[at-l] Dealing with medical issues on the trail

rcli4 at comcast.net rcli4 at comcast.net
Sun Sep 5 08:30:21 CDT 2010

Mostly I try to eat high protein. Lots of tuna, Gorp is very good because the nuts (whichever your favorites are...I like cashews, usually peanuts,  macadamias and other fancies...I'm a nut fan) are extremely nutritious, have lots of protein and low glycemic carbs, and good for you fats, etc. Gorp is almost a perfect food, even with a few chocolate chips or whatever thrown in for taste though I avoid the dried pineapple ad stuff just because I try to keep from perturbing my blood sugar too severely as much as possible. Also, protein powder, many brands of which contain sugar alcohols which you've probably heard of that have a tendency to burn very slow thereby stabilizing blood sugar somewhat...but really the most important thing is to get a handle on how little insulin you will probably need for any purpose...whatever dose you think you need at any time you will probably need far less than you expect, and that's where the danger lies...good food choices that don't give "spikes" are important to avoid the roller coaster, but a bit too much insulin can really mess you up. I had a lot of rough times with low blood sugar, and my most important lesson was learning not to overdo the insulin when correcting high blood sugars, in fact sometimes I would be high and would take what I thought was a conservative dose that would just barely do the job, and an hour later I'd be bottoming out and have to stop again and deal with the low. Learning to adjust insulin doses is probably something you've dealt with plenty already...over time you'll figure out how your body reacts to the hiking lifestyle and what adjustments to make. One thing...many times I've had the "feeling" of having high blood sugar but when I tested it was actually low, and vice versa...I'm not sure why exactly, but make sure to test rather than just depend on how you feel to tell you what your sugar is, especially before taking insulin...

The other lesson I learned was to calculate my carb burn rate while hiking. What I mean is, during a typical hike I sometimes need to consume around 20-30 grams of carb every hour or so to balance the effect hiking has on my blood sugar...more for more strenuous hikes and less at other times but you get the idea. This can be reduced by lowering the dose of long acting insulin, and I usually take aroud 1/2-2/3 as much as on a non-hiking day but lowering it too much reduces your energy and leaves you susceptible to high blood sugars, which puts you on the roller coaster of taking more fast acting insulin while hiking and dealing with the lows that may follow. So again, it's about self experimentation and finding a balance that works for you. But hiking for several hours without consuming carbs or testing isn't something that is possible. You must test frequently and stay on top of your eating schedule or nature will force you to.

One other thing that doctors and pharmacists seem not to know but you have probably realized is that insulin doesn't need to be refrigerated so no need to worry about that while hiking. But it mustn't freeze. So ...if your hiking in march or april you can expect at least a few sub-freezing nights...you gotta sleep with your insulin in your sleeping bag. Sometimes insulin is damaged by freezing weather but it still looks ok in the vial. So thats the big worry, not refrigeration.

The rest is just like when you're at home...the more precautions you take and the more meticulous your routine of testing and eating is the less problems you'll have. Always keep some prepared form of quick sugar someplace where you can reach it quick rather than deep in your foodbag. You'll be glad you did. I like skittles...easy to dose grams of carbs by counting skittles...I also use hot chocolate packets...each one has 22 grams and you can just pour the thing in your mouth and wash down with water..and they go down easy which other carbs sometimes dont.

Also...many people have many opinions about bear-bagging and hanging food and sleeping with food or whatever.. I have slept with my food in my tent throughout the entire AT without incident. The only stories I have ever heard of a bear getting food was food left out in a tree by a hiker. Bears simply do not steal well guarded food or come near people if they can avoid it, but they have been working the same trees year after year and are experts at getting the food (I call it bear bait) hung in them by hikers. The last thing I want is to be low in the middle of the night and have to get my food bag down to get something or to wake up in the morning and find out that sketchy guy who hiked out southbound early in the morning stole it or a bear or critters got it or whatever. Food is the number one concern and I recommend taking more than you think you'll need until you get your routine of hiking, eating, and insulin figured out. If I'm camping at a site where the authorities have installed  metal bear boxes or other devices i might use them, since that indicates they have had problems and maybe it's a good idea. ...but that's another debate...

Oh and bring a cell phone and keep it charged and don't waste the battery with long talks with your girlfriend. I never had to call 911 for myself, but...

----- Original Message -----
From: rcli4 at comcast.net
To: WILLIAM D VINCENT <vincentw at bellsouth.net>
Cc: at-l at backcountry.net
Sent: Sun, 05 Sep 2010 13:06:35 -0000 (UTC)
Subject: Re: [at-l] Dealing with medical issues on the trail

I have not hiked in the mountains since I was diagnosed with diabetes.  That being said, I have been hiking/camping 4 times on Cumberland Island.  My biggest problem has been keeping my sugar high enough without eating sugar.  I used an epipen type product from NovoNordisk.  It is called LevemirFlexPen.  It last 28 days without refrigeration.  I am going to hike in the mtns. in October, and will still carry it with me but I haven't used it since Feb. when I hiked 15 miles and ate M&M's all day to keep my sugar up.  There is a guy named Bfitz on Whiteblaze that has been hiking with diabetes for a long time.  I bothered him a lot with questions.  Real nice guy and far more knowledgeable then my Dr. about hiking with diabetes.  Hit him up, he really helped take away the fear.


----- Original Message -----
From: WILLIAM D VINCENT <vincentw at bellsouth.net>
To: at-l at backcountry.net
Sent: Sun, 05 Sep 2010 11:57:29 -0000 (UTC)
Subject: [at-l] Dealing with medical issues on the trail

I'm busy planning a 2011 thru hike attempt.  I'm an insulin dependent diabetic and take three shots a day.  That means three syringes  and individualized packaging X 5-6 days that I will need to pack in and pack out.  Plus a weekly PO visit to pick replacements.  Several folks have told me my medication needs will reduce but I will probably need to start at my current level and it is very unlikely that I could ever come off the meds completely.


I'm wondering if anyone knows of a particular brand of syringes that will minimize the packaging leftovers?  I'm currently using Monoject. 


						    thanks Cold Kettle 
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