Planning for fear

Last week I entered a time capsule. It was dark, damp, and cold as we prepared dinner after hiking into a fog so dense that I was shocked when we came to the fork at the base of Sam’s Knob, left to the creek and right to the summit. We had crossed the entire field in front of the mountain without once seeing its mighty figure in front of us. We headed left towards the creekside campsites that I remembered from many years and times before. In fact, I camped beside Flat Laurel Creek during my first ever backpacking trip. That trip, maybe ten years earlier, had started much the same way – with a rainstorm forcing us to pile on every layer we had brought within the first few hours. This time, turning off the parkway and into the parking area for Sam’s Knob, we were the only car save for one. The two guys in the other car were milling about while we worked with raincoats and pack covers to protect ourselves from the intermittent rain showers that threatened to soak us and our gear before we began. They, young, clean, and looking a little lost, wandered over and asked, “Hey, would this be a good time for a hike?” It was chilly and windy, nearly 6 pm, raining lightly, and there was surely standing water in the trails. “Absolutely not,” I said. “This would be a miserable time for a hike,” as my hiking buddy continued to layer and arrange our supplies. “You should come back tomorrow,” I concluded, as we hoisted our packs. “It will be beautiful then.”

That’s what we were banking on anyway. We’d delayed the trip by one day, hard for me once I have my mind set on the woods, but it promised to be a better plan. While it had been raining for the previous day and night, sun and clear skies was forecasted. All we had to do was stay mildly warm and somewhat dry until morning.

I started this blog years ago, inspired by the lessons I learned about diabetes management and myself while backpacking. It diverged, first into kayaking and other outdoor adventures with diabetes, then into topics like acceptance and identity transformation. As I’ve gained experience and had successes problem-solving around unexpected moments with diabetes, like a malfunctioning pod moments before boarding a plane, insulin that overheated in another country, low blood sugars alone, and other occurrences that throw the brakes on every other priority you thought you had, these same moments become less noteworthy. It’s been more likely in recent years for diabetes to surprise me in a philosophical way. So, when I stuck a test strip into my meter to check my blood sugar while simultaneously tending the pan of lentils and rice heating on my little MSR camp stove, I didn’t just see the message, “WARNING – Temperature too cold. Out of operating range. See Owner’s Booklet,” I also saw my younger self; imagined her sitting by the creek ten years ago, overwhelmed by a shock of fear.

There she was, running through a script in her head of everything that could go wrong, of everything that she had to pack in order to survive in the woods. Should the list be so long for one night? Should the consequences be so grave? And then, to be foiled by something you could have never predicted so early in the diabetes game – a meter too cold to function. I felt like hugging her now, as I sat calmly contemplating the crane fly who had been drawn to the screen’s bright glow.

It occurred to me in that moment that sometimes you have to go back to the diabetes basics. It’s not all about the esoteric details of acceptance. Sometimes it’s about snuggling your meter in your sleeping bag as if it were hypothermic until works again. Of course, I gently removed the bug first. This time, I felt confident that my meter would resume functionality because I’d been through similar, though not exact, situations before. I also knew that I had packed an extra meter that was buried deep within the pack, likely in a warmer spot. I had reached for my meter preventively, not waiting until so much time had passed that I had no sense of what my blood sugar was. In short, I was prepared enough to be confident instead of afraid while addressing the issue. I don’t say this in an arrogant way. I fully anticipate moments of fear arising in the future – am planning on it. But zooming out on this small experience was a powerful reminder of how much I’ve learned and grown with this condition.

I was recently talking to my backpacking buddy about the process of learning to do things that I had loved before diagnosis, like camping and kayaking, and new things like backpacking, with diabetes. That process was never just about learning the details of management during different activities; it was equally a process of letting the fear subside. I likened it to what I’ve heard some people say parenting the second child is like. With the first child, you’re on guard for everything. Danger abounds. But by the second child, you’ve gotten through emergencies and been ok enough times to realize that you have more wiggle room than you thought. As I was journaling about this trip though, I realized that it’s also about what those experiences teach you in terms of preparation. I remember being so disturbed when I was first diagnosed that I could no longer run off into the woods and survive “on my own.” That I was dependent not just on two types of insulin, but on meters and batteries and test strips and ketone strips and glucagon kits and glucose tabs and carbs and lancets and alcohol swabs and lancet devices and pen needles and frio packs© and backup of all those things – and that’s just diabetes. All these details and what to do with them and when. It wasn’t really that I was learning how to backpack with diabetes, but more like I was learning how to diabetes through backpacking. Of course, not just through backpacking. I’ve learned the most about diabetes by stepping out my comfort zone. Now, the woods have always been a comfortable zone for me, but the only truly comfortable diabetes zone is near the kitchen with all your supplies and an omniscient level of knowledge about what’s going on in your body. So, traveling, camping, or any other significant change to your routine presents the opportunity for a loss of control and subsequently, inevitable fear. My moments of fear with diabetes have taught me the most about how to handle it, what my margin of error is, and what it takes to be prepared in various situations, known and unknown.

When we reached Flat Laurel Creek, we found it had become a swirling, copper-colored river. I was overcome by its transformation; still beautiful, but ominous in its power. Part of why backpacking has felt like more of an escape even than usual during this pandemic time, is that being outside reminds me that our expectations for constancy are not mirrored by the Earth. Because, as I discussed last post I cannot predict the future, being prepared becomes a process of planning for things to look differently than the ideal. With backpacking, this is a fine line, because weight really does matter and discomfort and danger are two very different things. Sometimes, I find that because my mind is so preoccupied with packing everything I need for diabetes, I forget the importance of all the other gear. I over-emphasize diabetes preparedness as if it were isolated from the rest of me, but as previously mentioned, diabetes is just a bonus on top of all the other processes of survival, like staying warm, fed, and hydrated. So, recently, as I considered whether I could cut some of the weight that I add with diabetes supplies by just being dirtier, aka packing less clothes, I thought about dropping my customary backup pair of socks. I mean, if they get wet I can just dry them out, right? After splashing through several puddles in my decade-old hiking boots that were once waterproof, I was thankful that I had not yet enacted that plan. My feet were wet and I knew they would be cold soon if I didn’t act. For me this feels scary. Once my feet get cold, they just won’t warm back up on their own, which usually leads the rest of me to chill. I didn’t want to become like my meter, too cold to operate. The clouds hung heavy overhead and the wind was picking up, making the little stove work extra hard as I fumbled around in my pack to find the smaller bag that contained my clothes. My hiking companion was off searching for firewood as an exercise in optimism that we gave up on shortly after. Unzipping the smaller bag, I sorted through the layers I had brought – booties, long underwear, and then, just as I began to worry that I had left my spare pair in the car, my teal wool socks appeared. I layered my down booties over them and curled my feet under my body as much as possible. After a (finally) hot dinner I was feeling, if not toasty, warm enough.

Right before curling into the tent, after scraping the last bit of dinner from the pan and tidying our food and toothpaste into the bear canister, the clouds broke and the deep night sky emerged into view. The nearly full moon shone a spotlight on my yellow tent pitched in the middle of a small clearing by the little fork of Flat Laurel. I can’t say I slept warmly, but rested peacefully, nevertheless. The next morning was perfectly cloudless – not even the lightest dappling of shadows. Our solitude at Sam’s Knob quietly evaporated and was replaced by the voices of hikers ringing out as they passed by. After a breakfast of strong instant coffee and sweet instant oatmeal nestled amongst the Mountain Angelica and Ash, we were off.

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Free Range Humans

Against a deep black sky, a perfectly halved moon illuminated our small campsite set within the welcoming confines of a scrubby circle of tall grasses and short trees. Nearby, a tributary flowing down into Flat Laurel Creek gurgled the sound of its boundary.

We arrived at our home for the evening before nightfall, when the sun was just releasing its hold on the day. We’d hiked since noon, eating a picnic lunch on the crest of Tennant Mountain, right below the plaque that marks its peak. We hiked over wet and rocky trails where blobs of clear eggs, punctuated by the promise of new frog life, bobbed in pools and puddles. The only other real wildlife we saw was a pack of undergrad males on their spring break, all having reunited in Pisgah Forest from their various schools.

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I hadn’t been back in the mountains, like really back in them, since I moved away from AVL in August. I was afraid to return sooner – afraid that if I didn’t separate myself enough and bond with the land and people in the Piedmont that I’d just live in the mountains in my mind instead of in the world all around me. But coming back home on this trip to Black Balsam and Sam’s Knob felt solid. My friend from school, my backpacking buddy two trips in a row now, couldn’t stop commenting on just how perfect everything was. That’s a heavy word and yet she was so right. You know those moments when you have an awareness of how totally happy and satisfied you are at the time? The whole trip was like that for both of us (I’m willing to say from our continual debriefing). And I was aware, maybe because we’d spent the previous week running from classroom to computer to meetings to google hangouts, that it was so perfect because we had so much less. So much less stimulation, so many fewer options, so many less modes of communication.

And yet I felt more connected.

Laying under the stars, dreaming of life thousands of years ago, my mind was at peace.

It was a good break for my mind all the way around. Only reflecting back now, since this is a blog about life with diabetes, do I realize that thoughts about diabetes don’t dominate any aspect of the trip (except one, and I’ll get there). Of course I thought about diabetes the whole time, as a backdrop to everything else, but I didn’t notice so much that I was thinking about it. It didn’t frustrate me to be thinking about it and I didn’t worry about it. When I reached a level of competency with diabetes I assumed that I had grown with it as far as I would. I had learned that diabetes was in fact manageable but thought that it would never get easier. And that is true; the actual management and burden of diabetes doesn’t necessarily get easier in and of itself, although it does change. But it’s sort of like (I would imagine) a marathon runner training for something and then experiencing a level of ease with certain aspects of it. Yes the last couple miles, or shaving speed, or steep courses, are still a challenge, but there is a certain level of ease with running a distance that to me, a non-runner, seems insurmountable.

Ok, so I mentioned that one aspect of the trip when diabetes did announce itself loudly: the great Bear vs. Nightime-Low debate. If you’re a person with T1d you understand that you can’t go to sleep without knowing where the food is in the house. For me, I keep a honey bear right by my bed. But when I’m backpacking, my goal is to keep bears far, far away from my bed. So what to do?

And I really don’t know. What we did was secure and hang our food appropriately, far, far away from our campsite. One of the recent times that I went backpacking I had to tear the bear bag down from a tree in the middle of the night to get to more carbohydrates, and I just wasn’t prepared to do that again, so I decided to keep two honey zinger packets in the tent.

Sure enough I woke up in the middle of the night with a serious low. I’m not proud of these backpacking lows and I’m still trying to work them out. Walking all day with an extra 30-50 lbs. on my back exhausts my muscles in an unusual way. Even if I got to bed at 175 mg/dl, with very little insulin on board, I could wake up in the 30’s, like I did on this trip. Luckily I had the zingers. This time I stored them in my empty nalgene, which I thought, with it’s good seal, thick plastic, and odor of aquamura, would deter a bear as well as anything else I had. A pelican case could be another option.

So here’s the part where I need some diabexpertise: what do people with T1d who backpack do when they’re camping, say out West, where the stakes involve grizzlies? What do you do here in the East? I really appreciate your comments and dialogue!

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Give the Piedmont a Chance

Twenty-eight years and I don’t think I’ve ever missed a Fall in the mountains – until now. The suburbs of Atlanta where I grew up never felt like home, but I still remember being instantly embraced by the mountains on family travels. When I was a little over a year old, my parents carried me up Mt. LeConte, swaddled against the misty cold in a trash-bag poncho. We spent weekends in our cabin in Toccoa, GA, nestled in a soft pine forest interspersed with tall poplars and beech trees.

During high school my dad and I traveled from Atlanta to Wesser, NC, on Friday afternoons so we could launch into the icy waters of the Nantahala and feel the crisp breezes that sweep through the gorge in early Fall. Needless to say, moving to Asheville a decade ago was more like coming home than leaving it.

In August of this year I loaded up my belongings and drove away from my rented bungalow, my roommate for the past four years, a street full of friends, my nephew who came into the world just a few months before, my job and my mountains. I’m pursuing an MPH at UNC Chapel Hill, so leaving my job felt like a natural progression. The telephone, email and even Facebook help me stay in touch with friends and family. But you can’t call the mountains. I’ve scrolled back through my photo reel, read my old poetry, and meditated with their image in my mind, but still my heart aches for them. Their support and unwavering presence has always inspired me to seek that sort of peace in myself.

Maybe it was an effort to be strong like the mountains, probably it was just self-protection, but I decided I needed to stay in the triangle over fall-break. I would never miss the woods in October, so a girlfriend and I decided to make our Piedmont backpacking dreams a reality.

Read the rest here:

http://www.blueridgeoutdoors.com/hiking/give-the-piedmont-a-chance/

 

Getting Found in Lost Cove

Here’s a link to a recent article from Blue Ridge Outdoors online that I wrote after a backpacking trip with a bunch of friends in the Wilson’s Creek area of NC. It reminded me how much my friends care about my health and well-being and the way that Type 1 makes me think on my feet!

http://www.blueridgeoutdoors.com/go-outside/getting-found-in-lost-cove/

This is my friend Laura and I, super excited about life and the trail!
This is my friend Laura and I, super excited about life and the trail!

Ponies, pods, and Backpackin’ with Diabetes

I’m waking up dreaming of the trail and wishing that I was still out there in Grayson Highlands on the AT, trudging along with my loaded down pack and passing fields of wild ponies.

I want to talk in this blog post about packing the backpack with diabetes in mind because it’s a challenge on a physical and emotional level. Whenever I get ready for a backpacking trip, especially the first one of the season, I experience some level of dread at the thought of forgetting something vital. When I’m going through my mental and paper list I find myself playing through some of the ‘what if’ scenarios, that I might encounter if my pod alarmed, if my insulin vial broke or got too hot, if my pdm malfunctioned all together. To a large extent this sort of preventive troubleshooting is necessary, and it’s a little necessary, or has been for me, to spiral into the worst case scenario so that I’m literally prepared for it, because that is what T1 diabetes requires.

The problem for me is when that attitude carries over into the rest of my packing, and sometimes my life in general. I think the necessary preparedness of Type 1 makes it easier for me to keep this worst case scenario thinking, which often leaves me with a very heavy pack and a pretty stressed out mind, until I get about a mile down the trail and feel my whole body and being relax into the mountains.

On our trip this past weekend this moment came decisively after we had crested a small windswept knoll and entered a calm stretch of forest full of ferns and rhododendron, tulip poplar and beech trees. I was breathing heavier because my pack was so gigantic and on one inhale it felt as if I’d taken in the peace and simplicity around me. I exhaled out and came into the environment and felt my worries about the future and the stress I was holding onto from the past week fall away completely.

I did find that I could have left out a lot from my load. After all the necessary diabetes supplies and back-up supplies were in I didn’t have much time for finesse with the rest of my packing. Next time I will not throw in a whole pack of tortillas for one overnight trip in which I might eat 3, maybe 4 maximum. I won’t bring tupperware, but instead will use baggies for my celery and carrots. I won’t bring 5 oranges! Whoops. I wasn’t counting, I was just tossing things in.
I also probably didn’t need two water filtration systems on a trip with others who were bringing their own method too, but this is something I go back and fort on. I have really enjoyed using aqua mura because to me it is simple, I know it’s working, and it tastes…frankly I like the way it tastes which is almost imperceptible, but a little lemony. However I’m looking for any good water filtration recommendations and leaning towards a ‘Sawyer System’ that my friend recommended.

I plan on designing some methods and gear to help myself stay organized and cut weight on the trail, but I’m not there yet. Right now all I can think about is the next trip. One thing I won’t cut out is the tiny bottle of hot sauce I brought, because it easily pushed our food experience from good to great.
Wearing the pump was a really positive experience on the trail but only because I avoided disaster and changed a pod early the night before we set-off. I could see in the pod window that a little blood was pulling up and even though I was getting insulin because I was trending low, I decided to change it there on my wooden cot, versus in the woods. As soon as I removed the pod blood streamed from the infusion site and I knew I would have soon enough encountered a problem with poor absorption. My next placement seemed perfect, pod right below where my waist belt would fall, and it held firm the whole trip. I was also able to turn my basal rate way down and lessen the constant lows that I usually just eat my way through, drinking honey straight from a honey bear or eating clif shot bloks or glucose tab after glucose tab on the trail. I still ate constantly, but my mind was clear and my body felt strong most of the time.

I’m eager to hear any other T1’s experience’s hiking and backpacking, so please leave your tips and comments!

Carrying the Weight: Backpacking with Diabetes

When I was first with diagnosed with Type 1 diabetes, backpacking became yet another line on my mental list of things I’d probably not be able to do now that I was managing such a complicated condition.

Although the first thing they reassured me of (while I was still in the ER, without me asking), was that with the advent of modern technology, I would be able to safely have children, they did not assure me I’d still be able to romp through mountain streams, swim in crystal clear pools, and sleep under the stars. They did not go so far as to assure me that I’d still be able to stretch my skirt over my kayak and paddle all day, or travel to third world countries. Needless to say, the first consolation did not address my main concerns.

Read on below:

http://www.blueridgeoutdoors.com/hiking/backpacking-with-diabetes/

A Backpack and a Paper Home

September 2011

Well, it’s been a long, busy road since my last post – taking me out of N.C. and into France. From there I traveled through Switzerland, into the edge of Austria, up into the corner of Germany and back again to my home base in the Loire Valley. Along the way I stopped in Zurich, Montreaux, Chamonix, and other parts of France. I carried my insulin in frio packs from hostel to hostel, sometimes finding a refrigerator and sometimes continuing to re-wet the pack every day or so to keep them cold. I ate an elaborate array of cheeses and pates in Paris, sausage and pretzel breads in Austria, and not much in Switzerland since everything was so expensive! It was a bread-filled time for me, lots of baguettes and butter, but also a lot of walking. Traveling for 2.5 months without a car necessitates a lot of time on your feet. And for a month of that I carried a 40 lb. backpack with me, full of medical supplies, clothes, hiking boots, and the essential memory recording equipment; a journal, camera, and two sketchpads. This was a solo adventure for me in many ways, even through the times that I was with friends or my french family. It was part of my journey towards feeling unrestrained, and yet in many ways I did feel constricted for parts of it. I realize in hindsight how that has opened up my life now; how like in yoga class after an intense twist your body is filled with oxygen and energy once you release the bind. I feel a new sense of direction and motivation after my trip that releases at unexpected moments.

Diabetically speaking, carrying my supplies was less of a hassle and challenge than I expected. I guess I’m getting better at it. When I traveled in Costa Rica during my Junior year of college, I had a lot of scary lows, a lot of fear over not having my supplies or finding myself unprepared and without access to what I needed, food or medical-wise. But even though I traveled for much of the time alone, staying in hostels where no one knew I was diabetic and even if I’d wanted to tell them I might have had to do it in German (French and Spanish I can do, but there are so many languages in Europe!), I don’t have any poignant memories of diabetes impeding what I wanted to do. Realizing that makes me want to shout with joy. I have become accepting of this condition to the point that I was surprised to suddenly recognize at some point that I had not been thinking about it. That is like stage three acceptance! (I have a feeling there are many more stages).

So I want to talk more about the trip, but my brain is already catapulting into the future with dreams and plans of my life as a nutritionist, diabetes educator, and food policy activist. Maybe I’ll never call diabetes a blessing in disguise, but it is really powerful for me to admit that having this condition has and still is shaping my passion, my drive, and my relationship with my body for the better. It is even shaping my career choices at this point, and I am so excited to be on the cusp of dealing with this global epidemic that is such an indicator of the pressing issues of our time. The rise in diabetes correlates with our disconnection and disharmony with the Earth, it follows poverty and economic inequality, it speaks to racial and economic separation, it illustrates how our lifestyles and priorities have so rapidly changed, largely affected by media and marketing.

Whoo, I feel I’m off on a tangent. I am experimenting with using this technology information share free-for-all as a way to be more connected, not less so, and I think blogging is an amazing way to empower the individual. Between managing a new job and diabetes it’s hard to find time to write, but writing is one way I manage my stress, and stress is the main culprit in my diabetes management. I kept a journal all through my trip and wrote in it nearly everyday – I think it served as a friend and comfort to me through my lonely times, of which there were many. Journaling for me is a way to jump into a self-expression that requires no explanation, no background, and no structure; no sense has to be made. It almost always grounds me when I am floating for some reason or the other, maybe it’s traveling, searching for a job and purpose, or uncertainty in my relationships. It is for me, and it is simple. In a world of complicated diabetes management that changes everyday, my journal is stable and always ready to listen. In a strange way it holds me accountable to myself as well. I have read back over past journals and realized that at some level I knew all along whether a situation was going to be healthy or sustainable for me, even if I have not always heeded that intuition. I’ve realized too that I have the power to view diabetes as a blessing and the lessons that it has brought to me as gifts, all through reassuring myself before I ever needed reassuring. It is powerful and amazing to honor yourself by recording whatever speaks to you in the moment.

Diabetic Backpacking Pack List

October 2011

SUPPLIES
Take an Original + a Back-up that you store somewhere different in your pack or in your partner’s
Glucagon kit (know how to use it and teach your hiking partners)
Meter + xtra batteries
Test Strips
Pen Needles (double what you’ll need)
Syringes (as many as you’d need if your pens malfunction)
2 forms of each insulin you use
Example: Novonordisk insulin pen
Novolog vial
Lantus Flexpen
Lantus Vials
What if your vials break! What if your pen breaks? Do you have backup? Do you have enough of a method of delivery (pen needles/syringes) to use just one form for your whole trip?
Hand Sanitizer
Hand Wipes
Lancets
Lancet Device
PELICAN CASE!So useful for all water susceptible devices and supplies. I keep my meter, test strips, a few pen needles, and an insulin pen of each type in my pelican case along with some hand wipes. One kit for all your diabetic needs during a break.
Frio Packs!Another wonderful invention that is especially useful on the trail. Frio packs have an inner layer of dry crystals that retain moisture and keep supplies cool. The packs can be re-wet in a cold mountain stream when they begin to warm up and dry out.

FOOD!

Essential food supplies will cover all of your carbohydrate needs if you are low. In addition you will need power food that you can snack on and enjoy that won’t be pure carbohydrate. Here are some tips:
Bring a lightweight mug and a spoon!
Straight-up carbs:
* A full plastic tube of honey – I take 12 oz. and have made it through half of this on just a one night trip. Be over prepared.
*granola bars
*dried fruit
*crackers*Fruitabu organic fruit roll-ups (taste good, no added sugar, organic fruit!)Real Food food:Breakfast Example:*Organic instant oatmeal packets (3 for two people) – add hot water – add freshly picked mountain blueberries – add walnut pieces
+ Coffee! = hot and delicious and slow to release carbohydrates
Lunch Example:
*Low-Carb spinach tortillas – I like “OLE Xtreme Wellness
+ powdered hummus (fantastic foods) just add water (the oil is superfluous)
+ fresh basil leaves+ Shelton’s Turkey Jerky
Note:  chew well, turkey jerky is not your usual sandwich meat.
Follow with one low-carb whole wheat tortilla spread with NUTELLA, sprinkled with cranberries and walnut pieces
Dinner Time!:
Darn’ Good Chili from Bear Creek or Bear Mountain, something along those lines
(just add hot water, stir and simmer
+ Dr. Kracker crackers in pumpkin seed cheddar flavor as edible spoons
* throw in a can of veggies, fresh herbs, or eat with carrot sticks for some fiber and nutrients
* munch on jerky for protein, or just enjoy plant protein from the beans

On one or two night trips simply rearranging a few ingredients has proved delicious and different enough to keep us pretty happy.

Miscellaneous Considerations:

*Bring a phone but keep it turned off so that you can check the time but not risk receiving a call if you hit an area with service.  What a bummer to hear a phone ring in the woods.
*Coffee
*Warm clothes, especially rain gear should always be in your pack.  The first trip of the summer we did was in June and by afternoon we were soaked and freezing despite leaving the city on an 85 degree day.
*Extra contacts and your glasses if you require them
*A headlamp! + xtra batteries
*nutella
*Water bottles (@ least two nalgenes each)
*Water filtration system (We carry a pump and laser purifier) + backup (either iodine tablets or xtra method)
*a Map (and know how to read it)
*Flame Orange Vest (if you’re going in hunting season)
*a lighter and matches
*coffee
*Sock Liners (no more blisters protect those feet!)
*bandaids + first-aid kit, benadryl, neosporin, alcohol wipes, etc.)
*biodegradable soap for poison ivy contact, dirty hands, etc
*t.p. and trowel
*plastic bags
*nutella
*Swiss Army Knife
*Camera!
*and all those other backpacking things you can find out about online or in an REI catalogue or from friends who go, like a sleeping bag, etc.
 – This is by no means a comprehensive list, it is just the things I’ve found particularly helpful/essential for me on the trail. I would say to make a written list of your diabetic supplies and pack that in advance, ensuring you have functioning supplies and backup.  Go over your list and go through a typical day in your head to make sure you don’t leave any supplies out.  Teach your partner/s about diabetes and your routine, as well as what changes to look for in your behavior that would indicate low or high blood sugar.  Teach them how to use a glucagon kit.  You should have a kit and your partner should have one in their pack.  Honey is a particularly valuable carb because it can be squeezed directly in your mouth if you encounter a severe low without the risk of choking.  Tell your partner/partners that if you are coming up from a barely conscious or unconscious low, to roll you on your side to avoid choking risk because vomiting is likely.  These things do not make for a very sexy talk, but the more you and your partners know the more you can enjoy your trip and not worry about your health. 

Carrying the weight: Backpacking with Diabetes/2011

Disclaimer: I plan to write about my adventures and daily experiences as a Type 1 Diabetic, offering stories, tips, and questions to ponder. I do not consider myself an expert in anything that I can think of right now, nor am I certified or any type of authority on backpacking, paddling, or any other activity I may write about. So, in the words of LeVar Burton, “Don’t take my word for it.” But, enjoy reading and feel free to share your experiences so we can all understand that everyone’s life is an adventure of adaptation and acceptance!

Blogging is the perfect activity after hiking 35 miles in two and a half days. It takes a lot for me to be mellow enough to just sit down for awhile. My blood sugar dictates my activity level quite frequently; if it is low I’m making a snack, if it is high I’m putting on my running shoes to go exercise it down. But today is a rest day, no matter what it says, because my legs are sore. That being said, the main inspiration for this blog is the place of acceptance I’ve finally reached where diabetes is not my enemy, it is just my life, and by choosing to embrace it I can live joyously, safely, and fully.

My backpacking partner Jamie and I left our Asheville homes on Saturday headed for the Nantahala Gorge where we would leave Loretta (my faithful golden car) and travel onward to Franklin, NC to sneak into the woods and onto the Bartram Trail. William Bartram was a Philadelphia native born in the 1700’s who hiked along the Appalachian mountains botanizing, sketching flora and fauna, and writing of his experiences. The trail with his namesake runs about 115 miles from the mountains of North Georgia into our North Carolina mountains. We chose a chunk of it that spanned several ‘balds’ and meandered through stretches of deep wilderness before it crossed dirt and paved roads.

Before we left, I packed. I plan on making a separate article that covers my usual gear and method of packing for normal days as well as adventure trips. For this trip I made sure I had plenty of warm clothes since higher elevation would mean lower temperatures and October can be pretty chilly in the mountains anyway. I also made sure I had my key diabetic supplies and back-up, as well as double the carbohydrate rich food I would actually need to bring up low blood sugar. Supplies and full tubes of honey do add pounds to your pack, but the security of having back-ups is well worth the extra weight. Also, honey is just about the most delicious energy goo to squeeze into your mouth before hiking up a steep mountain and always strengthens my resolve.

The weather was beautiful – perfect I’d venture to say. The first day and a half there wasn’t a cloud in the sky and the last day the clouds only made the mountains more dappled and depthy. We built a crackling little fire both nights but my fears of being cold were never justified. The second night I did put on my long underwear, a vest, a jacket, my hat, and two pairs of socks, but this was mostly just because I wanted to wear all the clothes I’d been carrying. Jamie stayed in shorts and t-shirt. I do find as a diabetic I am suddenly cold-natured, where as before diabetes I felt like I stayed uncommonly warm. Luckily this means I have more excuse to wear the wonderful fleece hat I just bought that is made by a company who “upcycles” wool sweaters into cute little tobaggans hats.

I told Jamie about the blog idea and he suggested a “D Scale” to rate experiences based on their difficulty in relation to diabetes. This trip I would say rates a D5. Although on my personal “K Scale” 35 miles in 2.5 days rates a K8.5, I am getting better at managing my blood sugar in relation to backpacking and at feeling secure in my packing and planning skills. My first backpacking trip was probably a D9 if you factor in my fear of forgetting supplies and the stress of not knowing how I would adjust my insulin for the extra carbs in backpacking food or the sustained activity level. Now I anticipate one or two nights in the woods as a precious escape from the paved life I lead even in the wonderful city I call home.

We hiked about 6 miles the first day, setting up camp at the second marked site at the low-point of a valley a few hundred yards from a tiny water source. I was worn from the steady uphill but enthusiastic about a hot meal of dal makhani and green beans from a couple of cans we’d brought along. Jamie fired up the campstove and I got our supplies out, manuevering the funny little can opener we bought for a dollar and then checking my blood sugar. A little low. I’ve tended to spend the majority of our time backpacking a little on the low side. I usually cut my insulin in half or reduce it even more. For this dinner I took three units less than I would have at home since I’d been walking for hours and revving up my metabolism. Hot lentils in the woods is a pleasure. For someone whose life revolves so much around food, I might look forward to backpacking meals even more than dinner at home. We added fresh basil and parsley to our pot that I had brought from the yard garden. After a satisfying and restorative dinner we relaxed by the fire and listened to the waning insect chorus of autumn.

A mystery that may never be solved had me a little on edge the first evening. Everytime an acorn would fall in the quiet forest its loud boom would spook us. During the vibrant summer we could not have even heard acorns falling for the roar of cicadas and katydids, but now we were listening for every crack and thud in the forest. I was spooked already from earlier in the day when Jamie stopped ahead of me in the trail to stare and mumble about something at his feet. I asked him what the matter was and he told me I’d see, and when I reached him I understood his pause. In the middle of the trail was a black glove, dirty and worn, and on either side of it evenly spaced and aligned were three torn pieces of used toilet paper. It was some strange marker, probably by a teenage boy who was going for the gross factor, but still a little unsettling. Something about it was ominous enough to make me snuggle my sleeping bag closer to Jamie’s and stay alert until I could not resist sleep any longer.

The morning was fresh and calm. We pumped more water from the stream, walking back through lemony groves of some plant that was taking over the abandoned logging road near our little creek. I had cut my long-acting insulin down by one unit anticipating a heightened metabolism and busy next day, but still awoke a little low. The hardest hiking of the weekend was on the way back from the stream before we’d boiled water for coffee. If you’re addicted to coffee in your normal life, you will still be addicted in the woods. Don’t forget it or decide that it is a luxury. My dear friend gave me a small Maxwell House instant coffee before my birthday backpacking trip earlier in the summer, and now I crave its strange smokey taste while I’m in the woods. Granola bars, turkey jerky, and a cup of coffee later we were trudging up the hill.

The most beautiful vista was at lunch time on top of Wayah Bald that we had spent that morning hiking up. It was a steep 5.5 miles but we were rewarded with a panorama of orange and green mountains. After hiking away from the observation tower we lunched at a family picnic site set into the trees where a group was celebrating October birthdays and we could set our stove on a flat surface to heat a little water for our powdered hummus. I find that while maintaining constant movement and carrying a 30 lb. pack I can eat just about like anyone else and take less insulin while I’m at it. Jamie is an understanding partner and enjoys low-carb tortillas with me, but he did buy a jar of Nutella to accompany our little adventure, and I have to say, a “Backpacker’s Nutella Crepe” is almost reason enough for a diabetic to hike 5 miles before lunch. We take low-carb spinach tortillas, I’ll give you the exact brand in a ‘foods’ post, and fill them with hummus, basil, turkey jerky, carrots, or whatever else savory we bring. Then for dessert it is Nutella and dried cranberries with a few walnut pieces wrapped in low-carb whole wheat tortillas. Que rico. I cut my insulin dose in half, and still by four miles after lunch I was low again.

Camp the second night could not have arrived at a better time. I was on the verge of sitting down in the middle of the trail and staying through the night, but Jamie the map-champion attested we were “So close,” to our designated spot. We found it and water nearby again, as well as a view of Nantahala dam. We had walked 16 miles in a day, up one bald and over several more to reach our site, and wearily we collapsed onto the soft pine-straw earth. About an hour before we reached camp Jamie began what I like to call his “Chili Mantra.” It always starts a little while before we end the day of walking, very intermittently at first and escalating in frequency until its quite regular. We will be walking along in silence, either to tired or absorbed in the rhythm of walking to talk, and he will just shout, “CHILI.” Sometimes with longing, sometimes with exhaution, sometimes almost demanding it. I know we are close to camp when he says it with a hint of desperation. That second night we did make a big, bubbling pot of “Darn Good Chili.” This particular “Bear Creek” brand is well balanced between carbs and fiber and is fat free. We add one small can of tomato paste and seven cups of water to the lightweight packet of dried chili to make a delicious meal perfect for eating with Dr. Krackers as edible spoons. Jamie started building a little teepee fire out of pine wood which smoked instead of burning, just like my grandpa always said it would. We found some nice hardwood to burn and had another night next to a warm fire.

I slept like a big ol’ fallen log that night but it was Jamie’s turn to be on edge. He reported the next day that he stayed awake for hours listening for bears and creatures. He told me that he wanted me to tell our friends that he had to fight a really big bear and that he scared it so bad that it would never mess with humans again. So that is what happened while I slept.

Morning broke the darkness with far more energy than I felt. Jamie shouted for me to get up and I shouted back that I needed coffee, so he started the water boiling. Once I felt like coffee was well under way I crawled out of the tent to greet the cool morning air. Breakfast was a couple of instant oatmeal packets from a company that uses organic grains and chunks of dried apple and adds very little cane sugar to the individual packets. I added in dried cranberries and walnuts for energy and protein. Before hiking I checked my blood sugar and it was really high, like 346 high. I couldn’t eat like everyone else! I took 1.5 units of insulin and then started walking. In an hour I was low again. The back and forth of highs and lows in hard on a backpacking trip. It is important to check your blood sugar often, even if you feel distinctly low or high, exhaustion and previous fluctuations can affect your blood sugar intuition. I like to eat a meal and guess at a reduced dose of insulin and then hike for an hour or so before I check unless I feel low or strange in some way. Checking right after eating can lead to false conclusions since a steep trail can bring blood sugar down fast and insulin might take a few minutes to kick in but then hit suddenly with increased activity level. Another positive for me is an understanding partner who prioritizes my need for monitoring and snack breaks as much as I do. Jamie packs a glucagon kit and we’ve gone over how and when to use it. He carries extra snacks and encourages me to take breaks to manage my blood sugar whenever I need them. If you are not blessed with such an understanding partner and are managing diabetes within a group, you must advocate for yourself when you need to stop and prioritize your condition even if it means your experience and needs differ from that of other individuals. The more you ignore the requirements of diabetes the more it will limit you and stress your mindset. I have finally realized that if I embrace the changes and adaptations diabetes requires and really prepare, I feel healthier and more free to enjoy my experiences.

Our last day in the woods covered 14 miles through golden forests of beech trees and huge chestnut oaks intermixed with smaller sourwoods bearing bright red flags of fall. We climbed steadily up Rattlesnake Bald through quiet, peaceful forests interrupted occasionally by a drumming quail or the wooshing flight of a hawk. At one point Jamie was up ahead, looking a little bit like a bear lugging his black backpack, when a gust of wind unhitched a wave of crisp golden leaves from their trees that twirled down all around him in the most magical way. A smile overtook my face and stayed there for a mile afterwards.

We ended the day in the woods at the surge tower above Duke Energy’s Power Plant beside the Nantahala.  From the base of the tower we had a view of Cheoah Bald and several other mountains we’ve promised ourselves we will climb.  The woods had rusted even more orange and red since we started and the mountains looked welcoming and so alive.  From this last view we had only to tramp down a dirt road, coming out at the power plant and then walking down a paved road to the parking lot where Loretta faithfully waited for our return.