Phil Southerland’s Not Dead Yet: Memoir of a Bike Racer With Diabetes

Phil Southerland’s autobiography is an inspirational coming-of-age memoir about a type 1 baby who wasn’t supposed to live. But his doctor’s dismal prediction didn’t take into consideration his mother’s indefatigable determination that her baby would thrive no matter what, and Phil’s own fierce drive to conquer every single challenge he encountered, including his diabetes. It’s an engrossing book, a sports adventure story with a medical subplot and a roster of dynamic characters, the most dynamic of whom is Phil himself. If we could harness his energy, our dependence on foreign oil would be a thing of the past.

The bare bones of Phil’s story have been told so often that they have entered the realm of myth: How he was the youngest person ever diagnosed with diabetes at his hospital; how his mother defied the dire predictions of the medical establishment; how as a six-year-old, he was scared into managing his diabetes by the fear of losing his eyesight; how he met Joe Eldridge at a bike race and persuaded him to take control of his diabetes; and how the two of them originated Team Type 1. And then, of course, how Team Type 1 went on to win the storied Race Across America, proving that people with type 1 diabetes are capable of winning the most grueling of physical competitions. Since then, Phil has become a diabetes ambassador to the world, as well as the CEO and owner of a growing professional biking team and humanitarian organization that has a staff of 134 people.

But it’s the details of the story contained in Phil’s book that carry you through it in one sitting. It’s not only a memoir of diabetes and an inside look at the world of professional bike racing, but also a story of tigerish determination and the utter resolve to never give up, to win against all odds.

When we talked to Phil about writing a memoir at such a young age, he said, “I’ve made every mistake you can make in the world of diabetes, and learned from most of them. If my life and my stories and my lessons can ease the learning curve for everyone else out there with diabetes, help make their lives better, and maybe give them some new ideas about their dreams and goals, then why not tell that story?”

“I just want them to see that there really are no limits. There’s no dream that shouldn’t be dreamt because you have this disease, diabetes. Ultimately it’s the best thing that’s ever happened to me. I just wanted people to understand the story, the pathway to the team and its foundation, and how they can be a part of this team, of this group, as we work around the world trying to inspire people to take control and achieve their dreams.”

Phil’s dream for a while now has been getting Team Type 1 into the Tour de France. He says, “If you want to guarantee that you’re in the 2012 Tour de France, you have to be one of the top 18 teams in the world on November 15, 2011. Right now, I think we’re around the 25th ranked team out there, which is good, but we’ll be making improvements in our roster over the summer time. We should be all set on November 15 of this year to have a guarantee that we’ll be in not only the Tour de France, but also every major race in the world in 2012. That’s been my dream, that’s been my goal, and I’m so excited that we’re getting closer.”

Phil has a couple of other noteworthy projects in the works. He says, “We’re in the process of working with the Ministry of Health in Rwanda, the IDF and Rwanda Diabetes Association, the CDC, and the US Embassy, all coming together to build a blueprint for diabetes care and education and supplies in developing countries. We’re also working with researchers from the University of Pittsburg, with the goal of measuring outcome. They will do a clinical outcomes-based study over two years of delivery of four to six test strips a day, insulin, and education to the healthcare providers in Rwanda, and then see how we do from a clinical standpoint on the A1C. Right now, the average A1C there is 10.9%, so there is much room for improvement. We want to build that blueprint and then help rubber stamp it into all the developing countries around the world, making sure that everyone has supplies.”

“And then we’ve also launched a diabetes sports research institute that will be doing some studies during the Tour of California in May, which is the biggest bike race here in America. We’ll be putting CGMs on non-diabetic athletes, to find out what non-diabetics do during exercise that we don’t do currently. We want to find out what should be our target for leveling the playing field.”

Phil was formerly on the Omnipod pump, but has returned to multiple daily injections using Sanofi-aventis basal and rapid-acting insulins. He says, “I think the lesson and the curse of diabetes is that there is no cookie-cutter way to manage it. We all have to take different steps. The move back to injections was really just personal preference. When I was on a pump, it took a lot of tweaking to get the basal rates perfect for bike racing. It really was just a lot simpler to be on shots.”

“I had an A1C of 5.1% when I was on the pump, and it’s between 4.8% and 5.2% on shots. My message to the general public would be just because your doctor is telling you to get on a pump, that doesn’t mean you need to get on a pump. On the flip side, if you want to use a pump, and it’s going to mean that you are going to be more empowered to take control, get on a pump. You have to do what feels most natural for you and is going to really allow you to take control.”

Phil points out that for him, the real foundation of good diabetes control is monitoring his blood sugar. He says, “I find diabetes easier to control when I’m on the CGM. It not only tells you where you are, but is a fortuneteller of where you’re going to be. It’s interesting that with a CGM, I do a lot more injections. Most days, I’m doing about 10 injections a day. Some might say, ‘Wow, that’s insane,’ but by doing more injections, I’m actually using less insulin. If for some reason my blood sugar is 300, I have to do a six- or seven-unit bolus. But if I can do three one-unit injections that keep me from ever going above 150, that’s much better than one six-unit injection to bring me down from 300.”

“Diabetes can be difficult,” Phil admits. “There’s no other disease out there that everything that you do in life has an impact on what your next blood sugar is going to be. Am I standing and moving my arms right now, and what’s that going to do to my blood sugar? Or am I sitting and eating food, and what’s that going to do? It’s a tough pill to swallow.”

“Yes, I still get frustrated with diabetes at times. I want people to realize that I don’t wake up and have perfect blood sugars all the time. No matter whether it’s me, or Gary Hall, Jr., or the other professional athletes out there, we have the same challenges, we have the same problems and we work on the same playing field when it comes to diabetes. Last night when I thought I was going to bed with a perfect blood sugar, I woke up in the middle of the night with a not-so-perfect blood sugar. It’s frustrating, but hopefully I can make some adjustments tonight so that tomorrow is a better day. I think the big factor in where your next step is going to land is attitude. It’s all in how you want to perceive it.”

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