter freestyle race with a time of 21.76 seconds at the 2000 Olympic Games.

Most diabetics are instructed to regulate their diets and control their blood sugars with multiple insulin shots delivered through syringes and pens. Insulin pumps offer a lot of flexibility with the amount of insulin that can be delivered over specific periods of time, but can be burdensome, as they must remain attached to the body. Choosing which method of insulin delivery can be challenging, especially for a world-class competing athlete.

Hall noted that he alternated back and forth between wearing a pump and taking multiple injections as he trained for the Olympics Hall attempted unsuccessfully to wear an Omnipod pump in the water for training and meets as he adjusted to swimming as a diabetic. Unplugging his pump and no longer receiving basal insulin, his blood glucose levels would shoot up hundreds of points after a training session. Here he was competing in a sport where swimmers shave off their body hairs in attempts to gain an edge and facilitate speed. Hall on the hand was wearing injection sites for his pump that would fly off his body, forcing him to try such extreme measures and using duct tape to adhere the sites to his skin in the water. He settled finally on multiple injections for competition.

The daily activities of an athlete are so regimented; it’s nearly catastrophic when there are disruptions. Unfortunately, diabetic athletes are all too familiar with challenges which may disrupt their routines. When I asked Gary Hall what his biggest challenges were, he responded with his beliefs about the lack of resources for diabetic athletes on topics such as: post workout spikes, competition adrenaline spikes, and the differences in blood sugar management between anaerobic and aerobic workouts.

The best way to combat these challenges is to maintain a stringent routine of the same activities before competition. I am well aware that diabetic and non-diabetic athletes alike will follow a particular routine that works for them like a bible. I asked Gary to share with me his routine for the day leading up to a big race:

• Gary claimed he would test his blood sugar 20-25 times a day.
• He would carry his blood glucose meter with him at all times all the way up to the Ready-Room before a particular race (A small room near the pool where only competing athletes were allowed 5-10 minutes before each race)
• After the race he would test again, his blood sugar typically had shot up, sometimes up to 300 points
• He would then proceed to giving himself a bolus of insulin to get his blood sugar back down to a comfortable level (below 200) before it was time for his heat to participate in the next race

Despite all the precautions we take, diabetic athletes can still fall victim to complications related to their blood sugars. “Going Low” or experiencing hypoglycemia is a condition where blood glucose levels are too low. The body usually undergoes symptoms such as dizziness, sweating, and an elevated heart rate. If not treated, hypoglycemia’s can lead to seizure, coma, or death. Surprisingly, most diabetic athletes or far more concerned with not being able to compete than they are about their own safety.

Gary Hall recalls a hypoglycemic episode at the 2001 Goodwill Games in Australia. He remembered testing throughout the day, but approximately 15 minutes prior to the race, he checked his blood sugar (BS) on his meter and it read 60 mg/dl (anything under 80 is considered low and exercising at a two digit BS is not recommended). He quickly grabbed and drank a sports drink and waiting a few minutes before checking again. After the second reading he realized his blood sugar had actually dropped even more, and it was officially time to panic. He chugged down another sponsored sports drink in the ready room and grabbed a third on the way to the actual race. Holding his third sports drink during swimmer introductions, he gulped it down on the starting blocks legitimately moments before the sound of the gun. With a belly sloshing full of sugary hydrate, he started the race, but unfortunately vomited underwater at the 35 meter mark. Gary Hall Jr. solidified his cult hero status as he completed this task on national television, but still finished second in the race.

Hall admits his biggest fears related to going low include the serious risk of having a Seizure in the pool and drowning, but also the soul-crushing possibility of potentially having to stop what you love to do.  

On a more positive note, I asked Hall what he appreciated about his experiences participating in the Olympics as a diabetic athlete:

“I could not have imagined the level of support from the T1D community. I received letters of support from all over, motivating me to train harder.”

Hall continued to say his greatest accomplishments were being able to represent the USA and win on the greatest stage, and representing the entire diabetic population worldwide.

In November of 2008, Gary Hall Jr. retired from competition. Since retirement, Hall has been extremely involved in health initiatives related to diabetes and Type-2 diabetes prevention.

Alongside groups such as the Aspen Institute, the Clinton Foundation, the American college of sports medicine, and the T1D Exchange, Gary Hall works tirelessly with policymakers to improve the lives of Americans looking to take control of their health.

Hall is currently promoting “Project Play”, an initiative looking to increase youth access to physical activity and sport. Hall has testified before Congress and believes that when it comes to insurance, discounts that currently exist for corporate gym memberships and safe driving should be extended to children and families who consistently engage in physical activity and sport. He believes American children and families should be rewarded when they proactively protect themselves against obesity and Type-2 Diabetes.

When I asked him how he envisions the rest of us as citizens can help aid the cause, he replied that we should all be advocates. Anyone touched by diabetes in any way should open up and speak about the challenges he or she faces. He recalls that legislation back around the time of his diagnosis would not have allowed him to buy health insurance, despite being able to win a gold medal in the Olympics. Hall doesn’t believe in us as diabetics settling with the rules as they currently exist, and moving forward would like diabetics to have the ability to join the military. Overall, he preaches that more people should get involved.

I too agree more should be done, especially for those willing to work for their health and well being. I think we should all follow Gary Hall’s lead and take it upon each and every one of ourselves to promote initiatives beneficial to our cause.

When asked what other famous athletes or celebrities might’ve inspired Hall throughout his career, he chuckled and replied simply: “The people who touched me most weren’t world champions, they were ordinary folks doing what they loved, who wouldn’t be denied” In august of 2004, a 13-year-old version of myself sat and watched Gary Hall win the gold after a television segment explaining what he had gone through as a diabetic athlete aired. About a month later that boy would receive the news from his doctor that he too was diagnosed with Type-1 Diabetes. After recovering from the initial shock, he remembered Gary Hall Jr., and found comfort in knowing that he too could achieve his highest athletic dreams.

I will always be grateful for the inspiration given to me that year from Gary Hall, his performance encouraged diabetics and athletes across the world not to allow any shortcomings to stand in your way to greatness.

For more updates and tips on how to use fitness for diabetes management and prevention. Follow me on twitter @roycHealth !