Setting the standard
Phil Southerland is constantly on the move. As co-founder and CEO of cycling’s not-for-profit Team Type 1, he spent September in San Francisco; Orange County, Calif.; Las Vegas; St. Louis; Atlanta (home base, though he spent only one day there); Miami; Milwaukee; Newark, N.J.; and New York. September’s itinerary is typical; this year Southerland (BSA ’05) spent more than 200 days and 100,000 flight miles on the road, working via phone and computer to direct his team’s mission of helping diabetics live better lives.
But on this day in August he’s at Camp Kudzu near Cleveland, Ga., where kids with type 1 diabetes—like Southerland—come to play and learn how to better manage their disease. Tonight he’ll give a formal talk and share what he has learned as an athlete with diabetes, but for the moment Southerland, 27, is just another (big) kid having fun.
His arms and legs are painted with large red dots, the result of walking by art class at the wrong time. He’s gotten crafty, helping to create wooden battleships and felt pillows. He’s engaged in mock fights and been robbed repeatedly of his backpack. He’s pretty much the most popular guy here. Maybe the kids sense that Southerland is giving them something that he has very little of to spare—his time. And in the midst of pre-dodgeball chaos, he doesn’t miss an opportunity to share his mission. When one of the kids asks about Team Type 1, he doesn’t hesitate.
“I’m all about the Team Type 1. It’s for everybody with diabetes,” he says. “You’re part of it.”
The wrath of Joanna
Southerland was diagnosed with type 1 diabetes, also known as juvenile diabetes, at the age of seven months. He was nursing constantly but losing weight; doctors told his mother, Joanna Southerland, that he had the flu. When his symptoms persisted she took him to the emergency room. His weight was down from 21 pounds to 14, his skin was grey and his breathing was labored. Just hours away from death, he was finally diagnosed correctly.
“Phil was so young when he was diagnosed that the mortality rate for anyone at that age was 99.9 percent, so it was by the grace of God that he lived,” his mother says.
Diabetes is a group of diseases marked by high levels of blood glucose (or sugar) resulting from insulin resistance or defects in insulin production. Type 1 diabetics like Southerland produce very little or no insulin and depend on daily injections to control the levels of glucose in their blood. Type 2 diabetes accounts for 90 to 95 percent of all diagnosed cases and results when the body is deficient in or fails to properly use insulin. Type 2 diabetes often can be controlled with changes in diet and exercise, along with oral medication and sometimes insulin.
Phil’s diagnosis was just the first step in a long journey. The good news was that he would live; the bad news was that doctors didn’t expect him to live past the age of 25.
Joanna Southerland received this news about her son in 1982, well before the Internet made it easier to network with others in the same situation. Over time she learned how to make sure that Phil’s glucose level didn’t get too low—leading to seizures, passing out and possibly death—or too high—courting complications including amputation, blindness, heart disease and renal failure. Using the tools available at the time, she tested his glucose with urine she would wring from his diapers. When he was a year and a half old, blood glucose monitors made testing more accurate. In the beginning insulin took two hours to kick in, but gradually it got faster. And she discovered that Phil’s tendency to be active was helpful.
“It became increasingly evident as Phil got older that the more he moved around, the more his blood sugar would stay in a normal range, as long as you balanced it with food.”
At 12, Phil’s bike became a way to enjoy his favorite Snickers bars and to escape his mother’s nagging. He would ride his bike to the store, eat a Snickers, pedal around the neighborhood and come home with his blood sugar at a normal level. That meant he and Joanna wouldn’t have “the diabetes fight.”
Exercise was important to Joanna, who’d been a competitive water-skier and began teaching exercise classes while Phil and his younger brother, Jack, grew up. Phil was a natural athlete—he played football and baseball but discovered that coaches wouldn’t use him because he was “sick,” so he gravitated toward more individual sports. He was a swimmer and later a state racquetball champion, but in high school he got serious about cycling. After noticing that his performances improved when his blood sugar was under control, his competitive nature became an asset in the fight to manage his disease.
Phil started competing in races in their home of Tallahassee, Fla., and eventually traveled to races in other states. Joanna was nervous but prepared. His friends received a three-page document—she calls it The Wrath of Joanna—that outlined everything they needed to know.
“The disease is incredibly frustrating. You think that you have everything under control, and then you don’t, and you don’t know why,” Joanna says.
“God bless Phil, he never ever complained about diabetes. He just kept on keeping on.”
Team Type 1 was born in 2004 during a 300-mile bike ride from Athens to Tallahassee. While riding home for Christmas during his senior year, Phil Southerland contemplated the good feeling he’d gotten by helping his friend Joe Eldridge better manage his diabetes. The two met while racing—Southerland for UGA and Eldridge for Auburn University—and started comparing notes about their diabetes. Southerland noticed that Eldridge wasn’t managing his blood sugar very well and enticed him with a bet—whoever’s blood sugar was higher after a race would buy the other dinner. Eldridge bought burrito after burrito for three months before he finally took control, checking his blood sugar frequently and staying on top of insulin injections.
“Joe told me, ‘Hey man, thanks for your help. I’m going to change my life, I’m going to see my grandkids grow up,’” Southerland says. “That really struck a chord because I’d always been racing bikes just for me—to make money and have fun. Now I was like ‘I could race bikes for a reason.’”
Southerland and Eldridge formulated plans for a cycling team that would give them an opportunity to educate others about the importance of controlling diabetes. Using what they had learned, they would provide an example, proving that through diet, exercise and the use of the best treatments and technology available, any dream is achievable. They set a lofty goal—getting a rider with diabetes in the 2012 Tour de France, cycling’s premier road race.
In January 2005, Southerland began an agribusiness management class with Professor James Epperson. One third of his grade would be based on a business plan and though the students were supposed to develop ventures for profit, Southerland wanted to focus on a not-for-profit—Team Type 1. When Epperson challenged him to prove there was support for such a venture by conducting a survey, Southerland spent a day at the Mall of Georgia and came back with $400.
“He astonished me with his survey,” Epperson says. “He was already getting people ready to give him money, just in the class project survey. Not just saying that they would—they were ready to go.”
It was an early indication of the success Southerland would have in recruiting sponsors. His first big challenge was to raise $250,000 so the team could compete in the Race Across America, a grueling event of more than 3,000 miles from coast to coast. After raising money and forming a team of eight riders, Team Type 1 placed second in the 2006 race, its first big event. They came back the next year and won, then repeated that victory in 2009 with a record-breaking pace of five days, nine hours and five minutes. This year’s race was also the debut of Team Type 2, a group of non-professional cyclists with type 2 diabetes who completed the ride in seven days.
In just five years, Team Type 1 has expanded to include a pro men’s team, a pro women’s team, an elite team for developing new talent, a triathlon team and Team Type 2. That means 56 athletes, 65 percent of whom are diabetic. Collectively, the teams spend 900 days in the field each year working with and speaking to health care providers and educators as well as diabetes patients.
“The kids kind of look at you like you’re a superhero,” says Morgan Patton, a member of the pro women’s team.
Patton was diagnosed with type 1 diabetes at the age of 7. At 15, a self-described “brat,” Patton let her blood glucose level get well above the well above the American Diabetes Association’s recommended rate. Her doctor was concerned that she was doing irreversible damage to her body, and her parents were searching for answers when fate brought Patton’s mother and Joanna Southerland together one Friday during happy hour at a bar in Tallahassee.
After discovering that they both had diabetic kids, the two compared notes and Southerland had an idea. Phil was preparing for Team Type 1’s first Race Across America—perhaps Morgan could volunteer on the crew. When Phil said they were overstaffed, Joanna’s response was “Make room.” Patton flew to California and did grunt work like laundry and cleaning water bottles. She noticed the riders and crew checking their blood sugar a lot more than she ever had. And she set a new goal—becoming a cyclist.
“I was like, ‘I want to do that. I want to be faster than Phil,’” she says.
During the next two years Patton managed her diabetes aggressively, bringing her blood glucose level below the recommended rate and getting better results on the bike.
“Because of her we have a women’s pro team,” Phil Southerland says. “She’s now a role model and ambassador for young women struggling out there the way she did.”
Now 20, Patton says she doesn’t know where she would have ended up if she hadn’t found Team Type 1, but she suspects it might have been the hospital.
“It’s taught me that having diabetes is your disease, and only you can control it,” she says. “It’s given my life a positive direction.”
Doors and windows
2009 has been a big year for Team Type 1. The organization’s major sponsor, Sanofi Aventis (maker of Lantus long-acting and Apidra rapid-acting insulin, both of which Southerland uses), gave them a two-year commitment that will allow them to move the team’s headquarters to Atlanta next year and expand the roster. Team Type 2 achieved its goal of finishing the Race Across America, the first step in a campaign to reach out to an audience of 25 million type 2 diabetics. The pro men’s team earned its 100th victory. And Southerland and Eldridge appeared on the cover of the September issue of Diabetes Forecast magazine. But in the midst of all this success, Phil Southerland quietly has been accepting that his cycling career is over.
Southerland was sidelined last year by iliac artery endofibrosis, a condition not uncommon among elite cyclists and marked by damage to the arteries of the pelvis, groin or lower leg. The repetitive hip flexion, aerodynamic cycling position and high blood flow sustained during hundreds of hours of training causes the arteries to stretch, narrow or kink. During high-intensity exercise the blood flow decreases due to constriction or obstruction, causing numbness and lack of power. In May 2008 doctors operated on Southerland’s left leg, cutting through three layers of abdominal muscles to reach the artery.
After six months of rehabilitation and a winter of training, he was ready to race. But the numbness returned in March during the third stage of the Tour of Taiwan, the same place he first experienced the symptoms last year.
“It was 20 kilometers into the race, and when it happened it was like a knife into my back,” he says. “I knew the problem was back. Mentally that was a very tough pill for me to swallow.”
Southerland continued to ride, returning to Athens in April for the Twilight Criterium—his favorite race, and the reason he wanted to attend UGA. But by the end of the month it was clear that the problem was severe, and testing revealed that the blood pressure in his left leg was weaker than it had been before surgery.
“That was that,” he says. “This is what I’ve been working for for many years now, but the last four years were completely dedicated so that I could race my bike… It was pretty crushing.”
Eventually, he started thinking about what to do next.
“One night I decided ‘Screw it. I can’t ride, but that doesn’t mean I can’t live,’” he says. “So I signed up for the New York marathon.”
He started running the next day, hiring a coach and making plans to launch a Team Type 1 running team in 2010. Now he sees this as just another detour on a larger journey. So does his mother.
“I can’t imagine that he’s not pained by all this, that it’s not going to be him riding in the Tour de France,” Joanna Southerland says. “It just breaks my heart, but he now has 77 people working for him who are going out with this message of hope, and maybe he needs to take care of that. Maybe that’s why.”
At Camp Kudzu, the kids test their blood sugar several times a day under the supervision of staff. Southerland makes it into a game, asking each camper to guess his or her blood sugar before testing.
“Remember, it’s just a number,” says Alex Allen, Camp Kudzu’s executive director.
“Unless it’s perfect,” adds Southerland, “and then it’s…” He rolls his eyes upward and pushes his palms in the air, raising the roof.
“Phil’s specialty is being Phil,” Allen says. “He’s more engaged with the kids than the typical outside speaker. He sits with them at meals and talks to them; he’s very good at connecting with them.”
Southerland also connects with Team Type 1 fans via Facebook and a blog. He writes honestly about his struggles with diabetes control, encouraging others to use the tools at their disposal—diet, exercise and technology—to improve their lives. Their responses indicate that he’s making a difference.
“After seeing you in Diabetes Forecast, I now officially feel that anything is possible,” wrote one Facebook friend. “Keep up the good work… you’re my hero!”
Whether he’s riding in the team car during the Tour of Ireland, being interviewed on NBC or leading a conga line during a lunchtime sing-along at Camp Kudzu, Southerland is always working toward making his vision a reality.
“I fully believe I was put on this Earth to do something special in the diabetes world and help people live better lives,” he says. “Every second of every day that I can remember, I’ve dealt with this. I’ve done things right, I’ve done things wrong—I just hope that I can share my experiences and my mistakes with others so that they can do it better than I did.”
Team Type 1: http://www.teamtype1.org
Phil Southerland’s blog: http://philsoutherland.blogspot.com
Camp Kudzu: http://www.campkudzu.org
UGA Cycling: http://www.uga.edu/cycling